[Determination of beta2-microglobulin in breast, lung, colorectal and ENT carcinoma (author's transl)]. Significant increase of plasma level beta2-microglobulin in cancer patients (breast, bronchus, colorectal and ENT) occurs rarely. More, the highest levels observed are within the range of non malignant diseases. We cannot assume that beta2-microglobulin assay will be useful as tumor marker.


[beta2-Microglobulin and carcino-embryonic antigen in bronchogenic carcinoma (author's transl)]. In a series of 52 patients with bronchogenic carcinoma serum levels of beta2-microglobulin (beta2m) and carcino-embryonic antigen (CEA) were studied. No correlation was found between the increase of beta2m (greater than 3,2 mg/l) and CEA (greater than 40 ng/l). High levels were found in 10 % of cases for CEA and in 30% of cases for beta2m. The follow-up of serum levels of beta2m and CEA was studied during the evolution of the disease through monthly assays. Upon 15 cases followed, the same dissociation between beta2m and CEA was observed.


[Comparison of serum levels of beta2-microglobulin and carcino-embryonic antigen in the follow-up of lung cancer (author's transl)]. Serum levels of carcino-embryonic antigen (CEA) and beta2-microglobulin (beta2m) were assayed on 133 sera during follow-up of 31 patients with lung carcinoma (squamous cell ca. without recurrence : 2, squamous cell ca. with recurrence : 11, anaplastic cell ca. : 4, adenocarcinoma : 2, unclassifiable : 5). Normal creatinine (less than or equal to 12 mg/l) levels were found in all sera. CEA and beta2m levels showed no correlation nor in these groups, nor in the whole. The squamous cell carcinomas with recurrence showed the largest dispersion for CEA as for beta2m levels. However, the trends of serial beta2m values did not correlate with clinical features. Increasing or decreasing levels of CEA and beta2m levels showed no correlation in the whole nor in patients undergoing radiotherapy. In our experience, beta2m levels failed to correlate with clinical findings during the follow-up of lung cancer patients.


[Determination of plasmatic beta2-microglobulin in benign and cancerous diseases (author's transl)]. The authors report on their experience of the beta2-microglobulin dosage in cancerous diseases and note an increase of its rate in 47% of the cases. A comparative study with certain benign diseases of the digestive tract shows that this dosage proves to be interesting.


[Comparative study of the results of measurements of beta2-microglobulin and carcino-embryonic antigen in human digestive tract carcinomas (author's transl)]. The studies of the levels of the CEA and of the beta2m were both performed on 52 patients. The authors pointed out the interest of measurement of these 2 markers and above all the interest of their complementary before any therapy and during treatment by surgery or radiotherapy whether associated or not.


[Serum beta2-microglobulin and carcino-embryonic antigen in cancerous patients. A preliminary study of 258 cases (author's transl)]. In this preliminary study dealing with beta2-microglobulin (beta2m) levels in the series of 258 patients, two group are considered:--a group of 208 patients with evolutive tumour;--a group of 50 patients with no evolutive tumour. This study shows a significantly higher incidence of cases with elevated levels of carcinoembryonic antigen (CEA) and/or beta2m in group with evolutive cancer than in group with no evolutive cases. These elevated levels of beta2m are not related to other clinical, topographical, evolutive, immunological parameters. But the increase of serum beta2m levels in patients treated with combination of chemo and immunotherapy, may indicate a possible relationship between beta2m levels and lymphocyte activation.


[Occurrence of beta2-microglobulin in normal and carcinomatous renal tissue (author's transl)]. Fifty renal tissues and renal tumours are examined and the occurrence of beta2-microglobulin (beta2m) are measured. It is found especially in the solubilized fraction of the tissue. The renal tumours contain four time more beta-2m but they are to be divised into two populations in accordance to their microscopic and macroscopic aspects. This explains why only a part of the patients with renal tumours has an elevated blood beta2m.


[Comparison of the variations in the levels of beta2-microglobulin and carcino-embryonic antigen in the breast cancer and malignant melanoma (author's transl)]. A variety of markers have been used in the surveillance of carcinoma of the breast and malignant melanoma, including carcino-embryonic antigen (CEA) beta2-microglobulin (beta2m) and prolactin. The dual purpose of the surveillance was the detection of early recurrence or metastasis and the monitoring of the treatment. In cancer of the breast 92% of patients having bone metastases have elevated levels of CEA or beta2m. In malignant melanoma 2/3 of the patients in relapse have elevated beta2m levels.


[beta2-Microglobulin in synovial fluid (author's transl)]. In a series of patients with rheumatoid arthritis we found higher levels of synovial beta2-microglobulin (5,2 +/- 3 mg/l) than in gouty arthritis (2,4 +/- 0,6) or osteoarthritis (1,2 +/- 0,3 mg/l). The ratio of synovial/plasma beta2-microglobulin was always superior to unity (2,3 +/- 0,7) in the R.A. patients whereas it is always inferior to unity in the other groups. The correlation between plasma or synovial beta2-microglobulin and synovial lymphocyte count was highly significant in all cases in RA patients plasma and synovial beta2-microglobulin are significantly related to the degree of joint involvement as expressed by the joint count.


[beta2-Microglobulin in ankylosing spondylitis and in Reiter's syndrome (author's transl)]. In patients with ankylosing spondylitis (AS) the plasma level of beta2-microglobulin (beta2m) is signficantly higher (1.95 +/- 0.48 mg/l) than in osteoarthritis (1.48 +/- 0.47 mg/l). In Reiter's syndrome the level of beta2m is also higher than in controls, but the paucity of results do not allow definite conclusions. The plasma level of beta2m in AS and in Reiter's syndrome is not related to the presence of HLA B 27 antigen, neither to other biological parameters as sedimentaton rate, blood cell counts, electrophoresis of plasma proteins. In rheumatoid arthritis the plasma level of beta2m is 2,67 +/- 0.84 mg/l, significantly higher than in osteoarthritis or in AS even without any association with Sjögren's syndrome. In synovial fluid, the beta2m level is closely related to the degree of inflammation, suggesting a local production of this substance.


Distribution of beta2-microglobulin in cerebrospinal fluid and in cystic fluid of brain tumors. A preliminary study. The concentrations of immuno-reactive beta2-microglobulin (beta2m) were measured in the cerebrospinal fluid (CSF) and the cystic fluid (CF) of Central Nervous System (CNS) tumours (gliomas, n = 5; craniopharyngiomas, n = 5) and in the culture medium of established cell lines derived from CNS tumors. These data are compared with plasma and CSF values of beta2m in normal subjects (n = 15) and in a group of peripheral solid tumors (metastatic breast carcinomas, n = 9). In the control group the absence of correlation between plasma and CSF values, suggests an independant production of beta2m in the two compartments considered. The capacity of CNS tumor cells to synthesize beta2m is demonstrated in vitro. In vitro beta-2m concentrations in the CF embryonic tumors (craniopharyngiomas) is significantly more elevated than in non malignant astrocytomas.


[beta2-Microglobulin determination's estimation in cerebrospinal fluid (author's transl)]. beta2-Microglobulin levels were determined the serum and CSF by radioimmunoassay in various patients from departments of neurology and neurosurgery. Simultaneously a study of CSF protein levels was done. In normal subjects, there is a good correlation between blood and beta2m levels. In patients with pure subarachnoid hemorrhage, the beta2m was always found elevated in the CSF. In tumors of the nervous system, the number of cases studied is yet too small to allow any conclusion.


[beta2-Microglobulin and pulmonary tuberculosis (author's transl)]. Serum beta2-microglobulin levels, determined in 29 healthy adults were found to be 1,3 mg/l with an upper confidence limit (95%) of 2,0 mg/ml. In contrast, serum values in 101 patients with pulmonary tuberculosis were 2,1 mg/l with an upper confidence limit of 3,2 mg/l. The latter value is therefore to be taken into consideration if serum beta2m is to be used for discriminating between lung carcinoma and other pulmonary diseases.


[beta2-Microglobulin in human seminal fluid (author's transl)]. The expression of human beta2-microglobulin (beta2m) on human spermatozoa cell surface was investigated by cytotoxicity and immunofluorescence tests. beta2m was also found in human seminal fluid by use of immunochemical techniques. Seminal fluids obtained from couples with infertility problems were tested for beta2m, albumin and total proteins concentration. A higher level of beta-2m was found in azoospermia compared with that of normal sperms.


gamma-Globulin level and dietary protein intake during the first year of life. To investigate the possible causes of relatively low blood gamma-globulin levels (less than or equal to 0.5 gm/dl) during the first year of life, 287 patients less than 1 year of age who were suffering from mild diseases were studied retrospectively. They were divided into two groups, those with a gamma-globulin level less than 0.5 gm/dl and those with a gamma-globulin level greater than 0.5 gm/dl. By reconstructing the diets given, it was found that they had been receiving isocaloric diets that differed only in protein supply: patients with lower gamma-globulin levels received 2.9 gm/kg/day of protein and patients with higher gamma-globulin levels received 4.0 gm/kg/day. Fifty-five healthy subjects were studied prospectively during the first year of life on two isocaloric diets that differed only in their protein content: the first one supplied 2.5 gm/kg/day of protein and the second supplied 4.0 gm/kg/day. At approximately 5, 7, and 10 months of age, hemoglobin, total protein, albumin, globulins, immunoglobulins, and other common blood parameters were measured. Patients on the lower protein diet had a gamma-globulin concentration of less than or equal to 0.5 gm/dl and those on the higher protein diet had a gamma-globulin concentration of greater than or equal to 0.8 gm/dl. Immunoglobulin levels, particularly IgG, were lower in patients on the lower protein diet. The subjects with lower protein intake and lower levels of gamma-globulin and immunoglobulins showed significantly higher morbidity.


Audiovisual organization for conferences. Factors related to conference size, complexity, location and communication between the conference organization, contributors and support staff are identified and discussed. An audiovisual organization is described of which the main features are; the appointment of an audiovisual specialist to coordinate the organization, preview and controlled delivery of audiovisual material to support staff, and the use of an events chart as an aid to forecasting and identifying problems.


[Chronic hepatitis in sex linked agammaglobulinemia. One case (author's transl)]. The authors report the case of a 21 years old man, with sex-linked agammaglobulinemia, who presents a presumed viral hepatitis, followed two years. The evolution, does yet fear a progressive cirrhosis. About this report and analysis of literature, frequency, evolution and pathophysiologic hypothesis, particularly the lymphocyte T role, are also discussed as the problem of hepatitis prevention of these subjects, who receive gammaglobulin injections.


