Transformation of tracheal epithelium exposed in vitro to N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). Using an organ culture/cell culture system, we transformed rat tracheal epithelial cells in vitro by exposure to MNNG. Ten tracheal organ cultures per group were exposed twice (at days 3 and 6) to 0,0.001, 1.0 or 10.0 microgram MNNG/ml of medium. Following this exposure, the explants were placed on the bottom of culture dishes to initiate epithelial cell outgrowths and establish primary cultures. Each explant was replanted 8-10 times to produce multiple outgrowths. The number of primary cultures and the number of subsequently established cell lines obtained was carcinogen-dose-dependent. The average number of primary epithelial cell cultures per explant after exposure to 0, 0.001 1.0 and 10.0 microgram MNNG/ml was 1.3, 1.5, 3.3, and 4.6, respectively. The average yield of cell lines per explant in these groups was 0, 0.8, 1.3, and 2.0, respectively. It is apparent that cell lines could only be established from carcinogen-exposed epithelium. These cell lines are currently being tested for tumorigenicity in vivo. To date, of 35 cell lines tested between the 5th and 15th passages, 5 cell lines from the 10 microgram MNNG/ml group and 2 from the 1.0 microgram MNNG/ml group have produced palpable tumors upon injection into immunosuppressed recipients.


Enhancing lymphocytes in spleens of tumor-bearing mice: affinity chromatography on insolubilized histamine. Spleen cells from C57BL mice carrying the metastatic Lewis lung carcinoma (3LL) developed a transient cytotoxic response towards the tumor shortly after tumor transplantation. Later on, the cytotoxic activity was lost and enhancing lymphocytes could be demonstrated in the spleens of the tumor-bearing mice (TBM). Spleen cells that were transferred together with tumor cells into syngeneic recipients enhanced tumor growth. The enhancing activity could be eliminated by the removal of a cell population that bound to histamine/rabbit serum albumin/Sepharose (HRS). The adherent population was enriched for enhancing lymphocytes, since it enhanced tumor growth more than the unfractionated population. The non-adherent cells, on the other hand, lost their enhancing activity in vivo and were sometimes protective against tumor growth. In addition, these cells manifested in vitro cytotoxicity against tumor cells. Hence the suppression of the cytotoxic expression in TBM is, at least in part, due to suppressor lymphocytes that bind to unsolubilized histamine. These cells seem to enhance tumor growth by suppressing host reactivity. Thus the enhancing lymphocyte populations can be separated into two subpopulations, of which one is enriched while the other is depleted of suppressor cells.


Ascorbic acid prevents liver tumour production by aminopyrine and nitrite in the rat. Massive doses of vitamin C protected rats against liver tumour production by aminopyrine and sodium nitrite, but the protection against lung and kidney tumour production was not complete. The mechanism is in part due to blockage of in vivo nitrosation. Other unknown factors may operate to give the liver complete protection.


A mouse leukemia cell mutant resistant to blasticidin S. After nitrosoguanidine mutagenesis we isolated from mouse leukemia L5178Y cells a mutant cell (Bla-R) resistant to blasticidin S, an inhibitor of protein synthesis. Neither growth nor leucine incorporation into hot-acid insoluble fraction of Bla-R cell was inhibited by 5 to 20 microgram/ml blasticidin S, which almost completely blocked protein synthesis as well as growth of the parental L5178Y cells. However, other inhibitors such as fusidic acid, cycloheximide, ricin D or L-asparaginase blocked protein synthesis in Bla-R cells to the same extent as in L5178Y cells. Protein synthesis in vitro using S-30 extracts from the parental cell line L5178Y was almost completely blocked in the presence of the antibiotic, while no inhibition by blasticidin S occurred when S-30 extracts -rom Bla-R mutant cells were used. Protein synthesis assays were made by using the S100 fraction from rat liver together with ribosomes from either L5178Y cells or Bla-R cells. Blasticidin S inhibited protein synthesis when ribosomes were derived from L5178Y cells, but not from Bla-R mutant.


Solubilized TSTA and the major viral structural proteins, gp70 and p30, in the immune response to murine leukemias induced by Friend and Rauscher virus. Antigens present in gp70 and p30 purified from Rauscher virus, were tested for immunogenicity in various assays measuring the anti-tumor immune response against lymphocytic leukemias of Friend (FBL-3) or Rauscher (RBL-5) virus origin. p30 had no effect on in vitro cytotoxicity against tumor cell targets mediated by either an anti RBL-5 serum or lymphocytes from animals immunized with FBL-3 cells. gp70 had had no effect on serum-mediated cytotoxicity but used at high concentrations it inhibited cell-mediated cytotoxicity. When used to immunize mice directly against subsequent challenge with the RBL-5 and FBL-3 leukemias, p30 had no discernible effect, while gp70 afforded partial protection against RBL-5 but only at high concentrations. Cell-free preparations of tumor membranes containing negligible amounts of gp70 were antigenically superior to gp70 in both the in vitro and in vivo assays. It is concluded that antigens on these purified proteins that are also expressed on tumor cells are not major targets of the anti-tumor immune response in this system.


Influence of Mobiletten on the effect of alcohol drinking in man. First communication: Influence on the pharmacokinetics of ethanol. The interaction of the drug Mobiletten with the pharmacokinetics of ethanol was studied in 15 probands. In these experiments, the maximal ethanol concentrations in blood were found to be significantly decreased and delayed. The ethanol elimination remained unchanged. The uptake of Mobiletten resulted in a remarkable decrease of the urine volume. The quantitative determination of the ethanol content in the expired air by alcotest technique was not significantly affected.


Pharmacokinetics of Lidaprim in cases of impaired renal function. Elimination half-life times, plasma concentrations, and minimal cumulation factors are being determined resp. calculated for trimethoprime and sulfametrole (free as well as total amounts)--both combination partners of Lidaprim--in healthy volunteers and in patients with impaired renal function. There is a strong influence of renal function on the cumulation of the metabolized part of the sulfonamide, a weaker one on trimethoprime, and almost none on the free sulfonamide. On account of the sulfonamide metabolite cumulation, a reduction by half of the standard dose of Lidaprim is recommended if the creatinine clearance is below 20-30 ml/min.


Pharmacokinetics of sulfaclomide and sulfamerazine in patients with impaired renal function after first and after repeated application. At the beginning of the therapy with sulfaclomide resp. sulfamerazine elimination half-life of sulfaclomide was prolonged significantly in patients with impaired renal function (creatinine in serum greater than 2 mg/100 ml) on 119.6+/-6.9 h in comparison to control group (83.6+/-14.5 h). Half-life of sulfamerazine (23.6+/-4.1 h) did not differ from that of the control group (20.3+/-2.8 h). Renal excretion of both sulfonamides was sharply diminished. After treatment for 11 days with sulfaclomide resp. sulfamerazine in patients with impaired renal function, half-lives were prolonged to 117.3+/-6.1% resp. 119.3+/-3.9% of the initial value. In patients with impaired renal function elimination half-life of PAH as a measure of tubular function is three times that of control group. It is not statistically significantly influenced by repeated administration of the sulfonamides. In the control group there is a shortening of the PAH-half-life under the same conditions.


Biliary excretion studies with digoxin in man. In 4 patients with a T-tube the biliary excretion of digoxin was measured for 48 hours. One patient a single intravenous bolus of 0.6 mg digoxin, while the other 3 patients were on maintenance therapy with 0.4 mg digoxin/day. From the single dose a total of 8.8% and 9.2% were excreted with the bile within 24 and 36 hours respectively. During steady-state the daily excreted amount varied between 2 and 10% of the dose in the 3 patients tested. In 2 normal volunteers the effect of the intraluminal binding agent cholestyramine on the pharmacokinetics of digoxin was investigated. The cross-over experiment did not exhibit any differences in the plasma level time profiles. These results indicate that minor amounts of digoxin are excreted with the bile which could contribute only to an insignificant enterohepatic cycling.


"Intrinsic" heart rate in diabetic neuropathy. Changes of heart frequency have been studied in diabetic neuropathy by blocking autonomic innervation of the heart with atropine and propranolol (intrinsic rate). It was found that in diabetic neuropathy the initial heart rate was higher than in the controls and in non-neutropathic diabetics, but this higher frequency could not be increased any further by the administration of atropine and propranolol compared to the values registered in the other two groups.


The bio-availability of beta-acetyldigoxine alone and combined with aluminum hydroxide and magnesium hydroxide (Alucol). The bio-availability of Novodigal (beta-acetyldigoxine) alone and applied together with Alucol (aluminum hydroxide, magnesium hydroxide) was studied in six healthy probands. Bio-availability parameters were calculated from the areas under the plasma concentration curves and from the comparison of the blood levels after absorption during steady state. There was no significant difference between the bio-availability of beta-acetyldigoxine alone and that of the combination with Alucol. Thus, beta-acetyldigoxine combined with antacids of the aluminum hydroxide and magnesium hydroxide type can be applied in the same dosage as usual since no decrease of effect has to be apprehended.


[Pharmacokinetics of sulfaclomide in man under therapeutically relevant conditions]. Pharmacokinetic parameters of the long-term sulfanilamide Sulfaclomid (4-[4-aminobenzensulphonamido]2,6-dimethyl-5-chlorpyrimidine) were determined in 25 female subjects. Both the elimination half-life of Sulfaclomid in the serum and the maximum acetylation rate in the urine are genetically determined. They show a polymodal behavior. The half-life is unrelated to the protein binding, which shows considerable individual differences in the therapeutic relevant range of about 200 microgram/ml serum. This confirms the human pharmacological postulate according to pharmacokinetical dosage schedules including genetic factors. An individual therapy service is necessary in certain drugs and in highly endangered groups of patients.


