Automation of two-stage factor VIII assay. Two automated methods for two-stage factor VIII assays have been compared with one another, and evaluated in practice. The Depex method records the clotting time when an electric circuit is completed by the formation of a fibrin thread across a hook-type electrode; the Electra method is based on an optical density technique of clot detection. The two methods gave comparable results for measured levels of factor VIII when haemophilic or "normal" plasmas were assayed. Results from the two methods in practice also suggest that both are valid at low and "normal" factor VIII levels. The Electra method is also probably suitable for assays of concentrates; however, the Depex method appears to give falsely high values in these circumstances, and experimental findings suggest that the reason may be that increased viscosity due to the high fibrinogen levels in factor VIII concentrates causes premature closure of the circuit between the two ends of the Depex electrode. The main advantage of the Depex method is that, provided 3 or 4 machines are available, a given number of assays can be completed more quickly than on Electra. The main advantages of Electra are that it is probably subject to less laboratory error than Depex, and that it is suitable for assaying concentrates as well as haemophilic and "normal" plasmas.


Quantitation of radio-labelled vitamin K1 and vitamin K1 epoxide in plasma by high pressure liquid chromatography. A convenient, accurate and reproducible high pressure liquid chromatographic method for the quantitation of radio-labelled vitamin K1 and vitamin K1 epoxide in plasma is described. The method involves the determination of total ether extractable radioactivity, and a chromatographic separation to determin the relative quantities of radio-labelled vitamin K1 and vitamin K1 epoxide. The method is useful over a wide range of ratios of the two compounds, and has a coeffcient of variation of approximately 5%.


The hemostatic mechanism after open-heart surgery. III. Correlation between the appearance of an abnormal protein demonstrated by gel electrophoresis and of an inhibitor of the extrinsic coagulation system (PEC). A prospective study in 13 patients undergoing open-heart surgery with extracorporeal circulation revealed a marked decrease of the mean one-stage prothrombin time activity from 88% to 54% (p less than 0.005) but lesser decreases of factors I, II, V, VII and X. This apparent discrepancy was due to the appearance of an inhibitor of the extrinsic coagulation system, termed PEC (Protein after Extracorporeal Circulation). The mean plasma PEC level rose from 0.05 U/ml pre-surgery to 0.65 U/ml post-surgery (p less than 0.0005), and was accompanied by the appearance of additional proteins as evidenced by disc polyacrylamide gel electrophoresis of plasma fractions (p less than 0.0005). The observed increases of PEC, appearance of abnormal protein bands and concomitant increases of LDH and SGOT suggest that the release of an inhibitor of the coagulation system (similar or identical to PIVKA) may be due to hypoxic liver damage during extracorporeal circulation.


Thrombelastography during and after elective abdominal surgery. Thrombelastography has been performed on recalcified whole blood from 50 patients before, during and after elective abdominal surgery. The characteristic changes of the thrombelastographic indices r, k and mA are described. During operation r and k shortened, but no change in mA was observed. This response was in part associated with an increase in factor VIII activity. Following operation, while r time was somewhat shortened, much more marked changes in k and mA were evident. Increasing fibrinogen concentration was the dominant factor in determining the post-operative changes in the thrombelastograph.


Ornithine decarboxylase activity in cultured endothelial cells stimulated by serum, thrombin and serotonin. Ornithine decarboxylase (ODC) activity, the rate-limiting step in the synthesis of polyamines, can be demonstrated in cultured, bovine, aortic endothelial cells (EC). Serum, serotonin and thrombin produce a rise in ODC activity. The serotonin-induced ODC activity is significantly blocked by imipramine (10(-5) M) or Lilly 110140 (10(-6) M). Preincubation of EC with these blockers together almost completely depresses the 5-HT-stimulated ODC activity. These observations suggest a manner by which platelets may maintain EC structural and metabolic soundness.


[Reconstruction of the aorta in mycotic aortic aneurysm--report of two cases of salmonella infection (author's transl)]. Two patients with infected aortic aneurysm underwent surgical treatment. When using autologous tissue in place of the infected aorta a recurrent aneurysm was observed four months later. Extraanatomical bypass of the infected area with prosthetic material and consecutive removal of all infected tissue seems to be the only successful management. This is confirmed by another patient who was treated successfully in this way. Prolonged antibiotic therapy after resection of infected aneurysms seems to be mandatory.


[Isolated neoplastic foci in the central nervous system in generalized non-Hodgkin-lymphomas. A prospective pathomorphological study (author's transl)]. A comprehensive post-mortem investigation of the central nervous system (CNS) in 103 patients with malignant non-Hodgkin-lymphomas was performed. Neoplastic foci were revealed in the CNS in 21 cases. Five of them were visible at gross examination. Strong evidence exists that the incidence of the CNS-involvement is correlated with the lymphoma-type. Our cases were classified according to the Kiel-classification (Lennert 1975). The findings suggest that CNS-infiltrations are rather common in lymphoblastomas and immunocytomas whereas they seldom occur in plasmocytomas.


Circadian and circannual rhythms in plasma hormones and other variables of five healthy young human males. Every other month (plasma) and every month (urine) circadian rhythms were documented during the course of 14 months. Annual changes were validated in the 24 h mean of: plasma FSH (annual crest time: February), LH (March), thyroxine (September), cortisol (February), renin activity (April), testosterone (October), urinary 17-hydroxycorticosteroids (March), aldosterone (March), potassium (May) as well as sexual activity (September) [self-recorded daily]. Plasma prolactin did not show an annual variation. In addition, annual changes in the circadian acrophase (crest time location in the 24 h scale) occurred for some of the documented variables: plasma thyroxine, cortisol, renin activity, testosterone, urinary aldosterone and potassium.


Effects of two analgesic opiates (methadone and pentazocine) on the serum prolactin levels in breast cancer. In 18 female patients affected by advanced breast cancer, the serum prolactin (PRL) levels have been determined under basal conditions and after the administration of analgesic opiates such as methadone and pentazocine. A significant increase of prolactin serum values was found after the use of both drugs. This finding is considered to be of clinical importance.


Radioimmunoassay study of neurophysins in human plasma. Using a homologous system we have developed a specific and sensitive radioimmunoassay for the measurement of one of the human neurophysins in unextracted human plasma. This neurophysin is specifically secreted in response to oestrogen and has therefore been referred to as human oestrogen-stimulated neurophysin (h-OeSN). The plasma concentration was 0.57 +/- 0.17 ng/ml (SD) in females and 0.88 +/- 0.76 ng/ml (SD) in males. This difference is not significant. In women on oral contraceptives, plasma h-OeSN was 2.0 +/- 1.1 ng/ml. During pregnancy h-OeSN increased progressively to 3.7 +/- 2.9 ng/ml at the end of the first trimester, and 5.2 +/- 2.8 ng/ml at term. Plasma h-OeSN concentrations increased rapidly and markedly in men treated with ethinyl-oestradiol. We have also demonstrated the presence of h-OeSN in amniotic and cerebrospinal fluids. A second human neurophysin, which is stimulated by nicotine but not by oestrogen, was also measured. This neurophysin was monitored by a heterologous system using antiserum raised against bovine neurophysin II (b-NII), and b-NII as the standard and tracer.


The relationship of radioimmunoassay to bioassay: in vitro studies with synthetic lysine vasopressin in aqueous solution inactivated by heat. The relationship of radioimmunoassay to pressor assay and antidiuretic assay was investigated in a simple in vitro system of synthetic lysine vasopressin in aqueous solution inactivated by heating at 100 degrees C for 9, 18, 27, 36, 54 and 72 h. An apparent dissociation between radioimmunoassay and bioassay was demonstrated, with biological activity being lost more rapidly than immunological activity. The half-times were 32 h for radioimmunoassay, 23 h for antidiuretic assay and 22 h for pressor assay. However, ion-exchange chromatography showed immunological heterogeneity but biological homogeneity of the lysine vasopressin used, and indicated that the presence of impurities in the vasopressin might to some extent explain the discrepancy between assay results. Synthetic arginine vasopressin and arginine vasopressin of pituitary origin showed a similar immunological heterogeneity by ion-exchange chromatography.


Serum levels of TSH, T3, rT3, T4 and T3-resin uptake in surgical trauma. Changes in thyroid hormone metabolism induced by surgical trauma were studied by determination of TSH, T3, rT3, T4 and T3-resin uptake before, during and after mastectomy in 20 women and cholecystectomy in 10 women. Pronounced and reciprocal changes, explained by altered peripheral T4 metabolism were found concerning T3 and rT3. The decreased T3 and increased rT3-levels approached or exceeded the limits of the reference range on the first post-operative day. A significant increase in T3-resin uptake and a decrease in serum T4 were already observed during surgery and probably was caused by a decreased protein binding capacity. An increased concentration of TSH in the serum during surgery was followed by a significant post-operative decrease, possibly due to a suppressive effect of endogenous cortisol. No obvious difference in absolute values or the pattern of change was found between the mastectomy and cholecystectomy groups, although a somewhat more pronounced and retarded alteration in rT3 was found after cholecystectomy.


Pituitary-thyroid responses to surgical stress. The effect of surgery on pituitary-thyroid function was studied in 12 euthyroid patients. There was a sharp early increase in total thyroxine level, causing displacement of triiodothyronine from thyroid hormone binding proteins resulting in the elevation of the biologically more potent free triiodothyronine fraction. The serum triiodothyronine concentration fell rapidly during and after the operation, with a concomitant rise in reverse triiodothyronine level. Increased prolactin levels were found during and after surgery. With no post-operative complication, recovery of normal pituitary-thyroid function occurred after 4 to 7 days of convalescence.


Endocrine effects of lithium: II. 'Primary' hyperparathyroidism. Ninety-six manic-depressive patients were studied during long-term lithium treatment. Highly significant elevations were observed respecting the levels of serum immunoreactive parathyroid hormone (P less than 0.001) as well as the protein-corrected levels of serum calcium (P less than 0.001) and serum magnesium (P less than 0.001), thus indicating a state of 'primary' hyperparathyroidism. The patients as a group had normophosphataemia and normophosphatasia supporting the impression of a rather mild state of biochemical hyperparathyroidism.


The effect of oophorectomy on plasma oestrone and androstenedione levels in the rat. Plasma oestrone and androstenedione levels have been measured in oophorectomized and sham-operated rats by means of radioimmunoassay. The mean oestrone level in the oophorectomized animals was approximately two-thirds of that in the intact animals while the androstendione levels were about half of those in the intact rats. A direct relationship was observed between the plasma oestrone and androstenedione levels in the control animals and to a lesser extent in the oophorectomized animals. The results indicate that approximately 50% of circulating androstenedione and 30% of circulating oestrone originate in the ovaries in the female adult rat.