Atrial programmed pacing.

Atrial programmed pacing. Early experience with a J-shaped lead inserted transvenously into the right atrial appendage is reviewed in thirty-one patients. Fifteen patients are still being followed with satisfactory atrial programmed pacing for five to ten years. A dislodgement rate of twenty percent led to the development of the "tined" J lead in the hope that better fixation would be achieved. Experimental data has shown the new lead to be stable with evidence in both animal and man of firm fixation of the lead in the appendage. The lead has been inserted in twenty patients. Of these, fifteen are still being followed with satisfactory atrial programmed pacing. There has been no case of dislodgement of the lead in a follow-up period of two years and eight months.


Performance of implanted biogalvanic pacemakers. Seventeen unipolar cardiac pacemakers powered by hybrid biogalvanic cells were implanted in dogs. Long term clinical effects and electrical performance in vivo of the generators were investigated. The biogalvanic cells were designed to provide 50 years of generator operation. No systemic pathological changes which would be attributed to the generator or the biogalvanic cell were observed. Local reaction to implants was mild and not significantly different from the one observed in conventional pacemaker implantations to date. The electrical performance of the biogalvanic cells was very encouraging. Final steady-state cell voltage levels of .65V to .75V were reached in 100--150 days after implantation and remained constant in 3 units to date which represents over 36 months after implantation for each generator.


Suppression of demand mechanism by inactive myocardial electrodes. A 14 year old girl, at age 8, had had a bipolar pulse generator implanted with myocardial leads. Because one of the myocardial leads fractured near the electrode, a second pair of myocardial leads were implanted. Thus, the patient had two pairs of myocardial leads and one demand pulse generator implanted. When the patient was readmitted to the hospital because of light-headedness, the ECG monitor revealed frequent suppression of pulse generator pulses when hand pressure was exerted over the pulse generator site. Converting the pulse generator into the asynchronous mode with a magnet prevented inhibition. The pacemaker pocket was reopened. The pulse generator could not be inhibited either by pulling on the active myocardial leads or by moving the pulse generator, but the pulse generator could be inhibited by manipulation of the inactive leads which produced electrical signals having amplitudes and frequencies which were in the bandwidth of the sensing circuit. The probable cause of the electrical signals was the irregular contact of the terminals of the inactive leads with the patient's abdominal muscles. Replacement of the demand pulse generator by an asynchronous type resulted in cessation of the patient's light-headedness.


Influence of output capacitor, electrode and pulse width on power consumption in cardiac pacing. Three different types of unipolar endocardial electrodes--47 in all--were compared in regard to power consumption at stimulation threshold with six different output capacitors and seven pulse widths. Fifteen were conventional large surface electrodes (area 47 mm2); 18 were conventional small surface electrodes (area 6 mm2), and 14 had a specially designed tip with a large area but small active surface of 8 mm2. Pulse widths ranged from 0.15 to 2.0 msec and output capacitors from 1.0 to 22.0 microFarads. All in all about 2,000 measurements were performed. The average current drain to the pacemaker output stage was measured and power consumption was calculated for each electrode--pulse width--output capacitor combination. In all combinations, the two small surface electrodes consumed approximately the same amount of power and, in both cases, significantly less than the larger one. With regard to power economy at stimulation threshold, the pulse width of choice was about 0.5 msec and, furthermore, power consumption decreased with increasing capacitor size. The optimal combination was a small surface electrode, an output capacitor of 22 microF and a pulse width of 0.5 msec.


Clinical value of tests of sino-atrial function. Sinus node recovery times and the premature atrial stimulus test were studied in 36 patients, seven with gross sinus node disease, 25 with possible sinus node disease and four with no clinical evidence of sinus node disease. The corrected sinus node recovery time proved of most value in predicting which patients needed and would benefit from permanent pacemaker implantation, though there was one false negative diagnosis and two patients with abnormal corrected sinus node recovery times were asymptomatic. The premature atrial stimulus test usually proved to be of no practical value once severe sinus node disease was present and, in the group of patients with suspected sino-atrial disease, only 13 of 25 graphs could be analysed due to gross "scatter" in the others. When patients with symptoms have unequivocal evidence of sino-atrial dysfunction, invasive study seems unnecessary. With lesser degrees of sino-atrial disease, premature atrial stimulation may provide confirmatory evidence; but when sinus arrhythmia, atrial escape beats, or more marked dysfunction are present, one is likely to encounter useless "scatter" graphs. In the absence of regular sinus rhythm on the ECG, overdrive sinus node suppression in the only invasive study worth attempting.


Permanent cardiac pacing with electrodes of a new type of fixation in the endocardium. To improve electrode construction the following main problems have been considered: (1) reliable initial fixing in the endocardium, and (2) reducing the area of contact surface and improving threshold values. In this article we have described three original electrodes: 1) an endocardial electrode with a multi-edged tip (contact area 28 mm2), which gives high electric field strength and low thresholds; 2) a spreading tip electrode, which was created on the basis of morphological data. The tissues grow into the spread spaces of this tip and ensure better stability (contact area 17.8 mm2); and 3) a double-screw-in electrode which differs from the other corkscrew types. The contact end (surface area--10.4 mm2) consists of two sickle-shaped hooks. The sickle handle is 0.7 mm in length which prevents further hook penetration in the wall of the heart. It was found that a multi-edged electrode and electrodes supplied with a fixation device are, in terms of energy consumption, more effective compared to electrodes with spherical or cylindrical tips of the same area of contact surface. The double-screw-in endocardial electrode has useful features: reliable fixation and a small contact surface area and, therefore, a low threshold value. Thirty-five double-screw-in electrodes were inserted into an atrial position and 28 into a ventricular position. We have not observed any displacement of such electrodes during the past two years.


Unusual electrocardiographic pattern during transvenous pacing from the middle cardiac vein. This report documents the unusual occurrence of a left bundle branch block pattern of ventricular depolarization during permanent pacing from the middle cardiac vein. All previous reports of ventricular pacing from the middle cardiac vein have described a right bundle branch block pattern of ventricular activation (dominant R-waves in the right precordial leads), except in one case where both right and left bundle branch block patterns occurred at separate times. A high posterior infarct allowed early activation of the right ventricle from the middle cardiac vein. Undue reliance on the electrocardiogram may detract from the diagnosis of electrode malposition.


Self-conversion of supraventricular tachycardia by rapid atrial pacing. The use of pacemakers in the treatment of tachycardias is one of the most exciting and rapidly expanding applications of cardiac pacing. One of the more recent developments in this field has been the use of patient-activated radio frequency transmitted rapid atrial stimulation (RAS) in the treatment of paroxysmal supraventricular tachycardia (PSVT). Based on the previously established ability of asynchronous atrial pacing to interrupt a variety of re-entrant supraventricular rhythm disturbances, this modality of treatment is gaining increasing applicability in patients with PSVT associated with debilitating symptoms or other severe cardiovascular consequences in whom standard pharmacological regimens have either failed or are impossible to maintain for indefinite periods. This report describes our experience with five patients who underwent implantation of RAS units. The detailed electrophysiological studies required to ensure success and avoid any possible future complications are described. Over a follow-up period of four months to four years (mean 16 months) very few problems arose in the use of these units which have immeasurably improved the quality of life of the recipients. Our experience with RAS units has led to a few suggestions for future improvement and these are outlined in this report. The excellent patient acceptance and the reliability of this technique in terminating episodes of PSVT should, in the future, render RAS the treatment of choice in certain selected patients suffering from this common disorder.


Inapparent double puncture of the femoral artery and vein. An important complication of temporary cardiac pacing by the transfemoral approach. An important complication of temporary cardiac pacing by the transfemoral approach. This report describes three cases of inapparent double puncture of the femoral artery and vein as a complication of the transfemoral approach for temporary cardiac pacing. This complication may lead to the passage of a pacing catheter to the right ventricle by way of the femoral artery and vein and may remain undiagnosed until the rigid outer sheath of the introducer set is withdrawn over the pacing catheter. Therefore, we recommend immediate withdrawal of the rigid outer sheath as soon as the catheter lies freely in the iliac vein or the inferior vena cava. If double puncture has occurred, arterial blood will leak around the pacing catheter. Control of arterial bleeding by local compression should not be attempted without removal of the pacing catheter.


Electromagnetic interference in implantable pacemakers. The inhibited pacemaker (VVI or AAI) has become the most popular in recent years because of its ability to combine a physiological advantage with economical current consumption in cases with spontaneous activity. One of its disadvantages is its sensitivity to external electromagnetic interference. Though today's pacemakers possess effective protection against most interference signals there may be instances in which patients are subjected to uncomfortable or even life-threatening situations. This is the case of "amplitude modulated" or "pulsed" fields with modulation frequencies in the physiological range. Fields of that sort have been found in the vicinity of a welder, an electric steel plant, and in medical practice where therapeutic currents were applied. Even touch-actuated switches may influence a demand pacemaker. However, these situations may be overcome by a device within the pacemaker for simple time analysis which can be carried out with few components. If electromagnetic fields of diathermy equipment are applied, today's pacemakers may react with intolerably high or low rates. They should, therefore, be avoided.


The diagnosis of right ventricular perforation by an endocardial pacemaker electrode. The diagnosis of right ventricular perforation by an endocardial pacemaker electrode should be suspected when failure of pacing occurs without electrode displacement. Although a number of changes occur on the standard electrocardiogram (ECG), none of these are diagnostic. The intracardiac electrogram performed during electrode withdrawal is not only diagnostic of perforation but can also aid in electrode positioning. Two case reports highlight these changes in the intracardiac electrogram. The first case also illustrates that, with electrode perforation, the ability to sense the intrinsic intracardiac electrical activity may be retained.


Obscure syncope and the sick sinus syndrome. This report describes a 25-year-old vigorous young man who had a history of eight years of near syncope and syncope of unknown etiology. Repeat in-hospital observation and laboratory electrophysiologic functional testing did not elucidate the origin of the symptoms. Prolonged Holter monitoring finally showed that the syncopal attacks were caused by a sick sinus syndrome (SSS). On electrophysiologic study, a concealed rate-dependent unidirectional antegrade accessory A-V pathway (AP) was found to be present. The AP was an incidental finding and was unrelated to the patient's symptoms. The symptomatic SSS may occur in the young as well as in the elderly. Sinoatrial dysfunction may be intermittent and difficult to detect, may cause severe symptoms, and may even be life-threatening. Prior to definitive therapy (such as the permanent implantation of a pacemaker), the importance of relating symptoms to a rhythm disturbance has been stressed. In cases where the cause of the symptoms is not obvious, this is best accomplished by continuous Holter monitoring.


