Bovine venereal vibriosis: activity of inflammatory cells in protective immunity. The capability of bovine polymorphonuclear (PMN) and mononuclear phagocytes to kill Campylobacter (Vibrio) fetus venerealis was tested under various conditions in order to judge their roles in protective immunity. Bovine PMN killed C fetus in the presence of immunoglobulin G (IgG) but not immunoglobulin A (IgA) antibodies. Some phagocytosis occurred in the absence of antibody in glass-adherent cultures, but not in suspension cultures--indicating that surface phagocytosis by the neutrophils normally present during estrus could account for natural protection at this time. Mononuclear phagocytes also killed C fetus in the presence of opsonins, making this a likely factor in protection during the later stages of inflammation when mononuclear cells predominate. The presence of numerous lymphocytes in this mononuclear infiltration and the capability of C fetus antigens to induce delayed hypersensitivity (DH) are consistent with the possibility that cell-mediated immunity (CMI) also may be involved in protective immunity.


Detection of activity for various anthelmintics against in vitro-produced Cooperia punctata. The in vitro-grown parasitic stages of Cooperia punctata were used to evaluate 28 compounds with different kinds and degrees of in vivo activity. Using presumptive and confirmatory tests, it was possible to establish a group order of in vitro potency that compared favorably with an order based on established in vivo use of these compounds. The procedure lends itself to evaluating activity against a given parasitic growth stage and gives a quantitative estimate (range) of the concentration that produces 50% nematode kill. The system was most successful in detecting compounds with in vivo activity for C punctata, followed in order by compounds active against Cooperia spp, other gastrointestinal nematodes of ruminants, and other nematodes of non-bovine hosts. The procedure showed some differentiation between activity against nematodes versus that against cestodes, trematodes, and arthropods. The system permits considerable flexibility in experimental design, thus making possible the acquisition of the particular information desired. In addition to establishing lethal effects on the nematode, the procedure detected compounds with nematode-anesthetizing effects. The results indicate this in vitro system can be used with some expediency as a preliminary screening method in the search for new anthelmintic compounds.


[Pharmacokinetics of C14-olivomycin in the body of mice with lymphosarcoma (L10-1 strain)]. The pharmacokinetics of C14-olivomycin after its single intravenous administration to mice with lymphosarcome (LIO-I) was studied. It was shown that according to the specific radioactivity the organs may be placed in the following order: I hour after the antibiotic administration-the blood, liver, spleen, thymus, tumor, muscle; 3 hour after the administration-the liver, spleen, thymus, blood, tumor, muscle. Accumulation of olivomycin in the mouse organs was mainly in direct dependence on the dose of the antibiotic administered. Chromatography of the substances extraceted with ethylacetate from the urine collected at various periods after C14-olivomycin administration showed the presence of a new radioactive product (Rf 0.35-0.37) in addition to the unchanged antibiotic (Rf 0.53). Bioautographic analysis of the chromatograms showed that the product of C14-olivomycin conversion preserved its biological activity. The analysis of the substances extracted with ethylacetate from the liver, spleen and tumors 3 hours after the antibiotic administration reveiled (except of the liver) the presence of a spot with Rf corresponding to that of the initial drug.


[Use of prodigioza in the overall treatment of chronic osteomyelitis]. Treatment of 188 patients suffering from chronic osteomyelitis of various etiology and localization with prodigiosan, a bacterial lipopolysaccharide favoured an increase in the nonspecific immunobiological reactivity: the phagocytic activity and leucocytic intensity increased, the average titers of iso- and heteroagglutinins, as well as the complementary activity of the serum became higher. The results of the clinico-laboratory studies are indicative of advisable use of prodigiosan in complex therapy of cases with chronic osteomyelitis.


Psychotherapy in hospitalized research patients. Operations at the clinical-research interface exert a signal influence on the therapy of patients being treated on investigative units. The effect on the treatment milieu has been described but the impact of a research climate on individual psychotheraphy of hospitalized patients has not. We observed research-therapy interaction in 25 acutely schizophrenic patients. Analytically oriented psychotherapy was carried out on a National Institutes of Health clinical research unit where drugs are only occasionally used, and patients are subjects in psychobiological investigation. The subtle, and often neglected, interplay between therapy and research is examined, with emphasis on the shifting meanings of the patient's participation or refusal to participate in therapy, research, or both. A research transference and countertransference are defined, and some special behavioral patterns of research patients receiving dynamic therapy are considered in this framework.


Oscillation phenomena in black lipid membranes induced by a single alamethicin pore. In this paper we  show how alamethicin (a small cyclic peptide of molecular weight 1691) can produce voltage oscillations in black lipid membranes and how a nonactin-alamethicin oscillator can be constructed. Alamethicin alone induces oscillations only with an applied bias current, but with nonactin and appropriate salt solutions oscillations occur with no bias current. Both kinds of oscillations can be quantitatively understood in terms of the known properties of alamethicin and nonactin and both depend on the statistical nature of the formation opores in the membrane by alamethicin.


Psychological morbidity in a clinic for sexually transmitted disease. 100 first attenders at a clinic for sexually-transmitted diseases were interviewed using a semistructured schedule. 20 per cent. were regarded as probable psychiatric cases and a considerable amount of psychosocial morbidity was observed. Whilst the majority reported anxiety about their possible illness, in a quarter the anxiety and distress appeared to be of long standing, having arisen before the genital symptoms or risk of infection and being related to chronic social and psychological difficulties. There were no significant differences between those diagnosed as having or not having STD in such characteristics as psychological symptoms, mean psychiatric score, and delya in consulting. Whilst those without a sexually-transmitted infection were less likely to be female, and more likely to feel guilty, to have had a casual sexual partner, and not to complain of specific genital symptoms, there was no evidence to support the concept of a syndrome of 'venereophobia'.


Streptococcal pyoderma of the penis following fellatio. Gonococcal pharyngitis has been correlated with fellatio in both heterosexual females and homosexual males. This report describes another complication of fellatio, group A beta-eaemolytic streptococcal pyroderma on the penis after exposure to a male who probably had pharyngitis. the erythematous, purulent lesions should be cultured. After the organism has been identified, adequate treatment with either a long-acting parenteral penicillin or a 10-day course of oral penicillin is important in order to prevent the possible life-threatening complication of post-streptococcal glomerulonephritis.


The use of intrathecal phenol for muscle spasms in multiple sclerosis. A description of two cases. Two cases of multiple sclerosis are described, in both of whom the disease started in yound adult life. This disability gradually progressed to the stage of paraplegia-in-flexion in which the lower limbs were fixed in adduction-and-flexion. Both patients developed painful muscle spasms which made life intolerable. These patients were treated by intrathecal phenol in glycerine in an effort to convert this spastic paralysis into a flaccid paralysis. The three advantages sought were: 1. To relieve the muscle spasms so that the patient could sit in a wheelchair and propel herself. 2. To relieve the pain of the spasms. 3. To allow access to the perineum for proper hygienic care of bladder and bowel function. The first patient obtained an excellent result (Figures 1, 2, 3) but blocks had to be repeated after approximately five months. The second patient after the block developed a good result in the right leg, but still had mild, but painless spasms in the muscles of the left leg (Figures 4 and 5). However, she was able to use a wheelchair and was discharged to a chronic hospital where she died of bulbar paralysis six months later. Intrathecal phenol thus appears to be a useful method for relieving muscle spasms and pain in the lower extremities in advanced cases of multiple sclerosis.


A cat with Corynebacterium equi lymphadenitis clinically simulating lymphosarcoma. A cat with granulomatous lymphadenitis due to Corynebacterium equi is described. Clinically the cat was diagnosed as having lymphosarcoma. Bacteria were cultured from the lymph nodes.


Exophthalmogenic activity of the beta subunit of thyrotropin. The exophthalmogenic activity of the beta subunit of bovine thyrotropin is only 10% to 20% that of the thyrotropin molecule or of an exophthalmogenic factor produced by partial pepsin digestion of purified thyrotropin preparations. The alpha subunit of thyrotropin, luteinizing hormone, and both subunits of luteinizing hormone have no exophthalmogenic activity.


Minocycline: A review of its antibacterial and pharmacokinetic properties and therapeutic use. Minocycline is a semi-synthetic tetracycline derivative which is well absorbed and distributed in body tissues and is suitable for twice daily administration.  It appears to be as generally effective as other tetracyclines and analogues, but also to be effective in infections due to tetracycline-resistant staphylococci.  Side-effects are typical of those of other tetracyclines, but minocycline has been associated with a high incidence of vertigo in some studies.  On the other hand, minocycline appears to have little or no photosensitising potential.  It is not yet clear whether minocycline can be safely used in patients with moderate or severe impairment of renal function, but if used in renal failure, the plasma urea concentration should be monitored.


Effect of ergot drugs on central 5-hydroxytryptamine neurons: evidence for 5-hydroxytryptamine release or 5-hydroxytryptamine receptor stimulation. In combined biochemical and functional studies it has been possible to show that ergocornine (0.5-5 mg/kg) and the ergolene derivative (5R,8R)-8-(4-p-methoxyphenyl-1-piperazinylmethyl)-6-methylergolene (PTR 17402; MPME) (0.25-5 mg/kg) reduce in a dose-dependent way brain 5-hydroxytryptamine (5-HT) turnover in rat as evaluated with the tryptophan hydroxylase inhibitor, alpha-propyl-dopacetamide (H 22/54), whereas 2-Br-alpha-ergocryptine (CB 154; Br-EC) had no effect on brain 5-HT turnover. Effects on 5-HT receptor activity were evaluated using the extensor hindlimb reflex of acutely spinalized rats. It was found that ergocornine increased the 5-HT receptor activity independent of presynaptic 5-HT stores and that it didnot have any effects on uptake, retention and spontaneous overflow of 3-H-5-HT in vitro but reduced the fiedl stimulation-induced release of 3-H-5-HT in vitro. Therefore, it is suggested that ergocornine is a 5-HT recpetor-stimulating agent, an effect which may lead to reduction of nervous impulse flow in the 5-HT neurons and subsequently of 5-HT release and turnover. MPME, on the other hand, seems to increase 5-HT receptor release of 5-HT stores, mainly from extragranular sites. Thus, the increase in extensor reflex activity found after MPME was reduced by reserpine and H 22/54 and enhanced by nialamide and in vitro MPME markedly increased 3-H-5-HT overflow in cortical slices of nialamide-pretreated rats and inhibited uptake and retention of 3-H-5-HT (EC50 equals 1.6 times 10-minus 6 M) in cortical slices of normal rats. Inhibition of the 5-HT membrane pump does not seem to be of any major importance, since chlorimipramine was only weakly active on the extensor reflex in the pharmacological models used and since MPME did not block but rather enhanced the 5-HT depletion caused by 4-methyl-alpha-ethyl-m-tyramine. It is suggested that MPME is a releaser of extragranular 5-HT stores leading to increased 5-HT receptor activity and reduction of 5-HT turnover in the same way as indicated for ergocornine. This new ergolene derivative may represent a new class of antidepressant drugs acting via release of extragranular 5-HT stores.


