Schistosoma mansoni: localization of calcium-detecting reagents in electron-lucent areas of specific preacetabular gland granules. In an attempt to establish the exact location of calcium within the preacetabular glands of cercariae of Schistosoma mansoni, these larvae were exposed to reagents (potassium oxalate, potassium pyroantimonate, chloranilic acid, and silver nitrate) useful in the detection of calcium, and were subsequently observed with the aid of light and electron microscopes. Cercariae incubated in potassium oxalate and viewed in polarized light showed birefringence only in the preacetabular gland funduses. At the ultrastructural level, the preacetabular glands of potassium oxalate-treated cercariae had no electron-dense precipitate, but instead had translucent, irregularly shaped inclusions, similar to spaces left by volatilized calcium oxalate as described by others. Pyroantimonate treatment, on the other hand, localized the reaction in the electron-lucent areas of the light-spotted granules. The von Kossa silver nitrate procedure destroyed the secretory granules; therefore, an electron-dense precipitate was distributed throughout the gland. However, pretreatment with chloranilic acid before fixation preserved the granules, and subsequent exposure to the von Kossa silver nitrate gave a reaction identical to that obtained with the pyroantimonate alone. When viewed in polarized light, chloranilic acid-incubated cercariae showed birefringence in the fundus and duct areas.


The fine structure of spermatogenesis in Hymenolepis diminuta (Cestoda) with a description of the mature spermatozoon. The processes of spermatogenesis and spermiogenesis in Hymenolepis diminuta were studied by electron microscopy using improved preparative techniques. Spermatogonia (Type A) are characterized by nuclei 3.79 (+/- 0.17) micrometer in diameter, dense cytoplasm packed with free ribosomes and aggregates of mitochondria. After mitoses, certain spermatogonia (Type B) assume syncytial rosettes containing eight nuclei. Primary spermatocytes maintain the rosette syncytium and have large nuclei (4.28 +/- 0.24 micrometer in diameter), smooth endoplasmic reticulum, and polysomes. The secondary spermatocyte is short-lived and is characterized by nuclei (2.0 +/- 0.11 micrometer in diai (2.0 +/- 0.11 micrometer in diameter) and perinuclear membranous lamellae. The syncytial spermatid cluster contains avoid nuclei which condense and elongate to a final diameter of 0.22 +/- 0.04 micrometer. Once elongated, these nuclei become delimited from the syncytium by invaginations of the plasma membrane. During delimitation, cortical peripheral microtubules arise beneath the spermatozoon plasmalemma and a 9 + 1 axoneme extends the length of the mature lance-shaped spermatozoon.


Immunization of NMRI mice against virulent Toxoplasma gondii. Differing efficacy of eleven cyst-forming Toxoplasma strains. Mice were infected with eleven cyst-forming Toxoplasma strains of varying virulence and challenged 1 month later with highly virulent BK strain parasites. The early cellular reaction in vivo was estimated by collecting the peritoneal exudates 24 h after challenge. This consisted of 54.34--77.61% lymphocytes and 0-8.88% infected macrophages in the eleven immunized groups in contrast to 27.17% lymphocytes and 18.64% infected macrophages in the control group. The peritoneal exudate 72 h after challenge comprised of 55.88-73.86% lymphocytes and 0-6.97% infected macrophages compared to 25.88% lymphocytes and 92% infected macrophages in the control group. Following the virulent challenge, deaths occurred in seven of the eleven groups immunized with live strains and ranged 5-42% at the end of a 6-week observation period. The most virulent of the Toxoplasma strains used - Alt and Gail - gave higher mortality while the least virulent ones - 558, 1070, K8 and KSU - were solidly resistant. The significantly different mortality obtained with strains Alt, Gail and Witting in a similar experiment performed at an interval of 7 months is discussed.


The penetration of Fasciola hepatica miracidia into the snail host Fossaria bulimoides. A scanning electron microscope study. Snails of the species Fossaria bullimoides were exposed to miracidia of Fasciola hepatica for given periods of time. The course of penetration was followed by means of scanning electron microscopy. Topographical features of miracidial morphology were studied with emphasis on epidermal plates and body shape. Comparisons are made on the rate of penetration into this snail host.


On Schistosoma margrebowiei Le Roux, 1933: the morphology of the egg, miracidium and cercaria, the compatibility with species of Bulinus, and development in Mesocricetus auratus. The morphology of the egg, miracidium, and cercaria of Schistosoma margrebowiei are described. The compatibility of S. margrebowiei with species of Bulinus has been examined. The parasite develops well in the diploid, tetraploid and octoploid snails of the truncatus/tropicus complex with overall infection rates of 38.1%, 30.1% and 29.1% respectively, and in reticulatus group snails (Bulinus wrighti) with an infection rate of 45.8% of those snails surviving the prepatent period. Only two species of the forskali complex (Bulinus bavayi, Aldabra; Bulinus beccarii, South Arabia) are slightly compatible, and snails of the africanus group are incompatible. The overall worm return from 24 hamsters exposed individually to 100 cercariae was 39.8%; 82.1% of the worms were paired, the remainder unpaired. The growth of the paired worms was recorded from 28-60 days. The prepatent period in hamsters in 33 days, in sheep 38 days. The mean egg production was 837 eggs/day in infections ranging from 33 to 60 days. Most eggs (80.9%) were deposited in the intestine, and only 18.2% were deposited in the liver. The parasite is pathogenic in hamsters, and peak death rate occurred in the 50-60 day group infections which coincided with the period of peak egg production.


[Contributions to the micromorphology of the miracidium of Schistosoma mansoni. I. Fine structure of the tegument and its "associated structures" (author's transl)]. The body wall of the miracidium of S. mansoni has been studied by light and electron microscope. It has been found that the tegument layer contains so-called membrane-bound bodies. The tegument layer will be separated from muscle layer by means of a basal membrane. Special attention was focused on the associated structures of the tegument; these are cilia, microvilli-like appendices amounting to six in number at our test-organisms and finally two types of sensory papillae on the so-called terebratorium. After treatment of the miracidium in antiserum, fine granulated precipitate was formed around the cilia.


Experimental double infection of Biomphalaria glabrata snails with Angiostrongylus cantonensis and Schistosoma mansoni. Two groups of Biomphalaria glabrata snails primarily infected with Angiostrongylus contonensis were secondarily exposed to infection with Schistosoma mansoni. To investigate any anatagonistic effect of the first infection on a superimposed one and to compare to singly and non-infected snails, a series of experiments was undertaken in which snails were individually exposed, variously, to 1,000 and 2,000 first-stage larvae of A. cantonensis and then to 5 and 10 miracidia of S. mansoni 1 day and 3 weeks later. Snails became infected with S. mansoni in both groups of snails with double infections and shed cercariae after the same incubation period as in the singly infected groups. The number of snails shedding cercariae simultaneously was similar in single and double infection groups during the first two weeks of shedding, after which this number decreased somewhat in doubly infected groups. Snails with double infection showed higher cumulative mortality rates than in snail groups with single infection with either A. cantonensis or S. mansoni. Therefore, initial infection of B. glabrata with A. cantonensis produced no inhibitory or retarding effect on subsequent infection of snails with S. mansoni.


Stereoscan studies of rediae, cercariae, cysts, excysted metacercariae and migratory stages of Fasciola hepatica. The external surface of the redial body of Fasciola hepatica is provided with microvillus-like projections or short lamellae, and short cilium-like structures are common anteriorly. The anterior part of the cercarial body possesses a pattern of regularly arranged small depressions each containing a spine. Both long and short cilium-like structures occur anteriorly. The tail is spineless and provided with dorsolateral folds. The outer cyst wall is formed by granules secreted from the tegument all over the body apart from the ventral sucker. Most granules transform into fibrillae which form the thick outer spongy layer. The precursor of the inner cyst wall is at the beginning closely attached to the metacercarial surface, but later the membrane-like cyst wall extends, and when fully formed the metacercaria lies free in the flattened circular inner cyst. The ventral plug is formed by the ventral sucker. The tegument of newly excysted metacercariae is provided with simple pointed spines, but later during migration in the mouse the spines become flattened and multipointed. Very young migratory stages may be attached with host cells.


[Draft and course of a Basel Kindergarten study]. Programme and course of the Basle Kindergarten Study are presented. This study has to describe and analyse the somatic and psychosocial development of children of foreign workers, of people from other swiss cantons and of locals to get ideas referred to prevention.


[National Research Program on the prevention of cardiovascular diseases: plan of study]. The main objectives of the Swiss National Research Program on primary prevention of cardiovascular diseases are: 1) the reduction of known cardiovascular risk factors among the local populations of two intervention Communities compared to two "regular care" communities and 2) the provision of tested cost-effective methods for nation-wide use in the future control of CVD. The main focus during both the screening and the three years intervention phase will be on the total mobilization of community resources to induce behavior change (active participation of the population as well as the local health and social services system both in planning and implementation). A program such as this has to meet the challenge of developing a design that combines the needs for rigorous evaluation with a maximal amount of flexibility regarding the results of local initiative and involvement.


[Morbidity of alcoholic employees. Examples from 2 public facilities in Switzerland]. Morbidity of of alcoholic employees. Results of a case/control study on 2 samples of civil servants. The data of this retrospective study were obtained mainly from files kept at the centralized medical service. The observation period was 10 years. The alcoholics (n = 64) lost in the average 19.3 or 16.1 days more per year through sickness absence and they spent considerably more days in hospitals than their control groups. Significant differences occurred also concerning frequences of medical diagnoses.


[Mortality of a group of psychiatric patients under ambulatory care in Geneva]. It is known from former studies that psychiatric patients have a mortality rate higher than that of the general population. This cannot be explained by causes of death that may be specific of psychiatric illness (as suicide for example). The objective of our project is to find if there is such an over mortality in our population, to evaluate to what factors it is related and specially what are the causes of death.


[Incidence of cancer in the canton of Vaud. Etiologic hypotheses]. 1,600 deaths are attributed to cancer in the Canton of Vaud, representing 23% of the total mortality. The incidence rates by sex for 12 cancer sites are compared, the data being taken from 3 cancer registries : Vaud, Geneva and the Saar (West Germany). The most important risk factors are mentioned for those sites with the highest rates. For men, cancers of the upper digestive and respiratory tract rank second, when the expectation of life associated with the age of onset of tumours of this site is taken into account. The sex ratio of males to females is particularly high. Some hypotheses, based on epidemiological observations, are formulated as to the causes of cancer of the upper digestive and respiratory tract.