Hemodynamic consequences of atrioventricular and ventriculoatrial pacing. The effect of atrial-ventricular versus ventricular pacing and contraction were studied in seven open-chest dogs. Cardiac output, left ventricular, left atrial, right atrial and pulmonary artery pressures were recorded. The right or left ventricular apical areas were consistently superior as ventricular pacing sites. Appearance of cannon A waves within the pre- or ejection period produced a significant decrease in left ventricular and systemic blood pressure, and cardiac output with a concomitant increase in right atrial, ventricular and pulmonary pressures. Prominent "v" waves were also observed during these periods. Reducing the basic driving cycle length from 400 to 300 msec caused a marked deterioration of all hemodynamic parameters with the appearance of mechanical alternans. Random VA conduction or ventricular pacing in the presence of complete AV and VA heart block appeared to offer a more favorable hemodynamic result than constant 1:1 VA conduction. It is concluded that maintenance of a physiologic AV interval permitting atrial contraction to appear outside of pre- or ejection period of ventricular systole is an important determinant or ventricular function during cardiac pacing.


Persistent atrial standstill with atrial inexcitability. Electrophysiologic studies including His bundle recording, atrial, and ventricular stimulation, were performed in three symptomatic patients with persistent atrial standstill of unknown etiology. The rhythm was junctional in two cases and ventricular in one. In two cases, evidence suggestive of associated impairment of the His bundle conduction system was found. The atria were inexcitable at multiple sites and no retrograde conduction to the right atrium could be elicited by ventricular pacing. Follow-up in the three cases, respectively for 48, 42 and 12 months after pacemaker implantation, revealed no return of spontaneous atrial electrical activity.


Characteristics of intracardiac electrograms. Cardiac electrograms were measured on endocardial leads on patients undergoing pacemaker implantation. The data show that small area electrodes reduce R wave amplitude, decrease width of the complex, and increase slopes. The bandwidth of the electrogram increases as the electrode area decreases. The loading of the sensing amplifier changes these characteristics. Distortion is most pronounced for small area electrodes and low lead resistances.


Transvenous long-term pacing with an external pacemaker. What are the risks? Externalized endocardial electrodes were used for pacing 138 patients for periods of one month to 12 years. In the 416 patient/years of pacing by this method, 13 septicemias occurred. Implanted pacemakers with endocardial electrodes were used in 1186 patients. In the 3488 patient/years 11 septicemias occurred. The mortality and an assessment of the cause of death for pacing by the two methods is presented. It is concluded that the external method of transvenous pacing carries additional risk and is only justified in special circumstances.


Phantom pacemaker programming.

Phantom pacemaker programming. Spurious or "phantom" programming of programmable pacemakers may occur as the result of two phenomena. One is change in rate and/or output of the generator from an anomalous source (dysprogramming); the other is a generator response different from that intended and set on the conventional programmer (misprogramming). In either case, the result is a nuisance, at best. Conceivably, at worst, an irreversible subthreshold output could be induced. Despite wide usage of such devices, neither event has been reported. In the routine follow-up of 95 implanted Cordis Omni-Stanicor generators, we have observed three instances of dysprogramming upon application of a magnet commonly used to induce the asynchronous mode. Subsequent in vitro studies revealed magnetically induced programming reed switch vibration in 9 of 6,680 units, which could account for the in vivo observations. We also describe many instances of misprogramming, attributable, in most cases, to a faulty programmer emission count. In this series, none of the anomalies was clinically detrimental. However, anyone involved in pacemaker follow-up should be alerted to the existence of these potentially hazardous phenomena.


Effect of electroconvulsive therapy on cardiac rhythm, conduction and repolarization. Because sympathetic stimulation has been implicated in the genesis of arrhythmias, we studied the effects on arrhythmias of electroconvulsive therapy (ECT). Fifteen psychiatric patients (male: 8, female: 7, age: 19-51, mean: 29.8) without known heart disease underwent 24-hout Holter recordings before, during, and after ECT (25 episodes). All patients were taking psychotropic drugs and received atropine (0.4-1.2 mg, mean: 1.1 mg IV), methohexital, and succinylcholine prior to ECT. Following ECT, mean maximum heart rate increased (106 +/- 3.2 to 142 +/- 6.0 beats/min, p less than .001), PR interval decreased (149 +/- 3.3 to 131 +/- 3.7 msec, p less than .001) and QTc interval increased (132 +/- 6.5 to 454 +/- 9.7 msec, p less than .001) compared to values obtained after atropine administration. Mean PVC or PAC frequently immediately after ECT or per 24 hours did not change significantly (PVC per 24 hours 6.8 +/- 3.2 to 10.4 +/- 6.4, NS; PAC per 24 hours 0.4 +/- 0.3 to 0.3 +/- 0.2, NS) and no complex arrhythmias were noted. Rate and PR changes suggest adrenergic effects of ECT and QTc increase may be due to imbalanced sympathetic discharge. Autonomic stimulation produced by ECT did not induce arrhythmias in these patients without heart disease. The possible antiarrhythmic role of psychotropic agents or premedication is unknown.


The automatic rate adjustment pacemaker. The possibilities of rate hysteresis. Since the first use of pacemakers there have been attempts to regulate the fixed, or basic rate of implanted pulse generators. Earlier models employed the use of magnets or percutaneous needles to change the pacemaker rate after implantation. A recent development is the programmable pacemaker, which utilizes external electromagnetic signals to alter the basic rate. A series of engineering advances have resulted in automatic pacemaker rate changes, as first embodied in the hysteresis pacemaker. Notable modifications of the basic hysteresis concept include gradual pacemaker rate changes, and variable hysteresis or rate changes dependent on electrophysiologic events. Many of these technical advances are unknown to physicians, but are disclosed in patents. In general, negative hysteresis favors emergence of underlying non-pacer rhythms, whereas positive hysteresis suppresses underlying rhythms of any type. The automatic rate adjustment pacemaker represents an attempt to derive the advantages of negative hysteresis while eliminating the disadvantages of abrupt rate changes. The unit automatically searches for a sinus rhythm slower than the basic pacing rate, by periodically gradually slowing its rate to a lower level.


Evaluation of a rechargeable pacemaker system. A rechargeable-demand nickel-cadmium pulse generator for permanent transvenous cardiac pacing was evaluated in 66 patients. During a cumulative follow-up period of 2,333 patient months (194.4 patient years), failure of the pacing circuit occurred in 3 patients at 21, 25, and 27 months, respectively. Nine patients had difficulty accepting the recharging concept and, in 3 of these patients, it became necessary to replace the rechargeable generator with a conventional energy source. The overall failure rate of approximately 3% per year (including the 3 patients in whom it was necessary to remove the generator because of failure to recharge properly), coupled with the inconvenience of recharging, limits the usefulness of the rechargeable system compared to the newer lithium-powered generator.


Partial pacemaker recycling of implanted QRS-inhibited pulse generators. In the evaluation of twenty-three patients with implanted QRS-inhibited lithium-powered pulse generators (Intermedics C-MOS-1 and ARCO L1-2D), we repeatedly observed the phenomenon of partial pacemaker recycling (PPR), in which the escape interval induced by a premature ventricular beat is shorter than the automatic interval (AI). In order to determine the sensing properties of these pulse generators, programmed chest wall stimulation (CWS) was systematically performed in all 23 patients and, in addition, intracardiac programmed ventricular stimulation (PVS) via temporary intravenous pacing catheters was performed in 9 of them. The AI of these pulse generators ranged from 820 to 860 msec and absolute refractory periods (ARP) from 220 to 330 msec. Precise correlation in determining pacemaker sensing properties could be demonstrated between CWS and PVS. The phenomenon of PPR occurred 110 to 240 msec following ARP with both CWS and PVW, and appeared to be time- rather than voltage-dependent. We conclude that: (1) CWS is a safe, simple and accurate method for studying pacemaker sensing properties, and (2) time-dependent PPR is a normal electrical feature of certain implanted QRS-inhibited lithium-powered pulse generators.


Overdrive pacing for supraventricular tachycardia: a review of theoretical implications and therapeutic techniques. Rapid atrial pacing for treatment of supraventricular arrhythmias has been demonstrated to be safe and effective. Virtually any supraventricular tachycardia with the exception of atrial fibrillation, Type II atrial flutter, and probably sinus tachycardia can be treated successfully with pacing techniques. The recognition of the advantages of cardiac pacing over drug therapy or DC cardioversion has resulted in its widespread use, especially after open-heart surgery. Although the response to overdrive pacing may not reliably identify the underlying mechanism of supraventricular tachycardia, the response of the arrhythmia to pacing (i.e., whether it is interruptable or noninterruptable), is most useful in the approach to management of the individual patient.


Methods for recording intermittent contact signals in demand pacemaker arrhythmias (11 cases). This report describes some of the various techniques which may be used to demonstrate intermittent and/or incomplete fracture of a pacing lead. Eleven patients treated with an R-wave-inhibited demand pacer showed signs of paroxysmal arrhythmias. Intraoperative recordings of the ventricular electrogram showed the presence of spurious signals mimicking an R-wave. These signals varied from patient to patient but remained morphologically constant when a given technique was used in a given case. The most significant signals were picked up when pacing and recording on the same lead.


An unusual form of the bradycardia-tachycardia syndrome: paroxysmal A-V block and ventricular tachycardia. An unusual case of alternating bradycardia-tachycardia, paroxysmal Mobitz II A-V block and ventricular tachycardia is described. The patient presented with a normal resting (control) electrocardiogram and intracardiac conduction times (A-H and H-V intervals). The clinical evaluation, electrophysiology, and importance of defining the cause of serious rhythm disturbances prior to therapy are discussed.


The noise sampling period: a new cause of apparent sensing malfunction of demand pacemakers. Two patients with Omni-Stanicor pulse generators presented an apparent sensing problem characterized by intermittent reversion to fixed-rate pacing only during atrial fibrillation with a very rapid ventricular rate. Every fixed-rate cycle contained two unsensed beats. The first unsensed beat fell in the noise sampling period (the last 1/6 of the pacemaker refractory period) and, therefore, disabled the demand function of the pulse generator for a single timing cycle. The presence of two consecutively unsensed beats within one timing cycle (automatic or escape interval) during tachycardia suggests normal function of the noise sampling period of this particular pulse generator, rather than a true sensing problem. The diagnosis becomes evident if the sensing problem disappears when abbreviation of the refractory period occurs by reprogramming the pulse generator at a higher rate.


