Ultrastructure of Porocephalus crotali (Pentastomida) cuticle with phylogenetic implications. The cuticle of P. crotali is pro-arthropodan, composed of an epi-, exo-, and endocuticle. The exo- and endocuticles are separated by a 600-A intermediate cuticular zone. The epicuticle is homogeneous and varies from 100 to 350 A in thickness. The exocuticle varies from 2 to eight mu in thickness and is divided into superficial and deep exocuticular zones. The endocuticle is lamellate and varies from 8 to 30 mu in thickness. Lamellae result from ordered parabolic orientations of 40-A chitin fibrils. Underlying cells lack a basement membrane. Subcuticular muscle cells insert tonofibrils directly into the adjacent endocuticle. No apodemes or apophyses occur.


Effects of dung beetle activity on the number of nematode parasites acquired by grazing cattle. Parasitized steers were used to contaminate 3 pastures containing dung beetle populations of different densities. Six parasite-free calves were then allowed to graze the pastures for 43 to 45 days. Two calves that grazed a pasture with dung beetle population rendered lower than normal by screening and trapping acquired 9 times more parasites than 2 calves that grazed a pasture which captured beetles were released. Two calves that grazed a pasture with a natural dung beetle population acquired 4 times more worms than the calves on pasture with the increased beetle population. The results indicated that the 2 major genera of nematodes present (Ostertagia and Cooperia) were significantly reduced in number by dung beetle activity.


Calcium-binding of synaptosomes isolated from rat brain cortex, III. Binding with some divalent heavy metal ions and calcium-binding sites. Free ion concentration of some divalent heavy metal ions such as Mn2+, Co2+, Ni2+, Cd2+ and Zn2+ in the synaptosomal suspension was measured to determine binding with synaptosomes isolated from rat brain cortex. A dual wavelength spectrophotometer was utilized to monitor the absorbance changes of murexide raised by stepwise addition of these ions (as chloride salts). Such titration experiments of the synaptosomal suspension revealed that a part of the added divalent cation such as Mn2+, Co2+ or Ni2+ was almost instantaneously bound to synaptosomes in isotonic NaCl media. Our previous study (Kamino, Uyesaka & Inouye, J. Membrane Biol. 17:13, 1974) demonstrated that raised external K+ resulted in a specific noncompetitive inhibition of synaptosomal Ca-binding. Just like the Ca-binding, Mn-, Co- or Ni-binding was almost completely depressed by high external K+ or ruthenium red when the free concentration of the cations was 10 mum or less, while at higher concentrations the binding was not affected. The present results indicate that tested divalent cations bind with both "Ca-binding sites" and "non-Ca-binding sites" of synaptosomal membrane, the nature of the binding sites of both being quite different: the former is sensitive to high external K+ and to ruthenium red but the latter is not.


A Na+-independent, phloretin-sensitive monosaccharide transport system in isolated intestinal epithelial cells. A monosaccharide transport system in addition to the active Na+-dependent system characteristic of the brush border surface of vertebrate intestinal tissue has been identified in isolated chick intestinal epithelial cells. The newly described system differs in several characteristics from the Na+-dependent process, including function in the absence of Na+; a high sensitivity to phloretin, relative insensitivity to phlorizin; different substrate specificity; and a very high KT and Vmax. The system apparently functions only in a facilitated diffusion manner so that it serves to move monosaccharide across the cell membrane down its chemical gradient. An appreciable fraction of total sugar efflux occurs via the Na+-independent carrier from cells which have accumulated sugar to a steady state. Phloretin selectively blocks this efflux so that a normal steady-state sugar gradient of seven- to eightfold is transformed to a new steady-state gradient which is greater than 14-fold. Locus of the new system is tentatively ascribed to the serosal cell surface where it would serve for monosaccharide transfer between enterocyte and lamina propria of the villus.


Membrane effects of cytochalasin B. Competitive inhibition of facilitated diffusion processes in rat hepatoma cells and other cell lines and effect on formation of functional transport sites. Cytochalasin B competitively inhibits the transport of 2-deoxy-D-glucose and thymidine in a number of different cell lines (Novikoff rat hepatoma cells, mouse L, S180 and Ki-MSV-transformed BALB/3T3 cells, and human HeLa cells). The apparent Km values for the transport of these substrates as well as the  apparent Ki values for the inhibition by cytochalasin B are very similar for the various cell lines, and the effect is readily and completely reversed by removal of the chemical. Thymidine transport by Chinese hamster ovary cells however, is little affected by cytochalasin B, whereas the transport of 2-deoxy-D-glucose, uridine and guanine by these cells is competitively inhibited to about the same extent as in other cell lines. In addition and concomitant with the inhibition of cytokinesis and an alteration in cell shape, cytochalasin B also impairs and delays the formation of functional transport sites for thymidine,  guanine and choline in synchronized populations of Novikoff cells without affecting the apparent affinities of the transport systems for their substrates. This effect is unrelated to the direct inhibition of the transport processes, since the drug does not directly inhibit choline transport and has no effect on the formation of 2-deoxy-D-glucose transport sites in spite of the fact that it strongly inhibits the transport of this substrate. The inhibition of functional transport sites may be due to the induction of a structural alteration in the membrane by cytochalasin B which impairs the insertion of new proteins of certain but not all transport systems into the membrane.


Evidence that alpha-dihydrograyanotoxin II does not bind to the sodium gate. The basis for the ability of alpha-dihydrograyanotoxin II (alpha-2HG-II) to promote Na+ conductance in axons was sought. The apparent binding of tritiated alpha-2HG-II to neural and other preparations was studied, using equilibrium dialysis, with lobster axon membranes, Torpedo electroplax, housefly head, and rat brain, liver and kidney. In every case the "binding" was nonsaturating and was suggested to involve nonspecific partitioning into the tissue. Supporting evidence was the similarity of extent of "binding" in all tissues and its relative insensitivity to neuropharmacological agents. Alpha-2HG-II did not affect the Na+ conductance of phospholipid bilayers, nor did it permit transport of 22Na into a bulk organic phase. It was concluded that alpha-2HG-II did not bind to the sodium gate, but possibly to a sodium permease present at a frequency of less than one per mu2 of cell membrane.


Epidemiological and clinical aspects echinococcosis in East Iran. Three hundred and fifty two cases of hydatid disease were diagnosed in a three year study in Eas Iran, where the disease is found frequently in rural areas. Camel meat is consumed in this region. The offal is given to domestic carnivorous animals, for example sheep dogs, and in these circumstances camels could contribute to the cyclozoonotic spread of the disease. Clinical symptoms are briefly mentioned.


Dengue virus-induced modifications of host cell membranes. Enzymatic markers and electron microscopy were utilized to determine the cellular origin of the membrane types isolated from type 2 dengue virus-infected BHK cells by discontinuous sucrose gradient centrifugation. The results showed an apparent separation of plasma membrane, smooth and rough endoplasmic reticulum with increasing density. Virus-induced protein and RNA synthesis, as indicated by the incorporation of radiolabled precursors, was localized on the rough endoplasmic reticulum. Glycosylation, measured by the incorporation of radiolabeled glucosamine into membrane-associated proteins, was most active in the bands of intermediate and smooth endoplasmic reticulum. Polyacrylamide gel electrophoresis of isolated membrane bands, radiolabeled in the presence of actinomycin D, after pulse inhibition by cycloheximide, revealed seven virus-specific proteins associated with all membrane fractions. Viral structural protein V-3, and nonstructural proteins NV-3 and NV-2, increased with decreasing density, whereas NV-5 and NV-4 remained constant. The viral capsid protein V-2 was depleted in the intermediate and smooth endoplasmic reticulum, suggesting that these membranes may serve as the sites for viral maturation. NV-3 was the most prominent virus-specified protein found in the plasma membrane.


R17 bacteriophage replicase: association with the inhibition of Qbeta, fd bacteriophage and beta-galactosidase production. Superinfection of Escherichia coli with amber mutants of R17 phage which produce R17 replicase inhibits production of the RNA phage Qbeta, the DNA phage fd, and the host enzyme beta-galactosidase. Inhibition required R17 replicase production and was related to the amount of replicase produced.


Termination sites for adenovirus type 2 DNA replication. Termination sites for replication of adenovirus type 2 DNA have been demonstrated at both ends of the viral chromosome by the procedure of Danna and Nathans (1972). Single-stranded DNA from replicating intermediates was also characterized by hybridization with separated strands of viral DNA. The results indicate that both strands are exposed during replication.


Adenovirus type 2 DNA replication. II. Termini of DNA replication. Complete, mature adenovirus type 2 DNA molecules were isolated from virus-infected HeLa cells, pulse-labeled at 20 h postinfection in [3H]thymidine pulses shorter than the time necessary for one round of viral DNA replication. After digestion with the restriction endonucleases Eco RI, Hpa I, and Hind III, a temporal order of synthesis of different regions of the viral genome was established from the relative specific radioactivities in the restriction enzyme fragments. A comparison with the physical order of these fragments revealed the existence of two termini of DNA replication towards both the molecular right and left ends, respectively, of the viral chromosome.


Isolation and partial characterization of single-stranded adenoviral DNA produced during synthesis of adenovirus type 2 DNA. Single-stranded fragments of adenovirus type 2 DNA were isolated from infected KB cells under conditions which retarded reassociation of complementary sequences but did not denature native viral DNA. Of the total intracellular, virus-specific DNA labeled during a 1-h pulse with tritiated thymidine begining 15 h after infection, about 20% was single stranded when fractionated on hydroxylapatite. This DNA shifted predominantly to the double-stranded fraction on hydroxylapatite during an extended chase incubation, suggesting that it may represent single-stranded DNA in replicating intermediates. Furthermore, the single-stranded DNA annealed nearly equally to both strands of the adenovirus genome. These findings indicate that at least portions of both complementary strands of adenovirus type 2 DNA are exposed as single strands during the period of viral DNA synthesis.


