Mechanism of feminization in primary liver cancer. Primary liver cancer occasionally presents with feminization. The mechanism is unknown. We studied a young man with primary liver cancer associated with feminization that disappeared after removal of the tumor. Before operation, the serum estrone level was markedly (1113 pg per milliliter) and estradiol and estriol levels were slightly elevated. Human placental lactogen was also increased (0.52 microng per milliliter). Luteinizing hormone, follicle-stimulating hormone and prolactin levels were normal, and testosterone reduced. Beta subunits of human chorionic gonadotropin were not detected in the serum. In vitro assay of tumor tissue showed estrogenic activity and high levels of these subunits. With a reversed isotope dilution technic with crystallization to constant specific activity, we showed the tumor tissue to convert dehydroepiandrosterone sulfate and dehydroepiandrosterone to estrone and estradiol. Production of beta subunits of chorionic gonadotropin and raised serum levels of placental lactogen provided further evidence that the tumor was functioning as trophoblastic tissue.


Hospitalization for laparoscopy. The exception rather than the rule. After studying a series of patients who underwent laparoscopy, the authors found that they are currently hospitalizing only 6.6% of them. They found that more patients are hospitalized for diagnostic laparoscopy than for surgical laparoscopy because of the potential need for laparotomy.


[Application of CH50 assay to the detection of circulating immune complexes (author's transl)]. Detection and titration of circulating immune complexes appear as an essential tool for the diagnosis and prognostic evaluation of immune complex diseases. Authors propose a simple, rapid, senstive and quantitative method based on the evaluation of complement by soluble immune complexes measured by 50% hemolytic activity. This technique was compared to the I125 C1q binding test and may be recommended for clinical laboratory use.


[Cestodes of the genera Gyrocoelia Fuhrmann, 1899 and Infula Burt, 1939, 1939 (Acoleidae) from the snipes of the Soviet Union]. The data are given on the morphology of cestodes of the genera Gyrocoelia Fuhrm,. 1899 and Infula Burt, 1939. It has been found that in the spermatheca of the female of G. perversa there are spermatozoids with an elongated head typical for Plathelminthes. In the spermatheca of the female of I. burhini were found spermatids with long tails. The final formation of spermatozoids in I. burhini takes place in the spermatheca. The taxonomic position of the species of Gyrocoelia found in the waters of the USSR has been made more precise: G. polytestis Saakowa, 1952 and Gyrocoelia sp. II Schaldibin, 1960-1961 are reduced to synonyms of Infula burhini and Gyrocoelia sp. I Schaldibin, 1960-1961 to a synonym of G. perversa. The number and size of the hooks of proboscis in the species of the genus Gyrocoelia vary in wide ranges and cannot be used as a taxonomic character. The number of testes and the structure of the egg membrane are constant for the species of this genus.


[Monogenea of fishes from various fresh water ponds of the Kola peninsula]. 25 species of Monogenea were found in the basins of the Ponoi, Pjalitsa and Varzuga rivers. The belonging to faunistic complexes is indicated for 29 species of monogeneanus known at present for water bodies of the Kola peninsula. On the basis of the distribution of Monogenea in the Ponoi and due to its hydrological regime and geological past the introduction of freshwater fauna into this water body via the Varzuga river is suggested.


Immunologic study of the age-related loss of activity of six enzymes in the red cells from newborn infants and adults--evidence for a fetal type of erythrocyte phosphofructokinase. Blood from 10 normal healthy adults and cord blood from 8 healthy full term infants were infiltrated through a mixture sulfoethylethycellulose-Sephadex G 25 in order to eliminate the platelets and the leukocytes. Then the erythrocytes were fractionated into young and old cells by centrifugation in microhematocrit tubes. The enzyme activity and the immunologic reactivity of glucose phosphate isomerase (EC.5.3.1.9), phosphoglycerate kinase (EC.2.7.2.3), pyruvate kinase (ec.2.7.1.40), glucose 6-phosphate dehydrogenase (EC. 1.1.1.49), and 6-phosphogluconate dehydrogenase (EC.1.1.1.44) were measured in every fraction. As previously reported, the enzyme activities were far higher in cord blood than in adult blood red cells; nevertheless, the age-related loss of enzyme activity was similar in both cord and adult blood. The decrease of the enzyme activity of glucose phosphate isomerase and phosphoglycerate kinase in old cells was singly associated with a lowered concentration of the enzyme-related antigen; by contrast, the age-related decrease of the enzyme activity of pyruvate kinase, glucose-6-phosphate dehydrogenase, and 6-phosphogluconate dehydrogenase was associated with both a lowered concentration of the enzyme-related antigen and a lowered "molecular specific activity" (i.e., a lowered ratio of enzyme activity to enzyme-related antigen concentration). This phenomenon was especially marked for pyruvate kinase, which had a molecular specific activity in old cells that was 68% of that in young cells. Phosphofructokinase had a lower enzyme activity in cord blood erythrocytes than in adult blood erythrocytes; the difference was especially important in old cells from infants in which phosphofructokinase activity was 53% of that in old cells from adults. Phosphofructokinase from old cells of full term infants and from unfractionated cells from two premature infants (21 and 32 weeks of gestation) was less neutralized by anti-muscle phosphofructokinase serum and more inhibited by ATP than the enzyme from adult blood erythrocytes.


A new look at pediatric endoscopy.

A new look at pediatric endoscopy. As a result of recent developments in instrumentation, most endoscopic procedures can now be carried out safely in infants and children in less time and with less trauma than previously. In pediatric applications, laparoscopy is possible for the first time, bronchoscopy and esophagoscopy are greatly improved, and urethrocystoscopy can be done with accuracy and dispatch. Small flexible endoscopes have been evaluated for gastroduodenoscopy and colonoscopy.


Roles of proteins from inner face of plasma membranes in susceptibility of of (Na+ + K+)-stimulated Mg2+ adenosinetriphosphatase to ouabain. Purified right-side-out (RSO) and inside-out (IO) plasma membrane vesicles release 35% of the total plasma membrane proteins after EDTA treatment. After such a treatment both types of vesicles exhibited the same total activity of (Na+ + K+)-stimulated Mg2+ adenosinetriphosphatase (ATPase; ATP phosphohydrolase, EC 3.6.1.3) as in their native state. The EDTA treatment increases the enzyme sensitivity to ouabain by 350-fold in IO vesicles while being without any effect RSO vesicles. Thus, proteins released only from the IO vesicles led to a change in ouabain sensitivity of the (Na+ + K+)-stimulated Mg2+ ATPase. Moreover, only proteins released from IO vesicles, when added to treated IO vesicles with divalent cations, were able to restore the original resistance of the enzyme to ouabain; released proteins from RSO vesicles failed to make such a reconstitution. Thus, we assume that these proteins detach from the inner face of the plasma membrane upon EDTA treatment and are distinct from the enzyme. Polyacrylamide gel electrophoresis indicates that these inner face plasma membrane proteins are approximately 30,000 daltons.


[Fractional content of androgens in the urine of young sexually mature, old and castrated dogs]. Fractional composition of 17-KS was studied experimentally in the urine of young sexually-mature, old and castrated dogs. A reduction of the dehydroepiandrosterone, androsterone, ethiocholanolone and of the fraction of 11-oxidized 17-KS in the old, and particularly in the castrated dogs was demonstrated. Androsterone and ethiocholanolone  fractions were subject to the greatest reduction in excretion in the animals under study; the androsterone/ethiocholanolone coefficient was decreased more in old dogs than in the castrated ones. A relative prevalence of dehydroepiandrosterone and of 11-oxdized ketosteroids was noted.


Proposed involvement of an internal promoter in regulation and synthesis of mitochondrial and cytoplasmic leucyl-tRNA synthetases of Neurospora. Genetic analysis of an electrophoretic variant of the mitochondrial leucyl-tRNA synthetase [L-leucine:tRNALeu ligase (AMP-forming), EC 6.1.1.4] indicates that it is either an allele of or linked closely to leu-5ts, a mutant that is known to produce a cytoplasmic leucyl-tRNA synthetase with an altered affinity for leucine as well as being deficient in the production of the mitochondrial enzyme. Immunological analysis indicates that the two synthetases have little, if any, structural homology. The pattern of synthesis of the enzymes in leu-5ts revertants, the reciprocal relationship of the production of the two enzymes in response to a negative regulatory element, presumably of mitochondrial origin, as well as the lack of detectable structural homology, led to the proposal that the phenotype of leu-5ts results from a mutational alteration in the structural gene for the cytoplasmic enzyme in a region involved in the initiation of transcription of the adjacent gene for the mitochondrial enzyme.


Reconstitution of thermostable ATPase capable of energy coupling from its purified subunits. Purified dicyclohexylcarbodiimide-sensitive ATPase (TF0-F1) from thermophilic bacterium PS3 is composed of a water soluble part with ATP hydrolytic activity (TF1) and a water insoluble moiety (TF0). All of the five subunits (alpha, beta, gamma, delta, and epsilon) of TF1 were isolated. TF1 was reconstituted from the five subunits, which catalyzed an ATP-32Pi exchange and an ATP-driven enhancement of fluorescence of 1-anilinonaphthalene-8-sulfonate, when adsorbed on proteoliposome inlaid with TF0 (TF3-vesicles). Subunit epsilon and/or delta became firmly bound to TF0-vesicles and there was no preferential sequence in the binding. Both subunits were required for binding of the remaining subunits of TF1 to TF0-vesicles, but they did not modify the high H+ -permeability of TF0-vesicles. The addition of gamma but they did not modify the high H+-permeability of TFO-vesicles. The addition of gamma subunit together with epsilon and delta subunits caused a marked decrease of H+ -permeability of TF0-vesicles, similar to that induced by TF1. We conclude tentatively that the epsilon and delta subunits connect TF0 and the other subunits forming a part of a proton pathway, gamma is a gate of proton flow coupled to ATP hydrolysis (or synthesis), and alpha and beta subunits contain the active site for energy transformation. A possible model of subunit structure of TF1 is proposed.


