The role of lymphocyte-dependent antibody in kidney transplantation. The lymphocyte-dependent antibody (LDA) assay has been used in parallel with the microlymphocytotoxicity test detecting complement-dependent antibody (CDA) in 100 cadaver kidney transplant recipients, in order to assess the role of the LDA phenomenon in the rejection of human allografts. In 15 cases, acid eluates were prepared from the kidney graft after rejection or at autopsy and tested in parallel with pre- and post-transplantation sera. The results indicate a marked increase in sensitivity of LDA assay compared with the standard microlymphocytotoxicity test. In 12 patients the pretransplant serum was found retrospectively LDA positive, but CDA negative, using the kidney donor lymphocytes or allogeneic lymphocytes bearing the same incompatible antigen(s) for the recipient as targets. Ten of them lost their graft, mostly during the first month after transplantation. Graft survival was also poor in the 11 patients having both LDA and CDA activity in their pretransplant serum, even when the specificity of the serum did not appear to be directed against antigens shared by the donor. Although it is not clear yet, whether the two assays detect the same or different antibody molecules, it appears that the detection of even a low level of LDA activity before transplantation is associated with a high risk of early transplant failure.


Immune responsiveness and incidence of reticulum cell sarcoma in long-term syngeneic radiation chimeras. Long-term syngeneic radiation chimeras displayed a very low incidence of reticulum cell sarcoma as compared with control mice. Immune reactivity of these animals was studied in vivo by anti-dinitrophenyl antibody titer and affinity and in vitro by mitotic responsiveness to phytohemagglutinin, concanavalin A and lipopolysaccharide. Anti-body titer and affinity as well as the response to T lectins were found to be increased in chimeras. These results were attributed to increased function of mature T2 cells, which could explain the reduced incidence of reticulum cell sarcoma in chimeras.


Bilateral cervical transplantation of canine kidneys for study of canine renal preservation. Bilateral cervical autotransplantation of canine kidneys is described for comparative study of renal preservation techniques. Data are obtained from kidneys preserved by (1) initial intravascular flushing with modified Collins' C3 solution (Ursol) followed by cold storage, and (2) pulsatile perfusion (MOX 100). Preharvest condition of the donor and ischemia times are identical, thus eliminating major sources of potential data variation. Renal function studies performed at periodic intervals demonstrated better initial function for machine preservation but no difference after one to two-month period.


Effects of contraceptive pills and intrauterine devices on urinary bladder. The incidence of bacteriuria and cystoscopic changes in women on oral contraceptives or users of IUD (intrauterine devices) were evaluated compared with a control group. Subjects with bacteriuria accounted for 40.5 per cent of pill users, 20 per cent of women fitted with IUD, and 16 per cent of the control group. Bladder trabeculations were found in 50.5 per cent of the pill group, 8.7 per cent of the IUD group, and 8 per cent of the controls. Congested bladder trigone was observed in 24.6 per cent of women fitted with an IUD. The mode of action of ovarian hormones and their possible side effects on the bladder are discussed. The relation of IUD to pelvic inflammatory disease and its effect on the urinary bladder are evaluated.


Pyeloileocystostomy for ureteral necrosis in pediatric renal transplant recipient. A pediatric renal transplant patient who had ureteral necrosis treated initially by nephrostomy followed by a subsequent pyeloileocystostomy is reported. This unusual approach to a renal transplant complication is recommended, but only when other methods cannot be utilized.


Post-transplantation lymphocyst: use of ultrasound as adjunct in diagnosis. Ultrasound examination has proved to be a useful diagnostic tool in the differentiation of lymphocyst from other causes of upper urinary tract obstruction in the renal transplant recipient.


[Use of formalinized homologous bone in reconstructive operations on the mandible]. An experience with 69 osteoplastic operations with formalinized homografts in 66 patients having various affections and injuries of the lower jaw is summarized. The grafts were preserved in 0.5% formalin solution or gel containing 0.25% formalin and 0.25% betapropiolactone as sterilizing agents. Positive issues during the follow-up from 4 months to 4 years 7 months were noted in 60 operative procedures, negative--in 9. It is concluded that the formalinized homobone shows good osteoplastic properties and may be used as a plastic material in reparative operations on the lower jaw bone.


[Prognostic value of bacteriological studies in peritonitis]. Based on multiple bacteriological assays of lymph and blood, it is concluded that single detection of pathogenic microorganisms in lymph and blood should not be considered an unfavourable prognostic sign. A provisional external drainage of the thoracic duct would reduce intoxication in patients with peritonitis, and it is estimated as a valuable prophylactic method of combating against bacteriemia.


[Acute thrombophlebitis of the saphenous veins as a problem of emergency surgery]. It is stated that latent spread of thrombosis in v. saphena magna in proximal direction is observed in 37--40%. Radioisotope technic was employed to indicate the level of thrombus. The operative technic is described.


[Primary suture of perineal wound after extirpation of the rectum in rectal cancer]. A comparative estimation of a hermetic suture of the perineal wound in 53 patients and its tight tamponade in 68 patients after extirpation of the rectum for cancer is given. Primary suture may and should be employed during this operative procedure in the absence of diffuse bleeding from the lesser pelvis walls and a damage of the intestine. Hermetic suture of the wound shows some outright advantages: the possibility for patients' rising from bed in earlier terms prevents the occurrence of complications and contributes to shortening of the postoperative period.


[Combined method of rectopexy in rectal prolapse with the use of skin autoimplants]. During 1964-1973 twenty six patients were operated upon for grave rectal prolapse (6 patients after 1-2 unsuccessful operations elsewhere). The combined method of rectopexy by means of skin autoimplants after the technic suggested by B.A. Barkov was employed. All patients recovered and were completely rehabilitated, the follow-up being from 2 to 10 years. No recurrences were noted.


[Complications of catheterization of the subclavian vein and their prevention]. The frequency of complications related with catheterization of the subclavian vein was 16.2%. The most hazardous complications were as follows: the pulmonary artery embolism, migration of a catheter in the venous bed and thrombosis of the catheterized vein. The proper selection of indications, careful observation of the rules of puncturing and catheterization may reduce the incidence of complications to a minimum.


[Clinical pharmacokinetics of 2-C14-ftorafur in patients with astrocytoma]. Patients with dedifferentiated brain astrocytoma during an operation were injected intravenously 2-C14-fluorofur (3 muC/Kg). In different periods after the injection the level of radioactivity was determined in different sites of the tumor, brain tissue, as well as in blood plasma, cerebrospinal liquor and urine. Intracellular localization of the labeled substance in the tumor tissue was examined autohistoradiographically. 2-C14-fluorofur was found to readily penetrate the hemato-encephalic barrier and to be absorbed both by tissues of neuroectodermal tumor and adjacent brain tissues. In astrocytoma cells the labelled substance is localized mainly extranuclearly. Radioactive products are excreted from the organism slowly and their traces are observed in blood, cerebrospinal liquor and urine even on the third day postoperatively.


[Plastic surgery in skin cancer].

[Plastic surgery in skin cancer]. The results of 522 plastic procedures performed in patients with skin cancer are analysed. The following methods of skin plasty were employed: free skin graft plasty, local tissue plasty, the combined skin plasty. The best immediate results were obtained in using the pedicled graft plasty (4.4% of complications) and in free skin graft plasty (8.8% of complications). Without any signs of the recurrence and metastases 73% of patients are still alive for over 1 years, 49.4%--over 3 years, 31.8%--over 5 years, 23.9%--over 7 years and 7.28%--over 10 years.


[Pelvic promontory fixation of the vaginal stump in cases of prolapse (author's transl)]. The choice of operative technique in cases of prolapse of the vagina following hysterectomy is difficult in women still having intercourse. Amreich's original procedure of sacrospinal fixation of the vagina, recently recommended by Richter, is difficult and dangerous. Hence, the relatively easy procedure of pelvic promontory fixation of the vaginal stump described many years ago by G.A. Wagner was performed on 5 women with excellent results. A description is given of the operative technique.


[Oto-rhino-laryngological complications in patients receiving intermittent haemodialysis and in renal transplant recipients (author's transl)]. Patients with chronic uraemia and renal transplant recipients were examined for oto-rhino-laryngological diseases over the course of a five-year period. During dialysis treatment, 58 out of 77 chronic uraemic patients developed complications, mainly affecting the nose and the ear, on a degenerative or toxic uraemic basis. In the period under review, renal transplantations were carried out in 63 patients, in whom infectious processes had occurred mainly in the upper respiratory and digestive tracts; postoperative immuno-suppressive therapy is responsible for the morbidity in these cases. Particular reference is made to the necessity of eradicating any possible sources of infection already during the period of dialysis treatment and to the importance of cooperation between physicians and oto-rhino-laryngologists.


[Bilirubin metabolism (author's transl)]. The degradation of haemoglobin haeme of senescent red blood cells - involving NADPH-dependent haeme oxygenase and biliverdin reductase - in the reticuloendothelial cells of the spleen, bone marrow and liver accounts for 80 to 90% of the 250 to 300 mg of bilirubin formed in 24 hours. The remaining 10 to 20% derive from catabolism of other haemoproteins and from the destruction of maturing red blood cells in the marrow. In studies with isotopically-labelled metabolic precursors of haeme this fraction can be found in the early-labelled peak. In plasma virtually all the bilirubin is tightly bound to plasma proteins, largely albumin, because it is only sparingly soluble in aqueous solutions at physiological pH. In the sinusoids unconjugated bilirubin dissocates from albumin, enters the liver cells across the cell membrane through non-ionic diffusion and is bound by the two cytoplasmic proteins Y (or ligandin) and Z. Little is known about the transfer of unconjugated bilirubin from these binding proteins to the smooth endoplasmatic reticulum, where it is converted to a  water-soluble ester glucuronide by bilirubin UDP-glucuronyl transferase. The physiological significance of non-glucoronide conjugates (sulphate, disaccharides) is only of minor importance. Following conjugation, bilirubin is transferred rapidly across the canalicular membrane into the bile canaliculi. This process is energy-dependent and occurs against a concentration gradient. The epithelial lining of the intestine and of the gall bladder, which can easily reabsorb lipid-soluble unconjugated bilirubin, is virtually impermeable to organic anions of the size and charge of conjugated bilirubin, thereby ensuring efficient excretion of this pigment. In the intestinal tract bilirubin is reduced to urobilinogen, which is subsequently reabsorbed to some extent into the enterohepatic circulation, removed from plasma by the liver and excreted unchanged in the bile. This rapid bacterial reduction of bilirubin makes it unlikely that unconjugated bilirubin is formed and absorbed to an appreciable degree. The residual part of urobilinogen is further reduced to urobilin, stercobilin and dipyrrolmethenes and excreted in the faeces.