Temperature-sensitive mutants of influenza WSN virus defective in virus-specific RNA synthesis. Influenza WSN virus temperature-sensitive (ts) mutants were examined for defects in viral complementary RNA (cRNA) synthesis. The synthesis of viral cRNA was determined by hybridizing RNA from infected cells to radiolabeled virion RNA of known specific activity. Mutants in complementation groups I and III synthesized little, or no, cRNA at the nonpermissive temperature (39.5 C). When cells infected by these mutants were incubated for 5 h at the permissive temperature (33 C) and were then shifted to 39.5 C, net synthesis of cRNA ceased. This strongly suggests that mutants in these two complementation groups possess a ts defect in the transciptase complex. Mutants in group II and group V synthesize reduced amounts of cRNA at 39.5 C. In contrast to the group I and group III mutants, cRNA synthesis in cells infected by a group II or a group V mutant continues after a shift-up. This indicated that these mutants do not possess a ts transcriptase complex and that these mutants are most probably defective in some step in the amplification of cRNA synthesis. As will be discussed, the most likely defect in these mutants is in the synthesis of virion-type RNA. These results suggest that there are two influenza viral gene functions required for transcription and most likely two additional gene functions required for RNA replication.


Adenovirus gene function required for induction of nuclear acidic protein synthesis: binding of these proteins to adenovirus DNA. Two different viral DNA-defective temperature-sensitive mutants of adenovirus 12 (H 12) were defective in their ability to induce the synthesis of various molecular weight classes of nuclear acidic proteins, both virion and nonvirion components, after lytic infection of human embryo kidney (HEK) cells at the restrictive temperature. This finding indicates that the induction of nuclear acidic protein synthesis is an adenovirus gene function(s). Treatment of infected cells with actinomycin D at an early stage of virus maturation suppressed the synthesis of an acidic virion protein (hexon), but allowed the synthesis of other classes of nuclear nonvirion acidic proteins during the subsequent late maturation period, suggesting that different mechanisms control virion and nonvirion polypeptide synthesis. The interaction of the nuclear acidic proteins isolated from H 12-infected cells with native-labeled H 12 DNA was studied using the membrane filter technique. Measurements of the ability of different DNA preparations to inhibit the H 12 DNA-acidic protein complex formation suggest that the nuclear acidic proteins bound to native H 12 or HEK cell DNA with much higher affinity than to native calf thymus DNA. Moreover, native H 12 DNA was able to bind the acidic proteins more efficiently than did denatured H 12 DNA. The acidic proteins isolated from the cytoplasm of H 12-infected cells bound approximately 100-fold less to native H 12 DNA than did the nuclear proteins. Furthermore, the H 12 DNA binding affinity of the nuclear acidic proteins from uninfected cells, or from H 12-infected and 1-beta-D-arabinofuranosylcytosine-treated cells, was somewhat lower than that of the nuclear proteins from infected (untreated) cells.


Identification of early adenovirus type 2 RNA species transcribed from the left-hand end of the genome. Unique fragments of adenovirus type 2 DNA generated by cleavage with endonuclease R-Eco RI or endonuclease R-Hsu I (Hin dIII) were used to map cytoplasmic viral RNAs transcribed early in productive infection. Radioactive early viral RNA was first fractionated by polyacrylamide gel electrophoresis. Eluted viral RNAs were then tested for hybrid formation with DNA fragments. The Eco RI DNA fragment (Eco RI-A) which contains the left-hand 58% of the genome hybridized 13S and 11S RNAs. More detailed mapping of these RNAs was achieved by hybridization to the seven Hsu I fragments of Eco RI-A. The early RNA annealed only to Hsu I-G and C, two fragments which comprise the extreme left-hand 17% of the genome. Viral RNA migrating as 13S and 11S annealed to Hsu I-G, and 13S RNA annealed to Hsu I-C. A 13S RNA is transcribed from Eco RI-A late in infection (18 h). Hybridization-inhibition studies with Eco RI-A DNA, early cytoplasmic RNA, and 3H-labeled 13S late RNA demonstrated that this RNA synthesized at late times is an early RNA species which continues to be synthesized in large amounts at 18 h. This 13S RNA synthesized at 18 h hybridized to Hsu I-C but not to Hsu I-G DNA. These results establish that the 13S RNAs transcribed from Hsu I-G and C at early times must be different species.


Infantile enteritis viruses: morphogenesis and morphology. A new virus was found to be associated with acute gastroenteritis in children. In duodenal biopsies, it was observed infecting only intestinal epithelial cells, and it resembled orbiviruses in its morphogenesis. For diagnsotic purposes the virus was readily demonstrated by negative staining of fecal extracts. Two forms of particles were seen: double-sheeled particles (70 to 75 nm in diameter) resembling those of reovirus with a sharper outline, and single-shelled particles (60 nm in diameter) with obvious capsomer structure and resembling those of orbiviruses. The morphological resemblance of this human virus to the viruses of "Nebraska" calf scours and epizootic diarrhoea of infant mice is emphasized.


Interfering passages of Sindbis virus: concomitant appearance of interference, morphological variants, and trucated viral RNA. Serial passage of Sindbis at high multiplicities of infection resulted in cyclical variations in virus titer. Decreases in virus titer were correlated with the appearance of smaller-sized virions, interference and truncated viral RNA. The smaller particles were 37 nm in diameter, exclusive of the hemagglutinin spikes as compared with a diameter of 50 nm for standard virions. Passages which contained 37-nm partilces also interfered with infectious center formation by standard, plaque-purified virus. Polyacrylamide gel analysis of RNA isolated from virions present in interfering passages demonstrated the sequential appearance of three RNA species smaller than standard RNA with approximate molecular weights of 3.3 X 106, 2.7 X 106, and 2.2 X 106. The 3.3 X 106 RNA was evident in passage 5, by passage 8 both the 3.3 X 106 and 2.7 X 106 RNAs were present, and by passage 13 all three were present with the 2.2 X 106 RNA predominating.


Analysis of expression of the rII gene function of bacteriophage T4. Temperature-sensitive (ts) mutants of the T4 phage rII gene were islated and used in temperature shift experiments that revelaed two different expressions for the normal rII (rII+) gene function in vivo: (i) an early expression (0 to 12 min postinfection at 30 C) that prevents restriction of T4 growth in Escherichia coli hosts lysogenic for gamma phage, and (ii) a later expression (12 to 18 min postinfection at 30 C) that results in restriction of T4 growth when the phage DNA ligase (gene 30) is missing. The earlier expression appeared to coincide with the period of synthesis of the protein product of the T4 rIIA cistron, whereas the later expression occurred after rIIA protein synthesis had stopped. The synthesis of the protein product of the rIIB cistron continues for several minutes after rIIA protein synthesis ceases (O'Farrell and Gold, 1973). The two rII+ gene expressions might require different molar ratios of the rIIA and rIIB proteins. It is possible that the separate expressions of rII+ gene function are manifestations of different associations between the two rII proteins and other T4-induced proteins that are synthesized or activated at different times after phage infection.


Population distribution of Frank-vectorcardiographic measurements of healthy Japanese men. For elucidation of the type of population distribution of Frank-vectorcardiographic items of normal Japanese population, forty-eight measurements were obtained from 364 healthy Japanese men in the fourth decade. These measurements were studied with Fisher's g test of normality of population distribution, which showed that normal population distribution could be assumed in only six items (12.5%)-the maximal QRS vector angle and the directional QRS-T angle in the frontal plane, RX and TZ height, OZ duration, and anteorior accession time. The frontal maximal T vector angle was regarded to have an approximately normal population distribution. In the remaining forty-one items logarithmic normalization of distribution was attempted with a transformation formula, Y=Log10 (kX+c). Being applied to Y's, the variate logarithm-transformed with an appropriate value of c, Fisher's g test accepted the null hypothesis of normality of population distribution in 27 items (56.3%); in other words, the population distribution of 27 items was lognormal. These included the magnitudes of maximal QRS and T vectors and T/QRS ratios in the three projection planes, and some of vector angles. The population distribution was usually lognormal in scalar amplitudes and ratios except for items related to Q and S waves in leads X and Y. Bimodality of distribution was seen in six items (12.5%), which consisted of the maximal QRS vector angle and the QRS-T angles in the horizontal and left sagittal planes. In these planes the maximal QRS vector and the directional QRS-T angles showed biomodality attributed to combination of two normal distributions. Three of the four QRS-T angles in these planes and also the horizontal maximal QRS vector angle were lognormalized, although a lesser degree of bimodality still remained after seemingly successful logarithmic transformation in respect to the tg statistics. Chi-square test accepted the null hypothesis of exponential population distribution in four items (8.4%), which included the depth of QX, SX, and SY, and S/(S+R) ratio in lead Y. Exponential approximation appeared much better than normal one in the rest of measurements related to Q and S waves in leads X and Y. The following conclusions were drawn from the present study: i) statistical tests based on normal population distribution should be carefully applied to Frank-vectorcardiographic measurements of healthy Japanese men in the fourth decade and, presumably, of healthy Japanese adults regardless of age and sex; and ii) logarithmic transformation is an efficient means to normalize a skewed distribution in the majority of measurements.


Evaluation of the significance of scintillation angiocardiography for determination of the left ventricular volume. A method for the determination of the left ventricular volume by scintillation angiocardiography following a peripheral venous injection of a radioactive isotope was described. Salient points in its methodology were as follows: 1. This volume study was composed of non-gated scintillation angiocardiography and cumulative gated scintiphotography. 2. The non-gated scintillation data were stored into video recording system. 3. The gated scintiphotography was performed during a play-back of non-gated scintillation data, opening the gate at desired points of time during a cardiac cycle. 4. The left ventricular scintillation image was photographied in life-size on x-ray film by superimposing, 10-20 times, the gated image of the several consecutive heart beats during the "left ventricular phase" of the dilution of intravenously injected radionuclide. For validation of this method, the stroke volume obtained with this method was compared with that obtained by precordial radionuclide dilution curve recordable during the non-gated scintillation angiocardiography, and also with that obtained by non-simultaneous radiocardiography. It was concluded that the present method may be sufficiently accurate for clinical use.


Effects of verapamil on SA and AV nodal action potentials in the isolated rabbit heart. In the isolated rabbit heart, it was shown that verapamil suppressed the electrical activities of the SA and AV nodes without preventing regenerative responses in atrial muscle fibers. It was concluded that the different effects of verapamil on SA and AV nodal action potentials resulted from the operation of a different ionic channel (slow channel) from that of ordinary atrial muscle.


Zymogram analyses of various organs, glands and tissues from spontaneously hypertensive rats (SHR) and DOCA hypertensive rats. Esterase and Acid phosphatase isozymes were examined in a number of organs, glands and tissues from Spontaneously Hypertensive Rats (SHR) and kidney and liver from DOCA hypertensive rats at various stages in comparison with those of normotensive rats (CR). In  SHR, the abnormalities in the patterns of esterase isozyme were demonstrated in endocrine glands and respiratory tracts as well as in the kidney, liver and digestive tracts throughout the whole life span, and abnormalities in the patterns of acid phosphatase isozyme was also demonstrated in the liver after seven days of age. Moreover, in DOCA hypertensive Rats, minute alterations in esterase isozyme were demonstrated in the kidney and liver after seventh month of the duration of hypertension.


