Hormonal pattern in the blood of eight mares during the first weeks of pregnancy. The hormonal pattern in the blood of eight mares was studied during the first 5 to 6 weeks of pregnancy; in two of the eight animals early embryonic death was established on D-28 and on D-40, respectively. Progesterone peaks were found in the blood around D-5, D-12 to D-10, and D-17 to D-18. It is suggested that the decrease of the progesterone concentrations in the blood during the intermediate periods is due to the action of oestrogens. During the period from D-18 to about D-34 the concentrations both of progesterone and of pregnenolone were low in the pregnant mares. Thereafter a small increase of the progesterone content was observed. Sometimes rather large amounts of the compound "5.4", an isomer of pregnenolone, were found, indicating the presence of follicles containing oestradiol-17beta or possibly a stimulated uterus. It is suggested that early embryonic death may be expected. a. if the progesterone concentration in the blood is low on D-17 to D-18; b. if there is no increase of the progesterone or the "5.4" concentrations during the period from D-34 to D-37. A relatively high pregnenolone level on these days indicates reduced conversion of pregnenolone into progesterone.


[Effect of cleaning and disinfection in poultry processing plants (author's transl)]. The use of agar print plates was found to be suitable for checking the results of several cleaning and disinfection systems. Some poultry processing plants were tested several times with agar prints, as a control of the results of the cleaning and disinfection program. It seems that cleaning exclusively with water leads to no reduction of micro-organisms, in spite of a reasonable visual effect. Cleaning with cleansers produces a small micro-biological reduction. Really sterile surfaces however were only observed when, after cleaning with cleansers, disinfection was employed.


[An investigation of cows offered for the fourth time for insemination (author's tranls)]. In a few A.I. associations an investigation covering all cows offered for insemination for the fourth time was performed. In all, four hundred such animals were examined clinically. Depending on the findings, the animals put into a number of diagnostic groups. Later on, a survey was made of which animals had become pregnant and which had not. Some of the animals which had remained barren were brought in for a more detailed study. Special attention was here given to late ovulation.


[Testing for the presence of moulds and yeasts, and their significance, in deep frozen food of animal origin (author's transl)]. Forty-five samples of frozen beef, horsemeat, and pig-livers imported into Belgium were examined for the presence of fungal and yeast flora by means of the agar plate print method. Mainly Penicillium spp. was isolated from meat, whereas Fusarium spp. predominated in livers. From all samples a lot of yeast colonies were isolated; 14 yeasts were identified, of which 5 with their species. The importance of these fungi for the consumer is discussed.


[Meat-containing animal foods. (1) Histological study of tinned foods. (2) Legal regulations (author's transl)]. A number of random tinned foods marketed as dog or cat food in the Netherlands were studied histologically. The histological compositions of each food studied was described in terms of primary and secondary constituents. In almost every case, vegetable material was found to be the primary constituent. In addition, legal regulations regarding animal foods in the Netherlands are reviewed.


[Decolorization of methylene blue by bovine spermatozoa and its significance in artificial insemination (author's transly]. The mechanism of action of methylene blue reduction is discussed with special reference to its relationship to the metabolism of bovine spermatozoa. The results of experimental studies of the effect of metabolic inhibitors on decolorization of methylene blue are reported. Attention is also paid to the effect of the addition of methylene blue to semen on the oxygen uptake of bovine spermatozoa. Methods used to determine the decolorization time of methylene blue in artificial insemination are reviewed. One of these methods is described in greater detail. The results of a number of experiments is concerned with the effect of environmental factors on the decolorization times of suspensions of spermatozoa are reported. Finally, the relationship between the decolorization time of methylene blue and a number of other semen characteristics as well as usefulness of this method in artificial insemination are discussed.


HL-A in Sjögren's syndrome.

HL-A in Sjögren's syndrome. HL-A phenotype frequencies were studied in 36 patients with Sjögren's syndrome and compared with those of 350 healthy individuals from the same geographical area. Patients suffering from Sjögren's syndrome had a significantly higher frequency of HL-A8 (P corrected less than 0.01). The relative risk of developing Sjögren's syndrome is 3.96 for HL-A8 positive individuals.


Effect of lung parenchyma on bronchial collapsibility during maximum expiratory flow in dogs. Effect of peribronchial lung parenchyma on bronchial collapsibility during the maximum expiration was studied in the dog lung. Maximum expiratory flow volume curve (MEFVC) was obtained from dogs with intact parenchyma (I), parenchyma being dissected away from main lobar bronchi 1.5 cm in depth (II) and the dissected parenchyma glued to the bronchi with adhesive substance (III). Lung elastic pressure-volume curve and airway resistance were almost unchanged in the three conditions. Maximum expiratory flow (V max) in condition II was considerably decreased and the ratio of decrease to the control value was high at the lower lung volumes. V max in condition III was significantly higher than the control values except at the very low lung volumes. It was proved that even if the airway down to segmental bronchi was dessected from peribronchial lung parenchyma, V max was significantly limited. It was concluded that the radial traction of peribronchial parenchyma to the bronchi reduced bronchial collapsibility considerably, and in the dissected bronchi of condition II dynamic airway collapse would occur very easily.


Aging and hydroxproline content in human heart muscle. Hydroxproline content was chemically determined in 45 human hearts obtained at autopsy, in order to know possible correlations between aging and hydroxyproline content in the heart muscle. There were no significant differences in the mean total hydroxyproline content between the epicardium and the endocardium, between left and right ventricles, nor between young, middle and old age groups. The hydroxyproline content in NaCl-soluble fraction decreased, and that in TCA-soluble fraction and in residue fraction increased with age. There were significant differences in the mean hydroxyproline content in NaCl-soluble fraction between middle and old age groups, and in residue fraction between young and old age groups in the endocardium of the left ventricle. Accordingly, the ratio of the content in NaCl-soluble fraction to that in TCA-soluble fraction decreases with age. This tendency was more evident in the epicardium than in the endocardium on the left ventricle. These results indicate that total hydroxyproline content per 1 mg of lyophilized material does not show any quantitative changes, but does show qualitative changes with age.


Clinical significance of serum glutathione reductase in various clinical conditions, especially in liver diseases. Serum glutathione reductase activity was measured in various conditions including acute hepatitis, chronic hepatitis, liver cirrhosis, malignant neoplastic diseases, and obstructive jaundice. A statistically significant elevation of the enzyme activity was found in all of these clinical conditions above normal value, especially in patients with acute hepatitis, some liver cancer, and malignant biliary obstruction. Comparison with other liver function tests showed the existence of statistically significant correlations of serum glutathione reductase with SGOT, SGPT and alkaline phosphatase in acute hepatitis, and with alkaline phosphatase in cirrhosis. In parenchymatous liver disease, serial determination was found to be important. High values in obstructive jaundice suggest the malignant obstruction.