[Macrocytosis in renal transplant patients (author's transl)]. Since macrocytosis was observed in a high percentage of our renal transplant patients, a follow-up study was carried out on 36 patients with determination of the mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and haemoglobin concentration (MCHC). These parameters were determined monthly for periods of up to two years (16 cases) following transplantation. There was a rise in both MCV and MCH within one month. Macrooperative MCHC, however, remained normal. Anaemia was absent or mild. The bone marrow showed striking megaloblastic changes with nuclear-cytoplasmatic dissociation in both red and white cell precursors. Vitamin B 12 absorption tests were normal in all 8 patients investigated. Macrocytosis was not detectable in two patients with a low serum iron concentration. Macrocytosis disappeared in 4 patients with chronic rejection when progressive renal failure developed. It is concluded that azathioprine therapy induces macrocytosis in renal transplant patients provided renal function is satisfactory.


[Double-blind trial: ketoprofen versus phenylbutazone in acute gouty arthritis (author's transl)]. A double-blind study was carried out to compare the effects of ketoprofen and phenylbutazone in acute gouty arthritis. Two groups of patients, each consisting of 23 males, received intramuscular injections of either phenylbutazone (2 X 300 mg daily) or ketoprofen (2 X 50 mg daily) for a period of 7 days. The drug effects were assessed both subjectively and objectively. There was an excellent therapeutic effect in both groups. In general, no statistically-significant differences were detected between the two preparations. However, ketoprofen appears to be slightly better tolerated with respect to the incidence of systemic and local side effects. Thus, the administration of ketoprofen can be recommended in cases of acute gouty arthritis.


[Antigen spectrum of allergic rhinitis (author's transl)]. The results of 10.000 individual tests have shown that it is necessary to revise and supplement the influences and the emergence of new antigens support this demand. Refined testing for grass pollen seems to be of particular importance, whereby cross reactions must be taken into account. The test program we must, furthermore, take into consideration the geographical incidence distribution of trees and herbs. In Austria, a considerable amount of ragweed pollen has recently been ascertained to be a cause of pollinosis and asthma. The grain pollens are of great importance and so is household dust, which contains regionally different antigens. Animal hairs and epithelia must be tested if the case history indicates possible involvement of these factors. Special mention is made of the increasing significance of mold spores and bacteria. The variety of listed antigens, each of which may cause allergic rhinitis, shows the importance of supplementing the Hansen test. The new priorities in the test programme are incorporated in, and juxtaposed to the Hansen scheme (see Table 1) for clarification.


[Oral contraceptives (author's transl)]. A short review of the endocrinological basis of reproduction in the female is followed by a critical survey of the oral contraceptive methods in current use. The composition of the preparations, their use, their biological and use-effectiveness and mode of action are discussed.The importance is emphasized of complying with the basic principles of drug testing in the evaluation of effects of oral contraceptiveson health. Other effects than merely the contraceptive actions of these preparations are described in detail, including not only the undesirable, frequently neglected, yet very important beneficial effects on the drug-users, their children and families.


John F. Fulton, coccidioidomycosis, and penicillin. When the late Dr. John F. Fulton contracted severe pulmonary coccidioidomycosis in January, 1942, a metastatic lesion posed the threat of further progression and fatal dissemination. The possibility that an untested and generally unavailable antibiotic, penicillin, might be of value in Fulton's illness led his physician, Dr. John Bumstead, to appeal directly to Fulton to obtain this antibiotic, but ostensibly for the benefit of another patient succumbing to hemolytic streptococcal infection. While of no value for Fulton, penicillin was highly successful in the treatment of his other patient and soon of a second one with staphylococcal sepsis and pneumonia. This penicillin, administered in March, 1942, was the first clinical trial of penicillin under the control of the Office of Scientific Research and Development. The unique contribution of Dr. Fulton and of his illness to this event is described.


[Modification of isoprenaline-induced myocardial necrosis in the rat by means of pre-treatment with cerutil and piracetam]. The influence of the isoprenalin-induced necrosis of the myocardium by pirazetam and cerutil is described. A pre-treatment lasting seven days leads to a considerable increase of the formation of necrosis in two substances. In contrast to this in the acute application one hour before the application of isoprenalin an inhibition of the changes of the myocardium appears. It is referred to a possible clinical importance of the findings.


[Diagnosis of rheumatic fever].

[Diagnosis of rheumatic fever]. In a survey the frequent possibilities of the diagnostics of rheumatic fever are described. The rheumatic fever is a general disease on immunological basis caused by an infection with beta-haemolysing streptococci of group A. The disease appears as visceral form (carditis rheumatica, chorea minor) or as peripheral manifestation (acute polyarthritis, erythema anulare, subcutaneous nodules, purpura rheumatica). The diagnostics is essentially based on clinical, physical, biochemical and immunoserological findings on the basis of modified criteria after Jones. Immunological methods for the demonstration of circulating antibodies gain an increasing diagnostic significance.


[Clinical experiences with bretylium tosylate]. Because of its antiarrhythmic and antifibrillatory qualities as well as its positively inotropic effect bretylium tosylate increasingly finds interest. The first results of a clinical and haemodynamical mechanocardiographic investigation with bretylium tosylate are presented. In doses between 1.6 and 6.2 mg/kg body weight intravenously and intramuscularly after an initial increase of blood pressure a clear decrease of the systolic system blood pressure develops. The resistance of the peripheral vessels decreases by 10 to 20%. It is an increase of the heart index and the stroke volume index by 10 to 30% to be proved as an expression of a positively inotropic effect. In orientating investigations the antiarrhythmic effect could be confirmed. The side-effects observed cause us to give a strong indication and to observe the patients carefully. The main area of application of bretylium tosylate might be seen in the possibility to achieve a pharmacological defibrillation of the ventricles.


[Metabolic changes and assessment of kidney function after supercooling of the free-prepared kidney in animal experiment]. Aside from immunological problems, successful renal transplantation depends on preservation, properly maintaining its vitality and functional efficiency, also after transplantation. Complete restitution, slight functional less, reversible and irreversible renal failure, occurred according to chosen temperatures in the experiments. The best results were obtained at temperatures between 0 and +5 degrees C., mainly at an average value of +3C degrees. Irreparable renal damages developed at temperatures between 0 and -3 degrees C.


[Effect of hyperbaric oxygen on aerobic bacteria]. The authors investigated the growth of 8 species of pathogenic aerobic bacteria after treatment with hyperbaric oxygen. Within 24 hours the cultures were exposed three times for 2 hours to an absolute pressure of 3 atmospheres of oxygen at 37 degrees C. In the fluid cultures as well as in the controls the inhibitory effect of oxygen was assessed in percent by means of the densitometric method. From these in vivo experiments the authors conclude that hyperbaric treatment of superficial pyogenic events accompanying obliterating vascular diseases is reasonable.


[Intrathoracic parallel heart transplantation in the dog]. The authors report on intrathoracic parallel heart transplantation which was experimentally tried on 10 mongrel dogs. The described technique is advantageous since it can be performed without extracorporeal circulation. The results of hemodynamic studies on graft and recipient heart vindicate further employment of this technique to study several problems of heart transplantation still unsolved.


[Effect of acetylsalicylic acid on immunologically induced morphologic changes after experimental lung transplantation (light and electron microscopic study)]. In 3 comparing series the behavior of platelets after experimental lung transplantation was examined in 33 dogs. After allogenic transplantations (21 animals) the ultrastructural findings were pathologic changes of the platelets, such as hyperaggregability with irreversible aggregation prevailing, as well as capillary wall alterations. X-rays showed considerable reduction of functioning parenchyma. Since these findings were absent in animals which underwent merely pulmonary re-implantation (4 animals) and can be considered a controll group, the authors conclude that these alterations are caused by mainly immunologic reactions. Acetylsalicylic acid given to animals with grafted lungs significantly inhibited is specific and certainly immuneinduced pathologic development. Absolutely necessary, therefore, appears the application of such aggregation inhibitor as additional treatment in lung transplantations.


[Morphological studies in the late period after autotransplantation of the left lung and removal of the right (intact) lung]. Morphological examinations were carried out in 3 animals, in which during the late period after left-side pulmonary autotransplantation the right lung was removed. The results during long-term survival of these animals showed the cardinal importance for success lying in anatomical sufficiency of vascular and bronchial anastomoses, fair compensatory capacity of external breathing, absence of severe structural changes in the autografted lung, ventilation of physiologic atelectases, and development of compensatory hypertrophy after resection of the intact lung. Examinations of nerval structures of the main bronchus of the autografted lung showed recovery of nerve fibers. The pulmonary autograft  guaranteed normal function of organism after resection of the intact lung. This confirms the functional and structural restitution of the organism.


[Homologous liver and liver-kidney transplantation--experimental study]. Animal experiments were carried out for giving an opinion about several problems in hepatic transplantation, such as blood clotting disturbance, liver-kidney transplantation, and vitality of the graft. 54 allogenic orthotopic and heterotopic liver transplantations and liver-kidney transplantations were performed on pigs, the major part without portosystemic decompressing bypass, following the technique of Calne. 17 animals survived for a longer period. Preservation up to 20 hours could successfully be outlasted by help of hypothermic immersion or intermittant gravitational perfusion up to the limit of eight hours. Aside from biochemical observation, severe blood clotting disturbances only occurred after a longer ischemic period. After en-bloc transplantation the function of the graft was checked by means of angiography and intravenous pyelography. Due to higher tolerance against ischemia, the kidney of the en-bloc graft always started functioning when the function of the liver was intact. The changes of bioelectric resistance of the liver before and after transplantation, measured by help of the impedance method of Lechner and Rodler, correlated with the time of surviving and with several biochemic parameters.


[Studies of pulmonary ultrastructure after delayed autotransplantation and up-to-24-hour preservation under hypothermia]. After delayed lung autotransplantation with preservation up to 2 hours at +4 degrees C unessential ultrastructural alterations of the alveoli were observed. These alterations were more expressed after preservation for 24 hours, after which time edema of cells and structural elements of the aveoli were seen. This edema causes a lowered diffusion and disturbed function at the air-blood barrier. In a later period after delayed autografting with preservation up to 2, resp. 24 hours, structural and functional recovering of the autotransplanted lung occurred, proving that the organ was not grossly damaged and the changes arising at operation were reversible.


