Separation of helper and suppressor T lymphocytes. III. Positive and negative effects of mixed lymphocyte reaction-activated T cells. Using a Ficoll velocity sedimentation gradient, we provide evidence to show that stimulatory and inhibitory activities induced in mixed lymphocyte culture belong to two distinct subpopulations of T cells. Slow- to medium-sedimenting, nonproliferating cells enhance the humoral response of normal cells to SRBC whereas fast-sedimenting cells inhibit that response. Cytotoxic lymphocytes are found in the same fractions as suppressor cells but appear to be differentiable from the latter in terms of maturation kinetics and specificity.


Effects of vitamin B6 deficiency on thymic epithelial cells and T lymphocyte differentiation. Dietary vitamin B6 (pyridoxine) deficiency in young Lewis rats results in a reduction of T lymphocyte numbers and defects of cellular immunocompetence. In vitro studies of thymic epithelial (TE) cells, responsible for inducing T lymphocyte differentiation, revealed that maintenance on a vitamin B6 deficient diet for 2 weeks resulted in a severe defect in TE cell function. When the deficient animals were returned to a normal diet, TE cell function was restored. Exposure of lymphoid precursors from neonatally thymectomized or vitamin B6-deficient donors to normal TE monolayers resulted in their conversion to functional T lymphocytes, as measured by their response in MLR and to mitogens. However, TE monolayers from vitamin B6-deficient animals were unable to effect such a maturation of T lymphocytes. Therefore, it is suggested that the defect in cellular immunocompetence following this dietary deficiency is due, at least in part, to the inability of TE cells to effect the differentiation of T lymphocyte precursors to functional T lymphocytes. The dietary deficiency does not, however, impair lymphoid precursors, which can be stimulated to further differentiation by exposure to normal TE cell monolayers.


Isolation and characterization of naturally occurring subclasses of human peripheral blood T cells with regulatory functions. By utilizing naturally occurring autoimmune antibodies from patients with juvenile rheumatoid arthritis, we have isolated and functionally characterized two unique subpopulations of T cells. JRA+ T cells, i.e., those identified by sera from these patients, react poorly in response to allogeneic cells, respond to Con A but not PHA, and do not help in the synthesis and secretion of Ig by B cells. In contrast, JRA- T cells, i.e., those not identified by sera from these patients, respond very well to allogeneic cells, proliferate well in response to PHA but not Con A, and more interestingly, can greatly enhance the secretion of Ig by B cells.


Two functionally distinct subpopulations of human T cells that collaborate in the generation of cytotoxic cells responsible for cell-mediated lympholysis. A human thymus-dependent differentiation antigen, TH2 was defined by a rabbit anti-human T cell serum absorbed with autologous B lymphoblasts and leukemic cells bearing T cell markers from a patient with chronic lymphocytic leukemia. Anti-TH2 reacted specifically with thymus-derived lymphoid cells and exhibited two distinct profiles of reactivity with normal peripheral T cells as detected by indirect immunofluorescence on a FACS I. Isolation of strongly reactive, TH2+, from weakly reactive, TH2- T cells by fluorescence-activated cell sorting revealed that the TH2+ subset contained most of the killer activity in cell-mediated lympholysis (CML), but had a diminished response in MLC and a suboptimal or negligible proliferative response to soluble antigens (mumps, PPD, tetanus toxoid). In contrast, the TH2- subset contained markedly less killer activity but amplified cytotoxicity by TH2+ cells and exhibited a proliferative response to both alloantigen and soluble antigens that was often significantly greater than the response by unseparated T cells. The relevance of these findings to previously described human T cell subsets and to functional subpopulations of murine T cells is discussed.


Surface markers and mitogen response of cells harvested from cutaneous infiltrates in mycosis fungoides and Sézary's syndrome. It was the purpose of this study to characterize the proliferating cells in skin lesion of Sézary's syndrome and of mycosis fungoides by means of their surface markers and their response to Phytohemagglutinine mitogen stimulation. Viable infiltrating cells were freed from skin biopsy specimens by means of a disaggregating homogenizer and the cells yielded were tested with heterologius polyvalent anti-human Ig and with anti-human T-cell globulin, as well as for spontaneous rosette formation with sheep red blood cells (SRBC) and for their response to stimulation with Phytohemagglutinine. Most of the infiltrating cells in skin lesions of mycosis fungoides and Sézary's syndrome lack receptors for anti-human Ig but form spontaneous rosettes with SRBC and have receptors for anti-T-cell globulin, indicating the T-lymphocyte nature of the infiltrating cells; however, their response to Phytohemagglutinine is weak. The results indicate the atypical, presumably neoplastic, nature of T-lymphocytes proliferating in skin lesions of mycosis fungoides and Sézary's syndrome.


Interference of gestagens and androgens with rat uterine oestrogen receptors. The inhibitory effect of some gestagens and calusterone on the binding of oestradiol-17beta to its specific uterine receptors has been investigated in intact rats. Progesterone, medrogestone, clogestone, medroxyprogesterone acetate and calusterone reduce the specific oestradiol-receptor interaction in vitro; this effect is dose-dependent and does not differ significantly from one drug to the other. A more relevant decrease in the amount of oestradiol-17beta bound to specific receptors has been observed with calusterone. Progesterone, clogestone, medrogestone, medroxyprogesterone acetate and calusterone given orally induce a marked decrease (between 30 and 70% depending on the dose) in the binding capacity of oestradiol-17beta to specific uterine receptors in vivo. Results from a Scatchard plot analysis suggest that the interference with the binding of oestradiol-17beta caused by both progestogens and calusterone is due to a non-competitive interaction.


Regulation of glucose, fructose and sucrose catabolism in Rhodopseudomonas capsulata. Regulation of glucose, fructose and sucrose catabolism was studied in Rhodopseudomonas capsulata grown under phototrophic conditions. The sequence of preference for the utilization of the sugar substrates was fructose, glucose, sucrose. The presence of a preferred substrate did not completely suppress the utilization of the less preferred. Glucose-6-phosphate dehydrogenase, the key enzyme of glucose and sucrose catabolism, exhibited sigmoidal substrate saturation curves and was inhibited by phosphoenolpyruvate, whereas 1-phosphofructokinase, the key enzyme of fructose catabolism, exhibited hyperbolic substrate saturation curves and was not inhibited by phosphoenolpyruvate. Since phosphoenolpyruvate is a common intermediate of glucose, fructose and sucrose catabolism, the control of glucose-6-phosphate dehydrogenase may be responsible for the preferential utilization of fructose.


Congenital aneurysmal dilatation of the left auricle demonstrated by sequential cardiac blood-pool scintiscanning. Congenital aneurysmal dilatation of the left auricle is a rare condition often associated with cardiac arrhythmias and systemic emboli. The diagnosis is made often by surgical exploration or presurgically by contrast angiography. A case is reported in which the dilated left auricle did not fill during contrast angiography but was demonstrated by sequential cardiac blood-pool scintiscanning.


Hormonal changes in girls with precocious adrenarche: a possible role for estradiol or prolactin. Serum concentrations of dehydroepiandrosterone, DHA sulfate, estradiol, and prolactin in 20 girls with precocious adrenarche were compared with those of healthy girls of varying age and degrees of breast and sex hair development. Production of adrenal androgens, as reflected by serum DHA and DHA-sulfate concentrations, was significantly increased in PA above that in age-matched control subjects. Surprisingly, in spite of their lack of breast growth, the patients with PA also had serum estradiol levels that were higher than in the prepubertal girls and similar to those found in girls with both breast and pubic hair development. Serum prolactin concentrations in the patients with PA were not increased over those of the age-matched (less than 8 years) prepubertal girls. In the older prepubertal ( greater than 8 years) and early pubertal girls serum prolactin levels were lower. The finding of increased estradiol levels suggests that precocious adrenarche is not a distinct endocrine entity, but merely represents a variant of early adolescence in which estrogen secretion is sufficient to influence adrenal 3beta-hydroxysteroid dehydrogenase activity with a resultant rise in DHA production, but not sufficient to produce clinically apparent breast changes. The data do not support a similar role for prolactin.


GLC determination of floxuridine in plasma using a thermionic nitrogen detector. A specific GLC method was developed for the determination of floxuridine in plasma using the thermionic nitrogen detector. The method involves the isolation of the compound and internal standard from plasma on a strong anion-exchange column at pH 10, followed by elution with 0.3 M acetic acid in methanol. The eluate is evaporated to dryness, and the residue is dissolved in dimethyl sulfoxide and permethylated with potassium tert-butoxide and methyl iodide. The permethylated compounds are reextracted from the reaction mixture with cyclohexane-methylene dichloride (9:1). The organic solution is evaporated to dryness, the residue is dissolved in ethyl acetate, and an aliquot is analyzed by GLC on a 3% OV-17 column. The extraction recovery from spiked plasma was 93.2 +/- 2.1% (SD), whereas linearity for the overall procedure was in the 0-1-microgram/ml range. The detection limit of the thermionic nitrogen detector was 50 ng/ml. The within-run and within days precision (CV) were 4.0 and 6.2%, respectively, at 300 ng/ml.


Repression of glial RNA transcription during the development of 6-aminonic-otinamide (6-AN)-induced acute gliopathy. Administration of 6-aminonicotinamide (6-AN) to rats leads to an opposite effect on the rate at which [3H]UMP is incorporated in vitro into nuclear cerebral neuronal and glial RNA. The inhibition of glial RNA synthesis is temporarily accompanied by both a reduction of the number of RNA initiation sites on glial chromatin and a reduction of [3H]acetate uptake into glial chromatin-bound histones mainly as regards the fraction H2B, H3 and H4. The slight stimulation of neuronal RNA synthesis 6 hours after 6-AN seemed to be caused exclusively by a less steric restriction of neuronal chromatin, whereas the more pronounced stimulation at 24 hours may be related to both a higher activity and/or amount of endogenous neuronal RNA polymerases and an increase in the total number of RNA initiation sites present on the neuronal chromatin. The increase in the total number of neuronal RNA initiation sites is closely parallel with a higher degree of acetylation of neuronal chromatin-bound histone fractions. The 6-AN-induced variations of glial and neuronal in vitro RNA synthesis are discussed in correlation with the neurotoxic action of 6-AN in vivo.


Regulatory enzymes of carbohydrate and energy metabolism in the rabbit blastocyst. The activities of phosphofructokinase, pyruvate kinase, citrate synthase and creatine kinase were determined in blastocysts from rabbits at 144 h post coitum and in similar blastocysts cultured for 24 h with or without oestradiol-17beta (1 microgrm/ml). There was a significant increase in all the enzymes during the 24-h culture period but oestradiol had no effect.