Differentiaton of neuropharmacological actions of apomorphine and d-amphetamine. The dopaminergic agonists apomorphine and d-amphetamine elicit hyperthermic, hyperkinetic and stereotypic responses in the rabbit. The present investigation compares the influence exerted by various serotonergic antagonists upon these activities. Apomorphine-induced hyperthemia was antagonized by p-chlorophenylalanine (pCPA), cyproheptadine and cinanserin and was restored in pCPA-pretreated rabbits by regeneration of central serotonin levels, d-Amphetamine-induced hyperthermia was reduced by pCPA; restored in pCPA-pretreated animals by regeneration of central serotonin levels; and was uninfluenced by cyproheptadine and cinanserin. Apomorphine-induced locomotor stimulation was unaltered by serotonergic antagonists; however, these same doses of anti-serotonergic agents all markedly reduced d-amphetamine-induced hyperkinesia. Serotonergic antgaonists also failed to affect apomorphine-induced compulsive gnawing but did significantly enhance d-amphetamine-induced compulsive gnawing. It is concluded from these data that the neuropharmacological activities of apopmorphine and d-amphetamine in the rabbit differ in their dependence upon central serotonergic mechanisms.


Effect of beta-phenylethylamine and d-amphetamine on electrical self-stimulation of brain. beta-phenylethylamine (PEA) has been viewed as amphetamine-like in its effects on behavior. Support for this putative similarity of action has been derived primarily from observations that both of these structually related compounds increase locomotor activity in a dose-related manner and at higher doses evoke stereotypies. Since d-amphetamine (d-A) produces a dose-related increase in the rate of bar pressing for electrical stimulation of the medial forebrain bundle, the effect of PEA on this behavioral paradigm was examined. Male Long-Evans rats implanted with bipolar electrodes self-administered 250 msec 60 Hz constant current sine wave trains over a 30-70 micronA range of intensities in daily 20-min tests. Over a range of 1-40 mg/kg IP of PEA, a dose-related decrease in self-stimulation rate was observed; pretreatment with para-chlorophenylalanine or alpha-methyl-para-tyrosine did not alter the response to 2.5 or 3o mg/kg IP of PEA. Since within the dose range of PEA used in this study a dose-related increase in locomotor activity was observed, and since d-A increases self-stimulation rate at doses that increase locomotor activity, it would seem that there are qualitative differences in the actions of d-A and PEA on behavior.


The effect of para-chlorophenylalanine on the intake of ethanol and saccharin solutions. The effects of para-chlorophenylalanine (PCPA) on the ingestive behavior of rats offered a choice between ethanol (3%) and water, saccharin (0.125%) and water, or water alone were examined. Following a baseline period three saline or PCPA injections, 80 mg/kg, were administered. Decreases in both ethanol and saccharin intakes were observed. Increases in water intake occurred in the ethanol group without a change in total fluid intake. Increases in water intake did not occur in the saccharin group and these animals displayed decreases in total fluid intake. Water intake in the nonchoice group was unaffected. There were no changes in food intake associated with any of these effects. The data demonstrate that decreases in intakes following PCPA are not specific to ethanol solutions.


Effect of some substituted pyrimidines on development of desoxycorticosterone-induced hypertension in rats. Chronic (15-week) dietary administration of 2-thio-6-aminouracil (TAU, 1.0 and 2.0 g/kg food) provided significant protection against elevation of blood pressure and cardiac hypertrophy in male rats treated with desoxycorticosterone trimethylacetate (DTMA) (5.0 mg twice weekly for 10 weeks). Assessment of thyroid activity was made by measurement of 24 h 131I uptake by the thyroid gland, PBI concentration of serum, rate of oxygen consumption, hematocrit ratio, hemoglobin concentration, and thyroid weight. By all these criteria, the rats given either dose of TAU were hypothyroid. In contrast chronic (17-week) dietary administration of 5-carboxy-2-thiouracil (0.50 and 1.00 g/kg food) and 5-carboxy-4-hydroxy-2-thiouracil (2.00 g/kg food) provided minimal protection against elevation of blood pressure and cardiac hypertrophy in male DTMA-treated rats. These compounds appeared to possess little or no antithyroid activity at the doses used. The results suggest a rough correlation between the degree of hypothyroidism produced by the compounds and their effectiveness in preventing rise of blood pressure in DTMA-treated rats.


Spasticity: its physiology and management. Part I. Neurophysiology of spasticity: classical concepts. Spasticity, seen so frequently in clinical situations, presents motor signs resembling those produced experimentally by transecting the brain stem of a cat at the intercollicular level. This paper reviews experimental results which elucidate the roles of different brain regions in the genesis of classical decerebrate rigidity and demonstrate the function of the gamma motor system in the maintenance of the rigidity. Interruption of the gamma-spindle loop of a muscle (i.e. interrupting the monosynaptic reflex arc subserving the stretch reflexes) abolishes rigidity in that muscle. This reflex-mediated gamma support of decrebrate rigidity is also a prominent feature of clinical spasticity, making classical decerebrate rigidity a useful model for studying the neural mechanisms underlying spasticity. Not all rididities, however, are gamma dependent. Those rigidities surviving dorsal root rhizotomy are called alpha rigidity. Alpha rigidity results when a brain lesion disrupts descending systems which normally exert a net inhibitory effect upon alpha motoneurons.


Spasticity: its physiology and management. Part II. Neurophysiology of spasticity: current concepts. A review is presented of current information about the structural and functional details of the muscle spindle, denervation supersensitivity, neurotrophism, regenerative capabilities of the peripheral and central nervous systems, CNS plasticity as revealed by recovery of function following brain lesions, and the secondary functional consequences of long-term spasticity. If this recent basic information is to have any practical impact, it must ultimately be incorporated into our concepts of spasticity and applied to our clinical evaluation and treatment procedures.


Effect of autonomic blockers on the heart rate of intact rats and animals with artificial hyperthyroidism. The effect of various autonomic blockers on the heart rate (from the ECG recording) of intact rats and of animals with experimental hyperthyroidism induced by the administration of dried thyroid was studied. In intact rats, the heart rate fell significantly (by 22%) during the first week after the peroral administration of propranolol (0.05% in food), but trimepranol (0.02%), reserpine (0.001%) and guanethidine (0.1%) had no effect (in a suplementary experment, a small, but statistically significant decrease was also found after trimepranol). In experimental hyperthyroidism, using the same blocker doses, the heart rate fell significantly after propranolol (by 23%), trimepranol (22%), reserpine (16%) and, in a preliminary experiment, guanethidine (19%). On injecting 0.05 mg propranolol intravenously, the maximum drop in the heart rate in intact rats was 22%, while in hyperthyroidism it was hardly more than half this value (at all the intervals from 2 to 30 minutes the decrease was statistically significant). Practolol, in a dose of 0.3 mg i.v., was less effective -- in intact rats the heart rate fell by not more than 12% (at all the intervals from 2 to 30 minutes the decrease was significant), but in hyperthyroidism the drop was slower and statistically non-significant. The results do not furnish an unequivocal answer to the question of the role of adrenergic regulation of the heart rate under physiological conditions and in experimental hyperthyroidism in rats.


Effect of colchicine and demecolcine on the serum ceruloplasmin level in rats. Six hours after the administration of demecolcine (0.3 mg/100 g b.w.), a decrease in the ceruloplasmin level was recorded in rat serum. The time course of the decrease in the rat serum ceruloplasmin concentration after the same dose of colchicine was then studied. After two to three hours, the serum ceruloplasmin concentration fell significantly in both male and female rats. Eight hours after the administration of colchicine, the serum ceruloplasmin level began to rise again in female rats, but not in male rats. Mortality among females was lower than among males.


Development of spontaneous motility in chick embryos. Normal development and the activating effect of strychnine and picrotoxin. The longitudinal development of spontaneous motility in chick embryos was studied by Kovach's method (Kovach 1970) from the 10th day of incubation up to hatching, in completely intact eggs. From the 10th to 12th day of incubation, very low amplitude movements of a burst character predominated in spontaneous motility. From the 13th day, both low and high amplitude movements could be distinguished. From the 18th day, high amplitude movements alternating with intervals of motor inactivity preponderated. This discontinuous motility, which was most pronounced on the 20th day of incubation, changed to periodic strong hatching movements. Reduction of spontaneous motility after the 17th day of incubation was not confirmed. Strychnine already activated spontaneous motility in 11-day embryos, but typical convulsions did not appear until the 15th incubation day. With picrotoxin, motility was likewise stimulated in 11-day embryos and paroxysmal activation did not occur until the 15th incubation day. In older embryos, convulsions were gradually succeeded by a continuous increase in spontaneous motility. The effect of picrotoxin had a much longer latent period than the effect of strychnine.


Role of the autonomic nervous system in the development of cardiovascular changes during nasal apnoea and lung inflation. The role of the sympathetic system in the development of bradycardia during nasal apnoea and the role of the sympathetic and parasympathetic system in the development of cardiovascular changes during and immediately after lung inflation were determined in anaesthetized rabbits. Transection of the cervical cord (C5-7) completely blocked the hypertensive response to chemical stimulation of the nasal mucosa. The degree of nasal bradycardia was 72% lower than in stimulation of the controls. Propranolol had no effect on the hypertensive reaction, but inhibited nasal bradycardia, which was 68% lower than in the controls. Lung inflation induced tachycardia, which was only non-significantly reduced by bilateral vagotomy. Vagotomy inhibited the bradycardiac response to removal of occlusion of the trachea and the subsequent rise in blood pressure, however. Cervical cord transection likewise did not reduce inflation-induced tachycardia, but it significantly influenced the heart rate during the second phase of prolonged inflation, when the heart is affected by hypoxia. Inflation-induced tachycardia was likewise not influenced by bilateral vagotomy associated with cervical cord transection. Similar cardiac responses also occur in the presence of the simple increase in pericardial pressure produced by left pneumothorax without lung inflation.


The effect of diuretics and vasopressin on the osmotic permeability of the frog urinary bladder. 1. Large concentrations (in mM) of ethacrynic acid (0.1), furosemide (1.0), theophylline (5.0) and osmotic diuretics (100.0) sharply increased the flux of water along an osmotic gradient through the frog urinary bladder wall. Spironolactone (0.1), and hydrochlorothiazide (5.0) showed only a weak action on osmotic permeability. MercusalR, clopamide and triamterene did not affect water transport. 2. The presence of 0.2--1.0 mU/ml vasopressin (ADH) after pretreatment with a diuretic did not result in summation of the effects of both drugs used. 0.01--0.1 mM ethacrynic acid and 0.01 mM MercusalR significantly decreased the reaction to ADH. 1.0 mM furosemide, 0.1 mM spironolactone, 0.01 mM clopamide and 0.8 mM acetazolamide did not change the reaction to ADH. A reduction in the cellular response to ADH and a decrease in the osmotic permeability of the tubular wall may be responsible in part for the diuretic action of ethacrynic acid and MercusalR.


