Intestinal lymphoma associated with malabsorption. Of 18 patients with small-intestinal lymphoma associated with villous atrophy and crypt hyperplasia of uninvolved mucosa, most presented with acute obstruction or perforation preceded by abdominal pain and weight-loss. Malabsorption, thought to be adult coeliac disease, preceded the diagnosis of lymphoma in 5 cases. The lymphomas were composed of malignant histiocytes and were classified on morphological grounds as malignant histiocytosis. Of particular interest was the finding by immunohistochemical techniques of all major immunoglobulin classes within malignant cells of single tumors. Characterisation of this group of lymphomas as a specific entity should help in the further understanding of the relationship of malabsorption and lymphoma and in the rationalisation of treatment.


X-linked ichthyosis due to steroid-sulphatase deficiency. An assay of cultured skin fibroblasts identified several individuals with 3 beta-hydroxysteroid-sulphate sulphatase deficiency. All patients with this inborn error of metabolism had clinically apparent ichthyosis and a family history of this skin disorder compatible with X-linked inheritance. It is concluded that steroid-sulphatase deficiency is the bio-chemical basis of at least some cases of X-linked ichthyosis.


Upright posture and the efficiency of labour. The claim that an upright maternal posture during labour improves the efficiency of the uterus to the benefit of both mother and fetus has been investigated in a randomised prospective study. 40 patients undergoing induction of labour were allocated to a recumbent group or an upright group. No differences were found between the groups in the length of labour, mode of delivery, requirements of oxytocic and analgesic drugs, or fetal and neonatal condition. Our data do not support calls to change conventional intrapartum nursing attitudes.


Prediction of therapeutic response in acute leukaemia. The degree to which anticancer drugs suppressed incorporation of tritiated thymidine into leukaemic cells was measured in 26 patients with acute leukaemia. Subsequent achievement of remission correlated best with suppression by cytosine arabinoside (ara-C). 6 of 7 patients with acute myelocytic and myelomonocytic leukaemia whose cells demonstrated suppression by ara-C of 3H-thymidine incorporation of 15% or less of control counts subsequently achieved remission, while 4 of 6 patients whose cells showed smaller degrees of inhibition did not achieve remission. Patients with acute lymphocytic leukaemia showed a similar pattern.


Nutritional status of patients undergoing valve replacement by open heart surgery. In 10 patients undergoing heart-valve replacement with cardiopulmonary bypass total-body potassium was measured non-invasively with a whole-body monitor, and this measurement was used to derive the lean body mass as an index of the nutritional status. From measurements made before operation and on the 7th postoperative day, the metabolic response to surgery was found to be equivalent to a negative nitrogen balance of 10.8 g of nitrogen a day (50% greater than that calculated from conventional nitrogen-balance studies). 4 patients had a mean preoperative potassium depletion of 17.2%, and this was associated with increased morbidity. Well-nourished patients had a mean postoperative hospital stay of 16 days, whereas those in a depleted state before operation had an increased morbidity, as measured by their mean postoperative stay of 30 days. More attention needs to be given to the preoperative nutritional status of patients undergoing heart-valve replacement.


Accuracy of grey-scale ultrasound diagnosis of abdominal and pelvic abscesses in 220 patients. The accuracy of grey-scale ultrasound in the detection and localisation of abdominal and pelvic abscesses was assessed retrospectively in 220 patients in whom an abscess had been suspected at presentation. Thirty-six out of forty abdominal abscesses were correctly diagnosed (90%), while an abscess was correctly excluded in 112 out of 113 patients (99%). Thirty-two out of thirty-three pelvic abscesses were diagnosed (97%), and a pelvic abscess was correctly excluded in 33 out of 34 patients (97%). Thus the overall accuracy of the method was 96.8%, with a sensitivity of 93% and a specificity of 98.6%.


Beneficial effect of operation-day blood-transfusions on human renal-allograft survival. In 56 patients 1-year renal-graft survival was significantly better (71% vs 40%) in those who had received blood before operation, confirming previous observations. In addition, transfusion on the day of operation proved to have been beneficial, both in those previously transfused (82% vs 64%) and in those never previously transfused (71% vs 28%). Irrespective of pretransplant transfusion, 1-year graft survival was significantly better (79% vs 44%) in those transfused on the day of operation.


Pretransplant lymphocytotoxins and bone-marrow graft rejection. A correlation was demonstrated between bone-marrow graft rejection and pretransplant lymphocytotoxins. This finding might prove useful as a test for identification of patients at high risk of rejection who might benefit from more intensive immunosuppression.


Pressor amines and monoamine-oxidase inhibitors for treatment of postural hypotension in autonomic failure. Limitations and hazards. The short-term effects of pressor amines were investigated in four patients with postural hypotension caused by autonomic failure. In supine patients p-tyramine alone or with a monoamine-oxidase inhibitor produced pronounced supine hypertension without abolishing the symptoms associated with a postural fall in blood-pressure. Phenylephrine or ephedrine maintained a normal blood-pressure on standing but caused supine hypertension. Thus the effects of p-tyramine with or without a monoamine-oxidase inhibitor were unpredictable and did not include relief of postural hypotension. Phenylephrine or ephedrine had some beneficial effect, but since all these drugs influence standing pressure only at the expense of pronounced supine hypertension, alternative therapy must be sought.


Antibiotic treatment of guinea-pigs infected with agent of Legionnaires' disease. Erythromycin and rifampicin (rifampin) were able to prevent death of guineapigs given intraperitoneal injections of the agent causing legionnaires' disease. Penicillin, chloramphenicol, tetracycline, and gentamicin showed no significant effect. On the basis of clinical experience and experimental observations, erythromycin is recommended for patients suspected to have legionnaires' disease. Combined therapy with erythromycin and rifampicin may be justified in patients with confirmed legionnaires' disease who are not responding to erythromycin alone or as part of a controlled antibiotic trial among suspected cases during an outbreak of legionnaires' disease.


Immune response after splenectomy.

Immune response after splenectomy. The immune response to intravenously administered bacteriophage phiX 174 and subcutaneously administered tridecavalent pneumococcal polysaccharide vaccine was studied in 31 patients with anatomical or functional asplenia. Antibody responses to primary immunisation with phiX 174 were significantly decreased while clearance was normal. Secondary responses were quantitatively normal; however, production of antibody did not switch from IgM to IgG as seen in controls. All groups of asplenic patients accept those patients with Hodgkin's disease demonstrated significant seroconversions in response to pneumococcal polysaccharide antigens. One patient with Hodgkin's disease, treated with local irradiation only, demonstrated normal responses to pneumococcal capsular antigens. 10 of the 12 capsular antigens for which antibody was measured stimulated threefold increases in antibody in the 26 asplenic patients without Hodgkin's disease, which is similar to that observed in controls. Since the majority of cases of overwhelming postsplenectomy infection are caused by Streptococcus pneumoniae, all patients with either anatomical or functional asplenia should receive pneumococcal polysaccharide vaccine.


Radioimmunoassay of lactoferrin in pancreatic juice as a test for pancreatic diseases. Lactoferrin, a protein present in pancreatic juice and other exocrine secretions, was measured by radioimmunoassay in pure pancreatic juice obtained by endoscopic cannulation of the pancreatic duct. Lactoferrin concentrations were high in pancreatic juice from patients with chronic pancreatitis, but they were considerably lower in juice from control subjects and patients with carcinoma of the pancreas. The measurement of lactoferrin concentrations in pure pancreatic juice may be useful in the diagnosis of pancreatic diseases.


Acupuncture in gastroscopy.

Acupuncture in gastroscopy. The analgesic effect of acupuncture was evaluated by a double-blind controlled trial in 90 patients undergoing gastroscopy. The endoscopy was much easier and better tolerated after real acupuncture had been performed.


Identification of dihydrofolate reductase in human central-nervous-system tumours. Ten primary and two metastatic central-nervous system (C.N.S.) tumours were assayed. They all contained dihydrofolate reductase. This finding provides a biochemical rationale for antifolate therapy of C.N.S. tumours by methotrexate.


Persistence of drug-resistant malaria parasites. Mixtures of drug-resistant and sensitive forms of Plasmodium chabaudi were used to infect mice, and the resulting infections were maintained in the absence of drug. Both chloroquine-resistant and pyrimethamine-resistant mutans were able to survive in such mixed infections. The results of experiments on chloroquine resistance indicated an apparent selective advantage of the resistant over the sensitive form.


Smoking and industrial pollution, and their effects on menopause and ovarian cancer. The rodent ovary contains an enzyme system(s) capable of metabolising poly-cyclic aromatic hydrocarbons to reactive electrophilic intermediates known to cause cytotoxicity, mutation, and cancer. If the human ovary contains similar enzyme systems, metabolic activation of environmental chemicals could explain the earlier menopause in cigarette smokers and the higher incidence of ovarian cancer in industrialised areas.


Does ultraviolet-evoked prostaglandin formation protect skin from actinic cancer? The role of increased prostaglandin activity which results from exposure of human skin to ultraviolet light is uncertain. Evidence from the effects of prostaglandins on epithelial cells in vitro suggests that prostaglandin E reduces proliferative activity in the epidermis, probably through a cyclic-A.M.P.-dependent mechanism, thus reducing the vulnerability of epidermis to the mutagenic effects of ultraviolet exposure.


Management of malignancy in "cancer families". A further "cancer family" is described. Cancer patients from such a family require careful lifelong follow-up. All members of cancer families should be screened for cancer of the uterus and colon, and they should be educated in methods of cancer detection and the importance of early diagnosis.


Reduction of mercury vapour in a dental surgery. A restricted survey in one dental practice has shown that a considerable reduction in contamination by mercury vapour can be achieved by the use of a fume cupboard. Failure to employ this added protection may have legal implications.


Hypertension treated by salt restriction. 31 patients with a diastolic blood-pressure between 95 and 109 mm Hg have been treated for two years with a regimen involving a moderate restriction of salt in the diet. The results are compared with those in a control group and in a drug-treated group. Salt restriction has reduced the diastolic blood-pressure by 7.3+/-1.6 mm Hg, a result similar to that in patients treated with antihypertensive drugs. In the untreated group the diastolic blood-pressure rose by 1.8+/-1.1 mm Hg. Most patients did not achieve the desired amount of salt restriction and a stricter adherence to the diet might have caused further falls in blood-pressure. Excessive salt intake is probably a major cause of the epidemic of hypertension in "civilised" countries and a reduction in salt intake may help to control the epidemic. In persons with a diastolic blood-pressure between 90 and 105 mm Hg salt restriction should be tried before drugs.


