Molecular genetics of avian proteins. XIII. Protein polymorphism in three species of Australian passerines. An introduced species, the house sparrow (Passer domesticus), and two Australian native species, the welcome swallow (Hirundo tahitica neoxena) and the fairy martin (Petrochelidon ariel), have moderately low levels of protein polymorphism compared with domesticated or semi-wild 'managed' species of birds. Genetically varient proteins in these birds include transferrin, esterase, phosphoglucomutase, NADP-dependent isocitrate dehydrogenases, phosphogluconate dehydrogenase (decarboxylating) and glucose-6-phosphate dehydrogenase. Egg-white protein polymorphism confirms heterogeneity of egg colour, markings and shape, and suggests that approximately 10% of the 'clutches' in house sparrow nests represent infidelity (intraspecific nest parasitism). For the four enzymes capable of supplying reduced NADP for reductive biosyntheses in growth and detoxification, the house sparrow has more heterozygosity (29%) than either the welcome swallow (9-4%) or the fairy martin (2-3%) and the difference is highly significant statistically. The results are discussed in relation to possible biochemical correlates of MacArthur and Wilson's (1967) evolutionary strategies or r or K selection.


Studies on metatherian sex chromosomes. I. Inheritance and inactivation of sex-linked allelic genes determining glucose-6-phosphate dehydrogenase variation in kangaroos. Wallaroos (Macropus robustus robustus), which have the G6PD-F electrophoretic phenotype, crossed with euros (M.r.erubescens), of G6PD-S phenotype, produced F1 animals which had only the maternal G6PD type regardless of the direction of the cross. When F1 hybrids were backcrossed to wallaroos or euros, backcross progeny of either perental phenotype resulted. Sex-linked inheritance of allelic G6PD genes is shown to occur in wallaroos, euros and red kangaroos (M. rufus). Dose compensation for X chromosomes at the G6PD locus in kangaroow is achieved by inactivation of the allele of male parental origin.


On the relation between testes size and sperm reserves in the one-humped camel (camelus dromedarius). The size, weight and volume as well as the sperm content of the testes of 18 mature, 6-10-year-old camels with unknown breeding history were determined after slaughtering and then related to one another. It was found that the weight and the volume of the testes can be estimated fairly accurately by means of their length. The length of the testes can also be used to calculate the sperm reserves, although more accurate values can be obtained by taking the square numbers of the testes length, breadth, and thickness into account. The average values for gonadal and epididymal sperm reserves of paired testes and epididymides was 6.278 +/- 1.226 X 10(9) and 12.177 +/- 2.316 X 10(9) respectively. The sperm production per gram testes tissue was 40.55 +/- 15 X 10(6).


[Case of implantation of human fetal thymus on the immunological reactivity in patients with Hodgkin's disease]. Five patients with Hodgkin's disease (IV stage) were implanted with fetal human thymus. Implantation were performed under the fascia of rectus abdominis muscle. Thymuses were obtained from fetuses 4-5 month old in aseptic condition and stored in tissue culture medium 199, before implantation. Immunological studies carried out during 4-6 months, revealed the elevation of the number of the lymphocyte in the peripheral blood, normalization of the number of rosete forming cells (RFC) as well as the response of peripheral blood lymphocytes to phytohaemagglutinin (PHA) stimulation. Two patients had long improvement of immunological responsiveness, but the other 3 only a transitient one during the first month after implantation. The possibility of the immunologic treatment in the early stages of Hodgkin's disease is discussed.


[Current state of blood transfusion in Yugoslavia and its perspectives]. The current situation of the transfusion service in this country has been characterised by small-scale operational level, the lack of regional system and basic components of a single service. There is a great variety in the medical and expert point of view starting from the lack of elementary hygienic and technical conditions, down to developed institutions of the European level. This activity has been characterised for the last ten years or so by an effort to win blood-givers at all cost, to enhance production of intravenous solutions which in some factories have obtained factory production volume, to determine basic blood groups and a very modest diagnostics for haemolitic diseases of newly born children. A large number of doctors--transfusiologists have obtained specialists' titles, but without any prospects to change the present status of their work: blood conservation, efforts to win blood-givers and determine blood groups. The differentiation between transfusiologists and clinic-engaged personnel has been increasing, thus making the transfusiologists to be far from the problems of modern haematology and clinical therapy. Observing the situation and status of transfusiology in the developed countries of Western Europe, it is possible to state that the transfusiology is developing in the direction of cooperation and team-work with doctors engaged in clinics. Therefore, cooperation with doctors engaged in clinics should be cultivated and organise team work. The intermediary role of doctors-transfusiologist in the cycle of health improvement should be avoided by all means. 90% of packed blood in this country is consumed in the form of full blood or dry plasma and only 10% in the form of desired derivatives, instead of the contrary case, since the precisely set therapy using new haemostatic medicaments is an economical imperative. The electronic data processing of blood-givers enables doctors-transfusiologists to deal with these problems since this is much cheaper and more efficient than when it was done by the doctor. Application of plactic casings, its industrial production, use of multi-channel electronic systems when determining the blood-groups and anti-bodies, makes this more of a technical than medical problem dealt by doctors. Production of intravenous solutions and plasma drying requires an inter-republican integration into a powerful industrial group, similar to that in Great Britain. Our transfusiologist should in future be engaged in business done by pathologists related to problems of blood patho-physiology, similar to the activities done in USA and other Anglo-Saxon countries. Integration of American Association of Blood Banks with the Association for organs and tissue transplation in USA only underlines this...


[Our experiences in the blood supply by means of a blood bank]. "GIVE US BLOOD TODAY, YOU'LL GET IT WHEN YOU NEED IT". Under this slogan the blood transfusion service gathers the blood donors offering, in return for the given blood the security that, any moment and in required quantities, the blood will be provided for every donor i.e. every member of any collective that acts on the request and "deposits" blood in so called blood banks", at least twice a year. Agitation among the prospective blood donors is completely confided to prominent people, social and medical workers, who do it permanently, and not from time to time, and who, if possible, are also blood donors, and owing to their own example, more convincing. The obligations between the blood transfusion service and "the investors" are regulated by oral agreement. It is noticed that the mutual moral obligation has more positive influence on the fulfillment of obligation than the administrative measure--a contract. According to this experience, individual work, a personal contact with prospective blood donors, and the feeling of personal security that is offered to them give the best results in motivating the people to become blood donors.


[Glass, rubber and plastic material for production of the transfusion and infusion solutions equipment]. In this paper author gives the information about the International Standard (IS) as well as our National Standards (JUS) on the standardisation of the material and the unification of transfusion equipment for medical use. Initiative which was given by the Institute of Blood Transfusion Belgrade in 1953 year, and the past active work organized in the Blood Transfusion Service in Yugoslavia in this field--present the very important contribution in dissolving of many problems which appear in the production of sterile intravenous solutions and sets for transfusion.


[Biochemical characteristics of concentrated and rinsed erythrocytes]. The biochemical characteristics of concentrated and rinsed out erythrocytes in time function have been analysed. It has been concluded that five days after conservation and during the same day of preparing there was no evidence of significant differences between complete blood erythrocytes and concentrated and rinsed out erythrocytes. In course of preparing concentrated erythrocytes the number of leucocytes declined rapidly, but not completely. By triple rinsing of erythrocytes the number of leucocytes is somewhat less than in the samples of concentrated erythrocytes, but some leucocytes are left.


[Effects of plasmapheresis on the blood donors. Changes caused by long-term plasmapheresis in normal donors]. Following 115 donors during two years of regular plasmapheresis it was proved that the procedure is in no way harmfull for the donor. Even with intensified plasmapheresis to two times a week no substantial fall of protein has been observed. During the procedure a slight haemoconcentration has been seen and the loss of erythrocytes was not greater than 13 ml.


[Study on the distribution of erythrocyte population during blood preservation: correlation of the distribution after donating blood]. The aimes of paper attempts to answer following questions: 1. does distribution curve of the blood, that has been preserved for different time intervals, indicated the yeald of conservation, and 2. is there any difference in type of the RBC size distribution between donors who underwent multiple withdrawals and those undergoing single withdrowal. Our results confirms the already known choice in favor of ACD or CPD with Adenin added, this time the choice being supported by the RBC size distribution. Physiological reaction in donors organizm as estimated from RBC size distribution curves suggested that subjects undergoing blood withrowlas for the firs time react in a different fashion that those who are adapted.


[Providing of polytraumatized persons with blood transfusion, blood derivatives and infusion solutions]. The therapy by blood transfusion, blood plasma and infusion solutions, duration and dosage are individual for each patient and dependent on the previous state of health of a patient, size of injure, degree of bleeding, expressed shock and disturbed general state. For taking care of the polytraumatized persons and especially for taking care of the parenhematozic organs and gastrointestinal bleedings greater quantities of blood are required. We assessed the seriousness of shock and hypovolemia on the basis of the clinical picture, decreased arterial pressure, haemogram, hematocrytes and diuresis. On assessing hypovolemia we used the size of opening and depth of wound, as well as the size of extremity. In treatment of polytraumas there is need for harmonious cooperation of surgeons, orthopedists, transfusiologists, röntgenologists etc. Traumatism is an important and difficult problem of the society and health care; it requires imperatively better organization of the first aid service, medical care on the spot of injury, then, in transport, greater and better organized traumatological and transfuzion service, training and scientific research.


[Probable position of MN gene locus on the human karyotype]. Kariotype of the propositus and his father revealed a balanced reciprocal translocation between long arm of a chromosome No. 2, and the long arm of a No 19-20, so that their complements were 46, XY, t(2q-; 19--20q+). There is no connection with congenital malformations of the propositus, but his and kariotype of his father, as well as blood group pedigree of all members of his family, suggests, likewise to assertion of German and coworkers, that locus for the MN gene is on the long arm of the chromosome No 2.


[Up-to-date experiences of the Center for Tissue Typing of the Socialist Republic of Serbia]. Phenotypic, genotypic and haplotypic frequency of HL-A antigens in our population was presented. Special attention to the significance of performed anti HL-A antibodies in the patients heamodialized, and to the typing of their families with aim of obtain the complete results for the list of patients. Waiting of renal transplantation the significance is appointed to the production of own specific anti HL-A test sera. The method of organized kidney transplantation either from living donors or cadaver was presented in our paper.