HIS bundle electrogram in rheumatic mitral valve disease with special reference to Bachmann's bundle block in P mitrale. HBEs were recorded from either the right or left ventricle or simultaneously from both in 26 patients with chronic rheumatic mitral stenosis alone or in association with other mild valvular lesions during the diagnostic cardiac catheterization. Eleven of the patients had auricular fibrillation. Of the remaining 15 patients with sinus mechanism and P mitrale in the surface electrocardiogram, 12 were noted to have H potential preceded the termination of P wave and gave P2H interval of negative value- so-called "Bachmann's bundle block". Among these, double atrial activities (A and A' waves) could be identified on the HBE recorded from the left ventricular endocardial surface with catheter electrodes positioned at the subarotic region in 7 patients studied. Interatrial conduction time (P1A' interval) measured in these patients was prolonged in all and ranged from 47 to 82 with an average of 66 msec. Prolongation of intraatrial (or internodal) conduction time was noted in only one patient who also had first degree A-V block and prolonged A-H interval. There was no correlation of either P1P2 or P2H interval to the degree of left atrial enlargement. The P1P2 or P2H interval also had no correlation with hemodynamic parameters. In patients with auricular fibrillation, all impulses unable to conduct to the ventricle were blocked proximal to the His bundle and concealed conduction was not observed distal to it.


Tables for estimating the mean of distribution of logarithms of titers based on data with a pooled serum sample. A table was constructed for use in estimating the mean of distribution of logarithms of titers based on data obtained with a pooled material instead of those with individuals in a sample. A table of standard errors of the estimator was also constructed. Examples showing the utility and applicability of the tables were presented. Several relating problems were discussed.


Growth of measles virus in nervous tissues. III. Neurovirulence of SSPE virus in ferrets. The Niigata-1 strain isolated from a patient with subacute sclerosing panencephalitis (SSPE) was inoculated intracerebrally into ferrets. Neurological signs developed in about 1 week in most of the animals. Histopathological examinations of the central nervous tissues revealed degenerative lesions in the parenchyma of the brains and inflammatory reactions predominantly in the meninges and choroid plexus. Virus antigen was demonstrated mainly in the nerve cells by immunofluorescent staining. The results indicated high affinity of the Niigata-1 strain to the nerve cells. In contrast, the Mantooth strain of SSPE virus in cell-free state did not exhibit neurovirulence in ferrets.


Titration of tetanus antitoxin by passive hemagglutination. I. Titration of guinea-pig antitoxins at various periods of immunization. An improved technique for passive hemagglutination (HA) for titration of tetanus antitoxin was described. The use of highly purified tetanus toxoid and of improved diluent increased the specificity and reproducibility of the test. Several hundreds of specimens of guinea-pig serum taken at various stages of immunization were titrated by HA and toxin neutralization (NT) in mice. The ratio of HA to NT titers varied significantly depending on the immunization stage; higher at early stages and lower at later stages. The high HA/NT ratio was not due to the IgM antitoxin, which is very rare in guinea pigs. The variation in discrepancy between HA and NT titers decreased considerably by grouping the serum specimens with respect to the stage of immunization. Thus, it is possible to predict the in vivo titer of a tetanus antitoxin accurately enough for clinical study. The HA test may be useful as an alternative method for titrating tetanus antitoxin in the field trials. Moreover, it can be used for the study of characteristics of antitoxins.


Separation of Dirofilaria immitis allergen from the IgG-inducing antigens. Allergen in crude extract of Dirofilaria immitis was purified and separated from the IgG-inducing antigens by a combination of DEAE-Sephadex A-50 chromatography and Sephadex G-200 gel filtration. The molecular weight of the purified preparation was estimated to be approximately 20,000 by gel filtration. The carbohydrate content of the preparation was apparently low, about 2%. Rats immunized with the allergenic fraction developed only a homocytotropic antibody and no hemagglutination antibody.


Studies on complement-fixation reaction in equine infectious anemia. II. Identification of complement-fixing inhibitors. The substances responsible for inhibiting complement-fixation (CF) reaction of the late-stage serum of an equine infectious anemia (EIA)-infected horse were investigated. It was found that the IgG and IgG(T) classes in the late-stage serum were responsible for the CF inhibition. IgA could not be detected in partially purified IgG(T) by an immunodiffusion test using rabbit anti-human IgA serum. Other serum components could not be demonstrated in purified IgG by immunoelectrophoresis using rabbit anti-horse serum. The IgG class simultaneously showed CF and CF-inhibiting (CFI) activities, whereas the IgG(T) class showed only CFI activity. The IgG(T) class could exert CFI activity only when it had been reacted with the EIA antigen before addition of the reference CF serum and complement. In contrast, the IgG class converted the CF-active reference serum into a non-CF-reactive one irrespective of whether it was simultaneously reacted with the EIA antigen and the reference CF serum, whether it was added to the reaction mixture of the EIA antigen and the reference CF serum, or whether it was sensitized with the EIA antigen before addition of the reference CF serum. Inhibitory activities of the IgG and IgG(T) classes seemed to be different from each other in their reaction pattern as far as tested under our experimental conditions. Their CFI activities seemed to be specific for EIA, being negative in CFI activity in reaction with other antigens.


Changes of ultrastructure in spore coat of Bacillus thiaminolyticus during germination and outgrowth. Electron microscopic observation showed that the spore coat of Bacillus thiaminolyticus consisted of at least four layers; a high electron dense outer spore coat layer with five prominent ridges, a middle spore coat layer including two layers of a high and a low electron density, and an inner spore coat layer composing six to seven laminated layers. Rapid breakdown of the cortex and swelling of the core occurred in spores which were allowed to germinate by L-alanine for 45 min, whereas no change of surface feature was observed by scanning electron microscopy. Germination and outgrowth of spores in nutrient broth proceeded, being accompanied by morphological changes, in three steps; the first is a rapid breakdown of the cortex and swelling of the core, the second degradation of the inner layer at prominent region of the spore coat, and the last rupture of the spore coat and emergence of a young vegetative cell.


Ecology of enteroviruses in tropics. I. Circulation of enteroviruses in healthy infants in tropical urban area. A continuing surveillance on enterovirus infection in healthy infants was conducted from October 1971 through February 1973 in urban areas in Ghana, West Africa. About 40 infants were visited in every two months for collection of faecal specimens and examined for infection. Enteroviruses were recovered in tissue culture. The overall isolation rate of enteroviruses was approximately 44%, and there was no seasonal difference between rainy and dry seasons. The rate of virus isolation in urban areas was significantly higher than in rural areas. Within the urban areas, however, no difference in the rate of virus isolation was detected between densely populated and sparsely populated areas. The results of virus identification revealed that all three types of Poliovirus, many types of Echovirus and a few Coxsackieviruses were isolated during the course of the study. It was observed that improvement of sanitary facilities decreased the frequency of virus infection among infants, but the condition of water supply did not influence the virus infection rate. Neither the age of infants nor the size of siblings showed any relation to the virus isolation rate. It was suggested from the results that many types of enteroviruses have been circulation continuously in the tropical urban community throughout the year.


[Influence of a streptokinase-induced fibrinolysis on the extent of the acute experimental myocardial infarction (author's transl)]. In 17 unaesthetized dogs several side branches of the left descending coronary artery were ligated. The ST-segment elevation in the epicardial ECG ascended to 22 mV after 5 min and to 19 mV after 20 min. Aortic pressure, left ventricular enddiastolic pressure, heart rate and hemostasiological parameters (thrombin-time, thrombin-coagulase-time, reptilase-time, plasma-fibrinogen, staphylococcal clumping test) did not change significantly. 20 min after the beginning of coronary occlusion, the vessels were reopened. When ST-segment elevation had disappeared, a controlled fibrinolytic therapy (Streptokinase 1.5 Mega I.E. in 30 min, later on 0.75 Mega I.E./h) was induced. When an effective fibrinolysis could be demonstrated by the hemostasiological parameters, the same vessels were occluded again. Now the hemodynamic parameters too did not change significantly, but the ST-segment elevation was significantly diminished for more than 50% compared with simple ligation. A control group, which only got the solvent of the streptokinase, showed the same ST-segment elevation. This effect, induced by streptokinase is ascribed to fibrinogen degradation products and a diminution in the amount of fibrinogen which cause an improvement of microcirculation.


[Effect of higher molecular urine metabolites on lymphocyte transformation and autohemolysis (author's transl)]. Possible toxic effects of lyophilised not dialysable residue from urine of healthy persons obtained by 4 days dialysing against water were investigated. Therefore, the substance dissolved at a concentration of 2.22 mg/ml in Medium TC 199 respectively in physiological saline solution was added with increasing quantities (0.1 to 1.0 ml) to lymphocyte cultures (3 x 10(6) cells in 4 ml medium) and to erythrocytes (3 ml of blood after separation of granulocytes) from healthy persons. Spontaneous 3H-thymidine uptake of the lymphocytes ascertained 5 days after beginning of incubation was markedly depressed with dependence upon the doses up to 30.4% of the control value, whereas only 65.2% was reached after stimulation with 400 mug PHA. In both cases LDH activity in the supernatant culture medium measured as a parameter of cell destruction showed a dose-dependent increase with inverse trend as compared to 3H-thymidine uptake levels. This negative correlation may be due to impaired cell viability as the main cause for depressed lymphocyte transformation. The autohemolysis of the erythrocytes was diminished with dependence upon the doses until to 59.3% of the control value. Therefore, only cytotoxic effects of uremic serum on the lymphocytes may be due to higher molecular urine metabolites retained in uremia whereas increased autohemolysis will be induced by toxins of lower molecular weight.


[Diurnal variation of glucose tolerance and insulin secretion in man (author's transl)]. The present investigation was designed to determine whether the circadian rhythm of glucose utilization is based on a quantitatively different release of insulin and/or on changing secretory dynamics of the hormone. 22 healthy men received three oral glucose tolerance tests in the morning, afternoon and evening of the same day. The blood sugar levels in the afternoon and evening tests were significantly higher than those found in the morning tests. Also the plasma insulin response was higher in the afternoon than in the evening, but it showed a delayed rise and late peak response. In the evening the normal subjects responded as mild diabetics.


