Children's use of CROS hearing aids.

Children's use of CROS hearing aids. Ten children with unilateral hearing loss, aged 7 to 17 years, who were fit with contralateral routing of signal (CROS) hearing aids were followed up for three years to assess the suitability of this type of hearing aid fitting on children. The determination of the success of the fitting was based on follow-up visits, chart review, and response to a questionnaire sent to the parents. The fitting was considered to be successful if the child accepted the aid and if parents and teachers observed substantial improvement in academic performance and/or social behavior. Seven children were considered to be successful users of their CROS aids; one was unavailable for follow-up; one did better with a BICROS aid; and one did not do well with amplification. Our experience suggests that children with unilateral hearing loss can benefit from CROS amplification.


Olfactory sarcoidosis. Report of five cases and review of the literature. Changes in the olfactory system in five patients with sarcoidosis were studied by clinical and histopathological examination. Every patient studied had hypogeusia and/or hyposmia as measured by psychophysical testing. In two patients who died with this disease, the olfactory bulbs and tracts were involved by granulomatous infiltration. Two other patients showed granulomas and chronic inflammation in nasal biopsy specimens. The fifth patient was studied only clinically. Changes in olfactory and gustatory acuity are rarely searched for in patients with sarcoidosis, but they may be important indicators of major and later irreversible damage to the CNS. If diminished olfaction is established in suspect patients, nasal biopsy and examination of the CNS should be performed to confirm the presence of active sarcoidosis. Appropriate therapy may prevent damage to the patient's sensory capabilities and CNS function.


Posttraumatic endolymphatic hydrops.

Posttraumatic endolymphatic hydrops. A case of posttraumatic endolymphatic hydrops that was confirmed by a positive glycerin test is reported. Although head trauma has been implicated as a cause of hydrops, few such cases are reported in the literature. Careful consideration of perilymphatic fistula must be accorded before a diagnosis of posttraumatic hydrops is made.


The value of sialography in the diagnosis of parotid tumors. A clinicopathological correlation. The importance of sialography in the diagnostic evaluation of the condition of a patient with a parotid mass remains uncertain; some proponents advise use of sialography routinely, while others believe it to be worthless. To help resolve these conflicting opinions, a retrospective study of 40 patients was carried out that compared sialographical interpretations with respective surgical-histological findings. The results of this study show that generally reliable information, which may serve to influence therapeutic decisions concerning these patients, can be gleaned from sialography.


Cerebral cortical veins in otologic surgery. Proximity of the cerebral cortical veins to the overlying dura predisposes them to surgical injury. Labbé's vein, draining a major portion of the posterior temporal and inferior parietal lobes, occurs on the left in 77% and on the right in 66% of patients. Interruption of this vein during otologic surgery may produce devastating neurologic consequences. In this regard, the roentgenographic anatomy of cerebral cortical venous drainage is reviewed. Technical treatment of the temporal dura should include those techniques familiar to the neurosurgeon that ensure the pretection of the temporal lobe and its superficial venous drainage.


Laryngotracheoesophageal cleft. Diagnosis, management, and presentation of a new diagnostic device. Congenital posterior clefts between the laryngotrachea and the esophagus have rarely been encountered as evidenced by only 30 cases reported in the world literature. Of these, patients in nine have survived. We present another patient with this condition who was successfully treated. Important aspects in evaluation, including the need for an experienced endoscopist and cineradiography, are discussed. Postoperative management using a continuous infusion pump to administer formula per gastrostomy prevents gastric distension and emesis that lead to stress on the closure. This should be a basic consideration in the management of these patients.


Cricoarytenoid arthritis in a patient with ankylosing spondylitis. A 50-year-old woman with a 27-year history of ankylosing spondylitis developed cricoarytenoid joint arthritis that was indicated by hoarseness, sore throat, and vocal cord fixation. This unusual manifestation of ankylosing spondylitis responded to treatment with moderate doses of prednisone, but it recurred when the cortiocosteroid therapy was discontinued.


Preventive dentistry: guidelines for the family physician. The two major strategies of prevention are to decrease the intensity of attacking agents and to increase the resistance of the host tissues. The manner in which these principles can be applied to dental caries, periodontal diseases, oral mucosal diseases, oral cancer and traumatic injuries to the teeth is described.


Oro-facial pain.

Oro-facial pain. Oro-facial pain is commonly acute, and of dental origin. There are numerous other less common, but clinically identifiable types of oro-facial pain which can be attributed to an organic cause, and which usually respond to the appropriate treatment. There is a small proportion of oro-facial pain problems, however, which are chronic and which are found to have a psychogenic element of greater or lesser magnitude, and treatment is aimed at psychological or psychiatric therapy. The interim results of an ongoing study of chronic oro-facial pain of psychogenic origin are described in this presentation.


Endodontics or root canal therapy.

Endodontics or root canal therapy. This article discusses the diagnosis and treatment of pulp involved teeth. There are still some patients and some older physicians who associate certain systemic diseases with dead teeth. For this reason, the subject of focal infection is considered first. As many patients with facial pain or dental infection present first to their  physician, it is important for the medical practitioner to understand the cause and its treatment. Finally, brief reference is made to the treatment of teeth injured as a result of trauma with special emphasis on first aid where permanent teeth have become dislodged.


The temporomandibular joint pain dysfunction syndrome. This paper discusses a relatively common myofascial pain syndrome. Despite its commonness, it is frequently misdiagnosed and patients may be subjected to many forms of treatment without relief. Some of these treatments may be mutilating, or may produce complications which add to the patient's discomfort. It is therefore suggested that competent dental advice should be sought in all cases of atypical facial pain, and that pain clinics should include a dentist as a member of the team.


Use of a community health centre by general practitioners. The advent of community health centres has brought a change to supportive services in many areas. This situation has produced problems, both for the general practitioner confronted by new expectations and possibilities, and for the health centre seeking his cooperation. There is here an opportunity to observe the process of change in general practice. In the evaluation of a community health centre, GPs in an inner-urban area were interviewed to locate factors related to their use of services. The resulting observations of change in general practice suggested certain conclusions for the health centre's policy.


General practitioners in cancer education. At the request of the international Union Against Cancer, a committee was established to further "Doctor involvement in public education about cancer". One of the tasks first faced by this committee was the documentation of existing attitudes to cancer education of doctors in general practice in Melbourne, Victoria. This article presents the method used to collect this information, and a description and discussion of the results obtained. The implications for the future work of the committee on this project are also given in the light of these views held by general practitioners.


Social, ethnic and cultural aspects of Aboriginal health. The current development of new trends in the delivery of health care to Aborigines prompts a review of some critical aspects of the interactions between services and clients. Private general medical practitioners are inevitably involved in these services in many areas of Australia.


Medical aspects of Aboriginal health.

Medical aspects of Aboriginal health. The pattern of disease in the Australian Aboriginal population as a whole, and the manifestations of this pattern in the Aboriginal individual, are atypical for Australia in general. This requires some adjustment of the doctor's approach to diagnosis, immediate patient care and family medicine management when dealing with Aboriginal patients.


The case against 'pot'.

The case against 'pot'. There has been much ill-informed debate about cannabis and the fallacy has come to be accepted that little or nothing of scientific value is known about the effects of the drug. This paper presents definitive evidence concerning the hazards of cannabis use, particularly in terms of intoxication effects, driving hazards, progression to other drug use and interaction with other commonly taken drugs.


The alcohol problem on the road.

The alcohol problem on the road. Alcohol is the most important single cause of road accident fatalities and injuries. Recent legislative countermeasures extend the community's capability to detect and eliminate drinking drivers from the road and additionally identify road casualties with alcohol problems. Improved facilities are urgently required for re-education and rehabilitation programmes.


The family context of general practice problems. An aid for the new doctor. The usual way of presenting the content of general practice relates only to the main or presenting diagnoses. Although this is a valuable tool for epidemiological purposes, it seems inadequate as a description of the content of the actual contacts made between the doctor and his patient. The range of topics which are discussed, or thought of, at the consultation is far wider than the summary diagnosis would indicate.


Listening to patients.

Listening to patients. A complaint commonly heard from patients is that their doctor does not have the time to listen to them, yet in spite of all the recent technological advances, good primary and continuing care still depends on how the physician listens to his patient. This does not require expensive instruments, but does require time and an alert and interested listener trained to appreciate the significance of his patient's story. This article is an attempt to consider some aspects of the listening process.


Psychological health in general medical practice: a survey. The information gained from the National Morbidity Survey (1962-63) and the Australia Morbidity Survey (commenced 1969) indicates that there has been a general increase in the number of patients attending a general practitioner for mental disorders. This study was a survey to attempt to gain some insight into the incidence of both primary and secondary emotional/psychological problems in general medical practice. A sample of eight general practitioners completed questionnaires giving information on three areas: (I) Variables of sex, age, marital status and occupation (II) The form and incidence of concomitant somatic/psychological problems (III) The form and incidence of psychological problems. Each general practitioner completed the questionnaire for 200 consecutive patients, giving a total sample of 1600 doctor-patient contacts.


Unhappy bedfellows. Psychiatric consultation in general practice. Interviews with 20 general practitioners within a five mile radius of a State Psychiatric Clinic in Melbourne, revealed many difficulties associated with the reported increase in social and emotional problems presented by their patients. Most general practices are structured to cope best with the medical aspects of patients' problems. Those problems that are essentially non-medical, create situations where the general practitioner makes decisions in areas not taught to medical students in the past. The directions in which he turns for assistance depend upon a variety of attitudinal factors and the availability of appropriate facilities. An uneasy relationship between many general practitioners, psychiatrists, and psychiatric agencies was noted. A sociological analysis of the results suggests that status and role inconsistencies could be a major factor in some of the problems. This paper aims to stimulate participants towards the resolution of the conflicts.


Aspects of the physio-pathology of parasitic gastritis in the sheep. Sheep and calves prepared with separated, innervated pouches made from the acid secreting region of the abomasum were given single or multiple infections of Ostertagia spp and comparisons were made of the secretory changes of parasitised and non-parasitised mucosa by means of cannulas placed in the abomasum and pouch. Contrary reactions of the parasite-free pouches and infected main part of the abomasum are described and explained in terms of a two-part hypothesis. The inhibitory effect on acid secretion of the abomasum (resulting in its contents being pH 5 to 7) was postulated to be due to the direct suppressive effects of substances released locally by parasites or injured host tissues, whereas increased secretion of the hormone, gastrin, was thought to account for the stimulatory effects of infection on acid secretion from the pouches. In sheep treated with anthelmintic and then reinfected the inhibitory effects on abomasal pH were not obtained. The hypersecretion from the pouches still persisted.


