[Development of liver glycogen reserves in rats subjected to chronic alcoholic intoxication]. Literature offers many but very different informations about the effects of alcohol on the hepatic carbohydrates metabolism. Therefore we have tried to observe, in process of time, the evolution of the hepatic glycogen reserves on rats intoxicated by ethanol 40% during variable durations. Stuffing is made by oesophageal way at the rate of 6,4 g/kg/day. During this period of poisoning, we note a significant increasing of the hepatic glycogen reserves.


[Structure of scorpion hemocyanin: heterogeneity of its sub-units]. Six dissociation products isolated from the Androctonus australis scorpion haemocyanin are studied through analytical ultracentrifugation and acrylamide-SDS electrophoresis: the results show that one of these fractions exists as a dimer and that the five others are monomers. A genetical study shows that two subunits at least can undergo mutations.


[The cell wall fractions of Brucella are specific mitogens. Implications in the genesis of the primary immune response]. Phenol-water extracts from smooth B. melitensis or B. abortus induce specific proliferation of lymphocytes from Brucella-sensitized men or animals. These extracts have no effect on lymphocytes of uninfected subjects. Above findings imply that an antigen will not trigger the so-called primary response when administered to a immune virgin animal.


[Changes, induced by certain flavonoids, of the hypotensive effects of arachidonic acid]. In the rat, silybine and Z 12007, a derivative of rutoside, increase the vasodepressive activities of arachidonic acid, a prostaglandin precursor. They reduce the activity of PGE2. Quercetine also increases the hypotensive action of arachidonic acid. These three flavonoids are supposed to increase the prostaglandin biosynthesis.


[Exchange of adenylic nucleotides and bacterial growth]. Adenylic nucleotides pool reaches optimum with biomass. The ATP quantity decreases after exponential growth. AMP increases when ATP decreases. Energetic load is optimum two hours before optimum growth. E. coli prevent the growth of Pseudomonas. AMP is discharged in the medium at the beginning of growth of E. coli and every time by Pseudomonas.


[Influence of low energy alimentation and nitrogen on free amino acids in the blood of dairy cows at the beginning of lactation]. Dairy cows are fed low energy and adequate nitrogen (T), or low energy and low nitrogen (C) diets. Blood free aminoacids, urea and glucose are estimated. The relations between gluconeogenesis, protein catabolism, liveweight and milk production are discusssed.


[Rest and active potentials of dissociated rat heart cells in culture]. Intracellular investigation of bioelectrical properties is performed on cultivated rat myocardial cells. Electrophysiological parameters of cells dissociated from rat myocardium are very similar to those of in vivo cells. Fast sodium channels are found to be fonctional. Spontaneous arrhythmia are recorded from some impaled cells.


[Cytotoxic effect of peritoneal macrophages on an intestinal carcinoma in rats. Demonstration of a new cytotoxicity test]. Macrophages were isolated from the peritoneal cavity of rats treated by BCG. These macrophages were found to be cytotoxic for syngeneic intestinal cancer cells cultivated in vitro. Cytotoxicity was demonstrated by a new quantitative assay using acidic elution of methylene blue staining the residual cells.


[Effects of methy-2[(chloro-4'-benzoyl)-4-phenoxy]-2 propionic acid on the respiratory activity of isolated rat liver mitochondria]. The effects of methyl-2 [(chloro-4' benzoyl)-4 phenoxy]-2 propionic acid (LF 153) on mitochondrial respiration and oxidative phosphorylation are studied in vitro. Its activity is related to that of 3,5,3'-triiodo-L-thyronine (LT3), 3,5,3'-triiodothyroacetic acid (TA3), and to that of clofibrate, LF 153 acts as an inhibitory uncoupler of oxidative phosphorylation. Its uncoupling action is however very intense.


The comparative effects of dichloromethylene diphosphonate (C12MDP) and ethane-1-hydroxy-1,1-diphosphonate (EHDP) on growth and modeling of the rat tibia. Male rats weighing 100 g were assigned to groups and injected daily for 10 days with vehicle (control), 0.4, 2.0, 4.0, 10.0, or 20.0 mg/kg/day of ethane-1-hydroxy-1,1-diphosphonate (EHDP) or dichloromethylene diphosphonate (C12MDP). The proximal tibial metaphysis and epiphysis were assayed for changes in percentage of hard tissue and bone formation parameters. From the data, information about hard tissue resorption was deduced. All doses of C12MDP and doses of 2.0 mg EHDP/kg/day and greater caused significant increases in percentage of hard tissues with C12MDP being more effective than similar doses of EHDP in decreasing bone resorption. Osteoclast population parameters were increased with all doses of both C12MDP and EHDP with C12MDP having a greater effect than similar doses of EHDP. Decreases in the proliferation of the osteoprogenitor pool parallel the decreases in osteoblasts and bone formation parameters. These decreases in osteoprogenitor pool proliferation do not account for the increases with diphosphonates in osteoclast population parameters.


Effect of p-chlorophenylalanine on development of cross-tolerance between pentobarbital and ethanol. Rats developed cross-tolerance to the motor-impairing effects of ethanol after daily oral administration of pentobarbital. Chronic administration of p-chlorophenylalanine (p-CPA), in a dosage regimen previously demonstrated to maintain extensive brain serotonin (5-HT) depletion, slowed down cross-tolerance development. p-CPA did not appear to exert this effect by altering the disposition of ethanol, since blood ethanol levels measured 20 min after ethanol administration were not affected by p-CPA treatment. This study extends our previous findings with respect to the inhibitory effects of p-CPA on tolerance development to ethanol and pentobarbital, and suggests that 5-HT may play a role in cross-tolerance development between ethanol and pentobarbital.


Stimulation of cerebral cortical synaptosomal Na-K-ATPase by biogenic amines. The amines noradrenaline, dopamine, 5-hydroxytryptamine, and histamine (0.01-0.5 mM) enhanced the activity of Na-K-ATPase (EC 3.6.1.3) in rat cerebral cortical synaptosomal fractions. The activities of Mg-ATPase and Ca-Mg-ATPase were not significantly affected. No stimulation of Na-K-ATPase occurred in the presence of chelating agents (0.5 mM EGTA or EDTA) unless 0.5 mM calcium had also been added to the incubation medium. These results are consistent with the hypothesis that amines depress cerebral cortical neurones by activation of an electrogenic sodium pump. Calcium ions appear to be involved in this process.


Phosphofrucktokinase and glucose catabolism of Mucor and Penicillium species. The primary catabolic pathways in the fungi Penicillium notatum and P. duponti, and Mucor rouxii and M. miehei were examined by measuring the relative rate of 14CO2 production from different carbon atoms of specifically labelled glucose. It was found that these organisms dissimilate glucose predominantly via the Embden--Meyerhof pathway in conjunction with the tricarboxylic acid cycle and to a lesser extent by the pentose phosphate pathway. Phosphofructokinase (EC 2.7.1.11) activity could not be detected initially in Penicillium species because of the interference from mannitol-1-phosphate dehydrogenase (EC 1.1.1.17) and NADH oxidase (EC 1.6.99.3). A combination of differential centrifuging and a heat treatment of Penicillium cell-free extracts in the presence of fructose-6-phosphate removed the interfering enzymes. The kinetic characteristics of phosphofructokinase from P. notatum and M. rouxii are described. The enzyme presents highly cooperative kinetics for fructose-6-phosphate. The kinetics for ATP show no cooperativity and inhibition by excess ATP is observed. The addition of AMP activated the P. notatum enzyme, relieving ATP inhibition; slight inhibition by AMP was observed with the M. rouxii enzyme. In contrast M. rouxii pyruvate kinase (EC 2.7.1.40) is activated 50-fold by fructose-1,6-diphosphate whereas pyruvate kinase from P. notatum and P. duponti were unaffected by fructose-1,6-diphosphate.


Physical management of muscular low back pain in the athlete. The Canadian medical staff at the 1976 Olympic Games found that muscular low back pain was a common problem among the athletes. The problem had usually developed during training as a result of neglect of certain anatomic areas, particularly the abdominal region. A five-point treatment and prevention program was used with good results. It included (a) relief of spasm and pain, (b) stretching, (c) exercise, (d) alteration of the training program and (e) education to prevent future problems or worsening of the present problem.


Factors related to survival following resection for gastric carcinoma: analysis of 903 cases. This report is based on 903 patients with resections for gastric carcinoma between October 1957, and July 1969, entered in controlled trials of adjuvant therapy with Thio-TEPA and FUDR. Neither Thio-TEPA nor FUDR, as administered, prolonged survival. The extent of disease at the time of curative surgery is related to survival for the first 36 months postoperatively. Involvement of lymph nodes, resection of the esophagus, and serosal penetration are predictive of recurrence up to 36 months. There appear to be three groups of patients: 1) Cured (26%); 2) Slowly growing tumor--23% (median survival, 25 months); and 3) Rapidly growing tumor--51% (median survival, eight months). The absence of blood-vessel invasion, lymphatic invasion, lymph-node involvement, and serosal penetration characterize those patients in Group A.


The role of nicotinamide and of certain other modifying factors in diethylnitrosamine carcinogenesis: fusaria mycotoxins and "spontaneous" tumors in animals and man. Pretreatment of rats with large doses of nicotinamide, which has been shown to increase the incidence of pancreatic islet-cell tumors after streptozotocin and after heliotrine, appears to promote the development of kidney neoplasias in rats given several doses of diethylnitrosamine. Nicotinamide, one of the B vitamins, and a constituent of NAD coenzymes, will prevent the depletion of NAD coenzymes by alkylating agents. It may protect the animal to some extent from the acute effects of hepatocarcinogens but not from the induction of tumors, although it may change the localization of the latter. The possible mechanisms involved in the action of nicotinamide and of certain other modifying agents are discussed. Attention is drawn to the possibility that pituitary, mammary and certain other tumors that sometimes occur among the controls, as well as among experimental animals, may be due to the occasional presence in laboratory animal diets of estrogenic and/or toxic secondary metabolites of the field fungi, Fusaria. Mycotoxins, such as zearalenone and the trichothecenes, are also likely to contaminate human foods; this could explain why multiple tumors in man occur mainly in the sex organs and in the digestive tract.