Luteotrophic activity of ectopically developing rat blastocysts. The production of a luteotrophic hormone by ectopically transplanted rat blastocysts was demonstrated by transfer of blastocysts to the kidneys of cyclic and pseudopregnant mice and isogeneic rats. Pseudopregnancy was induced in nearly all cyclic mice bearing trophoblastic outgrowths but not in cyclic rats. In both mice and rats prolongation of pseudopregnancy was observed following ectopic transplantation of rat blastocysts at the time of normal egg implantation. It is concluded that ectopically developing rat trophoblastic tissue produces a luteotrophic hormone.


Endocrine effects of lithium. III. Hypermagnesaemia and activation of the renin-aldosterone system. Hypermagnesaemia is a well-known but as yet unexplained concomitant of lithium treatment. Prior suggestions implicating a role for aldosterone in magnesium homoeostasis prompted this study of plasma renin, plasma aldosterone and serum magnesium in 17 maniodepressive patients on long-term lithium treatment. In addition to hypermagnesaemia (P less than 0.001), this group of patients had raised plasma levels of aldosterone (P less than 0.001) and increased plasma renin concentration (P less than 0.05). Serum magnesium was positively correlated to plasma aldosterone (r = 0.58, P less than 0.02). The relation between activation of the renin-aldosterone system and the presence of hypermagnesaemia during chronic lithium treatment could conceivably be mediated through a lithium-induced hypovolaemic state.


Effect of (+)-amphetamine on the retention of 3H-catecholamines in slices of normal and reserpinized rat brain and heart. The effect of reserpine on the inhibition by (+)-amphetamine and cocaine of the accumulation of 3H-dopamine (DA) in striatal slices and 3H-noradrenaline (NA) in slices of cerebral occipital cortex and heart atrium of rats and the release of 3H-amines from these tissues were examined. Reserpine (5 mg/kg intraperitoneally) was injected 18 hours before the experiments. It was found that reserpine markedly enhanced the in vitro potency of amphetamine in the striatum and heart but only slightly in the cortex. After administration in vivo (+)-amphetamine was about 10 time more potent in reducing the amine accumulation in the cortex as in the striatum. Reserpine enhanced the effect in both regions. The inhibitory potency of cocaine in vitro was unchanged by reserpine in the striatum but was reduced in the cortex and heart. Reserpine did not change the inhibitory potency of desipramine in the cortex and heart. The release of the 3H-amines by (+)-amphetamine was enhanced by reserpine in the striatum and heart but the small release produced in the cortex was not increased. The release produced by cocaine was similarly enhanced by reserpine but cocaine was much less active than (+)-amphetamine. The results indicate that (+)-amphetamine and cocaine inhibit the amine accumulation by different mechanisms.


Formation of asbestos bodies under the influence of parenteral iron overload. The effect of parenteral administration of iron (dextran) on the number of asbestos fibers in the lungs, formation of asbestos bodies and the development of interstitial fibrosis was studied in guinea pigs exposed intratracheally to anthophyllite dust. The treatment did not accelerate, either qualitatively or quantitatively, the formation of asbestos bodies or retard the development of interstitial fibrosis. The number of naked asbestos fibers was also similar in anthophyllite-inoculated animals to those similarly inoculated, but having had, additionally, a previous saturation with iron.


Unaltered metabolism of phenytoin in thyroid disorders. The metabolism of phenytoin was studied in 9 hyperthyroid and 7 hypothyroid patients before and after treatment with either antithyroid drugs or 1-thyroxine. No difference in the half-life, volume of distribution and metabolic clearance rate was found between untreated hyper- and hypothyroid subjects. Furthermore, normalisation of thyroid function test did not change the kinetic parameters of phenytoin. The results indicate that the well-known correlation between thyroid function and antipyrine kinetics cannot be extrapolated uncritically to other drugs. It is concluded that no general rules are valid in the kinetics among different drugs in thyroid pathological conditions. Each drug must be evaluated by itself in different pathological conditions.


n-Butoxyacetic acid, a urinary metabolite from inhaled n-butoxyethanol (Butylcellosolve). Male albino rats were exposed to butylcellosolve (n-butoxyethanol). Collected urine was found to contain a characteristic metabolite, identified as n-butoxyacetic acid by mass spectrometry. The identity of the compound was confirmed by synthesis.


A comparative study of serum creatine phosphokinase (CPK) activity in rabbits, pigs and humans after intramuscular injection of local damaging drugs. Serum creatine phosphokinase (CPK) activity has been determined before and after intramuscular injection of lidocaine, diazepam or saline in humans and lidocaine, diazepam, digoxin and saline in pigs and rabbits. Two ml volum of each of the drugs was given to humans as well as to the experimental animals. No changes in CPK activity were found after saline in humans or rabbits but a minor increase was demonstrated in pigs. A marked increase of CPK activity was demonstrated after lidocaine or diazepam in humans and after lidocaine, diazepam or digoxin in pigs and rabbits. Post mortem examination of the injection sites in the animals revealed extensive muscle tissue necrosis after lidocaine, diazepam and digoxin. No damage of the tissue was found after saline. CPK activity was also determined in rabbits receiving 2 ml of dilutions of diazepam in saline. The injection sites were examined post mortem. The CPK activity was increased in animals receiving 1:2 and 1:8 dilutions while a 1:20 dilution did not give rise to changes in the enzyme activity. The necrotic area diminished when diazepam was diluted and no pathological changes were found at the injection sites after the 1:20 dilution. Measuring the CPK activity in rabbits after an intramuscular injection seems to be a sensitive method for the determination of local toxicity.


Pharmacological studies on the molluscicidal activity of phorate on Pila globosa (Gastropoda). Amongst heart, rectum and radula protractor muscles of Pila globosa, the heart showed a negative inotropic and negative chronotropic response while the rectum and radula protractor showed a positive tonotropic response to exogenously applied acetycholine (ACh). The anti-cholinesterase pesticide phorate substantially increased the response to ACh; at high doses it could also evoke cholinomimetic response from the heart. The anti-cholinesterase property of phorate gradually increased with an increase in its contact period to the tissue. The extent of alteration in ACh response caused by prior treatment with low and high doses of phorate were very similar, indicating that the efficacy of phorate is by and large time-dependent rather than dose-dependent. The effect of phorate remained irreversible even after prolonged washing. The mode of action of phorate has been discussed in the light of the above findings.


Influence of citalopram and chlorimipramine on uptake of 5-HT by isolated perfused guinea pig lungs. A method is described for the preparation and perfusion in vitro of isolated guinea pig lungs, 5-HT is rapidly taken up from a perfusing solution by the organ (about 70% uptake). In the concentration range 10(-7) to 5 X 10(-6) M citalopram concentration dependently inhibited the uptake of 5-HT by the lung preparation. Chlorimipramine inhibited the uptake of 5-HT only by 40--50%, and the inhibition was not concentration dependent. The method used seems to be a reliable model for studying the uptake of 5-HT.


Experimental anti-arrhythmic properties of melperone, a neuroleptic butyrophenone. The neuroleptic butyrophenone, melperone, has been compared with antiarrhythmics, neuroleptics, alpha-blockers and beta-blockers in various experimental arrhythmias. Melperone 0.01--1 mg/kg intravenously antagonized ouabain-induced arrhythmias in conscious rabbits to the same degree as propranolol 2 mg/kg and quinidine 10 mg/kg intravenously probably mainly via s CNS depressive effect. It was found to be considerably weaker than propranolol 2 mg/kg, when anaesthetized guinea pigs were used. Melperone 0.1--10 mg/kg was inactive against aconitine-induced arrhythmias. Melperone 1--5 mg/kg antagonized adrenaline-induced arrhythmias in halothane-sensitized guinea pigs like phentolamine 1--5 mg/kg intravenously and was more potent than chlorpromazine, propranolol and quinidine. This study and an electrophysiological study suggest that melperone might be a type III anti-arrhythmic drug, which at the same time depresses CNS and reduces afterload.


Terbutaline preventing permeability effects of histamine in the lung. In unanaesthetized guinea-pigs the effect of terbutaline on histamine-induced increase in lung weight was studied. Terbutaline 0.1 mg/kg and 0.3 mg/kg was given subcutaneously 5 min. before exposure during 60 min. to a histamine aerosol. Terbutaline markedly prevented the histamine-induced increase in lung weight. This effect is discussed in relation to the mechanism of action of mediator-induced increase in vascular permeability.


Cryptic mycotic abdominal aortic aneurysms: diagnosis and management. The incidence of cryptic mycotic abdominal aortic aneurysms has relatively increased since antibiotic therapy has become available. The causative organism is the salmonella group in about 50 per cent of cases. This diagnosis should be strongly entertained in patients with fever of unknown origin, vague abdominal pain, and progressive appearance of a pulsatile abdominal mass. Aortography may be helpful in establishing the diagnosis. Some postoperative graft infections may be due to unrecognized cryptic mycotic infection of the aorta and not from external contamination, as previously supposed. Construction of an axillofemoral bypass graft through clean tissue is advised for the successful treatment of the grossly infected infrarenal aortic aneurysm. Three surviving patients with cryptic mycotic abdominal aortic aneurysms are added to the sixteen surviving patients already reported in the literature.


[Effect of organic acids on the biosynthesis of macrotetralide antibiotics by an Actinomyces chrysomallus var. carotenoides strain]. The biosynthesis of macrotetrolides by Actinomyces chrysomalus var. carotenoides was stimulated by acetic, succinic, propionic, oxalic, malic, tartaric, citric, pyruvic, alpha-ketoglutaric and fumaric acids. Incorporation of 14C-acetate into the molecule of the antibiotic and the data on dependence of the stimulating effect upon the quantitative ratio and time of the organic acid addition were indicative of the role of acetic, succinic and propionic acids as precursors of macrotetrolides. The other organic acids increased the biosynthesis of macrotetolides when added to the culture within wide time ranges of the culture development and prolonged the period of the mycelium productive state.


[Effect of diuretics (diacarb and lasix) on the experimental antitumor activity, toxicity and pharmacokinetics of the antibiotic, olivomycin]. Diacarb or lasix in combination with olivomycin increased the antibiotic antiblastomic activity and toxicity when used for the course treatment of mice with transplanted lymphosarcoma LIO-I. The chemotherapeutic indices of such combinations did not differ from those of olivomycin used alone. Diacarb decreased excretion of olivomycin with the urine in healthy mice, while lasix increased it.


