The role of zinc in total parenteral nutrition. Zinc deficiency was observed in an infant receiving total parenteral nutrition (TPN) for chronic untractable diarrhoea. Clinical findings included low zinc plasma levels, skin lesions and loss of all the advantages of TPN such as weight gain, serum proteins and albumin increase and normalization of intestinal mucosa. Oral administration of zinc sulphate was the decisive factor making possible both the improvement of clinical and laboratory findings and alimentation by natural route.


Comparisons between serum concentrations of thyroxine and thyroxine-binding proteins in samples simultaneously obtained from capillary, peripheral vein, central vein and aorta in newborn infants. A total number of 40 newborn infants with various maturity were studied: 13 babies without perinatal events, 19 infants recovered from transient diseases, 6 infants with idiopathic respiratory distress syndrome and 2 infants with asphyxia indicating artificial ventilation. Comparisons were performed between serum concentrations of thyroxine (T4), thyroxine-binding globulin (TBG), prealbumin (TBPA) and albumin (Alb) in capillary versus peripheral vein, aorta versus central vein and, finally, in peripheral versus central veins. In healthy infants serum T4 concentrations in capillary blood and peripheral vein did not differ significantly. Although serum concentrations of thyroid hormone-binding proteins tended to be increased in aortic compared to central venous specimens no statistically significant differences appeared. In infants in good clinical conditions serum T4, TBG, TBPA, and Alb levels were 6--8% higher in peripheral than in central veins, possibly primarily due to a hemo-concentrating effect of venous stasis. Therefore, in evaluation of the thyroid variables in newborn infants the technique of blood sampling must be considered. In most infants with idiopathic respiratory distress syndrome and in one asphyxiated baby a remarkable tendency to a low serum TBG and T4 concentration in peripheral compared to central vein samples were observed.


Serum concentrations of thyroxine-binding globulin, prealbumin and albumin in healthy fullterm, small-for-gestational age and preterm newborn infants. Simultaneous serum concentrations of thyroxine-binding globulin (TBG), prealbumin (TBPA) and albumin (Alb) were measured in 130 fullterm, 32 small-for-gestational age and 25 preterm infants during their first six days of life. In all infants serum concentrations of TBG were higher and serum TBPA and Alb were lower than in male adults. Even higher serum TBG levels were found in the mothers. There was no correlation between serum concentrations in paired maternal and cord sera. In infants with birth weights appropriate for gestation serum TBG, TBPA, and Alb concentrations increased progressively with gestational age. In small-for-gestational age infants born at term serum concentrations of TBG and Alb were lower than those in fullterm, but higher than those in premature newborns. Serum TBPA in small-for-gestational age babies was even lower than seen in prematures. A positive correlation was found between thyroid hormones and TBG concentrations, not between serum TBPA and thyroid hormones. The ratios between serum concentration of thyroid hormones and proteins might indicate that more thyroid hormonebinding sites are occupied in fullterm than in low birth-weight newborns. However, the main reason for the different serum levels of thyroid hormones in fullterm, small-for-gestational age and preterm babies is probably the various serum TBG concentrations demonstrated in these infants.


Serum retinol-binding protein and vitamin A levels in malnourished children. Serum levels of vitamin A and retinol-binding protein (RBP) were measured in children with vitamin A deficiency, in children with protein-energy malnutrition (PEM) and in normal children, before and after administration of 100 000 IU of water-miscible vitamin A. Serum vitamin A and RBP levels were significantly low in children with vitamin A deficiency and in children with severe PEM, whereas the values in milder grades of PEM were similar to those of normal subjects. In severely malnourished children with corneal lesions, serum vitamin A concentration was reduced to a much greater extent than the level of serum RBP. Administration of vitamin A resulted in a significant increase in serum levels of both the components within 4 hours in all the 3 groups of children. The increase in RBP concentration observed in children with PEM was similar to that in vitamin A deficient children. These results indicate that in malnourished children, particularly in those who are at risk of developing keratomalacia, vitamin A is the main limiting factor. It is, therefore, recommended that children with PEM should be treated with vitamin A in addition to dietary protein and calories.


Laboratory identification of pathogenic Neisseria with special regard to atypical strains: an evaluation of sugar degradation, immunofluorescence and co-agglutination tests. Sugar degradation tests (SDT) were compared with immunofluorescence (IFL) and co-agglutination (COA) tests for the diagnosis of Neisseria gonorrhoeae (GC) and Neisseria meningitidis (MC). Somewhat more than 5% of the GC strains and 8% of the MC strains were misinterpreted by SDT. On most occasions the disagreement between SDT and serological tests was due to the inability of the MC strains (less so for GC strains) to degrade sugars correctly. Because of this, three out of 15 strains (20%) from pharyngeal specimens were primarily considered to be GC by SDT but were identified as MC by COA tests. Deficiencies in sugar degradations were also found in a group of clinical problem strains. Many of them were unable or had a decreased ability to degrade glucose or maltose but were diagnosed distinctly as MC by the COA test. There were no false positives with the IFL or COA tests, but 2% of the GC strains and 26% of the MC carrier strains (non-groupable) were not identified by COA. Both IFL and COA tests are good adjuncts to SDT for the diagnosis of GC and clinically significant MC, since the results are reliable and the tests rapid and simple to perform.


Purification of the first component of guinea-pig complement by gel chromatography. A method has been described for the purification of the first component (C1) of complement from guinea-pig serum. The procedure consists in euglobulin precipitation followed by gel filtration on agarose columns. The final product has low protein content and high specific activity. The protein obtained by this procedure has a molecular weight of about one million and has been further characterized using immunochemical and polyacrylamide gel electrophoresis techniques. The protein reacts with anti-C1 antiserum and forms the EAC1, 4-intermediate. The experiments indicated the existence of electrophoretic variants of C1. The dissociation of the C1 molecule by increasing the ionic strength is confirmed. The described procedure appears to be a useful method of obtaining functionally purified C1.


The copper induced modification of duodenal biotransformation reactions in rats during fat deficiency. The effect of ingested copper on the composition of duodenal postmitochondrial supernatnat fraction (PMS), the aryl hydrocarbon hydroxylase (AHH) and UDPglucuronosyltransferase (GT) activities was analyzed in rats given normal or fat free diets. There were only minor changes in the composition of PMS or in the activities of the measured enzymes when rats received a normal diet. During fat deficiency the phospholipid-protein ratio and the GT activity were markedly increased following 10 mM copper concentration in the drinking water. It is concluded that during fat deficiency copper modifies the structure of the microsomes, as analyzed in the PMS, and that this is reflected in the membrane bound GT activity.


Inhibition of compound 48/80-induced intradental sensory nerve activity by disodium cromoglycate and serotonin antagonists. Local application of compound 48/80 induced long lasting nerve activity in intradental sensory nerves in the teeth of cats and dogs. This effect was inhibited by pretreatment with disodium cromoglycate (DSCG) given locally (2 X 10(-2) M) or i.a. (20 mg/min). DSCG did not have any effect on the nerve excitability per se, as judged from the responses to hypertonic NaCl and air blasta applied to exposed dentin before and after administration of DSCG. Local treatment with lysergic acid diethylamide (0.1--1 mg/ml) and methysergide (0.05--0.5 mg/ml) selectively reduced or inhibited the compound 48/80 induced nerve activity. Systemic administration of methysergide (12.5 microgram/kg) prevented the excitatory effects of compound 48/80 but was without effect when administrated during a state of established activity. The present findings support the hypothesis that compound 48/80 has an indirect effect on intradental sensory nerves and indicate that vascular reactions take part in intradental sensory nerve excitation.


Neurologic complications after irradiation of malignant tumors of the testis. Of 156 consecutive patients with malignant tumor of the testis 99 were alive two years after treatment. Of these, 12 had radiation-induced neurologic complications which, in 5 instances, consisted of persisting, wholly or partially disabling paresis in the lower limbs. Five had mild, transient symptoms and had persisting symptoms which were not incapacitating. In all those with disabling symptoms the irradiation dose had been higher than 1 600 reu, corresponding to 54.5 Gy over 6 weeks with daily fractions 5 days a week.


Dose distribution in 42 MV roentgen irradiation of cervical carcinoma. The dose distribution obtained with two different techniques for external irradiation of cervical carcinoma is described. The dose to the central area is somewhat higher with the multiple beam technique compared with the newly introduced shielding block technique. The difference between the calculated CRE values for the two techniques is small. When the shielding block is not placed over the area corresponding to the position of the applicators from the previous intracavitary treatment the considerable difference in absorbed dose between the two techniques does not correspond to the difference in the calculated CRE values. A comparison of the relative distributions laterally, in total dose and CRE, shows that for central volumes the relative CRE is much higher than the relative dose, when the normalization is made at the pelvic wall.


Nutritional consequences of excess amino acid intake. Various mechanisms respond to intakes of amino acids in excess of those required for normal tissue function. When excessive amounts of amino acids are taken, catabolism by enzymes in the liver and elsewhere is accelerated when intake exceeds requirements. In addition, changes in the free amino acid levels in the brain signal the nervous system centers regulating food consumption, and eating patterns are affected. This central nervous system mechanism may even determine the proportions of protein and of energy--yielding nutrients chosen in the diet through a mechanism regulated by the entry of tryptophan and other neurotransmitter precursors into the brain. These observations on protective mechanisms are considered in relation to effects obtained by feeding disproportionate amounts of amino acids. Intakes of large amounts of amino acids can produce toxicities, in which plasma concentrations of the administered amino acid rise to very high levels. Antagonisms arise from feeding excess of one amino acid that can be relieved by feeding a structurally related amino acid. Finally, amino acid imbalances are produced by adding surpluses of essential amino acids other than the essential amino acid most limiting for growth; the growth depression caused by this addition can be relieved by adding more of the most limiting amino acid to the diet. In all circumstances involving feeding with disproportionate amounts of amino acids, there is evidence of changes in brain amino acid levels. It is suggested that these changes play an important role in initiating protective responses against abnormal amino acid intakes.