The effect of vasopressin on renal function in young rats a clearance and micropuncture study. Using micropuncture techniques, the author studied the effect of vasopressin on renal function in young rats at three stages of development -- in the middle of the weaning period (22 days), after weaning was over (30 days) and at the beginning of the sexual maturation period (42 days). In the presence of a hypotonic load, a small dose of vasopressin (12 muU/100 g b.w., i.v.) was most effective in the youngest age group, where it reduced the urine flow by 82% both by increasing water reabsorption and by reducing the GFR. In this group, vasopressin lowered the TF/P Na+ ratio and raised the TF/P K+ ratio in the initial part of the distal tubules of the superficial nephrons, but raised water absorption only beyond the initial part of the distal tubules. Vasopressin reduced the urine flow by 72% in 30-day-old rats by raising water reabsorption beyond the initial part of the distal tubules. The only ion to be affected was K+, whose concentration rose in the final urine. In 42-day-old rats the effect of vasopressin was manifested in only mild depression of the GFR. In this age group, as distinct from younger animals, anaesthesia and surgery evidently led to endogenous vasopressin release, so that the small dose of exogenous vasopressin did not significantly influence the test parameters. This is also underlined by the significant difference between the control urine flow of the 42-day-old and the younger rats.


The effect of denervation upon the functional properties of myosin and its fragments. A study has been made of some structural and enzymatic properties of myosin and its fragments from denervated white muscles of rabbit in the course of atrophy using different methods: UV-luminiscence, flow birefringence, electromicroscopy, viscosimetry and enzymatic measurements. All the studied parameters had a tendency to decrease; at prolonged observation some properties were partially restored. Considerable changes of structural properties of LMM were revealed: the ability of LMM from denervated muscle to form high-ordered structures which is characteristic of LMM from normal muscle decreased considerably.


Prenatal changes of lactate dehydrogenase isoenzyme patterns and activity in bovine tissues. Isoenzyme patterns, total lactate dehydrogenase (LDH, E.C. 1.1.1.27) activity and H and M subunit activity were determined in the tissues of Czech Spotted bovine foetuses. Total LDH activity rose in the skeletal muscles throughout the whole of the prenatal period. In the viscera it usually attained the maximum at a foetal length of 66.7 cm. Differences in the isoenzyme patterns of the various organs of an 8.1-cm foetus were relatively small (41.9--66.1% H subunits). In the heart and kidneys, in which LDH1 and LDH2 markedly predominate in adulthood, the isoenzyme pattern resembled the adult one at a length of only 13.3 cm, but in the liver, spleen and lungs not until 66.7 cm. The proportion of H subunits also rose in the part of the gastrointestinal tract where secretory and resorptive activity predominate (the abomasum, the small and the large intestine). Conversely, it fell in organs concerned mainly with the mechanical processing of food (the rumen, reticulum and omasum). The proportion of M subunits rose in all the skeletal muscles up to a foetal length of 66.7 cm. Later on, differentiation into muscles in which M subunits predominated (the longissimus dorsi and the triceps brachii), into muscles with approximately the same proportion of H and M subunits (the iliopsoas) and to muscles with a preponderance of H subunits (the masseter and the muscular part of the diaphragm) occurred.


Changes in the proportion of serum proteins induced by protein depletion in adapted and nonadapted rats. Comparison of the dynamics of changes in the proportion of the serum protein during progressive protein depletion in rats specially adapted to this situation and animals exposed to it for the first time, led the authors to conclude that the regulation of proteosynthesis is largely adaptable, that it can be influenced by nutritional leads and that the organism probably stores information on past nutritional loads and makes use of it to help to overcome fresh insults.


An inborn alcohol tolerance in alcohol-preferring rats. The lack of relationship between tolerance to ethanol and the brain microsomal (Na+K+) ATPase activity. Alcohol tolerance, measured as performance on the tilting plane after ethanol injection (2.5 g/kg body weight i.p.), was examined in the AA strain of rats which voluntarily drink large amounts of alcohol, in the ANA strain which drink very little alcohol, and in ordinary albino rats which consume intermediary amounts of alcohol. The AAs showed the highest innate ethanol tolerance; the ANAs had the lowest innate tolerance. After chronic alcohol administration, both AA and ANA strains increased their tolerance, but the AAs remained superior to the ANAs. The chronic ethanol treatment did not significantly change the (Na+K+) ATPase activity of the crude microsomal fraction of the brains of the strains.


Neonatal hydronephrosis: 146 cases.

Neonatal hydronephrosis: 146 cases. Recognition and precise etiologic diagnosis of neonatal hydronephrosis is worthwhile since, although often severe, it is usually treatable with at least partial success. This relatively favorable prognosis, despite dilatation that may be marked, suggests a greater regenerative capacity at this age, or may be due to the relative infrequency or short duration of the infection.


The radiologic and pathologic spectrum of the prune belly syndrome. The importance of urethral obstruction in prognosis. The definition, history, and clinical presentation of the prune belly syndrome are outlined. Review of autopsy material and survivors reveal three groups of patients, and the author describes the choices of management available for both groups. Highlighted is the role of the radiologist.


[Postbular duodenal ulcer. Problems of diagnosis and treatment. Role of vagotomy in surgical treatment]. A number of 43 cases is presented, of post-bulbar duodenal ulcers in which surgery has been performed between 1965 and 1974, of which 30 were located in the first portion of the duodenum, in the postbulbar area, and 15 in the second portion, above the ampula of Vater. Problems of terminology and pathological anatomy are discussed, especially in connection with the symptomatology, complications, methodology of investigations and treatment of post-bulbar ulcers. The particular frequency is stressed, of complicated clinical forms, with stenosis and hemorrhagies, and a detailed description is made of atypical forms, with misleading, predominantly biliary or pancreatic symptomatology. Conditions are stressed, of the radiologic gastroduodenal exploration, of major importance in the diagnosis preceding surgery, as well as of pre- and intra-surgery cholangiography. The risk must be carefully evaluated, in the choice of the surgical method, and exeresis of the ulcer must be balanced with the risk of its continued presence. Priority should be given to th risks entailed by surgery. The choice solution in many cases is vagotomy associated to exclusion resection or to gastric derivation.


[Clinical and therapeutic aspects of traumatic diaphragmatic hernia]. The authors present 5 cases of diaphragmatic hernia occuring after thoracoabdominal trauma (in one case the hernia was in the right hemidiaphragm, associated with partial hepato-thorax, the other four were in the left hemidiaphragm and were associated with intra-thoracic herniation of the stomach, transverse large bowel, large epiploon, loops of the small bowel and of the spleen). In three cases the lesion was treated by the thoracic route while in the other two the abdominal route was preferred. In one of the cases splenectomy and segmental transverse colectomy were performed by the transthoracophrenic approach. This was necessary because of the length of the pedicles, as well as of the risks entailed by an eventual attempt at re-positioning the viscera.


[Transureteral cutaneous ureterostomy].

[Transureteral cutaneous ureterostomy]. Two cases are presented, of transuretheral ureterostomy combined to cutaneous ureterostomy and total cystectomy (in a patient with invading neoplasia of the urinary bladder), or with a procedure of urinary derivation (in the second patient with complex urinary tuberculosis and advanced renal failure). The results obtained were very good.


[Treatment of spontaneous pneumothorax due to emphysema]. The authors make an analysis of 455 cases of spontaneous pneumothorax hospitalized and treated in the Clinic for Thoracic Surgery from Bucharest between 1952 and 1974. The therapeutic attitude recommended in such cases is the aspiration drainage through minimal pleurotomy (aspiration being carried out in relation with the parenchymal aerial losses). Introduction through the drainage tube of irritating substances will enhance pleural symphisis. The drainage will be maintained for 7--8 days. In the recidivating pneumothorax, or in cases where recovery is not achieved by aspiration drainage, thoracotomy becomes necessary for performing total pleurectomy and atypical resection of emphysema bubbles from the pulmonary cortical, since these are at the origin of the aerorrhagies (the Coman procedure). With the aid of these surgical techniques very good results have been obtained in all cases of spontaneous pneumothorax.


[Scintigraphic exploration of the peripheral arterial circulation, using macroaggregates of serum albumin labeled with Tc 99m]. The method of scintigraphic exploration is demonstrated of the peripheral arterial circulation, following intra-arterial administration of 99m Tc-labelled serumalbumin macroaggregates. The indications of the methods are mentioned and evaluations are made on the position they have in the peripheral arteriopathies.


[Metastatic fractures of the femur. Apropos of 100 cases]. The authors have treated one hundred fractures of the femur of metastatic origin. They conclude that surgery, when technically possible, should always be undertaken. Internal fixation gave better results than prosthetic replacement of the upper end of the femur. Intramedullary nailing can be followed by radiotherapy and shaft fractures may unite after such treatment. The treatment of the primary lesion must be started as soon as possible by radiotherapy or chemotherapy.


[Treatment of hallux valgus. Limitations and indications for exostosectomy]. The authors have treated 63 halluces valgi by simple excision of the exostosis and bunion. In 18 the results were unsatisfactory. It was concluded that this procedure was worthwhile in the following conditions: --absence of arthrosis,--halux valgus of less than 30 degrees,--and an angle between the first and second metatarsal of less than 10 degrees. The age of the patient and the morphology of the feet (Egyptian or Greek) did not influence the results. Fixation of the capsule to the metatarsal at the end of the operation is recommended.


[Scoliosis and congenital cardiopathies]. The authors have followed up 26 children suffering from severe scoliosis associated with congenital heart disease up to the end of puberty. The curve was usually a very severe idiopathic scoliosis developing early and requring surgical treatment. Two types may be distinguished: I. Scoliosis without excessive surgical risk, in patients in whom the heart disease is not associated with cyanosis or where the heart condition has already been treated surgically and in which there are no clinical, radiological or electrical signs of cardiac failure. 2. Scoliosis with considerable surgical risk because of heart disease with cyanosis not treated surgically, or with signs of heart failure or pulmonary hypertension. In such cases, the surgical treatment of the scoliosis is likely to endanger life.


[Bracket graft arthrodesis in the surgical treatment of spondylolisthesis]. A technique of anterior lumbosacral arthrodesis is described in which a tibial graft is inserted into the sacrum and acts as a bracket against the anterior surface of the fifth lumbar vertebral body. Eighteen patients were treated. There was non-union in four but only two had unsatisfactory clinical results. The technique can be applied to moderate displacement but is particularly appropriate in grade III spondylolisthesis. It does not decrease the stability of the spine. The functional results depend on fusion and are not affected by persistent displacement.