[Model for practicing suture technics for reconstructive surgery on coronary vessels]. Surgery on coronary vessels requires high surgical skill. For this reason generally, operations on experimental animals are carried out for exercise. These operative interventions require an extensive display of technique and personnel. A phantom, i.e. an arrested perfused porcine heart, was used to exercise the surgical technique. Material and personnel could be spared by this way, and a great number of exercising operations was performed. The phantom is described and its efficiency discussed.


[Myocarditis and insulitis following coxsackie virus infection]. We report on the case of a 5 7/12-year-old girl, who presented an acute insulin-dependent diabetes mellitus nineteen days after the operative suture of an atrial septum defect, and who died in a hyperosmolar coma diabeticum in spite of an intensive therapy. At the autopsy there was shown a myocarditis with the histological characteristics of a virus infection. The islet tissue of the pancreas was largely necrotic, the great majority of the islets of Langerhans presented lymphocytic infiltrates. In a neutralisation test against coxsackie-B-viruses (CBV), which was conducted after death, there was found among others an antibody titer of 1:192 against CBV-4. With FITC-marked CBV-antiglobulin, in the islet tissue intracellular CBV-antigen could be proved. It is discussed that virus infections have an etiological importance for the incidence of a so-called juvenile diabetes in man.


Cultivation of the erythrocytic stages of Plasmodium berghei in Leydig cell tumor cultures. Twelve different established cell-lines were used in attempts to cultivate the erythrocytic stages of Plasmodium berghei, P. vinckei vinckei, P. coatneyi or P. knowlesi. Intracellular parasites were seen in only mouse Leydig cell testicular tumor (LCT) cultures inoculated with red cells infected with P. berghei. Intracellular parasites were present at 15 to 96 h after inoculation, being most numerous at 36 h. Most intracellular stages were rings, trophozoites, schizonts and merozoites; gametocytes were few in number and present only at 36 and 48 h. Intracellular parasites were normal in general morphology and staining characteristics at 15 to 48 h, but were abnormal after 72 h. Infected host cells exhibited progressive nuclear and cytoplasmic degenerative changes, which ultimately resulted in death of the cell. Uninfected cells appeared normal. The ability of parasites in LCT cultures to produce infections upon injection into mice was similar to that obtained with control cultures without LCT cells.


[Clinic of the upper cervical spine and review of the medical history of the regional osteology (author's transl)]. After a brief review of the systematic clinical work up of this region within our century, the medical history of the osteology of the occipito-cervical junction is given special attention. It is looked upon the illustrations of the first printed anatomical textbooks that are linked with such famous names as Berengario, Dryander, Estienne, Vesal and Eustachius. Leonardo da Vinci's concept of the first two vertebrae is also mentioned.


[The history of the pathological anatomy in the Soviet Union (author's transl)]. The development of the pathological anatomy in Russia and in the Soviet Union is described, beginning from the foundation of the first prosecture in 1707 up to the present time. In the first half of the 18th century, this special branch was supported by Peter I, whereas it developed very slowly in the second half of the 18th and in the 19th century. The importance of the school of pathologists of Moscow as well as of that of Petersburg and Leningrad, respectively, which played an essential role in the pathological anatomy is demonstrated by the work of some of the most outstanding representatives of the Russian and Soviet pathology. After the Great Socialist October Revolution infectious and nutritional diseases were in the centre of the pathological investigations. At present, the development of the Soviet pathology is characterized by a rapid increase in the number of pathological institutes and departments as well as by the introduction of new apparatuses and technics into the research work. Some of the most important scientific problems are mentioned.


Reaction of the host to the tick-bite. II. Distribution of tick borne encephalitis virus in sucking ticks. No reactive histological changes of the dermis and no cement cone formation were observed at the insertion site of tick mouthparts by feeding of H. inermis larvae. Conversely, cement formation was observed by feeding of H. inermis female. Fully fed D. marginatus larvae on viraemic mice showed bright fluorescence in oesophagus, suboesophageal ganglion, salivary glands, a few gut cells and in lumen of Malpighian tubuli. We consider the penetration of virus from oesophagus to suboesophageal ganglion as the possible route of primary virus infection. Sections through the D. reticulatus nymphs during virus transmission (38 hours after attachment) showed specific fluorescence in epidermis and gut cells. This finding is in agreement with the secretory activity of epidermial and gut cells during feeding.


An investigation into factors affecting proteocine production by Proteus isolates. Proteocine production was found to the influenced by the medium used, the temperature of incubation and the length of incubation. Different amounts of proteocine were produced in different media. Production in liquid media was maximum in proteose-peptone No. 3 (Difco). This medium gave a very high titre (1:10000) of proteocine when inoculated with the producer strain, and the aerated culture was induced with mitomycin C. Therefore a method of producing a high titre proteocine was developed using proteosepeptone No. 3 (Difco) and cultural conditions of 25 degrees C for 24 hours.


Studies on the energetic metabolism of Shigella flexneri x Escherichia coli hybrids devoid of penetration ability. IV. Growth characteristics in the presence of some tricarboxylic acid cycle intermediates. The dynamics of avirulant lac+KCP- hybrids Sh. flexneri multiplication was investigated in minimal medium in the presence of some tricarboxylic acid cycle intermediates (fumarate, succinate, malate) and pyruvate. It was established that in spite of the loss of virulence in the rate of the multiplication of the hybrid strains, in comparison with that of the virulent recipient strains of Sh. flexneri, considerable differences were not observed.


[Environmental chemicals and their microbial breakdown (author's transl)]. Environmental chemicals are compounds synthesized by man which have entered our environment. Depending on their consitution, these compounds are either easy or difficult to break down. They are preferably broken down by microorganisms, but chemical and physical processes also play a role. Sometimes various microorganisms are involved in the breakdown of a compound simultaneously. The breakdown mechanism depends on the micro-organism. Depending on the type, certain compounds are broken down via various intermediates. Even several breakdown pathways may exist simultaneously in a single micro-organisms. Extrachromosomal elements may be involved in the breakdown. The breakdown of aromatic and chloro-substituted compounds is explained, as is also the microbial breakdown of herbicides, fungicides, antibiotics and alkaloids.


Histopathology of the endocrine pancreas of a fresh-water fish, Clarias Batrachus L. VII. Effects of hydrocortisone and thyroxine administration. Hydrocortisone treatment caused a hyperglycaemic state in Clarias batrachus within an hour. The blood glucose values remained significantly increased for 6 days. An initial increase in liver glycogen was followed by a decrease below the normal value. The muscle and brain glycogen levels remained unaffected. A mild degranulation of B cells was seen in the early hours and a conspicuous vacuolation and necrosis of both A and B cells appeared 72-96 h after treatment. Administration of thyroxine resulted in hyperglycaemia within 15 h but a distinct hypoglycaemic condition was seen 4 days after the treatment. Considerable drain in the liver glycogen deposits was noticed between 24 and 72 h while the muscle glycogen showed an increase. The brain glycogen did not change noticeably. Islets of the fishes autopsied between 72 and 96 h contained severely damaged B cells. The A cells remained unaffected. It is suggested that, in addition to several other hormones, hydrocortisone and thyroxine play an important role in carbohydrate metabolism and blood sugar homoeostasis in C. batrachus.


Experimental restoration of skin defects with Surgicel soaked in blood. Skin defects of full thickness were produced in 15 rabbits. The wounds were covered with Surgicel soaked in the animal's own blood and fixed at the edges with Histoacryl-N-Blau adhesive. A gradual epithelization took place under the covering layer. The method is suggested as an emergency measure in case of serious burns or other extensive skin injuries.


Progesterone-induced augmentation of pituitary gonadotrophin responses to luteinizing hormone-releasing hormone in oestrogen-pre-treated amenorrhoeic women. Modulating effects of oestradiol--17 beta and progesterone on the pituitary responsiveness in luteinizing hormone-releasing hormone (LRH) were investigated in 12 women with functional amenorrhoea. The pituitary reserve capacity for gonadotrophin section was investigated with repeated intravenous LRH tests before and after administration of oestradiol-1 beta followed by either progesterone or saline. Intramuscular injection of 1 mg of oestradiol-17 beta benzoate resulted in a suppression of both the basal gonadotrophin levels in serum and the gonadotrophin responses to LRH 24 h later. Progesterone, 25 mg im, was then administered in eleven experiments. Six h later, when the mean serum progesterone level had increased to levels similar to those seen in the early post-ovulatory phase of the menstrual cycle, there was a marked augmentation of the pituitary capacity to release both luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in response to LRH. This was not found in eight experiments where saline was given instead of progesterone after oestrogen pretreatment. These findings suggest that the greatly increased pituitary sensitivity to LRH at midcycle may be caused not only by the oestradiol increase in blood during the late follicular phase but also in part by the small pre-ovulatory rise of progesterone during the mid-cyclic LH peak. Furthermore, they add further support to the hypothesis that progesterone as well as oestradiol is involved in the induction of the LH peak at mid-cycle. Progesterone may be of importance to secure the release of enought LH for ovulation and normal corpus luteum formation to occur.


Effects of testosterone on gonadotrophin responses to synthetic LH and FSH releasing hormone (LRH) in normal men. LRH tests were performed in 6 adult men with intravenous injections of 25 mug, before and one week after an intramuscular injection of 250 mg testosterone oenanthate (Testoviron Depot). One week after intramuscular injection of Testoviron the tonic secretion of LH was completely suppressed, but the reactivity or the reserve capacity of LH secretion, as tested by LRH, remained unchanged. In contrast, the tonic secretion of FSH and the reactivity of FSH secretion to LRH were both partly suppressed. Three months after the Testoviron injection, the basal levels of LH were still significantly lower than the control values, but the basal levels of FSH were identical to the control values. These data indicate that, in man, the feedback action of testosterone on gonadotrophin secretion could be exerted, at least for LH, at the hypothalamic level rather than at the pituitary level . No significant effects of LRH were noted on the circulating levels of growth hormone and sugar. There was a distinct rise in serum prolactin, which was occasionally significant, within 30 min after LRH injection; this is considered to be without physiological significance.


