Hyperemesis gravidarum with gastric carcinoma. A 24-year-old multiparous female presented with a diagnosis of hyperemesis gravidarum and was found to have a gastric carcinoma. She underwent a gastric resection for carcinoma of the stomach and is alive and well 2 years after gastrectomy. X-rays, gastroscopy, and surgery were done while she was pregnant.


Amniotic bans syndrome in an immature fetus. A case of a 14-week fetus with congenital malformation due to amniotic bands is reported, including a description of the placenta. The literature is briefly reviewed, and attention is drawn to the occurrence of this syndrome in the immature human fetus.


Mesenteric supernumerary ovary.

Mesenteric supernumerary ovary. Following is a report and a review of literature concerning the supernumerary ovary. Up to now only 7 cases have been reported, and our case appears to be the eighth. The anatomic situation in this case was unusual since it was found in the mesentery. Of the cases previously reported, 2 have been associated with benign cystic teratoma.


The sitting posture: an electromyographic and discometric study. The disc pressure of the third lumbar disc and the myoelectric activity of several muscles of the back were measured. Three standing and nine unsupported sitting positions were studied as well as eight support parameters and six sedentary tasks. 1. Myoelectric activity is about the same in standing and in relaxed unsupported sitting. In the unsupported sitting positions the highest level of activity is found in anterior sitting and the lowest in posterior sitting. In the muscles of the cervical and lumbar regions the activity is always lower than in the muscles of the thoracic region. The disc pressure is considerably higher in unsupported sitting than in standing. In the unsupported sitting positions the highest disc pressure is found in anterior sitting and the lowest in sitting straight. 2. Both the myoelectric activity and the disc pressure decrease when the back is supported. Of the support parameters, the backrest inclination is the most important, myoelectric activity and disc pressure both decreasing with an increase in inclination. The disc pressure is considerably reduced also when the lumbar support is increased and when armrests are used. 3. Myoelectric activity and disc pressure are both comparatively low in writing, higher in typing, and still higher in lifting. In the car driver's seat the disc pressure increases both when the gear is shifted and when the clutch pedal is depressed. When the gear is shifted, there is also an increase in myoelectric activity.


Debridement and fusion in the lumbosacral area through an iliolumbar approach. In patients with recalcitrant sciatic and back pain due to disc degeneration and in symptomatic spondylolisthesis, surgery is recommended. Successful results can be achieved by exposing comfortable, by looking to the side, and by fusing from one side into the vertebral body.


Creep characteristics of the human spinal column. Thirty-two static compression tests were carried out on 52 intervertebral disks and their posterior articular facet joints. The spinal units were tested within a uniquely designed test apparatus. Following the experiment, each intervertebral disk was examined macroscopically to assess the degree of disk degeneration. Three experiments were carried out at suitably chosen load levels, which were statically appropriate for a given vertebral level and its loading history. In the first experiment a constant load was applied to a spinal segment and its decrease in height was measured as a function of time. The results were as follows: Under the application of a constant load, the vertebral unit suffers a gradual change in its dimensions. This typical behavioral response pattern is identified as creep. Creep may be defined as the time dependent part of the deformation that accompanies the application of a load to the disk. The measured creep did not continue indefinitely but decreased with time until the vertebral specimen was equilibrated. The time to equilibration was a function of disk grade. The rate of creep was found to be dependent upon the condition of the nucleus pulposus. Creep is of considerable importance because of its influence on the kinetics and kinematics of the vertebral unit. The effect of creep is to increase the modulus of elasticity with time; hence a reduction occurs in the compliance of the spinal unit. In the second experiment, incremental loads were applied to a spinal unit. The unit was allowed to equilibrate and an additional load was applied. Its purpose was to further delineate spinal unit mechanics in terms of constant load and creep behavior. It was concluded from these tests that the nucleus plays an important mechanical role in influencing the behavioral response of the vertebral unit to constant compressive load. As nuclear maturation occurs, the stiffness characteristics of the spinal unit were noted to increase as dis its deflection characteristics. Spinal unit geometry no doubt also plays a role in influencing these results. In the last experiment, load-deflection curves were determined for the vertebral unit. It was found that load-deflection curves are not uniquely defined by the relationship between the variables of load and deflection. The time each value of load is maintained must also be taken into account. The physiological and biochemical factors responsible for the observed spinal unit behavior are outlined, and the importance of the articular facet joints in governing spinal unit deflection stressed. Although it has long been known that the intervertebral disk suffers a slow and continuous deformation when subjected to mechanical load, the concept of spinal unit deformation as a time dependent function of load is comparatively new.


Sources of failure in laminectomies.

Sources of failure in laminectomies. Failures in laminectomy may be due to improper patient selection, of which the largest factor appears to be a lack of recognition of an underlying psychological disorder. Rarely an operative procedure is performed on the wrong side or at the wrong level. A number of elements relating to what might be termed the "wrong operation" fall under the heading of failure to recognize disease, and the largest factor here in our experience has been the inability to explore the wound because of uncontrolled bleeding. The problem also relates to a lack of understanding of the anatomy and potential disorder of the vertebral axis. This then merges with the other factor, failure to deal with disease, which may be unrecognized or, if identified, misinterpreted. Last are those elements for which there is professional responsibility, the most serious being dural or nerve root irritation predisposing to traumatic arachnoiditis.


Stresses at the lumbosacral junction.

Stresses at the lumbosacral junction. This report has presented a discussion of the mechanics of the spine in terms of an analogy with a curved, tapered beam. We have identified the existence of critical frequencies and locations in the spine and discussed the evidence from clinical experience with low back problems. We have also discussed the extrinsic mechanisms for protecting the spine and the lumbosacral junction. The question of the sensitivity of the lumbosacral junction to shear forces has been raised and experiments described that show that the shear forces that will injure the posterior elements of the fifth lumbar vertebra are low and occur commonly. The report also describes an instrument to measure the stiffness of articulations of the spine.


Effects of partial reinforcement on conditioning, conditional probabilities, asymptotic performance, and extinction of the rabbit's nictitating membrane response. Classical conditioning and extinction of the rabbit nictitating membrane response was investigated under 100 per cent, and two 50 per cent reinforcement conditions (50% equated total trials, and 50% equated reinforced trials) at average intertrial intervals (ITIs) of 30 and 60 sec. It was found that: (1) partial reinforcement reduced the rate of conditioning, but all groups eventually attained asymptomatic performance levels near 100 per cent; (2) first-order and second-order conditional probabilities following reinforced and nonreinforced trials were virtually identical; and (3) no partial reinforcement extinction effect (PREE) was observed.


What is a "schedule of reinforcement"?

What is a "schedule of reinforcement"? Several ambiguities in the present terminology of behavior theory obscure some important theoretical assumptions and experimental details in current research. Left unclarified, such ambiguities impede the accurate analysis of laboratory procedures, and prevent reliable communication among researchers. This paper focuses on the term "schedule of reinforcement". It points out that two distinguishable operational rules are implicated in the term: in the case where reinforcement is of the so-called response contingent type, the "schedule" is really a rule to identify the response to be reinforced; in the case of non-contingent reinforcement, the "schedule" is truly a rule for delivery of reinforcement. Other terminological ambiguities that are encountered in a discussion of this term include "reinforcement" and "intermittency." A resolution of these problems will necessarily involve the procedures of non-contingent reinforcement, and the parameter of reinforcement probability.


[Determination of 131-J-hippuran clearance in renal camera functional scintigraphy using simplified Oberhausen's method]. The determination of 131-I-Hippuran clearance in connection with renography or renal camera sequential scintigraphy will give a quantitative evaluation of total and individual renal function. The "single shot" method of Oberhausen yields clearance values corresponding very well to the PAH standard clearance. To simplify this method for routine use in connection with camera sequential scintigraphy, we studied some modifications of the method, using regional activity curves instead of the activity curve of the partially shielded whole body. Simultaneously with the camera sequential scintigraphy we measured activity curves of the partially shielded whole body (lead-shielding of kidneys and bladder, two probes), the shoulder (one probe), the head (one probe) and a background region of the camera (ROI) above the kidneys for 30 min. All four curves were analyzed, using computer analysis (bi-exponential curve fitting) as well as tables of Oberhausen, and his formula was used for clearance calculation. Under two conditions a) taking blood samples between 15 and 25 min. p.i. b) using the tables of Oberhausen for curve analysis, the clearance out of the regional activity curves correlates well with the clearance out of the partially shielded whole body activity curve (r greater than 0,97). Therefore, it is possible determine 131-I-Hippuran clearance in a simple manner without lead-shielding of kidneys and bladder, either with one additional probe measurement at shoulder or head or without any probe measurement, using the camera and measuring a background curve (ROI) above the kidneys. This simple clearance method can easily be performed simultaneously with 131-I-Hippuran renography or renal camera sequential scintigraphy in routine.


Technetium-99m polyphosphate bone image for early detection of skeletal metastasis. Correlation with other diagnostic parameters. Technetium 99m-polyphosphate bone images are correlated with bone roentgenography, and serum calcium, phosphorus and alkaline phosphatase in 91 patients with suspected bone metastasis. Technetium polyphosphate bone images are the most sensitive and serum level of calcium and phosphorus are the least sensitive indicator of bone lesions. Bone roentgenography is not as sensitive as technetium polyphosphate images. Abnormal bone images with normal or abnormal bone roentenography associated with increased alkaline phosphatase in the absence of liver metastasis are highly suggestive of metastatic bone disease. Abnormal bone images adjoining the joints, associated with normal serum alkaline phosphatase and abnormal joint roentgenography suggest arthritis. It is recommended that technetium 99m-labelled phosphate bone images are considered to be the diagnostic procedure of choice to detect skeletal lesions. Polyphosphate bone images are highly sensitive, with the combination of elevated alkaline phosphatase they become relatively more specific for a metastatic bone disease.