[Familial progressive dystonia with diurnal fluctuation. Case report. Remarkable therapeutic effect of 1-dopa (author's transl)]. The present report discusses two patients of a same family who have "familial progressive dystonia with diurnal fluctuation" (Segawa). One of them, a severely handicapped nine year-old girl was successfully treated with L-Dopa.


[Granulocyte dysfunction. Part II. Secondary defects. (authors transl)]. In the first part we reviewed both the molecular basis of granulocyte function and the inborn defects. The present chapter summarizes our knowledge of the secondary defects of chemotaxis, opsonisation, phagocytosis and intracellular microbicidal activity.


[Hypodysfibrinogenemia: fibrinogen giessen II (author's transl)]. A new case of facultative hemorrhagic diathesis is described in a 19 year old female and the coagulatory anomaly examined. The experiments show that the coagulatory disturbance should be ascribed to a defective aggregation of fibrin monomers associated with hypofibrinogenemia. Some of its characteristics are the markedly prolonged thrombin-, reptilase-time as well prolonged prothrombin and partial thromboplastin time. The plasma fibrinogen concentration measured by the immunologic method is reduced. The streptokinase induced digestion of fibrinogen Giessen II plasma occurred at a slower rate than normal plasma with persistence of the large fibrinogen degradation products. Fibrinogen Giessen II appears to be a congenital hypodysfibrinogenemia with abnormality of fibrinogen resulting in delayed coagulation and a retarded fibrinogenolysis rate.


[Quantitative determination of fragment erythrocytes (schistocytes) in healthy subjects and patients after surgery]. Fragmented erythrocytes (schistocytes) were counted in blood subjects and from 50 patients who underwent various surgical procedures. The results showed to be as follows: 1. The average number of schistocytes in healthy controls of both sexes was 1-20/00 (medium in Thoma chamber 1.4%0/00, in blood smears 2.030/00, with a range from 0-50/00 and 0-60/00, respectively). 2. There was an increase in the number of schistocytes two hours after a surgical procedure (average 60/00), the degree of which correlated with the extent of the operation. Higher values of fragmented erythrocytes were counted after intraoperative blood transfusion (average 100/00). In most cases schistocyte values returned to normal at about 24 hours after surgery. 3. The highest schistocyte counts (18-350/00) were observed in two patients undergoing splenectomy with persistence of elevated counts for a longer period. 4. The average schistocyte number in stored blood of various age was 2.50/00. 5. Both counting of schistocytes in Thoma chambers and in blood smears are applicable, though the values obtained with the latter technique are slightly higher. Quantitative estimtion of schistocytes proves a useful method for evaluating disturbances in microcirculation.


[Insulin and proinsulin secretion under contraceptive steroid administration (author's transl)]. An ivestigation has been performed in 49 women about the influence exerted on the glucose-tolerance, insulin and proinsulin secretion by hormonal contraceptives of different types and compositions. A disturbed dynamics of the insulin secretion with elevated values in the OGTT at two and three hours has been proven at a nearly equal degree using combined preparations (Anacyclin, Eugynon, Neogynon, Mikrogynon) or sequential preparations (Kombiquens, Ovanon). Though there has been interference with the glucose tolerance, the serum proinsulin in the OGTT showed increased levels too. When a combined preparation was applied, the proinsulin values were significantyl higher compared to a sequential type contraceptive. The observed disturbance of the insulin and proinsulin secretion is explained by a decreased sensitivity to insulin in the peripheral fat tissue. The actual dose of the estrogen-gestagen components has no influence on the described changes. Elevated insulin levels are demonstrable already during the first treatment cycle. The degree of the disturbance is independent of the duration of the medicamentous application during the first 6 contraceptive months. After withdrawal of the respective contraceptive steroid the insulin secretion showed nearly normal dynamics during the subseqeunt menstrual cycle.


[Glucose-assimilation and dynamics of insulin secretion. Measurements after intra-abdominal operations (author's transl)]. Insulin concentrations in peripheral venous blood and portal venous blood were measured in 18 patients after intraabdominal operations during 20 standardised glucose-infusion-tests (GIT). The conclusion is as follows: 1. In spite of similar preoperative situations and operative traumatisation the islets reactivity to a constant hyperglycemia and the glucose assimilation is individually ver different. 2. Measurements of insulin concentrations in the portal venous blood in man show a significant correlation between the profile of the insulin concentration curve and the k-value; the measurement of the insulin concentrations in peripheral venous blood fails to demonstrate a significant difference. 3. In patients with a pathologic glucose assimilation it is not the insulin secretion that is delayed but the insulin regression (disappearance rate) in portal venous blood. 4. In patients with a normal glucose assimilation the insulin concentrations curve in portal venous blood shows an oscillating course during the first 30 min. These oscillations registered for the first time in humans indicate an insulin-induced feedback mechanism of insulin secretion.


[The activity of erythrocyte glutathione peroxidase in chronic renal failure (author's transl)]. In 18 patients with terminal chronic renal failure on twice weekly maintenance hemodialysis, the predialysis activity of glutathione peroxidase was not impaired but rather slightly but slightly elevated when compared with healthy controls (2.7 versus 2.1 units/p less than 0.01). This was attributed to the reduced mean cell age.


The parachute mitral valve complex. Case report and review of the literature. A 10-month-old infant, the youngest patient thus far reported to have undergone successful correction of the developmental complex known as "parachute mitral valve," is presented. Severe mitral incompetence and aortic coarctation led to recurrent cardiac failure. Both anomalies were corrected in a one-stage procedure wherein the coarctation was resected under normothermia and the mitral valve replaced thereafter by a prosthesis employing deep hypothermia and total circulatory arrest. He made an uneventful recovery. Forty-two reported cases in the literature are reviewed and the pathologic and clinical features, diagnosis, natural history, and management briefly summarized.


Effects of myocardial ischemia on ventricular compliance. Protective role of hydrocortisone. The effects of hydrocortisone on left ventricular force-velocity relations, systolic length-tension curves, and diastolic pressure-volume curves (compliance) were determined before and 30 and 60 minutes after a 1 hour period of normothermic ischemic cardioplegia. Five dogs were given no hydrocortisone, 5 dogs 150 mg. per kilogram of hydrocortisone immediately after aortic unclamping, and 5 dogs 150 mg. per kilogram of hydrocortisone 20 minutes before clamping. Thirty minutes after unclamping, there was a 45 per cent decrease in contractility (p less than 0.005). At 60 minutes, there was a significant improvement (p less than 0.025), although a 32 per cent depression persisted. There were no differences among the three groups (p less than 0.05). Dogs not given hydrocortisone before clamping, compliance decreased 18 per cent (p less than 0.05), and in those given hydrocortisone immediately after unclamping, compliance decreased 28 per cent (p less than 0.025). The decreases in compliance in the hydrocortisone-treated dogs were significantly less (p less than 0.05) than the decreases observed in the dogs not given hydrocortisone.


Experimental mitral regurgitation: effects on left ventricular function before and after elimination of chronic regurgitation in the dog. Chronic left ventricular-atrial regurgitation (LVAR) was created in 8 dogs by means of an external conduit so that the effects of acute correction of regurgitation on the mechanics of left ventricular performance could be studied in detail. LVAR of 46 to 77 per cent of the total left ventricular (LV) output was associated with a depression of the LV inotropic state (downward displacement of the stress-velocity relationship, reduction in V max), reduced forward flow, and signs of cardiac failure. Acute occlusion of the shunt (analogous to return of mitral valvular competence) in the anesthetized, open-chest animal resulted in a statistically significant increase in the integrated LV systolic wall stress (afterload), which averaged 18 per cent. In the dog with greatest depression of the LV inotropic state, the increase in afterload was associated with a decrease in forward flow. Occlusion of the shunt had no significant effect on the inotropic state. This model of mitral regurgitation appears to be useful in assessing the effect of chronic LVAR on cardiac performance and may explain the hemodynamic deterioration observed in some patients with severe mitral regurgitation following valve replacement.


Traumatic rupture of the pericardium with luxation of the heart. Case report and review of the literature. A report is made of a case of left diaphragmatic and pericardial rupture with luxation of the heart from the pericardial sac, resulting from a steering wheel injury. The patient was successfully treated surgically. In the treatment of this injury, correcting the hemodynamic derangement caused by incarceration and torsion of the heart is stressed. A review of the literature on pericardial ruptures is presented.


The case for early surgical treatment of left-sided primary infective endocarditis. A collective review. Sixteen cases of infective endocarditis requiring valve replacement with a prosthesis are described. The indication for surgery was intractable congestive heart failure in all. Fourteen patients underwent aortic valve replacement, with five hospital deaths secondary to cardiac decompensation and one late death related to recurrent periprosthetic insufficiency. Two patients who required mitral valve replacement did well, with no early or late deaths. A collected review of 293 cases of left-sided primary infective endocarditis reported in the English literature confirms the feasibility, advisability, and life-saving potential of urgent surgical intervention in patients with persistent or progressive congestive heart failure, irrespective of the activity of the infective process or the duration of antibiotic therapy. All infected tissue should be resected, and Teflon bolsters should be used to minimize the incidence of periprosthetic leaks. The incidence of prosthetic infection is minimal, contrasted with the fatal potential of procrastination to achieve microbial cure.


The effect on blood coagulation of the exclusive use of transfusions of frozen red cells during and after cardiopulmonary bypass. The essentially indefinite storage life of previously frozen erythrocytes (PFE), combined with the virtual freedom from hepatitis, high 2,3-diphosphoglycerate (2,3-DPG) content, and low level of HL-A antigens, should make its use in open-heart surgery attractive. However, since the suspension medium for PFE is usually saline, the potential exists for creating a hemorrhagic diathesis by accentuating the dilution of plasma procoagulants by the pump prime. To test this possibility, we used PFE exclusively in transfusing a group of 13 open-heart surgery patients; they were given no plasma or platelets. A control group of 12 open-heart surgery patients were transfused with only shelf blood. Determination of prothrombin times (PT), partial thromboplastin times (PTT), platelets, and fibrinogen were done at various intervals. No clinically significant differences between the two groups were seen in any of these parameters at any interval, and there was no significant difference between the groups in amount of chest tube drainage or transfusions in the first 24 hours. It is concluded that most open-heart surgery can be safely performed exclusively with frozen blood.


Aspirin and gastric ulcer.