The effect of gonadotrophin releasing hormone on pituitary-gonadal function in Klinefelter's syndrome. The mean basal plasma LH and FSH levels in 8 patients with Klinefelter's syndrome were respectively 5 and 15-fold higher than in 8 eugonadal males, whereas plasma testosterone concentration were half the normal value. After an intravenous bolus injection of gonadotrophin releasing hormone (100 mug of LH-RH) the gonadotrophin increase in the Klinefelter patients was more marked than in the control subjects, but in both groups the plasma testosterone levels remained essentially unchanged. In contrast to the bolus injection, an 8 h infusion of LH-RH after the bolus elicited a significant plasma testosterone increase in both the eugonadal males (59%) and the Klinefelter patients (51%). These findings indicate that despite an impressive endogenous hyper-gonadotrophism, Leydig cells in Klinefelter's syndrome can still respond to a sustained further increase of these endogenous gonadotrophins and thus still have functional reserve.


Effect of an anabolic steroid (metandienon) on plasma LH-FSH, and testosterone and on the response to intravenous administration of LRH. Plasma levels of testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) as well as the response of LH and FSH to the intravenous administration of 100 mug of luteinizing hormone releasing hormone (LRH) were measured in 16 well-trained athletes (mean age 30 years) before and after 2 months of daily oral intake of 15 mg of metandienon, and anabolic steroid (Anabolin, 17 alpha-methyl-17beta-hydroxy-1,4-androstadien-3-one, Medica, Finland). All athletes continued to train regularly, just as they had done for several years. During administration of metandienon the mean plasma testosterone level fell 69%, from 29.4 +/- 11.6 nmol/1 to 9.1 +/- 7.5 nmol/1. The mean plasma levels of LH and FSH also fell significantly (P less than 0.001 and P less than 0.01, respectively), both about 50%. Because LH and FSH levels were low after administration of the steroid the maximum stimulation values after LRH administration were also lower than pre-treatment values although the mean increments did not differ significantly before and after administration of the anabolic steroid. However, after treatment, the FSH response curve had a biphasic pattern in most subjects, with peaks at 10 to 20 and 50 to 60 min after the iv injection of LRH. Administration of LRH after the treatment period had no effect on FSH secretion in two subjects and no effect on LH secretion in one. Our results show that administration of an anabolic steroid causes a pronounced lowering of plasma levels of testosterone, LH and FSH but causes no gross alteration in the response of LH secretion to stimulation by LRH. The reason for the biphasic response pattern of FSH to LRH administration in most subjects is not known.


"Insulin" induced insulitis.

"Insulin" induced insulitis. Insulitis, an inflammatory process restricted to the pancreatic islets, can experimentally be induced by active immunization with insulin or passive transfer of anti insulin serum. --Mice and rats injected with anti insulin serum from guinea pigs develop a polymorphcellular islet infiltration composed of many eosinophiles and neutrophiles. This inflammatory reaction is caused by the occurrence of immune complexes within the islet area produced by the injected insulin antibodies and the endogenous insulin. Thus polymorphcellular immune complex insulitis represents a type III immune response, respectively a local Arthus phenomenen. --Cattle, sheep and rabbits immunized with crystalline insulin preparations and Freund's adjuvant were found to develop a lymphoidcellular insulitis. As far as specific localization, histologic features, ultrastructure and an occasional manifestation of a diabetes mellitus-like syndrome are concerned lymphoidcellular immune insulitis suggests an immune response of the cell mediated type with temporary autoimmune characteristics to endogenous insulin evoked by the immunization with exogenous crystalline insulin. Insulin derivatives are the most probable candidates for the assumed insulitis-inducing antigen. --Whether immune reactions may also play a role in the pathomechanisms leading to human insulitis is until now an unsolved question.


Autoimmune insulitis. Pathological findings in experimental animal models and juvenile diabetes mellitus. Organ-specific, species non-specific anti-pancreatic cellular immunity has been reported as a feature associated with juvenile diabetes of short duration. In order to further elucidate a possible causal relation between autoimmunity and juvenile diabetes morphological studies were made on an autopsy material from 12 juvenile onset diabetics, dying within 1 year after the onset of the disease. Each patient was compared with 2 age and sex matched controls. In the group of patients the islets of Langerhans showed the following characteristics: 1. The B cells were degranulated and present in reduced number, 2. The A cells appeared normal, 3. A lymphocytic, non-cicatricial insulitis was detected in 50% of the patients. Those findings were correlated with animal experiments, in which rats and mice were immunized with A: heterologous and homologous preparations of endocrine pancreas, in complete Freunds' adjuvant, B: heterologous and homologous insulin in complete Freunds' adjuvant, and C: complete Freunds' adjuvant. Only animals of group A developed spleen cell migration tests positive to the pancreatic preparations, lymphocytic infiltrations of the islets and degranulation of the B cells. In addition, the B cells showed ultrastructural signs of degeneration. The morphological changes were reversible and were accompanied by a transient reduction in glucose tolerance.


Regeneration of islet cells.

Regeneration of islet cells. The number of functionally intact B-cells in the islet organ is of decisive importance for the development, course and outcome of diabetes mellitus. Generally speaking, the total B-cell mass reflects the balance between the renewal and loss of these cells. While factors resulting in damage and degeneration of the B-cells have attracted much attention there has been relatively little interest in the kinetics and regulation of B-cell proliferation. This paper briefly reviews the literature in the latter field with special attention to B-cell renewal in various kinds of diabetes. In early fetal life both the endocrine and exocrine pancreatic cells probably arise from a common "protodifferentiated" cell type. The islets subsequently grow according to a regular pattern characterized by a symmetrical distribution of the islet volume in relation to islet diameter. The growth of the islets reflects the replication of both B-, A1- and A2-cells in individual islets. Whether new islet cells are derived also from duct epithelium or by transformation of differentiated acinar cells remains a matter of controversy. The ability of the differentiated B-cell to replicate in adult life has been confirmed in many studies. Factors believed to increase the rate of replication in vivo include a high caloric intake, hypoglycemic sulfonylureas, various hormones and hyperglycemia. Recent studies in vitro have so far confirmed the mitogenic action of a high extracellular glucose concentration. The renewal of B-cells in diabetes has been studied in several animal models. Both in experimental diabetes, such as that induced by alloxan, and in hereditary diabetes, exemplified by the diabetic mutant mouse (gene symbol db), there is initial stimulation of the mitotic rate during development of hyperglycemia followed by a notable decrease in the B-cell renewal. In the diabetic mouse the decreased proliferation of B-cells is paralleled by the appearance of fulminant diabetes. These and other data suggest a limited capacity for B-cell proliferation, which may differ between species. According to this hypothesis, there is an increased risk of developing diabetes once the predetermined potential for B-cell division has been exhausted.


The immunogenicity of insulin preparations. Patients who had never received insulin were administered porcine or bovine Lente insulins prepared from either conventional USP-grade insulin, "single-peak" insulin (SPI), or "single-component" insulin (SCI) in an attempt to determine if insulin immunogenecity was related to the purity of various insulin preparations. Serum insulin antibody titers were monitored by a sensitive I125-insulin binding procedure. All six groups of patients had some degree of antibody formation after six months of continuous insulin administration. Based upon the percent of I125-insulin bound by the serum, the least immunogenic insulin preparation was the porcine SCI. The most immunogenic insulins were the bovine preparations, all three of which gave comparable antibody responses. The patients who received porcine USP insulin and porcine SPI had similar antibody titers, both of which were significantly higher than the titers from the patients on porcine SCI, but significantly lower than the antibody titers from the patients treated with any of the bovine preparations. The immunogenicity of bovine SCI was significantly reduced by administering multiple daily doses of the neutral regular form instead of one or two daily injections of the Lente form, Although these purer insulin preparations (SPI and SCI) are still associated with various degrees of immunogenecity, they are significant improvements for the treatment of insulin lipoatrophy and insulin allergy.


Effect of intermittent positive pressure ventilation on cardiac systolic time intervals. The measurement of systolic time intervals (STI) has been widely used as a non-invasive method of assessing the inotropic state of the heart, and normal values are available for healthy individuals breathing spontaneously. The present study was performed in order to evaluate how intermittent positive pressure ventilation (IPPV) affects STI. Ten subjects were investigated before and during halothane anaesthesia for routine surgery. Oesophageal pressure, respiratory minute volume and frequency, arterial blood-gas tensions, cardiac output and heart rate were also measured simultaneously. As expected, the institution of IPPV was associated with a reduction in cardiac output and an increase in oesophageal pressure. Paco2 was reduced. These changes were associated with a considerable lengthening of electro-mechanical systole. This was due to a lengthened pre-ejection period (PEP), whereas the left ventricular ejection time (LVET) was slightly shortened. These changes were even more marked during artifical hyperventilation. The changes in STI are attributed mainly to the reduction of venous return to the heart, subsidiary factors being intrathoracic pressure, myocardial inotropy and vascular resistance.


Airway closure and distribution of inspired gas in the extremely obese, breathing spontaneously and during anaesthesia with intermittent positive pressure ventilation. Airway closure (closing capacity, CC), FRC, total efficiency of ventilation (lung clearance index, LCI) and distribution of inspired gas (nitrogen washout declay percentage, NWOD) were determined by nitrogen washout techniques and arterial PO2and PCO2 measured by standard electrodes in 10 extremely obese subjects, prior to an during anaesthesia and artifical ventilation. CC was normal, but because of small FRC, airway closure occurred within a tidal breath in 9 out of 10 subjects during spontaneous breathing, when awake. PO2 was reduced, the hypoxaemia correlating to the magnitude of airway closure. LCI was normal, but NWOD was borderline. During anaesthesia, CC was unaltered by FRC was further reduced, so that in nine subjects sirway closure occurred above FRC and tidal volume together. A marked increase in relative hypoxaemia was recorded. LCI and NWOD rose, indicating less  efficient and less even ventilation. It is concluded that airway closure reasonably explains the marked hypoxaemia in obese subjects during anaesthesia, and that it may also be the reason for the uneven distribution of inspired gas.


Suitability of Althesin as a short-acting anaesthetic agent. A comparative study with equipotent doses of methohexitone. The suitability of Althesin as a short-acting anaesthetic agent was studied by comparing it to methohexitone. Twenty-eight anaestheias were given using equipotent doses of the two anaesthetics in order to anaesthetize 14 patients once with each drug. Thus the patients served as their own controls. Sleep induced by Althesin averaged 7 minutes, which was slightly but not statistically significantly longer than that produced by methohexitone (average 6 minutes). The time taken until orientation of the patients was complete was considerably longer with Althesin than with methohexitone. The responses to Althesin had a much wider range of individual variation in induction time, duration of anaesthesia and orientation time. After Althesin, three patients displayed mental confusion with anxiety on awakening. The recovery from anaesthesia was assessed by several recovery tests and observations, in addition to the patients' subjective assessments. Drowsiness was more manifest and persisted longer following Althesin than after methohexitone. Ninety minutes after anaesthesia, a tendency to collapse on standing was obvious following methohexitone, but this was not seen after Althesin. The level of test values and the physical status of the patients returned to pre-anaesthetic levels within 2 hours after both agents. The majority of the patients found anaesthesia with both compounds pleasant. However, they seemed to favour methohexitone as regards pleasantness and their subjective impression was of faster awakening or less postanaesthetic drowsiness.


