Nitrogen analyzer adaptation for use in the presence of halogenated anesthetics. Interposition of activated carbon between a nitrogen analyzer needle valve and gas mixtures containing halothane, methoxyflurane, enflurane, or isoflurane eliminated the interfering effects of these agents, but added sampling delays. Placement of a carbon-filled Swinney adaptor in the sampling line between the needle valve and analyzer also eliminated the interference. Linearity of response (range 0 to 80 per cent N2) and sampling delay (40 msec) were unchanged. The 90 per cent fall time (step change 80 to 0 per cent N2) increased from 35 to 100 msec. This adaptation allows rapid analysis of nitrogen concentrations during general anesthesia.


[Dicrocoelium dendriticum in sheep in the Democratic Republic of Germany district of Frankfurt/Oder]. In the district of Frankfurt/Oder of the German Democratic Republic, faecal examinations of 143 sheep stocks revealed a 31.3 percent infection with Dicrocoelium dendriticum. In different territories of the district, the intensity of the infection with Dicrocoelium dendriticum varied remarkably. Detailed investigations demonstrated, that the parasite was limited to pastures with Brownearth soil. Routine examinations revealed the fact, that the egg-output of Dicrocoelium dendritcum was very variable during the pasture season. During the whole time of the examinations, the authors found eggs in the faeces of sheep belonging to Dicrocoelium dendriticun. In the German Democratic Republic, this helminth species is not restricted to hills with limestones. It occurs also in lowlands with small amounts of lime like the Brown-earth zones of the district Frankfurt/Oder.


[Aggregation behavior of Blattela germanica]. 1. The adult males of the German cockroach Blattella germanica are less strongly aggregated in their resting period than the adult females; they seldom stay below the common hiding place. This tendency decreases in the course of a day.--2. The nymphs aggregate in the first days of their lives below the hiding places of the adults where they had left the oöthecae. Later the nymphs seek hiding places that are better adapted to their body size. An olfactory stimulus (aggregation pheromone) which is going out from the adult induces the nymphs to go back again to the adults in the course of a day. This tendency decreases more when the nymphs become older. At the same time the number of nymphs which are absent from hiding places increases.--3. A positive chemotactic and a positive thigmotactic reaction are responsible for this behaviour of the cockroaches. A phototactic negative reaction is less important.


[The minimum effective dosages of repellents]. Method of thin-layer chromatography was used to estimate threshold dosages of diethytoluamide, benzoylhexamethylene, dihexamethylenecarbamide, diethilamide of phenoxyacetic acid and dimethylphthalate for repelling of mosquitoes (Aedes hexodontus, Aedes vexans, Aedes caspius caspius), simuliids (Simulium venustrum), midges (Culicoides obsoletus) and sand-flies (Phlebotomus papatsi). Maximum sensitivity to all the preparations studied was shown by sand-flies (Phlebotomus papatasi, and most sensitive to repellents, out of all the studied species of mosquitoes, were Aedes caspius caspius. Giving recommendations on pellents one must take into consideration the level of sensitivity to repellents of dominating species of blood-sucking arthropods.


Administering allergy injections at linear rates of increase. Administering allergy injections with constant volume increases to build immunity, such as from .05 to .5cc, cause actual dosage effects on the body to vary from injection to injection, from no increase to 100% increase. A simple table shows appropriate volumes for constant increases of 25%, 35% and 50%.


The social worker's interview in chronic urticaria. Ten patients with chronic urticaria were interviewed by a psychiatric social worker as part of the clinical examination. The information obtained was evaluated in comparison with the allergist-internist's history by the allergist-internist, psychiatrist and social workers. The social worker's interview offered relatively little help to the managing physician or patient in this setting.


Comments on self-assessment programs.

Comments on self-assessment programs. Self-assessment programs have assumed an important position with respect to continuing medical education. Despite certain deficiencies, they subserve a number of functions in motivating meaningful study, in delineating for the individual and for those responsible for devising graduate courses, home study courses and study devices those areas or aspects requiring additional attention. Many efforts to improve their efficacy and significance are under way.


Serum IgE levels in normal subjects and allergy patients among the Chinese in Singapore. Serum IgE was determined in four groups of Singapore Chinese consisting of 292 normal subjects, 15 patients with atopic dermatitis, 39 with drug allergy and 14 with bronchial asthma. The results were compared with the findings of similar groups in western countries. In the normal subjects the range and means (numerical and geometrical) of serum IgE were four to seven times higher in the Singapore Chinese than reported in the western countries. However, the circulating levels in atopic dermatitis and bronchial asthma patients were comparable. In drug allergy moderate IgE elevation was noted. The serum IgE levels of the normal subjects and patients with atopic dermatitis and bronchial asthma were markedly lower than those found in nearby Papua New Guinea. The significance of these observations is discussed.


[Methods of isolation and determination of urinary 4-thio-6-hydroxypyrazolo(3,4 d)pyrimidine in patients treated with thiopurinol]. Oxithiopurinol, [4-thio-6-hydroxypyrazolo(3,4-d)pyrimidine] has been caracterized in urines of patients treated with Thiopurinol : the principle involved is the precipitation of both oxithiopurinol and uric acid in combination with cupric hydroxide. The urinary oxithopurinol content is determined by means of anion and cation exchange resins. 56 to 70 per cent of the daily dose of Thiopurinol are eliminated in urine as oxithiopurinol.


[Automatic assay of blood sugar by Trinder's method]. An automated method for determining blood "true glucose" has been adapted to the single channel "AutoAnalyzer". The action of the glucose-oxidase peroxidase system is directly coupled with an oxygen acceptor chromogen. The validity for accuracy, contamination and the absence of interferences by certain compounds have been tested. Experimenters proceeded then with a thorough examination of the relation existing between the "true glucose" determined by the present method combined with the Hexokinase method and the "true guclose" determined with the Beckman "Glucose Analyzer".


[Haptoglobin assay using the LKB 8600 reaction rate analyzer]. The reaction rate analyzer LKB 8 600 is used in a new haptoglobin evaluation method. This technique involves formation of peroxidatic complex between haptoglobin and horse or human hemoglobin (human hemoglobin is easier to prepare), then oxidation of gaiacol with registering of optical density rise. Results fit completely with those of the classical Technicon autoanalyzer technique. The method is accurate, fast, easy to perform, and appliable to large series, while necessitating only 10 mul of serum.


Evaluation of xylazine as a sedative and preanesthetic agent in horses. Xylazine administered intramuscularly (IM) to horses at the dose level of 2 mg/kg was an effective sedative and preanesthetic for thiamylal sodium narcosis or thiamylal sodium and halothane anesthesia. Evaluation of response of cardiovascular, respiratory, and hepatic function did not indicate serious untoward effects, although cardiac and respiratory rate decreased, calculated vigor of left ventricular contraction decreased, calculated peripheral vascular resistance increased, and transient innocuous cardiac arrhythmias occurred. Effects of the anesthetics used on respiratory function (blood gases and pH), using xylazine as a preanesthetic, were comparable with those observed when promazine was used. The onset of action of xylazine given IM was at least as rapid as that occurring when promazine was given intravenously; e.g., 5 minutes for first observable effects, and 15 to 20 minutes for maximal effect. Recovery, times from anesthesia when using xylazine administered IM as a preanesthetic agent were comparable with those reported after promazine was given intravenously; moreover, horses given xylazine were more calm during recovery and seldom tried to stand before they were able.


Effects of acetylpromazine on ventilatory variables in the horse. The influence of breathing various concentrations of carbon dioxide and oxygen upon minute volume, tidal volume, and respiratory rate were examined in acetylpromazine-tranquilized horses. Responses in the horses before (control period) and after tranquilization were qualitatively similar to increases in carbon dioxide and to alterations in oxygen. The quantitative responses to these changes were less in tranquilized horses than in the same horses studied in the untranquilized state. Tranquilization had its most prominent effect upon respiratory rate in horses breathing room air.


Morphologic alterations of Anaplasma marginale in calves after treatment with oxytetracycline. The morphologic features of Anaplasma marginale were determined after treatment of infected calves with oxytetracycline. By light microscopy, anaplasma bodies in erythrocytes of treated calves were enlarged and vacuolated, small and dense, or comma shaped. Several degenerated forms of anaplasma bodies were observed by electron microscopy. There was a blending of the 2 membranes surrounding initial bodies, aggregation of nucleoprotein at the periphery of the subunit, and vacuolation. A 2nd form of degeneration was coalescence of subunits in marginal bodies. A 3rd form of degeneration was unification of subunits of anaplasma bodies and clumping of nucleoprotein. A 4th form of degeneration was the persistence of an anaplasma body as a solitary, irregularly shaped mass containing electron-opaque clumps.


Clinical infectious bovine rhinotracheitis in cattle fed organic iodine and urea. The feeding of ethylenediamine dihydriodide (EDDI) at the dose levels of 50 and 500 mg/animal/day and urea at the dose level of 45 g/animal/day did not affect duration of clinical signs, body weight gain, magnitude or duration of fever, serum concentration of glutamic oxalacetic transaminase, packed cell volume, and differential white blood cell counts in feeder cattle experimentally infected with infectious bovine rhinotracheitis (IBR) virus. However, coughing and abundance of nasal discharge were significantly greater in calves fed EDDI before and during primary IBR virus infection. Those calves fed 500 mg of EDDI/day coughed more, had greater nasal discharge, and exhibited greater lacrimation than did those given the smaller dose. These 3 clinical signs were considered to reflect both the expectorant action of EDDI and the pathogenic effects of IBR virus. In all calves, including controls, the coughing, nasal discharge, and lacrimation were most prominent during the period of peak infection (7 to 14 days after the calves were given intranasal inoculation) of the IBR virus. Total serum iodine concentration became maximal (mean of 1,400 ng/ml) in 8 calves after they had been fed the larger dose of EDDI for 2 weeks. This value was maximal (about 300 ng/ml) in another 8 calves after 3 weeks' feeding of the smaller dose (50 mg/day). When EDDI exposure was maintained at the dose level of 50 mg/day for 5 weeks longer, mean serum iodine values remained at about 275 ng/ml, and those of control calves averaged 140 ng/ml.