[Lamellar coxitis. Apropos of 30 cases]. The authors have studied 30 cases of acute necrosis of articular cartilage complicating slipped capital femoral epiphysis. They recall the main features of this condition: stiffness and narrowing of the joint space. They analyse the importance of the degree of slipping and of the type of treatment in the aetiology of this complication. Weight bearing should be suppressed as early as possible, for a long period of time. However early signs of degenerative arthrosis were found in most of the hips.


Pain in the back and leg: a general practice survey. Over a two-year period, the data on all patients in a general practice with back and leg pain were recorded in a standardized way. Two broad categories were distinguished, those with low-back pain syndromes and those with back and leg pain syndromes. Within the former, four patterns of pain distribution could be indentified, and the latter were sub-divided according to severity, history, and neurological involvement. History, clinical features, and outcome correlated with these various types. The majority of these patients may be managed conservatively at home, only a small proportion requiring referral for specialist advice or treatment. It is suggested that the intervertebral disc can account for only a small proportion of these problems.


Chiropractors and the treatment of back pain. In a survey of British chiropractors and their practices, it was found that the majority of their patients attended for back pain. The average age of patients was 47 years, the sex ratio was equal, and most had had their complaints for longer than three months and had access to the chiropractor within a few days. They were largely housewives and persons from the executive and managerial occupations. The main investigative procedures used were static and motion palpation of the spine, and vital systems, orthopaedic, neurological, and radiological examination. Treatment was mostly manual and directed at the spinal column, and the benefit obtained, as assessed by the chiropractors, was comparable to that reported in other studies. Maximum benefit was usually recorded within seven attendances, although 39% of patients made further visits for maintenance treatment. The chiropractors are seen to be a young, growing, and largely male group, and their new patient numbers are at present likely to be at least one-twentieth that of hospital out-patient departments which deal with back pain.


A double-blind trial of an anabolic steroid (stanozolol) in the disabled elderly. Anabolic steroids have been widely recommended in the management of debility in association with the diseases of old age. Their action in promoting weight gain and in speeding rehabilitation is said to depend on nitrogen retention leading to increased muscle bulk reflected by increased fat-free mass (lean-body mass). In elderly patients undergoing rehabilitation a double-blind trial over 4 months of stanozolol, an orally active anabolic agent, is reported in which measurements of total body weight, body fat and fat-free mass were recorded. Physical activity and performance levels were also measured. Total body weight was found to have increased in both groups of patients, mainly due to increased body fat. There was no evidence of fluid retention due to the drug. Despite the absence of an anabolic effect, the group taking stanozolol increased their levels of physical activity significantly.


Development and metamorphosis of the larvae of Ascidia malaca in different experimental conditions. In larvae of Ascidia malaca that have developed in sea-water without sulphate ions, the cells of the caphalo-ventral region are devoid of sulphated mucopolysaccharides, and the chordal and muscular cells of the tail turn out to be altered; after metamorphosis no adhesive ampullae appear. The addition of cysteine to water lacking sulphate ions leads to a normal synthesis of sulphated mucopolysaccharides in the cells of the cephalo-ventral region, and to a normal secretion of matrix by the chordal cells; but the larvae do not regain the ability to swim. The addition of N-dichloroacetyl-DL-phenylalanine to sea-water does not alter the synthesis of sulphated mucopolysaccharides in the cells of the cephalo-ventral region, but, probably by acting as a competitive inhibitor of phenylalanine, it causes alterations in the muscular cells of the tail.


[Lumbar phlebography. Normal aspect and its value in diagnosis of herniated disk]. Our technique of lumbar phlebography involves selective catheterisation of the lateral sacral veins with or without catheterisation of the ascending lumbar veins. Injection of these veins, in association with abdominal compression, produces good filling of the intra-spinal epidural veins, particularly at L5-S1 level. The anatomy and radiological appearances of the epidural veins are discussed. The phlebographic signs of disc herniation are presented. The diagnostic potential of this technique seems very promising in disc pathology, especially in the diagnosis of L5-S1 herniation and lateral prolapse at all levels.


[Natural history of Huntington's chorea]. The scope of the work is to list and analyse, after a historical introduction on the subject, the principle clinical characteristics of "Huntington's Disease". The epidemiological aspects, those clinical-semeiotical, the course of the disease and the type of after affects of Huntington's Diseases are examined. The more significant details of the natural history of the chorea maior, as emerge from the literature, are compared with those that result from the study of the thirty cases of this chronic disease. In particular the following are analysed, the genetic aspects, the character of the psycho-organic deterioration of the chronic chorea, the psychiatric component and various clinical-semeiotical formalities, how the disease begins, its course, its duration, etc. The authors conclude pointing out the particular character of the dementia of Huntington's Disease, (of the pre-frontal type), the strong psychopathological incidence and the particular formalities of hereditary transmission of the mendelian type of this singular disease.


Surface features of Sezary cells: A scanning electron microscopy study of 5 cases. The surface features of circulating cells from 5 patients with typical Sezary's Syndrome (SS) are described using scanning electron microscopy (SEM). Sezary cells prepared by different methods, with and without prior fixation in cell suspension, showed similar surface architectures. SS cells were mostly spherical and moderate to markedly villous in appearance, and in this respect, resembled the majority of circulating lymphocytes from patients with chronic lymphocytic leukaemia (CLL). A proportion of cells were larger and more irregular in shape while others had small extensions of cytoplasm resembling small uropods with clusters of polarised microvilli. Despite the latter findings, most SS cells cannot be distinguished from CLL cells on the basis of their surface architecture under the SEM.


The activities of plasma-membrane marker enzymes in rheumatoid synovial tissues and fluids. The activities of 5'-nucleotidase, K+, Na+-activated Mg2+-dependent adenosine triphosphatase (ATPase) and leucine-beta-naphthylamidase were determined from 17 rheumatoid synovial fluids and from extracts of the corresponding synovial tissues. There was little correlation between the enzyme activities in the synovial fluids and those in the respective synovial-tissue extracts. In seropositive cases of rheumatoid arthritis the activities of 5'-nucleotidase and leucine-beta-naphthylamidase in the synovial-tissue extract were higher than in seronegative cases. Also, the ratios of the enzyme activities in the synovial fluids to the resepctive activities in synovial tissue were lower in the seropositive cases. The activity of 5'-nucleotidase in the synovial tissue decreased during gold treatment.


A clinical, neurophysiological and behavioral study of female workers exposed to 1,1,1-trichloroethane. Twenty-two female subjects working in a factory in which 1,1,1-trichloroethane was the only solvent used were investigated by means of clinical, neurophysiological and psychometric methods so that the neurotoxicity of the solvent could be evaluated. On the basis of the ambient air concentrations of 1,1,1-trichloroethane ranging from 110 to 990 ppm, the workers were divided into three risk groups and compared with a reference group. No significant difference was observed between the exposed and unexposed females with respect to clinical features, maximal motor conduction velocity, conduction velocity of slow fibers, and psychometric data. The most frequent complaints of the workers were of the "neurotic" type with a slightly higher, but not significant, difference in the exposed group. The results obtained favor the absence of a manifest neurotoxic effect of 1,1,1-trichloroethane under the specific work conditions of the investigation; generally unfavorable work conditions seem to have played a prominent role in the genesis of the neurotic complaints. The importance of a global methodological approach in the study of work-related risks, particularly in neurological and psychological surveys, is stressed.


[Exercise-induced muscular weakness, myalgia and contractures. I. A clinical review]. In the differential diagnosis of intermittent claudication some rare myopathies have to be considered. The most frequent is phosphorylase deficiency (McArdle's disease). Exercise-induced muscular pain, weakness, contractures and occasionally myoglobinuria are the most prominent clinical signs. Serum creatine phosphokinase, aldolase and lactic dehydrogenase may be elevated after exertion. In the ischemic forearm test there is no rise of serum lactic acid. The enzyme deficiency can be demonstrated by histochemical and biochemical examination of a muscle specimen. Further, but more infrequent, enzymatic disturbances of glycolysis are phosphofructokinase deficiency and phosphohexoisomerase inhibitor, which also yield an abnormal ischemic forearm test and must be demonstrated histochemically and biochemically. Apart from muscular signs, myopathy with lactic acidosis is associated with palpitation, dyspnea and exhaustion, and a disproportionate rise in serum lactic acid level after exertion. Histochemically and electronmicroscopically demonstrable fat accumulation in the muscle can be a sign of a disturbance in lipid metabolism. This type of exercise-induced myopathy has been reported only in a few cases with carnitine-pylmityltransferase deficiency, which has to be demonstrated biochemically. Muscular contractures also exercise-induced but painless and reversible within seconds may be due to deficient uptake of sarcoplasmic calcium in the tubular system. Dyskalemic paralysis causes painless paresis within minutes of hours after exertion, which disappears within hours to a few days. Myopathy with tubular aggregates can be differentiated from other exercise-induced myopathies by morphology. Myotonia combined with painful contractures characterizes myopathia myotonica.


Antimicrobial resistance and R factors in Salmonella isolated from humans and animals in Georgia and South Carolina. Three hundred and five strains of Salmonella isolated from humans and 152 strains isolated from animals in Georgia and South Carolina during 1973 were examined for resistance to 14 antimicrobial agents. S typhimurium was the most frequently isolated serotype (30% of human isolates and 13% of animal isolates). The overall incidence of antimicrobial resistance was 16% in human starins and 21% in animal strains. The most commonly found resistance were to streptomycin (11% in human strains and 16% in animal strains) and tetracycline (10% in both human and animal isolates). A higher prevalence of resistance to streptomycin, spectinomycin, and nitrofurantoin, which are currently used primarily in veterinary medicine, was found in animal Salmonella. Conversely, resistance to ampicillin, cephalothin, and kanamycin, which are used mainly in human medicine, was found more frequently in human Salmonella. No resistance to nalidixic acid, gentamicin, tobramycin, rifampin, or trimethoprim was detected. Sixty-five percent of resistant strains from humans and 60% of resistant strains from animals transferred their resistance patterns partially or in toto.


Cardiac aspect of Cooley's anemia.

Cardiac aspect of Cooley's anemia. The short- and long-term effect of multiple versus regularly spaced blood transfusions on cardiac size, electrocardiographic alterations, heart sounds, murmurs, and carotid pulse were studied in 18 children with Cooley's anemia. These parameters were evaluated before transfusions, one week after multiple blood transfusions (when hemoglobin levels had reached normal), and during the following year, when conventionally spaced transfusions were given. Results showed that enlarged hearts may regress to normal size after multiple transfusions. Chamber hypertrophies and second heart sound were inconstant, and the average of all mean QRS and T vectors was not altered significantly after transfusions. There was good correlation between hemoglobin levels and tachycardia, intensity of first heart sound, heart murmurs, and ejection systolic clicks. Upstroke time of carotid pulse increased with restoration of normal hemoglobin levels. It is concluded that patients maintained at a higher hemoglobin level are generally in better cardiovascular status.