[Thermography in sport injuries and lesions of the locomotor system due to sport]. Using the infrared-thermography a exact picture of the body surface can be obtained. Injuries are recognized by a local hyperthermy, if the impaired structures do not lie too deep under the body surface. In combination with anamnesis and clinical and radiological examination the infrared-thermography plays an important role in the diagnosis, management and control of therapy. The results of examinations of 82 patients with distorsions, ruptures of tendons or ligaments, injuries of the meniscus and tendo- and chondropathias as well as of 50 athletes are described. In all cases a hyperthermy was found in the area of injury. In those cases, in which an injury was not the cause of the hyperthermy, other processes could be found (furunculosis, phlebitis, tumor).


A comparative report on an on-line retrieval service employing two distinct software systems. A subjective evaluation comparing the National Aeronautics and Space Administration RECON and National Library of Medicine ELHILL 2 on-line information retrieval systems is presented as they relate to the delivery of a major service dealing with a collection of toxicological bibliographic references (TOXLINE). Comparisons of file structure, response time, command language, system environment, and other relevant features are made based upon actual experience with both systems.


SDC experiences with large data bases.

SDC experiences with large data bases. SDC operates a large-data-base system that permits users all over the United States and in several foreign countries to search very large bibliographic files interactively, by means of a terminal and telephone connection. Developing extensive use of such systems requires not only technical considerations--such as proper selection and handling of data base elements--but also a massive educational effort, to help provide the large user community necessary to share the sizable costs of data base acquisition, file development, and storage. The growing acceptance of on-line retrieval services attests to the success of that effort, as well as to their inherent cost-effectiveness.


Integration of pulsatile gonadotropin secretion by timed urinary measurements: an accurate and sensitive 3-hour test. The integration of pulsatile gonadotropin secretion by the radioimmunoassay of an acetone precipitation from a short-term urine sample was evaluated. FSH and LH excretion over a 3-h period was compared to the mean level of 10 blood samples obtained every 20 min for a similar time period from 71 patients. A highly significant correlation existed between blood and urine results. In addition, the gonadotropin levels obtained from a 3-h sample correlated well with the 24 h excretion of FSH and LH from the same individual. A 3-h urine collection can provide a simple, sensititve, and accurate means of assessing circulating FSH and LH levels.


Reduction in extrathyroidal triiodothyronine production by propylthiouracil in man. To determine if propylthiouracil (PTU) inhibited extrathyroidal thyroxine (T4) to triiodothyronine (T3) conversion in man, PTU was administered to T4-treated hypothyroid patients and serial measurements of T4, T3, and thyrotropin (TSH) carried out. All patients had proven thyroidal hypothyroidism and had been receiving 0.1 or 0.2 mg T4 daily for at least 2 mo before study. Hormone measurements were made for 5 consecutive days before and daily during a 7-day treatment period with PTU, 1,000 mg/day. In eight patients receiving 0.1 mg T4 daily, administration of PTU resulted in a prompt fall in mean serum T3 concentrations from 78 plus or minus 6 ng/100 ml (SEM) to 61 plus or minus 3 ng/100 ml after 1 day. The mean serum T3 concentrations ranged from 55 to 60 ng/100 ml during the remainder of the PTU treatment period (P less than 0.01). The mean control serum TSH concentration was 29.6 muU/ml and it increased to a peak of 40 muU/ml on the 5th and 6th days. In five patients receiving 0.2 mg T4 daily, the mean control serum T3 concentration was 84 plus or minus 7 NG/100ML. It fell to 70 plus or minus 5 ng/100 ml after 1 day and 63 plus or minus 7 ng/100 ml after 2 days of PTU administration and thereafter ranged from 6) to 69 ng/100 ml (P LESS THAN 0.01). Serum TSH concentrations did not increase. No changes in serum T4 concentrations were found in either group. In five patients who received 100 mg methimazole (MMI) daily for 7 days there were no changes in serum T4, T3, or TSH concentrations. These results indicate that PTU, but not MMI, produces a prompt and sustained, albeit modest, reduction in serum T3 concentrations in patients whose sole or major source of T3 is ingested T4. These findings most likely result from inhibition of extrathyroidal formation of T3 from T4.


Food intake and growth of guinea pigs fed a cholesterol-containing diet. Food intake and liveweight gain of 11 cholesterol-fed and 10 control guinea pigs were measured for 33 days to determine whether depressed growth previously observed in young guinea pigs fed cholesterol was due to decreased food intake or to reduced food utilization. The guinea pigs were fed a laboratory stock diet containing 5% cottonseed oil; 1% cholesterol was added to the diet for the experimental group. Results showed that food intake was significantly less in the cholesterol-fed group, while requirements for maintenance and for liveweight gain, as adjusted to metabolic body size (Wkg-0.75), were not significantly different. Food energy retention was estimated by comparing dry body weight and moisture, fat and protein content of two groups of four controls and four cholesterol-fed guinea pigs at the beginning and at the end of a 20-day food-intake period. Values derived for maintenance requirement in this comparative body composition study correlated well with those of the 33-day experiment. We conclude that feeding cholesterol to guinea pigs reduced food intake for unknown reasons but does not affect food utilization.


Physical and mental status at 4 years of age of survivors of the respiratory distress syndrome. Follow-up report from the collaborative study. Fifty-eight survivors of the respiratory distress syndrome were evaluated at age 4 years for deficits in neuromotor performance and physical growth in a prospective study. Comparisons between RDS survivors and 290 matched controls plus 35,198 unmatched controls demonstrated that for each group the neuromotor performance was adversely affected by either low birth weight or low socioeconomic standing. Except for infants with birth weights above 2.5 kg, the RDS survivors performed as well as the two control groups. Comparisons with siblings failed to reveal a decrement in the RDS survivors. Hypothyroidism was more frequent among the RDS survivors than among the control subjects in the highest category of birth weight.


Efficacy of BCG vaccination in prevention of cancer. From 1949 to 1951, a total of 191,827 children in Puerto Rico were enrolled in a controlled trial of BCG vaccination. Of these children, 1 through 18 years of age, 82,269 were classified as reactors to tuberculin and 109,558 as nonreactors. Of the nonreactors, 31,856 refused vaccination, 27,338 were left unvaccinated as controls, and 50,674 were vaccinated with BCG. By the end of June 1969, a total of 37 cases of cancer had been diagnosed among the controls and 98 among the "vaccinees," yielding average annual rates of 7.2 and 10.3 cases per 100,000 population, respectively. The vaccinated group had a slight deficiency of leukemia cases and an excess of lymphosarcoma and Hodgkin's disease. The excess risk of cancer was concentrated among children age 10 through 18 on entry into the trial.


Pulmonary surface tension and head injury. Previous studies have shown that exposure of monkeys to lethal experimental head injury by means of a captive-bolt mechanism results in a decreased lung compliance and a high minimum surface tension. Such changes which occurred in the absence of any increase in lung weight/body weight ratios were ameliorated by the prior administration of various sympathetic blocking agents. Exposure of monkeys and cats to stimulation of the pulmonary sympathetics via the stellate ganglion also resulted in similar compliance and surface tension changes without any increase in lung weight. The present experiments were carried out in order to determine the effect of lethal mechanical head injury in the cat on the surface tension of the alveolar lining layer and reasons for any possible changes. Previous reports have shown that the addition of very small amounts of cholesterol to lung wash fluid raised the minimum surface tension to abnormal levels. The results from the present study show that a sudden lethal blow to the occiput in cats results in an abnormally high minimum surface tension (over 20 dynes/cm) in the lung wash fluid and a nearly 200% increase in cholesterol content. There was little or no change in lung wet weight/dry weight ratios or gross lung appearance following this head injury. Thus the results from the present study strongly suggests that the previously reported decreased lung compliance and high minimum surface tension following a blow to the head may be due in part at least to the presence of increased intra-alveolar cholesterol.


Blastomycosis of the genitourinary tract. In a retrospective study of 51 cases of systemic North American blastomycosis 11 patients were found to have genitourinary tract involvement, the prostate and epididymis being most commonly affected. Diagnosis was made by culture of the fungus from urine, abscess or prostate secretions, morphologic identification of the characteristic organism in urine or secretions, or histologic examination of tissue specimens. Treatment with amphotericin B reduced the mortality rate of 90 per cent to as low as 10 per cent. Long-term followup is necessary because of a relapse rate of 10 to 15 per cent.


US citizens and foreign medical schools. The foreign medical schools that are accepting an increasing number of applicants rejected by US medical schools are not comparable to US medical schools. Until population trends lessen the number seeking a medical education, several pathways are available to identify and assist the qualified student to return to US medicine.


Fifth pathway in New Jersey. House officer preparatory course for US foreign medical graduates. The Fifth Channel in New Jersey is a Fifth Pathway program for US foreign medical graduates. In its third year, 83 percent of its 81 graduates are house officers at 18 US medical school-affiliated hospitals. Performance as house officers is characterized as competitive with peers, including US graduates. Positive attitudes toward work load, fellow workers, and patients compared with those of fellow house staff are noted. Quality of performance as house officers correlates most strongly with the change in mean scores of two batteries of clinical National Board examinations taken during the Fifth Pathway and less strongly with mean scores of single batteries of National Boards, Intelligence quotient, Educational Council for Foreign Medical Graduates (ECFMG) examination, ang age. Recommendations concerning the implementing of similar programs in other states are presented.


Warm bodies in white coats.

Warm bodies in white coats. Few generalizations can be made about graduates of medical schools outside of the United States and Canada, as these graduates vary tremendously in educational and cultural background. Of primary concern is the foreign medical graduate, with inferior education and limited knowledge of English, who does not quality for regular licensure in the United States but who, because of acute manpower shortages, is placed in a position of authority in a state hospital. This situation is possible because of existing state laws.