Unusual complication of bifascicular block during surgery under general anesthesia. This report describes the occurrence of Mobitz type II AV block during surgery under general anesthesia in a patient with apparently uncomplicated right bundle branch and left anterior fascicular block (RBBB and LAH). Although prophylactic pacing is not usually recommended in uncomplicated RBBB and LAH, the events in this case suggest that this abnormality may not always be benign during surgery. Continuous monitoring is essential and emergency equipment for temporary pacing should be readily available near the operating and recovery rooms.


Differential expression of poly(A)-adjacent sequences of mammary tumor virus RNA in murine mammary cells. Two DNA probes representative of either the entire mouse mammary tumor virus (MMTV) genome or the poly(A)-adjacent sequences at the 3' end of MMTV RNA were synthesized with calf thymus DNA or oligo(dT) primers, respectively. These probes were used to study the expression of endogenous MMTV sequences in several BALB/c mammary tumor cell lines, in normal lactating BALB/c tissue, and in a cloned C3H tumor cell line. Both probes were characterized with respect to their rates of hybridization with template RNA, their size as determined by alkaline sucrose gradient centrifugation, and the thermal stability of the cDNA.MMTV RNA hybrids. In addition, the ability of the calf thymus oligodeoxy-nucleotide- or oligo(dT)-primed probes to protect (125)I-labeled MMTV RNA or (125)I-labeled poly(A)-adjacent MMTV RNA sequences from S1 nuclease digestion was determined. Hybridization analysis with these two probes indicated that (i) there were approximately 20-fold more oligo(dT)-primed sequences in BALB/c lactating tissue than there were sequences representing the entire genome; (ii) in BALB/c tumor cells, the oligo(dT):random oligonucleotide-primed cDNA sequence ratio was reduced to 4:1; and (iii) in virus-producer C3H tumor cells, there was only a 2-fold excess of oligo(dT)-primed sequences over that observed with a representative cDNA. These results are consistent with the presence of subgenomic viral mRNA species, integration of partial proviral copies, or altered mRNA processing.


Nucleotide sequence at the junction between the coding region of the adenovirus 2 hexon messenger RNA and its leader sequence. We have determined a 139-base-pair sequence of adenovirus 2 DNA that is located immediately leftwards of the cleavage site for endonuclease Sma I at position 51.1. The established sequence includes the hexon AUG initiator codon, located 75--77 nucleotides leftwards of this cleavage site, and codons for the first 26 amino acids of the hexon polypeptide. By the use of purified hexon mRNA as a template and separated strands of small restriction enzyme fragments as specific primers, the complete 5' noncoding region of the hexon mRNA was synthesized and part of its sequence was determined. The tripartite leader sequence of the hexon mRNA starts 39 nucleotides upstream from the initiator AUG triplet and the total length of the 5' noncoding part of the hexon mRNA was estimated to be 235 nucleotides. The sequence at the junction of the leader sequence permits the formation of secondary structures that may be of importance for the splicing reaction.


Interaction of bleomycin with DNA.

Interaction of bleomycin with DNA. The sequence of oligonucleotides produced by the action of bleomycin and ferrous ion on double- and single-stranded DNA has been determined. In the presence of ferrous ion, bleomycin promotes cleavage at G-T and G-C sequences, while high concentrations of ferrous ion alone result in strand scission that is not base specific. In the presence of bleomycin and ferrous ion, pyrimidine bases located to the 3' side of guanosine are released preferentially and a low molecular weight product that forms a chromophore with thiobarbituric acid is produced from the deoxyribose moiety. Oligonucleotides produced by the action of bleomycin differ slightly in electrophoretic mobility from those produced by chemical or enzymatic cleavage. A model is proposed to explain the interactions of bleomycin with DNA.


Enhanced expression of beta2-microglobulin and HLA antigens on human lymphoid cells by interferon. Mononuclear cells from the blood of healthy normal humans were kept in cultures under nonstimulating conditions for 16 hr in the presence or absence of human interferon. The relative quantities of HLA antigens and beta(2)-microglobulin on the cultured cells were determined by quantitative immunofluorescence (fluorescence-activated cell sorter) and by the capacity of cells to absorb out cytotoxic antibodies against the relevant antigens. Interferons of different origin and purities enhanced the expression of HLA antigens and beta(2)-microglobulins, whereas membrane immunoglobulins and antigens recognized by antiserum raised against human brain and T cells were the same on interferon-treated and control cells. Similar interferon effects were observed on an Epstein-Barrvirus-negative Burkitt lymphoma cell line. The enhanced expression of histocompatibility antigen subsequent to intereferon treatment was observed on B- and T-enriched lymphocyte populations and was found to be dose dependent with the optimum with "physiological" concentrations of interferon. Pretreatment of lymphocytes with interferon for 2 hr was found to be as effective as having interferon present during the total culture period. The interferon-induced enhancement of antigen expression on cells was dependent on active protein synthesis.


Normal human placentas contain RNA-directed DNA polymerase activity like that in viruses. Extracts from over 100 normal human placentas have been examined for RNA-directed DNA polymerase (DNA nucleotidyltransferase, EC 2.7.7.7) activity. More than 80% of these placentas contained this enzyme activity, which banded at a density of 1.15-1.17 g/ml in sucrose. After heat treatment, this enzyme activity was shifted in density to 1.22-1.24 g/ml. The enzymatic activity was greater with (rC)n.(dG)12-18 than with (dC)n.(dG)12-18 and was not stimulated by (dG)12-18 alone. The product of the endogenous reaction, which was sensitive to RNase, had the characteristics of a small DNA associated with a large RNA by hydrogen bonding. Electron microscopic inspection of the material with a density of 1.15-1.17 g/ml revealed numerous retrovirus-like particles with central electron-dense cores and double-membraned envelopes. The enzyme may be associated with the retrovirus-lik particles noted in the trophoblast layer of some human placentas.


[Possibility of research specific utilization of clinical television setups]. The present study is intended to discuss use of video tape technics in psychiatric research in reference to method, engineering and clinical investigation. A self created variant of a clinical television system is debated. With the support of video tape methods will be realize improvements in quality of psychiatric investigation in view of procedure and determination of the results as well as reliability, objectiveness and exactitude in connection with a postgraduate continued professional training. Reconsiderations of psychiatric documentation systems with regard to reliability represent an other important field of employment.


Differences between nonprofessional recovering alcoholic counselors treating Bowery alcoholics: a study of therapist variables. Several treatment variables have been suggested as critical in the outcome of psychiatric therapy. These can be categorized as patient variables, therapy variables, and therapist variables. This study utilized a homogeneous Bowery-patient population, treated in a comprehensive inpatient treatment and rehabilitation program, and attempted to assess differences among nonprofessional recovering alcoholic counselors. The therapeutic outcome of the alcoholic patients was correlated with the values held by the counselors as assessed on the Rokeach Value Scale, suggesting that this instrument may provide an easy to administer and inexpensive screening method for counselors of patients suffering from alcoholism.


[Cytospectrophotometry of hepatocyte RNA in regenerating and neoplastic liver]. The present work consists in a quantitative cytospectrophotometric investigation of the cytoplasmic hyperbasophilia that characterizes the foci of neoplastic transformation and the tumor cells in rats fed hepatocarcinogens. It reveals that the increase in the dye-binding capacity shown by the cytoplasmic RNA of these cell populations results primarily form a qualitative alteration which raises the affinity for basic dyes by a factor of nearly 2, and also to a change in concentration due to volumetric changes which may again double the staining intensity of these hepatocytes. This phenomenon of hyperbasophilia differs radically from the weak variations in basophilia observed in normal regenerating liver and in hyperplastic liver parenchyma of rats fed the carcinogenic diet in which cases the changes appear to be related mainly to de nova RNA synthesis. Biochemical assays on cellular fractions indicate that the ribosomes are the organelles responsible for the hyperbasophilic properties that hepatocytes acquire in areas of neoplastic transformation.


Fc receptor bearing 'hairy cells' of leukaemic reticuloendotheliosis bind soluble antigen--antibody complexes and adhere to immobilized complexes, but fail to mediate antibody dependent cellular cytotoxicity. The majority of hairy cells from three patients with leukaemic reticuloendotheliosis were adherent cells bearing surface immunoglobulin, complement receptors, and Fc receptors. Highly purified populations of malignant hairy cells, which readily bound soluble antigen-antibody complexes in suspension and were able to adhere to immobilized antigen-antibody complexes, were examined for their ability to mediate ADCC. Two patients with greater than 90% FcR positive cells failed to mediate ADCC. When initially examined, a third patient, with fewer malignant cells, demonstrated a less marked impairment of cytolysis. When reexamined at a later date, this patient had an increased number of hairy cells and concomitantly demonstrated more impaired ADCC effector cell activity. Absorption of surface immunoglobulin bearing cells onto plastic surfaces coated with goat anti-human immunoglobulin resulted in a complete depletion of FcR, sIg positive, hairy cells. The remaining nonadherent fraction, containing 5.5% FcR positive, sIg negative cells, was able to mediate ADCC as effectively as the normal controls. These results indicate that although FcR bearing hairy cells readily bind soluble antigen-antibody complexes and adhere to immobilized complexes, they were unable to mediate ADCC.


Association of mouse major histocompatibility and Rauscher murine leukaemia virus envelope glycoprotein antigens on leukaemia cells and their recognition by syngeneic virus-immune-cytotoxic T-lymphocytes. Physical association was measured between MLV gp70, the envelope glycoprotein of Rauscher murine leukaemia virus (R-MLV), and serologically defined H-2 antigens on the surface of R-MLV transformed C57BL/6 (H-2DbKb) mouse leukaemia cells (RBL-5A). Capping and patching with antisera against H-2Db caused specific co-capping and co-patching of R-MLV gp70 antigens as seen by fluorescence microscopy. Despite the physical proximity of R-MLV gp70 and H-2Db antigens, high titre alphaR-MLV gp70 sera had no effect in blocking syngeneic T-lymphocyte mediated cytolysis of RBL-2A cells whereas alphaH-2Db sera were effective.


[HLA-DRW antigens and multiple sclerosis]. Previous studies of multiple sclerosis patients showed the existence of a positive association between multiple sclerosis and HLA-A3 and B7, as well as a negative association with B12, These observations have been confirmed. In addition, a more marked association has been observed with two recently identified B-cell antigens, DRW2 and DRW3, closely related to HLA-D locus. The presence of cold lymphocytotoxic antibodies was found to bear no relationship with those two specificities. These results suggest that two genes of the HLA-DR region may play a role in the pathogenesis of multiple sclerosis.