Primary biliary cirrhosis and coeliac disease: an association? The association of primary biliary cirrhosis and coeliac disease, not previously reported, was observed in 4 patients. In each case, the two conditions were diagnosed simultaneously, and although symptoms were due to coeliac disease, initial investigation drew attention to the liver condition. All the patients responded to a gluten-free diet and remain well 2 years later. Primary biliary cirrhosis remains asymptomatic in 3 patients, but pruritus has developed in the 4th. The significance of this association is unclear and may merit formal study. Coeliac disease should be considered as a possible cause of unexplained weight loss in primary biliary cirrhosis.


Improved survival-rates in presensitised recipients of kidney transplants by immunosuppression with maternal-source gamma-globulin. The effect on cadaver-kidney transplant survival-rates of a gamma-globulin concentrate, prepared from clotted blood centrifugally expressed from placental tissue recovered from postpartum women, was evaluated in a prospective controlled trial in 195 patients who were also given a standard immunosuppressive regimen. Allograft-survival rates were analysed according to whether or not the recipient had lymphocytotoxic antibodies before transplantation (responders) and whether the graft was a first or second transplant. The graft-survival rate was improved in responder-type recipients of first transplants who had received the gamma-globulin concentrate as adjunctive therapy (control group 28.8+/-10.1% vs. gamma-globulin 55.5 + 9.7% at 2 years, p less than 0.05). The survival-rate of grafts in non-responders was not affected by administration of gamma-globulin and data on its use in recipients of a second graft were insufficient for analysis. These results suggest that the gamma-globulin concentrate was suppressing immunological responses associated with humoral-type rejection.


Plama-thromboglobulin concentrations in diabetes mellitus. Abnormally high plasma-concentrations of the platelet protein thromboglobulin were demonstrated in a group of 72 diabetic patients. The highest concentrations were found in patients with clinical evidence of tissue damage. Many diabetic patients, without such complications have elevated thromboglobulin levels, and this blood abnormality may predate recognisable clinical lesions.


Elevated beta-thromboglobulin levels and circulating platelet aggregates in diabetic microangiopathy. beta-Thromboglobulin levels and platelet-aggregate ratios were determined in blood-samples from healthy control subjects and from diabetic patients with and without microangiopathic complications. Patients with diabetic microangiopathy had significantly elevated beta-thromboglobulin levels and also reversible platelet aggregates. In nine newly treated diabetics blood-glucose control was associated with a significant fall in plasma beta-thromboglobulin. Since beta-thromboglobulin is a platelet-specific protein the results indicate that diabetic microangiopathy is associated with evidence of platelet activation and that this may be influenced by the degree of biochemical control.


Migraine thrombocytopenia, and serotonin metabolism. Among 296 patients with thrombocytopenia, 14 had frequent migraine-like headaches, 6 of them having definite migraine. Only 1 of the 6 patients had had migraine before the onset of the blood disorder, and all 6 had migraine attacks during periods of bruising tendency and low platelet count. Control of thrombocytopenia with splenectomy or steroids was accompanied by dramatic improvement in migraine. It is suggested that migraine attacks are caused by abnormal platelet activity and abnormal serotonin metabolism. It is suggested that the immediate factor producing the abnormal platelet activity in our patients was immunological and that other cases of migraine may have an immunological cause.


Detection of atherosclerotic plaques in carotid arteries by the use of 123I-fibrinogen. A non-invasive method for detecting atherosclerotic plaques by the administration of radioactively labelled fibrinogen has been used in a pilot study in one non-atherosclerotic patient and in four patients with unilateral or mainly unilateral atherosclerotic changes. Immediately after 1 mCi 123I-labelled fibrinogen had been given intravenously, the cervical region was examined with a gamma camera and again after 4 h and 20 h. In the control case there was little difference in activity between the left and right carotid regions. The other cases showed a significant increase of activity over the region of the plaque after 4 h. This increased uptake had disappeared after 20 h. Studies to clarify the nature of this uptake and the usefulness of the method are in progress.


Effect of co-trimoxazole on normal creatinine clearance. The effect of co-trimoxazole on creatinine clearance was studied in six individuals with normal kidney function. The mean decrease in creatinine clearance during treatment was 47 ml/min and the mean increase in plasma-creatinine was 0.27 mg/dl (P less than 0.01). Although creatinine clearance decreased by 29%, sodium excretion increased by 22%. Discontinuation of co-trimoxazole resulted in a prompt return of creatinine clearance to pretreatment values, and a consistent antinatriuresis.


Aetiology of adenoma--carcinoma sequence in large bowel. A hypothesis, based on epidemiological and histopathological data, is proposed to account for the aetiology of colorectal adenomas and carcinomas. Adenomas are initially caused by an environmental agent which acts on the colorectal cells of adenoma-prone persons, a further environmental agent causes small adenomas to grow, and a carcinogen causes malignancy in a high proportion of large adenomas.


Ursodeoxycholic acid treatment of gallstones. Dose-response study and possible mechanism of action. To determine the optimum dose for the medical treatment of gallstones with ursodeoxycholic acid (U.D.C.A.), 11 non-obese patients with radiolucent gallstones were given 5 mg, 10 mg, and 15 mg U.D.C.A. kg body-weight-1 day-1 for 6 weeks each. Apart from 3 patients who required surgery for gallstone complications, treatment was well tolerated, and both dyspeptic symptoms and frequency of biliary colic were reduced. Neither diarrhoea nor hypertransaminasaemia occurred during therapy. Of 3 patients completing 6 months' treatment with an average of 8 mg U.D.C.A. kg-1 day-1, 1 showed complete and 2 partial dissolution of gallstones. There were significant correlations between the biliary cholesterol-saturation index and (i) daily dose of U.D.C.A. in mg kg-1, (ii) percentage U.D.C.A., and (iii) percentage U.D.C.A. + chenodeoxycholic acid (C.D.C.A.) in biliary bile acids. Mean gamma-glutamyl transpeptidase fell significantly during treatment, whereas other liver-function tests and hepatic histology remained normal. Mean serum-cholesterol levels did not change, and although there was a 13-35% fall in fasting serum-triglycerides, this difference was not statistically significant. U.D.C.A., like C.D.C.A., seems to act by inhibiting hepatic cholesterogenesis. In 5 patients treated with 5 mg U.D.C.A. kg-1 day-1 for 1-6 months, mean hepatic hydroxymethylglutaryl-coenzyme-A-reductase activity was 28% lower than in untreated gallstone patients. These preliminary results suggest that U.D.C.A. is as effective as C.D.C.A. in 1/2--2/3 the dose and that 10 mg U.D.C.A. kg-1 day-1 should be effective in most gallstone patients.


Abnormal fatty-acid composition of plasma-lipids in cystic fibrosis. A primary or a secondary defect? The percentage fatty-acid composition of the various plasma-lipid fractions from cystic-fibrosis patients with and without pancreatic insufficiency, obligate heterozygotes, and normal subjects was determined. Only the cystic-fibrosis patients with pancreatic insufficiency had significantly abnormal fatty-acid composition. This general observation did not correlate with vitamin-E deficiency, age, sex, or severity of the disease. Thus the altered fatty-acid composition of the different plasma-lipid fractions appears to be a secondary consequence of the pancreatic insufficiency commonly associated with cystic fibrosis and not a direct metabolic defect related to the cystic-fibrosis gene itself.


Cholestasis in acute alcoholic liver disease. 10 of a series of 108 patients with alcoholic liver disease presented with cholestasis associated with non-cirrhotic alcoholic liver disease and without evidence of extrahepatic biliary obstruction. In 7 patients liver histology and the associated conditions presenting as cholestasis were heterogeneous. However, in 3 patients who had been drinking excessively before cholestatic jaundice developed, cholestasis was a major feature of liver histology. The term acute alcoholic cholestasis is suggested for this apparently distinct syndrome of cholestatic jaundice in the absence of hepatitis.


Acute lymphoblastic leukaemia in children: Classification and prognosis. Immunological (surface-marker) tests have been used to define four subgroups of acute lymphoblastic leukaemia (A.L.L.) in childhood: T-A.L.L., B-A.L.L., common-A.L.L., and null-A.L.L. A study of 94 children shows that the common-A.L.L. subgroup achieves a much longer duration of remission than T-A.L.L.; our findings also confirm the association of some clinical features with T-cell A.L.L. Within the common-A.L.L. subgroup, initial white-cell count correlates with prognosis.


Close genetic linkage between HLA and congenital adrenal hyperplasia (21-hydroxylase deficiency). Congenital adrenal hyperplasia (C.A.H.) with 21-hydroxylase deficiency is an autosomal recessive disease. HLA genotyping of parents and children in six families in which more than 1 child had C.A.H. established that the gene responsible for 21-hydroxylase deficiency is closely linked to HLA. One patient had inherited a maternal HLA-A/B recombinant haplotype and studies in this family indicated that the abnormal gene is close to the HLA-B locus. The findings provide a method for identification of C.A.H. carriers and for prenatal diagnosis of affected children.


Pseudomembranous colitis: Presence of clostridial toxin. A toxin was found in the faeces of nine out of nine patients with pseudomembranous colitis and two out of two with antibiotic-associated non-specific colitis. The toxin was neutralised by Clostridium sordellii antitoxin but not by a commercial mixture of C. welchii, oedematiens, and septicum antitoxins. The in-vitro and in-vivo properties of pseudomembranous-colitis toxin closely resemble those of the toxin of C. sordellii.


Erythrocyte-sedimentation rate before and after in-vitro defibrination: A rapid and simple method for increasing its specificity. The erythrocyte-sedimentation rate (E.S.R.) was measured before and after in-vitro defibrination in 107 patients with high E.S.R.S. The reduction in E.S.R. on defibrination correlates with the fibrinogen level while the post-defibrination E.S.R. correlates with the globulin level. The ratio between the post-defibrination E.S.R. and the pre-defibrination, or standard, E.S.R. varies with different diseases; it is highest when an excess of globulins is the cause of the high E.S.R. and lowest when there is an excess of fibrinogen. Measurement of the post-fibrination E.S.R. is quick and easy and may help in the initial investigation of a high E.S.R.


Correction of renal hypertension in the rat by prolonged infusion of angiotensin inhibitors. Injection of saralasin or converting-enzyme inhibitor produced a small variable reduction of blood-pressure in rats with two-kidney hypertension. Prolonged infusion of the inhibitors gradually reduced blood-pressure to normal. Control infusions of saralasin in normal animals and of dextrose in normal and hypertensive animals did not reduce blood-pressure. Plasma-renin concentration correlated significantly with the early but not with the later fall of blood-pressure. Plasma-concentrations of renin and angiotensin II were closely related except in rats receiving converting-enzyme inhibitor, when angiotensin II was relatively reduced. The gradual reduction of arterial pressure by saralasin was not associated with increased urinary sodium excretion.