The influence of alcohol on the persistent effects on human performance of the hypnotics Mandrax and Nitrazepam. Psychotropic drugs are prescribed to modify human behavior but they have persistent central sedative activity which may become a troublesome side-effect. Alcohol is known to interact with psychotropes, often to potentiate their central effects. We have previously shown that residues of some hypnotic drugs persist in the body for up to a week after a single therapeutic dose and have demonstrated that alcohol decreases the elimination rate of methaqualone even when taken 2 or 3 days after the drug. We have therefore looked at the influence of alcohol on the residual effects of Mandrax and nitrazepam on three measurements of human performance. The study was a double-blind, 3-way, cross-over study in which the following treatments were used: drug + alcohol, drug + alcohol placebo, and drug placebo + alcohol. In each case the alcohol or alcohol placebo was given 1, 2, and 3 days after the drug or placebo. The subject's kinetic visual acuity was measured 40 minutes after the alcohol had been taken. This was followed by  a Stroop test. Changes in mental state and arousal were measured by an 18-item visual analogue scale. An interaction between alcohol and Mandrax was apparent in the results obtained from the Stroop and visual analogue scale on the third day. However, no interaction with nitrazepam could be clearly demonstrated by any of the tests on any occasion. The application of these results to the "real life" situation is discussed.


Notes on experiments with drugs in psychiatry. In this paper I develop some observations on the methods used for therapeutic experiments with drugs in a psychiatric department. After a general introduction I deal with the following points. 1. The researcher confronted with the problem of intra- and inter-disciplinary collaboration. 2. The operators and the question of the choice of subjects. 3. Some aspects of the insurance and rewards in favor of the patient. 4. Remarks on the application phase. 5. Summarizing methodological proposals.


Plasma digoxin concentrations in patients with atrial fibrillation and indications for the association with other antiarrhythmic agents. The influence of practolol or verapamil on the activity of digoxin in atrial fibrillation has been studied in 16 hospitalized patients by determining plasma levels of the cardiac glycoside and its effects on the ventricular rate, before and during the association with each of the above drugs. Digoxin alone (0.25 mg/day p.o.) demonstrated a rather feeble activity, giving a satisfactory control of ventricular rate in only 3 patients. The association with low doses of practolol (50 or 100 mg twice a day p.o.) or with verapamil (80 mg three times a day p.o.) clearly improves the effects of digoxin. The action both of practolol and of verapamil is related to the pre-existing ventricular rate, the tachycardic patients being the most sensitive ones.


[The effect of pindolol on carbohydrate and fat metabolism in diabetes mellitus]. Twenty-seven diabetic patients, nine treated with insulin, nine treated with tolbutamid, and nine placed on diet, were given either pindolol or placebo 5 mg, three times daily during a 6-week period. The following 6-week period those receiving pindolol in the first 6 weeks received placebo and vice versa. Pindolol had no influence on the concentration of blood glucose, free fatty acids, triglycerides, or total cholesterol. The effect of pindolol on carbohydrate and fat metabolism appears to be of no clinical relevance in diabetic patients receiving their usual therapy.


Choice of detectors and columns for the analysis of pesticides by GLC. After introductory remarks about the importance of accuracy in current gas chromatographic methods, this manuscript offers general comments on the choice and proper use of columns and detectors. These are interspersed with illustrative examples provided by the author's own research group.


Statistical comparison of the results from six analytical chemistry laboratories of the mercury content of muscle tissue of two species of sharks. Statistical tests were carried out on the results of chemical analysis for total mercury concentrations of replicate samples of muscle tissue of school shark Galeorhinus australis (Macleay) and gummy shark Mustelus antarcticus Guenther from six independent analytical laboratories. These tests showed that one laboratory produced results 9% below the overall average of all results, another 1% below average while the other four were all 5% above average. Moreover, one laboratory had significantly lower scatter of results than the others, and the percentage scatter (standard error expressed as a percentage of the mean) in two of the laboratories tended to diminish as the magnitude of the results increased. Correction for what were concluded to be wild points indicated that the scatter for all laboratories was below 14%.


'Workload' and risk of myocardial infarction--a prospective psychosocial analysis. The study group consisted of 5187 building construction workers aged 41-61 in Greater Stockholm who had all responded to a psychosocial questionnaire and had been in full-time work without long-lasting illness episodes in the year before the study. A factor analysis of about 60 psychosocial variables was performed, and on this basis three indices were formed. The study group was followed for two years in official registers yielding information on morbidity and mortality. The 'workload' index was demonstrated to be significantly associated with subsequent risk of myocardial infarction.


Cystic fibrosis in the Netherlands.

Cystic fibrosis in the Netherlands. In the Netherlands a retrospective study of the prevalence of cystic fibrosis (CF) at birth has been performed by means of an inquiry set up among 815 medical specialists (paediatricians, lung specialists and pathologists) and by analysis of hospital admission data, death certificates and data of the national CF foundation. The study was confined to the years of birth 1961-1965. On a total of 1,239,566 live births 342 infants and children were found to have CF (1/3600). A list of all studies on the frequency of CF in Caucasian populations is presented as an appendix. A seasonal trend in the expression of the CF gene at birth (either with or without meconium ileus) was noted.


Surveillance of malformations at birth: a comparison of two record systems run in parallel. The efficiency of two national record systems for malformation monitoring has been compared. During 1973 and 1974, two such registers were run in parallel in Sweden. One is based on specific report cards which are sent in when a malformed infant is born, the other is a computerised analysis of routine birth record diagnoses. Both systems lose a similar, and significant, proportion of malformed infants. The quality of diagnosis is lower in the system of routine birth records than in the system based on specific notifications--especially in infants with multiple malformations or with reduction malformations of the limbs. The specific report system is the only one suitable for monitoring of malformations; it is also somewhat quicker than the other system.


Hospitalizations in a southern rural community: an application of the 'ecology model'. The purpose of this study is to re-examine the concepts of health services utilization presented by White and his colleagues in 'The Ecology of Medical Care'. We re-test their model in a rural population in the southern United States using longitudinal instead of cross-sectional data and find that the general principles of the 'Ecology' model do, indeed, apply to rural populations like Rougemont/Bahama. Use of this model has implications for modifying and improving the organization of the health care delivery system and for a fundamental change of emphasis in medical education.


A study of mail survey method.

A study of mail survey method. A major disadvantage of the mail survey in medical research is non-response, which may introduce bias. This study measured the effect of two simple factors on the response rate to a questionnaire concerning headache and migraine in a survey of 2,508 electors. The two factors were the class of postage and the colour of envelopes used; neither was found to have a significant effect. It was concluded that cheaper mailing methods are not likely to jeopardise response.


Epidemiology for Canadian medical students--desirable attitudes, knowledge and skills. There is increasing recognition that the concepts traditionally taught by epidemiologists are essential for all medical graduates, most of whom will be clinicians, and not just for the minority who will specialize in population-based disciplines. This paper presents the recommendations of a Canadian conference which considered objectives for teaching epidemiology to medical undergraduates. These objectives are presented as the attitudes, knowledge and skills medical students should acquire. Recommendations concentrate on what should be learned, rather than what should be taught, or who should teach it. It was the concensus that epidemiologists are responsible for assuring that basic epidemiological attitudes, knowledge and skills be acquired, though the subjects need not be taught exclusively by epidemiologists themselves.


Cardiovascular risk factors among Japanese and American telephone executives. Cardiovascular risk factors were determined among two similar groups of telephone executives in Tokyo, Japan and New York City, USA. Both historical and electrocardiographic evidence pointed to a marked excess of coronary heart disease among American executives compared with their Japanese counterparts. In keeping with this finding, the Americans ate diets higher in animal fat, were fatter, and had higher serum cholesterol values but lower triglyceride levels. Mean blood pressures were slightly higher among the Japanese, and showed a greater increase with age. Urinary sodium/creatinine ratios were much higher among the Japanese, suggesting a higher salt intake. Cigarette smoking was more common among the Japanese. A review of other comparative studies between Japanese and Americans indicated that the only risk factors uniformly consistent with the frequency of coronary heart disease in the two countries were dietary fat, obesity, and serum cholesterol.


Pseudofolliculitis barbae. 2. Treatment. Pseudofolliculitis barbae (PFB) is a minor disease affecting essentially only and almost all Negroes who shave. It results from transepidermal or transfollicular penetration by sharp incurving beard hairs. Because of a continued requirement by the U.S. Army for clean-shaven faces, a significant racial furor and hostility has been aroused, and definitive medical care has been difficult to achieve. The disease can be cured only by complete cessation of shaving but it can be adequately controlled in most patients by carefully shaving the hairs neither too close nor too long and by meticulous lifting out of penetrating hairs.


Dental health status and dental satisfaction. In order to study the relationship between a person's dental health status, as judged by a dentist, and the person's satisfaction with his total dental condition, the author examined and interviewed 398 persons in middle Sweden. A multiple logistic model was used to investigate the probability of a person being satisfied with a dental status given certain conditions. It was found that most of the persons (83 per cent) were satisfied. There were no great differences in satisfaction rates between groups with good dental conditions and groups with worse conditions. The analysis did not reveal any factor strongly associated with satisfaction. The meaning of dental well-being is discussed.


Space-time and family characteristics of meningococcal disease and haemophilus meningitis. Significant space-time clustering was found for cases of meningococcal disease. This result was entirely accounted for by the occurrence of a small number of sibling pairs, and clustering was no longer found when these were omitted from the analysis. Meningococcal disease should still be regarded as potentially communicable between siblings. However, in this region of England the current level of infectivity of the disease outside the family is low. Space-time clustering was not convincingly demonstrated for haemophilus meningitis. This emphasizes that, even with diseases of known microbial aetiology, evidence for such clustering may be difficult to obtain. Only a small number of cases of haemophilus meningitis occurred in single-child families. Cases of single-child families tended to occur in older children than the remainder. Although children under three years of age are most susceptible to haemophilus meningitis, it is likely that the organism is usually introduced into the family by an older sibling.


Quantitative relationships between cigarette smoking and chronic productive cough. A close relationship between chronic productive cough and cigarette smoking was confirmed in an epidemiological study of airways obstructive disease in Tucson. Pack-years of smoking was closely related to symptom frequency and no threshold effect was noted. This relationship was affected by age and a history of childhood respiratory disease, but not by atopy. Among present smokers males and females did not differ significantly in their smoking habit specific rates of chronic productive cough, but males appeared to lose their symptoms less regularly than females when they quit smoking after many pack-years of cigarette use. When the relationship of smoking to chronic productive cough was removed, smoking was not significantly related to other aspects of 'chronic nonspecific respiratory disease' in this analysis.


