Angiographic demonstration of cervical extradural meningioma. The diagnosis of a cervical extradural meningioma was made preoperatively on the basis of angiographic criteria. The entire extent of the tumor that partially encircled the dural sac could be demonstrated with regional spinal angiography.


[Ultrasonics in the surgical diagnosis of thyroid diseases]. Echography enables a useful diagnostic distinction to be drawn between solid structures and cysts in the thyroid. Cold nodes measuring 1-5 cm in diameter, cysts (rarely malignant), and solid formations (more commonly malignant) can be differentiated to facilitate diagnosis, while changes in the size of a node can be followed without interrupting drug treatment to determine whether they are due to haemorrhage, resolution of a process, or an increase in node tissue. There is no risk to the patient and the cost of the examination is negligible. Its utility in the initial and subsequent investigation of such nodes is asserted.


[Subtotal parathyroidectomy. Indications and technic]. A close examination of recent views concerning metabolic diseases connected with uraemia is followed by an account of the therapeutic efficacy of subtotal parathyroidectomy, its indications, and the best technique to employ. A personal series is described.


[Diagnostic laparotomy in Hodgkin's disease]. The results of 38 cases of laparotomy with splenectomy in Hodgkin's disease are presented. After describing the results obtained, and modifications due to preoperative classification of Hodgkin's disease, the diagnosis and surgical treatment are shortly discussed.


[Varicothrombophlebitis of the lower limbs. Medical or surgical therapy?]. The aetiopathogenesis of varicothrombophlebitis and its frequency in terms of age and sex are examined in the light of the leading discussions in the literature. The prevention and treatment of its main complications are also discussed. Clinical and statistical data drawn from a personal series collected over a period of about 8 yr are presented. A personal opinion is expressed on the question of treatment. It is felt that the steps taken in any given situation will depend on the extent of the process. Immediate surgery (extended preventive crossectomy, or radical management of thrombotic varices) must be accompanied by suitable general and local medical management.


[Use of chlorhexidine in surgery].

[Use of chlorhexidine in surgery]. The extensive literature on the efficacy of chlorhexidine is reviewed. Personal experience with the substance in the daily and preoperative disinfection of the hands of medical and paramedical personnel in a surgical department, and the medication of surgical wounds, over a period of one year confirmed its low toxicity and long effectiveness against notoriously intractable Gram-negative forms.


[Melena due to malignant leiomyoma of the small intestine. Clinical case]. A case of malignant leiomyoma of the small intestine is reported. Emphasis is laid on the problem of diagnosing such tumours because of their abdominal symptomatology and the fact that they are sometimes associated with intermittent intestinal haemorrhage.


[Anthocyanosides and the walls of the microvessels: further aspects of the mechanism of action of their protective effect in syndromes due to abnormal capillary fragility]. On the basis of previous biochemical observations, which have demonstrated the formation of complexes between anthocyanosides and some phospholipids, the AA. investigate the modifications induced by local and general administration of anthocyanosides 1) on the foreign body granuloma and 2) on the composition of the protein fractions in the exudate from the capillaries of the granulation tissue, growing on post-thromboflebitic or varicose leg ulcerations. The biochemical and histochemical data may show that the anthocyanosides protect the altered capillary walls with a double mechanism: a) increasing the endothelium barrier-effect through a stabilisation of the membrane phospholipids and b) increasing the biosynthetic processes of the acid mucopolysaccharides of the connective ground substance, by restoring the altered mucopolysaccharidic pericapillary sheat. This last effect may explain the marked increase of new-formed capillaries and collagen fibrils induced by the anthocyanosides.


[Experience with chemotherapy in peritoneal carcinosis]. 5-FU i.v. and Ptc i.v. and intraperitoneally were used to treat 8 patients in the Ancona Oncology Centre suffering from metastatic peritoneal carcinosis. Tolerance was generally good and where side-effects were observed they were the same as those habitually encountered in patients treated with 5-FU and Ptc.  Ascitic effusion disappeared or reduced by more than 50% in almost all cases. General condition thus improved.


[Chemotherapeutic results in 62 cases of breast cancer in conjunction with several clinical variables]. Alkylating drugs, alkylating drugs + antimetabolites, and alkylating drugs + antimetabolites + Vinblastine were used to treat 62 patients. The results were assessed in terms of Karnofsky's classes and related to the following parameters: age, free interval, menopausal status, results of prior endocrine management, site of dominant metastases, length of survival. 44 failures (71%) and 18 objective responses (29%) were noted. A mean survival of 17.3 months was noted for the entire series. Subjects who failed to respond survived an average of 14 months, as opposed to 25.5 months for the responders. This difference was just significant. No relation could be shown between the results and the other parameters, whereas that between the results and the length of survival was highly significant. It is clear that the variables considered cannot be relied upon in predicting the outcome of chemotherapeutical management. If the latter is effective, however, survival will almost certainly be prolonged.


[Renal tubular acidosis during a course of liver cirrhosis]. In a group of 23 patients suffering from liver cirrhosis, metabolic acidosis was always observed, in most cases corrected by respiratory alkalosis. In 8,6% of cases a tubular renal acidosis (type I), in 8,6% (type II) and 8,6% a loss of urinary bicarbonate without acidosis were observed.


[Local regional recurrences after radical mastectomy. Studies of 50 cases]. Resection of locoregional recurrences was performed after mastectomy in 50 cases in the period 1961-1974. An incidence of 2% to 35% is reported for such recurrences, which are due to a variety of factors. In the present series, attention was directed to age at mastectomy and at recurrence, size of primary tumour, presence of axillary metastases, and details of menarche, menopause and pregnancy. Mean age at mastectomy was 50 yr and at recurrence 53 yr. Tumour diameter ranged from 2 to 5 cm in 73% of cases. Lympho node metastases were present in 42%. In 80%, the recurrence was paracicatricial, in 13% parasternal, and in 7% axillary. Treatment consisted of resection, radiochemotherapy or endocrino-ablative management.


[Epidemiological study of diabetes in the occupational environment]. Fasting blood sugar was determined in 277 subjects with early forms of silicosis during statutory outpatient examinations. Values were related to the clinical and occupational history and objective and blood chemistry parameters. The results showed that epidemiological examination is useful in the prevention and early diagnosis of diabetes in occupational environments.


[Acupunctural electric anesthesia. Comparison between the traditional Chinese technic and combined technic. Preliminary notes]. This preliminary note presents the anaesthetic results obtained in a series of general surgical operations using electro-acupuncture. Comparison between operations carried out under pure acupuncture analgesia of Chinese type and those under combined or mixed electroacupunctural anaesthesia (which involves induction with low doses of drugs and maintenance only by means of acupuncture), shows the evident advantages of the second type in almost all operations.


[Use of common glass in radiation protection]. The X-ray absorption meter (Diagnostic energy between 20-60 Kev) of common place-glass has been studied. The possibility of replacing lead glass with a reinforced type, also very cheap, has been examined.


[HBsAg in the prevention of post-transfusion hepatitis. General notes and data on the incidence in Umbria]. What is known about HBsAg and its usefulness in the prevention of post-transfusion hepatitis is briefly discussed. Personal data concerning its presence in the population of Umbria by application of electrosyneresis and inverse haemagglutination techniques are presented. As usual, the latter technique proved more reliable.


[Home dialysis. Review of clinical organizational and management problems encountered in more than 6 years of activity]. Together with other forms of self-dialysis (including limited assistance and self-service), home dialysis keeps down cost to much lower levels than those ruling within the hospital. Self-management, which is a common factor of various types of extra-hospital dialysis, also enables the patient to fit in better to society and, in the majority of cases, offers complete working rehabilitation by way of deeper consciousness of his disease and of the various treatments for it. Personal experience of home dialysis covering 6 years activity in the sector is reported. 91 patients have been trained in self-management and 65 of these have already been sent home or are about to be. The most important problems tackled over this period are examined and the experience analysed. Particular reference is made to clinical, organizational and management problems. The paper thus forms a practical guide for those wishing to direct their efforts towards a home dialysis programme.


[Case of bullous pneumopathy in an adult]. A case of bullous pneumopathy in an elderly subject is reported. The particular localization of the pneumonic process at the base of the left lung led to an initial suspicion of diaphragmatic relaxation. Subsequent development and the onset of pneumatoceles within the non-infiltrated pulmonary parenchyma led to a definite diagnosis of bullous pneumopathy which, from its clinico-radiological course, was attributed to a staphylococcic aetiology. Toxic-infective state with leucocytosis and polynucleosis; variability of radiological pictures; early pleural picture; sensitivity to Cephaloridine (which in the present case probably confined the condition to the left lung only); the benign course of the disease; all these elements pointed to staphylococcic bullous pneumopathy in the absence of any cultural demonstration. The different disease conditions in which pneumatoceles occur are reviewed along with the possible mechanisms for their formation.


Tumoristatic effects of nonimmune BALB/c peritoneal macrophages on syngeneic lymphoma cells in vitro. Peritoneal macrophages from unstimulated nonimmune BALB/c mice exerted nonspecific cytostatic effects of tumor cells in vitro. Incubation of syngeneic B40 lymphoma or allogeneic B16 melanoma cells with peritoneal macrophages or with macrophage culture supernatant fluids (SF) resulted in decreased target cell DNA synthesis and growth; in contrast, nontumorigenic syngeneic 3T3 fibroblasts were stimulated by macrophages but SF exerted no significant effects. Lipopolysaccharide activation of macrophages did not induce cytotoxicity for any target cell tested, and did not enhance the observed tumoristatic effects. The level of tumor inhibition associated with macrophage culture SF was dependent upon the concentration of fetal calf serum present in the medium as well as upon the numbers of macrophages cultured. Inhibitory SF could be harvested continuously from macrophage cultures for at least 7 days with no appreciable loss of activity.