Immune complex vasculitis as a cause of ascites and pleural effusions in systemic lupus erythematosus. A patient is described with systemic lupus erythematosus and large painless ascites and pleural effusions. Pleural and peritoneal fluid complement levels were depressed, and DNA binding was elevated in the presence of normal serum values. Immunoglobulin and complement deposits were demonstrated in vessels of the pleura, peritoneum, and skin, along with histologic evidence of vasculitis. The relation of the ascites and pleural effusions to the presence of widespread vasculitis and local immune complex formation is discussed. These complications responded poorly to corticosteroid therapy but slowly resolved following the addition of an immunosuppressive agent.


Acute massive pulmonary hemorrhage in systemic lupus erythematosus. Acute massive pulmonary hemorrhage is described as part of the clinical picture of SLE. Seven patients had sudden onset of high fever, dyspnea, tachycardia, and cough with blood-tinged sputum that within hours progressed to massive hemoptysis and death. There were no vasculitis or other inflammatory lung changes found at autopsy. Only one of the seven reported cases survived when treated with 2 g of intravenous hydrocortisone daily. The mechanism of this pulmonary bleeding is unknown but seems to be an immune complex mediated phenomenon.


In vitro induction of cell-mediated immunity to murine leukemia cells. III. Effect of methanol extraction residue fraction of BCG on the generation of cytotoxic lymphocytes against leukemia. Effects of the methanol extraction residue (MER) fraction of tubercle bacilli (BCG) on the generation of cytotoxic lymphoid cells were studied in vitro with the use of unidirectional mixed lymphocyte-tumor cell cultures. These cultures consisted of splenocytes of lymph node cells from normal donor C57BL/6, BALB/c, and strain A mice and mitomycin C-inactivated leukemia cells of both syngeneic and allogeneic origin. Addition of small amounts of MER (0.2-5 microgram/ml) to the cultures potentiated appreciably the elicitation of cytotoxic reactivity (as measured by the 51Cr-release assay) of the sensitized cells, whereas higher quantities (10-40 microgram/ml) had a strong suppressive effect. MER also induced some cytotoxic capacity in normal murine and human lymphoid cells not exposed to specific tumor cell stimulation. The stimulatory and suppressive effects were noted only when MER was present during the initial 24-48 hours of the 6-day culture. With the nylon wool fractionation technique, it was apparent that MER affected primarily the nonadherent cell population. MER could also prevent the generation of nonspecific suppressor cells by splenocytes maintained for 3-6 days in tissue culture.


The treatment of dracontiasis with thiabendazole. 400 cases of dracunculosis were treated with Thiabendazole and the results reported. Thiabendazole appears to be highly effective and its pleasant taste and lack of adverse effects account for its acceptability by the patients. The drug is cheap and can be recommended even for poor patients. The adverse reactions are minimal and do not necessitate stoppage of therapy. We conclude the Mintezol is highly efficacious and should prove a useful weapon against Guinea worm disease.


Morphologic and biochemical studies on the experimental chronic ischemic myocardium with the Ameroid constrictor. 1. Morphologic as well as biochemical alterations in chronic ischemic myocardial tissue without infarction were studied in dogs utilizing the Ameroid constrictor. 2. Serum creatine kinase activity elevated at around three weeks after placing the Ameroid constrictor around the circumflex branch of the left coronary artery suggestive of myocardial tissue injury followed by the initial activation caused by surgery. 3. Subendocardial proliferation of connective tissue was observed in about 60% of the experiments, but the middle and the subepicardial muscles were morphologically intact. 4. The marked increase in glycogen particles was observed in the subendocardial muscle cells in most of the experiments, and mild features of myocardial cellular necrosis were found in approximately 60% of the experiments. 5. ATPase activities of the structural proteins as well as sarcoplasmic reticulum in the ischemic myocardium shoed relatively higher values than those in the non-ischemic myocardium. However, no substructural changes were observed in SDS gel electrophoresis in both the fractions. 6. The alterations in the chronic myocardial ischemia are supposed to be essentially the same as those in myocardial necrosis followed by acute coronary occlusion.


Immune complex disease. VII. Experimental mesangiopathic glomerulonephritis produced by chronic immunization with thyroglobulin. Immunohistologic and electron microscipic studies were performed on the kidneys of rabbits given daily intravenous injections of porcine thyroglobulin in amounts adjusted to the immune response of the individual rabbits. Glomerular lesions were restricted to the mesangium, were characterized by varying degrees of proliferation of mesangial cells and increase of mesangial matrix, and were accompanied by accumulations of rabbit immunoglobulins, C3, and porcine thyroglobulin. Electron-dense deposits were localized to the mesangium and the adjacent subendothelial space. Less than 10 per cent of the animals with mesangila lesions developed obvious impairment of glomerular function. Thyroglobulin-containing immune complexes were found to be rapidly removed from the mesangium, so that overloading of the mesangium and consequent accumulation of complexes in the adjacent capillary loops could not occur. Thus, the results provide further evidence that when immune complex deposition is restricted to the mesangium, relatively little interference with glomerular function results. This situation is paralleled in man by the lesions of subclinical lupus nephritis, chance proteinuria and hematuria, and the early lesions of Berger's disease.


Experimental glomerulonephritis in the rat induced by antibodies directed against tubular antigens. IV. Investigations into the pathogenesis of the model. Heterologous immune complex glomerulonephritis can be induced in various strains of rats by one injection of heterologous antibody directed against antigens present in the brush border of the proximal. Although it is generally believed that an immune complex glomerulonephritis is caused by the deposition of soluble immune complexes from the circulation in the glomerular basement membrane, there are reasons for doubting whether this mechanism is also operating in the type of experimental glomerulonephritis presented here. In a study using injections of extra antibody and extra antigen to influence the formation and deposition of immune complexes, it is demonstrated that this type of glomerulonephritis is induced in a state of antibody excess. The theory that only immune complexes formed in antigen excess can deposit in the glomerular basement membrane, warrants the assumption that in our model a different pathogenetic mechanism is operating. The hypothesis is put forward that in the heterologous immune complex glomerulonephritis free antibody crosses the glomerular basement membrane to combine with the antigen. This antigen either crosses the glomerular basement membrane separately or is already present as an integral part of this structure.


Experimental glomerulonephritis in the rat induced by antibodies directed against tubular antigens. V. Fixed glomerular antigens in the pathogenesis of heterologous immune complex glomerulonephritis. In heterologous immune complex glomerulonephritis glomerular deposition of immune complexes occurs immediately after an injection with heterologous antibody directed against antigen, derived from the brush border of the tubules. The injected antibody is thought to combine with circulating Fx1A antigen to form immune complexes which subsequently are deposited in the glomeruli. However, perfusion of rat kidneys in absence of this antigen likewise resulted in prompt localization of immune complexes along the glomerular basement membrane. Further, Fx1A antigen was shown to be present in the capillary wall, especially in the filtration slits and on the cell membrane of epithelial cells. From these findings it was concluded that in this model of glomerulonephritis the deposited immune complexes are formed locally instead of being deposited from the circulation. This concept of "fixed antigen" may also be relevant to the pathogenesis of other forms of experimental glomerulonephritis and probably also for human glomerulonephritis.


Absolute morphometric study of myocardial hypertrophy in experimental hypertension. I. Determination of myocyte size. A method for determining the mean absolute volume of a specific population of cells within a tissue is described and applied to the measurement of endocardial and epicardial myocytes in the left ventricle of normal and hypertensive rats. The technique, based on nuclear counts per unit area in tissue slices of different known thicknesses, measures the mean cell volume per nucleus independent of previously unknown nuclear dimensions and systematic counting errors. Duplicate determinations, demonstrating reproducibility, were made in mutually perpendicular longitudinal and transverse sections of the myocardium. Combining these light microscopic measurements with electron microscopic data enabled the evaluation of the mean diameter and length of the cylindrical myocyte nuclei showing those in the epicardial cells to be significantly longer than the nuclei in endocardial cells. It was estimated that 2 to 4 per cent of ventricular myocytes are binucleate. After 1 to 4 weeks of hypertension, induced by constriction of the left renal artery, endocardial myocytes were enlarged 21 per cent, from 10,370 +/- 410 to 12,520 +/- 490 cu. micrometer., while epicardial myocytes showed a 37 per cent hypertrophy, from 12,600 +/- 1,600 to 17,300 +/- 1,100 cu. micrometer. The availability of a reliable determination of cell volume will make possible the interpretation of much biochemical, functional, and morphometric data at the whole cell level.


Absolute morphometric study of myocardial hypertrophy in experimental hypertension. II. Ultrastructure of myocytes and interstitium. The left ventricular myocardium of normal and hypertensive rats has been characterized morphometrically in the endocardial and epicardial zones. Compared to the epicardial regions, the normal endocardial regions contain 30 per cent more myocytes, 27 per cent less interstitial space, 48 per cent less capillary volume, 17 per cent less capillary surface, and the same capillary length per unit tissue volume. In terms of both the relative and absolute volumes and surface areas of their organelles, the cytoplasmic composition of normal endocardial and epicardial myocytes is nearly identical. After 14 weeks of hypertension, induced by constriction of the left renal artery, left ventricular weight is increased by 30 per cent, wall thickness by 42 per cent. The number of myocytes and the total length of capillaries remain constant. The epicardial region enlarged 37 per cent with proportional increases of myocyte and interstitial volumes. In contrast, the endocardial enlargement was only 26 per cent, comprised of 21 per cent hypertrophy of myocytes and a 55 per cent increase in interstitial components. Expansion of capillary lumina accounted for much of the interstitial enlargement throughout the myocardium. Hypertrophy of myocytes is 76 per cent greater in the epicardial region and is accompanied by a reduced mitochondria to myofibril ratio and disproportionately large increases (2- to 3-fold) in both smooth endoplasmic reticulum and T-system volume and surface area. On a cellular basis the absolute morphometric characteristics of myocytes from hypertensive rats are significantly different from normal, and significant differences occur between the inner and outer layers of the myocardium for practically every cytoplasmic component.


Cardiac hypothermia evaluated by ultrastructural studies in man. Transmural left ventricular biopsies from 13 patients undergoing cardiopulmonary bypass were studied. The hypertrophic myocardium was protected by deep hypothermia (15 degrees C.) during ischemic arrest for a maximal period of 96 minutes. Biopsies were taken at the start of bypass, at the end of aortic cross-clamping, and after 20 minutes of reperfusion. The structure of the mitochondria remained normal, whereas cellular alterations in the form of widened intercalated discs, interstitial and intracellular edema, myelin figures, and slight myofibrillar lysis were observed in all stages. As no clear correlation between these structural injuries and aortic cross-clamping time was seen, they are a result of cardiac hypertrophy rather than intraoperative ischemia.