Placental secretion of oestrogens and protein hormones. In order to trace the passage of steroids and proteins from the placenta to the maternal peripheral blood, samples of retroplacental blood, uterine vein blood and peripheral blood were taken from women undergoing Caesarean section at term. The concentration of unconjugated oestriol, total oestriol, human placental lactogen and pregnancy specific beta1 glycoprotein was measured. The oestrogen concentration in the uterine vein was higher than the peripheral blood, the placental lactogen was slightly higher and the pregnancy specific beta1 glycoprotein was the same in the uterine vein and the peripheral veins. In keeping with this, the retroplacental blood had a high concentration of oestrogen, moderately raised placental lactogen and a low pregnancy specific glycoprotein concentration. It is concluded that there is a rapid secretion of oestriol from placenta to the mother; a slower secretion of placental lactogen and no clear evidence of a flow of pregnancy specific glycoprotein from the placenta.


Studies on platelet function during different modes of administration of PgF2alpha in obstetrics and gynecology. Platelet function has been studied during intravenous, intraamniotic, and extraamniotic administration of prostaglandin F2alpha (PgF2alpha) for termination of missed abortion and missed labor, for therapeutic abortion, and for induction of term labor. The controls received oxytocin i.v. (missed labor and term labor). Our investigations have shown that there was a normalization of the increased spontaneous platelet aggregation and a significant reduction of ADP- and collagen-induced platelet aggregation in the groups given PgF2alpha i.v. The desaggregation in these groups was increased. The other groups given PgF2alpha showed no significant changes in platelet function. Inducing labor by oxytocin we found a tendency to increased platelet aggregation and decreased desaggregation. The clinical importance of these findings and the consequences for hemostasis are discussed.


[Adenocarcinoma in situ in a focus of ovarian endometriosis (author's transl)]. A 48 year old woman had a hysterectomy with bilateral salpingo-oophorectomy because of uterus myomatosus. Histologic examination of the surgical specimen revealed in one of the ovaries an adenocarcinoma in situ that had unequivocally developed within a focus of endometriosis. In addition, atypical epithelium was found in a small circumscribed area in one of the many islets of endometriosis in the myometrium.


[On the localisation of the adenocarcinoma in situ of the cervix uteri (author's transl)]. The position and the extent of 42 adenocarcinomas in situ were determined in representative sections of 27 cone specimens. At the same time all foci of a coincidental atypical squamous epithelium were registered. It was found that the glandular cancer arises rather in the canal than at the ectocervix. The topography of an additional pathological squamous epithelium follows the rules described for cases with malignant squamous epithelium only.


[The influence of endogenous hormones on the oestrogen and progesterone receptor determination in tissue of mammary carcinoma (author's transl)]. Oestrogen and progesterone receptors were determined in 48 primary tumors of invasive mammary carcinoma. 86% showed a positive oestrogen receptor binding, 53% were progesterone receptor positive. The binding capacity for oestradiol was 5-211 pmoles/g tissue protein, for progestin (R 5020) 7-146 pmoles. The question of the investigation was whether the content of determined receptors depends on endogenous oestradiol and progesterone concentrations. A clear dependence did not exist between the hormone level in the plasma, collected just before the excision of the tumor, and the amount of identifiable receptors in the tumor. On the contrary, in considering the quantities of endogenous hormones in the tissues, based on the plasma content of the tissue and the plasma hormone level, a correlation could be found. The content of identifiable receptors decreased with increasing amounts of endogenous hormones in the cytosol. It is postulated that rather the amount of endogenous hormones in the tissue than the plasma hormone level characterizes the degree of saturation of existing receptors by endogenous hormones. Apparently, the determined receptor concentrations at endogenous hormone values under 2 pmoles/g tissue protein reflect rather the true receptor content, whereas at higher values too low or false negative results should be reckoned with.


Whole-body retention of mercury and selenium and histopathological and morphological studies of kidneys and liver of rats exposed repeatedly to mercuric chloride and sodium selenite. Distribution and retention of mercury and selenium was studied in rats exposed repeatedly to HgCl2 injections (0.5 mg Hg/kg to the tail vein every other day) and intragastrically to Na2SeO3 (0.5 mg Se/kg every day), applying combined and separate administration of these metals for 2 weeks. Whole-body retention of mercury in the presence of selenium was augmented by 20% and that of selenium in the presence of mercury by 4% with respect to the administered dose. Combined administration of mercuric chloride and sodium selenite brought about damage to the epithelial cells of renal proximal convolutions and formation of protein casts in their lumen. These changes had the same pattern as those induced by administration of mercuric chloride alone, but the intensity was lower. Submicroscopic studies revealed that repeated combined administration of sodium selenite and mercuric chloride did not completely abolish the mercury-induced mitochondrial swelling and contributed to chromatin destruction in the hepatocyte nuclei.


[Chromosome studies on trichloroethylene workers (author's transl)]. On the basis of lymphocyte cultures, chromosome studies were carried out on 28 degreasers under different trichloroethylene load. Nine of these cases showed pathological rates of hypodiploid cells, but otherwise normal caryotypes; one case had a caryotype 47,XY,+mar (small metacentric extrachromosome). In these nine cases the trichloroethylene load, but not the exposure periods on the working place were significantly higher than in the control group.


Effect of NO2 and SO2 inhalation on benzo(a)pyrene metabolism in rat lung. Male Wistar rats were continuously exposed to NO2 (14.4 ppm), SO2 (46.5 ppm) and to a mixture of both gases and their effect on lung microsomal aryl hydrocarbon (benzo(a)pyrene) hydroxylase (AHH) activity was determined. The pre-exposed animals were administered methylcholanthrene (MC) to investigate the exposure effect on enzyme inducibility and pattern of B(a)P metabolites. NO2 significantly increased AHH activity but no marked change was noted with SO2. Induction of AHH by MC was markedly inhibited by SO2, only slightly by mixture of NO2-SO2 but not with NO2 alone.


High-sensitivity scanning calorimetric study of mixtures of cholesterol with dimyristoyl- and dipalmitoylphosphatidylcholines. A highly sensitive and stable scanning microcalorimeter is employed in a reinvestigation of the effect of cholesterol on multilamellar suspensions of dimyristoylphosphatidylcholine (DMPC) and dipalmitoylphosphatidylcholine (DPPC). Below 20 mol % cholesterol the DPPC mixtures give heat-capacity curves each of which can be resolved into a narrow and a broad peak, suggesting the coexistence of two immiscible solid phases; above 20 mol % only the broad peak is observed and this disappears at about 50 mol %. The DMPC mixtures show a more complicated behavior; from about 13.5 to 20 mol % cholesterol the observed curves appear to be the sum of three component peaks. As with the DPPC mixtures, only a single broad peak is observed above 20 mol % cholesterol, and this broad peak becomes undetectable above about 50 mol %. These results are discussed.


[Effect of oxygen and hypergravitation on alveolar surfactant]. The effect of prolonged exposure (up to 66 hours) to pure oxygen breathing and to short (5-minute) oxygen breathing combined with acceleration (+5Gz) on the surface tension and surface potential of the alveolar washout of the albino rat lungs was determined. Both experimental conditions produced atelectasis and a decrease of the surfactant surface activity. Possible mechanisms of shifts of the surfactant activity under hyperoxia only, and hyperoxia with accelerations are discussed.


The value of a psychiatric service within the venereal disease clinic. A significant proportion of attenders at venereal diseases clinics can be regarded as potential psychiatric patients. However, there have been few reports on the value of readily available psychiatric advice at such clinics. The findings during a three-month period when a psychiatrist attended a venereal disease clinic are described. Twenty-two patients were referred for psychiatric assessment. Of the 20 who kept their appointment, 18 were diagnosed as mentally ill or as having a personality disorder. Of these two were already under psychiatric care, but 11 had never previously sought psychiatric assistance. The major sources of common venereological and psychiatric concern appeared to be among the promiscuous and the hypochondriacal patients. The former consisted of persons with personality disorders who were thought unlikely to respond to psychiatric treatment; but some of the latter improved after treatment with pimozide. Some patients defaulted and not all who persevered were helped. Nevertheless the results of a questionnnaire showed that the staff considered there was an important place for a psychiatrist within their clinic.


Venereal disease education in West Virginia, USA. A venereal disease educational programme entitled Venereal Disease Education in West Virginia was constructed. It consisted of a preliminary test to assess the level of general knowledge of venereal diseases, a value survey list, a lecture illustrated by colour slides, and a final test. The programme was presented to 3210 students in Northcentral West Virginia who ranged in age from 12 to 20 years (7th to 12th grade). The mean score in the preliminary test was 7.97 (53%) correct answers out of 15, and the mean score for the final test was 11.55 (77%) correct answers out of 15. The ability of students to retain the information given to them was measured by testing the same class of 53 students one year later. These students obtained a mean score of 11.41 (76%) correct answers out of 15 in the later test which demonstrates that the students had retained much of the information.


Urinary tract infection in a clinic for sexually transmitted diseases. A study of the prevalence of urinary tract infection (UTI) in 430 women attending a clinic for sexually transmitted diseases and its relationship to sexual activity is presented. UTI, usually asymptomatic, was found to be slightly more common in women attending the clinic than in the general population, its prevalence being 4.9%. UTI was more commonly found in patients who gave a history of recent sexual intercourse, which suggests that recent coitus was a factor in the development of significant bacteriuria. The likelihood of finding significant bacteriuria was not related to the number of sexual partners in the previous year. Trichomoniasis was more common in the small group of patients with UTI than in other women. The most common causative organism of UTI was Escherichia coli, and the isolates were usually sensitive to ampicillin, sulphonamides, trimethoprim, and nitrofurantoin.


[Endogenous cortisol levels after intrathecal injection of triamicinolone acetonide in patients with neurological disease (author's transl)]. A single dose of 40 mg triamcinolone acetonide was injected intrathecally in 30 patients with multiple sclerosis and 20 with other neurological diseases. In 15 of them the endogenous cortisol level was determined on three successive days and their cerebrospinal fluid examined before the triamcinolone injection was given. Cortisol levels were then measured serially for another 15 days after the injection. Contrary to the response after intramuscular injection, the endogenous secretion of cortisol was not significantly depressed after intrathecal administration. The latter is, therefore, suggested in the treatment of inflammatory diseases of the central nervous system and its integuments, and for acute exacerbations of multiple sclerosis.


