Influence of maternal nutrition on birth weight. This paper discusses some conditions necessary to detect an effect of maternal nutrition on birth weight and the relative contribution of calories and protein to such an effect. The expected dose- and time-response relationships for nutritional interventions aimed at the improvement of birth weight are also discussed. There appears to be a minimal level of nutrients which must be available in order to obtain adequate birth weight. However, above this minimum level, pregnant women can adapt themselves to a wide variety of food intake, both in quantity and quality, without affecting birth weight. The relative contribution of calories and protein to an increase in birth weight depends on the limiting nutrients of the home diet in the population under study. Other factors like physical activity, prevalence of disease and magnitude of the maternal nutritional stores before pregnancy are also important determinants of the relative contribution of calories and protein to birth weight. The anticipated input of a nutritional intervention on birth weight should range between 25 and 84 g of birth weight/10,000 kcal ingested during pregnancy. This estimate was computed from analyses based on four sources of published data: weight gain during pregnancy, prepregnant weight, fetomaternal body composition, and food intake during pregnancy. The expected reduction in proportion of low birth weight (LBW less than 2.5 kg) babies following a nutritional intervention will depend not only on the estimated range of fetal weight increase but also on the total amount of supplemented calories ingested during pregnancy as well as on the existent proportion of low birth weight babies prior to the intervention. The offspring of women who have low prepregnant weight, poor diet, low level of replacement of the home diet by the supplement, low physical activity during pregnancy and good health status will show larger increase in birth weight per unit of supplemented calories. Finally, nutritional interventions during pregnancy as opposed to earlier in the life of the mother, should have the higher impact on birth weight. In consequence, interventions as of pregnancy are recommended.


A new approach to Chinese traditional medicine. Traditional medicine in China has as yet been unsatisfactorily analyzed from the point of view of the history of ideas. It has come to be viewed as a monolithic system of therapy, and overlooked has been the fact that as time passed various originally different traditions and concepts were made to fit into all-embracing systems, intimately connected with a general way of thought. Theoretical superstructure in medicine has to be delineated from simple empirical observations. Only the latter can be a meaningful object for medical interest today--the theories are better studied within other disciplines.


Ginseng: its history, dispersion, and folk tradition. This article presents a historical comparison of the traditions surrounding and uses of ginseng in Asia and in North America, with a focus on the triangle formed by the Chinese, the North American Indians, and the white American residents. The medicinal and folkloric applications of ginseng by the Chinese were remarkably similar to those independently developed by various North American Indian tribes. White Americans, however, largely disregarded the herbal root medicinal qualities in favor of the lucrative economic gains available from the export of ginseng to supply the Chinese market. Information was gathered primarily from Western sources and whenever possible was either drawn from or corroborated by original eighteenth and nineteenth century publications.


Rapid detection of bacteremia by an early subculture technic. Routine blood cultures in a pediatric hospital were subcultured after 4 to 14 hours of incubation (average 8 hours). Eighty-five per cent of all significant, positive blood cultures were detected within 24 hours of initial incubation. Contaminant organisms rarely grew on early subculture plates. Compared with the traditional 24-hour or 48-hour stain and subculture technics, the 4--14-hour (early) subculture method allows more rapid detection, identification, and sensitivity testing of most bacteria isolated from clinically significant positive blood cultures.


Aspergillus antibody in patients with cystic fibrosis. The respiratory flora of patients with cystic fibrosis (CF) frequently includes Aspergillus, and 30% of their serum samples have been observed to contain precipitating antibody to this fungus. Serum from 61 CF patients, 60 healthy persons, and three patients with CF and allergic bronchopulmonary aspergillosis was studied, using a quantitative assay for antibody to A fumigatus. Although CF patients had significantly higher levels of Aspergillus antibody, some antibody was found in all serum samples from normal individuals. Binding was immunologically specific for A fumigatus. Serum IgE levels and dermal reactivity to Aspergillus were similar in both CF and normal subjects. Increased levels of Aspergillus antibody in CF patients probably reflect pulmonary colonization, which only rarely causes infection or sensitization.


Breast abscess during the neonatal period. A review. Thirty-nine infants ranging in age from 1 to 7 weeks had breast abscess. The lesion occurred more frequently in girls (girl/boy ratio, 1.8:1), but this was due to cases developing after 2 weeks of age. During the first two weeks, the sex incidence was equal. No bilateral lesions were recorded. Eighty-four percent of the abscesses developed during the first three weeks of life. In general, there was a lack of systemic manifestations; a body temperature of 38.3 C (101 F) or more was found in only 25.7% of the patients and constitutional signs were found in four patients. Abscess cultures were obtained in 36 cases: 32 yielded Staphylococcus aureus, two Salmonella, one Escherichia coli, and one yielded both S aureus and E coli. Of six patients available for follow-up, decreased breast tissue was noted in two.


Filtration and infusion phlebitis: a double-blind prospective clinical study. The effect of final filtration on the incidence of infusion phlebitis was studied in a prospective, double-blind investigation involving 146 postoperative patients. The incidence of infusion phlebitis was found to be significantly reduced when an inline, 0.45-mum membrane filter was used. The greatest reduction of infusion phlebitis was in the filter groups receiving unbuffered solutions and no set change over the 72 hours of therapy. Buffering the infusion fluid or 24-hour change of the administration set did not have any effect on reducing the incidence of phlebitis. Antibiotic therapy appeared to have a slightly beneficial effect only when inline filters were employed. A significant rise in white blood cell count and an increase in sedimentation rate were observed in the patients receiving unfiltered fluids. It is recommended that inline final filters should be a part of routine intravenous therapy.


Successful renal transplantation in patients with prior history of malignancy. Eleven selected patients with a history of cancer have received renal transplants. In three patients the malignancies were diagnosed and treated before renal failure developed. Two patients underwent bilateral nephrectomies for the treatment of bilateral renal malignancy. In six patients the malignancy developed while they were uremic, and they received transplants after treatment of the tumor. Recurrent tumor developed in only one of the 11 (9 per cent) patients after receiving the transplant. Thus, patients with a history of malignancy can receive a transplant without accelerating growth of the tumor. We recommend a minimum period of one year between tumor treatment and transplantation to observe for tumor recurrences or metastases. A longer period of observation may be necessary in patients who have tumors with a poorer prognosis.


Hyperuricosuria and increased tubular secretion of urate in sickle cell anemia. Seven young adults with uric acid overproduction due to sickle cell anemia were normouricemic with a mean serum uric acid level of 4.9 mg/100 ml. Urate clearance was greater in these patients than in normal subjects or in patients with primary hyperuricemia due to uric acid overproduction. The increase in urate clearance was entirely accounted for by increased pyrazinamide suppressible urate clearance. Pyrazinamide administration abolished the uricosuric response to ribonucleic acid (RNA) feeding in these patients with sickle cell anemia, and maximal uricosuric response to the administration of probenecid was similar in the patients with sickle cell anemia and in normal subjects suggesting that reabsorption of both filtered and secreted urate was not impaired in sickle cell disease. Pyrazinamide suppressible urate clearance at maximal uricosuric response to probenecid was increased in patients with sickle cell disease suggesting increased tubular secretion of urate. This increase in urate secretion permits most young adults with urate overproduction due to sickle cell anemia to remain normouricemic and may account for the low frequency of secondary gout in this disease.


Gram-negative bacillary meningitis.

Gram-negative bacillary meningitis. All cases of unusual types of gram-negative bacillary meningitis in a university hospital over a five year period were retrospectively analyzed. These patients comprised 4.2 per cent of cases of bacterial meningitis among all patients, 69 per cent of neurosurgical cases and 42 per cent of neonatal cases. The over-all mortality was 40.3 per cent. The two most common bacterial isolates were Escherichia coli in patients younger than one year and Klebsiella species in patients above that age. Infection may be acquired at birth or at the time of surgery, or may be secondary to spread of infection from other body sites. Gram-negative bacillary meningitis is a nosocomial infection and this diagnosis should be suspected in patients in whom central nervous system infection develops in the hospital.


Mixed IgG-IgM cryoglobulinemia with glomerulonephritis. Immunochemical, fluorescent and ultrastructural study of kidney and in vitro cryoprecipitate. Comparative studies of renal biopsy specimens and in vitro cryoprecipitate were carried out in a patient with mixed immunoglobulin G (IgG)-immunoglobulin M (IgM) cryoglobulinemia associated with glomerulonephritis. The IgM isolated from the cryoprecipitate was an antibody with anti-IgG activity. Proliferative endocapillary glomerulonephritis was found in the kidney, with large amorphous deposits in the capillary walls. On immunofluorescent examination, these deposits contained IgG and C3. Ultrastructural studies of both cryoprecipitate and glomerular deposits revealed unusual structures designated as "cylindrical or annular bodies." The morphologic characteristics of these bodies were exactly the same in the kidney and in the cryoprecipitate. These findings suggest an identity between the glomerular deposits and the circulating cryoglobulin, supporting the hypothesis that the glomerulonephritis reported here is an immune-complex disease.


Effects of combining methylphenidate and a classroom token system in modifying hyperactive behavior. The combined effects of methylphenidate and a token reinforcement program in controlling a classroom behavior of 16 hyperactive, institutionalized retarded youngsters was investigated. A within-subject, placebo-controlled, double-blind design was employed. The results indicated that the behavior-modification procedures in the presence of placebo medication produced significant increases in work-oriented and related decreased in disruptive behavior. Few effects from the addition of active medication to the treatment program were found on any of the dependent measures. The findings suggest behavior modification to be a viable alternative to drug therapy for hyperactivity in retarded persons.


Nutrition and drug therapy for persons with developmental disabilities. Literature relevant to drugs reported as affecting or not affecting nutrient metabolism and diet for developmentally disabled persons was summarized. Many investigators have found side effects of anticonvulsant drugs on vitamin D, calcium, folid acid, and vitamin B12 metabolism. Growth-retarding effects of certain central nervous system stimulants have also been reported. It has beed found that tranquilizers and antidepressant therapy show no effects on nutrient metabolism. Vitamins used in pharmacologic doses are considered as drugs; their therapeutic use was briefly reviewed here. The need for more research on biochemical interaction of drugs and nutrients was recommended.


Corneal preservation using M-K medium.