Serotoninergic activation and inhibition: effects on carbohydrate tolerance and plasma insulin and glucagon. Glucose and arginine infusion tests were performed on 12 healthy volunteers (8 males, 4 females) before and after serotoninergic activation [oral administration of L-5-hydroxytryptophan (5-HTP-) for 6 days] and serotoninergic inhibition (oral treatment with D,L-p-chloropenylalanine for 6 days). 5-HTP treatment markedly increased urinary 5-hydroxyindoleacetic acid excretion, increased the mild hyperglycemic effect of arginine infusion, and lowered the glucose disposal rate constant. The adverse effect of serotoninergic activation on glucose tolerance is not sufficiently explained by the observed changes in insulin and glucagon secretion during the fasting state and after intravenous glucose and arginine infusions. Serotoninergic inhibition did not affect the carbohydrate tolerance of normal individuals. The results of this work supports the idea that excessive indoleamine production is probably the main cause for carbohydrate intolerance in carcinoid tumors.


Isolation of subunits from trypsin-cleaved sarcoplasmic reticulum Ca2+ transport adenosine triphosphatase. Controlled tryptic digestion of purified rat skeletal muscle sarcoplasmic reticulum (Ca2+ + Mg2+)-adenosine triphosphate yields two products designated Fragments 3a and 3b with molecular weights of 65,000 and 56,000 respectively. The isolation of these products in high yield should facilitate exploration of the molecular characteristics of this adenosine triphosphatase. A simple, rapid method for accomplishing this isolation was developed which provides a high yield and utilizes mild conditions. The fragments obtained by this method were used to determine the phospholipid and sulfhydryl contents of Fragments 3a and 3b. In addition, information was obtained on the orientation of these adenosine triphosphatase components in the enzyme lipoprotein complex.


[Polymorphous Juvenile Acne (author's transl)]. Many factors may be involved in the pathogenesis of acne, the most important of them lie in the sebaceous follicle, in disturbances of the cornification of the follicular channels and in the bacterial flora of the hair follicles. The latter consists of a yeast (pityrosporon ovale), coagulase-negative aerobic staphylococci and propionibacterium acnes. P. acnes is found in the depth of the follicle. It is of particular importance for the pathogenesis because it produces a lipase which releases fatty acids which stimulate the formation of comedones. Many questions are still unanswered. Presently, treatment consists of administration of estrogens or combination preparations of estrogen and progesterone (only recommended for women), of vitamin A acid and antibiotics. Tetracycline and its derivatives have proved particularly valuable for this purpose.


Differential diagnosis of inflammatory processes of the face. We have discussed some aspects of differential diagnosis of inflammatory processes of the facial skin. The disorders mentioned include: eczematous processes, rosacea-like dermatitis, steroid rosacea, acne, especially the diagnosis and therapy of cystic acne, psoriasis, atopic dermatitis, viral infection (Heck's disease) and circumscribed scleroderma versus systemic sclerosis and hemiatrophy of the face. Our own findings reveal that the cytocinetics in the psoriatic lesion differ fundamentally from other epidermal inflammatory processes, especially as the DNS synthesis time is prolonged. And so we consider psoriasis to be an inborn fault in the metabolism of epidermal and other cells, which is only provoked by secondary influences (drugs, allergic reactions, local traumas). To our surprise cytocinetics in atopic dermatitis do not significantly differ in the dermal infiltrate from subacute allergic contact dermatitis. Pigmentation of the face also suggests the possibility of mercury intoxication.


Quantitative histochemical studies of the hypothalamus. Control point enzymes following androgen sterilization. Three control point enzymes of the Embden-Meyerhof pathway, hexokinase (HK), phosphofructokinase (PFK) and pyruvate kinase (PK) were measured by quantitative histochemical methods in individual hypothalamic nuclei of adult neonatally androgenized female rats. HK activity was significantly increased in anterior hypothalamic nuclei: medial preoptic, lateral preoptic, and suprachiasmatic. PK was significantly elevated in the lateral preoptic and suprachiasmatic nuclei of the anterior hypothalamus and also in the medial mamillary nucleus and median eminence. No significant changes occurred in PFK activity.


[Arteriovenous aneurysm of the left internal thoracic artery with hypertrophy of the left upper limb (author's transl)]. Case report on a 5 years old boy suffering from a congenital arteriovenous fistula of the left internal thoracic artery. At the age of 9 months hypertrophy of the left arm combined with dilated veins in this area developed. Diagnosis was made by clinical examination together with a density in the left upper chest on x-ray and was confirmed by phlebography and thoracic aortography. A dilatation of the left heart, which was marked at the age of 9 months vanished in childhood without any therapy. The child was operated successfully.


[Experimental study of the factors influencing the multiplication and numbers of bream dactylogyrids]. Experiments conducted have shown that water temperature can affect dactylogyrids in two ways. From one hand, the direct influence stimulates the development and reproduction of the parasites that results in the increase of their abundance. From the other hand, the indirect effect can take place. The rise in the temperature increases the general resistence of the fish organism and favours the formation of immunological reaction to hyperinfection that causes the further fall in the parasite abundance. Thus, the seasonal dynamics of the abundance of dactylogyrids depends on the complex interaction of these two factors.


[2 new species of nematodes of the family Dolichodoridae (Nematoda: Tylenchida) from the soil around cotton roots]. The description and figures of two new species of nematodes of the genus Tylenchorhynchus Cobb, 1913 are given. T. variannus sp. n. is characterized by an asymmetrical position and variation of the width of cuticular rings in the trophic, genital and caudal parts of the body. It differs from T. irregularis Wu, 1969 in the shape of the stylet and tail and in the number and width of the tail rings. T. chirchikensis sp. n. differs from allied species by the protrusion of the cuticle into the body around the vulva, length of the ovary, structure of the head capsule, stylet and tail and by the ratio between the tail length and body width of the anus.


[Ecological and faunistic analysis of fish parasites in the Murgab River basin (Pamirs)]. The parasite fauna of fishes of the Murgab river basin (the Bartang, Murgab, Oksu rivers and Lake Sarez) was first investigated. 44 species of helminths, protozoans and crustaceans were recorded from the above area. The ecological analysis of parasite fauna of Schizothorax intermedius, Schizopygopsis stoliczkai and Nemachilus stoliczkai was conducted and the factors affecting its distribution in different parts of the basin and in different species of hosts were established. The data were obtained on the peculiarities of parasitological processes in water bodies investigated.


Imperforate anus and colon calcification in association with the prune belly syndrome. Two patients with the prune belly syndrome demonstrated colon calcifications and anorectal malformations. Bladder outlet obstruction was present in both cases. Calcifications were also found in the renal collecting system and bladder of one patient. No fistula was demonstrated between the genitourinary tract and bowel in either infant at autopsy. The calcification in the colon and urinary tract is probably secondary to stasis.


[New species of mosquito, Aedes (Ochlerotatus) gutzevichi sp. n. from Central Asia (Culiadae)]. A new species of mosquitoes. A. gutzevichi, is described. According to its structural peculiarities the species belongs to A. caspius group. According to the taxonomic characters (Gutzevich, Monchadsky, Stakelberg, 1970) larvae and females of the mosquito are close to A. mariae but differ from the latter in many morphological and ecological features. By the structure of hypopigium males belong to the group of the species A. mariae and A. pulchritarsis but differ from the former in smaller basal warts and approximated lobes of IXth tergite and from the latter in the square shape of phallosome, approximated lobes and in the absence of the thorn on the basal wart. Larvae of A. gutzevichi differ from all palaearctic species of Aedes in the size of siphon, its pubescence and pigmentation of hind valve of the stigmal plate.


Familial nonobstructive cardiomyopathy with endocardial fibroelastosis beyond infancy. A 10-year-old boy with congestive heart failure died in five months in spite of comprehensive medical treatment. Autopsy showed patchy areas of endocardial fibroelastosis of the left ventricle. The sister of this patient had followed a similar course at 13 years of age with death within six months of the onset of congestive failure. Her postmortem examination also showed endocardial fibroelastosis. The clinical presentation of familial endocardial fibroelastosis in the preteen and teenage years is a rare event. Probably the endocardial fibroelastosis was secondary to a familial nonobstructive cardiomyopathy.


[Development cycle of cattle sarcosporidia]. To establish the circulation of bovine sarcosporidia among wild animals of Uzbekistan foxes and young wolves were fed with bovine hearts and oesophaguses containing cysts of Sarkocystis bovicanis (= S. fusiformis). These animals were proved to be the final hosts of this species in nature. The prepatent period of S. bovicanis was found to be 7-8 and 7-9 days in foxes and young wolves, respectively and the patent one 33 and 28-34 days, respectively.


[The rheumatism of acne conglobata (author's transl)]. The authors report a case of painful joint, para-articular and muscular involvement accompanying acne conglobata. Fifteen other cases of rheumatism associated with this very special type of acne have been reported. The patients affected are young men suffering from acne conglobata (severe form of acne characterised by its ulcerating course and the possibility of its being accompanied by systemic manifestations), who suddenly develop fever, an altered general state and assymetrical arthralgia involving mainly the large joints, accompanied by signs of muscular involvement. The course is one of spontaneous recovery, relapses being possible. This falls within the context of the group of rheumatic disorders associated with the signs of an inflammatory skin disease.


[Low back pain of dorse-lumbar origin: surgical treatment of postérlor articular capsule excision (author's transl)]. Low back pain may be of dorso-lumbar spinal origin. Pain is transmitted via the posterior branches of the D11, D12, and L1 spinal nerves. The existence in the patient with lumbago of an area of localised pain along the iliac crest, of subcutaneous tenderness or pain in the buttock and of pain over the dorso-lumbar joints is indicative of the diagnosis. Local infiltration at the site of dorso-lumbar tenderness often causes the low back pain to disappear, often temporarily. Since the posterior branches of the spinal nerves are struck down to the capsules of the inter-apophyseal joints, it was felt that excision of these capsules would reproduce, in a permanent manner, the effects of these infiltrations. On the basis of initial results these are grounds for hope relief for certain cases of unexplained lumbar pain or of the sequellae of low lumbar surgery.


