Measuring barbiturates, sedatives, and anticonvulsants in serum by gas-liquid chromatography. We describe a method for measuring therapeutic and overdose levels of barbiturate, sedative, and anticonvulsant drugs in serum by gas-liquid chromatography (GLC). This method is a unique combination of techniques including a simple extraction, cochromatography of the specimen with authentic carrier drugs, and the use of multiple dissimilar gas chromatographic columns. In this way, a large number of drugs may be identified and quantitated without confusion.


A manual system for storage and inventory control of laboratory supplies. The demand for laboratory supplies has increased in relation to the increase in the quantity and complexity of the laboratory workload. This has created many problems for the laboratory administration and a major one has been the lack of a good system for storage and inventory control of supplies. This paper presents a manual system for such control and suggests the use of two different control procedures.


The National Clinical and Public Health Laboratory Survey--1977. In May 1976, the Laboratory Management Consultation Office, Center for Disease Control, conducted a survey of the clinical and public health laboratories in the U.S.A. in order to update data from a 1971 census of clinical and public health laboratories. The 1971 data were published in the January/February 1973 issue of Cadence of the Clinical Laboratory. The combined data from the 1971 census and the 1976 survey provide an extensive data base which will allow long-range planning toward improving laboratory service in the U.S.A.


Reading retention and transfer in TMR students. Twenty-one TMR students at two schools completed 2 years of reading instruction using a whole-word approach. Students were pretested and posttested both years on two word lists; one list was made up of words included in the reading program, the other of words not included. The former list was used to assess word acquisition and retention, the latter to assess transfer. A one-way repeated measures analysis of variance indicated a statistically significant increase in words recognized. By the close of the second year, the average student had completed 100 lessons and had learned 41 words. Students retained most of the words they had learned over the 3-month summer vacation. A separate one-way repeated measures analysis indicated statistically significant transfer to untaught words. The authors concluded that TMR students can profit from reading instruction.


Reduction of stereotyped behavior in profoundly retarded individuals. High-frequency, stereotyped behavior may interfere with the acquisition of appropriate behavior. Through the use of a procedure involving access to vibratory stimulation and its response-contingent withdrawal, stereotyped behavior of two profoundly retarded students was virtually eliminated. A reversal design, employed in Experiment 1, demonstrated that the nonoccurrence and the occurrence of stereotypic hyperventilation was a function of the presence or absence of the intervention procedure. In Experiment 2, a multiple-baseline design provided evidence that the procedure repeatedly produced suppression of stereotyped mouthing across three settings in which it was employed. The observed level of suppression was similar to that typically achieved by contingent application of aversive stimulus procedures. In addition, the procedures seemed to be learned quickly by teachers and administered effectively by public school personnel.


Stimulus relations, blocking, and sorting in the free recall and organization of EMR adolescents. Educable mentally retarded adolescents received a list of either clusterable or unrelated words according to one of three presentation methods. In blocked groups, words were presented both spatially blocked in fours and consistently ordered from trial-to-trial. In sorting groups, subjects were required to group the stimuli themselves into four groups of four. Subjects in the blocked-random conditions received the items spatially grouped in fours, but they were not consistently ordered; i.e., the groupings changed from trial-to-trial. Results indicated that clusterable items were recalled better than unrelated items and that both consistent blocking and sorting produced better recall than did the blocked-random treatment. The data for organizational measures generally parallel those for correct recall. The results were discussed in terms of appropriate techniques for remediating input organizational deficits.


Resident characteristics and staff behavior in two hospitals for mentally retarded adults. Results of part of a study aimed at evaluating the implications of different nurse staffing levels were reported. Two samples of 30 patients were observed in the two hospitals and measures were obtained of the proportion of time they were involved in adaptive and maladaptive activities, the frequency with which they interacted in particular ways with the nursing staff, and their Adaptive Behavior Scale scores. When these various measures were examined, we found that those patients who needed more attention received it but not necessarily of the appropriate type. While such results are understandable and even perhaps predictable, they do serve to reveal a situation deserving remedial attention. We in fact suggested that one possible means of countering this tendency to ignore the less attractive patients is for the nursing staff to be assigned much smaller groups of patients than is customary.


Assessing social ans prevocational awareness in mildly and moderately retarded individuals. The Social and Prevocational Information Battery, a series of knowledge tests developed for use with mildly retarded adolescents, was revised to facilitate assessment of moderately retarded persons knowledge in social and prevocational areas. In addition, the relationship between knowledge and applied performance in these domains was examined. Results indicated that the revised battery demonstrated adequate test and item difficulty and internal-consistency reliability and that mildly and moderately retarded persons' knowledge was substantially related to applied performance in these skill domains.


Intelligence, reaction time, and inspection time. Forty-eight subjects with IQ scores ranging from 57 to 138 discriminated between two lines of markedly different length, exposed for varying periods of time. Estimates of inspection time, lambda, a measure assumed to reflect the rate at which sensory input is processed, were obtained from the pattern of errors made by each subject and, therefore, independently from the reaction time (RT) required to respond. lambda correlated negatively with IQ scores. RTs of nonretarded subjects increased as stimulus-exposure duration decreased, whereas for retarded subjects RTs remained constant. This is interpreted as indicating differences between the groups in response strategy under conditions of difficult discrimination. The rate of information processing was also estimated in a different choice RT situation, using as an index the reciprocal of the slope of the function relating RT to degree of stimulus choice. Retarded subjects had slower rates and longer RTs than nonretarded subjects. A second experiment controlling for response-selection factors confirmed that this slowness could not be attributed to gross-movement difficulties and that a slower rate of information transmission seemed to be involved.


Encoding and high-speed memory scanning of retarded and nonretarded adolescents. A choice reaction-time experiment was performed in order to assess the encoding and memory-scanning processes of nonretarded and retarded adolescents. Random forms were used as stimuli, with stimulus-set sizes of 2, 3, and 4. The encoding process was evaluated by means of a stimulus-quality manipulation. The results indicated that both the rate of encoding and memory scanning are related to level of intellectual functioning. In addition, evidence suggesting an interdependence of these memory processes, at least for the retarded subjects, was revealed.


Learning concepts through modeling: using different instructional procedures with institutionalized mentally retarded adults. A group of severely retarded institutionalized adults was exposed to three different types of instructional procedures (imaginal instruction, verbal instruction, no instruction) and three types of reinforcement procedures (no reinforcement, reinforcing correct responses, reinforcing all responses) in learning concepts through modeling. Concept acquisition was tested, using Leiter-type items, in direct imitation as well as in a generalization task. In both imitation and generalization conditions, imaginal instructions were more effective than verbal instructions, which in turn were more effective than no instructions. The study of modeling procedures, especially with regard to the use of imagery, is called for in order to investigate the processes involved in their effectiveness with a severely retarded population.


Electroencephalographic correlates of prism adaptation in mentally retarded individuals. Sensorimotor adaptation was studied in 23 institutionalized, mentally retarded individuals. This was achieved by recording the pattern of off-target pointing errors resulting from viewing through a 20-diopter prism. The results showed a wide range of individual differences in prism adaptation. The electroencephalogram (EEG) was also recorded from four scalp locations and analyzed by computer to determine EEG intensity, coherence, and phase angle. Correlations between EEG and behavioral scores of prism adaptation revealed a number of significant relationships, especially negative correlations between alpha intensity and prismatic adaptation. These results indicate that patterns of central nervous system activity are meaningful related to sensorimotor capabilities in retarded individuals.


Proactive interference and its release in short-term memory of mildly retarded adolescents. Release from proactive interference in mildly retarded adolescents due to taxonomic shifts and rest periods prior to the final, critical-word triad was investigated. Interference accumulated rapidly across the first three trials; a shift in triad's taxonomic class on the final trial produced a substantial release (72 percent) from proactive interference. Although proactive interference dissipated when the interval between Trials 3 and 4 was increased to 120 seconds, the extent of recovery from proactive interference for the rest period plus taxonomic shift was no greater than a taxonomic shift alone. Results indicated that taxonomic category is a salient encoding dimension for retarded adolescents.


Adaptive and maladaptive behavior of idiots savants. A comparison was made of 25 institutionalized idiots savants and a control group of institutionalized retarded persons matched for age, sex, IQ, and length of institutionalization. As a group, idiots savants were found to be somewhat more disturbed and disturbing than their peers, although they did not show extreme emotional disturbance nor reflect a clear behavioral profile.


Eidetic imagery: longitudinal results in brain-damaged children. There have only been a few attempts to assess whether eidetic imagery is inversely related to age. A sample of 15 known eidetikers from a previous study, having particular forms of brain damage, were retested after a lapse of 20 months. The hypothesis of the study was that older children are most likely to lose their capacity for seeing eidetic images over a period of 20 months than are younger children. The data confirmed the hypothesis and was interpreted as supporting the theory that eidetic imagery is a developmental process that decreases in importance over the course of a child's development.


Pelvic exenteration: analysis of 296 patients. An analysis of 296 patients who had pelvic exenteration discloses a high risk of postoperative complications and death; however, the safety has been improved by technical modifications for urinary diversion and treatment of the denuded pelvic cavity. Recurrent cancer of the cervix or vagina was the main reason for the operation. Prognostic factors were sought to improve selection of patients who are able to withstand operation, tolerate postoperative complications, and remain free of cancer. The five-year survival rate for 296 patients with various types of cancer calculated by the Berkson-Gage method was 56.5 per cent after death from all causes were deducted, the rate was 42.1 per cent. The five-year survival rate for 196 patients with recurrent carcinoma of the cervix calculated by the Berkson-Gage method was 48.3 per cent; after deaths from all causes were deducted, the rate was 33.8 per cent.


Comparison of cancer cell surfaces of the lower reproductive tract by scanning electron microscopy. The squamous cells of the cervix simulate those of the vagina and vulva both histologically and by scanning electron microscopy. However, in areas of the cervix undergoing active metaplasia, there are cells which share some of the characteristics demonstrated by scanning electron microscopy of both squamous and columnar epithelium. In these cells there is a wide range of characteristics of each cell type, suggesting a possible gradual transition from columnar to squamous epithelium. Furthermore, the cells of severe dysplasia and of intraepithelial and invasive squamous cancers of the cervix, though histologically similar to those of vaginal and vulvar cancers, are distinctly different when examined by scanning electron microscopy. These findings suggest that both metaplastic and neoplastic squamous cells are derived from the same progenitor columnar cells of the cervix, by orderly transition in the former and by atypical transformation in the latter. Second, the distinctiveness from the vaginal and vulvar cells indicates different embryonic stem cell lines.