Leucocyte ultrastructure and folate metabolism in Down's syndrome. Electron microscopical and haematological investigation of peripheral blood has shown a higher percentage of leukaemia-like nuclear ultrastructural abnormalities in the leucocytes of 30 individuals with Down's syndrome (mean 6.3%) than in normal controls (mean less than 1%). Most of these aberrations consisted of nuclear membrane abnormalities. Red cell folate values were very low in the group with Down's syndrome. Although mean serum folate and vitamin B12 levels were normal in this group, these individuals displayed increasing macrocytosis and decreasing serum folate levels with age. The whole group with Down's syndrome showed an increased mean corpuscular volume (MCV). The percentage of ultrastructural abnormalities did not correlate with folate levels when they were analysed individually. The existence of nuclear membrane abnormalities and folate deficiency, both of which may be associated with increased chromosome breakage, may be partly responsible for the increased leukaemia risk in patients with Down's syndrome.


The survey of the low-income aged and disabled: an introduction. As 1974 began, the Social Security Administration started distributing supplemental security income (SSI) payment checks to aged, blind, and disabled poor persons throughout the Nation. Shortly before the first SSI checks were issued, the Bureau of the Census completed personal interviews with 17,551 individuals from which SSI's clientele would be drawn--aged and disabled welfare recipients and the aged and disabled poor persons in the general population. These data, collected for the Social Security Administration is late 1973, and comparable information gathered from the same respondents in late 1974 make up the Survey of the Low-Income Aged and Disabled (SLIAD). Its findings will be used to describe the circumstances of needy aged and disabled persons before SSI, determine the program's success in attracting those who qualified for its benefits during the first year of operations, and assess the effect of participation on the well-being of recipients.


Failure of knitted dacron as an arterial prosthesis. The incidence of failure of knitted Dacron arterial prostheses is thought to be significantly greater than that reported in the literature. Five cases of immediate and late defects in grafts of various manufacture are reported and a sixth case is discussed. The development of increased porosity to achieve more complete graft healing is thought to play a role in both early and late graft failure. Although the precise etiologic mechanisms are yet to be determined, the Dacron fibers were noted to become separated with subsequent widening of the graft interstices with resulting hemorrhage through the "intact" prosthetic material. Related theories of explanation are reviewed, and guidelines for study of these defective prostheses are suggested. It is essential that this complication of arterial grafting be recognized and that pertinent clinical experiences be documented in the surgical literature.


HLA--Dw3 in Sjögren's syndrome.

HLA--Dw3 in Sjögren's syndrome. The increased frequency of HLA-B8 in Sjögren's syndrome was recently reported independently by Gershwin et al. (1975) and Iványi et al. (1976). The association of HLA-B8 antigen with other diseases, characterized generally by impaired immunologic reactivity, has been shown (see Svejgaard et al. 1975, Dausset & Hors 1975), and in some of these diseases MLC typing has revealed the strong association also with the Dw3 determinant. The degree of association with each of the two, B8 and Dw3, varied between different diseases, in some of them having been reported to be higher for antigen B8 (Möller et al. 1976) and in the others for the determinant Dw3 (Thomsen et al. 1975, 1976). In some of the diseases, the association was found to be equally strong for both determinants (Solheim et al. 1976, Thorsby et al. 1975). In this communication, we describe the typing of HLA-Dw3 in 29 patients with Sjögren's syndrome (Ss). They represent part of the experimental group reported in a previous study (Iványi et al. 1976).


Sterilization failures in Singapore: an examination of ligation techniques and failure rates. The University Department of Obstetrics and Gynecology, Kandang Kerbau Hospital in Singapore, initiated a study in early 1974 of failure rates for various methods of sterilization and the factors responsible for the failures. During the period January 1974 to March 1976, 51 cases of first pregnancy following ligation were discovered. Cumulative failure rates at 24 months were 0.34 per 100 women for abdominal sterilization, 1.67 for culdoscopic, 3.12 for vaginal, and 4.49 for laparoscopic procedures. Findings for 35 patients who underwent religation showed that recanalization and the establishment of a fistulous opening caused the majority of failures. Clearly, more effective methods of tubal occlusion in sterilization are needed.


[Removal of nicotinic acid 7-14C from the body of rats on a varying supply of vitamin PP]. Dynamic was studied for nicotinic acid (NA-7-14C) and its total metabolites excretion with area of animals under different physiological states (standard PP-avitaminosis). Various "efficiency" is shown for systems regulating homeostasis of this vitamin. When it is administered both in the amount close to the physiological dose (50 mg per 1 kg of weight) and exceeding the dose (500 mg per 1 kg of weight). The data obtained make it possible to draw a conclusion that the biological halflife period of Na-7-14C administered in excess of a physiological dose depends mainly on the rate of the unchanged vitamin PP excretion with urea and when it is administered in the physiological amount the period depends on the rate of the acid-metabolic transformations in the organism.


[Preparation and the properties of a highly purified preparation of myosin from smooth muscles]. Myosin was isolated from the smooth muscles of small intestine of calf with good yield and its properties were compared with the myosin's properties from the skeletal rabbit muscle. The crude myosin was purified by means of DEAE-cellulose column chromatography, using a KCl gradient. The purity of the preparations was checked spectrophotometrically by the densities of adsorption D280/D260, viscosimmetrically by the sensitivity to ATP, electrophoretically and by ultracentrifugation. By the above-mentioned properties the smooth muscle myosin was similar to the high-purified skeletal muscle myosin. A comparative study of the enzymatic properties of myosin from two types of tissues, showed the following differences: (1) in the dependence the Ca2+-ATPase activity on the KCl concentration in the incubation medium; (2) in the degree of myosin activation by actin in the presence of Mg2+; (3) in the behaviour of Ca2+-ATPase dependence on pH; (4) the different temperature optima of the ATPase activity.


[ATPase systems of the skeletal muscle sarcolemma in E-avitaminotic muscular dystrophy]. The sarcolemma preparations isolated from the skeletal muscles of the normal rabbits and those with E-avitaminosis are characterized by electron microscopy according to the activity of 5-nucleotidase and different ATPase systems. As the data of electron microscopy evidence, the sarcolemma preparations of the normal and dystrophic muscles are deprived of admixtures of other subsellular structures. The 5-nucleotidase activity in the sarcolemma of dystrophic muscles is almost thrice as high as in the sarcolemma of normal muscles. On the basis of the results of studies in the kinetic parameters the optimal conditions are selected to investigate the Mg2+, Ca2+ and Na+, K+-ATPase activity. It is shown that under dystrophy the ATPase activity in the sarcolemma preparations in the presence of Ca2+ and Mg2+ does not change as compared to the norm. As to the Mg2+-dependent Na+, K+-ATPase system its activity in sarcolemma of muscles under dystrophy lowers noticeably. Ouabain-sensitive Na+, K+-ATPase of sarcolemma under dystrophy is considerably lower than at the normal level and is 4.1 and 12.1 mumol and phi n per 1 mg of protein for 1 h, respectively. Proceeding from the data on the changes in the lipid composition of sarcolemma of muscles with E-avitaminous dystrophy a problem is under discussion concerning dependence of the transport Na+, K+-ATPase activity on the structure of sarcolemma.


Feline Panleukopenia. I. Pathogenesis in germfree and specific pathogen-free cats. Germfree and specific pathogen-free cats were inoculated panleukopenia vivus. Total leucocyte counts decreased significantly in both germfree and specific pathogen-free cats. Clinical illness was not seen in any germfree cat. Specific pathogen-free cats had anorexia and slight diarrhea 5-6 days after inoculation. None of the cats died. Both germfree and specific pathogen-free cats had thymic involution. No other gross lesions were seen. Tissues for histological virus isolation and immunofluorescence studies were taken daily from days 2 through 6 after inoculation. Virus-infected cells and lesions of panleukopenia were seen in the small intestine of both germfree and specific pathogen-free cats. The incidence of virus-infected cells and lesions was greater in specific pathogen-free cats than in germfree cats.


The fine structure of ducts and subareolar ducts in the resting gland of the female breast. The ultrastructure of the ducts and subareolar ducts of the resting female breast have been described. In transverse section ducts have longitudinal folds, some of which are solid ridges of cells. Four distinctive cell types were distinguished; epithelial cells, lymphocyte type cells, basal clear cells and myoepithelial cells. The epithelium is single layered, multiple at folds, and similar in general morphology to the terminal ductal-lobular unit. Well developed terminal bars may prevent cellular disruption during contraction, and apical cytoplasmic vesicles represent possible secretory material. Basal cytoplasmic bodies may represent transport of secretory products into or from the periductal stroma. Intranuclear vesicles may also be linked to secretory activity. The myoepithelium is well differentiated with numerous cytoplasmic filaments and 9+0 cilia, forming a discontinuous layer around the epithelium. The basal lamina is generally multilaminate. Capillaries are 1-5mum in diameter and exterior to the delimiting fibroblasts of the epithelial-stromal junction.


On the lympho-epithelial relationships in the human oviduct. In order to study the lympho-epithelial relationships in human oviducts, lymphocytes situated in the epithelium were counted and the values found were correlated with differing physiological and pathological changes. In this process the following observations were made: 1. In the secretory phase there are significantly more lymphocytes to be found in the epithelium than during the proliferative phase. 2. In nonspecific purulent salpingitis the number of lymphocytes is not significantly different from that in a normal proliferative phase. 3. The values for fallopian pregnancy are significantly lower than those of a normal secretory phase and do not differ significantly from those of a normal proliferative phase. 4. The values observed for the reproductive period are significantly higher than those found postmenopausally. Examination by electron-microscopy showed that the lymphocytes in the epithelium of the uterine tube are intercellular. Pointers towards degenerative changes were not seen. It is presumed that the number of lymphocytes appearing in the epithelium of the fallopian tube depends on the hormonal activity of the ovaries.