Characterisation of human malignant melanoma cell lines. VI. Inhibition of 3H-thymidine uptake by normal stimulated lymphocytes. Cultured human malignant melanoma cells, when added to normal human lymphocytes stimulated to proliferate by mitogen or antigen, were found to inhibit the uptake of 3H-thymidine (3H-T) by the lymphocytes. A heat-labile factor present in the supernatants of the melanoma cultures is responsible for inhibition. Cell viability and blastogenesis are unimpaired in the lymphocyte cultures containing the inhibitor. Inhibition of 3H-deoxyuridine uptake was also noted indicating that both salvage and de novo pathways of DNA synthesis are involved. Lymphocytes appear to be preferentially affected as cultured colon cancer cells take up 3H-T normally in the presence of the inhibitor. Normal mitotic indices and biochemical estimation of DNA content in lymphocyte cultures containing the inhibitory factor indicate that DNA synthesis does proceed normally. The mechanisms of action of the inhibitor would appear to involve alteration of exogenous nucleoside rather than a metabolic inhibition of intracellular nucleic acid synthesis.


Colonic neoplasms in mice produced with six injections of 1,2-dimethylhydrazine. A highly effective but reduced injection schedule for the induction of the colon cancer in CF1 female mice is reported using 6 subcutaneous inoculations of 1,2-dimethylhydrazine at a dose level of 20 mg/kg body weight. Between the 20th and 45th week of the experiment, 83% of the animals were tumor-bearing with a frequency of 2.1 colonic neoplasms macroscopically visible per mouse. Tumors were isolated in nature and primarily located in the distal large bowel. Some degree of carpeting of the colonic mucosa and uncountable numbers fo tumors occurred in 30% of mice and these areas of confluent neoplasms also occurred predominantly in the distal colon. This spectrum of distribution of tumors closely parallels that seen in man thus enhancing the value of this time conserving colon tumor model.


Hypersplenism in Hodgkin's disease: a report of three cases presenting with cytopenias. A review of the last seventy-eight consecutive cases of Hodgkin's disease seen at our hospital revealed that two presented several hematologic cytopenias. These two cases and a similar case first seen at an associated hospital revealed pancytopenia in two and leukopenia in the third. All responded to splenectomy with hematologic improvement. All met the criteria for hypersplenism. This report illustrates that Hodgkin's disease can present cytopenias due to hypersplenism, and that early splenectomy can lead to hematologic improvement and tolerance of subsequent chemotherapy.


Crouzon disease in twins. Clinical and pathological contribution. After a survey of cases in the literature reported, two cases of Crouzon disease, in monovular twins are described. The observation in twins and the opportunity of histologic examination of optic nerve, permitted some considerations in order to help in understanding this syndrome.


The close interrelationship between increased vascular retinal permeability and blood pressure level. Evidence from retinal fluorangiography. A long-term study was done by means of interative fluorangiography on microvascular retinal permeability versus the blood pressure control carried out in 11 patients with a diastolic blood pressure of greater than or equal to 130 mm Hg and with retinal exudates, haemorrhages and oedema. No matter what the original disease was (i.e., essential, renovascular, endocrine hypertension or chronic nephropathy with terminal renal failure) the increased permeability appeared to be critically connected with the blood pressure level. Our results confirm that hypertension per se might be the cause of vascular permeability changes.


Ultrasonographic study of 100 emmetropic eyes. The results of the ultrasonographic measurements of the ocular components in 100 emmetropic eyes of nearly the same age, are presented and the possible relations between the various ocular parameters are discussed. A definite correlation was found (1) between the eye length and the curvature radius of the anterior corneal surface; (2) between the eye length and the anterior chamber depth, and (3) between the eye length and the vitreous length. No correlation could be demonstrated between the lens thickness and the eye length. This fact shows that in the wide range of axial eye lengths in emmetropic eyes, the emmetropization effect of the lens can only be provided by a change in the curvature radius of the lens surfaces. The mean eye length of 100 emmetropic eyes was 23.37 mm.


Catecholamine content of the lacrimal fluid of healthy people and glaucoma patients. The level of catecholamines was determined in the lacrimal fluid since it may serve as an index of the activity of the sympatho-adrenal system. 86 persons aged between 35 and 65 years were studied. Of these, 49 were glaucoma patients, 16 patients had preglaucoma, and 21 practically healthy subjects served as a control. The results of the study showed that dopa and catecholamines: dopamine, noradrenaline and adrenaline can be determined in the lacrimal fluid of healthy people. Preglaucoma patients were found to have a reduced level of dopamine and its precursor dopa. Glaucoma patients were found to have reduced levels of dopa and noradrenaline. Determination of the level of catecholamine and dopa is considered to be an immediate index of the state of the sympathoadrenal system in the initial glaucoma. Determination of catecholamines and dopa in the lacrimal fluid can serve as a test in glaucoma diagnosis.


How an American plaintiff's lawyer presents the spinal cord injury resulting from trauma. The author, a lawyer, describes how he learns the full implications of how spinal cord injury has affected his client. He teaches this to the jury and by describing the economic effects of the injury and its effect of the patient and his family, he obtains the maximum financial compensation.


Survival in marriage in the paraplegic couple: psychological study. In the study of sexual functions and marital relations in 16 couples involving a normal female and a paraplegic male, married following the injury, it was found that a major source of dissatisfaction on the part of the wives was their inability to become pregnant and bear children. Sexual relations were surprisingly of secondary importance. Common in all 16 couples was the almost total lack of knowledge on the part of the woman about the man's sexual capabilities and the effect of his injury on fertility. Premarital counselling seems to be of primary importance in assuring the survival of such marriages. It may be useful to suggest they have premarital experience. Later, counselling should include the importance and advantages of artificial insemination donor treatment as a solution to infertility.


Prophylaxis of venous thrombosis and pulmonary embolism in patients with acute traumatic spinal cord lesions. Twenty-one patients with acute traumatic spinal cord lesions, who were admitted to our spinal unit during 1974, have been treated with calcium heparin, using a dosage of 5000-7500 i.u. at 12-hourly intervals from the first days after the lesion until the use of a wheelchair, as a prophylactic measure in order to prevent venous thromboembolism. Of these 21 patients 18 received this treatment continuously, with a resulting 0 per cent of venous thrombosis and 0 per cent of pulmonary embolisms. In the three remaining cases, treatment had to be temporarily interrupted and in one case clinical thrombo-phlebitis was clearly evident. No case of pulmonary embolism was registered. We consider this technique to be very useful in the prophylaxis of thrombo-embolic complications in this type of patient. The use of this type of prophylactic therapy, results and conclusions are discussed.


Is positive-contrast myelography of value in acute cervical spinal cord injury? Positive-contrast myelography in 30 patients with acute cervical spinal cord injury has not provided any information of clinical value. Reference to the literature does not provide a definite set of indications for myelography in acute spinal cord injury. An attempt has therefore been made to evaluate the indications for this procedure. The potential hazards of myelography in patients with acute spinal cord injury are discussed. Specific contra-indications are described. Difficulties in the radiological interpretation of the usual myelographic appearances in spinal cord injury are mentioned. The advantages of negative-contrast myelography are briefly described. It is concluded that there is a very limited indication for positive-contrast myelography in acute spinal cord injury.


Flexion and supination deformities of the elbow in tetraplegics. Fixed flexion and supination deformities of the elbow occur occasionally in tetraplegics. The patients in whom this was seen were those who following injury had a neurological level at C5 and who subsequently developed radial wrist extension and brachioradialis function. They were generally patients who spent long hours with their elbows flexed and supinated. A simple effective method of biceps tenotomy and plaster correction is described. Recurrence of deformity was seen if the flexion supination posture was continued. Strength of elbow flexion was not reduced. Patients maintained correction if they refrained from poor elbow posture and wore a simple plastic splint. The procedure of correction is not difficult and because of its simplicity it can be repeated if deformity recurs.


Topical or no anaesthesia for external urethral sphincterotomy in neurogenic vesical dysfunction due to spinal injury. Considerable controversy exists regarding the ideal anaesthetic coverage for external urethral sphincterotomy in spinal injury patients with detrusor-sphincter dyssynergia. From this preliminary experience on 34 patients in whom this procedure was indicated and then attempted under topical (urethral instillation of 20 ml of 2 per cent Lignocaine jelly) or no anaesthesia, we are encouraged into believing that these patients may not require general or regional anaesthesia for this operation.


Some observations of 31 spinal cord injury patients on whom the Bricker procedure was performed. Only one-half of 31 spinal cord injury patients had good to fair results following cutaneous uretero-ileostomy. Poor results and deaths with urinary complications were more prevalent in the cervical and upper thoracic than in the more caudad cord lesions. There was a spread of 1/2 to 19 years in time interval from onset of spinal cord injury to performance of the Bricker procedure. A tendency for unsatisfactory postoperative courses was more associated with the longer time intervals.


Electrodiagnostic investigation of motor neuron and spinal reflex arch (H-reflex) in spinal cord injury. Twenty patients with spinal cord injury underwent serial electromyographic examinations. Fibrillation potentials and positive waves were noted in six patients in the spinal shock phase. In another subject, these potentials were found 27 months after injury. Our finding of significant slowing in the NCV of both nerves, indicates that lower motor neurons are indeed affected by upper motor neuron lesions. The H-reflex studies showed an increase in the mean H/M ratio. This may indicate an increase of reflex motor neuron excitability. No clear correlation was found between this increase and the degree of clinical spasticity. With repeat investigations, after a period of physical activity, a trend to reduction of the H/M ratio was noted with no clinical confirmation of reduction in spasticity. These findings emphasise the need for not assigning diagnostic terms to EMC abnormalities, but rather identifying them as neurophysiological changes which must be interpreted in the light of the clinical picture.


The flow-volume loop in tetraplegics.

The flow-volume loop in tetraplegics. We have studied the FVC and maximum flow-volume loop in 20 tetraplegics and the results have been compared with the predicted normal values. The FVC in sitting position is reduced at approximately half the normal predicted values and is significantly lower than in supine and Trendelenburg. At high lung volumes the flows are reduced at half the normal values. At low lung volumes the reduction is smaller (71.5 per cent).


The use of multistage exercise testing with wheelchair ergometry and arm cranking in subjects with spinal cord lesions. The primary aim of this investigation was to compare maximum wheelchair performance with arm cranking using a multistage progressive work load protocol. In five subjects with a wide range of neurological disability and two normal males the differences observed in maximum oxygen uptake, heart rate and ventilation during two forms of upper limbs exercise, were not significant.


Histological and hormonal testicular changes in spinal cord patients. Hormonal dosages and testicular biopsy are discussed in paraplegic patients of several neurological levels. There are no absolute biological criteria but histology showed slowing of spermatogenesis.