The Yugoslavia Cardiovascular Disease Study. 3. Death by cause and area. In the seven years following initial examination (1964--65) 758 deaths were observed in 11,121 Yugoslav men aged 35--62. The mortality rate was similar to that found for men in the Framingham (Massachusetts) study. However, coronary heart disease (CHD) mortality was much lower in Yugoslavia but mortality from cancer, accidents and violence and respiratory disease was much higher. The excess cancer mortality was chiefly from stomach cancer. The excess respiratory mortality was from both tuberculosis and chronic obstructive respiratory disease. Within Yugoslavia there were area differences in mortality by cause but little difference in total mortality: in Tuzla (Bosnia) there was a higher respiratory disease mortality but a lower mortality from accidents and violence than in Remetinec (Croatia). In the rural areas of the study there was a higher mortality from respiratory diseases and accidents and violence than in urban areas but a counterbalancing lower mortality from cardiovascular diseases. The low coronary death rates and high cancer of the stomach death rates in this population present an important epidemiological challenge.


Two shortened versions of the Cornell Medical Index--a new test of their validity. Two shortened versions of the Cornell Medical Index (CMI) were tested for concurrent validity using two reference groups. Sensitivity, specificity and relative liability were computed and found to be of relatively low value. The usefulness of the questionnaires for screening the emotionally disturbed was found to be affected by respondents' sociodemographic characteristics such as age and sex and, in particular, educational level and ethnicity.


Potential years of life lost between ages 1 and 70: an indicator of premature mortality for health planning. The indicator of Potential Years of Life Lost between ages 1 and 70 (PYLL) is proposed with the primary objective of ranking major causes of premature mortality. This proposal is based on a review of existing mortality indicators and indices and of the history of the concept of potential years of life lost. The method of calculation along with the corresponding rate and the age-adjusted rate are discussed and presented with applications to Canadian data and interpretation. Several methodological aspects are discussed, particularly the comparison with more sophisticated approaches based on life tables which do not appear to alter the ranking of major causes of premature death. This indicator fits well into the category of Social Indicators and can help health planners define priorities for the prevention of premature deaths. Epidemiological studies could also make use of this indicator of premature mortality. The simplicity of calculation and ease of comprehension should facilitate its use.


A competing-risk model based on the life table procedure in epidemiological studies. In this paper, a new non-parametric competing-risk model is proposed. This model takes relative susceptibility into account, and is thus free from the usual assumption of independence between competing causes of death. Another feature of the model is the adjustments of survivors and deaths as a results of the elimination of one of the causes of death in the previous time interval. The computational procedure of the model is simple and can be incorporated into the regular life table procedures.


Prediction of schistosome cercarial shedding with a physiological - time model. While making longitudinal observations on schistosome cercarial shedding, Pitchford and Visser found that there is an annual fluctuation in the minimum time for cercarial development, which is apparently related to temperature (1). Schistosome control strategy could be designed to take advantage of this fluctuation if it were predictable. Inspired by the successes of physiological time models ('heat-unit models') in predicting life-stage durations of various agricultural pests (2,3), we have developed a model of this type for the schistosomes. This model fits the data of Pitchford and Visser quite well. Coupled with recent temperature history and short term temperature forecast, it could be a useful tool for predicting the onset of cercarial shedding.


Investigating an epidemic: a seven-part simulation used in teaching. A seven-part exercise is described, based on published accounts of a school epidemic. Students have to complete each part before receiving the next: cumulative mistakes are therefore avoided. Analysis over four years shows consistent patterns of student responses. Details of statistical tests of the data are given.


The effects of denaturant and temperature on the circular dichroic spectrum of ovine lutropin-alpha. Circular dichroic (CD) spectra of the glycoprotein hormone subunit, lutropin-alpha, have been obtained under denaturing conditions (6 M guanidinium chloride, GdmCl) with the disulfides intact, reduced, and reduced and S-carboxymethylated. Above 260 nm, these spectra are similar (although not identical), showing that the disulfide chromophores do not contribute appreciably to the near ultraviolet CD spectrum under denaturing conditions. However, these spectra differ considerably from that of native lutropin-alpha over this spectral region demonstrating that the tertiary structure of lutropin-alpha has a major influence on the near ultraviolet CD spectrum. The magnitude of the 232.5 nm positive CD extremum of lutropin-alpha was found to increase with increasing GdmCl concentration and with decreasing temperature. Between 5 degrees C and 45 degrees C, the ellipticity [theta] at 232.5 nm changed in a linear fashion with temperature; at other wavelengths the thermal changes in [theta] were quite small. [theta] at 232.5 nm increased by about 80% over a 3 M GdmCl range; in contrast, [theta] at 216 nm (indicative of beta-structure) exhibited maximal changes over a 0.5 M GdmCl range. These results indicate some conformational flexibility in lutropin-alpha. The positive 232.5 nm CD extremum has been assigned to one or more tyrosyls which are influenced by an intact disulfide. The latter was demonstrated by showing that reduced and S-carboxymethylated lutropin-alpha failed to exhibit the positive extremum.


Asymmetric hydrogenation of unsaturated peptides. Eleven unsaturated peptides, containing one or two dehydro-phenylalanyl (dehydro-Phe) residues and a C-terminal L-amino acid have been hydrogenated in the presence of palladium-on-charcoal. Hydrolysis of the saturated peptides thus obtained gave optically active phenylalanine showing the occurrence of asymmetric induction during the hydrogenation. Both mono-unsaturated dipeptides and doubly unsaturated tripeptides with L-Glu, L-Leu and L-Val as chiral end-group afforded L-Phe in 40-50% optical yield. In the case of the tripeptide N-acetyl-(dehydro-Phe)-(dehydro-Tyr)-L-Glu the asymmetric induction was higher (70%) for the unsaturated residue which is farther from the chiral end-group along the peptide chain. The results are discussed on the bases of Prelog rule and the rigid dissymmetric conformation of the dehydropeptides in solution.


Conformation of polypeptide chains containing both L- and D-residues. II. Double-helical structures of poly-LD-peptides. Polypeptides with alternating L- and D-amino acid residues can take up stereo-chemically satisfactory coaxial double-helical structures, both antiparallel and parallel, which are stabilized by systematic interchain NH...O hydrogen bonds. Semiempirical energy calculations over allowed regions of conformational space have yielded the characteristics of these double-helices. There are four possible types of antiparallel double-helices - A3, A4, A5 and A6, with n, the number of LD peptide units per turn, around 2.8, 3.6, 4.5 and 5.5 respectively, while for the parallel double-helices there are two types, P3 and P4, having similar helical parameters as in A3 and A4. The hydrogen-bonding scheme restricts the pitch in all the models to the narrow range of 10.0 to 11.5 A. All these helices have large central cores whose radii increase proportionately with n. In this respect, A3 and A4 are suitable models for the structure of gramicidin A. In terms of their relative energies, antiparallel double-helices are marginally more stable than those with parallel strands. Our results indicate that the energy differences amongst the members in the antiparallel family are not significant and thus provide an explanation for the polymorphism reported for poly (gamma-benzyl-LD-glutamate).


Preparation of carboxyl-terminal tryptic peptides from proteins by cleavage at arginine. A method has been developed for selectively preparing the carboxyl-terminal tryptic peptide of proteins by cleavage at arginyl residues. The succinylated protein is digested with trypsin and the peptides produced are maleylated. Maleylated peptides are then submitted to cation-exchange chromatography in urea at low pH and ionic strength. Arginine-containing peptides are retained by the resin. The carboxyl-terminal peptide emerges unretarded and in pure form. This method has been applied to four proteins of known sequence. Yields as high as 88% have been obtained.


Studies on polypeptides. XXIV. Synthesis of the 5-17 and 1-17 peptide sequences of rat pancreatic ribonuclease. A description is given of the synthesis by fragment condensation of the peptides Glu-Ser-Ser-Ala-Asp-Lys-Phe-Lys-Arg-Gln-His-Met-Asp and Gly-Glu-Ser-Arg-Glu-Ser-Ser-Ala-Asp-Lys-Phe-Lys-Arg-Gln-His-Met-Asp respectively corresponding to the 5-17 and 1-17 amino acid sequences of rat pancreatic ribonuclease.


beta-endorphin: synthesis and morphine-like activity of analogs with D-amino acid residues in positions 1, 2, 4, and 5. The solid-phase syntheses of [D-Tyr1]-, [D-Ala2]-, [D-Phe4]- and [D-Met5]-beta c-endorphins are described. A comparison of certain methods of purification and criteria of homogeneity is made with the use of these compounds. Bioassay of these synthetic analogs both in vitro and in vivo show that [D-Ala2]-beta c-endorphin possesses significant opiate activity whereas the other analogs have minimal activity.


Conformational studies on sequential polypeptides. Part VII. Structural investigations on (Pro-Phe-Gly)n and (Phe-Pro-Gly)n. The conformational properties of (Pro-Phe-Gly)n and (Phe-Pro-Gly)n were investigated both in the solid state and in solution. In solid state X-ray diffraction patterns seem to indicate that (Pro-Phe-Gly)n assumes a single chain triple helical structure. In solution, by circular dichroism studies, it was possible to show the existence of beta-bends in the presence of ethylene glycol. Similar studies carried out on (Phe-Pro-Gly)n showed no collagen or polyproline II-like structure in the solid state. In solution the beta-bend formation was apparent in all the solvent systems studied.


Studies on the partial synthesis of protein analogs by direct coupling to terminal homoserine lactone derivatives. Experiments with basic pancreatic trypsin inhibitor. Treatment of basic pancreatic trypsin inhibitor (BPTI, I) with cyanogen bromide smoothly yields the chain cleaved derivative II. The utility of the seco-lactone (II) in the partial synthesis of protein analogues has been investigated. It is shown that the homoserine lactone ring is sufficiently reactive to combine directly with the radiolabelled synthetic peptide glycylglycylanine t-butyl ester in both aqueous and non-aqueous solution, leading to a BPTI analogue which has been purified and characterized.


Anxiety in self-confrontation: detection and measurement. This paper summarizes an attempt to measure and detect "anxiety" or "arousal" in self-confrontation in a university teaching methods training programme. Self-confrontation arousal is caused by viewing CCTV recordings of short micro-lectures. Arousal detection is important as the use of video-recordings is an important element in the training provision made for new members of the teaching staff. Using ECG detection the heart rate of staff viewing themselves teach was found to increase on initial confrontation, but to decrease as the initial cosmetic effect became more acceptable. The paper suggests that ECG detection and measurement is a suitable tool for investigating confrontation in training programmes that use CCTV recordings.