The current status of breeding for protein quality in corn. The current rapid expansion of the human population on earth, particularly in the less developed countries, raises the possibility of widespread, serious malnutrition and starvation for many unless agricultural technology can intervene with appropriate answers to these problems. Plant breeders have been charged with developing varieties that will yield larger quantities of improved quality protein. Since the realization that maize having the opaque-2 gene has markedly improved protein quality, much work has been done in many areas of research to apply this discovery as well as to learn more about alternative methods to attain the same goals. This discussion will be a review of the advances so far attained by plant breeders in their efforts to develop maize with improved protein quantity and quality. Work concerning the utilization of mutant genes that improve protein quality and efforts at exploiting the naturally occurring variation for protein quality and quantity will be examined. Work that has been done in other related fields that has relevance  to the protein improvement problem will also be examined. Screening and subsequent regeneration of tissue cultures as well as work concerning the biochemical energetics of yield and protein improvement will be examined in order to bring the problem of breeding for protein improvement into perspective. Finally, the corn industry's experience with improving protein quality and quantity will provide a basis for discussing the economic considerations of such improvement.


Bioavailability of acetylated derivatives of methionine, threonine, and lysine. Supplementation of vegetable proteins with various essential amino acids is an effective means of improving proteins quality. Unfortunately, simple amino acid additions to foods which must be heat processed and cooked is not without consequences. Under these conditions, methionine interacts with reducing sugars yielding methional through the Strecker degradation reaction. This generation of methional during heat treatment imparts undesirable sulfur odors and flavors to the food rendering it organoleptically unacceptable. Similarly, threonine and lysine are also susceptible to interaction with reducing sugars rendering them nutritionally unavailable. Acetylated derivatives of methionine, threonine and lysine have been studied to determine their utility in overcoming the inherent problems associated with each amino acid. To this end, N-acetyl-L-methionine and N-acetyl-L-threonine were found to be fully available to promote growth of rats. To the contrary, neither the alpha nor the epsilon, monoacetylated derivative of L-Lysine nor the alpha, epsilon diacetyl derivative of L-Lysine were effective in significantly promoting the growth of rats. Utilization of N-acetyl-L-methionine by humans has also been studied and shown to be as effective as methionine in improving the quality of vegetable proteins deficient in sulfur amino acids.


Yeast proteins: recovery, nutritional and functional properties. The future need for supplementary sources of food grade functional proteins is emphasized and the potential role of yeasts as a source of proteins is discussed. The problems of proteolysis and nucleic acid contamination can be circumvented by succinylation or derivatization of the yeast protein during extraction. Succinylated yeast proteins demonstrate improved functional properties though their nutritional value needs to be investigated.


Nutritional status of long-stay geriatric in-patients: effects of a food supplement (Complan). In a detailed nutritional study of 50 long-stay elderly patients, intakes of vitamins C and D and nicotinic acid were found to be sub-optimal compared to D.H.S.S. recommendations. Whole-food supplementation did not increase calorie, fat or carbohydrate intake, although it did increase protein, vitamins and minerals. However, it did not correct the intake of vitamins C and D and of nicotinic acid to those recommended by D.H.S.S. Supplementation affected neither serum albumin nor transferrin. No positive correlation could be established between physical disabilities and total dietary intake among these patients. However, the appearance of the skin improved and skin thickness increased in the supplemented patients and the blood urea diminished in them also.


Radiographic manifestations of Burkitt's lymphoma in American patients. Radiographic manifestations of Burkitt's lymphoma in 40 American patients are presented. Pleural effusions were the most common intrathoracic abnormality and were correlated with abdominal ascites more often than with intrathoracic tumor. Tumor involved bone in four patients had intrinsic bowel involvement; nine instances were in the ileum. Intrinsic renal tumor was seen in only two patients. Both ultrasound and computed tomography were useful.


Preoperative localization of nonpalpable breast lesions. Surgeons are increasingly required to resect nonpalpable breast lesions only detected by mammography. Methods for preoperative localization of such lesions were reviewed with emphasis on invasive radiologic techniques using injection, needle, and wire markers. Invasive localization of nonpalpable breast lesions is a relatively simple procedure that should be available wherever breast biopsies and mammography are performed. Its precision and success relate to the radiologist's experience in marker placement and to close cooperation between the radiologist and surgeon.


Primary mediastinal seminoma.

Primary mediastinal seminoma. Four new cases of primary mediastinal seminoma are presented, and the 103 previously reported cases reviewed. All of the tumors occurred in the anterior mediastinum, and generally appeared as lobulated noncalcified masses on chest radiography. Most patients were in the third and fourth decades, and about 30% were asymptomatic at the time of initial diagnosis. Although mediastinal seminoma is not commonly considered a cause of superior vena caval obstruction, about 10% of patients experience it. The tumors are radiosensitive and potentially radiocurable. A striking reduction in size of the tumor may be noted after radiation therapy. Prognosis is generally good, with a 5-year survival rate of 75%. The controversy surrounding histogenesis of this tumor is reviewed, and the pathologic criteria for making the diagnosis presented.


Computed tomography diagnosis of mesenteric masses. The computed tomographic findings of 30 mesenteric masses are presented. To delineate the mesentery accurately, oral contrast material must fill the entire small bowel. Of the masses, 23 were secondary to non-Hodgkin's lymphoma. These masses were irregular in shape and homogeneous in their tissue attentuation. Two of the 23 had a normal lymphangiogram in the upper paraaortic area. Both lymphangiography and CT were necessary to define the extent of disease in such patients. The six mesenteric metastases were irregular in shape. Four of these had areas of decreased attentuation eccentrically located within the mass which may be secondary to necrosis. One mesenteric cyst had a circular shape with smooth, sharp borders, and a centrally located area of decreased attenuation.


Bilateral concurrent renal neoplasms: report of eleven cases. Eleven patients with concurrent bilateral renal neoplasms are presented, including one case with dissimilar tumor histogenesis. In four cases urography showed only unilateral expansive lesions. The importance of high-dose nephrotomography and bilateral selective renal angiography is stressed. Literature review revealed 57 patients with concurrent bilateral renal cell carcinoma, indicating that this entity may be more frequent than previously believed.


Computed tomography in adrenal tumors.

Computed tomography in adrenal tumors. Computed tomography (CT) was used to evaluate 26 patients with a variety of adrenal lesions. Surgical proof was available in 22 patients and clinical confirmation with a variety of other studies in the other four patients. Nine patients ahd aldosterone-producing adrenal adenomas and CT correctly identified seven. Four patients had cortisol-producing adenomas and five patients had cortisol-producing carcinomas; CT identified each of these tumors. Prominent but normal shaped glands were seen in each of the four patients with adrenal hyperplasia. Adrenal metastases from malignant melanoma in two patients were identified. Only one of two pheochromocytomas in two patients could be seen on CT. CT is a noninvasive method of localizing adrenal tumors and may be helpful in distinguishing adenomas from adrenal hyperplasia.


Ultrasonic characteristics of chronic atrophic pyelonephritis. Six cases of chronic atrophic pyelonephritis were studied with gray scale ultrasound. The findings are analogous to those seen pathologically, namely a focal or multifocal process with loss of renal parenchyma, retraction of one or more calyces, decrease in renal size, and increased echoes from fibrosis. In the proper clinical setting, the diagnosis of chronic atrophic pyelonephritis can be made using ultrasound technique.


Persistent gallbladder opacification after iopanoic acid cholecystography: diagnostic implications for acalculous cholecystitis. Recent reports in the surgical literature state that persistent dense visualization of an otherwise normal-appearing gallbladder 36 hr after the administration of iopanoic acid is highly suggestive of acalculous cholecystitis. To determine the incidence and significance of persistent gallbladder visualization, 324 patients and 66 asymptomatic controls were evaluated. An equal percentage (about 10%) of both groups showed persistent dense gallbladder opacification 36 hr after iopanoic acid ingestion. The results do not support the contention that patients with acalculous cholecystitis can be identified by simply obtaining an additional abdominal radiograph the day after oral cholecystography.


Double blind comparison of meglumine iotroxate (Biliscopin), meglumine iodoxamate (Endobil), and meglumine ioglycamate (Biligram). Two new intravenous cholegraphic agents, iotroxate and iodoxamate, hold a lower general toxicity, lower protein binding, and claim a higher rate of biliary excretion. Both compounds proved to be equally effective in opacifying the gallbladder and the bile ducts in a double-blind clinical study comprising 400 cases. Iotroxate gave significantly earlier good or adequate visualization as a result of its higher excretion rate by the liver (P less than 0.05). Side effects were observed in fewer patients in the iotroxate group (11.6%) compared with the iodoxamate group (16.4%, P greater than 0.05). In a second double-blind study, an iotroxage group of 97 patients who received two thirds of the overall content of iodine (3.6 g) was compared with a group of 98 patients, who received ioglycamate (5.3 g). Visualization was equal in the two groups, while side effects were significantly reduced to 10.3% in the iotroxate group against 20.4% (P less than 0.05). The higher biliary clearance of iotroxate permits a reduction of the amount of iodine.


Significance of intrapancreatic gas demonstrated by CT: a review of nine cases. Nine patients with intrapancreatic air were encountered among 450 patients evaluated for pancreatic pathology. Eight of these patients had surgically proven pancreatic abscesses. The ninth had spontaneous perforation of a pancreatic pseudocyst into the gastrointestinal tract as an explanation of the intrapancreatic air. Computer tomography has been found to be very helpful, not only in the initial diagnosis of pancreatic abscessses, but also in the evaluation of distant spread of the infection. The presence of intrapancreatic air in our experience is the most reliable sign of a pancreatic abscess.


Neonatal intestinal opacification secondary to transplacental passage of urographic contrast medium. Neonatal intestinal opacification in five infants (one set each of triplets and twins) after maternal excretory urography is described, and mechanisms leading to this phenomenon are discussed. Transplacental passage of urographic contrast medium with subsequent excretion by the fetal kidneys and possibly liver and small bowel seems to explain the radiographic appearance. Although the contrast medium probably does not harm the fetus, it should be distinguished from other more sinister causes of colonic opacification in the neonate.


Scintiangiographic diagnosis of acute mesenteric venous thrombosis. Scintiangiographic findings of prolonged mesenteric activity in a case of acute mesenteric thrombosis is described and 105 cases with abdominal scintiangiography are reviewed. Usual peak mesenteric blush occurred 5--15 sec after initial visualization of the aorta. Normal clearance of this activity was 15--30 sec. Future cases should confirm the importance of this observation in early diagnosis of mesenteric venous thrombosis.