Evaluation of the effect of respiratory movements of the organs on the resolution index. The motions of the respiratory movement of the diaphragms were filmed and the character of the motion was evaluated. The line-spread function of a motionless line source was compared with that of a moving source (for two kinds of motion: regular and harmonic). Similar calculations were made for increasing the motion amplitudes of the source and for different values of static resolution. The final dynamic resolution was calculated. The results show that when respiratory motion exceeds 13 mm (which happens in about 50% of clinical examinations) the resolution decreases by more than 25% so that it is necessary to use special methods of eliminating these artefacts.


[Results of HPL radioimmunoassay in normal and pathologic early pregnancy]. Radioimmunological assays of HPL have been carried out in early pregnancy in uncomplicated cases (n = 100) and in cases of abortus imminens (n = 49). The earliest detection of HPL was possible in the 6th week of pregnancy. When the tendency of the HPL-level was decreasing follow-up examination showed a beginning abortus. In every case of decreased HPL-level the progress of pregnancy was abnormal. Conclusions about the prognostic value and the limits of the HPL-RIA are discussed.


A method for investigating the metabolism of the transportable fraction of plutonium aerosols. The metabolism of the transportable fraction of both 'soluble' and 'insoluble' forms of plutonium following their deposition in the respiratory system of the rat by either inhalation or pulmonary intubation has been investigated. The results have shown that the transportable fraction varied considerably with the chemical form of the plutonium. Thus at one week after the pulmonary intubation of a solution of plutonium citrate, the extrapulmonary tissue deposit was 69% of the initial pulmonary deposit whilst in the case of a suspension of plutonium dioxide the corresponding value was only 0.075%. However, the metalbolism of plutonium following its entry into the systemic circulation was largely independent of the original chemical form deposited in the lung. The liver accumulated only about 16% of the activity deposited in tissues from the blood, implying that plutonium was circulating in the blood predominantly in a momomeric form. The cumulative excretion of plutonium in the urine over the first week after pulmonary deposition as either the dioxide, citrate or nitrate was equivalent to about 4.5% of the extrapulmonary tissue deposit and the results suggest that this value could be used as a basis for calculating the activity deposited in tissue from the blood in man. This study also demonstrated that mixed aerosols of plutonium dioxide and sodium oxide are more transportable in the lung than aerosols of plutonium dioxide alone. A maximum transportability was reached at a Pu : Na atomic ratio of about 1:20, when the transportable fraction of plutonium was forty-five times that from a plutonium dioxide aerosol alone.


The oxygen clock-a dual tracer physiological timer. In vivo differential decay of the radioisotopic pair 19O/15O is used to measure the regional label 'age'. Simplified expressions are developed relating the measured age to oxygen transit times and utilization. Simultaneous production of the label pair employs a continuous flow, mixed-gas target irradiated by the University of Wisconsin tandem Van de Graff accelerator. Flow-through chemistry follows, with transport to the user site up to several hundred metres distant. Gamma energy spectra from a twelve-probe detector array are recorded in an on-line computer during prolonged normal breathing of doubly labelled air. While the dynamics of oxygen compounds are of great physiological importance, the lack of compartment specificity of the 19O/15O pair raises fundamental questions in the interpretation of the age results.


The influence of geometrical factors in 131-I-hippuran renography. Using a particular collimated NaI scintillation detector and a kidney phantom containing 131-I, the dependence of the resulting count rates on collimator-kidney geometry has been determined. These results have been used to calculate the geometrical contribution to the error in the measurement of relative effective renal plasma flow (REP) by 131-I-Hippuran renography. When radiographic and ultrasonic methods of localizing the kidneys are employed, this error has been found to follow a normal distribution with a SD of 2.6% in the case of equally divided function. Combination of this error with that from natural movement and statistical fluctuations, as observed using a dose of 10 muCi 131-I-Hippuran, has led to the estimation of a corresponding potential error 11%. Values of the potential error, which is defined as the 99% probability range, have been calculated covering the range of RFP.


Measurement of calcium in sections of a human skeleton using a reactor spectrum-in vivo activation analysis technique. Factors influencing the precision of measuring changes in the calcium content of sections of bone, including vertebrae, using reactor neutrons for partial body in vivo activation analysis have been examined and quantified. These factors include (a) the choice of incidient neutron spectrum, (b) the uniformity of activation with depth in the body, (c) reproducibility, (d) interfering reactions, (e) sensitivity and (f) dosimetry. It is concluded that an overall precision of 2.8%-3.2% (coefficient of variation) can be attained with a neutron dose of 50 mrad or 3-4% with a dose as low as 20 mrad.


The effects of x-irradiation on the mechanical properties of skin. The elastic properties of rat skin previously irradiated with single doses form 1000 to 3000 rad have been studied. The measurements were made 50 and 120 d after irradiation on skin specimens immersed  in saline at 37 degrees c. The tests were carried out on a tensile testing machine. The load extension curve, which was plotted to the point of rupture, exhibits two portions which are identified with the aligment of the collagen fibres and then their subsequent stretching. The elastic properties associated with fibre alignment are little affected by these doses of radiation but the stiffness of the collagen itself tends to decrease with increasing dose, exhibiting a shoulder in the dose response curve.


Neurophysiological effects of prolonged cooling of the calf in patients with complete spinal transection. The neurophysiological effects of prolonged cooling were examined in seven patients with complete spinal lesions. The twitch tension of the soleus muscle, the direct (M-wave) and relfex (H-wave) response to electrical stimulation of the popliteal nerve, the Achilles tendon reflex (ATR) and the degree of inhibition of the H-wave by muscle vibration were recorded before and after a minimum of forty-five minutes cooling of the calf. Changes in the configuration of the M-wave occurred, suggesting that cooling results in slowing of conduction in muscle or motor nerve fibers. Prolongation of the twitch contraction and half relaxation time was observed, implying that the contractile mechanism of the muscle is affected. A significant decrease in the ATR/M ratio was observed, indicating that cooling, in addition, affects the muscle spindle or its connections. No significant alterations in the H/M ratio or in the degree of suppression of the H-wave by vibration were observed.


Relationship of hyperextended gait pattern of chondromalacia patellae. A specific hyperextended gait pattern is seen in patients with chondromalacia patellae. A new program designed to correct this gait impairment was evaluated by a clinical study. The findings of the study suggest a direct relationship between the amount of hyperextension and clinical severity of symptoms. When the patient's gait deviation is corrected, the symptoms of pain and effusion are alleviated.


Factors influencing patient satisfaction with the results of esthetic plastic surgery. The Wise pattern is a convenient tool for marking the outlines of the areola recipient site, and for marking the lower skin flaps of the "skin brassiere" in most of the currently used operations for mammary hypertrophy and ptosis. We find it useful, at times, to draw the pattern outline before making a final decision on which procedure to do. Rather than limiting the surgeon's judgement, these preoperative marks leave a wide spectrum of options open to meet the esthetic requirements, while keeping the basic landmarks properly located.


The anesthetic management and intraoperative care of patients undergoing major facial osteotomies. Our experiences with 42 major craniofacial osteotomies--performed at The Hospital for Sick Children, Toronto, between July, 1971 and January, 1974--are related. Guidelines for operative care and anesthetic management are outlined--with regard to the length and positioning of endotracheal tubes, fluid and blood replacement, reduction of intracranial pressure, prevention of pressure necrosis, and postoperative airway care. Adherence to these principles and cooperative teamwork may prevent unexpected deaths or complications, and may minimize morbidity.


An evaluation of cryosurgery for basal cell carcinoma. Fifteen histologically proven basal cell carcinomas were treated by conventional cryosurgery. Three to 6 months following healing, the entire treated area was excised and serially sectioned. There was clinical and microscopic evidence of residual tumor in two of the 15 cases and microscopic evidence of recurrence in one additional patient (20 percent recurrence).


Carotid-cavernous sinus fistula occurring after a rhinoplasty. Case report. We report a case of carotid-cavernous sinus fistula which developed after elective nasal surgery. As the carotid-cavernous sinus fistula is a rare but major complication of craniofacial injury, surgeons who operate in this area should by aware of the entity.


Sahaja: an Indian ideal of mental health. Sahaja is an Indian ideal of mental and spiritual health that has received special emphasis in the Sikh scriptures--especially, the Adi Granth. Since the concept of sahaja has long been associated with mystical thought and practice, its description has become shrouded in peculiar esoteric terminologies. It is the purpose of this communication to divest sahaja of its esoteric, mystic connotations and to redefine it as a mental health ideal in the context of contemporary conditions.


The organization of treatment on a short-term psychiatric ward. While the medical origin of psychiatric treatment has led to a tendency for discussions of treatment to dwell mainly on what is wrong with the psyche of patients, the treatment process of a residential facility consists of interaction between patients and a variety of staff members. It is a social process, and to understand fully what is going on, one might ask not only who is doing and saying what to whom, but who expects what, and how do each of the participants interpret what is going on. In observing the treatment process in a short-term psychiatric ward of a community mental health center, I saw the interaction of at least two different concepts and styles of treatment--the traditional medical model, and another model based on mobilizing social support. I found that my sociological perspective was useful in looking at the organization of the ward, at the two models of treatment--their interaction, their support of each other, and their occasional conflict, and at the nature of the patient role and the treatment process.


Rebirth in a therapeutic community: a case study. In most research on human behavior the experience of the subjects is filtered through the perspective of the behavioral scientist as observer and interpreter. In the narrative which is the principal portion of this study, a subject--in this case, a patient--reports directly both as subject and social scientist. An alternate title for the study might be, "the experiencing of a total institution". In contrast to what might be expected from much of the sociological literature on total institutions, this experience turned out to be a pleasant and positive one.


Business as usual--at the state mental hospital. Despite official policy and professional emphasis to the contrary, the custodial mental hospital continues to exist as a major form of state-provided mental health care. In this paper, one such institution, "New England State Hospital", is described, and the various features of hospital organization that sustain a system of custodial care are discussed. Although the custodial hospital offers little to its patients, its persistent survival can be explained by the number of non-patient vested interests that are well served by the state hospital, precisely in its existing custodial form. The case study of New England State Hospital suggests that reform of state mental institutions depends less on a programmatic formulation of desired changes than on an understanding of the structured resistance to such changes.