Visuoperceptual processes in brain damaged patients on the digit symbol substitution test. Alcoholic Korsakoff patients, patients with right hemisphere damage, and chronic alcoholics are impaired on the digit symbol substitution task (DSST) of the WAIS. To determine whether these deficits were related to psychomotor or visuoperceptive factors, several tasks and modifications of the DSST were administered to these three patient populations. While it was evident that psychomotor retardation contributed to the patients' poor performance, impairments in visuoperceptive processing were also found to be involved in the DSST performance of the three patient groups. It was concluded that while a psychomotor factor is the crucial variable in the performance of intact normal subjects, any of a number of visual processing variables (e.g., visual scanning, contour formation and organization) must be considered in assessing the deficits of brain damaged patients.


Electrocutaneous input-output functions: magnitude estimation and reaction time. An experiment was conducted on the effect of electrocutaneous stimuli on the generation of two types of input-output functions, and their relationship to each other. The data indicate that increasing electrocutaneous stimulus intensity results in a monotonic growth of magnitude estimation and a negatively decelerating decrease in reaction time. Reaction time approaches an asymptote at high intensities. The dynamic range of reaction time (RT), i.e., the RT which decreases as a function of increases in intensity was subtracted from the asymptotic reaction time (RTmin) for the subsequent analyses. The two-parameter power function provides a better fit for magnitude estimation as well as for RT--RTmin as a function of stimulus intensity than either a two-parameter linear or log-linear equation. When RT--RTmin is plotted as a function of magnitude estimation on a log-log scale, the data are within 4% of the predicted linear equation with a slope of --1, with no significant nonlinear components. If these data are plotted on a linear-linear scale, the linear coefficient is 31% steeper than --1, and a significant nonlinear component is present.


Surgical problems in primary sclerosing cholangitis. The characteristics of primary sclerosing cholangitis are a diffuse inflammation with fibrous thickening and narrowing of the biliary ducts. All patients who have stones or have been operated on for biliary disease (risk of traumatic stenosis) must be excluded in discussions of this disease. Two observations illustrating the strict definition of its characteristics are related. From attacks of angiocholitis, the disease generally progresses to a permanent jaundice. Death occurs in a state of biliary cirrhosis. Liver histopathologic changes consist of fibrous rings constricting the segmentary interlobular ducts. Physiopathologic changes of the disease are difficult to define precisely except in cases with coexistent ulcerative colitis (1/3 of cases). The diagnosis is difficult. Illustrative examples are presented: A syndrome of stenosis in a patient in whom no stones were found during the operation but the lesions were typical of the passage of stones. The prognosis was good. One patient seemed rather typical but the rapid evolution and finally a finding of carcinomatous tissue led to the diagnosis of cancer of the biliary duct. One patient had cirrhosis with extrahepatic stenosis. Histologic studies, cholangiolitis and obstructive pericholangiolitis indicated the correct diagnosis. The disease is usually fatal within four years of onset despite administration of corticoids locally and systemically.


Projection of the triangle of auscultation on the human pulmonary surface. The projection of the triangle of auscultation on the posterior aspect of the pleuropulmonary surface was studied in 36 embalmed cadavers (19 males and 17 females). A total of 58 observations was made in 22 cadavers bilaterally and in 14 unilaterally, after introducing a long pin at each angle of the dissected triangle of auscultation deep into the pulmonary parenchyma. The projection of the triangle of auscultation, limited by the m. latissimus dorsi, m. trapezius and the medial margin of the scapula, was always found on the inferior lobe of the corresponding lung in one or more segments. It was found on the superior segment of the inferior lobe (43.1% isolatedly; 67.2% with other segments), the posterior basal segment (13.8% isolatedly; 43.1% with other segments) and on the lateral basal segment (10.3% isolatedly; 39.7% with other segments). Identical bilateral projections occurred in 50% of the cases.


Esophageal signs after resection of the gastroesophageal junction: endoscopic follow-up study. A follow-up examination was performed on 15 patients who had undergone esophagogastric resection or total gastrectomy for cancer an average of ten years earlier. Endoscopy was done in each case. None of the patients who had the esophagogastrostomy high in the esophagus had esophagitis. The diameter of the esophagogastrostomy appeared to have no direct effect on the patient's dysphagia if he adhered to his customary eating habits. Patients with postgastrectomy Roux-en-Y esophagojejunostomy had no dysphagia or esophagitis and mastication was no problem during eating.


Ultrasonic diagnosis in a case of hydronephrosis. A case of hydroneophrosis is reported in which the diagnosis has been confirmed on the ground of renal echography. The physical principles of the method are outlined. Its expediency, safety and efficiency are emphasized. It is considered the most reliable diagnostic procedure if hydronephrosis is suspected in case of renal occlusion.


The prognosis in carcinoma of the prostate, judged on the basis of clinical classification into stages and histological grading. On the basis of a retrospective study of 61 cases of carcinoma of the prostate, it is attempted to evaluate the prognosis, either by way of a clinical classification into stages or by histological grading. Both types showed a clear-cut correlation with the prognosis. Collation of the clinical classification into stages and the histological grading of the lesions in 33 patients showed that the two methods represented two unrelated types of classification.


Pericardioperitoneal shunt for massive recurrent pericardial effusion in patients with endomyocardial fibrosis. Massive recurrent pericardial effusion in patients with endomyocardial fibrosis presents a therapeutic challenge. Repeated pericardiocentesis and creation of a pericardial window is associated with significant morbidity and mortality in these critically ill patients. A new pericardioperitoneal shunt using a Holter valve and Harris catheter has been devised to solve some of these problems.


How is renal carcinoma detected?

How is renal carcinoma detected? The primary symptoms and signs, indicating urography, in 369 patients with renal carcinoma have been reviewed. Gross haematuria was noted in 33%, signs of malignancy in 20% and in 13% metastases were first diagnosed. In 15% the renal tumor was an incidental finding at urography performed because of prostatism, cystopyelitis, hypertension and prostatic carcinoma. It is concluded that every urography must have such a high quality as to be able to evaluate the entire urinary system in all patients, as a renal carcinoma may be found at urography in any patient above the age of 30 years.


Pattern of tumors of the male genitalia in Zambia. Tumors of the prostate, penis and testis respectively formed 3.5% and 0.5% of all male cancers. These findings are compared with those of various studies and some possible etiologic factors are discussed.


Unusual extraperitoneal lesion of the pelvis: cloacal cyst with transitional cell carcinoma. An unusual cystic tumor of retrovesical space was reported. After puzzling speculation on its histogenesis this extremely rare tumor was concluded to be a cloacal cyst with transitional cell carcinoma. Review of the literature revealed no similar case.


Pathology of malignant tumors of the nose and throat and their relationship to lymphatic metastasis. One hundred cases of malignant tumors of the larynx, pharynx, oral cavity, nose and paranasal sinuses were studied. The hypopharynx was the most frequent site and the most common type of tumor was squamous cell carcinoma. Lymph nodes were palpable in 59% of cases, of which 72.8% showed histological evidence of metastasis. The highest incidence of metastasis was found in nasopharyngeal growths and the lowest in the nose and the sinuses. In laryngeal tumors the site of the tumor was the most important factor influencing regional lymphatic metastasis. The grade of the tumor influenced the lymph node metastasis in the regions of the hypopharynx, tonsil and base of tongue. At other sites the differentiation of the tumor did not seem to have any correlation with the incidence of metastasis.


Buschke-Loewenstein tumour of the penis. Three cases of Buschke-Loewenstein tumour are reported. The clinical features of the process are described, its therapeutic aspects are outlined, the diagnostic problems involved by its microscopic structure are discussed. The features of the first case were typical of the process. The intermediate form between the Buschke-Loewenstein tumour and squamous cell carcinoma was exemplified by the second case. The small size of the tumour in the third case was compatible with an organ-saving surgical intervention.


The effect of electrophoretic lignocaine blockade in the region of the carotid sinuses on spontaneous and water diuresis. The effect of electrophoretic lignocaine blockade in the region of the carotid sinuses on changes in the intensity of spontaneous and water diuresis was investigated on anaesthetized dogs. After the blockade a reduction in spontaneous diuresis was observed and a marked and statistically significant restriction of water diuresis was noted as compared with the control experiments. The reduction in diuresis after the blockade was of a brief duration and did not appear to be related to changes in the intensity of the filtration through the kidneys, which was only slightly lower, but to changes in reabsorption. In all probability, the carotid blockade is connected with a dominance of hormonal effects by elimination of the effect of the nervi vagi, osmoreceptors of the carotid arteries and in particular the chemoreceptors of the carotid body.


Hereditary nephritis and the heart.

Hereditary nephritis and the heart. Eleven cases of hereditary nephritis were studied for cardiac abnormalities by means of ECG and BCG. With the exception of two cases no significant abnormalities were demonstrable, which indicates that this genetically transmitted process generally leaves the heart unaffected. It is thus to be expected that intermittent haemodialysis, as far as the heart is concerned, will be well tolerated by these patients.


Role of bilateral nephrectomy in the treatment of renal disease and hypertension. The case summaries of 13 patients who were bilaterally nephrectomized for treatment of various renal diseases and hypertension are described. The present concept concerning the role of bilateral nephrectomy in the treatment of renal disease and hypertension is discussed.


Effect of indomethacin on renal function in anaesthetized dogs. The inhibitory action of indomethacin administered as a single-dose injection (4mg/kg) was examined under general anaesthesia in dogs, moderate volume expansion having been induced with physiological saline infusion. At 20 to 30 min after the administration of indomethacin, excretion of Na and water showed a fall of the same extent, GFR remaining stable and the effective plasma flow (CPAH) declining. RBF estimated by the 86Rb method decreased from 411 +/- 96 ml/min/100 g to 292 +/- 53 ml/min/100 g (p less than 0.01). This fall was coupled with an intrarenal redistribution of blood flow. While the cortical fraction of renal blood flow increased from 79% to 83.9% (p less than 0.001), its outer medullary fraction decreased from 17% to 13.2% (p less than 0.001) and its inner medullary fraction from 4.0% to 2.8% (p less than 0.05). The renal, primarily the medullary, vasculature is assumed on these grounds to be under the influence of a continuous secretion of prostaglandins which thus seem to be involved in the physiological control of intrarenal distribution of blood flow and of sodium and water excretion.