[Comparative study of adenosine and inosine as corrigents of ACD (Acid Citrate Dextrose) solution in preservation of human blood]. The examination was made on the effects of adenosine and inosine on glycolysis in ACD stored human red cells. Total glycolytic capacity was checked by the incorporation of inorganic phosphate into the acid soluble nucleoside phosphates of erythrocytes. Adenosine and inosine increase the glycolysis in ACD stored human red cells. This stimulation depends on the nucleoside concentration used up to the saturation level (2.0 muM of adenosine or inosine/ml). By the saturation level it was demonstrated that adenosine gives 30%higher stimulation than inosine. It may be concluded that by the same conditions adenosine may serve as a better corrigens for ACD stored human blood.


[Clinical and pathohistological characteristics of aplastic anemia]. Clinical symptomatology, pathohystiological characteris of bone marrow and the effects of treatment achieved in 21 patients with aplastic anaemia (a.a.) have been presented in this paper. Compared to one of our previous analised serie the number of patients with a.a. of both sexes and age has doubled for the last few years. The ethiogenesis in 14 cases was of unknown origin. In tree cases chloramphenicol was a cause, paroxysmal nocturnal haemoglobinuria in three other cases and one appeared in pregnancy. Pathohystiology of bone marrow has in 7 cases acellular in 11 hypocellular and in tree partial hypercellular appearance. Immunohaematological examinations yielded positive antiglobuline tests in tree cases (out of 17 examined) and positive thrombocytic antibodies in 2 patients out of 14. Australia antigen has been found positive in 3 patients (out of 18), Au antibodies in one out of nine patients, while three developed manifest serum hepatitis duing the causee of treatment. Tree patients whose final diagnosis was paroxysmal nocturnal haemoglobinuria previosly were diagnosed and treted as a.a., while two with a.a. gave positive acid and sugar tests for that syndroma. The treatment in this seria of a.a. was by corticosteroids, testosteron. There has not been any significant impruvement in prolonging the patients lives in this seria comparing the previous one in which there had been given no anabolic hormones. Most of the patients (more than 50%) did not survive more than 24 months.


[Significance of radioimmune method for detection of HB antigen in blood donors]. The evaluation of frequency of HBag in 923 blood donors is given: the counterelectrophoresis demonstrates HBag positive cases in 1, 2% the radioimmunoassay (Ausria-125, Abbott) in 1, 5%. The haemagglutination (Hepanosticon, Organon) in 7 cases, which were negative with counterelectrophoresis, and positive with the radioimmunoassay, discovers HBAg in 3 cases. RIA method is more sensitive in the control of HBAg positive donors after two to three years, and in detecting of immuno complexes prepared in vitro. The titre of the antigen is 1000 times higher when made with RIA method, and up to 60 times higher when made with the method of haemagglutination than with the counterelectrophoresis. In 4 cases of hepatitis after transfusion of HBAg negative blood, determined with counterelectrophoresis, have been involved bottles, which were positive only with RIA Method. Austria II-125 (Abbott) method was comparatively tested with counterelectrophoresis on different groups--446 persons.


[Disseminated intravascular coagulation during a course of miliary tuberculosis]. Two patients with tuberculosis complicated with disseminated intravascular coagulation are presented. The first patient had spleenic and mesenteric lymph nodes tuberculosis (accompanied by gastrointestinal symptoms (diarrhoea) lasting for several years) in which DIC was terminal fatal complication. Coagulation disorder was characterized by a decrease of fibrinogen concentration in blood, thrombocytopenia and other disorders as well as haemorrhagic syndrome. The second patient had miliary tuberculosis presented by X-ray changes on the lungs, granuloma in the liver and positive cultures in the sputum. Both laboratory and clinical signs of DIC manifested in the beginning of the disease. Heparin treatment was successful: haemorrhages stopped already 24 hours later, while an increase of fibrinogen concentration and number of platelets in blood proceeded at slower rate. As the patient had overcome the critical period, treatment of the primary disease was successful and led to complete recovery.


[Bacteriological control of blood preservation, production of infusion solutions and dry human plasma under conditions of aseptic work and possible sources of their contamination]. In premises for blood conservation, production of dry human plasma and infusion solutions "notwithstanding the permanent measures for desinfection, new bacterial contamination occurs from time to time and whose source are the casings and material originating from non-sterile environment. Bacteriological control, which has primarily a preventive character, enables a due forecast for measures to be undertaken by the appropriate desinfection of the working surfaces and air, satisfactory conditions of aseptic work can be maintained. General hygiene should be paid attention to as well as mechanical cleansing of premises, avoidance of groups for lunch-time etc., since the treatment by desinfectors would not be sufficient for maintenance of aseptic working conditions. In order to prevent the transmission of bacterial contamination, premises for blood conservation should be strictly separated from other operations and also prevent the unnecessary movements of personnel through corridors. The results of the bacteriological control of the personnel show that greater attention should be paid to their health care since the workers there work in closed aseptic systems and thus avoid them as a bacteria transmittors in respect to danger of blood and dry human plasma contamination. It is also necessary to efficiently educate the personnel for work in aseptic conditions and also increase their elementary knowledge from bacteriology and hygiene. The bacterial skin-flora on the spot of donor's venepuncture also presents a certain danger for blood contamination. Therefore, it is necessary to establish the most optimal manner of skin desinfecate together with the most appropriate means having a fast bactericidal and fungicidal action. It would also be useful, on the basis of further test, to suggest certain standard for an allowed number of conditionally pathogenic and saprophytic microorganisms which would be used by the instutions performing the blood transfusion and production of the intravenous solutions during their bacteriological controls.


Serum uric acid in hypertensive patients. Both the average serum uric acid and annual increment were determined in 250 treated patients attending a hypertension clinic. The average serum uric acid was greater in men compared with women, in patients receiving a thiazide diuretic and in patients with a high average plasma urea. The mean annual increment in uric acid was close to zero (0.0017 mmol/litre per year) and was not related to sex, age, blood pressure control, diuretic therapy, or plasma urea. There was an unexplained positive association between annual increment and methyldopa therapy though this drug was not associated with a significantly high average serum uric acid. A table is presented giving the theoretical upper limits for average serum uric acid according to sex, plasma urea concentration, and whether or not a thiazide diuretic has been prescribed. It is hoped that this table will be of assistance in assessing the normality or otherwise of a high serum uric acid found in a hypertensive patient.


Effects of heart rate and atropine on 'dual AV conduction'. In patients with evidence of dual AV conduction, a premature atrial depolarization is normally conducted via a fast conducting pathway with a long refractory period. At a critically timed coupling interval, the effective refractory period is reached and now the impulse is conducted over a pathway with a slow conduction velocity and a short effective refractory period. At this moment in the His bundle electrocardiogram, a sudden increase in the AH interval occurs which is called the 'break' phenomenon. This phenomenon was studied in 14 patients, with a history of supraventricular paroxysmal tachycardia, at the patient's own heart rate, at different paced heart rates, and after the administration of atropine. In 11 patients the 'break' phenomenon could be elicited during sinus rhythm,; in 3 when the heart rate was accelerated. The effective refractory period of the fast conducting pathway was prolonged in 9 patients, remained unchanged in 3, and was shortened in 2 when the heart rate was increased. The effective refractory period of the slow conduting pathway was reached when block occurred proximal to the His bundle. This parameter was increased in 8 patients, remained unchanged in 3, and was decreased in 1 patient with augmentation of the heart rate. This effective refractory period was not measured in 2 patients. Atropine led to a shortening of the refractory period of both pathways in 8 patients studied. Atrial echo phenomena indicating the beginning of a re-entry circuit occurred at an AH prolongation that was not always identical to that measured at the point of 'break'. Widening, as well as narrowing, of the echo zone was found, indicating that the re-entry circuit was in a state of labile equilibrium. In cases where shortening of the pathways involved in the re-entry circuit was found, structures other than nodal may exist; therefore paranodal bypass must be considered.


Investigation of the safe withdrawal period for propranolol in patients scheduled for open heart surgery. The time necessary for dissipation of radioactive labelled propranolol and its metabolites and the cardiac effects of this agent in the hearts of patients undergoing open-heart surgery were studied. Isoprenaline produced chronotropic and inotropic responses in atrial muscle in tissue bath studies which were normal 8 to 12 hours after withdrawing propranolol. After the administration of either 25 or 75 muCi of 14C-labelled propranolol, the myocardial tissue concentration declined to insignificant levels between 24 and 28 hours. We conclude that withdrawal of propranolol therapy 24 to 48 hours before cardiac surgery should be acceptable.


Unstable angina. The problem of definition. Unstable angina is used interchangeably with a variety of other terms to refer to a clinical situation intermediate in severity between chronic effort angina and myocardial infarction. In most reports dealing with this syndrome, the patients were selected according to a number of criteria which varied from one study to another. Some authors recognized subgroups of patients with variable severity while others looked at unstable angina as one single group. This resulted in conflicting observations and consequent dilemmas in the management of these patients. Accurate definitions are, therefore, necessary. It is proposed to divide unstable angina into two main clinical categories. Type I: This includes three subgroups. (A) Patients with known chronic angina and sudden or accelerated progression of symptoms; (B) patients with chronic angina and onset of recurrent attacks at rest; and (C) patients with angina of recent onset and rapid progression into a severe condition. Type II: (severe unstable angima). Any of the subgroups described under unstable angina Type I will qualify for this classification if the patient develops recurrent episodes of prolonged ischaemic chest pains resistant to nitroglycerin lasting for 15 minutes or more. Accurate measurement of symptoms and laboratory criteria are suggested to qualify for the different subgroups of unstable angina.