Oestradiol applied locally to ripen the unfavourable cervix. The unfavourable cervix in late pregnancy presents a difficult clinical problem if labour has to be induced. In an attempt to improve the outcome, the effect of applying oestradiol directly to the cervix the day before planned induction was investigated. Two groups of twenty-five primigravidas were studied, one group receiving 150 mg oestradiol in viscous gel and the other the viscous gel alone. There was a significant increase in cervical ripeness in the group who received oestradiol and a reduction both in the length of the labour and in the need to resort to caesarean section.


Corticotropin-like peptides in central nerves and in endocrine cells of gut and pancreas. Extrapituitary corticotropin-like peptides have been found in central nerves and in gastrointestinal and pancreatic endocrine cells. Previous biological and immunological data strongly indicate that the immunoreactivity present in the central nerves represents corticotropin (A.C.T.H.) or a closely related peptide. In some areas of the brain, the distribution of A.C.T.H. nerves parallels that of nerves containing the endogenous opioid ligand, enkephalin. Since A.C.T.H. fragments bind to the opioid receptor the two neuronal peptides may interact. The antiserum used demonstrates the COOH-terminus of the A.C.T.H. molecule, which is devoid of adrenocortical stimulatory activity. A COOH-terminal A.C.T.H.-peptide, corticotropin-like intermediate peptide (C.L.I.P.), originally isolated from the pars intermedia, has been shown to stimulate release of pancreatic insulin. The presence of C.L.I.P.-like molecules in gut and pancreatic endocrine cells may indicate that C.L.I.P.'s insulin-releasing activity is physiologically important. Further, the occurrence of A.C.T.H.-related molecules in such cells may account for the ectopic A.C.T.H. syndrome associated with some tumours of gut and pancreas.


Platelet-monoamine-oxidase activity predicts response to lithium in manic-depressive illness. Platelet-monoamine-oxidase activity predicts treatment response to lithium in manic-depressive illness. In the treatment-responsive group enzyme activity is similar to that in normal controls, whereas in the treatment-refractory group enzyme activity is significantly less than both control and treatment-responsive groups.


Treatment of carcinoid liver metastases by hepatic-artery embolisation. Two patients with multiple hepatic carcinoid metastases experienced considerable symptomatic relief after the hepatic artery was embolised with fragments of absorbable gelatin sponge administered through a percutaneous arterial catheter. With adequate pharmacological cover the technique is a safe, effective, and relatively painless treatment for a condition which is usually very difficult to manage.


Peripheral vascular disease in cigarette smokers and impaired hepatic metabolism of lipoprotein remnants. The metabolism of very-low-density lipoproteins and chylomicrons includes the extrahepatic hydrolysis of their triglycerides by lipoprotein lipase. This results in cholesterol-rich "remnants" which are further metabolised by the liver. There is experimental evidence that in both patients with type-III hyperlipoproteinaemia and cigarette smokers hepatic-remnant metabolism may be depressed. In type-III hyperlipoproteinaemia the defect is inherited while in smokers it occurs in response to raised blood concentrations of carboxyhaemoglobin. The striking clinical similarity between type-III hyperlipoproteinaemic patients and smokers--namely, a high incidence of peripheral vascular disease--may be due to a common cause, the accumulation of cholesterol-rich remnants in the plasma.


The failure of preventive medicine.

The failure of preventive medicine. The failure to promote public health may be due, not to political or economic opposition, but to the fact that the arguments used to persuade people to change their behaviour or to agree to the passage of enabling legislation are set in a linguistic framework which has no meaning for them--namely, the concept of the future.


Interpersonal psychotherapies in medicine. One person can sometimes influence another in a face-to-face encounter, and in psychotherapy the aim is to maximise this effect, when appropriate and possible, for relief of distress, modification of disease processes, and/or growth of personality.


[The role of the anesthetist in the treatment of chronic pain conditions (author's transl)]. There are many causes of chronic pain. A clinic for the treatment of chronic pain conditions must therefore be based on the team work of various special disciplines. The anesthetist who is interested in this field may be a very useful member of such a therapeutic team. Chemical blockade of nerves, transcutaneous stimulation of nerves, chordotomy, all belong to his special field. The results of treatment also depend, however, on the personality of the patient and the nature of the disease.


[Oral longterm therapy with disopyramide phosphate in patients with atrial and ventricular arrhythmias (author's transl)]. The antiarrhythmic effect of longterm therapy with disopyramide phosphate (DP) was investigated in a single controlled trial in 34 patients. Of 11 patients with atrial fibrillation, 5 were successfully cardioverted to sinus rhythm with DP in the long run. In the treatment of extrasystole, the arrhythmia was eliminated or reduced by 75% in 15 of 23 patients. In 6 cases a moderate improvement was achieved and there was no change in 2. The average daily dose initially was 4.2 capsules, the maximum dose was 5.4, and for longterm therapy 4.3 capsules. With respect to its indications, DP is largely similar to quinidine, but in our experience it is characterized by better tolerance.


[Use of high doses of medroxyprogesterone acetate in the palliative treatment of advanced breast cancer. Clinical experience with 44 cases]. MAP was used in high doses (1 g/die up to a total dose of 45-50 g) in 44 cases of advanced mammary carcinoma (IIIrd and IVth stage of the T.N.M. classification), evaluated according to the criteria proposed by CBCG. The excellent tolerance to the drug, even at such high doses, is stressed. Therapeutic responses were best in cases of metastasis in the soft and bony tissues and in cases of pulmonary metastasis. It is pointed out that the effectiveness of the treatment is particularly evident in patients in whom the free interval has exceeded two years and in patients in the menopause for more than five years. In the light of results obtained, the possibility of introducing the drug into the therapeutic strategy of this condition is discussed.


[5 years of activity in a small coronary unit. Experiences and considerations]. Five years' experience at the coronary unit of the S. Angelo Hospital medical division is described. Practical considerations are offered with regard to the management of arrhythmia with drugs, electroconversion and electrostimulation.


Limitations of audiovisual aids and educational objectives in a clinical clerkship. The several components of a clinical clerkship were analyzed and correlated with Part II National Board scores and career choice. No positive correlations could be made between fulfilling educational objectives, utilization of audiovisual aids, general satisfaction and the clerkship, and eventual career choice or performance on National Board Examinations.


Use of an auditory cue to improve bowling performance of visually handicapped persons. This study investigated the effect of an auditory cue on the performance of visually handicapped. Bowling performance was significantly superior with the audible goal locater than without for both 15 acquired and 15 congenitally visually handicapped.


On validity of hypotheses derived from the rorschach: II. interpretation of card IV as "father" card and card VII as "mother" card. Research testing the validity of the hypothesis that Card IV of the Rorschach can be viewed as the "father" card and Card VII, the "mother" card was reviewed. Essentially the research suggests that such symbolic interpretation of the Rorschach stimuli is most characteristic of children and in particular emotionally disturbed children, but not adults, either normal or schizophrenic. The assumption that Cards IV and VII have universal symbolic meaning was, thus, called into question. A critical analysis of the research stratagems used in testing this hypothesis was offered and some suggestions made for future research.


An optoelectronic slide identifier.

An optoelectronic slide identifier. An inexpensive optoelectronic slide identifier that uses binary code is described. It can be attached to most automatic projectors and provides for automatic indexing of up to two-hundred and fifty-five different coded slides, while each slide is being projectd.


[Benign intracranial hypertension due to thrombosis of a transverse sinus. Diagnosis by scintigraphy using bleomycin labelled with cobalt 57 (author's transl)]. In a case of benign intracranial hypertension with no apparent aetiology, cerebral scintigraphy demonstrated abnormal uptake in the left transverse sinus 24 hours after injection of the isotope. This sinus was seen to be thrombosed by cerebral angiography. On the basis of this case, the role of cerebral venous thrombosis in cases of "pseudo-tumor cerebri" is discussed.


Moloney leukemia virus-induced cell surface antigen: detection and characterization in sodium dodecyl sulfate gels. An experimental procedure for detecting and characterizing tumor-associated, virion, and histocompatibility antigens has been developed. The method takes advantage of the high resolution that proteins, solubilized by Triton X-100 and reduced, display after sodium dodecyl sulfate gel electrophoresis. The antigens can be detected as distinct molecular weight species by a highly sensitive inhibition of cytotoxic reaction. When coupled to the lactoperoxidase-catalyzed iodination of intact cells, the procedure permits the determination of externally exposed antigens. In the present study, the method has been applied to the Moloney leukemia virus-induced YAC lymphoma cells of strain A mice, which express a Moloney leukemia virus-determined cell surface antigen (MCSA) in addition to the type C viral proteins gp71, p30, p15, p15(E), p12, and p10. MCSA was identified as an exposed surface protein distinct in size and antigenic determinants from the major envelope and core protein of Moloney leukemia virus and the histocompatibility antigens. Multiple molecular weight species possessing antigenic determinants for MCSA, gp71, and H-2(a) have been detected. These results provide direct confirmation that MCSA is unrelated to the known virion structural proteins or to the H-2(a) antigen. This method should permit the direct identification and molecular weight characterization of any antigen whose determinants are not solely dependent on a complex quaternary structure and for which serological reagents are available.


Evidence for a long-range conformational change induced by antigen binding to IgM antibody. The effects of antigen binding on IgM antibody conformation were investigated by measuring the immunological reactivity of the Fc-bound J polypeptide. For such measurements anti-azophenyl-beta-D-lactoside and anti-azobenzenearsonate IgM antibodies were examined in a J chain radioimmunoassay before and after complexing with various hapten-conjugates. The assays showed that (i) the accessibility of J chain determinants is very limited in uncomplexed IgM and (ii) their accessibility is significantly enhanced in the presence of an excess of specific antigen. In both antibody systems, enhanced J chain exposure was achieved with the homologous multi-hapten-substituted antigen (1.9-fold), with a small multivalent antigen in which three to four hapten groups were coupled to a heterologous carrier (1.55-fold), and with monohapten-substituted antigen (1.4-fold). Because the J chain is located in the terminal CH4 Fc domains, these data provide direct evidence that a change in Fc conformation is induced by the binding of antigen to the distant Fab combining sites. Moreover, the data indicate that the changes in J chain exposure do not depend on crosslinking by antigen, but can be induced by the interaction of antigen at individual IgM combining sites.