Serum biochemical and electrophoretic values from four deer species and from pronghorn antelope. Serums from 4 species of deer and 1 species of antelope were analyzed for various components in order to define an animal disease model for sickle cell disease in people. Animal species included black-tailed deer (Odocoileus hemionus columbianus), mule deer (Odocoileus hemionus), sika deer (Cervus nippon nippon), fallow deer (Dama dama), and pronghorn antelope (Antilocapra americana). The mean serum values for total bilirubin, total protein, albumin, creatinine, urea nitrogen, and electrolytes were similar in all species and were in the normal range for human beings. Cholesterol and uric acid values for all animals were lower than those for people. Alkaline phosphatase values in the 4 cervid species were higher than in the pronghorn antelope. Values for glutamic oxalacetic transaminase were lower in the cervids than in the pronghorn antelope. Lactic dehydrogenase values were similar in the 5 species. High activities for glutamic oxalacetic transaminase and lactic dehydrogenase in the 5 species probably related to muscle mass and great muscular activity.


Efficacy of Fenbendazole against gastrointestinal parasites of sheep. Lambs severely parasitized by Haemonchus, Ostertagia, Trichostrongylus, Cooperia, Oesophagostomum, and Nematodirus were treated with fenbendazole (methyl 5-(phenylthio)-2-benzimidazolecarbamate) given at 3 dose levels: 3.5, 5.0, and 7.5 mg/kg of body weight. Efficacies against these genera, except Haemonchus and Nematodirus, were 100% at the 3 dose levels. Efficacies for the 3 doses against Haemonchus were 93.4, 95.3, and 99.8%, respectively, and against Nematodirus, 99.5, 99.6, and 100%. Efficacies for the doses against Trichuris were 69.1, 83.6, and 98.2%. Toxicosis due to the durg was not seen in these lambs, although they were severely debilitated.


Survival of chromium-51-labeled autologous and homologous erythrocytes in goats. Apparent half-survival time of 51-Cr-tagged caprine erythrocytes after autotransfusion was 8 days. The 51Cr-tagged homologous caprine erythrocytes disappeared from circulation very rapidly, thereby indicating that it is not possible to produce sustained polycythemia in goats by hypertransfusing them with homologous erythrocytes without appropriate matching.


Surface ultrastructure of pyruvate kinase-deficient erythrocytes in the Basenji dog. The scanning electron microscope was used to study the surface morphologic features of erythrocytes from a Basenji dog with hereditary hemolytic anemia due to a pyruvate kinase-deficient erythrocytes (RBC). Cells from this dog were compared with RBC from normal dogs and from dogs with regenerative anemias unrelated to pyruvate kinase deficiency. Demonstration of spherical RBC with uniform spicules on their surface (spheroechinocytes) may provide a morphologic explanation for the shortened erythrocytic life-span previously reported in congenital hemolytic anemia of Basenji dogs. Spherical, spiculated RBC were not found in blood from normal dogs or from anemic dogs with reticulocytoses. The surface of reticulocytes from all dogs with regenerative anemia was roughened, with pronounced folding of the cell membrane.


Comparison of bioavailability of two chloramphenicol preparations in dogs after intramuscular injection. Aqueous chloramphenicol glycinate was compared with propylene glycol solution of chloramphenicol after equivalent intramuscular doses (22 mg/kg) were given to 10 normal, healthy dogs in a crossover study. Duration and magnitude of plasma concentrations of chloramphenicol were significantly longer and higher with the glycinate than with the propylene glycol solution.


Phytomitogen- and antigen-induced blast transformation of feline lymphocytes. A semiautomated microassay of blast transformation of feline lymphocytes was developed and used in a study of the response of normal cats to phytomitogen- and antigen-induced stimulation. Peripheral blood lymphocytes were isolated from defibrinated blood by ficolldiatrizoate gradient centrifugation and incubated at a concentration of 1 X 10(5) cells/culture. Blast transformation was measured by the incorporation of tritiated thymidine, to which the cells were exposed during the last 18 hours of incubation. Phytomitogens induced maximal transformation after 3 days' incubation. Greatest stimulation produced by 10 mug of concanavalin A (38- to 183-fold) followed by 4 mug of pokeweek mitogen (nine- to 51-fold), and finally phytohemagglutinin-P (three- to sixfold). Three of 4 cats sensitized to keyhole limpet hemocyanin responded when exposed to 50 mug of keyhole limpet hemocyanin in vitro, maximal transformation occurring after 4 days' incubation. Lymphocyte blast tranformation provides a convenient technique to assess lymphocyte function serially during experimentally induced immunologic alterations in the cat.


Pathogenesis of tularemia in immune and nonimmune rats. Pathogenesis of tularemia in nonimmune rats given (intraperitoneal inoculation) virulent strain (SCHU S4) or vaccinal strain (LVS) of Francisella tularensis and in immune rats given SCHU S4 is described. Both LVS and SCHU S4 caused pyogranulomas in liver and spleen of nonimmune rats. Nonimmune rats given 10(4) SCHU S4 organisms did not survive beyond 72 hours, but immune rats given challenge inoculum of 10(8) SCHU S4 organisms developed lesions and survived. Larger doses of LVS resulted in earlier onset of characteristic hepatitis and splenitis in nonimmune rats. Periportal lymphocytic infiltrates were present in the liver 48 hours after SCHU S4 challenge inoculation of immune rats and 96 hours after inoculation of LVS in nonimmune rats and were associated with intense macrophage aggregation. These changes indicate that the pathogenesis of tularemia is a result of the interdependency of the dose and virulence of the causative agent with the immune status of the host and that cellular immunity has a significant role in the response of the rat to tularemia.


Ultrastructure of Anaplasma marginale after freeze-fracture. Stained thin sections and freeze-fractured replicas of Anaplasma marginale-infected bovine erythrocytes were examined by electron microscopy. Freeze-fracture replication not only verified basic Anaplasma ultrastructure, but also allowed visualization of structures not previously reported. Because of the partial 3-dimensional views obtained with freeze-fracture replication, a new structure that appears as a protruding tip was discernible. Also, the surface of Anaplasma's limiting membrane was less granular than the fractured surface of host erythrocyte. A corrugated surface with a periodicity of 10.5 nm was seen when the limiting membrane was fractured.


Antigenicity of sodium carboxymethyl cellulose with or without 9-fluoroprednisolone acetate in the adult cow. Multiple intramuscular injections of sodium carboxymethyl cellulose with or without 9-fluoroprednisolone acetate were not antigenic in the cow, as measured by anaphylactoid response or delayed hypersensitivity.


A clinical comparison of CT1341, ketamine, and xylazine in cats. The new anesthetic agent CT1341 was compared to ketamine and xylazine in experimental and clinical situations with cats. Anesthesia with CT1341 was characterized by fast recovery times, good muscle relaxation, eyelid closure, occasional vomition, defecation, or urination during induction and recovery, generally smooth induction, and occasional hyperreflexive recoveries with much sneezing. The agent was moderately hypotensive, but caused little change in heart rate, central venous pressure, arterial pH, or blood gases.


Effect of aflatoxin on susceptibility of hamsters to Mycobacterium paratuberculosis. After oral administration of Mycobacterium paratuberculosis to hamsters, the organism passed the epithelial barrier of the intestine, and infection was established in the small intestine and mesenteric lymph nodes. The addition of aflatoxin to the ration of hamsters did not increase their susceptibility to M paratuberculosis but, rather, seemed to decrease susceptibility to the bacillus. Hamsters not treated with aflatoxin and infected with M paratuberculosis had higher bacterial counts in intestinal tract and mesenteric lymph node on necropsy than did infected hamsters that had been treated with aflatoxin. Aflatoxin-treated hamsters grew slowly, had an unthrifty appearance, and developed lesions of megalocytosis regardless of whether they were infected with M paratuberculosis.


Leukocyte response of bovine mammary gland to injection of killed cells and cell walls of Staphylococcus aureus. Injection of mammary glands of cows with heat-killed staphylococcal cells, staphylococcal cell walls, or distilled water induced leukocytosis. The magnitude of leukocytic response to staphylococcal antigens in cows of each treatment group depended on the extent of previous experience with staphylococcal cell materials. The 2nd intramammary injection produced greater reactions than did the 1st, and the 1st injection in cows previously parenterally vaccinated with killed cells in oil-water adjuvant produced responses comparable with those elicited by the 2nd intramammary injection in nonvaccinated cows. The implications that these changes have toward understanding the pathogenesis of, and immunity to, staphylococcal mastitis were discussed.


A field study of persistence of antibodies in California horses vaccinated against western, eastern, and Venezuelan equine encephalomyelitis. As a result of the continuing threat of Venezuelan equine encephalomyelitis (VEE), a study was made to determine if revaccination against VEE (TC-83 vaccine) was feasible and if revaccination could be incorporated into other routine vaccination practices. Of the horses given annual vaccination with bivalent western equine encephalomyelitis (WEE) and eastern equine encephalomyelitis (EEE) vaccine, 57% retained detectable serum-neutralizing (SN) antiboyd titers for VEE 18 months after the initial VEE vaccination was given. Of horses with no record of WEE-EEE vacinnation, 100% retained detectable VEE SN antibody titers over the same period. The VEE geometric mean titer was 25 times greater for horses not previously vaccinated against WEE-EEE than for horses given annual WEE-EEE vaccination at the time of VEE vaccination. In horses vaccinated against VEE 18 months previously, the geometric mean titer increased from 4 to 70 at 48 days after the intitial WEE-EEE vaccination. This increase indicated that similar antigenic factors for VEE are possibly present in bivalent WEE-EEE vaccine. In horses previously vaccinated against WEE-EEE and VEE, the best SN antibody response to VEE revaccination occurred when VEE vaccine was given simultaneously with the bivalent WEE-EEE vaccine. Of 150 serum samples tested by both the SN and the hemagglutination-inhibiton tests, agreement between positive reactions at greater than or equal to 1:10 was 70% for VEE, 81% for EEE, and 87% for WEE.


In vivo measurement of bone strain in the horse. Strain gauges were successfully bonded in vivo to the cranial, caudal, medial, and lateral aspects of the equine radium and tibia and to the dorsal, palmar, or plantar, medial, the lateral aspects of the metacarpus and metatarsus--all in the mid-diaphyseal region. Various activities were investigated, including walking, trotting or pacing, and standing up from anesthesia. The strain patterns showed that each stride produced a characteristic deformation cycle. The strains were measured and the axial loads were calculated as the horse performed certain activities. The tension band side of each bone was predicted from the results. The tension band sides of the metacarpus and metatarsus were the dorsomedial and dorsolateral aspects; for the radius and tibia, the tension band sides were the cranial and craniolateral aspects, respectively.