Nerve impulse sequences correlated with the four primary taste qualities in rat. Neural correlates of the taste qualities must be contained in transient impulse trains across many nerve fibres. In the present study, ten chemicals with primary tastes were used in two or three concentrations. Gustatory impulses were recorded from thin strands, consisting of one or at most three functional nerve fibres, dissected out of the chorda tympani nerve of twelve Wistar albino rats, and their numbers in every successive 50 msec were counted for 500 msec period after gustatory stimulus onset. The results obtained were as follows (pless than0.05): 1) Nerve impulse sequence produced by substances of the salty quality were different from those elicited by chemicals of the other three qualities in 250-300 msec after stimulus onset. 2) The same was true in the case of sour and sweet qualities provided that they became dissimilar to each other in 250 msec after stimulation. 3) No difference could be recognized between impulse trains of bitter and sour solutions as well as between those of bitter and sweet ones.


Postoperative course of blood pressure and plasma renin activity in patients with renovascular hypertension. Thirty patients with renovascular hypertension were treated surgically, and they were divided into two groups according to the kinds of operations they received; nephrectomized group (group A) and revascularized group (group B). Postoperative blood pressure was followed periodically in each patient of two groups. In all patients with an excellent result (diastolic pressure of 90 mmHg or lower without antihypertensive therapy), blood pressure returned to normal within 30 postoperative days. Normal blood pressures were obtained within 3 weeks in eighty-four per cent of them. The normalization of blood pressure following operation was more rapid in group B than in A. The postoperative plasma renin activity (PRA) was determined serially in 10 patients. PRA became normal in 9 within 3 days and in one within 7 postoperative days. The restoration of PRA preceded the normalization of blood pressure. The normalization of PRA was quicker in group A than in B. It is likely that the renal antihypertensive mechanism, suppressed in the ischemic kidney and set again in motion by revascularization, mainly causes this difference in the postoperative changes in PRA and blood pressure between the two groups. It may be concluded that these findings are suggestive of an important role of impaired renal antihypertensive function in the maintenance of high blood pressure in chronic renovascular hypertension in man.


Application of ultrasonic shift Doppler technique to record velocity changes of intrauretral urine flow. Velocity Changes of intraluminal urine flow were recorded using the ultrasonic shift Doppler principle on exposed ureters of five adult mongrel dogs. This method has been used for further understanding of the speed of urine transport within the ureter when it is affected by ureteral peristalsis and the level of diuresis. Simultaneous recording of urine velocity curves and electroureterograms were performed. The results indicate that there is a direct relationship between intraluminal urine flow and peristaltic contraction. The results also show that the velocity of a urine bolus is highest during olguric conditions (urine flow1 ml/min), and, at polyuric conditions (urine flow 3 ml/min) the flow through the ureter is continuous.


[Bronchioloalveolar metaplasia during experimental influenza in mice--histological and ultrastructural study]. Squamous and "adenomatous" metaplastic changes which developed in the lungs of mice during the healing phase of experimental influenza were studied by histology and electron microscopy. The squamous nests contained epithelial cells possessing bundles of tonfibrils and being similar to bronchial basal cells. The "adenomatous" cavities were lined, either by cells related to Clara cells or by basal type-cells, which underlined cells related to Clara cells. A local and transitory hyperplasia of type II pneumocytes occurred by the third week. Both kinds of metaplasia seemed to proceed from the bronchial or bronchiolar epithelium. The adenomatous cavities might partly result from progressive differentiation of squamous epithelial cells into cells of glandular type. A ten-month long histologic survey failed to exhibit carcinomatous transformation of metaplasia. Pleiomorphism of influenza regenerative metaplasia might arise from extensive and severe epithelial changes involving all levels of the lower respiratory tract. Such a long persistence of metaplastic changes remains unexplained.


Determination of O-hydroxylysyl-glycosides (OHLG) in urine. A new method for determination of urinary O-hydroxylysyl-glycosides (OHLG) is described. Human urine was extracted with 2 volumes of ethanol, followed by gel-filtration on a column of Sephadex G-10. The presence of OHLG in the alkaline hydrolyzate of the fraction obtained by gel-filtration was proved by paper chromatography and by liquid chromatography. The alkaline hydrolyzate was subjected to Dowex 50 X4 (H+ form) column chromatography, and OHLG were eluted with 1.5N NH4OH. Content of OHLG in the eluate was determined by the anthrone-H2SO4 method in terms of hexose. Excretion rate of OHLG in urine of adults was shown to be 20 mumoles in terms of hexose per day.


Sequential change of the pontine shape after cerebrovascular strokes. Pontine cross-sectional area (Ap) and its area factor (f) were correlated with the lapse of time from the onset of stroke to death in 77 autopsy cases cerebrovascular strokes. In the cases without pontine hemorrhage, the sequential change of Ap was different from that of f, which indicated that the recovery of shape lagged behind the recovery of size. The result was attributed in part to a plastic property of the edematous brain substance and was considered important in evaluating angiographical changes of the brain and some pressure cones at autopsy.


Phytohemagglutinin-induced lymphocyte transformation in liver diseases and in asymptomatic HBsAg carriers. Phytohemagglutin (PHA)-induced lymphocyte transformation was impaired in acute viral hepatitis. It was significantly correlated with grades of liver cell damage as shown by prothrombin time, GOT, or GPT. It was also lower in drug-induced hepatitis and in prolonged hepatitis than in controls. Of asymptomatic HBsAg carriers, only those with minimal hepatic change showed lower values in stimulation index as well as incorporated radioactivity.


The record of family planning programs.

The record of family planning programs. In the developing countries in recent years there has been a great expansion of public programs to provide modern means of fertility control. This paper is an effort to appraise the demographic impact of such programs through a comprehensive evaluation of the record. The paper briefly reviews the criticisms of such programs and the historical and comparative background before turning directly to issues of performance. After establishing the broad range of acceptance, the paper reviews the nature of acceptors and of fertility control methods as they affect overall impact. Then follow a series of tabulations and analyses of country performance by both social setting and program effort in an attempt to discern the effect of "modernization" and "family planning" in line with the current controversy over their relative importance. That detailed analysis is followed by an extensive review of 14 country cases, similarly organized, plus brief summaries of 15 major experiments/demonstrations in this field and one example of a developed country program. After a brief section on the alternatives to family planning programs, the paper concludes with a summary of major findings-underlined in the text-and the authors' personal commentary on their implications for both study and action.


Setting inventory levels for hospital blood banks. A method is devised to predict the hospital blood bank inventory of each of the eight blood types that will be adequate on all but a given fraction of days (shortage rate). Analysis of the model confirms and extends prior statistical models and provides a rationale for a number of observations made on some common blood inventory practices. Comparison of the relationship between inventory levels and shortage rates predicted by the model and that calculated from data from 21 hospital blood banks of varying sizes, located in four separate parts of the country, reveals agreement within approximately 10 per cent. A procedure is presented and allows blood banks to select inventory levels and shortage rates based on their mean demand for blood.


Storage of platelet concentrates.