Corneal preservation using M-K medium. Human eye bank corneas were preserved in M-K medium for varying periods of time after which viability of the endothelial cells was evaluated by vital staining and scanning and transmission electron microscopy. Endothelial viability and ultrastructural integrity was maintained in some corneas up to four days. Twenty-five consecutive keratoplasties were performed utilizing human donor material stored in M-K medium. There were clear grafts in 92% of the cases and there were no primary graft failures. After the ninth postoperative week, the average central corneal thickness was 0.47 mm and 23 of the 25 grafts remained clear to moderately clear. All of the donor material used for keratoplasty was stored in M-K medium for less than 80 hours.


Immunofluorescent studies of ocular cicatricial pemphigoid. Using direct and indirect immunofluorescent techniques, we studied ten patients with cicatricial pemphigoid (chronic cicatricial conjunctivitis). Serologic and histologic evaluation of 13 conjunctival, 12 mucous membrane, and 11 skin specimens from the ten patients showed that three had immunoglobulin deposition at the basement membrane zone of the conjunctiva. One patient had immunoglobulin deposited in the affected skin and oral mucosa. Two patients had circulating basement membrane zone antibodies that bound to their own tissue but not to guinea pig lip or human skin.


Hepatic disease in asymptomatic parenteral narcotic drug abusers: a Veterans Administration collaborative study. The Veterans Administration is currently conducting a collaborative study in three hospital-based drug treatment clinics to evaluate asymptomatic parenteral drug addicts for evidence of hepatic disease. Preliminary data are presented on 347 patients who have completed at least three months of follow-up evaluation. On admission, abnormal serum transaminase values were demonstrated in one half, HBs Ag in 7 per cent, and anti-HBs in 59 per cent. The frequency of these findings increased during the follow-up evaluation, only 19 (5.5 per cent) remaining entirely free of one or more of these abnormalities. Definable hepatologic disease (acute or chronic hepatitis, alcoholic hepatitis) developed in 46 per cent of the patients. However, among 60 of them subjected to liver biopsy, a poor correlation was noted between the clinical and histologic diagnoses. In particular, routine liver function and immunologic tests did not discriminate between histologically detected chronic active and chronic persistent hepatitis. However, HBs Ag was present significantly more frequently in those with chronic active hepatitis. Wide variability of histologic diagnoses was seen among patients subjected to more than one biopsy, apparent progression and regression of the lesion being noted. This demonstrates the hazard of attempting to assign a prognosis to the disease on the basis of a single liver biopsy specimen, and suggests that repeated biopsies should be mandatory for the evaluation of chronic liver disease in drug addicts.


The effect of prolonged prednisone treatment on human costal cartilage. Costal cartilage (biopsy) from a 13-year-old boy receiving prolonged prednisone treatment (discontinuously from 2 6/12 to 13 11/12 years) for hepatosplenomegaly and lymphadenopathy has been studied and compared with costal cartilage from untreated individuals. Optical and electron microscopic studies including histochemistry have been employed. Chondrocyte degeneration characterized by lipidic material and glycogen in cells is enhanced following prednisone treatment. Acid proteoglycans are reduced in comparison to those in the untreated controls. Amianthoid (asbestoid) collagen fibers, derived from electron-dense bodies which represent remnants of degenerating chondrocytes, occur in all cartilages. A type of collagen similar to fibrous long-spacing collagen has been observed and is prominent in cartilage from the prednisone-treated individual. Evidence suggests that this type of collagen is cellular in origin and represents a transitional form of native collagen. Morphologic changes suggestive of aging are present following prolonged prednisone treatment.


Inflammatory mediators in culture filtrates of Escherichia coli. Escherichia coli, when cultured on a simple medium containing only glucose and inorganic compounds, release soluble factors which have a variety of biologic effects on cells in vitro. These low molecular weight (less than 12,000) substances are capable of: a) reversibly inhibiting the migration of macrophages, b) causing chemotactic attraction of neutrophils, c) inducing blast transformation of lymphocytes, and d) producing cytotoxic effects on mouse fibroblasts in culture. Although these activities are functionally similar to those which have been described for various lymphokines obtained from antigen-activated lymphocyte cultures, lymphocyte and bacterial factors which share a given property do not appear to be identical. For example, the bacterial factor which inhibits macrophage migration is partially heat labile and is dialyzable, characteristics which distinguish it from conventional migration inhibition factor. Nevertheless, similarity of function may imply the existence of some degree of chemical homology which would have importance implications concerning the evolution of host-defense reactions. In any case, as is the situation for the lymphokines, the in vitro behavior of the bacterial factors suggest a role for them in in vivo inflammatory responses.


New aspects of chemotaxis. Specific target-cell attraction by lipid and lipoprotein fractions of Escherichia coli chemotactic factor. A chemotactic factor extracted from sterile filtrates of Escherichia coli cultures was strongly chemotactic for polymorphonuclear leukocytes (PMN) and rabbit alveolar macrophages (RAM). Electrophoresis of the cytotactic material yielded five lipid fractions: one that was protein-free and active toward both PMN and RAM, and four lipid-protein complexes that were strongly chemotactic only for RAM. Thin-layer chromatography of the lipid-protein complexes resulted in an unmasking of PMN activity in a peptide-free lipid extract, while the isolated peptidic components were essentially noncytotactic. The original RAM activity was retained in the unmasked lipid, which possessed chemical and chromatographic properties similar to those of a previously reported cytotaxin synthesized from arachidonic acid. These data indicate that a class of lipids derived from bacterial and cellular sources is intrinsically cytotactic for PMN and RAM. When peptide moieties are associated with cytotactic lipids, the resultant lipid-peptide complex may exhibit cellular specificity not evident in the free lipid.


Alternative services, professional practice, and community mental health. Innovative services staffed by nonprofessionals have become a significant means of meeting a variety of community mental health needs. Most such services have elements in common, and have adopted non-traditional approaches to meeting mental health needs. As viable community mental health resources, alternative services are examined from several perspectives, including their origins, their characteristics and attractiveness to the consumer, and their relationships to mental health professionals.


Na+ dependence of in vitro pancreatic amylase release. The effects of Na+ on the in vitro release of amylase from mouse pancreas were studied. Replacement of Na+ in the medium by Tris, choline, or sucrose blocked the stimulation of amylase release by bethanechol and caerulein, whereas replacement by Li+ was without effect. The inhibiton was rapid and reversible, with stimulated amylase release linearly related to the log of the medium Na+ concentration over the range of 20-100 mM Na+. In contrast to the inhibition of amylase release stimulated by physiological secretagogues, enzyme release stimulated by the Ca2+ ionophore A23187 was unaffected by removal of Na+ from the medium. Tissue and intracellular Na+ and K+ contents were unchanged after stimulation of secretion by physiological stimulants. It is concluded that Na+ may be important in the early steps of stimulus-secretion coupling leading to the putative rise in intracellular Ca2+ that triggers pancreatic enzyme release.


The theoretical bases of Soviet psychotherapy. Beginning in the 1930's all Western psychologic theories, especially psychoanalysis, were labeled reactionary. Pavlov's theory remained as the sole "truly materialistic" basis for Soviet psychotherapy. Only in recent years has theoretical research shown signs of life. Certain concepts from cybernetics, information theory, and even social psychology are now used widely.


Fatal falciparum malaria among narcotic injectors. Eleven narcotic injectors from a prison in Saigon were hospitalized with falciparum malaria. Coma and intense parasitemia were common and eight patients died soon after admission. Two of three autopsied cases also had purulent pulmonary infections. No non-addicted prisoners were hospitalized for malaria. Nine more unsuspected falciparum infections were found among 29 other addicts in the prison. The clustering of malaria infections among narcotic injectors who had not been in malarious areas indicates that the malaria was transmitted by the common use of needles and syringes. Cerebral malaria in an addict may be misdiagnosed as drug intoxication. Malaria surveillance is recommended for the increasing addict population in the cities of Southeast Asia.


Acetylator phenotype and response of individuals infected with a chloroquine-resistant strain of Plasmodium falciparum to sulfalene and pyrimethamine. Acetylator phenotype was determined in 33 volunteers who were infected with a chloroquine-resistant strain of Plasmodium falciparum and who received, for cure, 2 g of sulfalene and 50 mg of pyrimethamine. This drug combination did not cure 5 of 14 rapid acetylators and 3 of 19 slow acetylators. This difference is not significant. Plasma levels of non-acetylated sulfalene, acetylated sulfalene, acetylation, and biologic half-life of non-acetylated sulfalene after administration of the combination did not differ importantly between the two groups. Acetylator phenotype does not appear to influence the response to sulfalene and pyrimethamine of individuals infected with chloroquine-resistant falciparum malaria.


Comparison of the complement fixation, indirect immunofluorescence, and indirect hemagglutination tests for malaria. The complement fixation (CF), indirect immunofluorescence (IIF), and indirect hemagglutination (IHA)tests for malaria were compared by using sera from U.S. citizens with either natural infections or heroin-associated, needle-induced infections. In natural Plasmodium vivax infections, the CF, IIF, and IHA tests apparently detect malarial antibodies equally efficiently for the first 2 months after the onset of symptoms, but the titers obtained by CF and IIF rapidly decline within a year, while the IHA titers remain elevated. In the sera from heroin addicts who developed needle-induced P. vivax infections, sensitivities of all three tests were decreased: the IIF and IHA tests each detected 83%, but the CF test detected only 57.1%. False-positive reactions with this group were very high for the CF (76.6%) and IHA (15.9%) tests, but only 2% for IIF.


Effects of lowered environmental temperature on the growth of exoerythrocytic stages of Plasmodium berghei. The effect of lowered host-environmental temperature upon the development and maturation of the preerythrocytic tissue stages of rodent malaria parasites has been investigated in two strains of Plasmodium berghei originating from the highlands of Katanga. Young albino rats inoculated with massive sporozoite doses of P. berghei NK 65 and maintained for 48 hours at 12 degrees C developed small, stunted tissue schizonts, averaging 11 X 15 microns, of a distinct morphology. Control rats kept at room temperature of 27 degrees C showed mature tissue schizonts of normal growth averaging 24 X 29 microns. Blood from the rats kept at lower temperature for 48 to 50 hours failed to produce parasitemia when inoculated into susceptible recipient mice. All the mice given blood from control rats developed parasitemia. However, when sporozite-inoculated rats were kept for 96 hours or longer at 12 degrees C they developed parasitemia and their liver showed maturation of 10% of the preerythrocytic schizonts. Experiments with the ANKA strain of P. berghei did not show significant differences in size and morphology between parasites in rats kept for 46.5 hours at 9 degrees C and 12 degrees C and those in controls kept at 20 degrees C. However, subinoculation of blood from the low temperature experimental groups into recipient mice at 46.5 hours after intravenous sporozoite inoculation failed to produce parasitemia, whereas all the recipient mice from the control groups developed parasitemia in 4 or 5 days. The findings are discussed in the light of the evolution of plasmodia and the phenomena of relapse and delayed primary attack in certain malaria infections.