Oxygen transport and venous admixture in the extremely obese. Influence of anaesthesia and artificial ventilation with and without positive end-expiratory pressure. Eight extremely obese patients (mean weight 136 kg) were studied when awake and breathing air, and during anaesthesia with controlled ventilation (oxygen fraction in inspirate (FIO2): 0.5). During anaesthesia, the atients were first studied with zero end-expiratory pressure (ZEEP) ventilation. Then two different positive end-expiratory pressures (PEEP) were applied, 10 cmH2O and 15 cmH2O, in order to study the effect of an increase in functional residual capacity (FRC). Arterial oxygenation and oxygen availability, as well as cardiac output (QT) and venous admixture (QS/QT) were studied. With the institution of anaesthesia and ZEEP, the alveolar arterial oxygen tension difference (P(A-a)O2) rose from 3.5 +/- 1.1 to 28.4 +/- 2.6 kPa, and the oxygen availability fell from 1346 +/- 222 to 1039 +/- 239 ml/min, due to the additive effect of an increase in QS/QT from 10 +/- 4 to 21 +/- 5% and a fall in QT, from 7.7 +/- 1.2 to 5.5 +/- 1.1 1/min. With increasing levels of PEEP, despite a fall in P(A-a)O2, there was a reduction in oxygen availability. This was due to simultaneous reduction in QS/QT and QT. At a PEEP of 15cmH2O, the P(A-a)O2 was 21.2 +/- 7.1 kPa, oxygen availability 862 +/- 170 ml/min, QS/QT 13 +/- 4 and QT 4.4 +/- 0.6 1. It is concluded that PEEP ventilation significantly reduces QS/QT in extremely obese patients during anaesthesia and should be used in these patients if there is arterial hypoxemia despite a high FIO2.


Dialysis and renal transplantation of children in Europe, 1974. About a third of all children with end-stage renal failure in Europe were accepted for treatment by regular dialysis or transplantation during 1974. The number of specialised paediatric dialysis centres increased. The number of renal transplants also increased, but fewer living donor grafts and retransplants were performed in 1974. The best survival was again observed on home dialysis. Patient survival after a cadaver graft improved. Children more than ten years old appeared to have a better survival on dialysis and a somewhat better graft function than younger patients. Rehabilitation was similar on home dialysis and after transplantation, but full school activity in ordinary school was reported in only 40% of all children on hospital dialysis. Children on haemodialysis tended to dialyse more frequently in 1974, than before, but for fewer hours per week. Hepatitis was still a problem and only a small reduction in the incidence was noted during 1974. Children on dialysis required more blood transfusions than adults. Body growth on haemodialysis was retarded to a similar degree on boys and in girls; 70% of the haemodialysed and 63% of the transplanted children had a growth velocity below the third percentile. Growth rate was noted to fall after the first year on dialysis.


Septicaemia of the newborn, associated with ruptured foetal membranes, discoloured amniotic fluid or maternal fever. The incidence of neonatal septicaemia associated with prolonged rupture of foetal membranes, discoloured amniotic fluid and/or maternal fever was investigated. A total of 807 blood cultures were performed on 329 neonates, the placental end of 239 umbilical cords and on 239 mothers. The study showed that in 97% of the neonates with a complicated delivery there was no evidence of septicaemia. Septicaemia was verified in 3% of the infants, and was intimately associated with low birth weight (p equals 0.02), neonatal asphyxia (p less than 10(-4)), clinical evidence of septicaemia (p less than 10(-4) and maternal fever (p equals 0.002). The incidence was particularly high in premature infants with neonatal asphyxia (27%) and in neonates born to febrile mothers (20%). None of the mothers showed any evidence of septicaemia, and haematogenous, transplacental spread of infection to the child was not seen. Routine prophylactic antibiotic therapy in neonates with a complicated delivery should therefore be reserved, in our opinion, for those infants at high risk of infection.


A histopathological study on the islets of Langerhans and ductal epithelial metaplasia in atrophic lobuli of pancreas. In autopsy material isolated islets of Langerhans are frequently encountered in the fatty or the fibrous tissue replacing the pancreatic lobuli. The incidence of isolated islets of Langerhans was 27.0% in the file of a series of randomly selected 100 autopsy cases and increased with advancing age. Fifteen cases of these 27 showed multiple foci and the total number of foci counted 60. Fifty-two foci (86.7%) were found in the subcapsular area. Clusters of elastic fibers were found in 36 foci (60.0%). Small pancreatic ducts with goblet cell metaplasia were found in 29 foci (48.0%) in the surrounding tissue of the remaining islets of Langerhans. Squamous metaplasia was identified in only 1 focus (0.2%), and luminal dilatation of the duct was found in 4 foci (0.7%). Serial sections showed that the small duct ended without connection to acinar cells. "The isolated islets of Langerhans" should be the result of the atrophy of pancreatic lobuli subsequent to disappearance of acinar cells.


Genetic mapping of the K1 and K4 antigens (L) of Escherichia coli. Non-allelism of K(L) antigens with K antigens of O8:K27(A), O8:K8(L) and O9:K57(B). Escherichia donor strains having antigen K1(L) or K4(L) transfer these K antigens to recipient cells at a genetic locus (kps A) similar to that of K10(L) and K54(L) linked to ser A. In crosses between the K10 donor strain and recipient strains O8:K8(L), O8:K27(A) and O9:K57(B) all recombinants which inherit donor K antigen also inherit K antigen of recipient. This result is interpreted as non-allelism between donor and recipient K antigens, and it is assumed that the structure of all polysaccharide K antigens of strains having O antigens O8 or O9, whether termed L, A, or B, are controlled by genes which differ in their location on the chromosome from genes controlling polysaccharide K antigens associated with most other O antigens.


Streptococcal bacteriophage 12/12-borne hyaluronidase and its characterization as a lyase (EC 4.2.99.1) by means of streptococcal hyaluronic acid and purified bacteriophage suspensions. Hyaluronic acid was obtained from filtrates of heat-killed cultures of Streptococcus pyogenes group A, strain K56, by simple ethanol precipitation and treatment with an adsorbent. The hyaluronic acid is pure as judged from chemical and sedimentation analyses. Particles of streptococcal bacteriophage 12/12 were isolated from phage-lysed group A streptococci by polyethylene glycol precipitation and isopyenic centrifugation. Electron micrographs of negatively stained preparations showed a typical Bradley group B virus with a long, flexible, cross-striated tail and a knob- or star-like structure at the distal tip of the tail. The hyaluronic acid is depolymerized upon incubation with the phage 12/12 virions. After extensive digestion, a mixture of at least four oligosaccharides is formed, the two smallest of which are a tetra- and octasaccharide terminating in reducing N-acetyl-D-glucosamine. The tetrasaccharide shows an absorption maximum at 231.5 nm with a molar extinction coefficient epsilon = 4820 litres X mole-1 X cm-1, and it is therefore concluded that the bacteriophage-borne hyaluronidase catalyses a beta-elimination. Accordingly it is classified as a hyaluronate lyase (EC 4.2.99.1).


Preformed autologous ossicles. Experimental studies. On the basis of earlier experimental investigations concerning autogenous bone transplants a project is going on with the view to have a patient to create his own bone graft suitable for being used in reconstructive surgery of the middle ear. This theory was tested in 6 rabbits and 6 dogs where a titanium form was installed in the proximal tibial metaphysis. The healing time was 6-8 months. After extraction histologic examination of the facsimile showed that it consisted of an outer form-giving thin layer ocal bone and a system of spongious bone surrounded by marrow with haemopoetic cells. Microradiologic analyses revealed a well mineralized trabecular bone tissue. By means of microangiography a microvascular architecture with a mature appearance could be demonstrated.


Isolation of hyaluronic acid from cultures of streptococci in a chemically defined medium. A haemolytic streptococcus (Lancefield's group A) has been cultivated in a chemically defined medium. About 300 mg hyaluronic acid of a high degree of purity was isolated per litre of this culture.


The effect of anti-lymphocyte serum, mitogens and enzymatic treatment on the agglutination and surface charge of lymphoid cells. Agglutination of thymocytes and B-cells with anti-lymphocyte serum subsequent to treatment of the cells with trypsin or neuraminidase was slightly and similarly increased, independent of the effect on the surface charge shown previously. The enzymatic treatment did not increase capping of antiserum binding sites. Agglutination caused by binding of IgG antibodies of anti-lymphocyte serum was not accompanied by change in the net surface charge. Neither did binding of the mitogens phytohaemagglutinin, concanavalin A or poke-weed mitogen influence the surface charge of the cells.


Purification of immunolobulin G Fc-reactive factor from Streptococcus azgazardah. A factor from Streptococcus azgazardah (Lancefield's group C) capable of reacting with the Fc fragment of human IgG was partially purified and characterized. The bacteria were lysed by infection with phage, and the IgG Fc-reactive factor was purified from the crude lysate by affinity chromatography on a IgG-coupled Sepharose 4B column. The column was eluted with 3 M KSCN and the eluate gel-filtered on a Sephadex G 75 column. A 30-fold purification was obtained. The molecular weight of the IgG Fc-reactive factor was estimated to be 60,000. The factor was sensitive to trypsin treatment and to heating 95 degrees C, 10 min at pH 2.0. On polyacrylamide electrophoresis only one band was obtained. The trypsin-and heat-sensitivity, and the estimated molecular weight of the factor was similar to an IgG Fc-reactive factor preparation obtained from group A, type M 56 streptococci by heat treatment at 120 degrees C for 30 min.