[Risk groups in travel to tropical countries within the frame of mass tourism]. More than 10,000 tourists returning from tropical countries have been asked about health problems during their stay abroad. Preliminary results from the first 5,550 questionnaires indicate that 74,8% had complaints of any kind concerning their health and 13,6% can be considered as having been ill. The frequency of complaints and illness in relation to different variables is shown and the possibility of definition of high risk groups is being discussed.


[Length of stay of hernia patients: an international comparison]. A comparison of four community hospitals in four countries (U.S.A., Sweden, U.K., Switzerland) shows important differences regarding the average length of stay in these four countries. The mean stay for the diagnosis of inguinal hernia in Switzerland is about twice as high as in the other countries. Explanations for such variations lie with the shape of the system of care rather than with the medical needs of different populations.


[Problem of early registration of hypertension: combination of x-ray and blood-pressure determination]. In a program aiming at 30,000 blood pressure measurements per year 12,401 persons have been examined in the canton of Berne (population of approx. 1 million) from first of January 1976 to the end of April 1977. This group belongs to the active working part of the inhabitants (age 30 years and more). The introduction of this method was without any problems. 97 to 100 percent of the people participated on a voluntary base. A short personal history of hypertension and smoking habits were requested by a questionnaire. Some results obtained by the use of a general computerprogram are presented: 15.1 % of the screened population had a hypertension greater than or equal to 160/95 mmHg. 55.5 % were unknown to the examined persons. Connections with other findings than hypertension, such as pathologic images of the heart in the x-ray and smoking have been determined. 66.5 % showed one, two or three of the above mentioned findings. The advantages of this method are stressed.


[Discrimination and classification based on characteristics of bucco-dental data]. Discriminant analysis and its corresponding classification procedures are illustrated by means of two practical applications pertaining to a dental health survey. The discriminating variables refer to dental caries, oral hygiene, periodontal diseases and fracture of anterior teeth. Their relative discriminating power is discussed.


[Treatment of pharyngeal disease in general and pediatric practice]. Based on 1351 reports by 180 physicians, it was found that pediatricians and younger physicians conducted more diagnostic tests and judged a tonsillectomy as necessary less frequently than GP's, especially those without board certification, and older physicians.


[Influence of social learning on alcohol consumption]. The history of social learning in relation to the alcohol consumption of 50 heavy and 50 average drinkers, matched according to socio- demographic factors, was compared. The main differences concerned the situation at home and relations with young colleagues. Drinking on festive occasions, together with the parents, seems to favour normal consumption in later years, even if the drinking starts at a young age. If, however, the parents used alcohol as a means to relieve tensions, or if the subject was in near contact with heavy drinking young colleagues that rather despised people who did not drink much, an association with high consumption could be noted. No significant differences have appeared in the behavior of adult acquaintances.


[Educational and nutritional study on the reduction of myocardial-infarct risk]. The study aims to establish whether recovery from myocardial infarction is the strongest or, alternatively, the only motivation toward changing unhealthy habits of living and eating and to what extent such patients and overtly healthy persons are prepared to receive advice to take measures to prevent myocardial infarction.


[Modification of smoking behavior using long-distance methods]. 906 persons willing to quit smoking were allocated at random to several groups. The results show that (1) an extract of avena sativa has no effect on quantity smoked; (2) distribution of the various parts of a smoking cessation program over several days was no more effective than distribution at once; (3) stopping at once was more effective than progressive reduction of cigarettes smoked.


[Level of SO2 pollution and the prevalence of bronchitis]. The prevalence of chronic bronchitis (according to the BMRC questionnaire on respiratory symptoms) for 1182 male smokers, as well as their peak flow rate, are related to age (18-65 years), cagarette consumption (1-55 cig./day) and exposure to atmospheric SO2 pollution (20-65 microgram/m3).


[Effect of nicotine and amphetamine on body-weight regulation]. Twice daily c.c. injections of nicotine or amphetamine, for 6 weeks, produced a stabilization of the body weight at a level below that of the controls. This is attained by a transient hypophagia in normal animals and by a brief hyperphagia in animals emaciated prior to the treatment period. These effects confirm the hypothesis of Powley and Keesey (2) that the set-point for body weight is regulated, and not food intake.


[Living in modern apartments].

[Living in modern apartments]. 800 new flats were investigated. The comparison between the behavior or the judgements of the inhabitants with various physical parameters revealed many insufficient elements in the flats. Some recommendations can be deduced from this study.


[Illness behaviour: the influence of age, sex and socio-economic status (author's transl)]. Some results of a study done in 1975/76 in Basle are presented (N=422 people working in administrative and industrial firms). Generally medicine takers are to be found in a high percentage already in the group with little symptoms. On the other side many of those reporting a high number of symptoms do not consult a physician. The number of symptoms reported is higher with progressive age, women and lower socio-economic status. Nevertheless we do not find an increase of consultations with a physician in the same direction.


[The applied time interval as a learnable dimension]. The possibility of learning time intervals was examined. 7 male BDE-rats (70 days old at the beginning of the experiments) were trained (shock avoidance learning) in a modified test chamber to learn bar-pressing only in distinguished time periods (LD 12 : 12). In a second part of the experiment it was examined with 5 rats what effect an extension of the light phase has. The results show that there is a possibility of learning time intervals and of maintaining this behaviour under these specific conditions of training.


[The working place and psychovegetative disorders]. Concept of a questionnaire for industrial workers to investigate the characteristics of their job demands, their individual claims, psychovegetativ disorders and job dissatisfaction. First results of a preliminary test on 54 selected shift workers.


[Survival time and life quality after operative treatment of colonic cancer (author's transl)]. In regard to other intestinal malignomas colon cancer shows the chance of a long survival time. In cases of stage Dukes A and B the patient has a 5 year survival time of 100 to 82% depending on his age. In carcinoma of the rectum preoperative biopsy is necessary. In cases with grade III we prefer the exstirpation. The Erlangen magnetic closure of the colostomy gives continence in 70%.


[Problems caused by asbestos].

[Problems caused by asbestos]. Asbestos has become a pollutant of ambiant air and there is a lack of informations allowing a reliable evaluation of the health risk related to the levels of concentrations found in the community. Biological significance of short fibres, analytical methodology and permissible levels are discussed under the view of the future needs for research.


[Volvulus of the stomach in combination with hiatal hernia (author's transl)]. Cases of acute or chronic abdominal complaints in adults can be accounted for as conditions resulting from volvulus of the stomach with oesophagial hernia. In a total of 73 cases of hiatus hernias the author has observed 6 patients with a simultaneous volvulus of the stomach (8,1%) from 1967 to 1976. Pathogenesis, symptoms, surgical indication and the operative technique are discussed. By means of gastropexy, fundiplication and narrowing of the oesphageal hiatus the patients could be freed of complaints and recurrences.


[Time of disablement after partial gastrectomy for peptic ulcer (author's transl)]. From 1966 to 1975 1169 patients underwent a partial gastrectomy (Billroth-II). 944 patients (80%) were followed up by their surgeons in a so call "gastric after-care". On the average these patients were pstoperatively out of work for 58 days. This time depends on postoperative complications, disturbed gastric function but finally on the patient himself.


[Evaluation of occupational chromium exposure through the determination of urinary chromium]. Determinations of urinary chromium on 26 workers from 6 chromium electroplating workshops are presented and discussed in relation with results of airborne chromium. Rapid apparition of chromium in urine after the beginning of exposure tends to show that urinary analysis are a convenient test for the biological monitoring of chromium exposure.


[Intussusception of the vermiform appendix (author's transl)]. Intussusception of the vermiform appendix is reported in a frequency of 0.01%. Different aetiologic factors are implicated, a directed hyperperistalsis against intraluminal obstruction is thought to be the pathogenetic mechanism. There is a lack of typical symptoms, very often appendicitis or caecal tumor is diagnosed. Concomitant inflammation renders recognition more difficult. The caecum must be resected if a malignant tumour cannot be ruled out. Appendectomy is performed in definite findings. Our case report may remind of this uncommon occurrence.


[Intrauterine contraceptive devices (IUD'S) (author's transl)]. The IUD is an excellent and very effective contraceptive method. As contraception and coitus are separated, this technique is acceptable to many couples. It provides prolonged protection and cannot be "forgotten" like the Pill, the diaphragm, or the condom. Its pregnancy rate is 2 per 100 women per year. The greatest clinical experience exists with the Lippes loop. The loop should be the method of choice for parous women, the Copper-T for the nullipara and nulligravida. Regularly menstruating women should be advised to use additional contraceptive protection (condom, diaphragm, coitus interruptus, foam) during the week of highest fertility. This will make the IUD as effective as the Pill. Physicians prescribing this method should be available 24 hours per day for their patients, as emergency situations such as P.I.D., ectopic pregnancy, septic abortion--rare as they are--would need prompt attention.


[Infection hazards and complications following the use of IUDs]. Own experiences on IUD-complications especially irregular bleedings and infections underline that modern plastic intrauterine devices are second-rate contraceptives. Compared to hormonal contraceptive drugs intrauterine devices have a higher pregnancy risk and increased rates of infections. Therefore the IUD is in our opinion not suited primary contraceptive method used without indication. Because of the relatively often occurring ascendant genital infections the application of intrauterine devices should not be carried out in nulliparae.


[Management of functional sterility using clomiphene and cyclophenyl at the Karl-Marx-Stadt District Hospital Gynecologic Clinic]. We report on 39 barren patients suffering from anovulatory cycle disturbances or corpus luteum inadequacies. Them were given treatment in the Gynecological Hospital of Karl-Marx-Stadt County at Karl-Marx-Stadt in the past few years and were administered Clomiphendihydrogencitrate or Cyclophenyl to provoke ovulation. Before and during therapy, the total of estrogenes and pregnanediol were determined in the 24h-urine every two days. The clinical data and the results of the hormone investigations were analysed, and an attempt was made to derive a forecast from the estrogene and pregnanediol secretion so as to be able to form an opinion on the positive or negative result of the treatment.


[Endocervicoscopy].