Failure of levamisole to alter the lepromin reaction. In a study of 37 leprosy patients, the oral administration of levamisole failed to provoke an increase in both the Fernandez and Mitsuda reactions to lepromins of human and armadillo origin. We interpret this as evidence against an effective specific immunostimulatory capability of levamisole in leprosy patients under the conditions of the study. Current knowledge of the mechanism of levamisole action supports the concept that the fundamental immunologic defect in lepromatosus leprosy may reside in the lymphocyte and not the macrophage, or the respective related functions of these two cell forms.


Digitalis-thiopentone effects on myocardial function. A study of systolic time intervals in man. Systolic time intervals were measured in 10 patients with cancer of the esophagus who required two anaesthetic procedures, before and after an induction dose of thiopentone. The patients were digitalised between the first and the second procedures. Digitalis improved systolic time intervals and reduced the depressant effect of thiopentone on the heart as measured by systolic time intervals.


The first experiences with ether anaesthesia in Cambridgeshire and West Suffolk 1847. A search through the files of a local newspaper, the Cambridge Chronicle, has brought to light in numerous references to ether anaesthesia during the years 1847 and 1848. From this and other sources it has been possible to establish that the first operation under ether was performed at Addenbrooke's Hospital, Cambridge on 2 January 1847, only 12 days after Liston's well known demonstration in London. By 13 March over fifty operations under ether had been successfully carried out at this hospital. The first experiences with ether at Wisbech, Cambridgeshire and Bury St Edmunds, West Suffolk are also described. It is suggested that much material important in determining the extent to which the practice of anaesthesia was rapidly adopted in the English provinces awaits the historian in the local newspaper, since the early experiences with anaesthesia were often not recorded in the Minute Books of hospital committees, and indeed, often took place outside the hospitals.


[The biotransformation of inhalation anaesthetics and its relevance to clinical side effects (author's transl)]. The volatile anesthetics are not inert substances, but they are metabolised by means of a non-specific drug metabolizing enzyme system of the liver. Thus, in combined administration of several drugs, the knowledge of the metabolic pathways and the influence of the anesthetics on the transforming system is not only theoretically important, but represents a conditio sine qua non to the anesthesist as regards the handling of modern anesthetics. The occasionally observed liver and kidney injuries indicate a potential formation of toxic metabolites. Renal damage due to methoxyflurane may be caused by F- which is released during its biotransformation while, in the group of halogenated inhalation anesthetics, only chloroform is a true hepatotoxic substance. The explanation of the liver damage which is rarely observed after halothane administration, is an open question till now. For this, the investigator must go back to animal experiments where the quantity and quality of the metabolism differ considerably from one species to the other. In men it is widely unknown to what extent the microsomal enzymatic system is influenced by the disease itself and/or by the pharmacotherapy. Therefore great efforts must still be made in order to establish the formation of side-effects of halogenated inahlation anesthetics and, thus, to improve their therapeutic safety.


Morphological appraisal of gametogenesis. Spermatogenetic process in mammals with particular reference to man. The process of spermatogenesis in man can be subdivided into prenatal, postnatal and adult phases. Special attention is devoted to the cytomorphology of the germ cells in these phases, with a more detailed description of the proliferation, maturation and differentiation of the germ cells in the adult. Thus, spermatogonial renewal, meiotic division and the morphological transformations of the spermatids into mature spermatozoa are described. An outline of the structures characteristic of the latter is also given. The histological organization of the seminiferous epithelium is considered, whereby the concepts of the cycle, stage of the cycle and wave of the seminiferous epithelium are discussed. The duration of both the cycle and that of spermatogenesis of the adult are considered. The present review on mammalian, and chiefly human spermatogenic processes aims at: surveying of current concepts, and compiling of the more important facts and problems of spermatogenesis. The nomenclature and definitions advanced here arise from the concept of continuity of the processes of spermatogenesis from embryo to adult.


Continuous positive airway pressure and pulmonary and circulatory function after cardiac surgery in infants less than three months of age. Continuous positive airway pressure (CPAP) was used to support the ventilation of infants less than 3 months of age who had undergone thoractomy for cardiovascular surgery. The functional residual capacity, which was approximately 30 per cent of predicted at zero CPAP, increased 35 per cent in cyanotic and 33 per cent in acyanotic infants with the application of 5 mm Hg pressure. Increasing airway pressure from zero to 5 mm Hg increased PaO2 4 per cent in cyanotic and 13 per cent in acyanotic infants. There was no change in heart rate, respiratory rate, mean arterial pressure, pH or PaC02 under similar circumstances, but central venous pressure increased 1.5 mm Hg in cyanotic and 0.8 mm Hg in acyanotic infants.


Shunt, lung volume and perfusion during short periods of ventilation with oxygen. Twenty patients requiring ventilation for acute respiratory failure were studied to determine whether intrapulmonary shunt fraction (Qs/Qt) measured at an inspired oxygen concentration (FIO2) of 1.0 differs from Qs/Qt measured at the clinically indicated FIO2 and, if so, the mechanism by which this occurs. Qs/Qt increased from 15.5 +/- 1.8 per cent (mean +/- SE) at the clinically indicated inspired oxygen fraction (FIO2 0.3-0.6) to 21.7 +/- 2.1 per cent after 20 minutes at FIO2 1.0. Functional residual capacity (FRC) decreased by 6 +/- 6 per cent and total compliance (CT) by 10 +/- 6 per cent. Mean pulmonary arterial pressure fell from 21 +/- 2 to 17 +/- 2 mm Hg, whereas pulmonary capillary wedge pressure (PCWP) and cardiac output remained unchanged. Mixed venous oxygen tension increased from 37 +/- 1 to 45 +/- 2 mm Hg with 100 per cent oxygen. At 90 per cent oxygen, Qs/Qt increased from the value at low FIO2, but FRC and CT did not change. Simultaneous application of 100 per cent oxygen and a positive end-expiratory pressure (6 cm H2O) increased FRC, CT and Qs/Qt. Patients with increased PCWP showed smaller increases in Qs/Qt with 100 per cent oxygen. These findings suggest two mechanisms responsible for the increase in Qs/Qt: 1) redistribution of blood flow to nonventilated areas, resulting from the vasodilating effect of an increased oxygen tension in the vessels of hypoxic lung segments; 2) resorption atelectasis. Of the total change in Qs/Qt observed during ventilation with oxygen, 63 per cent was calculated to be due to factors other than a decrease in FRC. (Key words: Ventilation, positive end-expiratory pressure; Oxygen, pulmonary shunt and; Lung, compliance; Lung, shunts.)


Orthodontic and bone grafting procedures in a cleft lip and palate series: an interim cephalometric evaluation. An attempt is being made to observe the facial and dental development of a cleft lip and palate sample. The study is continuing and, hopefully, offers insight into what happens to these children who have undergone the placement of a dentofacial maxillary orthopedic appliance early at the time of lip closure and an additional surgical procedure and autogenous osteoplasty. Though the final answers to the two previously posed questions are not yet available, we are able to make some value judgments by observing the lateral cephalometric films of these children, and observing their occusion intraorally. Thus far, we are able to state that in our sample, using our treatment procedures in the sequence advocated, we have seen no growth attenuation in the posterior/anterior dimension. The maxilla, at least to the ages observed, does not appear to have been attenuated by our procedures. Further, it would seem that after a limited first phase of orthodontic treatment to align dental units, the degree of crossbite is considerably smaller from that reported in the literature by those using more conventional approaches; thus it is possible that we are doing some good. We are still using these procedures on our newborn and continue to feel that we have a real opportunity to be able to do more orthodontically for these children when they possess a full, permanent dentition and are ready for comprehensive treatment.


A kinin model of mediation for food and chemical sensitivities: biobehavioral implications. The plasma peptide hormone bradykinin is hypothesized to be a major mediator of the multiple-system functional symptomatology of adverse food and other chemical reactions. It is postulated that native foods as organic chemicals could act cumulatively with other stresses to mobilize directly the kinin-forming enzyme system.


Effect of bio-feedback techniques on chronic asthma in a summer camp environment. Bio-feedback mediated deep muscle relaxation procedures demonstrated significant improvement in 22 asthmatic children attending a summer camp for the care and rehabilitation of asthmatic children. However, caution is expressed in the interpretation of the findings pending a replication of the research with more rigorous controls.


Plasma luteinizing hormone concentration in mares treated with gondotropin-releasing hormone and estradiol. Three experiments were performed to study the luteinizing hormone (LH) and ovulatory responses to various doses and methods of administration of gonadotropin-releasing hormone (GnRH) in estrous pony mares and the influence of estradiol-17beta (E2-17beta) on LH response to GnRH treatment. In experiment 1, single injections of synthetic GnRH were subcutaneously given to 5 groups of estrous (day 2) mares (3 mares/group) on a body weight basis as follows: group A--isotonic saline solution; group B--GnRH, 0.14 mug/kg; group C--GnRH, 0.28 mug/kg; group D--KGnRH, 0.59 mug/kg; and group E--GnRH, 2.37 mug/kg. Significant increase of plasma LH concentration lasting for approximately 2 hours occurred only in mares of group E given the largest dose of GnRH (2.37 mug/kg). Plasma LH concentration increase at 1 hour after treatment approached significane (P less than 0.10) in mares of group D given the next smaller dose. In experiment 2, GnRH (2.37 mug/kg) was intravenously infused for 24 hours to a group of 6 mares (group F); 6 other mares (group G) were given saline solution infusion. Mean plasma LH concentration was increased at 3 hours, continued to increase until 6 hours, and remained at approximately the 6-hour concentration throughout the period of GnRH infusion. In the 3rd experiment, 3 groups of mares (4 mares/group) were subcutaneously given the following treatments on days 2 and 3 of estrus, respectively: group H--corn oil and saline solution; group I--corn oil and GnRH, 0.59 mug/kg; and group J--estradiol-17beta, 0.5 mg, and GnRH, 0.59 mug/kg. Plasma LH response was not seen in group H mares given corn oil and saline solution. Mean plasma LH concentration at 1 hour after administration of GnRH approached significance (P less than 0.10) in group I mares given corn oil and GnRH. For the mares in group J given E2-17beta and GnRH, E2-17beta pretreatment increased plasma LH after 24 horus; significnat increases of plasma LH concentration were seen from 1 to 6 hours after GnRH injection. None of the treatments in experiments 1, 2, and 3 significantly altered the time of ovulation.