Storage of platelet concentrates. The American National Red Cross has initiated a cooperative clinical study designed to evaluate the therapeutic effectiveness of fresh platelets and platelets stored at 4 or 22 C for up to 72 hours. Preliminary results, in confirmation of earlier work, indicate an inverse relationship between platelet count and bleeding time in patients with thrombocytopenia transfused with fresh platelets. Also, the observed rise in platelet count immediately following transfusion of fresh platelets is generally maintained for four to eight hours after which time it declines significantly.


In vivo distribution of injected 14C-dioxyadenine in tissues and organs of normal rats. A large dose of 2, 8-dioxyadenine-14C was injected intravenously into rats and its fate followed at several intervals during the first 24 hours after administration. The distribution of the radioactive material throughout the various tissues or organs was calculated and expressed as a percentage of the injected dose as well as a specific activity per unit organ weight. It appears that dioxyadenine is rapidly distributed throughout the organs and tissues of the rats and that specific concentration occurs in a few organs. High retention of the radioactive material and a very high specific activity are observed in the kidney. Smaller but significant concentrations of the 14C-compound are also observed in muscle and skin, and cannot be attributed to the presence of residual blood. The radioactive material is gradually released from these tissues and, by 24 hours after injection, 92 per cent of the injected dose is found in the urine. Microscopic observation shows deposition of crystals in the kidney. Crystals are also present in the urine and appear as small slightly yellow spheres.


Effect of high doses of methylprednisolone on the isolated, perfused canine kidney. The administration of methylprednisolone (MP) (2.125-4.125 G) To the cryoprecipitated plasma perfusate of 41 canine kidneys preserved with hypothermic pulsatile perfusion is associated with increased vascular resistance, decreased plasma flow, and rising perfusion pressure that become more pronounced over periods up to 20 hr. The magnitude of the increase in renal resistance is directly related in a bimodal fashion to the dose of MP and to the interval following drug administration. The increase in renal resistance is generally irreversible (three or four cases) under conditions of high MP dosage (2.125 g) administered for 4 hr or longer. Severe histological changes occurred in kidneys perfused with MP 20 hr or longer. These changes were primarily glomerular changes consisting of necrosis of capillary loops, occlusion of Bowman's space, basement membrane thickening, and endothelial cell damage; tubular changes consisting of occlusion of tubular lumens and tubular epithelial cell damage; and arteriolar changes consisting of occlusion primarily of afferent arterioles with dense eosinophilic material. These studies demonstrate that the administration of high doses of MP can produce irreversible hemodynamic and histological changes in the isolated, perfused kidney and may preclude its use in pretreating kidneys for transplantation.


Genetics of anti-A and anti-B levels.

Genetics of anti-A and anti-B levels. Hemolysins and agglutinins anti-A and anti-B were measured in 401 blood group O individuals belonging to 74 families. Levels of hemolysins and saline agglutinins reached a peak during childhood and decreased thereafter. Incomplete agglutinins showed a relative increase after childhood. Hemolysins and agglutinins were higher in blacks than in whites. Whites had higher anti-A than anti-B levels and the levels were higher in females than in males. In blacks the anti-B levels were almost as high as were the levels of anti-A and little sex difference was found. Levels of hemolytic anti-A and saline anti-A were closely correlated as were hemolytic anti-B and saline anti-B but low correlations were found between anti-A and anti-B levels. Anti-A and anti-B hemolysin and agglutinin levels were positively correlated with serum IgM levels but anti-A levels were not. Isoantibody levels were not correlated with IgA, IgD, and IgE levels. Correlation and regression analysis among relatives disclosed that from 20 to 30 per cent of the total phenotypic variation in isoantibody levels was accounted for by genetic variation. Age of the individual also contributed markedly to the variation in hemolysins and saline agglutinins, but about one-half of the total variation remained unaccounted for.


Granulocyte kinetics in donors undergoing filtration leukapheresis. Normal blood donors undergoing filtration leukapheresis (FL) have a profound transient neutropenia early in the procedure which is followed by a "rebound" neutrophilia. This phenomenon occurs in unstimulated donors as well as in donors pretreated with either prednisone or dexamethasone. The mechanism for development of the neutropenia was investigated in volunteers throug a nylon filter at 37 C, a significant but transient neutropenia was observed. Plasma rendered cell and stroma-free achieved the same result indicating that plasma alone, when exposed to nylon fibers, is capable of producing neutropenia.


Blood preservation XVI packed red cell storage in CPD-adenine. Interest has been renewed in CPD-adenine as a long-term liquid blood preservative. The question of whether the metabolic product of adenine, 2,8-dioxyadenine was toxic to humans has apparently been resolved by extensive animal and human studies in favor of there being no potential toxicity in the amounts used in blood preservation. Sweden is adopting CPD-adenine (0.25 mM) as its national blood preservative after ten years of clinical experience in trials. They have shown that each additional week of storage time beyond the current three weeks with CPD results  in a 50 per cent reduction of wasteage caused by outdating. They are adopting the 35-day time for regular use with 42 days for an emergency reserve supply. However, many units of blood in the U.S. are stored as packed red blood cells and the question has been raised as to whether there is sufficient glucose in the preservative to maintain red blood cell metabolism in the packed cell unit. The present investigation indicates that there is sufficient glucose for 35 days of packed cell storage in CPD-adenine (0.25 mM) but in some units this might be marginal at 42 days of storage.


A hand-held electronically switched array for rapid ultrasonic scanning. This paper describes the design and construction of a simple multi-element transducer array capable of converting an A-scan unit to a real-time, hand-held section scanner. Elements are connected in groups of four to give a finer stepping interval than is possible with discrete transducers. Application of the array as an inexpensive alternative to conventional B-scanners is discussed, in addition to its more obvious application as a non-invasive method of imaging the moving heart.


A real time 2-dimensional ultrasonic scanner for clinical use. The technical details of a real time 2-dimensional ultrasonic scanning system are described, with particular regard to the improved clinical performance over other 2-dimensional scanners. Our instrument is capable of being used with existing ultrasonic equipment extending certain standard ultrasonic machines for use as real time 2-dimensional scanners conveniently and at little cost. Initial results are given and future technical developments are discussed.


Contribution to the optimal use of human blood. VII. Increase of the yield of factor VIII in four-donor cryoprecipitate by an improved processing of blood and plasma. The influence of different variables on the yield of factor VIII in cryoprecipitate as prepared in the Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, was studied. The following conclusions may be drawn: (1) In case blood should be stored, the use of the anticoagulant solution acid citrate dextrose (ACD) is preferable to citrate phosphate dextrose (CPD) or trisodium citrate (TSC). (2) The temperature of stored whole blood should not decrease below 8 degrees C because of a spontaneous precipitation of factor VIII from blood (and plasma) below this temperature. (3) Cryoprecipitate derived from rapidly frozen plasma (1 min) contains a decreased amount of proteins in comparison with cryoprecipitate prepared from slowly frozen plasma (45 min to 4 h). On the other hand, equal amounts of factor VIII activity were obtained in the precipitate after freezing of plasma at varying rates. (4) Rapid thawing of plasma results in both higher yields of factor VIII procoagulant activity and a higher specific activity of this factor in the resulting cryoprecipitate. (5) The sedimentation of cryoprecipitate is completed after 5 min centrifugation at 1,500 g. (6) At temperatures higher than 8 degrees C, cryoprecipitated factor VIII starts dissolving into the supernatant plasma or in buffer. (7) Factor VIII in lyophilized cryoprecipitate is stable at room temperature. At elevated temperatures it rapidly looses its activity. (8) Evidence was obtained that the improvements which are introduced in the preparation of factor VIII do not lead to a product which is less stable in vitro as well as in vivo.