Arteriographic patterns early in the onset of the coronary syndromes. Coronary arteriography in 300 patients within one year of onset of symptoms of coronary arterial disease revealed already severe anatomical coronary disease in three patient groups: those with angina pectoris alone (164 patients), with subendocardial myocardial infarction (63 patients), and with transmural myocardial infarction (73 patients). The number of vessels diseased (larger than or equal to 50% obstruction), distribution of obstruction, and degree of stenosis were similar in the three groups. However, total occlusion of at least one artery was much more common in transmural myocardial infarction and in subendocardial myocardial infarction with elevation of enzyme levels. We suggest that such occlusions occurred at the time of the infarction. Similarities in coronary anatomy between patient subgroups with angina (on exercise or at rest and nocturnal) indicate that factors other than coronary anatomy intervene in precipitating the different types of angina. Vessel disease was not related to smoking, hyperlipidaemia, or hypertension but coronary disease was manifest earlier in life in smokers or those with hyperlipidaemia.


The 'rapid filling wave' of the apex cardiogram. Its relation to echocardiographic and cineangiographic measurements of ventricular filling. In order to study the relation between the 'rapid filling wave' of the apex cardiogram and left ventricular filling, simultaneous apex cardiograms, phonocardiograms, and echocardiograms were recorded in 57 patients. Continuous measurements of left ventricular dimension were derived from the echocardiograms by digitization using manual tracing and a computer. Possible errors in the use of a single dimension to assess left ventricular filling were investigated by frame-by-frame analysis of cineangiocardiograms in 37 patients, and the timing of changes in transverse diameter found to correlate closely with those in cavity area. Mitral valve opening, shown as the initial separation of the valve cusps by echocardiography, preceded the 'O' point of the apex cardiogram in all except 3 patients, the 'O' point appearing to correlate more closely with the time of peak rate of outward wall movement. A third heart sound was present in 29 patients, and in 25 of these it occurred later than the peak rate of wall movement (ment interval 51 ms). The end of rapid filling derived from the dimension trace occurred in relation to the third heart sound after a mean interval of 9 ms, with a range from 50 ms before to 80 ms after the third sound. Peak rates of wall movement were similar in patients with and without third heart sounds. The results show that outward left ventricular wall movement begins with a period of acceleration, with peak rates occurring synchronous with the 'O' point of the apex cardiogram and thus with the nadir of the ventricular pressure trace. Outward wall movement becomes less rapid thereafter, so that the rapid filling wave of the apex cardiogram does not reflect the time of rapid filling of the left ventricle. The 'O' point is not related to mitral valve movement nor does the third heart sound bear a consitent relation to any aspect of left ventricular wall movement.


Time relation between apex cardiogram and left ventricular events using simultaneous high-fidelity tracings in man. In 10 patients without left heart valvular disease and having normal function of the left ventricle, the left ventricular apex cardiogram with its first derivative (dA/dt), left ventricular pressure with its first derivative (dP/dt), aortic pressure, electrocardiogram, and phonocardiogram were reocrded simultaneously during cardiac catheterization. The apex cardiographic tracings were obtained by means of a transducer with infinite time constant and very high resonant frequency and the LV and aortic pressures with catheter tip-manometers. The onset of the systolic rise of apex cardiographic and LV pressures were found to occur almost simultaneously with the upstroke of LV pressure, preceding that of the apex cardiogram by only 2 +/- 4 ms (mean +/- 1 SD). The summit of the systolic upstroke of the apex cardiogram (called E-point) occurred 37 +/- 9 ms after opening of the aortic valve and 41 +/- 9 ms after peak dP/dt. The peak of dA/dt preceded peak dP/dt by 10 +/- 4 ms. The protodiastolic nadir of the apex cardiogram (called-O-point) occurred slightly earlier (19 +/- 16 ms) than the nadir of the LV pressure curve, with considerable variation. In conclusion, this study using external and internal transducers with similar characteristics gives a new definition of the time relation between the externally recorded apex cardiogram and the haemodynamic events within the left heart in human subjects with normal left ventricular function.


Truncus arteriosus communis associated with underdevelopment of the aortic arch. Two cases are reported of truncus arteriosus communis arising entirely from the right ventricle and associated with interruption in one case and tubular hypoplasia of the aortic arch in the other. A haemodynamic hypothesis of preferential blood flow is proposed to explain this rare association.


Effect of submaximal exercise on fibrinolytic activity in ischaemic heart disease. Fibrinolytic activity and platelet adhesiveness are normal in cases of angina pectoris and healed myocardial infarction, whereas fibrinolytic activity is diminished in acute myocardial infarction. Exercise increases fibrinolytic activity in normal people but the effect on it of submaximal exercise in patients with ischaemic heart disease is not known. Resting platelet adhesiveness and fibrinolytic activity were determined in 20 patients suffering from ischaemic heart disease and eight healthy controls. Both groups were then subjected to submaximal exercise on a motor-driven treadmill. The ST segment of the electrocardiogram and the heart rate were monitored during exercise by an on-line digital computer. Fibrinolytic activity determinations were repeated immediately after exercise. There was a significant increase in fibrinolytic response in both groups but it was significantly less in the ischaemic groups (36-2%) compared with the controls (55-9%) (P less than 0-01). The ST segment depression was 2-3 mm in the ischaemic group and 0-52 mm in controls--also a significant difference (P less than 0-01). There was no correlation, however, between the ST change and the fibrinolytic response. A diminished response in the ischaemic group may favour their predisposition to thrombotic episodes.


Transmission of audible praecordial gallop sounds to right supraclavicular fossa. To evaluate the significance of audible gallop sounds in the right supraclavicular fossa we performed simultaneous external heart sound recordings at 50 and 100 Hz at the left ventricular apex, left sternal border, and right supraclavicular fossa in 50 patients with audible gallop sounds at the left ventricular apex. In each patient heart sounds were recorded with a simultaneous jugular phlebogram, apex cardiogram, and carotid pulse tracing. In 44 patients an apical fourth heart sound coincident with the 'a' wave of the apex cardiogram was recorded, and in 32 (73%) the fourth heart sound was audible and recordable in the right supraclavicular fossa. A left ventricular third heart sound, coincident with the rapid filling wave of the apex tracing, was present in 25 patients but was recorded in the right supraclavicular fossa in only 7 (28%). Intracardiac phonocardiography (high-fidelity catheter) was performed in six patients with left ventricular gallop sounds and in each instance arterial transmission of the third or fourth heart sound, or both, was present. Five additional patients had a prominent jugular venous 'a' wave, but only two had a soft parasternal fourth heart sound. Intracardiac phonocardiography in these five patients failed to reveal transmission of right ventricular gallop sounds to the superior vena cava. We conclude that since left ventricular gallop sounds commonly are transmitted to the right supraclavicular fossa auscultation in this area is often helphful in their detection. In addition, a prominent jugular venous 'a' wave sometimes produces recordable presystolic vibrations that are occasionally audible as well.


Titrated energy cardioversion of patients on digitalis. Elective cardioversion with titrated energy was carried out under diazepam anaesthesia (38 procedures) in 26 patients on digitalis who presented with supraventricular or ventricular arrhythmias. Low energy shocks were given to establish the absence of latent digitalis intoxication, not unmasked by previous carotid sinus massage, and to restore sinus rhythm with the lowest possible energy discharge. In the absence of digitalis overdosage, titrated energy cardioversion restored sinus rhythm, at least temporarily, without dangerous ventricular arrhythmias. In one patient this precaution was neglected: a shock of 200 Ws provoked ventricular tachycardia. We present experimental and clinical evidence for the safety and effectiveness of titrated energy cardioversion in patients on digitalis.


Unusual fracture of cardiac pacing electrode. This report describes a patient with an epicardial demand pacing system in whom pacing failure two months after implantation was found to be due to a fracture of the helical wire electrode within its supporting structure. We know of no report of this site of failure of a Cordis 323-451 or similar electrode.


Similarity in uptake and retention of trace amounts of 31 silicon and 68 germanium in rat tissues and cell organelles. Uptake of Si and Ge (chemical analogue of Si) in rat tissues was compared to establish their subcellular localization and determine if Ge could be used to trace Si in situ. 31Si and 68Ge were found in tissues and in cell organelles after injection of 31Si (OH) 4 or 68Ge (OH) 4. Accumulation of 31Si and 68Ge in the tissues increased for 30 minutes, declined rapidly about 30 minutes and then was gradually but steadily depleted. Simultaneous double labelling with 31Si and 68Ge produced concomitant accumulation and release of both isotopes. After a single IP injection, some 68Ge remained in the spleen and kidney for up to 20 days. The 31Si and 68Ge concentration in the tissues and cell organelles increased linearly with the amount administered (31Si, 10-4 to 10-2 g/kg body wt and 68Ge, 10-9 to 10-3 g/kg body wt). Thus, substitution of 68Ge for 31Si can extend the limit of detection of Si by at least 5 orders of magnitude. Both 31Si and 68Ge were water extractable (47%-74% and 38%-89%, respectively) from liver cell organelles; 45%-81% 31Si and 66%-90% 68Ge were extractable in 10% TCA, while only 10%-59% of either isotope were extractable in organic solvents (acetone, chloroform, ethanol). A small percentage of Si may be bound or polymerized.


Classical conditioning of autonomic responses in alert and drowsy subjects. The primary purpose of this experiment was to study classically conditioned autonomic responses of alert versus drowsy subjects. Sixty-nine subjects in conditioning and pseudo-conditioning groups were subdivided into alert and drowsy groups on the basis of EEG recordings during conditioning trials, giving a total of four groups: conditioning-alert, conditioning-drowsy, pseudoconditioning-alert and pseudoconditioning-drowsy. Using the latency criterion to define responses, significant conditioning occurred only in the conditioning-alert group for the following measures: skin resistance anticipatory and UCS-omission responses, and finger plethysmograph anticipatory response. Both conditioning groups showed evidence of conditioned UCS-omission plethysmograph responses. Discussion centered primarily on (1) the implications of the results on the question of the feasibility of learning during sleep; and (2) the importance of including EEG recordings in studies of classically conditioned autonomic responses. The relationship between the various responses was also evaluated.