Preparation of human lung biopsy specimens by perfusion-fixation. A technique for perfusion-fixation of human lung biopsy specimens is described. The tissue is fixed in an expanded state by perfusing glutaraldehyde into cannulated blood vessels or bronchioles on the excisional surfaces. These specimens are ideally suited for histologic study and for both transmission and scanning electron microscopy.


Studies of thymus-derived and bone marrow-derived lymphocytes in renal transplant patients. Serial studies of levels and responsiveness of T and B lymphocytes were performed in human renal allograft recipients. Patients given prednisolone-azathioprine immunosuppression had only mild falls in levels and responsiveness of T cells. Patients given a quality controlled ATG preparation had marked and relatively selective falls in levels of T cells associated with a marked fall in T cell responsiveness as measured by PHA and Con-A responsiveness. In vivo correlates of this severe T cell deficiency suggest that T lymphocytes are central to acute allograft rejection and that acute severe T cell deficiency is not associated with risk of infectious complications above and beyond those seen in patients suppressed with prednisone-azathioprine alone. These studies suggest that ATG, produced under quality control conditions and having rather selective anti-T cell activity, is a useful adjunctive immunosuppressive agent for human renal transplantation.


Renal autograft survival after perfusion and hypothermic storage in a hyperosmolar high potassium-containing solution. A hyperosmolar high postassium-containing kidney perfusate and storage solution with demonstrated in vitro advantages over extracellular-like solutions was tested for renal preservation superiority in vivo. A model allowing simultaneous evaluation of creatinine clearance of both kidneys from the same animal, each having been perfused and stored for 24 hours in different preservation solutions, offered certain advantages over conventional models. Immediate function, greater ultimate creatinine clearance and preservation of cellular architecture during 24 hours of hypothermic storage was demonstrated convincingly in kidneys preserved in the hyperosmolar high potassium containing solution. Simplicity of preparation and absence of precipitates were additional desirable features of this solution. The use of Ringer's lactated solution for perfusion and cold storage of kidneys should be avoided.


[Mouse teratocarcinoma: differentiation in cultures of a multipotential primitive cell line (author's transl)]. A line of primitive cells of teratocarcinoma is able of differentiating during in vitro cultures. The differentiated cell types correspond to derivatives of the three germ layers. They appear according to a reproducible schedule. The differentiated cell types exhibit a normal karyotype. They have lost their tumorigenicity and have a limited life span. Agregates containing various numbers of primitive cells have been prepared and plated in culture dishes. Their study shows that the first differentiated cell types appear only when the agregates are greater than a certain critical mass. Primitive cells carry on their surface the F9 but not the H-2 antigen. During differentiation in culture, the H-2 antigen appears rapidly on certain cells. The fraction of H-2-carrying cells increases as a function of time while that of F9-carrying cells decreases.


[Fungicidal and phagocytic activity against "Candida albicans" of human neutrophils in serum depleted in C3 and C4 (author's transl)]. Cases of systemic infections caused by C. albicans are increasing in number and the kidney appears to be involved more often than any other tissue. The renal medulla is especially susceptible to infection by C. albicans and by bacteria - Previous works has showed that this is essentially due to hyperosmolality and to inactivation of the complement system. Polymorphs are one of the main host defense mechanisms against C. albicans and the authors have studied their power of phagocytosis against Candida and fongicidal activity in serum depleted in C3 and C4. Both are found to be normal.


[Construction of Hfr strains in "Salmonella montevideo" (author's transl)]. Lac+ variants of Salmonella montevideo were recovered from mating with an Escherichia coli strain harbouring the thermosensitive sex-factor Ft114-lac+. The properties of these variants suggest that this F' factor behaves identically in Salmonella and Escherichia. From these variants, it is possible to select mutants in which lac expression is stable at high temperature (42 degrees C) and it was proved that they behave as Hfr's. Twelve independently isolated Hfr's were similar with respect to both point of origin and sequence of markers transferred. These results suggest that our strain of S. montevideo carries an F-factor affinity site near met C gene.


[Sensitivity to bacteriophage ES18 of strains of "S. dublin", "S. enteritidis" and "S. blegdam" and related serotypes (author's transl)]. Sensitivity to bacteriophage ES18 may be used as an additional test for identification of strains of some serotypes of Salmonella. In the D group, the great majority (100/103) of the strains of S. enteritidis (H = g,m:-) and 7/7 strains of S. blegdam (H = G,m,q:-) are resistant. On the contrary, all the studied strains (111) of S. dublin (H = g,p:-) either Vi+ or Vi- are sensitive, as those of S. gallinarum-pullorum (61). Two strains of S. kiel (possibly derivated from S. dublin) are sensitive as that serotype, whereas 20 strains of S. paratyphi A, possessing the same O factors, are resistant.


A transferable kanamycin resistance plasmid isolated from Haemophilus influenzae. Kanamycin resistance was transferred by conjugation from a Haemophilus influenzae strain into Escherichia coli K12, and between E. coli K12 strains in subsequent transfers. Covalently closed molecules of DNA were isolated by sedimentation analysis of the DNA of the resistant E. coli K12 strains. These facts support the hypothesis that kanamycin resistance is mediated by a transferable plasmid in this strain of H. influenzae.


Polynucleotides containing 5-mercapto-substituted pyrimidines: inhibition of viral DNA polymerases and the biological implication. Partially thiolated polycytidylic acids MPC I-III, containing 1.7%, 3.5% and 8.6% 5-mercaptocytidylate units, respectively) inhibited the DNA polymerase of Friend leukemia virus (FLV) in the endogenic reaction as well as in the presence of poly(A)-(dT)14 or poly[d(a-T)] templates; the inhibitory activities were directly related to the percent of thiolation. Various partially thiolated RNA and DNA isolates from Ehrlich ascites cells (containing one 5-mercaptopyrimidine nucleotide/50-100 nucleotide units) also inhibited the DNA polymerases of FLV in the endogenic reaction, and also in the presence of the synthetic templates. The thiolated DNA was the most active, but the thiolated tRNA also showed substantial inhibitory effects, while the thiolated ribosomal RNA was less effective. In a bacterial DNA polymerase (E. coli-K12, using denatured DNA as template), MPC I-III showed no activity. By contrast, MPC III and several partially thiolated nucleic acid isolates significantly inhibited a regenerating rat liver DNA polymerase (I) system; among those tested, the thiolated DNA from Ehrlich ascites cells showed the highest activity. Kinetic analysis of the inhibitory action of this thiolated DNA in the rat liver enzyme system, using as template the corresponding unmodified DNA, demonstrated that the thiolated DNA acts as a competitive inhibitor of the template, with a Ki/Km ratio of 0.5.


Inhibition of methylated nucleoside synthesis in vivo: accumulation of incompletely methylated transfer RNA in ethionine-treated cells of Escherichia coli B. tRNA prepared from cells of E. coli B that had been incubated with 0.5% DL-ethionine (Ethio sRNA) was found to accept methyl groups from 14CH3-S-adenosyl-methionine in the enzymatic reaction catalyzed in vitro by tRNA methyl transferases from untreated cells of the same organism. tRNA from cells that were not exposed to ethionine did not accept a significant level of methyl groups when incubated with the same enzyme system. Base ratio analysis of the product obtained after in vitro addition of methyl groups to Ethio sRNA by enzymes from normal E. coli B indicated that a high proportion of uracil sites in this tRNA were available for enzymatic methylation. These results indicated that tRNA from ethionine-treated organisms was recognized by the homologous enzymes to be incompletely methylated, while, as previously shown, all methyl-acceptor sites on tRNA from normal cells were already filled, and that Ethio sRNA was preferentially deficient in methyl groups on uracil moieties in the RNA molecules. Ethionine thus appears to interfere with normal tRNA modification in vivo.


Scanning electron microscopy in ophthalmology. In the context the technique of the scanning electron microscopy is described and the results are shown gained by the scanning electron microscope in ophthalmology. It is pointed out that questions specific to surface can be answered quicker and easier, if superificial microscopy together with the scanning electron microscope is used an additional source of information. Scanning electron optical pictures are very useful for ophthalmologic science.


Oesophageal surgery.

Oesophageal surgery. A wide variety of benign conditions affecting the oesophagus which have long been recognized in association with hiatus hernia are now known to be attributable to reflux oesophagitis. The development of modern methods of treatment of these conditions is described with reference to a number of illustrative cases.


Development of the right outflow tract and pulmonary arterial supply. The branchial arch vessels of the human embryo have been studied by histological and radiographic methods and the modelling that occurs during the period Day 25-Day 52 postfertilization is described. It has been shown that the myoendocardial reticulum is reamed out by blood flow and it is suggested that hydrodynamic force is the fundamental factor which determines chamber structure of the heart and flow pattern in the outflow tracts and great vessels. The sixth aortic arch vessels contribute tissue to the pulmonary trunk and proximal pulmonary arteries. The 'postbranchial pulmonary arteries' are morphologically distinct and form the pulmonary arteries at the lung hila. The primitive pulmonary plexus around the tips of the developing tracheobronchial primordia is formed from segmental vessels arising from the dorsal aorta. Bronchial arteries can be demonstrated only late in intrauterine life. The numerous bronchopulmonary precapillary anastomoses which are found in the fetus at this time have been demonstrated radiographically.


The problem of the open safety pin.