Occurrence of second and third instars of Gasterophilus intestinalis and Gasterophilus nasalis in stomachs of horses in Kentucky. The occurrence of 2nd and 3rd instars of Gasterophilus intestinalis and Gasterophilus nasalis was determined in 476 horses during the 22-year period from 1951 to 1973. Overall, G intestinalis infected 98.7% of the horses and averaged 168/horse; whereas G nasalis infected 80.7% of the horses and averaged 52/horse. Aggregate average total numbers for G intestinalis ranged from a low of 50 in September to a high of 229 in March, and for G nasalis, from a low of 14 in September to a high of 82 in February. Horses were infected by 2nd or 3rd instars of both species on a year-round basis. Differentiation between the instars provided insight into the dynamics of the infections. For G intestinalis, the data indicated (1) 2nd instars from the previous year's generation of flies continue to arrive in the stomach until April; (2) arrival of the current year's crop of 2nd instars starts in July; and (3) 3rd instars from the previous year's generation of flies are not voided in appreciable numbers until August, when numbers of the current year's crop of 3rd instars appear in the stomach. For G nasalis, the data indicated (1) arrival in the stomach of the current year's generation of 2nd instars starts in July and terminates in January and (2) 3rd instars from the previous year's generation of flies are voided over a period beginning in March and extending into August, when the current year's crop of 3rd instars begin to appear. Acquisition of infections of horses with G intestinalis is nearly a year-round process, except for April, because of the persistence of viable larvae in eggs for a prolonged period after development and fly activity has ceased in the fall. In contrast, infection with G nasalis is interrupted between December and May, because eggs hatch naturally after a short period of development, and fly activity ceases in the fall.


Efficacy studies with three formulations of cambendazole in horses. Treatment with 3 formulations of cambendazole (paste, pellets, and suspension) was compared with thiabendazole treatment in 181 Quarter Horses (females and intact and altered males) of different ages in 2 experiments. The mean output of strongyle eggs, as measured by eggs per gram of feces (epg), was reduced by at least 95% by the 3 formulations of cambendazole compared with pretreatment epg and epg in simultaneously nonmedicated horses. Eggs of Parascaris equorum were seen in 19 of the younger horses in experiment I. Parascaris eggs were not seen in postmedication fecal samples from 14 horses treated wtih cambendazole. Of the 5 horses treated with thiabendazole, 2 had postmedication Parascaris egg counts.


Suppression of in vitro lymphocyte transformation by serum from dogs with generalized demodicosis. Serum from dogs with generalized demodicosis suppressed the in vitro reactivity of peripheral lymphocytes to phytohemagglutinin. Suppression occurred with peripheral lymphocytes from normal dogs or from dogs with generalized demodicosis. Serums from dogs in remission were no longer suppressive. The data indicate that peripheral lymphoid cells obtained from dogs with generalized demodicosis do not respond differently in vitro to phytohemagglutinin than do lymphoid cells from normal dogs when either is cultured in the presence of serum from normal dogs.


Hypervitaminosis A in the dog.

Hypervitaminosis A in the dog. Toxic effects of excessive vitamin A and of excessive vitamin ADE were studied in 9 mixed Labrador Retriever pups. Clinical signs were loss of body weight, dullness, emaciation, roughened coat, evident pain in limb joints, and retarded growth. Radiologic changes were decreases in overall length and thickness of long bones, development of osteophytes, periosteal reaction, and premature closure of epiphyses. Pathologic changes were degenerative epiphyseal plate, hemorrhage and exostotic proliferation of periosteum, fatty liver, and microcalculi in kidney. Toxic effects of excessive vitamin A did not appear to be so great when it was administered as vitamin ADE.


Experimental hexachlorophene intoxication in young swine. Hexachlorophene (HCP) intoxication in swine was studied as a possible model of HCP poisoning in human beings. Swine were topically or orally given HCP each day, and observations were made on central nervous system function, hematologic measurements, serum chemical analyses, necropsy, microscopic examination of tissues, and concentrations of HCP residues in blood and tissue. Intoxication was observed in orally exposed swine, but the syndrome was not consistently produced in topically exposed swine. Signs and microscopic lesions were all related to dysfunction of the central nervous system, e.g., incoordination, paresis, and status spongiosus. Occurrence of signs and lesions, mortality rates, and concentrations of HCP residue were positively correlated with the dosage of HCP given.


Comparative electrophysiology and pharmacology of mammalian (including one marsupial) intercostal muscle biopsy preparations. Characteristics of minature end-plate potentials (MEPP) of isolated external intercostal muscle preparations of 7 mammalian species (dog, cat, pig, horse, cow, and goat) including 1 marsupial (opossum, Didelphis marsupialis) were determined with intracellular microelectrodes. Mean amplitude (+/- standard error of MEPP for all species was 0.60 +/- 0.06 mV, and the range was 0.28 mV (opossum) to 1.07 mV (pig). Amplitude was inversely correlated (P less than 0.01) with muscle fiber diameter which ranged from 93 mum (opossum) to 51 mum (pig). Mean values for rise time, half-decay time, and frequency of MEPP for all species were 0.88 +/- 0.07 msec, 1.89 +/- 0.16 msec, and 0.44 +/- 0.12 MEPP/second, respectively. Species differences among these measurements were not statistically significant. Resting potentials ranged from 64 mV (pig) to 75 mV (cow and opossum). Amplitude of MEPP was reduced significantly by d-turbocurarine (0.06 muM) only in preparations from the dog (P less than 0.01), pig (P less than 0.05), cow (P less than 0.01), and goat (P less than 0.01), suggesting species variations in sensitivity to this neuromuscular blocking agent. Frequency of MEPP decreased in the prescence of d-tubocurarine, but the change was not significant. The techniques utilized in this study and the results obtained will have application in evaluation of intercostal muscle biopsy preparations from these species when affected by myasthenic diseases.


Interrelationships between athyroetic and copper-deficient states in rats. Possible interrelationships of copper-deficient (copper-deficient ration) and hypothyroid (thiouracil treatment) states in rats were examined. Clinical signs, necropsy changes, and thyroxine concentrations were determined in 6 groups of rats treated as follows: group A--nontreated control; group B--thiouracil treated; group C--fed copper-deficient ration; group D--thiouracil treated and fed copper-deficient ration; group E--thyroid-stimulating hormone (TSH) treated; and group F--TSH treated and fed copper-deficient ration. Clinical signs occurred first and were most severe in the thiouracil-treated rats fed copper-deficient ration and included conformational changes and slower maturation, weakening of ear cartilage, middle ear changes (reflected by tilting of heads), and alopecia. Fatty infiltration of hepatic tissue was found in all rats fed copper-deficient rations, and considerable fluid retention occurred in rats fed copper-deficient ration and subjected to daily TSH treatment. Adrenal gland weights were 81% of control values (adjusted for body weight) in thiouracil-treated rats fed copper-deficient ration, and hypophysis weights were 114 and 154% of control values in thiouracil-treated rats and thiouracil-treated rats fed copper-deficient ration, respectively. Thyroid gland weights were 281% of control values in both thiouracil-treated rats and thiouracil-treated rats fed copper-deficient ration. Plasma thyroxine concentrations were markedly reduced (9% of control value) in thiouracil-treated rats fed copper-deficient ration. Thus, copper-deficient and hypothyroid states were considerably enhanced when the 2 existed concurrently, giving added meaning and necessity to close surveillance of trace mineral concentrations and thyroid gland status.


Attachment of Corynebacterium renale to tissue culture cells by the pili. One or more cells of Corynebacterium renale strains (serologic types, I, II and III), which possessed numerous pili, frequently were attached to BHK-21 cells, primary dog kidney cells, and primary rabbit kidney cells. The percentage of the cultured cells to which C renal cells were attached was about 70%. The percentage was less with cells of C renale possessing fewer pili, around 30%. After C renale was treated with the homologous anti-pili serum, the percentage of BHK-21 cells to which bacterial cells were attached was even less (22%). In electron micrographs, the pili of C renale were observed to attach themselves to the membranes of BHK-21 cells. The adhesive property of the pili of C renale to tissue culture cells was thus demonstrated.


Cardiopulmonary measurements in nonanesthetized, resting normal ponies. Cardiopulmonary measurements were determined in 19 nonanesthetized, normal ponies. Mean values for arterial pressure, pulmonary arterial pressure, cardiac output, heart rate, packed cell volume, and hemoglobin are reported, as well as acid-base determinations of arterial blood and cerebrospinal fluid. Respiratory function test data include total ventilation, respiratory rate, alveolar ventilation, oxygen uptake, and carbon dioxide output. The data compare favorably with the available data from previous reports on ponies. Because of large day-to-day variations in total ventilation, alveolar ventilation should be measured if ponies are used in the study of pulmonary function.


Internal parasites of Washington cattle. The occurrence of internal parasites in Washinton cattle was estimated. During the survey period in 1972 and 1973, more than 3,700 fecal samples from 29 herds and 4 feedlots, and viscera from 55 cattle were examined. The percentage of fecal samples with parasite eggs or oocysts from herds was as follows: oocysts, 77%; "strongyline" eggs, 44%; Nematodirus eggs, 3%; Moniezia eggs, 3%; Fasciola eggs, 2%; Trichuris eggs, 2%; and Dictyocaulus larvae, 1%. The fecal samples from feedlots contained principally strongyline eggs which varied markedly in numbers among groups of cattle in the lots. The predominant parasite in viscera was Ostertagia spp, which was recovered from all of the cattle examined. Other parasites identified in the survey were found less frequently in these examinations. Cattle in dairy and beef operations utilizing irrigated pastures were particularly prone to Fasciola infections, and more strongyline eggs were observed there than in fecal samples from other management systems. Seasonal fluctuations in numbers of strongyline and Fasciola eggs were pronounced.


Respiratory complications of overdose with sedative drugs. The records of 195 patients admitted to an intensive care unit with a diagnosis of sedative drug overdose were reviewed with special reference to respiratory complications. Endotracheal intubation with mechanical ventilation was required in 150 patients (77 per cent). Complications associated with mortality included difficult or traumatic intubation (P less than 0.001), initial hypotension (P less than 0.001), alveolar hypoventilation (P less than 0.02), and the presence of chest roentgenographic infiltrates (P less than 0.01). Infiltrates appeared on the chest roentgenograms of 72 patients (37 per cent) and were related to hypotension (P less than 0.05) and evidence of gastric aspiration (P less than 0.001). Eight of 9 deaths were due to progressive respiratory insufficiency, and bacterial pneumonia was documented at autopsy in 4 of 7 cases. High serum drug concentrations and the presence of shock or gastric aspiration on admission characterized the 9 patients (4.6 per cent) who died.