Acquired circulating anticoagulant to factor VIII. Response to high doses of cryoprecipitate and immunosuppressive therapy. Hematuria, arthralgias, and bleeding from subcutaneous and soft tissues developed in a 56-year-old man with an allergic background following a course of sulfisoxazole for urinary tract infection, Coagulation studies demonstrated the presence of an inhibitor to factor VIII in high titers. Massive doses of antihemophilic factor concentrate (30,000 to 60,000 units/day), azathioprine, and corticosteroids were followed by an immediate decrease in bleeding and a reduced level of inhibitor units. Three months after the onset of symptoms, the partial thromboplastin time returned to normal and inhibitor units to factor VIII became undetectable.


Exophthalmos. The more commonly encountered neurosurgical lesions. A recent discussion of exophthalmos prompted a review of the medical literature and revealed the absence of a report that summarized the diagnosis and management of the more important neurosurgical lesions that produce exophthalmos. A general survey of lesions producing either unilateral or bilateral exophthalmos was therefore conducted. The more common pathophysiologic entities that lend themselves to neurosurgical intervention was selected for review. The present manuscript aims to unify previous studies into an informative survey that combines isolated diagnostic and technical details into a single report.


Distribution of fatty acids during germination of cottonseeds. Gas chromatographic determination of the fatty acids in the seeds of cottonseed (Gossypium sp.) showed linoleic, palmitic, oleic, and stearic acids, with linoleic acid being the major component. Changes in the composition of fatty acids during various stages of germination were measured in the cotyledons and in the roots. A decrease in the content of all the fatty acids and an 8-fold increase in the moisture content of the cotyledons were observed during the 10 days of germination. There were no significant changes in the fatty acid contents of the roots with the exception of those in linoleic acid which increased by 50 percent during 4-10 days of germination. The possible significance of these changes is discussed.


[Data on the epidemiology of venereal diseases in the Friuli-Venezia Giulia region]. Data relating to the diffusion of venereal diseases in the Fiuli and Venezia-Giulia region over the period 1946-71 are presented. The picture is much the same as that observed elsewhere in Italy and in other European and non-European countries. This was more true of the provinces of Trieste and Gorizia than those of Udine and Pordenone. Cases of syphilis fell after the war to minimum figures in 1955-57, since when there has been a considerable increase. Blenorrhoea has followed a more fluctuating pattern, but is still an epidemiological factor of some importance, particularly in the province of Trieste. These various patterns in terms of the many factors that may be involved. The main clinical features of venereal diseases today are described. While less striking than in the past, they still result in serious and by no means negligible pictures.


Prolonged fever in children: review of 100 cases. One hundred children admitted to a hospital over a six-year period with temperatures over 38.5 C for longer than two weeks and of undetermined etiology are reviewed. Fifty-two were infectious (21 presumed viral), 20 collagen-inflammatory, 6 malignancy, 10 miscellaneous, and 12 discharged undiagnosed. Children less than 6 years were more likely to have an infectious etiology while 80% of collagen-inflammatory disease occurred in the group older than 6. The overall mortality (9%) was not age-related. Careful history and physical examinations were helpful but the usual laboratory data (CBC, urinalysis, X-ray) were notably disappointing; however, sedimentation rates and serum protein electrophoresis were often reliable screening tests. Biopsy and laparotomy were less frequently done but when performed yielded productive information. Unusual presentations of common diseases comprised the majority of childhood fevers.


Dietary fluoride intake of infants.

Dietary fluoride intake of infants. The fluoride content of various commercially available food items used in the preparation of the infant diet for the age groups from birth to 6 months has been analyzed and the total daily fluoride intake has been calculated on the basis of these data. The dietary fluoride intake totaled 0.32 mg/day for infants in the age group 1 to 4 weeks, increased in the subsequent months due to increasing food intake, and totaled 1.23 mg for infants 4 to 6 months of age. These fluoride intakes expressed per kilogram of body weight ranged from 0.07 mg/kg in the newborn to 0.16 mg/kg in the 6-month-old infant.


Colony stimulating factor levels in human serum and urine following chemotherapy. The colony stimulating activity (CSA) of serum and urine specimens from 10 patients with lymphomas before and after treatment with standard multidrug chemotherapeutic regimens has been studied. Prominent rises in the CSA in the urine of eight of these 10 patients correlating temporally with initiation of therapy was demonstrated when compared to pretreatment control values. Hourly serum specimens were collected following the administration of intravenous chemotherapeutic agents in two of these patients. In one of these two patients there was a prominent and early rise in CSA which returned to control values by the 12th hr after intravenous drug administration. In two patients who developed little or no increase in CSA during therapy, urine specimens were studied for the presence of inhibitors to colony stimulating factor. Aliquots of urine from each of these two patients when mixed with a standard control urine of known CSA, produced marked inhibition.


Effects of heterologous anti-erythrocyte antibodies on the generation cycle of erythroblasts in rats. An injection of anti-rat erythrocyte rabbit serum or its 7S globulin fraction into rats resulted in immunohemolytic anemia associated with a positive anti-gloublin test examined with anti-rabbit gammaglobulin serum. However, an injection of 19S globulin fraction from the anti-erythrocyte serum failed to cause immunohemolytic anemia, although it induced a transient decrease in red cell count. These results indicate that 7S antibodies are responsible for the induction of anti-globulin test positive, experimental immunohemolytic anemia. The ferrokinetic and stathmokinetic studies revealed the prolongation of generation time of basophilic and polychromatic erythroblasts in rats injected with anti-erythrocyte serum or its 7S globulin fraction. The results from in vitro [3H] thymidine incorporation experiments also confirmed this prolongation. The analysis of in vivo [3H] thymidine labeling of erythroblasts in rats which were given the 7S GLOBULIN ANTIBODIES SUGGESTED THE PROLONGATION OF THE G1 time of the erythroblasts. These results suggest that the effects of anti-erythrocyte antibodies on the generation cycle of erythroblasts are to prolong their G1 time and keep them dormant.


Effect of oxethazaine HCl on control of food and water intake in the rat. Oral administration of the local anesthetic oxethazaine HCl was used to modify eating and drinking patterns in the rat. The addition of the oxethazaine HCl to the diet (0.5 gm/100 gm diet) markedly reduced food intake. Similarly, administration of the drug by gastric intubation (gavage) also reduced food intake. This reduction was of short duration. The inhibition of water intake associated with administration of the drug was shown to be a secondary effect of reduced food intake, rather than a direct action of the drug. The data indicate that local anesthesia of the gastrointestinal tract results in an inhibition of food intake.


Exophthalmus-myxoedema circumscriptum praetibiale-osteoarthropathia hypertrophicans (E.M.O.) syndrome in Graves' disease: a review of eight cases reported in Japan. Case 1 showed recurrence of hyperthyroidism accompanied by pretibial myxedema and digital clubbing 14 years after thyroidectomy for Graves' disease. Case 2 had had pretibial myxedema for the past 20 years and myxedema tuberosum at the right shoulder for the past 10 years, and on admission showed exophthalmos and digital clubbing with thyroid gland demonstrating histological picture of chronic thyroiditis. This case was in slight hypothyroidism and serum LATS was highly positive. Eight cases of E.M.O. syndrome have so far been reported in Japan, including our own. Six cases of these were males. Two cases did not show any sign of hyperthyroidism throughout their entire courses, including our Case 2 described here. Three cases had never received treatment for Graves' disease prior to the occurrence of this syndrome. The serum LATS was positive in all 5 cases thus far reported.


Kaposi's sarcoma of genitourinary tract. Kaposi's sarcoma of the external genitalia is rare.  Four cases with the initial lesion on the glans penis and 13 cases with secondary involvement of the external genitalia are presented.  A high association between Kaposi's sarcoma and malignant lymphoma is noted.  The natural history is one of multiple recurrences in the immediate vicinity of the primary site or at distant locations at varying time intervals.  Wide margin electron beam irradiation is the recommended treatment.  A variety of chemotherapeutic agents also have produced favorable responses; yet prognosis for cure is poor because of the generalized nature of the disease--the course of which is nevertheless often prolonged.


[Splenoportography in pancreatic tumors and retroperitoneal neoplasms]. Along with other methods of investigation splenoportography was performed in 29 patients  with tumors and in 2 patients with cystic affection of the pancreas. Moreover, in 5 cases splenoportography was performed due to a suspicion to pancreatic tumor, and also in 6 patients  with retroperitoneal tumors and in 7-with renal tumors. In all these patients with pancreatic tumors splenoportograms have shown changes on the part of a splenoportal trunk, which corresponded to the localization and degree of spread of a tumor in most cases. Splenoportography is felt to be rational in retroperitoneal tumors. In such cases splenoportography would contribute to a detailed determination of tumor localization and its relation with the liver.


[Raising the sensitivity threshold of the hypothalamohypophyseal system to the homeostatic action of estrogens in rats with transplanted tumors]. Daily injections of 0.57 mKg of diethylstylboestrol-propionate in hemicastrated female rats inhibited the compensatory ovarian hypertrophy in control animals by 50%, and in rats with transplanted homologous fat-muscular tissue--by 4-%. In animals with subcutaneously transplanted Walker carcinoma-256, sarcome-45 and Pliss lymphosarcome this effect of estrogens was not manifested at all. The data obtained appear to evidence an increased threshold of sensitivity of the hypothalamol-hypophyseal system to a suppressing effect of estrogens in animals during the process of growth of transplantable tumors.


[Dermatoglyphic investigations in respect to the genetic basis of autoimmune diseases (author's transl)]. Dermatoglyphics of patients with systemic lupus erythematosus, scleroderma and Sjögren's syndrome were very different from the striking findings in Hashimoto's thyroiditis established in 1971 (Weninger and coworkers). Hence, it was concluded that the characteristic dermatoglyphic pattern of Hashimoto's thyroiditis is specific for this autoimmune disease, but not the expression of a general genetic predisposition to autoimmunity.


A transducer probe for the detection of oestrogen effects on vaginal blood flow in sheep. A simple prototype vaginal probe was designid for the electronic detection of oestrogen-induced blood flow changes by measuring thermal conductivity, tissue temperature, and light reflectance. The probe was tested in six castrate ewes. Treatment with oestradiol-17beta (1.0 mg iv) produced marked changes in thermal conductivity and temperature, but had no detectable effect on reflectance. The study demonstrates the feasibility of multiple-sensor electronic probes for non-invasive monitoring of peripheral oestrogen effects in vivo.