The lecithin: cholesterol acyltransferase reaction, lysolecithin and red cell ageing in blood stored under normal transfusion service conditions. The lecithin:cholesterol acyltransferase (LCAT) activity and lysolecithin content of human blood stored under standard blood transfusion service conditions at 4 degrees C for 6 weeks has been investigated. Cooling the blood to 4 degrees C rapidly inactivates the LCAT reaction, but the enzyme is not denatured during storage under these conditions. Citrate in the anticoagulant did not activate the LCAT reaction in freshly-taken whole blood. The total phospholipid and total lysolecithin content of whole blood decreased during storage at 4 degrees C for 6 weeks. The lysolecithin content of fresh red cells (2.0-3.0 mumol lysolecithin x 10(-11) per cell) showed no significant change during the storage period.


Separation of two hepatitis B human antibody fractions by cold-ethanol precipitation. Antibodies to three different samples of hepatitis B antigen-positive serum were found to be absent from a Cohn fraction II hepatitis B immune globulin preparation, but present in the whole plasma from which the immune globulin was made. Fractions containing the antibodies specific for the three antigen samples were isolated from the plasma by euglobulin precipitation, and the antibodies were characterized as to immunoglobulin class and precipitability in the Cohn fractionation procedure. They appear to be IgG antibodies which, however, were detectable only in Cohn fraction I, while the remainder of the HB specificity present in the original plasma was found, as expected, in fraction II.


Activity of B-gene-specified galactosyltransferase in individuals with Bm phenotypes. Blood group B-gene-specified alpha-galactosyltransferase was determined in serums and erythrocyte membranes of several related persons with Bm phenotypes. The level of this enzyme in serums was similar to, but in erythrocyte membranes much lower than that found in normal B and AB persons.


Linkage studies between HL-A and GPT polymorphisms and other genetic markers. The phenotypes of 56 families with 126 children from the Hamburg area as well as gene frequencies and segregation of the genetic markers GPT, AP, ADA, AK, PGM1, PGM3, 6-PGD, CHE, C3, Gc, Tf, Hp and Cp were studied. In regard to linkage, the informative families were correlated to the results of HL-A and GPT typing. The linkage was tested according to the sequential test by MORTON (1955). See article. For other gene loci, linkage to the HL-A or GPT system could not be proved. But the positive lod scores of HL-A/GPT, HL-A/AP and GPT/6-PGD may give indication for linkage.


The HL-A system in Thais.

The HL-A system in Thais. The HL-A antigens were studied in 100 Thai subjects. HL-A2, 11 and 9 of the first series and W15, HL-A17, 5, and 13 of the second series were commonly found. HL-A2-11 and W15- were the commonest phenotypes observed in the first and the second series, respectively. The HL-A2, X2, and 2, W15 were the most common haplotypes. However, there was no significant gametic association.


Groups of alpha-D- galactosyltransferase activity in sera of individuals with normal B phenotype. II. Relationship between transferase activity and red cell agglutinability. In the Paris population of blood donors with normal B phenotype, two groups can be formed owing to their respective serum alpha-D-galactosyltransferase activity and red cell agglutinability with an anti-B antibody. Both parameters are closely correlated. The agglutinability groups partially overlap. In an African population from various ethnical origins, this correlation was observed only in some individuals. 11 among 20 subjects belonged to a third group defined by a high transferase activity. The third group with the strongest agglutinability previously described by GIBBS et al. [6] were not encountered. On the other hand, serum transferase activity varied inversely as agglutination scores with anti-H (Ulex). Both parameters are closely correlated but not in the same way in Caucasian as in African individuals. In the latter, this relation does not depend on the agglutinability group. The H antigen strength variability, according to ethnical origins, may explain these results.


An Alberta Cree Indian with a rare Duffy antibody, anti-Fy 3. Anti-Fy3, found in the serum of an Fy(a-b-) Cree Indian woman believed to have been transfused 5 years previously, caused moderate hemolytic disease of the newborn in her eighth live-born baby. Only three examples of anti-Fy3 are know. It is striking that two were made by non-negro people, amongst whom Fy(a-b-) is extremely rare, and only one by a Negro, in whose people Fy(a-b-) is by far the commonest phenotype. This suggests that Fy(a-b-) may be a heterogeneous phenotype, with the negro version conferring some impediment to immunization by Fya, Fyb or Fy3 antigens. The rare allele Fyx is also present in the kindred of the propositus, and is shown to correspond to weak Fy3 as well as weak Fyb anitgen.


Anti-Pr3: serological and immunochemical identification of a new anti-Pr subspecificity. A monoclonal IgM(kappa) anti-Pr cold agglutinin occurring after a rubella infection is shown to have the 'new' anti-Pr subspecificity anti-Pr3. Pr3 determinants are found on cat and sheep erythrocytes which lack Pr1 and Pr2 determinants. By carbodiimide treatment of human erythrocyte glycoproteins, which causes intramolecular coupling of N-acetylneuraminic acid carboxyl groups and nucleophilic centers of the glycoprotein backbone, Pr3 antigen activity is strongly increased, while Pr1 and Pr2 determinants are inactivated.


Study of antigenic varieties of group A red cells, platelets and lymphocytes using liquid phase electrophoresis. The authors attempt to study the presence of subgroups of the phenotype A on lymphocytes and platelets with the help of liquid phase electrophoresis. The results show that anti-A of B serum reduces the electrophoretic mobility of red cells, platelets and lymphocytes of group A but leaves unchanged the mobility of group O or B cells. The same variations are observed in red cell lymphocytes and platelets. The authors suppose that the distribution of antigenic sites is identical in these elements.


Capillary tube testing and enhancement with 30% Albumin. Capillary tube methods are reviewed and modifications with albumin are described with emphasis on detection of antigens in the major red cell systems and in HL-A and related systems using red cell suspension.


A simple technique for the inactivation of IgM antibodies using dithiothreitol. This report describes a simple method for inactivating 19S red cell antibodies using the odorless compound dithiothreitol (DTT). 30 sera which contained antiglobulin-active red cell antibodies showed virtually no alteration in activity after DTT treatment, while 30 different sera containing cold-active red cell antibodies showed almost total elimination of activity following DTT treatment. Six sera were separated into IgG and IgM fractions. All red cell activity was eliminated in the IgM fraction, but was unaffected by DTT treatment of the IgG fraction. This method of inactivating IgM antibodies should be of value in investigating cases of hemolytic disease of the newborn and in studying sera containing mixtures of warm and cold red cell antibodies.