Operation homecoming: psychological observations of repatriated Vietnam prisoners of war. While in military service as a psychiatrist stationed at Scott Air Force Base, I had the opportunity to do the psychiatric evaluations on a number of the prisoners of war returning from North Vietnam. Scott Air Force Base is an area medical center (North Central United States), and was responsible for administering the medical and psychiatric examinations on all the men whose homes were in this area. Our hospital processed 29 returning POWS, of whom I saw 14. This group of POWS was probably unique in military history in that it was comprised almost entirely of officers. Their period of confinement was considerably longer than that of the prisoners of World War II and the Korean War, with the typical Vietnam POW being in captivity about six or seven years. This paper is an attempt to share my observations and thoughts on the experience of being a Vietnam Prisoner of War.


Female heroin addicts in a city treatment program: the forgotten minority. Female heroin addict clients suffer neglect of various kinds in connection with research efforts dealing with addiction. Often they are omitted altogether. Or, if included, topics relevant to their lives are not always examined, or a double standard of evaluation or interpretation, which operates to their disadvantage, is sometimes utilized. The study reported here was undertaken as a partial remedy for these ills. Its primary aim was to characterize a group of female heroin addicts at the time that they entered a city-run treatment program. Males were studied as well, however, so as to permit an examination of sex differences which might suggest modifications in male-oriented treatment programs.


American Indian suicide--Fact and fantasy. This is an epidemiology report on American Indian suicide patterns in the Pacific Northwest. The purpose of this report is to: (1) describe the first three years of a pilot project in suicide epidemiology, (2) demonstrate significant differences in tribal rates, (3) show that the total American Indian population has equally significant differences in tribal comparisons, and (4) clarify previous misconceptions about the "American Indian suicide phenomenon".


A culturally patterned depression in a mother after loss of a child. The phenomenology of clinical psychiatric syndromes is conditioned by the cultural ambience of the patient. This paper describes a reactive depression in an Amerindian woman (Trio group) of Surinam, which followed the form, onset, and outcome prescribed by her tribal tradition.


Increased lever pressing for amphetamine after pimozide in rats: implications for a dopamine theory of reward. Low and high doses of a dopamine blocking agent had effects on lever pressing for intravenous amphetamine reward which resembled the effects of reward reduction and reward termination, respectively. Noradrenaline blockade had no such effects. A role in central mediation of reward perception is suggested for dopamine but not for noradrenaline.


Myogenic defect in acetylcholinesterase regulation in muscular dystrophy of the chicken. To determine whether inherited muscular dystrophy of the chicken is neurogenic or myogenic in origin, limb buds from homozygous normal and dystrophic chick embryos were exchanged prior to muscle differentiation and innervation. Biceps muscles of hatched chicks, in which muscle of the donor was innervated by nerves of the host, were analyzed for embryonic properties of muscle acetylcholinesterase and for fiber diameter, two distinctive markers for expression of the dystrophic gene. The results indicate that muscular dystrophy of the chicken is caused by an initial biochemical lesion in the limb and its muscle rather than in its innervating nerve.


Mezerein: antileukemic principle isolated from Daphne mezereum L. An alcohol-water extract of Daphne mezereum L., a plant widely used in folk medicine for treating cancers, showed antileukemic activity against the P-388 lymphocytic leukemia in mice. Systematic fractionation of the extract has led to isolation and characterization of mezerein as the principal antileukemic component.


Stroke in rats produced by carotid injection of sodium arachidonate. Unilateral cerebrovascular occlusion was produced in heparinized rats within 60 seconds after an injection of sodium arachidonate (in doses exceeding 0.45 milligram per kilogram) into the carotid artery. Electroencephalographic activity over the affected cerebral hemisphere was suppressed, and cerebral blood flow decreased by half. Microscopic examination revealed complete obstruction of the hemispheric microcirculation by platelet aggregates.


Basal forebrain and hypothalamic connection to frontal and parietal cortex in the Rhesus monkey. Horseradish peroxidase was injected in different parts of the frontal and parietal cortex in 17 rhesus monkeys. In all cases the enzyme was transported retrogradely to neurons in the substantia innominata and hypothalamus as well as in the thalamus. These new findings demonstrate that these cortical areas receive direct afferent fibers from limbic basal forebrain areas concerned with emotion and motivation.


Symbolic matching by pigeons: rate of learning complex discriminations predicted from simple discriminations. Pigeons had no greater difficulty learning a complex discrimination involving arbitrary among stimuli (symbolic matching) than one involving interrelations based on stimulus similarity (matching-to-sample). The relative rates of acquisitions of matching and symblic matching may be accounted for by the discriminability between sample stimuli and between comparison stimuli, with the former playing the more important role.


Extreme toxicity from combustion products of a fire-retarded polyurethane foam. The products from nonflaming combustion of wood and a trimethylol-propane-based rigid-urethane foam that was not fire-retarded produced elevated carboxyhemoglobin levels but no abnormal neurological effects. However, when this type of foam contained a reactive phosphate fire retardant, the combustion products caused grand mal seizures and death in rats. The toxic combustion product responsible for the seizures has been identified as 4-ethyl-1-phospha-2,6,7-trioxabicyclo(2.2.2.)octane-1-oxide.


Intestinal metabolism of phenacetin in the rat: effect of charcoal-broiled beef and rat chow. The intestinal metabolism of phenacetin in vitro was increased 1100 percent in rats fed charcoal-broiled ground beef in a semisynthetic diet. The intestinal metabolism of phenacetin was increased 200 percent in rats fed a chow diet, as compared to rats fed the semisynthetic diet. The results obtained suggest a need for studies in man to determine whether charcoal-broiled meat and other dietary constituents can stimulate the intestinal metabolism of phenacetin or other drugs and thereby decrease their absorption and bioavailability.


Evoked brain potentials as indicators of decision-making. The effects of decision-making processes on evoked brain potentials recorded at the vertex were studied in human subjects. Significantly different visual evoked potentials to the same physical stimulus were obtained in trails that resulted in different behavioral decisions. The results suggest that certain characteristics of evoked potentials may perhaps be used as indicators of specific behavioral outcomes.


Visual construction of color is digital. When disparate shapes are flashed under the appropriate temporal and spatial conditions, the human visual system resolves their disparity smoothly and continuously. No equivalent supplementations are found for color, which the system resolves by abrupt transformation. Shape and color reveal themselves, contrary to some modern theorizing, as properties handled in different ways by the visual nervous system, continuous or analog for shape, abrupt or digital for color.


Single gene cricket mutations: effects on behavior, sensilla, sensory neurons, and identified interneurons. Crickets are suitable for studying the effects of single gene mutations on single nerve cells. In one mutant, three classes of sensilla are lost sequentially. The absence of one class of mechanoreceptors throughout postembryonic development deprives certain sensory neurons of normal stimulation and results in abnormal physiological and structural development of an identified interneuron.


Trichlorofluoromethane in the Troposphere, Distribution and Increase, 1971 to 1974. Trichlorofluoromethane (CCl3F) measurements in the troposphere over the Atlantic in 1971 and over the Pacific in 1972 and 1974 were compared. A rapid increase of CCl3F in the troposphere is evident. The observed increase of CCl3F between 1971 and 1974 is proportional to the increase of industrially produced amounts of CCl3F in the same time period.


Porphyrin triplet state probing the diffusion of oxygen in hemoglobin. Laser photolysis study of porphyrin-globin shows that the triplet state of the porphyrin is detectable by its light absorption and that it can be used to determine the rate of penetration of oxygen into the hemoglobin pocket in which the porphyrin is embedded. The oxygen penetration rate does not determine the binding rate of oxygen to iron in hemoglobin.


Quantum sensitivity of rods in the toad retina. A dark-adapted toad rod can respond consistently to flashes of light which bleach an average of less than one pigment molecule in its outer segment. These responses are much less variable in amplitude than would be expected if rods were independent quantum detectors. Rods interact with one another by pooling their signals, so that at least 85 to 90 percent of the response recorded from a single rod is generated by pigment molecules bleached in other receptors.


Copulatory plugs in snakes: enforced chastity. The male of some snake species forms a copulatory plug which occludes the oviductal parts of the female's cloaca for a few days. The plug, apparently formed from secretions of the kidney immediately after insemination, probably prevents rival males from copulating with the same female.


Beta cell culture on synthetic capillaries: an artificial endocrine pancreas. Beta cells from neonatal rats were cultured on bundles of artificial capillaries perfused with tissue culture medium. Cells continued to release insulin and remained responsive to changes in glucose concentration. The quantity of insulin released was similar to that of conventional flask cultures.


Conjugal transfer of a chromosomal gene determining production of enterotoxin in vibrio cholerae. Matings between strains of Vibrio cholerae differing in toxinogenicity, nutritional requirements, and antibiotic susceptibilities were performed in order to determine the location of the gene tox that controls production of cholera enterotoxin. Segregation analysis shows that tox is linked to a gene required for histidine biosynthesis. Our data indicate that the tox gene is located on the bacterial chromosome and not on a plasmid in the strains of V. cholerae studied.


Mapping of functional neural pathways by autoradiographic survey of local metabolic rate with (14C)deoxyglucose. An enzymatic preparation from human brain converts tryptamine to tryptoline (9H-1,2,3,4-tetrahydropyrido(3,4-b)indole) in the presence of 5-methyltetrahydrofolic acid. Similarly, N-methyltryptamine and 5-hydroxytryptamine yield 1-methyltryptoline and 5-hydroxytryptoline, respectively. Neither in vitro nor in vivo formation of these compounds by human tissues has been described.


Stimulated vasopressin synthesis by a fetal hypothalamic factor. The hypothalamo-neurohypophyseal complex (HNC) of the fetal guinea pig shows a dramatic increase in its content of vasopressin and neurophysin between the 40th and 55th days of gestation. The values for radioimmunoassayable hormone and binding protein are at day 40, 2 milliunits and less than 0.1 microgram; and at day 55, about 100 milliunits and 10 micrograms, respectively. Isotope incorporation experiments with organ cultures of the fetal HNC taken prior to the 35th day of gestation added additional confirmation of the inability of the hypothalamic neurosecretory cells to synthesize vasopressin or neurophysin at this time. However, by the 45th day, similar organ cultures show a vigorous incorporation of labeled amino acids into both hormone and binding protein. Furthermore, the HNC of the 45-day-old fetus apparently contains a factor that stimulates specifically the biosynthesis of vasopressin and neurophysin in HNC cultures from the adult guinea pig. This factor is not detectable in either cortex or liver of the 45-day-old fetus or in the fetal HNC taken prior to or after the period of exponential rise (40th to 55th days) of hormone and binding protein.