The role of the parasympathetic nervous system in the maintenance of chronic airway obstruction in asthmatic children. To evaluate the role of the parasympathetic nervous system in the mediation and maintenance of reversible airway obstruction in perennially asthmatic children, we measured pulmonary function in 18 patients before and after the administration of atropine sulfate aerosol. The bronchodilatory effects of atropine were compared with those of isoproterenol hydrochloride and placebo aerosols. Placebo aerosol did not change any of the pulmonary functions tested. Atropine and isoproterenol aerosols improved forced expiratory flows, airway resistance, and specific airway conductance significantly and to the same degree. Hyperinflation was significantly lessened by atropine, but not by isoproterenol. Because atropine is not a direct smooth muscle relaxant, but rather a selective blocker of cholinergically induced smooth muscle tone, any significant improvement in the lung function of chronically asthmatic children by atropine suggests that at least some of their reversible airway obstruction is induced and maintained by parasympathetically mediated bronchial smooth muscle constriction.


Blood studies in untreated patients with acute asthma. Arterial and venous blood samples were obtained from 23 patients with acute asthma before they received systemic or intermittent positive-pressure breathing therapy. Serum lactate, electrolyte, and enzyme concentrations, arterial pH, arterial PCO2, arterial PO2, peak expiratory flows, and 2,3-diphosphoglycerate concentrations were measured. The serum glutamic oxaloacetic transaminase, lactic dehydrogenase, and creatine phosphokinase activities were increased in 90, 81, and 38 per cent of the patients, respectively, and the individual values correlated poorly with the arterial PO2. In addition, there was a close correlation between the 2,3-diphosphoglycerate concentration and arterial PO2 (r = -0.75), indicating an active intraerythrocytic compensatory mechanism for enhancing O2 delivery operative in acute asthma.


Gas exchange in the pulmonary collateral circulation of dogs. Effects of alveolar hypoxia and systemic hypoxemia. The left main pulmonary artery was ligated in 7 fully grown dogs. This resulted in an enlarged pulmonary collateral (systemic) flow to the left lung. By collecting gas from each lung separately, gas exchange in the pulmonary collateral circulation was studied and compared to that in the normal contralateral side. Studies were done repeatedly during a period of 3 years. Compared to that in the preoperative period, the ligated (left) side showed a decrease in ventilation (42.5 to 34.5 per cent of total), a marked increase in wasted ventilation (0.30 to 0.55), and a marked decrease in O2 uptake (45 to 11.2 per cent of total) and CO2 production (27.5 to 15.3 per cent of the total). There were no changes in arterial blood gases or pH. A significant, sustained, systemic hypertension was noted in all dogs in which the left main pulmonary artery was ligated (190/120). The mean blood flow through the pulmonary collateral circulation of the left lung with the dogs breathing room air was estimated to be 94 ml per min. When the dogs were made hypoxemic by breathing 12 per cent O2 through the normal right lung, there was a marked increase in pulmonary collateral (systemic) flow to the contralateral side (194 ml per min). This resulted in an increase in O2 consumption (29.4 per cent of total) and CO2 production (23.1 per cent of total) of the left lung. When the dogs were given 12 per cent O2 to breathe through the ligated left lung, there was no change in arterial PO2. There was a significant increase in blood flow through the pulmonary collateral circulation to 136 ml per min. Because of the gradient of O2 between the blood flowing into the left lung and that present in the alveoli, there was a net production of O2 from the left lung of 4.5 ml per min. When the pulmonary systemic circulation participates in gas exchange, it appears to increase during hypoxemia as well as during alveolar hypoxia.


Appraisal of a new test: Between-technician variation in the measurement of closing volume. To determine the between-technician variation in the measurement of closing volume, 24 subjects were divided into 3 blocks of 8 subjects each. Each block was then tested by a pair of technicians. Each of the 3 technicians involved in the study tested 16 subjects. It was later necessary to reject the tracings of 2 subjects in one of the 3 blocks, leaving 22 for analysis. The N2 method of determining closing volume was used. The statistical analysis was performed separately on the following measures derived from the tracings: expired vital capacity, planimetry of the area under the curve, total lung capacity, closing volume as a per cent of expired vital capacity, and closing capacity as a per cent of total lung capacity. All tracings were assessed by each technician. Two separate analyses of variance were then carried out to determine, respectively, the components of variance in the administration of the test and in the interpretation of the tracings. Because different persons were able to administer the test the same way, it seems that closing volume poses no problem in administration, provided that instructions as to how to perform the test are closely followed. In the interpretation of the tracings, significant differences were found for all measures, except planimetry; however, not all of these have the same practical implications. Some tracings were found "difficult" to interpret and contributed more to the over-all variation than did others. When making use of a new test in a population study, the between-technician variation should be determined before the study is begun.


Human granulocyte lysosomal elastase activity using t-butyloxycarbonyl-L-alanine p-nitrophenyl ester and elastin-rhodamine as substrates. Polymorphonuclear leukocyte lysosomal esterolytic activity on the synthetic substrate, t-butyloxycarbonyl-L-alanine p-nitrophenyl ester was observed to correlate well with polymorphonuclear leukocyte granule elastase activity measured on the natural substrate, elastin, bound to rhodamine. In addition, the effect of highly specific, irreversible chloromethyl ketone elastase inhibitors on leukocyte lysosomal elastase activity was similar, using t-butyloxycarbonyl-L-alanine p-nitrophenyl ester or elastin-rhodamine as substrate. Whether polymorphonuclear leukocyte lysosomal granules contain two different enzymes, a true elastase with esterase activity and a similar esterase without elastase activity, as found in the human pancreas, is, as yet, unknown. Both enzyme activities have been identified in isoenzymes of purified human polymorphonuclear leukocyte lysosomal elastase. The correlations observed between the two enzymes, if present in polymorphonuclear leukocytes, are sufficiently strong to use the esterase assay for clinical purposes.


The effects of dehydration on the radiologic and pathologic appearance of experimental canine segmental pneumonia. In an attempt to determine whether dehydration (intravascular fluid depletion) alters the radiologic or histologic picture of segmental Streptococcus pneumoniae pneumonia, we induced pneumonia in 2 groups of dogs, group 1 (normally hydrated) and group 2 (dehydrated). Five hours after the intrabronchial instillation of a brain-heart-Streptococcus pneumoniae mixture, all chest radiographs of dogs in group 1 and 2 were compatible with segmental alveolar pneumonia. Histologic lung sections obtained as early as 2.5 hours after infusion of the brain-heart-Streptococcus pneumoniae mixture revealed intra-alveolar edema with a minimum of leukocytes. By 24 hours after infusion, both groups showed marked intra-alveolar collections of edema fluid, fibrin, and leukocytes. We conclude that in a canine model, moderate dehydration has no effect on the radiologic or histologic features of Streptococcus pneumoniae pneumonia.


Bronchial obstruction by incorporation of aspirated vegetable material in the bronchial wall. The bronchoscpie, cytologic, and histologic features of a foreign body of vegetable origin embedded in the wall of a bronchus are described. The utility of bronchial biopsy in the diagnosis of this obscure cause of bronchial obstruction is emphasized, and the mode of treatment described.


Sporotrichoid Nocardia brasiliensis infection. Response to potassium iodide. A lymphocutaneous infection due to Nocardia brasiliensis occurred in a Maryland gardener. This infection responded rapidly and completely to potassium iodide therapy.


Coccidioides immitis. A rare cause of pulmonary mycetoma. Coccidioides immitis occurring as a fungus ball within a chronic pulmonary cavity has previously been reported twice and must be rare. We report a mycetoma composed of both spherule and mycelial forms of Coccidioides immitis, proved by culture and histologic sections. Fungus ball due to Coccidioides immitis is a logical progression from mycelia seen in the cavity wall in the active pulmonary coccidioidal lung cavity.


Lack of effect of rifampin on the antibody response to a viral antigen in patients with tuberculosis. Twenty-three volunteer patients with pulmonary tuberculosis were studied for the effect of rifampin on humoral immunity. The patients were matched for age and body weight with other patients not on rifampin treatment. Antibodies to influenza virus were measured 18 days after immunization. At the clinical doses used and for the periods of treatment between 3 and 8 months no difference in humoral immune response was observed between patients treated with rifampin and the control subjects. All but one treated patient showed an increase of antibody titers after vaccination.


Pulmonary calcification in chronic dialysis patients. Clinical and pathologic studies. A prospective study of 31 chronically hemodialyzed patients was made to investigate the incidence and pathology of pulmonary calcification and the relation of the latter to ventilatory function. Fifteen of the patients have died thus far; 9 had evidence of lung calcification. The lesions occurred predominately in alveolar septa and were associated with varying degrees of fibrosis and alveolar septal thickening. Only one patient had X-ray evidence of calcification. An X-ray diffraction analysis showed a predominant pattern of whitlockite (CaMg)3(Po4)2 in deposits. Patients with the severest pulmonary calcification had abnormalities of vital capacity, carbon monoxide diffusion, and Po2. Serum calcium levels were slightly higher in patients with calcification, but there was no measurable association with the duration of dialysis, serum phosphorus, calcium X phosphorus product, magnesium, bicarbonate, or arterial pH. These data show that pulmonary calcification occurs with high frequency in patients undergoing long-term hemodialysis and that such lesions are associated with restrictive and diffusion ventilatory defects.


Adult thyroid cancer after head and neck irradiation in infancy and childhood. We report the surgical-pathologic findings in 15 adults who had a history of irradiation of the head and neck in childhood. These patients we selected for thyroid surgery because of a "cold" area or areas detected on 99mTc thyroid scan, with or without palpable thyroid abnormalities. Eight of the fifteen patients had thyroid cancer, and 3 had atypical adenomas. We found multiple lesions in 12 patients. Macroscopic and microscopic malignancy in a location different from the cold area or areas occurred in 5 of the 8 cancer patients. In vitro of these findings, we recommend that adults who received irradiation to the head and neck in childhood and who have been found to have an abnormal thyroid scan or thyroid examination, or both, have a total thyroidectomy...


Management of anaerobic infections.

Management of anaerobic infections. Anaerobic infections are reviewed with emphasis on management. Most anaerobic pulmonary infections respond to penicillin G, even when Bacteroides fragilis (penicillin-resistant) is present. Clindamycin is suitable in penicillin-sensitive patients. Intraabdominal infections have a complex flora usually involving anaerobes, especially B. fragilis. It is desirable to use antimicrobial therapy to cover potential pathogens of all types. Surgical drainage and debridement are extremely important considerations. Anaerobic bacteria were found in 72% of 200 patients with female genital tract infections and were the exclusive isolates in 30%. Surgical therapy is primary, but antimicrobial and anticoagulant therapy are also important. A variety of soft-tissue infections involve anaerobes. Surgery is the major therapeutic approach. Anaerobic endocarditis is uncommon but may be difficult to manage. Chloramphenicol is ordinarily the drug of choice for brain abscess. New antimicrobial agents, which are under investigation and are promising, include new penicillins, new cephalosporins, new tetracyclines, and metronidazole.