[Endocervicoscopy]. The endocervicoscopy is particularly interesting with regard to the way of endoscopic observations and to the successful identification of praecarcinosis intercervicalis. The findings are of clinical importance in the early detection of praecarcinomatic dysplastic processes and of neoplastic disease of the uterine endocervix. It is a valuable source of information in early treatment, surgery and rehabilitation.


[Clinical peculiarities in a female patient with the Mayer-Rokitansky-Küster-Hauser syndrome]. Described is a case with the Mayer-Rokitansky-Küster-Hauser syndrome with normal pubescent female development, moderate hair virilismus, double rudimentary uterus, incomplete development of the vagina, ovarian dystrophy and abnormalities in the sex chromatin and the gonosomal complement. Discussion on the clinical variety and the ethiopathogenesis of the disease is performed.


Monoamine level and periodic activity in 6-hydroxydopamine treated mussels Anodonta cygnea L. In the central nervous system of the mussel (Anodonta cygnea) 6-hydroxydopamine (6-OHDA) causes a significant and prolonged decrease in the dopamine (DA) and noradrenaline (NA) concentration. The decrease of serotonin (5HT) level did not exceed 25 per cent and was observed only on the 2nd and 3rd day after the treatment. Parallel with the alteration of the monoamine level, there is a marked change in the activity of the animals. Two phases of the effect of 6-OHDA can be distinguished. During the first phase, not only the catecholaminergic but, presumably, also the serotoninergic system is injured. The long-lasting effect of the 6-OHDA administration is reflected in the predominance of the active periods and in the absence of rest periods of the animal.


Changes in chromosome complement in long-term pea callus cultures. A prolonged callus culture from pea (Pisum sativum L. var. Kiir) cotyledons subcultured for 7.5 years on Torrey's solid medium was examined cytologically. The initially (and up to 3.5-year cultivation) predominantly diploid pea callus strain changed into triploid. The frequency of aberrant ana- and telophases increased during 5 year cultivation from 9 to 40 per cent and thereafter returned to the initial rate maintaining it at least for one year of subculturing. Some possible mechanisms of chromosomal variation tendencies in vitro are discussed.


Inhibitory effect of adrenaline and hydrocortisone on the growth of Allium cepa roots. The roots of Allium cepa were allowed to grow in distilled water containing 10(-4) M adrenaline hydrochloride or 2 X 10(-3) M hydrocortisone sodium succinate. Adrenaline inhibited the growth of roots; they decreased in length, number and total dry weight. The total amount of DNA in the roots was reduced much less than that of extracellular root components after adrenaline. Also hydrocortisone treatment resulted in a considerable decrease of the length and dry weight of Allium cepa roots. Both DNA and extracellular root components were influenced.


Experimental investigations on hypokinesis of skeletal muscles with different functions. I. Changes in muscle weight, protein and contractile properties. In New Zealand white rabbits the right hind limb was immobilized in full extension with a plaster cast. The free left hind limb served as control. The masses of both the tetanic m. gastrocnemius and the tonic m. soleus considerably decreased as a consequence of immobilization for 5, 10, 14, 25 or 42 days. The decrease was more marked for the m. soleus. The water content of the muscle did not change substantially in the course of the atrophy. The total protein and myofibrillar protein contents of the immobilized muscles fell significantly. The tonic m. soleus atrophised sooner and was more extensive than the m. gastrocnemius. Superprecipitation of the myofibrillar proteins of the immobilized muscles decreased by 20-25% compared to the controls. The experimental model is considered suitable for further biochemical and ultrastructural investigations relating to the development of atrophy and to regeneration.


Experimental investigations on hypokinesis of skeletal muscles with different functions, II. Quantitative changes in the nucleic acids. The effect of hypokinesis on the quantitative changes in the nucleic acids was studied in functionally different muscles of rabbits on the 5th, 10th, 14th and 28th days following plaster cast immobilization of the limbs. As a consequence of the immobilization, the total amount of deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) decreased in both the tonic and the tetanic nuscles. The decrease was more marked in the tonic muscles. As a result of the hypokinesis, the RNA/DNA ratio increased in the m. gastrocnemius, and decreased in the m. soleus. The plaster cast immobilization has a greater effect on the homoeostasis of the nucleic acids of the tonic muscles than in the case of the tetanic muscles.


Experimental investigations on hypokinesis of skeletal muscles with different functions, III. Changes in protein fractions of subcellular components. Changes occurring in the protein fractions of rabbits' immobilized skeletal muscles with different functions were studied. Disuse of the muscles resulted in a gradual reduction in the contractile proteins. The specific proteins of the tonic muscle (m. soleus) were degraded to a greater extent than those of the tetanic (white) muscles (m. gastrocnemius). Parallel with the decrease in the structural proteins the sarcoplasmic protein exhibited a relative increase. The tonic muscles underwent greater damage than the tetanic muscles, indicating that the dedifferentiation was more marked in the tonic muscle. The results are explained by the biological importance of the function and activity of the cell: disuse leads to changes in the physiological and biochemical characteristics of the muscle, and to dedifferentiation of the cells.


Experimental investigations on hypokinesis of skeletal muscles with different function. IV. Changes in the sarcoplasmic proteins. The changes in the sarcoplasmic proteins of the m. gastrocnemius and m. soleus were examined by biochemical methods on the 5th, 7th, 14th and 28th days after plaster cast immobilization of the right hind limbs of adult rabbits. During 4 weeks the soluble/myofibrillar protein ratio increased from 0.47 to 0.75 in the m. gastrocnemius, and to 0.85 in the m. soleus. Evaluation of the relative quantities of the components identified after gel-electrophoresis separation led to the following results: (1) There was no, or no appreciable change in the glyceraldehyde-3-phosphate dehydrogenase, creatine kinase and enolase activities. (2) The enzymes lactate dehydrogenase, aldolase and the glycogenolytic enzymes showed a relative decrease in both muscles. (3) Phosphoglycerate kinase, phosphoglucose isomerase and pyruvate kinase increased in both muscles. (4) Changes of opposite directions were exhibited by myoglobin, myokinase and F-protein. These results provide new data on the biochemical characterization of these functionally different muscles, and on the mechanism of disuse atrophy.


[Ileal loop ureter substitute in a patient with a single kidney]. Substitution of the ureter by means of an isolated ileal loop was performed in a young, repeatedly operated patient. The operation was successful, 3 years later the patient was free from complaints and able to work.


[New findings on the mechanism of micturation]. The nervous and muscular events in the start and process of micturation are analyzed. The experiments have shown that in the start of voluntary micturation the close anatomical link between the perineal cross-striated musculature and the neck of the bladder plays an important role. The fact that the straining of the vesicular musculature leads to the contraction of the detrusor is attributed a major importance in the maintenance of the process of urination. The thrusting force of the vesicular musculature transports the urine into the neck of the bladder where the pressure rises and the muscles of the bladder wall become stressed. The arising stimulation enhances the contraction of the detrusor and this process prevails up to the end of micturation. The experiments support the clinical findings, since they explain the different behaviour of central and partial cystoparalysis, thus the almost normal functioning of the reflex bladder and the atony of the "non-reflex" bladder.


Rehabilitation renal failure due to poisoning. The cases of acute renal failures due to poisoning treated at the artificial kidney department of the University, Department of Urology in Budapest are received. The patients were readmitted later to check their renal function. Prognosis was best in the group with mercury poisoning where renal function of the survivors was completely restored. Similarly promising are the results in other types of poisoning if the patients can be made to survive the acute period. It is emphasized that if poisoning results in symptoms indicating acute renal failure, the patient must be transferred to an artificial kidney department as soon as possible.


[Diseases associated with double ureters]. Seventy-four children with double ureters were observed in the past three and a half years, out of whom 12 were operated because of vesico-ureteral reflux, 2 for lithiasis, 6 for hydronephrosis and 15 because of ureterocele, while in 10 cases operation was indicated by ectopic ureters opening into the area of the vulva. In these diseases intercurrent infection represents the greatest danger which might cause in children a toxic, septic and dystrophic state.


[Subtotal resection of ureterocele].

[Subtotal resection of ureterocele]. After a review of the diagnostic and therapeutic possibilities of ureterocele, the authors' own experience with transvesical subtotal resection is presented. After the resection of the ureterocele, two-third of the patients were free of complaints and symptoms, their pyuria ceased and subsequent intravenous pyelography showed normal conditions.


[Treatment of bladder tumors].

[Treatment of bladder tumors]. Experience with surgical and combined treatment of bladder tumours are reported. 587 patients were subjected to operation only, 71 received complex therapy. The patients were classified according to the TNM system, assessment of the results was based on five-year survival. In the group in which the tumour involved only the mucous membrane and did not infiltrate the bladder wall, the results were favourable (85%), while in the group when the bladder wall was deeply infiltrated, there was no five-year survival irrespective of the treatment having been purely surgical or surgical combined with cytostatic or X-ray therapy.


[Incidence of pyelectases and their surgical correction]. Among 1611 urological patients 90 (5.4%) displayed pyelectasis. In almost one-third of the cases dilatation was caused by the presence of a calculus In 33 cases plastic surgery mainly of the Anderson-type was applied. 78% of the operations was successful. The incidence of nephrectomy was higher in the group in which complaints were of more than two years standing (10 out of 33) than in the group where treatment was started less than two years after the appearance of complaints (7 out of 41). In 26 cases dilatation was caused by occlusion by a calculus; in one half of these cases, nephrectomy was the only operation which could be performed.


Non diffusible toxic polypeptides in uraemic sera: a new group of uraemic toxins. The composition and toxicity of polypeptides prepared from normal and uraemic sera by the combination of Dowex and Sephadex column chromatography have been studied. Significant changes in composition associated with an increased toxicity and decreased diffusibility of peptides (Mwt, 1800--2500 D) isolated from uraemic sera were detected. Due to their moderate of high toxicity as well as their poor or non-diffusibility, these uraemic polypeptides are proposed to be regarded as a new group of uraemic toxins.


[Primary ureteral tumors].

[Primary ureteral tumors]. The primary tumours of the ureter are reviewed, including the authors' ten-year experience in the field. Of the surgical solutions a radical intervention is advocated in the case of malignant tumours; postoperative irradiation is recommended.


[Bilateral testicular tumors].