Oxygen tension of the vaginal surface during sexual stimulation in the human. An oxygen electrode was maintained by suction on the vaginal wall in seven women. The basal value of pO2 was 9.3 mm Hg +/- 10.7 (mean +/- standard deviation) before clitoral self-stimulation was initiated. When stimulation took place the oxygen tension rose and peaked immediately after orgasm to 39.5 +/- 14.1 mm Hg. It then declined and fell to 20.1 +/- 13.8 mm Hg 10 minutes after the peak value. The changes correlate closely with changes in vaginal blood  flow. The increased oxygen tension may be one of the factors that enhance of even initiate the motility of spermatozoa when deposited intravaginally.


Acute pulmonary toxicity of a commercial fluorocarbon--lipid aerosol. The death of an adolescent after deliberate inhalation of the domestic fluorocarbon--lipid spray, PAM, triggered an investigation of the effects of this product on mammalian lung. Some of its constituents are known to destroy the lung-surfactant system, but death from its inhalation by earlier victims was usually attributed to the fluorocarbon's cardiac arrhythmogenic properties. In the present study, we applied methods and experimental models not previously used to study the effects of this aerosol material on the lung surfactant. We found morphological and functional acute disintegration of normal alveolar surfactant, leading to extensive alveolar collapse, with sustained and elevated surface tensions in vitro.  This could result in fatal hypoxaemia at inspired concentrations of fluorocarbons insufficient to cause cardiac arrhythmias, and may explain at least partly the large number of deaths associated with inhalation of such product.


Lipid composition of sputum from patients with asthma and patients with cystic fibrosis. Lipids from the sputum of patients with asthma and with cystic fibrosis were isolated and characterized. In both cases, lipids constituted approximately 30% of the dry material. Phosphatidlycholine was the most abundant lipid, Significant amounts of phosphatidylethanolamine and phosphatidylglycerol were present. Hexosyl ceramides, sphingomyelin, phosphatidylinositol, lysophosphatidylcholine, and lysophosphatidylethanolamine were present as minor lipid components. Apperciable quantities of neutral lipids were present, of which triglycerides and cholesterol were the main constituents. Phosphatidylcholine, sphingomyelin, and phosphatidylgycerol were highly saturated. Large amounts of phosphatidylcholine containing mostly palmitic acid, particularly in the asthmatic sputum, suggest htat this highly saturated. Large amounts of phosphatidylcholine containing mostly palmitic acid, particularly in the asthmatic sputum, suggests that this highly saturated phospholipid is synthesized in the upper airways for reasons other than its beneficial surface-active properties in the alveoli.


The mechanics of the knee and prosthesis design. The mechanisms controlling and limiting movement and serving to transmit load between the femur and the tibia are discussed. Having accounted for the transmission of all components of force and couple across the joint and noted the load-bearing role of the menisci, some principles which might guide the design of knee prostheses are deduced. It is shown that current designs transgress some of these principles. An experimental prosthesis is then described, which incorporates analogues of the natural menisci. The possible practical application of this novel principle has been studied in cadaveric human joints and in living patients.


Effect of phototherapy on serum bilirubin levels and red blood cell survival in congenitally jaundiced Gunn rats. Although phototherapy with blue fluorescent light effectively lowered the serum bilirubin concentration in congenitally jaundiced Gunn rats, no effect on red blood cell surivival as determined by chromium-51 labeling of homologous red blood cells and carboxyhemoglobin concentration was observed. Furthermore, attempts to demonstrate metabolic stress to the red blood cells failed to show increased glucose consumption. No oxidant damage to red cells as reflected by methemoglobin production and Heinz body formation was observed. Thus the anticipated hemolysis secondary to oxidant damage to red blood cells from phototherapy was not found.


[Ammonium-selective disc-electrode with the carrier-antibiotic nonactin. A method for the continuous enzymatic, electrochemical determination of urea, I (author's transl)]. An ammonium-selective disc-electrode is described; the membrane consists of a polyvinylchloride-matrix with an active phase of nonactin in tris (2-ethylhexyl)phosphate and diphenyl ether as the ion-selective plastic. One side of the membrane is in contact with the solution to be measured and the other with the front surface of a platinum wire, which is enclosed in acrylic glass. This arrangement results in a very low drift potential.


[A NH(+4)-selective-enzymatic flow-through system. A method for the continuous enzymatic, electrochemical determination of urea, II (author's transl)]. A flow-through system for the measurement of urea concentrations is described, using soluble urease and consecutive determination of liberated ammonium ions by a selective disc-electrode. The active component of the electrode membrane was the carrier-antibiotic nonactin which was incorporated in a polyvinylchloride matrix.


Retrograde movement of digesta in the duodenum of the chick: extent, frequency, and nutritional implications. Movement of digesta from the duodenum to the gizzard of chicks was assessed by injection of 99mTc-diethyl-triamino-pentaacetic acid via an indwelling cannula in the hepatic bile duct. The change in location of isotope with time was followed with a Gamma Camera. About 40% of the injected isotope refluxed to the gizzard within 2 minutes of injection. Clearance of the isotope from the gizzard had a T1/2 of some 20 minutes. Some possible implications of retrograde movement of digesta were examined. Cholesterol, bile salts and pancreatic enzymes were found in the gizzard at 10% to 20% of duodenal concentrations. The proteolysis and lipolysis in the gizzard and duodenum were determined in chicks fed a duet containing 91Y as a non-absorbed reference substance. Thirty percent of the feed triglycerides were found hydrolysed in the gizzard as compared to 50% to 60% in the duodenum. Proteins were 30% to 50% trichloroacetic acid soluble in the gizzard reaching almost 70% in the duodenum. A small net secretion of both fatty acids and protein was observed in the gizzard, probably due to reflux of endogenous secretions from the duodenum. The nutritional significance of these results is discussed.


Gastric shake test and pharyngeal lecithin/sphingomyelin ratios in new born infants. Gastric shake test and pharyngeal lecithin/sphingomyelin ratios were measured in newborn infants with respiratory difficulties, and in low birth weight infants in the immediate neonatal period. Both tests were useful in distinguishing infants with idioathic respiratory distress syndrome from those with respiratory difficulty due to other causes. However, in six infants with idiopathic respiratory distress syndrome, the pharyngeal lecithin/sphingomyelin ratio indicated mature lungs, and in three of these, the gastric shake test showed the presence of surfactant. Five of these six infants had been delivered by emergency lower segment caesarean section because of maternal complications, which might account for the discrepancy between the laboratory results and the clinical condition of the patient.


[Energy and nutrient supply during childhood. II. Protein supply (author's transl)]. The protein supply of 2--14 year old children in their families is reported. The food intake was measured with the precise weighing method. The protein intake amounts to 38 +/- 7 g/day (2.3 g/kg/day) for the 2--3 year old boys, 69 +/- 10 g/day (1.8 g/kg/day) for the 12--14 year old boys. The protein intake of girls, absolute and per kg bodyweight, averages 10% less. Protein constitutes 11--12% of the energy supply, 2/3 originating from animal foodstuffs, 1/3 from vegetable foodstuffs. Milk and dairy products have a proportion of 34--41%, meat and meat products of 20%. The protein distribution among the different meals is shown. After 25 days almost all the children reach their mean value for their individual protein intake with a standard error of +/- 5%. In each age group 54--59% of the children differ in their mean protein intake from each other. The protein supply recommended for a certain age group should not be obligatory for the individual child. The protein supply of the various age groups and of the individual child is discussed.


Effects of asphyxia on cardiac output and organ blood flow in the newborn piglet. Experiments were performed on newborn piglets 6--96 hr of age. When the respiratory dead space was increased arterial pO2 decreased and pCO2 increased. During this time cardiac output was unchanged (Fig. 1), while heart rate, respiratory rate, and blood pressure increased (Figs. 2 and 3). After 90 min of asphyxia blood flow to the stomach and small and large intestines decreased. Changes in blood flow were associated with dilatation of segments of the small and large intestine with scattered areas of hemorrhage. Pathologic examination revealed scattered areas of mucosal necrosis (Fig. 6).


Effects of tracheal instillation of natural surfactant in premature lambs. I. Clinical and autopsy findings. Ten pairs of twin lambs 118--122 days of gestation were given either natural surfactant or diluent endotracheally before the first breath. By using the premature twin lamb model, we have been able to show that instillation of natural surfactant produced 100% survival for the duration of the study period (2 hr); stable blood gases on room air; lungs that became increasingly compliant while on the respirator; generally well aerated lungs at autopsy; good lung pressure-volume relationships; normal lung surface tension measurements; and histologic evidence of good alveolar expansion with large amounts of free intraluminal phospholipid, no epithelial damage, and no hyaline membranes. It is concluded that tracheal instillation of natural surfactant into the premature lamb protects the lungs from developing many features characteristic of the respiratory distress syndrome.


[Vertebrate hormones influence on the reproduction of Biomphalaria glabrata and on Schistosoma mansoni infection (author's transl)]. The influence of fifteen vertebrate hormones on the B. glabrata reproduction and on S. mansoni infection have been studied. Hecogenine and pregnadienolone significantly increased the snail's number of eggs; testosterone, diethylstilbestrol and estradiol valerianate decreased their number of eggs and the mesterolone and progesterone produced a slight decrease in the number of eggs. Crude hecogenine, pregnenolone, prednisone, estradiol, cholic acid, diosgenin, estrone and pregnadione have not shown any significant alteration on the snail reproduction. None of these hormones presented any influence upon the S. mansoni cycle in B. glabrata. Molluscicidal, oocidal and cercarcidal activities have been observed with diethylstilbestrol in concentrations below 10 ppm.


Jaundice phototherapy: micro flow-cell photometry reveals rapid biliary response of Gunn rats to light. Hepatic pigment clearance in rats can be followed continuously with photometric detectors designed for high-pressure liquid chromatography. This method showed that light has a fast effect on bilirubin metabolism in homozygous Gunn rats, even at low doses and intensities. This is consistent with geometric isomerization of bilirubin IXalpha as a primary step in phototherapy.


Struma lymphomatosa and carcinoma of the thyroid. In patients with struma lymphomatosa treated by feeding thyroid, the indicence of lymphomas is low, and the prognosis of the patients is relatively good. The risk of thyroidectomy on all patients with uncomplicated struma lymphomatosa would greatly outweigh the benefits of preventing carcinoma. The association between struma lymphomatosa and carcinoma of thyroid does not appear to be causal. When patients are fed thyroid, there is little or no tendency for struma lymphomatosa to progress to clinically detectable carcinoma of the thyroid. The association of struma and papillary carcinoma comes from the observation of lymphocytic infiltration of the tissues surrounding papillary carcinomas of the thyroid, the result either of a lymphocytic reaction to the carcinoma or to radiation rather than that the carcinoma arose as a result of lymphocytic thyroiditis. Observation of 373 patients with struma lymphomatosa diagnosed by needle biopsy and treated by feeding thyroid failed to reveal a single instance of carconoma of the thyroid in 3,000 patient years of observation. In patients with uncomplicated struma lymphomatosa, the possibility of malignant tumor does not provide an indication either for open biopsy or for thyroidectomy.