A lymphocyte immunogenetic system, Atri, associated with the ABO blood group and the ABH secretor system. The antigen Atri can be detected on the lymphocytes of 5.19% of A, ABH secretor individuals. The Atri substance is present in the plasma of the same individuals and can be fixed on group O erythrocytes. It is also found in the saliva of 30 out of 32 A non-secretor individuals. Its existence in the saliva of A  secretor individuals, however, cannot be proved due to the presence of both the A and Atri antigens. The A AND Atri antigens have been shown to be distinct on lymphocytes by capping and by blocking of the A sites. The fact that in several families the Atri antigen is not expressed by the parents shows that its expression on lymphocytes requires the intervention of at least one gene in addition to ABO and Se.


Editorial: Red cell ageing and death.

Editorial: Red cell ageing and death. To obtain red cell populations of increasing mean age erythropoiesis was arrested through continuous actinomycin treatment or maintained transfusion polycythemia in mice and rats respectively. The parameters studied included cell indices, enzyme activities and rheological characteristics. Further, the life-span of aged cells was compared to normal, and the sequestration site was determined.  Mice erythrocytes, like those of rats, exerienced a continuous decrease in MCV1, an early rise in MCHC, and late MCH reduction. In ageing rat erythrocytes the activities of HK, GR and 6-PGD did not fall below the normal range during the first 9 tenths of the potential life-span. On the other hand, a borderline reduction of PK activity was found, and the activity of G-6PD underwent a steady though unimpressive decrease to 70% of the physiological average. Aged erythrocytes, forced through 15-mum capillaries differed in apparent viscosity from reticulocytes and normal cells by a factor of 1.31 and 1.16, respectively. Destruction of senescent cells was predominantly confined to the spleen, and prolonged erythrocyte survival followed splenectomy.


A new antibody specificity, anti-Rga, reacting with a red cell and serum antigen. A new antibody specificity, anti-Rga, which detects an inherited antigen on red cells and in serum, reacts with 97% of individuals in the British population.


Familial clustering of selective IgA deficiency. Serum IgA levels of 35 healthy IgA-deficient index cases, of their 180 first-degree relatives, and of 31 other family members were studied. IgA deficiency was detected in 7.2% of the first-degree relatives, which is significantly more than the 0.25% frequency of IgA deficiency in healthy Finnish blood donors. Subnormal serum IgA levels were found in additional 13 (7.2%) first-degree relatives. The familial clustering of IgA deficiency seemed to be controlled by multigenic factors. IgA-deficient persons and their family members were tested for antinuclear and antithyroid antibodies, for rheumatoid factor (by latex test) and for other anti-IgG antibodies (by Ripley test). Antibodies against bovine milk were also studied. The relatives of IgA-deficient persons did not have more of these antibodies than the controls. It is suggested that various serological abnormalities are a consequence of the IgA deficiency rather than of genetic defects per se.


HBsAG and anti-HBs among Israeli blood donors. Prevalence of HBSAg was studied by counterelectrophoresis (CEP) in 65,795 consecutive volunteer blood donors in Israel. The overall prevalence of HBSAg was 1.22% HBSAg was more prevalent in the young donors, more prevalent in male donors and varied according to the country of origin of the donors. The prevalence of HBSAg was 0.63% among donors born in Europe or the Americas and 2.83% for those born in Asia of Africa. The HBSAg prevalence among native Israelis followed the same pattern with higher prevalence rates among those born in Israel whose families came from Asia or Africa than those from Europe or America. The prevalence of Anti-HBS by CEP was studied in 39,519 donors. The prevalence of antibody was higher in females and was higher in the same ethnic groups in whom there was a relatively high HBSAg prevalence.


A study of red cell H-content in Ugandan Africans and Europeans of group O. The H-content of the red cells of 52 Ugandan Africans and 53 Europeans, all of group O, was measured using agglutination with an extract of Ulex europaeus. There was no appreciable difference between the scores in the two populations.


Action of African B gene on A, subgroup of A. The action of strong B gene on A1, subgroup of A is demonstrated in a family of 18 individuals. The inheritance of A2BHw and A2BHw is explained. Attention is drawn to these subgroups in parentage studies, especially in Africans.


Production of immune anti-Lewis sera in goats. Incomplete anti-Lec, anti-Led, anti-Les (anti-Leb+Led), anti-Lens (anti-Lea+Lec), anti-Lem (anti-Leb+Lec) and anti-Lex (anti-Lea+Leb) antibodies were prepared by the immunization of goats with boiled saliva, absorbing the resulting sera with trypsinized erythrocytes. The discovery (2) of anti-Led which reacts only with Le(a-b-) red cells of secretors, together with an analysis of the theories of GRUBB and CEPPELLINI led the present author to predict the existence of anti-Lec which would react only with Le(a-b-) red cells of non-secretors. GUNSON and LATHAM (1)reported their finding of an antibody fulfilling this latter criterion in the serum of a sample submitted for routine antenatal tests.


The HL-A type of Rg(a-) individuals.

The HL-A type of Rg(a-) individuals. The investigation of 2 examples of anti-Rga led to the observation that the phenotype HL-A 1,8 occurs very frequently among Rg(a-) individuals.


More Salvia agglutinins.

More Salvia agglutinins. Six further examples of haemagglutinins from Salvia are reported; one is anti-T and 5 are anti-Tn.


Optimal conditions for the use of sulphydryl compounds in dissociating red cell antibodies. Optimal conditions for the use of 2-mercaptoethanol (2-ME) and dithiothreitol (DTT) in the inactivation of IgM red cell antibodies were investigated. 0.2 M 2-ME was better than 0.01 M DTT; higher concentrations of these 2 substances could not conveniently be used because of gel formation. Incubation at 37 degrees C led to far more rapid inactivation than incubation at 22 degrees C; with 2-ME a period of 15 min at 37 degrees C was sufficient except with very potent antibodies, which were not inactivated even after 3 h incubation. When indirect antiglobulin tests were carried out on 2-ME-treated serum which had not been dialysed, false-positive results were obtained, although only with the mixture of equal volumes of undiluted serum and of 2-ME; results were negative in tests on dilutions of the mixture in saline. False-positive results could also be avoided by incubating the serum for 3 h with iodoacetamide, but this method also involves dilution of the serum. The only method whereby 2-ME-treated serum can be tested without diluting it and without obtaining false-positive reactions is to dialyse it overnight against saline. Since this method also gets rid of the noxious smell of 2-ME it is to be preferred for most purposes.


Neurosurgical microvascular bypass for stroke. A review of the present status of neurosurgical vascular bypass for problems of cerebrovascular occlusive disease is presented. In 70 patients who have undergone operations by one surgical team, the results are most encouraging in cases of transient ischemic attacks with hemodynamic lesions previously considered inoperable or inaccessible in the cerebral vasculature. The morbidity rate is acceptable and the present operative mortality rate is 1.4 percent.


Congenital dislocation of the hip.