[Bilateral testicular tumors]. Five patients with bilateral testicular tumours were treated in the ten year period 1966 to 1975. In two patients the tumour appeared on both sides at the same time, while in three cases it developed 3/4, 6 and 7 years apart, respectively. The tumour was detected in one case in a retained testicle; in 4 cases the testicles were in the scrotum. Factors promoting development of the tumour and the diagnostic possibilities are discussed. It is recommended to remove the testicle by high division of the funiculus and to apply postoperative radiotherapy. In the presence of metastases administration of cytostatics is necessary. The possibilities of hormone substitution are discussed.


[Mesothelioma of the tunica vaginalis].

[Mesothelioma of the tunica vaginalis]. After a brief review of the pertaining literature, the case of a 63 year old male patient with a histologically confirmed mesothelioma starting from the tunica vaginalis of the testis is described. The rare tumour developed after an injury of the testis suffered 15 years earlier.


[Analysis of uric acid stone formation through the marking of layers]. Administration at predetermined intervals of a dye which becomes incorporated into uric acid calculi offers information concerning the formation and growth of the calculi, as well as about the effect or failure of the therapy applied.


[Acute post-traumatic renal insufficiency with chronic pyelonephritis]. The course of acute renal failure induced by an injury of the chronically pyelonephritic kidney, the tests ensuring the diagnosis of subcapsular haematoma and the surgical correction of the lesion until its recovery, are described.


Platelet function during reconstructive peripheral arterial surgery. During reconstructive arterial surgery on nine patients suffering from obliterating femoral arteriosclerosis, the number of platelets, the percentage of reversible platelet aggregates, and the plasma concentration of a platelet release marker (platelet factor 4, PF-4) were determined. Blood samples were collected simultaneously from the popliteal vein of the leg operated upon, and from the superior caval vein and radial artery at various stages of the operative procedure. Only slight changes in platelet number were observed. Platelet aggregates increased in blood from all sampling sites during ischaemia, but corresponding values were in general lower in arterial than in venous blood. The percentage of reversible platelet aggregates in the popliteal vein rose considerably during ischaemia, and the rise correlated well with the arterial occlusion time (Rs = 0.96). PF-4 concentration rose throughout the procedure. Although the clinical implications of these findings are not clear, they seem to underline the importance of a swift but careful surgical technique and a short period of main vessel occlusion.


Blood flow in the calves during surgery. The volume flow in the calves was measured by means of plethysmography in 14 patients who had a cholecystectomy and in 3 patients who had a wedge biopsy of the breast. The blood flow increased 100% during abdominal surgery, while no change was observed during the extraabdominal operation. When the legs were placed horizontally during cholecystectomy clear signs of venous pooling were observed. Venous pooling in the calves increased when pillows were placed in the popliteal fossae to prevent over-stretching of the knees. Elevation of the legs 20 degrees in the hip joints decreased the venous stasis considerably. Except for intermittent effects on the circulation caused by strong retraction of the intestines, no clear-cut change in the degree of venous stasis was observed during the course of a cholecystectomy.


An approach to the surgical treatment of carcinoma of the oesophagus and cardia. No method of surgical treatment of carcinoma of the oesophagus and cardia is universally accepted. An approach to the problems of the choice of the side for thoracotomy, the organ for reconstruction of the continuity of the oesophagus and the combination of the abdominal and thoracic stages of the surgical procedure is presented. It is based on the following principles: (1) Selecting the side for the thoracotomy on the basis of the distance from the upper incisors to the upper margin of the tumour, determined by oesophagoscopy. (2) Separation of the laparotomy and the thoracotomy. (3) Starting the operative procedure with the laparotomy. The operative mortality in a series of 44 patients operated upon according to these principles is compared with that in a previous series of 77 patients and the advantages and disadvantages of this approach are discussed.


Staging laparotomy with splenectomy in Hodgkin's disease. The series includes 91 patients with Hodgkin's disease who underwent a staging laparotomy with splenectomy during the years 1971-1976, in 82% of them as part of the initial evaluation before therapy. Positive abdominal lymph nodes were found in 29% of the patients, a positive spleen in 37%, and a positive liver in 10%. Follow-up of patients who lacked abdominal involvement at laparotomy indicate that sampling error was only of marginal importance. Evaluation of the therapeutic implications of the operation indicated that 41% of the patients benefited from the procedure; 31% by changing stage and 10% by changing radiation therapy port. Five patients had minor surgical complications. The mortality rate was nil.


An evaluation of angiography, 75Se-methionine scintigraphy and the Lundh test in the diagnosis of pancreatic disease. In order to asses accuracy and consistency of diagnostic opinion in suspected pancreatic disease, using available diagnostic procedures 74 patients, subjected to selective angiography, pancreatic function test (Lundh test), and scintigraphy, were studied retrospectively. The patients were divided into four diagnostic subgroups, three of which represented defined pancreatic disease, the fourth serving as a control group since such disease could be excluded. The primary diagnostic results were compared. After a stipulated minimum of six months the angiographic films and scintigraphic recordings were re-appraised in a randomized manner without access to clinical data. The evaluations thus achieved were compared to those delivered primarily. The results of the present study seem to indicate that the Lundh test and pancreatic scintigraphy are screening tests with a high level of diagnostic reliability and consistency; when normal, practically ruling out pancreatic disease. Angiography is recommendable only if one or both of the above mentioned screening methods yield pathologic results, supported by clinical evidence. The principal aims of selective angiography in suscepted pancreatic disease, are to map vascular anatomy, to differentiate non-neoplastic disease from cancer and to assist estimation of operability. The results of the reappraisal indicate that the diagnostic accuracy of angiography, more than that of scintigraphy, is dependent on the experience of the examiner.


Simultaneous measurement of the propulsion and mixing of small bowel contents in the rat. A method is presented for the simultaneous measurement of propulsion and mixing of small bowel contents in conscious rats. Through a permanent duodenal catheter two differently labeled test substances (125I-PVP and 131I-PVP) were infused continuously one after the other. The radioactive label was changed once during the total infusion period of 5 hours. Studies were performed in six groups of animals which differed with respect to time for interchange of test substance. At the end of the total infusion period the border zone had travelled to six different locations in the small bowel. The animals were then killed and the two radioactivities were recorded from the excised bowel specimen. The resulting activity densities along the small bowel were peaky and the overlap between the two labels in the border zone was minute, indicating that the intestinal contents were transported in isolated portions with only minor exchange of luminal contents between adjacent regions. The transport apparently proceeded steadily in a mainly aboral direction with no indications of abrupt changes in transport velocity.


Non-occlusive intestinal infarction.

Non-occlusive intestinal infarction. In a retrospective study of all post-mortem examinations and all celiotomies carried out at Glostrup Hospital in the period 1959-76, 81 patients with non-mechanical intestinal infarction were identified. Of these patients, 23 had suffered non-occlusive intestinal infarction. In 15 of the 23 patients the infarction was associated with cardiac disease and its treatment, in 2 patients it was associated with septic and haemorrhagic shock, and in 4 patients with still other diseases. Two patients were completely healthy, when struck by intestinal infarction. The course was fatal in 20 patients. It is concluded that non-occlusive intestinal infarction occurs often enough to be taken into consideration, whenever non-mechanical intestinal infarction is suspected. The treatment should be directed towards the conditions causing intestinal ischaemia.


Alveolar soft part sarcoma. Report of a case. In 1967 an 18-year-old woman was operated on because of a tumour in her right thigh, of which she had been aware for one year. Histological examination led to a diagnosis of alveolar soft part sarcoma. Re-excision of the area was performed but not amputation of the extremity. Ten years later the woman is in good health. She is married and has two children. The patient must be kept under observation for years and should local recurrence arise, amputation will probably be necessary.


A new operation for the dumping syndrome associated with a small gastric pouch. A report of a case. A case of a 72-year-old man with a long-standing disabling dumping syndrome and close to 90% gastric resection is described. A combined iso- and antiperistaltic jejunal transfer which is described step by step with drawings resulted in complete relief of the syndrome. The operation is believed to produce a longer delay in gastric emptying than an isoperistaltic jejunal loop alone, yet avoiding the complications of a single antiperistaltic jejunal segment. The follow-up is now 3 years.


The effects of phenformin and metformin on fat and carbohydrate metabolism. In order to investigate the effects of two biguanide drugs, phenformin and metformin, on metabolic and hormonal changes with exercise, 6 healthy volunteers have been studied during and after 30 min of controlled moderate exercise on a bicycle ergometer on three occasions, two being for the drugs taken separately and the other without any drug, as a control study. Blood samples were taken for estimation of glucose, pyruvate, lactate, free fatty acids (FFA), glycerol, growth hormone (HGH) and insulin (IRI). Both drugs caused a greater rise in blood pyruvate and lactate concentrations during exercise compared with the changes in the control investigation. They also caused a delay in the disposal of pyruvate after exercise. In all investigations, the concentrations of FFA and glycerol rose to similar values at the end of exercise. In the control study, however, the pre-exercise value was achieved by the end of the investigation, whereas with the drugs the concentrations remained elevated. After exercise the rise of ketone-body concentrations was greater with the drugs. These observations indicate that the drugs interfere with aerobic utilization of metabolic fuels, reducing the utilization of pyruvate and glycerol and decreasing the rate of fat re-esterification: these metabolic effects are potentiated by exercise.


Dopaminergic stimulation of HGH in diabetes mellitus and in obesity. The behavior of HGH in basal conditions and after L-Dopa infusion was studied in a group of patients with diabetic retinopathy, in 9 obese and 8 control subjects. In both diabetics and obese subjects, increases found in HGH plasma levels after administration of the drug were slighter than in the controls. On the basis of these results it can be concluded that in diabetics the availability of energetic substrates may modify the HGH response to the L-Dopa stimulus. In obesity, the possibility is considered of a reversible response to the L-Dopa stimulus. In obesity, the possibility is considered of a reversible defect in the sensitivity of the dopaminergic receptors, induced by metabolic and endocrine factors.


Pancreatitis and altered glucose tolerance in mice infected with coxsackie B4 virus. CD1 mice infected with Coxsackie B4 virus showed an early polymorph infiltration of the pancreas, which later changed to a mononuclear exudate. A state of glucose tolerance developed concurrently and both events coincided with the inhibition of migration of spleen cells in the presence of the virus. The relevance of these findings to human juvenile-onset diabetes mellitus is discussed.