Mianserin in the prophylactic treatment of bipolar affective illness. Mianserin in a dosage of 20 mg 3 times daily, was given to 13 patients with bipolar affective illness, who were previously maintained on lithium. 3 patients left the trial at their own request within a few days due to drowsiness in 2 cases and insomnia in the third. Of the remaining 10 patients, 6 became manic within the 3-month trial period. This result indicates that mianserin may be capable of precipitating mania in susceptible subjects with bipolar affective illness. This may be a general property of antidepressants, since it has been previously described with other groups of antidepressants.


Scanning electron microscopy of corneal wound healing in the rabbit. Corneal lesions 7.5 mm. in diameter were made with an ocular trephine in rabbits. The time periods studied were 0, 30 min., and 1, 2, 4, 8, 16, and 24 hr. At the end of the time period, the cornea was flooded with 4% glutaraldehyde, buffered with cacodylate, pH 7.4, and kept moist until removed. It was then fixed for 24 hr. Half of the sample was dehydrated in graded alcohols, critical-point-dried, coated with gold palladium alloy, and viewed in an AMR-1000 scanning electron microscope at an accelerating voltage of 20 kv. From 0 to 4 hr. cell trauma, debris, and retraction are seen at the margin of the lesion. From 8 to 24 hr. a significant number of polymorphonuclear leukocytes are present over the total surface but in especially large numbers at the wound margin. At 16 to 24 hr. evidence of cell movement is present. Cells show ruffling membranes a decreased number of microvilli, and a few filopodia along the advancing edge.


The effects of hibernation on cone visual cells in the ground squirrel. The cone visual cells of active, hibernating, and aroused 13-line ground squirrels have been studied by microscopy and autoradiography. Major changes occur throughout the cells during hibernation. The outer segments are shortened, and the diameters of the membranous discs may be reduced. Mitochondria are diminished in size and number, ribosomes are depleted, and the Golgi complex is fragmented into vesicles. Calycal processes are thickened, and synaptic ribbons become aggregated ectopically within the synaptic body. When hibernation is terminated, the cells recover rapidly. First, the basic synthetic machinery (mitochondria, ribosomes, Golgi complex) is regenerated,, and then the outer segments are repaired. This process is completed within 1 week. Many of the structural changes observed during hibernation are interpreted as effects of a temporary metabolic imbalance in which degradative mechanisms, including autophagy, are emphasized. In contrast, recovery is achieved by a comparable imbalance in which there is a transient accentuation of formative mechanisms. The recovered cells thereafter maintain a steady state of continuous self-renewal, in which formation and degradation are in balance.


Evaluation of an electronic corneal pachometer. Sixteen patients who had never worn contact lenses underwent measurement of their central corneal thicknesses with the standard corneal pachometer and a new electronic corneal pachometer. Both instruments were able to produce repeatable and accurate results, although the overall measurements obtained were thicker with the electronic pachometer. The advantage of the electronic pachometer over the standard pachometer is that one is able to easily measure areas other than the central cornea with repeatable accuracy. With the addition of a microcomputer and print-out system, large populations can be studied, and changes in corneal thickness can be recorded on a day-to-day or hour-to-hour basis.


Basophils in vernal conjunctivitis in humans: an electron microscopic study. The histopathological changes of vernal conjunctivitis comprise stromal infiltration by lymphocytes, plasma cells, and neutrophilic, eosinophilic, and basophilic leukocytes and epithelial invasion by mast cells and eosinophils. Blood vessels show swelling and death of endothelial cells and increased permeability with associated extravasation of erythrocytes and fibrin. The presence of basophils in ocular tissue has not been reported previously, and their occurrence in conjunction with the other pathological changes enables vernal conjunctivitis to be compared with, and classified as a manifestation of, delayed-type hypersensitivity of the cutaneous basophil type. Thus the mechanism is probably a mixture of both delayed and immediate immunological responses.


The ultrastructure of human limbal collagen. In human limbal tissue from four glaucomatous and four nonglaucomatous eyes, the average collagen fibril diameter in the inner and outer layers was 100.86 and 115.33 nm., respectively. In both layers the fibrils occupied an average of two thirds of the total area The possible implications of this observation in the trabeculectomy procedure are discussed.


The permeability of the outer layers of limbus and anterior sclera. An in vitro study suggests that flow through the scleral flap of a trabeculectomy procedure can significantly increase outflow. It also suggests that this flow may be through vessels in the flap or through the ground substance of the flap.


Histopathological study of canine optic nerve retina treated by organophosphate pesticide. The fine structure of pathological changes was examined in the optic nerve and retina of beagle dogs after oral administration by capsule of the organophosphate pesticide ethylthiometon for 2 years. The optic nerve was invariably affected, and the number of myelinated axons markedly reduced. These were substituted for by delicate processes of astrocytes. Changes in the retina were mild and mainly seen in the peripapillary pigment epithelial cells and in the Müller cells of the peripheral retina. These histopathologic findings indicate that long-term administration of ethylthiometon involved both the optic nerce and selected portions of the retina.


Biochemical and biophysical properties of hepatitis B core particles derived from Dane particles and infected hepatocytes. Hepatitis B core antigen (HBcAg) was purified from Dane particles and from infected hepatocytes. An identical isoelectric pH of 4.0 was determined for labeled preparations of both Dane-derived and liver-derived HBcAg. Unlabeled liver-derived HBcAg demonstrated a lower isoelectric pH of 3.7. Molecular weight determinations by Sepharose 4B column chromatogrpahy revealed that liver-derived HBcAg had a molecular weight of 8.5-9.0 X 10(6) daltons. The sedimentation coeficient of both Dane- and liver-derived HBcAg was found to be 124S. PAGE revealed that iodinated HBcAg derived from Dane particles was very similar in polypeptide structure to HBcAg derived from infected liver tissue. Twelve polypeptides were resolved from Dane core particles, and seven to nine were resolved from liver core particles. Several of the polypeptides in both preparations co-migrated with iodinated hepatitis B surface antigen (HBsAg). However, three polypeptides (mol. wt. 88,000, 79,000 and 59,000) were found in both Dane- and liver-derived HBcAg but not in HBsAg, which suggests that these polypeptides are HBcAg-specific. Endogenous DNA polymerase activity was observed in both Dane- and liver-derived core particles.


[Extracrural manifestation of necrobiosis lipoidica. Isolated involvement of the head]. Necrobiosis lipoidica confined to the face and scalp is very rare. The clinical diagnosis is complicated by the granuloma anulare like aspect and in particular by the lack of typical localization of the extremities. Histologically prominent granulomatous dermal proliferation and less marked vascular changes can often be found in the involved areas of the scalp and/or in the absence of diabetes mellitus. For the microscopic classification the large variability of necrobiosis lipoidica must be considered. In our case with an exclusive localization in the face and capillitium, diabetes mellitus was excluded. The necrobiotic type of the necrobiosis lipoidica was predominant. The identity between necrobiosis lipoidica with other chronic granulomatous diseases and the possible treatment of this benign but long-term process is briefly discussed.


[Pathomorphology and therapy of hemorrhoids]. The newest investigations about the morphology and pathomorphology of the corpus cavernosum recti are given. The importance of the m. canalis ani and of the hitherto unknown transsphincteric course of the blood reflux from the arterially supplied corpus cavernosum for the pathogenesis of the hemorrhoidal disease as the adequate therapy are delineated.


[Granuloma multiforme].

[Granuloma multiforme]. A case of granuloma multiforme is reported. Granuloma multiforme has been seen so far only in blacks from Nigeria or East Africa. The disease does not affect children and adolescents. Common sites of infection are arms, chest, back, neck, and head. The differential diagnosis is tuberculoid leprosy and granuloma anulare. Granuloma multiforme also shows similarity to that of granuloma anulare or, if more of a tuberculoid nature, to that of sarcoidosis or that of granulomatosis disciformis chronica et progressiva Miescher. The etiology of granuloma multiforme is unknown. It may respond to intralesional corticosteroid therapy or show involution following a diagnostic biopsy. In the reported case response to intralesional corticosteroid suspension and topical application of dimethyldiphenylendisulfide was very satisfactory.


Forces and issues in the revival of interest in self-care: impetus for redirection in health. Most health and medical care is provided by families and individuals to themselves. Self-care has become a salient public issue because of the emergence of chronic diseases as leading causes of death and disability; a new awareness of the limitations of conventional medical care; and social changes which emphasize greater personal control. Challenges arise in definition of professional roles in relation to organized self-care efforts, economic implications, and development of appropriate social policies. A negative potential exists for exploitation by interests which would limit movements for more equitable and higher quality health services, but should not obscure the positive potential for a strengthened partnership in health between the lay and professional worlds.


Self-care in urban settings.

Self-care in urban settings. A variety of indicators favors the development of self-care systems for inner-city populations. This cannot be conceived as an isolated individual or a family enterprise. To be effective, self-care must be a community concept. This type of system requires (1) an information base; (2)an organized method of dissemination in a community; (3) support structures; and (4) an evaluation sybsystem. A community-oriented system would be an alternative and a complement to formal health services; individuals and families would manage common health problems, but would have ready access to formal services through community organizations. Links must also be provided between personal self-care and other forms of community development.


Family and self-help education in isolated rural communities. Family and self-help education courses were developed to promote better personal health through more appropriate utilization of health services in underserved rural areas. Instructional target areas were health problems of young children and the elderly and emergency situations. Objectives and evaluation criteria were formulated after consultation with representatives of participating communities and expert advisors. Community advisory committees were identified or created to supervise program development and implementation. Local instructors were utilized and developed specific course content. An evaluation of one course showed that knowledge and decision-making skills significantly improved for participants.


The cyanogen bromide and maleyl peptides of the alpha and beta chains of human hemoglobin. Procedures are described for the preparation of cyanogen bromide and maleyl peptides of the alpha and beta chains of human hemoglobin. These relatively large peptides have facilitated application of automated sequencing techniques to determine mutations in the primary structure of abnormal hemoglobins.