Semen collection and evaluation in the ram. The effect of method of stimulation on response to electroejaculation. Nine different methods of electrical stimulation with a bi-polar rectal probe, were used on 5 rams. The quantity and quality of semen collected, the time taken to produce ejaculation and the maximum voltage required were compared. Semen of good quality was collected by applying a stimulus every 7 seconds for a period of 3 seconds commencing at 1 volt and increasing by 1 volt at a time. A mean maximum voltage of 5.1 volts produced ejaculation. Electrical stimulation, using a voltage rise of 2 volts applied at 5 sec intervals frequently produced smaller volumes of semen, a greater number of collection failures, and severe physical stress to the rams.


Defining aims for a veterinary school.

Defining aims for a veterinary school. The Faculty of Veterinary Science at the University of Queensland has defined the aims of the Veterinary School for the future. The aims are to foster excellence in teaching, research, and other forms of professional activity in veterinary science. These aims are being used as a basis for future planning within the School.


National individual identification of horses. Methods of equine identification including signalment, blood typing tattooing and freeze marking are discussed. A new system of individually identifying horses with an unalterable freeze mark is proposed. Unalterable numerical and alphabetical symbols have been developed to apply a registration number to the animal.


Elective caesarean operation in Hereford cattle. An elective left flank Caesarean operation was performed on 56 Hereford cattle and the influence of various surgical techniques on the postoperative progress assessed. A paravertebral nerve block produced effective analgesia in all layers of the abdominal wall of all cattle. In contrast, tissue infiltration, in the form of an inverted L block, did not produce analgesia of the peritoneum and was generally only partly effective in the muscle layers of fat animals. The use of spasmolytic drug facilitated handling of the uterus. Xylazine, when given to unmanageable animals, noticeably increased uterine tone even when used in conjunction with a spasmolytic. Three animals (5.4%) died from generalised peritonitis. Peritoneal adhesions developed in 29 animals (51.8%) and minor wound dehiscence and/or suture infection occurred in 8 animals (14.1%). Postoperative subcutaneous emphysema developed in ;23 cattle (41%). The absence of sutures in the peritoneum was associated with a significant increase in the occurrence of subcutaneous emphysema. Although the prevalence of retained foetal membranes was high this did not seem to influence the postoperative progress of the animal.


The effect of dermally applied levamisole against the parasitic nematodes of cattle. A series of trials to establish the anthelmintic efficiency of levamisole, when applied dermally to calves, is described. The levamisole base was formulated in a suitable solvent system at 100 g/l and applied dermally at a dose rate of 8 mg base/kg. This gave efficiencies of 97.1-100%, 88.5-100%, 100%, 98.7-100% and 89.2-100% against adult Haemonchus placei, Ostertagia spp, Cooperia spp, Oesophagostomum radiatum and Trichostrongylus axei, respectively. Activity against the immature stages of H. placei was recorded at 100%, and against immature Cooperia spp the range was 96.3-100%. Extremely variable results were obtained against immature Ostertagia spp, efficiency ranging from 0% to 100%. Efficiency against adult Dictyocaulus viviparus was in the range of 84-100%. The potential advantage of a dermally applied anthelmintic is discussed.


Failure of vaccine strains of Babesia bovis to regain infectivity for ticks during long-standing infections in cattle. Two strains of Babesia bovis that were known to have lost infectivity for the normal tick vector, Boophilus microplus, due to repeated blood passaging in cattle, were studied to determine whether the strains would regain infectivity for ticks during longstanding infections. Parasitaemias were monitored in 4 chronically infected calves that were regularly infested with ticks. Two strains of ticks known to be susceptible to infection with unmodified strains of B. bovis were used. Adult female ticks that dropped from the calves on days that a parasitaemia was evident were tested for B. bovis infection. Sixty-six batches of ticks collected up to 279 days after infection of the calves produced 14 pools of larvae, none of which transmitted infection. Primary infections established from the chronic infections by subinoculation at 200, 259 and 333 days after infection of the calves were also not transmitted by ticks.


Pregnancy diagnosis in the sow by rectal examination. A detailed description is given of the reproductive tract of the sow as felt by rectal examination. Rectal examination was found to have a 94.3% accuracy in determining pregnancy when carried out between 30 and 60 days gestation. Rectal examination was also found to be a suitable method of detecting the onset of oestrus in the sow. The advantages of using rectal examination as a routine procedure to determine pregnancy in commercial sow herds are presented.


The effects of CT1341, thiopentone and induction- delivery time on the blood gas and acid-base status of lambs delivered by casesarean operation and on the onset of respiration. Caesarean sections were performed on 18 Romney ewes on day 144 of pregnancy. Anaesthesia was induced in 9 ewes with CT 1341 and in 9 ewes with thiopentone and maintained in both groups with halothane administered with oxygen. Surgery was performed with the ewes in lateral recumbency, with respiration unassisted. Blood samples were collected from the intact umbilical artery at the time of delivery and analysed for PO2, PCO2, pH (base deficit was derived). The intervals between ewe induction and lamb delivery (lD), delivery and the onset of breathing (TSR), and delivery and the lamb standing were recorded. Lambs in the CT 1341 group both breathed and stood sooner than lambs in the thiopentone group. Significant linear relationships were only found in the CT 1341 group between TSR interval and PCO2 and pH. No significant correlations were found between the lD interval and any of the biochemical characteristics. The results of this study suggest that lateral recumbency does not interfere with uteroplacental circulation, that CT 1341 (2.2 mg/kg) is associated with less neonatal depression than thiopentone (10 mg/kg) and that severe neonatal hypercarbia may delay the onset of respiration in lambs with minimal drug depression.


Cervical vertebral instability (wobbler syndrome) in the Doberman. Observations based on the case histories of 39 dogs and bitches (38 Dobermans and 1 Great Dane) diagnosed as "wobblers" are presented. Cases diagnosed at a young age were shown to have cervical vertebral instability particularly at the C6/C7 articulation. Older animals showed a variety of secondary degenerative lesions. Treatment by fenestration of intervertebral disc was effective in cases which showed only vertebral instability but was much less effective in older animals with associated degenerative changes.


An outbreak of Swainsona poisoning in horses. On 6 properties in south-western Queensland an outbreak of nervous disease occurred horses due to ingestion of Swainsonia (Darling pea). Loss of condition, depression, hyperaesthesia and hyperexcitability were seen in affected horses. At autopsy of 2 horses generalised c ytoplasmic vacuolation was seen in the neurones of the central nervous system and in the liver, adrenal and thyroid. The clinical and pathological features were similar to those described in horses suffering from Swainsona poisoning in Australia and Astragalus and Oxytropis in North America.


The effects of distension of the small intestine on myocardial blood flow in anaesthetised cats: possible relevance to coronary vasospasm. The haemodynamic effects of distending the small intestine (with a balloon in the lumen) were examined in cats anaesthetised with chloralose. Particular attention was paid to blood flow changes in localised areas of the left ventricular wall (as assessed using the heated thermocouple technique). Intestinal distension led to an increase in systemic blood pressure but usually to a reduction in myocardial blood flow; no cardiac dysrhythmias were observed. When the effect of increased systemic (perfusion) pressure on blood flow was eliminated (using partial correlation coefficients) flow then bore a negative relationship to intestinal pressure, probably indicating constriction of the myocardial blood vessles. This may indicate that distension of hollow organs can lead to a visceral-cardiac reflex. The resulting coronary vasospasm might be one cause of pain in certain patients with angina pectoris.


Studies on isoprenaline-induced myocardial lesions. 1. Quantitative evaluation by mercurascan uptake. For the quantitative evaluation of myocardial damage induced by isoprenaline (ISO) a method based on the uptake of 203Hg-labelled Mercurascan (MSC) in the heart was used. The increase of myocardial uptake of MSC in ISO-treated rats over control values was very rapid and might be directly proportional to the number of damaged myocardial cells actually present in the heart. MSC-uptake method of myocardial damage evaluation was more sensitive and precise than other methods tested (macroscopic evaluation according to Rona, increase of heart weight). Different modifications of MSC-uptake test may be selected in relation to experimental conditions. MSC test is especially useful for evaluation of early myocardial lesions induced by small doses of ISO (0.01 mg/kg).


The effect of graded coronary stenosis on myocardial blood flow and left ventricular wall motion. The effect of graded coronary stenosis on resting regional myocardial flow and left ventricular (LV) wall motion was studied in 18 anesthetized dogs. The left circumflex coronaary artery (LC) was constricted. The degree of LC stenosis and the changes in LV wall motion were determined by cineangiography of the coronary artery and LV. Regional myocardial flow was determined by tracer microspheres (TM), labeled with two different isotopes, Sr85, Sc46 or Ce141. The first TM1 and the second TM2 were infused after LC stenosis, and during a temporary complete LC occlusion respectively. Resting flow in areas with 70% stenosis was reduced, with a greater reduction of subendocardium and posterior papillary muscle, but minimum impairment of LV wall motion. No ST elevation was found. Animals with 80--90% stenosis showed a marked reduction of flow and wall motion, a significant ST-elevation and a delayed antegrade run-off in coronary arteriography.


Serum-growth hormone and free-fatty-acids levels following angiocardiography in children. Blood-free-fatty acids (F.F.A.) and growth-hormone levels were determined in 9 children subjected to cardiac catheterization and angiography. A significant rise of growth-hormone level was recorded immediately after angiocardiography, followed by a marked increase of F.F.A. levels 2--4 hours after termination of the catheterization. These results may indicate that the high levels of F.F.A. sustained after cardiac catheterization and angiography are probably due to the increase of growth -hormone secretion during the procedure.


Effects of collateral circulation on regional myocardial blood flow and left ventricular wall motion (A preliminary note). The effect of collateral circulation on regional myocardial flow and wall motion of left ventricle was studied on 5 anesthetized dogs with a surgically implanted constrictor on the left circumflex coronary artery (LC). The grade of LC stenosis and wall motion of left ventricle (LV) were determined by cineangiography of the coronary artery and LV at the period of acute and chronic occlusion. Regional myocardial flow was determined by tracer microspheres (TM), labeled with four different isotopes, Sr85, Cr51, Sc46, Ce141. The first TM1 was infused after LC stenosis, TM2 during a temporary complete LC occlusion at the period of acute occlusion; TM3 and TM4 in a similar way 3 to 4 weeks after the acute LC stenosis. Three to four weeks after LC stenosis, i.e. chronic period of occlusion, the degree of LC stenosis progressed from 70--80% to 100% occlusion, but collateral flow and collateral vessels to the ischemic LC area were increased together with an improvement of wall motion of the ischemic LC area. The results may support the idea that collaterals may be an effective compensatory mechanism for ischemia. In contrast to an increase of collateral flow to the ischemic LV free wall in all five dogs, an increase to the posterior papillary muscle was found only in two out of five dogs.