5'-Halogeno-2',3'-cyclic sulphite isomers in the preparation of 5'-halogeno nucleosides. Synthesis of 5'-deoxyuridine and 5'-deoxy-5-fluorouridine. When uridine (Ia) is reacted with thionyl chloride in hexamethylphosphoric triamide a mixture of isomeric 5'-chloro-2',3'-sulphites is formed, which can be separated to individual epimers IIa and IIIa, in 45% and 15% yields, respectively. Analogously, crystalline epimers IIb (37%) and IIIb (17%) can be obtained from 5-fluorouridine (Ib). Both isomers IIa, IIIa (or IIb, IIIb) afford a single 5'-chloro derivative IVa (or IVb, respectively) if treated with 0.1N sodium methoxide. From the mixture of sulphites IIa and IIIa (or IIb and IIIb) crystalline 5'-chlorouridine IVa is formed in 84.5% yield, calculated per starting uridine Ia (or crystalline 5'-chloro-5-fluorouridine IVb, 85.5% per starting 5-fluorouridine Ib, respectively). On reduction of 5'-chlorouridine IVa with tributyltin hydride 5'-deoxyuridine (Va) is formed in 79% yield. During the reduction of 5'-chloro-5-fluoro derivative IVb to 5'-deoxy-5-fluorouridine (Vb, 57%) a partial reductive elimination of 5-fluorine takes place under formation of 5'-deoxyuridine (Va, 9%).


Brain serotonin and epileptic seizures in mice: a pharmacological and biochemical study. 5-Hydroxytryptophan (5-HTP) reduced the intensity of both audiogenic and pentylenetrazol seizures. p-Chlorophenylalanine reduced audiogenic seizure (AGS) susceptibility but failed to change the pentylenetetrazol seizure (PTS). Drugs blocking brain serotonin (5-HT) receptors suppressed AGS but caused no clear effects upon PTS. Pentylenetetraziol-induced shock increased brain 5-hydroxyindoleacetic acid (5hiaa) concentrations and decreased 5-HT levels. Single audiogenic shock decreased the acumulation of 5-HT and 5-HIAA in the brains of mice pretreated with 5-HTP. On the other hand PTS increased the accumulation of 5-HT and 5-HIAA in the brains of mice pretreated with 5-HTP. It is suggested that AGS decrease brain 5-HT turnover whilst PTS cause an opposite effect.


[Action of O,N'-dichlorodiphenyldichloroethane (O,N'-DDD) on adrenal cortical ATPase]. The action of the inhibitor of the adrenal gland function of dogs--o,n'-DDD--on ATP-ases was studied experimentally. In a concentration of 0.2--1.0 mM o,n'-DDD inhibited the Na+, K+. Mg2+-ATP-ases of the homogenate, and also the mitochondrial and microsomal fractions of the dog adrenal cortex. The effect of the inhibitor became intensified with the temperature elevation. An inhibition of ATP-ases in the homogenate and the microsomal fraction was noted as a result of a single feeding of o,n'-DDD to dogs (50 mg per 1 kg of body weight). A double o,n'-DDD feeding caused activation of the enzymes in the homogenate and the mitochondrial fraction.


Human bronchus-mediated mutagenesis of mammalian cells by carcinogenic polynuclear aromatic hydrocarbons. Cultured human bronchial explants activated benzo[alpha]pyrene (BzaP) into electrophilic metabolites that bind to DNA in bronchial epithelial cells. Promutagenic and mutagenic metabolites of BzaP were also released into the culture medium. An increase in mutation frequency for ouabain resistance was found in Chinese hamster V-79 cells when they were cocultivated with bronchial explants in the presence of BzaP. The proximate carcinogenic form of BzaP, the 7,8-diol [(+/-)-r7,t8-dihyroxy-7,8-dihydrobenzo[a]pyrene], was 5-fold more potent as a promutagen than the parent compound. Neither BzaP nor the 7,8-diol increased the mutation frequency in V-79 cells when they were cultured without bronchial explants. The mutation frequency was directly related to the binding levels of BzaP to bronchial DNA and the concentratin of either BzaP or the 7,8-diol in the medium.


Effect of ovarectomy of females and oestrogen administration to males during the neonatal critical period on salt intake in adulthood in rats. The effect of interference in the neonatal critical period on water and salt solution (3% NaCl) intake by adult rats given a free choice of these fluids was studied. Consumption was expressed per animal, per 100 g body weight and as the NaCl concentration in the total daily fluid intake volume [NaCl]I. Newborn female rats were ovarectomized or sham-ovarectomized. Ovarectomy markedly reduces consumption and  [NaCl]I in adulthood and brought these values close to the values in normal males. Newborn male rats were injected with 1 mg oestradiol propionate dissolved in oil or just with oil. Oestradiol propionate severely inhibited growth, but produced no changes in fluid intake per animal. The [NaCl]I values were likewise unaltered, but owing to the lower body weight comsumption values per 100 g b.w. were higher in rats given oestradiol propionate than in those given oil. The relationship of the given growth changes to the regulation of salt intake and to hypothalamic function and its sexual correlates is discussed.


Triggering of discharges from an epileptogenic focus in the rat by stimulation of the contralateral hemisphere. an ontogenetic study. Fifty-two male albino rats aged 7, 9, 12 and 18 days and adult, immobilized with d-turbocurarine, were studied. Discharges were triggered from a penicillin focus with electrical pulses of double the threshold intensity needed to evoke an interhemispheric response (IHR). Developmental changes in the IHR and in spontaneous interictal discharges did not differ from the results described in earlier studies. Practically no discharges could be triggered in 7-day old animals (only a few at a very low stimulation frequency). In the other age groups, discharges were triggered at two optimal frequencies, of which the lower one rose from 0.1 to 0.6 c/s during development, while the higher one was relatively stable (about 1 c/s). With higher frequency triggering, marked signs of fatigue of the focus (intermittent triggering, loss of the main negative wave) appeared, especially in young animals. The averaged shape of triggered discharges was similar in 9- and 12-day-old rats. It consisted of a first IHR positivity which triggered the first positive wave of the focal discharge, followed by a high negative wave. In the 18-day-old and adult group, both initial positive waves merged to form a single wave. The duration of the individual waves of the triggered discharge was not significantly shorter than the duration of the corresponding waves of spontaneous discharge.


Capillary filtration during postischaemic hyperaemia in human limbs. The rate of capillary filtration after 5 minutes' ischaemia of the lower limbs was studied in man by the venous occlusive plethysmography method. The measured values were 3 times lower on an average than the control values. Comparison of the plethysmographic curves with isotope recordings after the intravenous administration of In-113m shows that volume changes induced by venous occlusion during reactive hyperaemia take place mainly intravascularly and do not allow any conclusions to be drawn on changes in blood-tissue fluid shifts.


Long systems of the dorsolateral fascicle: influence of afferentation from the splanchnic region. The influence of afferentation from the splanchnic region on the activity of long systems in the dorsolateral fascicle (DLF) was studied in chloralose-anaesthetized cats. Ascending axons (the dorsal spinocerebellar tract, DSCT and the spinocervical tract, SCT) did not respond to splanchnic stimuli. Conditioning from the splanchnic region modified their activity; the effect (mainly inhibitory) was strongest in the case of exteroceptive channels. The reaction of long propriospinal neurones depended on whether they belonged to ascending or descending pathways. No responses to splanchic stimuli were observed in the axons of ascending (proprioceptive, exteroceptive) units and conditioning from the splanchnic region only modified their activity. In decending axons, synaptic discharges with a long latent period (over 20 msec) were generated. The interaction of inputs from the visceral and somatosensory regions resulted in reciprocal inhibition of the tested activity. In axons descending from suprasegmental areas, splanchnic afferentation generated synaptic discharges with a time course comparable to spino-bulbo-spinal activity. Interaction with the responses from somatic nerves resulted inhibition of the tested activity. The results confirmed that the splanchnic region participates in modifying and evoking activity in the long DLF systems.


Induction of lipid synthesis in mammary organ cultures from mature virgin and pregnant goats. The hormones needed to induce lipogenesis in mammary organ cultures from mature virgin and pregnant goats were studied. In tissues from both mature virgin goats and goats at week 10 of pregnancy, cultivated in Waymouth medium without hormones, the rate of the incorporation of (1-(14C))-acetate into the lipids was low and decreased throughout culture. In the presence of insulin, the rate of acetate incorporation was maintained at a higher level. Cortisol acted synergistically with insulin, to produce a rate of lipid synthesis higher than that using insulin alone. The further addition of prolactin had little effect on the incorporation of acetate into the lipids of mammary explants from mature virgin goats, but markedly stimulated it in tissue from animals at weeks 9--10 of pregnancy. The maximum increase in the rate of lipid synthesis was achieved in the presence of 0.5 microgram prolactin/ml, whereas with growth hormone 50 microgram/ml was needed for the maximum effect. The initial rate of acetate incorporation into mammary explants from goats at weeks 13 and 18 of pregnancy was high. It was not stimulated by the hormones during culture, however, and decreased more rapidly in the absence of hormones than in their presence. The rate of acetate incorporation into the lipids was in agreement with the histological evaluation of the secretory response of the mammary explants after cultivation. The secretory response to prolactin and the rate of the incorporation of acetate into the lipids were highest in goats at weeks 9--10 of pregnancy while in tissues from goats at weeks 13 and 18 were not stimulated and decreased during culture.


Metabolic vasodilatation in skeletal muscle and the problem of the direct or indirect action of oxygen on resistant blood vessels. 1. Vasodilatation induced by venous blood infusion and reactive hyperaemia following the reduction of perfusion pressure for different lengths of time (1 to 128 sec) were studied in the haemodynamically isolated and denervated vascular bed of the dog gracilis muscle. The two local regulatory situations differed chiefly in respect to the oxygen concentration in the precapillary part of the blood bed (51.4% and 97.6% respectively) and in the size of the blood flow (100% and 48.5% of the resting value). 2. The interval between the time when venous blood entered the resistant precapillary vessels and the onset of the local regulatory response was 25.1 +/- 1.9 seconds. In prolongation of the duration of reduced perfusion pressure, the continuous increase in the maximum reactive hyperaemia value was interrupted, on reducing it for 16-32 seconds, by a significant (P less than 0.001) abrupt increase in this value. 3. We conclude from the good agreement of these two time values that: 1. reduction of the blood oxygen concentration to 51.4% does not directly affect the smooth muscle cells in the wall of resistant vessels; 2. an interval of 25.1 +/- 1.9 sec (16-32 seconds) is needed for interference with the metabolism of skeletal muscle to attain a critical value and for the relevant chemical signal to produce a dilatation response in the arterioles.