Effects of the luteinizing hormone on blood flow in the follicular rabbit ovary, as measured by radioactive microspheres. Previous reports on the ovarian hyperaemia induced by luteinizing hormone (LH) and human chorionic gonadotrophin (HCG) were based largely on direct observations and semi-quantitative methods. An accurate quantitation of ovarian blood flow changes would contribute to a better understanding of the mechanisms for and physiological significance of this rapid effect of the hormones. In the present study ovarian blood flow was determined before and after a single intravenous injection of LH to anaesthetized, post-pubertal virgin rabbits, using 15 plus or minus 5 mum microspheres, labelled with Ytterbium-169 and Scandium-46. Two min after administration of 100 mug of bovine LH a significant decrease in ovarian vascular resistance was noted. The response was even more pronounced after 20 min. Pre-treatment of the animals with an adrenergic beta-receptor blocker did not diminish the LH induced ovarian vasodilatation. The vasodilatation appeared specific to the ovary, as indicated by simultaneous determinations of blood flow and vascular resistance in other organs and tissues. The microsphere technique is considered to be the method of choice for future studies of the mechanism of the LH induced ovarian vasodilatation.


Studies on 17beta-hydroxysteroid dehydrogenase in human endometrium and endometrial carcinoma I. Subcellular distribution and variations of specific enzyme activity. Specific activity of  17beta-hydroxysteroid dehydrogenase (17beta-HSD) was measured in subcellular fractions of normal endometrium at different phases of the menstrual cycle, and of endometrial carcinoma at different degrees of differentiation. The purity of fractions was determined by marker enzymes, RNA/DNA ratio or electronmicrographs. Both in normal and neoplastic tissue 17beta-HSD activity was located mainly in mitochrondria and microsomal enzyme is bound tightly to the membranes of the endoplasmic reticulum. While in normal endometrium specific enzyme activity in subcellular fractions depended on the phase of the cycle, in endometrial carcinoma it depended on the degree of differtiation of the tumours. The highest values of 17beta-HSD activity were found in mitochondria and microsomes of early secretory endometrium (factor in mitochondria and microsomes of early secretory endometrium (factor 10 as compared to proliferative endometrium) and in particulate fractions of well differentiated carcinoma (factor 10 to  greater than 10 as compared to undifferentiated carcinoma).


Immunohistological localization of antigens related to human chorionic gonadotrophin and human placental lactogen in the uterus of pregnant beagle dogs. A cross-reaction of anti-HCG and anti-HPL sera with related tissue antigens in normal beagle dog pregnant uteri, from thirty days of pregnancy to term, is reported. Using the immunoglobulin-peroxidase bridge technique, specific staining is localized in the glands of the spongy layer and in the deep uterine glands, but it is absent from the trophoblasts of the placental labyrinth. A specific reaction product is also observed in the surface and glandular epithelium of the chorion laeve. These findings suggest that certain antigens, which share antigenic determinants with HCG and HPL, are produced in the endometrial epithelium and not in the trophoblastic villi of pregnant beagle dogs.


Influence of acute administration of human growth hormone and alpha-MSH on plasma concentrations of aldosterone, cortisol, corticosterone and growth hormone in man. The effect of acute administration of human growth hormone (HGH) and of alpha-melanocyte stimulating hormone (alpha-MSH) on plasma aldosterone, cortisol, corticosterone and growth hormone has been studied in normal man and in patients with panhypopituitarism. There is no acute effect of exogenous HGH on plasma levels of aldosterone, cortisol and corticosterone in normal man and in patients with panhypopituitarism. The plasma level of immunoreactive HGH measured during acute HGH infusion in man does not seem to be proportional to the dose administred in our study. Alpha-MSH raises the concentartion of plasma HGH, BYT THIS STIMULATION IS NOT DOSE-DEPENDENT. Aldosterone, cortisol and corticosterone concentrations are not influenced by the elevation of HGH mediated by alpha-MSH in normal man. Although in some patients with panhypopituitarism an elevation of plasma aldosterone concenntration following alpha-MSH infusion is observed, it is unlikely that MSH is directly involved in the acute regulation of aldosterone secretion in healthy subjects.


Testosterone 5alpha-reduction in the skin of normal subjects and of patients with abnormal sex development. Human pubic skin was obtained from normal subjects and patients with abnormal sex differentiation. Skin samples (200 mg) supplemented with NADPH, were incubated for 1 h with labelled testosterone. The conversion of testosterone to dihydrotestosterone, 3alpha- and 3beta-androstanediol was calculated. This conversion averaged 14.9 plus or minus 3.4% (SE) in 11 normal men and 3.6 plus or minus 1.4% (SE) in 8 normal women. In 4 children as in 4 young hypogonadotrophic hypogonadal men, the conversion rate of testosterone to 5alpha-reduced metabolites was low (0.8 to 3.5%) and increased at puberty (13.5 to 19.2%). After administration of HCG for 3 months to 1 of the hypogonadal men, it reached 30.2%. Inversely, the formation of dihydrotestosterone and androstanediols from testosterone was suppressed in 2 men treated with large doses of oestrogen. In 3 subjects with an incomplete form of testicular feminization syndrome, the conversion rate of testosterone to 5alpha-reduced metabolites was in the normal male range (6.4 to 18.3%), whereas it was low in one case of the complete form of the syndrome (1.5%). In 9 women with idiopathic hirsutism the rate of 5alpha-reduced metabolites recovered from testosterone was close to that of normal men (13.5 plus or minus 5.5% (SE). From these results, it is postulated that in human subjects, there is a good correlation between hair growth in skin from a sexual area and the extent of testosterone 5alpha-reduction in this tissue. Such an enzymatic activity might be induced by active androgens; this latter hypothesis is in good agreement with the increase of 5alpha-reduction activity observed at puberty or after treatment of young hypogonadal males. In addition, it is pointed out that a positive correlation is observed between the 5alpha-reductase activity present in each skin sample studied and the urinary 3alpha-androstanediol found for the same individual. This confirms our previous findings suggesting that the determination of urinary 3alpha-androstanediol might prove of clinical interest in the evaluation of the androgenic status in human subjects.


Patterns of body weight change in rats following neonatal hormone manipulation: a "critical period" for androgen-induced growth increases. The development of sexual behaviour and gonadal function is largely determined by the early postnatal hormone environment in the rat; testosterone propionate (TP) treatment in the neonatal female will stimulate development of predominantly masculine functional characteristics. On the other hand, removal of the testes from neonatal males results in feminization of these characteristics. It has been shown that an optimal neonatal steroid hormone environment is also essential for normal growth. We now report the effects of different doses of TP (10, 30, 90, or 270 mug) given on postnatal days 2, 3, 4, or 5 on growth as measured primarily by body weight. Only treatment in the 30-270 mug range on days 2 or 3 was effective in causing significant growth changes, however, these same doses caused sterility and impaired female sexual behaviour when given on days 4 or 5. Therefore, there appears to be a "critical period" before the fourth postnatal day when TP can affect processes leading to increased growth. Removal of the neonatal testes retards growth to the levels of the androgenized females. The ovaries of the female TP treated rats still have a restraining influence on growth since their removal produces an increment in body weight similar to, though not as great as, that of the normal ovariectomized rat. These findings suggest that neonatal TP administration may possibly reduce the responsiveness of rats to the growth depressing effect of ovarian steroids by action at a site functionally different from that producing sterility and impaired sexual behaviour.


Organ-specific ontogeneses of steroid hormone metabolizing enzyme activities in the rat. The development and sexual differentiation of 11beta- and 17beta-hydroxysteroid dehydrogenase activities was investigated in the liver, kidney, adrenal and gonads of rats over a perioid of 15-120 days of life. 11beta-Hydoxysteroid dehydrogenase in the adrenal and ovary was at the limit of detectibility at all the stages of life investigated. In the liver, kidney and testis the enzyme activity is restricted to the microsomal fraction and demonstrates an age-dependent development; in the liver, kidney and in the gonads it is additionally characterized by a sexual differentiation to higher values in the male sex. In all the organs investigated the cytoplasmic and microsomal fractons contain 17beta-hydroxysteroid dehydrogenase activity; the activities are very low in the microsomal fraction of the kidney and in the cytosol of the testis. In all the organs the enzyme activity of at least one cell fraction displays an age-dependent development. The only activities, not demonstrating an ontogenesis are those of the cytosol of the adrenal and those of the microsomal fraction of the kedney. The age-dependent development is accompanied by a sexual differentiation of the enzymes activities. The only activities, not demonstrating an ontogenesis are those of the cytosol of the adrnal and those of the microsomal sexual differentation of the enzyme activities. The only exception is the microsomal activity of the liver. The female sex shows the higher activity in the kidney, adrenal and gonads; whereas the male animal shows the higher activity only in the cytosol of the liver. The developmental processes of 11beta- and 17beta-hydroxysteroid dehydrogenase have the following properties in common: In the immature phase (day 15-30) the activities of the enzyme develop either very rapidly to manifold higher values or remain constant at the low neonatal level; no sexual differentiation of the enzymes activities occurs at this stage of life. The rapid increase in activity is found only in the liver and kidney, that is in the steroid hormone catabolizing organs. It does not occur in the steroid hormone producing glands.


Effect of CB-154 (2 Br-a-ergocryptine) on serum follicle stimulating hormone, luteinzing hormone and prolactin in women with the amenorrhoea-galactorrhoea syndrome. Four women with the amenorrhoea-galactorrhoea syndrome were treated with 2-Br-a-ergocryptine (CB-154). In 3 patients, lactation was inhibited and ovulation was induced. Furthermore, pregnancy was achieved in one of them. In the remaining case, neither was lactation inhibited nor ovulation induced. Serum follicle stimulating hormone (FSH), luteinizing hormone (LH) and prolactin (PRL) were measured sequentially in the 4 CB- 154 treated women. They showed high serum PRL levels and acyclic patterns of serum FSH and LH. CB-154 suppressed PRL secretion and stimulated FSH and LH secretion in 3 cases where lactation was inhibited and ovulation was induced. In the one unsuccessful case, serum PRL decreased only slightly and the serum FSH and LH showed no marked changes.