The problem of the open safety pin. The open safety pin lodged in the stomach or esophagus presents a challenge to surgical judgment and technical skill. Most foreign bodies causing trouble lodge in the esophagus. Once in the stomach, uneventful passage can be expected in 80 to 90% of cases. Active intervention is reserved for those where intestinal performation is likely or where there is failure to progress. We have used the fiberesophagoscope to remove three open safety pins from the stomachs of two patients whose symptoms and threat of perforation required intervention. The microbiopsy forceps was used successfully to retrieve the open pins,  but a newly developed grasping forceps for use with the fiberesophagoscope now provides a more secure hold on such foreign bodies. Rigid instruments retain their value for selected cases, but the flexible equipment now provides an important advance in the management of the open safety pin in the stomach.


Clonidine in the treatment of menopausal symptoms. Twenty-five women suffering from climacteric complaints after surgical castration were treated with clonidine in a placebo controlled trial. Clonidine in the dose of 75 to 150 mug daily diminished the attack rates of flushing and sweating significantly. It can be recommended as a safe therapy for climacteric patients, at least those with contra-indications to oestrogen therapy.


Predictive value of sympathetic cardiovascular reflexes and urinary catecholamines when selecting patients for antihypertensive treatment with beta-adrenergic blocking drugs. Two different sympathetic cardiovascular reflexes and the urinary catecholamines were studied to try to predict which patients would respond best to antihypertensive treatment with alprenolol, a beta-adrenergic blocking drug. The antihypertensive effect of sustained release tablets of alprenolol (200 mg twice daily) in 19 young patients with labile hypertension was confirmed. The treatment effectively reduced the tachycardia produced by the Valsalva manoeuvre and by nitroglycerin, and reduced the rise in systolic blood pressure after the Valsalva manoeuvre. The excretion of catecholamines was not affected. Neither the sympathetic cardiovascular reflexes produced by the Valsalva manoeuvre and nitroglycerin nor the excretion of catecholamines revealed which patients would respond best to alprenolol.


A controlled clinical trial of chlormezanone, orphenadrine, orphenadrine/paracetamol and placebo in the treatment of painful skeletal muscle spasms. Four hundred patients with painful muscle spasm caused by five common musculoskeletal diseases were included in a double-blind controlled trial of chlormezanone, orphenadrine, orphenadrine/paracetomol and placebo. Patients were treated for one week and then asked for their subjective assessment of the treatment. Fifty-three per cent improved on placebo, 57 percent on chlormezanone, 66 percent on orphenadrine and 71 percent on orphenadrine/paracetamol. There was no significant difference between chlormezanone and placebo, but orphenadrine appeared to have a beneficial effect, presumably because of its muscle relaxant activity.


Amyloidosis in rheumatoid arthritis.

Amyloidosis in rheumatoid arthritis. The clinical and pathological features of amyloidosis are reviewed with special references to amyloidosis associated with rheumatoid arthritis. Data concerning the nature of the amyloid substance are presented. The amyloid fibril which is the unique and principal component of all amyloid substances, can be constituted by different protein subunits. The amyloid fibril protein AA is a major subunit of the amyloid fibrils particularly seen in secondary amyloidosis including that associated with rheumatoid arthritis. The immunological and chemical properties of protein AA and a structurally related serum protein (SAA) are discussed. Increased knowledge of the nature of amyloid and its precursor proteins may provide better methods for the diagnosis and treatment of amyloidosis.


[The sensitivity of direct and indirect methods in immunofluorescence and immunoperoxidase techniques: a comparative study (author's transl)]. A comparative study of the sensitivities of the immunofluorescence and immunoperoxidase techniques was undertaken. The material used was tissue from experimental and human glomerulonephritis. With the direct method, immunoperoxidase was 10 to 30 times more sensitive than immunofluorescence. However, the sensitivities became equivalent if the level of the labeling in immunofluorescence was equal to or superior to 6. In the indirect method, the sensitivity of the immunoperoxidase technique was one to ten-fold greater than with immunofluorescence.


The biology of isolated immunocytes. I. Isolation into a closed liquid microchamber: application to PFC. Biological properties of isolated immunocytes directly involved in an immune response such as plaque forming cells may be studied in a closed liquid microchamber. Furthermore the selected cells can be cultured for over three days; immunocytological treatments of these cells permit also their characterization by electron microscopy.


Spontaneous antinuclear autoimmunisation in Swan and nude mice: comparative study. Spontaneous antinuclear autoimmunisation in both Swan and Nude mice seems due to a disparition of the T cell immunosuppressive function. Swan mice show a progressive diminution of thymic function, and thus T cell activity, with age; wherease Nude mice are congenitally lacking in a thymus and thus in T cells. Both strains of mice develop deposits of immunoglobulin in the glomerular membrane and the Swan mice have such deposits at the dermoepidermal junction. The antinuclear autoimmunity of the two strains of mice differs in that the number of Swan mice with detectable titres increases with age until, at 40 weeks, all the mice are positive, whereas the number of Nude mice positive at a young age rarely increase until the time of death. The antibodies produced by the Swan mice may be of any of the major immunoglobulin classes, whereas those produced by Nude mice are nearly always IgM.


[Proceedings: Treatment of excessive body height in adolescents with small doses of corticoids. Demonstration and advantages. 10 cases treated with prednisone]. Treatment of great heights has always been in endocrinology, especially in the U.S.A., a problem hard to solve, estrogenotherapy being the main drug and giving more and less convincing results. We present a treatment with small doses of corticoids which seems more satisfactory starting at a level of two centimeters under the expected height. This treatment allows to get the complete join of the long bones cartilage under the influence of a normal puberty. 11 teen-agers (1 male and 10 females) have been given such a treatment at variable ages (range = 12 6/12 and 16, mean = 14 2/12). The standard dose was 15 mg per day of prednisone, 5 mg every eight hours, during 7 to 25 months, with periodical supervising of clinical, biological and radiological state. Results are excellent on growth : breakdown of growth rate is immediately obtained, from 7,2 cm to 0,5 cm every year. During all the treatment and after, the complete gain of height will not exceed 1 or 2 cnetimeters over the initial height. Quality of results is better than that of other methods; side effects, if any, are mild and disappear when stopping the treatment.


[Comparative clinical pharmacology of gentamicin, sisomicin, and tobramycin]. Using a randomized crossover design involving 12 normal subjects, we studied comparatively the pharmacokinetics and tolerance of three aminoglycoside antibiotics, gentamicin, sisomicin, and tobramycin. Serum concentrations were determined during 8 h and the urine recovery rate was determined within 24 h after a 1-h intravenous infusion of the respective antibiotic in a dose of 1 mg/kg of body weight. Microbiological assay was performed with the agar diffusion test (Bacillus subtilis); pharmacokinetic calculations were performed by means of a digital computer on the basis of a mathematical model of an open, two-compartment system. Of the three antibiotics studied, gentamicin showed the lowest concentration in serum after termination of the 1-h infusion (3.85 +/- 0.67 mug/ml), and the serum-regression curve steadily lay below those of the two other antibiotics. Sisomicin had the highest serum concentrations (4,66 +/- 1.24 mug/ml) and the serum-level curve exceeded that of the two other antibiotics. Tobramycin occupied a position between sisomicin and gentamicin in form of its serum level characteristics. Corresponding to the serum kinetics we also found slight differences in the pharmacokinetic parameters, especially in serum half-lives, elimination constants, and areas under the serum level curves. The test of liver and kidney functions and the hematological systems, as well as the function of the stato-acusticus nerve, showed no pathological changes by any of the three antibiotics tested.


Stability of amphotericin B in fungal culture media. We have found that amphotericin B is unstable in two commonly employed fungal culture media. This instability leads to inaccuracies in determining the actual level of susceptibility of slow-growing strains that require prolonged incubation for growth. To help compensate for this problem, we have described two rapid methods of susceptibility testing.


Stimulation by haptenic Salmonella polysaccharides of murine and rabbit lymphocytes. The Freeman polysaccharide - the hapten of lipopolysaccharide - induced a blast transformation of mouse and rabbit spleen lymphocytes. The magnitude of the response in rabbit was quite similar to that obtained by lipopolysaccharide whereas in mice it was weaker. The stimulation of lymphocytes of both species did not require the presence of macrophages. Similar results were obtained with four LPS and their correspondent haptens prepared from S. typhi-murium, S. abortus-equi, S. johannesburg R+ and R-.


Prospective comparative study of variable dosage and variable frequency regimens for administration of gentamicin. In patients with impaired renal function, careful adjustment of gentamicin dosage is required to achieve therapeutic yet nontoxic concentrations. Two regimens that differ in pharmacodynamic characteristics have been recommended for this purpose: prolonging the intervals between administration of equal doses (variable frequency regimen [VFR]) or administering a loading dose followed at the usual intervals by reduced maintenance doses (variable dosage regimen [VDR]). These regimens were compared in a prospective, randomized study of 20 seriously ill hospitalized patients, 10 on VFR and 10 on VDR. Wide variability in peak serum levels of gentamicin was observed both between patients and in individual patients after separate injections of the same dosage. As predicted by the design of these regimens, the trough serum levels of gentamicin correlated significantly with the serum creatinine concentrations in patients on the VDR but not in patients on the VFR. A gentamicin trough level of >/=4 mug/ml was the only variable among those tested that correlated significantly with development or progression of renal insufficiency during treatment with gentamicin, but such trough levels were observed frequently on both regimens. Whereas this study does not permit a direct comparison of the therapeutic efficacy of VDR and VFR, no difference in the risk of nephrotoxicity with these regimens was observed.


Spontaneous development of plaque-forming cells against sheep erythrocytes by mouse peritoneal cells in culture. If cultured over 10 days, peritoneal cells from different strains-CBA/J, C3H, C57B1, DBA/2, Balb/C, NZB and congenitally athymic Nude (Nu+/Nu+), fifth backcross generation with Balb/C-of unimmunized mice developed high numbers of plaque-forming cells against sheep erythrocytes (up to 13 per cent of the recovered viable cells at day 6) without being triggered by antigen. Plaque-forming cells could be demonstrated by all methods of local hemolysis (agarose, liquid medium, CMC). This capacity increase with the age of the donor mice. The phenomenon is immunological, as plaque formation could be inhibited by specific anti-mouse IgM serum and is complement-dependent. It also displays immunological specificity: the erythrocytes from sheep, goat, cow, which cross react when tested in the classical mouse immune spleen cells system, give hemolysis plaques with cultured mouse peritoneal cells, while horse, rabbit rat erythrocytes, non cross reacting with sheep erythrocytes in the classical immune systems, give no plaques with peritoneal cells. The removal of cells adherent to glass does not diminish the ability of the peritoneal cell population to form plaques against sheep erythrocytes. These results suggest that peritoneal lymphocytes constitute a highly specialized population of already programmed cells which become derepressed when removed from their natural environment and exposed to cell-culture conditions.