Aspirin and gastric ulcer. Although acetylsalicylic acid (aspirin) can cause acute damage to human gastric mucosa, its relationship to chronic gastric ulcer has been less documented. A study of the aspirin intake of 61 patients with gastric ulcer revealed that 32 (52%) took 15 or more aspirins each week, compared to 6 (10%) age- and sex-matched controls who took such amounts (P less than 0.001). This difference remained significant when patients who took aspirin for relief of alimentary symptoms or when patients whose symptoms preceded aspirin use were excluded. The regular use of aspirin was especially associated with ulcers in the prepyloric region of the stomach. Fewer patients who had combined gastric and duodenal ulcers were regular users of aspirin when compared with patients who had gastric ulcer alone. The findings suggest that aspirin may be a common cause of gastric ulcer in man.


The value of cells in the pleural fluid in the differential diagnosis. Fifty samples of pleural fluid, collected from consecutive patients in a thoracic clinic who had diagnostic thoracentesis, were studied prospectively. Pleural fluid protein was of value in differentiating transudates from exudates. Pleural fluid red cell counts, white blood cell counts, and differential white blood cell counts have no specificity and no usefulness in the differential diagnosis of the origin of the effusion. Pleural fluid cytology was positive in 60% of all the malignancies studied in this series; for the group with metastatic breast carcinoma, there was a 78% positive pleural fluid cytology. Differential white cell counts revealed tumor cells in 45% of malignant effusions. In our experience, the finding of tumor cells is the only useful finding in differential cell counts of the pleural fluid.


Deficient cytochrome b5 reductase activity in nontoxic goiter with iodide organification defect. A 37-yr-old woman with nontoxic goiter is presented. The thyroid 131I uptake at 3 and  24 hr were, respectively, 77.1% and 81.4% dose. Thiocyanate discharged 65.5% of the accumulated 131I in 30 min. In vitro organification of iodine in the thyroid homogenate from the patient was impaired and it was restored to normal by the addition of H2O2, glucose, and glucose oxidase system, FAD, or reduced cytochrome b5. Riboflavin, FMN, oxidized cytochrome b5, oxidized or reduced cytochrome c, NAD(H), and NADP(H) were ineffective in the reaction. The microsomal NADH-cytochrome b5 reductase activity was definitely low in the patient's thyroid. It was augmented to a normal level by incubation of the microsomes with FAD for 30 min or more. The activities of thyroid peroxidase, G6-PD, 6-PGD, catalase, protease, and NADPH-cytochrome c reductase were within normal limits. The major thyroid protein was normal thyroglobulin which could be readily iodinated in the presence of H2O2 and horse radish peroxidase. These findings suggest the correlation of an iodide organification defect with a cytochrome b5 reductase deficiency. Administration of high doses of FAD led to the restoration of thyroidal iodide organification mechanism associated with an increased thyroid hormone production and to a marked decrease of the goiter. Riboflavin was given without effect even at a high dosage level. Consequently, it seems likely that the deficient cytochrome b5 reductase activity in this patient is due to a defect in the biosynthesis of FAD, the coenzyme of the reductase, from riboflavin.


Evidence for diabetes mellitus and genetic forms of hypertriglyceridemia as independent entities. Among 91 index cases whose diagnosis of a genetic type of hypertriglyceridemia was based on family studies, 27% had diabetes. To determine whether the familial forms of hypertriglyceridemia and genetic diabetes mellitus are inherited together or independently, the adult first degree relatives of these propositi were investigated for the presence of diabetes. Frequency of diabetes in first degree relatives of the 25 diabetic patients with a familial form of hypertriglyceridemia was identical whether such relatives were hyperlipidemic or not (13% versus 14.7%). The frequency of diabetes in both the hyperlipidemic and normolipidemic relatives of the 66 nondiabetic hypertriglyceridemic index cases also was not significantly different from each other (6.2% versus 4.0%). These results indicate that while diabetes is frequently associated with hypertriglyceridemia, genetic hypertriglyceridemia, per se, does not carry an increased risk of diabetes. Following treatment of diabetes, elevated triglyceride levels in index cases with both familial hypertriglyceridemia and untreated diabetes returned to lower but still elevated levels resembling those of affected (hypertriglyceridemic) relatives. Thus, the interaction of untreated diabetes and a familial form of hypertriglyceridemia determines the level of plasma triglyceride in a patient with both disorders.


Reversible abnormalities in postheparin lipolytic activity during the late phase of release in diabetes mellitus (postheparin lipolytic activity in diabetes). To test whether abnormalities in multiphasic release of lipoprotein lipase are associated with hypertriglyceridemia in diabetes mellitus, postheparin lipolytic activity (PHLA) was measured during a high-dose, constant heparin infusion in 20 diabetic subjects with hypertriglyceridemia, 25 nondiabetic hypertriglyceridemic subjects and 7 normal subjects. The standard low heparin dose PHLA and the PHLa during the early phase of the heparin infusion were the same in all groups. In constrast, the PHLA during the late phase of the heparin infusion was lower in the 12 untreated diabetic subjects than in the 25 nondiabetic hypertriglyceridemic and the 7 normal subjects (p less than 0.001). An abnormality in late phase PHLA in the untreated diabetic subjects was more apparent when it was compared to the level of PHLA attained during the early phase of the heparin infusion (Equilibrium PHLA/60 min PHLA). The relative PHLA in the late phase of the infusion was lower in the untreated diabetic subjects (0.671 +/- 0.147) than in the nondiabetic hypertriglyceridemic subjects (0.847 +/- 0.019, p less than 0.001), or in the chronically treated diabetic subjects (0.823 +/- 0.108, p less than 0.05). Among the untreated diabetic subjects, increasing fasting glucose levels were associated with both decreasing absolute PHLA levels at the late phase of the infusion (r = 0.61, p less than 0.02) and greater decreases in relative PHLA during the infusion (r = -0.80, p less than 0.001). Treatment of the diabetes with long-term oral sulfonylurea or insulin therapy corrected the abnormality in the late phase PHLA with an associated decrease in plasma triglyceride levels (p less than 0.001). In five subjects with a deficient PHLA response to a standard, low dose of heparin, the PHLA response was low throughout the heparin infusion. With treatment, the PHLA response to the low heparin dose corrected rapidly toward normal in those two diabetic subjects with PHLa deficiency, and the early PHLA response during the heparin infusion increased. However, the late phase abnormality in all untreated diabetic subjects did not correct to normal until after several months of antihyperglycemic therapy. In the untreated diabetic subjects the degree of elevation of the plasma triglyceride level appeared to result from the interaction of the abnormality in PHLA with the presence or absence of an inherited familial lipid disorder.


Absence of facilitated glucose disposal (Staub-Traugott effect) in subjects with hypopituitarism. Improved glucose tolerance follows glucose challenges given in rapid succession, the Staub-Traugott effect. The cause for this facilitated glucose disposal is not clear. Augmented insulin release, prior "insulinization" of cells, and suppression of a pituitary factor or free fatty acids (FFA) are previously suggested mechanisms. For information bearing on the role of the pituitary in this phenomenon, study of the Staub effect was undertaken in hypopituitary patients receiving replacement thyroid, cortisone, and sex-steroid therapy and in normal untreated controls. All subjects received three intravenous injections of glucose (0.5 g/kg) at hourly intervals. Plasma glucose, FFA, and insulin were measured. Whereas a definite Staub effect was seen in each control subject, this phenomenon was conspicuously absent in seven hypopituitary patients similarly studied. Patterns of peripheral insulin response were similar for both groups: FFA levels fell more slowly in the hypopituitary subjects. Normal pituitary function appears to be required for the Staub effect. Incremental peripheral insulin levels do not explain the effect. Subnormal suppression of free fatty acids and impaired induction of key glycolytic and glycogenic enzymes are alternative explantations for the absence of the  Staub effect in hypopituitary subjects.


Effects of portacaval anastomosis on glucose tolerance in the dog: evidence of an interaction between the gut and the liver in oral glucose dosposal. Continuous infusions of glucose (90 min duration) were given into the duodenum (ID), or the portal vein (IP), or a peripheral vein (IV) in conscious dogs, intact dogs, or dogs with portacaval anastomoses. In intact animals ID glucose tolerance was better than IV glucose tolerance, but IP glucose tolerance was not significantly different from IV glucose tolerance. Thus, the superiority of tolerance to ID glucose was not accounted for by relatively high levels of glucose in portal blood. IV glucose tolerance was not significantly affected by protacaval anastomosis with ligation of the portal vein, but ID glucose tolerance was markedly impaired. Disproportionate impairment in tolerance to enterically administered glucose in dogs with portacaval shunts, and the similarity of IP and IV glucose tolerance in intact dogs, suggest that both liver and the gut are important in determination of oral glucose tolerance through mechanisms that have little or no effect on responses to parenterally administered glucose. The results also suggest that the hepatic contribution is not dependent upon portal venous perfusion of the liver, and that a humoral interaction between the gut and the liver is involved which is not simply dependent on endocrine responses of the pancreas.


Effect of acute kidney exclusion by ligation of renal arteries on peripheral plasma glucagon levels and pancreatic glucagon production in the anesthetized dog. Bilateral kidney exclusion in the anesthetized dog resulted in an immediate and important increase in arterial plasma glucagon. Forty minutes after ligation of the renal arteries, plasma glucagon averaged 200% of the basal values and 90 min after ligation, mean plasma glucagon averaged 357% of the mean basal value. Comparable changes were observed when basal plasma glucagon was markedly suppressed by intravenous infusion of glucose. The rate of production of glucagon by the pancreas was not significantly increased by kidney exclusion. Since the uptake of glucagon by the kidney was previously shown to be quantitatively important, the present findings suggest that abrupt cessation of kidney glucagon uptake is the major factor responsible for the rise in peripheral plasma glucagon levels observed after ligation of renal arteries.


Effect of thyroid hormone on metabolic adaptation to fasting. The acute effect of triiodothyronine (T3) on mobilization of fat and protein energy stores has been measured in five fasting, normal men. Fasting subjects were chosen for this study to amplify catabolic effects occurring during brief thyroid hormone treatment. Subjects were fasted for 72 hr on two occasions with admintration of T3, 150 mug every 12 hr, for 72 hr before and during the second fast. Plasma beta hydroxybutyrate, acetoacetate, and free fatty acid levels as well as ketone, creatine, and urea excretion were measured during control and T3 fasts. T3 enhances catabolism of protein stores as indicated by the doubling of urea excretion during the T3 fasts. Likewise, creatine excretion is increased six to ninefold during the T3 fasts. Catabolism of fat stores is enhanced during the T3 fasts as shown by increased plasma free fatty acid and ketone levels, and increased ketone excretion. Brief T3 treatment for 3 days augments the expected protein and fat catabolism of starvation without causing subjective changes of hyperthyroidism. Much of the catabolic expression of hyperthyroidism may simply reflect inadequate caloric intake to fuel energy requiring processes stimulated by thyroid hormone such as cell membrane sodium pumping and protein synthesis.