[Effect of the digestive process on the survival of the plague agent in Xenopsylla gerbilli Minax fleas]. Hystological investigations of experimentally infected X. gerbilli minax have shown that at the early stages of the digestion, while in the intestine compact clots of non-digested blood, are preserved, proceeds the reproduction of the plague agent. With the decay of the alimentary clot it changes into the dying off of the microbe population and after the ceasing of digestion the accumulation of bacteria renews again. Simultaneously with the changes in the number of microbes their morphology varies. At the initial stage of blood digestion bacilli typical for the agent are dominant. With the decay of the alimentary clot they are replaced by ovoid and spheroid forms. After the ceasing of the digestion cycle the microbe mass is represented by small coccobacteria. During the decrease in the plague agent abundance bacteria are absent mostly often from the midgut and posterior parts of the alimentary canal. Most favourable conditions for their preservation exist in this period in the proventriculus and in adjoining to it oesophagus part.


[Suspecies criterion in ectoparasites (based on the example of bird lice)]. It has been proved on Mallophaga that the notion "hostal subspecies" can be applied at the level of intraspecies categories to constant parasites possessing, distinct specificity. The notion should be applied in those cases when there are but small differences between groups of parasites from different hosts (e. g. in sizes) and when hosts belong to different species of the same genus.


[Culicoides (Avaritia) sanguisuga, a new species of biting midges for the fauna of the USSR]. The occurrence in the USSR of C. (A.) sanguisuga Coq., a species recorded earlier only from North America has been stated. The species seems to have a wide distribution throughout the USSR. The description and figures of females and males collected in the south of Krasnojorsk territory are given. In the author's opinion the male of C. sanguisuga was repeatedly described in the Soviet literature but under other names (C. obsoletus, C. seimi). Morphological characters of females of four species of the subgenus Avaritia (C. sanguisuga, C. sinanoensis, C. chiopterus and C. filicinus) recorded from the region of observations are described.


[Sensory apparatus of the cercaria of 2 species of the genus Apatemon (Trematoda: Strigeidae)]. The sensory apparatus of cercariae of two species of trematodes (A. cobitidis and A. minor) is described. The species differ both morphologically and biologically. The only common feature in the sensory apparatus of the above species is the topography of sensillae in the posterior half of the lateral complex of the caudal trunk and of the furcal complex.


[Chromosomal apparatus of trematodes of the general Diplostomum and Tylodelphys (Strigeidida, Diplostomatidae) and its taxonomic significance]. The chromosomal apparatus of three species of trematodes of Diplostomum (D. spathaceum, D. indistinctum, D. mergi) and one species Tylodelphys (T. clavata) is described. It has been suggested that karyological investigations can be used for taxonomic purposes. The opinion has been expressed that the number of chromosomes in the karyotype of these trematodes plays no taxonomic role. Of great taxonomic significance are the size and morphology of chromosomes. Differences in karyotypes of trematodes belonging to different species and genera were revealed by these characters. The absence of close dependence between morphology of adult and specific peculiarities of karyotypes in species of the same genus enables in some cases the use of chromosomal apparatus as a most reliable criterion for a differentiation of close species.


Eimeria stiedai in rabbits: the presence of an oocyst residuum. Observations on 5 different isolates of Eimeria stiedai from pure infections in laboratory-reared rabbits have confirmed the presence of an oocyst residuum. This structure was seen in 89--100% of the oocytes in cultures prepared both from the liver and from the faeces at different times during the patent period. The residuum consisted of 1--7 or more granules situated centrally in the oocyst and partially concealed by 4 sporocysts. The differential diagnosis of E. stiedai and E. coecicola is discussed.


Schistosoma mansoni: differential cell death associated with in vitro culture and treatment with Astiban (Roche). A simple technique for the maintenance in vitro of mature Schistosoma mansoni is described and critically assessed at the ultrastructural level. Females were cultured for 4--6 days with no apparent ultrastructural change, but after this period changes appeared in the cells of the ovary and vitelline gland. At a later stage (10--12 days) lipid bodies appeared in the parenchyma cells. These changes occurred in worms which were active, paired with males and were egg-laying. Thus the activity, pairing behaviour and egg-laying characteristics are not adequate to reveal the true morphological condition and presumably the physiological and biochemical status of cultured worms. This technique was used to study the effect of Astiban on females and the results were compared with worms treated in vivo. Astiban concentrations greater than 30 microgram/ml killed worms within 7--20 h and acted non-selectively. Astiban at low concentrations (10 microgram/ml) during short-term culture (1--3 h) resulted in a selective action of the drug on maturing vitelline cells. Thus, although the degree of cell damage caused by drug treatment was more severe and occurred earlier than the effects observed in worms cultured in vitro without drugs, both treatments resulted in differential cell death.


[Parasitic fauna of the muskrat from the Upper Ob' pine forest]. The gamasid mites Laelaps multispinosus and Hirstionyssus isabellinus, flea Ceratophyllus (Megabotris) rectangulatus, trematodes Plagiorchis proximus, P. eutamiatis, P. obensis, P. multiglandularis, Quinqueserialis quinqueserialis and Opisthorchis felineus, cestodes Aprostotandria macrocephala and Alveococcus multilocularis, larvae, were found in 78 specimens of Ondatra zibethica from water bodies of the Upper Ob pine forest. The mite L. multispinosus is reported as the most abundant ectoparasite of this population of the muskrat. As to helminths most abundant and frequently encountered are Q. Quinqueserialis and A. macrocephala which at high infection intensity can cause decrease in the muskrat abundance.


Uptake of [14C]oxamniquine by Schistosoma mansoni. The uptake and retention of drug-related material by Schistosoma mansoni was studied in the mouse host following a single oral or intramuscular dose (50 mg/kg) of [14C]oxamniquine. Male worms took up more labelled material than did female worms but the amount in each particular sex of worm was found to be similar after both routes of administration. Exposure of worms was therefore independent of the route of administration. Six days after drug administration, at the time of an hepatic shift, significantly more drug-related material was present in male worms than in female worms. Examination of worms recovered from mice 4 h after treatment showed that metabolites of oxamniquine constituted 70--90% of the drug-related material present in the worms. Both sexes of worms were able to take up metabolites of oxamniquine in vitro.


Impairment of primary expulsion of Trichuris muris in mice concurrently infected with Nematospiroides dubius. Primary immune expulsion of Trichuris muris was markedly delayed by concurrent infection with Nematospiroides dubius. Maximum delay of expulsion was dependent on size and timing of N. dubius infection relative to T. muris infection. In NIH mice infection with 400 N. dubius larvae immediately before or after T. muris infection was found to be most effective in suppressing expulsion. Infection on day 8 of T. muris infection, when mice are sensitized to T. muris, also impaired expulsion. From this evidence it is suggested that the larvae of N. dubius are immunosuppressive and that the efferent role of the immune response to T. muris is inhibited. The results are discussed in terms of non-specific immunosuppression and their relevance to the tropical disease situation is emphasized.


Effect of the expulsion phase of Trichinella spiralis on Hymenolepis diminuta infection in mice. The rapid elimination of the intestinal phase of Trichinella spiralis in NIH mice is associated with progressive inflammation of the intestinal tract. The non-specific effects of this inflammation were studied in mice concurrently infected with an unrelated parasite, Hymenolepis diminuta, which does not stimulate a visible inflammatory response but is also immunologically rejected by this strain of mice. It was demonstrated that the rejection phase of T. spiralis infection had a marked effect upon the growth and survival of H. diminuta. The cestode either failed to establish or to grow; if the worms were already strobilate when inflammation developed then destrobilation occurred. There was no cross-immunity between the parasites, nor was the interaction a direct consequence of inter-specific competition.


Experimental investigations on the behaviour of the cercariae of an ectoparasitic digenean Transversotrema patialense: general activity patterns. The activity patterns of the cercariae of Transversotrema patialense have been examined by monitoring the behaviour of individual larvae. Records of three different behavioural modes, namely active, tail-first swimming, passive dropping and resting periods were made separately. The age- and temperature-dependence of the activity patterns during the spontaneously active life of the cercariae were examined and estimates made of the absolute speeds of swimming and dropping. Through the temperature range 25--32 degrees C, the spontaneously active life of cercariae declined from about 18 h to about 6 h. Within this interval, after an initial period of high activity rates, a gradual decline in activity followed. The decline was a result of a decreasing frequency of swimming events rather than any change in the durations of such events. The neural control and energetic significance of the cercarial activity patterns are discussed.


[Teredoika aspectabilis sp. n., a new endoparasitic copepod from the gastropod mollusc, Clinopegma unicum, in the Sea of Okhotsk]. A new species of the genus Teredoika Stock, 1959 is described. T. aspectabilis sp. n., the second species of the genus, was found in the kidney of Clinopegma unicum in the Okhotsk Sea while the type species is known from the stomach of the shipworm Teredo utriculus caught in the Gulf of Naples.


Pathological changes in the appendix: a review of 1000 cases. The pathological changes occurring in a series of 1000 consecutive appendicectomies are reviewed. Normal appendix was diagnosed in 14% of cases, while 561 (56%) exhibited acute appendicitis; 53 (5%) had chronic inflammatory infiltrate associated with obliteration of the lumen of the tip of the appendix. Epithelial abnormalities included carcinoid tumours (1.4%), and primary appendiceal adenocarcinoma (1 case). There were a large variety of other abnormalities found and each one is briefly described.


Secretory (juvenile) carcinoma of the breast. A case of secretory (juvenile) carcinoma of the breast is reported in a 26-year-old multiparous woman who had been taking oral contraceptives for 7 months. The tumour recurred 8 months after local resection and axillary metastases were found at radical mastectomy. No further recurrence has been detected but the follow-up period is only 8 months. It is emphasized that secretory carcinoma of the breast originally described in children occurs also in adults. Early reports stressed the slow rate of growth, often with intervals of many years before recurrence, and the small risk of metastatic spread, many cases being cured by local resection. However, axillary metastases have been found in approximately 15% of the recorded cases. Consequently it is recommended that the initial treatment should be simple mastectomy with at least a low axillary resection.


Lymphangiomyoma.