Homologous artificial insemination. A reappraisal. Homologous artificial insemination (AIH), with the use of a split-ejaculate technique, was performed in 62 couples following a complete infertility investigation. Fifty per cent of all men had a sperm count less than 50 million per milliliter and 80 per cent had sperm motility less than 50 per cent. More important, 85 per cent of the initial semen samples had greater than 40 per cent abnormal forms and liquefaction was delayed beyond 20 minutes in 67 per cent of specimen. The pregnancy rate for the 28 women who underwent the prescribed course of six or more inseminations was 46.4 per cent, for the group of 60 who received split-ejaculate AIH, 21.6 per cent; and for the entire group of 62 couples, 24.2 per cent. In the split-ejaculate group 50 per cent of the pregnancies resulted in first-trimester abortions. It is suggested that the pregnancy wastage in these couples might be due to male factors.


A new automated subjective optometer.

A new automated subjective optometer. A new optometer that utilizes optically simulated distance line and letter targets, focusable by patient or operator, is described. Refractive findings for 376 eyes tested on the new optometer were compared with the findings obtained by conventional clinical methods. Most differences were within the limits of repeatability reported for conventional refraction tests.


Changes in fundus reflex luminance with increased cognitive processing. A previous study using photoelectric retinoscopy at near showed an increase in fundus reflex luminance when the subject's task was changed from reading simple material to adding numbers. Unfortunately, it was not possible to attribute the luminance change to the change in cognitive task. The present experiment was designed to determine whether an increase in cognitive processing would produce an increase in fundus reflex luminance. When the subjects (N = 19, ages 22 to 27) changed from viewing 2-digit numbers at 40 cm to adding the digits, with no change in the visual stimulus, the increased in 47 of 54 trials--the mean luminance increased approximately 10% (p less than 0.01). This change in fundus reflex luminance is not attributed to change in eye position but rather to a decrease in accommodative lag.


Viewing time and stereoscopic threshold with random-dot stereograms. The effect of viewing time on the threshold for depth and form discrimination using random-dot stereograms has been investigated. For 12 subjects the relation between logarithm of threshold disparity and logarithm of viewing time was linear for both depth and form discrimination, but the threshold for form discrimination was approximately twice the threshold for depth discrimination. Stereo thresholds determined with random-dot stereograms were not significantly related to stereo thresholds measured with a Howard-Dolman apparatus.


Comparison of the STYCAR and lighthouse acuity tests. In a study comparing the Screening Test for Young Children and Retardates (STYCAR) and the New York Lighthouse Flash Card Test, 50 preschool children (median age of 4.4 yr) were evaluated twice with each instrument. Results indicate that the Lighthouse test had higher reliability, better visual acuity scores, lower untestability rates, and shorter testing times than the STYCAR.


Dynamic measures of vergence accommodation. Dynamic measures of vergence accommodation (VG-ACC) are necessary for complete analysis of the triadic near response but are difficult to obtain because eyeball rotation affects accommodative measures. A dynamic optometer that uses the third Purkinje image is shown to be insensitive to small eye rotations and permits dynamic measures of VG-ACC responses. Such measures are presented to demonstrate the feasibility of this method. Average latency measures of 260 msec for VG-ACC fall between the latency of 160 msec for disparity vergence and the latency of 380 msec for accommodation. Additional dynamic features of VG-ACC resemble those of other components of the near triad.


Phoria, vergence, and fixation disparity in oculomotor problems. Measures of horizontal phoria, vergence, and fixation disparity were obtained for 2 samples: 28 optometry students without symptoms and 32 orthoptic patients with symptoms associated with binocular oculomotor difficulties. Discriminant analysis was used to determine which tests or group of tests best discriminated between the 2 samples. Analysis was done for both samples and for exophoric and esophoric subsamples. Sheard's criterion was the best discriminator for the exophoric group, and amount of heterophoria was the best discriminator for the esophoric group. Fixation disparity was the next best discriminator for both groups.


Early treatment of anisometropic astigmatism and strabismus. A 4-year-old boy with uncorrected anisometropic indirect astigmatism showed amblyopia and strabismus. Over a period of approximately 3 yr, neutralization of the refractive error and treatment of the amblyopia and strabismus resulted in single binocular vision with good stereopsis. The results suggest that at least up to age 7 the visual system is sufficiently plastic to be modified by treatment.


Rocker jaws.

Rocker jaws. Most adult Polynesian mandibles are of the rocker form. Polynesian crania possess a very open cranial base angle and a large upper facial height. The mandibular growth rotations necessary to maintain occlusion in the presence of this cranial morphology lead to development of an exceptionally closed ramus-body angle, with consequent loss of the antegonial notch and appearance of the rocker form.


Dental reductions and dental caries.

Dental reductions and dental caries. Although first permanent molar hypoconulid absence, third molar agenesis, and small tooth size are all part of evolutionary trend of dental retardation, each bears a different relationship to dental caries. Caries prevalence in the maxillary and mandibular permanent first molars of the Burlington Research Centre serial experimental group at age 16 years was less in the children whose first molars were missing the hypoconulid. Conversely, caries prevalence in mandibular first molars was greater in the children who had agenesis of third molars. The extraction of first molars due to caries was more frequent in children with agenesis of third molars, less frequent in those with absence of hypoconulids of the first molars and unrelated to tooth size. Caries prevalence was less in small teeth, and occurred least in the small mandibular first molars with four cusps. Whereas this is in harmony with the hypothesis that evolutionary dental reductions resulted from the pressure of caries, the increased prevalence of caries and extractions coinciding with third molar agenesis does not support this view. In addition, agenesis of hypoconulids and agenesis of third molars were related to changes in structures unrelated to caries.


Homologies of the anterior teeth in Indriiadae and a functional basis for dental reduction in primates. In a recent paper Schwartz ('74) proposes revised homologies of the deciduous and permanent teeth in living lemuriform primates of the family Indriidae. However, new evidence provided by the deciduous dentition of Avahi suggests that the traditional interpretations are correct, specifically: (1) the lateral teeth in the dental scraper of Indriidae are homologous with the incisors of Lemuriadae and Lorisidae, not the canines; (2) the dental formula for the lower deciduous teeth of indriids is 2.1.3; (3) the dental formula for the lower permanent teeth of indriids is 2.0.2.3; and (4) decrease in number of incisors during primate evolution was usually in the sequence I3, then I2, then I1. It appears that dental reduction during primate evolution occurred at the ends of integrated incisor and cheek tooth units to minimize disruption of their functional integrity.


Effects of occlusal attrition and continuous eruption on odontometry of rat molars. Recurrent reports by others of posteruptive dimensional increase of the crowns of rat molar teeth were analyzed in the context of our present study of occlusal attrition, continuous eruption and alteration of the occlusal planes of rat maxillary molar teeth with age. Marked attrition of the anatomical crowns occurs, together with a considerable continuous eruption that increasingly brings the markedly convex mesial root of the maxillary first molar into the clinical crown. Further, a slight change in occlusal plane occurs. Previous workers used standardized planes of orientation and of registration prior to measurement, which masked the phenomena mentioned above. They thus mistakenly reported increased coronal dimensions.


The number of vertebrae in the Southern African Negro, the American Negro and the Bushman (San). The numbers of precoccygeal vertebrae (PCV) are compared in Southern African Negroes, Bushman (San) and American Negroes. The S.A. Negro and San males have an exceptionally high frequency of an increased total PCV number whilst the frequencies are significantly lower in a combined Caucasoid sample and the Mongoloid samples. The American Negro male, too, has a high frequency but not as high as in S.A. Negroes. The high frequency of increased PCV number in San, S.A. Negroes and American Negroes is in keeping with the view that the Khoisan peoples (here represented by the San), the Southern African Negroes and the African ancestors of American Blacks sprang from a common proto-negriform stock. Males have a significantly greater frequency of increased PCV to 30 or 31, whereas females are more likely to have a decreased number of 28 PCV. This sex difference is present in all the populations studied.


Presence of correlations between the five palmar area patterns. The true patterns and vestiges in the five palmar areas and their possible correlations in a series of four Sardinian populations are considered. Of the significant differences observed during the examination, a greater homogeneity was found in the males rather than in the females. The variability found both for the rate and for the correlations in the four samples of both sexes calls for caution in interpreting data from small samples. Also in evidence was a strong negative correlation between the third and fourth interdigital areas; but there is no correlation if only the patterns determined by accessory triradii are considered. Finally a few positive correlations between the other palmar areas exist.


Genetic studies in Ecuador: acetylator phenotypes, red cell enzyme and serum protein polymorphisms of Shuara Indians. Population genetic studies of Shuara Indians in Ecuador are performed for GPT, AP, PGM1, Ak, EsD, 6-PGD, Hp, Gc, C3, Bg, ChE, Tf, Pi, Bf phenotypes, IgG, IgA, IgM, C3, C3-proactivator, C4 levels and acetylator phenotypes. Some systems having a polymorphism in many other populations showed a lack of some of those alleles in the population under study (C3, ChE, Tf, AK and almost absent 6-PGD, Bg, Bf).


Number of epidermal melanocytes, hair follicles, and sweat ducts in skin of Solomon Islanders. The number of epidermal appendages and melanocytes in forearm skin of three groups of Solomon Islanders has been determined. There were no significant differences in the number of hair follicles or sweat ducts among Solomon Islander groups, nor between them and a Caucasian group used for comparison. The Nasioi and Kwaio, however, do have a significantly higher melanocyte population than Caucasian groups. This difference may in part be due to the exposure of the Solomon Islander skin used in this study to chronic solar radiation.


The dentition of the Queckchi Indians. Anthropological aspects. The incidence of nine minor dental traits, in 540 Queckchi Indians from Guatemala is reported. A combination of frequencies of neither Caucasoid nor Mongoloid groups was observed. The apparently Caucasoid elements of their tooth morphology might well be the result of admixture with Spanish genes during the conquest.