Hemoglobin Pyrgos (beta83 Gly replaced by Asp) in a Japanese family. A screening survey for abnormal hemoglobins at a hospital in Mizunami city, Gifu prefecture, Japan detected a fast-moving variant of hemoglobin in a family of Japanese origin. The abnormal hemoglobin constitutes about 45 percent of the total hemoglobin from the propositus and another carrier in the family, but neither of these persons had anemia, jaundice, cyanosis or splenomegaly. Structural analysis of this hemoglobin revealed that the amino acid substitution was at residue 83 in the beta chain, where a glycine was replaced by an aspartic acid. This hemoglobin variant has been previously reported in a Greek child (hemoglobin Pyrgos) (1). Oxygen affinity of hemoglobin Pyrgos was found to be normal.


Hemoglobin F Koelliker (alpha2 minus 141 (HC 3) Arg gamma2); a modification of fetal hemoglobin. An electrophoretically HbA-like hemoglobin component is produced in increasing amounts during storage in hemolysate preparations from macerated tissue (liver, kidney, spleen) of fetuses. Within twenty four hours after hemolysate preparation the "fast moving" fraction increases up to 40 per cent of total hemoglobin, while the concentration of HbA remains constant (5 - 7%) in hemolysates obtained from peripheral blood of the same donor individuals. By structural studies (fingerprint and aminoacid analysis) the HbA-like component was identified as an artefact of HbF, characterized by the absence of the C-terminal arginine of the alpha chains. From experimental data it is concluded, that the break down product results from a digestion of HbF by carboxypeptidase B, the enzyme being released from the macerated tissues. Analogous to a modification of HbA, i.e. Hb Koelliker (alpha2 minus 141 Arg beta2), the structure of the degradation product of HbF is alpha2 minus 141 Arg gamma2 (HbF Koelliker).


On the birth of an infant with sickle cell anemia. This is the first report in the English literature of the birth of an obligate SS infant whose parents both had sickle cell anemia. The young adult SS parents of this infant and their families did not wish to prevent the birth of this child but had, in fact, many positive reasons to continue the pregnancy to term even in the face of the increased personal risk of pregnancy for this mother. This unusual circumstance initiated a re-appraisal of the realistic expectations with respect to reproduction in patients with homozygous recessive genetic disorders. No definitive studies could be found which attempted to evaluate the influence of genetic counseling on reproductive behavior in patients with sickle cell anemia. The questions raised about the 'right to reproduce' and the realistic aims of genetic counseling in adult homozygote patients have been discussed. However, no conclusions seem warranted because of the paucity of available information.


Hemoglobin Arlington Park. A new hemoglobin variant with two amino acid substitutions in the beta chain. Hemoglobin Arlington Park was detected accidentally as result of the use of a hemolysate which contained hemoglobin with normal electrophoretic mobility as a control for peptide mapping. Peptide maps of this hemolysate revealed 3 new peptides resulting from 2 amino acid substitutions to give to new variant with the composition (beta6 Glu replaced by Lys, 95 Lys replaced by Glu).


Structure in relation to behavior of mutant hemoglobins in citrate agar electrophoresis. The comparative mobilities, in citrate agar electrophoresis, of 91 mutant hemoglobins are presented in relation to their molecular structure and in some cases, to their mobilities in other types of electrophoresis. More than a third of the alpha chain mutants (11 of the 27 examined) and half of the beta chain mutants (29 of 55) differ to some extent from Hb A. The helical location of the substituted residue is an important determinant of hemoglobin mobility, which is also affected by a complex interplay of other factors. When the data are combined with those of several other types of electrophoresis, they often provide presumptive (or in some cases highly specific) identifications of mutant hemoglobins and hemoglobinopathies.


Hemoglobin Karatsu: beta 120 (GH 3) lysine leads to asparagine, an example of HB Riyadh in Japan. Hemoglobin Karatsu was discovered in a Japanese male during a random survey of patients. Fingerprints of aminoethylated beta chain revealed an abnormal beta Tp12B-13 spot. Further chemical analyses and comparison with the corresponding tryptic peptide from Hb Hijiyama demonstrated an identical amino acid substitution with Hb Riyadh.


Hemoglobin Mizuho or beta 68 (E 12) leucine leads to proline, a new unstable variant associated with severe hemolytic anemia. A hitherto undescribed, unstable hemoglobin was discovered in a four-year-old Japanese girl with relatively severe hemolytic anemia requiring monthly blood transfusion. Although no abnormal hemoglobin was detectable by electrophoresis at pH 8.6 and 7.0, heat denaturation and isopropanol tests gave positive results. Chemical analyses of the heat labile hemoglobin have demonstrated an amino acid substitution of a prolyl for the leucyl residue at the beta 68th (E 12) position.  Remarkable clinical improvement was observed after splenectomy.


Properties of the double substituted hemoglobin C Ziguinchor alpha2A beta 2 6 Glu replaced by Val 58 Pro replaced by Arg. We have previously described the structural identification of the sickle hemoglobin variant Hb C Ziguinchor (alpha2A beta2 6 Glu replaced by Val, 58 Pro replaced by Arg). This hemoglobin was found in two generations (three members) of an African family. In two family members, the clinical picture resembled that typical of a sickle cell trait, while the third member showed a more extreme clinical condition due to complication by an iron deficiency anemia. The functional properties of Hb C Zig. in red blood cells or in dilute solutions were identical to those of Hb S. The gelling behaviour of deoxy Hb C Zig. was also indistinguishable from that of Hb S. These findings suggest that, in contrast to the case of Hb C Harlem, the second substitution in position beta58 in Hb C Zig. does not interfere with the intermolecular interactions determined by the sickle substitution.


The histochemistry of galactose residues of complex carbohydrates as studied by peroxidase-labeled Ricinus communis agglutinin. A peroxidase-labeled Ricinus communis agglutinin diaminobenzidine (PO-RCA-DAB) procedure has been utilized to determine the light microscopic localization of galactose residues of complex carbohydrates in a variety of tissues from different vertebrate species. In the same tissues, the localization of mannose and glucose residues was studied by means of a concanavalin A peroxidase diaminobenzidine (Con A-PO-DAB) procedure for comparison. The distribution pattern of galactose residues was found to be in distinct contrast with that of mannose and glucose residues in connective and epithelial tissues such as those involved in the umbilical cord, cartilage, aorta, comb, thyroid gland, submaxillary gland, duodenum, jejunum, colon and gill of various vertebrates. The results of the present study indicate that the PO-RCA-DAB procedure is useful in providing a means of dividing periodic acid-Schiff reactive neutral complex carbohydrates into subgroups in comparison with the intensity of their Con A-PO-DAB reaction in the histochemistry of complex carbohydrates.


[Cytochemical study of intestinal endocrine cells in rabbit fetuses during in vitro induced degeneration and differentiation (author's transl)]. Ontogenic differentiation of intestinal serotonin cells of 22 days old rabbit fetuses were studied in vitro. After 3 days of organotypic cultivation in solid medium, a great part of epithelial cells became necrotic and were eliminated into the lumen while a first flattened, then cuboïdal, then prismatic new growed epithelium in which FIF indicated some serotonin cells was present. Comparison of pictures obtained on the same slide by different methods was used in order to estimate correspondances between amine storage, argentaffin, argyrophilic and reductive properties. A new phase in serotonin cell differentiation was readily distinguished since young cells successively yeilded FIF, later argyrophilia, later argentaffinity. These datas, at variance with that occurs in vivo where FIF and argyrophilia appeared simultaneously, give a new criteria for differential mechanism studies, disprove the theory of an amine induced argyrophilia and enhance the hypothesis of a hyaloplasmic amine storage in very young cells.


An ultrastructural study of osmiophilia in normal human oesophageal epithelium. Oesophageal biopsies were obtained from patients with normal oesophagi during fibre-optic endoscopy for upper gastro-intestinal symptoms. They were studied with the prolonged osmication technique. The forming face of the Golgi apparatus was demonstrated in the basal and lower prickle cells. These cells also showed osmium deposition in their mitochondria, endoplasmic reticulum, perinuclear cisternae and lysosomes. The capillary endothelial cells also showed osmium deposition in their Golgi apparatus and endoplasmic reticulum.


[Direct laryngotracheobraonchoscopy (author's transl)]. The place of direct laryngotracheobronchoscopy since its introduction 80 years ago, and the necessary anaesthetic methods, lighting systems, magnification and recent use of flexible fibreoptic bronchoscopes are discussed and appraised. Its further development is dependent upon that of modern optical instruments, whilst the basic principles of its use diagnostically and therapeutically remain little changed.


[The painflu stiff shoulder following radical neck dissection (author's transl)]. 72 patients following radical neck dissection were studied. The accessory nerve was sacrificed in 60 patients and preserved in the remaining patients (for a control group). The most important clinical findings in all patients are reported. Most patients with loss of the accessory nerve complained more of postoperative pain and limitation of shoulder movement than of other clinical difficulties or cosmetic defects.


[A contribution on the manifestations of wegener's granulomatosis (author's transl)]. To facilitate the clinical understanding of Wegener's granulomatosis, the morphological changes involved are discussed. Such changes may be found in the entire respiratory tract or may be limited to either the upper or the lower respiratory tract with varying severity. When confronted with the nasopharyngeal course of the disease, the ENT specialist should realize that nasal and pulmonary variants can coexist. Classifications such as Granuloma gangraenescens, lethal midline granuloma or midline granuloma stress localized processes and fail to associate possible pulmonary involvement or manifestation in other organs. Such descriptions are therefore unsuitable for an understanding of the disease.


[An index for paresis and defective healing--an easily applied method for objectively determining therapeutic results in facial paresis (author's transl)]. Residuals of facial paralysis consist of a great variety of cosmetic and functional anomalies which differ in quality and/or quantity. An internationally standardized evaluation of such defects is mandatory for the assessment of the results of different therapeutic procedures. In the present study, a system has been developed to record the results of facial paralysis following therapy. Such a system does not require specialized training, instrumentation or require significant time for completion. A clearly-defined "Yes-No" evaluation criteria is established which creates a high interscorer reliability. The usefulness of this scoring system was tested by three examiners on 42 patients following facial nerve surgery, with an obtained interscorer reliability of 93%.