Insulin receptors in adipocytes of non-diabetic and diabetic subjects. Preliminary report. We have measured insulin binding to human adipocytes isolated from subcutaneous adipose tissue removed during surgery in normal and insulin-independent diabetics. Collagenase digestion, 125I-monoiodoinsulin and Scatchard's plot were employed to analyze the results. Different kinetic patterns emerged together with differences in the dissociation constant and receptor numbers: in normal subjects K1 was 4 X 10(-9) moles/1 and K20.5 X 10(-8) moles/1, and in diabetic subjects K1 was 2.24 X 10(-9) moles/1 and K2 0.52 X 10 10(-8) moles/1; the two classes of receptors were 100,000 and 300,000 per cell in normals and 50,000 and 180,000 in diabetics. It was clear that even slight diabetes leads to receptor deficiency in adipocytes, though it could not be determined whether this a primary, perhaps genetic, defect or secondary to antibody damage, as suggested by some workers. Feed-back between circulating insulin and specific receptor availability in cells is another possibility.


Advantage in management of diabetic coma by intensive care. A brief review of some therapy results in 763 episodes of diabetic coma from 1960 to 1973 reveals a significant decrease in lethality after institution of an intensive care unit. Present aspects of management are: intensification of shock therapy, potassium substitution and treatment of cerebral edema. The possibly dangerous role of hypotonic solutions is discussed. The lowering of the as yet high lethality of diabetic coma is an urgent necessity.


Dupuytren's disease in diabetes mellitus. Dupuytren's disease (DD) was demonstrated in 169 of 959 diabetics (17.6%) and in 9 of 1,396 non-diabetic patients (0.64%). One hundred and seventy-nine of the 185 patients with DD had overt or latent diabetes mellitus (96.7%). The relative frequency of DD increased with age, the conditions was seldom found under the age of 40. DD should be regarded as a non-hyperglycemic manifestation of diabetes mellitus and its presence in a patient should prompt the investigation of glucose metabolism.


The different responses of the hepatic arterial bed to hypovolaemia and to halothane anaesthesia. Ten dogs were subjected to a period of hypovolaemia (bleeding volume: 2% of body weight) and to a period of halothane anaesthesia (end-tidal halothane concentration: 1%). Mean arterial blood pressure decreased to 79% of control value during hypovolaemia and to 58% of control value during halothane anaesthesia. Mean total peripheral and preportal vascular resistances increased during hypovolaemia and were unchanged during halothane. Mean hepatic arterial and portal venous blood flows decreased to 82% and 55% of control values, respectively, during hypovolaemia, and to 41% and 56% of control value, respectively, during exposure to halothane. Mean hepatic arterial resistance was unchanged during hypovolaemia, but increased during halothane. Mean hepatic oxygen consumption did not change significantly during hypovolaemia, but decreased during halothane anaesthesia, in spite of an increased extraction of oxygen from both the hepatic arterial and the portal venous blood. Possible mechanisms which may maintain oxygen supply to the liver by increasing the hepatic arterial fraction of total liver blood flow when portal venous blood flow is reduced are discussed. It is concluded that this mechanism is upset or inhibited during halothane anaesthesia.


[Analysis of 300 cases of secondary pancytopenia]. Clinical analysis of 300 cases of secondary pancytopenia treated in a period of 10 years is reported. The disease was more frequent in women than in men. The most frequent single cause were drugs, among them chloramphenicol. Most patients had pancytopenia and hypoplastic bone marrow. The mortality was 37%. Death occurred most frequently in the first 6 months of the disease due to infection or thrombocytopenic heamorrhagic diathesis. The results of treatment with corticosteroids and androgenic steroids were unsatisfactory.


[Disorders of various links in heme synthesis in subjects with occupational exposure to nitrogen oxides]. In 35 male subjects with long-standing exposure to low concentrations of nitrogen oxides the morphotic elements of peripheral blood, the activity of delta-aminolaevulinic acid dehydratase(ALA-D) in erythrocytes and urinary elimination of delta-aminolaevulinic acid (ALA), coproporphyrin (CP) and porphobilinogen (PBG) were determined. The control group comprised 29 healthy men not exposed to toxic substances. Statistically significant methaemoglobinaemia, decreased heamoglobin concentration and reduced mean heamoglobin weight in erythrocytes were found in the exposed subjects. At the same time the activity of ALA-D in erythrocytes was increased and urinary elimination of coproporphyrin was increased while that of ALA was decreased. Decreased haemoglobin concentration in peripheral blood in cases of chronic exposure to  nitrogen oxides may depend on their effect on the enzymes participating in haeme synthesis. However, increased ALA-D activity in erythrocytes found in these cases may be of some importance in evaluation of exposure to nitrogen oxides.


Antagonism of fentanyl with naloxone during N2O+O2+ halothane anaesthesia. To investigate the antagonistic effect of naloxone on fentanyl-induced respiratory depression, 55 patients (randomly divided into various study and control groups were studied during nitrous-oxide-oxygen-halothane anaesthesia. Respiratory depression after 0.1 mg of fentanyl was totally reversed by 10 microgram/kg of naloxone, measured as 100% restoration of spontaneous respiration, normal minute volume and end-tidal CO2, while 15 microgram/kg of naloxone was needed to antagonize 0.2 mg of fentanyl. The respective control groups remained apnoeic. If no fentanyl had previously been administered, there was no difference in the respiratory behaviour of naloxone-treated and control patients, which indicates that no unspecific analeptic effect of naloxone could be demonstrated. The circulatory changes after fentanyl were nearly reversed by naloxone, as has been found earlier with other narcotics. Recovery from anaesthesia was scored from 0 to 10 (using a modification of Apgar scores for newborns), and somewhat higher mean scores were obtained with the naloxone-treated patients than with their controls. However, higher postoperative pain scores were recorded in these patients as well as a higher incidence of nausea and vomiting. The study demonstrates the dose-relationships of fetanyl and naloxone for estimation of total antagonism; however, the use of naloxone for partial antagonism at the termination of anaesthesia cannot be based on these findings.


Naloxone as narcotic antagonist after balanced anaesthesia. Different modes of naloxone administration were studied in 100 patients following N2O-O2-relaxant anaesthesia, where fentanyl was administered for analgesia according to a standardized dose schedule (mean 4.3 microgram/kg/h). After reversal of muscular relaxation, the patients were randomly given naloxone--either 1.0 or 2.5 microgram/kg i.v. or 2.5 or 5.0 microgram/kg i.m., or none (control). Each group consisted of 20 patients. Awakening was fastest after 2.5 microgram/kg i.v. of naloxone (1.8 +/- 0.1 min), the time being significantly shorter (P less than 0.025) than in the control group (2.7 +/- 0.4 min). After 15 min, the minute volume and frequency of respiration were significantly higher (P less than 0.05) in all naloxone groups than in the control group. However, the arterialized venous PCO2 did not show significant differences during the recovery. It is therefore suggested that naloxone reversal may cause an increase in CO2 production. The immediate postoperative pain (score 0-3) was mildest in the control group (1.0 mean) and severest after 2.5 microgram/kg i.v. of naloxone (1.8 mean); the difference was statistically significant (P less than 0.05). The groups receiving 1.0 microgram/kg i.v. and 2.5 microgram/kg i.m. did not differ from each other (1.2 mean). Nausea and vomiting were reported more often after 5.0 microgram/kg im. of naloxone than in other groups. After moderate doses of fentanyl during balanced anaesthesia, routine use of naloxone does not seem to be necessary, but if rapid recovery is essential, 1.0 microgram/kg i.v. or 2.5 microgram/kg i.m. of naloxone may be recommended and these doses do not cause a higher incidence of side effects.


Effects of intercostal nerve blocks (bupivacaine 0.25% and etidocaine 0.5%) on chest wall mechanics in healthy men. Bilateral blockade of the 5th to 11th intercostal nerves, inclusive, was produced in 14 healthy subjects. In seven, bupivacaine 0.25% was used, and in the other seven, etidocaine 0.5%. The latter has been found to have a stronger motor-blocking action than the former. Before and after the blockade, the vital capacity (VC), peak expiratory flow rate (PEF), tidal volumes, respiratory variations in rib cage and abdominal circumferences and in oesophageal and intragastric pressures were recorded. By transthoracic electrical impedance pneumography, measures indicating changes in the functional residual capacity (FRC) were obtained. Although it was considered that changes in the parameters investigated mainly demonstrated changes in motor function, no differences were found between the drugs. With this form of blockade they seem to have equivalent effects in this respect. Thus, VC decreased by an average of 7% and PEF by 6%. Signs of a reduction of FRC after the blockade were also observed. The blockade had no effect on the partitioning of costal and abdominal breathing at rest. Analysis of the relations between the fractions of costal and abdominal breathing and the corresponding variations in intragastric pressure gave support to the view that in normal individuals both intercostal and abdominal muscles remain passive during respiration at rest. This is thus achieved by the diaphragm alone.


[Immunochemical and biological properties of rapid monoclonal proteins of the IgG class]. Four proteins M class IgG were analysed in detail in view of their more rapid electrophoretic migration in starch gel among most proteins in this class. On the basis of these investigations two protein (from sera 212 and 244) corresponded to subclass IgG-4, one (serum 119) probably to IgG-4 with polyclonal impurities from other subclasses, and the fourth protein (from serum 210) to subclass 3 or 1. Since subclass IgG-4 contains the greatest amount of sialic acid residues of the remaining IgG subclasses finding of more rapid migration of the observed proteins seems to be due to this. A hypothesis has been put forward that if rapidly moving IgG do not belong to subclass 4 then they have, probably, atypically arranged carbohydrate groups, e.g. in Fab fragment. It was found also that the studied proteins M were carried during chromatography with DEAE cellulose only when a buffer with higher concentration of NaCl was used.


[Storage of platete concentrates at +4 degrees C and +22 degrees C]. The relationship between the conditions of platelet preservation and their ultrastructure, metabolic activity, and the ability to carry out physiological functions was studied. It was found that storage of platelet concentrates at +4 degrees C for 72 hours reduced the number of platelets, changed their shape decreased the ATP level and the ability of release of adenine nucleotides in response to thrombin. The platelet at +22 degrees C for 72 hours preserved the initial number, normal ultrastructure, intact metabolic activity and the ability of participation in heamostasis processes.