Study of nitrogenase activity in the mycorrhizal rhizosphere of pine and oak. No nitrogenase activity was observed in the rhizosphere of pine and oak having mycorrhizal associations. It is concluded that mycorrhiza did not play any role in stimulating the nitrogen fixing system. More work with pine and oak mycorrhiza by isotopic method is suggested.


[Interest of some additional biochemical tests for the classification of "Bacillus" (author's transl)]. In addition to previous taxonomic work, eight biochemical tests have been applied to the study of 580 Bacillus strains belonging to 22 species. The attack of chitin, melibiose and amygdalin can be used for the differentiation of some species. It is the same with most of the enzymes studied here, although Tween-esterase and DNase are often present in the majority of the isolates. RNase is still more frequent, being found in nearly all the strains. On the other hand, arginin-dihydrolase appears to be very rare and ornithin-decarboxylase seems always absent.


[Nutrition and taxonomy of "Enterobacteriaceae" and related bacteria. I. Technical procedure for auxanograms (author's transl)]. Study of nutritional capacities of 186 strains of Enterobacteriaceae or related bacteria has been undertaken for a taxonomic purpose. In this paper, the auxanographic method is described and discussed. Unlike other techniques in which the medium is supplemented by each substrate, at fixed concentration, the method described here consists in achieving diffusion of the 146 substrates tested as sole source of carbon and energy, in a medium without other energetic substrate. The results of these tests will be described in a further paper.


[The enzymatic hydrolysis of cell wall applied to yeasts classification (author's transl)]. The rigid structure of yeast cell wall may be a taxonomic criterion. Using the Helix pomatia juice (with mercaptoethylamine hydrochloride) as a polyenzymatic system, we have always obtained protoplasts from ascomycetous yeasts and never from basidiomycetous yeasts tested. Then, we have applied this enzymatic analysis to the Fungi imperfecti yeasts and, according to this test, separated genus looking like basidiomycetous behaviour: Trichosporon, Pityrosporum, Rhodotorula, Cryptococcus and non fermentative Candida (group II). Oppositely, we have put together the Fungi imperfecti yeasts looking like ascomycetous behaviour: Kloeckera, Trigonopsis, Brettanomyces and fermentative Candida (group I). With the second lytic system made of mercaptoethylamine-HCl and beta-(1-3)-D-glucanase, we have selected ascomycetous yeasts giving protoplasts: Saccharomycoidea with genus Saccharomyces, Kluyveromyces, Pichia, Hansenula, Citeromyces, Debaryomyces; we have joined Saccharomycodes and Hanseniaspora to this second group. The other ascomycetous yeasts studied did not give protoplasts with the definite lytic system made of purified beta-(1-3)-D-glucanase and thiol. These results seem to demonstrate that the structure of cell wall can act as an important taxonomic criterion.


[An intracellular polysaccharide involved in sporulation of "Clostridium butyricum" I. Cytology, production and preliminary enzymic analysis (author's transl)]. Free glucose concentration and polysaccharide production in Clostridium butyricum cells have been studied with an enzymatic method. Results indicated a substantial decrease in intracellular glucose content simultaneously with a production of polysaccharide prior to the end of exponential growth. Then the polysaccharide accumulated rapidly to reach a maximum just before the first refractile spores appeared, and it decreased by 50% during the last stages (V and VI) of sproulation. Electron micrographs of ultrathin sections have demonstrated that most of the polysaccharide is located inside the mother cell cytoplasm as large granules when the remaining is dispersed within the spore cytoplasm beginning during stage III of the sporulation. Overall results showed that production and use of C. butyricum polysaccharide were closely related to sporulation. The isolated polysaccharide exhibited poor water solubility, iodine spectrum with a lambda max at 545 nm and 72% beta-amylolysis. Total hydrolysis occurred with amyloglucosidase indicating an alpha-glucan containing alpha(1 leads to 4) and alpha(1 leads to 6) glucose linkages. The debranching from its beta-dextrin limit by pullulanase revealed the presence of a glycogen like-type structure with some external chains which are longer than those of a normal glycogen. This glycogen arrangement appeared to be of clusters linked by linear chains at least as long as the longest external chains.


[Isolation of water vibrios in Greece (author's transl)]. "Water vibrios" were isolated from 3 superficial wells in the province of Attika, from 3 rivers situated at about 300, 180 and 100 km North-West of Athens, and from 4 samples of sea water from the seashore South of Athens.


[On the taxonomy and physiology of bacteria utilizing hydrocarbons in the sea (author's transl)]. Using mineral media with gas oil as sole carbon source, 191 bacterial strains were isolated from the costal area of Marseille. These strains were attributed to Achromobacter, Alcaligenes, Pseudomonas, Acinetobacter and Arthrobacter genera. Amongst isolated strains there was a predominance of the Alcaligenes-Achromobacter group over others genera. Growth and respiratory activity of 5 strains were studied on hexadecane and acetate. Respiratory activity on hexadecane of 32 strains cultured on acetate has been measured. These strains could be placed in two groups. The group 1 shows an immediate respiratory activity which is not abolished by chloramphenicol. The group 2 presents either an immediate or a delayed respiratory activity which is always abolished by chloramphenicol. Maintenance or suppression of respiration by chloramphenicol is a character which is homogenously distributed amongst the species.


[Energy metabolism in the liver of rats fed a diet contaminated with dithiocarbamates]. Young male rats, Wistar CF strain, weighing about 100 g, were fed during 14 days with a well-balanced diet, but containing either 275 p.p.m. nabame, either 600 p.p.m. thirame or 3 600 p.p.m. zinebe. The animals given the non-contaminated diet were the controls. On the evening before the experiment, they were all fasted and some of them, forced to walk during 18 hours in a restraint wheel. On the morning of the experiment, some of the rats which have not been working were placed in a cold room at + 4 degrees C, and some others were given an i.p. injection of 2,6 g glucose per kg body weight. The animals were then killed, those that received the glucose treatment 30 mn after the injection, the cold-exposed rats 90 mn after the beginning of their exposure. The redox and energy potentials of the liver tissue were determined after the enzymatic assay of the following liver metabolites : lactate, pyruvate, beta-hydroxybutyrate, acetoacetate, ATP, ADP, AMP, inorganic phosphate. The thirame group rats had the smallest body weight and the lowest food intake. All the pesticides-exposed animals has a higher liver weight than predicted by their body weight. The pesticides-containing diets decreased liver lactate concentration and the lac/pyr ratio. Thirame was the more efficient and it partly impaired the glucose induced increase of the cytoplasmic redox potential, as estimated from the variation of the lac/pyr ratio. The pesticide-containing diets also lowered the liver concentrations of beta-hydroxybutyrate, acetoacetate, and their ratio. Last the pesticides, which but slightly modified the liver contents in adenine nucleotides and inorganic phosphate in the fasting state, increased the ATP fall following cold exposure and decreased the net ATP synthesis produced by glucose administration. The thirame diet was the more efficient in our experimental conditions, the zinebe diet the least one. It was concluded in our discussion that dietary dithiocarbamates either induced a hyperthyroidic status in the animal, or acted themselves as thyroxin-like compounds, because the liver metabolism was more directed towards heat production than towards that of chemical energy available for syntheses.


[Metabolism of L-ascorbic, L-dehydroascorbic and 2,3-diketo-L-gulonic acids during a short duration fast in guinea pigs]. Tricolor variety of guinea-pigs, two or three months old, received, without sex distinction L(+)-ascorbic or L(+)-dehydroascorbic acids intraperitoneally injections as 20 mg p. 100 by weight, three or twenty-four hours after starting a forty-eight hours fast. Ascorbic, dehydroascorbic and 2,3 diceto-L-gulonic acids are estimated by the Roe, Mills, Oesterling and Damron differential 2,4-dinitrophenylhydrazin method in whole blood, urines, kidneys and liver. Food absorption during twenty-four hours after the end of the forty-eight hours fast is not suffisant for guinea-pigs regain first state, during this time, especially in their kidneys and liver. Three hours after the beginning of the fast, urinary excretion of the injected acid increases during the first twenty-four hours of fast; at the end of the forty-eight hours fast their kidneys are deficient in ascorbic acid. Twenty-four hours after the beginning of fast, urinary excretion of ascorbic, dehydroascorbic and 2,3-diceto-L-gulonic acids rises importantly, especially when L-ascorbic acid is injected; it is only the quantity of ascorbic acid which increases in their kidneys and liver, its level being higher in their liver. L-dehydroascorbic acid is utilized immediately. L-ascorbic acid is distributed slowly, stored in a reduced form and it prepares the animals to face a prolonged fast. When the animals are injected three hours after the fast begins, it will be protected for forty-eight hours; if it is injected twenty-four hours after the beginning of fast, the animal will be better prepared to face a prolonged state of stress or a fast lasting more than forty-eight hours.


[Immunosuppressive effect of ethionine in rats. Resistance of this effect to methionine, tryptophan, ATP, adenosine and uridine]. One hundred eleven male adult rats of a pathogen-free Sherman or Charles River strain were divided into 3 series. Each of them contained non-treated controls and rats treated with intraperitoneal (i.p.) injections of DL-ethionine (E) [75 mg/d p. 100 g] for 6 weeks (series 1) or for only 2 weeks (series 2 and 3). Series 1 and 2 included also rats injected simultaneously with E and DL-methionine (68.4 mg/d p. 100 g). In the series 2 there were also groups receiving at the same time E, ME and tryptophan (5 mg/d p. 100 g) or E, Me and ATP (1.65 mg/d), and in the series 3, groups were injected with E + adenosine (31.2 mg/d p. 100 g) and (or) uridine (284 mg/d p. 100 g). All animals were immunized i.p. 1 week before killing with sheep red blood cells (SRBC): either 2.4 X 10(9) SRBC p. 100 g without adjuvant (series 1 and 2) or 1 X 10(9) SRBC with Freund's adjuvant added (series 3). Rosette-and plaque-forming cells (RFC and PFC) were counted in the spleen, and titers of serum hemagglutinins and hemolysins were determined with separation of 2-mercaptoethanol-resistant IgG from non-resistant immunoglobulins. E provoked within 2 weeks a drastic inhibition of the immune responses: drop in the RFC and PFC levels p. 10(6) (approximately 2900 leads to approximately 320 and approximately 415 leads to 40 respectively, in the study 3), and significant decrease in the serum antibody titer, especially IgG. Addition of Me still amplified the immunosuppression. Supplementation with tryptophan, ATP, adenosine and (or) uridine was also ineffective. Though not displaying any immunoprotective potency, Me partly neutralized the non-immunological effects of E: arrest of the body growth and involution of lymphoid organs and male genital organs, particularly apparent after 6 weeks of treatment. In conclusion, the ethionine-induced immunosuppression does not result from a metabolic exclusion of labile methyl groups or from an acute ATP deficiency due to an excess trapping of adenine as S-adenosyl-ethionine. Lack of pyrimidines or tryptophan must also be discarded. On the other hand, the possibility of maintaining the immunosuppressive activity of E, while reducing the toxicity of this compound, by addition of Me deserves to be emphasized.