[Study of the functional reserves of the parathyroid glands in diffuse toxic goiter and hypothyroidism]. The author studied functional reserves of the parathyroid glands in patients with diffuse toxic goiter with thyrotoxicosis and in euthyroidism, and also at various periods after subtotal resection of the thyroid gland, in patients with autoimmune thyroiditis, and with postoperative hypothyroidism. Functional reserves of the parathyroid glands proved to decrease in 15 to 54 patients with toxic goiter and in 6 of 16 patients with hypothyroidism. Surgical intervention on the thyroid gland usually led to functional parathyroid insufficiency which compensated later. Calciemia (below 8.5 mg%) 4 hours after the beginning of the test pointed to the parathyroid gland insufficiency the intensity of which could be more accurately determined by checking calcium level 12 and 24 hours after the beginning of the test.


[Aneurysms of the coronary arteries].

[Aneurysms of the coronary arteries]. Report on a mycotic and arteriosclerotic aneurysm of the right coronary artery in a 13-year-old girl and a 43-year-old man. With the help of the casuistics and the existing literature the author adopts a definite attitude to genesis, frequency, localisation and complication of the aneurysma.


Effect of antenatal glucocorticoid administered in a single dose on the incidence of respiratory distress syndrome in premature infants. Authors administered glucocorticoid in the cases of 116 pregnant women admitted with premature delivery beginning between 28--36 weeks of gestation to prevent respiratory distress syndrome (RDS). Prednisolone-sodium succinate (Di-Adreson F. Organon) was given intramuscularly in a single dose of 100 mg. 314 infants born before introduction of the corticosteroid prevention on the 28--36 weeks of gestation whose mothers had not been given corticosteroid served as a control group. The frequency of RDS on the treated group was 8,62% while 101 of 314 infants on the control group showed RDS (32,16%). Number of infants of hyaline membrane disease was 3 and 40, respectively. A close correlation could be observed between the interval lasting from therapy to delivery and RDS incidence. In infants born within 24 hours after administration of Di-Adreson F. aquosum injection RDS developed in 58,33% while in those born within 24--48 hours RDS was diagnosed only on 3 cases (8,57%). No RDS was found in babies born after 2 days following the therapy. There were no significant differences between treated and control groups in Apgar scores and the mean weights of infants. These findings seem to suggest that 100 mg of prednisolonesodium succinate administered in a single dose significantly reduces the incidence of RDS in premature infants.


In vivo resistance and in vitro cellular reactivity against lymphosarcoma cells in immunized mice. In an earlier report we have shown that an allogeneic but not a syngeneic immunization of mice with lymphoma cells evoked a humoral complement-dependent cytotoxic response against lymphoma cells syngeneic with the serum. Here we report the results of an investigation, using the same experimental model, on the cellular antitumor response in vitro and the in vivo tumor resistance. Both the allogeneic and the syngeneic antitumor immunizations induced a cellular immune response that was detectable in vitro and that not inhibited by the correspondent antiserum that was obtained with the same type of immunization. The humoral and cellular immune responses evoked in our system seem, therefore, directed against different antigenic determinants. In the in vivo experiments the maximal antitumor protection was obtained in mice immunized syngeneically, whereas the allogeneic immunization gave a protection that was similar to that obtained in mice immunized with normal allogeneic thymus cells. However, mitomycin-C-blocked thymus cells were unable to induce any protection against the tumor challenge, whereas blocked allogeneic tumor cells conferred the same degree of protection as that obtained with untreated cells. The in vivo transfer in untreated mice of sera obtained with syngeneic or allogeneic antitumor immunization did not give any protection against the tumor challenge.


Plasma levels of growth hormone in female rats of different ages. Radioimmunoassayable growth hormone (GH) was determined in fed and fasted female rats of different ages. In 6-40 day-old rats blood was collected at hourly intervals in groups of rats at different time intervals during the day. Within each age group the variation in plasma GH was considerable. In 6-14 day-old rats plasma GH was generally elevated. By day 18 levels declined, lowest on day 22 and by day 26 again increasing. In 14 day-old rats the median plasma level of GH was 22 ng/ml, in 22 day-old rats less than 5 ng/ml and in 40 day-old rats 43 ng/ml. In 14 day-old rats levels ranged from less than 5 ng/ml--148 ng/ml, in 22 day-old rats from less than 5 ng/ml--34 ng/ml and in 40 day-old rats from less than 5 ng/ml--greater than 200 ng/ml. A 20 h fasting period was associated with a significant decrease in plasma GH. In 45 day-old rats, the variations in plasma GH of individual animals were studied by obtaining sequential blood samples from unrestrained, undisturbed animals with implanted intra-aortic cannulae. In these rats GH secretion was characterized by an episodic release, occurring every 2--4 h. After a 20 h fasting period major peaks were depressed and occurred less frequently. It is concluded that there is an age-related as well as a circadian rhythm in growth hormone secretion in the rat and that sequential sampling of blood is essential for the evaluation of the secretory pattern.


The relationship between levels of thyroid stimulating hormone and of thyroxine and triiodothyronine in blood of hypothyroid patients. Serum TSH values and the free concentration of T4 and T3 in serum expressed as the free T4- and T3-indices showed a curvilinear relationship in 24 patients with manifest hypothyroidism mainly due to extremely elevated serum TSH levels associated with very low thyroid hormone levels. The same degree of negative correlation was found between the log serum TSH concentration and serum free T4-index (r = -0.51, P less than 0.05) and between log serum TSH concentration and serum free T3-index (r = -0.47, P less than 0.05). The correlation coefficients dropped to non-significant levels when the interdependence between the free T3- and T4-indices was taken into account and eliminated by partial correlation analysis. The degree of negative correlation between serum TSH and the thyroid hormones was also of the same order of magnitude in 5 hypothyroid patients studied prosepctively during treatment with L-thyroxine (TSH vs. T4: mean r = -0.71; TSH vs T3: mean r = -0.79).


Short-term effect of acetylsalicylic acid analogue on pituitary-thyroid axis and plasma cortisol level in healthy human volunteers. The effect of acetylsalicylic acid analogue (aloxiprinum; Superpyrin Spofa) administered perorally in a daily dose of 1 g per 10 kg body weight on serum levels of free thyroxine (FT4), total thyroxine (T4), triiodothyronine (T3), cortisol (F) and thyrotrophin (TSH) was studied in healthy human volunteers. In a first experiment the drug was administered for 3 days to 7 subjects, the total daily dose being divided into 4-5 aliquots, while the same total dose was administered within 4 h to another 8 subjects in a second experiment. In both experiments a highly significant increase of FT4 was found during the period of treatment, while the levels of other hormones i.e. (T3, T4, F and TSH) were decreased, in most cases significantly. After the withdrawal of the drug there was not only a return of all levels to the initial value, but in most cases an "overshoot" above this value was detected.


A case of Hashimoto's thyroiditis with thyroid immunological abnormality manifested after habitual ingestion of seaweed. An interesting case of iodide induced goitre with immunological abnormalities is described. The patient who was sensitive to synthetic penicillin had previously been treated for exudative pleuritis, congestive heart failure and acute renal failure. Following recovery, he began to ingest large amounts of seaweed after which he developed goitrous hypothyroidism. It was of interest that the serum level of gamma-globulin increased, and subsequently the antithyroid microsomal antibody became strongly positive, suggesting that thyroidal autoimmune processes had been precipitated. Biopsy of the thyroid gland revealed chronic thyroiditis, with evidence suggesting extreme stimulation by TSH. Hight thyroidal uptake of 131I, positive perchlorate discharge test and biochemical analysis of the thyroidal soluble protein showed severe impairment of hormone synthesis following continuous accumulation of excess iodide. While there is evidence suggesting that increased iodide may be an important factor in the initiation of Hashimoto's thyroiditis, this may result from the marked increased sensitivity of Hashimoto's gland to the effects of iodine. Thus an occult lesion could be unmasked in this manner. The mechanism by which iodide mediates this effect is not clear.


Serum somatomedin activity measured as sulphation factor in peripheral, hepatic and renal veins of patients with alcoholic cirrhosis. Serum somatomedin (SM) activity, measured as sulphation factor on chick embryo cartilage, and growth hormone (GH) levels were measured in peripheral, hepatic and renal veins of 23 patients with a alcoholic cirrhosis. SM activity (mean +/- SEM) was 0.65 +/- 0.05 U/ml in peripheral vein, 0.59 +/- 0.04 U/ml in hepatic vein, and 0.74 +/- 0.07 U/ml in renal vein. Mean GH levels were respectively 2.8, 2.5 and 3.1 ng/ml. Compared to peripheral vein, SM increase in renal vein was 19% (P less than 0.05). Serum SM activity was significantly lower in 13 patients with alcoholic hepatitis associated with cirrhosis than in other 10 patients (P less than 0.02 in hepatic blood and P less than 0.05 in peripheral blood). The decrease of SM activity seems related to cytolysis and hepato-cellular insufficiency. At last, in patients with alcoholic hepatitis, SM activity was lower in the hepatic vein than in the peripheral vein (P less than 0.05). The cause of this difference remains under discussion, no SM inhibitors being found in the serum samples used in this study.


Effect of graded oral doses of oestradiol on circulating hormonal levels. A single oral dose of micronized oestradiol (1, 2 or 4 mg) was administered to 10 normally menstruating women on the second day of 3 consecutive menstrual cycles. The order in which the 3 doses were given was chosen randomly for each subject. Samples of peripheral blood were withdrawn on 3 occasions (10, 5 and 1 min) before and on 9 occasions (0.37, 0.75, 1.5, 30, 6.0, 12.0, 24.0, 48.0 and 72.0 h) after the ingestion of oestradiol. Oestradiol, oesterone, oestradiol sulphate, oestrone sulphate, testosterone and LH were measured by means of radioimmunoassays in blood plasma on all occasions. The levels of all oestrogens increased significantly following the ingestion of oestradiol, although to a greatly different extent. The largest and most prolonged increase was seen in the case of oestrone sulphate, the levels of which--depending on the dose ingested--were 20-50 times higher than the pre-treatment levels 3 after the ingestion of the oestradiol capsule. The increase of the levels of oestrone sulphate was still significant (P less than 0.001) after 24 h, and following the ingestion of 2 and 4 mg of oestradiol even after 72 h (P less than 0.05). The levels of oestrone and oestradiol sulphate exhibited smaller increases 3 h after ingestion, i.e. 4-10 and 2.5-5 times, respectively, and the plasma levels of oestradiol showed a minor increase only (1.4-1.8 times). The concentration of oestradiol metabolites studied increased proportionally with the dose of oestradiol administered. On the other hand, a clear-cut dose--effect relationship could not be observed between the amount of oestradiol administered and the plasma levels of LH and testosterone. The data indicate that the bulk of perorally administered oestradiol is transformed to oestrone sulphate accompanied by smaller quantities of oestrone and oestradiol sulphate and that the ratios of circulating oestrogens seen after the ingestion of oestradiol deviate considerably from those observed in the normal menstrual cycle.