The craniofacial pattern of the Lengua Indians of Paraguay. Lateral cephalometric headfilms of 30 male and 30 female Lengua Indians taken in the Chaco area of Paraguay were compared with a sample of 23 male and 25 female South African Caucasoids with excellent occlusion. The most obvious difference noted between the two population groups was the degree of prognathism evident in the Lengua. This was attributed to the generally shorter anterior cranial base in the latter group rather than to the size or forward positioning of their jaws. The significantly larger ANB (Subspinale, Nasion, Supramentale) angle observed in the Lengua was attributed to one or both of two factors, namely, the short anterior cranial base or the clockwise rotation (forward tipping) of the jaws relative to the anterior cranial base. Chinpoint position relative to the anterior cranial base in the Lengua is not much different from that of our Caucasoid sample. The lower incisor teeth in the Lengua, but not the upper ones, are more labially inclined than those of the Caucasoids.


Age-related differences in naming latency. Older people seem to have difficulty learning new materials, perhaps because it takes them longer to retrieve relevant encoding information from memory. To assess the effects of age on speed of retrieval, 60 healthy males from 25 to 74 were shown pictures of common objects they were to name aloud as quickly as possible. The older subjects took longer to name the pictured objects. This difference was minimized with practice or when the name was cued, but did not interact with word frequency. The pattern of results for healthy older subjects was not similar to that found by Wingfield for brain-damaged subjects.


Prevention of ankle sprains.

Prevention of ankle sprains. Ankles are sprained when supported on an unstable foundation, while too rididly fixed to the playing surface, or when forced into unnatural positions by extrinsic muscle tightness. The unstable foundation may be the shoe itself, a chuck-hole, or another player's foot. Undue fixation may be by 1-inch mud cleats, baseball spikes, or a modern wrestling mat. When these circumstances occur, heel cord tightness may alter the ankle's response. Thus, prevention of ankle sprains may be by modification of any of these factors.


[Stability of streptokinase incubated in various solvents at different temperatures (author's transl)]. Streptokinase was dissolved in various solvents and the decay recorded. The method employed was a recently described clot lysis assay for quantitative streptokinase determination. The decrease in activity of 5 u streptokinase, 1500 u streptokinase, and 50,000 u steptokinase dissolved in one milliltre of different solvents (NaCl solution, glucose solution, laevulose solution, dextran solution (Rheomacrodex), gelatin solution (Haemaccel, starch solution (Plasmasteril,albumin solution, Michaelis buffer, heparin-glucose solution) and incubated over various periods of time (15 min, 30 min, 45 min, 60 min, 4h, 8h, 12h, 48h) was investigated. Solution media tested for streptokinase-potecting quality were broken down into three groups.-Group I: Solvents displaying excellent stabilizing properties (gelatin, albumin).-Group II: Solvents displaying medium stabilizing properties (dextran, levulose)--Group III: Solvents displaying properties (starch, NaCl, glucose, Michaelis buffer).--In testing streptokinase concentrations as used for therapeutic purpose (1500 u/ml, 50,000 u/ml), no decay was found to take place over observation periods as long as 48 h. This finding was independent of the different solvents (Group I, II or III) employed. Heparin stored with streptokinase at rooom temperature did not alter the streptokinase stability. From the clinical point  of view, the choice of solvents for streptokinase infusion turned out to be of minor importance.


[On precipitation in clinical dextran solutions (author's transl)]. Dextran precipitation has the same molecular weight distribution as the raw material. However, there are also high molecular shares of associates (aggregates). Precipitation which can be caused by change of temperature passes three stages: 1. Formation of dextran associated. 2. Growth of a dextran film (micro gel) 3. Exsiccation and precipitation.


Long-term nasotracheal intubation in an adult patient. A case of 174 days in spontaneous breathing. A 67 year old female whole trachea was compressed by malignant thyroid tumour complained of severe dyspnoea. Tracheostomy was considered but was rejected because of the risk of massive bleeding. Nasotracheal intubation improved markedly her condition. The patient underwent radiation and chemotheraphy with the tube in place. By these treatment compression of the trachea was alleviated, and the nasotracheal tube was removed uneventfully on the 174th day of intubation. The management of long-term nasotracheal intubation is discussed and the literature is reviewed.


Microorganisms in the hair of staff and patients in an intensive care unit. Bacteria in the hair of staff members and patients of the Intensive Care Unit were studied. Pathogenic organisms were isolated in both groups indicating possible dangers and the need for the awareness of hair as a carrier of bacteria is stressed.


[X-ray control of position of subclavian catheter necessary or not? (author's transl)]. After subclavian vein cannulation of a 49 year old woman, the catheter was found within the pleural space by a special X-ray-technique. The rare complication stresses the importance of checking the position of a vena cava catheter by X-ray, using radio-opaque dye.


Failure of general anesthesia to potentiate propranolol activity. To determine whether halothane and morphine, commonly used during anesthesia for cardiac operations, potentiate the  beta blocking activity of propanolol, hemodynamic changes induced by five incremental doses of propranolol (10, 20, 50, 120, 200 microgram/kg) were measured during halothane, 1 per cent, in oxygen, and morphine, 4 mg/kg. Against a background of contant beta stimulation by infusion of isoproterenol, 0.1 microgram/kg/min, and vagal blockade by atropine, 3 mg, propranolol produced significant dose-related decreases in heart rate, cardiac index, stroke volume index, and left ventricular dp/dtmax and significant increases in mean aortic pressure, systemic vascular resistance,  and pulmonary capillary wedge pressure. Compared with basal anesthesia with pentobarbital, 15 mg/kg,  neither morphine nor halothane increased sensitivity to any measured effect of propranolol expressed as the slope of the log dose-response relationship. It is concluded that the beta blocking activity of propranolol is not potentiated by morphine and halothane anesthesia but, rather, their effects are additive.


Suppressive effect of morphine on single-unit activity of cells in Rexed lamina VII. Using an extracellular microelectrode recording technique, the effects of intravenously administered morphine sulfate upon the single-unit activities of cells in Rexed lamina VII of the lumbar spinal cord were studied in cats following decerebration and spinal cord transection at L1. These neurons responded principally to high-threshold mechanical and thermal stimuli applied to a receptive field in the ipsilateral hind limbs. Morphine sulfate, 0.25, 0.5, and 1.0 mg/kg, caused dose-related suppression of the spontaneous activities of these neurons. The firing rates at maximum suppression, observed 5-10 min after administration of morphine, were 63.9 +/- 9.2 (mean +/- 1 SE), 43.0 +/- 5.4, and 26.5 +/- 6.0 per cent of the control values, respectively. Since these cells have been shown by  others to be associated with the spinothalamic and spinoreticular pathways, the results suggest that the analgesic state may result from the action of morphine on the cells of origin of these major ascending pathways in the spinal cord.


On a triple infection of strigeid metacercariae in an Indian fresh-water fish, Xenentodon cancilla. Three new species of strigeid metacercariae viz., Neascus hoffmani n. sp., Neascus nanaksagarensis n. sp. and Tetracotyle aglandulata n. sp. are described here from a fresh-water fish, Xenentodon cancilla (Ham.); of these, the former two resemble N. xenentodoni PANDEY, 1970 as well as N. hepatica CHAKRABARTI, 1970 while the latter one T. xenentodoni CHAKRABARTI, 1969. - N. hoffmani and N. nanaksagarensis are pharyngeate forms and each has its own pattern of reserve excretory system. N. hoffmani has a spinose body, while N. nanaksagarensis has an aspinose body. - Tetracotyle aglandulata has a lobed hold-fast organ, but lacks a hold-fast gland. Further, in this form fore-body and hind-body is not marked and it has its own characteristic reserve excretory system.


[The effect of dimethoate selection on trichlorfon and dimethoate sensitivity in Musca domestica]. Selecting of strain a Musca domestica resistant to trichlorphon with Bi 58 (active ingredient: dimethoate) resulted in an only slight (1.33-fold) increase of the resistance to dimethoate between 1974 and 1975. In the same time the resistance to trichlorphon rose to 5.28 times the original degree. The resistance extends to some other organophosphates, especially malathion, dichlorvos and bromophos, but not to diazinon. Among the insecticides registered for control of flies in pig-sties Bi 58 has the greatest chance, though there exists neither a certainty for the decrease of the resistance to trichlorphon nor for the non-appearance of a resistance to dimethoate. To overcome the problem of flies in stables and sties, particularly in plants of industrial cattle-breeding, complex measures must be taken.


Disappearance rates of intravenously injected canine alkaline phosphatase isoenzymes. The serum half-life of various canine alkaline phosphatase isoenzymes has been determined. Isoenzymes can be divided into 2 groups with regard to their half-life. Isoenzymes with a half-life of approximately 3 days include the hepatic alkaline phosphatase and the steroid-induced alkaline phosphatase. Those with a half-life of under 6 minutes include the alkaline phosphatase from placenta, kidney, intestine, and the hepatic and steroid-induced iosenzymes after removal of sialic acid. The inability to demonstrate some of the isoenzymes of alkaline phosphatase in serum of diseases animals is attributed to their short half-life. The relationship of the short half-life to the sialic acid moiety of the protein is discussed.


Comparison of furazolidone and carbadox in the feed for treatment of Salmonella choleraesuis in swine. Furazolidone and carbadox, as feed additives, were only partially effective for the treatment of experimentally induced infections of Salmonella choleraesuis var kunzendorf in swine. There was little difference in mortality between the medicated exposed and the nonmedicated exposed swine, and medication did not markedly decrease rectal temperature. In experiment I, the mortality in groups fed furazolidone was lower than in those fed carbadox, but higher than in the nonmedicated exposed. In experiment II, there was little difference in mortality between the medicated and the nonmedicated exposed swine. In both experiments, however, exposed swine that survived had body weight gains significantly (P less than 0.05) higher in 3 of the 4 medicated exposed groups than in the nonmedicated groups. With the exception of the swine fed carbadox for 2 weeks, the feed and water consumption of the survivors in the medicated exposed groups during the recovery phase was higher (but not significantly (P greater than 0.05) higher) than that of the nonmedicated exposed groups. The problems with medicating in feed for treatment of S choleraesuis were that the infected swine frequently vomited the feed and became partially anorectic.