In vitro inhibition of human leukemic cells (CCRF-CEM) by agarose-immobilized neocarzinostatin. Neocarzinostatin (NCS) is an acidic protein (molecular weight, 10,700) isolated from Streptomyces carzinostaticus that has antitumor activity both in model rodent systems and in humans. In vitro it inhibits the growth of a human lymphoblastic leukemic cell line (CCRF-CEM) at a very low concentration (the amount of drug that causes a 50% inhibition of growth compared to control cultures as extrapolated from a dose-response curve (ID50), 2.4 X 10(-9) M). We covalently coupled NCS to the N-hydroxysuccinimide ester of agarose and obtained a product that, by a variety of biochemical and immunological criteria, has been demonstrated to be devoid of any free or loosely bound NCS. Agarose-bound NCS, which is unable to enter cells because of its size, retains a significant amount of inhibitory activity (ID50, 6 to 15 X 10(-9) M) and is also capable of inhibiting tritiated deoxythymidine incorporation into CCRF-CEM cells. Since agarose-bound NCS cannot enter mammalian cells, the above findings indicate that NCS is able to exert its toxic effects by binding to or reacting with receptors on the cell membrane.


Intralesional Bacillus Calmette-Guérin immunotherapy of canine venereal tumors. Canine transmissible venereal tumors were studied for response to intralesional Bacillus Calmette-Guérin (BCG) therapy. Six pairs of littermates, identical for the major histocompatibility complex, were evaluated. One member of each pair received intralesional BCG to one of two growing tumors. Lesions of control animals received 0.9% NaCl solution. Both injected and noninjected lesions of BCG-treated animals underwent regression within 63 days, as compared to an extended period of tumor growth (beyond 100 days) for controls (p less than 0.05). Serial in vitro assays during therapy included; (a) mixed lymphocyte-tumor culture, (b) phytohemagglutinin stimulation, and (c) assessment of lymphocyte surface markers. Lymphocytes from BCG-treated dogs were significantly more responsive to tumor cells in mixed lymphocyte-tumor culture assay than were those from controls (p less than 0.05). Maximal responses occurred during tumor regression. T- and B-lymphocyte levels as assayed by rosette formation and surface marker immunoglobulins were not influenced by BCG therapy. It was concluded that intralesional BCG therapy of canine venereal tumors was highly effective in  causing regression of injected and noninjected lesions. This tumor model system may be useful for the evaluation of the effectiveness of new immunotherapeutic approaches on established neoplasms in large, randomly bred animals.


Peritoneoscopy: a technique to evaluate therapeutic efficacy in non-Hodgkin's lymphoma patients. Peritoneoscopy was performed in 22 patients with non-Hodgkin's lymphoma as a re-staging technique to rule out relapse or persistence of active disease after intensive chemotherapy and/or radiotherapy. Fifteen patients with previous hepatic involvement achieved a complete clinical remission; however, five patients (33%) had persistent disease proved by biopsy at peritoneoscopy. In seven patients suspected to have a clinical relapse, peritoneoscopy biopsies documented relapse in three patients (43%), including two patients with negative percutaneous liver biopsies. Because of its low morbidity rate (4%), peritoneoscopy can be utilized to re-stage hepatic involvement by non-Hodgkin's lymphoma patients more accurately than percutaneous liver biopsies and with less morbidity than laparotomy.


Some observations on the diurnal variation of mitosis in the stratified squamous epithelium of wounded tympanic membrane. A study of mitosis in the stratified squamous epithelium of the tympanic membrane of the guinea-pig was made after wounding this organ at 09.00 h in one series of animals and at 21.00 h in a second series. It was found that the diurnal variation of mitosis was abolished by the injury. This finding corresponds with a basic requirement of the chalone-adrenaline hypothesis which is considered to be a factor in the mitotic control of epidermal cells. It was also found that the maximum number of dividing cells was at the wound edge in the group wounded at 09.00 h, which also agrees with the chalone concept. In the group wounded at 21.00 h, however, the initial mitotic response was in cells distally placed from the wound edge which is more difficult to explain. Perhaps these cells are inhibited mitotically by the factors normaly producing a low nocturnal mitotic rate and undergo migration to cover the defect in the first instance, and only divide at a later time when the mitotic inhibition is lifted. It appears that the factors responsible for the increased mitotic rate after wounding are different from those responsible for the diurnal variation.


Actin-activated adenosine triphosphatase activity of native and N-ethylmaleimide-modified cardiac myosin from normal and thyrotoxic rabbits. The Ca2+-ATPase activity of cardiac myosin is increased in thyrotoxic animals. However, the physiological significance of this observation is uncertain since, in living muscle, Mg-ATP is hydrolyzed by myosin under the stimulating influence of actin. In this study, we have compared the actin-activated ATPase activity of myosin from euthyroid (myosin-N) and thyrotoxic (myosin-T) rabbits and the derivatives of myosin-N and myosin-T formed by blocking the most rapidly reacting class of thiols (SH1) with N-ethylmaleimide (NEM). Also, we have studied the activity of these myosins in the presence of a complex of troponin and tropomyosin that confers calcium sensitivity on the system. Vmax for the actin-activated ATPase of myosin-T was about 168% greater than for myosin N. The apparent dissociation constant for actin, Kapp, for myosin-T was about 42% of the normal value. After NEM modification, Vmax and Kapp for NEM-modified myosin-T and myosin-N decreased, becoming essentially the same for both myosins. In the presence of troponin-tropomyosin complex, the actin-activated ATPase of myosin-T exhibited calcium sensitivity that could be reduced by thiol modification. These results suggest that the SH1 thiols or the region near these groups are important to the actin-activated ATPase of myosin-N and are essential to the increased activity of myosin-T. Also, they suggest that the changes in the enzymatic properties of myosin induced by thyroxine may be responsible for altering the contractile properties of the heart.


The pathology of wear in the Beall model 104 heart valve prosthesis. We examined 13 Beall model 104 prostheses recovered at surgery or autopsy 10 to 84 1/2 months after insertion and observed the pattern of prosthesis wear. We defined wear as  "mild" when the disc was notched but neither the metal of the struts was exposed not the cloth seat torn. In "moderate" wear the disc was notched, the Teflon coating of the struts was worn away exposing the underlying metal but the cloth of the set was not torn. The cloth seat was torn in "severe" wear, exposing the metal seat and causing a different pattern of disc erosion. In one case this allowed the disc to tilt into the valve lumen and, later, to escape from its cage. Most of the prostheses studied showed "moderate" or "severe" wear. We believe that some degree of wear is inevitable. Clinical signs and symptoms were not specific but a rough correlation existed between the severity of hemolysis, as indicated by serum LDH levels, and the degree of prosthesis wear. When wear was "severe", the results of cardiac catheterization studies usually mirrored the change, but there were a few exceptions. All patients with the Beall model 104 prosthesis may eventually develop "severe" wear, and we recommend regular reassessment with a view toward prosthesis replacement.


Right and left heart size and function in infants with symptomatic coarctation. Right and left heart volumes, ejection fractions and ventricular outputs were determined from biplane cineangiocardiograms in infants with symptomatic coarctation of the aorta and correlated with clinical and hemodynamic alterations. Patients were divided into two age groups: group 1, aged 3.5 to 14 days and group 2, 5 weeks to 7 1/2 months. Infants in group 1 had severe depressions of left ventricular ejection fraction and output associated with normal left ventricular size. The massive cardiomegaly in these infants results from right heart enlargement secondary to left-to-right atrial shunting, and pulmonary hypertensive right heart failure, and possibly a more distensible right than left ventricle. Infants in group 2 also have right, and to a lesser degree, left heart enlargement. Group 2 patients differ from group 1 infants in having less impairment of left heart pump function and significant left ventricular myocardial hypertrophy. Echocardiographic measurements of left ventricular pump function are normal or increased in postoperative patients. Thus alterations of left ventricular function in infants with symptomatic coarctation appear to be largely afterload related and do not indicate permanent impairment of left ventricular contractile function.


Education of lymphocytes in vivo following a transient take of a matched unrelated bone-marrow graft in man. A patient suffering from aplastic anaemia was treated by bone-marrow transplantation from an ABO- and HLA-identical, MLC- and CML-negative, unrelated donor. MLC and CML became positive after transplantation indicating that a cellular immune response had developed against lymphocyte determinants not recognized prior to sensitization in vivo. Whether these determinants are governed by genes of the HLA region is unknown at present.


The effects of menadione, ethyl biscoumacetate, and sodium salicylate on the metabolism of mucopolysaccharides in the aortic wall and liver of rats. In rats with hyper- and hypovitaminosis the contents were determined of acid mucopolysaccharides (MPS) on the basis of contents of hexuronic acids; the total contents of biopolymers containing hexosamines (acid MPS, glycoproteins), on the basis of contents of hexosamines in the aortic wall and in the liver; and the activity of glutamine-fructose-6-phosphate aminotransferase (GPAT; EC 2.6.1.16) in the liver. Menadione-induced K hypervitaminosis was accompanied by moderate elevations of indicators of MPS metabolism. Protracted administration of ethyl biscoumacetate or sodium salicylate lowered the contents of acid MPS and of biopolymers containing hexosamines in the aortic wall and in the liver. Simultaneously, the GPAT activity in the liver markedly decreased.


[Traumatic abdominal-wall hernia in childhood]. In recent years an increased occurrence of posttraumatic abdominal-wall hernias, i. e., subcutaneous abdominal ruptures, has been observed in children. The causal trauma is a fall on a scooter or bicycle handlebar. The predilectional place of injury lies near the linea alba or lateral of the rectus sheath. After several days of observation in order to exclude the possibility of an additional intra-abdominal injury, the hernial gap is operatively closed. An important safety measure would be remodelling bicycle bars.


Anterior sacral meningocele: report of five cases and review of the literature. Five new cases of anterior sacral meningocele are presented, including one secondary to neurofibromatosis, a previously undescribed association. The literature is reviewed, drawing attention to the relationship between anterior sacral meningocele, sacral dysgenesis, and other congenital anomalies. Special consideration is given to the clinical features of this entity, as well as to the techniques and results of surgical management.


Neonatal polycythemia and chest roentgenograms. Chest roentgenograms of 34 newborns with a hematocrit of 75 or more at the age of 12 hours were studied. An analysis was made of the findings during the first four days of life and the results were compared with those of 18 newborns with a hematocrit of 65 or less. The cardiothoracic ratio (CTR) was found to be greater in the polycythemic infants than in the non-polycythemic infants, and greatest of all in infants with symptomatic polycythemia. Prominent pulmonary vascularity and pulmonary hyperaeration were seen more often in polycythemic newborns than in non-polycythemic infants. Eleven infants in the polycythemic group and three in the non-polycythemic group had some symptoms or signs.