Alanine-induced amino acid interrelationships. Six normal subjects received 10 g of alanine both orally and as a 60-min intravenous infusion. In both studies blood samples for hormones and substrates were obtained every thirty minutes for 2 1/2 hour. Significant increases in whole blood levels of threonine, serine, glutamine, proline, glycine, and alpha-amino-n-butyric acid were found, which were mainly due to increases of these amino acids in the plasma compartment. In contrast, whole blood levels of leucine, valine, and isoleucine declined, mainly due to increases in the cell compartment. Plasma glucagon levels increased in both studies while insulin levels rose significantly only during the oral study. Plasma free fatty acids and blood glycerol levels declined while lactate and pyruvate increased. Glucose concentration did not change during both tests. These data suggest that the administration of large quantities of alanine is capable of inducing significant alterations in levels of other amino acids and substrates as well as changing hormone levels.


Reactive hypoglycemia.

Reactive hypoglycemia. The hypoglycemoses include a large category of distinctly unique entities. Guidelines for a clinical, physiological approach to these disorders is presented. Within this diagnostic spectrum of hypoglycemia lies the reactive hypoglycemic disorders that are characterized by their postprandial onset, adrenergic mediated symptoms, and relatively benign causes. The spectrum of reactive hypoglycemia includes early alimentary-reactive hypoglycemia, late diabetic-reactive hypoglycemia, hormonal deficiency states, and idiopathic hypoglycemia. A new postprandial hypoglycemic disorder, fructose 1-6 diphosphatase, can be added to this list. The frequent sampling of blood-glucose values in the postprandial state will frequently lead to the finding of a biochemically low blood-glucose value of below 50 ml/100 ml, and these individuals show no hypothalamic-pituitary-adrenal stress to the low blood sugar and do not manifest adrenergic symptoms. Their low blood-glucose value simply reflects the transition in intermediary metabolism between the fed and fasting state and provides a biochemical marker of this event. We refer to this asymptomatic biochemical event as transitional low blood-glucose state. It has no clinical implication and may frequently be confused with the bona fide reactive hypoglycemic disorders. Using a symptomatic, counter-regulatory model to define hypoglycemia as a bona fide disorder, findings are presented in patients with the varying types of reactive hypoglycemia, and their results are compared to normal controls and to a weight-matched and disease patient controls. Abnormalities in insulin secretion are discussed as relating to the pathophysiology causal in the hypoglycemia. An approach to therapy is presented based upon the classification of the patient as to the type of hypoglycemia and their abnormalities in insulin secretion.


Evaluation of copper-7 intrauterine device in Malaysian women. A study of 300 Malaysian women who were fitted with the Copper-7 intrauterine device is presented. Two per cent of the acceptors were nulliparous. Insertion was easy in 97-7% of the cases and the side effects were minimal. In a study of over 4,634 women-months a low cumulative expulsion rate, at 12 and 24 months of use, of 3-1 and 3-6 respectively, was observed. However, relatively high cumulative rates of pregnancy of 4-3 and 9-2 occurred at 12 and 24 months of use respectively. Out of a total of 19 pregnancies, in 12 cases the device was found to have descended, a finding not commonly reported. One woman experienced translocation of the device five months after insertion, and in this instance, the device was removed by laparotomy. The findings in this study and their implications are discussed.


Tetracycline-induced tooth changes. Part 5. Incidence in extracted first permanent molar teeth: a resurvey after four years. First permanent molar teeth extracted during 1972 from patients aged 6 to 18 years attending the Royal Dental Hospital of Melbourne were sectioned sagittally and examined under ultraviolet light for fluorescent tetracycline deposits. The prevalence of fluorescent teeth increased with decreasing age to 84% in patients aged 10 to 11 years, then decreased in the younger children until only 67% were affected at six to seven years of age. Detailed analysis of the distribution of antibiotic in teeth demonstrated a marked decline in tetracycline experience since 1962-1964, i.e., fewer children received courses of the antibiotic, and confirms the trend demonstrated in a similar survey four years age. This trend is associated with a lower incidence and severity of crown discoloration and accompanying enamel hypoplasia in the youngest children examined.


Squamous papilloma of the cervix uteri. A two year prospective cytological study. Squamous papilloma of the cervix uteri were found in 27 patients from 147,813 consecutive cervical smears, an incidence of 1 : 5,475. These were young women (16 to 35 years of age), 17 (63%) of whom were pregnant. When this group was compared with a matched control group, a statistically significant increase in trichomonad infections and a reduction in fungal infections were observed. Smears from every patient with cervical papilloma showed dysplasia of squamous cells which, with one exception, regressed to a lesion of lesser severity, or reverted to normal. The role of cytology, histology and clinical history in the diagnosis and management of this lesion is discussed.


A fundal cyst of the gallbladder: An unusual abdominal mass. A female, aged 80 years, presenting with a large abdominal mass causing distension and right-sided hydronephrosis, is presented. The mass proved to be a unilocular cyst attached to the fundus of a thick-walled gallbladder. Histological examination demonstrated invasive adenocarcinoma in the gallbladder. The cyst was lined by gallbladder type epithelium which showed the appearances of carcinoma-in-situ. The aetiology of this cystic lesion is discussed. It seems most likely that it is an acquired lesion caused by occlusion of the communication into a fundal diverticulum. This lesion is unusual, but should be considered in the differential diagnosis of obscure intraabdominal masses.


Fifteen years on.

Fifteen years on. Sixty students who graduated from the University of Queensland in 1958 were traced 15 years later. Sixty per cent were in private practice and 40% were in full-time salaried jobs. Those who ultimately became physicians had the best average course performance. After specialization, there appeared to be a tendency for the less academically able students to take on full-time salaried jobs rather than to enter private practice. Seventy per cent of women were still in substantially full-time practice.


Hydroxyproline-2-epimerase of Pseudomonas: active-site peptides. Hydroxyproline-2-epimerase was treated with 14C-iodoacetate under conditions that produced almost complete inactivation of the enzyme and concomitant incorporation of almost one molar equivalent of iodoacetate. Both processes were prevented by saturating concentrations of substrate. From reaction mixtures in which both incorporation and inactivation were 85 to 90% complete, two radioactive tryptic peptides were isolated by paper chromatography-electrophoresis. The incorporated radioactivity was divided between the peptides in an approximately 2:1 ratio. Analysis of the isolated peptides suggested that they both contained 9 amino acids and had similar composition; one appeared to be a lysine, the second an arginine peptide. Attempts to sequence each peptide failed, apparently because of the conversion of the S-carboxymethylcysteine to S-carboxymethylcysteine sulfone, indicating that the cysteine residue was N-terminal in each peptide.


Labelling kinetics of RNA containg poly(A) in liver subcellular fractions. Kinetics of incorporation of (3H) uridine into cytoplasmic RNA fractions of rat liver is investigated. The fractions include free and membrane bound polysomes, rough membranes sedimenting with mitochondria and free cytoplasmic RNA particles. (1) Poly(A) containing RNA, isolated by oligo-dT cellulose, amounts to 0.4% of the total RNA in the homogenate, 0.5% in bound polysomes, 3.4% in free polysomes and 16% in free cytoplasmic RNA particles. (2) The rate of (3H) uridine incorporation into RNA lacking poly(A) proceeds uniformly in all subcellular fractions except for free cytoplasmic RNA particles, which accumulate negligible amounts of radioactivity. (3) The initial labelling of RNA containing poly(A) is most active in free cytoplasmic RNA particles supporting their identity as mRNA en route to polysomes. The initial specific radioactivities decrease in the following order: homogenate, bound polysomes, rough membranes sedimenting with mitochondria, free polysomes. The data suggest that mRNA is supplied to free and membrane-bound polysomes via different routes. The kinetic analysis indicates that free cytoplasmic RNA particles may be a precursor of mRNA of free polysomes rather than that of bound polysomes. (4) The kinetic differences of free and membrane bound polysomes are also demonstrated by comparing the radioactivity of RNA containing poly(A) to the total radioactivity at various incorporation times. In bound polysomes this decreases from 31% at 1 h to 10% at 25 h, whereas in free polysomes the corresponding ratio increases from 10 to 13%. RNA containing poly(A) of free cytoplasmic RNA particles represents 64% of the total radioactivity throughout the experiment.


Diversity of cross-bridge configurations in invertebrate muscles. X-ray diffraction patterns from relaxed invertebrate muscles reveal the thick filament symmetries and cross-bridge configurations. The cross bridges are substantially angled to the filament axes. The results on symmetry are generally consistent with Squire's model.


Frequency-force relationship in guinea-pig ventricular myocardium as influenced by magnesium. 1. In guinea-pig papillary muscle, the characteristic relation between force of contraction and frequency is changed by the sithdrawal of magnesium from the incubation medium. In magnesium-free solution, reduction of contraction frequency below 0.1 Hz leads to an increase in force of contraction which reaches its maximum at a frequency of 0.00166 Hz (i.e., one contraction every 10 min). After magnesium withdrawal, the frequency-force relationship in guinea-pig ventricular muscle resembles that of guinea-pig atrial muscle in magnesium-containing solution. 2. The increase by magnesium withdrawal in contractile force of guinea-pig papillary muscles contracting at low frequencies is the result of an increase in contraction velocity. The time to peak force is shortened and the relaxation time is prolonged. 3. After obtaining steady-state values of contractile force at 1 Hz contraction frequency, stimulation was terminated and the time course of changes in the inherent contractile activity of the muscle was determined by eliciting single contractions at time intervals of between 0.5 and 10 min duration. After cessation of stimulation, the contractile activity declines exponentially in solution containing 1.2 mM Mg2+; in magnesium-free solution an initial decline is followed by a slowly developing increase. This rise in contractile activity is reduced at 3.2 mM Ca2+ by the presence of 0.075 mM Mg2+ and is prevented by 0.3 mM Mg2+. 4. The increase in contractile activity obtained in the papillary muscle during rest by magnesium withdrawal depends in its magnitude on [Ca2+]0. 5. The rested-state contractile activity of ventricular muscle in magnesium-free solution is reduced by 75% with the first and by 90% with the second contraction after onset of 1 Hz stimulation. 6. Possible mechanisms are discussed by which Mg2+ inhibits the development of rested-state contractile activity in the guinea-pig ventricular myocardium.