In vitro effect of 16alpha-hydroxyprogesterone on the enzyme activities related to androgen production in human testes. Progesterone was converted in vitro to 16alpha- and 17alpha-hydroxyprogesterones in the presence of NADPH by the testicular microsomal fraction (precipitate at 10 000 x g-105 000 x g) obtained from patients with prostatic carcinoma. 16alpha-Hydroxyprogesterone was not metabolized by either the microsomal or the cytosol fractions, and accumulated in the incubation medium. 16alpha-Hydroxyprogesterone competitively inhibited the activity of the C-17-C-20 lyase in the testicular microsomal fraction with an estimated inhibitor constant of 72 micron. Moreover, the 16alpha-hydroxyprogesterone non-competitively inhibited the activity of the 20alpha-hydroxysteroid dehydrogenase in the testicular cytosol fraction and had an estimated inhibitor constant of 52.9 micron. Other testicular enzymes related to steroid metabolism, such as delta5-3beta-hydroxysteroid dehydrogenase coupled with the delta4-delta5 isomerase, 16alpha-hydroxylase, 17alpha-hydroxylase, and 17beta-hydroxysteroid dehydrogenase were not influenced in vitro by 16alpha-hydroxyprogesterone at the concentration of 0.1 mM. From these findings, it is concluded that 16alpha-hydroxyprogesterone inhibit specifically the cleavage of the side-chain of 17alpha-hydroxypregnenes in the course of androgen formation from pregnenolone in vitro.


The determination of 5alpha-androstane-3alpha, 17beta-diol in human plasma by radioimmunoassay. Antibodies have been raised in rabbits against 3alpha, 17beta-dihydroxy-5alpha-androstane-6-0-carboxymethyloxime coupled with Cohn's fraction IV-4. The antiserum exhibited significant cross reactions with 5beta-androstane-3alph1, 17beta-diol, 5alpha-dihydrotestosterone, and testosterone. No cross reactions were observed with 5alpha-androstane-3beta,17beta-diol and 5-androstene-3beta,17beta-diol. The methodological criteria for the measurement of 5alpha-androstane-3alpha, 17beta-diol in human plasma were as follows: The specificity was ensured by separating the cross reacting steroids by thin layer chromatography. The intraassay and interassay coefficients of variation were found to be 6.2 and 10.2%, respectively. The sensitivity was 30 pg. The recovery of different amounts of 5alpha-androstane-3alpha,17beta-diol added to human plasma (80, 120, and 200 pg) yielded 91.3, 92.5, and 93.5%, respectively. The following concentrations of 5alpha-androstane-3alpha,17beta-diol have been determined in human plasma (mean +/- SD, ng/dl): Normal males: 18.98 +/- 5.9; normal females: 2.65 +/- 0.27; females with idiopathic hirsutism: 11.9 +/- 6.4; prepubertal children: not detectable.


Plasma levels of testosterone in bulls. Response to repeated HCG injections. Administration of 6000 IU HCG to 4 bulls was followed by an elevation of plasma testosterone lasting for 9-13 days. When HCG administration was repeated, the testosterone response was shortened to 4-6 days in 3 bulls due to the formation of antibodies against HCG. The appearance of HCG antibodies coincided with a sharp decrease in the plasma testosterone level, indicating that Leydig cells have to be under continuous HCG stimulation to maintain increased testosterone production. No antibody against bovine LH was detected in the plasma samples containing antibodies against HCG. In one bull the response following the second HCG injection was similar to the plasma testosterone pattern following the first. No antibodies against HCG were found in this bull. Five bulls received 750 IU HCG twice. Following the period with elevated plasma testosterone levels, subnormal levels were observed after both injections. One injection led to decreased levels without development of antibodies against HCG while the second HCG injection led to subnormal testosterone levels concomitant with measurable antibodies against HCG.


Histological and histochemical studies on the distribution of a few enzymes in the neoplastic liver of Uroloncha malabarica (Linnaeus). The present work describes histological and histochemical observations made on the neoplastic liver of Indian silver bills, Uroloncha malabarica. The histology of neoplastic tissue as well as liver has been discussed. Further, a few enzymes like alkaline phosphatase, acid phosphatase, 5-nucleotides and non-specific esterase have been localized in the diseased liver. The occurrence of lymphocytoma caused a marked change in the localization of the enzymes. Sometimes total inhibition of the enzyme was encountered. Damaged sinusoid cells and bile canaliculi of the neoplasm as well as liver lobules show no reaction for alkaline phosphatase. However, its counterpart, acid phosphatase, exhibits intense activity in both neoplastic tissue and liver cells. Aggregates of neoplastic tissue give moderate 5-nucleotidase reaction while it gives poor activity in hepatic tissue of the diseased liver. Parenchymatous cells are able to give some activity for the non-specific esterase while it is very dull in the neoplastic tissue.


Cataract and pseudoexfoliation. A clinicopathological study. 100 lenses from 98 consecutive patients with senile cataract were investigated histologically for pseudoexfoliation. The patients came from an area known for its high incidence of pseudoexfoliation. The examiner was not aware of the clinical examination at the time of histopathological study. Pseudoexfoliation was observed in 33 lenses. There seemed to be an increasing incidence of pseudoexfoliation with increasing age of the patients. Only 16 of the cases of pseudoexfoliation had been recorded preoperatively, but routine pupillary dilatation had not been carried out. The use of alpha-chymotrypsin at cataract extraction did not preclude histological diagnosis of pseudoexfoliation.


The ultrastructure of the deep layer of the lens capsule in fibrillopathia epitheliocapsularis (FEC), so-called senile exfoliation or pseudoexfoliation. A scanning electron microscopic study. The epithelial surface of the lens capsule and the capsular surface of the epithelium have been studied in six cataractous lenses from persons with fibrillopathia epitheliocapsularis (FEC) or so-called senile exfoliation or pseudoexfoliation by scanning electron microscopy. Five of the lenses came from eyes with capsular glaucoma. Three senile cataractous lenses have been used as controls and two of the control lenses came from eyes with simple glaucoma. The investigation revealed round discoid plaques closely adherent to the capsule. The plaque surfaces had numerous smooth tentacle-like projections and matching pits in the underlying epithelium. These plaques were only found in FEC lenses and corresponded both in size and location to the structure known as the deep or amorphous layer of the lens capsule. The findings indicate that the epithelial cells are the source of origin.


Treatment of basal cell carcinoma of the eyelid. 109 cases treated for basal cell carcinoma of the lid are presented. Of the 79 patients who received radiation treatment alone, 65 (82%) were recurrence-free at two years and of the 45 followed for five years, 31 (69%) were recurrence-free. Of the 30 cases radically excised, 27 (90%) were cured at two years, and all of the 15 who were followed for five years. Small tumours were cured as effectively with irradiation (98%) as with excision (92%). Larger tumours with a diameter of more than one cm seemed to have a less favourable result with radiotherapy, 20/33 for two years and 9/21 for five years, than with excision, 6/7 and 5/5, respectively.


Cannula-probing combined with nasal procedure for dacryocystitis neonatorum. Between 1973-1976 a total of 2063 cases of dacryocystitis neonatorum have been treated by cannula-probing in our department. In 37 cases the cannula-probing had to be combined with a nasal procedure for opening the closed nasolacrimal membrane: a periosteal elevator was passed into the inferior meatus of the nasal cavity and its tip was rubbed against the tip of the cannula-probe through the imperforate mucosa of the ostium. The patency of the duct was tested by simultaneous syringing. In 34 cases the lacrimal pathway became permanently patient after one nasal procedure and in 2 cases after two operations. This kind of nasal proceudre is indicated: 1) in those cases where the cannula-probing meets with resistance at the ostium; 2) in those cases where control syringing--made while slowly withdrawal the cannulaprobe--is repeatedly unsuccessful at the beginning of the withdrawal.


Ocular hypertension. A 15-year follow-up. A group of 55 subjects with ocular hypertension were followed-up after 15 years. They were detected at a glaucoma screening on the island of Falster between 2031 volunteer blood donors, and they had an applanation pressure of greater than or equal to 20 mmHg in one or both eyes. All the subjects were traced. Nine have died, all from general causes, and one of the deceased subjects was treated for simple glaucoma. Of the remaining 46 living subjects, 3 developed glaucomatous visual field defects despite treatment. In another 4 subjects anti-glaucoma treatment was felt to be indicated. Of the non-treated 39 living subjects, 20 had a decreased applanation pressure, well below 20 mmHg, and 19 had an unaltered applanation pressure. We found that neither the common blood groups nor a water provocative test performed in 1962 were of any help in predicting glaucomatous visual field defects. Central corneal thickness measurements performed in 1977 could not allocate the subjects to the groups simple glaucoma, applanation pressure greater than 20 mmHg or less than or equal to 20 mmHg.


Corticosteroid response in dominant congenital glaucoma. The parents of six children with goniodysgenesis and hereditary infantile congenital glaucoma were tested with corticosteroid eye-drops. Their response on provocation demonstrated a clear trend: In five families one parent of each couple responded with a tensional rise of 9 mmHg or more, whereas the other parent responded with a rise of 9 mmHg or less. Of the six parents with the greater response, five had glaucoma in their ancestry and displayed a distinct goniodysgenesis. The findings support the previously presented view that hereditary infantile congenital glaucoma is caused by a dominant goniodysgenesis with varying expressively. The high corticosteroid response in the families of our study appears to be correlated to this goniodysgenesis. The inherited corticosteroid response is obviously not a specific genetic trait confined to families with simple glaucoma.


HLA histocompatibility antigens in open-angle glaucoma. HLA-typing of 125 patients with open-angle glaucoma (glaucoma simplex) showed no statistically significant deviations from a control series of 1197 blood donors. Some earlier, but mutually inconsistent, reports contradict this result. In evaluating investigations of this kind care must be taken to avoid statistical pitfalls.