Histopathological features in mixed types of chronic aggressive hepatitis and primary biliary cirrhosis. Correlations of liver histology with mitochondrial antibodies of different specificity. A histopathological study was carried out on 27 patients with chronic inflammatory liver disease and clinical and/or biochemical evidence of cholestasis who had either mitochondrial antibodies against mitochondrial antigen fractions of 1.19 density ("PBC antigen"; 14 cases) or of 1.13 density ("CAH-PBC mixed-type antigen"; 13 cases). For comparison, the liver biopsies of 17 patients with chronic-aggressive hepatitis (CAH) and antinuclear and/or anti-smooth muscle antibodies but without cholestasis and mitochondrial antibodies, were evaluated. The 14 patients with mitochondrial antibodies against the PBC antigen showed the typical histological features of primary biliary cirrhosis (PBC). The 13 patients with mitochondrial antibodies against the CAH-PBC mixed-type antigen had heterogenous liver alterations. In 11 cases highly active CAH and/or active postnecrotic cirrhosis (AC) were found both with augmented ductular proliferation. Some of these cases showed distinct criteria of PBC as early bile duct lesions or absence of regular bile ducts. The liver histology of one case corresponded to classical PBC; another case to chronic persistent hepatitis. The CAH-patients without cholestasis and mitochondrial antibodies only occasionally showed bile duct proliferation. In conclusion, a high correlation was found between mitochondrial antibodies against the CAH-PBC mixed-type antigen and highly active CAH or early AC with augmented ductular proliferation. This represents an overlapping of CAH and PBC. In contrast, the cases with antibodies reacting to the PBC antigen showed the slowly progressive liver changes of typical PBC.


Amyloid of human islets of Langerhans. II. Electron microscopic analysis of isolated amyloid. Isolated amyloid from the islets of Langerhans of patients with maturity onset diabetes mellitus was compared with amyloid fibrils from patients with different types of systemic amyloidosis. It was found that systemic amyloids had in common rigid and non-branching filaments with a width of about 75 A and that these filaments sometimes were attached laterally, forming thicker fibrils. Similar filaments could also be extracted from islet amyloid but the main part of this amyloid was built up by large aggregates of very thin and often very wavy units. This structure, which has not been previously described in human amyloid, probably explains some properties of isolated islet amyloid.


Histologic, microradiographic and electron microscopic investigations of bone tissue in a case of craniodiaphyseal dysplasia. The results of histologic, microradiographic and electron microscopic investigations carried out on two bone biopsies pertaining to a case of craniodiaphyseal dysplasia are reported. They show that the affected skeletal segments are chiefly characterized by enhancement of bone volume, and defective calcification of the bone matrix. Moreover, interstitial calcification of skeletal muscle has been found.


[The influence of beta-sympathomimetics and so-called Ca++-antagonistic inhibitors on human heart muscle in vitro (author's transl)]. In an in vitro assay on fetal human heart muscle it was demonstrated for the first time that overstimulation by beta-sympathomimetics could cause elective parenchymal necrosis. Fenoterolhydrobromide, which is used for tocolysis on a longterm scale, induces in vitro necroses of individual heart muscle fibers according to a pathogenetic principle postulated by Flekkenstein. The combination of Fenoterolhydrobromide with a Ca++-antagonist prevents elective parenchymal necroses by reducing the Ca++-influx into the heart muscle fibers. These results suggest that elective necroses of heart muscle fibers may be not only of coronarogenic but also of metabolic origin.


Acute interstitial pancreatitis in the rat induced by excessive doses of a pancreatic secretagogue. Conscious rats were infused via a jugular vein catheter with 5 x 10-6 g/kg/h caerulein for periods up to 24 h. On macroscopic inspection a progressive interstitial oedema is seen to develop in the pancreas, from one hour of infusion on and is most marked at twelve hours. This oedema is largely reabsorbed after 24 h treatment, but the pancreas is considerably indurated by this time. Serum amylase levels increase consistently to reach a tenfold elevation above controls after three, six or twelve hours infusion. Premature fusion of condensing vacuoles and secretory granules leads to formation of large vacuoles in the cytoplasm of exocrine pancreatic cells. These vacuoles fuse with the lateral and basal plasma membrane and realease their content into the extracellular space. Regular discharge of zymogen granules at the cell apex into the duct system does not occur. Vacuole formation is associated with cytoplasmic destruction of the pancreatic cells. The rate of protein synthesis decreases consistently as a result of these structural alterations and this change corresponds largely to a reduction of cellular respiration. Release of amylase from isolated pancreatic lobules of caerulein infused animals shows a progressive increase of unstimulated discharge, while in vitro stimulation with 5 x 10-6M carbamylcholine gives secretion patterns of wash-out kinetics. Stimulated discharge of labeled secretory proteins indicates a progressive reduction in the in vitro sensitivity of the pancreatic cells to secretagogues. After 24 h infusion of 5 x 10-6 g/kg/h caerulein the pancreatic lobules are totally insensitive to the in vitro effect of carbamylcholine or caerulein.


Medical treatment of sexually transmitted disease in developing countries I: Gonorrhoea. The statistics relating to the incidence of sexually transmitted diseases in many developing countries are not available and where there are, they are unreliable. Nevertheless, the impression of many physicians is that they constitute serious public health problems as they are endemic in some developing countries. The facilities for diagnosis and treatment of the diseases have been briefly discussed. The merits and the demerits of various antimicrobial agents have been outlined with the causes of failure of treatment in the developing countries. The economic importance of the "traitment minute" in the tropical environment has been stressed because of its economic advantage in terms of time spent in overcrowded hospitals. The resultant effect of the widescale misuse of antibiotics in developing countries has been suggested as a cause of the increasing resistant strains encountered. A plea is made for stricter control of the antimicrobial agents in developing countries.


[Acne vulgaris--principles and results of treatment with retinoic acid and tetracyclines (author's transl)]. According to the results obtained in a recent clinical trial over a four-year period retinoic acid represents the most effective single agent available for the topical management of acne vulgaris. Retinoic acid yields impressive therapeutic results not only in patients with manifest acne, but, provided it is applied early enough, it is also effective in preventing the severe inflammatory manifestations of this disease. In medium to severe cases of inflammatory acne, topical retinoic acid therapy should be combined with a low-dose, long-term systemic tetracycline regimen. The course of treatment may extend over months or years, depending on the severity of the condition. Particularly patients in the acne-prone age group are candidates for long-term therapy. Retinoic acid therapy, alone or in combination with tetracyclines, proved far superior to conventional regimens with respect to the effective treatment and prophylaxis of acne.


[Spectinomycin (Trobicin) in Male Gonorrhoea (author's transl)]. 28 male patient with uncomplicated acute gonorrhoea were treated with a single intramuscular injection of 2.0 g spectinomycin. All of them were cured. The suitable alternative to penicillin in the treatment of uncomplicated gonorrhoea, but it will not cure simultaneously-acquired syphilis. Its use should, therefore, be restricted to specific indications.


[Delayed manifestation of Costa's acrokeratoelastosis]. Acrokeratoelastoidosis, first described in 1952 bei O.G. Costa, belongs to the group of diffuse palmoplantar keratoses without associated symptoms. Probably it is an autosomal dominant trait. We observed a 49 year old female who has noticed her typical skin lesions for 2 years. The most marked histological features are proliferative hyperkeratosis, an almost complete lack of the fine subepithelial elastic fibre network and a marked rarefication of the coarse elastic fibres in the dermis.


Interaction of streptolysin-O with natural and artificial membranes. 1. Kinetic studies on the binding of 125I-streptolysin-O exhibited immediate fixation of activation toxin to natural and artificial membranes. Once fixed to the membrane no release of Streptolysin-O or Streptolysin-O-lipid-complexes has been observed. 2. In contrast to activated toxin (free SH-groups!), oxidized Streptolysin-O was shown to become also fixed to membranes, however, with different binding kinetics. The binding of oxidized amterial was clearly dependent on temperature and time. When the toxin was oxidized twice the amount of labelled material was bound as compared with the hemolytically active Streptolysin-O. This suggests that oxidized Streptolysin-O, too, possesses a "binding site" within the molecule, though free SH-groups were expected to be essential for toxin fixation at the membrane. It has been shown that oxidized (inactive) and reduced (active) Streptolysin-O forms stable "complexes" with liposomes in aqueous which could be separated by chromatography on Sepharose gels. 3. The binding of 125I-toxin to membranes and liposomes was specific since specific antisera against Streptolysin-O inhibited fixation of toxin completely. 4. Hydrolysis of phospholipids and release of lysophosphatides by Streptolysin O esterase (EC 2.1.2.2) has not been observed, thus providing no evidence for an enzymatic concept for membrane damage.


The active center of methemoglobin Hb(H2O) investigated by Mössbauer and susceptibility experiments. A fast freezing technique using liquid propane was used to obtain frozen solutions of methemoglobin at pH 7. With this method it was possible to eliminate largely the presence of a low spin component which is usually found in slowly frozen solutions but not present in the sample at room temperature. The magnetic susceptibility and Mössbauer spectra of Hb(H2O) in the temperature range 4.2 K less than or equal to T less than or equal to 250 K have been measured. The data of the high spin compound of Hb(H2O) were evaluated with a Hamiltonian comtaining the Coulomb repulsion of the five 3d-electrons of the Fe3+ ion, a crystal electric field of C2V symmetry and the spin orbit coupling. The term describing the crystal electric field depends on five energy parameters epsilon1, epsilon2, epsilon3, D, and E which are determined by least squares fits to the experimental data. The most relevant parameters epsilon 2 and epsilon 3 which equal the energies of the antibonding single 3d-electron orbitals 3dz2 and 3dx2-y2 with respect to the 3dxy orbital are compared with earlier results of these energies epsilon 2 and epsilon 3 of the high spin compound of Mb(H2O). From this comparison conclusions regarding the different spatial arrangements of Fe3+ in Hb(H2O) and Mb(H2O) are drawn.


Purification of histone F3 by covalent chromatography. The arginine-rich histone F3 has been purified by covalent affinity chromatography. By the use of activated Thiol-Sepharose 4B for the purification of cysteine containing histone F3 a highly purified protein was obtained. The simple purification procedure offers the opportunity to get larger amounts of pure histone F3 within short time.


Fluorescence and membrane-action of tetracaine. The fluorescence of tetracaine depends on the micro-environment of the molecule and increases with increasing hydrophobicity. The presence of erythrocyte membranes strongly enhances tetracaine fluorescence. The results support the view that the alkyl chain and aromatic part of tetracaine is embedded in apolar regions of the lipid or protein phase of the membrane.


Ribosome crystals in the oocyte of Gerris najas (Heteroptera). Oocytes of the pond skater, Gerris najas, display ribosome tetramers that are arranged in the form of sheets in the vicinity of the nucleus. This is the first finding of ribosome crystals in an insect and suggests that ribosome crystallization may be a common phenomenon of cells that are inactive in protein synthesis.