Mobilities of complex glycosphingolipids in SDS gel electrophoresis. Poly/glycosyl/ceramides, highly complex and blood-group active glycosphingolipids of human erythrocyte membranes were subjected to SDS polyacrylamide gel electrophoresis. The substances exhibited similar electrophoretic mobilities as membrane sialoglycoproteins.


Epidural block in twin labour and delivery. In a clinical study, 28 twin mothers were provided with epidural block during labour and delivery. This group was compared to 24 twin mothers who received conventional analgesics throughout labour. General anaesthesia was administered when operative delivery was indicated in the control group. In the epidural group, duration of labour was significantly prolonged. A delayed second stage of labour caused an increased number of operative vaginal deliveries. Intra-uterine asphyxia was not more frequent in the epidural group. Judged by the Apgar score and the neonatal course, there was no difference between the newborn in the two groups. Neither clinical evaluation, nor acid-base investigations showed any difference between the condition of Twin I and Twin II in the epidural group.


Effect of atropine-pethidine premedication on peripheral blood lymphocytes. Phenothiazines, which are also employed for premedication, are known to have an inhibitory effect on the cell-mediated immunity. Therefore, the effect was studied in nine patients of the most commonly used atropine-pethidine premedication on the leucocyte and differential count, the number of T-and B-lymphocytes and the lymphocyte transformation by phytohaemagglutinin (PHA), Concanavalin A (ConA), pokeweed mitogen (PWM) and purified protein derivative of tuberculin (PPD) in cultures of separated lymphocytes and of whole blood. The premedication increased the proportion and absolute number of surface immunoglobulin-positive (B) lymphocytes in the peripheral blood and reduced the PHA and PPD responses in whole blood cultures. These vague changes in the immune response after premedication are of no importance in clinical work.


Splanchnic elimination and systemic toxicity of bupivacaine and etidocaine in man. Fifteen healthy young volunteers were studied in connection with an intravenous infusion of a local anaesthetic agent. Seven received bupivacaine and eight etidocaine in a dose rate of 2 mg.min-1 over a period of 150 min. The hepatic blood flow and arterial-hepatic venous differences of the two drugs were measured. The estimated hepatic blood flow increased during the infusion of both drugs. While the splanchnic extraction ratio decreased during infusion of bupivacaine to 0.41 +/- 0.13, the same variable did not change (0.76 +/- 0.07) when etidocaine was infused. After 150 min infusion, the splanchnic clearance of bupivacaine and etidocaine was 0.76 +/- 0.27 and 1.32 +/- 0.21 1.min-1, respectively. Slight symptoms of central nervous toxicity were noted towards the end of the bupivacaine infusion, while no such symptoms appeared with etidocaine. A comparison between earlier published data on the blocking properties and the disposition pharmacokinetics of the two drugs shows that etidocaine is likely to confer a clinical advantage over bupivacaine as regards toxicity.


Postoperative ventilatory response to carbon dioxide following neurolept anaesthesia. In order to investigate the duration of respiratory depression following neurolept anaesthesia, 21 patients who had hemilaminectomia performed were subjected to ventilation-carbon dioxide response tests by a rebreathing method in the post-operative period. Up to 3 1/2 h after start of anaesthesia all patients had a decreased ventilatory response to carbon dioxide. After this period some patients showed a normal respiratory response, while others remained depressed for up to 6 h, the period for which the investigation lasted. Most patients in the depressed group were premedicated with pethidine. We conclude that additional narcotics are contraindicated for a period of 3 1/2 h following the start of neurolept anaesthesia for surgical procedures lasting 1-2 h, while clinical control is still necessary before administration of additional narcotics within 6 h, especially if narcotics have been used as premedication.


Intubation of newborns and infants: a solution to the problem of water condensation. Treatment with humidified air in intubated newborns and infants its often complicated by the embarrassing problem of water condensation. This problem is solved by the humidification system described below, in which the tube delivering humidified air is surrounded by an Armaflex-insulated spiral-wire tube. Through the space between the two tubes, an adjustable air warmer delivers dry air at a temperature and flow rate such that the temperature of the humidified air in the delivery tube is maintained above its dew-point temperature.


Psychological changes in children after anaesthesia: a comparison between halothane and ketamine. The psychological reactions to hospitalization, anaesthesia, and operation in a group of 107 children from 1 to 12 years old, anaesthetized with ketamine or halothane after randomization were investigated through questionnaires, which the parents answered 1 month postoperatively. The percentage of replies was 96.3%. Fifty-three children were anaesthetized with ketamine and 50 with halothane. Thirteen children in the ketamine group and nine in the halothane group reacted with negative personality changes; the reactions were of less than 1 month's duration and were most frequent in the youngest children. The parents' preparation of the children had no influence on the results. The number of personality changes caused by the two anaesthetic agents did not differ significantly. Furthermore, the investigation showed the nine children reacted for the better. Thirty-six per cent of the parents felt insufficiently informed of what the hospitalization implied for their child.


Lymphocyte stimulation in multiple sclerosis patients untreated and treated with transfer factor. Long-term studies on the effect of different stimulants on myo-(2-3H)inositol incorporation into phosphatidylinositol of lymphocytes. The lymphocytes from controls, untreated MS and MS patients treated with transfer factor were stimulated with PHA, PWM, PPD, LPS and MA and the increased incorporation of myoinositol into phosphatidylinositides was determined. As compared with controls, the untreated MS patients revealed significantly lower index of stimulation with PHA, LPS, PPD and MA. The response of lymphocytes from MS patients treated with transfer factor was intermediate. No correlation between disease progression and stimulation of inositol incorporation was observed. Analysis of variance showed that the myoinositol test is not applicable in long-term studies to distinguished single subjects, however it is useful to determine differences between MS patients and controls.


Discrimination of elevated immunoglobulin concentrations in CSF due to inflammatory reaction of the central nervous system and blood-brain-barrier dysfunction. Inflammatory reactions of the central nervous system (CNS) are diagnosed by the determination of elevated immunoglobulin concentrations in cerebrospinal fluid (CSF) due to local production of immunoglobulins. However, unspecific disturbances of the blood-brain-barrier (BBB) can also cause an increase of CSF immunoglobulin concentration as a result of filtration from blood serum. The methods described here attempt a more precise characterization of immunoglobulins in CSF and to define that portion of CSF immunoglobulin derived from the CNS. Albumin and the immunoglobulin fractions IgG, IgA and IgM are determined in serum and CSF. The ratio of albumin in serum and CSF is taken as an indicator of BBB function. By the determination of quotients an overproportional immunoglobulin elevation in CSF as expression of an inflammatory reaction of the CNS can be detected. Methodological problems and the definition of normal ranges are discussed.


Chronic progressive external ophthalmoplegia in a heredo-ataxia: neurogenic or myogenic? A clinical, neuropathological and submicroscopic study. A patient with Friedreich's disease and chronic progressive external ophthalmoplegia is descirbed. An investigation was performed into the nature of the ocular motor disorders, which appeared clinically to be supranuclear. The EMG of the ocular muscles suggested myopathy. A specimen of ocular muscle was obtained by biopsy and examined with the light microscope and-for the first time-under the electron microscope. Signs of mitochondrial myopathy were found alongside neurogenic features. Postmortem examination of the central nervous system confirmed the diagnosis of Friedreich's disease with lesions of the motor cells in the anterior horn of the spinal cord. No evidence was found for a supranuclear or inernuclear origin of the ocular palsies, but 20-30 per cent of the neutrons in the nuclei III and IV were atrophic. Lesions of the non-medullated motor nerve fibres were also visible under the electron microscope. That the origin of the c. p. e. o. in this heredo-ataxia is neurogenic-nuclear is postulated on the grounds of the neuropathological and electronmicroscopic findings. Resemblances to the microscopic and submicroscopic and submicroscopic appearance of many types of "ocular myopathy" and "ophthalmoplegia-plus" throw doubt upon the myogenic character of these conditions. Possibly chronic, slowly progressive atrophy in the nuclear areas of the ocular motor nerves must in these cases also be held responsible for the c. p. e. o. Perhaps Moebius's Kern-Schwund theory may be revived after 85 years.


Plasma O-methyldopa in levodopa-induced dyskinesias. A bioclinical investigation. The peripheral metabolism of Dopa has been studied in correlation with the clinical occurrence of Leyodopa-induced dyskinesias in Parkinson patients. Within the group of patients treated with a peripheral decarboxylase inhibitor (PDI), the combination of all the plasma levels of O-Methyldopa from patients with dyskinesias shows significantly higher values than those from patients without dyskinesias. For Dopa itself, no significant differnece can be detected. Such high O-Methyldopa levels seem to be due to a progressive accumulation of this compound and not to a higher degree of formation. In contrast, no significantly different Dopa or O-Methyldopa levels are found within the group of patients treated with L-Dopa alone. These results are discussed in relation to some of the suspected mechanisms involved in Levodopa-induced dyskinesias.


Effect upon serum insulin, glucose and potassium concentrations of acetazolamide during attacks of familial periodic hypokalemic paralysis. In four patients with periodic hypokalemic paralysis paralytic attacks were induced in the untreated state and later, after the patients had been treated with acetazolamide. There was a distinct, clinically favourable effect of acetazolamide upon the length as well as the severity of paralysis. The maximum fall in serum potassium was less marked during acetazolamide therapy. After treatment all four patients showed significantly reduced serum levels of glucose and insulin during induced attacks of paralysis as compared with the levels obtained during paretic attacks in the untreated state. These findings indicate that the prophylactic effect of this drug does not relate merely to metabolic acidosis. The hypothesis is advanced that the lower serum insulin and glucose levels might represent reduced absorption which would amount to an indirect prophylactic action.


Erythrocyte glutathione perioxidase deficiency in multiple sclerosis. The present study demonstrates a significant decrease in glutathione peroxidase activity in erythrocytes of 24 patients with multiple sclerosis (MS) when the data are expressed as enzymic units per mg hemoglobin and compared to data from normal controls without known family history of demyclinating diseases. Since selenium is an essential part of glutathione peroxidase, this study also compares the topographic differences in selenium availability (expressed as selenium content of forage) withage) iwth the prevalence and death rates of MS in the USA. The comparison cannot exclude the possibility of a relationship between low selenium content and high prevalence as MS. The data are discussed in relationship to current theories on the pathogenesis of MS.