Chronic impairment of leg muscle blood flow following cardiac catheterization in childhood. In 99 patients with congenital heart defects of chronic respiratory disease without clinical symptoms of disturbances in peripheral circulation, resting and maximal blood flow in the anterior tibial muscle of both extremities were investigated 2.7 years (average) after cardiac catheterization. The method used involved 133Xe clearance. Resting blood flow was normal and no difference could be demonstrated between the extremity originally used for catheterization and the contralateral control extremity. No disturbance in maximal blood flow could be proved in the extremity used for catheterization by the venous route only. Maximal blood flow was significantly lower in that extremity where the femoral artery had been catheterized or cannulated for pressure measurement and blood sampling. The disturbance in maximal flow was shown regardless of whether the arterial catheterization involved the Seldinger percutaneous technique, arteriotomy, or mere cannulation of the femoral artery. The values in the involved extremity did not differ significantly from the values in a healthy population.


Role of radionuclide imaging in osteoid osteoma. Radiophosphate bone scans readily disclosed osteoid osteomas in 20 symptomatic patients, including nine patients whose radiographic findings had been negative. In five of the nine patients adjuvant radiogallium imaging was performed, and four showed a disproportionately low uptake relative to radiophosphate. When this occurs, osteoid osteoma can be distinguished from subacute osteomyelitis, which is particularly helpful if the radiograph is equivocal. Radiophosphate bone imaging's generally accepted excellent sensitivity in disclosing obscure symptom-producing focal bone disorders makes it the screening procedure of choice, especially if osteoid osteoma is considered in the differential diagnosis. Only abnormal areas need to be radiographed to add specificity and more precise delineation.


"Step-off" vertebral body: Gaucher's disease versus sickle cell hemoglobinopathy. Two patients with Gaucher's disease and radiographic findings in the spine similar to sickle cell hemoglobinopathy are reported, making a total of four known patients with Gaucher's disease who have these steplike vertebral endplate deformities. Serial films of a patient having Gaucher's disease compared with patients having sickle cell hemoglobinopathy suggest that different events lead to formation of the vertebral deformities. In Gaucher's disease, there is an initial collapse of the entire vertebral body with subsequent growth recovery peripherally. In sickle cell hemoglobinopathy, the endplate deformity is nontraumatic and is caused by an underlying growth arrest.


Gray scale ultrasonography in the diagnosis of endometriosis and adenomyosis. Ultrasound findings in 25 patients with surgically proven endometriosis are presented. Of the 31 lesions characterized at ultrasound examination, 17 were described as cystic, four as polycystic, five as mixed, and four as solid. Nine patients had a diagnostic pattern of sonolucent zones within the uterus representing blood lakes (adenomyosis) associated with extrauterine masses. In the remaining 16 patients, ultrasound alone could not differentiate endometriosis from diseases such as tubovarian abscess, ruptured ectopic pregnancy, ovarian cyst(s), or tumor. Clinical history contributed to proper diagnosis in these patients.


Doppler evaluation of extracranial cerebrovascular disease. The carotid Doppler examination is an accurate means of screening the extracranial carotid system for stenotic lesions. Comparison of 100 patients (200 vessels) examined by the Doppler method and arteriography showed agreement in 90% of the vessels and a significant error rate in only 3.5%.


A second look at the utility of radiographic skull examination for trauma. A prospective study tested the hypothesis of Bell and Loop (1971) that 21 high yield findings are significantly associated with the presence of a skull fracture and can be used to decide which patients need skull radiography. In our study, 17 fractures were detected in 594 patients who had skull radiography because of trauma to the head. Six of these fractures occurred in children who had none of the 21 Bell and Loop high yield findings. These six patients were asymptomatic except for superficial injury at the site of trauma. Had the Bell and Loop criteria been used to decide which patients had skull radiography, 35% (all in children) of the fractures would have gone undetected. Thus, in our study population, the Bell and Loop high yield findings were not satisfactory criteria for the decision about obtaining skull films in children.


Effects of ether anesthesia and surface-induced hypothermia on regional blood flow. Regional blood flow and distribution of cardiac output (CO) were evaluated by the radioactive microsphere technique in seven rhesus monkeys prior to anesthesia, following the induction of deep ether anesthesia and throughout the cooling course during surface-induced hypothermia to temperatures of 20 degrees C. As given, deep ether anesthesia alone significantly decreased CO 10% to 15% and output fraction (Qt) was decreased to the carcass, increased to the splanchnic circulation (although not statistically significant), and unchanged to other organs, while total vascular (TVR) and organ resistances were reduced. With the addition of cooling, CO progressively decreased. Individual organ Qt's, however, did not change from anesthetized normothermic values; thus organ flows decreased parallel to the reduction of CO as cooling progressed. TVR and organ vascular resistances increased to levels in excess of 150% of anesthetized precooling values, apparently as the result of viscosity rather than vascular changes.


Acute coronary occlusion in the pig: effect of nitroglycerin on regional myocardial blood flow. Myocardial blood flow was studied in 10 closed chest, anesthetized pigs after an acute balloon catheter occlusion of the left anterior descending coronary artery. With use of radioactive microspheres (15 mu), myocardial blood flow was measured before and during an intravenous nitroglycerin infusion and during a combined nitroglycerin-phenylephrine infusion. A significant zone of ischemis (myocardial blood flow less than 50 percent of normal zone flow) was produced by the occlusion and involved 15 percent of the combined left ventricular and interventricular septal mass. More than 50 percent of this ischemic zone was intensely ischemic (myocardial blood flow 0 to 3 percent of normal). Nitroglycerin resulted in a 20 to 30 mm Hg decrease in systolic blood pressure. Myocardial blood flow was unchanged in intensely ischemic areas but varied directly with the product of heart rate and systolic blood pressure in the moderately ischemic area (myocardial blood flow 26 to 50 percent of normal). S-T segment elevation was significantly increased during nitroglycerin infusion and returned to control level with the added infusion of phenylephrine sufficient to restore the systemic blood pressure to prenitroglycerin values. No improvement in ischemic zone perfusion could be demonstrated  during the infusion of nitroglycerin alone or with phenylephrine. The endocardial-epicardial flow ratio in moderately ischemic areas was slightly lower than the normal zone flow ratio and decreased slightly during infusion of nitroglycerin. With the addition of phenylephrine, the ratios rose slightly and no longer differed from prenitroglycerin values. Blood flow distribution in acutely ischemic pig myocardium differs considerably from that observed in the dog. Nitroglycerin was not shown to have any beneficial effects with or without its relative hypotensive effect. More extensive study in animal models other than the dog is needed.


Parenteral vitamin requirements during intravenous feeding. Serum vitamin levels of 40 patients undergoing parenteral nutrition over a 5-to 42-day period were studied while the subjects received daily water-soluble and once weekly fat soluble vitamin formulations intravenously. Initial serum deficiencies of vitamins A, C, and folate were noted in a large portion of the severely malnourished population. At the replacement levels used in this study a small number of patients developed subnormal levels of vitamins A and D. Improvement in levels for vitamin C and folate were noted for most patients. Vitamin B12 deficiencies were not noted in any patient. Currently available commercial vitamin preparations can be used with safety in the parenterally nourished population and recommended guidelines for weekly infusion of both water and fat soluble vitamins are presented.


Preparing for the next round: convalescent care after acute infection. Infections pose a nutritional stress on the growing child. No therapeutic goal is as important as the rapid recovery of preillness weight after acute infections. Successful convalescence, with supernormal growth rates, can be achieved with relatively brief periods of intensive refeeding, offsetting any tendency toward reduced immune defenses or other nutritionally determined susceptibilities to further infection. Since the mother is the only person who can effectively manage convalescent care, she must be given specific tasks with measurable targets in order to reliably oversee the child's rehabilitation. Not generally considered in the realm of preventive medicine, effective home-based convalencent care is the first crucial step in preventing the next round of illness. An approach to the widespread mobilization of mothers to monitor and sustain their children's growth is proposed in this paper. Rather than a passive recipient of health services, the mother becomes the basic health worker, providing diagnostic and therapeutic primary care for her child. Only the mother can break the malnutrition-infection cycle.


A study of lymphoproliferative diseases comparing immunofluorescence with immunohistochemistry. Sections of lymph nodes from patients with lymphoproliferative disorders were stained by immunofluorescence and immunoperoxidase methods. Staining with anti-kappa and anti-lambda antibodies employed F(ab')2 fragments of purified antibodies to avoid binding via Fc receptors. Frozen-section immunofluorescence revealed that B-cell lymphomas were composed of monoclonal populations of Ig-bearing cells. With immunohistochemical technics, however, a significant number of B-cell lymphomas either did not stain for Ig or showed spurious staining. The possible reasons for lack of staining in some cases and spurious staining in others are discussed. As currently applied to lymphoproliferative disorders, immunofluorescence appears to be more senitive and more speific than immunohistochemistry.


Efficiency of serologic tests in the diagnosis of systemic candidiasis. Candida antibody tests for systemic candidiasis were conducted on 53 sera from patients with the disease and 170 sera from control patients by agar gel diffusion, counterimmunoelectrophoresis (CIE), latex agglutination, and whole-cell agglutination. The agar gel diffusion test and CIE had sensitivity, specificity, and efficiency of approximately 90%. The whole-cell agglutination test scored significantly lower, whereas the latex test scored in between. The agar gel diffusion test had the highest reproducibility and the whole-cell agglutination test the lowest in tests of identical sera by six independent laboratories. The agar gel diffusion and CIE tests make significant contributions to the diagnosis of systemic candidiasis.


American Burkitt's lymphoma-hand-mirror variant. A detailed investigation of cytologic, ultrastructural, and immunologic features. Previous studies of patients with lymphoid malignancies have suggested a relationship between survival and the presence of more than 40% hard-mirror cells in the bone marrow. This report represents the first detailed study of a patient with American Burkitt's lymphoma with numerous hand-mirror cells in the bone marrow during the course of the disease. The Burkitt cells were atypical because of their hand-mirror configuration in the bone marrow, the presence of cytoplasmic glycogen, the finding of an IgG surface marker, and a strongly positive acid phosphatase staining reaction. The presence of increased numbers of hand-mirror forms in the bone marrow during the course of the patient's illness may have clinical significance, because they were replaced by non-hand-mirror Burkitt cells in the terminal phase. More reports and investigations of patients with large numbers of hand-mirror forms in the bone marrow are needed to elucidate the full significance of this unusual cellular phenomenon.