Congenital dislocation of the hip. Congenital dislocation or subluxation of the hip (congenital acetabular dysplasia) is a complete or partial displacement of the femoral head out of the acetabulum. The physical signs essential for diagnosis are age related. In newborns the tests for instability are the most sensitive. After the neonatal period, and until the age of walking, tightness of the adductor muscles is the most reliable sign. Early diagnosis is vital for successful treatment of this partially genetically determined condition. Various therapeutic measures, ranging from abduction splinting to open reduction and osteotomy, may be required. Following diagnosis in the first month of life, the average treatment time in one recent series was only 2.3 months from initiation of therapy to attainment of a normal hip. When the diagnosis was not made until 3 to 6 months of age, ten months of treatment was required to achieve the same outcome. When the diagnosis is not made, or the treatment is not begun until after the age of 6, a normal hip will probably not develop in any patient.


High risk perinatal care in California.

High risk perinatal care in California. Rates of perinatal mortality are still too high in California. Mortality and morbidity, particularly for high risk pregnancies, can be reduced by the use of modern technology in the hands of highly trained personnel. New goals for perinatal care have been published by the California Medical Association reflecting these changes. This kind of care is too costly to be developed in all the small obstetric units presently providing services in California. Consolidation of obstetric and neonatal units into fewer hospitals can make it economically possible for these units to meet present-day standards.


[Indications and findings in the electronic monitoring of the fetus during birth]. From 1971 to 1974 in the Department of Gynecology and Obstetrics of the Humboldt-University of Berlin we monitored 1132 fetuses. The extent of the analysed groups runs to 306 to 632 cases, according to the completeness of the investigations and documentation. We have compared our CTG-findings with those of other authors. We found relationships between the risk factors and the CTG findings: for low weight fetuses more frequent Dip I, for maternal vitium cordis more frequent fetal tachycardia, for meconium stained liquor more frequent smooth baseline (silent) for EPH-gestosis (toxemia) more frequent Dip II (late deceleration) and variable deceleration. The relationships between the risk factors and the CTG findings are loose and not suitable to verify the great differences in frequency of the CTG pattern, published in the literature. We believe, that these differences are caused by different definitions and subjective interpretation of the CTG.


[Influence of electronic monitoring of the fetus on the frequency of surgery and on the status of the newborn infant]. In the years from 1971 to 1974 the rate of fetal monitoring of high risk deliveries rose from 3.0% to 23.7%. In this time our clinic become a center of high risk pregnancies (reproductive failure and prematurity). By this way we could not show a decrease of the perinatal and intranatal mortality. The increase of caesarean sections from 3.0% (1968) to 6.0% (1974) was caused by the increasing of high risk patients. Fetal monitoring is not a cause for rising of operative frequency. By means of fetal monitoring the Apgar score of the newborns from mothers with severe diseases is not significant worse than from newborns of mothers with more easy diseases.


[Clinical problems in extreme fetal retardation]. Three cases of extreme fetal somatic retardation are reported. Fetal retardation is the consequence of chronic placental insufficiency and is affected with a high lethality. It is necessary to recognize suspicious cases by anamnesis and clinical findings; a method of differential diagnostic procedure is described. After demonstrating the placental insufficiency and sufficient fetal maturity the indication for finishing pregnancy is given even though the fetus is extremely small.


[Use of hypertonic solutions through umbilical cord vessels]. The authors report on a newborn with skin necroses and fibularis paresis after postnatal administration of NaHCO3 via the umbilical cord. Then some problems of postnatal buffer therapy are discussed. After a review of advantages and disadvantages of puncture or cannulation of the umbilical vein on the one hand and its catheterization on the other, the former procedures are preferred for an effective buffer therapy, provided strict indications are followed.


[A case of complete amelia in a newborn infant. (Contribution on the etiology of breech presentation)]. The authors related a case of complete absence of all extremities (amelia) in a newborn delivered by the breech. The cause of the breech presentation has been attributed to the shape of the fetus and to lack a fetal movements. The reflexes of the fetus are important for establishing a normal presentation.


[Ectopic pregnancy carried to full term with a living infant]. A section delivery was performed for transverse lie on a fourth para of 38 years at the beginning of labour on term. Thereby a full term extrauterine gravidity was found. According to the placental insertion in the ampullar part of the tube, on the ovary and upon the visceral peritoneum it can be classified as tubo-abdominal pregnancy which probably had developed after rupture of a tubal pregnancy which initially was established in the ampullar part. Blood supply was accomplished mainly by the hypertrophied ovarian vessels of the right side. After removal of the amniotic sac and partial resection of the great omentum the uterus had to be amputated supracervically for excessive loss. The postoperative course was uneventful, mother and child were discharged healthy.


[Results of rigid osteosynthesis treatment of diaphyseal fractures of the tibia]. The data for 301 patients (90% of the patients operated on), has been worked out. Those who had received rigid osteosynthesis treatment, were patients who had sustained fractures too critical to be treated with more conservative means. 64.8% of these fractures were of the complicative multifragment type. Of the indirect type, only the open fractures, and those that had become redislocated, were surgically repaired. It is believed that R. O. of open fractures is a routine part of primary surgical treatment. The patients' age ranged from 20-90 years; most of whom (55%) were involved in traffic accidents. All of the R. O. procedures were done urgently, in so much as no contraindications existed. 78% of the patients were operated on two hours following their admittance to the hospital. The material used during the R. O. procedure included platetted immediately following the R. O. procedure. Total anatomic reposition was accomplished with 95% of the cases. Repeat osteosynthesis due patients. 9.3% resulted in perifragmental purulence, whereas only 1.8% of the closed fractures resulted in the same. Sequestration had never occured when the bone was unexposed, however, this was found to occur in one out of every 4 patients in which the bone was exposed. Seven of the patients had expired, 4 due to fat embolism, 2 due to pulmonary embolism, and 1 due to a brain contusion; only one amputation was performed due to gas gangrene. Rehabilitation of the patients was carried out in the immediate postoperative course, and lasted a relatively short time. 90% of the patients had to change jobs due to poor rehabilitation.


[Pelvic ectopia of the kidney in children]. The authors presented the problem of pelvic ectopia of the kidney in children on their two patients. Pelvic ectopia of the kidney is a rare anomaly, while an ectopia of only one kidney is an extremely rare phenomemon. One of the two patients, which are the subject of this summary, was an 18 months old child who had one normal kidney and one ectopic kidney; a nephrectomy was performed. The second patient was an 11 years old child with pelvic ectopia of only one kidney, and a cysto-ureteric reflux. In this case, a reimplantation of the ureter into the vertex of the urinary bladder was performed.


[Transthoracic truncal vagotomy as an operation necessary in peptic ulcer of the jejunum]. Peptic ulcers require radical surgery in most cases, typically involving resection of the gaster and a vagotomy. However, as post partial gastrectomy recidive peptic ulcers are usually recistant to internal treatment, and since often patients so afflicted are in poor physical condition, the surgeon must choose the least radical procedure. Because of this, the authors feel that in cases of perforative and/or bleeding peptic ulcers of the jejunum, the transthoracic truncal vagotomy in the procedure which is least taxing for both the patient and surgeon. The operation is short, easy to perform and does not considerably alter the condition of the patient. To date, at the Surgical Clinic of the "Braca Dr. Sobol" Hospital (Rijeka), on about 2000 gastric resection, only 11 transthoracic truncal vagotomies, as exclusiv operations, were performed. Postoperatively, these patients were supervised several months to ten years or longer. In all cases the pain and bleeding subsided. For these reasons, the authors recommend this minimal but necessary operation.