[The diagnostic value of the Stepping Test of Unterberger (author's transl)]. Of the vestibulo-spinal reactions, the "stepping test" is considered to be the most important, especially for unilateral peripheral vestibular disturbances. Electronystagmography was performed on seven patients after transtemporal neurectomy of the vestibular nerve, 17 patients with a nearly compensated vesitbular defect after vestibular neuronitis, and seven patients after suboccipital removal of acoustic neuromas. These results were then compared to the spontaneous stepping test. The test could not be performed on six of the seven patients with the operated acoustic neuroma, and on three other patients. The test was positive in only ten of the other 22 patients. It was incorrect in five patients and equivocal in seven. A reliable spontaneous vestibulo-spinal reaction with nearly compensated peripheral vestibular defects could not be determined during the present study.


[Laryngeal mucosal changes experimentally produced by endogenous and exogenous factors in mice (author's transl)]. Experimentally an attempt was made to demonstrate the effects of exogenous factors on the hormonally altered laryngeal mucosa of mice. Albany mice were divided into 4 groups of 8. In the first group of males, testosterone was injected daily; in the second group of males, no testosterone was given; in the third group of females with previously removed ovaries, testosterone was given daily; and, in the fourth group of females, no testosterone was given. All 4 groups were exposed to cigarette smoke for one hour daily for six weeks. Histopathological examination of the mucosa showed that the larynx can be considered a "target" organ for male hormones and that exogenous factors produce changes that lead to malignancy.


[Facial palsy in benign tumours of the parotid gland (author's transl)]. Facial paralysis caused by benign parotid gland disease in 2 patients is reported. In one patient there was an acute parotid inflammation and a parotid cyst, to the medial wall of which the facial nerve was adherent. In the other patient the paralysis was assumed due to the toxic effects of a necrotizing lymph node, which was adherent to the nerve.


[Chiropractic management of the cervical syndrome in oto-rhino-laryngology (author's transl)]. The pathogenesis of the cervical syndrome as seen in the speciality of Oto-rhino-laryngology is explained, and the possibility for its successful treatment through chiropractic medicine is described.


[Transconioscopy of the larynx--10 years' experience (author's transl)]. Transconioscopy is an additional aid to the diagnosis, localization and functional consequences of laryngeal lesions. This endoscopic examination is especially relevant to management. The technique is described and the findings in a large number of cases are demonstrated.


[Endoscopic surgery in bilateral vocal cord paralysis (author's transl)]. The surgical treatments of bilateral vocal cord paralysis are briefly described, and the various endoscopic excisions of the arytenoid are presented. For this latter surgery careful preoperative assessment is necessary. Problems related to the optimal time for surgery and to the surgical technique itself are discussed.


[A new surgical orientation to the internal auditory canal (author's transl)]. The transtemporal extradural approach to the internal auditory canal is made easier by use of certain definite landmarks. These, which are novel, can be demonstrated with the use of a newly developed instrument that is attached to the dura retractor.


[Applied phoniatry. VI. The dysarthria and aphasia syndromes as a result of cranial nerve palsies (author's transl)]. Dysarthria and aphasia represent primary symptoms of cerebral nerve dysfunction, and may particularly involve the facial and the hypoglossal nerves. In order for management to be effective, careful examination of the muscular functions of the oral cavity is required, with particular emphasis placed on the movements of the tongue and velum. Such evaluation, which utilizes both neuropsychologic and linguistic determinations, permit an accurate differentiation of the possible causes of aphasia to be made. During the evaluation, both verbal and non-verbal responses by the patient are included for proper diagnosis and therapy. Of great value in obtaining an accurate differential diagnosis is the exclusion of disturbances of hearing or buccofacial apraxia.


[Psychological tasks in phoniatry (author's transl)]. Multidiscipline roles in diagnostics and therapy of speech and voice disorders of childhood are practised by the otorhinolaryngologist, the psychologist and the logopedist. The psychologist in the phoniatric practise had additional tasks which include preparing the patient for the examination, consultation and prevention. As a contribution to the differential diagnosis, psychological examination of a patient's intelligence and the level of his learned vocabulary are necessary. The psychodiagnostics of cerebral dysfunctions are of great importance and are discussed in depth in studying language disorders of childhood.


[Deafness after oral poliomyelitis vaccination--case report and review]. The occurrence of deafness following oral poliomyelitis vaccination is reported. Recognition of the harmful effects of vaccination and the assessment of these are discussed and reviewed. Reference is also made to the legal implications of such cases.


Acoustic reflex threshold and loudness discomfort level: relationships in children with profound hearing losses. Acoustic reflex thresholds (ART) and loudness discomfort levels (LDL) were obtained from 51 ears of 34 deaf children using broad band noise and pure tones. Both thresholds and levels were recorded using the psychophysical method of tracking. Results indicate that the relationship between ART and LDL is at variance with similar data for normal hearing individuals. Specifically, in over 39% of these deaf children LDL was obtained at a lower intensity than ART. Implications for hearing aid fitting with deaf children are discussed.


Protocol for evaluation of the effect of hearing aid electroacoustic parameters on perception of amplified speech. A protocol for the evaluation of the effects of changes in hearing aid electroacoustic parameters was developed and evaluated. The protocol called for the creation of a matrix with as many dimensions as there are parameters to be evaluated. The protocol also called for each dimension to have as many divisions as there are possible variations of a parameter. The cell entries in the matrix were the listener speech discrimination scores in noise. It was found that one cell within the matrix always uniquely contained the highest listener speech discrimination score. It was concluded that use of such a protocol would allow the establishment of the precise electroacoustic settings of a master hearing aid which would result in best speech understanding for the listener.


Training severely hearing-impaired children in the discrimination of the voiced-voiceless distinction. Six severely hearing-impaired children who were initially unable to set voiced-voiceless boundaries at voice onset times between 20 and 40 msec in the discrimination of speech were trained to do so by means of a structured auditory training program. An additional tactile cue, gradually withdrawn over four training steps, was used to signal presence of voicing (voice onset times 20 msec or less) during the initial phases of training. Half of the subjects were trained only with the bilabial stops /b-p/ and the remainder with the bilabial, alveolar, and velar stops /b-p/, /d-t/, and /g-k/. Although only syllables containing the vowel /a/ were used in training, all subjects generalized to syllables containing the vowels /u/ and /i/ and some subjects generalized to stop-initiated words. Implications for structured auditory training procedures are discussed.


Effect of age on clinical hearing aid evaluation results. A retrospective analysis of clinical hearing aid evaluation data was done to examine the aided and unaided speech discrimination ability in quiet and in noise across five age categories. The subjects, ranging in age from 30 to 90 years, 20 in each decade, were matched for degree and slope of sensorineural hearing loss. There were no statistically significant differences in aided or unaided speech discrimination scores in quiet or in noise among the different age groups. Phonetically balanced word list scores in noise showed significantly greater improvement than those obtain in quiet.


Performance of normal-hearing listeners on the time-compressed modified rhyme test. This study sought to evaluate word discrimination performance of normal-hearing listeners on a time-compressed version of the modified rhyme test. Six lists (A-F) of the modified rhyme test were presented to 60 young normal-hearing adults at 0, 30, 40, 50, 60, and 70% time-compression ratios. Results were consistent with earlier findings for the Northwestern University Auditory Test no. 6 and demonstrated that word discrimination decreased as a function of increasing percentage of time compression. Differences among the six lists were found to exist at high levels of time alteration.


Effects of intense continuous- and impact-type noise on pupil size and visual acuity. The data obtained from these studies suggest that continuous noise at high levels will produce an increase in arousal, as indicated by pupil size, and that there is a tendency toward adaptation. At lower noise levels the effect is, at most, transitory. This papillary change does not appear to mediate a change in visual acuity. Impact noise such as that used here does not appear to produce reproducible changes in pupil size or visual acuity. For the noise conditions used here, concern for nonauditory sensory effects seems to be unwarranted.


Comparison of tympanometry and otoscopy in establishing pass/fail referral criteria. Impedance tests, pure tone screening, and pneumatic otoscopy were performed on two groups of children. For the second group, two physicians, one an otolaryngologist and the other a pediatrician, performed the otoscopic examination. Agreement between tympanometry and otoscopy was not influenced by the presence or absence of acoustic reflexes or passing or failing the pure tone screening, but did depend on the criteria used in classifying the tympanograms. Tympanograms classified as having significant negative pressure were those showing the poorest agreement between tympanometry and otoscopy. Between examiners, agreement in otoscopic findings was generally poor. Results are discussed as they apply to establishing pass/fail criteria for screening with impedance.


The manual LOT test.

The manual LOT test. This study was conducted to determine the feasibility of a manual variation of the lengthened off-time (LOT)-Békésy test. The procedure requires that the audiologist vary the attenuator of an audiometer while the signal paradigms of the LOT test are delivered to the patient. Ten nonorganic hearing loss subjects were tested using the automatic LOT test and the manual LOT test. Results were equivalent to the automatic test lending support for the new procedure. The technique can be used with most wide-range audiometers without the additional expense of an automatic recording device.


Spectral changes produced by earphone-cushion reproduction of hearing aid-processed signals. This investigation was conducted to assess the extent to which hearing aid-processed signals present an acoustic signal to the subject which has a frequency response equivalent to that which the hearing aid itself would have provided. The frequency response of a hearing aid receiver which was coupled directly to the ear canal ("aided" condition) was compared with the frequency response of the same receiver when its output was recorded on magnetic tape and then presented to the subject via a TDH-49 earphone ("pseudoaided" condition). Results indicated that when the earphone was mounted in an MX-41/AR cushion or either of two circumaural cushions, the spectrum of the sound arriving at the subject's eardrum in the pseudoaided condition was substantially different from the spectrum delivered in the aided condition.


Time-compressed speech discrimination in children and its relationship to articulation. The Word Intelligibility by Picture Identification (WIPI) Test of Speech Discrimination was time compressed at 0, 30, and 60% and administered to 48 normal-hearing children. The children, all between the ages of 5 years, 6 months and six years, 7 months of age, were equally divided into three groups on the basis of articulation ability. Significant effects were found for test groups and levels of time compression, with differences increasing as time compression increased. The implication is that children with multiple articulation errors demonstrate a developmental lag in the ability to process time-compressed speech. Time-compressed speech may be a useful tool in the study of auditory perception in children.