Pseudomonas colonization in patients with spinal cord injury. Pseudomonas has been an important cause of urinary tract infection in patients with spinal cord injuries. To determine the possible reservoirs of Pseudomonas, colonization with Pseudomonas was studied in 52 inpatients and 28 outpatients with spinal cord injuries. Body sites, the environment, and hospital staff were cultured. There was a high prevalence of colonization of the urethra, perineum, and rectum. Pseudomonas was isolated from one or more of these sites in 85% of male inpatients and in 71% of male outpatients. Significant bacteriuria with Pseudomonas was found in 37% of inpatients and 13% of male outpatients. Urethral colonization in men was significantly associated with the use of the external urethral catheter. Culturing the patient's perineum was a sensitive indicator of patient colonization. The urinary drainage bag was another frequent reservoir of Pseudomonas. More than one-half of these patients did not have significant bacteriuria and presumably the drainage bag was colonized from the urethra or perineum. The rates of urethral, perineal, and rectal carriage were higher than those described previously. These rates may be accounted for by the use of the external urethral catheters. Other factors, such as rectal manipulation, and fecal incontinence may be important in these groups of patients.


Savings achieved through use of a less concentrated amino acid solution. The administrative process of adding a 5.5% crystalline amino acid solution to the formulary of two affiliated hospitals and the results of the addition are discussed. A formulary change was sought after it was found that many patients on parenteral nutrient therapy were receiving more amino acids than they needed. Nearly all patients on parenteral nutrient therapy were receiving 8.5% crystalline amino acid solution. The approach to achieving the pharmacy and therapeutics committee's approval of the formulary change included documenting amino acid needs from the literature, securing a multidisciplinary base of support and providing economic impact information. A standard TPN order form for physicians, education through the pharmacy newsletter, and presentations at surgery and medical conferences and grand rounds were implemented to assure that the change was effective. During the 12 months following approval of the formulary addition, 66% of the more than 20,000 total parenteral nutrient solutions were prepared using 5.5% amino acid solutions. This resulted in an annual savings of $41,028


Postnatal growth of the cranial base in Macaca nemestrina. Postnatal growth of the cranial base was longitudinally studied in 21 male and 11 female Macaca nemestrina. The basicranium of each animal was marked with tantulum implants in order that the tracings of each serial roentgenogram could be superimposed. Between the ages of 3.0 and 5.0 years the degree of sexual demorphism in both angular and linear dimensions increased. The cranial base flattened as a result of the upward and forward migration of nasion and the upward and backward relocation of basion. The movement of basion was primarily due to differential growth recorded at the spheno-occipital synchondrosis. Sexual difference in the relative growth of this synchondrosis resulted in a longer and somewhat flatter male cranial base. Male and female velocity curves showed accelerations that coincide with their estimated age for the onset of puberty.


Mandibular biomechanics and temporomandibular joint function in primates. There is disagreement as to whether the mandibular condyles are stress-bearing or stress-free during mastication. In support of alternative models, analogies have been drawn with Class III levers, links, and couple systems. Physiological data are reviewed which indicate that maximum masticatory forces are generated when maxillary and mandibular teeth are in contact, and that this phase lasts for over 100 msec during many chewing strokes. During this period, the mandible can be modeled as a beam with multiple supports. Equations of simple beam theory suggest that large condylar reaction forces are present during mastication. With unilateral molar biting in man, the total condylar reaction force may be over 75% of the bite force. Analysis of a frontal projection demonstrates that up to 80% of the total condylar reaction force is borne by the contralateral (balancing side) condyle during unilateral molar biting. A comparison of human, chimpanzee (P. troglodytes), spider monkey (A. belzebuth), and macaque (Macaca sp.) morphology indicates that the frugivorous chimpanzee and spider monkey have a relatively lower condylar reaction force than the omnivorous macaque or man during molar biting. The percentage reaction force during incisal biting is lower in man than in the other primates, and lower in the frugivorous primates than in the macaque.


The effect of nitroglycerin on gas exchange, hemodynamics, and oxygen transport in patients with chronic obstructive pulmonary disease. The present study was designed to investigate pharmacological vasodilation in patients with chronic obstructive pulmonary disease (COPD). This may have long-term therapeutic implications. Sublingual nitroglycerin (GTN) was administered to 16 patients with COPD and no evidence of organic heart disease (except one patient) in an attempt to determine severity of the decrease in arterial oxygenation. Gas exchange and hemodynamic studies were performed before and after GTN. Alverolar-arterial O2 tension gradient increased 5 mm Hg, arterial PO2 decreased 2 mm Hg, and cardiac output decreased from 4.36 to 3.85 liters/min. There was a decrease in pulmonary artery pressures, but pulmonary vascular resistance did not change. Total O2 transport (the product of cardiac output and arterial O2 content) decreased, due mainly to a decrease in cardiac output. From these studies we conclude that GTN significantly decreases O2 transport in patients with COPD and normal left ventricular function; this decrease is due mainly to a reduction in cardiac output. Impairment of gas exchange is slight. Based on these considerations pharmacological vasodilation with nitroglycerine in COPD is probably not warranted.


Plasma concentrations of total and free corticosterone during development in the rat. A sensitive protein-binding assay has been used to measure plasma concentrations of total corticosterone during postnatal development in the rat. These concentrations were extremely low on days 6--12, showed a significant rise by day 14, and then continued to rise until peaking on day 24. Plasma titers of corticosteroid-binding globulin rose even more dramatically from day 12 onward. Consequently, the percentage of total plasma corticosterone, which was protein-bound, showed a gradual rise from 78% on day 12 to 98% on day 24. Despite this trend, when concentrations of free corticosterone were calculated, they were found to have a developmental profile very similar to that of total corticosterone. Assay of jejunal lactase and sucrase in the same animals that were used for the corticosterone studies showed that the ontogenic rise of both total and free corticosterone preceded the developmental changes in the activities of these enzymes by approximately 2 days. The data suggest that the rise in free corticosterone that begins on day 14 acts as a cue for enzymic changes in both liver and intestine.


Immunohistochemical localization of the prostaglandin-forming cyclooxygenase in renal cortex. An immunohistofluorescence procedure for detecting prostaglandin-forming cyclooxygenase has been used to localize the enzyme in the renal cortex of the cow, guinea pig, rabbit, rat, and sheep. Cyclooxygenase antigenicity was found in endothelial cells lining all arteries and arterioles and in cortical collecting tubules in each species examined. The enzyme was also detected in epithelial cells of Bowman's capsule in the rabbit and in mesangial cells in both ovine and bovine glomerular tufts. That prostaglandins can be formed in renal resistance vessels suggests that it is the synthesis occurring in these vessels which is responsible for the effects of prostaglandins on renal blood flow. Of further note is the correlation that exists between the location of the cyclooxygenase and that of the antidiuretic hormone-responsive adenyl cyclase in the distal nephron.


Dual effects of amphotericin B on ion permeation in toad urinary bladder epithelium. The mechanisms of action of amphotericin B on the electrical properties of the toad urinary bladder epithelium were studied with microelectrode techniques. Cell membrane and transepithelial electrical potentials and resistances were measured in the absence and in the presence of the drug during exposure to bathing mediums of different ionic compositions. As observed previously by other investigators, amphotericin B produces a dramatic decrease of transepithelial electrical resistance (Rt) and an increase of the rate of sodium transport. Our results indicate that the effect of the drug on Rt depends in part on an increase in Na conductance across the luminal cell membrane (amiloride-insensitive), but is caused mainly by an increase of ionic conductances (with the sequence GK greater than GNa greater than G choline greater than GCI) at a site in parallel with the impaled cells (i.e., across a cell type not investigated by the microelectrode measurements or across the paracellular pathway.


Effects of sympathetic nerves on cerebral vessels in dog, cat, and monkey. Cerebral vascular responses to sympathetic stimulation and denervation were examined in three species during acute severe hypertension as well as normal conditions. Cerebral blood flow (CBF) was measured with microspheres after the superior cervical sympathetic trunk was cut and during electrical stimulation of the superior cervical sympathetic ganglion. Sympathetic denervation did not increase CBF in anesthetized cats or monkeys. Under normal conditions, sympathetic stimulation decreased CBF significantly in monkeys (-26 +/- 3%) (mean +/- SE) but not in cats. During acute severe hypertension, decreases in CBF due to sympathetic stimulation were greatly augmented in cats (-29 +/- 7%, compared to -3 +/- 3%), only modestly augmented in dogs (-9 +/- 3%, compared to -1 +/- 2%), and not augmented in monkeys (-17 +/- 3%, compared to -23 +/- 4%). Disruption of the blood-brain barrier during hypertension was reduced by sympathetic stimulation. We conclude that 1) sympathetic tone to cerebral vessels is minimal because denervation does not increase CBF; 2) sympathetic stimulation decreases CBF under normal conditions in monkeys and during severe hypertension in cats, dogs, and monkeys, and it reduces disruption of the blood-brain barrier; and 3) there is an important species difference in responses to sympathetic stimulation under normal conditions and during acute hypertension.


Measurement of multiple simultaneous small dimensions and study of arterial pressure-dimension relations in conscious animals. This paper describes the development of several important modifications that were incorporated into the ultrasonic, transit-time dimension system in order to obtain multiple simultaneous, instantaneous, and continuous measurements of the external dimensions of the aorta and its major branches in conscious, unrestrained animals. At operation a pair of small piezoelectric crystals was sutured to arterial adventitia, and a miniature pressure gauge was implanted in the vessel at the same cross-sectional plane. After recovery from surgery, wall motion was not altered appreciably and scarring was minimal. This technique allows long-term monitoring of aortic pressure-dimension relations and is applicable for small (fetal and neonatal) as well as large (adult dogs and sheep) animals. When vessel wall thickness is measured, stress-radius analysis can be performed so as to compute vascular elastic stiffness as a function of stress. Moreover, the suitability for radiotelemetry of the pressure and dimension signals measured with this technique enables the study of these parameters in unrestrained animals, e.g., during spontaneous severe exercise.