Aspects on the design of an automatic perimeter. Since the first description (1976) of the computerized perimeter Competer, some small modifications and new routines have been introduced. An account of a new mode for presentation of the test results and a procedure for their storage is therefore provided. Some elementary technical facts are included to make the relations computer--computer language--perimeter comprehensible. The construction of efficient test logics is discussed and the meaning of "threshold level" explored.


Corneal sensitivity and vibratory perception in diabetes mellitus. 36 patients suffering from diabetes mellitus and 45 controls were subjected to blind studies for corneal sensitivity using Cochet & Bonnet's aesthesiometer and of vibratory perception of the left index finger and great toe by biothesiometer. 83% of the diabetics had a corneal sensitivity below 60 mm against 38% of the controls. Likewise a significantly reduced vibratory perception was noticed among the diabetics. Further, the reductions of corneal senstivity and vibratory perception were correlated in the diabetics. In both groups falling corneal sensitivity and vibratory perception were found with increasing age over and above 50 years. There is evidence to suggest that a reduced corneal sensitivity in relation to diabetes mellitus forms part of a polyneuropathy.


Mechanical properties of succinylcholine activated muscle fibers in the inferior oblique muscle of the cat. To determine the mechanical properties of the multi-innervated fibres in inferior oblique muscle of the cat, these fibers were selectively activated by means of an intravenous injection of succinylcholine chloride (Sch). For small sinusoidal length changes (+/- 1 mm) of low frequency, tension in the Sch activated muscle exhibited a component that was sensitive to the direction of stretch but was independent of the velocity. At higher frequencies of length change (16 Hz) a form of negative friction was observed. Negative friction had not been previously noted in mammalian muscles, although a similar friction was observed both in the muscles of insects and amphibians. These properties were expressed in the form of a simple mechanical model.


Indirect evaluation of corneal endothelial cell density. In 16 whole flat corneal mounts stained by alizarine red and trypane blue it was investigated whether estimates of central numerical endothelial cell density could be based on peripheral cell density, on age or on morphological cell characteristics. With certain precautions estimates of central cell density could be based on peripheral cell density, on age and on the occurrence of large central or peripheral cells. Estimates could not be based on the occurence of other cellular morphological characteristics.


EOG in a large family with hereditary macular degeneration. (Best's vitelliform macular dystrophy) identification of gene carriers. A total of 128 descendants from one large family with a history of hereditary macular degeneration (HMD) were examined with EOG. Of these, 42 were affected patients, 48 were healthy offsprings to affected parents, and 38 were normal controls. Affected subjects had a light peak/dark trough ratio smaller than 1.40. In the group of offspring of affected parents the Lp/DT ratios showed a bimodal distribution dividing the group into two parts, one with values less than 1.40 and another with values larger than 1.70. Thus carriers of the HMD gene can apparently be identified by use of EOG. The affected subjects and the carriers had a lower base value of the standing potential than the controls.


beta-Glucuronidase activity in liver and spleen homogenates of mice experimentally infected with Schistosoma mansoni. A study on the beta-glucuronidase activity in liver and spleen homogenates of mice infected with an Egyptian strain of Schistosoma mansoni and of non infected control animals was carried out for a follow up period of four months. A decreased enzyme activity was observed in the spleen up to the 40th day after infection. From the 60th day on, the enzyme level in both liver and spleen was found above that in the control. The possible causes for such changes in enzyme activity are discussed.


Biochemical studies on beta-glucuronidase in the urinary bladder of normal and Schistosoma mansoni infected mice treated with hycanthone. beta-Glucuronidase activity is elevated in the urine of patients with bilharziasis hematobium. In the present study the enzyme level was estimated in whole urinary bladder tissue homogenates of mice experimentally infected with Schistosoma mansoni. In the infected mice the enzyme activity is significantly higher than in the controls. The effect of the schistosomicidal drug hycanthone was also evaluated. Treatment with the drug did not affect the level of the enzyme activity in the infected mice; it induced an increase in the enzyme activity of the controls.


[Vitamin B1 and autonomic drugs: a reprint]. The problem of the relationship between the thiamine and autonomic system drugs was studied about 30 years ago. To the vitamin was attributed an excitatory effect upon the peripheric section of parasympathetic nervous system and a synergic action with acetylcholine. Both an acetylcholine-like substance and thiamine are liberated at the nerve terminals after a stimulation. A similar synergic action of thiamine with adrenaline was also demonstrated. The study of the relationship between these drugs and the vitamin B1 is also now interesting. We want to stimulate a new series of experiments on this subject with the reprint of this review.


Use and abuse of oxygen in the newborn.

Use and abuse of oxygen in the newborn. Hypoxia must be prevented in the newborn. It causes atelectasis, acidosis and pulmonary vasoconstriction, which leads to further hypoxia and, ultimately, brain damage. On the other hand, retrolental fibroplasia and bronchopulmonary dysplasia may result from too-vigorous use of oxygen therapy. Frequent blood gas measurements are required. Administered oxygen must be humidified and heated, and the oxygen concentration must be monitored with each delivery system. It is not enough to know the oxygen flow rate; an oxygen analyzer is essential.


Infective aneurysm of the left ventricle: angiographic and echocardiographic features. A 17-year-old man with staphylococcal endocarditis of the mitral valve developed an infective aneurysm of the posterior left ventricular wall. Echocardiography revealed an echo-free space posterior to the posterior left ventricular wall. This echo-free space undoubtedly represented the aneurysmal sac, because it could be temporarily obliterated by injecting saline into it and was no longer detectable following surgical closure of the sac. Thus echocardiography may be helpful in the detection of an infective aneurysm of the left ventricle.


Intestinal lactase deficiency and milk drinking capacity in the adult. The milk drinking capacity of 200 adults was determined experimentally and the results correlated with their milk drinking habits and intestinal lactase activity as judged by a lactose tolerance test. Of the group 65.5% were found to have deficient lactase activity and 5.3% experienced severe gastrointestinal symptoms with 250 ml of milk; 28.2% with 500 ml; 26.0% with 750 ml; 15.3% with 1000 ml and 25.2% tolerated the latter amount without difficulty. Of the normal individuals, 92.7% tolerated 1000 ml without symptoms. Intestinal lactase activity seemed to be important in determining the extremes of milk ingestion: four or more glasses per day or no milk ingestion, but had little effect in the intermediate pattern of milk consumption. It is concluded that intestinal lactase deficiency has clinical relevance and should be considered when nutritional supplementation with milk is contemplated.


Manifestation and occurrence of selective adult-type lactose malabsorption in Finnish teenagers. A follow-up study. In 1969--1970, a simple random sample of 129 Finnish school-aged children was examined to study selective adult-type lactose malabsorption (SLM) in this age category. SLM was found in 8 children. All subjects were reexamined 5 years later. SLM was reconfirmed in these 8 persons and found in 3 additional subjects who had normal lactose absorption in the first examination. The prevalence of SLM was 9.3%, being 8.5% in the age category 12--15 years and 9.9% in that 16--20 years. Low rise of blood glucose in the lactose tolerance test of the first examination, very low milk consumption, milk intolerance, and history of gastrointestinal symptoms were found to be of low predictive value as indicators of SLM. It was also concluded that information about dietetic sources of lactose is important to persons with SLM, but categorical exclusion of lactose from the diet is not necessary, at least in the Finnish population.


Cancer of the cervix--a sexually transmitted disease. Cytologic screening in a prostitute population. The epidemiology of cervical cancer has been the subject of many articles centered around the question, "Is cancer of the cervix a sexually transmitted disease? A group of 750 Taiwan prostitutes had cervical cytology performed at the time of required gonorrhea screening. The prostitutes represented a unique group in which the variables of frequent intercourse with multiple partners and multiple infection can be separated from early coital experience. Cervical cytology was obtained and processed by the Pathology Department at Navy Medical Research Unit No. 2. A bilingual questionnaire was completed with the aid of a medical interpreter. The results included only eight of the 750 specimens in the "dysplasia plus" category for a rate of 10.7 per 1,000. The low yield of abnormal cytology suggests the factors of multiple partners, frequent intercourse, and high gonorrhea infection rate are not significant epidemiologically if they occur after the phase of active metaplasia, occurring during the first pregnancy or early adolescence.


The pharmacology of cycloplegics.

The pharmacology of cycloplegics. A brief review of the pharmacological action of cycloplegic drugs is followed by a specification of the doses and actions of five commonly used cycloplegics. Some criterion for selecting a cycloplegic are presented.


Hidden food ingredients, chemical food additives and incomplete food labels. Many foods and medications containing hidden ingredients are described; labelling is usually incomplete and often misleading. Patients sensitive to foods and chemicals are advised to read and interpret labels. Consumers, manufacturers, government agencies and allergists should cooperate to ensure an adequate national food supply without unduly jeopardizing an increasingly sensitive population.


Pituitary oncocytoma. Indispensable role of electron microscopy in its identification. Two surgically resected pituitary adenomas that appeared to be chromophobe or poorly granulated acidophil adenomas by light microscopy were correctly identified as oncocytomas by electron microscopy. The tumor cells ahd markedly hyperplastic, moderately pleomorphic mitochondria in the cytoplasm of virtually all cells. Scattered secretory granules were displaced to the periphery of the cytoplasm but the secretion type of pituitary cell remained obscure. Histochemical and immunocytochemical methods imperfectly characterized these unusual tumors. Even though these neoplasms have been considered rare, they are now being recognized more often after ultrastructural study. Eventually their pathobiologic features may be better understood. One of our patients was 24 years old and is the youngest patient, to our knowledge, in whom a pituitary oncocytoma has been documented.


Amyloidosis. An unusual complication of Gaucher's disease. Gaucher's disease has been associated with plasma cell dyscrasias. A patient had Gaucher's disease, nephrotic syndrome, and systemic amyloidosis. Plasmacytosis in the bone marrow, the presence of light chains in the urine and renal glomeruli, and the finding of low circulating immunoglobulin levels suggest that the amyloid in this patient is related to a plasma cell dyscrasia.


Thymolipoma in association with myasthenia gravis. A patient with a 100-g thymolipoma and myasthenia gravis experienced marked improvement in neuromuscular symptoms following removal of the tumor. Although 60 examples of thymolipoma have been reported, we believe that this is the first example of this tumor associated with myasthenia gravis. The clinical, radiologic, and histopathologic manifestations of previously reported cases of thymolipoma are discussed in relation to our patient's case.


Diabetic myelopathy.