Visualization of the binding of IgG myeloma proteins to some group A streptococci. The interaction between streptococci and human IgG, which does not involve the antibody combining sites, was visualized in the electron microscope by the use of human IgG myeloma proteins and ferritin labelled rabbit anti-human IgG antibodies. The streptococci were allowed to react with human IgG myeloma proteins and the human IgG was then marked by addition of ferritin labelled rabbit anti-human IgG antibodies; sections of streptocci studied in electron microscopy showed localization of the ferritin on the surface of the cell wall of all the streptococci of type M 1, M 3, M 12 and M 56 studied. Similar results were obtained if the ferritin labelled rabbit anti-human IgG antibodies alone were allowed to react with the streptococci. The uptake of ferritin labelled rabbit anti-human IgG antibodies could be inhibited by addition of normal rabbit serum.


Leucocyte migration inhibitory activity (LMIA) on concanavalin A (Con-A) stimulated human lymphocytes. Comparison of leucocyte migration capillary technique (LMCT), leucocyte migration agarose technique (LMAT), and leucocyte migration fibrinolysis technique (LMFT). Leucocyte migration and migration inhibition in fibrin medium may reveal new aspects of lymphokine activity associated with immunological inflammation. Leucocyte migration fibrinolysis technique is compared with the leucocyte migration capillary technique and the leucocyte migration agarose technique. In the present model experiment the three methods gave comparable results. The leucocyte migration fibrinolysis technique involves a new principle for detection of lymphokines and can probably be developed to give more exact information about the interrelationship between thrombosis, fibrinolysis and lymphokines.


Freezing of rat lymphocytes. III. Freezing of plaque-forming cells and restoration by frozen-thawed normal cells of antibody production in irradiated rats. The present investigation is an extension of earlier work with dimethyl sulphoxide (DMSO) protected frozen-thawed rat lymphocytes. In the present work it is shown that some 85-90% of the haemolytic plaque-forming cells (PFC) survived the freeze-thaw process. Irradiated rats were restored with fresh and frozen-thawed cells and immunized against sheep red blood cells (SRBC). Evidence is presented that a restrictive control of the PFC response by suppressor cells present in the spleen cell suspension is lost during the freeze-thaw process, giving a higher number of PFC/spleen in recipients of frozen-thawed mixed spleen and lymph node cells than in rats receiving the corresponding fresh preparations.


Immunological in vitro parameters in patients with multiple sclerosis and in normal individuals. The general immunological capacity of 40 patients with multiple sclerosis has been evaluated with lymphocyte transformation test including both mitogens (PHA and PWM) and antigens (PPD, Candida albicans, Staph. aureus and E. coli). Determination of T and B cells was performed by E-, EAC-rosetting and immunofluorescence for surface immunoglobulins. Compared with the results obtained in 42 normal individuals only minor differences were found.


Lymphocyte transformation in vitro in dermatophytosis. Peripheral blood lymphocytes from 59 patients with dermatophytosis and from nine young healthy women were studied by the lymphocyte transformation test (LT) using mitogens and bacterial as well as fungal antigens. The latter included Candida albicans (CA) and four dermatophyte species, viz. Trichophyton rubrum (TR), Trichophyton mentagrophytes (TM), Epidermophyton floccosum (EF) and Microsporum canis (MF). Most of the patients showed normal transformation in response to mitogens and non-dermatophyte antigens, indicating that they have no functional T-cell deficiency. Dermatophyte antigens act as stimulators in LT. In general, patient lymphocytes responded more strongly to these antigens than lymphocytes from controls. In most patients suffering from TM infections, response to the TM antigen was significantly stronger (p less than 0.05) than that in the other patients, indicating that this antigen preparation shows species specificity. In patients with Trichophyton (TR + TM) infections, response to the corresponding antigens was significantly stronger than that in the other patients, which suggests the existence of genus specificity. Any differences between patients suffering from chronic TR infections and those with acute TR infections were not observed, a finding which is in contrast to those obtained in other studies. However, a few patients with chronic TM infections responded weakly to mitogens and non-dermatophyte antigens. LT in four patients with id-reaction to TM infection was not found to differ from that in the remaining TM patients.


The effect of serotonin (5-HT) on insulin secretion. The present study was aimed at observing the effect on insulin secretion of serotonin (5-HT) administered intraportally to anesthetized adult dogs. The influence of 5-HT on insulin release was also studied in mouse pancreatic islets isolated by a collagenase method. In the in vivo studies, 6 mg of 5-HT rapidly injected in the portal vein of dogs induced hypoglycemia, and a significant increase of immunoreactive insulin plasma levels (IRI) in blood samples taken from the pancreatoduodenal vein. The phenomenon was registered throughout three consecutive 10 min periods after serotonin administration. With 3 mg of 5-HT the IRI increases were not observed. When serotonin was slowly infused at doses of 3 and 6 mg, no increases of IRI were recorded. In the in vitro studies, 5-HT at 100 mug/ml stimulated the output of insulin in the presence of a low concentration of glucose (0.6 mg/ml); when the islets were incubated with glucose at a higher concentration (3.0 mg/ml) there was a lower insulin release in the presence of serotonin (100 mug/ml) than that obtained with glucose alone at the same concentration (3.0 mug/ml). The results obtained suggest that serotonin stimulates insulin release under certain conditions in the intact dog and also in the isolated pancreatic islets of the mouse incubated in vitro.


A double-blind trial of baclofen against placebo in the treatment of schizophrenia. Twenty male chronic schizophrenic patients participated in a double-blond between-patient study of the GABA-like drug baclofen to evaluate the antipsychotic effect of baclofen. No difference was found between the 10 patients who received baclofen and 10 who received placebo with regard to the number of days before a worsening of their psychiatric condition necessitated treatment with chlorpromazine, the total score for psychotic symptoms before and after treatment for 10 weeks, or the total consumption of chlorpromazine. Discontinuation of baclofen did not exacerbate the psychotic symptoms. Baclofen was superior to placebo in the treatment of anxiety, which is of particular interest in view of the recent theories on the mechanism of action of benzodiazepines. The relationship between the gabergic system and the dopaminergic system with regard to the substantia nigra and the corpus striatum is discussed as well as the suggestion based on animal experiments that baclofen has an antipsychotic effect.


A comparative double-blind study of the side effects of Litarex and Lithionit Durettes. Side effects of two lithium salts of the sustained-release type were compared in a cross-over double-blind study. Eighteen patients with uni- or bipolar type of manic-depressive diseases were included in the trial. The drugs compared were lithium citrate (Litarex, Dumex Ltd.) and lithium sulphate (Lithionit Durettes, Hässle Ltd.). After the patients had been adjusted to a serum concentration of 0.8-1.2 mmol/l, self-assessment of the frequency and intensity of 16 side-effect variables was performed during a period of 4 weeks. The most common side effects were tremor, fatigue, polyuria, polydipsia, and reduced power of concentration. There was no difference in the frequency or intensity of the side effects between the two drugs. The side effects are, accordingly, considered an effect of the lithium ion, rather than of the lithium salt. The difference in the size and appearance of the tablets was of very little practical significance.


Anatomical rationale of ablative surgery for temporal lobe seizures and dyscontrol: suggested stereo-chemode chelate-blockade alternative. Anatomical data now strongly suggest that the common factor in curative ablative operations for the commonest (i.e. ammonshorn-sclerosis) form of temporal-lobe epilepsy is the cutting of the ipsilateral temporoammonic perforant path's "nozzle" where it leaves the entorhinal cortex to "spray" along the length of the ammonshorn. This substantially deafferences ipsilateral dentate granule-cells and hence the unsclerosed pyramidal neurons notably in "resistant sector" CA2, which are probably the source of the seizures. Stereo-chemoding of long-lasting (experimentally tested) chelates along the zone of peculiarly zinc-rich synapses of the mossy fibre system should block the commissural as well as the ipsilateral inputs to these residual neurons, to give higher percentage cures, and could probably be performed bilaterally (where indicated, in adults) without endangering memory function.


Stereotactic fornicotomy in temporal epilepsy: indications and long-term results. An analysis of the long-term results of 42 patients with epilepsy and behavioural disturbances treated by stereotactic fornicotomy has been carried out. An attempt has been made to classify the indications for this surgical method. Patients must be selected according the following criteria: the lower age groups, severe behavioural disturbances and epileptic symptomatology unchanged by any other form of treatment, normal I,Q. and electroencephalographic demonstration of a temporal lobe epileptic focus. The stereotactic lesion of the fornix was always carried out homo-laterally and was without morbidity and mortality. The results have been satisfactory in 70% of our patients but mainly when aggression was the main feature. The best results are related to a high I.Q. and a short clinical history.


Stereo-electroencephalographic exploration and epilepsia partialis continua. Somatomotor status epilepticus in infatnts consisting of continous repetitive clonic jerks as a sequel of involvment of the sensorimotor area cortex has rarely been explored by multiple depth electrodes. The authors report 3 cases, which were examined stereo-electroencephalographically. Two girls, a 5 year old and a 3 year old showed sustained jerks of one foot with intermittent Jacksonian seizures. Both had a primary epileptogenic focus in the medial prerolandic and postrolandic cortex. The third case, an 8 year old girls, was a borderline case of Kozevnikov epilepsy. All 3 patients were operated on following the stereo-electroencephalographic exploration and the focus was removed. The study shows that it is possible to explore children with depth electrodes and that this exploration is the safest way to localize a focus and, consequently to cure the patient by surgery.


Basic targets and the different epilepsies. The follow up of 49 stereotactically operated epileptics is graphically demonstrated and the 79 operations in basic targets within the amygdala and the area of the anterior pole of the thalamus are described. The patients had valuable gaining in 80%; The continued developement of stereotactic methods in the future is urgent, so long as 30% of the epileptics respond poorly to drug therapy and only 5-10% are suitable to the traditional resection methods.


Effects of stereotactic operations in the treatment of epilepsies--neurological aspects. In 81 patients with intractable epileptic seizures 121 stereo-electroencephalographic (SEEG) examinations and 91 operations with stereoencephalotomy (SET) were carried out. SEEG and SET targets were chosen in 22 different subcortical structures and in the medial frontal cortex. In 6 of 18 temporal epilepsy cases SET was followed by classical hippocampectomy. With the exception of temporal lobe cases all others were unsuitable for classical neurosurgery. Of 61 controlled patients 24.5% were cured or greatly improved cured, 39.5% improved and 36% unimproved; Correlations among the clinical, EEG and SEEG findings; SET and therapeutic effects are discussed together with the role of stereotactic procedures. In our experience (Cigánek 1962) among patients unsuccessfully treated by conservative methods over 60% are unsuitable for classical procedures based on the criteria of the Montreal neurosurgical school, because of the absence of leading epileptogenic area or because they represent cases with completely or almost completely generalized seizures. In these cases stereotaxy offers prospects diagnostic refinement and treatment.