Lymphangiomyoma. A case report is presented of the incidental finding of a lymphangiomyoma in a 50-year-old woman who underwent total hysterectomy for squamous cell carcinoma of the cervix. The condition seems to occur only in women after puberty and so far, has been mainly reported in association with chylothorax or chylous ascites. There is no evidence of any clinical complication more than 2 years after removal of the lesion. The lesion is most likely a hamartoma although the term lymphangiomyoma is acceptable. The term lymphangiomyomatosis is best reserved for the fully developed clinico-pathological syndrome.


Multiple biogenic amine-secreting 'carcinoid' tumour of the stomach: a case report. An unusual case of a gastric carcinoid tumour producing multiple biogenic amines is described in a patient with pernicious anaemia. Electron microscopy demonstrated two distinct types of secretory granules.


Human temporal behavior and discrimination-reversal learning. The present study demonstrates that a relationship exists between individual differences in temporal behavior and individual differences in human discrimination-reversal learning behavior. When the results of performance on a time-estimation task employing the method of reproduction are compared with the results of acquisition performance on a complex form of discrimination-reversal learning task is can be demonstrated that underestimation of time is associated with faster learning and overestimation of time is associated with slower learning of the discrimination task. The experimental design was based on the historical fact that the Sechenov-Pavlov and Spence-Hull formulations assigned a primary role in learning to excitation and inhibition as intervening variables between the input of stimulation and output of response. The present study also used the tasks of time estimation and discrimination learning as dependent variables; and the concept that underestimation of time is associated with and underlying predominance of excitatory processes as a hypothetical construct. The conclusion was reached that one of the many theoretical processes which may be used to explain discrimination learning is the concept that acquisition of the correct response may be viewed as a function of the individual rates at which excitatory processes come to be conditioned to a predominance over existing inhibitory processes.


Studies of the glycine cleavage enzyme system in brain from infants with glycine encephalopathy. Glycine content and enzyme activity of the glycine cleavage system were compared in autopsied brain from five infants dying with glycine encephalopathy and four control infants, including two with other types of hyperglycinemia. Glycine content was elevated 2- to 8-fold and glycine cleavage enzyme activity was undetectable in the brains of the glycine encephalopathy patients. Glycine content and enzyme activity were normal in the brains of the control patients, including one with ketotic hyperglycinemia secondary to methylmalonic acidemia. Prolonged dialysis failed to restore glycine cleavage enzyme activity in brain homogenates of glycine encephalopathy patients, and these homogenates failed to inhibit enzyme activity when added to homogenates of control brain. Radioactive bicarbonate was converted to radioactive glycine by control brain, but not by glycine encephalopathy brain. This finding, together with the results of recombination experiments between solubilized human brain enzymes and purified protein components of the bacterial glycine cleavage system of Arthrobacter globiformis, indicates that the enzyme defect in glycine encephalopathy involves at least the second or H protein of the 4-protein glycine cleavage enzyme system.


Visual motion detection models: features and frequency filters. Two kinds of models have been proposed for taking into account the sensory processes at work in the detection of visual motion: the feature model and the frequency-filter model. The problem of the complementarity of these models is raised. On the basis of empirical data, it is proposed that they are consistent.


Area 18 of the cat: the first step in processing visual movement information. In cats, responses of area 18 neurons to different moving patterns were measured. The influence of three movement parameters--direction, angular velocity, and amplitude of movement--were tested. The results indicate that in area 18 no ideal movement detector exists, but that simple and complex cells each perform complementary operations of primary visual areas, i.e. analysis and detection of movement.


Developmental constraints of motion detection mechanisms in the kitten. The influence of deprivation procedures on the development of motion detection mechanisms has been studied in twenty-two kittens. Superior colliculus neurons did not acquire direction selectivity and normal ocular dominance in animals reared in the dark or in stroboscopic light; Neuron immaturity persisted in spite of a five week additional recovery period in normal conditions. Exposure to unidirectional visual motion for 10 h during the fifth week ofpostnatal age produced an asymmetric development of the two superior colliculi. Finally, unilateral neonatal ablation of visual cortex permanently impaired development of the ipsilateral superior colliculus. In the same or in different animals, development of optokinetic nystagmus, a typical visuomotor response, was similarly influenced by the global or selective deprivation procedures. These results suggest that motion detection mechanisms (both afferent and efferent) strongly depend upon constraints imposed by the visual world during the first weeks of life.


Perceptual grouping in audition.

Perceptual grouping in audition. The present experiments evaluated the effect of relative frequency as a determinant of the figure-ground organization of sequences of auditory tones. Observers counted sequences of 20 ms tones that were presented at the same frequency or that alternated between two different frequencies. The alternating tones differed in frequency by one whole tone, seven tones, or nineteen tones. Counting accuracy increased with increases in the silent interval between the tones. When the alternating tones differed by seven or nineteen tones, counting was disrupted at rates of presentation of eight tones per second or slower. In contrast to this decrement in the counting of tones that alternated by over an octave, very little decrement was observed when the tones alternated by just one whole tone. The best subjects counted these alternating tones more accurately than the tones presented at the same frequency. The poorest subjects showed a small decrement even when the tones alternated by just one whole tone. The results were discussed in terms of determinants of figure-ground organization in auditory information processing.


The perception of musical rhythm and metre. The occurrence of relatively long notes, and the repetition of melodic phrases are important cues to the metre, or regular beat, of a piece of music. A model of how people use this information to infer the metre of unaccompanied melodies is described here. The model is in the form of a computer program, and involves a definition of melodic repetition which encompasses repetitions that include certain kinds of variation. The program has been applied to the task of analysing the metric structure of the forty-eight fugue subjects of the Well-Tempered Clavier by J S Bach. The program is discussed in relation to other models both of musical understanding and of sequential concept learning.


Expanding angles? Systematic distortions of space involving angular figures. Using simple, single angular figures, including figures containing only one line, we have shown systematic misestimations of distance defined by these figures. These misestimations are not related to the absolute distance per se, but are related both to the size of the angle defining the distance, and to the part of the angle defining it. Some implications of these findings are discussed.


Visual stimuli for strabismic suppression. The effects of orientation and spatial frequency of grating stimuli upon suppression were examined with a binocular rivalry paradigm in a group of ten strabismic patients and in a control normal group. Duration, frequency, and period of rivalry were examined as functions of differences in orientation and spatial frequency of dichoptic achromatic sinusoidal gratings. Records were made of responses by the sighting and by the nonsighting eye as well as responses during periods of combined binocular vision. Strabismic subjects reported normal binocular rivalry when presented with gratings of dissimilar orientation. Suppression of the deviating eye in strabismic subjects occurred with stimuli of similar orientation and was unaffected by spatial-frequency differences between dichoptic stimuli. Suppression was most intense under conditions that normally stimulate stereopsis and sensory fusion.


Perceived bending motions from a quadrangle changing form. In an earlier study by Jansson and Johansson it was found that rotation of a rigid object is perceptually preferred over bending motion, and that bending motion in turn is preferred over two-dimensional stretching. The aim of the present experiment was to study if the same preference order is retained also when the proximal stimuli are changing in a physically more complex way. The stimuli were quadrangular outline figures with two stationary and two moving corners; the figures differed in degree of phase lag between the motions of the two corners. The result was that the preference order found earlier was retained. It was also found that the relative frequency of two subcategories of bending motion, bending proper and folding, varied with phase lag. The relation of the result to a principle of minimum object change was discussed.


Illusory line linking solid rods.

Illusory line linking solid rods. A solid object--a frame enclosing rods--can be seen as having an illusory 'line' joining the tips of the rods.


Pleuropneumonia in swine caused by Haemophilus parahaemolyticus. A study of the epidemiology of the infection. Haemophilus parahaemolyticus infection was studied in a herd with continuous production, i.e., continuous introduction of stock to replace animals delivered for slaughter. None of 30 seronegative pigs contracted the infection when exposed to contact with two pigs that were seropositive after inoculation with H. Parahaemolyticus three weeks earlier. After aerosol infection had been applied in the building an acute outbreak with a morbidity rate of 100 per cent developed in less than 24 hours. Following recovery the majority of the 16 pigs present became seropositive, and when 30 seronegative pigs were introduced 7 weeks later, antibody response occurred in three of them. The persistence of H. parahaemolyticus in pigs that had been infected during the acute outbreak was confirmed at slaughter, in that the organism was re-isolated from the tonsils of 2 of these pigs. Most serum titres persisted for several months, but some animals showed just a transient antibody response.


Herd distribution of seropositive reagents to Chlamydia in Danish cattle. 19% of 733 cows and heifers in 25 Danish milking herds had CF antibodies against Chlamydia. The number of seropositive reagents in the individual herds varied from 0-45%. In one herd especially studied, the majority of reagents were among calves, while the number of reagents was reduced with increasing age, which indicated a coherence with enzootic pneumonia in calves. Apart from this and few cases of sporadic abortions, seropositive reactions could not be connected with any known chlamydial syndromes. A few old cows suffering from paresis puerperalis had titre increase or comparable high titres, indicating outbreak of a persistent infection. The demonstrated differences in serological results from individual herds and areas (Table II) may reflect a difference in the age of animals tested.


Effects of atropine, isoprenaline, neostigmine and practocol on cardiac arrhythmias induced by potassium in anesthetized dogs. Either atropine, isoprenaline, neostigmine or practolol was given intravenously in therapeutic doses to dogs anesthetized with pentobarbitone sodium. Cardiac arrhythmias were induced by potassium chloride intravenously as a bolus injection in a dose of 0.3 mmol/kg. The standard electrocardiographic lead II was recorded continuously. pH, Po2 and Pco2 were checked from arterial blood samples before and after the injection. The isoprenaline treated dogs showed the smallest amount of arrhythmias and all the dogs survived. More severe arrhythmias were seen in the neostigmine and practolol treated dogs and the most severe occurrences were encountered in the atropine treated dogs.


[The influence of estrogen therapy on triglycerides. Importance of the choice of substance and the route of administration (author's transl)]. The effects of the percutaneous administration of estradiol in circulating lipid levels (triglycerides, cholesterol, total lipids) were studied in 53 post-menopausal women. During treatment, plasma estradiol rose from 20 +/- 15 to 82 +/- 30 microgram/ml, a value identical to that in the normal woman during the follicular phase. Despite this increase in plasma estradion, no increase in blood triglyceride levels was noted. In addition, in the 11 cases where triglycerides were high under basal conditions (1.65 +/- 0.32 g/l) there was a significant fall during the course of treatment from that value to 0.97 +/- 0.16 g/l (p less than 0.001). These changes in triglycerides under the influence of percutaneous estradiol may be contrasted with the hypertriglyceridaemia usually seen in association with the oral administration of synthetic estrogens. The physiopathological implications of these results are discussed.