Chloramphenicol binding site with analogues of chloramphenicol and puromycin. The effect of a series of puromycin analogues and aminoacyl chloramphenicol derivatives on poly(U,C)-directed polyphenylalanine synthesis in an Escherichia coli cell-free system was examined. A comparison between the structures and activities of the puromycin and chloramphenicol analogues was made to examine the proposal that ribosomal binding sites for both antibiotics overlap. Our results suggest that the dichloroacetamido group in the chloramphenicol molecule does not correspond to the role of the aminoacyl moieties of either puromycin or aminoacyl transfer ribonucleic acid. These results comparing the structures and activities of puromycin and chloramphenicol analogues also seem inconsistent with a common binding site for the p-substituted phenyl moieties of the two antibiotics. Previous data have indicated that both sites are mutually affected by the prior binding of either antibiotic. Although it is possible that chloramphenicol and puromycin may have overlapping bindings sites, no common structural features between the two antibiotics are supported by our data.


Tetracycline resistance in Escherichia coli isolates from hospital patients. Hospital isolates of Escherichia coli resistant to tetracycline (TC) were studied to identify mechanisms which regulate TC resistance levels and ability to transfer TC resistance. Antibiotic resistance patterns, resistance levels to TC, and ability to transfer TC resistance were determined for the isolates. Similar data were obtained for the transferable plasmids after transfer to several new host strains of E. coli. Of the 110 isolates, 50% were able to transfer TC resistance by conjugation. There was a nearly linear relationship between the minimum inhibitory concentration (MIC) of TC for the hospital strains and the percentage of strains at a given MIC that could transfer TC resistance. The strains that were simultaneously resistant to tetracycline, streptomycin, and ampicillin had relatively high MICs of TC and high ability to transfer TC resistance. These results and surveys of TC-resistant E. coli by others suggest that TC resistance levels and transmissibility may be influenced by other resistance markers. The isolates which did not transfer TC resistance by conjugation were tested for the presence of TC resistance plasmids by mobilization or by transformation with deoxyribonucleic acid from the isolates. Evidence for plasmid-mediated TC resistance was found in 92 (84%) of the 110 hospital strains.


Change in the cell envelope of Escherichia coli carrying the thermosensitive drug resistance factor, Rts 1, at the nonpermissive temperature. Escherichia coli, harboring the temperature-sensitive drug-resistant factor Rts 1, formed filaments on solid medium at the nonpermissive temperature (42 C). In addition, the rate of adsorption of T4D phage progressively decreased during growth at 42 C. Susceptibility to a variety of antibiotics increased suggesting that the permeability barrier to these antibiotics may be disrupted at the nonpermissive temperature. These observations were interpreted to suggest that the target of the temperature-sensitive Rts 1 gene product responsible for altering host growth may be the cell envelope.


Enumeration of high numbers of bacteria using hydrophobic grid-membrane filters. Printing a wax grid on a conventional membrane filter yields a device functioning as a most probable number apparatus (MPN), used at a single dilution but with a very large number of growth compartments (e.g., 3,650). By restraining the lateral spread and confluence of colonies, the hydrophobic grid-membrane filter (HGMF) allows growth- or colony-forming units (GU) to be resolved at levels far above those which produce an uncountable lawn on a conventional membrane filter. It also eliminates the size variation of normal bacterial colonies. As a result, the HGMF can give more accurate estimates of the concentration of GU. The method by which grid-cell count observations can be used to obtain MPN estimates of the number of GUs is described, and estimates obtained using the MPN method on the HGMF are compared with those resulting from conventional colony count procedures on membrane filters. A linear relation was observed between MPNGU and the number of GUs, at levels up to 30,000 GUs, for pure cultures of bacteria and for samples of natural waters. The HGMF has great potential for reducing the labor required in quantitative microbiology, since it allows, with one filter, enumeration of microorganisms over a very large concentration range and therefore reduces the need to make dilutions.


Effects of an antibacterial soap on the ecology of aerobic bacterial flora of human skin. The effects of ad lib use of an antibacterial soap containing 1.0% trichlorocarbanilide and 0.5% trifluoromethyldichlorocarbanilide on the bacterial flora of six skin sites of 132 subjects were measured by comparison with the flora of 93 control subjects who avoided the use of topical antibacterials. Each subject was examined once. The test soap produced significant reductions in geometric mean counts of the total aerobic flora on the back, chest, forearm, calf, and foot; counts were also reduced in the axilla, but not to a significant extent. The overall reduction by the test soap on all sites was 62% (P less than 0.001). Neither age nor sex influenced the effect of the soap on the flora. The antibacterial soap also reduced the prevalence of Staphylococcus aureus on the skin, mostly by virtually eliminating it from areas other than the axilla. Partial inhibition of the gram-positive flora was not accompanied by an increase in gram-negative species. The latter were found principally in the axilla; Klebsiella pneumoniae and Enterobacter aerogenes were the species most frequently found.


Evaluation of a semiautomated system for direct fluorescent antibody detection of salmonellae. A semi-automatic system under development by Aerojet Medical and Biological Systems for the direct fluorescent antibody detection of salmonellae was evaluated with various food, feed, and environmental samples. All samples were simultaneously examined by Automated Bioassay System (ABS), manual direct fluorescent antibody procedures and cultural procedures. The ABS gave satisfactory results with the processed samples. It detected all of the culturally positive powdered egg and candy samples with no false-negative results and gave only 6.6 and 5.3% false-positive rates, respectively. With meatmeal samples the ABS failed to detect one culturally positive specimen that was also positive by manual fluorescent antibody and gave one (1.1%) false-positive result. A high rate of false-negative results was obtained by ABS on unprocessed samples of creek water, poultry, and sausage. Adding another enrichment step to the protocol reduced the false-negative rate considerably but severely increased the false-positive rate. The instruments worked reasonably well, but research is needed to improve enrichment procedures for samples to be processed by the system.


Gas chromatographic presumptive test for coliform bacteria in water. A gas chromatographic procedure which shows promise as a presumptive test for coliform bacteria in water is described. Total coliform bacteria concentrations were determined from the incubation times at 37 C required for ethanol to be produced. Fecal coliform densities were determined in a similar manner at 44.5 C. The culture medium was filter sterilized M-9 salts supplemented with 1% lactose, 0.1% Casamino Acids, and 0.1% yeast extract. Best results were obtained when the initial total coliform concentrations were 5 per ml or higher and when fecal coliform concentrations were 50 per ml or higher. Minimum detection times at these concentrations were 9 and 12 h, respectively.


Evaluation of excitation light sources for incident immunofluorescence microscopy. A variety of fluorescent excitation light sources were compared using a standard fluorescein solution or a bacterial conjugate with immunofluorescent microscopy. Quantitative data were obtained with microscope photometric apparatus. Both the quantitative data and comparative conjugate titering suggest that the 450-W xenon arc excited significantly more fluorescence than did the more commonly used 250-W mercury arc or the 100-W halogen lamp. The conjugate could be diluted 4 to 32 times more using the 450-W xenon. Additional advantages of 450-W xenon excitation include sufficient energy of wave lengths between 470 to 490 mm, thus permitting narrow-band excitation resulting in less autofluorescence and the ability to perform fluorescent-antibody procedures without the darkening of ambient room light.


Autoradiography and immunofluorescence combined for autecological study of single cell activity with Nitrobacter as a model system. Specific detection of a particular bacterium by immunofluorescence was combined with estimation of its metabolic activity by autoradiography. The nitrifying bacteria Nitrobacter agilis and N. winogradskyi were used as a model system. Nitrobacter were incubated with NaH14CO3 and 14CO2 prior to study. The same preparations made for autoradiograms were stained with fluorescent antibodies specific for the Nitrobacter species. Examination by epifluorescence and transmitted dark-field microscopy revealed Nitrobacter cells with and without associated silver grains. Direct detection and simultaneous evaluation of metabolic activity of Nitrobacter was demonstrated in pure cultures, in a simple mixed culture, and in a natural soil.


Optimum membrane structures for growth of coliform and fecal coliform organisms. The purpose of this study was to determine the optimum membrane filter structure and characteristics for recovery of coliform organisms. Additionally, other factors such as sterilization method and membrane composition were examined. Fecal coliform growth tests with varied samples indicated that the most critical factor in recovery was surface pore morphology and not other factors previously suspected. Fecal coliform counts showed a dramatic increase, with increasing surface opening sizes. Membrane structures with surface openings large enough to surround the entrapped bacteria are required for optimum growth of fecal coliform organisms. Maximum fecal coliform recoveries are obtained using membranes composed of mixed esters of cellulose exhibiting a surface opening diameter of 2.4 mum and a retention pore size of 0.7 mum.


Comparison of the new millipore HC with conventional membrane filters for the enumeration of fecal coliform bacteria. Fecal coliform recoveries were determined for six types of membrane filters using 65 nonchlorinated water samples. Results showed that the membranes could be ranked in order of decreasing recovery as follows: Millipore HC greater than Gelman greater than Johns-Manville approximately Sartorius greater than Millipore HA greater than Schleicher & Schuell.


Topically applied griseofulvin in prevention and treatment of Trichophyton mentagrophytes. Griseofulvin is not considered effective in treatment of superficial fungal infections. However, when applied topically in organic solvents, the drug appeared in very high concentration in all levels of stratum corneum, and it generally persisted there in measurable amounts for four or more days after a single application. Based on this observation, double-blind experimental prophylactic and therapeutic studies were conducted. Topically applied griseofulvin in alcohol solution was highly effective in preventing experimentally induced Trichophyton mentagraphytes infection, but it had no therapeutic effect once the infection was initiated. Topically administered griseofulvin may prove useful in prevention of recurrences or as an adjunct to therapy in selected cases of superficial fungal infection.