Transplacental transmission and fetal parasitosis of Trypanosoma cruzi in outbred white Swiss mice. Two strains of Trypanosoma cruzi, isolated from humans and assayed for their biological capacity to kill outbred white Swiss mice (HaM/CR-CD) following reticuloendothelial system blockade with thorium dioxide, were used in these experiments: the Maria Cristina strain, which killed all blocked mice at a rate following a rectangular dose-response curve, and the José Cardoso strain, which did not kill blocked mice at comparable dosages. When inoculated into pregnant HaM/CR-CD mice, the non-pathogenic José Cardoso strain did not cross the placental barrier, in either blocked or unblocked mice, to cause fetal parasitosis. The pathogenic Maria Cristina strain did not cross the barrier in non-blocked mice, but in thorium-dioxide blocked mice it produced an incidence of fetal parasitosis of 8.9% (7 of 79 fetuses). These results indicate that the transplacental transmission of T. cruzi was dependent on two restrictions: pathogenicity of the strain of T. cruzi, and blockade of phagocytic activity by thorium dioxide, suggesting that transplacental transmission of T. cruzi is related to interference with the phagocytic activity of the placenta.


House construction, triatomine distribution, and household distribution of seroreactivity to Trypanosoma cruzi in a rural community in northeast Brazil. Household distribution of seroreactivity to Trypanosoma cruzi in inhabitants was analyzed in relation to house construction and the distribution of Panstrongylus megistus, the principal domestic vector of Chagas' disease in a rural area in northeast Brazil. No children residing in mud-brick houses were seroreactive to T. cruzi. The highest rates of seroreactivity occurred in residents of unplastered mud-stick houses, and were twice as high as those found in persons living in mud-brick houses or plastered mud-stick houses. Two-thirds of seroreactive children in this area resided in unplastered mud-stick houses. Over 90% of the P. megistus infestations were found in mud-stick houses. Mud-brick houses had the lowest infestation rates of P. megistus and the lowest household rates of seroreactivity to T. cruzi.


Trypanosoma cruzi infection in dogs and cats and household seroreactivity to T. cruzi in a rural community in northeast Brazil. The prevalence of Trypanosoma cruzi parasitemia as determined by xenodiagnosis on domestic dogs and cats was correlated with household rates of seroreactivity to T. cruzi and household Panstrongylus megistus infestation in a rural area in northeast Brazil where P. megistus was the only domiciliary triatomine vector. T. cruzi infection was present in about 18% of domestic dogs and cats. Two-thirds of seroreactive children below age 10 resided in houses with T. cruzi-infected animals. In houses with a T. cruzi-infected dog or cat, as well as at least one infected P. megistus, the household rate of seroreactivity to T. cruzi was five times greater than in houses with non-infected domestic animals and no infected triatomine vectors. Domestic dogs and cats are important reservoirs of T. cruzi in an endemic area where P. megistus is the only domiciliary triatomine vector.


Studies of the coagulation system and blood pressure during experimental Bolivian hemorrhagic fever in rhesus monkeys. Experimental infection of rhesus monkeys (Macaca mulatta) with Machupo virus produced a hemorrhagic disease similar to that of Bolivian hemorrhagic fever in humans. The disease in infected animals was also characterized by the development of hypotension and coagulation abnormalities as indicated by severe thrombocytopenia and prolongation of the activated partial thromboplastin time. Evidence for disseminated intravascular coagulation was inconclusive due to the presence of normal to elevated fibrinogen levels, relatively low levels of circulating fibrin split products, and the lack of widespread fibrin thrombus deposition. The most likely causes of the hemorrhagic tendencies of this disease in infected monkeys were thrombocytopenia and decreased synthesis of coagulation and other plasma proteins due to severe hepatocellular necrosis. Hypotension may also have been due to decreased plasma protein synthesis.


Distribution and prevalence of spotted fever group rickettsiae in ticks from South Carolina, with an epidemiological survey of persons bitten by infected ticks. Live ticks removed from human hosts were tested for the presence of spotted fever group rickettsiae from 1974 through 1976. Spotted fever group rickettsiae were detected in Dermacentor variabilis, Amblyomma americanum, Amblyomma maculatum, and Ixodes scapularis. Persons from whom positive ticks were removed in 1974 and 1975 were questioned about ensuing illness. Eleven of 51 persons from whom rickettsia-positive D. variabilis were removed reported some unexplained combination of symptoms compatible with Rocky Mountain spotted fever. Persons with positive ticks other than D. variabilis reported no illness in the 2 weeks following exposure. D. variabilis from the Coastal Plain of South Carolina have a higher percentage of infection than those from the Piedmont region. Conversely, most reported human cases of spotted fever are from the Piedmont.


Identification and antigenic typing of Rickettsia tsutsugamushi in naturally infected chiggers (Acarina: Trombiculidae) by direct immunofluorescence. Rickettsia tsutsugamushi organisms were detected and typed antigenically by direct immunofluorescence in mites from laboratory-maintained infected colonies of Leptotrombidium (Leptotrombidium) fletcheri and L. (L.) arenicola. Rickettsiae were identified most readily in unengorged larvae, but were also discernable in engorged larvae and all post-larval stages of the vectors.


Partial protection of Plasmodium falciparum-vaccinated Aotus trivirgatus against a challenge of a heterologous strain. Two Aotus trivirgatus griseimenbra monkeys which had been immunized with the merozoite-enriched FUP strain of Plasmodium falciparum were protected against a primary challenge with the homologous strain. The results described here show that these two monkeys were protected against a subsequent challenge with a heterologous strain (FVO) of P. falciparum. The unimmunized control monkey died of FVO infection by day 18.


Cost-effectiveness of operative cholangiography. (1) Three hundred seventy-seven of 1,616 patients undergoing cholecystectomy between January 1, 1971 and December 31, 1975 had intraoperative cholangiograms and form the basis for this study. (2) The cholangiograms of thirty-seven patients were interpreted as positive for ductal disease, but only twenty-three had confirmed disease on common bile duct exploration. The average false-positive rate was 38 per cent per year. (3) One hundred nine patients had cholangiograms because of small stones in the gallbladder, and only one study was true-positive. (4) One hundred nineteen patients had cholangiograms without any clinical indication for the study. Only one was true-positive for intraductal disease. (5) Operative cholangiograms done routinely or for multiple small stones rarely reveal intraductal disease (2 of 228, or 0.9 per cent). (6) Of 149 cholangiograms in patients with clinical indications other than multiple small stones, twenty-one of twenty-six positive cholangiograms were true-positive, for an 81 per cent accuracy. (7) Operative time was prolonged an average of 31 minutes when cholangiography was performed. (8) The 377 cholangiograms cost $21,866. Of the 228 studies done routinely or for only multiple small stones, two were positive, for a cost of $6,612 per positive examination. (9) Therefore, to be cost-effective, the use of intraoperative cholangiography is indicated only when standard criteria for ductal exploration, with the exception of the presence of small calculi, are present.


Electromotor feeding responses of primate ileum and colon. Serosal bipolar electrodes to record spike discharges and strain gauge force transducers to record circular muscle contractions were placed in pairs on the terminal ileum, cecum, right colon at the ileocecal valve, ascending colon, and proximal transverse colon of sixteen primates. After an overnight fast, electromotor responses to continued fasting or to ingestion of a meal (randomized order) were recorded in awake animals. Feeding led to increased spike discharges and increased frequency of muscle contractions at all sites. The onset of these responses usually was within 6 minutes after feeding; the responses increased progressively during 30 to 45 minutes and then remained more or less at a constant plateau of increased activity. Atropine completely blocked the postcibal responses of ileum and proximal colon for up to 30 minutes. Transit time data of labeled meals excluded direct stimulation by a food bolus as the mechanism of the observed postcibal colonic response. The pattern of response was consistent with humoral mediation.


Corneal nerve access in monkeys.

Corneal nerve access in monkeys. Electron microscopical examination of corneal nerves in rhesus and cynomolgous monkeys revealed that limbal, subepithelial nerves gained direct access to the corneal epithelium. Epithelial axons occurred singly and infrequently and they were confined to the basal layer of cells. All nerves of the stroma terminated within the layer and rami perforans were not found. The apparent barrier to nerve passage presented by Bowman's layer in monkeys was discussed in relation to primates in general. The isolation of stromal and epithelial nerve fibres confirms that terminals occur in both layers and their respective potential for excitation was briefly discussed.


Associations between the cells of the walls of Schlemm's canal. The associations between the cells of the corneoscleral and trabecular walls of Schlemm's canal from the three primate species human, baboon and rhesus monkeys were examined by transmission electron microscopy. Small gap junctions and occluding junctions modify the lateral borders between the canalicular endothelial cells. The endothelial monolayer on the corneoscleral aspect of Schlemm's canal is separated from several layers of fibrobasts by a continuous basement membrane. The fibroblasts are embedded in a dense collagenous matrix and at the regions of cellular association, modifications are restricted to simple maculae adhaerentes. The endothelial monolayer on the trabecular aspect of Schlemm's canal does not have a continuous basement membrane but maintains its association with the underlying endothelial meshwork by means of process connections. In the endothelial meshwork, the native meshwork cells link with each other by gap junctions and maculae adhaerentes.


Development of Dickie's small eye, a mutation in the house mouse. A new semidominant mutation in the laboratory mouse, Dickie's small eye (Dey), is described. It is localized on chromosome 2. Heterozygotes show reduced body size, small eyes with coloboma, small or lacking lens with cataract, abnormal folding of the retina and reduction of the pigment layer. The anterior chamber is usually missing. Homozygotes apparently die early in pregnancy.


Double-blind trial of oral papaverine in chronic cerebrovascular ischemia. A preliminary analysis of the effect of long-term therapy with oral papaverine has been made in 11 patients with chronic cerebral ischemia due to cerebral arteriosclerosis. The cases were classified as remote cerebral infarction (6 patients) or vertebrobasilar arterial insufficiency (5 patients). The patients received 225 mg or 450 mg daily, assigned in a double-blind manner. Most showed clinical improvement and improvement on the EEG. There was a statistically significant increase in regional cerebral blood flow in the vertebrobasilar arterial distribution, including the brain stem and cerebellar and posterior cerebral regions, particularly in the right hemisphere. Evidence appears to indicate that zones of severe remote cerebral infarction are refractory to pharmacologically induced vasodilation.