Diabetic myelopathy. Diabetic myelopathy occurred in 41% of 75 consecutive, unselected diabetic patients in an autopsy study; clinical peripheral neuropathy occurred in 13%, and histologic radiculopathy in 21%. Infection represented 2.7% of the cord lesions. Posterior column demyelination, seen in 27%, apparently has the same metabolic-toxic origin as diabetic neuropathy and radiculopathy; it is an independent lesion, not a secondary manifestation of peripheral demyelination. It occurs slightly more frequently in those with juvenile-onset diabetes. Spinal cord infarcts, seen in 19%, are related to anteriolar sclerosis of the intrinsic vessels of the spinal cord. They have a higher incidence in diabetics than in a nondiabetic aging population, show a predilection for the white matter, and are usually small. The myelopathy is not related to patient age or duration of diabetes. It is often clinically occult.


Breast biopsy evaluation by paraffin-block radiography. The presence of occult breast carcinoma in breast biopsy specimens originally interpreted pathologically as benign has been reported in up to 2.4% of cases. Paraffin-block radiography of 658 blocks from 119 breast biopsies obtained prior to the use of mammography and initially interpreted as benign was performed to determine the frequency and relevance of "significant" calcifications. Of all cases 87.4% demonstrated some calcifications within the breast tissue; 19.3% contained calcifications considered significant. Step sections of the original blocks containing significant calcifications did not demonstrate malignant neoplasms.


The myofibroblastic nature of the uterine plexiform tumor. Electron microscopic study of rare, benign, plexiform tumor of the uterus showed that of its component cells exhibit characteristics of both smooth muscle cells and fibroblasts, which allows for their identification as myofibroblasts. Although such cells have been more frequently associated with reactive processes, their presence in some malignant soft tissue tumors, viz, fibrosarcoma and malignant fibrous histiocytoma, has been noted by others. Analysis of recorded accounts, as well as our own limited personal experience with the ultrastructural characteristics of smooth muscle neoplasms and those putatively regarded as being of such origin, indicates that many of these may contain a relatively large complement of myofibroblasts. The spectrum of myofibroblastic differentiation of smooth muscle cells and/or fibroblasts may account for the varied interpretations that concern the derivation of some of these neoplasms, particularly hemangiopericytoma.


Persistent creatine kinase MB isoenzyme without cardiac disease. Although the creatine kinase MB isoenzyme may be useful in the diagnosis of myocardial injury, it is also found in the sera of patients with a number of noncardiac diseases. It may also occur in apparently normal individuals, as described in this case report. Hence, the diagnosis of myocardial injury should never be based solely on the presence of creatine kinase MB isoenzyme in the serum, but should be supported by additional clinical and laboratory data.


Access of metronidazole into the chronically inflamed middle ear with reference to anaerobic bacterial infections. Strictly anaerobic bacteria were found in about one third of 138 consecutive cases of active chronic otitis media. These infections were always mixed involving aerobes as well. In 79 cases only aerobes were found and 16 cultures were sterile. To provide a basis for possible clinical trials, the penetration of metronidazole into the ear was studied after an oral dose of 2.4 g to patients with chronic otitis media. Significant amounts of biologically active metronidazole were found in 8 of 12 middle ear discharges at 2--4 h, the concentrations varying between 9.4 and 65.0 microgram/ml. Between 2 and 13 h after administration, significant drug concentrations all exceeding the highest reported bactericidal ones were found in the middle ear mucosa in 6 cases of the 8 in which the determinations were possible. Neither the mucosal nor the discharge concentrations correlated with the simultaneous serum levels of metronidazole, which were high in all 23 patients studied.


Scanning electron microscopy of human ossicles. Human middle ear ossicles removed from cadavers and during surgical procedures have been examined with scanning electron microscope (SEM). Two kinds of bone tissue compose ossicles: periosteal and endochrondral bone. Periosteal bone occurs in the form of external covering on the ossicles. In the middle of the ossicles there is endochrondral bone which shows various spatial arrangement of collagen bundles. Lamellar bone occurs also in this bone around vascular channels but rarely in the form of typical osteons. Surface appearance of periosteal, coarse-fibred bone and lamellar, fine-fibred bone is almost the same. Lamellar bone is composed of coarse collagen bundles arranged tightly in the rows. The space between the rows is filled by fine fibres which link the coarse bundles.


Effects of alpha- and beta-adrenergic receptor blockade on the isoamylases of rat-parotid gland. The in vivo activity of rat-parotid isoamylases was increased following alpha-receptor block by phentolamine. Additional inhibition of the beta-receptors by propranolol did not further augment the isoenzyme activities. After 21 days, the isoamylase concentrations were even lower than after alpha-receptor block alone. Based upon these results, an alpha-receptor mediated discharge from the duct system of already secreted gland protein and a possible role of the alpha-receptors in protein secretion from the parotid gland are discussed.


[Ultrastructural morphometric changes in spiral ganglion cells of the rat after broad band noise (author's transl)]. The comparison of ultrastructural and ultrastructural-morphometric findings in spiral ganglion cells subsequent to broad noise with 105 dB SPL over a period of 40 min demonstrates that there are morphometric changes of the cytoarchitecture of granular ganglion cells even without evident ultrastructural changes. Morphometric analyses shows a significant extension of the volume proportion of mitochondria per unit volume cytoplasm. The volume and the surface of the rough endoplasmic reticulum, the volume of the free ribosomes and the average single volume of the nucleoli increase per granular ganglion cell. The physiologic significance of these changes is discussed. The results show that changes of the cytoarchitecture of granular spiral ganglion cells are earlier detected by morphometry than by ultrastructural description.


[Alveolar surfactant and experimental diabetes (protective action of citicoline)]. Above normal or normal S.R. values (0,70-0,90) (S.R. = 0,81 +/- 0,11), were noted in 13 alloxaneinduced diabetic rabbits treated with CDP-choline, and decreased values (S.R. = 0,57 +/- 0,06) in 9 diabetic rabbits not so treated. This difference was statistically significant (P less than 0,001). The results show that CDP-choline can protect surfactant from damage caused by alloxane-induced diabetes. The most likely explanation is increased synthesis of dipalmitoyllecithin, by intervention of CDP-choline, as cofactor, on lipid metabolism in the lung.


[Scanning electron microscopy studies on epithel surface of the plica vocalis in male rats (author's transl)]. The epithelial surface of the Plica vocalis in adult male rat is studied by scanning electron microscopy. It's structure is compared with that of the plica and of the recessus ventricularis. The transition of the epithelium in the plica vocalis to the epithelium of the joining parts of the larynx is documented. Special attention is paid to the occurrence of microridges at the apical poles of epithelial cells in the larynx. Up to now microridge cells have been said to be characteristic for the plica vocalis.


Infravestibular horizontal partial laryngectomy. A new surgical method. We have developed a new functional surgical technique for cancers of the larynx specially those situated glottically and subglottically which are considered remedial to a total laryngectomy. Specifically an infravestibular horizontal partial laryngectomy can be performed to remove neoplasms together with the glottis and subglottis. The larynx then may be reconstructed by suturing the bands to the ascended trachea and the conserved upper half of the tyroid cartilage. The results have been encouraging. Swallowing, phonation and respiration by the natural vias has been obtained in 8 of the 12 patients so operated.


A simple procedure for surgical repair of vocal cord synechia. With a simple method performed since 1962 on six patients for the correction of anterior vocal cord synechia, a paladon granule reinforced with a thread is brought into the larynx from outside after severance of the synechia. With convalescent treatment of the cartilaginous frame, it lies in the anterior commissure for 6 weeks. After endoscopic removal, free glottis and good voice. Tracheotomy is not necessary.


Measurement of specific laryngeal muscle function by ultrasound. Ultrasonic dimension gauges were implanted in the crico-arytenoideus dorsalis muscle in a mature horse. Resting and contracted muscle length and average contraction rate were measured serially in the conscious state over a period of 25 days. Results suggest that specific laryngeal muscle function in the horse may be defined with this approach. Since man and horse are both known to suffer from laryngeal hemiplegia, this experimental preparation may help provide information of benefit to both species.


[Position nystagmus (author's transl)].

[Position nystagmus (author's transl)]. Detailed research about the positioning nystagmus show important and characteristic qualities. Now and then, nystagmus qualities permit a differential diagnosis of the diseased organ (peripheral versus central). In general, the peripheral paroxysmal benign nystagmus is proceeded by a short latency, showing mainly a rotatory component towards the inferiorly positioned labyrinth. A paroxysmal pattern is typical as compared to the central position nystagmus.


Abnormal "hair-like" filaments in chronic maxillary sinusitis . A scanning electron microscopic investigation. Scanning electron microscopic investigations were performed on the maxillary sinus mucosa of five healthy persons and seven patients with chronic maxillary sinusitis. The occurrence of previously undescribed hair-like filaments in one case of chronic maxillary sinusitis is presented. These abnormal filaments are much longer (about 50--60 micron) and thinner (about 0.08 micron) than normal kinocilia (about 0.2 micron thick and 5--7 micron long), thus exhibiting a hair-like appearance. As the microvilli (cytofila) in maxillary sinus mucosa have the same thickness (about 0.08 micron), these hair-like filaments could be regarded as abnormally long microvilli. The possible significance of these abnormal filaments is discussed.


Histological effect of ultrasonic irradiation in Menière's disease. The lateral semicircular canal and the crista ampullaris from five patients previously treated with ultrasound for Menière's disease showed the following histological and ultrastructural changes: 1. The lateral semicircular canal was completely obliterated by dense connective and osteoid tissue. 2. In the subepithelial tissue in Crista ampullaris no signs of degeneration was found. The nerve fibers were normal. 3. Also the sensory cells with nerve-endings and supporting cells appeared normal. 4. In the transitional epithelium there was vacuolization and extensive swelling with protrusion of the cells into the endolymphatic space. 5. The secretory cells showed pronounced cellular vacuolization and increased intercellular space. It is concluded that the massive destruction of the normal anatomy in the lateral semicircular canal may be the morphological basis of a functional endolymphatic fistula for drainage of the endolymphatic hydrops.


[A caloric vestibular test with increased positive evidence (author's transl)]. The positive evidence of the caloric test increases, when the time-course of the induced heat wave in the petrous bone was eliminated, which differs from man to man. This is possible by changing head position during calorisation, so that a nearly rectangular stimulus results.


[Perilymphatic perfusion of the cochlea (guinea pig) with fluorocarbon emulsion (author's transl)]. Because oxygen is at least ten times as soluble in fluorocarbon liquids as in plasma or saline, we investigated the principle possibility of perilymphatic perfusion of the cochlea with perfluortributylamin. Our experiments show that fluorocarbons in spite of the excellent O2-solubility in it are not suitable for the perilymphatic perfusion due to their physical properties (density 1.91 g/ml, non-solubility in water, necessity and difficulties of emulsification).