Experimental cardiac hypertrophy induced by isoproterenol in the rat. Isoproterenol (IPR) administered to rats in a dose of 5 mg/kg for seven days induces cardiomegaly. To determine the degree of myocardial enlargement, wet and dry heart weight, myocardial RNA, DNA, protein content and protein synthesis were measured. Wet and dry heart weight, and the level of cardiac RNA, DNA and protein were augmented by IPR treatment, with RNA increasing more than DNA and protein. Incorporation of 14C-leucine into the protein of the heart was enhanced by IPR. Thus the IPR-induced cardiomegaly may serve as a model for studying the development of cardiac hypertrophy under various conditions.


Effect of aldosterone and methylprednisolone on cardiac NaK-ATPase. Aldosterone (15 microgram BID) and methylprednisolone (8 mg QD) administration to female guinea-pigs augmented both the total and the specific activity of NaK-ATPase but not the activity of adenylate cyclase in the cardiac sarcolemma. The rise in NaK-ATPase was due to increase in the number of enzyme molecules; catalytic activity and ouabain-sensitivity of individual molecules did not change.


Steroid metabolism by mouse preimplantation embryos in vitro. Mouse preimplantation embryos were incubated with radioactive pregnenolone, progesterone or dehydroepiandrosterone for various periods of time. These substrates were not converted to metabolites even after incubation of 120 h. We suggest that preimplantation mouse embryo does not possess enzyme activities for steroid metabolism.


Alloimmune anti-H-2 mouse sera inhibit human mixed lymphocyte reactions. The inhibitory effect of alloimmune congenic mouse anti-H-2f serum on human mixed lymphocyte cultures was investigated. The anti-H-2 serum tested produced a strong inhibitory effect on human allogeneic MLR. This effect was more pronounced when HLA-A2 positive cells were involved in the MLR. More experiments are needed to substantiate the finding that both stimulator and responder functions of the human lymphocytes are impaired. The anti-H-2 serum also inhibited the human lymphocyte response to PHA.


[Reactivity of the liver to administration of cholic acid to rats subjected to polychloropinene expsoure for a long time]. It was found that in healthy rats cholic acid caused a moderately increased intensity of bile secretion and raised the content of bile acids in it. In animals with toxic hepatitis produced by a long-term action of the chemical poison polychlorpinene in a dose of 1/10 DL50 and following introduction to such rats of cholic acid in a dose of 30 mg/100 g an intensified elinination of cholates and cholesterol excretion were evident. Combined action of polychlorpinene and cholic acid was conductive to a reduced conjugation of cholic acid with taurine and to a greater conjugation with glycine, this being attended by an increased content of free bile acids in the bile.


[Toxicological characteristics of thaliblastine[]. The toxic action of the antiphlogistic drug thaliblastin, containing 93-95 per cent of the alcaloid thalicarpine was investigated. With its single intraperitoneal injection to mice the DL10 of the drug amounts to 273-306 mg/kg, DL50-325-350 mg/kg and DL90-370-402 mg/kg. With its 5-day long administration the respective figures for mice are 102-165, 125-201 and 154-243 mg/kg and for rats--170, 203 and 272 mg/kg. The respective figures for a 20-day long introduction to mice are 155, 185 and 220 mg/kg. Introduction of thaliblastin in doses of DL10 single and multiply results in a marked loss of the mass in mice.


'Sezary-like' cells in malignant and non-malignant diseases. Lymphocyte-like distinctive cells with cerebriform and serpentiform nuclei, as described in 'Sézary syndrome' were detected in the peripheral blood of two patients, one with plasma-cell leukemia and one with bacterial sepsis. These observations suggest that 'Sézary cells' are not strictly specific, neither for a neoplastic nor for a nonneoplastic disease, but rather representing a reactive form of lymphocytes to different stimuli.


Genetic influence of the streptozotocin-induced insulitis and hyperglycemia. Multiple injections of subdiabetogenic doses of streptozotocin (SZ) to CD-1 male mice produce a diabetic syndrome that includes a cell-mediated immune reaction against the pancreatic islet. The importance of the host genetic background in the pathogenesis of this model of diabetes was studied by comparing various inbred strains of mice. Of eight strains of mice studied, only C57BL/KsJ developed insulitis and hyperglycemia comparable to that observed in CD-1 mice. In two mouse strains (DBA/J and BALB/cJ) having an H-2d haplotype similar to the C57BL/KsJ, only mild insulitis and glucose intolerance were observed. These data suggest that major histocompatibility complex genes, as presently defined, cannot be the only determinant of the severity of hyperglycemia and insulitis in this model.


Spontaneous recovery from streptozotocin-induced diabetes in rats pretreated with pertussis vaccine or hydrocortisone. Following the intravenous injection of streptozotocin into rats, postprandial hyperglycaemia was sustained from 24 hours over a subsequent period of some weeks and the rats were glucose intolerant. When streptozotocin was similarly injected into pertussis-sensitized or hydrocortisone treated rats, the postprandial hyperglycaemia observed at 24 hours did not persist, but showed a progressive decline until near normoglycaemia was obtained a week later. These animals manifested normal glucose tolerance one week after streptozotocin. Thus, a spontaneous recovery from streptozotocin-induced diabetes occurred under these conditions. This spontaneous recovery from diabetes was associated with hyperinsulinaemia in the fed state.


[Ultrasound for differentiated carcinoma of the thyroid, autonomous adenoma and thyroiditis (author's transl)]. The article deals with a number of thyroid abnormalities which produce similar sonographic patterns, characterised by a paucity of echos of low amplitude. It concerns three more or less circumscribed changes (differentiated carcinoma of the thyroid, autonomous adenoma and focal thyroiditis) and two diffuse thyroid conditions (sub-acute and lymphocytic diffuse thyroiditis, hyperthyroidism). Carcinoma of the thyroid is of particular interest. The distinguishing features and differential diagnosis are discussed.


Angiographic management of gastrointestinal bleeding with vasopressin. Selective arteriography and infusions of vasopressin have become valuable tools for localization and therapy of acute gastrointestinal hemorrhage. Gastric mucosal hemorrhage can be treated successfully in about 84% of cases. Gastric ulcers can be treated successfully in about 65-70%. Acute colonorectal bleeding is controlled in about 90% of patients.


Prognostic value of angiography in management of severe acute renal transplant rejection. Angiograms of 34 kidney transplant patients with progressive decrease in renal function after multiple doses of intravenous methylprednisolone (MP) were evaluated retrospectively in regard to the prognostic value of angiography. The following parameters were included in evaluation: prolonged arterial washout time, large vessel vasculitis, presence of arteriovenous shunting, poor cortical perfusion as evidenced by non-filling of cortical vessels, poor definition of cortico-medullary junction, and a poor nephrogram. When 1 to 3 of these abnormalities existed in angiogram, 67% of living related donor transplants (LRD) recovered under continued MP-therapy. With 4-6 angiographic abnormalities the recovery rate was reduced to 30%. The overall recovery rate for LRD transplants was 44%. Cadaveric transplants (CAD) had a statistically significant poorer prognosis as evidenced by only 8% recovery rate under continued MP-therapy.


Liver and spleen scanning as a useful diagnostic test in the management of liver trauma in young patients. Liver and spleen scanning is a safe, fast and noninvasive diagnostic procedure. With the advent of mobile Gamma Cameras it can be ideally performed in a casualty department. The number of patients with traumatic blunt injuries to the abdomen is increasing and in correlation with the increased speed and concentration of traffic. In eleven patients with ages ranging between 4 and 23, and under observation for violent trauma to the abdomen, liver and spleen scanning was performed either as an emergency procedure or as a follow-up study. Very useful information was obtained regarding the integrety of these organs, before and or after emergency surgical treatment.


[Scintigraphic studies of skeletal abnormalities during childhood (author's transl)]. An extensive application of nuclear medical examination in the field of pediatric diagnostics was only made possible by introduction of short-lived radionuclides. On the one hand, they cause low radiation exposure, on the other they allow short-term check-ups. Analysis carried out on examination results of 47 children revealing various skeletal disorders showed a combination of radiologic-nuclear medical examination methods to produce maximal information suitable for both diagnostics and therapeutical planning. Specific questions such as termination of pathologic alteration process within the skeleton, can be answered only by the use of the scintigraphy. With reference to 4 cases the wide range of possibilities and limitations of skeletal scintigraphy in pediatrics are shown.


[Intraosseous angiography in the investigation of the pathogenesis of osteochondromas (author's transl)]. By means of intraosseous angiography it was possible for the first time to demonstrate the vessels in an osteochondroma during life. The vascular structure as demonstrated and the well known histopathological appearances indicate that an osteochondroma represents an error of enchondral development which is due to an anomaly of the diaphyseal vessels. With fusion of the epiphyseal plate, the osteochondroma becomes an independant tumour with malignant potential.


[Symmetrical cortical calcification of the cerebrum following pre-natal encephalitis (author's transl)]. Purely cortical cerebral calcification without involvement of the cerebellum was observed radiologically in a 3-month old girl; the calcification was extensive and symmetrical. During a three year period of observation, she showed severe psychomotor retardation, spasticity, microcephaly, a secondary scoliosis, subluxation of the hips and fits. These changes have only been observed so far following pre-natal herpes encephalitis. Following this condition there may also be periventricular calcification. Therefore it is assumed that the extensive cortical calcification is due to a virus, but not necessarily a specific one and that it depends on the age of the foetus at the time of the infection.


[The radiological anatomy of the tear ducts in neonates (author's transl)]. This position and relationship to the facial skeleton of the tear ducts in neonates were studies during 25 post mortem examinations by injection of contrast material into them and the findings were correlated with microscopic appearances. This produced the following results: in more than 50% cases there was unilateral or bilateral narrowing of the distal end of the duct due to persistence of Hasner's membrane. The ration of length of the tear duct and the ductus in neonates is 1:2 (adults 1:3). The proximal portions of the ducts between the saccus and the ductus show multiple transverse mucosal folds. There are several more or less acute curves in both planes. The examination indicates that in the treatment of neonatal dachryostenosis it is necessary to use a combination of dilatation and pressure injections.