Effects of stereotactic lesions in intractable epilepsy. The eras of surgical treatment of epilepsy are described and experience with the epilepsy operations, especially those obtained in the course of temporal epilepsy operations, and stereotactic attempts based on multielectrode EEG investigations, and ES. Classical, exposure and resection still seems adequate whilst stereotaxy develops in the selective elimination of the structure activating the coded seizure-pattern.


Results of amygdalotomy and fornicotomy in temporal lobe epilepsy and behaviour disorders. 8 patients with drug-resistant epilepsy underwent amygdalotomy in some cases followed by fornicotomy. There was no definite improvement in seizure frequency. The behaviour improved in 3 cases.


Stereotactic surgery of the limbic system in epilepsy. During the routine follow-up of results of stereotaxic surgery in the patients treated for behaviour disorders, it was found that some of them had a bonus relief from seizures, Out of 260 amygdalotomies, 54 hypothalamotomies and 5 thalamolaminotomies performed for behavioural problems, 107 patients suffered from associated seizure disorder. 76 of them (71%) showed considerable relief from seizures following surgery. This is detailed. It is hypothesized that probably these nuclei of the "limbic system" either initiate and/or propagate seizure activity. This view is supported by the "improvement" in EEG in addition to the clinical improvement seen in these patients.


Spontaneous autoimmune thyroiditis in the BUF rat. The inbred BUF rat develops autoimmune thyroiditis spontaneously. The incidence is related to the age of the animal and is increased by neonatal thymectomy and by treatment with methylcholanthrene. Autoantibodies to thyroglobulin can be demonstrated by indirect immunofluorescence and hemagglutination, but skin tests are negative. The "spontaneous" autoimmune disease may be due to the conjunction of an unusually vigorous immunological response to thyroglobulin and the loss of thymic suppressor function.


Genetic regulation of macrophage functions. Normal phagocytic function is genetically determined but maintained in a rather narrow range of variation. Phagocytosis stimulation induced by different agents is variable according to species, strains or individuals. Variation is environmental, to a great extent, but has also a genetic component which differs in each case. Selective breeding for macrophage responsiveness to triolein stimulation was successful. However, the relevant genes have only a small effect on antibody synthesis. Macrophages of mice selected for high and low antibody synthesis have a similar phagocytic function but their capacities of antigen processing are quite different.


The present view of RES and shock.

The present view of RES and shock. Conclusive evidence emphasizes the need for a functionally intact RES function in shock states and in the critically ill patient. Effort must be made to restore and maintain homeostasis also with regard to the RES. RES-research must be intensified in order to define the exact mechanism of the post-traumatic RES depression, since little seems to be gained from pharmacological stimulation of the RE cells, but more from replenishing apparently missing plasma factors. Attention must also be paid to the RES in the therapeutic situation by restricting the use of potential RES depressors.


Introduction to cardiovascular research on prostaglandins. The prostaglandins have diverse cardiovascular effects, differing not only among themselves but also according to the organ affected and the species. Some of the pharmacological actions of the prostaglandins may have practical application in hypertensive crises, shock, peripheral vascular disease, and to maintain the patency of the ductus arteriosus in congenital heart malformations. They may play physiological roles as locally produced modulators or regulators of kidney function and blood flow to specific organs or tissues. Such roles are yet to be firmly established.


The response of normal and asthmatic subjects to prostaglandins E2 and F2alpha by different routes, and their significance in asthma. Although PGE2 and PGF2alpha have potent effects on the human bronchus by aerosol, they are less potent when given by the intravenous route. Prostaglandin E2 may cause bronchoconstriction. Indomethacin had no effect on day-to-day asthmatic symptoms, or challenge-induced asthma, suggesting that prostaglandins are not fundamental to the pathogenesis of asthma.


A test experience with a machine-processed electrocardiography diagnosis: the recognition of "normal" and some specific patterns. Five hundred ECG's, machine processed by the commercially available IBM Bonner-Mt. Sinai System, have been reviewed. The diagnostic printouts were of value as an adjunct to the physician's interpretations, but were not sufficiently reliable--in regard to either sensitivity (identification of the abnormal or borderline) or specificity (accuracy in predicting typical abnormalities)--to allow us to condone any claim for it being an independent reliable diagnostic service to noncardiologist clinicians. Despite this desclaimer for current diagnostic reliability of ECG computer analyses, specifically the IBM-Bonner system, we continue to be of the firm conviction that progress through this method of ECG analysis will have much to contribute in future years.


High sodium-low potassium environment and hypertension. The high sodium-low potassium environment of civilized people, operating on a genetic substrate of susceptibility, is the cardinal factor in the genesis and perpetuation of "essential" hypertension. The noxious effects begin in childhood, when habits of excess salt consumption are acquired at the family table, and are perpetuated by continuing habit and by increasing use of convenience and snack foods with artificially high concentrations of sodium and low levels of potassium. Present methods of food preparation leach out the protective potassium. Extradietary sodium chloride is a condiment not a requirement. Some primitive populations clearly preferred potassium chloride to sodium chloride. Chronic expansion of extracellular fluid volume induced by excess salt consumption causes the central and peripheral circulatory regulatory mechanisms to work at cross purposes, resulting in increased arterial pressure. The protective effect of potassium is dramatic and easily demonstrable in animals and man but its mechanism is not known. It cannot be entirely a direct effect on blood pressure because rats protected with extra potassium against a moderately high salt intake live much longer than control rats but have the same elevated blood pressures. In hypertension with a demonstrable "cause," the high sodium-low potassium environment makes a bad matter worse. In nature, feral man and his forebears were not confronted with excessive sodium and deficient potassium; indeed, the reverse was the case. Evolution has provided powerful mechanisms for conserving sodium and eliminating potassium, but no efficient physiologic mechanisms for conserving potassium and eliminating excess sodium. Most laboratory animal "control" diets contain an amount of sodium that fully suppresses aldosterone secretion, and the same is true of the "average" diet of the American people. Inadequate attention to dietary sodium and potassium makes many studies in both animals and man of uncertain validity. Internally, essential hypertension is an exceedingly complex mosaic of physiologic interactions. Viewed from outside, it is a disorder for which genetic material sets the stage; excessive sodium precipitates it and perpetuates it. Extra salt makes all forms more rapidly progressive and accelerates the onset of terminal events; extra potassium is everywhere protective. When an entire population eats excessively of salt, hypertension will develop among those genetically susceptible, but epidemiologic studies of salt versus blood pressure will not show a relation of salt to hypertension. This is the saturation effect. Low sodium diets are therapeutically effective but generally regarded as an impossible or an unnecessary nuisance. Effective prevention programs must be instituted at as early an age as possible. The efficacy of a prophylactic/therapeutic low sodium-high potassium diet should be weighed against the uncertain hazards of a lifetime of pill taking.


Electrophysiologic effects of atropine on sinus node and atrium in patients with sinus nodal dysfunction. Electrophysiologic studies were conducted in 21 patients with sinus nodal dysfunction before and after intravenous administration of 1 to 2 mg of atropine. The mean sinus cycle length (+/- standard error of the mean) was 1,171 +/- 35 msec before and 806 +/- 29 msec after administration of atropine (P less than 0.001). Mean sinus nodal recovery time determined at a aced rate of 130/min and maximal recovery time were, respectively, 1,426 +/- 75 and 1,690 +/- 100 msec before and 1,169 +/- 90 and 1,311 +/- 111 msec after atropine (P less than 0.001 and less than 0.001). Mean calculated sinoatrial conduction time, measured in 16 patients, was 113 +/- 8 msec before and 105 +/- 9.7 msec after atropine (difference not significant). Mean atrial effective refractory period, measured at an equivalent driven cycle length, was 262 +/- 11.1 msec before and 256 +/- 10.3 msec after atropine (not significant). Mean atrial functional refractory period was 302 +/- 12.5 msec before and 295 +/- 11.3 msec after atropine (not significant). The shortening of sinus cycle length and sinus recovery time with atropine was similar to that noted in patients without sinus nodal dysfunction. In contrast, atropine had insignificant effects on sinoatrial conduction and atrial refractoriness in this group whereas it shortens both in normal subjects. This finding may reflect altered perinodal and atrial electrophysiologic properties in patients with sinus node disease.


Clinical efficacy of amiodarone as an antiarrhythmic agent. Amiodarone, administered orally in doses of 200 to 600 mg/day, was remarkably effective in the treatment and prevention of a wide variety of atrial and ventricular arrhythmias. Total suppression and control was provided in 98 (92.4 percent) of 106 patients with supraventricular arrhythmias and in 119 (82 percent) of 145 patients with ventricular arrhythmias. The rates of total control of the arrhythmia were: 96.6 percent in 30 patients with recurrent atrial flutter or fibrillation, 96.6 percent in 59 patients with repetitive supraventricular tachycardia, 100 percent in 27 patients with Wolff-Parkinson-White syndrome and 77.2 percent in 44 patients with recurrent ventricular tachycardia unsuccessfully treated with other drugs. Excellent results were obtained in 6 to 8 patients with repetitive ventricular tachycardia and ventricular fibrillation related to postinfarction ventricular aneurysm and in 12 of 14 patients with ventricular extrasystoles and ventricular tachycardia related to Chagasic myocarditis. Amiodarone proved safe in patients with severe congestive heart failure and severe myocardial damage. Its clinical efficacy was related to its electrophysiologic properties and to two unique properties: its wide safety margin and its cumulative effect. The latter liberates patients from a rigid hourly schedule and provides for continuous antiarrhythmic control, days and even weeks after treatment is discontinued.