Stimulation frequency and visually evoked scalp potentials with brief flashes of light. Recording of the visually evoked scalp potential (VESP) elicited with flash stimulation was completed in six subjects presenting with normal vision. From the four separate signals recorded over the visual cortex, it was concluded that stimulation frequency affects some of the components of the VESP. Accordingly, in studies of the VESP character, the influence of stimulation frequency is a critical factor which must be taken into account when analyzing the resultant activity.


The effects of toxic and non-toxic serum phenytoin levels on carbohydrate tolerance and insulin levels. The effect of toxic and non-toxic phenytoin levels on carobhydrate tolerance and insulin levels was studied in 18 patients with epilepsy and 17 control subjects. Toxic levels were defined as a serum level greater than 20 microgram/ml. Toxic levels occurred in 11 patients and nontoxic levels in seven patients. Blood glucose and insulin levels were measured at 30-min intervals for a period of 3 h following the ingestion of 50 g glucose. Blood glucose levels were measured by the ferricyanide method, and serum insulin levels by immunoassay of insulin with insulin antibody precipitate. Serum phenytoin levels were measured by gas liquid chromatography. The insulin profiles were the same for all three groups, but there was a significant delay  in reaching peak glucose concentrations in patients with toxic levels of phenytoin. It was therefore confirmed that non-toxic levels of phenytoin do not affect carbohydrate tolerance or insulin levels when phenytoin is used in the routine treatement of epilepsy, and it has also been shown that toxic levels of phenytoin do not affect carbohydrate tolerance when the high levels are detected at an early stage.


The development of the extensor digitorium brevis muscle in progressive proximal muscular antrophies. The development of the extensor digitorium brevis (EDB) muscle was studied in 39 healthy subjects, 27 patients with progressive proximal spinal muscular atrophy, 20 patients with limb-girdle muscular dystrophy and three with facioscapulohumeral muscular dystrophy. The EDB muscle is spared and usually hypertrophic in patients with muscular dystrophy, whereas it is often atrophic and weak in patients with spinal muscular atrophy. It is proposed that the degree of development of the EDB muscle can be used as a clinical sign in the differential diagnosis of progressive muscular atrophies.


Juvenile neurolipidosis of Bernheimer-Seitelberger's type. Histopathological and biochemical findings. Two children are reported, who became diseased at the age of 4 and 2 years, respectively, with progressive upper motor neuron symptoms leading to severe disability within a few years. The boy died at age 10 and autopsy disclosed a severe gangliolipidosis throughout the central nervous system, maximal in the brain stem and cerebrellum, corresponding with his early and dominantly bublar symptoms. The girl is still living, although severly disabled. The etiology was confirmed through biochemical studies which showed lower activity of galactosaminidase and galactosidase in frontal lobe tissue from the boy, in liver tissue from the girl. The activity of galactosaminidase A isoenzyme was more than 50 per cent lower in serum from the girl and in serum from healthy relatives of the boy, the father, mother and one of two brothers. Furthermore, the galactosidease activity was within or below the lower normal range limit in leucocytes from relatives of the boy with exception of the father. This abnormality was also encountered in serum from our girl patient.


Interaction between carbamazepine and propoxyphene in man. This investigation was carried out because of a clinical suspicion of drug interaction between Propoxyphene (PRX) hydrochloride and Carbamazepine (CBZ). Seven out-patients, six suffering from epilepsy and one from trigeminal neuralgia, treated with CBZ alone or in combination with phenobarbitone, received PRX hydrochloride capsules, 65 mg three times a day. Two patients stopped the PRX intake after 2 days due to severe side effects. Three of the remaining patients had symptoms and signs of drug intoxication. Blood samples were examined by thin-layer chromatography. A marked increase (45-77 per cent) in CBZ plasma level was found in all patients on combined treatment of CBZ and PRX. There were no significant changes in CBZ-10,11-epoxide level. The results suggest an inhibition of CBZ metabolism when CBZ and PRX are administered simultaneously.


Immunoglobulin concentrations in first-degree relatives of epileptic patients with drug-induced IgA deficiency. Serum immunoglobulins A, G and M were studied in parents and siblings of 16 patients being treated for epilepsy. Five healthy families served as controls. Seven of the patients were low IgA-responders and the rest of the patients had shown normal IgA-levels during treatment. None of the parents and siblings studied showed a serum-IgA deficiency, with the exception of one mother who was being treated for rheumatoid arthritis with naproxen. Low serum concentrations of IgG and IgM were not found. A significantly increased IgM-level was found in first-degree relatives of the low IgA-responders, and the siblings of low 2gA-responders had significantly raised IgA in their sera.


Treatment of familial periodic hypokalemia with propranolol (Inderal). Four patients suffering form familial periodic paralysis with hypokalaemia (FPP) were subjected untreated to standardized induction of paralysis. The induction was repeated after pre-treatment with the beta receptor blocker propranolol (Inderal). In three of the patients propranolol had no or even a negative effect upon the development of paralysis or upon the fall in serum potassium. In one patient a slight prophylactic gain was achieved. It was not possible to demonstrate any difference in the serum level of glucose or insulin during the induction of paralysis according to whether the patients were untreated or treated with propranolol. Short-lasting out-patient treatment of the patient who had apparently had some slight prophylactic benefit from propranolol had to be discontinued after 11 days because of an unusually severe and long-lasting attack. It is concluded that propranolol has no major effect in the treatment of FPP-unlike its favourable effect in thyrotoxic familial periodic paralysis (TFPP).


Pathological, histochemical and ultrastructural studies on sea-blue histiocytes and Gaucher-like cells in acquired lipidosis occurring in leukemia. Smears of bone marrow aspiration from 82 patients with leukemia and major hematopoietic organs, such as bone marrow, spleen, liver and lymph nodes, obtained from 97 autopsy cases of the disease, were light-microscopically examined. As the results, occurrence of either sea-blue histiocytes or Gaucher-like cells, or of both, was observed in bone marrow smears of 23 patients and in the hematopoietic tissues of 44 out of the examined cases, particularly marked in those of chronic myelogenous leukemia. In acute myelogenous leukemia, these lipid storage cells were also confirmed though less in frequency or degree. Histochemically, the sea-blue histiocytes were substantiated to contain ceroid-like pigments in their cytoplasm uhile the lipid materials stored in the Gaucher-like cells were presumed to be glycolipids. Ultrastructural morphology of the inclusions in the sea-blue histiocytes uas almost consistent with that of ceroid previously reported, but showed more marked variegated and heterogeneous features. Intracytoplasmic inclusions of the Gaucher-like cells differed from those of Gaucher cells seen in Gaucher's disease and were dominated by fibrillar or linear deposits. Transitions from phagocytized leukemic cells to the inclusions characteristic of each type of the cells were traced.


Induction of atrophic gastritis in ICR mice by the administration of an allogenic antigen. In an attempt to produce experimental autoimmunity in small animals the experiment was sought to induce atrophic gastritis in ICR/JCL mice. The stomach antigen of ICR mice was extracted and emulsified with an equal volume of Freund's complete adjuvant. This was subcutaneously injected in 5-week-old ICR/JCL mice at 1 week intervals for a total of 1 to 4 administrations. The stomach antibody in the serum gradually increased up to 2(6) until four weeks after the last injection of the stomach antigen. At the same time pyknosis and a decrease in number of the gastric mucosal cells, which ultimately led to the atrophying of gastric mucosa, developed. Thereafter, concomitant with the decrease in serum antibody against mucous cells, regeneration of mucous cells was especially remarkable, but atrophy of the fundic gland continued.


Pathological study on amyloidosis--scanning electron microscopic observation of amyloid-laden mouse liver. Amyloidosis of liver in mice induced by casein injection was studied by scanning electron microscopy (SEM). In the fractured-surfaces of the central portion of amyloid nodules, they appeared as chestnut-bur-like structures and were composed of numerous thread-like structures of fasciculated amyloid fibrils and of stick-like structures of amyloid bundles in three dimensional figure. In the cytoplasm of the Kupffer cell, amyloid bundles were revealed as band-like bulges. These bulges were projected from the Kupffer cell into the Disse's space and continued with thread-like structures outside the cytoplasm of Kupffer cells.


Arhinencephaly (holoprosencephaly) associated with external hydrocephaly. A female infant, weighing 2,263 g had been spontaneously delivered at the 33rd week of gestation. The only noticeable abnormality was a cleft palate, but within the next few days, she developed low temperature, spastic movements in the extremities, and depressed respiration. These abnormalities soon became worse and she died on the 12th day. Clinically, she was not suspected of having malformations of the brain, but on autopsy, an external hydrocephaly (400 ml) and small arhinencephalic brain (75 g) were noted. In the brain, the growth of the diencephalon was exceedingly poor but the growth of the rhombencephalon was relatively favorable. The olfactory bulbi and tracts in the telencephalon were absent. These findings were similar to those seen in cases of arhinencephaly (or holoprosencephaly). In the cerebral ventricles, the lateral ventricles and the IVth ventricle were enlarged, but the IIIrd ventricle could not be identified. Communication could only be found between the lateral apertures of the IVth ventricle and the subarachnoidal spaces.


Morphological and biochemical changes in the gastric mucosa of A/HEJ mice injected with a xenogeneic stomach antigen. Subcutaneous injection of W/Fu rat stomach antigen emulsified with an equal volume of Freund's complete adjuvant at 1 week interval for a total of 2 administrations induced atrophic gastritis in A/HeJ mice. From the second week after the last injection the parietal cell mass decreased. At the same time, Alcian blue-PAS positive cells and Paneth-like cells appeared. Furthermore, the activity of alkaline phosphatase and disaccharidase of the small intestinal mucosa was biochemically demonstrated in the atrophic glandular stomach.


Clear cell adenocarcinoma of the uterus--ultrastructural and hormonal study. A clear of clear cell adenocarcinoma of the uterus combined with early invasive squamous cell carcinoma of the cervix was reported. The adenocarcinoma was found to be in histologic continuity with the squamous cell carcinoma as well as with the cervical glandular epithelium. Ultrastructurally, the epithelial cells of the adenocarcinoma showed junctional complexes, well developed microvilli, parallel stacks of granular endoplasmic reticulums and twisted rope-like nucleoli, all of which were in accord with the cytologic characteristics of endometrial carcinoma. Hormonal study of the tumor suggested the presence of estrogen receptor and a lack of endocrine productibility. These findings provide an additional support for the Müllerian duct origin of uterine clear cell adenocarcinoma.