Biological action of the lipotrophic peptides A and B from pig pituitary glands. In vitro lipolysis was stimulated by porcine pituitary peptides A and B in the rabbit, rat, mouse, and guinea pig. The minimal effective doses were calculated from log dose response curves for free fatty acids and free glycerol liberation. The rabbit was most sensitive responding to 0.008 mug/ml (1.4 pM/ml) peptide A and 0.06 mug/ml (5.3 pM/ml) peptide B respectively. Minipig adipose tissue showed no reaction up to a peptide concentration of 100 mug/ml. After intravenous injection of either peptide at the concentration of 50 mug/kg, FFA and free glycerol increased rapidly in the rabbit with maximal concentrations at 30 min, returning to near normal concentrations after 240 min. Blood glucose concentrations increased continuously in spite of hyperinsulinaemia with a peak concentration at 60 min and complete normalisation after 2 h. Hypertriglyceridaemia and hypocalcaemia were observed in both lipotrophin and control groups. Furthermore, the saline injected rabbits also displayed a slight increase of glucose, FFA, and free glycerol plasma concentrations towards the end of the experiments, suggesting stress stimulated lipolysis. The insulinotrophic effect of both peptides was verified by the fact that injection of lipid emulsion plus heparin led to a comparable increase in FFA and glucose, but to no change in insulin concentrations.


Changes in pituitary prolactin levels of female hamsters as a function of age, photoperiod, and pinealectomy. Exposure of intact female hamsters to light:dark cycles of 1 h light alternating with 23 h darkness (LD 1:23) led to involution of the reproductive organs, a drop in prolactin levels within the anterior pituitary gland, and hypertrophy of the intrascapular brown fat. All of these changes were prevented if the animals were pinealectomized. Pituitary prolactin levels in control hamsters maintained in LD 14:10 cycles also decreased during the 8 week experimental period. Pituitaries of hansters killed at the end of the experiment contained about four-fifths less prolactin than those necropsied at the beginning of the study.


Effects of calcium and sodium on vasopressin release in vitro induced by a prolonged potassium stimulation. Groups of isolated hemilobes of rat neurohypophyses were stimulated for 90 min with a 56 mM K+ concentration in the surrounding medium. The rate of release of vasopressin into the medium showed an early maximum followed by a long phase of decline which lasted for most of the stimulation period. When 3 min collection periods were employed, higher secretion rates were obtained than when using 10 min periods. This may be due to a higher rate of removal of vasopressin from the tissue and a lower vasopressin inactivation when 3 min periods are used. When Na+ was replaced by sucrose in the incubation medium for the whole stimulation period, much higher secretion rates than previously reported were obtained (13% of the total hormone content in the first 30 min period and 21% for the total 90 min period). When Na+ was removed from the incubation medium late in the stimulation period, a new high secretion rate was induced, provided that extracellular calcium was present. When Ca-2+ was removed from the medium 3 min after start of the stimulation with 56 mM K+, the secretion rate fell very rapidly. Reintroduction of a normal Ca-2+ concentration caused a new marked increase in secretion rate. These results further stress the importance of extra-cellular calcium for release of vasopressin. In addition they show that a considerable fraction of the vasopressin present in the neurohypophysis can be mobilized during a continued strong stimulation if sodium is omitted from the medium.


Age dependent changes in iodine metabolism and thyroid function. Absolute iodine uptake (AIU), serum thyroxine (T4), free T4 index and serum triiodothyronine (T3) were studied in 48 women and 63 men aged 20 to 90 years. AIU decreased with age in both sexes to values in the oldest age groups of about 60% of the values in the youngest age groups. AIU values for females were about 75% of the values for males. Free T4 index was found to be unaltered with increasing age but serum T3 decreased with age. These findings and the previous demonstrated decrease in T4 degradation rate seem consistent with the assumption that T4 and T3 production decreases with advancing age.


Correlation of lactase activity, lactose tolerance and milk consumption in different age groups. Small intestinal lactase activity in the health adult is either the same as in early infancy or may drop to very low levels. The behavior of the enzymatic state varies with the ethnic group studied. In those adults with low lactase activity little information is availalbe as to the age at which the lactase decreases. We attempted to determine a) the frequency of low intestinal lactase activity and b) the age at which the change occurs. For this purpose we reviewed in a large number of intestinal biopsies both histologically as well as for disaccharidase activities. The biopsies were obtained from a heterogeneous group of Caucasians, including patients, their siblings and parents. The patients were those with failure to thrive in whom no organic cause could be elicited, and those with the irritable colon syndrome. Patients ranged in age from 6 weeks to 50 years and out of a total of 1, 077 jejunal biopsies, 172 morphologically normal biopsies were selected. The milk drinking habits of 118 subjects and their families were elicited and 31 oral lactose tolerance tests performed. The mucosal lactase activity and sucrase-to-lactase ratio in those 172 individuals were plotted against age. In the first 3 years the mean lactase activity was 32.1 plus or minus 10.1 mumoles/g protein per min and the sucrase-to-lactase ratio was 1.7 plus or minus 0.5 with no change from year to year. However, after age 5 two separate groups emerge. A small group (24.6% of the population) with low lactase activity, and a second group possessing the same mean value for lactase activity as noted in the first 3 years. The low lactase activity group included children and adults with clinical lactose intolerance. These individuals consumed relatively small amounts of milk and when 12 of them were tested with an oral lactose tolerance test the result was a "flat" curve with a maximum rise in blood glucose of 9 plus or minus 3.2 mg/100 ml. The second group consumed more milk averaging 1 quart/day with no discomfort and when 19 were tested with oral lactose tolerance tests the values were normal. This study indicates that low lactase activity in the Caucasian population may make its appearance at the age of 5 years.


Idiopathic thrombocytopenic purpura in two children with Graves disease. Chronic idiopathic thrombocytopenic purpura (ITP) and hyperthyroidism coexisted in two children. In one, hyperthyroidism developed nine years after the onset of purpura. In the other, the two diseases appeared concomitantly. It is important to distinguish the thrombocytopenia due to ITP from that due to antithyroid drugs.


Eggshell aspiration in infants.

Eggshell aspiration in infants. Two infants inhaled eggshell fragments. The first aspirated a small fragment into the upper part of the trachea and resuscitation attempts resulted in descent of the foreign body to the right lower lobe bronchus. Two attempts at bronchoscopy were unsuccessful and spontaneous disintegration occurred. The second infant aspirated an eggshell fragment to the entrance of the larynx where it was removed by laryngoscopy. Laryngeal or tracheal foreign body in infants under 1 year of age are rare, and the diagnosis and removal are difficult.


Recognition and treatment of adult respiratroy distress syndrome secondary to viral interstitial pneumonia. Four cases of adult respiratory distress syndrome secondary to viral interstital pneumonia were treated successfully. The illnesses started with a prodrome of upper respiratory symptoms. The development of dyspnea was a key symptom from which point respiratory failure developed within 24 to 48 hours. Chest roentgenograms showed alveolar infiltrative patterns which later became coalescent. The clinical course consisted of fever, dyspnea, hypoxia and acidosis, There was no response to therapy with antibiotics, 100 per cent oxygen by mask and intermittent positive pressure breathing (IPPB) over the first 24 hours. Supportive therapy then initiated included endotracheal intubation, the administration of humidified oxygen by volume cycled respirator with positive end expiratory pressures of 10 to 15 cm H2O and corticosteroids. It is concluded that early recognition of the syndrome, coupled with prompt insituition of aggressive supportive respiratory management may be lifesaving in patints with severe interstitial pneumonia.


The amniotic fluid foam test, L/S ratio, and total phospholipids in the evaluation of fetal lung maturity. The results of the L/S ratio, TPL (total phospholipids) concentration, and the FT (foam test) from 126 amniotic fluid samples (105 of which were obtained less than 48 hours before delivery) between weeks 26 and 43 of gestation were compared in evaluating fetal lung maturity. A perfect correlation between an L/S ratio of 2 or more and TPL of 2.8 mg./100 ml. or more and pulmonary maturity was found. L/S ratio of 1.4 or less and TPL of 1.5 mg./100 ml. or less were associated in all cases with RDS. The intermediate zone between these values, where pulmonary maturity could not be predicted, contained 3.8 per cent of the cases when L/S ratio is evaluated compared to 21.9 per cent by TPL assessment. The intermediate and positive FT were associated in all cases with fetal lung maturity and mature values of L/S ratio and TPL; the negative FT cases (36 out of 105) were associated with a wide range of TPL and L/S ratio values including immature, intermediate, and mature values. No RDS occurred in cases in which the FT was positive or intermediate. It is concluded that the FT is highly valuable as a screening test. If positive or intermediate, the risk of RDS is very small; when negative, the sample should be subjected to chemical analysis.


Changes in amniotic fluid lecithin-sphingomyelin ratio following maternal dexamethasone administration. The effect of dexamethasone on amniotic fluid lecithin-sphingomyelin (L/S) ratio was measured in 15 fetuses of 34 weeks or less of gestation. Six of the patients presented with premature rupture of the membranes. A rise in the L/S ratio is mature levels (two or more) was observed 24 hours to 11 days after the start of treatment in 12 patients. In 2 patients (one second twin and one anencephalic fetus), no rise in L/S ratio occurred. Of 12 cases whch ended in premature delivery (29 to 35 weeks) only one infant, a second twin delivered at the thirtieth week with a posttreatment L/S ration o1.4 weighing 1,240 grams, developed severe respiratory distress syndrome and died. Tt is suggested that dexamethasome accelerates fetal lung maturation by increasing surfactant synthesis or release, and this may be achieved as early as the twenty-eighth week of pregnancy.


Studies of paralytic ileus. Effects of intraperitoneal injury on motility of the canine small intestine. This study is significant in demonstrating that the small intestine of the dog is extremely resistant to paralytic ileus. The various types of intra-abdominal irritation studied were quite severe. After a transient period of inhibition, however, in most instances motility of the small intestine returned and continued until near the time of death. Various types of intra-abdominal irritation were used to study paralytic ileus in dogs, including intraperitoneal injection of gastric juice, gastroperitoneal fistula, appendiceal ligation, intraperitoneal injection of Lugol's iodine solution, retroperitoneal injection of blood, and mechanical and thermal irritation of the intestine and peritoneum. The electrical and mechanical activity of the small intestine was observed by means of a Thomas cannula implanted in the jejunum. The presence or absence of fluid accumulation within the intestinal lumen or peritoneal cavity was noted at autopsy. Intra-abdominal chemical irritation caused a transient inhibition of intestinal motility, which was reversed when the irritation was stopped. Repeated irritation did not appear to cause progressive, irreversible inhibition of intestinal motility. When intestinal motility was depressed, spike potentials were absent in the recordings of electrical activity of the intestine. The "slow" electrical waves were distinguishable at all times. With the exception of the gastroperitoneal fistulas, the procedures were tolerated with only transient inhibition of intestinal motility. Accumulation of intraperitoneal fluid occurred in dogs subjected to gastroperitoneal fistulas. A small amount of intraluminal fluid accumulated in dogs subjected to repeated thermal and mechanical irritation of the intestines and peritoneum. In the other groups of dogs no significant increase in intestinal or intraperitoneal fluid was observed.