[Distribution of the lymph vessels in the mouse heart. A light and electron microscopic study (author's transl)]. The lymphatic system in normal mouse heart was investigated by light and electron microscopy. Lymph vessels were only demonstrated in the subepicardial layer and the outer half of the myocardium. Here above all they were situated in close vicinity to arteries and thin-walled veins, rarely separated in the interstitial space, never in the subendocardial layer of the left ventricular wall. The myocardium contains only 2 lymph vessels per mm2. By means of electron microscopy all lymph vessels were regarded as lymph capillaries. Their ultrastructure is described in detail. This investigation shows that lymph vessels in normal heart are rarer than supposeed till now. It is possible that most of the ultrafiltrated fluid is drained by the cardiac venous system, while the lymphatic system only has to transport a small amount of protein-rich fluid.


[Influence of cycle length shortening, atropine and beta-receptor blockage on sinus node recovery time (SRT) in patients with healthy sinus node (author's transl)]. Sinus node recovery time (SRT) was measured in 30 patients with healthy sinus nodes to examine the influence of the increase in atrial frequency, atropine and beta-receptor blockade. The measurements were performed following pacing with 3 atrial frequencies before and after administration of 1 mg atropine i.v. (13 patients) and 0.4 mg prindolol (Visken) i.v. (17 patients). Total group; Increase of frequency alone caused prolongation of the SRT in 17 patients and shortening in 13 patients.  Atropine group: Blockade of the parasympathicus alone induced a highly significant reduction in the SRT. Simultaneous increase in frequency and blockade of the parasympathicus led to greater SRT-shortening during low frequency than with high frequency. This interrelationship of frequency and blockade of the parasympathicus influencing the SRT is statistically significant. Visken-group: Blockade of the sympathicus causes a highly significant prolongation of the SRT. Simultaneous increase in frequency and blockade of the sympathicus led to greater SRT-prolongation during low frequency than with high frequency. This interrelationship of frequency and blockade of the sympathicus influencing the SRT has slight statistical significance. The results are discussed in respect to the electrophysiological influences of atrial cycle length shortening, acetylcholine and catecholamines on the sinus node, the perinodal atrial fibres and the atrial working myocardium.


[Methodical studies on determination of the number of micro-organisms in Cuban soils]. In four Cuban soils (ferrallitic soil, non-calcareous and calcareous brown tropical soil, and fersiallitic sandy soil) the suitability was tested of 7 dispersion solutions and of 4 culture media for determining the total number of bacteria, fungi and actinomycetes. The results were as follows: (1) The dispersion solution and the culture medium most suitable for the most comprehensive determination of the number of microbes is dependent on the physical and chemical soil properties. (2) The optimum combination of dispersion solution and culture medium was found for the various soils as follows: -Na-pyrophosphate in the soil extract and concentrated agar bouillon, respectively, for ferrallitic soils, -Na-K-tartrate solution and concentrated soil extract, respectively, for non-calcareous brown tropical soils, -Na-pyrophosphate solution in water and concentrated bouillon or soil extract, respectively, for calcareous brown tropical soils, -soil extract as a dispersion solution and as culture medium in fersiallitic sandy soils.


Changes in ventricular fibrillation threshold during repeated short-term coronary occlusion and release. The time course of changes in VFT was determined during the 1st phase of arrhythmia following coronary occlusion and during consecutive reperfusion in five repeated periods of occlusion and reperfusion in 10 mongrel dogs (17--24 kg). VFT was determined using a square wave pulse series of 140 ms duration which was triggered by the R-wave of the ECG and placed into the vulnerable period of the cardiac cycle. After acute occlusion VFT decreased to a minimum level within a few minutes and then increased again slowly up to the control value which was reached about 20 min after the ligation. When the occlusions were repeated several times the extent of the decrease in VFT became increasingly less and its duration increasingly shorter until finally there was no significant decrease in VFT. Reperfusion after coronary occlusion led to an abrupt decrease in VFT within 1 min, followed by a rapid increase to the control value. This time course did not depend upon the number of prior occlusions. The results show that in the case of repeating short-term coronary occlusions one cannot expect comparable VFT time courses for the consecutive periods of occlusion except for the 1st and 2nd ones. Differing mechanisms leading to the occurrence of VF after coronary ligation and during reperfusion are discussed.


The deterioration of duck meat during storage as investigated for free amino acid nitrogen and organoleptic characteristics. The carcasses of 8 week old Pekin ducks were stored in the refrigerator at + 5 degrees C up to 21 days. After 11 days the occurrence of free amino acids reached its maximum and then decreased to the end of the storage period. It showed a significant linear and quadratic trend. The fresh meat is rejected after 9 days of storage due to off odour at 202, 179, and 159 mg of free amino acids in the breast, thigh, and drumstick muscles, respectively. The flavour of the broiled meat indicated deterioration after 11 days of storage. At this stage slime appeared on the carcasses.


Incorporation of sodium bicarbonate into laying rations. I. Effect on egg production and hatchability. Two experiments were carried out on Fayoumi (I) and Rhode Island Red (II) pullets to study the effect of substituting NaCl (0.67% of the ration) by NaHCO3 (1% of the ration) and the concentration of NaHCO3 (1% and 2% of the ration). Both breeds showed different reactions to the NaHCO3 additions: the laying increased in (I) by 5-6%, whereas it decreased in (II) by 7-14%. Fertility and hatchability increased significantly. The Ca content of the shells showed an increasing trend. The incorporation of 1% sodium bicarbonate into the laying rations is recommended under the conditions of the AR Egypt.


Incorporation of sodium bicarbonate into laying rations. II. Effects on egg quality. The replacement of 0.67% NaCl in the ration by 1% NaHCO3 leads to improvements of several parameters of the shell quality and some other egg quality characteristics in the Rhode Island Red breed. In the Fayoumi breed this influence was not clearly discernible. This also holds for an increase of the NaHCO3 content in the ration to 2%. Under the conditions in the AR Egypt the addition of 1-2% NaHCO3 for the Rhode Island Red is recommended in order to improve the shell quality and the internal quality of the eggs.


[Control of the effects and side-effects of detergents]. An examination of detergents on the skin has to take into account the facultative sensibilisation and the wear and tear. In this connection the effect of summation between soapbody and perfume is pointed out as well as the different results of skin tests. To control the obligate effects, first of all a reliable technical reference has to be established; this is the washing activity, to which the side-effects then are related. To measure the hydratation, the resonance-frequency method of Tronnier and Wagener is used, where especially the syndets react very differently: partly similar to water and partly similar to soft soap. Further methods of examination are the measurement of the roughness and the quantitative determination of the fat of the skin. Concerning certain hand wash detergents and industrial cleaners the grade of rubbing is also of interest. Finally the relatively good compatibility of the bioactive detergents and the rinsing agents is discussed.


The effect of replacement of L-alanine residue by glycine, L-serine or D-alanine in an N-acetylmuramyl-L-alanyl-D-isoglutamine on immunoadjuvancies of molecules. Substitution of the L-alanine residue by L-serine and glycine in an N-acetylmuramyl-L-alanyl-D-isoglutamine, the minimum structural unit essential to the immunoadjuvancies characteristic of bacterial cell wall peptidoglycans, was shown to bring about significant increase and some decrease, respectively, in the adjuvant abilities of molecules to induce delayed-type hypersensitivity and to stimulate serum antibody levels to ovalbumin when administered to guinea pigs as a water-in-mineral oil emulsion. N-Acetylmuramyl-D-alanyl-D-isoglutamine, on the other hand, was found to be adjuvant-inactive.


An estimate of the amount of genetic variation in the common mussel Mytilus edulis. Allozyme variation in a population of the common mussel Mytilus edulis in Mumbles, South Wales, has been studied by starch gel electrophoresis. On the basis of data obtained for 34 loci, we estimate the proportion of loci polymorphic to be 30%. Using only the 29 loci for which individual genotypes can be accurately typed, the average heterozygosity is estimated to be 9.5 +/- 3.6%. The calculated expected average heterozygosity based on Hardy-Weinberg expectations is identical with the observed value. Allele frequency data at six polymorphic loci are given for several other British populations. There is no significant geographic heterogeneity. The results are discussed in relation to genetic adaptive strategies and are shown to be inconsistent with the predictions of the neutral hypothesis.


Genetic control and development expression of malate dehydrogenase in Apis mellifera. Starch gel electrophoresis of extracts of Apis mellifera indicates that genetic variability exists for the enzyme cytoplasmic malate dehydrogenase (E.C. 1.1.1.37). Analysis of individuals throughout development indicates that the isozyme patterns are identical for larvae and adults and suggests a dimeric structure for the molecule. The isozyme pattern observed in pupae is more complex than that of larvae and adults may be due to an additional pupal-specific MDH gene being expressed or to an epigenetic modification of the isozymes. Forty-three colonies with artificially inseminated queens were used to study the Mendelian pattern of inheritance. The data revealed that the MDH isozymes are encoded by three alleles, Mdh-1A, Mdh-1B, and Mdh-1C. The frequency of the Mdh-1 alleles is different in two analyzed subspecies, A. m. adansonii (African bees) and A. m. ligustica (Italian bees), with Mdh-1A and Mdh-1B in the African bees being 0-768 and 0.202, respectively. For the Italian bees, these frequencies are 0.136 and 0:154, respectively.


Isozyme and allozyme patterns in embryonic Drosophila cell culture lines. Two independently derived embryonic Drosophila cell culture lines were examined for 19 gene-enzyme systems. At two loci, alpha-glycerophosphate dehydrogenase on chromosome 2, and isocitrate dehydrogenase on chromosome 3, allelic variation was detected. These can now serve as genetic markers to identify hybrid cell clones. Quantitative differences between cell lines were found for five enzymes.