Electrodermal responses, subject control and delay of aversive stimulation. The aim of this study was to investigate the effect of different delays between a shock releasing motor response and shock (UCS) on the anticipatory and unconditioned SCRs within the subject-control paradigm, assuming a smaller degree of control with increasing delay. Four groups of 12 subjects receiving the UCS with no delay, 0.5,2 and 6 sec delay respectively, between motor response and shock, were run together with a control group not receiving the UCS. The latter group was included to control for the effect of the motor response on the SCR. All groups were given 20 trials with signals when to perform the motor response. The results were that no or very short delay of shock produced larger first-interval anticipatory responses than longer delays. For the UCR, it was found that the effect of shock on the UCR was an increasing function of the duration of the delay, when the effect of press on the UCR magnitude was taken into account.


The cardiac responses of schizophrenics to orienting, signal and non-signal tones. The cardiac responses of schizophrenics were examined under three conditions: (1) to repeated 75 dB, 1000 Hz (orienting) tones of no attentional significance; (2) to 75 dB, 1000 and 2000 HZ tones presented randomly and requiring a motor response to the 1000 HZ (signal) tone; (3) to 85 dB, 1000 HZ orienting tones. Responses of non-psychotic psychiatric patients were examined to the 75 dB tones. All patients were subdivided upon the basis of electrodermal responsivity during conditions (1) and (3), into groups of responders - no habituation of responses; non-responders - no responses; habituators - responses habituated to criterion. All groups exhibited a decelerative response with a latency of less than 1 sec. The groups were differentiated by the second component of the response to the orienting tones: responders - acceleration; habituators - deceleration; non-responders - predominantly no response. All exhibited accelerative responses to the signal tones. Parallels between cardiac and electrodermal responsivity are outlined.


The electroencephalogram in the prediction of human reaction time during growth and development. Characteristics of the distributions of electroencephalographic (EEG) half waves recorded in children during performance of a simple auditory reaction time (RT) task were investigated. The purpose was to determine the extent to which difference in these distributions could account for children's slow RT. The durations of a sample of 760 EEG half waves in each of a group of 41 healthy children aged 5-17 yr were measured and distributed into an interval histogram, and the first four central moments of the 41 distributions were computed. All four of the moments-which measure the central tendency, dispersion, skewness and kurtosis of the distributions-proved to be significantly correlated (p less than 0.01) with RT. The multiple correlation (R) between RT and the four moments was equal to 0.68 and was statistically significant. R was unchanged when only the measures of dispersion, skewness and kurtosis were used as predictor variables, suggesting that the predictive value of the central tendency is low. The predictive capability of a multiple regression equation based on these three predictor variables was tested in an independent group of 42 children also aged 5-17 yr. EEGs and RTs were recorded and this group was treated in exactly the same way as the other group. The correlation between these children's average RTs and their RTs as estimated from the other group's regression equation was 0.53. These findings suggested that knowing the degree of dispersion, skewness and kurtosis of the children's EEG distributions reduces from chance by about 28% the error of predicting their RTs.


Creativity and cortical activation during creative, intellectual and EEG feedback tasks. Thirty-two male subjects were divided into four groups based on their performance on the remote associates test and alternate uses test, two measures of creativity. Right EEG alpha presence was monitored under basal conditions, while subjects took tests of creativity and intelligence, and while they attempted to enhance and suppress the amount of alpha in a feedback situation. High scorers on the alternate uses test operated at a high percentage of basal alpha during all tests while high scorers on the remote associates test showed differential amounts of alpha presence across tests, with the highest percentage of basal alpha during tests of creativity and the lowest percentage during an intellectual test. Both high creative groups tended to show increases in amount of alpha across trials when trying to suppress alpha as well as when trying to enhance it, but did not differ in overall control from the low creative groups.


Electrochemical behavior of some commercial dental amalgams in artificial saliva. Cathodic, linear anodic, and anodic polarization studies conducted on three commercial dental amalgams, Caulk Fine Cut Alloy, Spheralloy, and Dispersalloy, showed that all amalgams were in a passive state at the corrosion potential in synthetic saliva solution. The corrosion currents at the corrosion potential were therefore small for all the amalgams, in the range 0.08 to 0.30 muA/cm2. However, the Caulk Fine Cut Alloy and Spheralloy amalgams exhibited a breakdown of passivity and high anodic currents at potentials only approximately equal to 100 mV more noble than the corrosion potential whereas Dispersalloy amalgams maintained passivity at potentials up to 700 mV more noble than the corrosion potential. The breakdown of passivity in Caulk Alloy and Spheralloy amalgams is attributed to the presence of the gamma2 phase (Sn7-8Hg) whereas the passive behavior of Dispersalloy amalgam is attributed to the absence of the phase. It is concluded that none of the amalgams will exhibit severe general corrosion in use, but that both Caulk Alloy and Spheralloy amalgams will exhibit pitting corrosion whereas this type of corrosion should be minimal in Dispersalloy amalgams.


Aging of dispersalloy and its effect on the anodic behavior of its amalgams. Anodic polarization measurements of Dispersalloy amalgam in Ringer's solution have shown that its electrochemical behavior is significantly altered by the aging of the alloy at room temperature. Amalgams fabricated from aged alloy are characterized by polarization profiles associated with the presence of Sn7 Hg (gamma2) and Cu-Sn (Cu/Sn less than 3) whereas polarization profiles of amalgams fabricated from relatively fresh alloys are free of current density peaks associated with both of these phases. This aging effect has been attributed to the room temperature oxidation of Ag-Cu eutectic, a component of Dispersalloy. Such oxidation, it has been hypothesized, hinders amalgamation, impairs the effective role of the Ag-Cu eutectic in eliminating the gamma2- phase, and produces corrosion-prone Cu-Sn intermetallics (Cu/Sn less than 3).


Design of a hydraulic analog of the circulatory system for evaluating artificial hearts. A major problem in improving artificial heart designs is the absence of methods for accurate in vitro testing of artificial heart systems. A mock circulatory system has been constructed which hydraulically simulates the systemic and pulmonary circulations of the normal human. The device is constructed of 1/2 in. acrylic sheet and has overall dimensions of 24 in. wide, 16 in. tall, and 8 in. deep. The artificial heart to be tested is attached to the front of the device, and pumps fluid from the systemic venous chamber into the pulmonary arterial chamber and from the pulmonary venous chamber into the systemic arterial chamber. Each of the four chambers is hermetically sealed. The compliance of each chamber is determined by the volume of air trapped above the fluid in that chamber. The pulmonary and systemic resistances are set automatically by bellows-operated valves to simulate the barroreceptor response in the systemic arteries and the passive pulmonary resistance response in the pulmonary arteries. Cardiac output is measured by a turbine flowmeter in the systemic circulation. Results using the Kwan-Gett artificial heart show a good comparison between the mock circulatory system response and the calf response.


Evaluation of a microcrystalline bovine collagen hemostatic agent in canine solid viscera injury using abdominal impedance plethysmography. Bioelectric impedance as a sensitive noninvasive technique for detecting and monitoring changes in compartmental body fluid volume was used to compare the efficacy of two hemostatic agents in controlling postoperative abdominal bleeding following surgically induced solid viscera injury. Gelatin foam-oxidized cellulose sponge and bovine MCHH were both effective topical hemostatic agents. It appears that MCCH has certain advantages over conventional agents.


Limitations and prospects of coronary artery surgery. Coronary atherosclerosis is discussed from the standpoint of natural history and survival. The operative treatment for ischemic heart disease is reviewed beginning with the advent of the venous autograft to the most recent advance, the internal mammary artery graft. Comparative survival between medical and surgical modes of treatment are described as well as factors in the revascularization selection process that directly influence longevity. During the last 6 years, experience in selection and a steady improvement in technical proficiency have brought about a decline in operative mortality and morbidity, thus yielding further improvement in postoperative long-term survival.


VoiceBak--speech for the speechless.

VoiceBak--speech for the speechless. The use of plastics in this device has and is playing an important role. The early developmental models of Dr. Taub incorporated a lot of cutting and cementing of plastic tubes and parts in experimenting with the valve design. This provided a much needed flexibility to evolve a workable design. The units being manufactured today by LaBarge, Inc. are a product of the workability of the plastics being used. The durability, or toughness, and ease of cleaning are two important features. The molded silicone rubber parts for the fistula flanged tubes and tension collar replaced the hand-dipped latex rubber tubes. The trach interconnect assembly has replaced the metal trach tube, which was a possible source of irritation to some laryngectomees. The use of silicone rubber parts has been a major milestone in the development of the VoiceBak. For the laryngectomee who wants to talk and is psychologically motivated, the VoiceBak can mean the difference between existing and living. For this laryngectomee, the VoiceBak is truly speech for the speechless.


Platelet-surface interaction: effects of dextran 70 on platelet retention in extracorporeal surfaces. Dextran 70 infusion into dogs prevents platelet adhesion to extracorporeal surfaces as effectively as direct coating of the surfaces with albumin. This is demonstrated by two experimental approaches. One of these involves a detailed analysis in 14 mongrel dogs of the effects of hemoperfusion on the systemic platelet levels, hematocrits, and dextran concentrations. The second approach is in the form of 23 platelet retention tests carried out in four mongrel dogs.


Surface roughness of composite filling materials. Seven commercial composite filling materials were studied as regards 1) differences in their ability to take a smooth polish as measured by an electronic roughness gauge and 2) their relative loss in smoothness due to toothbrushing. A series of test formulations indicated that polishability and ability to retain a good polish are interrelated and are functions of filler particle size and filler hardness. Optimization in the filler particles from the point of view of polishability also results in improved wear resistance to toothbrushing.


Effect of non-ionic detergents on the absorption of oleic acid in the anaesthetised rat. The effects of bile salts and of the non-ionic detergents Tween 80 and Pluronic F68 on the absorption and esterification of oleic acid (in presence of monoglyceride) by loops of rat intestine "in vivo" were studied. Absorption of oleic acid was highest from 10mM taurocholate, but was also substantial from the non-ionic detergents. Tween 80 acted synergistically with low concentrations of bile salts. Most of the absorbed fatty acid recovered in the intestinal wall was esterified, the proportion found as triglyceride being greater when a non-ionic detergent had been present. Under the conditions of these experiments a much smaller proportion of radio-active label left the intestine after absorption from 10mM taurocholate than from 2mM taurocholate or from the non-ionic detergents. The detergents Tween 80 and Pluronic F68 in low concentrations may improve absorption of fatty acids where this is impaired due to bile salt deficiency.