Anti-DNA antibody determination in systemic lupus erythematosus (SLE). Predictive value as compared with the LE-cell test. All pathological LE-cell tests and anti-DNA antibody determinations were registered in a prospective study over a period of 9 months at a department of internal medicine with rheumatology as a subspecialty. The results were compared with the clinical diagnosis of the patients, and correlated to SLE disease activity, as evaluated clinically and by blood analysis of five acute-phase reactants. Of 159 positive LE-cell tests, 43 were from patients with SLE, giving a diagnostic value of 27%. Of 37 positive anti-DNA antibody values, 30 were from patients having SLE, giving a diagnostic value of 81%. All of the 7 false-positive anti-DNA antibody determinations were only slightly above the normal range (22--26%: normal range less than or equal to 21%). No correlation was found between the activity of the SLE and the degree of the positive LE-cell test. Pathological levels of anti-DNA antibodies were always found when the patient had active SLE--clinically and by elevation of acute phase reactants. On the other hand, it was impossible to evaluate the disease activity from the level of the anti-DNA antibody test. It is concluded that the anti-DNA antibody determination should be preferred to the LE-cell test in the evaluation of patients with connective tissue diseases.


Stimulation of human periaqueductal gray for pain relief increases immunoreactive beta-endorphin in ventricular fluid. Immunoreactive beta-endorphin was measured in the ventricular fluid of six patients with chronic pain. Stimulation of the periaqueductal gray matter in three patients with pain of peripheral origin resulted in significant increases (50 to 300 percent) in the concentration of ventricular immunoreactive beta-endorphin. In three other patients suffering deafferentation dysesthesia, stimulation of the posterior limb of the internal capsule did not alter the concentration of this peptide. These results provide evidence of the release of human immunoreactive beta-endorphin in vivo and suggest that naloxone-reversible pain relief achieved by stimulation of the periaqueductal gray matter may be in part mediated by the activation of beta-endorphin-rich diencephalic areas.


Radioimmunoassay of the insulin receptor: a new probe of receptor structure and function. A sensitive and specific radioimmunoassay for the insulin receptor has been developed employing receptor autoantibodies from the serum of a patient with insulin-resistant diabetes. The assay detects insulin binding sites at concentrations as low as 0.1 nanomolar; distinguishes between receptors originating from human placental membranes, human lymphoblastoid cells, and mouse liver membranes; and measures the receptor independently of its binding function. Down-regulation, or loss of binding after exposure to insulin, is associated with loss of immunoreactive receptor.


Transfer of experimental allergic encephalomyelitis with guinea pig peritoneal exudate cells. Incubation with specific antigen, myelin basic protein, greatly enhances the ability of guinea pig peritoneal exudate cells to transfer experimental allergic encephalomyelitis. Reproducibly successful transfers are obtained with 10(7) cells. With this relatively small number of cells, in vitro studies to determine the immunologic mechanisms involved in the disease process are now possible.


Scapulectomy for the treatment of malignant tumors of the scapula. Two cases of Tikhor-Linberg resection for rhabdomyosarcoma and malignant chondromyxoid fibroma and two cases of scapulectomy for metastatic disease of the shoulder girdle are reviewed. After resection of the scapula, active motion of the shoulder will be severely restricted, but normal function of elbow, wrist, and hand permit use of the extremity in many activities of daily living. Surgical treatment for metastatic bone disease in the upper extremity and the role of radiation therapy for metastatic bone disease are discussed.


Studies on the effect of plasminogen activator on the interaction between alpha 2-macroglobulin and plasmin. Six different plasmins were prepared by incubating human plasminogen with various amounts of streptokinase or urokinase. It was confirmed that the six different plasmins possessed similar caseinolytic activities, and the inhibitory effects of a alpha 1-antitrypsin on caseinolytic activities of the six different plasmins were all the same. On the other hand, interactions between the six different plasmins and alpha 2-macroglobulin were complicated. Plasmins activated by cleavage of plasminogen were almost immediately or effectively inhibited by alpha 2-macroglobulin. However, plasmin activated by complex formation of plasminogen with streptokinase was not so immediately or effectively inhibited by alpha 2-macroglobulin. It was supposed that the difference between these two results on the interaction between plasmin and alpha 2-macroglobulin might be due to the difference in molecular form of plasmin. In the present study, it was also confirmed that streptokinase or urokinase, in free form in the reaction mixture, interfered with the interaction between plasmin and alpha 2-macroglobulin. The cause for such interference was discussed.


Effect of lindane on mouse peritoneal macrophages. Among the effects of lindane in vitro on mouse peritoneal macrophages, the inhibition of uridine incorporation correlated with the reduction of intracellular uridine pool was the most pronounced. This decrease was significant at a concentration of 10(-4) M after 12 h of treatment. The rate of leucine incorporation did not show any change during the 24-h study. The decrease in pinocytosis rate and acid phosphatase activity occurred with lindane concentrations superior to 10(-4) M or after treatment of more than 12 h. Pinocytosis inhibition may have been associated with cytoplasm vacuolation. The high lindane doses necessary to inhibit some of these macrophage functions belong to the range of concentrations exerting biological effects unrelated to its insecticidal effects, which involves stereochemical specificity. The effects of lindane on mouse peritoneal macrophages, similar to the effects of anesthetics, seemed to be determined by its lipophilicity, which may exert disordering effects in the lipid domains of the membrane. Such perturbations could involve changes in the conformation of transport sites as well as in the integrity of the membrane and cytoskeleton structures which govern the processes of pinocytosis and lysosomal fusion.


[Effects of the combination of a pesticide, lindane, and a sulfur depleted diet on pregnancy in the rat]. Effects of assocation of lindane ingestion and sulfur depletion on pregnancy in the rat. Sulfoconjugation stands as one of the main processes of foreign compound detoxication in mammals. When feeding conditions are adequate, sulfate ions necessary to form sulfoconjugates are provided by the sulfur aminoacids of the diet. The feeding to pregnant rats of a diet containing lindane, when sulfur aminoacids are limiting factors, should lead to competition between their utilisation for anabolic or detoxifying processes. The balance between stimulation of glucuroconjugation and sulfoconjugation seems to depend on which of the 2 compounds necessary for detoxification is the most limiting factor. Glucuroconjugation spares sulfur aminoacids for foetal growth; sulfoconjugation spares glucose for foetal utilisation. The foetal needs appear to modulate the orientation of the maternal detoxication processes; foetal anabolism is predominent over detoxication.


A new staining technique for microfilariae. A rapid whole mount staining method is described to identify and differentiate microfilariae without elaborate processing. A single solution combining Hoyer's mounting medium and hematoxylin stain facilitates light microscopic examination of nuclei and sheaths of microfilariae. The new technique stains microfilariae adequately in three to seven minutes at 60--64 C making the method preferable to conventional methods that may take as long as 45 to 60 minutes. Lantern heat may be used to heat slides in rural areas with good results.


A differential stain for neuronal nucleoli in unfixed cryostat sections. The Klüver-Barrera procedure, using luxol fast blue and cresyl violet for a combined nissl and myelin stain, was adapted to unfixed cryostat sections. Neuronal nucleoli appeared as distinct dark blue structures. The color contrast between violet Nissl substance and the nucleoli facilitated their recognition in human and in rat central nervous systems. This modified staining procedure enabled us to combine a counting of nerve cells with a histochemical investigation by applying each technique to a different set of sections cut from the same block of unfixed, frozen brain tissue.


A permanent cell viability assay using alcian blue. The alcian blue dye exclusion method for glutaraldehyde-fixed cells has been utilized with "centrifugal cytology" to prepare permanent records of the viability of individual cells present in suspensions. The viability of spleen cell suspensions separated by linear bovine serum albumin density gradient centrifugation has been measured with this method. Combined light and scanning electron microscopy of nonviable and viable cells demonstrated membrane alterations in alcian blue-stained nonviable cells, while viable cells were spherical and displayed uniform surface features.


Evaluation of eight fluorochrome combinations for simultaneous DNA-protein flow analyses. Eight fluorescent dye combinations for simultaneous DNA-protein staining have been evaluated spectroscopically and flow microfluorometrically: propidium iodide (PI) with fluoresceinisothiocyanate (FITC), fluorescamine (FC), and dansylchloride (DANS); diamidinophenylindole (DAPII) with sulphorhodamin (SR101), tetramethylrhodamin isothiocyanate (TRITC), and nitrobenzodiazole (NBD); acriflavine (AF) with stilbene isothiocyanate sulphonic acid (SITS), and DAPI. Three different experimental tumor cell lines have been employed in the investigations. Simultaneous DNA-protein analyses have been carried out with the newly developed HEIFAS instrument. Spectroscopically two groups of dyes were distinguishable according to their excitation maximum below 400 nm and above 450 nm respectively. DANS and NBD were found to be unsatisfactory with respect to their protein distributions obtained by flow analysis. The remaining stains involved in the dye combination revealed comparable flow distributions of the cellular DNA and protein content. With respect to preparation time and number of centrifugal steps involved in the staining protocols, and in connection with the stability of the dye used, the DAPI-SR101 method proved to be fastest and easiest. With this combination DNA and protein flow analysis can be performed simultaneously within 30 min.


Borax methylene blue: a spectroscopic and staining study. Borax methylene blue is quite stable at room temperatures of 22-25 C. At 30 C polychroming is slow; during 50 days in a water bath at this temperature the absorption peak moves from 665 to 656 nm. At 35 C, the absorption peak reaches 660 nm in 7 days, 654 nm in 14. At 60 C polychroming is rapid, the absorption peak reaching 640-620 nm in 3 days. When the pH of the borax methylene blue solutions, normally about 9.0, is adjusted to pH 6.5, the absorption peak remains at 665 nm even when incubated at 60 C for extended periods. When used as a blood stain 0.4 ml borax methylene blue (1% methylene blue in 1% borax), 4 ml acetone, 2 ml borax-acid phosphate buffer to bring the solution to pH 6.5, and distilled water to make 40 ml, with 0.2 ml 1% eosin added just before using, an excellent Nocht-Giemsa type stain is achieved after 30 minutes staining. The material plasmodia P. falciparum, P. vivax, and P. berghei stain moderate blue with dark red chromatin and green to black pigment granules. The study confirms Malachowski's 1891 results and explains Gautier's 1896-98 failure to duplicate it.