Dissociation-recombination of sunflower seed acid phosphatase. Formal genetic studies of sunflower (Helianthus annuus) seed acid phosphatase (ACP, E.C. 3.1.3.2) had suggested that the functional enzyme consists of two polypeptide subunits. The dimeric quaternary structure was demonstrated by dissociation-recombination procedures. Dissociation of electrophoretically distinct homodimers was effected upon freezing of extracts in a pH 8-9 buffer containing 1 M NaCl and 0.1 M 2-mercaptoethanol. Reassociation, as indicated by the formation of the hybrid isozyme, occurred during 12 hr dialysis against a pH 7.0 buffer.


Detection and quantitation of the fetal hemoglobin variant Hb F-Malta-I in adults. A variant of fetal hemoglobin (Hb F-Malta-I) has been detected and quantitated in adult blood with a sensitive radioimmunoassay employing monospecific antisera. The concentration of Hb-F-Malta-I was 0.002-0.05%, with an average value of 0.011%. The ratio of Hb F-Malta-I/Hb F in adults was about 4.8%, compared to a ratio of about 27% in the newborn. Since the F-Malta-I variant is a product of a mutated Ggamma locus, which is one of the nonallelic structural genes directing the gamma chain synthesis, its presence in blood of adults shows that the synthesis of this gene is not completely suppressed after birth, as was previously suggested.


Isolation and partial characterization of human parotid basic proteins. Methods are presented for the isolation of basic proteins (Pb proteins) from human parotid saliva collected from humans possessing different alleles at the Pb locus. The proteins were found to be extremely basic, with an isoelectric point above 9.5. They contain approximately 45% of the basic amino acids histidine, lysine, and arginine, and are devoid of cysteine, proline, threonine, valine, methionine, and tryptophan. They are free of carbohydrate. A comparison of the amino acid sequence data of Pb protein to all available amino acid sequences revealed that no sequence similarities exist between the Pb proteins and any other proteins reported, although proteins of similar amino acid compositions have been reported by others. A model is presented with accounts for the several forms of allelic proteins based on observed amino acid sequence differences.


Creatine phosphokinase activity in dysgenic (mdg/mdg) mouse muscle. The specific activity of creatine phosphokinase (CPK) was measured in the muscle of mdg/mdg and control embryos of 14-18 days' gestation. CPK specific activity values were similar in mutant and normal embryos at the earliest stages examined (14-15 days). However, after 15 1/2 days, the specific activity of the enzyme in the mdg/mdg embryos was approximately 50% lower than in the controls. The dysgenic and normal muscle extracts exhibited comparable stability after storage at -85 C. CPK activity levels in the muscle of adult heterozygotes (+/mdg) and wild-type (+/+) controls were found to be statistically identical. The findings suggest that the mdg mutation does not have a primary or direct effect on CPK activity.


The isolation and further characterization of the bilirubin tetrapyrroles in bile-containing human duodenal juice and dog gall-bladder bile. Bilirubin and its conjugates were extracted from either dog gall-bladder bile or bile-containing human duodenal juice into chloroform containing 10mm-tetraheptylammonium chloride. The intact bilirubin tetrapyrroles were then separated by t.l.c. Structural elucidation was made after coupling of the individual pigments with diazonium salts. Four azopigments were detected: azopigment alpha(o) or dipyrrolic azobilirubin; azopigment delta or dipyrrolic azobilirubin monoglucuronide; azopigment alpha(3) or dipyrrolic azobilirubin monoglucoside; and, from dog gall-bladder bile, azopigment alpha(2). The last conjugate required further verification of its structure. After methanolysis, it was shown by combined g.l.c.-mass spectrometry to contain xylose in a 1:1 molar ratio with the azopigments of bilirubin. Human bile contained 86% bilirubin diglucuronide, 7% bilirubin monoglucuronide monoglucoside diester, 4% bilirubin monoglucuronide and 3% bilirubin. Dog gall-bladder bile had a considerably different composition; it contained 47% bilirubin diglucuronide, 40% bilirubin monoglucuronide monoglucoside diester, 8% bilirubin monoglucuronide, 4% bilirubin diglucoside, 1-2% bilirubin and traces of conjugates containing xylose. The total bilirubin content and proportions of the conjugates did not change in bile that was frozen and stored at -20 degrees C under N(2), whereas in the chloroform/tetraheptylammonium chloride extract, similarly stored, total pigment was slowly lost and the diglucuronide conjugate converted into the monoglucuronide.


The substrate specificity and stereochemistry, reversibility and inhibition of the 3-oxo steroid delta 4-delta 5-isomerase component of cholesterol oxidase. 1. 5-Cholesten-3-one was shown to be an intermediate in the conversion of cholesterol into 4-cholesten-3-one by Nocardia cholesterol oxidase. 2. The absence of a C-17 side chain from 5-androstene-3,17-dione slightly increased the Vmax. of the isomerase activity relative to 5-cholesten-3-one (1.7-fold), but greatly increased the Km. 3. Incubations of [4alpha-2H]-and [4beta-2H]-cholesterol with cholesterol oxidase showed that the 4beta-hydrogen atom can be transferred to the 6beta-position. However, incubations of cholesterol, 5-cholesten-3-one and 4-cholesten-3-one with the enzyme in 2H2O led to some incorporation of 2H into the 4-cholesten-3-one products, mostly at position 6beta. 4. Both the isomerase and the oxidase activities of cholesterol oxidase were inhibited by 5,10-seco-19-nor-5-cholestyne-3,10-dione.


Purification and properties of myosin light-chain kinase from fast skeletal muscle. 1. A procedure is described for the isolation of myosin light-chain kinase from rabbit fast skeletal muscle as a homogeneous protein. 2. Myosin light-chain kinase is a monomeric enzyme of mol.wt. 77000. Under some conditions of storage it is converted into components of mol.wts. about 50000 and 30000 that possess enzymic activity. 3. The enzyme is clearly different in structure and properties from any other protein kinase so far isolated from muscle. 4. The enzyme is highly specific for the P-light chain (18000-20000-dalton light chain) of myosin and requires Ca2+ for activity. 5. The P-light chain is phosphorylated at a similar rate whether isolated or associated with the rest of the myosin molecule. 6. The effects of pH, bivalent cation and other nucleotides on the enzymic activity are described. 7. The role of the phosphorylation of the P-light chain of myosin in muscle function is discussed.


Characterization of lipid A and polysaccharide moieties of the lipopolysaccharides from Vibrio cholerae. Lipid A and polysaccharide moieties obtained by mild acid hydrolysis of the lipopolysaccharides from Vibrio cholerae 569 B (Inaba) and Vibrio el-tor (Inaba) were characterized. Heterogeneity of lipid A fractions was indicated by t.l.c. and by gel filtration of the de-O-acylated products from mild alkaline methanolysis of the lipids. Presumably lipid A contains a glucosamine backbone, and the fatty acids are probably bound to the hydroxyl and amino groups of glucosamine residues. Approximately equal amounts of fatty acids C16:0, C18:1 and 3-hydroxylauric acid were involved in ester linkages, but 3-hydroxymyristic acid was the only amide-linked fatty acid. Sephadex chromatography of the polysaccharide moiety showed the presence of a high-molecular-weight heptose-free fraction and a low-molecular-weight heptose-containing fraction. Haemagglutination-inhibition assays of these fractions showed the heptose-free fraction to be an O-specific side-chain polysaccharide, whereas the heptose-containing fraction was the core polysaccharide region of the lipopolysaccharides. Identical results were obtained for both organisms.


The purification and properties of p-cresol-(acceptor) oxidoreductase (hydroxylating), a flavocytochrome from Pseudomonas putida. The enzyme that catalyses the hydroxylation of the methyl group of p-cresol was purified from Pseudomonas putida. It has mol.wt. 115000 and appears to contain two subunits of equal molecular weight. One subunit is a c-type cytochrome and the other is a flavoprotein. Reduction of the cytochrome occurred on addition of substrate. The same enzyme catalyses both p-cresol hydroxylation and the further oxidation of the product, 4-hydroxybenzyl alcohol. The stoicheiometry of acceptor reduced per molecule of substrate oxidized is that for two dehydrogenation reactions. The Km for p-cresol is 7.3 x 10(-6) M and that for 4-hydroxybenzyl alcohol is 47.6 x 10(-6) M. The enzyme, which is assayed with phenazine methosulphate as electron acceptor, was stimulated by particulate material, which probably contains the acceptor in vivo.


Degradation of (+/-)-synephrine by Arthrobacter synephrinum. Oxidation of 3,4-dihydroxyphenylacetate to 2-hydroxy-5-carboxymethyl-muconate semialdehyde. 1. Cell-free extracts of Arthrobacter synephrinum catalyse the oxidation of 3,4-dihydroxy-phenylacetate. 2. The product of oxidation was characterized as 2-hydroxy-5-carboxymethylmuconate semialdehyde from its chemical behaviour as well as from nuclear-magnetic-resonance spectra. 3. A 3,4-dihydroxyphenylacetate 2,3-dioxygenase (EC 1.13.11.15) was partially purified from A. synephrinum. 4. The enzyme had a Km of 25 micrometer towards its substrate and exhibited typical Michaelis-Menten kinetics. 5. The enzyme also catalysed the oxidation of 3,4-dihydroxymandelate and 3,4-dihydroxyphenylpropionate, at reaction rates of 0.5 and 0.04 respectively of that for 3,4-dihydroxyphenylacetate. 6. The enzyme was sensitive to treatment with thiol-specific reagents. 7. The molecular weight of the enzyme as determined by Sephadex G-200 chromatography was approx. 282000.


Solvent accessibilities in glycyl, alanyl and seryl dipeptides. Theoretical studies on glycyl-alanyl and seryl dipeptides were performed to determine the probable backbone and side-group conformations that are preferred for solvent interaction. By following the method of Lee & Richards [(1971) J. Mol. Biol. 55, 379-400], a solute molecule is represented by a set of interlocking spheres of appropriate van der Waals radii assigned to each atom, and a solvent (water) molecule is rolled along the envelope of the van der Waals surface, and the surface accessible to the solvent molecule, and hence the solvent accessibility for a particular conformation of the solute molecule, is computed. From the calculated solvent accessibilities for various conformations, solvation maps for dipeptides were constructed. These solvation maps suggest that the backbone polar atoms could interact with solvent molecules selectively, depending on the backbone conformation. A conformation in the right-handed bridge (zetaR) region is favoured for both solvent interaction and intrachain hydrogen-bonding. Also the backbone side-chain hydrogen-bonding within the same dipeptide fragment in proteins is less favoured than hydrogen-bonding between side chain and water and between side chain and atoms of other residues. Solvent accessibilities suggest that very short distorted alphaR-helical and extended-structural parts may be stabilized via solvent interaction, and this could easily be possible at the surface of the protein molecules, in agreement with protein-crystal data.