Effects of physical training on enzymatic activity of human skeletal muscle. Enzymatic activities of GOT, LDH, MDH and CPK were assessed in four normal subjects, before and after a 12 week training period on a cycle ergometer. Determinations were made in muscle at rest and immediately after submaximal and maximal exercise tests and in serum at rest. Muscle biopsies were obtained from the quadriceps by the needle biopsy technique. Maximal oxygen uptake (VO2) increased significantly after training. The after training GOT and MDH muscle resting activities increased significantly. Correlations were found between resting muscle GOT and MDH vs maximal VO2. An increase on resting enzymatic serum activity after training was found for LDH and CPK and a decrease for MDH for the same period. Correlations were found between resting serum and muscle activities of LDH; MDH and LDH serum resting values vs maximal VO2. Finally, it were observed after training increments of muscle activities of GOT and MDH at rest and that these increments correlated adequately with performance. It was also found that muscle GOT activity changes after exercise were modified by training and that it could partly explain serum modifications. Resting serum enzymes levels did not necessarily correlate with muscle levels and these serum levels could be an index of the achieved training.


The kinetics of the interaction of heterologous anti-tumor serum and heterologous complement in non-tumor bearing mice. The persistence of heterologous antitumor serum in the periphery of normal, non-tumor bearing mice was analyzed following intravenous, intraperitoneal, and subcutaneous injection. Intravenous injection of guinea pig complement subsequent to antibody administration resulted in the immediate disappearance of tumor-specific antibody from the periphery. Such studies suggest that appropriate therapy by the passive administration of antiserum requires the initial administration of antibody to allow for preferential binding to tumor-specific antigens followed by the subsequent injection of complement to mediate tumor cytolysis.


A study on the clinical significance of urinary beta-aminoisobutyric acid in patients with urothelial tumours. Urinary beta-aminoisobutyric acid (beta-AIB) has been measured in 141 patients with urothelial tumours and 60 controls. Ninetyone of the patients have been followed-up for an average period of about 2 years, which included many determinations of the beta-AIB excretion. Thirtysix patients died during the control periods. Urinary beta-AIB was found to be significantly correlated to the grade of tumour cell dysplasia, but not to the clinical tumour stage. The treatment had no major influence on the excretion. Characteristic changes in the excretion preceding high-grade tumour recurrences are demonstrated. Autopsy findings with tumour tissue in the urinary tract and distant metastases were significantly correlated to a low urinary beta-AIB in the terminal phase of the disease. The results are discussed in relation to the degradation of thymine, the dual origin of beta-AIB and the tumour-host metabolism. It is concluded, that urinary beta-AIB can contribute to the graduation of malignancy, but is not valuable as a general screening procedure for urothelial cancer.


Statistical study on double paraproteinemias. Evidence for a common cellular origin of both myeloma globulins. Double paraproteinemias (DPP) are usually considered as resulting from a proliferation of two independent clones of cells. The present study describes a statistical analysis based on 141 published cases of DPP. The incidence of the heavy chain classes as well as of light chain types association has been compared with the frequency of occurence of the same H and L chains in simple paraproteinemias. Computation of the frequency of associations showed that different heavy chains are randomly associated in DPP. However, light chains are more frequently of the same type in both immunoglobulins more so than could be expected on the basis of a biclonal hypothesis (p less than 0.005). This preferential occurence of identical light chains suggests a linkage in the synthesis of two proteins and it favours a monoclonal origin of myeloma cells in DPP.


Soluble complexes and antiglobulin factors detection by immunofluorescence and immunoadsorption in rheumatoid sera. In this report is was demonstrated that in rheumatoid factors (RF) positive sera, 19 S IgM rheumatoid factor can form soluble complexes with different proteins (IgG, albumin) of sera. In these complexes the antiglobulin activity of IgM is not inhibited. When immunofluorescence and immunoadsorption procedures are used for the detection of antiglobulin activities of rheumatoid sera, the proteins which are bound to IgM rheumatoid factor, even if they are devoid of any antiglobulin character, may be revealed simultaneously with IgM. Moreover in some cases the detection of IgM may be hindered, while the linked proteins remain detectable. In these conditions, these complexes in RF positive sera may give false negative results for IgM rheumatoid factor, and may give rise to artefactual appearance of IgG and other proteins (albumin antiglobulin-like activities. This paper points out that before investigating IgG and IgA antiglobulin activities, IgM rheumatoid factor should be previously eliminated, for example by immunoadsorption.


Post translational modifications of glucose-6-phosphate dehydrogenase in human leukemias. The modifications of the electrofocusing pattern, the immunological reactivity and the kinetic properties of glucose 6 phosphate dehydrogenase have been studied in malignant blood cells of various leukemias and myeloproliferative disorders. 1. Granulocytic G-6PD forms with decreased isoelectric points have been found in all the acute myeloid leukemias and erythroleukemias, and in most of the chronic granulocytic leukemias and myelofibrosis. In contrast, granulocytic G-6PD from patients with polycythemia vera always was normal. On the same way leukemic lymphocyte or lymphoblast G-6PD was identical to that from normal lymphocytes. 2. The ratio of enzymatic activity to immunological reactivity (=molecular specific activity) was markedly decreased in the myeloblasts of two patients with acute myeloid leukemia, and in the erythroblast-rich cellular fraction of a patient with erythroleukemia. In these cells the decrease of molecular specific activity was parallel to the alteration of the electrofocusing pattern of G-6PD. 3. The enzymatic forms with decreased isoelectric point also exhibited an altered affinity for glucose 6 phosphate. These modifications are post translational alterations of the neosynthesized G-6PD, since this enzyme is a single molecule, coded by the same gene in all tissues; they seem to correspond to an accelerated molecular aging due to an increased concentration of "G-6PD modifying factors". The significance of such an increased concentration of these G-6PD modifying factors in malignant cells is discussed.


[Method of quantitative assessment of morphological changes in the central nervous system]. The author present a variant of quantitative assessment of the degree of morphological changes in the central nervous system neurons. It is suggested that the following groups of the changed neurons should be distinguished: swollen neuron with the initial manifestations of breaking large tigroid lumps into smaller ones; swollen neuron with marked phenomena of breaking large tigroid lumps into smaller ones and initial phenomena of hypochromatosis; swollen neuron with total tigrolysis with hyper- and hypochromatosis; dehydrated hyperchromic neuron; vacuolized neuron; contracted atrophic neuron; perished neuron. Each of the mentioned groups is given a mark, characterizing the degree of morphological changes. A formula for the assessment of the degree of morphological changes for individual formations and zones of the central nervous system is suggested.


[Organ culture of urinary bladder tissue]. Bladder explants of young rats were cultivated in Carrel flasks on millipore filters, cellophane or polyvinyl chloride film. Nutritional mixture consisted of Eagles' medium, human serum and lactalbumin hydrolysate with addition of glucose, insulin and penicillin. On a millipore filter and a polyvinylchloride film the explants survived for up to 50 days, preserving a histotypical structure of the bladder mucosa. The technique described could be used for modelling various pathological conditions occurring in the urinary bladder.


[Changes in local cerebral blood flow during increased general arterial pressure in animals]. General blood pressure was increased in normal rabbits and in the animals with experimental renal hypertension by intravenous injection of noradrenaline; local cerebral circulation was recorded in two areas of the cortex the white matter of the large hemispheres by the method of hydrogen clearance and also by EEG. A number of successive changes of the local cerebral circulation was observed; these changes could be unitypical or different by duration and character on different electrodes. The appearance of pathological forms of electrical activity was noted on the EEG.


[Change in cerebral bioelectric activity during whole body hypothermia and regional cooling of the head]. Two series of experiments were conducted on dogs. In the first series of experiments dogs were subjected to deep hypothermia with an external chilling of the organism; in the second series-to the isolated deep hypothermia of the head with the maintenance of normothermia in the organism. Bioelectrical activity of the brain and circulation minute volume were recorded in the animals of both series. As revealed, depression of the bioelectrical activity was more pronounced and a prevalence of slow waves was observed in general hypothermia; at the same time a more even reduction of the electrical activity in all the EEG frequencies under study was seen in the series with local hypothermia. A reduction of the circulation minute volume was also more pronounced in the first series of experiments; in the authors' opinoin this was associated with the difference in the character of the EEG evolution with the same depth of hypothermia of the brain.


[Change in phosphatase and acid cathepsin activity in the dog cerebral cortex in terminal states]. Acid phosphatase, alkaline phosphatase and acid cathepsin activity increased in the subcellular fraction of the grey matter of dog brain in proportion to the duration of compression ischemia, particularly in the postmitochondrial supernatant. An increase in the alkaline phosphatase and of the acid cathepsin activity in the postmitochondrial supernatant was also observed at the period of clinical death caused by blood loss and preceded by hypotension of different duration and various levels of arterial pressure. Comparison of the above data indicated a common mechanism of proteolysis activation in the nervous tissue in the terminal states under study.


[Oxidative phosphorylation in rat spinal cord mitochondria in tetanus]. The mitochondria isolated from the spinal cord of rats with local tetanus utilized oxygen and inorganic phosphate more intensive than the mitochondria of normal animals. Ratios of P/O were similar. In experiments in vitro purified tetanus toxin in doses 5 X 10(2) = 1 X 10(5) MLD (for mice) did not effect on oxidation of intact mitochondria.


[Effect of adrenaline, noradrenaline, dopamine, DOPA and phenylalanine on lipid peroxidation in liver mitochondria membranes]. A method of superweak hemifluorescence was applied to the study of the effect of catecholamines on the process of chain peroxidation of lipids in the membranes of hepatic mitochondria in the presence of of Fe2+ ions. It was revealed that catecholamines in the concentrattion range of 10(-6)--10(-4) inhibited this process. On the basis of a mathematical study of the kinetics of the process a calculation was made of the constants of the antioxidative activity of catecholamines which constituted 1.13-10(4) for noradrenaline, 1.04-10(4) for adrenaline, 7.6-10(3) for dophamine, 5-.10(3)M(-1) for DOPA. The antioxidant action of catecholamines was associated with the presence in their molecule of a free phenol group. The mechanism of inhibition consisted in the interaction of catecholamines with the free radicals the leading of the oxidation chain. It is supposed that the antioxidative action of catecholamines could be of significance for the regulation of permeability of the biological membranes.