[Thyroid gland morphological and functional indices in the experimental action of chromium]. The influence of chromium added to food (from 3.0 to 2250 microgram per 1 kg of body weight) on the morphology and function of the thyroid gland was studied in experiment on albino male rats. On the basis of the results of study of the histological structure and the thyroid gland weight, the level of the protein-bound iodine and the effective thyroxin coefficient the dose of chromium of 3 microgram per 1 kg of body weight should be considered to be most physiological.


Endogenous New World primate retrovirus: interspecies antigenic determinants shared with the major structural protein of type-D RNA viruses of Old World monkeys. A reverse transcriptase-containing virus has recently been isolated from a squirrel monkey (Saimiri sciureus). Molecular hybridization studies demonstrate that the squirrel monkey retrovirus (SMRV) is endogenous to this New World primate, yet lacks detectable nucleotide sequence homology with cellular DNAs of representative Old World primates or with the genomes of previously isolated Old World primate retroviruses. The 35,000-dalton major structural protein (p35) of SMRV was purified and shown to possess antigenic determinants distinct from those of known retroviruses. While SMRV was found to lack antigenic determinants broadly shared among mammalian type-C viruses, immunologic crossreactivity was demonstrated between SMRV p35 and the major structural protein (p26) of Mason-Pfizer monkey virus, a prototype type-D retrovirus of Old World monkeys. These findings support the concept that SMRV and Mason-Pfizer monkey virus are evolutionarily related, and raise the possibility that a progenitor of type-D retroviruses became genetically associated with primates at a very early time in their evolution.


Kepone--hazard evaluation.

Kepone--hazard evaluation. Kepone is a persistent chlorinated hydrocarbon pesticide which is no longer manufactured in the U.S.A., its uses having been cancelled on April 11, 1977; previous food uses included control of the banana root borer, and non-food uses included control of tobacco wireworm, ants, and cockroaches. An adduct of Kepone, Kelevan, is now distributed by Spiess and Sohn, Chemische Fabrik, Germany, with an as yet unknown manufacturer, for control of the Colorado potato beetle in Eastern Europe and Ireland, and for control of the banana root borer in the cameroons, Caribbean, and South America. Kepone is acutely toxic and induces cumulative and delayed toxicity, neurotoxicity, and reproductive impairment, in a wide range of species including birds, rodents and humans; it is also carcinogenic in rodents. Extensive environmental dispersion, with major evidence of aquatic toxicity has been demonstrated following its recent manufacture in Hopewell, Virginia, U.S.A.


Cholestyramine: use as a new therapeutic approach for chlordecone (kepone) poisoning. In rats, as reported in humans, chlordecone (Kepone) is excreted predominantly in the feces. Cholestyramine, an anion exchange resin, binds chlordecone in rat intestine, increases its excretion into the feces, and decreases its content in the tissues. The resin appears to offer a practical method for treating chronic poisoning with this and possibly with other lipophilic toxins.


[Demonstration of neonatal blood].

[Demonstration of neonatal blood]. The authors present a method for demonstrating alpha -1- fetoprotein in neonatal blood spots. The results as obtained with the method used since 1973 are referred to as good. The method can be regarded as highly specific if the respective person can be ruled out to have, in particular, hepatic carcinoma. The specificity can be supported by a simultaneous demonstration of fetal haemoglobin. The positive result of the two methods permits to conclude that the blood examined originated from a fetus or a neonate, thus contributing to the resolution of some cases of illegal interruption of pregnancy or murder of a neonate.


Malignant hepatoma with disappearance of alpha-fetoproteinaemia after hemihepatectomy: a case report. A 62-year-old Black man was found to have a malignant hepatoma localized to the right lobe of the liver but multicentric in origin. Alpha-fetoprotein (AFP) was found to be present in the serum, but, after a right hemi-hepatectomy, it was no longer detectable. The implications are discussed.


Analysis of thy-1 variants of murine lymphoma cells. Cells obtained from a radiation-induced T-cell lymphoma of BALB/c mice, RLmale-1, were adapted to long-term tissue culture. Clones of cells were obtained in soft agar and a clonally derived population studied for the frequency of mutation in the expression of the surface antigen Thy-1.2 (OC3H) by immunoselection. The mutation rate was 1.05-1.50 X 10(-6) per cell per generation. Antigenic and structural analysis of prototype positive and negative clones demonstrated clear differences between them.


Further studies on hybrid cell-surface antigens associated with human chromosome 11. A new human immunogenetic cell-surface activity associated with human chromosome 11 in the AL human-Chinese hamster ovary cell hybrid is described. Like a1, but not a2, it is present on the human erythrocyte. By mutagenesis and selection, specific, stable, variants of the AL hybrid have been prepared exhibiting various combinations of a1, a2, a3, and lactic dehydrogenase A activities. The antigens of the AL system can be demonstrated by the horseradish peroxidase system which offers a promising approach to scanning of tissue cells.


Primary mediastinal trophoblastic teratomas. Three cases of primary mediastinal trophoblastic teratoma are described. One patient died from respiratory failure during the initial chemotherapy, Another patient with advanced disease is now apparently free from disease after multiple-drug chemotherapy. The third patient is alive and well four years after a combination of surgery, radiotherapy, and multiple-drug chemotherapy. In the diagnosis and assessment of response to treatment in these tumours emphasis is placed on the measurement of the tumour cell markers, chorionic gonadotrophin and alpha-fetoprotein, by radioimmunoassay. The efficacy of multiple-drug regimens is discussed together with a review of the literature.


Enhancement of the cancer chemotherapeutic effect by anticancer agents in the form of fat emulsion. Utilizing the lipid-adsorbing ability of lymphatic capillaries, anticancer agents were given in the form of fat emulsion in order to deliver them to regional lymph nodes. The emulsion, in which the drug solution is contained as the innermost phase, yielded high drug concentration in the lymphatic system. Intratumoral injection of emulsified anticancer agent resulted in significantly prolonged retension of the drug within the tumor tissue. Therapeutic experiments of the emulsion also disclosed remarkable tumor reduction and cure rate as compared with aqueous solution of drugs. Oral administration of emulsified 5-Fluorouracil (5-FU) was also attempted for stomach cancer. With 5-FU, the maximum concentration of drug in thoracic lymph and stomach was greater when administered as an emulsion than as an aqueous solution, and a high concentration persisted longer. As a clinical trial of the emulsion method, eight patients with inoperable malignant growth were injected locally with emulsified anticancer agents and 121 patients were given 5-FU emulsion orally. From the clinical and histological findings, it was thought that the emulsion enhanced the chemotherapeutic effect of the anticancer agent on lymph node metastasis.


A technique for the simultaneous staining of both nucleolar organizer regions and kinetochores of human chromosomes with silver. Pretreatment of human metaphase chromosomes with NaOH at a pH of 8.5, followed by staining with silver nitrate, differentially stains both the nucleolar organizer regions on the 10 acrocentric chromosomes as well as the kinetochore centers on all 46 chromosomes.


A simple stain for myelin in frozen sections: a modification of Mahon's method. A simple and rapid method for demonstrating myelinated nerve fibers in frozen sections of the central and peripheral nervous system is described. Material fixed by perfusion with mixed aldehydes gives the best results but the method also works on specimens fixed by immersion in formaldehyde. Frozen sections varying in thickness from 15-50 micron are mounted on slides subbed with chrome alum-gelatin. After hydration (60-120 min), sections are mordanted (20-40 min) in 2.5% iron alum and rinsed briefly in three changes of distilled H2O (total 2 min). Staining is for 60-180 min in 20 cc freshly made 10% alcoholic hematoxylin diluted with 165 cc distilled H2O to which 15 cc saturated Li2CO3 is added. The sections are washed in distilled H2O (5-15 min) and dehydrated in graded alcohols without differentiation in mordant, and covered. Myelin stains a dark blue-purple against a light grey background. Fiber tracts, as well as individual myelinated fibers, are clearly demonstrated.


A method of relating craniofacial sections to topography in embryos. The transparent properties of the embedding agent glycol methacrylate facilitate orientation of the complex embryonic craniofacial region. This technique allows for consistent and reproducible section-to-topography orientation. We find it to be a valuable adjunct for envisioning three-dimensional relationships. The contrast of external features of the embryo is enhanced when stained lightly with hematoxylin prior to embedding. The craniofacial region of the embedded embryo is removed with a fine surgical saw and reimbedded. Section-to-topography relationships are readily monitored and documented photographically. Furthermore, it is possible to "preview" sections for symmetry and other considerations of orientation by viewing the cutting face of the block under oblique illumination. A relief image of structures is then visible.


Differential staining of calcified tissues in plastic embedded microtome sections by a modification of Movat's pentachrome stain. Movat's pentachrome I stain has been adapted and modified as a stain for undecalcified bone sections. After embedding in methyl methacrylate, this procedure yields consistently good results, with an excellent and colorful contrast between mineralized and unmineralized compartments of both cartilage and bone. In addition, osteoblasts, osteoclasts, and other cells and tissue components can easily be differentiated. The staining properties of the lacunar wall surrounding the osteocytes are considered to reflect various states of osteocytic activity. The method is especially useful for the study of bone growth and bone repair, and as a stain for conventional histomorphometry and computer-assisted image analysis in bone biopsies.


Flow cytometry: long-term storage of propidium iodide/citrate-stained material. Single cell suspensions stained by the propidium iodide/hypotonic citrate method for DNA content analysis by flow cytometry can be mixed with an equal amount of 70% alcohol for long-term storage and shipping without introduction of artifacts or loss of fluorescence.


Techniques for histological reconstruction of brain stem recording sites. The masseter muscle of Sprague-Dawley rats was injected with 10 mg of horseradish peroxidase. The electrical activity of the trigeminal motor nucleus was investigated 24-36 hours later using micropipettes filled with a 2.0 M NaCl-7% fast green FCF solution. A parallel series of penetrations at 200 micron intervals was made through the motor complex at known depths. The grid formed from these penetrations was reconstructed using the following techniques. Marks were made at known depths in one or more of the tracts by iontophoresing fast green from the microelectrode tip with a hyperpolarizing current of 10 muA for 10 minutes. To assure proper alignment of the tissue containing the green marks, two agar-India ink plugs were placed caudal and parallel to the recording sites. The frozen tissue was sectioned on a microtome, first through the agar plugs and then through the tissue containing the green marks. The tissue could be incubated for the peroxidase reaction product or stained for Nissl substance. These combined procedures offer a means to correlate the structure and function of brain stem nuclear groups.