Incorporation of 14C-thymidine into liver and brain DNA of protein-deficient rats. The authors studied the effect of a protein-free diet on 14C-thymidine incorporation into rat liver DNA in vivo and found, after 2-3 weeks, a marked decrease in uptake of the radioactive base into the liver DNA, followed by a decrease in the proportion of DNA in liver cell homogenates. The total nuclear count/mg liver tissue displayed an increase during protein depletion, except for the 5th week, when a decrease was recorded. The incorporation of 14C thymidine into the brain DNA likewise displayed no great differences, although a significant drop was observed during the 2nd to 4th week of depletion. In the 5th week we recorded an increase in uptake of the radioactive base by brain DNA, exceeding the incorporation values in the controls.


Development of spontaneous motility in chick embryos supraspinal control. Changes in spontaneous motility were studied in 11- to 19-day-old chick embryos after acute and chronic decapitation. Chronic decapitation was performed on the 2nd day of incubation, at stage 11--14. Up to the 15th day, acute decapitation merely reduced the frequency of spontaneous movements. In 17-day embryos it was followed by typical spinal shock, with transient complete disappearance of spontaneous movements of the embryo. The duration of spontaneous motor depression was proportional to the age of the embryo. After the 15th day of incubation, spinal decentralization changed continuous to discontinuous motor activity, with spontaneous paroxysms of high amplitude movements followed by long intervals of motor rest. Chronic decapitation was manifested, from the 15th day of incubation, in significant reduction of spontaneous movement frequency and again in discontinuous motility. A microscopic anatomical analysis of the spinal cord of decapitated embryos showed defects of the tracts in the lateral and ventromedial area of the cord and degenerative injury of the motoneurones in the ventral horns. Supraspinal control thus does not begin to act effectively on the spontaneous motility of chick embryos until about the 15th day of incubation. Supraspinal factors modulate both the frequency and the rhythm of spontaneous movements and are evidently also indispensable for normal morphological development of the spinal cord motor apparatus of chick embryos.


Fatty acid synthesis in vitro in the liver and adipose tissue of rats of various ages. In white male Wistar rats aged 2, 4, 6, 9, 12, 18 and 32 months, receiving a standard laboratory diet (25 cal% proteins, 22 cal% fat and 53 cal% glycides) we assessed the total amount of fatty acids in the carcass and in vitro lipogenesis in liver and adipose tissue by the means of glucose-14C(U). The amount of body fat increased with age; the highest rate of increase in the percentage of body fat occurs 2 to 4 months after birth. Incorporation of 14C of glucose into total liver lipids attains maximum values in the group of rats age 2 to 4 months. By the age of 6 months lipogenesis decreased to a level observed in all the remaining age groups. In adipose tissue, the incorporation of 14C into total lipids decreased between the age of 2 to 4 months, a further decrease was observed around the age of 6 months. No appreciable changes were noted in any of the older age groups.


Effect of p-chlorophenylalnine on the loss and maintenance of tolerance to ethanol. Rats were rendered tolerant to the motor-impairing effects of ethanol by daily oral administration. Subsequently, ethanol was withdrawn and the effect of p-chlorophenylalanine (p-CPA) on tolerance loss was examined. In two separate studies it was demonstrated that p-CPA, in a dosage regimen that produces extensive depletion of brain serotonin (5-HT), accelerated tolerance loss. These experiments suggest that at least part of p-CPA's inhibitory effect on net tolerance development to ethanol can be accounted for by its accelerating effect on tolerance loss; however, an inhibitory effect on tolerance acquisition cannot be excluded. On the other hand, once tolerance was established, p-CPA did not affect the maintenance of tolerance to ethanol.


Abnormal intestinal motility in gastroschisis. The authors describe abnormal intestinal motility with a very slow transit time in eight children with gastroschisis. Other abnormal findings include malrotation, dilatation, and fixation of the loops of the bowel.


[Fractures of long bones in Paget's disease treated by plating (author's transl)]. The author advocates the fixation by plating of the fractures and curves of long bones in Paget's disease. This method is described as easy and three cases of fractures of the femur are described. The biomechanical problems of pagetic bone are analysed. It is concluded that straightening of the curves and fracture fixation must be performed simultaneously. Therefore the plates must be long enough for bridging the pathological area of the bone. Later on the plate should be left in place for prevention of further increase of the curves.


[Aneurysm due to an exostosis of the upper end of the tibia (author's transl)]. The authors describe a case of aneurysm of the popliteal artery which developed in the vicinity of a solitary bony exostosis. In a review of the literature they found 33 other cases, in the majority of which the aneurysm was a false aneurysm. Diagnosis was made by arteriography. The results of treatment were good unless complications such as thrombosis or emboli were already present. In the authors' case, resection of the exostosis and arterial grafts were performed with a good end result.


[Simultaneous bilateral avulsion of the quadriceps and Achilles tendons in 1 limb and of the patellar tendon in the other in a hyperparathyroid patient on chronic hemodialysis]. A case of simultaneous rupture of three tendons is reported in a patient who had suffered a bilateral nephrectomy six years earlier and was on chronic haemodialysis. The quadriceps tendon and the patellar tendon were repaired surgically. The rupture of the tendo Achillis was left untreated. Six days later a parathyroidectomy was performed; nine months later recovery was excellent. A review of the literature has been made. The role of hyperparathyroidism in the strength of the bone-tendon junction is discussed.


Alpha-hydroxylation in the metabolism of N-nitrosopiperidine by rat liver microsomes: formation of 5-hydroxypentanal. Metabolism of n-nitrosopiperidine by a purified microsomal preparation from rat liver was shown to yield 5-hydroxypentanal. This is the predicted product for a pathway involving an initial oxidation of the nitrosamine at the carbon atom alpha to the nitroso group.


ATP-ase activity of purified human normal T- and B-lymphocytes. In 15 healthy individuals the ATP-ase activity of circulating B-lymphocytes was found to be significantly higher than of T-lymphocytes. Two different methods were used for the purification of B- and T-lymphocytes and the result was independent of which one of these methods was used. The demonstration of different ATP-ase activities of unstimulated B- and T-lymphocytes corresponds well with previously published histochemical findings in lymphatic tissues examined for ATP-ase activity. It is concluded from the present study that because of overlapping values determination of the lymphocyte ATP-ase activity cannot serve as a single marker for the B- and T-cell nature of human lymphocytes, but demonstration of an unusual high ATP-ase activity in unstimulated lymphocytes will serve as additional identification of these as belonging to the B-lymphocyte population.


Lumbosacral arachnoiditis.

Lumbosacral arachnoiditis. One hundred patients with lumbosacral adhesive arachnoiditis documented either directly at surgery or by unequivocal myelography served as the basis for this report on the pathologic process. Nomenclature for this disease, involving radiculitis, arachnoiditis, and adhesive arachnoiditis, is proposed. The entity appears not to be rare, as previously thought, but common in patients with severe back and/or leg pain and functional incapacitation due to the failed back surgery syndrome. While true incidence and relationship to a combination of causal factors remains to be accurately documented, the importance of Pantopaque in contributing to this disease process appears to be quite significant.


1972 Survey of disabled and nondisabled adults: chronic disease, injury, and work disability. The Social Security Administration 1972 Survey of Disabled and Nondisabled Adults showed that an estimated 15.6 million adults aged 20--64, or 15 percent of the total noninstitutionalized population of those ages, were disabled as a result of some chronic condition or impairment. Yet more than three times as many persons (51.8 million) reported that they suffered from one or more chronic health conditions. The diseases reported most frequently by the adult population of working age were cardiovascular and musculoskeletal disorders, each with prevalence rates of 200 persons per 1,000 population. The prevalence rate for neurological disorders was only 7 persons per 1,000; their disabling potential, however, was much greater than that for the diseases with the highest prevalence rates: 80 percent of those suffering from neurological disorders were also currently disabled. For almost every disease group, older persons were more likely to suffer from a chronic condition or impairment and more likely to be disabled as a result. Women were more likely than men to report a chronic disease or impairment and more likely to be severely disabled as a result. White persons were somehwat more likely than blacks and members of other races to report one or more chronic conditions but less likely to be disabled as a result and even less likely to be severely disabled. Among the nondisabled, less than one-tenth reported a condition caused by accident or injury but close to one-fourth of the disabled reported a disease or impairment of accidental origin.


Laser surgery in gynecology.

Laser surgery in gynecology. More experience and time are required to determine the advantages of laser surgery in gynecology. For precision surgery through the colposcope, the carbon dioxide laser beam appears to be useful in the control of neoplastic lesions of the vaginal mucosa and possibly of the cervix uteri. Tumor volume reduction through laser vaporization, especially when a recurrent tumor is attached to the bony pelvis, is an outstanding advantage. Adhesiolysis during myomectomy and reconstructive surgery of the fallopian tubes might be facilitated by the laser beam. Laser surgery on the vulva, both colposcopically directed and grossly with the CO2 laser scalpel, might prove to be important for the treatment of various lesions. Detailed technical knowledge, rigid safety precautions, and judicious clinical considerations are essential for competent laser surgery.


Criteria for evaluation of new arterial prostheses by comparing vein with dacron femoropopliteal bypasses. Significant initial and long term salvage can be achieved with popliteal arterial bypasses using either autogenous saphenous vein or woven Dacron. Long term experience with these materials show that they should serve as standards for the comparison of newer materials. Autogenous vein femoropopliteal bypasses result in higher average initial and long term graft function than do Dacron femoropopliteal grafts. However, depending upon the anatomic area, the superiority of vein grafts is not always apparent. Arterial prosthetic materials must be carefully evaluated in regard to initial and long term function. Before general use of recently developed arterial substitutes is recommended, their function must be shown to be superior to that of well known arterial prostheses.


Radioimmunoassay of an early plasmin degradation product of human fibrinogen, "fragment A", and its clinical application. Upon the plasmin digestion of human fibrinogen, an early cleavage product, which has been designated as fragment A, was isolated, and to study the action of plasmin in the circulation, radioimmunoassay for fragment A was carried out. This assay used rabbit immune serum obtained by injection of fragment A mixed with complete Freund's adjuvant, and fragment A was labeled with 125I using the Chloramin-T method. In 20 normal healthy donors its serum level was 3.57 +/- 1.62 microgram/ml (mean +/- SD), and it was increased significantly in certain diseases, such as acute leukemias, cardiovascular disorders, malignancies, renal failure, systemic lupus erythematosus and sepsis.