Treatment of nocardial mycetoma with trimethoprim and sulfamethoxazole. Two cases of nocardial mycetoma were successfully treated with a mixture of trimethoprim and sulfamethoxazole (Bacterim). The patient in case 1 showed resistance to treatment with antibiotics and sulfamethoxypyridazine, and the causal agent of the disease could not be isolated. In case 2, bone involvement was seen; the causal agent was N asteroides. No adverse effects of the drug occurred in a period of treatment ranging from three to nine months.


DermLit. A year's experience with a computerized literature search service. DermLit is a service providing bibliographies prepared by computer from a file of the four basic English language dermatology journals beginning with January 1969 and including the current issues. An abstract of each article cited is returned with the report. Both the title and the abstract of each article in the file is searched for the word, words, or phrases requested by the user. In the year since DermLit was introduced, more than 1,600 searches have been performed for dermatiologists all over the United States and Canada. The service is used primarily by dermatologists away from the large teaching centers. The topics of the search requests cover the entire field of dermatology.


Dermatologists of San Francisco, 1870 to 1920. Although there were relatively few dermatologists in the United States in the years 1870 to 1920, San Francisco was well represented by the nine dermatologists who were active in the city during that time. These included George J. Bucknall, Alfred E. Regensburger, Douglass W. Montgomery, Howard Morrow, Harry E. Alderson, George D. Culver, Ernest D. Chipman, Hiram E. Miller, and Lawrence R. Tuassig. Seven were members of the American Dermatological Association, all but one were active academically, and several rose to great heights in their profession, community, and nation.


Enteropathogenic Esch. coli gastroenteritis in premature infants and children treated with fosfomycin. Forty-two infants, some premature, with enteropathogenic Esch. coli (EPEC) gastroenteritis were treated with an oral suspension of fosfomycin in a dose of 100 and 200 mg/kg per day. After the treatment there were 11 secondary clinical infections (6 reinfections and 5 relapses) which received a second treatment with fosfomycin. In total, 53 treatments were made with fosfomycin and in 92% of the cases there was both clinical and bacteriological cure. 93% of the EPEC strains were sensitive to fosfomycin in vitro, their minimum inhibitory concentrations being less than 64 mug/ml. The concentration of fosfomycin in blood and faeces was assayed by a diffusion plate microbiological method in a group of these children, showing that this antibiotic is partly absorbed and the rest eliminated in the faeces, where its concentration was found to be very high. Tolerance of the product was good, and there were neither toxic nor side effects.


Effect of placebo substitution during long-term betamethasone valerate aerosol treatment in asthmatic children. Ten children with severe asthma, who had been well controlled on maintenance betamethasone valerate aerosol for an average of 11 months, were given placebo aerosols without their knowledge. The period of placebo substitution was campared with one 28-day period of betamethasone valerate therapy beforehand, and two 28-day periods afterwards. Symptoms were increased during the placebo period, and patients did not return to their previous well-controlled state until the second month after reinstitution of therapy. Changes in the means of twice-daily peak expiratory flow readings (PEFR) followed the same pattern as changes in symptoms. The exacerbation of asthma which occurred during placebo treatment was accompanied by a widening in the diurnal variation between morning and evening PEFR. In comparison with the previous period, morning PEFR fell by a greater amount than evening PEFR. Standardized running tests suggest an increase in exercise-induced bronchoconstriction and in the Exercise Lability Index when the child was receiving only placebo treatment as compared with betamethasone valerate treatment. The trial provided further evidence of the efficacy of betamethasone valerate aerosol in the prophylatic therapy of severe childhood asthma. As 2 of these children were able to discontinue long-term therapy it is unlikely that this drug causes dependency.


Plasma digoxin concentrations and urinary excretion during a 'simpler' regimen of infant digitalization. We have measured the plasma concentrations in sick  neonates and infants being administered digoxin by a safer regimen. In the presence of normal renal function  the plasma concentrations appear to be satisfactory.


Frusemide in respiratory distress syndrome. Savage, M. O., Wilkinson, A. R., Baum, J. D., Roberton, N. R. C. (1975). Archives of Disease in Childhood, 50, 709. Frusemide in respiratory distress syndrome. The effect of frusemide on urinary volume, urinary sodium excretion, and urinary calcium excretion in 7 premature infants with severe respiratory distress syndrome (RDS) has been studied. The results are compared with similar measurements on 13 infants of comparable gestational age and birthweight with less severe RDS who did not receive frusemide. The effect of frusemide on PaO2 and PaCO2 tensions in 5 infants with RDS was also investigated. Frusemide produced a fourfold increase in urinary volume and a tenfold increase in urinary sodium and urinary calcium excretion compared with the untreated group. It caused no improvement in blood gas tensions. The use of this diuretic for the routine management of RDS cannot be recommended.


Inhibition of glucose-6-phosphate dehydrogenase activity by betamethasone and three of its esters with dermatological importance. Betamethasone, betamethasone-17-valerate, betamethasone-17-benzoate, and betamethasone-17,21-diproprionate were investigated for their inhbitory action on glucose-beta-phosphate dehydrogenase (G-6-PDH) activity (pure enzyme from yeast, enzyme from human skin homogenate). Between these four compounds, marked differences were encountered which could not be attributed to the presence of an esterified or unesterified steroid. According to these data it does not seem to be justified to consider betamethasone esters simply as the transport forms of the topically inactive betamethasone but one must consider the betamethasone esters having biochemical actions of their own.


Reiter's disease in three boys.

Reiter's disease in three boys. Three cases of Reiter's disease occurring in boys under the age of 16 are reported. One of these presented with a Salmonella enteritidis diarrhoea. This conforms to the 'dysenteric' form of Reiter's disease usually seen in Europe and rarely reported in England. Another presented with a monarticular arthritis of the knee, and the third has developed a chronic relapsing erosive arthritis as a result of sexually acquired Reiter's disease--an occurrence not previously reported in this age group. We draw attention to the frequency of diarrhoea in these children and the sex incidence of 1 female to 4--5 males, which agrees more with Reiter's disease of dysenteric origin than that acquired venereally.


Comparative evaluation of pancreas transplantation techniques. Three operative techniques for pancreatic transplantation have been compared: pancreaticoduodenal, pancreatic duct-jejunostomy and pancreatic duct-ureterostomy. There were no significant differences in results among these techniques when the autotransplant model was used. The pancreatic duct anastomosis without duodenum probably offers more advantages in the allograft recipient.


In situ preservation of cadaver kidneys for transplantation: laboratory observations and clinical application. Many kidneys obtained from cadaver donors undergoing sudden cardiac arrest cannot be transplanted due to the long periods of warm ischemia from the moment of arrest to nephrectomy. A double-ballon-triple-lumen catheter for the rapid in situ preservation of cadaver kidneys has been designed. Used in combination with equipment routinely found in any hospital, it can cool human kidneys in situ to 10-15 C and maintain this temperature until nephrectomy can be performed. Kidenys preserved with this catheter have functioned after transplantation into suitable recipients. This report describes the design and laboratory evaluation of this new device, its clinical effectiveness and technique of insertion.


Posterior subcapsular cataracts: posttransplantation in children. Posterior subcapsular cataracts (PSC) were noted in 41 of 69 (60%) recipients of renal allografts. The PSC were noted during the first posttransplant year (Group 1) in 21 (30%) recipients and after the first posttransplant (Group 2) year in 20 (30%) recipients. The dosage of prednisone during the first posttransplant year corrected for patient weight showed a significant correlation with the development of PSC during the first posttransplant year. The severity of the PSC were correlated with time of onset and prednisone dosage. Four recipients in Group 1 required cataract extraction to obtain sufficient vision to facilitate school work.


The incidence and management of pulmonary mycosis in renal allograft patients. A retrospective analysis of 193 renal transplant recipients yielded 15 patients who developed pulmonary mycosis posttransplantation and one case in which mycotic lung infection existed at the time of transplant surgery. Agent responsible for infection included Nocardia asteroides in 8 cases, Asperigillus flavus in 5 cases, Cryptococcus neoformans in 4 patients and Candida albicans in 2 cases. Two cases had mixed mycotic infections. Ten patients died, of which 7 had diagnosis established antemortem. Two cases had diagnosis established by thoracotomy and 1 case by transtracheal aspiration. Problems in establishing accurate diagnosis are discussed with emphasis placed on the need for more frequent use of transtracheal aspiration and thoracotomy for precise diagnosis.


Congenital duodenal diaphragms in adults: a delayed cause of intestinal obstruction. Congenital duodenal diaphragms in the adult are uncommon, unsuspected lesions that infrequently cause intestinal obstruction. The diaphragms may be single or multiple and are usually located near the ampulla of Vater. Three cases are summarized and the recent literature reviewed. At least 35 cases have been reported. Treatment most often consisted of duodenotomy,excision of the web and duodenal closure.


Pancreaticoduodenal preservation by hypothermic pulsatile perfusion for twenty-four hours. Pancreaticoduodenal grafts remained viable after transplantation only if a modified plasma perfusate with high osmolarity was used during the 24 hours of preservation. When regular plasma perfusate was used during the pancreaticoduodenal preservation, irreversible damage resulted, and all dogs died of ischemie or vascular changes in the first few days after transplantation.


Acceptable size of the pulmonary valve ring in congenital cardiac defects. Because congenital defects are being corrected at progressively younger ages, knowledge of the normal sizes of cardiac orifices and their acceptable limits is becoming increasingly important. A graphically corrected table of normal children's heights and pulmonary artery diameters is given. In addition, reasons are presented for the belief that a decrease in the cross-sectional area of up to 50% of normal may be considered acceptable during corrective procedures; in light of present knowledge any further decrease in cross-sectional area, in particular below 25% of normal, should probably not be left uncorrected.


Biliary cysts.

Biliary cysts. This review brings the total number of biliary cysts reported in the world literature to 955. Eighty-one per cent of patients are females and 61% were discovered before age ten. The classical triad of right upper quadrant pain, right upper quandrant mass, and juandice is present in 38% of cases. The duration of symptoms prior to diagnosis ranged from less than one week to more than 40 years. The etiology is multifaceted and evidence of the existence of both acquired and congenital cysts is presented. The most useful diagnostic tool is fiberoptic endoscopy with retrograde contrast injection of the common bile duct and pancreatic duct. The incidence of biliary carcinoma in patients with biliary cysts is found to be 2.5%; 24 cases have been reported. Considerable controversy has existed concerning the best operative procedure for biliary cysts; no treatment or medical treatment yielding a 97% mortality rate. In an analysis of 235 patients presented since 1968 with an average followup of 5.2 years, the best procedure appears to be excision with either choledochocholedocostomy or Roux-en-Y hepaticojejunostomy. The operative mortality for all procedures is now 3 to 4%.