The effects of some drugs--pentamidine, stibocaptate, Hoechst 33258, F 151, compound 'E' and Nifurtimox--on Onchocerca volvulus in chimpanzees. Several drugs were investigated for action against Onchocerca volvulus in chimpanzees. Pentamidine at 4 mg/kg daily for 16 days had no filaricidal action; nor did stibocaptate at 10 mg/kg monthly for 8 months. Hoechst 33258, a substituted bis-benzamidazole, showed micro- and macrofilaricidal activity; F151 (an arsenical compound) showed a purely macrofilaricidal action; and Compound E (a reaction product of Hoechst 33258 and F151) was micro- and macrofilaricidal. The toxicity of the three last-mentioned compounds was high, and further trials were not made. Nifurtimox, at doses of up to 40 mg/kg for 10 days, was shown not be microfilaricidal, but there was a suggestion that this drug may have some macrofilaricidal action.


Cholinesterase activity in the microfilaria of Wuchereria bancrofti Cobbold. The distribution of cholinesterase activity in the microfilaria of the nocturnally periodic Wuchereria bancrofti has been described. Using histochemical methods, cholinesterase activity has been demonstrated in the amphids (Mundgebilde), phasmids (Schwanzgebilde), nerve-ring, excretory and anal vesicles of the microfilaria. It has been found that the enzyme activity disappeared completely after treatment with the specific cholinesterase inhibitor eserine. Evidence is presented that the greater amount of the cholinesterase activity detected is related to acetylcholinesterase and the functional significance of the enzyme in the enzyme reactive structures is discussed.


[Combined surgical and cytostatic therapy in patients with advanced metastatic nonseminomatous testicular cancer (author's transl)]. Lymphadenectomy and chemotherapy were carried out on 18 patients with grossly disseminated nonseminomatous testicular cancer. Of the 14 patients so far evaluable, remission was obtained in 13 (92%), complete remission in 7 (50%). Results suggest that even when the disease is advanced, lymphadenectomy is of diagnostic, therapeutic, and palliative value.


[A bladder-prostate model on which to practice using transurethral resection instruments (author's transl)]. A metal container, open on the top, with a rubber collar on the front and a place inside for mounting an apple, can be used for practicing the TUR of the prostate with all types of resection instruments. The device can be strapped to the resection table, and all technical aspects of the TUR with the exception of blood stanching, can be simulated. The removal of the prostate as far as the capsule can be accomplished with the apple, which is resected from the core to the peel. In addition, a learning method for actual resection is described.


[Ultrasonic examination of the prostate, with rating apparatus for tumor recognition (author's transl)]. The prostate was examined by ultrasonic waves to diagnose tumorous changes of the organ. We scanned directly from the abdominal wall through the full bladder (transvesical). The classification of the resulting B-pictures is based on patterns that are specific for normal, adenomatous, or cancerous tissue. The results show that adenomas and carcinomas are recognizable in 85% of the examined patients by ultrasonic waves and can be differentiated from normal prostate tissue. Ultrasonics, Prostate, Recognition of Tumors.


Submucosal fibromatosis: prostatism in a young boy? A seven-year-old boy was seen with a urodynamically significant, obstructing, posterior urethral mass. It was believed to represent either a fibromuscular prostatic enlargement or a nonpedunculated congenital polyp. The differential diagnosis is discussed. Transurethral resection of the mass resulted in decreased voiding pressure and relief of symptoms.


[Molecular mechanisms of mediator secretion]. A review is presented discussing problems of transmitter localization in nerve endings, their replenishment in synaptic vesicles (SV), reuptake of transmitters and their degradation products from the synaptic cleft, the structural variations in the presynaptic membrane (pre-SM) during rest and excitation and the role of contractile proteins in the mechanism underlying transmitter secretion. A hypothesis is proposed about the universality of the mechanisms involved in transmitter release and utilization and the key role of the membrane ATP-ase system in these processes. During depolarization of the pre-SM the increase in membrane permeability is ascribed to the loosening of protein-lipid bonds and inhibition of ATP-ase activity involved in transport mechanisms. During depolarization the number of complementary contacts between SV and the pre-SM increase probably through the action of myosin-like and actin-like proteins localized on the SV and pre-SM, respectively. The release of transmitters and polypeptides is thought to be initiated by an increased concentration of Ca2+ in the synaptoplasm which induces contraction of the actomyosin-like complex. Changes in the Na-gradient brought about by the activity of Na, K-ATP-ase, are involved in the active reuptake of transmitters from the synaptic cleft. The newly-synthesized transmitters and those taken up from the synaptic cleft are stored in the SV by a Mg-ATP-ase dependent mechanism. Transmitters are stored in SV bound to acid polypeptides containing nucleotides. The presynaptic action of different neurotoxins is also discussed.


Human granulocyte antigens detected on leukemia cells and a chronic myelogenous cell line. Normal human granulocyte alloantigens were found on chronic myelogenous, acute myeloblastic leukemia cells, and a cell line of chronic myeloblastic origin (K562). Antigens were detected by human antisera positive for normal peripheral blood granulocytes but devoid of HLA activity. Very few acute lymphoblastic leukemia cells reacted positively, and none of the chronic lymphocytic leukemia cells seemed to bear granulocyte surface antigens. The recognition of these normal tissue isoantigens on myeloblastic leukemia cells is a necessary prerequisite for the identification of "leukemia-specific" of "leukemia-associated" antigens.


Number of B sites generated on group O red cells from adults and newborn infants. When red cells from the group O blood of adults and newborn infants (cord blood) were incubated with UDP-galactose and group B serum, over 200,000 B sites per cell were generated on adult O cells but only 40,000--70,000 sites per cell on cord cells. It is concluded that smaller amounts of substrate for the B transferase are present on cord cells.


GcT (Toulouse): a fast variant of the groupspecific system in an Pyrenean family. In the course of a genetic investigation carried out in a Pyrenean population, a family with a new allele of the Gc system was found. Electrophoretic analysis revealed a faster migrating variant with a double band pattern. Presumably, this variant represents a mutant of the Gc1 allele. The variant is transmitted as an autosomal codominant trait. This additional allele at the Gc locus is named GcT (TcToulouse).


Intravenous gamma-globulin infusions in patients with hypo-gamma-globulinemia: prevention of adverse reactions with corticosteroids. A gamma-globulin preparation for intravenous use was given to 11 patients with antibody deficiency syndromes. Most of them had reacted earlier to intramuscular injections of normal gamma-globulin. The gamma-globulin employed produced adverse reactions, often quite severe in 8 of 9 intravenous infusions in three patients. After premedication with hydrocortisone, side effects appeared on 18 of 48 occasions in 10 patients, but only twice were they so severe that the infusions had to be interrupted. Thus, it seems that hydrocortisone diminishes the risk of side effects. The intravenously administered gamma-globulin seemed to be just as effective as the preparations for intramuscular use, and no severe infections appeared during the period of observation. There was no indication that the single hydrocortisone injections, usually 200 mg, increased the risk of contracting infections, but still such medication should be used with great caution in antibody-deficient patients.


wVariants of the hepatitis B surface antigen in Israeli populations. A survey of w variants of the hepatitis B surface antigen (HBsAg) among native and immigrant Israelis revealed that the subtype ayw2 predominated among asymtpomatic HBsAg carriers (69%), and patients with acute (83%) and chronic active hepatitis B (81%). The subtypes ayw3, ayw4 and adw2, uncommon in native populations, were detected in carriage by immigrants and transients. Nevertheless, the high prevalence of ayw2 among native Israeli carriers (87%), and in particular natives with acute 93%) and chronic active hepatitis B (86%), indicates that the introduction of nonindigenous viral strains has not overtly altered the anticipated geographic distribution of hepatitis B viruses.


[Effect of heparinoids on the blood sugar level and blood lipids in diabetes mellitus]. The paper is a clinical experimental work, studying the heparinoid effect upon blood sugar level, blood lipid fractions, endogenic heparin and lipo-brigther-becoming activity in diabetics. Heparinoids are applied in acute experiment. A total of 37 subjects were examined--22 diabetics with adult type of diabetes, 10 clinically healthy subjects and 5 diabetics examined only with 500 ml physiologic salt solution. The same patients were examined with heparin as well for a comparison. Blood sugar, NEFA, lipolyzing activity, total lipids, total cholesterol, beta-lipoproteins, total phospholipids, triglycerides and endogenic heparin were determined prior to and post infusion introduction of heparinoids. The results reveal that heparinoids have two basic biochemical effects decrease blood sugar lever in diabetics and change the blood lipid fraction level. They depend on the structural peculiarities of the preparations. Heparinoids stimulate heparin activity as well, through which they realize their biochemical effect to a certain extent. The decreasing effect on blood sugar level of heparinoids is stronger as compared with heparin.


[Serodiagnosis of a chronic pyelonephritis using common antigen]. By means of the indirect haemagglutination reaction we examined for antibodies against the enterobacterial common antigen 113 sera of blood-donors and 588 sera of patients with chronic pyelonephritis. It could be shown that this antigen is not suitable for the proof of antibodies and thus for the serodiagnostics of a chronic pyelonephritis. Also the combination with the results of the antibody determination against the O-antigen of the homologous strain of the urine is without diagnostic relevance.


[The different biochemical course of HBsAg-negative and HBsAg-positive hepatitis (author's transl)]. In 73 patients with HBsAg negative hepatitis and in 94 patients with HBsAg positive hepatitis (hepatitis B) laboratory findings were compared: GOT, GPT, AP, gamma-GT, bilirubin, sedimentation rate and gamma-globulins. In the beginning of the disease there was little difference. But comparing the maximal values patients with hepatitis B showed significantly higher GOT, GPT, de-Ritis, and bilirubin levels than patients with HBsAg-negative hepatitis. There was a correlation between de Ritis quotient and bilirubin. The difference of HBsAg negative and HBsAg positive hepatitis might be due to different reactions of cellular mediated immunity.


[Strain differences in the neuraminidase specificity of subtype N 1]. Nine strains having neuraminidase of subtype N1 and two strains in which the appurtenance of neuraminidase to subtype N1 was determined in the course of the study were examined for the antigenic specificity of the functional center of the enzyme in the cross neuraminidase activity inhibition test. Neuraminidase of the strains A/Swine/Tatarstan/64 and A/Swine/Ikshurminsk was shown to belong to the subtype N1 but to differ from neuraminidase of the strain A/Swine/Iowa/15/30. Neuraminidase of the strain A/Chicken/USSR/314/67 differs from neuraminidases of A/PR8/34, A/WS/33, and A/Swine/Iowa/15/30 but is related to neuraminidases of the strains A/New Jersey/8/76, A/duck/Germany/1868/68 and A/Chicken/Scotland/59. The A/New Jersey/8/76 neuraminidase is not related to neuraminidases of the strains A/PR8/34 and A/WS/33 but is related to neuraminidases of strains isolated from swine and domestic fowl. The disclosed considerable strain variations in the antigenic specificity of neuraminidases attest to heterogeneity of the subtype N1 and the possibility of its subdivision into groups.