The structure of lipids and proteins studied by attenuated total reflection (ATR) infrared spectroscopy. II. Oriented layers of a homologous series: phosphatidylethanolamine to phosphatidylcholine. Polarized infrared ATR spectra of dry oriented multilayers of dipalmitoylphosphatidylethanolamine, sheep brain phosphatidylethanolamine, dipalmitoylphosphatidyl-N-methylethanolamine, dipalmitoylphosphatidyl-N-N-dimethylethanolamine, dipalmitoylphosphatidylcholine and egg phosphatidylcholine are reported. Structural features of hydrocarbon chains and polar headgroups are discussed. The average deviation fo hydrocarbon chains from the normal to the plane of the bilayer was found to be 20-30 degrees. However it was not possible to decide whether the chains are oriented parallel to each other. The fatty acid ester groups in beta- and gamma-position have different conformations. The phosphate group of dipalmitoylphosphatidylethanolamine exists probably in the protonated (formula: see text) and not in the ionized (greater than PO2-) state. However, the latter state is expected for all other phospholipids of this series. The deviation of the bisector of (formula: see text) of the greater than PO2- group from the normal to the bilayer is less than 45 degrees and the mean orientation of all polar head groups is rather parallel than perpendicular to the plane of the bilayer. The polar headgroup of phosphatidylcholine assumes at least two different conformations of the O-C-C-N moiety, i.e. gauche and trans. A variety of conformers has to be expected also for the polar head groups of most of the other phospholipids investigated in this work.


[Normal development of the fruitfly Drosophila in VLF magnetic fields (author's transl)]. Attempts to substantiate irreversible actions of a variety of magnetic fields on the fruitfly, Drosophila melanogaster, have been successful and unsuccessful in about equal numbers. The most conspicuous mutagenic effects apparently induced by pulsed HF-fields failed to appear under continuous electromagnetic irradiation. This seems to correlate the observed damage with the VLF-components of the pulsed fields. The present investigation is motivated by the occurrence of these components both in the atmosphere and in the vicinity of electrical appliances. A strain of normally viable wild type males and subnormally viable Attached X y w females was used in which the yield, and the sex ratio, of the progeny indicate, respectively, the extent of developmental damage and of sex-linked recessive lethal mutation induced by the exposure of detrimental conditions. Evaluation of 73,800 flies from subsequent generations of a control group and two test groups raised in steady, or rotating, homogeneous 9.6 kHz magnetic fields of about 2.5 G did not reveal any developmental or hereditarc load in the test groups. (Pressman 1970; Mittler 1973).


Further compounds from the pedal gland of the bontebok (Damaliscus dorcas dorcas). The identification of four further major constituents of the pedal gland exudate of the bontebok, Damaliscus dorcas dorcas, viz. alpha-terpineol, 2-n-heptylpyridine, m-cresol and (A)-6-dodecen-4-olide and the investigation of the stereochemistry of the double bond in (Z)-6-dodecen-4-olide by means of iterative computer analysis are described. An improved synthesis of this compound is outlined.


[Preparative isolation of protein III of the human erythrocyte membrane (author's transl)]. The paper describes a method for the large-scale isolation of protein III (protein E, major intrinsic protein) from the human erythrocyte membrane with little expenditure of time. By treatment of the erythrocyte ghosts with deluted HCl at pH 2.3 and 0 degrees C some membrane proteins can be extracted. From the remaining "rest" membranes, whose major constituents, besides phospholipides, are protein PAS-1, other carbohydrate containing proteins and protein III, the latter can be separated in pure form by means of gel filtration. The paper reports on the amount, purity and possible structural modifications of the protein III obtained by this isolation method.


[On amino acid antagonists: beta-diketoesters and their corresponding gamma-enolethers]. Starting with well known beta-diketoesters the corresponding gamma-enolethers are synthesized and described. Both classes of compounds inhibited the growth of some microorganisms. The inhibition is abolishable by addition of certain amino acids to the definite medium. A possible mechanism of inhibition is discussed and compared with the mechanism of some beta,gamma-unsaturated alpha-amino acids. The known unsaturated alpha-amino acids, their origin and their biological activity are summarized in two tables.


Renaturation of alkali-denatured T7 DNA molecules complexed with ethidium bromide. Free and ethidium bromide (EB) complexed alkali denatured T7 DNA molecules were renatured at 58 and 62 degrees C respectively for 1--3 h. The structures of the renaturation products of the free candidates were as usual showing native like, branched and unrenatured DNA whereas the structures of the ethidium bromide complexed one were somewhat different, showing non-renatured loop-like and entangled regions present inbetween the renatured segments. On the basis of the linear base sequence of T7 DNA, these non-renatured parts are indicative of the inhibition of renaturation by the complexed EB molecules. Mapping of the non-renatured regions showed that they were present at some specific sites, which inturn suggested that the EB-binding has some base sequence specificity.


[Experiences in the fixation of vaginal prolapse using Fletcher's method]. The advantages of Fletcher's operation for vaginal pouch prolapse after previous hysterectomy or total extirpation are reported with a slightly modified method in eight cases. The following results show this surgical procedure to be especially advantageous: A permanent good fixation of vagina without shortening, no recurrence no pain and neither so-called antefixation complaints. A complete rehabilitation of cohabitation and orgasm was effected. Urological complications, such as obstruction of urine or micturition difficulties are eliminated by this surgical intervention.


[Status of laparoscopy in the examination repertoire of small and middle gynecologic departments]. During nearly 2 years 155 laparoscopies were performed in a gynaecological-obstetrical department with 75 beds. The indications and results are discussed. Because of the important advantages, like better diagnosis, reduction of the duration of clinical treatment, reduction of costs and better utilization of clinical capacity laparoscopy especially is suitable for the indications "suspicion on tubal pregnancy", "suspicion on tumor in the lower abdomen", "not clear findings" and "chronic pain in the lower abdomen" in little and middlesized gynaecological departments.


[Correlation between the perfusion, perfusion pressure and contractile activity in the nonpregnant uterus]. This paper presents the results of investigations on the dependence between the flow and intravascular pressure and uterine contractile activity. The pressure in the vascular bed was monitored with a pressure transducer and the contractile activity by means of an intrauterine ballon was measured. In a part of experiments, the flow was recorded with a flowmeter. The investigations were performed on 27 nonpregnant human uteri in various phases of the menstrual cycle. Uterus was perfused with a perfusion pump, starting from the perfusion pressure of 50 to 60 mm Hg and on up to maximum values of 140 mm Hg. It has been found that with an increase in the uterine flow, intravascular pressure increases too. This pressure-flow relationship is linear. An increase in flow through the nonpregnant uterus leads to an increase in intravascular pressure from 61.5 mm Hg to 142 mm Hg with a simultaneous increase in the human uterine basal tonus from the 6.2 mm Hg initial value to the average value of 25 mm Hg at the perfusion pressure of 140 mm Hg and an decrease in frequency from 6.6 to 5.2 contractions/10 min. With an increase of flow, however, there is a increase in amplitude which reaches highest values at the 100 mm Hg perfusion pressure and than no significant increase in amplitude is observed. An increase in amplitude is accompanied by an increase in contractile activity. It should be concluded that hemodynamic conditions and the state of vessels play a controlling role in the process of the uterine activity.


[Epidemiologic analysis morbidity with meningococcal infections in the USSR]. The authors present the analysis of the incidence of epidemic cerebrospinal meningitis in the USSR from 1937 to 1974, and of meningococcus infection from 1965 to 1974. A rise of the meningococcus infection incidence from 1969 to 1974 was recorded 28 years after the elevation of 1940-1942 and was 1.5 times below this latter rise. The rise in 1969-1974 was characterized by marked signs peculiar to the infection with the droplet transmission mechanism; among those who contracted the disease prevalence was seen among children aged under 14 years (63-72%). A marked affection of juveniles was noted. Three types of the dynamic of the meningococcus infection incidence in the republics located in different climatic-geographical zones of the USSR were noted: slow, gradual increase of the level, interrupted and explosive. Such character was determined in the dynamics of the seasonal elevations of morbidity. Antiepidemic measures including a complex of nonspecific measures could not be assessed as sufficiently effective. This finds reflection in the natural course of the epidemic process of the meningococcus infection which remains uncontrolled. From the patients with generalized form of the disease meningococci of group A were isolated in 80-100% of cases, from the number of those typed. The group-specific reference of the nasopharyngeal strains depended on the epidemic situation: strains of serological group A prevailed at the period of the morbidity elevation, and other serological groups (particularly of C and B) increased at its decline.


Renal blood flow as measured with 133Xe wash out and 86Rb uptake techniques and with an electromagnetic flowmeter. The values for total RBF measured with 133Xe and 86Rb methods are nearly equal to that measured simultaneously with an electromagnetic flowmeter. A high degree of correlation was found between the values estimated by the three methods. No significant correlation was, however, found in the perfusion of the individual kidney regions (cortex, outer and inner medulla) measured with 133Xe wash-out and 86Rb uptake techniques.


Comparative morphological and histochemical aspects of selected arteries in the chicken and rat. Morphologic and histochemical characteristics of selected portions of normal arteries from two species known to differ in susceptibility to vascular disease were examined. Arteries were classified as predominantly elastic, muscular or complex. Species differences in the structural organization of the abdominal aortic segment were observed. Arterial mucopoly-saccharides were stained more intensely in the tunica intima and media of chicken vessels than within those of the rat, and tended to be most concentrated in proximity of the internal elastic membrane. Histochemical procedures for the demonstration of enzymatic activity revealed inter-and intraspecies variations in vascular metabolism. Pronounced differences in reaction intensity for hydroxybutyrate dehydrogenase and malic enzyme, affecting chicken and rat coronary arteries, were noted. In contrast, theses vessels displayed only minimal activity for acid phosphatase. Marked endothelial deposition of alkaline phosphatase reaction products in the arteries of the chicken was demonstrated, while this enzyme's activity in the vessels of the rat was restricted to the tunica adventitia. The implications of these structural and histochemical factors with regard to vascular susceptibility to disease were discussed.