[Maillard reaction. 10. Effects of premelanoidins on reproduction in rats]. The early soluble premelanoidins are obtained by a wet heat treatment (1 hour at 90 degrees C) of isomolecular quantities of glycine and glucose. It is know that these products decrease the nitrogen digestibility and the biological value of the diet. These premelanoidins are used as a well-balanced ration for the female rats at the rate of 2.15 g of degraded nitrogen by kg of diet. They disturb the reproduction phenomena: -- the fertility of the female is of 56 p. 100 instead of 76 p. 100 in the control females; -- the still-born youngs are twice more numerous and the intrauterine resorptions five time more numerous with the premelanoidin diet than with the control diet; -- the living youngs of experimental litters are 30 p. 100 less important than control litters. Yet, they have an lower weight at the birth and also at the end of the lactation phase. The damages induced by early premelanoidins can be imputed to an antinutritional character. of these substances, or -- more accurately -- to a nitrogen inefficacy that they could provoke. The premelanoidins have not a significant effet on the liver weight, but hypertrophy the kidneys and principally the caecum. The premelanoidin metabolism seems difficult and is similar to the lactose one.


Effects of diet and cold acclimation on lipid composition of rat interscapular brown adipose tissue. The effects of diet and of cold acclimation on lipid composition of interscapular brown adipose tissue (BAT) were studied in rats. Three groups of animals were acclimated for 20 weeks to 28 degrees C (controls), 5 degrees C (CA) or to a daily fluctuating temperature (Cy). They received either normal fat (5 p. 100 lipids) [NF] or high fat (26 p. 100) [HF] diets. Cold acclimation increased the tissue weight and its protein, phospholipid, free fatty acid and cholesterol content. It decreased the total lipid proportion in the tissue. HF diet led to an increase in lipid content and to a decrease in the protein content only in control and Cy groups. The mean chain length of triglyceride or phospholipid fatty acids was increased by HF diet and cold acclimation. The proportion of unsaturated acids was not changed in cold acclimated rats, but the amount of arachidonic acid bound to phospholipid was significantly increased. It is concluded that the total amount of lipid in the diet acts on the synthesis of BAT lipids. The cold dependant changes in lipid composition which are similar but less important in cyclic cold acclimation than in constant cold adaptation seem to be proportional to the increase in the tissue energy metabolism.


[Lipid metabolism in rats fed a diet rich in various carbohydrates. I. Results after I.P. injection of lipogenic precursors]. Male rats, Wistar CF strain, weighing 120 g at the beginning of the experiment, were fed during 7 months with one of the following diets, containing 72 p. 100 (w/w) carbohydrate: starch, fructose, glucose and sucrose. These diets were about 18% (w/w) in protein content and were conveniently balanced with respect to vitamins and mineral nutrients. After an overnight fast, the animals received by the i.p. way, 30 mn before their killing, one of the following lipogenic precursors: glucose (considered as the control treatment), fructose ethanol or acetate, thus forming 16 experimental groups. In their liver, heart and blood were determined the concentrations of 6 lipid compounds: triglycerides, non-esterified fatty acids, free, esterified and total cholesterol, phospholipide. a. The sucrose diet gave the heaviest animals, with a liver and heart which were the richest in triglyceride content. They had also the highest liver and blood cholesterol, but their blood phospholipid was the lowest. The starch diet also increased, compared to the glucose diet, liver and heart triglycerides and liver cholesterol. As regards the fructose diet, it had the same effects than the sucrose one in elevating liver weight, blood triglycerides and cholesterol; conversely, it lowered liver and chiefly heart triglycerides and increased blood phospholipide. The glucose diet was for almost all parameters the one which displayed the lowest values. b. Relative to the glucose injection, other ones increased liver triglycerides, cholesterol and phospholipids and non-esterified fatty acids of the 3 assayed tissues. We observed that some differences between the effects of two given injections varied according to the previous diet, e.g. the sucrose-fed rats had more liver triglycerides and cholesterol, more heart and blood cholesterol after i.p. fructose than after i.p. glucose, which was not the case for the starch-fed animals. The importance of liver esterification reactions, which are increased with a long-term administration of a fructose-containing diet, is emphasized in the discussion. However dietary fructose could not be able to display its lipogenic effets in the absence of dietary glucose and that is why sucrose is more efficient than glucose in promoting a net lipid synthesis.


Cryotherapy of proliferative sickle retinopathy. Part I. Single freeze-thaw cycle. Transconjunctival cryocoagulation was used to treat proliferative sickle retinopathy in 6 patients. Ten eyes were treated with a single freeze-thaw cycle and were observed for 3 to 18 months. Nine of 13 (70%) neovascular lesions were completely closed without occluding major vascular trunks, while the remaining 4 (30%) showed marked attenuation.


Macular hole following topical pilocarpine. A unique case of macular hole following the instillation of pilocarpine is presented. Miotically induced vitreoretinal traction was postulated as the mechanism for hole formation.


Toxic maculopathy. Part I. A result of quinine usage. A group of 16 heroin-dependent patients undergoing voluntary detoxification were studied to detect "toxic" quinine amblyopia." No true "amblyopia" was found but 8 of 16 (50%) patients had positive Amsler grid tests. This was called "toxic maculopathy." A control group of US Army reservists showed 1 of 25 (4%) to have positive Amsler chart tests. The difference between the two groups is significant and probably represents a chronic, low dose quinine macular toxicity. The strongly suggested relationship between chronic low doses of quinine and subtle macular changes led us to create a second study to document objective abnormalities. This study is presented in Part II.


Cysteine in corneal ulcer: part I. An experimental study. This study was undertaken to see the healing effect of cysteine in corneal ulcer of traumatic origin (nonalkali burn). In both eyes of 11 albino rabbits, central corneal ulcers in a 5 mm diameter area were produced. Cysteine drops of 0.1 M were instilled in one eye while placibo (normal saline) drops were used in the other eye. This work was carried out as a blind study. The result of present work showed that the average rate of healing was enhanced with cysteine--it was 74 hours with cysteine while with placibo (normal saline) 98.7 hours. The statistical analysis of the present observation, ie, p and t value was highly significant.


The effect of light deprivation on the B-wave input-output function. Adult cats were subjected to monocular light deprivation for periods ranging from 12 to 20 days. Deprivation resulted in a significant decrease in the slope of the dark-adapted b-wave amplitude-luminance (input-output) function, as well as what appears to be a truncatee amplitude-luminance function, it is exaggerated in the light-deprived eye.


Some clinical aspects concerning microtropia. The present study is concerned with the specific nature and the multiformity of microtropia, which is characterized by unilateral convergent small angle (under 10delta) strabismus with amblyopia and abnormal retinal correspondence. Three types of microtropia may be distinguished: Type I: Showing a positive cover test, amblyopia and abnormal retinal correspondence. Type II: Showing in addition to the above, heterophoria. Type III: Showing a negative cover test, a positive 4delta base-out prism test, amblyopia due to anisometropia, eccentric fixation and harmonious abnormal retinal correspondence, where the angle of anomaly is equal to the angle to eccentricity. For the prevention of microtropia all children aged under 4 and irrespective of the presence of any symptoms should undergo an eye examination. At a more advanced age the diagnosis of this clinical entity is of importance chiefly from a prognostic point of view, because it permits us to avoid futile efforts at correcting visual acuity by means of covering up to sound eye.


Present surgical approaches to vitrectomy. The present techniques of vitrectomy employ the open sky method (anterior approach) which is usually performed using cellulose sponges and blunt scissors, or the pars plana approach (transcleral approach) which uses a vitreous nibbler. The indications for each technique and the techniques themselves are briefly discussed. In addition, mechanical vitreous nibblers used for the open sky approach are reviewed.  The results of present techniques of anterior vitrectomy are better than the results obtained when no vitrectomy was performed for vitreous loss. The results of pars plana vitrectomy for certain pathologic entities compare favorably to results obtained in vitrectomies performed during keratoplasties. Newer surgical approaches to the vitreous and other technical advances promise to greatly improve the results of vitreous surgery.


Difficulties in the phaco-emulsification of soft senile cataracts. Several difficulties arise when a surgeon embarks upon the Kelman-Phaco-Emulsification method of cataract extraction. The most common but yet the least expected are technical difficulties with a soft cataract. A step by step, illustrated method of avoiding the disasterous pitfalls is outlined in order to aid the novice or occasional surgeon using phaco-emulsification on the "ideal" candidates for this operation.


Limbal trepanation: fourteen years' experience. Limbal trepanations on 264 eyes were observed postoperatively for 6 months to 14 years. Excellent results were obtained in patients over 35, particularly those in the 50 to 70 age group, with chronic open angle and chronic angle closure glaucoma. Results were poor in younger age groups, and in those with secondary glaucoma, especially where it was associated with inflammatory disease.


The absorbable sutures in cataract surgery. An unusual case of cataract extraction is presented in which 6-0 chronic catgut sutures persisted over 2 years and 8 months and caused repeated attacks of conjunctival inflammation and iritis. This along with the discussion in this paper shows that despite is other advantages the chronic catgut is not a suitable suture for routine use in cataract surgery. However, because of the distinct advantages it is suggested that its use be limited to the selected cases, eg, in nervous persons where difficulty in removal of sutures is a problem.