The amino acid sequence of rabbit slow-muscle troponin I. Troponin I was isolated from six red muscles in the hind leg of the rabbit. Soleus, semi-tendinosus, vastus intermedius and adductor longus muscles contained primarily slow-muscle troponin I, vastus lateralis contained fast-muscle troponin I and quadratus femoris contained a mixture of the two. The complete amino acid sequence of the troponin I from slow muscle was determined. Seven CNBr fragments were isolated and sequenced by using the dansyl-Edman technique after digestion with proteolytic enzymes. The CNBr fragments were ordered by isolation of tryptic peptides containing carboxy[(14)C]methyl-methionine. Direct evidence for the conjunction of residues 8 and 9 has not been obtained, and one of the carboxyl groups between residues 71 and 79 may carry an amide group. Slow-muscle troponin I is a single polypeptide chain of 184 residues with a mol.wt. of 21146. It has a net overall positive charge of 18 at pH7, and an absorption coefficient, A(1%,1cm) (280), of 5.43. The protein was isolated with both a blocked and an unblocked N-terminus, although the nature of the blocking group was not determined. Proline was found to be the N-terminal amino acid. Two forms of the protein could also be distinguished by the presence of an extra two residues at the C-terminus. Comparison of sequences of troponin I from rabbit slow, fast and cardiac muscle shows that homology is most marked in the C-terminal half of the molecules. Towards the N-terminus the homology becomes much less marked. Detailed evidence on which the sequence is based has been deposited as Supplementary Publication SUP 50079 (32 pages) at the British Library (Lending Division), Boston Spa, Wetherby, West Yorkshire LS23 7BQ, U.K., from whom copies may be obtained in the terms given in Biochem. J. (1977), 161, 1.


Reaction of the aminic form of aspartate transaminase with difluoro-oxaloacetate. Addition of difluoro-oxaloacetate to the aminic form of aspartate transaminase causes a rapid shift of absorbance maximum of the enzyme from 332 nm to 328 nm, followed by a much slower shift to 360 nm corresponding to complete conversion of the aminic form of the enzyme into the aldimine form or a species with similar spectral parameters in rapid equilibrium with it. Kinetic analysis of both the initial fast reaction and the overall slow reaction by using repeated spectral scanning and stopped-flow techniques allows formulation of a basic reaction mechanism involving at least two intermediate enzyme complexes. Computer simulation of the progress curves of the initial fast reaction based on the suggested reaction mechanism gives kinetic parameters that are consistent with all the data obtained by other methods. A molecular reaction scheme involving a ketimine Schiff-base intermediate is proposed.


Synthesis and use of bifunctional chloromethylalkanedione derivatives of variable chain length for cross-linking thiol groups in oligomeric proteins. Specific cross-linking in glyceraldehyde 3-phosphate dehydrogenase. Bischloromethylpentanedione, bischloromethylhexanedione, bischloromethyloctanedione and bischloromethyldecanedione were synthesized from their corresponding dicarboxylic acids via the bis-acyl chloride and the bisdiazomethylketone derivatives. These compounds proved to be highly specific cross-linking reagents for rabbit skeletal-muscle glyceraldehyde 3-phosphate dehydrogenase. Incubation of the enzyme with cross-linking reagents resulted in both a time- and concentration-dependent formation of covalently linked oligomeric structures. The major cross-linked product detected by sodium dodecyl sulphate/polyacrylamide-gel electrophoresis was the dimer (mol. wt. 72000). Sepharose 6B chromatography of the cross-linked enzyme showed that it still existed as the tetramer. Cross-linking was dependent on the native structure of the enzyme, since it was abolished on denaturation of the enzyme. The actual covalently linked product depends on the conditions of modification and the chain length of the reagent. The maximum yield of dimer (70-80%) was obtained with bischloromethylhexanedione, and the yield decreased with either shorter- or longer-chain compounds. The calculated distance between the two reactive points in bischloromethylhexanedione is 1.21-1.45nm. Bischloromethylhexanedione modified at least two thiol groups per monomer. Modification of the active-site thiol, cysteine-149, was not essential for cross-linking, since glyceraldehyde 3-phosphate dehydrogenase carboxymethylated on cysteine-149 still reacted to form the dimer. The rate of chemical cross-linking was markedly decreased by increasing the NAD(+) occupancy of the enzyme active sites. These experiments are discussed in terms of the asymmetry of the enzyme structure in solution.


Kinetic studies of the phenol sulphate-phenol sulphotransferase of Aspergillus oryzae. Arylsulphatase II of Aspergillus oryzae exhibits both hydrolytic and sulphotransferase activities. The kinetic data suggest the formation of an intermediate covalent enzyme-sulphate complex with transfer of sulphate from donor to acceptor proceeding via a Ping Pong mechanism. The unusual kinetic behaviour when 2-hydroxy-5-nitrophenyl sulphate is the substrate is also consistent with this mechanism.


Free and lipid myo-inositol in tissues from rats with acute and less severe streptozotocin-induced diabetes. Acute diabetes with ketosis was induced in rats by intraperitoneal streptozotocin and also a milder form of diabetes without ketosis by injecting less of the drug. The acutely diabetic rats were killed 72h after injection and the others after either 2 or 13 weeks. Free and lipid myo-inositol was then measured in various tissues and body fluids by g.l.c. of the trimethylsilyl ether. Serum inositol was increased in the acutely diabetic group, whereas liver inositol was decreased. Brain and kidney inositol concentrations were increased in the mildly diabetic animals at 13 weeks and there was a progressive decrease in sciatic-nerve inositol. Lipid inositol of sciatic nerve was decreased in the acutely diabetic group only. Brain lipid inositol concentration was decreased in mild diabetes at 13 weeks. Possible implications of these findings in relation to diabetic neuropathy was discussed.


Enzymically iodinated human salivary proteins. Fractionation and characterization by column chromatography and electrofocusing. Human salivary proteins were enzymically iodinated by the 125I-lactoperoxidase system. The proteins were than subjected to DEAE-cellulose column chromatography, preparative column electrofocusing and thin-layer polyacrylamide-gel electrofocusing. The radioactivity in the resolved protein pools and bands was determined. Results show that salivary proteins differ in their susceptibility to iodination carried out by this enzymic method. Two major iodine-binding protein fractions were discovered: one behaved like serum albumin on electrofocusing and was most susceptible to iodination by lactoperoxidase, and other had pI characteristics similar to those of salivary amylase. The physiological significance of the iodination of salivary proteins, which can also take place in vivo, is discussed.


The involvement of the bridging imidazolate in the catalytic mechanism of action of bovine superoxide dismutase. The pulse-radiolysis method has been used to study the catalytic mechanism of O2 leads to dismutation by the Co(II)-substituted bovine erythrocuprein (superoxide dismutase, EC 1.15.1.1). Catalysis is accompanied by spectral changes that may be interpreted in terms of rapid protonation and deprotonation of the Cu-facing nitrogen atom of the imidazolate that bridges the Cu(II) and the Co(II) [or Zn(II)] in the oxidized enzyme. This rapid change permits the possibility that the imidazole is a proton donor in the catalytic reduction of O2 leads to.


Chemical differences between thyrotropin isohormones. Amide determinations have been carried out, with a newly developed g.l.c. method, on thyrotropin hormones prepared by isoelectric focusing. The observed differences in amide content fully account for the differences in the electrochemical properties of the isohormones.


Release of alkaline phosphatase from membranes by a phosphatidylinositol-specific phospholipase C. Purified phosphatidylinositol-specific phospholipase C from Staphylococcus aureus released a substantial proportion of the total alkaline phosphatase activity from a wide range of tissues from several mammalian species. Co-purification of the phospholipase C and alkaline phosphatase-releasing activities and the inhibition of both these activities by iso-osmotic salt solutions suggested that the releasing effect was unlikely to be due to a contaminant.


A second activation peptide from bovine cationic trypsinogen. 1. Although only one activation peptide of bovine cationic trypsinogen has been reported previously, the peptide fraction obtained from activation mixtures shows several bands on paper electrophoresis at pH 6.5. 2. The major band was the peptide previously described. The band second in intensity of staining with ninhydrin (10-20% of that of the main band, as judged by eye) had an electrophoretic mobility consistent with its being related to the main peptide. It appeared on activation both of bulk commercial samples of trypsinogen and, as the Appendix shows, of samples prepared from pancreases obtained at the local abattoir. 3. The second peptide proved to be Phe-Pro-Val-Asp-Asp-Asp-Asp-Lys, and we conclude that it is another activation peptide. We discuss briefly the genetic and phylogenetic implications of our findings.


Correction of partial amino acid sequence of erabutoxins. The amino acid sequences of erabutoxins a and b were re-examined. The previously reported sequence of Ser-Glu at positions 21 and 22 of erabutoxins was corrected to Glu-Ser.


Lysostaphin endopeptidase-catalysed transpeptidation reactions of the imino-transfer type. The glycylglycine endopeptidase in lysostaphin has been found capable of catalysing both hydrolysis and transpeptidation reactions when acting on glycyl peptides. The ability of the enzyme to utilize dansyldiglycine (5-dimethylaminoaphthalene-1-sulphonylglycylglycine) as an acceptor molecule in transpeptidation reactions, although it is incapable of hydrolysing the peptide bond in this compound, indicates the enzyme must be capable of forming the equivalent of an imino-enzyme intermediate during the catalytic process.


The effect of matrix on the binding of albumin to immobilized Cibacron Blue. With Cibacron Blue as a ligand, the suitability of Sepharose, Sephacryl, cellulose and Ultrogel as column supports for the affinity chromatography of human serum albumin was examined. Sepharose and Sephacryl were the most effective matrices. Albumin was readily removed from such columns by using an electrophoretic desorption technique.


A direct assay for urinary kallikrein.

A direct assay for urinary kallikrein. The first protein-binding assay is described for the direct determination of kallikrein in rat urine. Isolation of urinary kallikrein and preparation of its specific antibody have been previously described. Outlined here are the methods for 3H-labelling of kallikrein, for isolation of 3H-labelled immunoreactive enzyme, and for separation of free and antibody-bound kallikrein with the aid of double antibody. Assay and equilibrium conditions were characterized and a protocol is presented for the measurement of kallikrein concentration. The direct assay is sensitive, accurate and it correlates well (r = 0.81) with a functional assay. The assay may hold promise to determine catalytically active and inactive enzyme in urine, tissues and biological fluids.