Amniotic fluid total proteins, electrophoretic patterns, total amino acids and creatinine in diabetic women. Total proteins, total-acids, creatinine and the five major protein-fractions were determined in amniotic fluid of 9 diabetic mothers and 42 normal women. The mean value of the estimated patterns in the diabetic subgroup of living full-term infants was within normal, except a significant decrease in creatinine, albumin and gamma-globulin. A highly significant decrease in albumin, gamma-globulin and total amino acids in the amniotic fluid of those given stillbirth infants (SB), while a significant increase was found in both of total proteins and albumin in cases developed respiratory distress syndrome (RDS). In addition to a significant increase in creatinine, alpha 1-, alpha 2- and beta-globulins in both subgroups of SB and RDS. The A/G ratio of the 3 subgroups were significantly decreased especially those of SB.


[Virus-like particles in the sera of patients with viral hepatitis and donors with antigenemia]. Isopicnic centrifugation in cesium chloride gradient produces sufficiently homogeneous fractions of large (42--45 nm) and small (20--22 nm) particles detectable in sera from patients with viral hepatitis and donors with antigenemia. In addition to morphological criteria, differences between these particles were indicated by a greater buoyant density (1.24 g/cm3), higher sensitivity to lower pH values and a lower resistance between. No antigenic determinats inherent in small particles could be found in large particles.


Antibody dependent cellular cytotoxicity (ADCC) against human erythrocytes, mediated by blood group alloantibodies: a model for the role of antigen density in target cell lysis. Antibody dependent cellular cytotoxicity (ADCC) of human mononuclear cells against human erythrocytes could be obtained with anti-A and anti-D sera. The degree of lysis varied considerably depending on the antigen system and on the experimental conditions. Anti-D mediated in contrast to anti-A mediated ADCC turned out to be very sensitive to conditions which interfere with target cell lysis: for most of the anti-D sera, removal of unbound IgG was found to be crucial to detect their ability to mediate ADCC. Pretreatment of the target cells with various enzymes dramatically improved specific lysis and left spontaneous release and spontaneous cytotoxicity essentially unaffected. In the case of neuraminidase treatment it could be shown that the effect was independent from the exposure of additional binding sites. When enzyme treatment and removal of excess IgG were applied in combination, as little as 10(4) antigenic determinants proved to be sufficient to induce specific lysis.


[Resection arthroplasty of the metatarsophalangeal joints after Clayton (10 years of clinical experience) (author's transl)]. 57 resection arthroplasties of the metatarsophalangeal joints using the method of Clayton were performed in arthritic and arthrotic deformities of the forefoot. 43 feet were controlled after an average of 5 years postoperatively. The good postoperative position of the toes changes into a progressive shortening, dorsal transposition and frequently valgus direction of the toes during the first year after operation. The deformity is much less than preoperatively. Passive mobility is good, but there is little active motion. The splay foot deformity is reduced in 50% of the cases. No arthritic recurrences were observed, callosities, clavi and mild pain were rarely found. Foot movements, walking ability was improved in all patients and 50% were wearing standard shoes. The results are influenced negatively by errors in resection technique, particularly lack of plantar rounding, exaggerated resection and unfavourable differencies in length of the metatarsal bones, and occasionally by secondary ossifications.


[Methods for the biological testing of dental materials on cell cultures]. This paper discusses some of the methods used by for making basic biological tests of stomatological materials. Although we do not dispense with the use of methods based upon the observation of fixed and, possibly, stained cells and allowing the states assumed by cells in a certain period of time to be noted, yet we believe that far better results may be obtained from tests enabling the development of changes of living cells cultivated in vitro to be followed. The results of the experiments conducted by the authors indicate that it is possible for the final effect to be modified in dependence upon the type of material used, its concentration, or the time allowed to elapse from the preparation of the particular material and that an observation of living cells procides much more information about the character of alterations and, more specifically about the time course of changes. If necessary, this method may be supplemented by an electronmicroscopical analysis of the changes produced.


Use of electron microscopy for soil microbiology capabilities and limitations. Soil dilutions were studied by different techniques: They were retained on cellulose filters and observed either directly by scanning electron microscopy or after inclusion and ultra-thin sectioning by transmission electron microscopy. Morphology and locomotor organs of bacteria were observed after negative staining. They were plated on various culture media in order to isolate and identify most of the nonexacting microorganisms. Results are compared and the use of electron microscopy in soil studies is discussed.


[Qualities and application of macromolecular volume substitutes (author's transl)]. The effective volume substitution in shock requires normalizing of the circulating blood volume as well as the restitution of microcirculation. Saline solutions are unsuited for their missed oncotic efficiency and their short intravenous staying. Also stored blood is unsuitable because of its rheological properties, plasma protein preparations for economical and infectious reasons. The different qualities and effects of the known plasma substitutes on the basis of dextran, gelatine and starch are described, their special indications being explained. Haemodilution and the so-called secondary effects limit the dosage of volume substitution.


[Relationships between Streptococcus pyogenes T4-antigens and haptoglobin types (author's transl)]. Some strains of beta-haemolytic streptococci were agglutinated with high titers (1:200-1:6400) by human sera of the haptoglobin types 2-2 and 2-1. No agglutination or with low titers (up to 1:20) was observed with sera of the haptoglobin type 1-1. This reactivity depends from the contents of Streptococcus pyogenes T-antigens of the T-complex 4,24... This T4-antigen is present in group A streptococci (Strep. pyogenes) of the types 4, 24, 26, 28, 29, 46, 48 and 60 but it may be present also in some strains of streptococcal groups C and G. During a 10-year period we isolated 12 strains of Strep. equisimilis (group C) carrying the T-4 antigen (1.6%) and 50 group-G streptococci with T-4 antigen (6.4%) of all group G streptococci). These strains were agglutinated without an exception with high titers by Hp 2-2 and Hp 2-1 sera but not by sera of the haptoglobin type 1-1. The same particuliarity was shown by Streptococcus pyogenes types of the T-complex 4, 24... One strain of type 26 (BC 179) has no T antigen and therefore it was not agglutinated in the above mentioned manner. The phenomenon depends from the medium; it occurs after cultivation of the streptococci in Pope broth or in meat-infusion with glucose but not or only reduced in beef heart-proteose-medium. The agglutination reaction is caused by the haptoglobin but not by agglutinins against the T4-antigens.


Neutralization of heterologous toxicities in mice immunized with proteins from S. typhimurium and from a human pathogen (S. emek). Groups of mice immunized with proteins from S. typhimurium and from a non-pathogenic Salmonella for mice (S. emek) were infected with S. tymphimurium, S. emek, S. blockley and S. paratyphi A. The mice immunized with the S. typhimurium proteins were, as always protected against infection with the pathogen and resisted the toxicities, which killed the controls, of S. paratyphi A and S. emek but not of S. blockley. The mice immunized with S. emek proteins resisted the toxicity of S. paratyphi A and, to a lesser degree, that of the homologous S. emek. The animals did not resist the toxicity of a similar concentration of S. blockley and the immunized mice died, like the controls, within 20-40 hours. Mice in this group infected with S. typhimurium had a much longer delay before dying, than the controls. Antiprotein antibodies present in the sera of the immunized mice are, apparently, responsible for the neutralization of the toxicities of the heterologous strains and for the eventual protection against infection.


[In vitro and in vivo activity of tiamulin against leptospires (author's transl)]. The minimal growth inhibiting concentration of tiamulin, a derivative of the diterpen antibiotic pleuromutilin, was evaluated in vitro against 11 different serogroups of leptospira interrogans by twofold serial dilution technique, in comparison to tetracyclin, dihydrostreptomycin and tylosin. The range of the MIC values of tiamulin is between 0.07 and 2.5 microgram/ml and thus comparable to the activities of the standard antibiotics tested (see table 1). The chemotherapeutic efficacy (ED50) of the compound was examined in two experimental leptospiral infections of the Syrian hamster, in comparison to tetracyclin. Both compounds were administered orally for 3 days. In the L. canicola infection, the ED50 values were 103.8 mg/kg and 306.3 mg/kg body-weight for tiamulin and tetracyclin, respectively. In the L. grippotyphosa infection, the ED50 values amounted to 35.16 and 277.5 mg/kg bodyweight for tiamulin and tetracyclin, respectively. Based on these values, tiamulin in comparison to tetracyclin showed 3-8 fold higher efficacy in vivo after oral administration.


[Use of serologic reactions for determining the concentration of the determinants of an antigen and its valence]. By the serological tests with the erythrocytic diagnostic agents it is possible to estimate the concentration of the determinants in the antigenic preparation under study. For this purpose it is necessary to have at one's disposal the data on the molecular weight and concentration of the reference antigen, valence of erythrocytes loaded with the antigen or antibodies, and antibody heterogeneity index. If these values are known, then one can calculate the concentration of antigenic determinants in terms divided by the valence of the reference antigen. With the aid of pure antibodies preparation obtained with the immunosorption procedure it is possible to measure the determinant concentration of the antigen tested and the valence of the reference antigen. For the capsular antigen of plaque bacilli the valence was estimated by two independent methods and in both cases it was close to 10. The valence of the reference capsular antigen permits to calculate the concentration of the antibody molecules in the hyperimmune sera without isolation of pure antibodies.


Nonalcoholic fatty liver with alcoholic hyalin after long-term glucocorticoid therapy. Alcoholic hyalin was found in liver of a nonalcoholic patient with fatty liver after long-term glucocorticoid therapy for systemic lupus erythematosus. Hepatocytes including hyalin bodies showed fatty change or vesiculated degeneration. Occasionally, basophilic substance which was recognized in the hepatocytes with or without hyalin was noticed showing the feature quite similar to delicate alcoholic hyalin.


Gastric mucosal histamine in duodenal-ulcer patients: release by secretin. In 5 duodenal-ulcer patients with anaphylactic skin reaction to intradermal secretin and in 4 healthy controls, biopsy samples from the fundic region of the stomach were superfused with phosphate buffer alone and with phosphate buffer containing 20 C.U./ml synthetic secretin. In response to secretin, the mucosa from duodenal-ulcer patients released significantly increasing amounts of histamine (P is less than 0.05) whereas control tissue did not respond. Additionally, in duodenal-ulcer patients the histamine content of untreated gastric mucosa was about twice as high as in controls (P is less than 0.02). It is suggested that the elevated mucosal histamine could account for the basal and stimulated gastric hypersecretion of duodenal-ulcer patients. In addition, the results are compatible with the concept that in a certain type of duodenal ulceration, secretin does drive rather than inhibit gastric secretion.