The effect of microinjections of morphine and haloperidol into the neostriatum and the nucleus accumbens on self-stimulation behaviour. The effect of stereotaxic injections of morphine and haloperidol via permanently implanted cannulas into the neostriatum, the nucleus accumbens or the ventricular system was studied on self-stimulation behaviour of rats with electrodes implanted into the ventral tegmentum. The self-stimulation rate was depressed by injections of haloperidol into the neostriatum or into the nucleus accumbens. Unilateral injections of haloperidol into the neostriatum depressed the self-stimulation rate either with applications ipsilateral to the electrode or contralateral to the electrode. Bilateral applications of haloperidol into the neostriatum (2 X 2.5 mug) were more effective as unilateral applications (5 mug) and were more effective as applications into the ventricular system (5 mug). Morphine had a strong depressant action on self-stimulation when applied into the ventricular system and was ineffective when applied into the neostriatum. It is concluded that these results do not favour the hypothesis that morphine interferes with dopaminergic transmission with the neostriatum.


Clinical experience with naproxen in rheumatoid arthritis. A total of 42 patients participated in three controlled clinical trials, each of different design, to demonstrate the efficacy and safety of naproxen in the treatment of rheumatodi arthritis. First, a double-blind comparison of aspirin and naproxen was made in 24 patients. As judged by objective and subjective measurements of disease activity, naproxen was at least as effective as aspirin and the incidence of severity of side effects were less with naproxen than with aspirin. Second, the safety and efficacy of naproxen administration was followed in 42 patients for up to two years. Third, the continued efficacy of naproxen during these two years was tested by interspersing a short period of double-blind placebo administration for some patients. The observations made in this clinical study suggest that naproxen is an effective and well-tolerated drug in the long-term treatment of rheumatoid arthritis.


Recognition of streptococcal pharyngitis in adults. In order to devise a strategy for the management of acute pharyngitis, the clinical features of 418 adults with sore throat were noted and throat cultures were obtained. Patients with cultures positive for group A beta-hemolytic streptococci had a significantly higher (P less than or equal to .01) frequency of recent exposure to streptococcal infection, pharyngeal exudate, enlarged or tender cervical nodes, and high fever (greater than or equal to 38.3 C [101 F]. Patients with negative cultures complained more frequently of cough. On the basis of these symptoms and signs, a clinical algorithm was developed and discriminant function scores were computed that identify patient populations with different probabilities of having streptococcal pharyngitis. The patients with moderate and high probabilities included 91% of patients with positive cultures but only 67% of the total patient population. These methods could be the basis for more efficient evaluation of adults with sore throat.


Aortocoronary vein graft surgery in a cadaver kidney transplant recipient. A case of Prinzmetal angina occurred in a recipient of a cadaver kidney transplant who was treated with aortocoronary vein graft. The patient had severe retrosternal chest pain associated with ST-segment elevation in the precordial leads. Coronary arteriograms disclosed two major lesions in the proximal anterior descending artery. Aortocoronary vein graft was successfully performed with no untoward effect on the renal status. The patient has been free of angina approximately two years postoperatively.


Experimental investigation of the bound dissipation function: change of the psi u-function during the growth of yeast. By means of a microcalorimeter (direct calorimetry) and a Warburg-apparatus (indirect calorimetry) that part of the dissipation of a growing culture of yeast cells which remains irreversible in the cells is determined (psi u). The course of the psi u-function with time correlates with the increase of the specific cell concentration being conditioned by the growth phase of the culture but similar for fermentative and respirative metabolism.


[Comparative studies on the significance of the "cornea test" in the diagnosis of rabies]. Foxes that were positive by the fluorescent antibody test on brain were also positive by the corneal test. The corneal test gave a false-negative results only when the specimen was in a macerated state. Out of 133 foxes in which rabies virus was demonstrated in the optic nerve by animal inoculation, only one was negative to the corneal test - this may have been a case of centripetal spread of the infection which was examined at a stage when virus was present in the optic nerve but not in the cornea or the brain. Hence it is possible that the virus may be absent from the cornea. False-positive results seem unlikely to occur, for only one fox was negative upon inoculation of animals with optic nerve and vitreous humour, while the fluorescent antibody test of corneal cells was positive. Animal tests revealed virus inhibitors in the vitreous humour of this animal. All the other cornea-test positive foxes were also positive in tests on brain, lacrimal gland and optic nerve.


Characterization of Rhodopseudomonas capsulata. Thirty-three strains of Rhodopseudomonas capsulata have been studied in order to develop a more comprehensive characterization of the species. On the basis of morphological, nutritional, physiological and other properties, the characteristics of an "ideal biotype" have been defined, which can be used to distinguish Rps. capsulata from similar purple bacteria. In this connection, two properties of Rps. capsulata are of particular note: a) sensitivity to penicillin G is 10(3)-10(5) times greater than that shown by closely related species, and b) all strains examined are susceptible to lysis by one or more strains of host species-specific virulent bacteriophages. It appears that members of the species Rps. capsulata form a stringent taxonomic grouping.


[Immuno-prevention of coli infections in swine using live vaccine. 1. Use in coli infections during the 1st days of life]. Live vaccine prepared from streptomycin-dependent mutants of E. coli was well tolerated in various doses and at various times of administration, for there were no adverse reactions. There was no evidence of reversion to a virulent form. Efficacy was closely related to frequency of application of the vaccine. Vaccination must be performed as early as possible to immunize against infection during the first few days of life. It was possible to confer protection against the diarrhoea that occurs at 3-4 weeks of age. The use of an oral vaccine under intensive husbandry systems was shown to be safe. When the piglets were kept in cages, the vaccine could be administered in the existing mixing tanks for water supply, without the need for special equipment. Oral immunization of pigs already infected or already ill did not aggravate the existing infection, whether the animals were housed individually or in pens. Because of the dilution effect of the mixing tank and water supply pipes, the dose of vaccine, given on ten successive days, should be calculated at 10(9) organisms of the E. coli mutant per animal. This should supply a number close to the desired bacterial count of 10(10) organisms per animal daily. Immunization significantly reduced the frequency of gastrointestinal diseases during the first three weeks of age in piglets.


[Toxicity of S-, R- and M-forms of enteropathogenic E. coli O149:K91:H10]. Toxicity of freeze-dried lysates of the organism for unweaned mice (3-4 days old) increased in the order:smooth-mucoid-rough. The toxicity was neutralized by mixing the toxin with immune serum of group O149. All toxins of the smooth, rough and mucoid variants of the Escherichia coli strain possessed hypersensitivity, skin necrosis, abortion and diarrhoea factors, which could be partly or completely neutralized by binding with homologous immune serum.


[Detection of pathogenic leptospira in the waste water and sewage sludge of large pig breeding sites]. Sewage effluent and sludge from the purification plant of 8 large piggeries was examined for the presence of pathogenic leptospires. By using the methods of Appelman and Van Thiel it was found that 43.1% of samples of effluent were contaminated with L. pomona and O. tarassovi. Altogether 33 strains of pomona and three mixed cultures of pomona and tarassovi were obtained. The isolated strains were shown to be pathogenic by experimental infection of guinea-pigs, rabbits and pregnant and non-pregnant sows. The average period of survival of pathogenic leptospires in sewage effluent was 24 to 48 hours, with a maximum of 96 hours. Leptospires were killed within 24 hours in decanted sludge, owing to its strong acidity.


[Relapsing parotitis: onset of Sjögren's syndrome]. Report of a case of lymphocytic parotitis associated with important inflammatory syndrome, anti-salivary antibodies and rheumatoid factor. The study of the cases of literature suggests that it might be the mode of onset of a Sjögren's syndrome.


[Paraneoplastic precocious puberty in a child. Mediastinal teratoma with chorionic gonadotropin secretion]. A case of precocious puberty in a 5-years old boy with a rapid increase of androgens, small testes, a high level of urinary bioassayable gonadotrophins, but no response of pituitary gonadotrophins of LH-RH injection. The cause was a mediastinal teratoma secreting chorionic gonadotrophin (HCG and beta subunit).


Accelerated human renal allograft rejection. A series of 125 renal transplants were analyzed in order to ascertain the characteristics of accelerated allograft rejection. An intense accelerated rejection could be identified within the first five days in 12 of 67 transplants (18%) with good immediate renal function. Accelerated rejection differed from the usual acute rejection reaction by higher fever, increased duration and intensity of the rejection, and increased difficulty in reversing the reaction. Accelerated rejection was reversible and associated with satisfactory renal function one year posttransplant in 58% of patients. Lymphocytotoxic and heterophil antibodies in preoperative serum and eluates of removed kidneys were not present. Contrary to recent reports, accelerated renal allograft rejection is a potentially reversible process and not necessarily due to humoral antibody presensitization.


[Methodological peculiarities of the preliminary preparation of the thyroid gland for histochemical and electron microscopic study]. Cryostate sections of tissues preliminarily frozen in benzine cooled with liquid nitrogen are recommended for use in a histological for use in a histological and histoenzymological study of the thyroid gland. In electron microscopic study the thyroid gland should be fixed by injection of a 4% solution of glutaraldehyde on a 0,075M cacodilate buffer immediately into the thyroid parenchyma.


[Ultrastructural bases for the postnatal development of the capillaries]. The work has been devoted to establishment of main regularities in the process of developmental reconstruction of the ultrastructure of blood capillaries. The objects of the study were the capillaries of the heart, adrenals, exo- and endocrinous portions of the pancreas of Balb white mice of the following age groups: new-borns, 3-, 7-, 14-, 30-, and 90-day old mice. It has been established that the structural organization of capillaries is not completed by birth-time and actively proceeds during early postnatal ontogenesis. Thickening of the endothelium cytoplasm, high activity of the synthesis organells, imperfectness of intercellular contacts etc., registrated against the background of a decreased transport function of the endothelium represent a common rule for capillaries of newly born animals. In the process of differentiation of organs the synthetic potencies of cells were found to decrease and the motor activity of the endothelium to increase; the developmental reconstruction of capillaries had organic specificity and correlated with processes of development of working structures of the organ.