[Coronary thrombosis on oral contraception (author's transl)]. A case of myocardial infarction observed in a 27 years old female taking an oestrogen-progestogen combination for contraception, who died suddenly two months after the resection of a left ventricular aneurysm, provided unprecedented anatomical documents. Their histological examination allowed to state the thrombotic mechanism of the coronary occlusion and brought arguments in favour of an alteration of the coronary arterial wall in the form of thickening of the intima, likely to have been the starting point of this thrombosis.


[HLA markers and periodic disease [familial Mediterranean fever (F.M.F.)] (author's transl)]. Thirty-one unrelated patients, 15-52 years old, were typed by microlymphocytotoxicity for 27 alleles of the HLA system. In addition, 12 families including 1 or more patient were also analysed. This criteria for diagnosis were those of Sohar et all. (Am. Intern. Med., 1967, 43, 227-253). All patients were of Israelite-Sephardin origin except two (Armenian and French); they were from North-Africa (Tunisia, Morocco and Algeria) and Israël. The results were compared to the antigen frequencies of 3 reference normal populations. The frequencies of the studied alleles do not differ from those of controls, except for HL-A28 and B14 slightly increased when compared to the normal frequencies. The study of 7 families with at least two sibs suffering from FMF shows a random distribution of the genotypes : 2 HLA identical, 6 different and 10 haploidentical diseased sibs. This distribution differs significantly (p less than 0.01) from that expected in the case of a recessive inheritance. These data do not support the hypothesis of a linkage between genes controlling FMF and HLA genes.


[Do lithium salts have a place in the treatment of severe hyperthyroidism? (author's transl)]. In a patient with hyperthyroidism resulting in cachexia, severe cardiac complications and functional renal failure, and a second case of hyperthyroidism refractory to carbimazole as a result of iodine overload, the administration of 1 to 3 g of lithium gluconate every 1 to 3 days, in association with carbimazole, led to persistent clinical and biological improvement in 8 to 16 days. In the first case, the course was complicated by neurological intolerance (blood lithium 0.98 mEq/l) which responded to the temporary interruption of treatment and by a transient escape of thyroid function from the effects of lithium which disappeared after a slight adjustment in the dose. In the second case, the course under treatment was favourable from the outset. Thus in forms of hyperthyroidism in which usual forms of treatment are inadequate and where there is a risk of "acute crises", lithium may be valuable as adjuvant therapy. If the dose is regularly modified in order to obtain a daily blood lithium level of less than 0.60 mEq/l, and on condition of close clinical, electrocardiographic and ionic surveillance, cardiac and renal failure and neuropsychiatric disturbances do not prevent the use of lithium, which the authors feel to be of irreplaceable value.


[The possibility of the detection of His bundle potentials using thoracic surface electrodes (author's transl)]. Under certain conditions, it is possible to record His bundle potentials from thoracic surface electrodes. These potentials, which are extremely weak on the chest wall, must be extracted from the "background noise" using an averaging method. The required signal being situated before the R wave, and at a constant distance from the latter, the potentials collected from the thoracic electrodes are amplified, numerised and despatched to a memory which retains only the values preceeding the R wave and produces a summation of successive cycles, causing them to coincide using a synchronisation signal. This is achieved with the aid of a correlator. Amongst 66 patients studied, a signal which most likely corresponded to His bundle activity was obtained in 1/3 of cases. Correlation obtained in 7 cases by the use of invasive techniques indicated that the principal source of error was the "after potential" of the P wave when the PR interval is short. This was seen in one case, correlation in the other 6 being good. The method will require further work before being available for clinical use, where its primary indication would seem to be the study of long PR intervals.


[The course of hydatidiform moles, followed by the radio-immunological estimation of choriogonadotrophin (author's transl)]. The evolution of 50 hydatidiform moles was followed through repeated radioimmunoassays of choriogonadotropin (hCG), either in urine or plasma. In 37 cases a spontaneous regular decrease was observed, but it generally slowed down after the first week. In fact, only 30% of the total number of moles examined cleared up spontaneously within a month and 54% within 8 weeks. In 12 cases a diagnosis of retention of trophoblastic tissue was made: three times during the first month of evolution on the basis of a stagnation of the decreasing curve. In the 9 cases without radioimmunoassay of hCG between the 10th and 40th days after evacuation, the diagnosis was not made until after two months. The specific assay of hCG with an anti beta-hCG antiserum enables the resolution of diagnostic problems raised by the cross-reaction of hypopituitary LH when using the classic antiserum and particularly the differential diagnosis between the retention of trophoblastic tissue and a beginning pregnancy immediately following a mole, or a high level of LH after castration.


[Short choledochus. Attempted systematization]. It is necessary to clearly characterize: -- The short choledochus which, in fact, is a long cystic duct joining the ampulla of Vater (4 obs.). -- The choledochus with a high implantation, above the end part of the duodenum (4 obs.). -- The choledochus shortened by the retraction of the duodenum, more often than not induced by a distant duodenal ulcer (1 obs.). The long cystic must be removed if possible. The high implanted choledochus, when associated with a duodenal ulcer leads to etiological (-- mutual action of the two diseases --) and practical problems: it seems preferable, in this case, to leave the ulcer and cure it by an indirect operation.


[Alcoholic cardiomyopathies (author's transl)]. In 108 patients suffering from congestive type cardiomyopathy, there were 42 alcoholics and 66 non-alcoholics. Comparisons between the two groups were made on the basis of clinical data, paraclinical investigations and prognosis. It was possible to distinguish an alcoholic cardiomyopathy which differs from primary cardiomyopathies by the greater severity of the clinical picture and a gloomier prognosis.


[Secretion of a beta lipotropine type substances by a corticomelanotropic adenoma in Nelson's syndrome (author's transl)]. Using radioimmunoassay of human melanotropic hormone (beta-MSH), were studied in one female patient with Nelson's syndrome the properties of the immunoreactive beta-MSH (beta-MSH-IR) secreted in the circulation in vitro by a pituitary adenoma. With Sephadex G-50 gel, beta-MSH-IR of plasma or from a culture mediium is eluted in greater part in a volume corresponding to a molecular weight of some 6,000 to 10,000. In the radioimmunological systems employed, the dilution curve of beta-MSH-IR in a culture medium is not parallel to that of synthetic human beta-MSH; by contrast, it is parallel to that a lipotropine, purified human beta-LPH.


[Routine examination for the presence of antierythrocyte antibodies. Practical consequences with regard to indications for transfusion in a surgical context (author's transl)]. Routine examination in pre-operative patients revealed the presence of anti-erythrocyte antibodies in 1.23 per cent of cases. Such examination made it possible to avoid, despite strict compability in ABO Rhesus groups, a transfusional immunological conflict in 0.45 per cent of cases, i.e. 7 patients in one year. This provides preventive cover wihich would seem, in surgical context, to be the easiest ti undertake, the most reliable and, in fact, the most economical: widened application of examinations for anti-erythrocyte antibodies together with the avoidance of all unnecessary transfusions.


[Rupture of an infective aneurysm of the sub-renal abdominal aorta into the inferior vena cava. One case (author's transl)]. An aorto-caval fistula developed in a 62-year-old woman secondary to the rupture of an infective aneurysm of the aortic bifurcation. Treatment in relation to local and, above all, general infection is discussed, emphasising the value of epiplooplasty and prolonged appropriate antibiotic therapy. However, adequate follow-up is essential in order to be able to affirm cure, recurrence of the infectious process always being possible, even late.


[Essential flat foot in the child. Definition, diagnosis and therapeutic indications (author's transl)]. There exists considerable confusion in the definition and classification of essential flat foot in the child. In an attempt to put an end to this confusion, the authors define the radiological characteristics and course of the abnormality. The latter is defined radiologically on lateral films of the foot whilst weight bearing by study of the angle of the calcaneum over the horizontal (Angle C) and by the measurement of the angle of talo-calcaneal divergence (Angle T.C.D.). Three groups may be distinguished on this basis: Group I - of minimal gravity; Group II - which may correct itself spontaneously and is, in general, well tolerated; Group III - which alone requires surgical correction. Treatment is only surgical in severe forms and is based upon the "Horseman" operation, orthopaedic treatment by special soles being rarely indicated.


[Monitoring of the pulmonary artery pressure after open heart surgery (author's transl)]. A monitoring technic of recording the pulmonary artery pressure and cardiac output after cardiac surgery (valvular prothesis or aortocoronary bypass) is described. This monitoring is realised by introduction of catheter into pulmonary infundibulum during surgery, emerging through a cutaneous incision. This method was applied to 60 patients with two accidents at the beginning of the procedure. The technic's indications and cares are discussed.


[Treatment of a case of grave orthostatic hypotension (Shy-Drager's syndrome) by an association of L-dopa and mono-amine-oxidase inhibitor (author's transl)]. The authors report a case of grave orthostatic hypotension (Shy-Drager's syndrome) with major postural disturbances. The biological test confirmed a catecholaminergic deficiency. After several drugs were tried unsucessfully, an association of L-Dopa and fractionated doses of mono-amine-oxydase inhibitor was proposed. The increase blood pressure was sufficient to block the diturbances of postural adaptation, without inducing hypertensive jerks. The functionnal result have been stable for three years, while the parkinsonian syndrome have shown little progression.


[Immobilisation hypercalcaemia (author's transl)]. Hypercalcaemia would seem to be rare during immobilisation, whilst osteoporosis and hypercalciuria are constant. In fact, it often goes unnoticed. The case presented here confirms its predominance in the adolescent male. The reason for immobilisation seems to be irrelevant. The clinical symptoms are very variable: polydipsia, nausea, headache, apathy, anorexia. Blood calcium levels are raised, up to 14 mg%. This hypercalcaemia is due to very marked bone loss in adolescents, secondary to hyper-resorption and a temporary stoppage in osseous formation. The differential diagnosis from primary hyperparathyroidism is sometimes difficult but is aided by laboratory and histological findings. The essential is to consider the possibility of immobilisation hypercalcaemia in the presence of any suggestive symptoms in an immobilised adolescent. Treatment includes a return to weight bearing, adequate water intake and the administration of phosphorus, calcitonin, furosemide, and corticosteroids.