Effects of intramuscular injections of selenium and vitamin E on selenium-vitamin E deficiency in young pigs. Effects of intramuscular injections of selenium and vitamin E on lesions in pigs with selenium-vitamin E deficiency syndrome were determined in 2 factorial experiments, using a total 69 pigs. The pigs were fed a selenium-vitamin E deficient, 22.3% protein ration, supplemented with methionine, minerals, and vitamins. Weekly intramuscular injections of isotonic saline solution, vitamin E, selenium, or vitamin E and selenium were given to the respective treatment groups. Selenium-vitamin E deficiency lesions occurred only in pigs that were given saline injections. Weekly intramuscular injections of either selenium (as selenous acid buffered to pH (7.3) at the rate of 0.05 mg/kg of body weight or vitamin E at the rate of 20 IU/kg of body weight or the combination of selenium and vitamin E prevented cardiac and skeletal myodegeneration, hepatic necrosis, and death. Significant increases of serum aspartate aminotransferase activity values were noted in pigs with liver, heart, or skeletal muscle lesions, but these increases were not correlated with the extent of the lesions. Vascular lesions, epicardial and endocardial hemorrhages, and yellow discoloration of body fat were not features of this experimentally induced disease. These lesions may be related to factors other than the deficiency of selenium, vitamin E, or selenium and vitamin E in rations previously used in reported studies.


Antimicrobial sensitivity of aerobic gram-negative rods isolated from bovin udder infections. Antimicrobial sensitivity of 214 aerobic gram-negative rods recovered from infected bovine mammary glands was determined. Seventeen antimicrobial agents were used. More than 90% of the cultures were sensitive to chloramphenicol, gentamicin, and polymyxin B. These 3 antimicrobials are not approved for infusion into the bovine mammary gland. Escherichia coli was most sensitive to the 17 antimicrobials, and in decreasing sequence, Klebsiella pneumoniae, Citrobacter spp, Enterobacter spp, and Proteus spp were sensitive to fewer antimicrobials. Pseudomonas spp were most resistant.


Morphologic alteration of Paranaplasma caudata following treatment of calves with oxytetracycline. The morphologic features of Paranaplasma caudata were determined in whole blood, blood clots, and liver biopsy specimens after treating infected calves with oxytetracycline. Following staining of blood smears with new methylene blue, light microscopy showed that paranaplasma bodies in erythrocytes of treated calves were vacuolated, but tails were normal in appearance. By electron microscopic examination of parasitized erythrocytes of treated calves, paranaplasma bodies were found to be degenerated (aggregation of nucleoprotein granules in initial bodies and condensation and coalescence of initial bodies), but tails were normal. The identical degenerative changes of paranaplasma bodies and lack of alteration of tails were evident in erythrocytes in sinusoids of liver biopsy specimens from treated calves.


Experimentally induced infections bovine keratoconjunctivitis: effectiveness of a pilus vaccine against exposure to homologous strains of Moraxella bovis. A study was conducted to determine whether vaccination with sonicated pili of Moraxella bovis would protect cattle from subsequent infection and disease when experimentally challenged by exposure to homologous cultures of M bovis. Some calves were intramuscularly inoculated 2 times with pili of M bovis suspended in water, and others were subcutaneously inoculated 2 times with pili of M bovis suspended in oil; 21 days were allowed between inculations. Controls were nonvaccinated calves. Fourteen days after the last inculation, all calves were exposed to virulent homologous cultures of M bovis. The results indicated that vaccination with sonicated pili of M bovis may induce protective immunity against homologous strain challenge exposure. Vaccines in oil that were injected subcutaneously protected to a greater extent than did vaccines in water that were injected intramuscularly. The development of inflammatory nodules at the site of inoculation was associated with resistance to infection and disease. Only 1 of the vaccinated calves that resisted disease lacked precipitating antibodies against sonicated pili at the time of the challenge exposure. This calf had antibodies 2 weeks later.


Alkaline phosphatases in tissues and sera of cats. The numbers and widths of bands of alkaline phosphatase (ALP) activity in polyacrylamide gels and the comparison of their electrophoretic mobility to that of a reference substance (Rf value) were found to be reliable aids in the identificaiton of various isoenzymes in in serum and organ extracts from cats. The hepatic isoenzyme was identified in sera of clinically normal adult cats, pregnant cats late in gestation, and cats with common bile duct occlusion. In addition to the hepatic isoenzyme, placental ALP was found late in gestation in sera from queens. Sera from kittens less than 15 weeks of age contained only the osseous ALP isoenzyme.


Intradermal mitogen response in dogs: correlation with outcome of infection by canine distemper virus. Gnotobiotic and conventional dogs of different ages were examined for intradermal skin test responses and in virtro peripheral blood lymphocyte responses to the phytomitogens, phytohemagglutinin-P (PHA-P) and pokeweed mitogen (PWM). All adult dogs skin tested with these mitogens demonstrated a positive skin reaction consisting of erythema and induration within 24 hours. In contrast, a positive reaction was obtained only with PHA-P when both mitogens were tested in conventional and gnotobiotic neonatal dogs. Lymphocytes from both adult and neonatal dogs underwent blastogenesis if cultured with PHA-P and PWM. Infection of gnotobiotic dogs with canine distemper virus (CDV) resulted in depression of PHA-P skin test response along with in vitro depression of lymphocyte blastogenesis. Persistent loss of skin test response correlated with eventual death due to CDV-associated encephalitis, whereas dogs which responded to PHA-P 14 to 21 days after viral inoculation survived CDV infection. The results of this study indicated that intradermal mitogen tests can be used as a rapid method for in vivo assessment of cell-mediated immunity in this species.


Sensory nerve conduction velocity: technical requirements and normal values for branches of the radial and ulnar nerves of the dog. Conduction velocities of compound action potentials of sensory axons of alteral superficial radial (LSR) and dorsal ulnar nerves (DUN) of the dog were determined by averaging potentials evoked and recorded through subcutaneous needle electrodes. Suitable locations for electrodes were identified and specificities of sites for LSR and DUN were verified by recording before and after cutting the nerves. Stimulus rates of 4/second to 20/second did not markedly affect conduction velocities. Increasing stimulus intensity in steps from threshold to 8 X threshold recruited more axons into the compound action potentials but resulted in interference from movement and muscle potentials at 4 X or 8 X threshold. Mean conduction velocities at 2 X threshold were: LSR = 61.7 +/- 0.76 SEM; DUN = 68.1 +/- 2.71 SEM.


Autologous lymphocyte-mediated cytotoxicity against monocytes in canine ehrlichiosis. The 51Cr-release technique for detecting cytotoxicity had been adapted to immunologic studies of canine ehrlichiosis. Lymphocytes from dogs infected with Ehrlichia canis, cause of canine ehrlichiosis, were shown to be cytotoxic for autologous monocytes. The effect was dependent on the concentraton of lymphocytes, being optimal at 100:1 lymphocyte:monocyte ratio. Neither immune serum and complement, nor anti-canine globulin had any observable effect on cytotoxicity. The monocytotoxicity bore a temporal relationship to the thrombocytopenia. It is suggested that T lymphocyte activation accompanying ehrlichiosis contributes to pathogenesis of the disease and that the specific immune elimination of parasitized monocytes is antibody independent.


Infectious coryza: cross-protection studies, using seven strains of Haemophilus gallinarum. Bacterins prepared from 7 strains of Haemophilus gallinarum were used to immunized chickens for cross-protection studies. Three distinct immunotypes were distinguished. Slight protection between immunotypes was evident for some strains. Airsacculitis could be prevented by use of these bacterins; however, prevention was related to immunotype specificity. Hyaluronic acid found in 2 strains rendered them inagglutinable in homologous antiserums. Treatment with hyaluronidase rendered them agglutinable.


Infectious coryza: in vivo growth of Haemophilus gallinarum as a determinant for cross protection. Four strains of Haemophilus gallinarum representing 3 immunotypes were used in exposure and challenge exposure studies to determine if in vivo growth of the organism would induce cross protection in chickens. Birds which recovered from infection to 1 immunotype were refractory to reinfection with the heterologous immunotype. In contrast, in vitro-produced bacterins produced immunotype-specific protection.


Experimentally induced synovitis of chickens with Mycoplasma synoviae: effects of bursectomy and thymectomy on course of the infection for the first four weeks. Specific pathogen-free chickens (bursectomized and x-irradiated (SBx-X), thymectomized and x-irradiated, x-irradiated, as well as nontreated) were inoculated (in the right tibiometatarsal joint) at the 4th week after hatching with a synovitis-derived Mycoplasma synoviae strain. Differences were not observed in recovery rate of mycoplasmas from tissues among these groups. The SBx-X chickens which were killed at 2 and 4 weeks after the intraarticular inoculation or which died during this period and bacteremia and severe synovitis with edema and heterophil infiltration in synovial fluid and in area from synovial membrane to subcutaneous tissue. Swelling of left leg joints or foot pads were observed mainly in the SBx-X group. A significant difference in the mortality rate and severity of airsacculitis was observed between SBx-X and other groups. The thymectomized and x-irradiated chickens did not show edema, synovial fluid, or swelling in the joint area. However, small lymph follicles composed of lymphoid and plasma cell were formed locally in synovial membranes of various joints. These results indicated that bursa-dependent lymphocytes are correlated with resistance to develop the lesions and that thymus-dependent lymphocytes are necessary for macroscopic lesions to develop.


Experimental induction of bacillary hemoglobinuria in cattle. An open-surgery technique for intrahepatic inoculation of Clostridium haemolyticum spores, suspended in calcium chloride as the hepatic debilitant, was used to produce bacillary hemoglobinuria in cattle. All calves (n=3) died of the disease, and the controls (n=2) given calcium chloride without spores survived. Clinical signs and gross pathologic changes produced by this method resembled those described for the disease in its natural form.


Infectivity of Anaplasma marginale after ingestion by potential insect vectors. Anaplasma marginale-infected erythrocytes retained viability and infectivity for at least 3 days after ingestion by Hippelates pusio Loew and up to 2 days after ingestion by species of Tabanidae. The organism does not appear to have a developmental sequence in the insect vector.


Technique for sampling subcutaneous fat from the tailhead of sheep. Previously reported fat biopsy techniques (either omental or subcutaneous) require extensive restraint of the animal, require anesthesia methods, are time-consuming to do, or demand much postoperative care. The biopsy technique reported in the present paper involves the subcutaneous fat located around the tailhead of sheep. With minimal restraint of the sheep and local anesthesia, up to 1 g of subcutaneous fat can be obtained using this surgical procedure. Michel clips facilitate closure of the surgical wound, making this method brief in operative time.


Serum half-life of intravenously injected intestinal and hepatic alkaline phosphatase isoenzymes in the cat. The serum half-life of feline intestinal alkaline phosphatase (ALP) in the cat was 2 minutes, and that of feline hepatic ALP, 5.8 hours. The feline hepatic ALP could not be identified in the urine of the cats, nor was the clearance rate affected by bilateral nephrectomy. These data indicated  the shor serum half-life of hepatic ALP was not a reusult of renal excretion. Since canine hepatic ALP cleared from feline blood at the same rate as the feline hepatic ALP, possibly the discrepancy in hepatic ALP half-life between the species was related to the cats' ability to clear the blood of the enzyme.