Physiology and pathophysiology of the lower esophageal sphincter. The physiologic factors controlling lower esophageal sphincter (LES) function are interrelated in a complex fashion and include the autonomic nerve supply, gastrointestinal hormones, and specific characteristics of the circular smooth muscle at the esophagogastric junction. It might be expected that a defect in any of these three controlling mechanisms would result in a clinically recognizable symptom complex. Abnormalities with either high or low LES pressure have been shown to relate to these specific aspects. Studies of the effects of various foods and other agents which decrease or increase LES pressure are of therapeutic interest in relating to patients with reflux symptoms. Decreases in LES pressure occurring after fat ingestion may explain a mechanism for many cases of fatty food intolerance. Pressure decreases after chocolate ingestion, after smoking, and after alcohol all have strong therapeutic implications in patients with chronic heartburn. Gastric alkalinization will increase pressure for up to one hour in patients with basal sphincter hypotension and reflux symptoms. Recent studies with drugs that work through the cholinergic mechanism have important therapeutic considerations. Anticholinergic agents produce definite decreases in LES pressure and are to provided in treatment of patients with reflux symptoms. On the other hand cholinergic drugs such as bethanechol have been shown to increase LES pressure in normal subjects and in patients with chronic sphincter incompetence. Recently, a double-blind therapeutic trial with bethanechol in patients with chronic heartburn has indicated that this drug, when given on regular basis, is an effective adjunct to therapy in these patients.


Early lung cancer detection and localization. The Mayo Lung Project was established to develop and evaluate a screening program for early lung cancer in high-risk subjects. Men who are more than 45 years of age and who smoke one package of cigarettes or more daily are screened by the use of thoracic roentgenograms, three-day pooled sputum cytology, and lung health questionnaires at four-month intervals. These data are compared with data from similar subjects screened only on entry into the project. During the past three years, 34 patients who had no roentgenoraphic evidence of lung cancer were identified and examined because of carcinoma cells in sputum. Of these 34 patients, 27 have had bronchoscopic localization of their tumors and definitive treatment and 3 had upper respiratory tract neoplasms and also have been treated. Of the remaining four, one patient died suddenly after myocardial infarction and three patients have not had localization or treatment because of other severe complicating medical problems. Localization of roentgenographically occult lung cancer is reliable by the use of bronchofiberoscopy and meticulous, thorough sampling from the tracheobronchial tree. A search must be made for upper airway cancers in the same high-risk population, and the possibility of second primary bronchogenic tumors also must be considered. Although follow-up is short, 22 of the 27 treated lung cancer patients were found with stage I disease. The outlook for 19 of these 27 is encouraging an average of 16 months after surgical resection.


Clinical experience with pleuroscopy utilizing the bronchofiberscope. The gas sterilized bronchofiberscope has been utilized as a pleuroscope for visual exploration of the pleural space and forceps biopsy of abnormal lesions in 16 patients with undiagnosed pleural disease. The instrument was inserted through a small (1-2 cm) incision. Aspiration of pleural fluid and instillation or aspiration of air to produce a controlled pneumothorax are easily accomplished through the instrument's suction channel. In eight patients with undiagnosed pleural effusion, biopsy of visualized nodules established the diagnosis of carcinoma. Three patients with bronchogenic carcinoma and pleural effusion had no pleural metastases at pleuroscopy which was confirmed in two patients who had thoracotomy and lung resection. Parenchymal subpleural nodules of metastatic carcinoma were confirmed by pleuroscopic biopsy in one patient. Biopsy via the pleuroscope was unsuccessful in two patients, one with pleural fibrosis, probably related to asbestosis, and one with mesothelioma. Both required open surgical biopsy of the pleura. There has been minimal patient discomfort and no serious complications.


Unexpected radiographic findings related to foreign bodies. In two asymptomatic patients, routine preoperative radiographs revealed three pennies in the esophagus in one patient and a spring from a toy in another patient. In contrast two symptomatic patients, one with a flip-top cap from a beer can in the esophagus and the other with a piece of photographic film in the larynx, had negative findings on their radiographs. Salient points of the cases are that diagnosis can be delayed by inadequate history, misinterpretation of signs and symptoms, and unexpected radiographic findings. Special attention should be focused on the flip-top cap ingestion case. Sixty-five percent of 677 people polled have placed flip-top caps into full cans. Fifty-two people almost swallowed a flip-top cap. Otolaryngologists should be alerted about the radiolucency of this metallic foreign body, and the general population should be discouraged from this dangerous practice.


Special new low resistance to flow tube and endotracheal tube adapter for use during fiberoptic bronchoscopy. This paper describes endotracheal tubes and adapters which are designed specially for fiberoptic bronchoscopy; the tubes are designed in such a way that they are wide at the upper part but are narrow and thin walled in the part of the tube which goes through and below the cords. By designing tubes in this manner, the resistance to flow of gas through the tube when the fiberoptic bronchoscope is in place is very much reduced and the safety of the whole precedure is enhanced. A special adapter for use under these circumstances is also described which utilizes a commercially available swivel tracheostomy adapter with a special silicone diaphragm fitted onto the top to enable the fiberoptic bronchoscope to be placed through the diaphragm and keep a sealed system. A plug is available for the hole in the diaphragm when the fiberoptic bronchoscope is not being  used. Clinical and laboratory data show that these pieces of equipment perform the function for which they were designed.


Evaluation of major airway lesions using the flow-volume loop. The flow-volume (FV) loop is another way of representing spirometric data from combinations of forced expiratory and forced inspiratory vital capacity breaths. The FV loop is of use in identifying, and often localizing, lesions of the larynx and the trachea (down to the carina). Three general patterns have been recognized. When the lesion behaves in a fixed fashion (as might occur with an artificial orifice), maximal expiratory and inspiratory flows are almost equally compromised. This results in a rectangular FV loop, irrespective of whether the lesion is located intrathoracically or extrathoracically. When the lesion behaves in a variable fashion, two distinct patterns are seen, depending on the location of the lesion (intrathoracic or extrathoracic). The variable lesion acts as a fixed lesion during one phase of forced respiration only. The extrathoracic variable lesion results in a predominant reduction in forced inspiratory flow, with little effect on expiratory flow, whereas the intrathoracic variable lesion produces a characteristic reduction in expiratory flow. These patterns reflect the transmural forces existing at the site of the lesion.


Hyoid autograft repair of chronic subglottic stenosis. A previously unreported surgical technique has been evaluated for the correction of chronic subglottic (cricoid) stenosis. The principle of skeletal support as the primary means of repair was examined. Severe stenoses were created in sixteen adult, mongrel dogs. One to three months later a hyoid bone autograft on a sternohyoid muscle pedicle was employed for repair. The dogs were sacrificed at regular intervals from two weeks to six months. The majority of the animals maintained a widely patent lumen after repair. Vocal cord mobility remained normal in every case. The results are illustrated by photographs and histologic sections. This study convincingly demonstrates a successful surgical technique for correcting a most difficult laryngeal lesion.


Postgraduate surgical training in Makerere. The crystallization of ideas. The need for the postgraduate training of medical practitioners in the environment in which they will eventually work is well recognized, and in 1967 it was felt that the University of East Africa had reached sufficient maturity to undertake postgraduate instruction and certification in medicine. This paper describes the evolution and the present structure of the MMed (Surgery) degree at Makerere.


An antibiotic policy for surgical patients. This paper offers guidance on antibiotic usage in surgical patients. A policy is outlined rather than the comprehensive coverage of every surgical situation. The principles of antibiotic prescribing are given. The antibiotics available and their routes of administration are reviewed. Indications for the prophylactic and therapeutic use of antibiotics are discussed. Factors causing the failure of antibiotic therapy are considered in brief.


A method of removing starch powder from surgeons' gloves. A method of washing the outside of surgeons' gloves with cetrimide is described. Experiments on animals showed that the method resulted in a considerable reduction in the amount of intraperitoneal contamination by starch powder.


Perforated appendicitis--lavage or drainage? A comparison was made regarding the observed frequency of intraperitoneal complications between two groups of patients operated upon for perforated appendicitis during a 5-year period (1968-73). The two groups, corresponding to two different general surgical departments at the same hospital, were given different forms of adjuvant treatment. The first group (78 patients) received postoperative intraperitoneal lavage, with antibiotics added to the lavage solution. In the other department (77 patients), the peritoneal cavity was drained postoperatively. No lavage was performed in this group, but antibiotics were given systemically. Sixteen patients in the drainage group developed intraperitoneal complications, as compared with 5 in the lavage group.


Fat embolism in severely injured patients. Forty-five patients with severe blunt injuries were examined during eight posttraumatic days. At random, 14 patients were given three doses of methylprednisolone intravenously; 10 mg/kg at 8-hour intervals. Fat embolism syndrome was diagnosed in 13/45 patients, only one of whom had received corticosteroid (p = 0.03). Shock, acidosis and elevated plasma catecholamines showed no correlation with the occurrence of fat embolism syndrome. Platelet counts immediately after trauma were significantly lower in the fat embolism patients than in the other trauma patients, indicative of early platelet aggregation. Prophylactically administered methylprednisolone in pharmacological doses appeared to inhibit the emergence of fat embolism syndrome.


Hypogeusia, dysgeusia, hyposmia, and dysosmia following influenza-like infection. Hypogeusia, with or without dysgenusia, and hyposmia, with or without dysosmia, followed an influenzal-like infection in 87 of 143 consecutive patients who presented at the Taste and Smell Clinic at the NIH with taste and smell abnormalities. Findings in this disease included pale nasal mucous membranes with marked patency of the nasal airway, a postive Rudolph sign, elevated detection and recognition thresholds for several tastants and odorants, disruption of the pore region of the tast dub observed on electron microscopy and infiltration of the upper lamina propria of the nasal mucous membrane wih chronic inflammatory cells observed on light microscopy. These findings, taken together, are relatively specific for the diagnosis of this surprisingly common disorder.


Cavernotomy in renal tuberculosis. Seven cases. Review of the literature. During the period 1957--1973 the author treated 7 cases of renal tuberculosis where cavernotomy was performed. Some views presented in the literature concerning the development and the detrimental effects of renal cavities are discussed. The diagnosis is purely radiological. Because of impaired renal function, drip infusion urography is recommended for such cases. The indication for operation is an isolated focus near the renal surface containing active tuberculosis with presence of tubercle bacilli. Vascular circulation is impaired locally and renal function diminished. This consitutes a latent danger for the host. The present findings are discussed and compared with results from the literature.