Coagulative and fibrinolytic studies on postmenopausal women treated with a new non-steroidal oestrogen. Treatment of postmenopausal women with a non-steroid oestrogen (P1496) in a dose of 50 mg a day for 2 ,days before operation for prolapse did not suppress the histochemically determined fibrinolytic activator content of the vessel wall. Neither was any change found in the concentration of P&P-complex (prothrombin, factor VII, factor X), factor VIII, antithrombin III, alpha1-antitrypsin, alpha2-macroglobulin or the inhibitors of urokinase induced plasminogen activation. Nothing suggested a thrombogenic effect of this non-steroidal oestrogenic compound.


A comparison between the lecithin/sphingomyelin ratio and the Nile blue sulphate test in the estimation of fetal maturity. Functional fetal maturity was assessed in 72 patients by measuring in amniotic fluid the lecithin/sphingomyelin ratio and the differential cell count. The correlation between these two tests is presented. Only one fetus with a lecithin/sphingomyelin ratio of 2 or more developed the respiratory distress syndrome after delivery: that was the child of a diabetic mother. The technical limitations of the lecithin/sphingomyelin ratio meant that it could not be measured in 12% of samples obtained.


Electron microscopic demonstration of meshwork structure in human and bovine glomerular basement membranes. With the electron microscopic and the negative staining method, the glomerular basement membrane of human and bovine kidneys was shown to have a definite fine meshwork structure. The pores of the meshwork of bovine glomerular basement membrane appeared to be pentagonal or hexagonal in shape. Strands of the meshwork branched three-dimensionally and made up the whole basement membrane. The portion of the sgrand between two neighboring branches was presumed to be a structural unit of the basement membrane. Glomerular basement membrane in man showed a structure similar to that seen in cattle, although the pore size of the meshwork was smaller in man than in cattle.


Demonstration of microorganisms in tissues by the ABT and KOH-ABT topo-optical reactions. The aldehyde-bisulphite-toluidine blue (ABT) reaction, as a selective topo-optical test of vicinal OH and amino-OH groups is suited for the selective demonstration in tissues of microorganisms of polysaccharide containing cells. Alkaline pretreatment of the polysaccharide cell walls, releases, by splitting the O-acyl radicals, further vicinal OH groups for the ABT reaction, thus actually increases the sensitivity of the method. The topo-optical reactions are characterized by a strong birefringence induced by oriented dye-binding, due to the linear arrangement of polysaccharides composing the cell wall. Differences in the character of birefringence have made it possible to work out a new method for the analysis of the cell wall ultrastructure as well as to demonstrate microorganisms in tissues. The practical value of the reactions is illustrated by examples.


Demonstration of mast cell granules by the cetylpyridinium chloride-acid dye (CPC-AD) and cetylpyridinium chloride-phosphotungstic acid (CPC-PTA) methods. Cetylpyridinium chloride (CPC) and cetyltrimethylammonium bromide (CETAB) are bound to polyanionic substances by ionic bonds between the positively charged nitrogen of the quaternary salts and the negative groups of polyanions. The mast cell granules and some other structures treated with CPC or CETAB react selectively with acid dyes and fluorochromes. In ultrathin sections treated with CPC, phosphotungstic  acid (PTA) greatly enhances the electron density of the granules of mast cells. The possible mechanism of acid dye and PTA binding by CPC or CETAB treated tissues is discussed.


Topo-optical study of the pulmonary ciliary membrane surface. In hydrophilic media of high refraction index the cilia of the epithelium of the tracheo-bronchial mucous membrane and the mucous film demonstrate birefringence positive to the longitudinal axis of the mucous membrane owing to the identical orientation the glycoprotein macromolecules and of the fatty acid chains of the ciliary membrane. By means of toluidine blue staining the mucous film and the ciliary zone can be studied selectively by polarization microscopy. The opposite optical character suggests that the dye molecules are perpendicularly connected to the long glycoprotein chains of the mucous, and there is an oriented connection perpendicular to the longitudinal axis of the cilium in its lipid membrane. In smears of bronchial secretion or mucous membrane scrapings after staining, with toluidine blue pH 7.0, the selective optical reaction of the cilia provides a possibility for the study of isolated desquamated ciliary cells. The reaction is given by the lipid membrane boundary of the cilia. In embedded, lipid-extracted sections, the cilia and the mucous film show a minimum of birefringence in the unstained state. After toluidine blue staining or aldehyde-bisulphite-toluidine blue (ABT) reaction the mucoid surface and the ciliary zone display an opposite optical reaction originating from the dehydrated mucoproteins adsorbed onto the surface of lipid-extracted cilia.


Ultrastructure and cytochemistry of cardiac intramitochondrial glycogen. Authors have observed abnormalities of glycogen localization in cardiac muscle, after normothermic cardiac arrest. The identification of these intramitrochondrial particles as glycogen was confirmed by selective staining with periodic acid-lead citrat, periodic acid-thiosemicarbazide protein methods and by their selective removal from tissue sections by alfa-amylase. The intramitochondrial glycogen particles were of beta-type. Some intramitochondrial particles were surrounded by paired membranes which resulted from protrusion of parts of mitochondrial membrane.


Stabilization and preservation of the antigenic specificity of Trypanosoma (Trypanozoon) brucei variant specific surface antigens by mild fixation techniques. Living bloodstream trypansomes fixed by suspension in a 1% formalin solution maintain both their morphology and the immunological specificity of their variant specific surface glycoprotein, so allowing precise identification of the variant types present in a trypanosome population by direct or indirect immunofluorescence combined with phase microscopy. The technique is simple, adaptable to the study of low parasitaemias and should facilitate analysis of the phenomenon of antigenic variation both in the field and the laboratory.


Purification and some properties of formamidase from rat and pig liver. Formamidase was purified 4700-fold from rat liver cytoplasma. Its main molecular and catalytic properties are reported. In pig liver three active forms were observed.


Serological relationships between certain avian and animal paramyxoviruses. An avian paramyxovirus designated Robin/Hiddensee/19/75 proved to be related to the Yucaipa virus group in cross haemagglutination inhibition test (HIT). Whereas the prototype parainfluenza viruses did not react with the antiserum raised against the Robin virus, a newly isolated bovine parainfluenza 3 virus was shown to be inhibited up to half the homologous titre. Possible antigenic relationships between avian, mammalian and human paramyxoviruses are discussed.


Diagnosis and management of systemic lupus erythematosus. Systemic lupus erythematosus (SLE) is not a rare disease. There are several common clinical signs which should alert the physician to a possible diagnosis of SLE and which should condition him to look for specific clinical and laboratory findings. In addition to simple screening tests, useful procedures include a search for antinuclear antibodies, lupus erythematosus (LE) cells, anti-DNA antibodies and low serum complement. Management is determined by the type of course encountered but most patients will do well under the care of their family physician.


The effects of psychological stress and vagal stimulation with morphine on vulnerability to ventricular fibrillation (VF) in the conscious dog. Ventricular vulnerability to fibrillation was assessed in 12 conscious dogs in aversive and nonaversive environments using the repetitive extrasystole (RE) threshold method. In the average environment, RE threshold was 45 per cent lower than in the nonaversive setting and heart rate and blood pressure were significantly elevated. This decrease in RE threshold occurred within 10 minutes of exposing the animals to stress. In contrast, the recovery in RE threshold in the nonaversive setting occurred over a 40 minute period. When morphine sulfate (MS) 0.25 mg./Kg was administered to dogs in the aversive environment, the RE threshold was significantly increased. Cholinergic blockade of vagal efferent activity with atropine (0.2 mg./Kg) annulled partially the effect of MS on RE threshold MS was without effect in the nonaversive environment. It is concluded that MS exerts a significant protective effect on increased ventricular vulnerability associated with psychological stress. This effect is mediated by the vagotonic and sedative actions of morphine.


Group teaching of auscultation. Use of a new wireless stethoscope-type headphone. A new technique using infrared light for the transmission of heart sounds and murmurs is described. This method enables the simultaneous transmission of heart sounds and murmurs to large groups of persons without the need for hard-wire connections to the amplifying device. The method facilitates teaching of cardiac auscultation at the bedside as well as in the setting of conferences, seminars or postgraduate education programs.


Combination of silver and fluorescent staining for metaphase chromosomes. A convenient and reliable method for simulatneous visualization of silver staining (Ag-NOR) of the nucleolus organizers and fluorescent bandings in metaphase chromosomes is described. Studies employing this combined procedure on human chromosomes revealed that the Ag-NOR patterns may be characteristic for each chromosome of each individual.


Amniotic fluid alpha-fetoprotein elevation with fetal omphalocele and a possible mechanism for its occurrence. Prenatal diagnosis of genetic disease and congenital malformations has become a major area of study in obstetrics. The assessment of amniotic fluid alpha-fetoprotein (AFP) is useful for the diagnosis of neural tube defects. As more patients have been evaluated abnormal increases have been found in other defects, such as omphalocele, duodenal atresia, and congenital nephrosis. Two patients with omphalocele are reported with AFP measurement. A tenfold elevation of AFP was found in the first patient. In the second case a small omphalocele associated with exstrophy of the cloaca was not accompanied by an abnormal AFP increase. The mechanism of AFP elevation is discussed.


Effect of pregnancy on thyroxine binding globulin (TBG) in partial TBG deficiency. An unusual opportunity was afforded to study the effect of endogenous increase in estrogen on thyroxine binding globulin (TBG) throughout pregnancy in a partially TBG-deficient female who conceived subsequent to initial examination. TBG binding of 125I-thyroxine (T4) before and up to four months of pregnancy was low in comparison to normal. Starting from six months and up to the end of pregnancy, TBG activity showed a definite increase although still below normal. TBG binding capacity increased from a low value of 4.2 microgram T4/100 ml ,efore pregnancy to a value 9.3 microgram T4/100 ml in the last month of pregnancy. This was accompanied by an increase in immunoassayable TBG from less than 1 mg/100 ml in the second month of pregnancy to 1.9 mg/100 ml in the last month, and an increase of T4 from 3.1 microgrom/100 ml to 4.3 microgram/100 ml. Two weeks after delivery, TBG binding of 125I-T4 showed a precipitous decline to the abnormally low distribution noted prior to and during the early months of pregnancy. TBG binding activity was normal in the cord blood of the infant. These studies provide the first direct evidence that increase in endogenous estrogen results in detectable increases in TBG concentration in the human with partial TBG deficiency.