Pyridoxal kinase: decreased activity in red blood cells of Afro-Americans. The mean pyridoxal kinase activity in red blood cells of American blacks was approximately 50 percent lower than that of American whites. Lymphocytes, granulocytes, and cultured skin fibroblasts from black and white donors contained identical pyridoxal kinase activity. The pyridoxal kinase of blacks was indistinguishable from that of whites with respect to heat stability, chromatographic mobility on microgranular diethylaminoethyl cellulose, Michaelis-Menten constant for pyridoxine, and susceptibility to inhibition by 4-deoxypyridoxine. The difference of the activity of this enzyme in whites and in blacks is much greater than any previously observed biochemical difference between the races.


Inhibition of catecholamine release by tolbutamide and other sulfonylureas. Tolbutamide and other sulfonylureas inhibited spontaneous and nicotine-induced release of catecholamines from the perfused cat adrenal gland and nicotine-induced release of [3-H]norepinephrine from isolated guinea pig hearts. Of the sulfonylureas tested, the order to potency of this inhibitory effect paralled the hypoglycemic action. These results raise the possibility that the inhibition of the sympathoadrenal system may contribute in part to the hypoglycemic action of sulfonylureas.


Prostaglandins in human seminal fluid: two novel compounds. Human seminal fluid frozen immediately after ejaculation contains two novel prostaglandins. These are present in larger quantities than the previously reported prostaglandins. They are characterized by gas chromatography and mass spectrometry as 19-hydroxyprostaglandins E1 and E2. Most of the previously identified prostaglandins may be artifacts.


Localized desensitization of Limulus photoreceptors produced by light or intracellular calcium ion injection. Spots of light were used to measure the light sensitivity of spatially separated regions of single Limulus photoreceptors. The desensitization caused by irradiating part of the cell was largest in the irradiated region. The desensitization caused by intracellular calcium ion injection was largest near the infection site. The spread of desensitization away from the injection site suggests that calcium ion can diffuse over neuronal dimensions, but that the effective rate of diffusion is not so high as to abolish calcium gradients. The results are compatible with the previously proposed hypothesis that a rise in the intracellular calcium ion concentration mediates light adaptation.


Male-induced pregnancy termination in the prairie vole, Microtus ochrogaster. Postimplantation as well as preimplantation pregnancy in prairie voles can be terminated by replacing the original stud male with an unfamiliar male. The pregnancy is disrupted by the ensuing male-induced estrus. Females spontaneously abort their litters, become receptive, and successfully breed again 4 or 5 days after introduction of the new male.


Evidence for origin of insect sex pheromones: presence in food plants. Compounds identified as sex attractant pheromones in a number of phytophagous insects were found in a variety of host plants. These agents vary in chemical composition in different plant species, which suggests that dietary factors may provide an evolutionary mechanism for diversification of certain insect species. A theoretical framework to explain this phenomenon is postulated on the basis of experiments with the oak leaf roller moth.


Douglas-fir tussock moth: sex pheromone identification and synthesis. The sex pheromone of the Douglass-fir tussock moth Orgyia pseudotsugata (McDunnough) has been isolated and identified as (Z)-6-heneicosen-11-one. This compound and its E isomer have been synthesized and are highly potent in laboratory bioassays and field trials.


Malignant hemangioendotheliomas produced by subcutaneous inoculation of Balb/3T3 cells attached to glass beads. The Balb/3T3 mouse embryo cell line has been frequently used in cancer research as representative of nontumorigenic cells with the characteristic in vitro properties of postconfluence inhibition of cell division, low saturation density, and anchorage dependence. On the reasoning that anchorage dependence might also apply in vivo, each of nine mice were subcutaneously inoculated with an average of 15,400 Balb/3T3 cells attached to two glass beads 3 millimeters in diameter. After 8 weeks, all the mice had developed large bloody tumors that microscopically proved to be hemangioendotheliomas. Ther inoculation of Balb/3T3 cells alone or beads alone produced no tumors. Transplants of each tumor into normal mice grew to kill the animal within 6 weeks. Tumor cells from collagenase-disaggregated tumor tissue had a plating efficiency of 21.2 percent compared to that of normal adult subcutaneous fibroblasts of less than 0.1 percent. The tumor cells in vitro closely resembled Balb/3T3 cells in appearance and were tumorigenic at a dose of 10-4 cells. A second, repeat experiment produced the same type of tumors grossly and microscopically in 17 of 25 mice between 99 and 211 days after inoculation of the Balb/3T3 cells attached to glass beads. These findings require a reassessment of the postulate that low saturation density, postconfluence of cell division, and anchorage dependence are characteristic in vitro properties only of nonneoplastic cells.


Light-induced changes in the structure of pigmented granules in aplysia neurons. Pigmented granules in Aplysia neurons prepared in the dark contain material that appears to be composed of 50-angstrom globules and a precipitate, probably a calcium salt. On illumination the globules rearrange into paracrystalline arrays and membrane-like lamellae. The morphologic transformation may be related to calcium release from the granules, and the released calcium may mediate the light-evoked hyperpolarization described by others.


Phototransduction in aplysia neurons: calcium release from pigmented granules is essential. Increased free intracellular calcium mediates increased membrane potassium conductance in illuminated Aplysia giant neurons. The calcium source was examined by microprobe analysis of cytoplasmic pigmented granules. Illumination markedly depleted granules of calcium and altered them structurally. Release of calcium from granules is essential for phototransduction.


Fever and survival.

Fever and survival. The significance of fever in response to a bacterial infection has been investigated using the lizard Dipsosaurus dorsalis as an animal model. These lizards develop a fever of about 2 degrees C after injection with the bacterium Aeromonas hydrophila. To determine whether this elevation in body temperature increases the resistance of the host to this infection, as measured by survival, lizards were infected with the live bacteria and placed in a neutral (38 degrees C), low (34 degrees or 36 degrees C), or high (40 degrees or 42 degrees C) ambient temperature. An elevation in temperature following experimental bacterial infection results in a significant increase in host survival.


Evaluation of the synchronism of cleavage divisions. A method is described for estimating the degree of asynchronism of cell divisions in individual embryos at early developmental stages by means of a relative measure of asynchronism.


Temperature dependence of cleavage rates in carp, pike, and whitefish. The time taken by the first four cleavage divisions has been determined for the carp, pike, and whitefish (Coregonus peled) at various temperatures; a quantity tau-0 was calculated, and plotted against temperature. From the curves plotted for all species investigated, it was found that in the salmon but not in the more thermophile species the rate of division within the spawning temperature range could be described by a constant Q 10 which had a value exceeding 2 or 3. Criteria for determing the lower temperature limit of the range for optimum development of teleosts are discussed.


Proliferation and growth of intestinal epithelium in Ascaris suum (Nematoda) during postnatal ontogeny. Communication III. Mitotic anomalies and changes in ploidy and nucleus size. It was established by cytophotometry that the amount of DNA in intestinal-epithelium cells rises from the diploid to a tetraploid level during the early postnatal ontogeny of ascarids so that eventually nuclei with a diploid quantity of DNA practically disappear. Apart from this, there appear cells with a higher DNA content: 8c, 16c, 32c, and even 64c. Pictures of anomalous mitotic processes, as well as polypoid meta- and anaphases, were also observed. A result of the polyploidization is an increased size of nuclei and cells, but nucleus size is not always correlated with the DNA content. The previously established sixfold increase in the mean volume of intestinal cells during postnatal ontogeny of the ascarid is due to their transition to the new ploidy level and additional "paragenomic" growth of the polypoid cells.


Cultivation of the notochord of a Balanoglossus species in diffusion chambers. Minute fragments of the notochord of Balanoglossus sp. were cultivated in diffusion chambers implanted into the arm cavities of starfish, Asterias rubens. The surface properties of the cells migrating from these fragments and the intercellular contacts between them were examined in a scanning electron microscope type "Stereoscan." The two types of cell constituting the initial notochordal transplantate migrated already on the 2nd day of cultivation; these were rather large (10-12 mu) round cells with characteristic outgrowths, which grouped into colonies already on the 3rd-5th day of growth in culture, and small cells (5-7 mu) of elongated shape that at early cultivation stages were found scattered in a disorderly manner over the filter. At later cultivation stages (days 10-12), the small cells migrated toward the colonies of round notochordal cells and penetrated inside them. As a result, large colonies (counting 100 or more cells) developed in the cultures, their arrangement resembling that of the donor animal's notochord.


Proliferation of cells of pigmentary epithelium of retina in adult newts at late regeneration stages after retinectomy. The proliferation of pigmentary-epithelium cells after they have given rise to cells of the regenerating retina is associated with the growth of the pigmentary epithelium and not with additions to the regenerating retina. The proliferative activity of pigmentary-epithelium cells during this period takes place against a background of simultaneous synthesis of specific proteins.


Relative degree of endopolyploidization of silk-gland cells in diploid and triploid silkworms. Photometric measurements showed that DNA content of the cells in the posterior portion of the silk gland to be higher in triploid caterpillars than in diploids. The somatic polyploidy level of posterior silk gland cells therefore increases as the number of cells in the organ decreases with rising overall organism ploidy.


Role of the female genotype in the formation of structural anomalies in the organs of Drosophila virilis female times D. litoralis male hybrids. The role of the female genotype of Drosophila virilis in the formation of structural anomalies of the organs in the progeny after crossing with D. litoralis males was studied. The frequency of appearance and the character of the anomalies are shown to depend on the genotype of the original maternal line.