Cysticercosis of the brain in dogs in México City. In a study of 150 dogs with neurologic disorders, on the prevalence and location of Cysticercus cellulosae, 3 (2%) were parasitized and several C cellulosae were located in subarachnoid spaces, cerebral cortex, white matter, and ventricles of the brain. A chronic inflammatory exudate was found in host tissues surrounding the parasites. Unlike human infected brains, basal granulomatous inflammation or Cysticercus racemosus were not found in the canine brain tissues.


Susceptibility of turkeys to Georgia strain of Marek's disease virus of chicken origin. Two experiments were conducted to study the susceptibility of turkeys to Georgia strain of Marek's disease virus (MDV). One-day-old chickens and turkeys were experimentally inoculated with Marek's disease (MD) infective plasma (experiment 1) or tumor homogenate (experiment 2) and raised in isolation for 29 weeks. The MDV inoculums were pathogenic for chickens and turkeys and caused high mortality (chickens, 100% and turkeys, 70%). Macroscopic lesions of MD were observed in liver, spleen, lungs, proventriculus, and other viscereal organs. Microscopically, affected tissues were infiltrated with the pleomorphic population of neoplastic lymphocytes. Uninoculated turkeys did not show gross or microscopic lesion of MD. The MDV was reisolated from the experimentally inoculated, but not from the uninoculated, chickens and turkeys. Antibodies to MDV were detected in experimentally infected chickens. Uninoculated chickens and all turkeys lacked precipitating antibodies to MDV. The present study suggests that turkeys are highly susceptible to experimental infection with GA strain of MDV.


Influence in rats of dietary fats during the perinatal period: effects upon development and behavior of dams and offspring. Female rats were fed purified rations containing 20% fat during gestation and lactation. The fat content was butter oil, an equal mixture of butter oil and lard, or safflower oil. Each litter size was reduced (at random) to 2 male and 2 female pups 1 day postpartum, and these offspring were feed a commercial ration after weaning and until they were 20 weeks of age. When dams were fed safflower oil, fewer of them produced litters after mating, and their behavior during lactation was less than optimal. Litter size and birth weights were similar in all dams producing litters. The type of fat fed to the dam in the perinatal period did not influence the growth, development, and spontaneous activity of the offspring. However, the offspring from the dams fed safflower oil exhibited poorer learning performance in a T-maze and sometimes had a longer time of inactivity following auditory stimulation than did the offspring from dams fed the other types of fats.


Influence in rats of dietary fats during the perinatal period: effects upon brain chemistry of dams and offspring. Female rats were fed a purified ration containing 20% fat during gestation and lactation and the offspring were fed a commercial ration after weaning. The fat content of the purified ration was butter oil, a mixture of equal parts of butter oil and lard, or safflower oil. Brains of the dams were analyzed 1 month after parturition and brains of the offspring were analyzed when they were 20 weeks of age. Brains of the dams and offspring fed the safflower oil (about 75% linoleic acid) exhibited changes if comparisons were made with those fed other fats. In the dams, the percentage of cerebral weight as related to total brain weight was increased and the dry weight percentages of the cerebrum and brainstem were increased. In the cerebrums of male and female offspring, the DNA concentrations were increased and the RNA:DNA ration were decreased.


Subcutaneous exposure of calves to Myobacterium paratuberculosis compared with intravenous and oral exposures. Three groups of calves, 21 days of age, were exposed to Mycobacterium paratuberculosis by oral, intravenous, and subcutaneous routes. Fecal cultural examination and intradermal tests were made, and at 150 days after exposure, the calves were euthanatized and tissues were collected for histopathologic and bacteriologic cultural examination. Calves in the 3 groups were infected. Those exposed intravenously had significantly higher colony counts than did either of the other groups. There was no significant difference between colony counts of cultures from tissues of calves exposed orally and those of calves exposed subcutaneously.


Observations on the life cycle and prevalence of Eimeria leuckarti in horses in Montana. Of 22 foals from 4 localities in southwestern Montana, 59% were found to be infected with Eimeria leuckarti. Oocysts collected from feces of 4 positive horses were sporulated and subsequently administered to a 5- to 6-month-old foal. The prepatent period was 31 days and the patent period was between 5 and 10 days.


Telemetric measurements of strain in the metacarpus of the horse: a pilot study. The advances made by the use of a telemetric system in the study of bone strain in a free-moving horse are reported. A rosette strain gauge was bonded to the craniomedial aspect of the metacarpus of the horse. Attachment of a miniature FM transmitter to lead wires facilitated telemetric transmission of of resistance changes which corresponded to limb movement. During 3 different gaits, the trace pattern remained similar, although frequency and amplitude varied. The tracings were similar to those reported in other species in which nontelemetric transmission was used.


Immunosuppression of humoral and cell-mediated responses in calves associated wtih inoculation of Mycoplasma bovis. Calves were given (subcutaneous inoculations) viable Mycoplasma bovis with and without Freund's complete adjuvant (FCA). In the calves given M bovis with FCA, immediate and delayed cutaneous reactivity to formolized M bovis and increases in serum indirect hemagglutination (IHA) titers were pronounced. None of the calves showed evidence of an anamnestic response to a 2nd inoculation of M bovis. Treatment of the test serums from all calves with 2-mercaptoethanol (2-ME) revealed the presence of increased immunoglobulin M-IHA activities throughout the 70-day postinoculation (PI) period. Strong cell-mediated responses, as shown by the lymphocyte-activation test, were not observed until PI day 44. Lymphocytes from calves given M bovis with FCA gave the greatest response to M bovis antigens. However, the lymphocyte activation response to M bovis rapidly decreased after day 44 PI. The in vitro lymphocyte responses to phytohemagglutinin (PHA), as well as the control rates of lymphocyte incorporation of tritiated thymidine, appeared to be depressed as a result of the M bovis inoculations. The aqueous "supernatant" of M bovis was generally suppressive to in vitro lymphocyte blastogenesis. Mycoplasma bovis appeared to affect the immune responsiveness of the host directly by either stimulation of suppressor cell function or transiently depressing T-lymphocyte activities. The addition of FCA with M bovis had an enhancing effect on humoral and cell-mediated responses probably by increasing macrophage presentation of antigen to T-lymphocytes. The delayed development of cell-mediated immune responses may assist in the explanation of why some hosts are unsuccessful in mounting an effective immune response against M bovis.


Hemodynamic effects of acute hypoxia and minute amounts of endotoxin in awake swine. Hemodynamic measurements and arterial blood gases were determined from awake swine (n = 8) during acute hypoxia (12% O2, balance N2 for 5 minutes) and following injection of Escherichia coli endotoxin (4 microgram/kg of body weight) into the pulmonary artery. Comparison of baseline data with these treatments indicated: (1) swine exhibited a marked pulmonary pressor response to acute hypoxia (deltaBPpul = 9 to 12 mm of Hg): (2) injection of minute amounts of endotoxin led to a marked increase of pulmonary arterial blood pressure 10 to 20 minutes following the injection (deltaBPpul = 15 mm of Hg); and (3) the pulmonary pressor response to a 2nd exposure of acute hypoxia was unaffected by the intervening endotoxin injection.


Uterine position and presentation of minipig-fetuses and their order and presentation at birth. Uterine position and presentation of fetuses in 17 minipigs during pregnancy were compared with their order and presentation at birth. Fetuses from 1 or both uterine horns were marked between day 80 and day 105 of gestation by 1 or more transuterine injections of either a 2.5% solution of dianil blue (3 animals) or a radiopaque substance (14 animals). Roentgenograms of the newborn pigs, which were ear-notched immediately after birth, enabled making individual identification. Pigs seemed to be delivered randomly from the 2 uterine horns. They either followed a neighbor from the same horn (n = 42) or followed a pig from the contralateral horn (n = 52). Only in 3 dams did 1 uterine horn become empty before delivery from the other horn started. In 4 dams, 1 pig passed its neighbor from the same horn, thereby being born earlier than expected. Moreover, passing of pigs could have occurred and gone undetected in those dams from which the pigs of only 1 horn were marked. This passing might have taken place within the uterine body. From 18 of 95 pigs (19%) , the presentation at birth differed from the one observed at laparotomy.


Plasma clearance of [51Cr] albumin into the intestinal tract of normal and chronically diarrheal horses. Five clinically normal, mature horses and 11 with chronic diarrhea were given 51Cr-tagged Cohn fraction V equine albumin intravenously. All urine and feces were collected separately, and blood for plasma analysis was taken periodically for 5 to 8 days after injection of the isotope. Plasma clearance of albumin into the intestinal tract of normal horses was calculated as 0.67 +/- 0.23 (SD) ml/kg of body weight/day, with 1.33 +/- 0.69% of the 51Cr dose appearing in the feces in 5 days. Of the 11 diarrheal horses, 8 had a plasma clearance of 0.49 +/- 0.21 ml/kg/day with 1.12 +/- 0.68% of the dose of 51Cr in a 5-day fecal collection, suggesting that excessive losses of plasma protein into the bowel was not a component of their intestinal disease. The 3 other diarrheal horses had a marked protein-losing enteropathy; 1 of these horses had granulomatous enteritis due to Mycobacterium avium infection; another had severe intercellular edema of small and large intestinal mucosa, cause unknown; and intestinal biopsies were not obtained from the 3rd horse. The results suggest that: (1) as with other species that have been studied, daily loss of plasma protein into the bowel of horses is small; (2) most horses with chronic diarrhea do not have protein-losing enteropathy.


Erythrocyte rosette formation of equine peripheral blood lymphocytes. Erythrocyte rosette (ER) formation of equine peripheral blood lymphocytes (PBL) was characterized. Guinea pig and, to a lesser extent, human erythrocytes formed ER; cat, cow, dog, hamster, mouse, rat, and sheep erythrocytes showed negligible rosetting properties. Conditions of the assay were varied to determine which procedure allowed the largest percentage of rosette formation. The PBL from 20 normal horses were then assayed, averaging 38 +/- 2% ER. To characterize the erythrocyte receptor as being on T or B cells, equine thymocytes from 6 foals were assayed; the thymocytes formed an average of 66 +/- 5% ER. Mixed ER and erythrocyte-antibody-complement rosette assays showed no PBL which bound both ER and erythrocyte-antibody-complement rosettes. The PBL which was stimulated with phytohemagglutinin formed more rosettes (69 +/- 2%) than nonstimulated, control PBL (42 +/- 3%).