Presence of soluble SLA histocompatibility antigen in pig plasma. The major histocompatibility antigens of the pigs (SLA 1 and SLA 15) were solubilized by papain and then iodinated according to Greenwood's chloramine T method. These antigen preparations were used in radioimmunoassays for the detection of soluble inhibitors in pig plasma. Specific soluble substances were demonstrated in addition to a certain amount of cross-reactivity with other so far unidentified antigens.


A clinical study of concanavalin A-induced histamine release utilizing a single isotopic enzymatic assay of histamine. Concanavalin A (Con A)-induced histamine release from cells of subjects with extrinsic asthma, intrinsic asthma or urticaria and normal individuals was examined utilizing a single isotopic enzymatic assay for histamine. Maximum histamine release by Con A occurred with 0.9 to 4.5 microgram/ml. The mean percentage of maximum histamine release by Con A from cells of donors with extrinsic asthma was 36(+/- 19.3)% while that from cells of normal individuals was 21.4(+/- 23.7)%. However, there was no significant difference between the two groups. The higher reactivity to Con A of cells from individuals with intrinsic asthma or urticaria was not observed compared to that of the normal group. The histamine release by Con A was not correlated with IgE level in the plasma (r = 0.35). It was observed that compound 48/80 inhibited the enzymatic reaction in the isotopic, enzymatic assay.


Serum angiotensin converting enzyme level in bronchial asthma. Using hippuryl-L-histidyl-L-leucine as a substrate analogue, serum angiotensin converting enzyme (ACE) was spectrophotometrically estimated in patients with bronchial asthma. The mean level of asthmatic patients was significantly lower than that of the control subjects. The reduced serum ACE activities did not change during an acute asthmatic attack. Significantly lower levels of serum ACE occurred in patients with chronic asthma than in those who only suffered with occasional asthma. Serum ACE activity was not reduced when the patients were taking steroids. Serum ACE activity could not be correlated with either the systolic blood pressure or the diastolic blood pressure of our asthmatic patients. However, serum ACE activity was correlated with the serum beta-globulin fraction in asthmatic patients.


[Study of various serum proteins in lung cancer. Immunoglobulins A, G, M, haptoglobin, alpha-1-antitrypsin, alpha-2-macroglobulin]. A statistical study of the plasma concentration of immunoglobulin, alpha-1-antitrypsin, haptoglobin, and alpha-2-macroglobulin in 153 patients with primary carcinoma of the lung showed a strong increase in alpha-1-antitrypsin, haptoglobin and A and C immunoglobulins, whilst alpha-2-macroglobulin increases very moderately, and IgM does not vary. The relationships between variables are also modified, thus there appears a correlation between IgA and IgG to the detriment of the IgG/IgM relationship. Furthermore the coefficient of the correlation IgG/alpha-2-macroblobulin is lower in cancer patients.


[Pattern of suspended particles in the air of an urban zone]. Measurements of suspended particulates have been carried out throughout one year in a fixed station located in a street with medium-high traffic intensity, in a urban area of Rome. Determinations have been made by gravimetric method on samples obtained by filtration through micropores membrane filters. Monthly patterns and weekly and daily patterns of particulates in summer and winter in the monitored area are reported, as well as the frequency distribution in average daily concentration classes over a period of one year.


[Determination of atmospheric lead].

[Determination of atmospheric lead]. The AA. discuss the analytical determination of airborne lead, pointing out the importance of a good standardization of the sampling conditions to obtain comparable data. Results of an experimental study on several sampling techniques for lead in air particulates are reported. The investigated factors were: location of samplers, time and rate of sampling and type of filter used. The study includes the comparison of low and high volume sampling techniques, as well as the distribution of blank and deposited lead values on the surface of the glass fiber filter used in the high volume sampling technique.


[H1 histone - giemsa competition and chromosome labeling]. The deposit of histone H1 on metaphasic chromosomes in situ or isolated for KB cells shows that there is a H1-Giemsa competition at the same sites of fixation. Different banding techniques show that histone H1 gets fixed uniformly along the chromosomes.


Casein and other tumor markers in relation to cancer of the breast. Five tumor markers can be simultaneously determined in the serum by radioimmunoassay: carcinoembryonal antigen (CEA), alpha-fetoprotein (alpha-FP), human chorionic gonadotropin (HCG), beta-subunit of HCG (beta-HCG) and kappa-casein. In a series of 935 healthy subjects, these antigens remain detectable or are detected within very precise limits. At the start of the clinical evolution of breast cancer, the incidence of pathological concentrations is increased as compared with the highest level observed in normal subjects. This high incidence is mainly due to a concomitant determination of CEA, kappa-casein, HCG and beta-HCG. The alpha-FP test is never positive, while the kappa-casein concentration is particularly high in the first clinical stages of breast cancer and with metastases. The concomitant determination of these tumor markers may be a biological element contributing to the diagnosis of neoplasia, although it is neither an absolute nor a specific criterium. Indeed, a pathological concentration of at least one antigen was observed in 5.5% of the subjects presenting with benign mastopathy. When metastases occur (25 patients), the incidence of pathological concentrations of at least one antigen increases: 88%, the absolute values of these levels increasing simultaneously. The determination of the antigen concentration therefore allows an evaluation of the extension of the disease. Surgical removal reduces the incidence of positivity of these antigens to 34%. Persistence of pathological levels seems to be related to a possibility of relapse or metastatic spreading. Finally, chemotherapy and radiotherapy applied on a tumor which is not excised, does not decrease the incidence of positivity of the tumoral markers, although their levels seem to fluctuate with the clinical evolution.


Light microscopical examination of glomerular basement membrane in systemic lupus erythematosus. To obtain as much information as possible from light-microscopy about changes in the glomerular basement-membrane, a thin section microtome attachment is necessary in order to produce 1 to 3 micron sections. The most informative staining method of paraffin embedded tissue is the Muller-Mowry-Masson trichrome (M-M-M) combination stain. The deposits, e.g., in systemic lupus erythematosus (SLE), stain red, the basement membrane light orange and the endothelial cell cytoplasm light pink. With this stain, as with the Muller-Mowry stain, normal glomeruli show an uninterrupted line of blue acid mucopolysaccharides along the basement membrane, where it is joined by foot processes of the epithelial cells. In contrast, in glomeruli from patients with SLE, focal loss of acid mucopolysaccharides is noted.


The development of laboratory tests for cancer in Japan with special reference to carcinoembryonic proteins. The present paper describes the present status of clinical tests for cancer in Japan. Since no cancer-specific substance has been found so far the clinical tests for cancer at present are always quantitative but not qualitative. Among these substances, alpha-fetoprotein is one of the most specific substances for cancer and its test is essential for diagnosis of hepatoma beins used worldwide. AFP is a specific product of liver cancer cells. The measurement of carcinoembryonic antigen in patient blood is a hopeful method for cancer diagnosis. This substance is not specifically produced by cancer cells, but the phenomenon of appearance in bloodstream appears to be cancer-specific. This may reflect the invasion of blood vessels in tissues such as colorectum, lung, etc., by infiltration of cancer cell. This is the reason for the appearance of CEA in a wide variety of cancers. There are many other clinical tests at present but these are only secondary aids for the diagnosis of cancer. This is the reason why the description concentrates mostly on AFP and CEA. The companies manufacturing the kits for these tests in Japan are also listed in this paper.


Microbial transformations of styrene and [14C] styrene in soil and enrichment cultures. Two different mechanisms were responsible for the disappearance of styrene in enrichment cultures: (i) a mixed population of microorganisms, capable of utilizing styrene as a sole carbon source, oxidized this substrate to phenylethanol and phenylacetic acid; (ii) the culture also mediated polymerization of the monomer to low-molecular-weight styrene oligomers. This chemical reaction probably occurred as the result of microbial degradation of butylcatechol, an antioxidant polymerization inhibitor present in commercial styrene. The resultant polymer material was subsequently metabolized. In soil incubation studies, 14CO2 evolution from applied [8-14C] styrene was used to estimate microbial degradation. Approximately 90 percent of the labeled carbon was evolved from a 0.2 percent addition, and about 75 percent was lost from the 0.5 percent application over a 16-week period.


Isolation and characterization of Arthrobacter bacteriophages and their application to phage typing of soil arthrobacters. Seventeen bacteriophages, active against 19 Arthrobacter soil isolates, were isolated from concentrated samples of river water and sewage. Attempts to isolate Arthrobacter bacteriophages from filtrates of broth cultures of the soil isolates or from ultraviolet light-irradiated cultures were unsuccessful. Bacteriophages were not detected in either concentrated or unconcentrated soil extracts. Electron microscopic studies of 11 phages showed morphologies characteristic of Bradley's groups B (exhibited by 9 phages) and C (exhibited by 2 phages). Moles percent guanine plus cytosine, calculated from the deoxyribonucleic acid density of three phages, ranged from 60.2 to 65.3. The phages were characterized by their plague and virion morphology, host range, and serological specificity.


Electron microscopical study of psoriasis pustulosa. Five cases of psoriasis pustulosa were examined by electron microscopy. The main features within the dermis were dilated capillaries filled with polymorphonuclear leukocytes and red cells. Neutrophils passed out of the vessels through the gaps and fenestrations and migrated towards the epidermis throughout the distinctly edematous corium. Lymphatic vessels could be found. Histiocytes containing Langerhans granules were observed in the dermis and epidermis. The morphological changes of the epidermis depented on the place examined and were most evident near fully developed pustules in the upper layers. The presence of previously described morphological findings could be confirmed. Perinuclear cytolysis and other changes in the keratinocytes, however, seem to be secondary, resulting from edema and accumulation of neutrophils within the epidermis. Immunological phenomenona may be responsible for the latter event.


[Concentration of intravenously administered gammaglobulin preparations in dog skin (author's transl)]. Chemical modification of standard gammaglobulin with enzyme treatment (pepsin) or stabilization (beta-propiolactone) is able to influence elimination, fragmentation and organ distribution of intravenously administered gammaglobulins as shown in 36 dogs after i.v. application of allogenic and xenogenic gammaglobulin preparations. Pepsin-gammaglobulin was eliminated and fragmented most rapidly. Gammaglobulin concentrations of all preparations in the skin showed as slower decrease than comparable blood concentrations. The highest skin concentrations 10 days after i.v. application were found for beta-propiolactone gammaglobulin with 6.2 +/- 1.6 microgram/g compared to a blood level of 7.9 +/- 0.9 microgram/ml.