Radiology and fine needle aspiration biopsy in the diagnosis of tumours of the kidney. The value of angiography and fine needle aspiration biopsy in detecting, grading and staging of renal tumours was studied in 55 patients with renal tumours suspected clinically or on urography. 42 patients had malignant tumours. A correct angiographic diagnosis was made in 94% of the renal adenocarcinomas, the corresponding percentage for the aspiration biopsies was 71%. A combination of angiography and cytologic examination gave the correct diagnosis in 97%. In 4 cases of renal pelvic carcinoma the angiography showed extensive hydronephrosis only, the final diagnosis in these was cases achieved by fine needle aspiration biopsy. Angiographic staging of 30 renal adenocarcinomas was made according to the TNM system. The radiological staging was correct in 30% of T3 tumours, but in only 50% of T1 tumours and in one out of five T2 tumours. The difficulties seemed to be in determining the relation of tumours situated marginally near the renal capsule. Angiographic grading of the tumour was made according to the vascular pattern and the time of venous filling. Sparse vascularity and venous filling time of over 5 seconds was found in highly differentiated carcinomas and abundant vascularity and fast venous filling in neoplasms of moderate or low differentiation. The cytologic grading correlated fairly well with the histological grading. This study shows that angiography combine with fine needle aspiration biopsy provides good facilities for obtaining a correct diagnosis in renal tumours and preoperative information of the extent and degree of differentiation of renal malignant tumours.


Effective drainage of the bladder after transvesical prostatectomy. The series presented consisted of 94 patients who underwent transvesical prostatectomy and whose bladders were drained by using a cystostomy tube (silastic) with an 8 mm lumen, in addition to a urethral catheter. Retention by blood clot was avoided. The wounds healed well, and no infection of the urinary tract occurred. The mean period of postoperative hospitalization was 9.5 days.


Vesico-ureteral reflux following transurethral slitting of the ureteral orifice. A series of 14 patients treated with transurethral slitting of the ureteral orifice is presented. In 6 cases there was a stone at the distal end of the ureter and in 8 cases a ureterocele. Half the patients developed vesico-ureteral reflux. Other complications, such as urinary infection or renal scarring, have not been observed during the mean follow-up period of 47 months from the time of operation.


Effect of irrigation of vas deferens on sperm analyses after vasectomy. 70 men were operated for voluntary sterilisation by vasectomy alone and 20 men by vasectomy and irrigation of distal vasa with acid Kystosol solution. Postoperative semen analyses 2 weeks later showed azoospermia in only 2% of cases after vasectomy alone and in 25% of cases following vasectomy and irrigation, and 2 months postoperatively in 44% and 90%, respectively. Non-motile sperm cells in seminal analyses was the most common finding in both series 2 weeks after vasectomy. The problem whether the non motile sperm cells are viable or not is discussed. However, two azoospermic semen analyses must be obtained before sterility after vasectomy can be ascertained.


Non-traumatic chylous effusion in the thorax and abdomen. A female of 31 with chyloascites and bilateral chylothorax is presented. The thoracic duct was obstructed below the diaphragm. The lymph vessels in the left iliac and para-aortic areas were enlarged and there were lymphocysts. When the lymph loss was greatest the patient was in a state of grave malnutrition with marked hypoalbuminaemia and an absolute and relative lymphocytopenia in the blood. "Malignant" cells were demonstrated in the chylous fluid, but no malignancy could be found at laparotomy. It is possible that the cells were confused with immature lymphocytes. The lymphatic cysts were excised and the lymph vessels ligated. Decortication of the right lung was performed. The patient recovered. The follow up time has been over four years.


Broncholithic casts. A case report.

Broncholithic casts. A case report. A case of multiple broncholithic casts is reported. The diagnosis was made on clinical and radiological findings without histological verification. Tuberculosis was regarded as the probable cause.


Headache as a symptom of endometriosis externa. Prior to an abdominal operation, 125 patients were asked if they regularly had headache during the menstrual period together with or without pain in the lower pelvic region. Pelvic pain patients with endometriosis externa reported headache significantly more often than those without endometriosis. Headache proved to be almost as common a symptom as lower pelvic pain in patients with endometriosis.


Multiple repeat caesarean sections on one patient. A case history is presented of a patient with 8 consecutive caesarean sections over 1965--1973. Total hysterectomy was performed during the last section because of thinned uterine wall, marginal placenta praevia and heavy bleeding. The aspects of repeated caesarean sections are discussed in the light of the present case.


Luteectomy in early pregnancy. A report of three cases. The exact day in early pregnancy when the corpus luteum could be dispensed with without deleterious effects on the pregnancy has been a matter of some dispute. It seems that there is a difference regarding the prognosis of the pregnancy if luteectomy or oophorectomy is performed where the corpus luteum alone could be dispensed with somewhat earlier. Three cases are presented. In case one luteectomy was performed at the end of week six or day 42 according to Naegele's rule. Plasma progesterone values decreased initially but increased steadily thereafter. No abortion occurred. Patient No. two was oophorectomized unilaterally at day 53 on the side where the corpus luteum was situated. She aborted three days later. Patient No. three was oophorectomized in the same was as patient No. two at day 49 and treated with Progesterone substitution thereafter. No signs of threatening abortion could be seen.


Blood lipid changes in musculoskeletal trauma of the rabbit. After multiple long bone fractures, signs of excessive fat transport were observed in rabbits. Staining of albumen in the lipoprotein electrophoresis suggests an increased free fatty acid mobilisation. During the five day experimental period the beta lipoproteins increased while the alpha1 lipoproteins decreased. On the second post-traumatic day, the proportion of pre- beta lipoproteins increased simultaneously with a four-fold increase in plasma triglycerides. Some increase in cholesterol was also observed. An augmented de novo synthesis of fat is proposed as an explanation for part of the increased post-traumatic lipid transport. The changes were compared with a simultaneous occurrence of fat in the lung and kidney.


HL-A27 and arthritis.

HL-A27 and arthritis. In patients with recent inflammatory arthritis HL-A27 was seen in 6 out of 7 patients with ankylosing spondylitis, in 15 out of 18 patients with Reiter's disease, in 9 out of 12 patients with reactive postinfectious arthritis, in 22 out of 45 patients with rheumatoid arthritis, and in 2 out of 14 patients with other types of inflammatory arthritis. In two control series HL-A27 occurred in 46 out of 326 persons and in 3 out of 34 persons. The high frequency of HL-A27 in RA patients is in disagreement with previous results by other investigators. The explanation for this may be either that the diagnostic criteria do not apply at the early stage of the disease, or that there is a high prevalence of HL-A27 associated RA in Finland.


A population study of rheumatoid factor in Iceland. A 5-year follow-up of 50 women with rheumatoid factor (RF). The subject of this paper is a 5-year follow-up of 50 women found with Rose-Waaler Titre greater than or equal 1 : 10 or with a Acryl Fixation Titre greater than or equal 1 : 10 in a general health survey conducted in the Reykjavik area in 1968-1969. The average annual incidence of RA was 2.3 percent. Of four women who died during the follow-up period, three were amongst those with the highest titres. Two of the decreased had cancer mammae and one had lung cancer. Changes in RF-titres and New York Criteria are also discussed. It is suggested that RF-positives could be divided in three different riskgroups.


Osmic acid treatment for rheumatoid synovitis. 47 patients with rheumatoid arthritis and synovitis were treated with intra-articular injection of hydrocortisone and 52 patients with both hydrocortisone acetate and osmic acid. In another series of 24 patients with synovitis in both knees were injected with osmic acid to the more seriously affected knee and with methylprednisoloneacetate to the other knee. Osmic acid gave better improvement than corticosteroid alone, although the difference between th groups of the latter series was not statistically significant. On the basis of previous investigations and this study osmic acid is one alternative to radiation or surgical synovectomy in rheumatoid synovitis. The therapeutic result is not always satisfactory but facility of treatment and minor side effects are the advantages of osmic acid therapy.


Radiation synovectomy of the rheumatoid knee with yttrium 90. The use of radioactive yttrium (90Y) in the treatment of rheumatoid knee joints is described. Clinical results in 48 knees after a mean observation period of more than 3 years are reported: 60 percent excellent or good at one year, 46 percent at two years, 33 percent at three years and 17 percent at four years. The number of failures or relapses exceeded 50 percent between 30 and 36 months. The average rate of relapse in successful cases was 12.8 percent per year. The most important factors associated with unsatisfactory result were advanced articular destruction and progression of the systemic disease.


The pathogenesis of ankylosing spondylitis. Various factors of possible pathogenetic significance in ankylosing spondylitis are surveyed, with the conclusion that ankylosing spondylitis may be due to more than one cause and have varying symptomatology: It is not a disease but a syndrome. Terms such as spondylarthritis ankylopoietica or ankylosing spondylitis, which have such direct reference to symptoms, are not necessarily applicable. It is difficult to find an adequate name, but Bechterew's sydrome is suggested.


Rheumatic fever in adult patients.

Rheumatic fever in adult patients. A study of rheumatic fever in adult patients (diagnosed according to the Jones revised criteria; Circulation 36: 664, 1965) was performed by examining 26 patients during the acute phase of the disease, and by re-examining 22 of them from 6 months to 64 months later (mean 33 months). Polyarthritis and carditis were the most common major manifestations. 23 patients had polyarthritis and 3 monoarthritis. 18 patients had signs of acute cardiac involvement. Carditis appeared to be rather benign: at the acute stage no patient developed congestive heart failure or any other serious complication. Five patients had erythema marginatum, but we saw no chorea or subcutaneous nodules. Of the 22 patients examined in the follow-up study, 4 had persistent signs of cardiac involvement and 15 showed chronic joint manifestations. Yersinia enterocolitica infection was by far the most difficult differential diagnostic problem, since polyarthritis and carditis associated with this enteric infection were very similar to those in patients with rheumatic fever. Current literature on rheumatic fever and the results of this series suggest that the diagnostic criteria of rheumatic fever (Jones) should be re-evaluated, at least in industrial countries.


[Androgens and regression of the Mullerian ducts in the male mammalian embryo(author's transl)]. 1. The capacity of androgen biosynthesis by the mouse embryo testis was studied in vitro. Testosterone and androstenedione were obtained from 14C-sodium acetate by testes undergoing sexual differentiation (12-12 1/2 days). 2. the question was examined whether testosterone or any other androgen could be regarded as the causative factor in the regression of the Mullerian ducts. Mullerian ducts from 13-14 - day - old mouse embryos were cultivated in vitro in the presence of a crystal of either testosterone, dihydrotestosterone or androsterone, but in none case could any regression be observed. Our conclusion tends to support the earlier view expressed by Jost (1970) and Josso (1970 beta) which holds that the regression of the Mullerian ducts in the male mammalian embryo is brought about by a factor different from androgens.


[Ultrastructural study of the interrenal tissue in the Pekin duck(author's transl)]. The fine structure of the interrenal tissue in the Pekin duck has been studied utilizing intravascular perfusion method of fixation. The adrenocortical cells were found to contain considerable amounts of lipid droplets, mitochondria, ergastoplasm, endoplasmic reticulum and a well-developed Golgi apparatus. The subcapsular and central regions of the adrenal cortex can be distinguished mainly by the abundance of liposomes and mitochondrial size and shape.