Sequence of expression of paternal and maternal esterases in the ontogeny of Drosophila virilis. The order of appearance of the parental fractions of the enzyme in ontogeny was investigated in hybrids between laboratory strains of Drosophila virilis differing in the electrophoretic mobility of certain esterases. Activity of the esterases was shown to persist at a low level during most of embryogenesis and to increase toward its end, especially after emergence. At the 16th-20th hour of embryonic development the maternal fractions are accompanied by the manifestation of paternal fractions of the slowly migrating esterase-4. Paternal forms of fast-migrating esterases (esterases-2 and -6) are found only after emergence in age I larvae.


Growth and respiration of regenerating tissues of the axolotl tail. Changes in the weight and oxygen consumption were studied during regeneration of the tail in adult axolotls and larvae. The curve of the increase in weight of the regenerating tail in both age groups is S-shaped. The intensity of respiration of the regenerating tail increases in adult axolotls and in larvae at the blastema stage; in adult axolotls there is also a second increase in the intensity of respiration of the regenerating tail during differentiation of the muscles. The relationship between weight and the rate of respiration was compared during regeneration of the tail in axolotl and the normal growth of the animals. Whereas growth of the animals was characterized by the relationship QO2 equals aPk with a constant value of k, during regeneration the various stages of this process have their own corresponding values of k.


The place of surgery in nodular thyroid disease. The case records of 419 patients undergoing thyroidectomy for nodular goitre are examined in the light of the final pathology and the incidence of carcinoma. In patients presenting with a clinically single nodule, the incidence of carcinoma was 10%; in multinodular goitres this incidence was 4%. A policy for the surgical treatment of nodular goitre is proposed.


The treatment of neuroblastoma.

The treatment of neuroblastoma. A protocol for the management of children with neuroblastoma is described. The appearance of peri-orbital ecchymosis and radiologically demonstrable skeletal metastases are of poor prognostic significance. The relatively infrequent occurrence of neuroblastoma in the Black population of Johannesburg is stressed.


Lipoid proteinosis. Report of 2 cases with histology of the vocal folds. Two cases of lipoid proteinosis, in which biopsies of the vocal cords were done, are presented. The condition is briefly discussed.


The diagnosis and initial management of the acutely injured knee with particular reference to sport injuries. A series of 115 consecutive cases of acutely injured knee, occurring mainly as a result of rugby-football, is analysed. It is suggested that the successful management of an acute knee injury often depends on the doctor of first contact. A scheme of diagnosis and early management is outlined. Acute subluxation of the patella is shown to be a definite entity in the differential diagnosis of an acute knee injury, and a classification for the purposes of the doctor of first contact is proposed.


Postgraduate training amd qualification in community medicine in South Africa. Problems associated with training, experience, practice and recruitment in community medicine are outlined. Academic trends in South Africa and overseas are discussed, and various viewpoints of different authorities in this country are evaluated against the priority of community need. Amedian approach of optimum benefit to the health of all communities and the future of this discipline is sought, and the steps taken in implementation are outlined.


Undergraduate education in social and preventive medicine at the University of Rhodesia. Since 1967, the academic discipline of social and preventive medicine has been taught to medical students at the University of Rhodesia. The emphasis has been on the basic principles underlying the epidemiology of disease and the medical services required to suit the needs of Rhodesia. In 1970, a course in medicalsociology and in 1972, a course in pschology were introduced, and these courses havesupplemented the teaching of medicine in general and of social and preventive medicine in particular. The course is examined in some detail and evidence is submitted concerning the particular content and methodology used in this course of instruction for undergraduates. Reference is also made to a scheme of attachment to medical practitioners and a period spent during the final undergraduate year in a rural situation as part of the faculty programme of instruction in community medicine.


Pure gonadal (46, XY) dysgenesis--an XY female. A case of pure gonadal dysgenesis is reported, the patient having a 46,XY genotype associated with female internal and external genitalia and bilateral streak gonads. The rarity of this syndrome is stressed. Reasons for not regarding this syndrome as synonymous with Swyer's syndrome are given.


Schistosomiasis of spinal cord and skin. We record the simultaneous occurrence of cutaneous and spinal cord lesions of schistosomiasis and speculate upon the mode of this distant spread.


Humoral immune response in children with measles. Twenty-eight Black children with complicated measles were investigated for their capacity to produce antibodies when stimulated with TAB antigen. Their measles antibody titres were also measured. Antibody production to TAB was defective, especially the "H" antibody. Production of measles antibody was sometimes delayed in its appearance but subsequently reached normal levels.


Clinical experience of eclampsia at the University Teaching Hospital, Lusaka. An analysis of 50 cases. A clinical analysis of 50 cases of eclampsia for the period June 1971-June 1973 is presented. During the same period there were 32 011 deliveries--an incidence of 0,156%. Of these 50 cases, only 8 were booked. There were 40 primigravidas. The highest number of fits recorded in any one patient was 6, and 13 patients has had fits before admission. Thirty-four patients were in established labour on admission. Only 12 patients had postpartum fits. The basis of management was heavy sedation, anticonvulsant therapy and emptying of the uterus as soon as it could be achieved. Biochemical studies and urine production measurements were important supplementary measures. Twenty patients achieved vaginal delivery and 3 had symphysiotomy, assisted by vacuum extraction, low forceps and midcavity forceps, to complete the delivery. Seventeen patients were delivered by Caesarean section. The remaining 10 had vaginal delivery assisted by vacuum extraction. One mother did not survive. Of the 51 babies, 7 did not survive the neonatal period, and 4 were stillborn.


Aberrant left pulmonary artery: a rare cause of congenital stridor. Aberrant left pulmonary artery is a rare cause of stridor and respiratory difficulty in infancy and childhood. Diagnosis can be made on oesophagram, and is confirmed conclusively on angiography. Surgery can be curative, especially in cases without severe associated cardiovascular anomalies. A case report is presented of the condition occurring in a South African Black infant.


Antibiotic peritoneal lavage in severe peritonitis. A preliminary assessment. A method of intra- and postoperative antibiotic peritoneal lavage, using 0.015% gentamicin in dialysis solution, has been assessed for the treatment of life-threatening peritonitis. It is believed to be the first time that the use of gentamicin for this purpose has been recorded, and the first time that antibiotic peritoneal lavage has been used for the treatment of a series of patients with peritonitis of gynaecological or obstetrical origin. At Baragwanath Hosital, gynaecological patients with life-threatening purulent peritonitis arising from septic abortions, tubal sepsis (ruptured pyosalpinx) or postoperative causes, were studied. Thirty-eight such patients undergoing standard operative treatment had a mortality of 47.4%, which is in accordance with world figures for serious peritonitis. In 38 patients, after the addition of antibiotic peritoneal lavage, mortality was halved to 2397%, with minimal morbidity. The procedure used has been fully described, and is recommended for wider trial in patients with life-threatening peritonitis or peritoneal soiling.


Angiographic appearances in Paget's disease of the calvarium. A case is presented to demonstrate the angiographic findings in Paget's disease of the calvarium. These angiographic changes suggest that the blood supply to the calvarium is mainly through its inner aspect via the distal branches of the external carotid artery.


Acute uric acid nephropathy in thalassaemia. Hyperuricaemia may complicate thalassaemia and may, on occasion, result in obstruction of urine flow on the basis of crystal formation. Prophylactic therapy with xanthine oxidase inhibitors may prevent this complication, but once it has developed, accurate diagnosis and aggressive therapy can reduce morbidity. The present case report illustrates one approach to the management of acute uric acid nephropathy.


The dental treatment of problem children under ketamine analgesia. Twenty children requiring dental treatment who were unsuitable for local or inhalational analgesia were all successfully treated using subanaesthetic doses of ketamine.


Renal papillary necrosis associated with acute pancreatitis. A case of acute renal failure with renal papillary necrosis due to acute pancreatitis is described. The association of renal papillary necrosis with acute pancreatitis has not been previously recorded, and the possible mechanisms for the production of renal papillary necrosis in this entity are discussed.


Results of hyperthermic perfusion for melanoma of the extremities. Our studies show that the malignant melanoma cell in human beings is more sensitive to the lethal effect of heat than its normal counterpart, the melanocyte. Malignant melanoma of the extremities presents unique problems; at times, local control can be extremely difficult. The addition of heat to regional perfusion with melphalan has dramatically improved the objective response of melanoma. Complications rise as the tempreature and duration of perfusion increase. These risks must be weighed carefully against the volume and extent of tumor. One hundred and eighty-five hyperthermic perfusions have been perfomed on 165 patients. When done with meticulous attention to details, this procedure is accompanied by minimal morbidity and mortality. Hyperthermic perfusion is currently the best treatment for recurrent melanoma of the extremities and has almost eliminated the necessity for amputation. Perfusion is recommended as a prophylactic measure for the more deeply invasive primary lesions. It reduces the incidence of regional recurrence. A retrospective statistical analysis of survival rates of patients treated with nonheated and heated perfusion for recurrent melanoma, State IIIA, was conducted. If the experience of the heated group continues, which from a clinical standpoint appears likely, then a striking advantage of heated perfusion over nonheated perfusion will be demonstrated. This superiority in survival rates for the heated group is now three to one or 300 per cent. The most reasonable explanation for the improvement in survival time of patients in State IIIA is stimulation of the immune response. As a result of our experience with heated perfusion of limbs, we are investigating the possibility that systemic hyperthermia may enhance the antitumor effects of various chemotherapeutic agents on melanoma.


An evaluation of endoscopic pancreatocholangiography in surgical patients. Retrograde pancreatocholangiography was successful in 110 or 83 per cent of 133 patients suspected of having pancreatobiliary disease. Cannulation of the pancreatic duct was successful in 95 per cent of the patients suspected of having disorders of the pancreas. In 84 per cent, the biliary tree was successfully visualized among the group suspected of having disorders of the biliary tract. Dilatation of the main pancreatic duct in association with cholelithiasis and choledocholithiasis was observed in 33 and 72 percent, respectively.