Treatment of intermittent claudication. Lumbar paravertebral somatic block with phenol. Our experience of twenty-eight patients with intermittent claudication treated by means of paravertebral lumbar somatic nerve block is presented. There was immediate demonstrable improvement in 92-5% of the twenty-six patients included in this follow up. At the end of 6 months the improvement was maintained in 72-7% of the patients and in about 70-0% of patients at 6 months and at 9 months. Six of the seven patients followed up for 1 year had a claudication distance at least twice that prior to the block. The results of this indicate that lumbar somatic nerve block is less disturbing and more effective than other forms of conservative treatment for intermittent claudication.


Prolonged sympathetic activation and pulmonary surfactant: absence of effect in anesthetized cats. Cats were anesthetized with either sodium pentobarbital or ketamine hydrochloride, paralyzed, and artifically ventilated. The stellate ganglion was electrically stimulated for one hour (10 V, frequency = 10 per sec, and 0.5 to 1.0 msec pulse duration), alternating periods of stimulation and rest of 20 sec each, while control animals were sham operated. After stimulation, static deflation pressure-volume relationships of the excised lungs were compared. Regardless of the anesthetic used, no change in static lung compliance was found between experimental and control groups, and one hour of stellate stimulation did not produce significant changes in lung volumes at maximum distending pressures, in lung weight/body weight ratios, or in minimum surface tension measurements of lung extracts. We concluded that prolonged intermittent stimulation of the stellate ganglion does not alter significantly the function of alveolar surfactant.


Electroanatomy of the lateral wall of the cochlea. Metabolically, the most active membrane in the stria vascularis is the marginal cell membrane adjacent to the intermediate cells. It is probably at this site that K+ions are actively transported in and Cl minus ions are actively transported out by the Na+ in equilibrium K+, K+in equilibrium H+, and Cl minus ion pumps. Support for this hypothesis was derived from the work of other authors, from our own earlier results and the experimental results presented in this paper. Our experiments indicate that the marginal cells of the stria vascularis facing the endolymphatic space have a positive intracellular potential similar to the potential of the scala media, Therefore, the major portion of the active ion transport takes place on the intermediate cell side of the marginal cells. The pumping mechanisms, localized in this membrane, are responsible for the generation of the positive endocochlear potential (EP).


Verrucous carcinoma of the larynx.

Verrucous carcinoma of the larynx. Verrucous carcinoma of the larynx in a middle-aged male patient is reported. The related diagnostic problems are described in detail and clinical and morphological differentiating features from other variants of squamous cell carcinoma are outlined on the basis of literary data and our own experience.


Histological research concerning cryotonsillectomy in dogs. Resistance to freezing can be considered in connective tissue, blood vessels, and also epithelium and mature lymphocytes, but the tonsils are highly receptive to freezing, and thus during the 2 min two-cycle freezing the tonsils were able to be removed sufficiently. In addition, the edema in the peripheral tissue reached its peak in 12 to 24 hrs, and during this period it can be thought that dyspnoe could easily be induced. Histologically as well, necrosis was apparent after 12 hrs, with the peak coming during the first 3 days, and it was difficult to discern necrotic areas after 7 days. Revitalization of the epithelium, thrombosis, and fibrosis were also apparent as the 7th day. At the same time, dilated and regenerated capillary vellels were apparent. On the 14th day, collagen fibrosis of the deep layer tissue was found, and as of the 24-day collagen fibrosis up to the level of the epithelium was observed.


The effect of clonidine treatment on the salivary glands of the rat. Results of biochemical and histological investigations. The side-effects of clonidine, dryness of the mouth and parotid pain, as displayed by this clinically frequently used antihypertensive drug prompted us to investigate its effect on the salivary glands of the rat. After daily intraperitoneal injections for 3 weeks clonidine decreased the specific amylase content of the submaxillary glands caused by fall of activity in 2 of the 4 isoamylases. On the other hand, both activity of alpha-amylase and its isoenzyme pattern remained unchanged in the parotid glands as did their histological and histochemical appearance. The lymph nodes situated in front of the submaxillary glands, however, were considerably affected showing large abscesses. In the adjacent glandular parenchyma, round cell infiltrations and, occasionally, acinic cell necroses were observed.


Aortic bacterial endarteritis.

Aortic bacterial endarteritis. Micotic aneurisms are very rare. They are produced as a consequence of a bacterial infection of the endartery. They are divided into "primary", or those of an unknown septic focus, and "secondary" to bacterial endocarditis, to intravascular in infection or to infection located in a neighboring region. Two cases of the National Institute of Cardiology of Mexico are presented, with "primary" micotic aneurysm, which is the least frequent. One of them was because of bacterial endarteritis located in the thoracic aorta, an extremely rate entity. Due to the frequent rupture of these aneurysm with a very high mortality, emphasis is placed on the convenience of rapid surgical treatment of patients diagnosed.


[Electronystagmographic esaminations of caloric latency (author's transl)]. The initial phase of caloric nystagmus has been investigated. The nystagmussignal does not start in a really discrete manner. It shows a development from eye movements which are no clear cut sawtooth signals to the real nystagmus beats with easily detectable slow and fast phases. 601 ENGs of caloric tests have statistically been evaluated during the first 80 sec from the onset of the irrigation. In 68% of all of the reactions there was an underlying spontaneous nystagmus. A same directional spontaneous nystagmus covers the latency period mostly that much, that the latency period is short or hidden. An opposite directional spontaneous nystagmus leads to a prolongation of the latency period. This definition refers to the real saw tooth nystagmus signals, which are beating in the expected direction. A definition of the latency period after the so called initial nystagmoids is being discussed, too.


Effect of aerosolized dipalmitoyl lecithin on oxygen-toxic rat lungs. Pulmonary surfactant is reduced in oxygen toxicity but whether this represents a decrease in production or inactivation of surface-active material already present is not known. We divided 200 g male Wister-Lewis rats into different experimental groups. The animals were exposed continuously to 0, 48, 56 or 72 h of close to 100% oxygen at atmospheric pressure. Administration of aerosolized dipalmitoyl lecithin (DPL) in phosphate buffer had no effect on lung deflation compliances or lung stability indices of any group. Exposure to DPL by spontaneous respiration and/or controlled ventilation made no difference. Lung dry/wet weight ratios fell in animals exposed to aerosols of DPL + buffer + O2, buffer + O2, or water + O2, to aerosols of DPL + buffer + O2, buffer + O2, or water + O2, as compared to animals with similar lengths of oxygen exposure not exposed to an aerosol. If the initial pulmonary pathophysiological response to 100% oxygen at 1 atm pressure is capillary logical response to 100% oxygen at 1 atm pressure is capillary endothelial damage with leakage of intravascular fluids into the alveoli, then exogenously administered DPL would not be of benefit in pulmonary oxygen toxicity. Our study suggests that aerosolized DPL administered to normal animals and animals exposed to oxygen for 48-72 h had no effect on lung compliance or stability.


Effects of apomorphine, ergocornine and piribedil on audiogenic seizures in DBA/2 mice. Audiogenic seizures in DBA/2 mice have been studied after administration of drugs believed to act as dopamine agonists. Apomorphine at 0.4 mg/kg delays all phases of the response, the tonic phase is absent after 2.0 mg/kg; the clonic phase is abolished by 10 mg/kg. Ergocornine (0.5-8.0 mg/kg) produces effects on the latency and occurrence of seizure stages similar to those of apomorphine. Piribedil, ET 495 (4-100 mg/kg) is less potent; even after 100 mg/kg clonic and tonic phases occurred in 50% of the mice.


Histopathology of regression of tumor metastasis in the lymph nodes. A transplanted rat lymphosarcoma (SGT-4), induced by Gross virus and inoculated s.c. into the foot of a normal syngeneic rat, initially grew but ultimately regressed. The tumor cells metastasized to the regional popliteal, lumbar, and inguinal lymph nodes and formed massive metastatic foci there. These lymph node metastases also regressed spontaneously. However, in Gross-tolerant rats inoculated with Gross virus at birth, no regression was observed. Histopathologically, infiltration and proliferation of lymphoid cells, reticulum cells, and bifrocytes occurred in the regressing metastatic tumor in lymph nodes as well as in the regressing transplanted tumor in the foot. Only in lymph nodes of normal rats, in which tumor metastasis regressed, was the characteristic "starry sky" appearance observed. Our results suggest that regression of metastatic tumor in lymph nodes, as well as of transplanted tumor in syngeneic rats, was due to an immunological reaction by the host and that an immunological factor may be responsible for the "starry sky" picture.


Serum triiodothyronine concentration in the diagnosis of hyperthyroidism. The serum triiodothyronine concentration is superior to the serum thyroxine concentration, the resin uptake test and the free thyroxine index in the diagnosis of hyperthyroidism. Over a 14 month period fifty-five patients attending an endocrine clinic with suspected thyrotoxicosis of all degrees of severity had blood taken on initial attendance and the serum was stored for routine thyroid function tests and triiodothyronine estimation. The patients were followed up and forty-six proved to be toxic and seven to be euthyroid; two could not be classified. Analysis of the initial serum showed that the serum triiodothyronine concentration was superior to the serum thyroxine concentration, the resin uptake test and the free thyroxine index in predicting the clinical outcome.


Arthrography of the knee.

Arthrography of the knee. Arthrography of the knee is  becoming an integral part of the evaluation of the patient with a suspected internal derangement of the knee. The examination is relatively simple, and can be performed on out-patients with conventional radiographic equipment or a modified fluoroscope. Knee arthrography has been proven safe in a large series of patients. The technique is reliable, particularly in the diagnosis of meniscus lesions. The knee arthrogram is helpful to the orthopedic surgeon to confirm suspected abnormalities, to reveal unsuspected or multiple lesions, to exclude some conditions which could be confusing clinically, or to plan a surgical approach to the knee.