Nitrosobenzene-induced ferrihemoglobin formation in Japanese quail erythrocytes. The significance of ferrihemoglobin reduction. Quantitative aspects of nitrosobenzene-induced ferrihemoglobin formation were studied in quail erythrocytes in comparison to goat red cells. Many similarities exist with the mechanism in mammalian red cells such as a NADPH-dependent enzymatic recycling of phenylhydroxylamine from nitrosobenzene. Also the mechanism of ferrihemoglobin reduction is similar in both species, it is a NADH-dependent process. However, the reducing activity of quail red cells exceeds by far the activity of the majority of mammalian erythrocytes.


Effect of mercuric chloride on contractility and transmembrane potential of the guinea-pig myocardium. 1. The effect of HgCl2 in concentrations from 1 times 10(-4) to 4 times 10(-3) M on the force of contraction of the guinea-pig papillary muscles was investigated. A rapidly developing negative inotropic effect was found to be interrupted by a transient increase in contractile force. 2. In papillary muscles from reserpine-pretreated animals only the decrease of force of contraction was observed. Thus the positive inotropic effect is due to an indirect sympathomimetic action of HgCl2. 3. Mercuric chloride in concentrations above 1 times 10(-3) M raised the threshold of stimulation in more than half the muscles. 4. HgCl2 shortened the time to peak force (t1) and the relaxation time (t2); in muscles of animals pretreated with reserpine, however, t2 increased above the control value. 5. When exposed to HgCl2 all muscles developed a contracture beginning during the 5th min. 6. The time course of membrane resting potential, overshoot, and duration of action potential gradually decreased under the influence of mercuric chloride. The direct negative inotropic effect had a slightly faster onset than had the changes of the electrical parameters.


Action of bombesin on the motility of the stomach. 1. The tetradecapeptide bombesin was tested for its activity on the stomach in rats, dogs and men. On the rat stomach bombesin displayed a striking spasmogenic activity apparently independent from the autonomic nervous system. 2. In the dog the peptide was spasmogenic on the denervated Heidenhain pouch and the antrum. The inhibitory activity predominated on the innervated stomach and body fundus. 3. In man the peptide exerted a contracting effect on the antrum and the pylorus and an inhibitory effect on the stomach body and the fundus. In vitro studies performed on human stomach isolated strips showed a constant stimulant effect. 4. Apparently bombesin has a direct effect on the in situ rat stomach and on the isolated preparations, whereas it has an indirect effect on the other in situ innervated preparations.


Effects of concanavalin A on the isolated perfused rat liver. In the isolated perfused liver, Concanavalin A provoked a significant decrease of flow rate within 2 to 4 min. which was dose-dependent and could be partly inhibited by specific antagonists. Furthermore it was found that the lectin led to a decline of the respiration, an increase of the lactate/pyruvate ratio and a release of the transaminases into the medium. It was suggested that Concanavalin A displaced endothelial cells in the liver capillaries, which occluded the vessels and decreased the flow rate. The decreased respiration was considered to be secondary to this effect.


Inhibition by dopamine of 3H-noradrenaline release elicited by nerve stimulation in the isolated cat's nictitating membrane. After loading the isolated nerve muscle preparation of the cat nictitating membrane with 3H-(+/-) -noradrenaline the effects of exogenous dopamine and (-)- noradrenaline were determined on 3H-transmitter overflow elicited by nerve stimulation in the presence of cocaine, 29 muM. Dopamine, 0.20 muM, and (-)- noradrenaline, 0.18 muM, inhibited 3H-noradrenaline release elicited by nerve stimulation at 4 or 10 Hz. Similar results were obtained with apomorphine 0.03 or 0.1 muM. Chlorpromazine, 1 muM, or pimozide, 1 muM, antagonized selectively the reduction in 3H-noradrenaline release obtained with dopamine or apomorphine, without affecting the inhibition obtained with (-)-noradrenaline. Phentolamine, 1 muM, antagonized more effectively the inhibitory effects of (-)-noradrenaline than those of dopamine. Phenoxybenzamine, 0.29 muM, prevented the inhibition of 3H-transmitter overflow obtained with (-)-noradrenaline, dopamine or apomorphine. In the absence of cocaine neither chlorpromazine nor pimozide were able to increase 3H-transmitter overflow during nerve stimulation. Inhibition by dopamine probably located in the outer surface of adrenergic nerve endings. These dopamine receptors differ from the prejunctional alpha-noradrenaline release by nerve stimulation. The prejunctional inhibitory dopamine receptors are not involved in an endogenously mediated regulatory mechanism for noradrenaline release by nerve stimulation under normal conditions. The possibility that these dopamine receptors are involved in the hypotension commonly observed in patients with chronic L-Dopa treatment is discussed.


[Recordings of spinal cord bioelectric currents in man]. The method of recording of bioelectric currents in the spinal cord used by the author in patients demonstrated similarities between the spinal and the cerebral bioelectric rhythms. In certain pathological processes, especially in spinal tumours, ESG changes were observed, particularly evident at the level of the lesion. The method of bioelectric activity recording in the spinal cord may be useful for early recognition and localization of spinal diseases.


[Electromyographic studies of nape and temporal muscles in headaches of various etiology]. The author reports the results of electromyographic investigations of the muscles of the nape and temporal muscles in 132 patients with headaches of different aetiology (migraine, cervical migraine, vasomotor headache, symptomatic headaches) and in 51 controls who had never had headaches. In the healthy subjects no bioelectric activity was observed when the patients relaxed completely. On the other hand, in most patients with headaches continuous bioelectric activity was observed at rest in these muscles indicating their involuntary contraction. This phenomenon is called by the author "cephalalgic" spasm of head and neck muscles, which is rather characteristic of various headaches.


[Allergologic aspects of epilepsy].

[Allergologic aspects of epilepsy]. The author describes 6 cases in which an unquestionable temporal correlation was observed between the appearance of epileptic seizures and the action of certain allergens. Allergy is considered only rarely as a cause of epileptic seizures. The pathological mechanisms of such seizures seems to be a complex one. In some cases there is probably a direct influence of allergens or biochemical agents released by them on the central nervous system. Data from the literature and own observations show that not infrequently partial complex seisures appear in connection with allergy, besides generalized attacks. The former are frequently a response to the action of chemical and pharmaceutical allergens. Sometimes, anticonvulsants are the agents releasing epileptic seizures. The diagnosis of allergic epilepsy is facilitated by coexistence of local or systemic signs of allergy. The prognosis depends on early recognition of the cause of attacks and appropriate therapeutic management.


[Electrocardiographic changes in acute and past cerebral stroke]. An analysis of 617 cases of cerebral strokes was done, including 534 acute and 83 past ones treated in the years 1966-1972. The patients were divided into 4 groups: I -- cerebral haemorrhage, II -- cerebral embolism, III -- cerebral arterial thrombosis, IV -- failure of cerebral circulation. The classification was based on clinical criteria and in dying patients also on autopsy findings. ECG changes were analysed in all patients. In the acute period of stroke the greatest proportion of cases were cerebral arterial thrombosis (197 cases --37%) and in this group acute myocardial infarctions were most frequent. This group was followed by cases of acute cerebral circulatory failure (191 cases -- 35%). The electrocardiographic correlate of the cerebral changes were in this group signs of myocardial ischaemia (84 cases -- 15%). Cerebral embolism (134 cases -- 24%) was associated with arrhythmia (109 cases --19) of various origin. In the group of cerebral haemorrhages (95 cases -- 17%) no unequivocal ECG changes were observed. In all patients with myocardial infarction during cerebral stroke atheromatous changes of coronary arteries were present. No correlation was observed between the location of the cerebral focus and the type of electrocardiographic changes.


[Childhood myasthenia. Clinical picture and therapeutic results]. The paper contains an analysis of 37 cases of myasthenia beginning in childhood, including 3 cases of congenital myasthenia and 34 cases of infantile myasthenia. The cases of transient myasthenia of newborns, were excluded. The age of patients at the onset of the disease, diagnostic difficulties, clinical course and therapeutic results are discussed. Surgical treatment (thymectomy) was performed in 24 cases with severe clinical course and improvement was achieved in 17 cases (72%). In 13 cases conservative treatment was applied. The weights and the histological findings in exised thymus are presented.


[Treatment of parkinsonism with L-dopa and peripheral decarboxylase inhibitor]. In 38 patients with Parkinson's syndrome Madopar preparation was used (L-dopa with peripheral decarboxylase inhibitor) in 33 cases as the main drug and in 5 cases as an addition to L-dopa. In the group of 33 patients 39 could complete the treatment, one patient died suddenly, three had the treatment withdrawn in view of side effects. The effectiveness of Madopar was assessed by means of five-rate scoring systems NUDS and ART. Clinical improvement was found in 22 cases (about 67%). The improvement included mainly bradykinesia and rigidity, while tremor was only slightly improved. Side effects developed in about 40% of patients and were slight and transient (apart from 3 cases). The main contraindications seem to be psychotic disturbances. In the group of 5 cases treated with Madopar as an additional drug in low doses improved the result of long-term treatment with L-dopa.


[Epidemiology of vascular headache and migraine in the population of Warsaw]. An inquiry investigation carried out in a randomly selected group of adult population of Warsaw comprising 3 518 subjects showed that 37% of men and 68% of women (54% of the whole group) had headaches. The index of migraine prevalence (Mg) and vascular-tension headaches prevalence (Nbg) estimated on the basis of medical examination of 10% of the sample was 4% and 13% respectively in women and 2% and 6% respectively in men. For the whole sample this index was 3% and 10% respectively. The percent prevalence of Mg and Nbg among patients complaining spontaneously of headaches was 12% and 39% respectively, and among patients answering to questions about headaches this index was 6% and 19% respectively. On the basis of these results the prevalence of Mg and Nbg in the general population was calculated. No greater prevalence of Mg was found among epileptics and first-degree relatives of epileptics.


[Early complications following intracranial surgery]. The authors discuss early non-inflammatory postoperative complications developing in the first week after operations. The reported material comprised 97 patients from among 1 815 cases treated surgically in the years 1971--1973 at the Departments of Neurosurgery and Neurotraumatology, Medical Academy in Cracow. The most frequent causes of reoperations were brain oedema, epidural haematoma and haematoma in the empty space left after evacuation of lesion. In the group of reoperated patients the percent of fatal cases increased to 56,7%.