Effects of listener sophistication on respiration audiometry. Thirty normal-hearing college-age adults were tested by standard and respiration audiometry (RA) at 1000 Hz to investigate the effects of subject knowledge of the RA procedure. Three levels of sophistication were employed: (1) no knowledge, (2) full knowledge, and (3) deception. No significant effects on RA thresholds were revealed as a function of subject knowledge. RA itself was found to be less satisfactory as a means of measuring auditory threshold because of the difficulty in obtaining responses from some subjects and the degree of subjectivity required to judge responses.


Dutch audiology.

Dutch audiology. In the Netherlands audiological care is given at different stages. An attempt is made to screen the hearing of all Dutch babies between the ages of 8 and 12 months. At the age of 4 or over, general audiological care is given by the school medical service; referral is first to a family doctor, who may refer to an otolaryngologist. Curative medical care (examination and therapy) is the province of the family doctor and the otolaryngologist. Otolaryngologists and pediatricians can refer patients to one of 19 Audiological Centers distributed around the country, where a number of workers in different disciplines cooperate for habilitation and rehabilitation. These may include an otolaryngologist in charge, a psychologist, a speech and hearing therapist, an audiologist (usually a physicist or university-trained engineer), social worker, technician, ortho-pedagogue, audiology assistant, and teacher. There are at the moment 25 schools for the hard of hearing and 5 institutes for the deaf. These are often found in conjunction with Audiological Centers, the latter providing paramedical assistance to the pupils by agreement. Finally, the Dutch Organization for Preventive Medicine works to prevent hearing loss in noisy industries.


Conjunctivorhinostomy: a surgical method for the control of epiphora in the dog and cat. Conjunctivorhinostomy, a surgical technique for the control of epiphora, was developed for use in the dog and cat. The method was performed 32 times in 21 animals, with varying degrees of success. It was concluded that the technique has potential as an effective procedure.


Recall and repetition of time-compressed sentential approximations by normal-hearing young adults. This study investigated the performance of a group of normal young adults on time-compressed five-word first-order sentential approximation. The results supported the contention that intelligibility decreased as a function of increasing time compression and decreasing presentation level. The findings are discussed with regard to the perceptual strategies employed for the recall of these stimuli, and the stimuli's potential clinical utility for assessing auditory processing abilities of both children and adults.


Effects of blood contamination on cerebrospinal fluid analysis. Data were obtained from 190 cerebrospinal fluid samples collected from both clinically normal and diseased dogs, cats, cows, and horses. Red blood cells, indicating blood contamination, were identified in 115 samples. White blood cells were a rare finding in normal animals. Blood contamination appeared to have little effect on white blood cell numbers even though, in several samples, thousands of red blood cells were identified. An accepted formula to correct for blood contamination was found to be an unreliable method to determine "uncontaminated" values for white blood cells, total protein, or creatine phosphokinase.


Synthetic sentence identification as a function of the age of the listener. Synthetic sentences with ipsilateral competing message (SSI-ICM) were presented to 40 normal-hearing listeners in four distinct age ranges at five message-to-competition ratios (MCR). Children, ages 10-12 years and adults ages 20-29, 40-49, and over 60 years were presented SSI-ICM at MCR's of 20, 0, -10, -20, and -30 dB. Discrimination scores decreased with increasing MCR for all groups. Discrimination scores demonstrated a curvilin-ear function with a maximum in the 20-29 age group. The age effect was most pronounced for the more difficult MCR's. The results are discussed relative to the clinical use of the SSI-ICM and the implications for clinical speech discrimination testing in general.


Prevalence of seropositive reactions to Brucella canis in a limited survey of domestic cats. The prevalence of Brucella canis agglutinins was determined in 170 cats (114 from animal shelters in California and 56 from an animal hospital in Texas). Seropositive reactions in the cats from animal shelters were 5.3, 11.4, and 0%, respectively, the the rapid slide agglutination test, salt 2-mercaptoethanol tube agglutination test, salt 2-mercaptoethanol tube agglutination test, and brucellosis card test. For hospitalized cats, the respective percentages were 7.1, 8.9, and 0%. One (0.9%) of 114 cats from the animal shelters and 5 (8.9%) of 56 hospitalized cats were seropositive by the salt 2-mercaptoethanol tube agglutination test at titers greater than or equal to 1:200. Isolation of bacteria was not attempted; thus, the findings of this study may need cautious interpretation.


Filter effect of earmold venting: comparison of electroacoustic and psychoacoustic methods of evaluation. The filter effect of venting an earmold was evaluated by measuring the coupler-acoustic and threshold responses to open versus closed earmolds. In the coupler-acoustic technique the effect of venting was determined by measuring the output of the experimental earmolds seated on a modified 2-cc coupler with a specified signal impressed upon the earphone. The real ear threshold technique called for the determination of threshold by five listeners for the same earphone-earmold system. The data indicated that the difference between the coupler and threshold measures were of the same order of magnitude as the difference seen by other investigators reporting coupler and real ear-probe tube microphone measures. It was concluded that the threshold technique provides the same general description of the effects of venting an earmold as does the probe tube technique and should thus provide a useful method for determination of the filter effects produced by the venting of an earmold.


Evaluation of a carbamate-impregnated flea and tick collar for dogs. To acquire information regarding the potential hazard of pesticide-impregnated collars to dogs, 13 male Beagles were allotted to 2 groups; 8 of the dogs were fitted wtih propoxur-impregnated tick and flea collars and the other 5 were fitted with placebo collars. All dogs wore their collars for 42 consecutive days. The dogs wearing test collars had significant (P less than 0.01) depression of erythrocyte and plasma cholinesterase activities at day 1 after collar application; however, the enzyme activity values returned to the preexposure range within 3 days. Miosis, with decreased pupillary response, was noticed during the 1st week of exposure. Irritation of the skin of the neck was mild and transient in both the test and control groups from the 2nd week onward.


Variability of the ear advantage in dichotic listening. Thirteen listeners received eight dichotic-listening trials. Each trial consisted of 30 pairs of consonant-vowel nonsense syllables spoken by a male talker. The average percentage ear advantage varied by no more than 0.6% over four two-trial blocks, but the test-retest correlation coefficient between the first and second two-trial blocks was only +0.66. The same data, plotted in cumulative percentage form, were distributed approximately as a normal curve with a mean right ear advantage of 6.1%, but with a standard deviation of 17.0%. As a result, 33% of the 104 trials yielded a left ear advantage. The variability in percentage of ear advantage was relatively similar for all listeners, independent of the size or direction of the average ear advantage.


Adverse reactions to drugs in a veterinary hospital. In a one-year period (July 1, 1975, through June 30, 1976), 130 cases of suspected adverse drug reactions were reviewed in the Veterinary Medical Teaching Hospital, School of Veterinary Medicine, Davis, Ca. Sixty-six of these cases had sufficient evidence to link the reaction to the medication administered. Most of the reactions were attributed to anti-infective agents (antibiotics and parasiticides) and to anesthetics and related drugs. In 28 (42.4%) of the cases, uncomplicated recovery occurred without supportive medication. Four animals (6.1%) died as a direct result of adverse drug reactions. It was concluded that a higher degree of adverse drug reaction awareness is needed in the veterinary profession to enable the accumulation of meaningful data.


Evaluation of two microhematocrit methods for quantitating plasma fibrinogen. Blood samples from several animal species, including man, were used to compare 2 heat-precipitation assays (Millar et al and Schalm et al) with a reference assay (Ratnoff-Menzie) for quantitating plasma fibrinogen. Compared with the Ratnoff-Menzie assay, the heat-precipitation methods significantly underestimated plasma fibrinogen content. The reproducibility of the Millar et al assay was significantly better than that of the Schalm et al assay and approached that of the Ratnoff-Menzie method. The Millar et al assay, a practical test not requiring specialized equipment, is recommended for clinical use in animals.


Dystrophic myodegeneration in adult horses. Five horses with histories of colic developed signs of myocardial failure and skeletal muscle disease. Necropsy revealed pale areas in the cervical, pectoral, pelvic, and cardiac musculature; histologically, the lesions were indicative of dystrophic myodegeneration. Serum vitamin E concentrations were normal in 2 of the horses but serum selenium concentrations were normal in 2 of the horses, but serum selenium concentrations were low when compared with values obtained from clinically normal horses.


Antibacterial sensitivity patterns of bacteria isolated from dogs with otitis externa. From January, 1973, to December, 1975, the most prevalent microorganisms isolated from ear swab specimens taken from 323 dogs with otitis externa were Staphylococcus aureus, Pseudomonas aeruginosa, and Proteus spp. Comparison of the antibiograms of these isolants to those reported from England in 1961 and from the United States in 1970 suggested emergence of a greater proportion of bacterial strains with resistance to antibacterial agents commonly used to treat otitis externa of dogs.


Blood pressure measurement in the dog.

Blood pressure measurement in the dog. An indirect method of blood pressure measurement was evaluated in 169 dogs, including 114 that were hospitalized because of a variety of diseases, 10 clinically normal dogs presented for neutering, and 45 privately owned, clinically normal dogs. Measurements correlated well with values obtained by simultaneous direct arterial puncture. Normotension was considered to be 130 to 180 mm of Hg, systolic, and 60 to 95 mm of Hg, diastolic. As a group, 20 dogs with advanced renal disease had significant (P less than 0.001) hypertension, compared with the groups of clinically normal dogs. Of 94 dogs with a variety of diseases exclusive of renal disease, 10 had hypertension and 2 had hypotension.


Fortimicins A and B, new aminoglycoside antibiotics. I. Producing organism, fermentation and biological properties of fortimicins. A culture of Micromonospora species MK-70 was found to produce two new antibiotics, fortimicins A and B. Antibacterial and paper chromatographic data on an eluate from IRC-50 treatment of fermentation beers indicated that fortimicins A and B are new antibiotics with broad-spectrum, basic and water-soluble properties. Fortimicin A exhibited potent, unique, broad-spectrum antibacterial activity against Gram-positive and negative bacteria both in vitro and in vivo, while fortimicin B was only weakly active.