Comparisons among HC 20-211 (Ketotifen), clemastine, DSCG and beclomethasone dipropionate in nasal challenge. Nasal challenge tests were used to compare the protective effect of pre-treatment with HC 20-511 (Ketotifen), a new antiallergic compound, clemastine, DSCG and beclomethasone dipropionate in 14 patients with hay fever. HC 20-511 and clemastine were tested in a double-blind fashion and DSCG and beclomethasone openly. Most of the patients experienced an intense nasal reaction when challenged with pollens without pre-treatment. The intensity of nasal reactions was determined by subjective symptoms, clinical findings and nasal peak expiratory flow values. All the drugs tested relieved the symptoms and signs induced by pollens in nasal challenge tests. This tendency was not, however, statistically significant for any of the drugs. When using the changes in nasal expiratory flow rate as a criterion of protectiveness, the differences among the compounds tested were also slight. HC 20-511 seems to be a promising antiallergic agent. However, long term clinical trials still are needed to establish its efficacy in various allergic disorders.


Cell-mediated immune response after Brucella abortus S19 vaccination. Cell-mediated immunity to Brucella abortus S19 vaccine was measured in young heifers by the microassay for stimulation of protein synthesis (SPS) with [3H]leucine and the skin test for delayed hypersensitivity. Brucella melitensis protein allergen and a crude B abortus S19-soluble antigen were compared in the SPS test. The SPS test was negative in 5 unvaccinated heifers and strongly positive in 3 twice-vaccinated steers. However, the SPS test was positive only in 13 of 30 S19-vaccinated heifers and the delayed hypersensitivity in 9 of 29 S19-vaccinated heifers. The 2 tests gave good agreement. Vaccination-induced residual antibody titers were partly correlated with the outcome of the tests used to measure cell-mediated immunity.


Light and electron microscopic study of the livers of pregnant mice infected with Listeria monocytogenes. Listeria monocytogenes cells were observed in the hepatic cell cytoplasm or in the phagosome at 24 and 48 hours but not at 72 hours after inoculation in pregnant mice. The presence of bacteria initially in a membrane-bound vesicle indicates that the bacteria enter the hepatic cells by endocytosis, resulting in eventual destruction of hepatic cells. Characteristic lesions of the liver at 24 and 48 hours after inoculation consist of multiple focal areas of necrosis. The initial neutrophilic reaction seems to give way to a mononuclear reaction (listeriomas) at 72 hours after inoculation. Dilation of rough endoplasmic reticulum and release of many of the bound ribosomes with a relative increase in the number of free ribosomes was observed. Hepatic lesions were not observed in control (nonpregnant) mice.


[Salmonellosis in children. II: management and follow-up (author's transl)]. The clinical records of 185 cases of Salmonellosis have been reviewed retrospectively, in order to study a relation between the evolution and the treatment given, so as to be able to determine the therapeutic criteria. 139 cases showed as gastroenteritis, 48 of which received antibiotic treatment and 91 did not. Statistic differences were observed in favour of the non treated cases where, the average time of hospitalization, the negative copro-cultive and the onset of complications were more favourable. All the cases with Tipho-Paratific fever were treated with antibiotics without finding any significant differences in the clinical evolution not withstanding the antibiotic used. The data here obtained is compared with that previously reported. According to the results a treatment planning is suggested.


Multiple systemic and periocular malformations associated with the fetal hydantoin syndrome. Anticonvulsants remain necessary during pregnancy and the removal of such drugs is not recommended. However, on the available evidence, the physician may expect an increased risk of malformation including eye abnormalities as has been outlined. The abnormalities include growth deficiencies and delayed motor/mental development together with dysmorphic features, the most common of which seems to be cleft lip/cleft palate. Additionally, many of these children suffer from eye abnormalities including hypertelorism, ptosis, strabismus, epicanthal folds, and in this case abnormalities of the lacrimal apparatus.


Solitary plasmacytoma of the larynx and upper trachea associated with systemic lupus erythematosus. Solitary plasmacytoma rarely involves the larynx and trachea. This tumor caused severe laryngeal and tracheal obstruction in an adolescent female with systemic lupus erythematosus of nine years' duration. Her systemic disease had been in remission at the time she developed symptoms of laryngeal and tracheal obstruction by plasmacytoma invasion. A complete survey failed to reveal any other focus of tumor. Because steroid therapy failed to clear the plasma cell infiltrate, she was treated with irradiation after the tumor was surgically debulked endoscopically. Postirradiation biopsy showed no evidence of tumor, but the patient continued to experience moderate airway obstruction from fibrosis in the irradiated trachea. The patient has been followed, and is free of disease nine years after establishing the diagnosis.


Wegener's granulomatosis causing laryngeal and tracheobronchial obstruction in an adolescent girl. A 12-year-old girl presenting with a painful neck mass and ulcerated gingival lesions was found to have Wegener's granulomatosis involving the gingivae, paranasal sinuses, ears, mastoids, larynx, trachea, bronchial tree, lungs, kidneys and joints. The initial illness and two subsequent exacerbations were treated with intravenous and oral cyclophosphamide and prednisone. Secondary infections have been managed with establishment of good drainage and use of appropriate antibiotics. The patient is well with a normal sedimentation rate 4 1/2 years after the onset of her disease.


Primary lymphosarcoma of the larynx in a child. A 4 7/12-year-old Caucasian female with a history of "croup-like symptoms" and persistent airway obstruction, was found to have a primary lymphosarcoma by biopsy at the time of laryngoscopy and bronchoscopy. No metastatic disease was found. After an induction course of vincristine, prednisone and local irradiation, she received CNS prophylaxis with intrathecal methotrexate and cranial irradiation. Maintenance therapy, administered over a 2 3/4 year period, consisted of cyclophosphamide, methotrexate, and 6-mercaptopurine. Excluding the diagnostic evaluation, she was hospitalized only once for the management of suspected sepsis, gastrointestinal ulceration and severe bone marrow depression. Since discontinuing treatment 27 months ago, she has remained free of disease.


Epidermolysis bullosa associated with laryngeal stenosis. A boy with epidermolysis bullosa developed progressive laryngeal obstruction after age six months, with tracheotomy necessary at age three years. By eight years, the larynx was completely occluded by web and scar. Stenosis recurred repeatedly over the next seven years, three to six months after each corrective procedure, but laryngeal patency has been better-maintained since age 15. Laryngeal stenosis, presumably secondary to epithelial detachment, although a rare complication of epidermolysis bullosa, can be serious and life-threatening.


Differential craniofacial skeletal changes after postnatal experimental surgery in young and adult animals. To find answers to the many questions about abnormal postnatal growth and change of the craniofacial skeleton, a series of surgical experiments was carried out in both young and adult animals. The purpose of this review is to relate this information to basic ideas about bone change and some local factors which may or may not affect skeletal changes. No gross regional deformity was noted after resection of sutures in young animals. The growth of bone at sutures was secondary or compensatory to other factors. In young animals, increase in size of the nasal or orbital cavities decelerated considerably after resection of either nasal septum or orbital tissues. With an increase in volume of orbital contents, orbital volume increased. These prominent gross changes in young animals were not noted in adult animals after resection of nasal septum, enucleation of the eye, or intrabulbar injection of silicone. After unilateral resection of the mandibular condyle in both young and adult monkeys, an extreme unilateral facial skeletal deformity developed. The important factor apparently was loss of integrity of the temporomandibular joint rather than loss of a growth site. The craniofacial skeleton, a three-dimensional mosaic of bones and cavities, develops as a result of the synchronous coordination of the differential activities at various sites. The dynamics of the growth and change are a fascinating, complex, incomplete chapter of biology. An understanding of factors that may or may not influence the craniofacial skeleton in both young and adult animals can aid diagnosis and surgical treatment.


Neurofibroma of the larynx in a child.

Neurofibroma of the larynx in a child. Laryngeal obstruction due to neurofibromatosis in a girl with von Recklinghausen's disease first occurred in the neonatal period, and recurred by age seven years. She has done well for four years following laryngofissure surgery. Pharyngeal and laryngeal neurofibromatosis are rare manifestations of von Recklinghausen's disease. The dominant hereditary pattern of this disease requires that the condition be considered when respiratory distress occurs in the child of an affected parent, whether or not skin tumors or other features are present.


Distribution of cerebral blood flow in the dominant hemisphere during motor ideation and motor performance. Distribution of activity in the dominant (left) hemisphere was studied with a multidetector instrument during diagnostic measurements of regional cerebral blood flow in 6 patients, 4 of them neurologically normal. Computercalculated charts, in color, of the flow/activity distribution--"cerebral ideograms"-- were obtained in three situations: at rest, during motor ideation (attempts to conceive of rhythmic clenching movements of the right hand), and during actual movements of the right hand. Motor ideation changed the normal "hyperfrontal" resting flow distribution, and an increase of the hemisphere mean flow was recorded. The increase was especially marked in frontal and temporal structures. This pattern differed from the one during actual hand movements, when a rolandic flow increase was seen. The result suggests that centers for motor ideation have a different cerebral location than those which control the actual hand movement.


Lymphomatoid granulomatosis in a child with acute lymphatic leukemia in remission. Lymphomatoid granulomatosis, a tumor-like process of unknown etiology, produced progressively destructive disease of the larynx, trachea and bronchi in an eight-year-old girl with acute lymphoblastic leukemia of five years duration. The leukemia had been in remission for 4 1/2 years at the clinical onset of the lymphomatoid granulomatosis. Whether this occurrence suggests that lymphomatoid granulomatosis is a type of neoplasm, or is associated with immunologic depression, cannot be stated. Fortunately rare, and of poor prognosis, the disorder may become more frequent with improved survival rate of patients with leukemia and other neoplasms.


A divided mind: observations on the conscious properties of the separated hemispheres. Each cerebral hemisphere in Patient O.S., a callosum-sectioned patient, appears to possess mental properties deserving of conscious status. The observations seem to answer many questions concerning the issue of whether the mechanisms of consciousness can be split and doubled by split-brain surgery. As P.S. is the first split-brain patient clearly to possess double conscious processes as well as the first with extensive bilateral linguistic skills, the observations suggest that the special nature of human conscious experience is closely tied to linguistic processes.


Ann Otol Rhinol Laryngol [Suppl].