Biochemical changes noted during intermittent administration of streptokinase. An intermittent dosage scheme of streptokinase (standard initial dose 600,000 units SK infused over 30 min and repeated injections of 250,000 units SK at 24 hr intervals) was applied during 4 days in 9 patients with chronic obliterative arterial disease and in 8 patients with venous occlusion. Each dose of streptokinase produced an immediate fall in plasminogen to 17% (SEM 5.1) of the initial value, the level then rose to 50% (SEM 5.4) within 24 hr. Lowered levels of antiplasmin and fibrinogen (both less than 40% of the initial values) were maintained. This safe level of fibrinogen was maintained despite brief but high peaks of plasmin activity after each injection of SK. A parallel increase of the thrombin time and the fibrin (ogen) degradation products was obtained following each infusion. No bleeding was observed. The relative therapeutic effect of intermittent infusions of streptokinase has still to be compared with the continuous administration of streptokinase in controlled clinical trials.


Dexamethasone suppressibility of plasma dehydroepiandrosterone (3beta-hydroxy-5-androsten-17-one) in normal men. 9 AM and overnight dexamethasone suppression tests were performed in normal adult subjects and plasma dehydroepiandrosterone (DHA) levels were radioimmunoassayed. The results were as follows: 1) In the 9 AM test, plasma DHA was suppressed to the lowest level at the time between 4 hours and 6 hours after dexamethasone; 2) 2 mg (overnight test) or 3 mg (9AM test) of dexamethasone induced the maximum DHA suppression; 3) after dexamethasone administration in both the tests, plasma DHA was not suppressed below 30% of the basal level, nor below 2 ng/ml; and 4) there was no significant difference in dexamethasone suppressibility of plasma DHA between 9 AM test and overnight test.


Liver and immune responses. IV. Characteristics of the liver cell-lymphocyte interaction. Rat liver cells prepared by collagenase treatment and separated by density gradient centrifugation with Ficoll-Hypaque solution (specific gravity 1.120), containing only hepatocytes (80%) and Kupffer cells (20%), were found to stimulate strongly Ag-B-incompatible lumphocytes without 2-mercaptoethanol in culture. The same liver cells could also stimulate Ag-B-compatible lymphocytes in the presence of 2-mercaptoethanol. A positive response was only seen when the liver cell numbers were 1 approximately 2% of the responding lymphocytes. Viable liver cells inhibited the reaction in a two-way culture.


Metabolic profiles of canine cerebrovascular tree: a histochemical study. Intriguing questions have recently been raised regarding the applicability of direct observations of the pial microcirculation to the behavior of the total cerebral microcirculation. Operating under the assumption that arteriolar tone and, thus, cerebrovascular resistance is, to some extent, directly related to the intrinsic energy metabolism of the arteriolar wall, a comparative histochemical analysis of cerebral microvessels, both pial and parenchymal, was undertaken. Reactions were chosen on the bases of representation of substrate and of enzymes of glycolysis, the hexose monophosphate shunt, beta-oxidation of fat, Krebs cycle, cytochrome system and ATP hydrolysis. Three metabolically distinct segments of the cerebral microvasculature were delineated with the pial vessels showing strong capacities for glycolysis, beta-oxidation of fats and utilization of glucose through the hexose monophosphate shunt. Microvessels of the gray matter have a qualitatively similar metabolic profile but the capacities of each pathway are lower when compared to pial arterioles. Arterioles of the white matter demonstrate the weakest energy-yielding capacities.


Topological analysis of the morphogenesis of liver cirrhosis. Cirrhotic and precirrhotic livers consist of three-dimensional parenchymal networks. Topological analysis has been carried out using the total connectivity number p1 on the livers from 6 autopsy cases of chronic liver diseases of different types. The total p1 amounts to 6,100,000 in chronic hepatitis of periportal type and 6,350,000 in portal cirrhosis, but to only 100,000 in posthepatitic cirrhosis of coarse-nodular type. In view of the similarity of values for p1 in chronic hepatitis and portal cirrhosis, the former is considered to give rise to the latter by continuous change in structure or through "piecemeal" progression of the periportal lesion. Development of posthepatitic cirrhosis from chronic hepatitis is possible only through a substantial reduction in p1, which is brought about by parenchymal necrosis sufficient in extent to cause multiple disconnection of the network.


Immunoglobulins and secretory component in endometrium and cervix. Influence of inflammation and carcinoma. The synthesis of immunoglobulins and secretory component in the cervix and the endometrium was studied by tissue culture and immunofluorescence. Out of the 75 cervical biopsies studied, 17 were epidermoid carcinomas, 8 were carcinomas in situ and 23 tissues had inflammatory or metaplastic lesions. A total of 49 samples from endometrium were studied, out of which 22 were in the proliferative phase, 17 were in the secretory phase and 4 were carcinomas. In the cervical tissues without lesions, there were very few plasmacytes, the synthesis of immunoglobulins was low and in 66% of the tissues the synthesis of IgG was equal to or higher than that of IgA. With local modifications, the IgG synthesis was even more preponderant and was very important in epidermoid carcinomas which were infiltrated with numerous IgG plasmacytes. Secretory component was synthesized by almost all the tissues except the epidermoid carcinomas. The endometrium did not synthesize immunoglobulins; secretory component was synthesized only by endometrial tissue in the secretory phase and by 2 of the 4 carcinomas studied. It seems that in the cervix and the endometrium there is no relationship between the production of secretory component and the presence of IgA plasmacytes which probably localise as a result of other influences. The conditions in which the local secretory immunological system would react preferentially remain to be determined.


Vascular lesions in testes associated with male infertility in Cameroon. Possible relationship to parasitic disease. Testicular biopsies in 40 of 41 infertile males with severe oligospermia in Cameroon presented massive subendothelial "fibrinoid" deposits in the small and medium sized vessels. Fibrinogen, complement and IgM were demonstrated in these deposits by immunofluorescence. Evidence strongly suggestive of parasitic testicular involvement was also observed in 2 cases. It is postulated that the "fibrinoid" deposits are the result of repeated formation and deposition of circulating immune complexes by reaction of antibodies with antigens. These antigens could be of various origins and in the cases described here they could be derived from living or dying parasites in the region. The accumulation and incorporation of the "fibrinoid" deposits may lead to vascular stenosis resulting in chronic ischaemia, tubular atrophy and fibrosis, and finally oligospermia.


Scanning electron microscope studies of rabbit aortic endothelium in areas of haemodynamic stress during induction of fatty streaks. Young male rabbits were fed a diet containing 0.2% cholesterol for 4, 6, 12 and 20 weeks. At death the aortas of each animal were prepared for scanning electron microscopy (SEM) and the size of the atherosclerotic lesions surrounding the aortic ostia was measured by planimetry. Under SEM the early fatty lesions appeared as small discrete swelling of the endothelial cells. These cells were often larger than normal endothelial cells and their cell boundaries stained poorly with silver salts. Large confluent lesions were observed distal to the aortic ostia both 12 and 20 weeks after commencement of the diet but were still found to be endothelialized. No lesions however were observed immediately proximal to the entrance of an aortic branch. Haemodynamic forces, such as a high shear force, were presumably responsible for the localisation of these lesions.


Citrullinemia.

Citrullinemia. The pathological findings in two cases of neonatal citrullinemia are reported. One patient survived for eight months with treatment using alpha keto-analogues of essential amino acids. The untreated patient expired at eight days of age. Necropsy findings in these two cases are compared. The major histopathological changes were present in the brain and liver. They were much less prominent in the treated patient. Changes in a section of rib from the untreated patient were consistent with growth arrest and suggest than damage may occur in utero in neonatal citrullinemia.


Antibody formation and transient immune complex glomerulopathy in A-strain mice with C1300 neuroblastoma tumors. One to three-month-old A-strain mice, inoculated subcutaneously with 2 x 10(6) viable syngeneic C1300 neuroblastoma cells (clone NB9R) developed a palpable tumor within 9-12 days and died within 28-30 days. A transient glomerulopathy developed after 16-24 days. Despite a normal histologic appearance, the nephropathy was clearly demonstrated by electron microscopy and was classified as a focal mesangiopathic glomerulonephritis. Deposits of host 7S-G immunoglobulins and C3 complement fragments were detected in these same kidneys by immunofluorescence. Radioimmunoprecipitin determinations on sera obtained from mice at different intervals from tumor cell inoculation, revealed that untreated mice contained circulating antibodies capable of reacting with 125I-labeled gp69-71 glycoprotein from Gross murine leukemia virus (MuLV). Antibodies to p30 MuLV antigen and to crude membrane antigen (s) (CMA) solubilized from NB9R cells were found in sera only after tumor cell inoculation. Circulating immune complexes formed by host 7S-G immunoglobulins were clearly detected from day 16 to 22. Antibodies eluted from kidneys with nephropathy were shown to react with NB9R cells in vitro and to react specifically with CMA and the p30 MuLV antigen.


[Clinical evaluation of the complex diagnosis of ovarian tumors]. For earlier recognition of ovarian tumors the complex diagnosis for ovarian tumors was estimated clinically. The conception is supported concerning females that should be classified as ovarian cancer high-risk groups. A system is elaborated for active identification of patients with ovarian tumors, using the complex diagnosis, the latter in vast majority of cases enables the difficulties of the differential diagnostics to be overcome; also the indications to and sequence of application of the recommended methods of investigation are formulated, some practical recommendation are given. The system of active and early establishment of the diagnosis is to recognize, at mass prophylactic examinations, females showing high-risk factor, the former also includes their dispensarization, hospitalization and examination, using the complex of accessory methods of investigation. All this enabled in 4% clinically unsuspected ovarian tumors to be detected, 2 per cent of them being in early stages.


[Effectivity of murein preparations in the phage inhibition test--effect of Ca++ions and EDTA]. The inactivating efficacy for the typing phages 54, 83A, and 187 of the peptidoglycan of Staphylococcus aureus is decreased by increasing the Ca++-content of the medium; the irreversible inhibition of phage 187 becomes reversible. The percentage of its inhibition is proportional to the Ca++-content of the medium. Minute amounts of phage 187 bound irreversibly under Ca++-deprivation can be loosened by addition of Ca++-ions. Addition of EDTA up to the equivalence concentration of Ca++ present in the medium has no influence. Addition of EDTA up to the tenfold equivalence causes a significant increase of the inactivating efficacy of the peptidoglycan.


[Oedema of the leg--a rare case of artefact? (author's transl)]. For malignering a venous oedema of the leg can be artificially manipulated. Two cases of this kind are reported.


[Late complications after dacron-grafts (author's transl)]. In a series of 850 reconstructive operations for chronic occlusive arterial disease we found 17 anastomotic aneurysms and 6 infections over a period of 8 to 10 years after the operation. In case of vascular infection the excision of the graft is urgent, "extraanatomic" reconstruction can prevent loss of limb and live.