Comparison of patterns of fecal bile acid and neutral sterol between children and adults. The patterns of bile acids and neutral sterols in the feces of five infants under 1 1/2 years of age, five children 4 years of age, and nine adult subjects without histroy of gastrointestinal diseases were studied by gas-liquid chromatography. Progressive changes in both bile acid and neutral sterol profiles were observed with maturation in infants and children. The patterns in the 4 year olds appraoched those observed in adults. In the infants under 1 1/2 years, cholic and chenodeoxycholic acids constituted 20.7 +/- 4.8% and 7.5 +/- 2.3% of the total bile acid in the stool, respectively. Deoxycholic and lithocholic acids made up only 4.4 +/- 1.7% and 2.9 +/- 1.0%, respectively. In the 4 year olds, the corresponding primary bile acids decreased to 3.9 +/- 1.9% and 5.6 +/- 4.3%, whereas secondary bile acids increased to 21.3 +/- 5.4% and 33.2 +/- 2.2%. Normal adults on regular mixed diets had only small amounts of primary bile acids (2.4 +/- 0.5% and 3.4 +/- 0.6% for cholic and chenodeoxycholic acids). The secondary bile acids in their feces were 34.3 +/- 2.2% and 38.9 +/- 2.0%, respectively. In the neutral sterol fraction, unmodified cholesterol decreased with age: 94.7 +/- 3.7%, 27.0 +/- 1.5% and 25.0 +/- 4.8% of the total neutral sterols in the feces for infants, children, and adults, respectively. On the other hand, coprostanol, the principal metabolite of cholesterol in humans, increased with age: 3.8 +/- 3.4%, 62.6 +/- 3.5% and 65.8 +/- 4.7% for the respective groups. Total bile acid excretion  expressed as mg/day, also increased with age: 34 +/- 17, 47 +/- 17 and 293 +/- 69 (for five adult subjects only) for the respective groups. These differences disappeared, however, when the data were expressed as mg/kg of body weight per day: 3.8 +/- 2.0, 3.0 +/- 1.1, and 4.1 +/- 1.0 for the respective groups. Daily excretion of cholesterol metabolites, when expressed as mg/day increased with age: 139 +/- 38, 278 +/- 54 and 719 +/- 211 (for five adult subjects only) for the respective groups. The corresponding values after correction by body weight were 15.4 +/- 4.5, 17.9 +/- 3.0 and 10.3 +/-3.0 mg/kg per day for the respective groups. The production of coprostanol was correlated with 7 alpha-dehydroxylation of cholic acid and chenodeoxycholic acid.


Metabolic epidemiology of colon cancer: enzymic activity of fecal flora. Because of the potential significance of secondary bile acids and cholesterol metabolites formed by the intestinal microflora in the pathogenesis of colon cancer, fecal microbial 7alpha-dehydroxylase and cholesterol dehydrogenase activities were assayed in colorectal cancer patients, patients with adenomatous polyps, asymptomatic controls, and normal controls. The mean 7alpha-dehydroxylase activity per 100 mg of dry feces per 2 hr incubation for colorectal cancer patients was significantly greater than either asymptomatic controls or normal controls. Patients with polyps had greater activity than controls, but did not differ significantly from the cancer patients or asymptomatic controls. The mean cholesterol dehydrogenase activity for colorectal cancer patients was significantly greater than controls. Patients with polyps also had greater activity than controls. No differences in the level of fecal beta-glucuronidase activity were found among the four risk groups. These data support the concept that patients with colorectal cancer are more able to convert primary bile acids and cholesterol to microbial products in colon contents than are controls. Such differences in the activity of intestinal microflora may serve as biochemical indicators that will reflect the enzymic activity of the fecal flora as well as the key intraluminal compounds in identifying populations at different risk for developing colorectal cancer.


Enterobacteriaceae in the jejunal microflora prevalence and relationship to biochemical and histological evaluations in healthy Colombian men. When 23 healthy native Southwestern Colombian men were studied to determine the prevalence of Enterobacteriaceae in the jejunal microflora in a sample of thoroughly evaluated tropical inhabitants who were normal by physical examination, chest x-ray, and medical history, 14 of the 23 proved to be Enterobacteriaceae-positive, with counts of 10(3) to 10(9) per milliliter of jejunal aspirate. Thirteen had Escherichia coli, and the fourteenth had Klebsiella pneumoniae. Four had a second species of Enterobacteriaceae associated with E. coli: three were K. pneumoniae, and one was Proteus morganii. Laboratory studies routinely done on all subjects disclosed a total of 18 low biochemical values, 17 of which were associated with 12 of the 14 Enterobacteriaceae-positive subjects: six were low in serum cholesterol, four low in serum vitamin B12, four low in D-xylose excretion, and three low in creatinine coefficient; whereas, the Enterobacteriaceae-negative subjects had normal values for all biochemical tests except for serum vitamin B12 in one case. Nitrogen balance means were significantly different for the two groups: 3.39 g for the Enterobacteriaceae-positive subjects and 1.94 g for the Enterobacteriaceae-negative. No relationship was evident when the histology of the jejunal biopsies was compared with the microbiological or laboratory findings. When the 23 subjects were grouped into those (N = 19) with significant microbial recoveries of any type and those (N = 4) without, the data yielded no meaningful relationships.


The effect of dietary fiber supplementation in man. II. Alteration in fecal physiology and bacterial flora. Fecal weight and water content and fecal quantitative and qualitative bacterial studies were compared on six volunteer subjects during regular diet periods and when on 5.4 g of diet fiber supplementation. There was a statistical mean stool weight increase for the group from 103 +/-  40 g to 226 +/- 90 g. The water content of the stool remained constant under the diet conditions of this study. The total anaerobic counts increased significantly while the subjects were on the high fiber diet. Trends in bacterial genus changes appeared but were not significant and total aerobic counts were stable.


Agglutination with O antisera of salmonella exposed to antibiotics. Five strains of Salmonella were grown on agar containing subinhibitory concentrations of ampicillin, gentamicin, tetracycline, or chloramphenicol, and on drug-free agar (control). Antigens were prepared by heating bacteria suspensions in saline solution at 100 C or by suspension in alcohol. Antigens were tested for agglutinability with somatic O antisera and fluorescent antibody staining. The alcohol-treated antigens prepared from organisms grown in the presence of antibiotics other than ampicillin had lower agglutination titers than did the control grown on drug-free agar. Heat-treated control antigens had lower agglutination titers than did the alcohol-treated control antigens. The agglutinability of heat-treated antigens prepared from organisms that had been exposed to antibiotics was preserved or enhanced. The agglutinated filaments produced a flocculent sediment, in contrast to the granular sediment of the controls. No significant morphologic abnormality in cell-wall structures of antibiotic-exposed cells could be detected by either electron microscopy or the fluorescent antibody staining.


Sickle-cell disease and poststreptococcal acute glomerulonephritis. The cases of three children with sickle-cell hemoglobinopathy and acute poststreptococcal glomerulonephritis are described and discussed. Light and electron microscopic findings in three cases, and immunofluorescence microscopic findings in two are described. Since proliferative glomerulonephritis of either poststreptococcal or non-poststreptococcal etiology may be seen in patients who have sickle-cell disease, immunofluorescence and/or electron microscopic examination is essential for accurate diagnosis.


Evidences for duodenopancreatic reflexes and an anti-CCK factor with lidocaine infused intravenously and sprayed topically on pancreatic papilla in nonalcoholic and alcohol-fed dogs. In 14 duodenal Thomas fistula dogs, four of them alcohol-fed for two years, lidocaine, applied topically to the duodenal pancreatic papilla, inhibited secretin-induced pancreatic secretion probably by interrupting duodenopancreatic reflexes that contribute to the "pancreon's" cholinergic tone. Opposite effects were observed with lidocaine administered against a CCK plus secretin background stimulation of the pancreas. The significant rising of volume and protein output above plateau levels were enhanced by chronic alcohol feeding. Lidocaine infused intravenously did not change secretin-induced pancreatic secretion but raised CCK and secretin evoked plateau secretion levels. Chronic alcoholism enhanced these latter effects. Atropine perfusion superimposed on CCK and secretin stimulation did not prevent but raised the intravenous lidocaine-induced pancreatic secretion changes. It is postulated that the modifications elicited by lidocaine sprayed topically and infused intravenously on CCK plus secretin evoked pancreatic secretion plateau levels are due to depression of an anti-CCK factor secreted by the small intestine mucosa.


Theoretical foundation of the medieval preparations of urinary derivatives. It has been recently brought to light that the Chinese, as early as 1025 A.D., had already devised a preparation which would extract hormones from urine. This paper attempts to trace the development of Chinese medical thought, from 25 A.D., which had led to such a sophisticated preparation.


Hospital-acquired infections. II. Infection rates by site, service and common procedures in a university hospital. Over a three-year period, 3432 nosocomial infections occurred in a university hospital admitting 55,476 patients over a three-year period (6/100 admissions). A single system of surveillance was used, and overall monthly rates varied from 4-9/100 admissions with particularly high rates in the Newborn Intensive Care Unit (24/100). Annual rates greater than or equal to 10/100 admissions were found in major surgical services of Gneral Surgery, Neuro-Surgery, Thoracic Cardiovascular Surgery (TCV), Plastic Surgery and Urology; 1243 urinary tract infections (2.24/100 admissions/ accounted for 36% of the problem. The rate of urinary tract infections after catheterization was 13/100 procedures overall with unusually high rates for patients in Neuro-Surgery (37/100), Orthopedics (23/100), and Plastic Srugery (18/100). There were 524 nosocomial pneumonias (.94/100 admissions), and the rate was especially high (3.7/100) for patients admitted to the TCV service or for those placed on a respirator (3.4/100 patients). Identifying high risk areas and high risk procedures in a hospital is a practical starting point for infection control.


Modification of cardiovascular function in dogs by acupuncture: a review. Acupuncture at Jen Chung (Go-26) in dogs under halothane anesthesia produces sympathomimetic-like effects on the cardiovascular system. This response can be inhibited by pretreatment with propranolol and to a lesser extent with phentolamine. Severe hypotension and cardiac arrest produced by hypoxia in dogs under halothane anesthesia can be reversed by acupuncture at Jen Ying (St-9). This also was interpreted as a sympathomimetic-like effect. Acupuncture at Tsu San Li (St-36) results in a parasympathomimetic-like effect on the cardiovascular system which can be inhibited by atropine. A parasympatholytic-like effect resembling that produced by atropine can be obtained in dogs with sinus arrhythmia and pulsus alternans by acupuncture at Yang Hsi (LI-5).


Theoretical foundation of Chinese medicine: a modern interpretation. The theoretical foundation of Chinese medicine as laid down in Hwang Ti Nei Ching is presented and interpreted here in modern language and conception. Our attempt is to bring Chinese medicine in harmony with Western science. Three Yin-Yang laws are formulated based on I Ching and Nei Ching and are justified from physics, mathematics and biology. The Wu-Hsing dynamic model is explained on the basis of dynamic interactions rather than static elements. The Ching-Lo doctrine is stressed upon its apparent correlations with the autonomic nervous system. Finally, the Chi is taken to play a role in life as the fields (gravitational, magnetic, nuclear, etc.) do in the physical world.