Clearing, cuticle removal, and staining for the fertile bracts (lemmas and paleas) of grass anthoecia. The epidermis of the bracts enclosing the flower of grasses contains epidermal cell patterns which are indicative of phylogenetic and systematic relationships among taxa. Treating the heavily cutinized anthoecial bracts (fertile lemma and palea) with 10% NaOH results in the removal of sufficient cuticle to allow examination of the cells of the epidermis. After clearing and removal of the cuticle, the bracts are bleached, washed, dehydrated, and if studied by light microscopy, stained in 2% chlorazol black E and mounted in Diaphane; or, if studied by scanning electron microscopy, dried by the critical-point method and either left uncoated or coated with a film of various conductive metals.


[Efficacy of the use of combinations of teaching aids in propaedeutics education]. Audio-visual and printed teaching and learning aids are used for the instruction in the subject of "propaedeutics of prosthetic stomatology". The achievements and the time required for the guidance and supervision of the students were evaluated. Furthermore, the use of the teaching and learning aids by the students was assessed. It was found that audio-visual means of demonstration favour the process of learning and facilitate considerably the task of the teaching staff.


Five subtypic specificities of the Bw22 complex in four racial groups. Five subtypic specificities of Bw22 were defined using 38 informative local and Seventh Histocompatibility Workshop sera: Bw54, 22.2, J2, Bw42, and a new Bw22 associated antigen Te90. The previously defined specificity, 22.1, associated with Cw3, could not be distinguished from Bw54 in this study. Marked restriction in the distribution of four Bw22 specificities (Bw54 excepted) in white, Mexican, black, and Oriental populations was described and provided supporting evidence for the identification of these antigens.


A complex of HLA-D specificities detected by HTC typing: Dw7, Dw11, and TMo. Homozygous typing cells defining HLA-D antigens related to Dw7 appear to identify a complex of partially overlapping structures. The relationships between these specificities were analyzed using 7th Workshop cells and other cells sent to the reference laboratory. The local cells JLe and KA seem to fit the antigen Dw11, which is in large part included in Dw7. TMo defines a component that is rare in normal whites and frequently observed in children with rheumatoid arthritis.


HLA-DR-specific suppressor cells after repeated allogeneic sensitizations of human lymphocytes in vitro. In conclusion, DR-specific suppressor cells can be induced by repeated in vitro sensitizations. They were able (1) to decrease a secondary proliferation, (2) to suppress consistently, in a primary proliferative assay, when added as third cells (primed twice against a DR antigen [PLT II] and gamma-irradiated), the response of unprimed cells towards stimulating cells, which share a DR specificity with the priming cell of the PLT II. The suppression follows the D part of the recombinant haplotype within an HLA-B/D recombinant family and is specific for the DR antigen used twice as stimulator for production of the PLT II.


Specificity of human cytotoxic responses to chemically modified autologous cells. Human PBML can generate cytotoxic responses to autologous cells that have been chemically modified with TNP or DNP. The cytotoxic effectors have precise hapten specificity. The DNP-specific effectors recognize DNP in association with cell surface alloantigens, which appear to be at least partially associated with HLA-A and -B. The TNP-specific effectors recognize TNP in association with several classes of determinants--some of which are HLA-linked alloantigens that are incompletely associated with HLA-A and -B, while other determinants are widely shared among humans.


[Effect of substances that alter the level of intracellular cAMP on the reaction of human lymphocytes blast transformation]. Effects of cholera toxin, cholera anatoxin, theophylline and dibutyryl cyclic AMP (db-cAMP) on the PHA-induced DNA synthesis have been studied. It was shown that toxin, db-cAMP and theophylline suppressed mitogen-induced 3H-TdR incorporation and blast-transformation in a dose-related manner. When both toxin and theophylline were given together to PHA-stimulated lymphocytes, the inhibitory effects of these two agents were additive. The inhibitory effects of db-cAMP and theophylline were additive too. This inhibitory effects could be due to the elevation of intracellular cAMP. Cholera anatoxin exerted an inhibitory action on the PHA-stimulated lymphocytes. The inhibitory effects on lymphocyte DNA synthesis by anatoxin and theophylline were not additive. These results suggest that the effects of cholera toxin are mediated by cyclic AMP, but effects of cholera anatoxin may be associated with some other mechanism.


[Suppression of leukocyte migration by autologous and allogeneic tumor extracts in kidney cancer patients]. The reaction of leucocyte migration inhibition (RLMI), using antigens of autochthonous and allogenic tumors, was utilized to examine 21 patients with renal cancer and in 37 control patients. The antigens of renal cancer (AG RC) would suppress specifically leucocyte migration in all patients with cancer of the kidney, as compared with the migration without antigens or in the presence of normal tissue antigens of the tumor involved kidney. In 5 of 37 cases AG RC as well as those of normal renal tissue inhibited leucocyte migration in patients with urolithiasis and pyelonephritis. Autologous blood plasma in patients with renal cancer would contribute to inhibition of leucocyte migration by cancer antigens. There are some common specific antigens in renal cancer, recognized by lymphocytes from different patients with the tumor in question. RLMI may be used to establish the immune diagnosis of cancer of the kidney.


[Late results of the combined treatment of bladder cancer depending on the histological form of the tumor]. The writers present an analysis of the remote results of the combination therapy in 208 patients with cancer of the urinary bladder, depending on the histological form of the tumor. Radical surgery was performed in 193 patients, palliative--in 15. All types of surgical intervention were associated with radiotherapy in the pre- and postoperative period. The survival for 3 years and longer was noted in 153 patients, for 5 years and longer--in 69. Transitional-cell papilloma is characterized by the most favourable prognosis.


[Sudden cardiac death in the case of an apparently healthy heart]. After a brief survey the authors present two of their observations on sudden death with obviously intact heart. The first observation was on a male, aged 43, with three incidents of sudden death, successfully reanimated. Between the paroxysms, frequent ventricular extrasystoles, type "early" were recorded, falling upon T-wave. After the anti-arrhythmic treatment the ventricular extrasystoles disappeared and no new incidents occurred. Three years later the patient was capable of working, without complaints. The second case concerns a female, aged 32, pregnant 7--8 month, hospitalized with light manifestations of late toxicosis and auricle extrasystoles, type parasystoles some of them recorded upon T-wave. The patient suddendly died in obviously excellent health. Ventricular fibrillation was recorded on ECG, not overcome very likely, because of the delayed reanimation. At necropsy, a heart with normal dimensions was found with scanty small cicatrices in the myocardium, probably resulting of past myocarditis.


The formation of phenylethane-1,2-diol 2-acetate in the metabolism of styrene oxide by rabbit liver microsomes in vitro. 1. Phenylethane-1,2-diol 2-acetate has been isolated from the incubation of styrene oxide or styrene diol with liver microsomes of phenobarbital-pretreated rabbits. 2. Observed ratios of phenylethane-1,2-diol to its 2-acetate in the incubation mixtures ranged between 19 : 1 and 5 : 1 with different microsomal preparations and different periods of incubation. 3. The formation of phenylethane-1,2-diol 2-acetate may be a source of errors in the radiometric determination of epoxide hydrase activity in microsomes.


An alteration in outer membrane permeability associated with a division lesion in a strain of Salmonella typhimurium. Salmonella typhimurium strain 4a is a temperature sensitive mutant with defects in both septation and separation. The separation lesion was reversed by phenethylalcohol but this agent failed to allow septation or growth at restrictive temperature. Organisms of strain 4a grown at 42 degrees C were, unlike the parental strain, resistant to lysis by lysozyme plus EDTA and lipopolysaccharide was poorly extracted by EDTA from cultures of strain 4a grown at 42 degrees C. Such cultures may, therefore, be resistant to lysis with lysozyme plus EDTA not because the murein is altered but because the EDTA fails to permeabilize the outer membrane to lysozyme. In confirmation of this, murein isolated from strain 4a after growth at 42 degrees C showed the same sensitivity to lysozyme as murein from the parental strain. In spite of the altered envelope properties of strain 4a after growth at 42 degrees C, no major changes in protein or phospholipid composition have so far been demonstrated.


Photochemistry and photobiology of 5-azacytidine: effect of repair on photostabilization of Escherichia coli. The photochemical stability of the anomalous nucleic acid base 5-azacytidine (z5Cyd) on irradiation at 254 nm is by about one order of magnitude less than that of cytidine (Cyd). Contrary to the photochemical behaviour, incorporation of z5Cyd into the nucleic acids of E. coli strains SR 20 (uvr+ rec+), SR 74 (uvr+ rec-) and SR 22 (uvr- rec+) produced a higher resistance to UV light. Only the SR 73 (uvr- rec-) strain was shown to have an increased UV sensitivity. This latter finding is in accord with the photochemical properties of z5Cyd. The results led to the conclusion that excision and recombination repair processes contribute to the observable protective effect. The fact that inhibition of excission repair by caffeine or proflavine of the mutant uvr+ rec- changes protection into sensitization supports this idea.


[Diagnosis of placental sulphatase deficiency (author's transl)]. In a 23-year old primipara who was in her 34th week of pregnancy, serum oestriol could not be identified, with no other abnormal clinical and endocrinological findings, which is why the authors suspected placental sulphatase deficiency. The placental sulphatase activity was tested by the intravenous application of dehydroepiandrosterone sulphate, and compared with the data obtained from a control patient with normal endocrinological findings. There was a slight increase in DHEA from 7.5 ng/ml to 18.0 ng/ml, whereas the serum values of oestrone and oestradiol did not change. In contrast, the control patient showed an excessive increase of DHEA from 5.5 ng/ml to 56.8 ng/ml. Oestrone and oestradiol also reacted with a strong increase of activity from 12.7 ng/ml to 42.7 ng/ml or 25.2 ng/ml to 61.2 ng/ml, respectively. A placental sulphatase deficiency with absence of hydrolysis of the applied DHEAS must be assumed as the reason for the deficient or absent reaction of DHEA and the oestrogens. The patient gave birth to a healthy boy in the 41st week of pregnancy, delivery being performed by caesarian section. Clinically normal course of pregnancy with lowered oestriol values, delivery by caesarian section in the case of primiparae, as well as male sex of the newborn, are criteria of placental sulphatase deficiency. These criteria correspond to the few observations published so far.


[Mass media. Prevention and the media].