Double contrast knee arthrography in the evaluation of osteochondritis dissecans. Double contrast knee arthrography is an invaluable adjunct in the evaluation of patients with osteochondritis dissecans. The cartilage overlying the osteochondritic defect can be evaluated and unsuspected meniscal pathology accurately diagnosed. In our series, there were three unsuspected medial meniscal tears, diagnosed by arthrography and confirmed at surgery. The location of the osteochondritic defect was atypical in all four of our female patients.


Development of a knee scoring scale.

Development of a knee scoring scale. Two knee scoring scales have been tested against post-osteotomy knees for degeneration arthritis and post-arthroplasty knees (McIntosh Operation) and were found to be acceptable for both conditions. Scoring Scale I was slightly better than Scale II. This scale should be tested on other types of knee reconstruction. Modifications in this scale may be needed in the future in an effort to produce as near perfect an objective knee function scoring method as is possible.


The degenerative effects of partial and total resection of the medial meniscus in dogs' knees. An experimental effort to determine the degenerative effects in the articular cartilage of the knee joint caused by meniscectomy was performed by doing partial and total meniscectomies on the medial compartment of dogs' knees.  Gross and microscopic pathological changes in teh articular cartilage were studied by sacrificing the dogs at intervals of three to ten months.  Results indicated that meniscectomy is not a benign procedure, and the removal of a meniscus in itself can lead to degenerative changes in the knee joint.  Partial meniscectomy leads to less severe degenerative changes with the degree of change directly related to the amount of meniscus removed.  In total meniscectomies when meniscus regeneration occurred, the cartilage surfaces where the meniscus had regenerated were protected.  The degree of degenerative change was directly related to the amount of fibrocartilage that remained absent.  Therefore, the knee menisci function to protect the articular cartilages from degenerative damages, but the exact mechanism of this is unknown.


The role of the menisci in force transmission across the knee. Fourteen knees were studied by a method called spatial location, to determine the contact and load-bearing areas between the femur and the upper tibia in non-loaded and loaded conditions, at various angles of flexion.  Under no load, contact occurred primarily on the menisci; the lateral aspects contacted at 0 degrees flexion, moving to the posterolateral aspects at 90 degrees flexion.  An area of cartilage which frequently contacted was the medial tibial spine.  Under loads of up to 150 kg, the lateral meniscus appeared to carry most of the load on that side of the joint, while on the medial side, the load was shared approximately equally by the meniscus and the exposed cartilage.  These findings were verified on two knees by measuring contact pressure with a miniature transducer.  Two implications of these findings are that the area of load-bearing is greatly increased and that the stability of the knee joint is enhanced by the menisci.


Electromyography in the localization of spinal cord and nerve root neoplasia in dogs and cats. In 8 cases (6 dogs and 2 cats) of spinal cord and nerve root neoplasia, electromyography was used to localize the area of involvement. The locations of the lesions were confirmed at necropsy.


Hyperammonemia and hepatic encephalopathy in the dog. Thirteen dogs with hepatic encephalopathy were found to have hyperammonemia and increased retention of plasma sulfobromophthalein. Six dogs had abnormal portal circulatory systems and 4 had heptic disease. The cause of illness was undetermined in 3.


Dissociation of serum LATS activity and hyperfunction and autonomy of the thyroid gland in Graves' disease. LATS was measured with the double isotope technique in IgG serum concentrates of 23 patients with Graves' disease before treatment and of 18 patients during treatment with carbimazole and triiodothyronine. LATS activity was present in 18 out of 23 patients before treatment (78%). When the second measurement was taken into account the incidence did increase to 95%. No difference could be found in the mean values of total thyroxine, thyroid 131-I uptake and thyroid weight of the group of LATS positive and LATS negative patients before treatment. Also no relation could be established between LATS activity and suppressibility of thyroid 131-I uptake during treatment. It was found that LATS positive patients who suppress during therapy have lower initial LATS blood levels than LATS positive patients who remain unsuppressed. It is concluded that it is more likely that LATS is a "marker" of Graves' disease rather than the cause of the hyperthyroidism.


Hippocampal and cortical activity during sexual behavior in the female rat. Hippocampal and cortical activity were studied during sexual behavior in the female rat. Hippocampal theta appeared during her soliciting behavior. High-frequency theta accompanying the male's pursuit slowed when the male mounted the female and then increased in frequency during the brief continuation of lordosis following mounts without vaginal penetration. During prolonged lordosis after intromissions and ejaculations, slow theta continued. No changes in cortical frequencies were observed during mounts, intromissions, or ejaculations. During immobility (standing, sitting, and lying down) hippocampal activity became slow and irregular. High-amplitude hippocampal and, eventually, cortical spindles developed during immobility as sexual exhaustion was approached. Immobility and its accompanying electroencephalographic spindling are interpreted as indicative of a sexual satiety or inhibitory process.


Changes in the concentration of follicle-stimulating hormone in plasma during development in the guinea-pig. The concentration of FSH in the plasma of guinea-pigs from day 50 of gestation to day 45 of postnatal life was assayed by a radioimmunological procedure utilizing a cross-reaction with the NIAMDD S6 antiserum to rat FSH. At 68 days of gestation the mean plasma FSH concentration of female foetuses was greater than that of the males, although the concentrations in the two sexes were similar on day 50 of gestation. Maternal levels remained consistently low throughout gestation. Postnatally there were no marked changes in plasma FSH levels through to maturity, although a transient rise in the male occurred over the first 3 days after birth. Gonadectomy on days 0, 5, 10, 15, 25 or 35 of postnatal life, or when adult, resulted in a significant increase in plasma levels of FSH within 10 days. The rise in plasma FSH concentration was greater in males than in females at all ages, although, a larger increase was observed in females spayed at 5 or 10 days of age than at other times.


GLC determination of phendimetrazine in serum. A sensitive, specific, and quantitative GLC method for the determination of phendimetrazine in serum is described. The procedure involves the addition of an internal standard to serum samples, followed by extraction at pH 13 into toluene. The extracted bases are back-extracted into 1 ml of 4 M hydrochloric acid and again into 100 mu1 of chloroform after making the 4 M hydrochloric acid extract basic with 1.5 ml of 4 M sodium hydroxide. The sensitivity of the method is such that 25 ng of material can be detected in 5 ml of serum.


Freeze-fracturing and freeze-etching of cardiac myosin filaments. Myofilament structure was studied in freeze-etch replicas of unfixed, glycerinated beef cardiac muscle. The information which is revealed depends upon the direction of metal shadowing in relation to the filament axis. Shadows oblique to this axis reveal that the outer surface of a longitudinal half of a thick filament comprises three, sometimes four, rows of myosin molecules. These molecules are generally assembled in a braided manner with both left and right-handed helical components. Occasionally a more parallel to the myofilament axis reveal cross-bridges linking thick and thin filaments. These bridges are readily detectable by optical diffraction techniques, giving an axial bridge spacing of approximately 40 nm. In unetched preparations cross bridges appear as vertical rows of beads. In all replicas the effects of plastic deformation of proteins must be considered.


An autoradiographic study of the binding of 3-H-chlorambucil to cells of a drug-sensitive and drug-resistant strain of the Yoshida ascites sarcoma. The binding of chlorambucil to drug-sensitive and drug-resistant. Yoshida sarcoma cells has been investigated by an autoradiographic technique. The cells were treated with the drug at various concentrations both in vitro and in vivo. Using both light and electron microscope techniques, and by counting grains on various areas of the cell, the following conclusions were reached. (1) At all drug concentrations there was general cytoplasmic and nuclear uptake by both cell lines. There was no evidence of a specific localization in one site only or for specific exclusion of any one site. (2) At high dose levels (equivalent to 2 mM) the binding was approximately equal in both cell lines, although a few damaged cells bound much greater amounts of drug. (3) At low dose levels (equivalent to 3 mu-M) there was a higher uptake by the nucleus of the sensitive cells compared with the nucleus of the resistant cells; the cytoplasmic binding was similar.


A robust micromanipulator for the scanning electron microscope. A simple device for holding and moving mechanical tools in the region of a sample being viewed in the scanning electron microscope is described. The unit has a 20:1 mechanical reduction and when fitted with a tungsten carbide dental chisel, it is sufficiently rigid to cut biological hard tissues. Alternately, when fitted with an electro-etched tungsten needle, it can be used, in conjunction with specimen stage controls, to remove individual cells from the surface of soft tissues. Examples of these applications are illustrated.


Cortisol-induced lymphocytolysis of P1798 tumor cells in glucose-free, pyruvate-free medium. Exposure of corticoid-sensitive P1798 tumor lymphocytes to cortisol resulted in progressive cell dissolution either with or without exogenous glucose and pyruvate. Therefore, inhibition of glucose transport is not required for cortisol-induced lymphocytolysis.


Hepatitis in dental professionals.

Hepatitis in dental professionals. To characterize some epidemiologic characteristics of viral hepatitis among dentists, information was obtained with a mailed questionnaire from 434 dentists and 787 attorneys in Dade County, Florida. Dentists had a significantly higher incidence of hepatitis than did lawyers, 6.7% vs 2.4%, with the highest rate among oral surgeons (21%). The incidence of hepatitis B antigenemia among asymptomatic dentists was not significantly higher than that of volunteer blood donors. Twenty-two percent of dentists with hepatitis reported treating more than ten drug addicts per year, as compared with 10% of those dentists without hepatitis. No differences were noted between dentists with and without hepatitis in methods of sterilization, the wearing of gloves during procedures, or the use of disposable needles. The increased risk of hepatitis among dentists, however, may be related to the omission of adequate prophylatic measures, particularly when treating high-risk patients such as drug abusers.


Medical care by nurses in an internal medicine clinic. Analysis of quality and its cost. The quality and cost of medical care provided by specially trained nurses in an internal medicine clinic was evaluated prospectively during a three-month period. Clinic physicians referred patients to these nurses when they believed that the nurse could contribute to the patient's overall health care. Nurse care was judged to be adequate in dealing with 98% of old problems (defined by the physician) and 85% of new problems (detected by nurse). Scheduled visits to the physician and unscheduled visits decreased significantly (P less than .05) during the period of nurse care vs a control period, but the overall cost of health care per patient was increased significantly during the nurse care period (P less than .01) because of a disproportionate increase in visits to the nurse. We conclude that nurse care was feasible and of adequate quality. However, it was not cost-effective.