[The urethrogram in children with neurogenic bladder dysfunction (author's transl)]. Various types of neurogenic bladder dysfunction in children show characteristic changes on micturating cystograms. The reflex bladder shows a short area of narrowing of the urethra at the pelvic floor; the autonomous bladder, during voiding by straining or Credé shows an elongated and deformed urethra, which is narrowed at the pelvic floor and which, because of the low position of the bladder, is angled. Both spastic and paretic pelvic floor in association with neurogenically determined abnormalities of bladder emptying may result in functional obstruction of the urethra. This, like any other stenosis, leads to morphological changes, first in the lower, but subsequently in the upper urinary tract. Children with neurogenic bladder dysfunction occasionally have micturating cystograms which resemble the appearances of urethral valves. The occurrence of so-called occult neurogenic bladders is mentioned and the difficulties in diagnosis associated with this condition are stressed.


[Transvenous removal of a catheter which has embolised to the heart (author's transl)]. The removal of intravenous catheters that embolized into the vena cava superior and the right atrium, is described. This is done with a "Dormia basket", in conjunction with a controllable Medi-Tech-Selection-Catheter. This set is especially suited for the removal of intracardial foreign bodies. The extraction of a catheter is a relatively expedient procedure without undue discomfort for the patient.


[Radiological heart volume determination--a new method carried out in the sitting position (author's transl)]. A method is described for the determination of cardiac volume with the subject in a sitting position. The results correspond with those of other accepted methods, but there are several significant advantages: 1. The position is easily maintained by the subject and the method is therefore acceptable for patients with cardiac disease. 2. The risks connected with a Valsalva effect are reduced. 3. There is no need to change the position of the x-ray tube during the examination. 4. Contrary to the traditional technique, the x-ray room does not require a very high ceiling. 5. Because of even blood distribution, the cardiac volume determinations also provide information regarding the lungs.


[Pericardial effusion: its demonstration through the epicardial fat (author's transl)]. The statement by Torrance and Kremens that it is possible to demonstrate radiologically pericardial effusions by analysing the epicardial fat layer is confirmed. Our retrospective study of 33 patients was used to determine the best technique of examination and the accuracy of the method.


[Marginal atelectasis of skin fold? (author's transl)]. R. Haubrich (1976) described marginal atelectasis of the lower lobes in chest films in patients in bed. Two such patients were studied in detail and a retrospective analysis of examinations of 546 patients carried out in their beds was undertaken. In the first two of these patients it was possible to prove that the so-called marginal atelectases were, in fact, due to skin folds. The retrospective analysis produced a strong correlation between so-called marginal atelectasis and the presence of skin folds. It is concluded that one should not assume the presence of marginal atelectasis until the possibility of a skin fold has been excluded.


[Limitations of detail recognition in radiographs due to threshold contrast values (author's transl)]. The minimal contrast was studied which can be recognised by the eye, using similar, neighbouring images under varying conditions of brightness. Subsequently the effect of contrast thresholds on the recognition of detail in radiographs has been examined.


[Gray-scale sonographie. Vascular anatomy of the abdomen (author's transl)]. Gray scale sonography produces an exact topographical visualization of the following abdominal arteries and veins in longitudinal and transverse sections: Aorta, V. cava inferior, portal and splenic veins, mesenteric and renal vessels, coeliac trunk, intrahepatic systemic and portal veins. This allows for new possibilities in organ diagnosis with more exact localization of pathologic lesions.


[The accuracy of sonography in the diagnosis of renal disease (author's transl)]. The accuracy of sonography in the diagnosis of spaceoccupying renal lesions was evaluated by a retrospective study of 221 patients. There were 15 incorrect diagnoses. In 93% of cases the sonographic diagnosis was correct. Erroneous diagnoses, which would have been difficult to avoid even retrospectively, were usually due to complex lesions which were partly cystic and partly solid. In order to differentiate cysts from solid lesions it is considered essential to use both A- and B-scans and step-wise variations of sound energy. These results emphasise the great value of ultrasound in the differentiation of renal abnormalities. Sonography should be used, during the clinical work up, after the urogram, but before angiography or other invasive methods are employed.


[Advances in cerebral angiography (author's transl)]. During recent years, catheter angiography of the cerebral vessels has tended to displace direct puncture of the carotid arteries. The method has significant advantages for the radiologist and the patient. A number of procedures are described which make this examination more easily performed, increase its diagnostic value and, most important, render it safer for the patient. Changes in catheter technique, in the radiographic apparatus and in the scope of the method are discussed.


[Angiography for intracranial aneurysms of the vertebrobasilar system (author's transl)]. Amongst 112 patients with a total of 122 intracranial aneurysms, there were eleven (9%) in the vertebro-basilar system. Four of the vertebral artery aneurysms were situated at the origin of the inferior posterior cerebellar artery, three at the bifurcation of the basilar artery; there were three rare aneurysms situated peripherally on the cerebellar vessels and there was one circumscribed aneurysm of the basilar artery stem. Selective vertebral angiography, with high position of the catheter, is recommended for the demonstration of these aneurysms. If there is insufficient reflux into the opposite vertebral artery from a left-sided injection, bilateral vertebral angiography must be carried out. Special projections, such as transoral (open-mouth) or transfacial may be of advantage. Angiotomography has also proved valuable and magnification can be helpful. Subtraction is particularly indicated for sagittal projections.


[Arterio-venous malformations of the dura (author's transl)]. Two supra tentorial arteriovenous malformations of the dura are described. In one there was a direct localised shunt between the anterior and middle meningeal arteries, and the superior sagittal sinus. The shunt had resulted in varicosities of the cortical veins in both hemispheres. The second malformation was situated in the tentorium and the left occipital lobe and resulted in thrombosis of the left transverse sinus.


[Occlusion phlebography. Technics and possibilities of use]. The technique and use of occlusion phlebography is described. The method is based on temporary occlusion of blood flow by means of a balloon catheter. Various balloon catheter systems were used and their technical properties were evaluated. The distal veins can be demonstrated by using double lumen catheters, distal and proximal veins by using a catheter with three lumina. Occlusion phlebography is a suitable method for demonstrating hepatic and renal veins; it improves the demonstration of the azygos vein, the suprarenal vein and of visceral pelvic veins, including the iliolumbar veins. It also permits demonstration of the inferior vena cava and parietal veins in the pelvis in separate stages. Occlusion phlebography is the method of choice for the direct demonstration of splenorenal shunts.


[Magnification technique in peripheral angiography (author's transl)]. Fourteen exactly similar conventional and magnified serial angiograms were compared and the advantages and disadvantages of magnification angiography are discussed. Particular attention was paid to exact comparability of the series in order to make the analysis valid. In three patients small end-vessels and collaterals were visible on the magnification angiogram which could not be seen on the ordinary series even in retrospect. Macro-angiography was also valuable in cases of microsurgery, both before and after operation. Considering the well-known disadvantages of magnification angiography, such as increased radiation and cost, its use appears to be indicated only for the elucidation of special problems.


[Embolisation techniques for renal tumors (author's transl)]. We have performed ten embolisations in nine patients with vascular renal tumours, eight of these pre-operatively. One patient had an inoperable hypernephroma which was embolised twice. We have used gelatine sponge particles (Gelaspon). In every patient it was possible to occlude the arterial supply. There were no complications.


[The value of early urographic films in the investigation of arterial hypertension (author's transl)]. The value of early films during a urogram in the investigation of arterial hypertension was investigated (402 urograms on unselected hypertensives, with arteriographic examination in 80). The diagnostic accuracy in cases of proven unilateral reno-vascular disease was 58%, signs suggestive of renal artery stenosis were found in 6.5% of the total material. Possible causes of the low degree of accuracy are discussed.


[Comparative investigations of osteotropic radiopharmaceuticals. V. Demonstration of abnormal uptake with various scanners (author's transl)]. Experiments with phantoms have shown that there is a higher probability of showing areas of increased uptake when using a camera than with a scanner. In 49 patients with suspected bone metastases, scans were performed during their pre-operative work-up, under identical conditions, using a whole body scintigraphic scanner with a 5-inch double head and a scintillation camera with total body facility. The scintillation camera showed a significantly higher sensitivity to bone metastases, but there was no difference in the pick-up rate of distant metastases. Despite the possibly more frequent use of the camera, its cost is no higher than that of the scanner. Both on diagnostic and economic grounds, we consider the scintillation camera, with a total body facility, to be the instrument of choice for total skeleton scintigraphy.


[Aplasia of vertebral bodies (author's transl)]. The article reports two cases of congenital absence of vertebral bodies illustrated by radiographs. Only a few such cases have been reported in the literature. The author discusses whether the condition is to be considered as "asoma" (Putti) or absence of ossification of a pre-existing cartilagenous vertebral body. Its origin must lie in a very early teratogenic period of embryonic development.


[Idiopathic multicentric osteolysis with craniodysplasis and mental retardation: a new syndrome? (author's transl)]. A new case of idiopathic multicentric osteolysis presenting with cranial malformation and mental retardation is described. The patient could be followed for some years. Differential diagnosis is considered and a classification of osteolytic syndromes attempted.


[The differential diagnosis of aneurysmal bones cysts and non-ossifying fibromas (author's transl)]. With the help of intraosseous angiography, and bearing in mind the plain films and histopathological basis of the lesions, it is now possible to differentiate with certainty between a non-ossifying fibroma and an aneurysmal bone cyst. Since 20% of aneurysmal bone cysts recur after curretage or excision and most non-ossifying fibromas disappear spontaneously, intraosseous angiography has a valuable place in diagnosis.


[The "crescent sign" in older children (author's transl)]. The "crescent sign", a dense, convex line parallel to the surface of the kidney, has only been reported in small children with obstructive uropathy during urograms. Two patients (aged 13 and 14 years) with this sign are described. The cause of this appearance is discussed and related to the striations seen on late films in adults with urinary obstruction. The practical value of the "crescent sign" is the possibility of diagnosing obstructive uropathies in the absence of contrast filling of the upper urinary tracts. According to the literature available to us, this is the first time the sign has been reported in older children.


Fetal uptake of an intravascular radiologic contrast medium. Trans-placental passage of methylglucamine diatrizoate was studied in 11 human fetuses after intravenous injection to the mother 5 to 49 minutes prior to abortion by hysterotomy. The contrast medium passed the placental barrier and was detected in all fetal tissues measured. No evidence was found of selective uptake by any fetal tissue. The hazards of fetal exposure should be taken into consideration before the administration of intravascular radiographic contrast agents to pregnant women.