[Mass media. Prevention and the media]. Though the information communicated by the media is important in so far as it wakes and upholds the interest of the population on a subject such as preventive medicine, it is not sufficient to change the behaviour of this population. The real reasons why opinion shows too much indifference towards preventive medicine should be analysed and the people responsible of this sector be made familiar with the needs and the language of the media.


[Nutrition. Prevention through nutrition: approaches to further development]. 1. More research in nutrition will help those engaged in the practical aspects of the field, because the better the knowledge, the easier they can achieve their objectives. 2. Attractive and understandable publications continuously must bring the results of this research to the attention of the general public. 3. Cooperaation of key professions like physicians, teachers, managers and cooks has to be developed. All have to work together to achieve that healthy nutrition is perceived as a contribution to the immediate well-being. 4. The main goal of all these providing foods has to consist in maintaining health while covering the daily needs but also in making healthy nutritional habits the gastronomy of the future.


[Test suitable for assessing the immunocompetence of the tumor host in prostatic carcinoma]. The aim of our investigations is a control of the immunocompetence of the host of the tumour during the course of the tumour disease with the help of the spontaneous rosette test (proof of the T-lymphocytes). The results hitherto got are traced back to 21 patients with adenoma of the prostate and 9 patients with carcinoma of the prostate compared with healthy persons. The methods of the test is explained. Issuing from the formation of spontaneous rosettes which is anyway decreased in patients older than 60 years up to now no clear difference could be found between patients with adenoma and carcinoma. The decrease of the formation of spontaneous rosettes is unequivocal after operation as well as in the cytonal therapy.


[Ca of the head of the pancreas and the ampulla of Vater (150 cases) (author's transl)]. From 1968 till 1977 we observed 150 patients with carcinoma of the head of the pancreas and the ampulla of Vater. In 29% a radical operation (duodeno-pancreatectomy) could be practiced. The prognosis of carcinoma of the head of the pancreas is much less favourable in comparison to the carcinoma of the ampulla of Vater.


[Effects of serums and plasmas of various species on a protease of Staphylococcus aureus. Human alpha2-macroglobulin as an inhibitor (author's transl)]. Serums and plasmas from various animals and man inhibited 85-100% of the activity of a purified protease from Staphylococcus aureus, strain M 135 (table 1). The inhibitory effects of corresponding serums and plasmas were approximately equal. The inhibition in human serum was caused by alpha2-macroglobulin. On the other hand, alpha1-antitrypsin proved to be ineffective (table 2). The complex alpha2-macroglobulin-protease could be separated by vertical polyacrylamide discelectrophoresis. Immunelectrophoretic analysis revealed no changes by the staphylococcal protease neither on alpha2-macroglobulin, nor on other human serum proteins. Only fibrinogen was split into at least 2 components (fig. 1).


Behaviour of S. paratyphi A in mice immunized with homologous and heterologous bacterial proteins. Mice immunized with proteins from S. typhimurium and from S. paratyphi C resisted the toxicity of a concentration of S. paratyphi A which killed the controls; this is in contrast to the results found in mice immunized with the same amount of proteins from the homologous S. paratyphi A. For the neutralization of the S. paratyphi A toxicity a higher quantity of homologous proteins was necessary in the immunizations. It is assumed that either S. paratyphi A synthesizes--on artificial media--a small amount of proteins responsible for the induction of neutralizing antibodies or that it is an intrinsic weak immunogen. In the sera of mice in which sufficient neutralizing antibodies were induced, the proteins of S. paratyphi A cross-reacted in agar-gel, with the proteins from S. typhimurium and from S. paratyphi C.


The immunoglobulins response in rabbit to single antigenic factors of leptospira. Investigations with two serovars from saprophytic leptospira. The agglutinating antibodies formed after immunization of rabbits with viable leptospira consist of 19S and 7S immunoglobulins. IgM and IgG are formed already earlier in the course of immunization. after a lapse of one month more IgG is found than IgM. The specificity of agglutination with the main antigenic factors is due mainly to IgG.


A comparative study of antigens of Aspergillus fumigatus isolates from patients and soil of ornamental plants in the immunodiffusion test. The strikingly frequent and constant presence of Aspergillus fimigatus in the soil of potted ornamental plants kept in private houses and hospitals has been the reason for studying the antigens of the strains found from the diagnostic and epidemiological angles. Culture-filtrate antigens of A. fumigatus strains isolated from the soil of 4 different ornamental plants, epiphyllum (Epiphyllum truncatum), orange tree (Citrus sinensis), Alpine rose (Azalea indica) and Christmas flower (Euphorbia pulcherrima), were compared, in the immunodiffusion test, with antigens of A. fumigatus strains from aspergillosis patients prepared in an identical way. When tested against 8 different sera from different aspergillosis patients there was a good coincidence of results. Control sera from patients suffering from diseases other than aspergillosis, no false-positive reactions could be observed. The findings are discussed in respect of diagnosis and epidemiology.


Inhibition of leptospiral agglutination by the nondialyzable delipidized serovar-specific main antigens of leptospiras. Microscopic agglutination of leptospiras was inhibited by the homologous nondialyzable delipidized serovar-specific main (NDTM) antigens of leptospiras. The agglutination was not inhibited by the heterologous NDTM antigens. The results may indicate that the substance participating in the microscopic agglutination of leptospiras with antiserum is the NDTM antigens.


[Surgical treatment of tumors in the tentorial region]. On the basis of findings and results obtained in the treatment of 509 patients affected with tumours growing into the tentorial slit (Burdenko Institute, Moscow) the considerably improved surgical possibilities are discussed. Only 17 patients had to be excluded from the operation because of their bad general condition. Ways of access are: supratentorially with transecting of the tentorium, infratentorially with exposure of the tentorium, and the combined infra- and supratentorial method with separation of the tentorium. Subdivision of the access paths according to location and kind of the tumours. Total removal of the tumour in 43.3 per cent, partial removal of the tumour in 41 per cent, palliative intervention in 15.7 per cent of the cases. Relapse operations in 26.2 per cent (mainly trigeminal neurinomas, tentorial meningiomas, cerebellopontine angle meningiomas and cerebellar astrocytomas). After-observation for a period of up to 12 years. The longest survivae times were found for tumours with an anterior-laterial position in the tentorial slit.


Fluorescence microscopical visualization of rat mast cells by means of fluoresceine isothiocyanate labeled protamine sulfate. Using fluoresceine isothiocyanate labeled protamine sulfate it is possible to stain rat mast cell fractions of isolated periotoneal cells in a selective way. The cells are not degranulated, though they have lost their histamine completely. The method shows the dissociation of the mediator release and the extrusion of the granules.


Purification of the pregnancy zone protein by affinity chromatography. A method for purification of the pregnancy zone protein (PZP) by affinity chromatography was developed. A monospecific immunoglobulin fraction, covalently coupled to Sepharose 4B, was used as binding agent and the elution conditions for PZP are described. The purified protein was shown to have identical properties compared to native PZP with regard to molecular weight, immunodiffusion precipitation and immunosuppressive activity.


Histochemical investigation of acid mucopolysaccharides in amyloid, colloid and hyaline. The carbohydrate component in amyloid was histochemically compared with that in colloid or hyaline. Alcian blue, azure A, and periodic acid Schiff were used to stain mucopolysaccharides. In a further attempt to identify various polyanions, staining was carried out with alcian blue containing various concentrations of electrolytes. Methylation, saponification, acid hydrolysis, and digestion with streptomyces or testicular hyaluronidase, or chondroitinase ABC were also employed. The results obtained suggest that the presence of heparitin sulfate in amyloid, of chondroitin sulfate A in hyaline, and of chondroitin sulfate C in colloid.


Acetylcholinesterase resynthesis after DFP poisoning; histochemical and biochemical study. DFP (0.4 to 2.0 mg/kg) was injected into the rat spinal ganglion leads to N. ischiadicus model system and examinations were made of the AChE inhibitory affect and the influence on the transport and resynthesis of the enzyme. It was concluded that the intraganglionically administered DFP inhibits the enzyme activity of the pseudo-unipolar large ganglion cells, but the specific ChE remains in some of the small neurones. Autoradiographically, 3H-DFP could be demonstrated at the same morphological sites as the AChE histochemically. The labelled material migrates from the perikaryon towards the axon terminal by slow transport (10 mm/24 h). The intraganglionically administered DFP inhibits (96%) the AChE activity of the spinal ganglion. However, the enzyme activity of the ganglion cells begins to return 3 h later, and in 12 h it has attained 27% of the original activity. The enzyme undergoing transport from the perikaryon displays a proximo-distal gradient in the axon, and hence the results do not support the hypothesis of local axonal synthesis of AChE.


Cell yield obtained with various cytopreparatory techniques for urinary cytology. Information concerning the main pitfalls of cytopreparatory techniques, e.g., cell loss, is of paramount importance for general acceptance of the routine use of urinary cytology. Therefore, we studied the cell yield obtained with five Papanicolaou and two May-Grünwald-Giemsa (MGG) smear techniques commonly used in diagnostic cytology laboratories, and compared the results with those obtained with the Millipore filter technique. All smear methods using wet fixation gave very low cell harvests (2-26%), and all methods using air drying gave high cell yield (55-95%), the spray fixation method giving intermediate results (about 40%). Since the morphometric studies showed that there was no preferential cell loss, the cells remaining on the slides can be considered representative of the original cell population. However, if the cell concentration of the urinary sample is extremely low, the Millipore filter and the albumin MGG methods, in both of which cell loss is minimal, are recommended. The results obtained with the spray fixation Papanicolaou method are quantitatively acceptable and qualitatively excellent.


The use of fluorescent and special staining techniques in the aspiration of nocardiosis and actinomycosis. This report outlines the techniques and illustrates the utility of special stains and fluorescent microscopy when applied to aspiration cytology material. This procedure allowed quick and accurate diagnosis of opportunistic infectious organisms, specifically nocardiosis and actinomycosis.


Histochemical fibre types in human extraocular muscles, an investigation of inferior oblique muscle. In order to test histochemical fibre types in human extraocular muscles, 2000 fibres from 5 inferior oblique muscles were examined in serial sections for myosin ATP-ase following preincubation at pH 4.3, menadione-linked alpha-GPD and NADHTR activity. In ATP-ase 4.3, +/- 15% of fibres in central and peripheral areas stained dark, the other fibres were slightly stained or unstained. Nearly all fibres with high activity in ATP-ase 4.3 had type I-like histochemical characteristics with high or very high NADHTR activity and low alpha-GPD activity. Fibres with low activity in ATP-ase 4.3 had a spectrum-wide variation in activity of NADHTR and alpha-GPD and could be divided into 3 subtypes with IIA, IIB and IIC-like characteristics. The histochemical profile of the fibres with type IIC-like characteristics differed from that of type IIC fibres in other skeletal muscles, by a lower ATP-ase 4.3 activity. In the central areas all 3 subtypes were more or less equally represented. In the peripheral areas most fibres with low ATP-ase 4.3 activity belonged to the IIC-like subgroup.