[Pathogenesis of syringomyelia in the light of our observations]. The author treated surgically 10 patients with syringomyelia. In 6 cases Arnold--Chiari syndrome was found, in 2 cases platybasia with basilar impression, besides that 2 patients had complete or partial occlusion of Maganide's foramen and in 4 cases a persisting central canal communicated widely with the 4th ventricle. In 3 cases these findings were associated with postinflammatory changes. In only one case the changes in the atlanto-occipital area could not have been defined clearly. The author compares his observation with those reported by others reaching the conclusion that they confirm the hydrodynanic mechanism of syringomyelia. In most cases syringomyelial  is a result of congenital or congenital and acquired malformations in the medullo-bulbar area leading to distrubances in the circulation of cerebrospinal fluid.


[Acid-base equilibrium in cerebrospinal fluid following intracranial surgery]. In 48 patients the acid-base equilibrium in the CSF and blood was determined on the 2nd day after intracranial operation. In the postopertive period various disturbances of this equilibrium were found which were probably various stages of metabolic acidosis compensation in the CSF which was a reflection of metabolic (lactate) acidosis developing primarily in the damaged brain area. On the basis of determinations it was found that changes in the CSF of the type of metabolic acidosis (21 cases) corresponded most frequently to respiratory alkalosis in the blood (11 cases). Changes of the type of respiratory acidosis in the CSF(13 cases) corresponded usually to metabolic alkalosis in the blood (7 cases). The development of metabolic acidosis in patients in severe and moderately severe condition (19 cases) was associated with poor prognosis as to survival since the mortality in this group was 10 (about 53%). The favourable effect of dehydrating treatment may be due also to facilitation of passage of bicarbonates from the blood into the cerebral tissue and CSF since their level is increased in the blood during metabolic alkalosis (during a decrease in the extracellular space) resulting from dehydration.


The pineal gland and the effect of neonatal administration of androgen upon the development of spontaneous salt and water intake in female rats. The effect of pinealectomy (PX) and sham-pinealectomy (SPX) on the calculated concentration of NaCl in the total volume of fluid drunk per day ([NaCl]I) in female rats offered a free choice between water and 3% NaCl solution was measured. In normal rats the [NaCl]I increases after attainment of sexual maturity. The increase can be accelerated by neonatal PX. Neonatal 'masculinization' of female rats by testosterone propionate (TP2) removes the increase of [NaCl]I in adult females and suppresses the acceleration due to PX. Neonatal SPX interferes with this decreasing effect of TP2 in adult female rats. The role of the pineal gland in the regulation of water and salt intake is discussed in relation to sex differences, sexual maturation and neonatal stress.


Effects of drugs influencing brain catecholamines on GH release in rats with hypothalamic surgery. The effect of pretreatment with alpha-methyl-p-tyrosine (alpha-MT) on the basal levels of plasma growth hormone (GH) and the responses to chlorpromazine (CPZ) were investigated in urethane-anesthetized rats with either complete hypothalamic deafferentation (c.d.), hypothalamic ablation (H.A.) or sham operation (Sham). Basal GH levels were high in C.D. rats, intermediate in H.A. rats, and low in Sham rats without any pretreatment. Pretreatment with alpha-MT caused a significant increase in basal GH levels in both C.D. and Sham rats, but not in H.A. rats. GH release following the intravenous injection of CPZ, which was observed in C.D. and Sham rats without alpha-MT pretreatment, was blunted by treatment with alpha-MT. In H.A. rats CPZ failed to stimulate the secretion of GH regardless of alpha-MT pretreatment. Neither the injection of L-DOPA nor DL-DOPS affected basal GH levels in non-alpha-MT pretreated C.D. rats. However, plasma GH levels significantly decreased following the injection of L-DOPA, but not DL-DOPS, in C.D. rats pretreated with alpha-MT. These findings suggest that the injection of CPZ causes an enhancement of GH release by inhibiting the catecholaminergic (dopaminergic) mechanism, which is active within the basal medial hypothalamus (BMH) and plays an inhibitory role in GH secretion. They also suggest that the extrahypothalamic inhibitory neural pathway, which is connected to the BMH and is interrupted by hypothalamic deafferentation, is not catecholaminergic.


[Dermoid fistula of the nasal root complicated by frontal lobe abscess]. The authors describe a case of dermoid fistula of the nasal root reaching to the dura in the anterior cranial fossa and complicated by development of frontal lobe abscess. Cure was obtained after administration of antibiotics and complete removal of the walls of the fistula with radical intracranial removal of the abscess.


Unilateral dilatation of the internal auditory canal. An unusual and functionally insignificant variant of the internal auditory canal is presented. Marked dilatation of one canal was demonstrated by petrous bone tomography. Pantopaque cisternography revealed a large intracanalicular extension of the subarachnoid space with no evidence of tumor. No patients should undergo exploration of this region without prior Pantopaque studies.


[Connection between severe perivenous retinitis with retinovitreal hemorrhage and disseminated sclerosis]. In a 49-year-old man with temporal pallor of the left optic nerve papilla and increasing spastic paraparesis and with slight lymphocytosis in the cerebrospinal fluid perivenous retinitis was diagnosed. The peripheral retinal veins were covered with characteristic white sheaths, focal formation of new blood vessels, retinal microscopic haemorrhages and residues after vitreal haemorrhage were found. The authors discuss the possibility of a connection between disseminated sclerosis and perivenous retinitis and their possible common aetiology.


The osseous and angiographic features of vertebral chordomas. Eight cases of vertebral chordoma, exclusive of the sacrococcygeus, are presented. The conventional radiographic signs in descending order of importance in differential diagnosis are: destruction of multiple adjacent vertebral bodies; a paravertebral or precervical soft tissue mass; osteosclerosis, seen mainly at the periphery of the destructive lesion; and involvement of the intervening intervertebral disc space. All eight patients had a demonstrable intraspinal extension of chordoma on myelography. Four patients had complete blocks, two epidural in configuration, and two intradural in appearance - indicative of dural invasion by the neoplasm. Four patients had angiographic evaluation. Two demonstrated angiographic features usually associated with soft tissue malignant tumors. Angiography in all four cases was helpful in determining the full extent of the lesion, more so than either conventional radiography or myelography.


Inflatable and released balloon technique experimentation in dog -- application in man. Experimental carotid jugular fistulas have been created in dogs and at a later time obstructed with an inflatable and released balloon. Experimental carotid aneurysms in dogs have also been obstructed with the same procedure. This new technique allows the inflation and release of a balloon in an arteriovenous fistula or in an aneurysm. The present case concerns a human vertebral fistula treated by this technique.


A triad of airencephalographic findings in patients with mental impairment: a controlled prospective study. A controlled prospective study of 82 patients examined consecutively during one year by airencephalography was made. Care was taken to excude bias and to assess observer error. A close correlation was found between mental impairment (as a sign of "organic brain syndrome", resulting from various cerebral diseases), and three airencephalographic findings, namely 1) lack of air filling over the parietal convexities (parietal air block), 2) widening of the lateral and third ventricles and 3) widening of the Sylvian and interhemispheric fissures. Of these, parietal air block was found to be the most sensitive sign. In addition to the patients with normal-pressure hydrocephalus, the majority of patients with presenile dementia and alcoholic encephalopathy had parietal air block. The results are in agreement with those reported in an earlier retrospective study. Leptomeningeal changes may account for the finding of parietal air block in certain patients, but in the majority of cases there is no complete obstruction of the subarachnoid space, as judged from the results of isotope cisternography. Organic changes in the brain and leptomeninges may create special physical conditions for the appearance of convexity air block at airencephalography. Recognition of convexity air blocks seems to have considerable diagnostic and therapeutic implications, since it contributes appreciably to the judgment whether a patient's condition is basically determined by an organic brain syndrome or constitutes a functional mental disorder. The possible pathophysiological association between mental impairment and parietal air block warrants attention.


[Current status of the treatment of purulent bacterial meningitis]. There are several stages in the management of purulent bacterial meningitis: anti-infective measures, respiratory resuscitation, treatment of mechanical neurological complications, sepsis and shock. The way in which ordinary antibiotics cross the blood-brain barrier is described, together with the anti-infective treatment of choice applicable to different aetiologies. A series of cases is presented. It is felt that, in spite of the positive influence exerted by antibiotics, the treatment of purulent bacterial meningitis is still a complex matter. In addition to careful selection of a drug against infection, rational use must be made of various forms of treatment to prevent respiratory infufficiency, neurological complications, sepsis and shock.


Human intestinal specificity toward dietary sterols studied by balance methods. Human intestinal specificity toward sterols was studied by a balance method in 10 hyperlipoproteinemic patients fed plant sterol mixture with chromium sesquioxide as fecal flow marker. The mean fecal recovery of campesterol (C28) was 20% less than that of beta-sitosterol (C29). This difference persisted when corrected for fecal flow (by marker recovery), indicating differences in their intestinal uptake (C28 greater than C29). The ratio of fecal cholesterol to its 5beta-reduction products was lower than that of beta-sitosterol in all patients; in vitro, 5beta-reduction of both sterols was similar. The recovery of sterols from patients was unrelated to their 5beta-reduction in the intestine.


Protein-energy interrelationships during dietary restriction: effects on tissue nitrogen and protein turnover. Young adult female rats were fed diets containing either 50 or 0% lactalbumin at levels of 2, 4 or 6 g diet/day for 2, 8, and 16 days. There was no other protein in the diet. Tissue nitrogen and loss of radioactivity from tissues labeled with 14C- and 3H-glutamate were measured. In a second study, similar rats were fed graded levels of lactalbumin at food intake levels of 3, 5, or 7 g/day. Change in tissue nitrogen varied with the tissue, the time of observation, and the severity of the food restriction. After 8 days, animals fed high levels of protein at the most severe food restriction showed increases in gastrocnemius nitrogen and losses in liver nitrogen, while after 16 days both tissues had marked nitrogen losses. Nitrogen losses at the lowest level of food intake increased with the dietary protein level, whereas dietary protein was protective of tissue nitrogen at higher food intakes. Severity of energy restriction had no effect on loss of tissue radioactivity and the apparently longer tissue protein half-lives from animals fed protein-free diets are attributed to increased amino acid recycling. Such results indicate that short-term studies and overall nitrogen balance experiments will fail to identify changes occurring in different tissues and may yield misleading results.