Vasculature of the equine and canine iris. Methyl methacrylic casts were prepared and tissue was freshly collected for histologic examination to compare the vascular supply and the structure of the vessels of the iris in the adult horse with those of the dog. In the horse, ciliary blood vessels divided in the iris and formed a complete major arterial circle of the iris. In the dog, the ciliary blood vessels divided in the ciliary body and, by means of recurrent branches, formed a complete arterial circle. From this circle, radial arteries extended toward the pupillary margin. The radial vessels in the horse were nearly straight and joined to form a prominent minor arterial circle of the iris at the level of the sphincter pupillae muscle. Radial blood vessels in the horse did not appear to be controlled by the sphincter muscles. Venous blood of the iris of the horse was carried to the ophthalmic vessels via 4 prominent vortex veins. Drainage from the iris of the dog was by way of 4 to 6 circular collecting veins in the ciliary region. From this site, blood passed either via the ciliary veins or via small vortex veins to the dorsal and ventral external ophthalmic and then to the ophthalmic plexus.


The cruciate ligaments of the canine stifle: an anatomical and functional analysis. Fifty canine stifles were used to study the anatomy and function of the cruciate ligaments. The morphology of the ligaments and the shape of their bony attachments were determined by dissection. The relative tension of the ligaments in flexion and extension was determined by identifying the points of attachment of ligament fibers with small pins and making multiple radiographs as the stifle was taken through a range of motion. The distance between these points was then measured and the linear changes in the ligaments were defined. Measurements of rotation, craniocaudal displacement, extension, and flexion were made before and after cutting of one or both ligaments. It was found that both cruciate ligaments were composed of 2 component parts and that the geometry of their femoral attachments was responsible for a reciprocal loosening and tightening of these components through a range of motion. It was also found that transection of one or both cruciate ligaments resulted in marked joint instability.


Canine peritoneal macrophages: cultivation and infection with Ehrlichia canis. Canine peritoneal macrophages were obtained by repeated peritoneal lavage of dogs at 14 day intervals. Intraperitoneal administration of sterile mineral oil increased the leukocyte yield approximately 20-fold and the macrophage recovery approximately 35-fold. Cell recovery was maximum 7 to 21 days after administration of oil and declined slightly by 35 days. Restimulation with a 2nd injection of oil promptly revitalized cell recovery. Peritoneal macrophage cultures were well established by 6 days after seeding and were maintained for at least 30 days. Initially, cultured macrophages were mononuclear, but binuclear cells appeared after 6 days' cultivation and multinucleated giant cells were observed after 14 days. Canine peritoneal macrophages and peripheral blood monocytes were equally susceptible to infection with Ehrlichia canis. Infected cells were detected by 60 hours after inoculation, and replication was evident by 12 to 18 days.


Acute canine ehrlichiosis: platelet survival and factor 3 assay. Ten dogs experimentally inoculated with Ehrlichia canis were thrombocytopenic 14 days after inoculation. Circulating platelet concentrations had declined rapidly by postinoculation day 10, but remained at or slightly below the 14-day concentration during the remainder of the 42-day experimental period. The percentage of circulating megathrombocytes also increased to 8.7 times preinoculation concentrations indicating the existence of accelerated thrombocytopoiesis. The release of platelet factor 3 (PF-3) from normal canine platelets was delayed after incubation of the platelets in globulin fractions from infected dogs. Inhibition of PF-3 release was attributed to the effect of an unidentified substance present only in the dialyzed globulin fraction of infected canine serums. The presence of antiplatelet antibody in these dogs was not evident. Survival of 51Cr-labeled platelets was decreased in infected dogs, but was most abbreviated in infected dogs that were thrombocytopenic when injected with labeled platelets. Thus, accelerated nonantibody-mediated destruction of platelets contributes markedly to the development of thrombocytopenia in dogs with acute ehrlichiosis.


Isoflurane potency in the dog and cat.

Isoflurane potency in the dog and cat. Cardiopulmonary effects of isoflurane, a new inhalation anesthetic, were investigated in healthy unpremedicated dogs and cats under conditions of spontaneous and controlled (dogs only) ventilation. Measurements were made at minimal alveolar concentration (MAC) multiples of 1.0, 1.5, 2.0, and 3.0 in dogs and 1.0, 1.5, 2.0, and 2.4 in cats. The isoflurane MAC was previously determined in these animals and was 1.28 +/- 0.06% for dogs and 1.63 +/- 0.02% for cats. We found that as anesthetic dose increased, mean arterial pressure consistently and significantly (P less than 0.05) decreased. Cardiac output, measured only in dogs, was sustained only during light-moderate levels (1.0 to 2.0 MAC) of anesthesia because the heart rate significantly increased. Stroke volume, total peripheral resistance, and left ventricular work tended to decrease as anesthesia deepened. We found no significant difference in cardiovascular measurements in dogs between spontaneous and controlled ventilation at equal MAC multiples. That isoflurane is a profound respiratory depressant in dogs and cats is supported by our findings of a dose-dependent increase in PaCO2. In addition, the alveolar isoflurane concentration required to produce at least 60 seconds of apnea divided by MAC (i.e., the anesthetic index) averaged 2.5 for dogs and 2.4 for cats. The anesthetic index which we determined for isoflurane in dogs equals or is less than the index reported for other inhaled anesthetics in this species.


Evaluation of a lateral retinacular fascia technique for cranial cruciate ligament rupture in the dog. A new fascial technique was used to repair artificially induced rupture of the cranial cruciate ligament in 20 dogs. Although technically simple to perform, the procedure resulted in only 12 animals free of lameness. In addition, a drawer sign was present in the stifle of 14 animals 31 days after surgery. Arthritis changes typical of cruciate ligament instability were observed in 16 joints; changes were slight to moderate in 10 joints.


Calibration of the Schiøtz tonometer for the normal canine eye. The Schiøtz tonometer with 5.5-, 7.5-, and 10-g weights was calibrated for the normal canine eye, using a transducer with open and closed reservoir systems. The line of best fit for the observations was determined, and the equation of this line was utilized to derive a calibration table for the conversion of tonometer scale readings to mm of Hg intraocular pressure.


Effects of polyvinyl chloride ingestion by dogs. Polyvinyl chloride (PVC) acrylic thermoplastic sheeting was fed to 6 dogs to determine whether ingestion during periods of normal transit of military working dogs would be toxic and thus affect the safety of this material for construction of shipping containers. The test dogs were fed PVC acrylic (0.125 g/kg of body weight; by gelatin capsule) twice each day for 5 days: for 2 dogs, the test material was in a shredded form; for 2 dogs, the material was diced; and for 2 dogs, it was powdered. Two other dogs were used as controls. Dogs were observed for clinical signs, and feed consumption and body weights were recorded. Blood and urine samples were examined. All animals were necropsied approximately 10 days after the feeding was stopped. Clinical or pathologic indication of a toxic effect of PVC was not seen within the time limits of the study.


Chromosome identification of the flat-headed cat, Felis planiceps: one more down and five to go. There are 38 recognized feline species in the world. With successful chromosome analysis of the flat-headed cat, Felis planiceps or Prionailurus planiceps, from the secluded river banks and lower mountain slopes of the jungles of Malasia, Borneo, and Sumatra, there remain only 5 rare and endangered species yet unstudied. Although some, including the flat-headed cat, have somewhat distinctive chromosome configurations, all cats thus far karyotyped show 38-chromosome counts, excepting 5 new world "tropicals" which have 36. A pattern of probable feline mutations can be read from the chromosome variations in the different species.


Bovine spastic paralysis: results of surgical desafferentation of the gastrocnemius muscle by means of spinal dorsal root resection. A dorsal laminectomy of L-4, L-5, and L-6, followed by resection of the dorsal (afferent) roots of the gastrocnemius muscle (desafferentation) was performed on 3 calves which had spastic paralysis. All signs of the condition disappeared after desafferentation. This suggests an overactive stretch reflex to be the cause of the spastic paralysis.


Induced infectious bovine keratoconjunctivitis: vaccination with whole cell bacterins of Moraxella bovis mixed with Freund's incomplete adjuvant. Our studies on vaccination against infectious bovine keratoconjunctivitis were extended to include the use of adjuvant bacterins. Seventeen calves were given 2 doses of killed Moraxella bovis mixed with Freund's incomplete adjuvant; 15 calves were given 2 doses of whole cell bacterin without adjuvant. Four weeks later, all vaccinated and non-vaccinated (control) calves were challenge exposed by the conjunctival administration of virulent M bovis. The incorporation of Freund's incomplete adjuvant did not enhance the immunogenicity of M bovis bacterin for protection of calves against infectious bovine keratoconjunctivitis. Results indicated that the use of Freund's incomplete adjuvant does not compensate for a reduction in the number of doses which are required for protective vaccination of cattle.


Fate of occupational asthma. A follow-up study of patients with occupational asthma due to Western Red Cedar (Thuja plicata). Thirty-eight patients with red cedar asthma proved by inhalation provocation test were studied after they had left exposure for more than 6 months. Twenty-seven patients became asymptomatic, with normal lung function (group A). Three patients had persistent chronic bronchitis with a moderate degree of airway obstruction, probably as a result of cigarette smoking (group B1). Eight patients continued to have recurrent attacks of asthma that decreased in severity after cessation of exposure, and their symptoms were probably due to previous exposure (group B2). The effect of breathing helium on maximal expiratory flow at 50 per cent of the vital capacity was studied. All except one patient in group A were responders (change in maximal expiratory flow at 50 per cent of vital capacity greater than 30 per cent). Two patients in group B1 and 2 in group B2 were nonresponders, suggesting obstruction in the small airways. All patients with red  cedar asthma demonstrated bronchial hyperreactivity to methacholine to the same extent as patients with nonoccupational asthma. This hyperreactivity persisted after they left  exposure, irrespective of symptoms. It is not known at present whether bronchial hyperreactivity is the predisposing factor in occupational asthma or is the result of the disease.