[Implantation of nuclear pacemaker].

[Implantation of nuclear pacemaker]. A case of a patient who received a QRS synchronous pacemaker following an AV block as a permanent therapeutic measure was presented. During reimplantatoon, a nuclear pacemaker, as opposed to the conventional type, was implanted. The nuclear pacemaker derived its energy from Prometium 147. The nuclear impulse generatory, and the principles of its function have been described in the introduction.


[Luxatio pedis subtalo].

[Luxatio pedis subtalo]. A case of an open external subtalus dislocation was presented, this dislocation was successfully reduced at our institution 9 hours after injury.


[Cysts of the choledochus. Report of a case]. Cysts of the common bile duct, (also known as common bile coeles, or as common bile cysts) are quite rare. Those of the ampulla of Vater are a curious phenomena. Cysts of the extrahepatic part of the common bile duct can be quite large, excentrically located, and produce a triad of symptoms: pain, tumor and jaundice. These symptoms are intermittent, however, due to the periodic emptying of the cysts' contents into the duodenum. Cysts of the ampulla of Vater are those which occur in the intraduodenal part of the bile duct, and almost always found projecting into the lumen of the duodenum--imitating a tumor as it was in our case. Preoperative diagnosis of these cysts is extremely difficult, especially if the cyst is situated on the ampullar part of the common bile duct, and they are usually discovered during the operation. Possible compression of the ampulla of Vater, and the pancreatic duct can result in recidivating pancreatitis. The operative approach is dependent on the size of the cyst, and its location. The best is the complete removal of the cyst, and a correction of bile flow.


[To treat or not to treat chronic lymphocytic leukemias with a mild course?]. The study is based on a material of 60 patients with chronic lymphocytic leukaemia of mild course with survival over 4 years. The method used was a comparison of the patients treated from the time of diagnosis establishment with the group of similar patients not treated throughout the whole period of follow-up and with another group of patients treated from the time of exacerbation of the proliferative process. The following data were taken into account: survival length, degree of splenomegaly and lymphadenopathy, leucocyte and platelet counts, haemoglobin level, infectious complications. It was demonstrated that cytostatic and/or hormonal treatment started at the time of diagnosis establishment did not prolong the survival. A statistically significant prolongation of survival time was observed, on the other hand, in cases treated from the time of exacerbation. Cytostatic agents increased the risk of infections and the risk of thrombocytopenia.


[Surface immunoglobulins of lymphocytes in chronic lymphocytic leukemia]. Using the fluorescence technique the presence of various immunoglobulin classes (IgG, IgA, IgM) was determined on the surface of peripheral blood lymphocytes obtained from healthy subjects (10 cases) and from patients with chronic lymphatic leukaemia (65 cases). In the investigations the effect of treatment and clinical course on the values of these parameters was taken into consideration. Nearly in all cases of this leukaemia the percent of lymphocytes binding immunoglobulins on their surface was raised in comparison with the lymphocytes of healthy subjects. Presence of one or more classes of immunoglobulins was demonstrated on the surface of leukaemic lymphocytes.


[Hematological studies of the populations of Lower Silesia living in different ecological conditions]. Haematological investigations were carried out in different population groups in Lower Silesia. The total material investigated included 439 men and 229 women. The investigations demonstrated that the haemoglobin level, erythrocyte count haematocrit index were lower in the population of villages lying around copper processing plants. The mean reticulocyte count exceeded significantly that in the control group. The highest parameters of erythrocyte system were found in the group of men from a large city despite their occupational exposure to exhaust gases. The leucocyte count was 6-7000/mul in all groups with the exception of the urban group in which it was 1000-1500/mul lower than the mean values in the remaining groups. Lymphocytosis was observed most frequently in this group. The highest mean percent of granulocytes and the lowest incidence of lymphocytosis were observed in the control group from a rural population in a non-industrialized area while rural groups around industrial centres showed intermediate values. In the female group from a locality exposed particularly to industrial pollution low platelet count was frequent.


[Effect of cytostatic drugs on the metabolism of incubated human blood platelets]. Degranol was chosen from the group of cytostatic drugs and Cytosar and Flucrouracil from the group of antimetabolites for investigations on the effects of cytostatics on the metabolism of thrombocytes. After isolation from blood collected on ACD fluid thromtocytes were suspended in own plasma containing EDTA and the cytostatic agent in a concentration of 6 x 10(-3)M and were subjected to incubation during 3 hours at 37 degrees C. After incubation the thrombocyte count, the levels of nucleotide compounds, and adenine nucleotides (ATP + ADP) released by thrombocytes under the action of thrombin, and the activity of dehydrogenase glucose-6-phosphate and lactic dehydrogenase were determined. The results of these determinations showed that only Degranol as a compounds belonging to the group of alkylating cytostatics caused lowering of ATP level (by about 30%) in the incubated cells. The drugs from the group of antimetabolites caused no significant changes in the studied parameters.


[Leukemic form of lymphosarcoma (clinical study of 7 cases]. Seven cases of leukaemic form of lymphosarcoma are presented. In all studied patients three characteristic signs were present: generalized lymphadenopathy, presence of lymphosarcoma cells in peripheral blood, spontaneous proliferation of white blood cells in short-term culture. Differential diagnostic difficulties with regard to chronic lymphatic leukaemia are stressed. It is thought that the sign of spontaneous proliferation may be used as a differential diagnostic criterion.


Studies on the human evoked electrospinogram. II. The conduction velocity along the dorsal funiculus. The propagation velocity of the ascending volleys along the dorsal funiculus of the human spinal cord was studied in 31 normal volunteers. Intrathecal recordings from lower cervical and lower thoracic intervertebral levels were made after the supramaximal stimulation of the posterior tibial nerves. When the electrode tip was behind the cord dorsum at the cervical level, it was easily possible to obtain very clear triphasic compound action potential on stimulation of the posterior tibial nerve of one leg or both legs. This "Tractus Potential" was found to originate mainly from the dorsal funiculus fibres, i.e. Fasciculus gracilis. The maximal conduction velocity of the ascending afferent volley from the leg was then calculated to be, on average, 37 meters/sec between lumbar and cervical spinal enlargements. Intrathecal stimulation and recording of the spinal cord gave the distinct triphasic wave with low threshold. This was also found to be related to dorsal funiculus activity. In these intraspinal stimulations and recordings, very early small and some late long-lasting deflections appeared, especially in the lateral position of the intrathecal electrode.