Keratinization of the bulbar conjunctival epithelium in superior limbic keratoconjunctivitis in humans. An electron microscopic study. A prominent histological feature of superior limbic keratoconjunctivitis is the presence of keratinization of the superior bulbar conjunctiva. Ultrastructurally the affected conjunctival epithelium shows all of the characteristics of keratinization as described in skin. There is a superficial layer of horny cells with reduced organelles and thickened cell membrane. In the intermediate layers, the cells contain an increased number of cytoplasmic filaments which are sometimes aggregated into dense masses, keratohyalin granules, both in the cytoplasm and in the nucleus, membrane coating granules, lysosomes and various other types of membranous structures.


[Latent iron-binding capacity of normal serum proteins by means of Fe-59]. Experimental investigations were carried out for confirming the possibility of saturation of the basic serum components with exogenous iron (not only transferin). In gel chromatography, paper electrophoresis and acetate cellulose electrophoresis it was demonstrated that the latent capacity for iron saturation is a feature of not only transferrin belonging to beta1 globulins, but also to some extent of albumins and alpha-globulins. Iron distribution was studied after 59Fe administration. The iron-binding capacity of alpha-globulins was many times higher than that of albumins.


Atypical hyperplasia of the prostate. A pitfall in the cytologic diagnosis of carcinoma. The cytomorphologic features of atypical hyperplasia were studied in fine-needle aspiration biopsies of the prostate. Atypical hyperplasia material was found in 31 cases. The most usual and distinctive cytologic features of atypical hyperplasia were clustering of poorly-differentiated epithelial cells with acinic pattern and fairly regular nuclei. Another relevant feature was the lack of cytoplasmic fluorescence after acridine orange staining. These features make possible the diagnosis of atypical hyperplasia and the distinction from poorly-differentiated carcinoma. The recognition of atypical hyperplasia cells in fine-needle aspiration biopsies of the prostate is important in the avoidance of cytodiagnostic errors.


Bronchial artery infusion of mitomycin-C in advanced bronchogenic carcinoma. Bronchial angiography was performed in 17 patients with advanced non-oat cell bronchogenic carcinoma. The patients were treated 1 to 5 times with infusions of 10 mg of mitomycin-C (MMC) into the tumor-feeding bronchial artery. All but 2 patients received in addition small doses of vincristine (intravenously) and bleomycin (intramuscularly) or only bleomycin to potentiate the effect of MMC. No major side effects occurred and the systemic toxicity was insignificant. An objective tumor reponse was encountered in 11/17 patients. Intraarterial chemotherapy is strictly local and therefore effective especially in patients with limited or locally advanced disease. In patients with more extensive disease an adjunctive therapy of a more regional or systemic modality must be given.


The course of endocrine ophthalmopathy during antithyroid therapy in a prospective study. In a prospective study the ocular manifestations of 105 thyrotoxic patients were carefully observed and registered during a 24-month antithyroid drug therapy. The treatment was supervised very closely and every effort was made to avoid iatrogenic hypothyroidism. None of the patients required any ocular surgery and in none did the ophthalmopathy become significantly worse. This favourable experience may indicate that a careful antithyroid regimen as outlined is not likely to be accompanied by worsening of the endocrine ophthalmopathy.


Surface coats on human lymphocytes: freeze-drying and staining with cations. Surface coats can be demonstrated on human peripheral blood lymphocytes by staining with ruthenium red, alcian blue, Thorotrast, and cationized ferritin, which are similar in distribution to a 40- to 65-nm layer of amorphous extracellular material recently reported on fixed, freeze-dried lymphocytes. Several additional lines of evidence, including X-ray microanalysis, suggest that the latter is not a contaminant added by freeze-drying. Freeze-drying may provide the means for a morphological assessment of the lymphocyte surface, including the extracellular coat, which may give additional insight into the immune response.


Feline GM1 gangliosidosis: characterization of the residual liver acid beta-galactosidase. The residual liver acid beta-galactosidase (beta-gal) activity from a case of feline GM1 gangliosidosis was partially purified and characterized with respect to its pH optimum, kinetic properties, thermostability, isoelectric point, molecular weight, and antigenicity. In comparison to the normal enzyme, the mutant enzyme had the same pH optima for the three substrates tested, a reduced Km for 4-methylumbelliferyl-beta-gal, elevated Km's for GM1 and asialofetuin (ASF), and increased thermolability. In addition, the mutant beta-gal had a higher isoelectric point, a reduced molecular weight, and appeared to be antigenically different from normal. The results suggest that the mutation in the Birmingham GM1 cat is structural and that the residual enzyme activity is a structurally altered acid beta-gal. The apparent lack of antigenic identity between the mutant and normal enzymes, in contrast to the situation in many human GM1 patients, is most unusual.


The autonomic margins of safety of metocurine and d-tubocurarine in the cat. The potencies of metocurine and d-tubocurarine for neuromuscular and autonomic blockade and histamine release were determined in cats anesthetized with chloralose and pentobarbital. The autonomic margins of safety of these drugs were determined by measuring the ratios of ED50 for sympathetic block to ED95 for neuromuscular block; ED50 for vagal block to ED95 for neuromuscular block; ED50 for histamine release to ED95 for neuromuscular block. Metocurine is 14 times more potent than d-tubocurarine as a neuromuscular blocking agent in the cat, but its autonomic blocking action is three times weaker than the of d-tubocurarine and its histamine-releasing action is less than half that of d-tubocurarine. The combination of higher neuromuscular blocking potency and weaker autonomic effect gives metocurine a much higher autonomic margin of safety than d-tubocurarine in the cat.


[Enzymo-immunological estimations. Principles and applications (author's transl)]. Diagrams of the reactions of enzymo-immunological estimations are similar to those of radio-immunoassay. The only difference is that an enzymatic label is substituted on the antigen or the antibody for the isotopic label and that consequently a measurement of enzyme activity replaces isotopic counting. One must therefore add a further stage of substrate addition and a stage of enzyme reaction. There is however a technic which has no equivalent in radio-immunoassay, the EMIT system, where one measures the change in activity of a haptenised enzyme under the influence of the corresponding anti-haptene antibody. The author reviews the main problems raised by the first group of technics and gives a few examples of the results of estimation of alpha-foeto-protein obtained with 3 different reactions with fairly similar performances. The advantages and disadvantages of enzymo-immunologic technics are reviewed. The two major advantages seem to be the stability of the reagents and the fact that they avoid the administrative controls which restrict the use of isotopes.


[Immuno-enzymatic estimation of steroids (author's transl)]. The authors present a reliable and sensitive estimation of progesterone using a conjugate progesterone IIalpha-hémimaleate-beta galactosidase to identify the immunological reaction, the antibodies being obtained from the rabbit by means of a progesterone 11alpha-hemisuccinate bovine serum albumin. The free and bound fractions are separated by addition of rabbit antigamma globulin antibodies bound on glass beads by glutaraldehyde. This method is applied to estimations of cortisol and oestrone.


A comparative study of Kystosol and glycine as irrigating solutions during transurethral prostatic resection. The author has compared Kystosol and glycine as irrigating solutions during transurethral prostatic resection. Astrum analyses during the operations revealed the development of acidosis in half of the patients in the Kystosol group, whereas in the glycine group, only 4 out of 27 developed a slight decline of base excess. Development of acidosis was directly proportional to the volume of irrigation fluid used and the duration of the operation.


[Rapid detection of viruses by electron microscopy. Interest of negative staining for the diagnosis of some skin lesions of viral origin (author's transl)]. Viral particles can be visualized by electron microscopy using negative staining. Such an approach, widely used in research, provides a method for detecting virions which are present in clinical specimens. It is considered to be the method of choice in cases with suspicion of smallpox. Direct visualization has been systematically applied for the diagnosis of viral diseases in dermatology. Negative staining by pseudoreplication appears to be simple, rapid and efficient. It was thus possible to detect viruses in vesicle fluids, in scrapings and in crusts. During the course of this study 66 cases have been analyzed and viruses have been demonstrated in 49. If a skin lesion seems to be of viral origin, direct examination may confirm the clinical impression.


Experimental allergic encephalomyelitis in cobra venom factor-treated and C4-deficient guinea pigs. Experimental allergic encephalomyelitis (EAE) was studied in guinea pigs with an inherited deficiency of the fourth component of complement (C4) and in guinea pigs injected with cobra venom factor to deplete the third component and late-acting components of complement. EAE was elicited by immunization with homologous spinal cord or purified basic protein. Administration of cobra factor after the injection of encephalitogenic emulsion delayed the onset and reduced the intensity of the clinical manifestations of EAE. In addition, cobra factor markedly reduced mortality during the sixty days of observation. However, pathological changes of perivascular infiltration and demyelination were similar in cobra factor-treated and untreated animals. Clinical signs of EAE an mortality in C4-deficient guinea pigs were no different from those in normocomplementemic controls. Thus, although activation of the classic complement pathway does not appear to be involved in the production of EAE in guinea pigs, our results suggest a possible role of the alternative complement pathway in the pathogenesis of EAE.


Liver tumors and oral contraceptives: pathology and pathogenesis. Since 1973, over 200 cases of liver masses associated with oral contraceptive usage have been reported. Nearly 100 have been liver cell adenomas and 11 have been hepatocellular carcinomas. Focal nodular hyperplasia (FNH) appears only coincidentally associated, but with a particular hemorrhagic tendency. Bile duct proliferation distinguishes FNH from liver cell adenoma. Two typical cases are presented. Right upper quadrant pain with intra-abdominal hemorrhage is the single most common clinical presentation. Mestranol-containing preparations appear more hazardous. Liver enzymes are usually normal or slightly elevated. Most cases are resectable. Lesions have regressed following discontinuation of pill use; however, close observation is required. Although mammalian liver possesses estrogen receptors, these agents have induced few or no liver tumors in numerous animal studies. Mutagenicity tests indicate that estrogenic compounds do not damage DNA. However, diethylstilbestrol can promote the growth of rat hepatomas initiated by a carcinogen. Further experimental studies may better characterize estrogens as hepatoma promoters.