[Interrelation of oxygen anion-radical generation and lipid peroxidation in liver microsomes]. Consumption of O2-radicals and malondialdehyde accumulation was studied in the liver microsomes (LM) of rat after phenobarbital and 3-methylcholantrene induction, and in the LM of rabbits; there was revealed a suppression of lipid peroxidation, but a sufficiently high level of O2-radical generation. It is supposed that the absence of any direct association between the lipid peroxidation activity and the O2-radical generation in the LM of rats induced with the mentioned agents and in the LM of rabbits depended on increase in the antioxidant level.


[Mechanisms of central regulation of blood sugar content]. Acute experiments were conducted on adult cats. Injection of insulin microdose (0.025 U/kg with 0.025 ml of saline) into the posterior hypothalamic nucleus caused an increase in the blood sugar level 10 and 70 min after the injection. Changes of the blood sugar level correlated with the EEG activation of the posterior hypothalamic nucleus in response to the insulin injection, spreading to the lateral hypothalamus. However, hormonal stimulation of the posterior hypothalamic nucleus against the background of bilateral coagulation of the lateral hypothalamus produced no increase in the blood sugar level in 10 min. This is indicative of the participation of the lateral hypothalamus in the realization of hyperglycemic reactions in response to the insulin injection into the posterior hypothalamic nucleus.


[Dynamics of Ca2+ transport in rat liver mitochondria in anoxia]. Tetracycline was used as a fluorescent test-antibiotic for Ca2+ ions in rat liver mitochondria. Incubation of the isolated mitochondria under anaerobic conditions at 20 degrees C resulted in a rapid (in 30-min) loss by the mitochondria of the property to accumulate Ca2+. Disturbances of the mitochondrial Ca2+-accumulating property during the survival of the liver developed much more slowly (it took over 2 hours) and were not monotonous; the maximal values were recorded during the 5th-10th and the 60th minutes of survival.


[Adrenergic component in the mechanism of action of sodium oxybutyrate]. The influence of sodium oxybutyrate on the adrenergic neurotransmitter content in the nerve fibers and the synaptic vesicles and the uptake of exogenous noradrenaline (NA) by the sympathetic nerves of rat Vas deferens was studied by spectrofluorimetry, fluorescent-histochemistry and cytochemical electron microscopy. Sodium oxybutirate failed to influence the stores of the adrenergic mediator, but was capable of blocking the uptake and accumulation of the exogenous NA.


[Histotopography of changes in the enzyme activity of rat brain exposed to fluorophenazine]. The influence of fluorophenazine on succinic-, citric acid-, NAD-H2-and NADP-H2-dehydrogenases in different structures of rat brain was investigated by histochemical methods. Three hours after a single subcutaneous injection of fluorophenazine (1 and 5 mg/kg) the enzymatic activity was the greatest in the limbic and the frontal regions of the cortex. The inhibitory effects of fluorophenazine in these structures were greater than those of the neuroleptics trifluoroperazine, chlorpromazine.


[Effect of phenamine and gutimine and gutimine on adaptive changes in arterial pressure occurring during skeletal muscle contraction]. Effects of amphetamine (0,1--11 mg/kg) and gutimin (5--50 mg/kg) on the pressor reflex originating in the exercising muscle were studied on nonanesthetized decerebrate cats. Isometric exercise of the hind limb muscles was elicited by stimulating the spinal ventral roots L6--S1. Amphetamine (0.1 mg/kg) increased the level of arterial pressure and the amplitude of the pressor reflex. Higher doses of amphetamine decreased the pressor reflex to exercises and there was a fall of arterial pressure. Gutimin elevated the arterial pressure and failed to alter the pressor reflex to exercises.


[Pharmacologic study of adrenergic mechanisms of compensatory hypertrophy of the ovary]. Treatment of hemicastrated adult female rats with adrenoblockers, chlorpromazine and alpha-methyl-DOPA decreased the ovarian compensatory hypertrophy (OCH) and prevented the stilbestrol suppression of the OCH. Disulfiram (dophamine-beta-hydroxylase inhibitor) potentiated the stilbestrol suppression of the OCH. Small doses of L-DOPA stimulated the OCH, and high doses of L-DOPA and dilantin failed to act on the ACH, but potentiated the estrogeninduced OCH inhibition. It is suggested that the FSH secretion was mediated by the release of norepinephrine in the central adrenergic neurons and that the estrogen action inhibiting the FSH secretion was mediated through the stimulation of dophamine release.


[Effect of immunodepression on virus multiplication and interferon and antibody formation in animals]. Administration of high doses of imuran had no significant effect on the multiplication of influenza A/PR8 and Coxsackie A6 viruses. However, the serum levels of interferon and antibody were completely suppressed. Peripheral leukocytes of mice given imuran produced no interferon in vitro. These data suggest that the impairment of formation of the antiviral immunity factors resulting from the administration of high doses of immunosuppressants, such as used during the graft rejection crises, could serve as one of the main causes facilitating viral infections in the course of the transplantation therapy. The results could be of practical importance for the development of the optimal immunosuppression schedules during the organ transplantation.


[Participation of the lung in capturing subcutaneously injected antigens]. Experiments were conducted on guinea pigs. With the aid of fluorescein-labeled antibodies it was shown that following a single or a two-fold immunization into the footpad complete typhoid antigen was revealed in the lung macrophages as soon as the first days (or after a two-fold administration-in several hours) and persisted there for 30 days. There was a tendency to concentration of the antigen-containing macrophages in the perivascular and the peribronchial tissues. The dynamics of the antigen spread along the lymphoid organs is also described.


[Components of cholinergic excitation coupling with smooth muscle contraction in the guinea pig taenia coli]. In concentrations of 10(-9)-10(-7) g/ml acetylcholine increased the tone of the smooth muscles of the longitudinal band of the large intestine of a guinea pig, increasing the permeability of the cellular membranes for the entering flux of 45Ca2+. In concentrations of 10(-6) g/ml and over acetylcholine caused a release of the membranous calcium and in the concentrations of 10(-5)-10(-3) g/ml markedly increased the permeability of the membranes of the smooth muscle cells for the 22Na+ ions causing depolarization and an increase in the frequency of the action potentials. It is supposed that the coupling of the cholinergic stimulus with the end effect (muscle contraction) included 3 components: intensification of the entrance of Ca2+ into the smooth muscle cells, release of the membrane calcium and adhesion mechanism.


[Accelerated determination of the carcinogenic activity of preparations under study]. There was revealed a correlation between the activity of erythropoiesis and the resistance of the mouse organism both to the induced carcinogenesis and to the growth of the transplanted tumour. By choosing animals with a weakened erythropoiesis into experiment it is apparently possible to decrease considerably the period of the examination of the carcinogenic activity of the preparations under study.


[Lactate dehydrogenase isoenzyme spectrum in spontaneous mouse mammary tumors and lung neoplasms]. The report deals with the LDH isoenzymatic spectrum in the mannary glands, lung, spontaneous tumours of the mammary glands and in metastases into the lung in mature female C3H mice. The difference in the metastases and the tumour LDH isoenzymatic spectrum was in the higher activity of the anode fraction of metastases. The presence of lung metastases was accompanied by a cathode drift of the LDH isoenzymatic spectrum to this organ tissue.


[Temperature limits of mitosis in mammalian cell cultures]. Mammalian cells of different origin (11 strains) were cultivated at the temperature of 25--41 degrees to measure the temperature limits of mitosis. Different strains of the cells reacted to the increase or decrease in the cultivation temperature in a dissimilar way. The difference between the upper temperature limit and the optimum one was not over 5 degrees. Cell division did not end with the temperature fall by over 10 degrees. Various cell strains responded to the temperature decrease in a different way. Most cellular population had three cell types. The majority of the cells were capable of dividing at the threshold temperature; some cells could enter mitosis without completing it and stop at the metaphase. The temperature limits of mitosis were not related to the species and tissue origin of the cells.


[Presence of biologically active glutamyl peptide in rabbit bone marrow]. The presence of chromatographically pure and biologically active glutamylpeptide in the rabbit bone marrow was shown and methods of its isolation were given. The substances had an unusual circular dichroism contrary to that of the natural proteins. In a concentration of 10(-5) M the isolated peptide decreased the survival of the Chinese hamster culture cells to 30%. It was analogous to the peptide isolated formerly from plants by a number of physical and chemical characteristics; the latter possessed cytogenetic activity and increased the mutagenic action of the ionizing radiation.


[Electron microscopic study of monoaminergic fibers in the posterior lobe of the rat hypophysis]. Monoaminergic fibers and their swellings containing dense core vesicles, 700-1000 A in diameter, were found by electron microscopic studies in the posterior pituitary of rat. Most of them are situated far from capillaries and are surrounded by neurosecretory fibers and pituicytes. There are usually no specialized structures at the sites of contact between them. Single monoaminergic fibers come in contact with the capillaries and even penetrate the pericapillary space. Large swelling of these fibers which sometimes occur contain different polymorphous inclusions, degenerating mitochondria and numerous small tubules along with the dense core vesicles.


[Nature of rhythmic discharges in ventral spinal cord roots]. Rhythmic "locomotor discharges" recorded in the ventral spinal roots by Perret et al proved to increase during asphyxia and disappeared during apnea. Thus, rhythmic discharges in the ventral spinal roots depended on irradiation from the respiratory centre and could not confirm the fact of existence of a special "locomotor pacemaker".


[Synthesis and characteristics of proteins in inner mitochondrial membranes of the myocardium of rats with disseminated necrotic heart diseases]. Two fractions of the inner membranes of the mitochondria were isolated from rat myocardium: complex-the inner membranes-matrix (fraction A); the aggregates of the inner membranes deproved of the matrix (fraction B). Both fractions of the membranes effectuated the incorporation of the radioactive amino acids with the same activity. With the aid of gel electrophoresis the amount of the protein components of A and B fractions was found to bary from 20 to 30. The mol wts were from 10000 to 200000. Disseminated myocardial necrosis produced by novodrine injection based on the ischemic state of the heart led in two days to a considerable decrease in the protein synthesizing activity of fractions A and B. The protein profiles and the mol wt of the membrane protein components displayed no marked changes.