Ann Otol Rhinol Laryngol [Suppl]. Mandibular replacement subsequent to major extirpative head and neck surgery is predisposed to complications in the best of hands. The most suitable prosthesis appears to be the previously resected mandible, both from the standpoint of antigenicity and configuration. This study establishes that in the canine mandible a healthy, revitalized osseous network is reestablished subsequent to resection, freezing and replacement of the mandibular body when the graft is immobilized. The neoosteogenesis is borne out by in vivo (technetium 99, methylene diphosphonate scanning) and histopathological (tetracycline fluorescence and polarizing microscopy) studies. This early work in the canine suggests the potential for application in the human when the procedure is further refined and perfected.


Multiple sclerosis: diagnostic usefulness of cerebrospinal fluid. Early, atypical, or progressive cases of multiple sclerosis (MS) may be hard to diagnose. Until recently, assays of the most common abnormalities in cerebrospinal fluid were not available in clinical diagnostic laboratories, but now they can be done with relative ease and adequate standardization. With the newer techniques the CSF is abnormal in more than 90% of clinically definite cases of MS, and determination of such changes can be a major aid in diagnosis. The most common CSF abnormalities are discussed: elevation of immunoglobulin G(IgG), expressed as percentage of total protein; elevation of the IgG/albumin index; and presence of oligoclonal IgG bands. Not only does assessment of these CSF proteins provide an improved aid to diagnosis, but their study may furnish important clues to the cause and pathogenesis of MS as well.


Juvenile neuroaxonal dystrophy: clinical, electrophysiological, and neuropathological features. We describe 2 brothers with progressive myoclonus epilepsy that began in the second decade and was associated with cerebellar ataxia and intellectual deterioration. Electroencephalographic and cerebral evoked potential studies showed findings associated with myoclonus epilepsy. Neuropathological examination of 1 of the brothers, who died at age 23 years, revealed widespread changes of neuroaxonal dystrophy without pigment deposition in the basal ganglia. We propose the term juvenile neuroaxonal dystrophy (JNAD) to distinguish this condition on clinical grounds from infantile neuroaxonal dystrophy on the one hand, and on clinical and pathological grounds from Hallervorden-Spatz disease on the other hand. JNAD, while exceedinly rare, must be considered in the differential diagnosis of the progressive myoclonus epilepsies.


Local cerebral glucose utilization in the normal conscious macaque monkey. The [14C]deoxyglucose method for quantitative determination of local cerebral glucose utilization was extended to the macaque monkey. The necessary constants required by its operational equation were evaluated. The lumped constant, measured in 7 normal conscious monkeys, was found to equal 0.344 (SEM, +/- 0.036). The rate constants were also estimated and found to be very similar to those obtained previously in the rat. With these essential constants evaluated, the method was applied to normal conscious monkeys. Local cerebral glucose utilization was found to vary marked throughout the brain but to fall within two distributions, a higher one in gray matter and lower one in white matter. In general, the values fell in a range to be expected from previous measurements of average energy metabolism in the brain as a whole. The values were considerably lower than those observed previously in the conscious rat. Marked heterogeneity of rates of glucose utilization were observed in a number of anatomical structures. In some cases the patterns of heterogeneity were consistent with known histological cytoarchitecture; in others the heterogeneity did not conform with known cytoarchitectural features but corresponded to patterns previously demonstrated by electrophysiological techniques. Many of the regions of the cerebral cortex showed columnar patterns of distribution of higher and lower rates of glucose utilization. These may be a metabolic reflection of the columnar organization of function within the cerebral cortex.


Recurrent seizures induced by cortical iron injection: a model of posttraumatic epilepsy. A single injection of 5 or 10 microliters of ferrous or ferric chloride into rat or cat sensorimotor cortex resulted in chronic recurrent focal paroxysmal electroencephalographic discharges as well as behavioral convulsions and electrical seizures. Iron-filled macrophages, ferruginated neurons, and astroglical cells surrounded the focus of seizure discharge. Recurrent focal epileptiform discharges caused by cortical injection of iron salts suggests that the development of human posttraumatic epilepsy may depend, in part, on neurochemical alterations induced by the principal metallic ions found in whole blood.


A serological study among two endogamous groups of chamars. On a sample of n = 320 unrelated Kureel Chamars (Lucknow district) and n = 314 unrelated Jaiswar Chamars (Jaunpur district) ABO- and Rh(D)-typings have been carried out. The two Chamar groups occupy the lowest position in caste hierarchy. In this paper the question is examined, whether the geographical fission of the both Chamar groups, followed by isolation, has had genetical effects.


Susceptibility of the anaerobic bacteria, group D streptococci, Enterobacteriaceae, and Pseudomonas to semisynthetic penicillins: carbenicillin, piperacillin, and ticarcillin. Sodium piperacillin T-1220, a new semisynthetic penicillin, was tested in vitro against 297 clinical isolates of anaerobic bacteria and 669 aerobic bacteria by the conventional agar dilution method and compared with carbenicillin and ticarcillin. At a 100-mug/ml concentration the three drugs showed comparable effectiveness against the anaerobes tested. However, at 20 mug/ml, piperacillin was the most effective drug against Bacteroides fragilis, peptostreptococci, and group D streptococci. At this drug concentration only 48% of the B. fragilis strains exhibited susceptibility to carbenicillin only, 64% exhibited susceptibility to ticarcillin but 90% exhibited susceptibility to piperacillin. Similar findings were observed with peptostreptococci and group D streptococci. On a weight basis piperacillin was statistically shown to be the most effective antibiotic of the three tested against these anaerobes. At 20 mug/ml, piperacillin exhibited a statistically significant difference (P < 0.01) over carbenicillin and ticarcillin for Serratia marcescens, Escherichia coli, Klebsiella species, Klebsiella pneumoniae, Pseudomonas isolates, and Citrobacter diversus. At both 20- and 100-mug/ml concentrations, piperacillin appeared to be the most effective (calculated P < 0.01) upon Klebsiella species, K. pneumoniae, S. marcescens, and C. freundii in activity over ticarcillin and carbenicillin.


Antimalarial activities of WR-194,965, an alpha-amino-o-cresol derivative. Pilot appraisals of the activities of WR-194,965 and WR-204,165, two closely related o-cresol derivatives (both Mannich bases), in owl monkeys infected with the multidrug-resistant Vietnam Smith strain of Plasmodium falciparum showed that these compounds had similar levels of efficacy. Total course doses effecting 90% cures (CD(90)s) were 27 and 37 mg/kg of body weight for the respective compounds, values almost identical to the CD(90) of mefloquine (a highly promising 4-quinolinemethanol) against infections with the same strain, and the CD(90)s of chloroquine against infections with 4-aminoquinoline-susceptible strains. Expanded studies of the activities of WR-194,965 against infections with the Smith strain of P. falciparum and Vietnam Palo Alto strain of P. vivax, designed to guide projected evaluations in human volunteers, showed: (i) that the activity of this compound was a function of total dose administered, with single doses as effective as the same amount delivered in three or seven successive daily fractions; (ii) that all regimens effected rapid clearance of parasitemia; and (iii) that based on CD(90)s, this agent was twice as active against infections with the Palo Alto strain of P. vivax as against the Smith strain of P. falciparum. These findings, together with results of preclinical pharmacological studies pursued elsewhere, provided support for studies in human volunteers now underway.


Antimalarial activities of the 4-quinolinemethanols WR-184,806 and WR-226,253. WR-184,806 and WR-226,253, two 4-quinolinemethanols structurally similar to WR-142,490 (mefloquine), have been studied in depth in owl monkeys infected with various drug-resistant and drug-susceptible strains of Plasmodium falciparum and P. vivax in an effort to provide support and guidance for projected evaluations in human volunteers. The results of these studies, confirmatory of preliminary appraisals, showed that WR-184,806 was approximately one-third as active as WR-142,490 against infections with a multidrug-resistant strain of P. falciparum, whereas WR-226,253 was twice as active. Additionally, the current studies showed: (i) that both WR-184,806 and WR-226,253 were significantly more active against infections with blood schizonts of P. vivax than against those of P. falciparum; (ii) that their activities against established infections with either Plasmodium species were functions of the total doses delivered, single doses being as effective as three or seven fractional doses given on successive days; (iii) that WR-184,806 could be administered intravenously as the phosphate salt and was curative via this route in single doses; and (iv) that based on comparative curative doses, WR-184,806 was slightly more active and WR-226,253 was seven times more active against infections with a multidrug-resistant strain of P. falciparum than was chloroquine against infections with a 4-aminoquinoline-susceptible strain.


Effect of two cancer chemotherapeutic agents on the antibacterial activity of three antimicrobial agents. Cancer chemotherapeutic agents and antibacterial antibiotics are often given concomitantly. Daunorubicin, cytosine arabinoside, and three antibiotics (gentamicin, amikacin, and ticarcillin) were tested individually and in combinations to determine their antimicrobial activity against Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli. These cytotoxic agents are commonly employed in the therapy of acute nonlymphocytic leukemia for remission induction therapy, and these antimicrobial agents are used in infection therapy. The maximum concentrations of the two cytotoxic drugs were chosen to be twice the known peak plasma levels of commonly employed dosage schedules. Neither of the cancer chemotherapeutic agents, alone or in combination, demonstrated bactericidal activity at the levels tested. However, in the presence of these agents, the antimicrobial activity of gentamicin and amikacin, although not that of ticarcillin, was depressed for 11 of 15 K. pneumoniae strains and 8 of 15 P. aeruginosa strains, but for none of the strains of E. coli. This level of decreased activity occasionally resulted in a minimal inhibitory concentration of the tested aminoglycoside well above the standard serum levels. Daunorubicin was more likely to antagonize gentamicin than was cytosine arabinoside.


Effects of thiamphenicol and chloramphenicol in inhibiting Neisseria gonorrhoeae isolates. Thiamphenicol was compared with penicillin, tetracycline, and chloramphenicol for its ability to inhibit 530 isolates of Neisseria gonorrhoeae, including 13 penicillinase-producing isolates. Thiamphenicol proved to be as active as chloramphenicol in inhibiting all of the isolates.