Histopathology of the conduction system in patients with atrioventricular or intraventricular conduction disturbances. In 9 lethal cases where clinical signs gave rise to the suspicion of acute myocardial infarct (AMI) where well-characterized e.c.g.-changes, permanent or intermittent, were found by monitoring, a very careful autopsy of the heart was carried out, combined with a meticulous histological investigation of the conduction system. Acute changes of mild degree in the conduction system were found only in one case, possibly explaining the left bundle branch block found in this case. In the remaining cases, nothing but chronic changes were found and they did not exceed significantly the changes otherwise to be found in the agegroups concerned in a "control series" of violent deaths not preceded by symptoms of heart disease. According to an estimate there was good correlation between the conduction disturbances demonstrated and the localization of histopathological changes in seven of nine patients; in one of the latter correlation was relatively good; correlation was dubious only in one case. On this basis the authors conclude that present changes in the conduction system which are assumed mainly to be age-related, are the factors to determine the type of conduction disturbances from which the patient will suffer if acute heart ischaemia sets in, for instance due to an AMI, in fact, changes by which he will be predisposed to such disturbances.


Histochemical studies of striated muscle after temporary ischemia in the rat. Temporary ischaemia of the hind linb of the rat was produced using a tourniquet with controlled pressure. Changes in the muscle seen after Gomori trichrome staining and after histochemical reactions for NADHdiaphorase, ATPases and phosphorylase were correlated with the duration of the ischaemia and the time of recovery. Histopathological changes were seen first after 2 h of ischaemia and increased thereafter; necrosis of most of the muscles occurred between 4 and 6 h of ischaemia. Necrosis and phagocytosis of muscle fibres and later the amount of regenerating fibres with characteristic histochemical staining properties increased linearly with increasing duration of ischaemia. Even after the most severe lesions of seemingly total necrosis of the muscle after 6 h of ischaemia most of the muscle regenerated within 18 days. Morphological alterations such as variation in fibre size, split fibres and central nuclei were still observed 226 days after ischaemia at which time the follow-up was terminated. Fibre type grouping was seen first after 45-90 days subsequent to 4 and 6 h ischaemia after incubation for ATPase, indicating concomitant neurogenic lesion in addition to the direct ischaemia of the muscle fibres.


Renal Na-K-ATPase activity during saline infusion in the rabbit. During saline infusion, sodium reabsorption (RNa) in the diluting segment (thick ascending limb of Henle's loop) increases acutely. The mechanism for this higher pumping rate of outer medullary Na-K-ATPase is unknown. Following left-sided nephrectomy, immediate i.v. infusion of hypertonic saline increased RNa in the remaining whole right kidney by 28 +/- 14% (p less than 0.05). Na-K-ATPase activity in outer medulla was raised by (delta) 23 +/- 4% above the left kidney (p less than 0.05), whereas cortical activity was unchanged. The mechanism for this increase in Na-K-ATPase activity was explored. The catalytic rate per enzyme did not differ in the two kidneys and equalled 5 340 min-1. The increase was therefore due to higher tissue concentration of active enzyme. The response was fully developed during continuous infusion within 20 min, and of equal magnitude whether protein synthesis had been inhibited by cycloheximide (delta = 23 +/- 7%) or stimulated by unilateral nephrectomy 6 days earlier combined with saline infusion for 2 h (delta = 34 +/- 10%). Thus, during hypertonic saline infusion, the increased RNa in the outer medulla was partly accounted for by the activation of latent Na-K-ATPase. High delivery of sodium to the diluting segment for more than 20 min during hypertrophy caused no further activity change.


Physical stigma and academic performance as factors affecting children's first impressions of handicapped peers. The effects of four variables on attitudes toward children were studied: the sex and social status of the rater and the physical appearance and academic competence of the target child being rated. The results indicated that competent and physically nonstigmatized children were rated more favorably than incompetent and physically stigmatized children. The data also revealed that girls had a significantly more positive stereotype than did boys of a competent male target child but that boys were more willing to be in physical proximity to the male target child as measured by a social-distance scale. Finally, the results indicated that popular children rated the attractive and competent target child less favorably than children who were not so popular. However, the popular children rated the attractive and incompetent target child more favorably than the less popular children did. The findings were discussed in terms of the salience of physical labels (i.e., stigma) on attitudes toward children.


A new uterine mobilizer for laparoscopy: its use in 518 patients. A new instrument for manipulating the uterus during laparoscopy has added the dimension of uterine version to increase the mobility of the uterus. Allowing elevation, rotation, and version of the uterus, the instrument has increased the case and efficacy of visualization of pelvic viscera in an experience of 518 cases in seven hospitals where it underwent assessment.


Steroid hormone changes in fetal blood during labor. Radioimmunoassays of pregnenolone, progesterone, dehydroepiandrosterone (DHA) 16 alpha-hydroxy-DHA, estriol, and cortisol were performed on a total of 0;1 ml; of fetal plasma, collected during the course of normal vaginal delivery. The mean hormone concentrations +/- standard errors of fetal blood in the first and second stages of labor and of the umbilical arterial and venous blood at delivery were as follows: pregnenolone, 0.53 +/-0.06, 1.13 +/- 0.16, 1.48 +/- 0.14, and 1.34 +/- 0.27 micrograms per milliliter; progesterone, 0.12 +/- 0.01, 0.14 +/- 0.01, 0.26 +/- 0.02, and 0.34 +/- 0.02 micrograms per milliliter; DHA, 0.98 +/- 0.11, 0.94 +/- 0.08, 1.51 +/- 0.25, and 1.23 +/- 0.11 micrograms per milliliter; 16 alpha-hydroxy-DHA, 1.54 +/- 0.22, 1.49 +/- 0.31, 2.27 +/- 0.25, and 1.82 +/- 0.21 micrograms per milliliter; cortisol, 1.82 +/- 0.15, 1.91 +/- 0.24, 2.39 +/- 0.19, and 2.35 +/- 0.17 micrograms per milliter; cortisol, 0.11 +/- 0.01, 0.09 +/- 0.01, 0.16 +/- 0.02, and 0.14 +/-0.01 micrograms per milliliter. Except for cortisol, the levels in the fetal blood of all the steroids studied rose significantly at delivery of the infant, when compared to the titers in the first stage of labor. During delivery, increased titers of pregnenolone and DHA, steroids which are of fetal adrenal origin, suggest enhanced adrenal activity during the final phase of labor.


Down's syndrome and autoimmunity.

Down's syndrome and autoimmunity. A patient with Down's syndrome (DS) with multiple autoimmune phenomena is described. She suffered from hypothroidism, a celiac-like enteropathy and hemolytic anemia, and displayed cellular immunity directed against peripheral nerve antigen and basic myeloprotein and serum autoantibodies to many other tissue antigens. Her mother did not suffer from any overt autoimmune disease, but similar autoantibodies were found in her serum. It is suggested that DS resembles other autoimmune  diseases, especially that which occurs in the NZB mice. The resemblance is based on the assumption that in both cases genetic and/or viral factors cause T-cell dysfunction which leads on the one hand to increased susceptibility to infections and leukemias, to autoimmune phenomena and to depressed cellular immunity, and on the other hand to increased B--cell reactivity.


Abnormal myocardial fluid retention as an early manifestation of ischemic injury. Fifty-seven isolated, blood perfused, continuously weighed canine hearts have been utilized to study the development of abnormal myocardial fluid retention during early myocardial ischemic injury. Inflatable balloon catheters were positioned around the left anterior descending coronary arteries (LAD) of 54 hearts or the proximal left circumflex coronary arteries of three hearts for study of the following intervals of coronary occlusion: a) 10 minutes followed by 20 minutes of reflow, b) 40 minutes followed by either no reflow or by 20 minutes of reflow, and c) 60 minutes without reflow. After 60 minutes of fixed coronary occlusion, histologic and ultrastructural examination revealed mild swelling of many ischemic cardiac muscle cells in the absence of interstitial edema, cardiac weight gain, and obvious structural defects in cell membrane integrity. After 40 minutes of coronary occlusion and 20 minutes of reflow, significant cardiac weight gain occurred in association with characteristic alterations in the ischemic region, including widespread interstitial edema and focal vascular congestion and hemorrhage and swelling of cardiac muscle cells. Focal structural defects in cell membrane integrity were also noted. The development of abnormal myocardial fluid retention after 40 minutes of LAD occlusion occurred in association with a significant reduction in sodium-potassium-ATPase activity in the ischemic area, but with no significant alteration in either creatine phosphokinase or citrate synthase activity in the same region. Despite the abnormal myocardial fluid retention in these hearts, it was possible pharmacologically to vasodilate coronary vessels with adenosine and nitroglycerin infusion to maintain a consistently high coronary flow following release of the coronary occlusion after 40 minutes and to even exceed initial hyperemic flow values following release of the occlusion when adenosine and nitroglycerin infusion was delayed until 15 minutes after reflow. Thus, the data indicate that impaired cell volume regulation and interstitial fluid accumulation and focal structural defects in cell membrane integrity are early manifestations of ischemic injury followed by reflow, but fail to establish a major role for the abnormal fluid retention in altering coronary blood flow prior to the development of extensive myocardial necrosis. In contrast, fixed coronary occlusion for 60 minutes results in mild intracellular swelling but no significant interstitial edema and no obvious structural defects in cell membrane integrity.


Hyperfunction with normal inotropic state of the hypertrophied left ventricle. Conscious dogs were instrumented with an inflatable cuff around the ascending aorta, a high-fidelity micromanometer in the left ventricle (LV), and pairs of ultrasonic crystals for measurements of LV wall thickness and internal LV diameter. Wall stress (WSt) and mean velocity of wall shortening (VCF) were calculated. Mean force-velocity relations and WSt-diameter loops in single contractions were then analyzed over a range of matched systolic pressures during acute aortic constrictions both before and after induction of chronic hypertrophy by sustained aortic constriction. At normal LV systolic pressures and at each matched level of systolic LV pressure, wall shortening velocity was increased in the hypertrophied ventricle. However, force-velocity relations obtained by relating mean VCF to mean WSt at various stress levels fell on the same relation as during control. The linear relation between LV diameter and pressure at the end of ventricular ejection was shifted to the left in the hypertrophied ventricle, indicating enhanced shortening. However, linear WSt-diameter relations at end-ejection were not different in control and hypertrophied hearts. These findings indicate that the ventricle hypertrophied by pressure overload exhibited hyperfunction as a pump but that its myocardium had a normal level of inotropic state.


The clinico-epidemiological profile of guinea worm in the Ibadan district of Nigeria. An epidemiological survey of guinea worm infection was carried out in 17 rural village communities north of Ibadan in western Nigeria from 1971 to 1975. The incidence was 13.5% in a population of 8,200. The sexes were equally affected although there were significantly more cases amongst boys than girls. A majority of the worms emerged from the lower limbs and the incidence of complications and disability was higher in those with lesions around the ankles and feet. The average duration of incapacity from effective work among this predominantly rural population was 100 days. A case is made for a concerted effort to eradicate this easily prevented disease by the provision of wholesome potable water to all persons.