Maximal expiratory flows at functional residual capacity: a test of lung function for young children. Maximal expiratory flows at functional residual capacity were measured noninvasively from partial expiratory flow-volume curves in 65 awake, healthy children, 4 to 6 years of age. The variabilities within and between subjects were nearly identical to those reported for flows low in the vital capacity obtained from older subjects. This test of maximal expiratory flow at functional residual capacity has the advantage that the subject does not have to inspire to total lung capacity, exhale to residual volume, or make a maximal effort, and it is therefore applicable to the testing of young children who cannot perform a vital capacity maneuver. Measurement of this flow rate in 20 patients of the same age with lung disorders of varying severity revealed abnormal flow rates in more than 50 per cent of patients. Functional residual capacity was measured by the closed-circuit helium-equilibration method. When flow rates in liters per sec were compensated for lung size, girls had significantly larger flow rates than did boys. This suggests that the lungs of young children may grow differently according to genetic determinants related to sex.


Comparison of flow-volume and closing volume variables in a random population. Data obtained from results of single-breath N2, or closing volume, tests were compared with maximal expiratory flow-volume parameters in 725 subjects, 25 to 54 years of age, from a random, stratified, cluster sample of the population of Tucson, Arizona. Results of the 2 tests showed poor concordance. A greater proportion of abnormalities was revealed by maximal expiratory flow-volume measurements than by the single-breath N2 test in population subgroups defined as other than "normal". Among the 114 subjects reporting physician-confirmed asthma, chronic bronchitis, or emphysema, less than one half of those with maximal expiratory flow-volume abnormalities also had an abnormality in the single-breath N2 test. Results of this comparison do not indicate that the closing volume test, when applied to a general population, consistently reveals abnormalities of clinical significance.


Abnormal response of cultured lymphocytes to phytohemagglutinin and autologous serum in cystic fibrosis. Lymphocytes from adults homozygous or heterozygous for cystic fibrosis show biochemical abnormalities when cultured for 48 hours in the presence of phytohemagglutinin and autologous serum. In contrast to the 45 per cent increase in total protein and beta-glucuronidase concentrations seen in healthy control subjects when measured per 10(10) cells, both concentrations decreased by 1 per cent in adults heterozygous for cystic fibrosis and by 18 per cent in adults homozygous for cystic fibrosis. The abnormal response of the lymphocytes from persons with cystic fibrosis was due to a serum factor and not to any intrinsic abnormality of the lymphocytes. An abnormal response to hytohemagglutinin occurred in only 14 per cent of 44 healthy control subjects, but in 100 per cent of 14 adults homozygous for cystic fibrosis and in 85 per cent of 26 adults presumed to be heterozygous for cystic fibrosis. As a result of this phenomenon, lymphocytic beta-glucuronidase concentrations were significantly lower than normal in patients with cystic fibrosis when the cells were cultured with phytohemagglutinin and autologous serum. The demonstration of this phenomenon in both homozygotes and presumed heterozygotes (parents) suggests a relationship to the genetic defect in cystic fibrosis.


Sources of Mycobacterium avium complex infection resulting in human diseases. Human disease caused by organisms in the Mycobacterium avium complex occur virtually worldwide. A 20-year ongoing study conducted in Western Germany has been analyzed to elucidate the ecologic and epidemiologic characteristics of these infections in man. Organisms included in this investigation have been cultured from man, from domestic and wild animals and fowl, and from a variety of environmental sources. In addition to the usual taxonomic studies of these bacilli, infrasubspecific typing by seroagglutination has enabled identification of 3 distinct serogroups: the classical Mycobacterium avium strains (serovars avium 1, 2, and 3), the intermediate group (avium serovars 4, 5, 6, 8, 9, 10, and 11), and the less frequently encountered organisms, the 11 remaining avium serovars (7 and 12 through 21). Analysis of the number of strains in each of the 3 serogroups, derived, respectively, from man, from animals, and from the environment, has enabled us to draw some conclusions regarding reservoirs and sources of human infection with these agents.


Megaesophagus and pneumonia associated with Mycobacterium chelonei. A case report and a literature review. The case of a 37-year-old woman who developed a subacute, bilateral, noncavitary pneumonia 5 years after a colon interposition esophagoplasty is presented. Mycobacterium chelonei, subspecies abscessus, was assigned a pathogenic role based on the findings of (1) a clinical and roentgenographic picture consistent with tuberculosis, (2) sputum smears showing acid-fast bacilli, (3) repeated sputum cultures yielding heavy growths of Mycobacterium chelonei, subspecies abscessus, and (4) a 12-mm by 12 mm-skin test response to homologous antigen (purified protein derivative-CL) with no response to an equivalent dose of purified protein derivative-S. The patient recovered fully without significant antituberculous chemotherapy. A survey of the literature revealed 11 similar case reports featuring a documented association between megaesophagus and pulmonary infection with rapidly growing mycobacteria.


Tracheal leiomyosarcoma: a unique cause of stridor. A 26-year-old man presented with a 2-week history of hemoptysis and progressive upper airway obstruction. Roentgenograms and bronchoscopy confirmed a tracheal tumor, and a primary leiomyosarcoma was resected.


Spherulin skin testing and histoplasmal and coccidioidal serology: lack of effect. This study demonstrated that the administration of a spherulin skin test to subjects whose skin-test reactions were either positive or negative, at the dose used (Usual Test Strength), did not elicit an antibody response to antigens of Coccidioides immitis or Histoplasma capsulatum, as determined by standard serologic methods. Of 32 subjects, one developed a seroconversion by the latex agglutination test. The data suggested that spherulin can be used clinically as a diagnostic reagent without affecting the serologic reactions, which are of both prognostic and diagnostic value.


[Bacterial meningitis in valencia: epidemiology and therapeutic results in 208 cases (author's transl)]. Review of 208 patients with bacterial meningitis, admitted from march 1, 1971 to march 1, 1976. Incidence peak was found in Winter (december to march). Etiologically N. meningitiditis, 39, 9%, was the mainly predominate germ. In 49% of the patients C.S.F. cultures were negative, significantly influenced by the previous treatment with antibiotics (P less than 0.001). Cure was obtained in 86.5% Convulsions, 12%, were the most frequent complication, followed by subdural effussion, 3.8%, and arthritis, 2.4%. Twenty patients died, 9.6%; fifteen of them with endotoxic shock. Definitive sequelae was present in the 3.8%, mainly hidrocephaly. A comparative study with other series in Spain is performed.


[Pediatric intensive care (author's transl)]. In the Intensive Care Unit of our General Hospital, where an important obstetric-pediatric unit exists, 392 infants have been treated from August 1974 to 1976. Although the results of all age groups are shown, the neonatal one is specially considered. All those patients who recovered and were discharged from the hospital were called for revision and the results of those whom attended are shown. The convinience of the regionalisation and hierarchisation of these intensive care units and the necessity of adequately organise the communication and transport of these patients from the peripheral small units to the regional one, is emphasized.


[Corrected transposition of the great arteries. Study of 14 cases (author's transl)]. We have studied 14 patients of corrected transposition, 12 with situs solitus and 2 with situs inversus. In all the patients, excepting one, a clinical, radiological and angiocardiographical study was performed. The associated anomalies were determining elements of the clinical situation; the patients with pulmonary obstruction and interventricular communication had cianosis, while the 4 patients with aortic obstruction or anomalies type left Ebstein show cardiac insufficiency. The simple radiological study helped us to determinate the ascendent aorta in the left side of the heart, in 9 cases. It was unusual to see the droped hilium in the right hemitorax. The more significants electrical signs were: The presence of complete A-V block, Q-waves in D2, D3 and aVF, absence of right waves in precordial leads in most of the patients and a negative T wave in a VL. Summarizing, authors believe that in this type of defects selective injection of contrast in both ventricles is the best method to establish the difference between corrected transposition and other cardiopathies with the aorta situated at the left side of the pulmonary artery.


[Renal pathology and ultrasounds (author's transl)]. In our present work we inttend to apply the ultrasounds to the field of child nephrology, by using the Vidoson 635 model. The advantages brought about by this new diagnostic method, which does not exclude others, lyes in its tridimensional vision, of easy handling, the fact of not requiring previous preparation of the patient and very little risk. In this work we present images of normal kidneys, renal agenesia, renal hypoplasia, hydronephrosis, hydrocalcinosis, cystic disease and nephroblastoma, emphasizing its use in the differential diagnosis of liquid and solid renal mass.


[Craniosynostosis: a review of 14 cases (author's transl)]. Fourteen cases of single and polimalformative craniosynostosis are presented. A Crouzon's syndrome, and Apert's syndrome and a Carpenter's syndrome are included. On the cranial deformities, 7 cases of scaphocephaly, 4 cases of oxycephaly and 3 cases of acrocephaly were diagnosed. The eye abnormalities, the mental retardation and the intracranial hyperpressure symptomatology were analyzed. A lineal descompresive craniectomy was performed in 10 cases. The applied surgical criterium was the appearing of intracranial hyperpressure. The postoperative results upon the clinical symptomatology and the cranial deformity are commented, showing a real improve of the hyperpressure symptoms in all the cases, a correction of the scaphocephalic defect and a lack of effect on those clinical manifestations resulting from the cerebral damming. Finally, the timing of operation is discussed.


[Normal values of zinc, copper and copper/zinc ratio in healthy children (author's transl)]. Zinc and copper seric values have been determined in 120 healthy children between the ages of 0 and 7 years. Percentile grafics of normal zinc, copper and copper/zinc ratio values, are also described.


[Thrombosis of intracraneal sinuses in homocystinuria (author's transl)]. The case of a child affected with piridoxinresistant homocystinuria who developed early on the disease an aseptic thrombosis of intracraneal sinuses, of chronic evolution is presented. Pathogenesis and therapy of the thrombosis are discussed emphasizing the value of measures directed to avoid the aggregation of platelets.


[Intrauterine renal vein thrombosis (author's transl)]. One case of renal venous thrombosis in a male foetus, born of a diabetic mother is reported. The intrauterine origin and the long age of the thrombosis were confirmed by pathologic studies. Some speculation about the etiopathogenic mechanisms of intrauterine renal venous thrombosis are made.


[Iatrogenic evolutive skull fracture (author's transl)]. A case of growing skull fracture secondary to a maxilofacial operation is reported. Frequency, clinical symptoms, phisiopathology and treatment of growing skull fractures are reviewed and the rarity of the iatrogenic mechanism is stressed.