Abdominal bruits. Clinical and angiographic correlation. The results of abdominal auscultation were correlated with abdominal angiograms in 503 patients. Bruits were heard in 106 (21%). The majority of bruitswere in the epigastrium, mainly because of a high incidence of celiac artery stenosis usually of the extrinsic compression type. Sixty-seven patients had stenoses or occlusions of one or more renal arteries and 27 (40%) had bruits. Most of these patients, however, had other possible causes for their bruits, usually related to atherosclerosis of coincidental celiac compression. Collateral channels were considered to be the cause of epigastric bruits in eight of ten patients with complete occlusion of the celiac artery and in two patients with spelic artery occlusions. Collateral channels may be partly responsible for bruits in many patients with celiac artery  stenosis.


Habituation and urinary retention.

Habituation and urinary retention. Four subjects with partial or episodic complete urinary retention and bladder hypotonicity with large urinary residuals underwent "habituation" treatment. Results indicated an exponential decrease in urinary residuals to 0 ml and disappearance of partial or complete urinary retention within 20 weeks. This study is presented as an example of how conditioning therapy may be applied to the treatment of certain neurological disorders.


Reye syndrome. A correlated electron-microscopic, viral, and biochemical observation. Liver biopsy specimens of two patients with Reye syndrome were examined for ultrastructural features, viral isolation, and urea-cycle enzyme activity. Concurrent presence of herpes-like virus and myxovirus/paramyxovirus was demonstrated by electron microscopy, and viral infections were confirmed by isolation or serologic tests. A concomitant hepatic ornithine transcarbamoylase deficiency was also noted. The pathogenesis in these instances seems to consist of an initial synergistic insult on the liver by mixed types of viruses and subsequent breakdown of urea cycle, Krebs cycle, and possible other hepatic functions. An exodus of glycogen granules into the hepatic spaces of Disse and sinusoids suggests that the viruses have injured the plasma membranes as well as the mitochondria of hepatocytes. Since Kapila et al reported similar disorders five years before Reye et al, the name of Kapila-Reye disease is suggested.


Antibiotic batch certification and bioequivalence. All antibiotics marketed in the United States must undergo batch certification by the Food and Drug Administration. It is often assumed that the different brands of a particular antibiotic that pass in vitro batch certification tests have equal in vivo bioavailability. The fallacy of this assumption is clearly supported for commercially available lots of tetracycline hydrochloride that had passed batch certification tests yet had different serial serum concentrations.


Intensive respiratory care unit. Review of ten years' experience. In ten years' experience in the respiratory care units serving both medical and surgical patients, 18,077 consecutive patients received ventilatory support for 24 hours or more. The overall survival rate including all patients was 75.2%. Survival rate has not changed appreciably during the past five years. The respiratory care unit provides technical assistance and consultation to primary physicians of the medical and surgical services. This system of intensive respiratory care is flexible and applicable to general hospitals that treat large numbers of patients with acute respiratory respiratory failure.


Pasteurella multocida. Infections after domestic animal bites and scratches. Pasteurella multocida is a common cause of infection followingbites or scratches caused by dogs and cats.  However, it is rarely reported and appar-ently often overlooked as a pathogen.  It causes the typical clinical manifestationsof a rapidly developing cellulitis at the site of injury.  The infection is potentiallydangerous and can cause a chronic local infection of deep tissues and septicemia.  However, it responds well to several antimicrobials, with penicillin being the drug ofchoice


Acute venous thrombosis. A case of progress and confusion. Acute venous thrombosis is a common peripheral vascular disorder that is frequently difficult to diagnose on clinical grounds alone. We describe several new diagnostic methods availabe that can be helpful.


Medical school, residency, and eventual practice location. Toward a rationale for state support of medical education. Because of the shrinking charity dollar, a growing number of state governments are being asked to provide financial support to private medical schools. Such expenditures are more likely to appeal to legislators and to benefit medicine in the state if they can be related to existing manpower deficits.


Epidemiology of congenital rubella syndrome. The role of maternal parity. Rubella vaccination policies are primarily directed at control of congenital rubella syndrome. In the United States, vaccination of children of both sexes, ages 1 theough 12 years, has been recommended. This policy depends on the hypothesis that children are the major source of infection for pregnant women. If true, then as maternal parity increases one would expect an increasing prevalence of rubella antibody or an increase in the frequence of rubella syndrome in babies. A serologic survey of 3,081 pregnant women has failed to show an increase in prevalence of rubella antibody with increasing parity. Case-control studies comparing groups of children with rubella syndrome to birth certificate and hospital control groups also have failed to show an excess of multiparae among the mothers of babies with rubella syndrome. Thus, these results do not support the hypothesis that children are the major source of infection for pregnant women.


A rapid test for sickle hemoglobin.

A rapid test for sickle hemoglobin. Vigorous shaking of oxygenated sickle hemoglobin (Hb S) in solution causes precipitation of the hemoglobin. This unusual property of Hb S forms the basis of a simple test for the presence of Hb S. Comparison of results of this test with those from cellulose acetate electrophoresis in blood samples from 599 patients showed no false-positive or false-negative results. The group tested included 55 persons with sickling disorders and 47 others with unusual hemoglobin patterns. This test may be used to confirm the presence of Hb S or to establish the diagnosis of sickling disorders rapidly in the clinic or at the bedside.


Superior vena cava obstruction and dissecting aortic aneurysm. A dissecting aneurysm of the aorta led to formation of a fistula from the aneurysmal sac to the left atrium and caused obstruction of the superior vena cava. We do not know of any previous reports of this clinical syndrome.


Osteoarthritis in knees of aged persons. Relationship between roentgenographic and clinical manifestations. One hundred five (70%) of the knee joints of 75 elderly people showed roentgenographic changes of osteoarthritis (OA); occurrence rates for each of ten clinical manifestations ranged from 7% to 76%. Clinical manifestations were more common in knees with OA by x-ray film than in those without. Crepitus, decreased range of motion, pain, bony enlargement, and instability were simultaneously common in the roentgenographically abnormal knees and significantly less frequent in normal knees. Overall functional disability was verified in 22% of the knees with changes on x-ray film. The findings suggest a more positive and specific pattern of correlation between clinical and roentgenographic findings than has generally been believed. Nevertheless, the frequency of dissociation confirms the importance of making therapeutic decisions according to each patient's individual situation.


Evaluation of clonidine hydrochloride (Catapres). A new antihypertensive agent. Clonidine hydrochloride is a new antihypertensive agent with a primary site of action in the central nervous system. When administered with a diuretic, it is effective for long-term therapy and may be particularly useful in patients with moderately severe hypertension. Clonidine is comparable to methyldopa in efficacy but may cause side-effects more frequently. The only potentially serious adverse reaction that has been reported is a rebound increase in blood pressure that may occur following rapid withdrawal.


[New findings in the differential diagnosis of acute ileus (author's transl)]. Knowledge of the patho-physiological behaviour present in the colon is the deciding factor for a reliable differential diagnosis of mechanical or paralytic ileus. A quick and sure diagnosis can be got with irrigoscopy (barium enema). In paralytic ileus, a radical change in the function of the right colon is present; instead of resorption, exudation and paralysis have taken place. Barium enema shows this behaviour; the left colon stays contracted, the contrast medium passes easily into the right colon, where it mixes with the fluid levels. This picture is proof of paralytic ileus. A completely different picture is to be found in mechanical ileus of the small intestine; the small intestine is gas-inflated, with fluid levels, and passes nothing on to the colon which, therefore, is contracted in its whole length. This picture also is diagnostic. Barium enema is already known in the diagnosis of mechanical ileus of the large intestine. It can also be used in the diagnosis of paralytic enterocolitis (without diarrhoea) in childhood and old age. In the case of post-operative early ileus it gives a quick and sure differential diagnosis.


Total body irradiation in lymphosarcoma. Total body irradiation has shown encouraging result in the treatment of advanced lymphosarcomas. The response rate and remission rates are high. 66 percent (4/6) went in unmaintained complete remission. Good response was also observed in patients who had previous chemotherapy.


[The interrelationship between electrolytes and phase analysis of systole in toxic goiter]. Potassium, sodium, calcium and magnesium were determined in the plasma and erythrocytes of 129 patients suffering from toxic goiter; phasic structure of the systole of the left ventricle was studied as well.  Correlation coefficients between the indices of electrolyte metabolism and the phasic structure of the systole were studied for the purpose of ascertaining the relationship between the changes in the contractile function of the myocardium and the electrolyte level.  The most significant correlative association was revealed between the electrolytes and the period of ejection, the mechanical and the acoustic systoles.


[The concentration of nucleic acids in the subcellular structures of the thyroid gland in several of its diseases]. As a result of examination of whole tissue and subcellular structures of the human thyroid gland there was revealed an increase in the nucleic acid content in the whole tissue, nuclei and the RNA in the microsomal fractions--in toxic goiter, adenoma of the thyroid gland, and strumitis.  The content of nucleic acids in the mitochondria increased only in strumitis.  Nucleic acid level changed but little in the whole tissue and subcellular structures in nontoxic goiter.


Polyspermy block of Spisula eggs is prevented by cytochalasin B. The eggs of the surf clam Spisula solidissima have a built-in mechanism that prevents polyspermy: the eggs show a 70 percent decrease in sperm receptivity 5 seconds after fertilization, and become completely resistant to sperm by 15 seconds. When the outer egg coat (vitelline layer) was removed, there was no change in fertilizability or the timing of the block to polyspermy. This suggests that the alteration occurs in or at the plasma membrane. Such changes in the egg surface were sensitive to low concentrations of cytochalasin B.


IgG monoclonal gammopathy associated with lymphoproliferative disorders. The association of IgG monoclonal gammopathy with lymphocytic lymphoma and chronic lymphocytic leukaemia is reported. Although rare, such immunoglobulin synthesis may have prognostic importance and is of value in monitoring the effect of therapy. The morphological features which should draw attention to this pattern of protein abnormality are briefly reviewed. This finding emphasises the histogenesis of these tumours from the immune system and questions their classification on a purely morphological basis.


Histological survey of tumours of the horse, with particular reference to those ofthe skin. In a histological survey of 244 tumerous growths from 155 horses, the tumours commonly found were fibromas, squamous cell carcinomas, sarcoids and papillomas, most frequently affecting the skin, external genitalia, eye and orbit. The histological features that differentiate fibroblastic citaneous growths are detailed so that the clinical behaviour of these distinct neoplasms can be studied.