Sclerema neonatorum associated with systemic fibrosis and endocardial fibroelastosis. A female newborn infant whose illness was diagnosed as sclerema edematosum on the basis of diffuse edematous skin induration having rapidly occurred until her death on the third day of life, was pathologically investigated. Autopsy revealed notable interstitial fibrosis of the subcuteneous adipose tissue, variable increases of fibrous connective tissue in various visceral organs, particularly prominent in the alimentary tract, as well as endocardial fibroelastosis of the heart. Although the skin lesion is similar to that of sclerema neonatorum presented by HUGHES et al., systemic fibrosis in the visceral organs has not been reported in the literature with respect of this disease. Furthermore, this case presented striking histopathological differences from scleroderma neonatorum and infantile subcutaneous fat necrosis in many respects. It is conceivable that this case is a peculiar disorder at least pathologically different from the previously known cutaneous indurative disorders of newborn infants. Possible pathogenesis of this case was briefly discussed.


The ultrastructure and distribution of micropores in the various developmental forms of Eimeria brunetti. The structure and distribution of micropores in the various developmental stages of Eimeria brunetti was examined. Micropores were observed in all the endogenous forms with the exception of the microgamete. Oocysts from chicken faeces were also examined at various stages of sporulation and micropores were demonstrated in zygotes, sporoblasts, sporozoites, and the residual cytoplasmic masses. The number of micropores per organism appeared to be correlated with the surface area of the organisms irrespective of whether these were endogenous or sporulating forms. The increase in the number of micropores did not appear to be related to micropore activity because semmingly active micropores were observed only in the trophozoites, in the early multinucleate forms (early shizonts and microgamonts), and in the early macrogamonts. All these forms, however, possessed relatively few micropores. No active micropores were ever observed within the sporulating oocysts.


Rabbit polymorphonuclear leukocyte migration in vitro in response to lipopolysaccharides from Bacteroides, Fusobacterium and Veillonella. Puriified lipopolysaccharides (LPS) from strains of Bacteroides, Fusobacterium and Veillonella incubated with guinea pig serum, were tested for chemotatic activity against rabbit polymorphonuclear leukocytes (PMNs) in modified Boyden chambers. Comparisons were made to a Salmonella LPS (S. enteriditis S-795). Submicrogram amounts of LPS induced positive chemotaxis, and a typical dose-response relationship up to certain dose levels was observed. The difference in chemotactic activity between the Veillonella LPS and LPS-S-795 was not statistically significant. The Fusobacterium LPS showed either a non-significant or a highly significantly lower chemotatic capacity than LPS-S-795. The Bacteroides LPS were also clearly chemotactic, but considerable less when compared to the Salmonella LPS. When serum was not added, the LPS preparation showed no chemotactic activity.


Rabbit polymorphonuclear leukocyte migration in vivo in response to lipopolysaccharides from Bacteroides, Fusobacterium and Veillonella. Subcutaneously implanted chambers in rabbits were used for testing the migration of polymorphonuclear leukocytes in response to injected LPS isolated from strains of Bacteroides, Fusobacterium and Veillonella. A salmonella LPS was used as reference endotoxin. No differnece in chemotactic activity between the Veillonella LPS and LPS from Salmoneila was found. Fusobacterium LPS whoed insignificantly lower chemotactic capacity than the Salmonella LPS. The Bacteroides LPS were all significantly less chemotactic than the reference endotoxin. An insignificant correlation between the amount of exudate aspirated from the chambers 5 h after injection of the different LPS preparations and the number of leukocytes per microliter of exudate was found.


Erythropoietic activity and interferon production in LCM virus-infected nude mice. The distinct haemopoietic lesions induced in ordinary mice during acut LCM virus infection are not mediated either by immunopathological mechanisms or by a direct cytopathogenetic effect of the virus. Medication has recently been artibuted to the high interferon activity found in mice with acute LCM virus infection. In this work, erythropoietic activity and interferon production have been studied in LCM virus-infected nude mice. Compared with ordinary mice, nude mice displayed a more moderate suppression of erythropoiesis and a very poor interferon response. Erythropoietic activity of thymus-transplanted nude mice was not significantly suppressed during the infection, and interferon responsiveness was not restored either by thymus-transplantation or by transfer of large numbers of spleen lymphocytes. The observations support the hypothesis that interferon plays a decisive role in the induction of haemopoietic diorders of mice with acute LCM virus infection. The puzzling question as to why nude mice and reconstituted nude mice are incapable of mounting a normal interferon response is discussed briefly.


Experimental mycoplasmal pneumonia in dogs: electron microscopy of infected tissue. Thin sections of lung tissue from dogs with pneumonia induced by endobronchial inoculation of Mycoplasma cynos were examined by electron microscopy. Mycoplasmas were observed extracellularly in lumen of bronchus and in alveoli in the earlier stages of the infection. The infection also resulted in degenerative changes in the bronchial epithelial cells, including in particular destruction and loss of cilia.


Surface markers in non-phagocytic hairy cell leukemia. By phase contrast and scanning electron microscopy hairy cells were demonstrated in the peripheral blood, bone marrow and spleen of a patient with hairy cell leukemia. Immunofluorescent tests revealed IgD on the surface of 92 per cent, IgG, on 76 per cent, IgM on 12 per cent and albumin on 95 per cent of the cells from the spleen. After overnight culture, IgG and albumin were detected on 4 and 6 per cent of the cells respectively, while the number of IgD and IgM positive cells persisted. Fifty-two per cent of the hairy cells formed rosettes with erythrocytes sensitized with IgG antibodies (EA), whereas 70 per cent formed rosettes after trypsin and protease treatment. The hairy cells did not form rosettes with erythrocytes sensitized with IgM antibodies and complement (EAC), or with sheep and mouse erythrocytes. Cryostat sections of spleen strongly adsorbed EA, whereas no adsorption occurred with EAC or sheep erythrocytes. The hairy cells did not phagocytize latex particles or ingest a strain on yellow staphylococci. The results suggest that hairy cells from this patient probably were of B-lymphocyte origin.


Elimination of protein A-IgG complexes from the blood circulation in rabbits: role of spleen and liver. We studied the elimination from rabbit circulation of soluble immune complexes made with staphylococcal protein A and rabbit IgG. In in vivo experiments the complexes were cleared from the circulation by the liver and spleen. In the saline perfused isolated liver there was rapid uptake of protein A-IgG complexes which indicated that the elimination of these complexes by fixed tissue macrophages may occur independent of complement components.


Relative rates of the non-covalent and covalent binding of secretory component to an IgA dimer. The rate of binding of free secretory component to an IgA dimer in vitro was studied by high-voltage gel electrophoresis at different times after mixing. The rate of the formation of the covalent component of the interaction (i.e. the disulphide interchange reaction) was monitored separately by denaturing the proteins in 6 M guanidine hydrochloride at different times after mixing and subsequently estimating the amount of covalently bound secretory componenet by gel chromatography in the denaturing solvent. The rates of the two reactions could not be distinguished in experiments at 37 degrees or 20 degrees C. At 4 degrees C, however, secretory component bound to the IgA dimer almost as rapidly as at higher temperatures, while the rate of the disulphide interchange was considerably lower. This indicates that the noncovalent interactions are the primary type of bonds formed between secretory component and IgA, and that the formation of these bonds initiate the disulphide interchange reaction, the rate of which is highly dependent on temperature.


Effect of respiration on cardiac motion determined by cineangiography. Implications concerning three-dimensional heart reconstruction using computer tomography. Based on 39 cineangiographies in 23 patients performed during respiration with tracing of the cardiac chambers and the diaphragm, it has been found that the heart moves significantly with respiration, approximately half as much as the diaphragm during shallow or normal respiration. The cardiac respiratory motion indicates that gating of the respiratory cycle as well as the cardiac cycle is necessary in three-dimensional reconstruction of the heart using a large number of heart beats for recording.


Proteinuria following nephroangiography. I. Clinical experiences. Following nephroangiography with an ionic contrast medium (metrizoate) proteinuria occurred in 25 of 28 patients, reaching its maximum with 1/2 to 24 hours. It fell to preangiographic values within 6 days. The degree of proteinuria varied but was massive, i.e. more than 10 g albumin/g creatinine, in 9 patients. The underlying mechanism is a marked, reversible increase in glomerular permeability.


Transcatheter arterial embolization of normal livers and experimental hepatic tumours in the rat. Transcatheter hepatic arterial embolization with Spongostan (99.3% gelatin) was performed in a group of normal rats. By repeat angiography could be demonstrated that arterial occlusions lasted for at least 1 to 8 days in most rats. Microscopy of these normal livers gave no evidence of parenchymatous liver injury. At postembolization angiography in a group of rats with experimental liver tumours it could be demonstrated that arterial supply of these tumours was temporarily completely arrested. Microscopy of some of these neoplasms revealed extensive necroses. The eventual future clinical applications of this procedure as an alternative to hepatic artery ligation is discussed.


Superselective arterial embolization for the control of postsurgical bleeding. Superselective catheterization and Gelfoam embolization of a muscular branch of the deep femoral artery was successfully performed; a profuse postsurgical bleeding requiring repeated transfusion of blood was stopped. The time of persistence, advantages and disadvantages of commonly used embolic materials are discussed. It is concluded that embolization is an effective method to stop bleeding in selected patients.


The spherical index. A measure of the roundness of the femoral head. The sperical index is introduced as a new, simple method of measuring the roundness of the femoral head and capital epiphysis. The index may be applied both in children and adults. Means and standard deviations are presented for both sexes in different age groups. The index increases with age until maturation. In adults the index is constant.


Determination of sagittal instability of the knee joint. For measuring sagittal instability in the knee joint a radiologic method has been developed which requires no complicated equipment, is easy to apply, and is relatively insensitive to the sources of error commonly associated with determination of sagittal instability, such as difference of flexion angle and changes in the projection. Measurements are made between reference points located in the femur and the tibia. The reproducibility of the method is high enough to make it suitable for testing instability before and after reconstructive surgery. By the use of constructed reference points sagittal instability can be distinguished from rotational instability.