Ultrasonically guided percutaneous fine needle biopsy of the pancreas. By ultrasonic scanning, it is possible with reasonable accuracy to demonstrate space occupying lesions in the pancreas, and with a delicate ultrasonic technique, a puncture needle can be guided to a predetermined mass in the pancreas. In 25 patients with suspected pancreatic lesions, scanning demonstrated a solid mass lesion in the pancreas. Twenty-one patients had carcinoma; four had chronic pancreatitis. In 17 of the 21 patients with carcinoma, tumor cells were aspirated. The cells were numerous and easily recognizable, fulfilling the usual cytologic criteria of malignant disease. In three of the 16 patients with carcinoma, the aspirations were inadequate, and one showed normal pancreatic cells. In the four patients with chronic pancreatitis, normal pancreatic cells were aspirated. There were no immediate complications due to fine needle biopsy. The combination of ultrasonic scanning and ultrasonically guided percutaneous fine needle aspiration is an important adjunct to the management of pancreatic lesions.


Steroid protection of the liver during experimental eschemia. Temporary occlusion of hepatic inflow would be ideal during extensive operations for liver trauma or tumors, since this always is handicapped by accompanying massive blood loss. Since the liver is relatively low in tolerance to ischemia an attempt has been made to protect the liver with steroids during experimental warm ischemia. Total hepatic ischemia was produced in rabbits by ligating the portal triad and gastrohepatic ligament for 30 minutes. A survival rate of only 10 per cent was obtained in controls, whereas if methylprednisolone was given before occlusion, 100 per cent of the rabbits survived. If methylprednisolone was given immediately after the occlusion, the survival rate was 54 per cent. Further experiments extending occlusion to one hour resulted in a 50 per cent survival rate as compared with zero per cent in the one hour controls. Methylprednisolone protects the liver during warm ischemia, especially if given before occlusion, and dramatically decreases the mortality rate from this maneuver in our model. The mechanism of protection is probably by stabilizing and protecting the integrity of the hepatic cell during the anoxic insult.


Aneurysms of the popliteal artery.

Aneurysms of the popliteal artery. Thirty-one aneurysms of the popliteal artery in 23 patients have been studied. Twenty-nine aneurysms were secondary to atherosclerosis, while one was secondary to trauma and one was associated with a coagulopathy. The lesions were bilateral in eight patients and were associated with extra-popliteal aneurysms in ten patients; the abdominal aorta was the most frequent extrapopliteal site. All except two of the 23 patients were over 50 years of age, and many exhibited atherosclerosis and related symptoms in other vessels. Ischemic rest pain was the most common presenting symptom in patients with popliteal aneurysm, but three of the patients were asymptomatic. The most common physical sign was a palpable popliteal mass in 25 patients, with impending gangrene distal to the aneurysm in four. Thrombosis occurred in 11 of the aneurysms, embolism in three, and rupture in two. Amputation was eventually necessary in five patients with thrombosis and in one patient with embolism. Of 16 patients presenting with a complication of popliteal aneurysm, six patients eventually required amputation. All popliteal aneurysms should be treated surgically and arterial continuity restored unless contraindicated by the over-all condition of the patient. The saphenous vein represents the optimal replacement material available at this time, but fabric grafts can be used successfully.


The difference in the clearance of interstitial albumin by the lymphatics from the stomach and the small and large intestine. The capacity of the lymphatics to clear interstitial albumin was compared between the stomach, small intestine, and colon. The lymphatic and vascular transport in the stomach and colon was similar, clearing approximately 9 per cent of interstitially injected radioiodinated serum albumin by the thoracic duct lymph and 2 to 3 per cent by the blood in a five hour period. More than a third of the injected material remained at the site of injection. The small intestine was cleared of 37 per cent of the albumin by the lymph and more than 6 per cent by the blood, leaving less than 9 per cent at the injection site in the same period of time. Evidence that the small intestine was more effective and rapid in clearing interstitial albumin than either the stomach or colon was statistically significant.


Liver scan and carcinoma of the breast.

Liver scan and carcinoma of the breast. The results of 100 liver scans obtained as part of the preoperative evaluation of patients known to be harboring a potentially resectable carcinoma of the breast were evaluated. Of the five positive results of these studies, four were found to be falsely positive. During the period included in the study, 317 other liver scans were performed on patients known to have recurrent, residual, or metastatic disease or on patients returning for routine postoperative evaluation. The information derived from these studies was of practical significance only in the group receiving therapy for the secondary tumor. On the basis of this small series, the routine use of the liver scan in evaluating the patient with carcinoma of the breast cannot be supported.


Hemodynamic changes in the liver of the rabbit after hepatic dearterialization. Quantitative determination of the development of collateral arteries and change in portal flow after an 80 per cent dearterialization of the liver of the rabbit was carried out with radioactive microsphere technique. The livers operated upon were classified macroscopically into two type groups. In the recovery type, the dearterialized lobes reverted to the preoperative state. In the necrotic type, necrosis in the dearterialized lobe progressed, and the nonarterialized lobe was compensatively hypertrophied. The rate of rearterialization into the dearterialized lobe was different according to the type. In the recovery type, collateral arteries developed rapidly until the fourteenth postoperative day, when the arterial flow reached 55 per cent and, thereafter, increased gradually. In the necrotic type, rearterialization progressed more rapidly, and arterial flow exceeded the preoperative value in the third postoperative week and, thereafter, decreased. In the necrotic type, portal flow in the dearterialized lobe had been significantly impeded within 12 hours after the operation. The state of portal flow in the dearterialized lobe is, we believe, a more important factor for the prognosis after the hepatic dearterialization than the rate of rearterialization or oxygen concentration of portal blood. High activity of serum glutamic oxalacetic transaminase and serum glutamic pyruvic transaminase of more than 90 units per milliliter on the seventh postoperative day can be an indicator for the impeded portal flow in the dearterialized lobe.


The anterior approach to percutaneous liver biopsy. Anterior subcostal percutaneous liver biopsy using the Tru-cut disposable needle is safe and simple; there were no major complications in our experience. It avoids completely the known thoracic complications of the posterior or lateral approach to percutaneous liver biopsy and has the added benefit of making any of the remaining complications easier to manage.


Repair of common bile duct defects using the gallbladder or cystic duct as a pedicled graft. To repair defects in the common bile duct, part of the gallbladder and the cystic duct may be used as a pedicled graft. This has the advantage of an independent blood supply and a related mucosal lining. The method is illustrated by four patients who had excellent primary and short term results. In two patients, the defect was due to large cholecystocholedochal fistulas caused by migrating large gallstones. In one patient with marked stenosis of the duct, the defect occurred when the stenosis was opened through a longitudinal incision. The fourth patient had a large duodenal ulcer that penetrated into the common duct, causing a defect that could not be closed by suture. A definite evaluation of the procedure must await a longer period of follow-up study.


Oral contraceptive continuation rates in the Singapore National Program. 1966-1972. A study of a random sample of 3,564 oral contraceptive acceptors in the Singapore national program clinics with a maximum of 60 months of experience produced findings as follows: The typical pill acceptor was aged 26.9 years with 2.5 children, married for 4.2 years, had at least primary education, was not working, and started on the pill 2.3 months after her last pregnancy. Thirty-three percent of the oral contraceptive acceptors were still continuing with the pill by the cutoff date for the study, 30 June 1972, and the median period of pill use among those still using was 33.6 cycles. The median number of cycles of pill use among discontinued users was only 5.2. The main reasons for discontinuation were side effects of the pill and planned pregnancy. For the discontinued users, 43 percent had used alternative methods of protection, mainly condoms. Cumulative continuation rates per thousand women were 792 after the first cycle, 680 after the third, and 475, 346, 247, and 225 after cycles 12, 24, 48, and 59, respectively.


Fertility reduction in an MCH/family planning program: a model for projection. One of the important questions in an integrated maternal and child health/family planning program is the likely effects on fertility rates if given proportions of a stated target population can be reached and provided with family planning services. The question is easy, but the process of obtaining viable estimates of potential fertility decline from this type of program is complicated. First of all, the number of women in the target population must be estimated. Next, it is necessary to make various assumptions and estimates concering the types of contraceptives accepted, the age distribution of acceptors, the sets of continuation rates that go with each age/method specific group of women, and a variety of other factors. This article describes and illustrates a procedure for estimating potential fertility declines with an integrated maternal and child health/family planning program.


Ultrasonic irradiation and pupillary response. The effect of ultrasonic irradiation on the pupillary response was investigated over an intensity range from 0.1-1.5 W cm-2 measured at the surface of the applicator head at frequencies of 0.8 and 2.4 MHz.


[Injection therapy of the prostate in prostatic tuberculosis]. Oral therapy of prostatic tuberculosis so far has only been able to achieve conversion in one-fifth of the cases. Since 1970 we have practiced the transcutaneous injection of the prostate and have achieved conversion in all cases within a short time. Injection of 1 g Streptomycin and 0.1 g INH twice a week over a period of four to five weeks was carried out in 90 patients. Complications contraindicating the treatment was not seen. The transcutaneous injection treatment of the prostate is indicated in all patients where cavernous changes in the prostate have been demonstrated by urethrography.


[Complete bilateral renal vein occlusion in a patient with right sided hypernephroma and renal insufficiency: report of successful thrombectomy and nephrectomy]. A 66 year old female patient was successfully operated following complete obstruction of the inferior vena cava and left renal vein by tumor thrombi from a right sided hypernephroma. The effect of the compensatory development of venous collaterals of the left kidney and the therapeutic consequences of a thrombectomy following long standing thrombosis of the left vein are discussed.


[Xenon exhalation measurements in the diagnosis of bladder diseases]. Using an exhalameter radioactive marked Xenon, absorbed following bladder instillation, was determined in the expired air of 111 patients. In 65 of these patients the usual criteria in the diagnosis of bladder diseases were simultaneously ascertained. The functional disturbances of the epithelium of the bladder obtained through 133Xenon exhalation measurements did not correlate with the morphological changes. Especially in the so-called "Reizblase" (irritable bladder) functional disturbances were found without a morphological equivalent. Compared with the low Xenon exhalation found in patients with healthy urinary bladders there is a marked Xenon exhalation increase (10-15 times) in inflammation of the urinary bladder. In our opinion Xenon exhalation measurements is at the present time the most sensitive method for determining inflammatory diseases of the urinary bladder.