Variation in the distribution of two human heart ferritin species. Isoferritin profile and subunit composition in normal and iron-overloaded subjects. On polyacrylamide slab electrophoresis two ferritin species, termed fast and slow, were present in three control and four iron-loaded human hearts. The ratio of the fast to slow species varied between hearts and correlated with the distribution of isoferritins, which had pI values ranging from 4.8 to 5.6. The acidic isoferritins were prominent in all hearts, but one control and the four iron-loaded hearts contained, in addition, basic isoferritins. All ferritins were composed of two subunits, an acidic H type and a more basic HL type, which was the main subunit in normal liver. Hearts with the highest proportions of acidic isoferritin contained the highest proportion of the H subunit.


Preparation and properties of co-reticulated invertase supported by an ultrafiltration membrane. Yeast invertase was co-reticulated with glutaraldehyde to bovine serum albumin to give a soluble bound enzyme that was immobilized as a tightly adhering layer on the active surface of an ultrafiltration membrane. The Michaelis constant and stability of this immobilized-enzyme system are compared with those of the enzyme either in the native form or immobilized as a dynamically formed gel layer on an ultrafiltration membrane, as previously described by us [Drioli, Gianfreda, Palescandolo & Scardi (1975) Biotechnol, Bioeng, 17, 1365-1367].


Griseofulvin-induced aggregation of microtubule protein. Griseofulvin (7-chloro-2',4,6-trimethoxy-6'-methylspiro[benzofuran-2(3H),1'-[2]cyclohexene]-3,4'-dione) induces aggregation of microtubule protein at 0 degrees C. This aggregate contains approx. 90% of the microtubule-associated proteins originally present in the microtubule protein. The supernatant obtained after removal of the griseofulvin-induced aggregate does not form microtubules on warming at 37 degrees C. Addition of the griseofulvin-aggregated protein to this supernatant and warming to 37 degrees C gives rise to a limited amount of microtubule assembly. The possible involvement of griseofulvin-induced aggregation of microtubule protein at 0 degrees C in the inhibition by griseofulvin of microtubule assembly in vitro is discussed.


Purification and subunit structure of argininosuccinate lyase from Chlamydomonas reinhardi. Argininosuccinate lyase (EC 4.3.2.1) was purified by (NH4)2SO4 fractionation, chromatography on DEAE-cellulose and gel filtration on Sephadex G-200. The final enzyme preparation was purified 46-fold compared with the crude extract. Electrophoresis of this preparation revealed three bands, the major one having the enzyme activity. Analysis of the enzyme by gel filtration and by disc electrophoresis (in two different concentrations of acrylamide) gave mol.wts. of 200000 (+/- 15000) and 190000 (+/- 20000) respectively. Treatment with sodium dodecyl sulphate and mercaptoethanol dissociated the enzyme into subunits of mol.wt. 39000 (+/-2000). The results are indicative of the multimeric structure of the enzyme, which is composed of five (perhaps four or six) identical subunits.


Characterization of the serum lipoproteins and their apoproteins in hypercholesterolaemic guinea pigs. 1. Hypercholesterolaemia was induced in male guinea pigs after 6 days on a chow diet supplemented with 1.6% (w/w) cholesterol and 15% (w/w) corn oil. Both the VLD (very-low-density) and LD (low-density) lipoproteins were increased in cholesterol-fed animals, although the low concentrations of HD (high-density) lipoproteins remained essentially unchanged. LD lipoproteins of d 1.019-1.100 were the major class, accounting for 74% of the total substances of d less than 1.100. 2. Both VLD and LD lipoproteins exhibited alterations in their chemical composition, physical properties and apolipoprotein content. The VLD lipoproteins in cholesterolaemic animals were rich in cholesterol (25.9%), deficient in protein (4.9%) and exhibited electrophoretic mobility greater than that of beta-globulin; their average particle size (64.5 nm) was larger than that in controls (46.3 nm). The LD lipoproteins in animals fed on the experimental diet were also richer in cholesterol (53.1%) and of larger diameter (24.3 nm) than in the control group (41.1% and 21.4 nm respectively). 3. The apolipoprotein-B content of both VLD and LD lipoproteins was elevated in cholesterolaemic animals, particularly in the VLD class, where it represented 74.8% of the total protein moiety. 4. Apo-VLD lipoprotein exhibited an increase from 6 to 19% in its complement of tetramethylurea-soluble apolipoproteins with low electrophoretic mobility (relative mobility less than 0.29); this was primarily accounted for by apolipoproteins characterized by high arginine (7.2 and 6.4% respectively) and glutamic acid (20.1 and 20.0% respectively) contents. 5. By contrast, there was little change in the soluble apolipoproteins of LD lipoproteins in hypercholesterolaemic animals.6. These studies show the response of the guinea pig to dietary fat and cholesterol to be distinct from that elicited by similar stimuli in the rabbit, rat, pig and dog.


[Prognostic value of echography in threatened abortion]. After a short description of the most important echographic pictures for diagnosis of spontaneous abortion in the first trimester, the clinical development in 89 patients with threatened abortion symptoms, is examined. The interruption of pregnancy has been predicted in 97,05% of the cases resulted in abortion and normal prosecution of pregnancy in 98,18% with regular outcome. These results are very reassuring and no doubt more reliable than pregnancy-test, which for its prompt applicability, may be compared with echographic examination.


[Biparietal diameter and growth rate: employment in the diagnosis of PIFG]. The ultrasound-examination of 107 pregnancies, submitted to several serial measurements of B.P.D. and B.P.D Growth Rate, showed the diagnosis of Poor Intrauterine Fetal Growth to be possible in only 56,25% of the cases. This result is evidently inacceptable and agrees with literature data showing that head circumference measurements in Small Gestational Age, are, at birth, above the 10 degrees percentile in 54% of the cases.


[Erythrocyte changes (echino- and stomatocytic) in muscular dystrophy: research on possible applications in diagnosis and eugenics]. The Authors, after a brief review of the factors which influence the echino and stomatocytic erythrocyte's deformations and of the biochemical basis of these alterations, report the comparative study of the echino-stomatocytogenesis in both normal subjects and myodystrophic patients. In order to investigate whether this phenomenon is more developed in pathological condition, the results confirm that between normal subjects and myodystrophic patients or healthy carriers there is a quantitative significant difference which can be utilized for diagnostic and eugenic purposes. To obtain reliable results, the evaluation should be made at regular intervals of time from the blood drawing and after the exclusion of the presence of other disease or echino-stomatocytogenetic factors (drugs, etc.).


[Modification of surgical reconstruction of the glottis]. A personal modification to Staffieri's technique is presented. This change respects the principles of the operation but is different on the practical performance in order to avoid the incontinence of the neo-glottis. A partial decartilagination of the tracheal or crico-tracheal stump over the definitive tracheostome is performed, so that it can be funnel shaped and idoneus to the end to lateral anastomosis with the mucous membrane of the ipopharinx.


[Food consumption in a community of the Parma district (Langhirano). Clinico-metabolic considerations]. Referring to the results of a "pilot" nutritional investigation carried out in a representative mixed sample of a small community of Parma district (Langhirano), the AA. underline the clinical and metabolic implications resulting from the not quite correct nutritional behaviour observed. In fact, in agreement with the national average data reported for italian population from ISTAT, caloric excess, particularly of dietary fat and proteins, was confirmed in this community too. Nevertheless, want of vitamins (D, B1, B2), and minerals (Ca) was paradoxically found. Considering in detail the results some immediate clinical and metabolic consequences come out: namely, want of Ca is prevailing in women and just in the critical age classes (20-40 and 50-59 years, that is in fertile and climacteric ages). When the recommended intake levels are higher. Ferthermore in male-populations, in the class aged 30-50 (that is more vulnerable as to atherosclerosis), was found the highest caloric intake besides in fat and particularly in cholesterol, as to the recommended safety levels. The A.A. conclude pointing out the importance and the necessity of a nutritional notions wide spreading, involving the various responsible public health and social politic organisation of the Country.


Increase in dopamine content of the rat median eminence after long-term ovariectomy and its reversal by estrogen replacement. The norepinephrine (NE) and dopamine (DA) concentrations of the median eminence and the remaining hypothalamus of female rats were assayed using a sensitive radioenzymatic method. There were no changes in the catecholamine concentrations of either brain region when measured in the mornings of the different days of the estrous cycle. Four to 5 weeks after ovariectomy there was a marked increase in the DA but not the NE content of the median eminence, and the daily administration of estradiol benzoate for 7 days prior to sacrifice reversed the ovariectomy-induced increase in DA. Ovariectomy did not alter catecholamine concentrations in the remaining hypothalamus.


Anticonvulsant induced increase in 25-hydroxy-vitamin D3-1alpha-hydroxylase. Osteomalacia has been shown to be associated with long-term anticonvulsant therapy. Anticonvulsants modify the hepatic metabolism of vitamin D3 and decrease serum 25-hydroxy-vitamin D3 (25-OH-D3) levels. We have confirmed this and have shown that diphenylhydantoin (DPH) and phenobarbitone (PB) enhance the activity of kidney 25-hydroxy-vitamin D3-1alpha-hydroxylase (1-hydroxylase) in the chicken. Thus, anticonvulsant osteomalacia may not be due to a lack of the active metabolite of vitamin D, 1,25-dihydroxyvitamin D3 (1,25 (OH) 2D3).


[Delayed hypersensitivity in pediatric patients with cancer]. Possible relationship between childhood cancer and host immunity was studied by assessment of delayed hypersensitivity assayed by skin testing. Reactivity to a battery of potential secondary skin test antigens and a primary antigen, dinitrochlorobenzene (DNCB) was determined in 46 children with various malignancies and 28 healthy controls. Rechallenge to DNCB 50 and 100 mcg was tested in 26 children an in the controls. Secondary antigenic patterns showed little difference from controls or between surviving or living patients. Anery to DNCG rechallenge was a prominent finding in children dying with cancer. Immune altertion of some non tumor specific factors therefore seems to be associated with prognosis in some childhood cancers.