[Extrachromosomal antibiotic resistance of the intestinal bacterial flora. II. The role of resistance acquired by endogenous intestinal bacterial flora (author's transl)]. In a previous paper, we have shown that multiple resistant bacteria in the human gut flora may have two origins: firstly, through food which carries resistant bacteria and secondly, our present study, resident intestinal bacteria which become resistant to antibiotics, either because they are chromosomic mutant or because they acquire resistance plasmid from an exogen strain. In all cases these resistant bacteria can implant and multiply in the gut only if there are disorders in the normal bacterial equilibrium. Antibiotherapy can create this inbalance and especially if it is not carefully followed up: it selects resistant bacteria, allows their implantation, and promotes plasmid R transfer. The resistant bacteria are able, in some cases, to spread out from the intestinal tract and give rise to further infections.


Interactions of norharman and harman with DNA. The interactions of norharman (9H-pyrido [3,4-b] indole) and harman (1-methyl-9H-pyrido [3,4-b] indole) with DNA were studied. DNA caused remarkable fluorescence quenching and change in the absorption spectra of the dyes. Scatchard plots obtained by optical titration gave Kd values of 2.2 X 10(-5)M and 7.7 X 10(-6)M, and apparent numbers of binding sites of 0.13/base and 0.12/base for norharman and harman, respectively. Agarose gel electrophoresis of circular DNA, closed in the presence or absence of norharman revealed that the dye intercalates DNA, thereby causing 17 +/- 3 degrees unwinding of the double helix.


Interaction of chromosomal proteins with BrdU substituted DNA as determined by chromatin-DNA competition. Chromatin-DNA competition has been utilized to examine the general nature of chromosomal proteins interacting more strongly with BrdU substituted DNA. When chromatin is incubated with an excess of purified DNA, a portion of the chromosomal proteins will exchange to the purified DNA. These two complexes can then be separated on Metrizamide gradients due to their differing protein/DNA ratios. Using this technique we observe that most nonhistone chromosomal proteins will exchange to a competitor DNA, the extent of exchange being directly dependent upon the competitor DNA being present in excess. While essentially the same proteins will migrate to either unsubstituted or BrdU substituted DNA, the substituted DNA is found to be a quantitatively better competitor and its effectiveness as a competitor is directly related to the level of BrdU substitution.


Mapping and cloning of Eco RI-fragments of bacteriophage T5+ DNA. The Eco RI-fragments of bacteriophage T5 DNA were mapped using a technique which involves primarily length measurements of molecules observed in the electron microscope. Since Eco RI cleavage generates termini with 4-nucleotide long cohesive ends, fragments of complete and partial Eco RI digests were covalently circularized with DNA ligase at dilute DNA concentrations before measuring relative to internal length standards. This established the order of the internal Eco RI fragments. The two external Eco RI fragments, which had only one Eco RI terminus, were positioned relative to the internal fragments by identifying the location of some of the naturally-occurring nicks in partially denatured linear Eco RI fragments. An attempt was made to clone each of the internal Eco RI-fragments of T5 DNA via transformation into E. coli after ligation in vitro with the plasmid pMB 9. Only one fragment could be cloned and this fragment did not specify any new polypeptides in minicells of either the E. coli EK1 host, X1411, or the EK 2 host, X1776.


Intramolecular base composition heterogeneity of human DNA. The intramolecular base composition heterogeneity of human DNA has been investigated by electron microscopic observations of partially denatured structures and by equilibrium solution thermal denaturation techniques. DNA sequences having an average length of less than 2000 base pairs are found to be heterogeneous in base composition. These heterogeneous sequences occupy a minimum of 67 to 81% of the human genome.


A low resolution model for the chromatin core particle by neutron scattering. Neutron scattering studies have been applied to chromatin core particles in solution, using the contrast variation technique. On the basis of the contrast dependance of the radius of gyration and the radial distribution function it is shown that the core particle consists of a core containing most of the histone around which is wound the DNA helix,following a path with a mean radius of 4.5 nm,in association with a small proportion of the histones. Separation of the shape from the internal structure, followed by model calculations shows that the overall shape of the particle is that of a flat cylinder with dimensions ca. 11x11x6 nm. Further details of the precise folding of the DNA cannot be deduced from the data, but detailed model calculations support concurrent results from crystallographic studies(25).Images


Determination of the sequence homology between the four RNA species of cucumber mosaic virus by hybridization analysis with complementary DNA. The method of Taylor etal., (11) has been used to transcribe complementary DNA probes from the four major RNA species of cucumber mosaic virus (RNAs 1 - 4 in order of decreasing molecular weight). Analysis of the kinetics of hybridization of these probes in homologous and heterologous complementary DNA-RNA hybridization reactions has shown that the sequence of the smallest RNA (RNA 4), which contains the coat protein gene, is present within RNA 3. RNAs 1 and 2 are unique RNA molecules while each has a region of approximately 300 nucleotides in common with RNA 4.Images


Characterization of a unique enzyme complex composed of S-adenosyl-L-methionine-tRNA-methyltransferase and aminoacyl-tRNA synthetase activities. S-adenosyl-L-methionine-tRNA methyltransferases of a murine leukemia cell line were found to exist in a high molecular weight enzyme complex. Aminoacyl-tRNA synthetase activity always co-chromatographed and co-sedimented with methyltransferase activity in evidence of a unique association of these two groups of enzymes. Molecular weight studies showed a probable molecular weight of 9 X 10(5) daltsons for the intact complex which dissociates to complexes of 6 X 10(5) and 3 X 10(5) daltons. The complexes contain discrete polypeptides of 25,000-90,000 daltons as determined from SDS-gel electrophoresis. High resolution fatty acid analysis showed that only very small amounts of saponifiable lipids were associated with the purified enzyme complex. Similarly very little protein-bound sugars was found within the complex indicating that neither lipids nor sugars were involved in the protein-protein interactions of the complex. Analysis of tRNA methylated in vitro indicated the presence of most methyltransferase activities in the purified complex. Of note was the absence from the complex of the methyltransferase responsible for the production of ribo Tp.


Urea-induced structural changes in chromatin obtained by sedimentation. Sedimentation coefficients have been determined for fractionated preparations of whole and stripped (depleted of very lysine-rich histones and non-histone proteins) chicken erythrocyte chromatin fragments in 0-10 M urea. Significant differences in urea effects are observed between these preparations; differences which can be interpreted structurally by use of Kirkwood's dynamical theory of the translational frictional coefficient. This type of analysis implies that urea-induced chain-swelling in stripped chromatin is due largely to the urea effect upon the constituent nu-bodies, whereas the much larger swelling observed in whole chromatin appears to involve also the effect of urea upon the region between adjacent nu-bodies.


Structural transition in chromatin induced by ions in solution. Structural transition in chromatin was measured as a function of counter ions in solution (NaCl or MgCl(2)) and of histones bound on the DNA. The addition of counter ions to aqueous solutions of chromatin, partially dehistonized chromatin, and DNA caused a drastic reduction in viscosity and a significant increase in sedimentation coefficient. Transitions occurred primarily at about 2 x 10(-3) M NaCl and 1 x 10(-5) M MgCl(2) and are interpreted as a change in structure of chromatin induced by tight binding of cations (Na(+) or Mg(++)) to DNA, either free or bound by histones, and is an intrinsic property of DNA rather than of the type of histone bound. At a given ionic condition, removal of histone H1 from chromatin had only a minor effect on the hydrodynamic properties of chromatin while removal of other histones caused a drastic change in these properties. An increase in the sedimentation coefficient of DNA was observed also for protamine. DNA complexes wherein the bound protein contains only unordered coil rather than the alpha-helices found in histones.


Stereochemical model for proflavin intercalation in A-DNA. Linked-atom molecular modelling was employed to determine the steric and torsional requirements for intercalation of proflavine into a double-stranded region of DNA compatible with adjacent regions of cohelical A-DNA. The optimum intercalation conformation is characterized by the dihedral angles xi and psi becoming trans, with all sugars retaining the characteristics C3'-endo pucker. This extended conformation results in virtually no helical unwinding, suggesting it may be an appropriate model for an intercalative intermediary in mutagenesis by virtue of its similarity to standard helical DNA.


Steady state kinetic studies of initiation of RNA synthesis on T7 DNA in the presence of rifampicin. The steady state kinetics of initiation of T7 DNA transcription by RNA polymerase holo enzyme from E. coli in the presence of rifampicin and the two substrates ATP and UTP were studied. Under these conditions, the enzyme catalyzes exclusively the promotor specific synthesis of pppApU. The kinetic data are in agreement with the mechanism of a truly ordered reaction. Binding of the initiating nucleotide ATP to the transcriptional complex occurs prior to the binding of the substrate UTP. Release of pppApU is most probably the rate limitinig step. Km constants were found to be 0.6 mM for ATP and 0.31 mM for UTP, respectively. The substrate inhibition pattern indicated that the substrate site exhibits a finite affinity for incorrect nucleoside triphosphate (Ki = 2.3 mM). A similar non specific binding to the 3-OH site could not be demonstrated.


Subunit associations among chromatin particles. The self-association of oligonucleosomal chromatin particles in solution has been studied by light scattering and sedimentation. In the absence of magnesium ions no association is observed. In the presence of 70mM sodium or 2mM magnesium ions mono, di, tri and tetranucleosomes self-associate only if they contain bound histone 1. This association leads to the formation of compact aggregates and is continuous and non-cooperative. The relevance to higher order arrangements of nucleosomes is discussed.


Purification and properties of tyrosyl tRNA synthetase of rat liver. Purification of rat liver tyrosine tRNA synthetase yields two protein fractions A and B and both fractions are required for charging of tyrosine to tRNAtyr. Fraction B catalyzes the activation of tyrosine. Fractions A and B have been purified to near homogeneity and they are composed of single polypeptide chains of 62,000 daltons each. Gel filtration studies suggest a molecular weight of 120,000 for the synthetase.