Radiation damage in mouse embryos exposed to 1 rad x-rays or negative pions. Pregnant mice of two different strains (F/A and NMRI) were exposed to 1 rad of whole-body pion- or X-irradiation at day 8 of gestation. Lucanthone (Miracil D), a known radiosensitizer in various biological systems, was applicated 30 min before irradiation. Five days after treatment the fetuses were observed for developmental anomalies. In both strains of mice it was found that the radiation dose as low as 1 rad results in a significant increase in the rate of abnormal fetuses compared to nonirradiated, but restrained fetuses. Comparing the effectiveness of negative pions (peak irradiation) with X-rays for teratogenic effects, the RBE was between 1.7 and 1.9. The application of Lucanthone increased the number of damaged fetuses and led to various degrees of sensitization depending on the mouse strain and dosage used. Differences between the strains as regards the frequency of damages are explained by different development stages at the time of treatment.


[The medical uses of radio-active substance in North Rhine-Westphalia during the last ten years (author's transl)]. On 1st April 1977, legislation for protection from ionising radiation has replaced the law of 24th June 1960. This appears to be an appropriate occasion to consider the medical use of radioactive substances in North Rhine-Westphalia in the last ten years. The supervisory function of the competent authority has been statistically investigated. The extent to which the most commonly used controlled radioactive substances are employed in medical practice has been studied. The controls used and the radiation dose received by personnel are summarised.


Determination of seven unconjugated steroids in the blood and seminal plasma of the fertile male rabbit. Seven unconjugated steroids were measured in the blood and seminal plasmas of fertile male rabbits by radioimmunoassay. The blood plasma testosterone concentration was 4--5 times that of the seminal plasma. Dehydroepiandrosterone, estrone and 17beta-estradiol were found in measurable amounts in the blood plasma; however, these steroid levels were slightly lower in seminal plasma. Androstenedione and 5alpha-dihydrotestosterone were present in equal quantities in both the seminal and blood plasmas. By contrast, seminal plasma pregnenolone level was about twice that of the blood plasma. The determination of seminal plasma steroids may lend itself as a complementary assessment to blood steroid determinations for the evaluation of the normal function of various reproductive organs.


Partial trisomy 21. Further evidence that trisomy of band 21q22 is essential for Down's phenotype. Cytogenetic analysis of a 6-year-old girl with moderate mental retardation revealed 46 chromosomes with a tandem translocation (21;21) resulting in a partial trisomy 21. Only the terminal band 21q22 was not in triplicate. G-, Q-, R-, and C-banding techniques and silver nitrate staining of the nucleolus organizer regions (NORs) were used to identify this chromosome fully. The phenotype of the patient was not typical for Down's syndrome, providing additional evidence that trisomy of band 21q22 is pathogenetic for the phenotype of Down's syndrome. This is also a new example in human pathology of a stable 'dicentric' chromosome in which one of the centromeric constrictions appears to be nonfunctional.


Fetal cells in the maternal blood. Lack of response of fetal cells in maternal blood to mitogens and mixed leukocyte culture. In an attempt to stimulate fetal cells in the maternal blood to mitotic division, peripheral blood lymphocytes were cultured from ten primiparous women and six multiparous women. In the case of the ten primiparous women, PWM was used to stimulate lymphocytes in 3- and 7-day cultures made at the 16th, 20th, 24th, and 28th week of gestation. Altogether, 10565 mitoses were analyzed after quinacrine staining of cells from five mothers who each subsequently gave birth to a male infant, and not a single XY mitosis was found. In the case of the multiparous women, lymphocyte cultures, with PHA or LPS as mitogen and MLC, were initiated between the 13th and 20th week of pregnancy. Four of the mothers were pregnant with a male child, and two with a female child. From cultures of each of the four mothers expecting a boy, a total of 9721 mitoses were analyzed after quinacrine staining, and not a single XY mitosis was found. However, one XY cell was found in the culture from one of the two women who delivered a girl. The XY mitosis probably originated from a pregnancy 8 months earlier which terminated in a male infant. In an attempt to culture and obtain good chromosome preparations from small numbers of cells, it was shown that a good mitotic response and good chromosome preparations could be obtained from as few as 6000 lymphocytes.


Two cases of trisomy 21 and one XXY case with atypical clinical features. Three patients with mental retardation and multiple congenital abnormalities are described. Although their clinical appearance was not suggestive of Down's syndrome, chromosome studies showed a non-disjunctional trisomy 21 in two of the patients. The third case had an unsuspected XXY karyotype.


Down's syndrome: chromosome analysis of 362 cases in Hungary. A survey is given of the karyotypes observed in 362 children clinically diagnosed as cases of Down's syndrome from whom material was sent to 8 collaborating cytogenic laboratories in Hungary during the period 1965-1974. The sample studied cytogenetically constitutes about 20% of all children born in Hungary in this decade with Down's syndrome. The ways in which patients were selected for cytogenetic examinations could not be specified. In the sample, standard trisomy 21 was found in 91.7%, translocations in 3.9% and mosaicism in 4.4%. The mean age of the mothers of the children investigated was 29.05 years, a relatively low figure which may be explained by the decrease of the mean maternal age over the last decades.


The planning environment of health systems agencies: a strategy for intervention. In this study, the dependence of the health systems agency, formed under P.L.93-641 in its planning environment, has been analyzed. After presenting some generic barriers to the implementation of the Act, the specific components of the planning environment that support the HSA were identified. The hypothesis is that the viability of the new HSA depends largely upon an improved planning environment. The present constituencies of the HSA are weak, or even negative. A strategy of interventions is tailored for each major component of the planning environment, on the assumption that each is unique in its structure and objectives and therefore in its client relationship to the HSA. The innovative planning processes required by P.L.93-641 will not be achieved without vigorous support from each component.


Inability of spleen cells from chancre-immune rabbits to confer immunity to challenge with Treponema pallidum. Although several lines of evidence suggest that cellular immune mechanisms play a role in controlling infection due to Treponema pallidum, recent studies have shown that induction of acquired cellular resistance by antigenically unrelated organisms fails to protect rabbits against syphilitic infection, thereby casting doubt on this hypothesis. In the present paper we describe attempts to transfer immunity to syphilis by using spleen cells from chancre-immune rabbits. Intravenous infusion of 2 X 10(8) spleen lymphocytes was capable of transferring acquired cellular resistance to Listeria and delayed hypersensitivity to tuberculin. However, in eight separate experiments using outbred or inbred rabbits, 2 X 10(8) spleen cells from syphilis-immune animals failed to confer resistance to T. pallidum whether by intravenous or intradermal challenge. Mixing immune lymphocytes with treponemes immediately before intradermal inoculation also failed to confer resistance. Despite the fact that syphilitic infection stimulates cellular immune mechanisms and induces acquired cellular resistance to antigenically unrelated organisms, cellular immunity may not play an important role in immunity to syphilis.


The relative proliferation index as a more sensitive parameter for evaluating lymphoproliferative responses of cancer patients to mitogens and alloantigens. Lymphocyte proliferation (LP) assays were performed in microculture using the T-cell mitogens phytohemagglutinin (PHA) and concanavalin A (Con A); the T + B cell mitogens, pokeweed mitogen (PWM) and staphylococcal phage lysate (SPL); and a pool of allogeneic stimulating leukocytes in one-way mixed leukocyte cultures (MLC) in lung and breast cancer patients and normal individuals. The resultant data were expressed in three different ways: (1) as mean counts per minute (CPM) of tritiated thymidine incorporation; (2) as a stimulation index (SI) and (3) as a relative proliferation index (RPI). The RPI is defined as the ratio of net CPM (nCPM) in experimental cultures with stimulant (E) minus medium control cultures (C) of a test individual to the mean nCPM of three or more normal individuals examined in the same assay on the same day. These expressions were then compared for their ability to discriminate between LP responses in cancer patients and normal individuals. The RPI value and selected cut-off values gave the most sensitive measure for the determination of depressed proliferative responses. These analyses demonstrated that lung carcinoma patients were depressed to PHA (50%), MLC (47%), PWM (43%) and Con A (40%). To a lesser degree, breast carcinoma patients were also depressed to MLC (36%), PHA (31%), PWM (27%) and Con A (19%). Our data indicate that the use of the RPI in the analysis of LP response represents an improved method for detecting impaired response of lymphocytes to general mitogens and alloantigens which can consistently reveal immunosuppression in many cancer patients and may be useful for serial monitoring of individual patients.


[Effect of wash-active substances in hair-washing preparations]. Standardized hair washes have been carried out at weekly intervals over a period of four weeks in a total of 35 male subjects. A standard surfactant solution was applied in all subjects for the first two washes. For the third and fourth wash three different surfactant solutions were used in three groups of subjects. It was observed that the microbial splitting of the triglycerides into fatty acids can be inhibited by surfactants. We think that in this way a seborrhoea oleosa can be changed into a seborrhoea sicca. Moreover some but not all surfactants have a strong "keratolytic" action when they are used in shampoos.


[Pityrosporum orbiculare in acneiform eruptions]. Six patients with acneiform eruptions in the predilection sites of pityriasis versicolor are briefly described. Histologically there were abscesses below the acroinfundibulum wherein yeasts could be found with the characteristics of pityrosporum orbiculare. The possible pathogenity of these fungi is discussed.


The ultrahistochemical picture of the so-called reversed ATPase in the gastrocnemius muscle of the rat. The ultrahistochemical localization of the "reversed" ATPase activity was investigated. Red muscle fibres showed permanent sarcomere contraction, enzymatic activity in the inner membrane and matrix of mitochondria, and large, osmiophilic, probably calcium-containing structures within mitochondria and on their outside. White muscle fibre sarcomeres were relaxed, and activity within their sarcoplasmic reticulum was marked, but slight in the mitochondria. The relaxed state of the sarcomere in the white muscle fibres is supposed to be connected with inactivation of myofibrillar ATPase by acid preincubation, whereas red muscle contraction indicates that acid preincubation does not inactivate their myofibrillar ATPase. That the product of its activity failed to become visible in the sarcomeres is probably due to imperfection of the method. Two sub-types of red muscle fibres were distinguished: those showing only enzymatic activity in mitochondria, and those containing large intra- and extramitochondrial osmiophilic structures. The origin and composition of these structures is difficult to explain. A relation seems to exist between their presence within mitochondria and outside.


Visualization of atrial myocardium with thallium-201: case report. An adult patient evaluated for cyanotic congenital heart disease was found to have pulmonary atresia with intact ventricular septum, hypoplastic right ventricle, and right atrial enlargement. Thallium-201 myocardial imaging before surgical correction showed thallium activity in the right atrium. Following the establishment of a conduit from the right atrium to pulmonary artery, the right-atrial thallium uptake was even more prominent.