Chalone-like inhibition of Ehrlich ascites cell proliferation in vitro by an ultrafiltrate obtained from the ascitic fluid. An aqueous ultrafiltrate (10 000-50 000 dalton) prepared from the cell-free ascitic fluid of mice bearing Ehrlich ascites tumour (EAT) in the plateau phase of growth (12-16 days after transplantation) was investigated with regard to its inhibitory effects on the proliferation of EAT cells in a 24-hr suspension culture. The following results were obtained: (1) The in vitro proliferation of cells obtained from the plateau phase of in vivo growth was reversibly inhibited. (2) The dose-response curves show a plateau with a maximum inhibition of about 50%, which suggests that not all cells can be affected. (3) Young cells (4-6 days after transplantation) were not inhibited. (4) Preincubation of plateau phase cells in the culture medium before treatment abolishes the inhibitory effect of the ultrafiltrate. This effect of preincubation is dependent on time and serum concentration. It provides the possibility to differentiate between true "chalone-like" and cytotoxic effects. (5) the inhibitory properties of the ultrafiltrate are destroyed by heating or trypsin treatment. (6) Extracts prepared in the same way from ascitic fluid of mice bearing lymphocytic leukemia L1210 do not inhibit the proliferation of EAT cells. Corresponding extracts from ascitic fluid of mice bearing myelocytic leukemia YM were found to be inhibitory; however, the inhibitory effect was also found on preincubated cells and is therefore considered to be due to an unspecific cytotoxicity. In conclusion, evidence was obtained for a factor from the ascitic fluid of mice bearing EAT, which prevents EAT cells from entering the proliferating state.


Binding of MgATP to yeast phosphofructokinase. Binding of MgATP to yeast phosphofructokinase was investigated by the gel filtration equilibrium dialysis technique. Per subunit of yeast phosphofructokinase two molecules of MgATP are bound in the absence of fructose-6-phosphate, one to a high-affinity and one to a low-affinity site. The experimental data were compared with a kinetic model of yeast phosphofructokinase as described by Freyer et al. [3].


Thyroid function tests in adults with Down's syndrome. Thyroid status was studied in 24 patients above the age of 40 years with Down's syndrome. Three patients had thyroid function tests indicating hypothyroidism. Eight patients had thyroid autoantibodies in serum and 8 patients had a higher than normal level of thyroid stimulating hormone in serum. None of the patients had figures indicating thyrotoxicosis. None of the patients showed any of the clinical signs usually seen in patients with hypothyroidism. It is concluded that biochemical tests indicating hypothyroidism are much more often seen in patients with Down's syndrome than in normal subjects and that thyroid status should be assessed in old patients with this disease.


Proprioceptive afferent fibers in the cranial nerves III, IV and VI. The purpose of the present works was to clarify whether the cranial nerves III, IV and VI carry proprioceptive afferent fibres from the extrinsic ocular muscles. In sheep the picture is now clear. The cranial nerves III, IV and VI carry many large proprioceptive fibres (12-16 micrometer) to the central nervous system. These nerves also contain many small fibres of the y-range (2-6 micrometer) which innervate the intrafusal muscle fibres in the spindles. In man the picture is still vague: most of the spindles are not typical, the large proprioceptive fibres (12-16 micrometer) and the small y-fibres (2-6 micrometer) are very few in the cranial nerves III, IV and VI. It is to be concluded that in sheep the cranial nerves III, IV and VI are not purely motor nerves to the extrinsic ocular muscles, but they also carry many of the large fibres of the proprioceptive function. In man, such large fibres are not found and the pathway of proprioceptive afferents from the orbital muscles is still not certain.


Alzheimer's disease: distribution of protein on sucrose density gradient centrifugation. Material has been examined from eighteen brains, postmortem and from 3 cortical biopsies. The case were classified on clinical and morphological criteria and include cases of dementia and of nonneurological disease. Fractions were isolated from homogenates of neocortex and caudate nucleus by means of discontinuous sucorse density gradient centrifugation. The fractions were analysed for protein content. The mean protein content of fraction 1, at the interphase between 0.32 M and 0.8 M sucrose, from the cortex of the 6 Alzheimer cases was reduced. (P less than 0.005) by 25%. This deficit in protein content represents less than 5% of the total tissue protein. There were no significant differences in the protein content between other fractions from the control and Alzheimer cases.


Histochemical studies on the distribution of adenosine triphosphatase and 5'-nucleotidase amongst the constituents of the thoracic ganglia and the associated nerve of Periplaneta americana. The present study deals with the distribution of adenosine triphosphatase and 5'-nucleotidase in the various constituents of thoracic ganglia and associated nerve of Periplaneta americana. The localization of both the enzymes in the thoracic ganglia is identical. The neural lamella is devoid of any activity for both the enzymes. The ganglion cells are intensely positive at their borders. The neuronal cell surface and/or glial cell processes which envelope the neurons show intense activity for these enzymes. Adenosine triphosphatase and 5'-nucleotidase are present around "giant fibres" and small axons. The activity appears to confine itself in the sheaths. The cytoplasm and the nuclei of the neurons are devoid of enzymatic activity, whereas the nucleoli are slightly active. The nerves are positive for both the enzymes. The role of these enzymes at different sites has also been discussed.


Inferior myocardial infarction as a cause of asymmetric septal hypertrophy. An echocardiographic study. The diastolic thickness of the septum and posterior left ventricular wall were measured with M mode echocardiography in 68 patients 2 or more months after a single transmural myocardial infarction. In 42 patients with inferior wall infarction, the septal thickness of 12.4 +/- 0.6 mm (mean +/- standard error of the mean) was larger than the mean measurement in 26 patients with anterior wall infarction (9.6 +/- 0.6 mm, P less than 0.01). Twenty-five of these 42 patients (59 percent) had increased septal thickness (greater than 11 mm), including 12 (48 percent) who had hypertension and 11 (26 percent) who had decreased posterior wall thickness. The ratio of septal to posterior wall thickness was greater in the patients with inferior infarction than in those with anterior infarction (1.36 +/- 0.06 versus 0.89 +/- 0.06, P less than 0.001). This ratio exceeded 1.3 in 22 patients with an inferior infarction (52 percent) but was increased in only 1 patient with an anterior infarction. Hypertension did not predict the presence or absence of an abnormal ratio. Increased septal thickness on echocardiography may occur after interior infarction and result in an abnormal septal to posterior wall thickness ratio that meets current echocardiographic criteria for asymmetric septal hypertrophy.


Exercise testing for detection of myocardial ischemia in patients with abnormal electrocardiograms at rest. This review consists of two parts: (1) discussion of the electrophysiologic mechanisms that are believed to produce ventricular repolarization changes during the electrocardiographic stress test, and (2) clinical assessment of the electrocardiographic changes with stress in patients with an abnormal electrocardiogram at rest. In the first part, the mechanisms of S-T segment elevation, S-T segment depression, T wave changes and linked S-T and T wave changes are reviewed. In the second part, all electrocardiographic abnormalities at rest are grouped into four categories: (1) changes that mask the manifestations of ischemia, (2) changes that stimulate or exaggerate the manifestations of ischemia, (3) changes that have no important effect on the manifestations of ischemia, and (4) changes that reproduce the patterns of acute myocardial infarction after an apparent healing. The reported studies of electrocardiographic stress testing in patients who have abnormal electrocardiogram at rest are summarized.


Thermistor use to monitor urine flow rates in dogs. The small size of a new thermistor flowmeter  facilitated implantation in ureters in anesthetized dogs. It consisted of a self-heating thermistor bead which was suspended centrally within an open catheter and dissipated heat as a function of fluid velocity. A continuous record of instantaneous flow rate was obtained, since the flowmeter catheter maintained a constant cross-sectional area around the thermistor bead. A continuous record of volume output was obtained simultaneously with an additional measurement technique. Spurt volumes of urine delivered in concert with ureter peristalsis were directly correlated to peak flow rates delineated by the flowmeter.


A reproducible model of moderate to severe concentric left ventricular hypertrophy. A reproducible model for the production of moderate to severe concentric left ventricular hypertrophy has been developed in this laboratory. Coarctation-banding of the ascending aorta was performed successfully in 10 puppies. There were no late deaths related to aortic rupture, and in the dogs surviving for 1 yr no evidence of congestive heart failure was present. A second operative procedure was performed in seven dogs for chronic instrumentation, and all survived. Severe supravalvular aortic stenosis with a marked peak systolic pressure gradient was noted in each dog. Postmortem examination revealed a substantial increase in left ventricular mass and in the ratio of left ventricular to body weight.


Vascular trauma secondary to diagnostic and therapeutic procedures: laparoscopy. Diagnostic and therapeutic laparoscopy are safe procedures that only rarely cause significant morbidity. However, major abdominal arterial and venous injury may occur, requiring prompt recognition and laparotomy. Direct compression will control major hemorrhage until resuscitation is complete. Vascular repair utilizing principles of proximal and distal control, good exposure, appropriate anticoagulation, and lateral suture technic should result in restoration of normal blood flow without significant sequelae.


Prognosis of adequately treated hypertensive patients. Adequate antihypertensive therapy will lower blood pressure to normotensive or near normotensive levels in 80-85% of patients. Long-term treatment results in a marked decrease in strokes and stroke recurrence, heart failure, renal failure, and progression to accelerated hypertension. The effects of long-term therapy on the occurrence of coronary artery disease are unclear.


Severe mitral regurgitation with a normal-sized left atrium. The syndrome of severe mitral regurgitation with a normal-sized left atrium may or may not be associated with pulmonary hypertension and prominent left atrial V waves. To explain these pressure alterations by a single pressure-volume relationship is probably not adequate. It would appear that, whatever the clinical circumstances, normal pulmonary vascular pressures cannot exclude the diagnosis of mitral regurgitation.


Parenteral immunization of pigs against infection with Treponema hyodysenteriae. Six intravenous injections of formalin-inactivated Treponema hyodysenteriae were given to 8 specific-pathogen-free pigs at 6-day intervals. The 8 vaccinated and 8 control pigs were challenged intragastrically with pure cultures of T hyodysenteriae 7 and 8 days after the last intravenous injection. Clinical signs of swine dysentery were observed in all 8 control pigs, but was observed in only 1 of the immunized pigs. Three control pigs died. These findings suggest that parenteral immunization with T hyodysenteriae provided a marked degree of protection against subsequent intragastric challenge exposure with the homologous isolate of T hyodysenteriae.