[Compensatory growth in children with intrauterine growth retardation of different etiologies]. Postnatal growth of infants born with low birth-weight for gestational age was studied by measuring monthly weight, supine length, head circumference and triceps skinfold from birth to seven months. Three groups were studied: twins (group A, N 15), babies with no apparent cause of their IGR; group B, N 20) and babies born from mothers with moderate to severe toxemia during pregnancy (group C, N 9). The three groups had a similar degree of birth-weight deficit, but birth-length was significantly more reduced in group C. The three groups presented some degree of catch-up-growth, reflected by a higher-than-average growth velocity, present during the first 3-4 months only; after this age, growth rates were not different from normal average. Groups A and B had a greater catch-up-growth than group C in weight and triceps skinfold, reaching 50th percentile in three months. Incomplete catch-up of group C may be due to interference of toxemic injury on critical period of fat cell replication. The prognosis of postnatal growth of babies with IGR is strongly dependent on the degree of catch-up-growth during the first months of extrauterine life; this is, in turn, related to the etiology responsible for IGR.


[Serum immunoglobulins in the idiopathic nephrotic syndrome]. In 78 children with idiopathic nephrotic syndrome, the levels of serum immunoglobulins were studied. In 45 cases with lipoid nephrosis, 7 with segmentary and focal sclerosis and in 26 with membranoproliferative glomerulonephritis, a reduction in per centum values of IgG were found in similar magnitude in the groups. Levels for IgA were not found abnormal and there was an increase in values for IgM exclusively in cases of lipoid nephrosis. There was no difference between disorders shown by cases of active lipoid nephrosis at the beginning or following relapse after some time of evolution. On the other hand it was found that disorders that appeared significantly in magnitude in cases undergoing remission, but specially in those with a greater time of evolution. The difference in these findings with those reported by other authors are attributed to multifactorial causes of lipoid nephrosis and it is supposed that disorders of immunoglobulins represent a functional defect of the lymphocytes T similar to that described as "immunodeficiency linked to chromosome X with high IgM". The association of lipoid nephrosis with certain types of locus HL-A suggest that these immunity alterations might signify a predisposing factor genetically transmitted and suggest the systematic study of these abnormalities in parents and siblings of patients with this disease.


[Various biosociological aspects of women during childhood]. Several biosociocultural characteristics that define the woman's form of evolution during her first stages of growth and uterine development are analyzed. In order to outstand these features, a comparison is established between the events that take place in the woman and those that occur in men. For instance, the apparent immunologic deviation in the female sex and the greater incidence of certain congenital anomalies and metabolic diseases in man. On the other hand, the somatic differences are stressed, apparently as a result of metabolic peculiarities of one or the other sex, together with the unique behavior of women from a very early age in life. Finally, the behavior of the Mexican before the birth of a female is outlined in this statement, the series of sociocultural restrictions confronting women from the initial stages of her growth and development are pointed out.


[Bezoars in childhood].

[Bezoars in childhood]. Hospital Infantil de México reports 13 cases of bezoars out of which, 12 were trichobezoars and one fitobezoar. Bezoars are uncommon, but they must be known by the pediatrician as well as by the children surgeon in order to be able to reach a diagnosis and give the treatment. A complete review of the main points is given.


[Diencephalic cyst].

[Diencephalic cyst]. Two cases diagnosed as diencephalic cyst are reported. This disease is a congenital malformation of the central nervous system attended constantly by partial or total agenesia of the corpus callosum. The embryologic disturbances distinctive of this disease are pointed out and a clinicoradiological correlation is made. Therapeutic procedures are described.


[Malnutrition as an expression of social disease (conceptual models)]. Considering the complexness of the factors involved in the genesis of malnutrition, several patterns are set forth in this assay that stress the sequence with which biosociocultural variables participate in it. The evolution the causality concepts have had, allow the interpretation of the initial interest to explain the origin of disease with the purpose of offering a treatment in a scientific basis. Once the relation between malnutrition and the energetic and protein deficiencies have been recognized, another phase of knowledge was initiated having primarily a preventive goal; under this new guidance, the attention of research workers was directed to the identification of the disease as a manifestation of the inadequate social integration of man in the economical, political and cultural aspects, as in the psychosocial.


[Early and late ligature of the umbilical cord and the acid-base equilibrium of the newborn infant]. A comparative study was made between two groups of healthy newborns. In the first group (A), partial placental transfusion was propitiated and in the second group (B), the umbilical cord was ligated previous to the first inspiration. The behavior of the internal means was investigated carrying out a study of its acid-base equilibrium in umbilical vessels and in arterial blood of the newborn at 30 minutes of independent life. The analysis of the results confirmed significant statistical differences between both groups under study and the usefulness of one minute partial placental transfusion was substantiated. It verified besides that, although both groups showed similar behavior, the group where placental transfusion was propitiated showed a greater metabolic resource which was statistically confirmed. This circumstance propitiated a better accomplishment of homeostasis.


[Complications of BCG vaccine].

[Complications of BCG vaccine]. The different types of complications encountered with the application of BCG vaccine are described together with a scheme of its characteristics and application techniques. The use of oral vaccine is discarded. The normal and the different abnormal reactions are described; likewise, atypical localizations and all their consequences. Finally, pertinent recommendations for the application of this vaccine are made.


[Coronary arteriovenous fistula. Considerations on differential diagnosis]. Review is made of the literature of coronary arteriovenous fistula, since its first description up to 1975; we mention the most important points treated by each author. Two cases are studied clinically, by entheterization and coronariography. We take into consideration the differential diagnosis with patent ductus arteriosus, ventricular septal defect with aortic insufficiency, and rupture of congenital aneurysm sinus of valsalva to right cavities. The result of these studies is that, if an atypical continous murmur for an arterial duct is present, we may suspect a coronary fistula as a first possibility, since an aneurysm of valsalva's sinus is a rare entity.


[Intraosseous lymphangiectases].

[Intraosseous lymphangiectases]. These are osteolytic type bone lesions conditioned to congenital malformations of the lymphatic system. Most cases become evident during adolescence. At the clinical study, extraosseous lymphatic changes may be found and frequently there is chylous pleural effusion caused by trauma, wounds, surgery or congenital anomalies of the thoracic duct. Pathologic fractures may show the anomaly. Lymphangiectatic lesions studied at the X-rays, especially if they are multiple and affect long bones, flat bones and skull, may show the lesion. Lymphography is used as a clue diagnostic procedure and shows dilated engorged lymph vessels with stagnation of the contrast medium at the cistern of Pecquet. The diagnosis must be clinical and radiological. The prognosis varies according to the extension of the process. Diets rich in proteins are given in the treatment and fractures are managed by orthopedic means.


[Familial juvenile nephronopthisis].

[Familial juvenile nephronopthisis]. For the last 20 years, 11 patients with clinicopathologic diagnosis of nephronopththisis or medullary cystic disease, have been studied at the Nephrology Department of the Hospital Infantil de México. The initial manifestations took place at ages from 3 to 12 years and consisted of polyuria and polydipsia with reduction of vasopressin resistant urinary concentration capacity. Most cases showed anemia and pondostatural delay even at periods previous to renal insufficiency initiation. All cases showed normal urinary sediment with persistently negative urine cultures and progressed to chronic renal insufficiency after 1 to 10 years of evolution. Eight cases showed familial character. Histopathologic findings were similar and consisted of tubular disorders with alternation of atrophic tubuli having thickened basal and dilated tubuli having normal or flattened epithelium; renal medullary cysts were shown in some cases.


[Furosemide in the early diagnosis of acute renal insufficiency in the newborn infant]. The study included 13 infants under one year complaining of acute gastroenteritis and dehydration who were still in oliguria or anuria 6 hours after rehydration was initiated. They were given a single dose of furosemide at the rate of 1 mg/kg and indices of U/P of urea and osmolarity, ratio urea/plasmatic creatinine, urinary volume, natriuresis and evolution of urea plasmatic figures and of creatinine were determined. Four patients showed no response to the diuretic; all of them died and through clinical and histopathologic evaluation they were classified as having acute renal insufficiency (IRA). The nine patients showing response to the drug with an increase of 5 to 30 times the control figure for urine and natriuresis showed an index U/P of urea of 5.52 +/- 3.82, U/P of osmolarity of 1.32 +/- 09, ratio urea/plasmatic creatinine of 58.7 +/- 19.8 and the figures for urea and creatinine in blood turned normal within 2 to 4 days. This was classed as prerenal azotemia (APR). It is thus concluded that furosemide appears to be a good parameter to make an early differentiation of cases with IRA, but that this measure, the same as the rest of the indices cannot show an absolute value since there are important variations in each individual.


[Teaching of pediatrics within the plan of studies for general medicine (plan A-36)]. In this article the author exposes some of the bases about the instruction program of General Integral Medicine (plan A-36); also, he compares the teaching aspects of pediatrics of this plan and the traditional plan, both carried out at the medical School of the National Autonomous University of Mexico. The author points out the best distribution of the pediatric aspects through the medical curriculum, which results in more effective teaching hours, besides, the application of the most current pedagogic and didactic technics in Plan A-36. Also the pediatric clinical practice is performed in more appropriate places and the relation between practice and theory shows more adequate equilibrium than the traditional plan.


[Current concept of chronic secretory otitis]. Excess trust in antibiotic therapy, as well as omission in paracenthesis in treating acute otitis media, are the main factors to account for the development of a new problem in the middle ear: secretory otitis media; that is, presence of liquid, usually of mucoid type, in the tympanic cavity, which constitutes the most common cause of hearing loss in children. The eustachian tube obstruction, being an important mechanical obstructive factor in this pathologic type problem, as well as recent evidence from studies, showing that the mucosa of the middle ear, suffering repeated infections, undergoes metaplasic changes, to a glandular epithelium that maintains the presence of liquid in the cavity. Stress is placed on symptoms and signs in infants and in older children as well as on the medical and surgical therapy of this entity.


[Two autopsy cases of adult central nervous system toxoplasmosis: light and electron microscopic studies (author's transl)]. Two autopsy cases of adult central nervous system toxoplasmosis were reported. Two cases treated with immunosuppressive agents and corticosteroids under a diagnosis of Hodgkin's disease were considered to be an acquired CNS toxoplasmosis associated with the underlying diseases. The first case, a 73 year old woman with Hodgkin's disease, showed toxoplasma lesions in the cerebrum. The second case, a 22 year old man with pulmonary tuberculosis, showed toxoplasma lesions in the cerebrum, basal ganglion, thalamus, cerebellum, pons, and medulla oblongatta. Each toxoplasma lesion showed small hemonecrotic softening. Toxoplasma cysts were seen around the hemonecrotic lesion. Encysted toxoplasma organisms were examined in detail with electron microscope.