[The effect of electrohydraulic waves and ultrasound on the urothelium]. An experimental study on 30 rabbit urinary bladders showed that the ultrasound lithotripsy causes less tissue damage and fewer complications than the use of electrohydraulic waves. The danger of perforation using electrolithotripsy is high whereas bladder wall perforations never were caused by ultrasound using the usual amplitudes and frequencies. An increase in temperature and edema formation in the bladder wall was caused by the ultrasound but this probably would be a minor damage in the clinical use.


[Epididymitis Tuberculosa in the Change of Time. A study of the bioptic material of forty years (1932-1971)]. Significance and course of epididymitis tuberculosa are explored by means of all the bioptic material of a forty years period. The results from the time before and after the introduction of the tuberculostatica are compared with each other. Shortly before and during the second world war and also at the end of the fifties the epididymitis tuberculosa was seen very frequently. It decreases since 1959. Generally the isolated epididymis is affected. In a number of cases the tuberculous inflammation is also spreading out to the homolateral testicle, the vas deferens and the tunica vaginalis testis. Evidently during the third decade the tuberculous epididymitis is increasing rapidly. Most cases are observed in the forth decade. The morphologic picture of the epididymitis tuberculosa has changed. During the first 20 years more cases of the granulomatous type have been observed, whereas during the following 20 years more cases of the necrotising type are present.


Renovascular hypertension. Secondary to traumatic occlusion of supplemental renal artery. A case is reported of documented renovascular hypertension due to traumatic occlusion of the main renal artery in a double renal artery system. Emphasis is placed on the value of the oblique renal arteriogram in assessing segmental vasuclature prior to surgical intervention. Oblique arteriography may also aid in the preoperative evaluation of patients with segmental renal ischemia due to other causes.


Simultaneous closure of low cutaneous loop ureterostomies and excision of congenital ureterovesical junction strictures. A case report of a child is presented in which double sectioing of the lower ureter was required to close simultaneously low cutaneous loop ureterostomies and to excise congenital ureterovesical junction strictures. One ureteroneocystostomy required revision. The vasculature of the ureteral segments was preserved by not mobilizing the ureter.


Hydrostatic bladder distention for bladder tumor. A fatal outcome. Hydrostatic bladder distention has been advocated for treatment of tumors and bemorrhagic radiation cystitis. The appeal of this procedure, especially for use in poor-risk patients, stems from its apparent lack of morbid complications. In the case reported here, death followed a major complication of this procedure.


Foreign body in lower urinary tract.

Foreign body in lower urinary tract. A forty-four-year-old white man had a stout rubber cable extruding 2 cm. from the external urethral meatus. He had introduced an 82-cm. rubber cable via his urethra into his bladder to assist in clearing dysuria and hematuria. Suprapublic removal of the rubber cable was accomplished, and his postoperative course was benign.


Antigenic cross reactivity between benign prostatic hyperplasia and adenocarcinoma of prostate. Tissue cultures were established from biopsy specimens of adenocarcinoma of the prostate (ACP) and benign prostatic hyperplasia (BPH). Generally, peripheral blood lymphocytes from BPH and ACP patients were cytotoxic to both ACP and BPH cells, but not normal fibroblasts nor cells cultured from other types of malignant tissue. Peripheral blood lymphocytes from normal control patients or from patients with other types of cancer were not cytotoxic to ACP- or BPH-derived cells. These findings are consistent with a cross reactive autoimmune response in ACP and BPH patients, directed against a common antigen(s) present on both ACP and BPH cells.


Fluorescence of testicle. An indication of viability of spermatic cord after torsion. We present an objective measure of testicular viability intended to aid the surgeon in salvaging the testicle at the time of operation for torsion of the spermatic cord. Following the intravenous administration of 5 to 10 cc. of sodium fluorescein, the viability of the untwisted testicle can be determined by its fluorescence when exposed to a portable long wavelength Wood ultraviolet light source.


Comparison of Gil-Vernet and classic flank approaches to pyelo- and ureterolithotomy. We review our experience with the posterior approach to the kidney and compare it with the classic flank approach to pyelo- and ureterolithotomy. Our results show a decrease in morbidity with the posterior approach


Preoperative urography in hypotensive patients with severe trauma. In hypotensive patients with severe trauma including renal injuries, the preoperative urogram is generally of poor quality. In many instances these patients are taken to the operating room with no films at all. We have proposed a protocol for the resuscitation of severely injured patients, following which we performed a carefully monitored high-dosage urogram. We demonstrated in 16 patients that diagnostic films can be obtained even in severely injured patients who were initially in shock.


Neurogenic bladder in normal pressure hydrocephalus. Five patients wíth normál pressure hydrocephalus who had urinary incontinence were found to have neurogenic bladders by cystometry. The bladder disturbance in this disorder whould be considered the result of a specific defect of brain function and not just and artifact of gait disturbance or of dementia.


Torsion of spermatic cord and testicular appendages. Forty-seven cases of torsion of the spermatic cord and testicular appendages have been reviewed. Twenty-eight patients with acute spermatic cord torsions underwent surgical correction. Only 10 were treated in time to preserve viability. The other cases were either gangrenous and required orchidetomy or were questionably viable. Acute, painful scrotal swelling with negative e findings on urinalysis is a surgical emergency. Ten patients had warning attacks, but because of delay in diagnosis and treatment, 4 required orchidectomy. Those patients with spermatic cord torsion who were detorsed before twelve hours had elapsed had viable testes. Patients with complaints of intermittent scrotal sweling and pain, with negative urinalysis, may be suffering from intermittent patients were treated in this manner. Six of these had a transverse lie of both testes, which suggested the underlying anatomic defect leading to torsion of the spermatic cord. The diagnosis of epididymitis or epididymo-orchitis is untenable with a negative finding on urinalysis and results in delay incorrect diagnosis and treatment.


Pulmonary emboli. Prevention, diagnosis, and treatment. Pulmonary embolism is responsible for 50,000 deaths each year. A high diagnostic index of suspicion is necessary if the diagnosis of embolism is to be made prior to death since the classic triad of chest pain, dyspnea, and hemoptysis occurs infrequently. Preventive measures including preoperative anticoagulation will reduce the incidence of trombus formation. Treatment depends on early recognition, rapid anticoagulation, and, in selected cases, partial occlusion of the vena cava.


Hypertension and unilateral hydronephrosis. Three patients with unilateral hydronephrosis, a normal contralateral kidney, and sustained hypertension were investigated by means of arteriography and differential renal vein renin determinations. The close correlation of the onset of hypertension to the obstructive uropathy, as well as the increased renin production from the affected side, were indicative of a causal relationship. Nephrectomy produced a prompt cure of hypertension in each instance.


Ureteropelvic junction obstruction in nephrolithiasis. An etiologic factor. Obstruction is rarely accepted as the sole cause of calculi. We have reviewed 106 cases of nephrolithiasis for which surgery was performed at the St. Luke's Hospital Center during the past ten years. In 17 of these cases, obstruction of the ureteropelvic junction was demonstrated, an incidence of 16 per cent. We propose the theory that too frequently the responsible ureteropelvic junction obstruction goes undetected when a "routine" pyelolithotomy or nephrolithotomy is performed.


Blind-ending branches of bifid ureters.

Blind-ending branches of bifid ureters. Three new cases are utilized to illustrate the anatomy, embryology, and symptomatology of blind-ending branches of bifid ureters. Diagnosis can usually be made by intravenous pyelogram. The complications are recurrent urinary tract infections, calculi, and hydroureteronephrosis. Selection of management by observation, resection, nephroureterectomy, or ureterolithotomy is discussed. The specific techniqie for simple resection is stressed.


Unsuspected duplex ureters.

Unsuspected duplex ureters. Three cases of unsuspected duplex ureters are presented. It is suggested that nonvisualizing upper pole segments should be suspected whenever a duplication occurs on the contralateral side regardless of the radiographic appearance.


Experience with Kaufman III procedure for urinary incontinence. The Kaufman III procedure for urinary incontinence is an effective means of treating postprostatectomy incontinence. The technique was modified by the routine inclusion of suprapubic cystostomy; operative assessment of the efficacy of the prostheses was possible. Four of our 7 patients (57 per cent) achieved excellent results, 2 of 7 (29 per cent) good, and 1 (14 per cent) poor. In the surgical technique it is important to stress that the mobilization of the crura from the pubic arch should be limited to allow only for the straps. Excessive dissection in this area will limit the degree of compression. This was thought to be a factor in the failure of our first case. Although the Kaufman III procedure for postprostatectomy urinary incontinence may not be ideal, the ease of insertion, good results, and low morbidity make it a desirable method of combating urinary incontinence in many male patients.


Intermittent catheterization in children. Many children with myelodysplasia are ideal candidates for intermittent nonsterile urethral catheterization to manage urinary incontinence. This method of urinary management becomes no permanent commitment and is preferred by patients and parents to supravesical diversion when successful.


Neurogenic bladder of paraplegic patients: Management with radical Y-V-plasty. In an effort to relieve subvesical resistance in the established paraplegic with unacceptable neurogenic vesical dysfunction while simultaneously preserving potency, a radical Y-V-plasty was carried out in 5 patients. The operation was successful in achieving low residual urines and freedom from clinically evident urinary tract infection without unfavorably affecting potency, but it committed the patients to a dependency on a condom appliance which some were unable to tolerate satisfactorily. The procedure is thought to have merit in selected cases; but whenever it is comtemplated, a trial with a condom catheter preoperatively is recommended.


Extragenital gonadal neoplasia and metastatic testicular tumor. Patients with retroperitoneal or mediastinal neoplasms of gonadal tissue type and clinically normal testes pose interesting therapeutic dilemmas. Three major groups of patients are recognized: (1) tumor is primary extragenital gonadal neoplasm; (2) occult microscopic primary neoplasm in a testicle with metastases; (3) area of fibrosis in a testicle representing local regression of tumor, but with distant metastases. Review of case reports often indicates lack of data sufficient for classification. Every effort should be made to group patients into proper categories, since treatment will vary. Two patients classified as group 2 are presented.