Nucleosome mono, di, tri-, and tetramers from chicken embryo chromatin. The fractionation of gram quantities of nuclease digested chromatin from chicken embryos into nucleosome mono-, di-, tri-, and tetramers is described in detail. Each of these nucleosomal species contains a fraction soluble in 0-1 M KC1 that decreases with increasing repeat number. Less histone H1 is associated with the nucleosome fractions soluble as compared to the respective fractions precipitated in 0.1 M KC1. Thermal denaturation profiles of the four nucleosomal species are monophasic. The same Tm of 78 degrees C has been determined for the KC1-soluble nucleosomes and for the KC1-insoluble monomer. The Tm of the KC1-insoluble oligomers is 79.8 degrees C. Multiphasic melting curves were recorded for nucleosomal material that was concentrated by lyophilisation or stored at 4 degrees C in 0.25 mM EDTA. Total nucleosome mono-, di-, tri-, and tetramers (consisting of both the fraction soluble and insoluble in 0.1 M KC1) have been analyzed concerning their sedimentation, diffusion, partial specific volume, and molecular weight and compared with the sedimentation and molecular weight data of KC1-soluble nucleosome mono- and tetramers.


Metrizamide dissociates nuclear particles containing heterogeneous nuclear RNA. Metrizamide gradients were tested for the possible fractionation of the constitutive units of nuclear particles. Material from 35-55 S monoparticles was indeed distributed along the gradient but rerun experiments, CsCl density determinations, formaldehyde fixation prior to centrifugation suggested that the separation was due to dissociation or (and) action of endogeneous ribonucleases rather than to monoparticle fractionation. That dissociation had indeed occured was confirmed by the study of 60-110 S polyparticles. They were dissociated into ribonucleoproteins rich in phosphoproteins and into free proteins. These products were essentially similar to those obtained after NaCl treatment of the particles though the modes of action of metrizamide and NaCl are likely to be different. The loss of proteins from particles reaches 60-70% and we conclude that metrizamide gradients are not utilizable for the fractionation of the units of nuclear particles.


Polynucleotide recognition by DNA alpha-polymerase. In a survey of template-primer preference of a mouse myeloma DNA alpha-polymerase, the fastest rate of DNA synthesis was with poly(dT) as template and (rA)24 as primer. Such a preference for poly(dT).oligo(rA) was not observed with other DNA polymerases of mouse origin. DNA synthesis in this system resulted in formation of oligo(dA) chains, not template-length poly(dA); thus, the average enzyme molecule bound to a poly(dT).(rA)24 complex and initiated a new oligo(dA) chain many times during the incubation. Binding experiments revealed that the alpha-polymerase had high affinity for poly(dT). Although the alpha-polymerase did not bind to poly(dl) and failed to replicate it inreactions with a base pair complementary primer, poly(dl) was replicated after a (dT) block had been grafted to its 3'-end and the oligo(rA) primer had been added. In similar experiments, the (dT) block was found to be much more effective than other 3'-terminal blocks in promoting replication of denatured calf thymus DNA. The results indicate that specific base sequences may regulate initiation of DNA syntehsis by this alpha-polymerase.


A 13C NMR study of poly(adenosine diphosphate ribose) and its monomers: evidence of alpha-(1'' leads to 2') ribofuranosy1 ribofuranoside risidue. The 13C NMR spectra of poly(adenosine diphosphate ribose), ribosyl adenosine 5', 5''-bis(phosphate) and related compounds were analyzed. The structure of the ribose-ribose linkage was determined as alpha-(1'' leads to 2')ribofuranosyl ribofuranoside, from the 13C chemical shifts of methyl-alpha- and methyl-beta-D-ribofuranosides, and from the downfield displacements of 13C NMR signals by glycosidic bond formation.


Repair of ionizing radiation induced DNA damage in human lymphocytes. Phytohemagglutinin stimulated human lymphocytes exhibit a 20 fold increase in DNA repair synthesis following ionizing radiation damage compared to the level of repair in unstimulated cells. The peak of repair synthesis coincides with that for DNA replication. Stimulated lymphocytes provide a relatively simple assay for ionizing radiation repair defects.


Sequence data handling by computer.

Sequence data handling by computer. The speed of the new DNA sequencing techniques has created a need for computer programs to handle the data produced. This paper describes simple programs designed specifically for use by people with little or no computer experience. The programs are for use on small computers and provide facilities for storage, editing and analysis of both DNA and amino acid sequences. A magnetic tape containing these programs is available on request.


Purification and properties of rabbit uterus preuteroglobin mRNA. The mRNA for preuteroglobin, a precursor of the hormonally induced protein uteroglobin, has been partially purified from the endometrium of progesterone treated rabbits. The purification procedure starts with total endometrial polysomes and involves treatment with proteinase K and dodecylsulfate, chromatography on oligo(dT)-cellulose, sucrose density gradient centrifugation, electrophoresis in polyacrylamide gels containing dodecylsulfate, and a second absorption to oligo(dT)-cellulose. The final mRNA preparation codes exclusively for preuteroglobin in a wheat germ cell-free system and migrates as a single band in polyacrylamide gels containing 99% formanide. The average length of the poly(A) segment is 60 nucleotides and the translation of the preuteroglobin mRNA is inhibited by m7G(5')ppp(5')A, indicating that it contains a "capped" 5'-terminus. Comparison with known standards yields a molecular weight of 200,000 (600 nucleotides) for preuteroglobin mRNA, approximately twice as many nucleotides as required for encoding the 90 aminoacids of its cell-free product.


Specific fragmentation of T7 phage DNA at low-melting sites. A method has been developed for selective fragmentation of T7 DNA at AT-rich regions. The molecules have been subjected to complete digestion with single-strand-specific SI endonuclease after fixation of DNA AT-rich regions in the denatured state by glyoxal. The treatment resulted in three fragments having molecular weights of 13.6 +/- 0.4, 8.2 +/- 0.4 and 3.5 +/- 0.16 megadaltons as determined by electron microscopy. The position of these fragments along the T7 DNA molecule has been determined by means of analysis of the intermediates during SI-cleavage.


[Isotope angiographic measurement of blood flow velocity in the human aorta and major arteries. I. Methodology and physiological considerations]. A special 8-channel detector arrangement was used to determine atraumatically the mean blood flow velocities in the aorta and the large arteries of the lower extremities in man. Following intravenous injection of 99mTc-pertechnetate time-activity curves were recorded over defined measuring points over the arteries, from these the appearance times of the tracer determined, and the mean blood flow velocities calculated from the differences between appearance times (the minimal transit times) and the distances between measuring points. The simultaneous determination of the minimal transit times between the vena cava inferior and the root of the aorta, which correspond closely to the total cardiac transit times, permits recognition of cases in whom blood flow velocity is reduced as a result of cardiac disease.


[Automated method of determining blood circulation time in nuclear medicine cardiology]. In this paper a method of computer-assisted evaluation of circulation times using a scintillation camera is described. Eight segments of the central circulation are defined on a graphic display unit. Then the analysis of time-activity curves and the normalization of circulation times to hear rate is performed. The automatic analysis is based upon the hydrodynamic meaning of the first inflection point of a time-activity curve. The differences between inflection points are nearly identical with appearance time differences under the experimental conditions used in 131 cases. A mathematical model is presented to defined the conditions for this behaviour and to explain some deviations observed if time differences exceeded a certain value. It can be shown that the method described is largely independent of extraneous influences. It offers haemodynamically relevant parameters that correspond to the minimal cardiac transit times.


[Trend scintigraphy].

[Trend scintigraphy]. Focal changes in activity concentration for given time function. The increase per time interval is calculated for each pixel and arranged into a result matrix. Areas with increasing activity are displayed in a "positive trend scintigramm", those with decreasing activity in a "negative trend scintigram", using a gray scale of color format. Statistical fluctuations are suppressed using this method; the data smoothing over the chosen time period and the fact that several individual pictures are included in the calculations provide displays with increased informational content as compared to serial imaging methods. The clinical interpretation of localized changes in activity concentration during a specific time interval is facilitated. The method is simple, can be adapted to different camera and computer systems, and requires no additional examination procedures on the patient.


201Thallium scintigraphy--a new method for radionuclide imaging of the uterus. A new radionuclide method for uterus imaging is described. After intravenous application of 201Tl chloride the myometrium can be displayed by means of a gamma camera and a small digital computer. Early results suggest that Tl accumulation by the uterus depends on its histopathologic structure. After intra-uterine injection of 133Xe in saline demarcation between myometrium and uterine cavity is possible.


The effect of apomorphine injection into caudate nucleus on electrical activity of some structures of the rabbit brain. The studies were carried out on rabbits with chronically implanted electrodes and cannulas. Apomorphine, dopamine, or haloperidol were injected into the caudate nucleus of wakeful rabbits at a volume of 2 microliter. EEG was recorded from gyrus cinguli anterior, nucleus dorsalis raphe, and dorsal part of hippocampal formation. Apomorhine produced a dose-dependent desynchronization of EEG in the structure tested. This effect did not appear when dopaminergic receptors were blocked by previous systemic (1.2 mg/kg) or intracaudal (10microgram) injection of heloperidol.


Dependence of pentobarbital kinetics upon the dose of the drug and its pharmacodynamic effects. Pentobarbital (PB), at dose range of 20--50 mg/kg, displays in rabbits non-linear, dose-dependent kinetics. Pharmacokinetics parameters of drug elimination depend largely upon the dose, while the distribution phase is dose-independent. The rate of disappearance of PB from the central compartment (plasma) decreases with the increase of the dose. The analysis of pharmacodynamic parameters has shown that this dose-dependent retardation of PB elimination is probably caused by an impairment of metabolic processes, resulting from disturbance of the circulatory system. A close correlation has been found between the hypotensive effect of PB and the elimination constant, k13, and also between the hypotensive effect and beta.Vd(extrap), a coefficient proportional to the rate of metabolism of PB [23, 29]. The results indicate the necessity of considering the changes in the functional state of the organism, related to the action of a drug, in pharmacokinetic studies.