[Clinical observations of intracranial arachnoid cyst of the middle fossa (author's transl)]. The patients are 15 year old and 13 year old males who complained of a headache, vomiting and general malaise. The plain skull films showed thinning and bulging of the left temporal squama, forwards enlargement of the middle fossa and the elevation of the lesser wing of the sphenoid. The left carotid arteriography indicated significant elevation of the middle cerebral artery and the opercular portion of the middle cerebral artery was absent. Left frontotemporoparietal craniotomy was performed, and the large cyst as the space taking mass lesion of the middle fossa was noted. The cyst contained xanthochromic fluid and its wall probably consisted of arachnoid membrane. In both cases the cyst occupied anterior 6 cm of the left middle fossa and no brain tissue was noted between the cyst and the anterior part of the middle cranial fossa. Histologically, the membrane of the cyst was arachnoid. Their recognition and management are discussed.


[A study of excitability changes in DSCT neurons of the cat (author's transl)]. Excitability changes in the dorsal spinocerebellar tract (DSCT) neurons of the cat were extracellularly studied with correlation analysis. Most of the interval histograms were classifed as normal distribution, and occasionally bimodal distributions were observed, which resulted from an occasional "double spiking" in the spontaneous background discharge (BD). The conduction velocity was measured in 72 DSCT fibers. The histogram showed a peak at 40-50 M/S. The majority of the units had BD with coefficient of variation less than 0.2, which suggest BD with regular firing. Based on cross-correlelograms, DSCT responses to electrical stimulation of the muscle nerves of the hind leg were classified into at least three types. Type 1 response, constituted approximately one-fifth of the total, is monosynaptic activation. Type 2 response, observed most frequently (47%), is inhibition of DSCT cells with a short latency. Type 3 responses, observed nearly as often as type 2 (34%), is a long latency excitation, undoubtedly polysynaptic. Changes in stimulation intensity showed complex changes in the pattern of response. Type 1 and 2 responses were unaffected by increasing stimulus rate. Peak correlations in type 3 response were reduced by increase in stimulus rate. There were no data demonstrating feedback circuitry associated with collaterals of DSCT axons. This suggest that axon collaterals have no direct effect on the activity of Dsct cells.


Prognosis of patients with acute myocardial infarction admitted to a coronary care unit. I: Survival in hospital. On a basis of history, clinical examination, and the electrocardiogram it was possible to identify groups of patients with acute myocardial infarction with good and bad prognoses as regards hospital survival. Individual adverse factors were age, prevous history of ischaemic heart disease, anterior infarction, persistent sinus tachycardia, pulmonary crepitations, hypotension, and raised venous pressure. Multivariate analysis showed four factors remaining significant--age, tachycardia, hypotension, and pulmonary crepitations. As a result of treatment of cardiac arrest, hospital mortality, which would otherwise have been 20 percent, was 17 percent. Preceding unstable angina did not worsen the immediate prognosis.


Prognosis of patients with acute myocardial infarction admitted to a coronary care unit. II. Survival after hospital discharge. The factors adversely affecting long-term prognosis differed from those affecting outcome of acute infarction. Individual factors were previous history of infarction or hypertension, tachycardia, cardiac arrest, ventricular arrhythmia, atrial fibrillation, 3rd heart sound, raised venous pressure, and pulmonary crepitations. Multivariate analysis reduced these to 6--previous infarct or hypertension, sinus tachycardia, cardiac arrest, ventricular arrhythmia, and artial fibrillation. Of those who survived 5 years, approximately half had angina. Two-thirds of the under 60 survivors were at their normal work.


Teeside coronary survey--fatality and comparative severity of patients treated at home, in the hospital ward, and in the coronary care unit after myocardial infarction. An epidemiological survey of myocardial infarction in Teesside County Borough was completed between April 1972 and April 1973. Cases were notified and divided into those who had suffered a 'definite', 'possible', or 'not' myocardial infarction. Severity factors were measured in the 'definite' cases and the distribution of the various factors studied among home, ward, and coronary care unit treated cases. Increasing severity was found to be related to increased fatality. The fatality of patients treated at home was less than that of those treated in the ward or the coronary care unit. Those who survived to be treated at home were not less severe than those who survived in a comparable group to be treated in hospital using the objective criteria described in the assessment of severity. It is emphasised that the results must be interpreted with caution as other essentially subjective criteria not so easily measurable, but which might have been of considerable influence in the assessment of severity, were not measured in this study.


Loss of electrically active myocardium during anterior infarction in man. A method has been developed of praecordial mapping of changes in R/S ratio and the appearance of Q waves in acute myocardial infarction. Observation of the serial changes in R and Q waves in 40 patients with uncomplicated anterior infarction shows that the loss of electrically active myocardium occurs within 6 hours of the onset of chest pain. Complications, such as recurrent chest pain, associated with extension of myocardial necrosis can be identified and assessed. The total praecordial changes in R/S ratio and Q wave amplitude correlate with the total MB fraction of creatine kinase activity released into the plasma in 20 patients after uncomplicated anterior infarction. This technique for identifying those factors that may modify the progressive loss of active myocardium in the early phase of acute infarction of the heart is noninvasive and repeatable.


Prognostic significance of isolated left anterior hemiblock and left axis deviation in the course of acute myocardial infarction. In 700 patients with acute myocardial infarction admitted to the intensive coronary care unit of our hospital, the incidence and significance of left anterior hemiblock and left axis deviation has been studied in the acute phase of disease. In 102 (14.6%) of the 700 patients, isolated left axis deviation (mean QRS axis-45 degrees) was found and 69 of them (9.9%) met the criteria of left anterior hemiblock. Of the 69 patients with left anterior hemiblock, 61 had acute anterior myocardial infarction, 5 had inferior infarction, and 3 had subendocardial infarction. The anterior hemiblock was transient in 5 patients, but persisted in 64. All patients with and without isolated left anterior hemiblock and left axis deviation were compared statistically with reference to mortality rate and the incidence of arrythmias; no significant difference was noted. However, in patients over the age of 65 and also in those with hypertension, the incidence of left axis deviation was significantly higher (P less than 0.05 and P less than 0.001, respectively). It was concluded that isolated left anterior hemiblock and left axis deviation occurring in the course of acute myocardial infarction no influence on the prognosis of acute myocardial infarction.


Metabolic and hormonal studies in patients with essential hypertension. In 106 patients with essential hypertension and different plasma renin activity several hormonal and metabolic factors were studied: urinary excretion of catecholamines, blood levels of cholesterol and triglycerides, levels of glycaemia and insulinaemia after glucose load and plasma fibrinolytic activity. The plasma renin activity in 46.2 percent of patients was normal, whereas in 25.5 percent it was low, and in 28.3 percent it was high. In patients with high plasma renin activity the excretion of noradrenaline and adrenaline was relatively high while that of dopamine was low. Significantly lower triglyceride levels were found in patients with low plasma renin activity in comparison with those with high and normal plasma renin activity. There was also a statistically significant difference in the euglobulin lysis time which was shorter in patients with low and longest in patients with normal plasma renin activity. The results of the study show that patients with different plasma renin activity may also differ in some hormonal and metabolic values.


Coronary arteries in d-transposition. A necropsy study of reimplantation. The coronary arteries are a major concern in anatomical correction of d-transposition of the great arteries. The necropsy study was undertaken to assess the feasibility of direct bilateral reimplantation as described  by Fatene et al. This seemed possible in only 30 per cent of 100 cases, and furthermore was related to the type of coronary artery pattern.


Coarctation of aorta with special reference to infants. Long-term results of operation in 126 cases. A review of 126 cases of coarctation of the aorta confirms the need for surgical resection in infants with intractable congestive cardiac failure. The high association with additional cardiovascular abnormalities in patients presenting in early infancy contributes significantly to the mortality. Patients with large ventricular septal defects and coarctation of the aorta are at risk and may require pulmonary artery banding at the time of resection of the aortic coarctation. Long-term complications included restenosis (18 cases) and persistent hypertension (10 cases). In order to prevent persistent hypertension, it is suggested that elective resection of the coarctation be done at 1 year of age.


Cardiovascular anomalies in thoracopagus twins and the importance of preoperative cardiac evaluation. Four pairs of thoracopagus twins have been described. Cardiac catheterisation was performed in all the cases. Angiocardiographic and necropsy findings suggest that the most common abnormality was some form of univentricular heart. The communication between the 2 hearts was at atrial level in 2 cases. Separation was performed in 1 of these cases but only 1 of the twins survived for 14 hours after operation. It is suggested that full cardiac catheterisation with selective angiocardiogram is essential before separation is considered. Identical heart rates were observed in each pair and there was invariably a major communication between the hearts of the twins.


Effect of additional valve lesions on left ventricular ejection time in aortic stenosis. Rate-corrected left ventricular ejection time was measured from the aortic pressure tracings of 171 catheterised patients with aortic valve area less than or equal to 1.2 cm2. In 50 patients with pure aortic stenosis, left ventricular ejection time in increased with decreasing valve area and was significantly higher (468 +/- 5 ms, mean +/- SEM) than in 13 normal subjects (435 +/- 5 ms). Additional aortic regurgitation in 72 patients further increased the left ventricular ejection time to 484 +/- 4 ms. Significant mitral stenosis (mitral valve are less than or equal to 1.2 cm2) in 6 patients with aortic stenosis and 33 patients with aortic stenosis and regurgitation reduced the left ventricular ejection time to normal. Similarly, severe mitral regurgitation in 3 patients with aortic stenosis and regurgitation reduced left ventricular ejection time to normal, though slight or moderate mitral regurgitation in 4 of these patients did not. These data show that the prolonged left ventricular ejection time in aortic valve disease may be restored to normal in the presence of coexisting significant mitral disease.


Detector electrode introduced by mediastinoscopy for atrial triggered cardiac pacing. A follow-up of electrode function in 82 patients. An atrial detector electrode was introduced by mediastinoscopy in 82 patients requiring permanent cardiac pacing. There were no complications. An adequate P wave was recorded in 80 patients. During the following week, the P wave became ineffective in 5 patients; angina occurred in 2 and atrial arrhythmias in 2. Atrially triggered ventricular pacing established in 73 patients and was followed in 71 patients for a period of 1 to 113 months. In 17 cases, it had to be terminated because of an ineffective or unstable P wave,in 6 cases because of atrial arrhythmias, and in 4 cases because of advanced age and recurrent infections. The method is technically simple and place little stress on the patient.