Implantable penile prostheses in impotent males. Surgical experience with thirty-one implantable Silastic penile prostheses in 28 patients is reviewed, with success in all but 2 patients. Surgical technique, indications for the procedure, postoperative complications, and results are reviewed. It is suggested that consideration be made for use of an implantable penile prosthesis in patients with organic or psychogenic impotence unresponsive to other therapeutic techniques.


A coital technique for promotion of fertility. In selected cases of subfertile men, the first portion of the split ejaculate is superior to the specimen considered as a whole with regard to sperm density, motility, and cytology, and also in those cases in which there is increased seminal viscosity in the whole ejaculate. Use of the coital technique in which the husband withdraws his penis from the vagina after deposition of the better first portion of the ejaculate during the fertile time of the wife's cycle has resulted in rapidly achieving pregnancy in many instances in which the marriages had been barren for years. A total of 33 cases of pregnancy ascribed to this coital technique in the past four years, with detailed analyses of whole and split ejaculates, is presented.


Adenocarcinoma of prostate and malignant pericardial effusion. A case of widespread adenocarcinoma of the prostate presenting as a symptomatic pericardial effusion is reported. The administration of high doses of estrogen produced a marked objective response in this patient


Benign mesothelial tumor of bladder.

Benign mesothelial tumor of bladder. Two cases of benign mesothelial tumor of the bladder are presented, one causing urinary retention following surgery for stress incontinence and the other a softball-sized fibroma with a fifteen-year follow-up.


Metastatic disease to kidney from lung.

Metastatic disease to kidney from lung. Two cases are reported of primary carcinoma of the lung, presenting as tumors of the kidney. It was found that metastases to the kidney from the lung is frequent. It is recommended that in all cases of primary lung carcinoma the kidneys be examined for metastatic disease. If cancer is found and is treatable, the cure rate may be improved with early and aggressive treatment.


Auto-amputation of penis from carcinoma. A case of squamous cell carcinoma of the shaft of the penis leading to auto-amputation is presented. Despite delay in treatment, a good result was obtained following surgical excision.


Accessory urethra with juxtaposed meatus. A case report is presented of a juxtaposed urethral meatus and accessory urethra. The need for careful examination of the urethral meatus is emphasized.


Urinary retention and hydronephrosis in a child caused by contact dermatitis of external genitalia. Contact dermatitis of the external genitalia is added to the list of entities that can cause urinary retention with hydroureteronephrosis in a child. The urinary tract returned to normal following successful treatment of the acute penile edema with topical and systemic steroids.


Transitional cell carcinoma of ileal loop following cystectomy. This is the second case reported in the literature involving transitional cell carcinoma in an ileal loop. The case is described and the literature reviewed.


Urinary incontinence: a challenge and a solution. III. Plication of muscles of deep perineal pouch. A new operation, very simple to perform under local anesthesia, is described for urinary incontinence caused by operations on the prostate gland or the bladder neck; satisfactory results have been obtained, with no complications to date. The surgical procedure consists essentially of plication of the external urethral sphincter and other muscles in the deep perineal pouch thereby increasing their tone, which appears to assist the smooth muscle sphincter for urinary continence.


Orchioblastoma or infantile embryonal carcinoma: pediatric testis tumor. A case of orchioblastoma in a two-and-one-half-year-old boy treated with orchiectomy and lymph node dissection is presented. Review of previously reported cases of orchioblastoma and embryonal cell carcinoma in boys reveals that these tumors differ in histologic appearance, but their pathophysiologic behavior and prognosis are similar. As with embryonal cell carcinoma, retroperitoneal lymph node dissection has improved the survival of patients with orchioblastoma.


Spermatic granulomas of epididymis.

Spermatic granulomas of epididymis. This report is of a patient with spontaneous spermatic granuloma of the epididymis, an uncommon condition to occur without antecedent surgery, trauma, or clinical infection.


Congenital renal arteriovenous malformation: angiography in its diagnosis. Two patients with renal arteriovenous malformations are presented along with the distinct changes shown by urography, arteriography, and pharmacoangiography. The relevant roentgen signs in such patients include multiple small cobblestone-like identations caused by well-formed vascular channels projecting into the collecting structures, no angiographic or urographic evidence of a mass displacing the intrarenal vessels or collecting structures, normal sized arteries and veins leading to and from the malformation, and a decrease in size of the malformation after intra-arterial infusion of epinephrine. These patients may have flank pain or hematuria later in life or may remain asymptomatic. A complete urographic and angiographic examination will help to determine the appropriate therapy. Corrective surgery is usually reserved for symptomatic patients and, when indicated, require only surgical ligation of the vessels feeding and draining the malformation.


Influence of anthelmintic treatment on the liveweight of outwintered ewe hoggs. Three systems of outwintering ewe hoggs are normally practised on Scottish hill farms. A series of field trials involving some 2000 different animals was conducted to determine the response in liveweight from anthelmintic treatment for roundworms. The results suggest that, under field conditions, a strategic dosing programme using a modern anthelmintic can prevent liveweight loss in ewe hoggs wintered either on the hill or "inbye". The best response may be expected from a two dose regime--one in early winter (mid October to mid November) and the other in winter (mid January to mid February). In away-wintered hoggs, the kinder climate, better pssture, and, in the vast majority of cases, less contaminated ground, appear to outweigh the advantages of dosing after the late autumn.


Early pregnancy diagnosis in cattle.

Early pregnancy diagnosis in cattle. Progesterone concentrations in peripheral plasma and in milk were determined by competitive protein-binding assay each day throughout the oestrous cycle of heifers and a dairy cow and also in animals after insemination. The accuracy of detecting and forecasting pregnancy and non-pregnancy was assessed in studies involving blood-sampling of heifers on the 20th and 23rd day after artificial insemination, and milk sampling of cows on the 21st and 24th day after mating. The high degree of accuracy obtained using this procedure for an early pregnancy diagnosis would be particularly useful in herds involved in a controlled breeding programme.


Pregnancy failure induced by human chorionic gonadotrophin in pony mares. Ten pregnant Welsh pony mares were each treated with a series of three intravenous injections of 2000 iu human chorionic gonadotrophin (HCG) on alternate days.  In four mares the first dose was given before the 39th day of gestation and conceptual loss followed treatments in all mares.  The other six mares were first treated between the 40th and 97th days.  No conceptual loss occurred despite five of the mares being given a fourth dose of HCG. Two mares first treated on days 36 and 38 of pregnancy subsequently produced PMSG although foetal death had occurred.


Salmonella excretion by terrapins and the associated hazard to human health. The isolation of Salmonella java (phage type Worksop) from the water of a terrapin tank is described.  Two terrapins excreted the organism throughout a nine month observation period.  Attention is drawn to recent reports of human illness associated with these animals kept as domestic pets.


Newcastle disease antibody levels in chickens after vaccination with oil emulsion adjuvant killed vaccine. Chicks vaccinated with live Hitchner B1 Newcastle disease vaccine at 17 days old and subsequently re-vaccinated with an oil emulsion killed Newcastle disease vaccine at either 38 or 52 days old showed high and persistent HAI antibody levels for at least eight months. Re-vaccination of these birds at 17 weeks old caused a further rise in antibody level to log212 which, even at 38 weeks, had dropped only to log210. Chicken primarily vaccinated with oil emulsion killed vaccine at six weeks old developed HAI antibody levels after four to five weeks of log29 which re-vaccination four weeks later increased to log211. Chicken given killed aluminium hydroxide adjuvant Newcastle disease vaccine were serologically HAI negative 13 weeks after vaccination while those given the oil emulsion vaccine still showed an antibody level of log28. Groups of birds inoculated with oil emulsion vaccine and then, at 20 weeks old, challenged with virulent Newcastle disease showed a 100 per cent survival rate. The particular merits of oil emulsion killed Newcastle disease vaccine for laying and breeding birds are discussed.


A and B and A1Leb substances in glycosphingolipid fractions of human serum. A and B and A1Leb substances were adsorbed onto red cells exposed to glycosphingolipid fractions prepared from the serum of group A and B and A1,Le(a minus b plus) donors. Group O cells exposed to fractions prepared from the serum of group A or B donors were agglutinated by an IgM cross-reacting antibody present in some group O sera. Cells exposed to fractions from A1,Le(a minus b plus) serum were agglutinated by anti-A1Leb. The amount of A substance in the fractions was related to the A subtype (A1 or A2) and to the Lewis and secretor phenotype of the donor. The uptake of blood-group substances from the lipid fractions was inhibited by the addition of whole serum to the fractions.


Complement fixing and lymphocytotoxic antibodies in serum of pregnant women at delivery. IV. Serology. The paper concerns 275 sera of pregnant women at delivery containing complement fixing platelet antibodies (CFPAb) and/or lymphocytotoxic antibodies (LCTAb). 79 sera contained operationally monospecific antibodies against platelets and/or lymphocytes. 10 sera had only CFPAb, 4 of these were C-fix anti-A. 41 sera had CFPAb and LCTAb, 18 of these were monospecific against platelets and/or lymphocytes. In 224 sera only LCTAb could be demonstrated, 57 were monospecific. Furthermore in 8 of 258 primigravidae, screened for LCTAb 6 months post partum antibodies were detected. Generally the antibodies present at delivery had disappeared or narrowed, but in 3 cases the antibodies were detectable only in the postpartum sample.


Histocompatibility antigens in leprosy.

Histocompatibility antigens in leprosy. Results of HL-A typing are presented in 82 patients with leprosy and 50 normal Filipinos from Cebu, and 144 normal Filipino immigrants from the Luzon area. Comparisons of HL-A antigen frequencies among the total patients and normals of Cebu showed no statistically significant differences; however, HL-A10 was increased in frequency among the patients with lepromatous disease compared to the normals, and HL-A5 was increased among the tuberculoid patients compared to the lepromatous patients. None of these comparisons was statistically significant when corrected for the number of antigens tested. Comparisons of HL-A antigen frequencies between normal Filipinos of the Cebu and Luzon regions showed increased W-5 in the Luzon population (corrected p smaller than 0.025).