Norepinephrine stores in the hypertrophied bovine heart. Influence of hypertrophy on the cardiac stores of norepinephrine (NE) and epinephrine in different chambers of the heart were studied in calves with experimental left or right ventricular enlargement. In the control calves, concentration of NE was markedly higher in the atrial than in the ventricles, the left atrial body had a lower concentration than the right atrial body. The same was true of the left ventricular tissue compared to the right ventricular tissue. Marked depression of the cardiac NE concentration was observed in all chambers in the groups with right and left ventricular enlargement. The magnitude of changes was roughly related to the severity of the stenosis. Depletions in the concentration of NE were not noticed in the operated nonresponsive calves. By contrast, epinephrine was in small concentrations in control calves, amounting on the average to less than 10% of the amount of NE concentration in the same cardiac tissues. However, alterations in cardiac epinephrine values were not observed in the cardiac tissues obtained from animals with cardiac hypertrophy.


[Comparison of plasma testosterone (T), androstenedione (A) and dhea variations after métopirone in 10 normal and 12 hirsute women (author's transl)]. Plasma testosterone; androstenedione and DHA were measured by radio-immunoassay before (J1) under (J2) and 24-hour after (J3) oral metyrapone (4,5 g) in 10 normal and 12 hirsute women. Although individual values were dispersed, hirsute women, as a group, had significantly higher values at each time for each steroid. Hirsute women with normal basal T had normal T and A values for J1, J2, J3; while these with elevated basal T had elevated T and A value for all samples. Plasma DHEA was elevated in the two groups, before, under and after métopirone.


The Sézary syndrome. A case with fetal-type glycogen and lymphocytic lymphoma. A patient had Sézary syndrome and lymphocytic lymphoma. Cytoplasmic inclusions within the Sézary cells were demonstrated by histochemistry and electron microscopy to be composed of fetal-type glycogen. Results of tests for the presence of virus were negative. It is suggested that the Sézary cell represents a reversion of metabolic systems to more youthful types. Previously reported differences in diastase reactivity of the PAS-positive cytoplasmic inclusions are probably based on whether the glycogen is in fetal or mature configuration.


Variation of chemical composition with age in human femoral head cartilage. The chemical composition of intact femoral head cartilage was investigated with age. Full-depth cartilage showed a decrease in water content and an increase in keratan sulphate and noncollagenous material with age. When analyzed through the depth of the cartilage, keratan sulphate was shown to appear first in the deep zones and later in the surface, while water content was lost mainly in the deep zones. On a dry weight basis collagen content decreased with age. This was not a real loss but was due to a change in the proportions of other materials, mainly in the deep zones.


Mesoatrial shunt: a new treatment for the Budd-Chiari syndrome. A patient is presented with the Budd-Chiari Syndrome. Because of a thrombosed inferior vena cava, none of the standard portal-systemic shunts could be utilized for decompression of the engorged liver. A new shunt constructed by interposing a Dacron graft between the superior mesenteric vein and the right atrium was performed. Portal pressure was reduced by the shunt from 30 cm of H2O to 10 cm of H2O. Patency has been confirmed post-operatively by catheterization and with angiography. The patient is asymptomatic with normal liver function tests nine months following the procedure. A surgical approach is outlined for symptomatic patients with the Budd-Chairi Syndrom.


Vasoative intestinal peptide and the watery diarrhea syndrome. A sensitive and specific radioimmunoassay for the detection of vasoactive intestinal peptide has been used to study patients with the watery diarrhea syndrome. In eleven patients the syndrome was associated with tumors, and plasma levels of vasoactive intestinal peptide were elevated. VIP levels returned towards normal in five treated patients coincident with amelioration of symptoms. Normal values were obtained in patinets with chronic pancreatitis, sprue, medullary carcinoma, Zollinger-Ellison Syndrome and laxative abuse. In six other patients with indistinguishable syndrome and no findings of tumor at laparotomy and autopsy, vasoactive intestinal peptide levels were normal. The results suggest that VIP may be the causative agent in patients with the watery diarrhea syndrome and tumors, but that an indistinguishable syndrome exists for which VIP is not the cause.


Surgical treatment of annuloaortic estasia: experience in 7 consecutive patients. Seven patients with annuloaortic ectasia were treated according to the method described by Bentall and De Bono. A Björk-Shiley valve in a composite graft was the prosthesis of choice and was used in all patients except 1, who received a Starr-Edwards valve. Profound topical cooling without selective coronary perfusion was applied in 5 patients for myocardial preservation during aortic occlusion. The was 1 operative death and 1 late death, the latter from cerebral thromboembolism. Five survivors have been followed from 1 year 5 months to 2 years 10 months with an average follow-up of 2 years. Excellent results were obtained in all survivors, their physical capabilities putting them in Class I of the New York Heart Association Functional Classification. Postoperative aortograms showed no signs of kinking or compression of vascular prostheses nor abnormalities of prosthetic calves. A modified technique to secure graft fixation is discussed.


Concepts and practices in surgery for total anomalous pulmonary venous connection. In the last ten years there have been extensive refinements in the surgical approach to total anomalous pulmonary venous connection (TAPVC). This communication reviews determinants of hosptal mortality and controversies in surgical management. As examples of current experience with repair of TAPVC, recent results at the University of Alabama and a combined analysis of hospital mortality for Alabama, Children's Hospital Medical Center in Boston, and Green Lane Hospital are reported. From July, 1974, to July 1977, the Alabama hospital mortality among the 17 infants with supracardiac, cardiac, and infracardiac TAPVC was 12% (2 infants).


Echocardiographic detection of cardiac involvement in patients with chronic renal failure. Echocardiography was performed in 50 patients in chronic renal failure with symptoms suggestive of possible cardiac involvement. Pericardial effusions were detected in 33 and pericardial thickening in 22. In five patients solid material, probably fibrinous, was seen adherent to the parietal or visceral pericardium. The left ventricle was dilated in 18 patients and showed definitely impaired contractility in 16. The left ventricular (LV) posterior wall was abnormally thick in 19 patients. In two, the ventricular septum was more than 1.3 times as thick as the LV posterior wall. Other echocardiographic findings included calcification in the mitral annulus region, mitral valve vegetations, and thickened chordae tendineae. Echocardiography has proved to be of great help in the assessment of symptomatic patients with chronic renal failure not only in diagnosing the presence and extent of pericardial effusion and thickening, but also in detecting impaired myocardial contractility, calcification in the posterior mitral annulus region, and vegetations of bacterial endocarditis.


Skin lesions treated with azathioprine and prednisone. Comparison of nontransplant patients and renal transplant recipients. Cutaneous complications were studied in 120 patients who received azathioprine and prednisone for six months to ten years. Questionnaire, chart review, and physical examination were used to assess skin infections, rash, verrucae, herpes zoster, tumors, condylomata acuminata, hair loss, and color changes. One hundred patients with renal allografts were compared with 20 nontransplant patients with systemic disease. Dermatologic problems were more frequent in transplant recipients (P less than .02) than in nontransplant patients. Verrucae were more frequent in transplant recipients (P less than .001). There was no significant increase in the total number of skin manifestations with increasing length of therapy, although warts and herpes zoster increased with time. This study suggests that the increase in the total number of skin lesions noted in previous studies of renal transplant recipients is not as prevalent in nontransplant patients who receive azathioprine and prednisone, due primarily to fewer verrucae in nontransplant patients.


Ultrastructural study of microcyclic macroconidiation in Neurospora crassa. Heat-shock of macroconidia of Neurospora crassa at 46 degrees C followed by shift-down to 25 degrees C determines premature conidiogenesis. The nuclei and cytoplasmof heat-treated, swollen conidia contain spots of a dense material especially concentrated around the nucleolus in short time treated ones. In the first proconidium apically budding on the enlarged tip of the premature conidiophore, small vesicles are later seen lining the initially simple septum separating the proconidial units into conidia. The doubling of this interconidial septum is surface viewn as a thick annulus. Disarticulation of the conidial untis intervenes along a septal furrow of electroluscent material. Interconidial continuity through the septal proes is transiently insured by a connective which is ruptured for final liberation of the conidia.


Energy cost of ambulation in health and disability: a literature review. The literature concerning ambulation of normal and disabled persons--amputees, hemiplegics, and paraplegics--is reviewed. Also reviewed are studies of the energy cost of ambulating with assistive devices and of wheelchair locomotion. According to an average of the results available from the literature, a normal expenditure (Ee) of 0.063 kcal/min/kg and 0.00764 kcal/meter/kg. The disabled person walks more slowly, to avoid incurring an increase in Ec/minute. The more disabled the person, the more determinants of gait lost; thus, the more slowly he walks and the less efficient he becomes in terms of Ee/kcal/unit distance. The importance of a common terminology when measuring the energy cost of ambulation and the need to allow subjects to walk at their own most comfortable walking speed are stressed.


Ultrasonic evaluation of ventral hernias disguised as intra-abcominal neoplasms. Most cases of ventral hernias are easily diagnosed by palpation, but palpation is a subjective examination that may be difficult or even misleading, especially in obese patients. In cases of diagnostic uncertainty, ultrasonic examinations offer an objective means of distinguishing between a mass in the abdominal wall and one actually deep to the peritoneum. In addition, if such a mass is detected, these studies provide information that can characterize its physical nature.


Protective effects of adenosine triphosphate administration in burns. The effects of intramuscular adenosine triphosphate (ATP) administration after thermal skin injury on the ATP content and morphology of the liver and heart were studied in male Sprague-Dawley rats. The results showed that exogenous ATP injected during the early post-burn period could restore the ATP content of the liver and heart to near normal values and modify the burn-related morphological alterations in the liver.


[Electron-microscopic histochemistry of phosphohydrolases in the normal mucosa and in the cells of human gastric adenocarcinoma]. Electron-histochemical study of phosphohydrolases (ATPase, acid and alkaline phosphatases) in cells of the normal gastric mucosa, duodenal mucosa and gastric adenocarcinoma of man was carried out. In cancer cells retaining to a certain extent the ultrastructural features of the chief cells, parietal cells of enterocytes, the distribution of the product of reaction for ATPase and acid phosphatase in nucleoli, endoplasmic reticulum membranes, intracellular cannaliculi, plasmalemma, mitochondria, the distribution of the product of reaction for ATPase and acid phosphatase in nucleoli, tural features of enterocytes, no activity of alkaline phosphatase could be demonstrated in membranes of the villi of the striated border. Alongside with the retention or disappearance of electron-histochemical features, some of them may be enhanced. Thus, the activity of acid phosphatase was increased in lysosomes of cancer cells (of the type of chief cells). So, in cancer cells of adenocarcinoma the structure-functional rearrangement going in different directions is observed in addition to the process of simplification and unification.