Control of occupational exposure to nitrous oxide in the dental operatory. Methods were developed for controlling the dental team's occupational exposure to nitrous oxide. The most applicable and effective use of these methods included the use of properly maintained gas delivery equipment, a double-walled scavenging nosepiece and vented suction machine, and minimizing speech by the patients. These methods were evaluated by measuring concentrations of nitrous oxide present in the air inspired by dental personnel. Before their use, the dentist inhaled 900 ppm nitrous oxide; their application reduced his inhaled concentration to 31 ppm, representing a 97% reduction. These methods were well accepted during 157 procedures completed by a group of eight dentists engaged in private practice (four general practitioners, two pedodontists, and two oral surgeons).


Custom finger guard-mouth prop as an alternative to conventional mouth props. Conventional mouth props are an essential part of a dentist's armamentarium and are irreplaceable in certain dental situations. These props, however, may provide too harsh an approach or be injurious in other situations. The custom-made finger prop is a valuable alternative to the other mouth props when treating the young or handicapped.


Occupational health hazards resulting from elevated work rate situations. Some occupational health hazards resulting from an elevated rate of work due to recent mechanization and automatization are discussed on the basis of results of health examinations. A rapid increase of a cervicobrachial disorder among young cash register and packing machine operators has been observed. Switching to the use of electronic cash registers has been shown to have only limited efficacy due to increased operation speed, and high-speed complex finger and hand movements of packer operators have also proven to be as hazardous as key-board operations. The high incidence of low-back pain, in particular gradually developing pain, among workers in electric power supply work has been suggested to be the result of quick and intensified work to meet increasing supply demand. Likewise, the workload of electric locomotive and bullet train drivers has increased in accordance with increased train speeds, and has been shown to have had significant effects on their health particularly in regards to neural strain, intra-cab environment such as air pressure change, vibration, and noise, and rotation on irregular shifts. New steps seem required therefore to meet the new health problems arising from a combination of modern technological changes and elevated working speeds.


The in vitro drug resistance of Salmonella dublin isolated from cattle. The resistance of Salmonella dublin to eight antibacterial drugs was assessed under diagnostic laboratory conditions. Two techniques were used consecutively and the differences in the results are described. Strains of S. dublin isolated from either calves, adult cattle or abortion material showed no differences in resistance for either of the techniques, though differences between the two techniques were found.


Skin surface lipid composition, acne, pubertal development, and urinary excretion of testosterone and 17-ketosteroids in children. Fifty-two children, age 5-10, from acne-prone families, were studied for a period of 1 year to examine the interrelationship between sebum, acne, pubertal development, and urinary steroid excretion. In each of the subjects, 30 boys and 22 girls, the composition of forehead skin lipid was determined 4 times yearly by thin-layer chromatography, with measurement of triglycerides, diglycerides, free fatty acids, wax esters, squalene, cholesterol, and cholesterol esters. Twice yearly, examination was made of the presence or absence of acne, pubertal maturation and the 24-hour urinary excretion of testosterone as determined by radioimmunnoassay, and of total 17-ketosteroids, dehydroepiandrosterone, androsterone, and etiocholanolone, as determined by paper chromatography. The relative amount of sebaceous lipids was positively correlated with age of the subjects (wax esters p less than .001, squalene p less than .05), as was the triglyceride-diglyceride component (p less than .05). No significant correlation was seen with the fatty acids. Acne, primarily comedonal, occurred in 27/52 subjects (15 girls, 12 boys) and was associated with higher sebum values. One-half of the children with acne had no signs of pubertal development. A significantly positive correlation was observed between the relative amount of sebaceous lipid and the urinary excretion of 17-ketosteroids, androsterone, and etiocholanolone in both sexes, and of testosterone and dehydroepiandrosterone in boys. The development of acne in children is an early pubertal event, often evident before other signs of pubertal maturation, and it is associated with an increase in sebum and in the urinary excretion of androgenic steroids.


Inhibition of Na+, K+-adenosinetriphosphatase by endotoxin: a possible mechanism for endotoxin-induced cholestasis. Cholestatic jaundice is one complication of nonhepatic gram-negative bacterial infection. The endotoxin of Escherichia coli has been reported to cause cholestasis by inhibiting the bile salt-independent fraction (BSIF) of bile in the perfused rat liver. Accordingly, the effects of lipopolysaccharides (LPS) of E. coli and Salmonella enteritidis on the Na+, K+-adenosinetriphosphatase (ATPase) in canalicular-enriched plasma membranes of rate liver were examined. At 20 microgram/ml, both endotoxins inhibited this enzyme by approximately 40%. Maximal inhibition (70%-80%) occurred at concentrations of greater than or equal to 120 microgram/ml. The LPS of neither organism exerted any effect on the activity of Mg++-ATPase or 5'-nucleotidase in the same preparations. Inhibition by the E. coli LPS appeared to be noncompetitive in nature, and the calculated Ki was 45 microgram/ml. Since the Na+, K+-ATPase may be responsible for the elaboration of BSIF, inhibition of this enzyme could be the underlying mechanism for the endotoxin-induced cholestasis.


Treatment of autologous immune complex glomerulonephritis with vasoactive amine antagonists. AIC nephritis produced in rats by a single injection of FxIA in CFA was treated by agents with known antihistamine and antiserotonin activity. The effect of this drug regimen in altering the deposition of Ag-Ab complexes in the glomerulus was assessed by light, immunofluorescent, and electron microscopy. The vasoactive amine antagonists Chlortrimeton, Vistaril, Azatadine, and Sansert, when given singly or in combinations which completely abrogated histamine and serotonin-induced skin wheal formation, were unsuccessful at reducing apparent glomerular deposition of the circulating immune complexes of AIC nephritis.


Serotonin as a factor in depression of collateral blood flow following experimental arterial thrombosis. The relationship of serotonin to the inhibition of collateral blood flow was investigated. Five cats, in which the aorta contained a 6 microgram injection of serotonin in a closed aortic segment exhibited depressed hindlimb blood flow. The serotonin effects were eliminated in three animals by pretreatment with cinarserin HCl, a serotonin antagonist. The caudal 1.5 cm of the aorta was occluded in 24 cats by a blood clot formed by injection of thromboplastin subsequent to ligation. Eight of these animals were pretreated with cinanserin HCl and exhibited a significant improvement in hindlimb collateral blood flow. Serotonin was reduced in nine of these animals with reserpine/p-CPA treatment, and they exhibited the most significant recovery of all treated animals. Seven of the cats with blood serotonin reduced by decreasing blood platelets showed no improvement in hindlimb blood flow. The results of this study indicate that serotonin is a factor in the inhibition of collateral blood flow which follows arterial thrombosis.


Effect of mithramycin on hydroxyproline metabolism in Paget's disease. Hydroxyproline was measured in the plasma and urine of six patients with symptomatic osseous Paget's disease before and after parenteral mithramycin treatment. The plasma profile data included free, peptide, and protein hydroxyproline values. Corresponding urine samples were analyzed for total hydroxyproline content and, in some instances, for free hydroxyproline. Plasma values of free and peptide hydroxyproline fell promptly toward the range of normal within 24 hr after the first intravenous injection of mithramycin. Protein hydroxyproline in the plasma was slightly but significantly lower than in the 15 normal control subjects, and this value did not change appreciably over the 4-day period during which the patients were treated. The urine excretion rate of total hydroxyproline decreased precipitously. Our results support the hypothesis that mithramycin rapidly reduces the accelerated rate of "collagenolytic" activity of osteocytes and osteoclasts in this disorder, presumably by an inhibiting effect on these bone-modeling cells. The major degradative lesion, as reflected in the plasma and urine, is characterized by the production of non-TCA-precipitable peptides containing hydroxyproline, which rapidly fell to normal levels after the administration of mithramycin.


Psychosomatic backache.

Psychosomatic backache. It is contended in this report that the majority of pain syndromes involving the neck, shoulders, and low back are the result of a benign, reversible process in the musculature which is psychosomatic in nature and which has been called tension myositis. The natural history of the disorder, findings on physical examination, and diagnostic studies are briefly described. The theoretical basis for the conclusion that it is psychosomatic is discussed, the therapeutic program is described, and long-term results with a group of treated patients are presented. The results suggest that a program of physician counseling and physical therapy is generally successful. The author believes that the psychosomatic nature of the disorder places it within the purview of the behaviorally oriented specialty of family practice.


Biochemical aspects of Huntington's chorea. Fifteen patients affected by Huntington's chorea were divided into two groups, 'slow' and 'fast', according to IQ scores on the Wechsler-Bellevue scale, and scores on some motor performance tests. A possible correlation was looked for between some biochemical data (cerebrospinal fluid (CSF), homovanillic acid (HVA), and 5-hydroxyindolacetic acid (5HIAA) levels, plasma dopamine-beta-hydroxylase (DBH), dopamine (DA) uptake by platelets), and clinical data (duration of illness, severity of symptoms, age of patients, IQ scores, 'slow' and 'fast' groups). The CSF, HVA, and 5HIAA levels were found to be significantly lowered in comparison with normal controls. DBH activity and DA uptake by platelets did not differ significantly from normal subjects. Treatment with haloperidol in all patients and with dipropylacetic acid in three patients did not appear to modify the CSF, HVA, and 5HIAA concentrations, the plasma DBH activity, or the DA uptake. There were no significant differences in the CSF, HVA, and 5HIAA contents between the two groups of patients, and there was no correlation between biochemical data and clinical features.


Regeneration following denervation of minced gastrocnemius muscles in mice. Gastrocnemius muscles in mice were minced and orthotopically implanted. At the same time all nervous supply to this muscle was completely removed. It was observed that initially the pattern of muscle regeneration was similar to what was observed in a normally innervated implant. But by day 6, distinct degeneration of regenerated muscle fibres sets in, which continues unabated so that by about 3 weeks there usually remains only a thin band of connective tissue in place of the implant. Histochemically, there is a gradual loss of SDH, myofibrillar ATPase and cholinesterase activities within the degenerating muscle fibres and a corresponding appearance of these enzymes in the regenerating fibres. In the denervated implants, with the onset of degeneration of the regenerating fibres, the enzymatic activities were also lost. Histochemical fibre typing was not achieved within the regenerating fibres. The regeneration and degeneration pattern of the denervated muscle observed in the present study is compared with the one observed in other animals.