Inhibition of beta-lactamase in Neisseria gonorrhoeae by sodium clavulanate. Sodium clavulanate at subinhibitory concentrations affected the activity of penicillin G, ampicillin, or amoxicillin on beta-lactamase-positive strains of Neisseria gonorrhoeae as demonstrated by marked reduction in the minimal inhibitory concentrations of the drugs for the organisms. The compound did not affect the activity of these penicillins on beta-lactamase-negative strains of N. gonorrhoeae. It also had no effect on the activity of cefoxitin against either beta-lactamase-negative or -positive strains. The reduction in minimal inhibitory concentrations of the penicillins for the beta-lactamase-positive organisms brought about by sodium clavulanate is probably due to inhibition of the beta-lactamase by the compound.


Further observations on the syndrome of chronic encephalitis and epilepsy. This report is a sequel to our 1958, 1960 and 1968 reports on a series of patients operated upon for focal epilepsy whose surgical specimens unexpectedly showed histological lesions typical of active encephalitis. None of these patients, now 27 in number, exhibited the clinical picture ordinarily associated with encephalitis. With one exception, all showed a severe focal seizure tendency beginning in infancy or childhood, often associated with episodes of epilepsia partialis continua. In addition, all except 2 showed slowly progressive neurological deterioration, usually hemiparesis and mental retardation, which advanced over periods of months or years before the progression became arrested. No infectious agent has yet been identified by standard viral studies carried out in the most recent 14 patients or by investigation for slow viruses in 6 patients operated upon between 1966 and 1971. The clinical course of this condition is outlined and the role, the timing and the results of treatment by craniotomy and cortical excision are discussed.


Discussion on the causes of failure of surgical treatment of partial epilepsies. Despite continuous improvement in diagnosis and surgery, persistence of seizures following surgical treatment of partial epilepsies still occurs in a relevant number of cases (30--40%). The analysis of personal material and of data from the literature appears to indicate that relevant causes of surgical failure are difficulties in delimitation of the epileptogenic zone and therefore of complete surgical removal. These difficulties are illustrated and discussed.


Anaerobic fecal bacteria of the baboon.

Anaerobic fecal bacteria of the baboon. The predominant bacterial genera of baboon feces were enumerated and identified by established procedures. The predominant genera isolated were Lactobacillus, Eubacterium, Streptococcus, and Bacteroides.


Characterization of methanol-oxidizing bacteria by their growth response to various chemicals. "Fingerprints" of strains of methanol-oxidizing bacteria were obtained by exposing them to a set of chemicals which could stimulate or inhibit the growth. The chemicals gave quantitative results, which were used to calculate the similarities between the strains. The method has been used for establishing identity or nonidentity between isolates, and its use in a search for random mutants is also outlined.


Microbial degradation of glycerol nitrates. The fate of glycerol trinitrate when exposed to microbial attack has been investigated. Contrary to some earlier reports, this compound was readily biodegraded by employing batch or continuous techniques under a variety of cultural conditions. Breakdown of glycerol trinitrate took place stepwise via the dinitrate and mononitrate isomers, with each succeeding step proceeding at a slower rate. After a residence time of 8 to 15 h, none of the glycerol nitrates could be detected in the effluent from a continuous-culture apparatus (chemostat) supplied with an influent containing 30 mg of glycerol trinitrate per liter.


Dry-heat destruction of lipopolysaccharide: dry-heat destruction kinetics. Dry-heat destruction kinetics of lipopolysaccharides from Escherichia coli, Serratia marcescens, and Salmonella typhosa at 170 to 250 degrees C are described. The destruction rate seems to follow the second order and can be linearized by the equation, log y = a + b . -10cx. Because c is the slope, 1/c = D3. Both a and b are constant at a given temperature and are linear functions of temperature. The D(3)170, D(3)190, D(3)210, D(3)230, and D(3)250 values for E. coli lipopolysaccharide are 251, 99.4, 33.3, 12.3, and 4.99 min, respectively, with a z value of 46.4 min. The D values for lipopolysaccharides from S. marcescens and S. typhosa are not significantly different from those from E. coli lipopolysaccharide.


Frequency of F116-mediated transduction of Pseudomonas aeruginosa in a freshwater environment. Transduction of Pseudomonas aeruginosa streptomycin resistance by a generalized transducing phage, F116, was shown to occur during a 10-day incubation in a flow-through environmental test chamber suspended in a freshwater reservoir. Mean F116 transduction frequencies ranged from 1.4 X 10(-5) to 8.3 X 10(-2) transductants per recipient during the in situ incubation. These transduction frequencies were comparable to transduction frequencies determined in preliminary laboratory transduction experiments. The results demonstrate the potential for naturally occurring transduction in aquatic environments and concurrent environmental and ecological ramifications.


Improved identification of methanogenic bacteria by fluorescence microscopy. Methanogenic bacteria can be tentatively identified by fluorescence microscopy. This technique was improved by carefully selecting a series of excitation and barrier filters that matched the excitation and emission spectra of some unique coenzymes viz., F420 and F350, in methanogenic bacteria.


Liver mixed function oxidases in chickens: induction by polychlorinated biphenyls and lack of induction by DDT. Microsomal hydroxylase and demethylase activities were compared in livers from White Leghorn cockerels fed polychlorinated biphenyls (PCBs) containing 21 to 68% chlorine, or p,p'-DDT. The higher chlorinated PCBs, Aroclor 1254 and 1268, were potent inducers of hepatic enzyme activity while DDT did not induce these enzymes. Aroclor 1254 was the most potent inducer because feeding 5 ppm increased liver aminopyrine demethylase activity 1.5X but did not affect liver weight. Feeding 50 and 500 ppm of Aroclor 1254 and 1268 increased liver weight and demethylase activity per mg of protein. A differential response in the two enzymes occurred. Only 500 ppm of Aroclor 1268 increased hydroxylase activity. Aroclor 1242 had no effect on liver enzyme concentration but 50 and 500 ppm of Aroclor 1242 increased liver weights and consequently increased total enzyme activity. Our data demonstrated that in the avian species DDT and PCB did not have the same effect on hepatic microsomal enzyme activity.


Abnormalities of zinc and copper during total parenteral nutrition. Changes in serum zinc and copper levels were studied in 19 tumor bearing patients undergoing parenteral nutrition (TPN) for five to 42 days. Before initiation of intravenous feeding mean serum zinc and copper concentrations were within normal limits but during TPN levels decreased significantly below those measured prior to parenteral nutrition. During TPN nitrogen, zinc, and copper intake, urinary output and serum levels were studied prospectively in nine of these patients. These nine patients exhibited positive nitrogen retention based upon urinary nitrogen excretion, but elevated urinary zinc and copper excretion and lowered serum zinc and copper concentrations. Neither blood administration nor limited oral intake was consistently able to maintain normal serum levels of zinc or copper. Zinc and copper supplementation of hyperalimentation fluids in four patients studied for five to 16 days was successful in increasing serum zinc and copper levels in only two. The data obtained suggest that patients undergoing parenteral nutrition may require supplementation of zinc and copper to prevent deficiencies of these elements.


Intimal thickening and hyperlipidemia in experimental primate vascular autografts. Intimal thickening is a significant cause of late failure of aorto-coronary vein grafts. The microscopic appearance of this thickening has some similarities to the microscopic appearance of arterial atherosclerosis, and it has been suggested that hyperlipidemia may play a role in its pathogenesis. This study examines the morphology and lipid composition of autologous vein and artery grafts in normal and hyperlipidemic rhesus monkeys. Grafts were examined six months after insertion by light and electron microscopy and tissue lipids were determined quantitatively. Intimal thickening occurred in all grafts. Specific morphological and lipid compositional features of the grafts were influenced by the type of tissue used for grafting and the presence or absence of hyperlipidemia. However, the degree of intimal thickening per se could not be related to either of these two factors. It is concluded that surgical transplantation in this model provides the most powerful stimulus for intimal thickening and any additional effect on this process by hyperlipidemia is small.


ABO and Rho(D) blood groups in IMSS population in the State of Nuevo León (estimation of simple and double incompatibility frequency in married couples and their offspring). ABO and Rho (D) blood groups were studied in  61,023 people receiving medical care at the medical units or blood banks of the Instituto Mexicano del Seguro Social in the metropolitan area in the city of Monterrey, Nuevo León, so as to determine the genetical inheritance patterns that control these blood antigens, and that were used in the stimation of ABO and Rho (D) incompatibility in married couples and in births with maternal fetal incompatibility. It was found that IMSS populations, regardless of the medical units, can be considered as part of the same one and are different to those observed in blood banks. From the married couples, 28.58 percent were found to be incompatible with ABO and 7.15 percent with Rho (D); in 2.04 percent of cases, maternal fetal incompatibility had a ratio of 15.63 percent in the ABO group and 5.60 percent in the Rho (D) group. Double incompatibility was found in 0.88 percent of cases. The importance of these facts is stressed, considered as significant data for neonatologists and for those working in maternal fetal isoimmunization clinics.


Pyruvate fermentation in light-grown cells of Rhodospirillum rubrum during adaptation to anaerobic dark conditions. Pyruvate fermentation in Rhodospirillum rubrum (strains F1, S1, and Ha) was investigated using cells precultured on different substrates anaerobically in the light and than transferred to anaerobic dark conditions. Pyruvate formate lyase was always the key enzyme in pyruvate fermentation but its activity was lower than in cells which have been precultured aerobically in darkness. The preculture substrate also had a clear influence on the pyruvate formate lyase activity. Strains F1 and S1 metabolized the produced formate further to H2 and CO2. A slight production of CO2 from pyruvate, without additional H2-production, could also be detected. It was concluded from this that under anaerobic dark conditions a pyruvate dehydrogenase was also functioning. On inhibition of pyruvate formate lyase the main part of pyruvate breakdown was taken over by pyruvate dehydrogenase. When enzyme synthesis was inhibited by chloramphenicol, propionate production in contrast to formate production was not affected. Protein synthesis was not significant during anaerobic dark culture. Bacteriochlorophyll, however, showed, after a lag phase, a clear rise.


Effects of imipramine treatment of separation-induced social disorders in rhesus monkeys. Two groups of young rhesus monkeys were subjected to repetitive peer separations, a procedure that has been shown to produce depressivelike reactions in infant monkeys. Midway through the procedure one group was treated with the antidepressant imipramine hydrochloride, the other with a saline placebo. In comparison with placebo treatment, the imipramine treatment yielded significant behavioral improvement in a form and with a time course similar to that seen when the drug is given clinically to human depressives. We discuss the implications of the findings.