[Role of the inner elastic membrane in forming the surface microrelief of blood vessels]. A study of the aortic walls with and without the endothelial cells by means of the raster electron microscope showed the great folds of the blood vascular microrelief to be formed by the inner elastic membrane.


[Stimulation of fibrillogenesis in granulation tissue]. RNA synthesis by fibroblasts in healing wounds of mice and passage of the newly-formed RNA from the nucleus into the cytoplasm were studied in control mice and those treated by potassium orotate. Potassium orotate accelerated the passage of the RNA from the nucleus into the cytoplasm of the fibroblasts. Formation and maturation of the collagen fibrils in the wounds were studied by scanning electron microscope.


Relations between performance on the advance matrices and the EPI in high-intelligence subjects. This study continues the investigation of the relationship between performance on tests of intelligence, and the personality parameters of the Eysenckian theoretical framework. Candidates for admission to an honours degree course (n = 281) were given the Advanced Progressive Matrices as a screening device. Those admitted to the course were on later occasions given both forms of the Eysenck Personality Inventory (EPI). In view of problems of test-retest on the EPI, scores were analysed in a novel fashion to give three groups: 'introverts', 'extraverts' and 'ambiverts'. The 'introverts' scored significantly highest on the Matrices, but the scores of the 'ambiverts' were lowest. Neuroticism showed little interaction with other variables. These results are discussed in terms of the theory of reactive inhibition. New data on the Advanced Progressive Matrices are given which are significantly higher than the published university norms.


Stimulus generalization and anxiety in schizophrenic and normal subjects. Sixty schizophrenics and 60 normal subjects were compared on a test of stimulus generalization. The generalization stimuli were lines differing in length. Both schizophrenics and normals were divided into two groups (30 subjects each) and trained either on a short line or on a long line. In addition to the generalization stimuli, subjects were presented with an irrelevant stimulus (circle). Although there was a significant difference between the generalization gradients of the groups, this difference was limited to generalization stimuli away from the negative training stimulus. The concept of peak shift was invoked to interpret these data. That the groups did not respond to the irrelevant stimulus is inconsistent with interference theory and gives some support to the differentiation between conceptual overinclusion and perceptual overinclusion. The relationship between stimulus generalization and scores on the Manifest Anxiety Scale was inconsistent.


A developmental approach to delineate components of cognitive dysfunction in schizophrenia. Two developmentally based tests were devised to study the nature of schizophrenic cognitive dysfunction within a psychopharmacolgical framework and to relate the data to developmental and psychophysiological models. The Colour-Form Preference Test was designed to evaluate cognitive style in terms of early maturational stages and provided a subscale for assessing arousal-related cognitive growth. The Egocentricity of Thought Test, adapted from Piaget's developmental study of right-left positional concepts, enabled investigation in terms of the later stages of cognitive growth. These and other clinical measures were taken of schizophrenic patients at various points of treatment and also administered to a non-psychotic comparison group. Test results supported their validity, reliability, longitudinal sensitivity and capacity for nosological and prognostic discriminations. The data also suggested a distinction between two components of schizophrenic cognitive dysfunction -- one drug-sensitive, which could be considered as arousal-related, and the other drug-resistant, which might best be described as developmental. A two-factor model encompassing the psychophysiological and developmental hypotheses is thus offered as a more comprehensive representation of the cognitive disorder.


Colour form representation test: a developmental method for the study of cognition in schizophrenia. The Colour Form Representation Test (CFR) was devised as one of a series of developmentally rooted objective measures of schizophrenic cognitive dysfunction. Based on the observations of Piaget and others in relation to the conceptual use of colour, form and representational cues, it provided a four-level response hierarchy corresponding to the preverbal and early verbal stages of cognitive growth. The CFR was tested with 66 schizophrenics and 42 non-psychotic subjects and found to distinguish between these two groups and among schizophrenic subtypes. It showed significant correlations with measures of cognitive and attentional dysfunction and, longitudinally, was observed to be a reliable instrument that reflected the differential therapeutic outcome of various schizophrenic groups. The research potential of the CFR and its relevance to developmental and psychophysiological theories of schizophrenic cognitive disorder were discussed.


Constituents of urinary calculi containing struvite. In a collection of 615 stones containing struvite and in which the sequential deposition of the constituents from the nucleus to the surface had been determined, other substances were found to follow a marked deposition of struvite in 139 cases. In 122, the compound was accompanied by struvite, in 16, struvite was replaced by it and in 1, both types of deposition had occurred in different layers. All urinary stone constituents could accompany struvite and many could replace this compound.


IgG catabolism in anephric patients.

IgG catabolism in anephric patients. The catabolism of purified human 125I labelled IgG has been studied in patients with chronic renal failure, both nephrectomised and non-nephrectomised, on intermittent haemodialysis. In all patients the T 1/2 of IgG was the same as in normal controls, and using chromatographic separation on Sephadex G200, there was no evidence of alteration of molecular size as a result of dialysis. The results do not support the notion that the kidney is an important site of IgG catabolism in humans.


Grey-scale ultrasound imaging: assessment of acute hydronephrosis. Rapid changes in the renal anatomy during the development and resolution of an acute hydronephrosis may require multiple imaging procedures. The ionising radiation hazard limits the extent to which this may be achieved by intravenous pyelography. Grey-scale ultrasound offers a safe, non-intrusive technique for visualising the renal pelvis which may be repeated daily. The value of such an ultrasound facility is illustrated by 3 case histories.


Nephroscopy.

Nephroscopy. Nephroscopy is a simple and valuable procedure, which may be used to differentiate between stones within the calyces of the kidney and calcification in the pyramids and to locate stones and stone fragments. The ordinary ifnant panendoscope is a suitable instrument to use.


The long-term management and social consequences of ureterosigmoid anastomosis. It is regrettable that while the recognised complications of ureterosigmoid anastomosis - recurrent urinary tract infection, and acidosis- can be avoided and obstructive uropathy can be recognised early and so treated, the operation frequently condemns the patient to a restricted life with an unpleasant ritual of bowel frequency and incontinence. It seems that the lack of awareness of this bizarre life-style and the occasional true successes have allowed the operation to remain in use. Our experience confirms the unpredictability of the end result of ureterosigmoid anastomosis and suggests that the operation should be largely abandoned, in favour of the conduit type procedure.


Transperitoneal ureterolithotomy.

Transperitoneal ureterolithotomy. The transperitoneal approach to the pelvic ureter has many advantages over the extraperitoneal technique for ureterolithotomy but the operation is safe only if contamination of the peritoneal cavity is avoided by establishing extraperitoneal drainage after closing the incision in the peritoneum over the ureter.


Urological complications following aortofemoral bypass graft. 3 cases of ureteric obstruction secondary to aortic femoral bypass grafting are presented. This complication has been infrequently reported and we feel that it may be more common than is recognised. In all other published cases the ureter lay behind the prosthesis but the authors present a surgically proved case where the ureter lay in its normal position. The aseptic vascular reconstructive surgical procedures are to be preferred to ureteric reconstruction.


Pathogenesis of ureteric reflux in vesical calculus disease of childhood: a clinical study. A clinical, radiographic and endoscopic study of 34 children suffering from vesical calculus disease and manifesting ureteric reflux has been presented. The oedema and inflammatory changes from the vesical calculus and infection were responsible for the reflux in the majority of these children. The reflux was eradicated by simple removal of the stone. The importance of detailed urological investigation of all the children presenting with lower urinary tract calculi has been emphasised.


The management of pyocystis following ileal conduit urinary diversion in children. 27 cases of pyocystis following ileal conduit urinary diversion are discussed. In those cases not responding to medical treatment, vagino-vesicostomy is recommended as an alternative to cystectomy. The operation of prophylactic vagino-vesicostomy at the time of the original diversion is discussed.


Prolonged bladder distension in the treatment of the unstable bladder. 11 patients underwent 12 prolonged bladder distensions for bladder instability. In no case did the cystometrogram revert from an unstable to a stable pattern, through 6 patients noted symptomatic improvement which was attested as moderate by 2 and marginal by 4.


Automatic bladder irrigation after vaginal surgery. Comparing Cystomatic irrigation of the bladder with conventional gravity drainage, there was no decrease in immediate urinary infection rates nor was there any obvious improvement in the speed of recovery of bladder function.


Double bladder with complete sagittal septum: diagnosis and treatment. A case of double bladder with complete sagittal septum in which the excluded bladder and septum were removed (together with the silent kidney and ureter) is described. Long-term follow-up has confirmed the success of the operation. Cases of this rare malformation reported in the literature are reviewed and diagnosis and therapy are discussed.


The nature of the abnormality in bladder neck obstruction. There is no dispute that there exists, in men, a condition of obstruction at the bladder neck in the absence of fibrous stricture or prostatic enlargement. The condition was clearly described by Guthrie (1836) and Young (1913) reported the results ff punch resection operation in over 50 cases. The large measure of success now achieved following resection of the bladder neck in these patients has perhaps been allowed to mask our ignorance of the nature of the abnormality and thus discourage studies of its cause. It is perhaps most often thought to result from fibrosis but a number of studies--for example Baadenoch (1949)--have shown no associated increase in fibrous tissue. Certainly the condition is in no way similar to the hard fibrous stricture seen more often in the distal urethra, or at the bladder neck as an occasional complication of prostatectomy. Our study shows that the obstruction if functional in nature and is due to the tightening of the bladder neck as the detrusor contracts.


Suprapubic prostatectomy combined with vesico-urethroplasty. A new look at the operation of suprapublic prostatectomy is suggested in view of the continuing substantial morbidity associated with traditional techniques. The proposition is that a reconstructive as distinct from a simple ablative operation is possible, notwithstanding long-standing beliefs to the contrary. The writer goes on to outline the principles, and to describe and illustrate in detail the steps in a new technique of prostatectomy combined with a urethroplasty, which uses full-thickness bladder wall flaps to provide immediate epithelial cover for the denuded surfaces of the prostatic urethra. The theoretical advantages of such a technique are borne out by the results in the first 400 cases so treated, which are contrasted with those from a comparable personal series of 200 retropubic prostatectomies and other representative series.