[K+]o clearance in cortex: a new analytical model. 1. It has been suggested that passive diffusion is the principal mechanism of the clearance of locally elevated extracellular potassium, K+o, in the cerebral cortex. This concept was based on the assumption that elevated K+ could be modeled as a point source. In the present study, the functional role of passive diffusion was reevaluated in the anesthetized cat cortex following local electrical stimulation. 2. The initial spatial distribution of extracellular potassium activity, [K+]o, elevated by monopolar stimulation, could be modeled by a two-dimensional Gaussian function at and below the 500-micron cortical depth. Azimuthal symmetry around the stimulating electrode was assumed and cylindrical spatial coordinates were used. 3. The observed clearance of transiently elevated [K+]o as a function of space and time was much more rapid than that predicted by an analytical model consisting of the homogeneous diffusion equation whose initial condition was the Gaussian spatial distribution of [K+]o at the onset of the clearance process. 4. It is concluded that passive diffusion does not significantly contribute to the rapid clearance of locally elevated extracellular potassium in the cortex. Active uptake of potassium by cortical cells should be more seriously considered as being primarily responsible for the potassium clearance.


Responses of primary and secondary endings of isolated mammalian muscle spindles to sinusoidal length changes. 1. Responses of primary and secondary endings of isolated cat spindles to sinusoidal length changes have been recorded before and after block of impulse activity by tetrodotoxin. 2. Primary endings may discharge with each cycle of sinusoidal stretch at 25-50 Hz, with stretch amplitudes applied to the spindle poles as small as 1 micron. Thresholds are higher at lower frequencies. 3. In primary endings, amplitude of the receptor potential varies with frequency and magnitude of sinusoidal stretch. At a given stretch amplitude, the receptor-potential response increases markedly between 1 and 10 Hz. At a fixed frequency, for example, at Hz, the response to graded amplitude of sinusoidal stretch is highly nonlinear, sensitivity decreasing with large amplitudes. 4. Secondary endings show a much higher threshold than primary endings to sinusoidal stretch. Thus, at 25 Hz, secondary endings required stretch amplitudes of 50-100 micron to evoke discharge. Relatively large amplitudes of stretch were also required to evoked detectable receptor potentials. Over the range studied, the receptor potential varied more linearly with stretch amplitude in secondary than in primary endings.


Structures in sensory region of snake spindles and their displacment during stretch. 1. Structures within the sensory region of short- and long-capsule snake muscle spindles have been visualized using differential interference contrast microscopy. Profiles seen with Nomarski microscopy have been identified by electron microscopy of the same preparations. 2. Sensory nerve terminals, nuclei and other cytoplasmic inclusions in the intrafusal fiber, collagen bands, and capsular cells may be seen in the living preparation. 3. The length changes of various elements within the sensory region in response to stretch of the spindle have been measured using high-speed ciné photomicrography. This has been corrleated with the impulse response from sensory endings in short-and long-capsule spindles. 4. Short-capsule spindles, which have a high dynamic sensitivity, show length changes in the sensory region in response to ramp-and-hold stretch, which are not parallel to the changes in impulse frequency. The implications for mechanical models of spindle behavior are discussed.


The role of HLA B27 in the diagnosis and management of low-back pain and sciatica. Present diagnostic criteria for ankylosing spondylitis (AS) lean heavily on the x-ray examination, but there is much dispute as to its efficacy, especially in mild or early cases. Determinations of the HLA B27 histocompatibility antigen appear to define the population at risk far better than any other means. Of 31 patients who had the HLA B27 antigen, all had negative latex fixation tests and axial polyarthritic complaints (seronegative spondyloarthropathy or rheumatoid variant). Three had Reiter's syndrome and one had ulcerative colitis. Of the remaining 27 patients, nine had definite AS, 11 had probable AS, and seven had possible AS. Eleven of the 27 underwent at least one invasive spinal procedure (myelogram, laminectomy, fusion, facet denervation) before a diagnosis of AS was made.


TLC determination of iodochlorhydroxyquin and its conjugate in plasma. A simple, specific, reliable, and sensitive method for the determination of iodochlorhydroxyquin and/or its conjugate in biological fluids is described. The method is based on a quantitative ether-acetone (1:1) extraction of plasma samples followed by TLC separation, visualization, elution, and determination at 267 nm. Iodochlorhydroxyquin released by hydrolysis of its conjugate was analyzed. Both compounds are detectable in amounts as low as 0.04 microgram/ml. Application of the one-compartment open model to the data (assuming the biotransformation of the drug in conjugated form) provides a pharmacokinetic profile for the 50-mg/kg dose of iodochlorhydroxyquin in Wistar male rats.


The effect of bumetanide on cation transport in human red blood cells. Bumetanide, a sulfamyl-aminobenzoic acid derivative, is a new and highly effective diuretic agent. The present studies were designed to examine its effects on cation transport in human red cells. At a concentration of 10(-3) M, the drug inhibited both active and passive unidirectional sodium fluxes, as well as active potassium influx. It also caused a significant inhibition of glycolysis. The inhibition caused by bumetanide was less than that seen with ouabain alone, but a bumetanide effect was also present in ouabain-treated cells. Bumetanide had no effect on red cell Na-K adenosine triphosphatase activity and did not affect net transport of sodium in sodium-loaded cells. The data are consistent with a model in which the inhibition of monovalent cation movement in red cells by bumetanide is related to an effect of this compound in decreasing the permeability of the red cell membrane to sodium.


Effects of fusimotor stimulation on the response of the secondary ending of the muscle spindle to sinusoidal stretching. 1. The responsiveness of the spindle secondary ending to sinusoidal stretching has been studied using the soleus muscle of the anaesthetized cat. The sensitivity (impulses/sec firing per mm stretching) and the phase of the response were determined by computer averaging. The small linear range was studied at frequencies of 0.5-500 Hz, and also the larger non-linear range at 1 Hz.2. In the linear range, stimulation of single fusimotor fibres (which were presumed to be static axons) approximately halved the sensitivity of the ending to low frequency stretching (up to 30 Hz), but did not produce any change in the phase of the response. Thus, from the point of view of motor function, fusimotor activity provides control of gain and a biasing signal, but not control of the relative sensitivity of the secondary ending to length and velocity.3. In contrast, such stimulation slightly increased the responsiveness of the secondary ending to high-frequency stretching (100-500 Hz) and slightly advanced the phase of the response above that of the passive ending.4. The results are discussed in relation to the effect of static fusimotor stimulation on the primary ending, and to findings on secondary endings in the decerebrate cat.


Role of lipids in the Neurospora crassa membrane. II. Membrane potential and resistance studies; the effect of altered fatty acid composition on the electrical properties of the cell membrane. The effect of doubling the saturated fatty acid content on the electrophysiology of Neurospora crassa membranes was studied. Intracellular membrane input resistance (Rm) and potential (Em) were measured for wild-type (w/t) and cel- (Tween 40) organisms as a function of temperature. Over the 0 to 40 degrees C temperature range studied, mean Em values of both w/t and cel- (Tw 40) organisms increased from -160 to -210 mV. This difference is greater than that expected from Nernst potential considerations, indicating an active component of Em. This active component is insensitive to a doubling of the saturated fatty acid content. Rm exhibits a temperature dependence and hysteresis. Averaged data indicate an increase in Rm with decreased temperature. The slope of the temperature dependence varies among individual hyphae. Above 17.5 degrees C cel- (Tw 40) hyphae averaged greater than 70% higher values of Rm than w/t. Below 17.5 degrees C w/t Rm data divided into low and high temperature dependence groups, while cel- data exhibited a low temperature dependence. The results are discussed in relation to gel-liquid crystal phase transitions, membrane fluidity, and the contribution of fatty acid structure to membrane electrical properties.


Studies on isolated subcellular components of cat pancreas. I. Isolation and enzymatic characterization. Pancreas of the cat was fractionated into its subcellular components by centrifugation through an exponential ficoll-sucrose density gradient in a zonal rotor. This enables a preparation of four fractions enriched in plasma membranes, endoplasmic reticulum, mitochondria and zymogen granules, respectively. The first fraction, enriched by 9- to 15-fold in the plasma membrane marker enzymes, hormone-stimulated adenylate cyclase, (Na+K+)-ATPase, and 5'-nucleotidase, is contaminated by membranes derived from endoplasmic reticulum but is virtually free from mitochondrial and zymogen-granule contamination. The second fraction from the zonal gradient shows only moderate enrichment of the above marker enzymes but contains a considerable quantity of plasma membrane marker enzymes and represents mostly rough endoplasmic reticulum. The third fraction contains the bulk of mitochondria and the fourth mainly zymogen granules as assessed by electron microscopy and marker enzymes for both mitochondria and zymogen granules, namely succinic dehydrogenase, trypsin and amylase. Further purification of the plasma membrane fractions by differential and sucrose step-gradient centrifugation yields plasma membranes enriched 40-fold in basal and hormone-stimulated adenylate cyclase and (Na+K+)-ATPase.


Effect of hyperthermia on the functional activity of cytotoxic T-lymphocytes. The effect of hyperthermia on the functional activity of murine cytotoxic thymus-derived lymphocytes (CTL's) has been investigated. CTL's were generated in vitro in mixed leukocyte cultures (MLC's) and assayed for cytotoxicity on 51Cr-labeled allogeneic P-815 mastocytoma cells. Exposure of MLC cells to temperatures of 43 degrees C or above rapidly inactivated CTL function. The degree of inactivation depended on temperature and time of exposure to heat. CTL function was much more sensitive to hyperthermia than was the reproductive capacity of tumor target cells (assessed by a cloning assay), and the heat sensitivity of CTL's appeared to depend on their stage of differentiation. CTL function dramatically increased when MLC cells were incubated at 37 degrees C after exposure to hyperthermia or when a total exposure to heat was split into two equal fractions separated by an interval at 37 degrees C. These latter findings were operationally analogous to the repair of potentially lethal and sublethal radiation damage, respectively, and suggested that further studies are required to assess the complex interrelationships between hyperthermia, cell-mediated immunity, and tumor cell survival.


Problems and solutions in achieving uniform dose distribution in superficial total body electron therapy. In treating mycosis fungoides (MF) and Sezary syndrome patients with electron beam, the entire thickness and the area of the skin from crown to sole should be irradiated uniformly. To achieve irradiation of the entire thickness of the skin, electron beams of 3 - 4 MeV energy with 80 percent depth dose at 6 mm is sufficient. This unique property of limited penetration of electron beam does not cause any systemic toxicity during or after total body electron therapy. However, this property of limited penetration of electrons poses the problem of self-shielding in the curvaceous human body. The optic lens, which is within the range of penetrability of electron beam energy used for total body electron therapy, is to be shielded artificially.The purpose of this paper is to discuss the problems of self and artificial shielding in the superficial total body electron therapy for MF and Sezary syndrome.