Binding of sulfonylurea derivatives to bovine serum albumin: part II. The relationship of binding to albumin, chemical structure, and hypoglycemic activity of sulfonamide derivatives of 2-pyrazoline-1-carboxamide. The relationship of binding to protein and hypoglycemic activity of 11 sulfonamide derivatives of 2-pyrazoline-1-carboxamide was tested. It has been shown that the hypoglycemic effect of the most potent compound of the series, SPC-703, is related to the unbound, but not to the total concentration of the drug in the rat serum. Binding to albumin increased with the increase of hydrophobic properties of the compounds investigated. The increased affinity to albumin may be responsible for low hypoglycemic activity of some of the compounds tested.


Quantitative comparison of the anticholinergic and antiarrhytmic actions of disopyramide and quinidine. With the purpose of estimating quantitative differences between disopyramide and quinidine two experimental series were designed. In order to establish the atropinic potency of both drugs, pA2 values were determined in rabbits right atria, using acetylcholine as agonist. The capacity to prevent ventricular fibrillation in albino mice subjected to chloroform apnea was also tested using various doses of the drugs. An effective median dose (ED50) to each of the drugs was calculated and the relative antiarrhythmic potency was compared. Disopyramide showed in both experimental series to be a more potent agent than quinidine.


Soluble biomedical polymers.

Soluble biomedical polymers. The first part of the paper is a review of literature data on the uses of synthetic soluble polymers in medicine. The second part is devoted to a discussion of the trend of investigation of medical polymers with a special attention to the development of new types of carriers of biologically active compounds.


Free fatty acids and lipolytic activity of the pancreas of irradiated rats. The effect of X-ray irradiation (800 R) on the lipolytic activity of pancreas was studied in rats. Lipase activity was assayed in the granules of zymogenmitochrondial fraction and in the perfusion fluid and free fatty acids (FFA) content was determined in blood serum, pancreatic homogenates and in perfusion fluid. The irradiation caused a marked increase of the activity of lipase released from zymogen-mitochondrial fraction. In the perfusate the enhancement of lipase activity accompanied by a simultaneous increase of FFA content. Irradiation resulted in an increase of FFA in pancreatic homogenates and a decrease of their content in blood serum.


Search for potential anticonvulsant drugs: part I. Synthesis of 2-phenyl-3-benzimidazolyl/-alkyl (alkyl-aryl)--quinazolin (3H) -4-one. By the condensation of 2-phenyl-3-carboxy alkyl/aryl-quinazolin (3H)-4-one and substituted (unsubstituted o-phenylenediamine, fifteen new 2-phenyl-3-benzimidazolyl(-alkyl/alkyl-aryl) -quinazolin (3H)-4-ones were prepared. All the fifteen compounds were tested for anticonvulsant activity in mice against pentylenetetrazol. A good protection was obtained by most of the compounds.


Potential biologically active agents. X. Synthesis of 3-arylimino-2-indolinones, and their 1-methyl- and 1-morpholino/piperidinomethyl derivatives as excystment and cysticidal agents against Schizopyrenus russelli. Isatin and N -methylisatin have been condensed with alkylaminobenzoates to furnish 3-arylimino-2-indolinones and 1-methyl-3-arylimino-2-indolinones respectively. 3-Arylimino-2-indolinones were then subjected to Mannich reaction conditions to yield 1-morpholino/piperidinomethyl-3-arylimino-2-indolinones. The compounds thus synthesised were evaluated for their ability to cause excystment and cysticidal activity against Schizopyrenus russelli.


Prevention of infection in nurseries for the newborn. Prevention of infection in nurseries involves consideration of the design of hospitals, wards and equipment, the study of nursing and domestic procedures, the monitoring of environmental flora and the planning of antiseptic and antibiotic policies. These subjects cannot be considered in isolation from each other and are most suitably managed by a Control of Infection Committee. Ultimately the safety of infants in nurseries rests upon the degree to which each individual involved in their care pays attention to the agreed policies of general and personal hygiene.


Chlamydial, gonococcal, and herpes virus infections in neonates. The incidence, type of lesions, portal of entry and treatment of chlamydial, gonococcal, and herpetic infections of neonates are briefly discussed. Herpes neonatorum is potentially the most serious of these conditions and major efforts in its prophylaxis are called for.


Maternal genital chlamydial infection as a cause of neonatal conjunctivitis. Infections of the cervix with Chlamydia trachomatis are common, at least in those groups of sexually active women of child-bearing age who are seen in STD (sexually-transmitted diseases) clinics. Persistent untreated infection presents a hazard to the women themselves during pregnancy and to their infants who may develop chlamydial conjunctivitis. The clinical and laboratory findings in 1009 women and in 103 infants with conjunctivitis are presented. Practical problems of diagnosis and control of neonatal chlaymdial conjunctivitis are described. A possible association between prematurity and chlamydial infection is discussed.


Neonatal meningitis.

Neonatal meningitis. Some of the main features of neonatal meningitis, studied in a defined population of infants, are reviewed. The incidence rate was twenty-six cases per 100 000 live-births. The case fatality rate was 43%. Gram-negative intestinal bacilli were the commonest infecting organisms. Streptococci accounted for an important minority of cases. It is stressed that neonatal meningitis usually presents as a non-specific illness, without the clinical signs of meningitis which are familiar in older patients. Twenty-three of the seventy-six infants in this study (30%) weighed 2500 g or less at birth. Another eight infants were born to mothers whose membranes had been ruptured for 24 hr or more.


Toxoplasmosis in the perinatal period.

Toxoplasmosis in the perinatal period. Although many of the fundamental biological features of toxoplasmosis are today well appreciated, the practical problem of prevention of its most serious consequence--disabling congenital disease, remains unsolved. The reasons vary in different communities, but are concerned with detection of the chief mode of spread, assessment of incidence, delineation of vulnerable antenatal women in latently infected populations, and assessment of the risks of therapeutics. The results of some of the approaches to these problems in Scotland are reported and discussed.


Listeriosis.

Listeriosis. The incidence, clinical picture, natural history, epidemiology and sequelae of perinatal listeriosis are discussed along with treatment and diagnosis.


The carpal tunnel syndrome in congestive cardiac failure. A case of the carpal tunnel syndrome is described which occurred simultaneously with congestive cardiac failure. As the cardiac failure responded to treatment the carpal tunnel syndrome improved dramatically.


Naevus striatus unguis.

Naevus striatus unguis. Three patients presented with an asymptomatic longitudinal pigmented band in a nail. A junctional melanocytic naevus in the nail matrix was suspected; this was confirmed by histological examination in each case. Differential diagnosis and management are discussed, together with a review of the literature. Local excision is considered to be the treatment of choice.


Hereditary angio-oedema with mesangiocapillary glomerulonephritis. A patient with hereditary angio-oedema (HAO) developed mesangiocapillary glomerulonephritis (MCGN) under observation. HAO is characterized by an inherited defect of complement-deficiency of C1 esterase. MCGN is often associated with another complement abnormality which leads to depression of serum C3 and there is some evidence that the complement abnormality precedes the nephritis. The coincidence of these two rare diseases in the present patient, and in one previously described, suggests that other complement abnormalities may predispose to the development of MCGN.


Prostaglandins and the lung.

Prostaglandins and the lung. Evidence exists implicating prostaglandins as mediators of asthma and of chronic inflammation in the lung. In addition to their spasmogenic effects, PGs are also potent in vitro regulators of mediator secretion by basophils, mast cells, or lymphocytes. These regulatory effects of E-series PGs may have considerable significance in drug design and evaluation in both asthma and chronic inflammation.


Inflammation in human skin induced by ultraviolet irradiation. Pharmacologically active mediators of inflammation were obtained from suction bullae raised on normal and ultraviolet B (290-320 nm) inflamed human abdominal skin. The exudates obtained from the bullae were examined by superfusion cascade bioassay, by radioimmunoassay for PGF2alpha and by column, thin-layer and gas-liquid chromatography. Ultraviolet B (u.v.-B) irradiation of human skin produced an erythema which appeared after 2 hr, increased in severity up to 24 hr and persisted for more than 48 hr. Bioassayable and radioimmunoassayable prostaglandin activity was elevated at 6 hr, was maximal at 24 hr and had returned to normal 48 hr. Topical application of indomethacin suppressed both the erythema and the increased concentration of PGF2alpha as measured by radioimmunoassay. Chromatographic studies confirmed increased prostaglandin activity at 6 and 24 hr and in addition demonstrated an increase in arachidonic acid-like activity. The results suggest that prostaglandins may play an important role between 6 and 24 hr of u.v.-B-induced erythema. Whether the reduction of erythema by indomethacin can be partially or wholly attributable to inhibition of prostaglandin biosynthesis is uncertain.


Oedema and vasodilatation in inflammation: the relevance of prostaglandins. The role of prostaglandins in inflammation is still disputed. Some workers have attempted to fit prostaglandins into a simple model, i.e. inflammatory leads to chemical mediator leads to vascular response. Recent work has shown that this approach may be misleading. An alternative model is proposed, involving the interaction of two chemical agents, i.e. a vascular permeability-increasing mediator (such as histamine or bradykinin) and a vasodilator (prostaglandin) which potentiates the plasma exudation produced by the permeability-increasing mediator. The results obtained in testing this model support the further proposal that non-steroidal anti-inflammatory compounds suppress inflammatory swelling by inhibiting vasodilatation.


Prostaglandins and model aspects of thrombosis. The possible role of prostaglandins (PGs) in thrombosis was determined by examining their effects in models of thrombosis which included platelet aggregation (in vitro), blood flow (in vivo) and thrombus formation (in vivo). It was found that blood flow and thrombosis can be effectively modulated by the various types of prostaglandins produced by the blood and the vascular tissue.


The coagulopathy associated with aortic aneurysms. The authors in this article record their experience with eight-four patients with abdominal aortic aneurysms. Twenty-seven patients (32%) presented with ruptured aneurysms with an overall mortality of 56%. Of the unruptured aneurysms, 67% were operable with a mortality of 5.3%. The highest mortality amongst the patients with ruptured aneurysms was in the group who was shocked. In the group with ruptured aneurysms, of those in whom platelet counts were performed, 50% were abnormally low, and 56% had evidence of abnormal coagulation. Seventy per cent of those with coagulation abnormalities died. In the unruptured group 28.2% had thrombocytopenia but no other abnormalities of coagulation. All patients undergoint aneurysm resection should have a platelet count and a full clotting screen. Therapy should be directed to normalization of the coagulation system.