Blood levels of 25-hydroxyvitamin D in nephrotic syndrome. Studies in 26 patients. The blood levels of 25-hydroxyvitamin D (25-HCC) in 26 patients with nephrotic syndrome (proteinuria of 6.5 g/24 h +/- 0.8 SEM) ranged between 1 and 18.6 ng/ml (8.6 +/- 1.0 SEM). This value was significantly lower (P less than 0.01) than that in normal subjects (21.8 +/- 2.3 ng/ml) and patients with chronic renal failure (24.8 +/- 2.3 ng/ml). There was inverse correlation (P less than 0.01) between levels of 25-HCC and magnitude of proteinuria and a direct relation (P less than 0.01) with serum albumin. Reduction in proteinuria was rapidly followed by a rise in blood 25-HCC toward normal. Ionized calcium levels were low in 16 of 26 nephrotic patients irrespective of degree of renal failure. In four of seven nephrotic patients with normal renal function, ionized calcium levels were low and showed an inverse relation with levels of parathyroid hormone. These data show that patients with nephrotic syndrome have low blood levels of 25-HCC probably due to its loss in urine. This derangement is probably responsible for the disorders of calcium metabolism in nephrosis.


Use of calcium and secretin in the diagnosis of gastrinoma (Zollinger-Ellison syndrome). Sixty-five patients with peptic ulcer disease were evaluated for gastrinoma (Zollinger-Ellison syndrome) by measuring changes in serum gastrin concentration after intravenous (i.v.) administration of calcium or secretin, or both. The presence of gastrinoma was established in all 20 patients whose serum gastrin increased by 395 pg/ml or more after i.v. calcium and in all 18 patients whose serum gastrin concentration increased by 110 pg/ml or more after i.v. secretin. The experience with these 65 patients shows that stimulation by calcium or secretin may confirm the presence of gastrinoma in cases where the diagnosis would otherwise remain obscure. Although a positive response to calcium or secretin is diagnostic for gastrinoma a negative response does not exclude this diagnosis. Stimulation with secretin is preferred for screening for gastrinoma because it is quicker and more reliable than calcium.


Tamoxifen (antiestrogen) therapy in advanced breast cancer. Fifty-nine postmenopausal women with advanced breast cancer were treated with tamoxifen (antiestrogen), 20 mg orally twice a day for at least 2 months. They had been previously treated with other types of hormonal therapy or intensive chemotherapies, or both. Nineteen of the 59 patients (32%) had either a complete response (seven patients) or partial response (12 patients). The median duration of response was 9+ months. Tumors containing estrogen receptors and those that responded to previous hormonal manipulation tended to respond to tamoxifen (60% and 69%, respectively). Patients with receptor-negative tumor or with a history of failure of previous hormonal treatments did not respond to tamoxifen therapy. Tamoxifen is effective against advanced breast cancer. Side effects of the treatment were mild.


Wegener's granulomatosis, lymphomatoid granulomatosis, and benign lymphocytic angiitis and granulomatosis of lung. Recognition and treatment. Observations on 35 patients with pulmonary angiitis and granulomatosis show the value of separating pulmonary lesions of this type into three categories. Fifteen patients had Wegener's granulomatosis characterized by necrotizing granulomatous inflammation of lung, frequent upper airway and renal involvement, and responsiveness to cyclophosphamide. Nine had lymphomatoid granulomatosis characterized by necrotic atypical lymphoreticular infiltrates and frequent cutaneous and neurologic involvement, usually fatal despite intensive cytotoxic drug therapy. Eleven had benign lymphocytic angiitis and granulomatosis, in the past included in the above categories and characterized by nodular collections of mature lymphocytes and plasma cells, with predominantly pulmonary involvement and consistent responsiveness to chlorambucil. Wegener's granulomatosis and benign lymphocytic angiitis and granulomatosis were frequently associated with serum immunoglobulin elevations, with intact cell-mediated responses. Clinical and immunologic assessment was useful indistinguishing benign lymphocytic angiitis and granulomatosis from lymphomatoid granulomatosis.


Pharmacokinetics of lidocaine after prolonged intravenous infusions in uncomplicated myocardial infarction. The kinetics of the elimination of lidocaine upon discontinuation of lidocaine infusions lasting more than 24 h were studied in 12 patients with uncomplicated myocardial infarctions. In this group of patients the mean half-life of the elimination phase was found to be 3.22 h. This is significantly different from the half-life of 100 min that has been reported after bolus injections or infusions lasting less than 12 h. This longer half-life should be taken into consideration in estimating the duration of toxicity and the rate of administration of the drug during and after intravenous infusions lasting 24 h or more.


Iron balance in hemodialysis patients.

Iron balance in hemodialysis patients. Iron deficiency is a frequent complication in chronically hemodialyzed patients because of the significant blood losses associated with this technique. Quantitating iron stores (by marrow examination or serum iron and total iron-binding capacity) on a repetitive basis had been difficult or unreliable, often resulting in failure to recognize iron deficiency superimposed on the existing anemia of chronic renal failure, or overtreating, which can lead to iron excess. Use of the serum ferritin allows easier quantitation of iron stores and, when measured serially in dialysis patients, can predict the emergence of iron deficiency. There was no correlation between serum ferritin levels and serum iron, total iron-binding capacity, or percent transferrin saturation. Iron absorption studies show that food iron absorption is physiologic, increasing when the serum ferritin is below 30 ng/ml, decreasing when more than 300 ng/ml. Treatment of iron deficiency with oral iron compounds increases serum ferritin levels and usually can maintain iron balance.


Control of influenza in the hospital.

Control of influenza in the hospital. Nosocomial transmission of influenza has been reported infrequently; however, patients in general hospitals are often among the most susceptible to the complications of influenza infection. Hospital-acquired influenza may occur more often than is reported, but it may be recognized because of lack of diagnostic facilities or the time required for virus isolation and identification. Based on the mode of transmission in the hospital, the established reservoirs of influenza virus, and duration of virus shedding, isolating patients with influenza may occasionally be useful but restricting visitors is probably not required. Vaccinating hospital personnel with influenza vaccine and, if influenza A is prevalent, giving amantadine hydrochloride to high-risk patients or personnel should both be considered.


Overdiagnosis and overtreatment of pulmonary embolism: the emperor may have no clothes. Pulmonary embolism is being overdiagnosed and overtreated, especially in previously normal women using oral contraceptives, with undesirable consequences in heparin treatment. This is in part a consequences of high estimates of its occurrence based on postmortem data and in part of technologic developments in diagnostic methods. Blood gas data are not diagnostically very helpful. Perfusion scans should be used, largely to exclude the diagnosis. Ventilation scans are only occasionally helpful and are expensive. Pulmonary angiography is the most accurate diagnostic means currently available. Further studies are needed to elucidate the prevalence and natural life history of pulmonary embolism in the previously healthy person.


[Monoclonal paraproteins other than in Kahler's and Waldenström's diseases. Apropos of 67 cases]. On the basis of 67 cases of patients suffering from monoclonal dysglobulinaemias other than multiple myeoloma and Waldenström's disease, the authors report the characteristics of their series. The review current diagnostic criteria and, in this context, present their experience of caryotypic determination which was carried out in 24 subjects. These dysglobulinaemias may occur in isolation, on a familial basis or in association with some other pathology, which leads to the suggestion of a number of aetiopathogenic hypotheses, which are probably interlinked.


[Interventricular communication caused by nonpenetrating injury of the thorax]. Previously fatal in the majority of cases, traumatic interventricular communications are now curable by surgery. This is illustrated by the case described here of a 20 year old man. 62 other cases were found in the literature. A systolic murmur is the essential feature in diagnosis but it may be discovered some time after the accident. The demonstration of cardiomegaly has less diagnostic significance than ECG signs suggestive of an infarction. Haemodynamic studies are essential to confirm the diagnosis and to provide an accurate assessment of the lesion. The spontaneous course is serious since death results in two thirds of cases. Surgery is indicated, other than in well tolerated forms with a minimal shunt. The approach used has almost always been right cardiotomy. However, incision of the left ventricle offers better visibility of the lesions which may be masked by the papillary muscles when a right-sided approach is adopted. This was used in the present case with an excellent result since the patient was able to continue the military career for which he had opted.


[Changes in the aortic prosthesis surgical risk]. Between May 1963 and December 1976, 889 patients underwent single valve aortic replacement by prosthesis. Hospital (30 day) mortality fell, with an exponential decrease (r = 0.94, p less than 0.01) to 4 per cent in 1976. Early risk factors are studied, taking into account the changes affecting them respectively over the time period considered. The average age of the patients increased but did not significantly affect operative mortality. Cardio-thoracic ratio, sex and the duration of extracorporeal circulation had little or no prognostic value. Only classification in class IV of the N.Y.H.A. and the type of valvular disease (severe incompetence) were of clearly pejorative significance. Most deaths occurred early in a context of signs of poor cardiac output, severe disturbances of ventricular rhythym, visceral (digestive) syndromes and/or thrombotic complications. They were characterised at autopsy by sub-endocardial haemorrhagic lesions. The prevalence of these lesions and that of early deaths appeared to decrease with techniques for myocardial protection during the operation.


[Generalized saturnine paralysis. Discovery of a double congenital disease: glucose-6-phosphate dehydrogenase deficiency (new variant) and distal tubular acidosis]. A case of severe lead poisoning with haemolytic anemia, extensive polyneuropathy and arterial hypertension is reported in a patient for whom G-6-P-D deficiency and renal tubular acidosis were discovered. Both traits were present in his family. Incomplete regression of paralysis and persistant biological abnormalities after chelating treatment were demonstrative of heavy saturnine load even though the toxic exposure was brief. The role of the two deficiencies in the mechanism of intoxication is discussed: facilitation of haemolysis by enzymopathy and bone lead redistribution resulting from osteolysis probably due to the tubulopathy. The authors emphasize the fact that thorough and serial biological investigation is essential in the discovery of factors which may precipitate lead poisoning, as well as in the determination of follow-up criteria of efficient toxic epuration with sufficient delay. Typing of the enzyme has led to the identification of a new variant of glucose-6-phosphate dehydrogenase deficiency.


[Model for the recall of dreams upon waking, proposed to account for impairment of memory of dreams]. A two-stage model is presented to account for the difficulties found in sleep learning and dream recall. The model assumes that information processing in a short-term memory store facilitates subsequent retrieval from long-term storage and that such processing is impaired during sleep. As a result, it is suggested that information confronting the sleeping person very likely can only be retrieved if an awakening occurs during the life of the short-term memory trace. However, it is proposed that material occurring during or shortly after awakening, competes with information occurring during sleep for space in the limited capacity processing system, with the most important being favored for processing. Interference and repression are included as additional factors affecting retrieval from longterm storage.