Bladder evaluation in pediatric patients before undiversion in previously diverted urinary tracts. An easily performed test is described for simulating physiologic micturition in the defunctionalized bladder. Accurate clinical observations of continence and emptying capabilities before undiversion or transplantation are therefore possible. The test has predicted accurately adequate functional capabilities of the bladder in a series of children after total reconstruction. Moreover, when abnormal bladder function is identified by this technique a more physiologic state is provided for further investigation by more sophisticated urodynamic techniques. Successful retesting after appropriate corrective measures have been taken will avoid complications in the undiverted patient.


Prune belly syndrome in the female subject. The prune belly syndrome of marked abdominal muscle deficiency and associated genitourinary anomalies has been found almost exclusively in male subjects. Of the few reported cases of female patients with this entity most are questionable or incomplete forms. The light microscopic histology and electron microscopic ureteral abnormalities in male subjects have been reported previously. A female newborn with marked abdominal muscle deficiency and severe bilateral ureteropyelocaliectasis is described. Chromosomal studies showed 46 XX karyotype. Histologic examination of the ureter by light microscopy was compatible with the diagnosis.


Bile canalicular membrane pathology in cytochalasin B-induced cholestasis. The mechanism of cytochalasin B-induced intrahepatic cholestasis was examined using electron cytochemical techniques. Since previous studies suggested that the earliest lesions were in hepatic canaliculi, markers were used for three canalicular membrane components, namely ruthenium red for the glycoprotein-rich surface coat, the Mg2+-ATPase reaction as an example of a membrane-bound protein, and uranyl acetate en bloc and ruthenium red staining for the canalicular membrane-associated microfilaments. In rat liver infused in vivo with cytochalasin B, reduction in bile flow correlated with bile canalicular dilation, loss of the ruthenium red-positive surface coat from the canalicular membrane, and loss of demonstrable Mg2+-ATPase activity. In addition, structural alterations in microfilaments with widening of the ectoplasmic zone were noted. In isolated liver cells in vitro, identical changes were found. Bile canaliculi isolated from the in vivo cytochalasin B-infused rat liver lacked their normal investment of microfilaments. Detachment of the filaments from the bile canalicular membrane may be involved in the mechanism of cytochalasin B-induced cholestasis.


Congestive cardiomyopathy in Noonan's syndrome. We report a clinicopathologic study of intractable congestive cardiomyopathy in a teenaged patient who had features of Noonan's syndrome. Various forms of congenital cardiac malformations occur commonly in Noonan's syndrome, and there are also a few reported cases of cardiomyopathy in this entity. Unlike previously documented cases, our patient was found at autopsy to have nonobstructive hypertrophic cardiomyopathy.


[Tracheal transplantation in inbred strains of rate--I. Microsurgical technique (author's transl)]. Tracheal transplantations in isohistogenic strains of rats are performed to obtain reproducable conditions in experiment. A microsurgical technique of tracheal transplantation in rats is described. The results are summarized without discussing the problems of immunology, histology or the regeneration of tracheal epithelium.


[Long term experience of using preserved cartilage in reconstructive surgery of the nose (author's transl)]. Long term experience of nasal surgery using cartilage homografts preserved in merthiolate shows the implants to have the following properties: 1. They heal without complications and are well tolerated. 2. Rate of resorption varies according to the quality of the recipient site and the stresses on it from outside. 3. Very suitable for support to replace resected or destroyed cartilage. 4. Limited use in reconstructing weight bearing areas because of unduly high resorption rate in 50% of implanted struts. 5. No clinical evidence of resorption in areas not subject to stress. 6. Resorption in areas of stress varies from a virtual absence to a rapid process.


[Middle ear pressure after rhinoplasty surgery (author's transl)]. Middle ear pressure after rhinoplasty surgery was determined by tympanometry. Measurings were done in 94 patients (total of 177 ears) before the rhinoplasty operation and during the following 6 days respectively in special cases up to three weeks. In 153 ears normal middle ear pressure was found before the operation. After the rhinoplasty in about 2/3 of all cases negative pressure up to 300 mm Ws developed. This negative pressure was equalized in the vast majority of cases (84.3%) after the tamponade was removed. In some cases negative pressure persisted for 6 days after the operation (9.8%); in few cases (5.9%) up to three weeks. In 13 out of 24 patients having negative middle ear pressures together with rhinomanometrically objectified impaired nasal ventilation rhinoplasty led to normal middle ear pressure. Reasons for the development of negative pressures in the middle ear are discussed. The results of the investigations lead to consequences concerning tympanoplasty in connection with rhinoplasty operations. Rhinoplasty and tympanoplasty should not be performed on the same day--there should be an intervall of 4--6 days between these operations. Negative pressure in the middle ear in cases of impaired nasal ventilation can be improved by rhinoplasty.


[A method for the reconstruction of perforating radiogenic defects of the auricle (author's transl)]. Perforating radiogenic defects of the auricle in the area of the cymba, conchal cavity and triangular fossa can be reconstructed in a one stage procedure by a pedicled composite flap of conchal cartilage and skin. The conchal donor area is covered with a free skin-fat-graft from the lobule or with a full-thickness retroauricular graft from the unaffected ear. The defect reconstruction on the retroauricular side can be carried out with a pedicled skin flap from the unaffected adjacent retroauricular region.


[Wiresutures for improvement of swallowing after Alonso-operation (author's transl)]. After the horizontal hemilaryngectomy by Alonso there very often are deglutitions, where it is very strenous for the patient, to put the base of the tongue over the entrance of the larynx. Especially, since through the defect of the operation the base of the tongue and the rest of the larynx disperse in consequence of the weight of the lungs. Wiresutures between the remaining parts of the hyoid and between hyoid and cartilage thyroid, could hinder this dispersion. In that way the preoperative topic of these parts could quarantee and enable frequently undisturbed swallowing after a few days.


[Reconstructive procedures in the oral cavity and oropharynx following tumor resection (author's transl)]. Even in far advanced carcinomas of the oral cavity and oropharynx (T3-tumors) with extensive resections there are methods of plastic reconstruction which provide an acceptable functional and esthetic result for most patients. For immediate reconstruction of the soft tissues the forehead flap of McGregor, the deltopectoral flap of Bakamjian and the posteriorly pedicled tongue flap are particularly useful. Following surgical removal of the chin portion of the mandible a titanium implant is recommended for immediate replacement. Inspite the advances in plastic reconstructive surgery, these procedures rarely lead to a five-year cure rate; regarding palliation and hope for cure they are more promising, however, than radiation therapy alone.


[Computer documentation of allergological data on patients suffering from allergies of the ENT-tract (author's transl)]. After a brief discussion of the purpose of EDP in medicine an EDP system is described that serves the collection of data on patients of an allergy department. It was taken into account that in addition to data concerning case histories and the general and special status data on the different courses of therapies and test results can be collected. The system is specifically adapted to the problem of allergies of the respiratory tract, but may also be used--with minor additions or alterations--for internal or dermatological cases. The aim of this documentation is the systemization and at the same time the rationalization of the examination course, without, however, ruling out individual extensions. Such a system facilitates and accelerates not only the collection of data, it also allows a faster systematic disclosure of errors and makes a meaningful scientific evaluation possible.


[Diagnostic reliability of ipsilateral evoked impedance changes of the tympanic membrane (author's tranl)]. The ipsilateral registration of impedance change is necessary in case of unilateral cochlear or retrocochlear disease with middle ear impairment of the other ear and, therefore, impossibility of contralateral evocation of the reflex. If contralateral evocation fails, moreover, it will be useful in order to clarify, whether the evocation did not succeed or the registration at the contralateral ear; thus enabling a differentiation between lesions of the reflexe's afferent and efferent way. In ipsilateral impedance-change-measurements it should be distinguished between an increase of the acoustic impedance (as searched for--turn to the right at the balancemeter) and a decrease of it (turn to the left at the balancemeter). The "turns to the left" at ipsilateral evocation occur without latency and only at SPL 100 dB or more. They can be observed in patients suffering from otosclerosis, complete deafness and indissected temporal bones as well. This acoustic-mechanical effect rises at high sound pressures from the non-linearity of the sound-field, which produces an extra pressure unbalancing the pressure before and behind the tympanic membrane. This effect may interfere with the real reflex-response, but only at more than 100 dB SPL; however, it must be distinguished from the proper response in order not to find the reflex falsely positive. In three clinical examples (angioblastoma of the right cerebellum hemisphere, multiple sclerosis, cerebello-pontine angle lesion) the absence of ipsilateral impedance reflexes (isolated or additional) is demonstrated.


[Aspiration biopsy cytology of salivary gland tumours (author's transl)]. Tumours of the salivary glands can be diagnosed in most cases by fine needle aspiration biopsy followed by cytological investigation of the biopsy samples. Compared with the histological results obtained from 194 samples, the diagnostic accuracy amounted to 75.5%. When the assessment of dignity of the tumour is carried out without further classification of the tumour, the accuracy increases above 90%. Possible errors involved in the aspiration technique and in the cytological assessment are discussed. The advantages of the fine needle aspiration biopsy for diagnosis and therapy of salivary gland tumours are stressed.


[Clinical features of papilliferous cystadenolymphoma of the parotid (Whartin's tumour) (author's transl)]. Out of 222 parotid tumours treated by surgery 22 (10%) proved to be cystadenolymphoma papilliferum. The tumour was found predominantly in men over fifty, tended to grow rapidly often causing pain. Suspicion of papilliferous cystadenolymphoma (a parotid tumour in older men) must be confirmed by early operation. The surgical procedure for cystadenolymphoma is like that for pleomorphic adenoma (exposure of the facial nerve followed by partial parotidectomy). An extracapsular dissection is not recommended.


[Calcifying epithelioma of Malherbe masquerading as a parotid-tumour (author's transl)]. 3 cases of epithelioma calcificans Malherbe are being reported on, which were observed on children in the parotid area. The scarcity of such lesions in the regio parotidea is stressed, conclusions concerning differential diagnosis are following. The sometimes high concentration of mitoses is discussed under consideration of eventual diagnostic problems regarding cytological investigation.