Urinary tract infection following trans-rectal biopsy of the prostate. An unacceptably high incidence of urinary tract infection was found in a retrospective survey of patients undergoing trans-rectal biopsy of the prostate. The incidence was considerably greater than that found in a prospective survey of bladder endoscopy alone. It is suggested that preoperative antibiotic prophylaxis might be worthwhile in this situation.


Iglesias resectoscope with continuous irrigation, suction and low intravesical pressure. A resectoscope with continuous irrigation, suction and low intravesical pressure is described. Advantages of this instrument include: no interruption, better endoscopic vision by a continuous clear inflow of more than 600 ml per min, a constant intravesical pressure less than 10mm Hg during the resection, shorter operating time, less bleeding, easier teaching and no more wet floor and wet surgeon. Since the entire amount of irrigating fluid is collected, blood loss can be calculated and the amount of absorption determined.


Cysts of the prostrate.

Cysts of the prostrate. 2 rare cases of prostatic cysts are described. The first was considered to be a congenital cyst originating in the Müllerian system and the second a large retention cyst of the prostate. The problems arising from the present classification of prostatic cysts are briefly noted.


Spinal motoneurons of the goldfish, carassius auratus. The spinal cord of goldfish (Carassius auratus) was examined in normal and experimental animals by light and electron microscopy. Comparisons of Golgi material and electron micrographs have shown the large ventral horn motoneurons to have dendrites with few spines. The axon may arise from a ventral dendrite. Synapses on the motoneuron may be chemical or combined electrotinic and chemical or electrotonic between dendrites. Transection of the cord produced degeneration of small boutons, but large boutons remained intact. Small boutons were found on dorsal root axons and large boutons on interneurons in Golgi preparations. Boutons en passant may arise from myelinated fibers.


Primary afferent fiber distribution at brachial and lumbosacral spinal cord levels in the opossum (Didelphis marsupialis virigniana). This paper describes the spinal cord distribution of primary afferent fibers from forelimb and hindlimb in the North American opossum. Fibers entering the cord distribute to all ipsilateral laminae (I-IX) within their segment of entry, often have a small crossed projection to the contralateral dorsal horn, and extend as well into adjacent segments of lumboseacral and cervical enlargements. Segmentally derived afferents have a longitudinal extent of up to 10 segments into laminae VI and VII, of 5-6 segments into dorsal horn laminae I-IV, and are most restricted in their projection to maina IX (2-3 segments). The total extent and the detailed pattern of distribution of these fibers is very similar to that of previously studied placental mammals.


Termination of supraspinal descending pathways in the spinal cord of the tegu lizard, Tupinambis nigropunctatus. Descending fiber projections to the lizard spinal cord were studied using anterograde axonal degeneration. Following hemisection of the cord at the first spinal segment, degeneration was found in the white and gray matter as far down as the 31st (caudal) segment. Degenerating fibers in the white matter were confined to the ipsilateral side and were found in the medial longitudinal fasiculus and the outer half ot the lateral and ventral funiculi. Degeneration was more intense in the dorsolateral and ventromedial funiculi than in the ventrolateral funiculus. In the gray matter, REXED's criteria were applied to Nissl-stained material to delimit boundaries of ten laminae. Degeneration of suprospinal axons was most intense in the medial part of VII, dorsal and ventral commissures to ramify contralaterally in the medial part of VII, in VII, and in medial IX. No degeneration was present in the lateral part of the spinal gray on the contralateral side. In Golgi-stained material, dendrites of lateral IX cells were seen to extend into lamina VII, the dorsolateral part of VII, and the lateral funiculus. Thus, fibers of the ventromedial supraspinal pathway may make axodendritic contact with motoneurons of lateral IX as well as medial IX, ipsilaterally. In addition, there is a possibility of a crossed connection to contralateral motoneurons.


Cortical and brain stem projections to the spinal cord of the American opossum, Didelphis marsupialis virginiana. The present report describes the results of experiments designed to study supraspinal systems in the American opossum by several techniques. The data indicate that although spinal fibers from the opossum motor-sensory cortex are small and limited in their distribution, those from the brain stem are comparable in their origin, course, caudal extent and distribution to those described for placental mammals. Such results support the use of the opossum as an experimental animal for nervous system research; but, furthermore, suggest that its marsupial embryology makes it an ideal model for experiments designed to elucidate the ontogeny of the nervous system.


Atropine dose in acute myocardial infarction in man. Heart rate response to intravenous atropine therapy in acute myocardial infarction (MI) was assessed from detailed studies performed on 18 of 492 consecutively admitted coronary care unit patients. Atropine was given for extreme bradycardia (less than 40/min) or bradycardia (less than 60/min) coincident with hypotension or ventricular premature beats. 14 patients had posterior and 4 anterior infarction. Degree of cardioacceleration evoked by atropine depended upon drug dose and route of administration. Atropine, 0.0053-0.0088 mg/kg, given within 15 sec increased heart rate by 20-72/min but never beyond a peak rate of 120. Larger atropine doses, 0.120-0.148 mg/kg, increased heart rate by 51-92/min and, in four to five instances to a peak rate exceeding 120/min. Intramuscular atropine was associated with paradoxical slowing of heart rate in one case. Multiple neural, hormonal, and circulatory factors can modify heart rate response to fixed amounts of intravenous atropine but 0.008 mg/kg represents a safe and suitable initial drug dose for use in acute MI.


Atrial myxoma: a review of 9 cases.

Atrial myxoma: a review of 9 cases. The clinical symptoms, laboratory findings, apexcardiograms, phonocardiograms and echocardiographic features are related to hemdoynamic and angiocardiographic measurements in 9 patients with atrial myxoma (6 left atrial and 3 right atrial tumors). Emphasis is placed on the clinical clues to the diagnosis. Echocardiography has become the most useful non-invasive method of investigation. However, angiocardiography remains the definitive diagnostic procedure.


Isolated U wave-inversion in acute myocardial infarction. Three patients are presented in whom an isolated inversion of the U wave preceded by several hours typical electrocardiographic changes of an acute myocardial infarction. The association of transient hypertension and an acute U-wave inversion during this period of myocardial ischemia is discussed. It is suggested that within the appropriate clinical context an isolated U-wave inversion may portend an acute myocardial infarction.


Fascicular conduction blocks and their relationship to complete heart block in Nigerians. Following electrocardiographic analysis, isolated or combined blocks in the intraventricular trifascicular system including predivisional left bundle branch block with left posterior hemiblock in Nigerians are presented and the underlying causes reviewed. The rarity of complete heart block, despite the not uncommon fascicular blocks, is of interest and may be related to the population age structure considering the invariably slow rate of degeneration of conduction fibres in the system.


Five-year follow-up of resting and postexercise phonocardiogram in asymptomatic persons. Phonocardiograms were recorded in 200 clinically normal adults, mean age 51 +/- 6 years, at rest and after a double Master's test. Five-year follow-up clinical data was obtained in 199 of these 200 subjects. The resting fourth heart sound correlated with the subsequent development of coronary heart disease within 5 years (p = 0.036). Neither the postexercise fourth heart sound nor the resing or postexercise third heart sound showed any correlation with the subsequent development of coronary heart disease within 5 years.


Persistent reversal of severe systemic hypertension after prolonged toxic reaction to hydralazine. A patient with severe progressive hypertension was treated with parenteral hexamethonium and large dosages of hydralazine. He developed a 'hydralazine syndrome', the etiology of which was not recognized for approximately 9 months. Upon discontinuance of hydralazine the patient was easily kept normotensive for over 20 years, using only small dosages of cryptenamine, reserpine and/or bendroflumethiazide. Similar observations are cited in the literature in seven other patients who were treated with hydralazine for significant periods of time after toxic symptoms occurred.


The cytotoxic effect of serum from patients with Addison's disease and autoimmune ovarian failure on human granulosa cells in culture. Human granulosa cells growing in culture were used to study the effects of sera from twenty-three patients with idiopathic Addison's disease. There were two women with primary amenorrhoea, thirteen with premature ovarian failure following a normal menarche, and one man with testicular atrophy in this group. The sera from all twenty-three patients contained antibodies which reacted with fresh sections of human corpus luteum using an in vitro immunoflorescence test. Serum fron nine of the twenty-three patients contained antibodies which were cytotoxic to human granulosa cells in tissue culture; the cytotoxic effect was complement dependent, and related to the immunofluorescent staining properties of the serum and dilution of antibody present. No cytotoxic effect was observed when granulosa cells were cultured in serum from the remaining fourteen Addisonian patients, or from normally menstruating women, post-menopausal women or in serum containing organ-specific antibodies to other endocrine tissues. The cytotoxic effect was paralleled by a fall in progesterone production by the granulosa cells. The production of progesterone by cells cultured in any of the non-cytotoxic sera was significantly greater than that produced by cells in the presence of cytotoxic antibody.


Leucocytotoxicity in malignant and non-malignant colonic diseases. The survival of cells from five different cultures of allogeneic malignant colonic carcinoma, two from normal adult colonic epithelium and eight from foetal colonic epithelium in the presence of leucocytes from patients with neoplastic and inflammatory disorders of the colon has been compared. Cytotoxicity assessed by the reduction of the number of adherent target cells in microplate wells compared with those surviving in wells treated with tissue culture medium alone was observed with leucocytes from donors in all categories examined including those from individuals without any known abnormality. Patients with ulcerative colitis were the only group to reveal consistent reactivity against cultures derived from all three sources, an observation which may reflect sensitization to organ-related antigens in this disease. In contrast, leucocytes from patients with bowel neoplasia showed reactivity for cells derived from colon carcinoma tissue, which was comparable to that of healthy donors. Evidence for tumour-specific cytotoxicity was therefore lacking in this study. It is suggested that the detection of tumour-associated antigens on cultured cells may be limited by a number of factors of which the wide variation in reactivity among controls and unspecified nature of the target cells are likely to be of greatest importance.