Studies on the human evoked electrospinogram. I. The origin of the segmental evoked potentials. Evoked potentials from the human spinal cord were studied in 39 normal volunteers. Intrathecal recordings from lower cervical and lower thoracic intervertebral levels were made after the supramaximal stimulation of the median, ulnar and posterior tibial nerves, respectively. It was shown that the segmental cord potentials varied in shape and size according to the spatial relationship between the position of the electrode tip and the spinal cord and roots within the vertebral canal. Three main types of segmental evoked responses were obtained. One of them was recorded behind the cord dorsum and around the midline, and was composed of fast, sharp early, and slow, late components. This was called a CD potential and its first component was related to the activity of the ascending dorsal funiculus fibres. The second evoked response was the DR potential, and this triphasic compound action potential of very high amplitude and longer duration had no remarkable late component. It was recorded when the tip of the intrathecal electrode was lateral to the midline within the vertebral canal, and was then related mostly to activity of the spinal roots. Another kind of potential was called PH potential. It had a very small triphasic spike and two later components with prominent negativities being higher than the first spike. This potential might be related to the electrode tip position facing, and close to, the posterior horn of the spinal gray matter. Late components of the segmental evoked potentials were related to the pre- and post synaptic activity of the horizontally oriented fibre within the segmental gray matter of the posterior horn.


Circulating IgE, allergy and multiple sclerosis. Serum levels of IgE, other immunoglobulins and complement (C's) in patients with multiple sclerosis in exacerbation and other neurologic diseases. Serum levels of IgE, other immunoglobulins and C'3 were measured in 36 MS patients, and the results compared with those of 40 age- and sex-matched patients hospitalized on Neurology Service. Diagnoses among controls included cerebral infarction, cervical spondylosis, nonmigrainous headache, seizure disorders and peripheral neuropathy. Six patients in the MS group and seven in the non-MS group had a past history of allergy to food, drugs, dust or other substances. IgE levels were measured by double-antibody radioimmunoassay. Other immunoglobulins (G, M, D and A) and C'3 were quantitated by Mancini's method. Results indicate that the median IgE and C'3 levels of MS patients were slightly lower than those for non-MS subjects. Concentrations of other immunoglobulins were similar for the two groups. CSF samples from 12 MS and five non-MS patients were studied and none of these contained measureable (greater than 7.5 U/ml) IgE. In view of: 1) recent reports describing mast cells in  MS plaques, 2) the suggested role of biogenic amines in the pathogenesis of demyelinating diseases, and 3) because IgE exists in free and cell bound state, it is suggested that tissue surveys of MS plaques for IgE deposits similar to those seen in glomeruli in nephrotic syndromes may provide a clue to the pathogenesis of MS.


The linoleic acid depression (LAD) test for multiple sclerosis using the macrophage electrophoretic mobility (MEM) test. With the macrophage electrophoretic mobility (MEM) test of Field & Caspary, lymphocyte sensitization to thyroid antigen (F1-fraction) is demonstrable in all subjects--multiple sclerosis (MS) patients, those with other (destructive) neurological diseases (OND) and normals. The MEM-LAD test enables a further differentiation to be made in neurological patients compared ot normals: Linoleic acid inhibits the positive result by about 95 per cent in the case of MS, 58 per cent in normals and 45 per cent in OND. The high reduction appears to be a characteristic of MS. It is seen at all stages and in all forms of the disease and is not materially influenced by moderate immunosuppressive therapy. The mothers of MS patients show an intermediate result of about 78 per cent, suggesting a familial (genetic) background to the metabolic phenomenon described here; there is, however, evidence of an added exogenic factor for the development of the disease. The theoretical basis of the LAD test suggests further therapeutic trials of linoleic acid in treatment of MS.


Malignancy grade and long-term survival in brain tumours of infancy and childhood. 281 histologically verified brain tumours in children were revised and reclassified according to degree of histological malignancy. Survival graphs based on 100 per cent follow-up after 15-40 years show that, of those who survived for more than 1 month after diagnosis and possible operation, 40 per cent were still alive more than 15 years later. There was a clear correlation between survival and degree of malignancy. Sixty-five per cent of those with tumours of malignancy grade I and only 3 per cent of those with malignancy grade IV were alive after 15 years.


The prognostic significance of subfebrility and fever in ischaemic cerebral infarction. The prognostic influence of subfebrility and fever during the first week after an ischaemic cerebral stroke was analysed retrospectively in 110 patients with varying neurological disabilities. The results indicate that fever, and even subfebrility, carry a bad prognosis with respect to residual symptoms. It is concluded that fever and subfebrility, irrespective of their genesis, should be intensely combated during the early stages of an ischaemic stroke.


Experimental cerebral ischemia in Mongolian gerbils III. Behaviour of the blood-brain barrier. The behavior of the BBB in cerebral ischemia was studied in symptom-positive Mongolian gerbils subjected to left common carotid artery occlusion using Evans Blue dye as indicator of BBB injury. The BBB damage was demonstrable grossly by the presence of areas of blue discoloration, and microscopically by the presence of a bright red fluorescent tracer, localized mostly in the neurons. The survey of various groups of animals revealed a direct relationship between the incidence and time of appearance of the BBB lesions and the duration of the ischemic occlusion. This relationship can be interpreted as another example of the previously described "maturation" phenomenon. A relatively late occurrence of the BBB injury in cerebral ischemia, at the time when the affected brain tissue shows severe, edematous histopathologic changes indicates that the brain edema, as the main complication of ischemia, could be regarded as being primarily of the cytotoxic type.


Localizations of beta-glucuronidase activity in sections and cultures of human gliomas. The histochemical activity of beta-glucuronidase was studied in sections and cultures of human gliomas. The intensity of reaction paralleled the growth pattern of tumours, but not the degree of their differentiation. The highest activity was found in dysplastic gliomas.


Changes of ventricular ependyma and choroid plexus in experimental hydrocephalus, as observed by scanning electron microscopy. Hydrocephalus was induced in rats by the injection of silicone oil or kaolin suspension into the cisterna magna. One to 5 weeks later the walls of the lateral ventricles were studied with the scanning electron microscope after killing the animals by perfusion fixation. In contrast to controls, the hydrocephalic animals killed 1 or 2 weeks after injection showed degeneration of ependymal cilia and infestation of the ependymal and choroid plexus surface with reactive cells, which presumably may be identified as Kolmer phagocytic cells by their ultrastructural features as studied by the transmission electron microscope. A coating of debris on the surface of the choroid plexus in the hydrocephalic animals possibly bears upon the ciliary degeneration with consequent deficiency of the clearing effect of ciliary movement. In the longer surviving hydrocephalic animals regeneration of cilia seemed to have occurred.


Capillaries in the subarachnoid space.

Capillaries in the subarachnoid space. The fine structure of the small vessels of the subarachnoid spaces in the rat and mouse cerebral and cerebellar cortices was examined. Small vessels with lumen under 7 mu and whose walls consisted of a single layer of endothelial cells were found. These vessels are regarded as true capillaries.


Serum lipids and fatty acid composition of serum lecithin in the non-pregnant state in patients with previous cholestasis of pregnancy. Serum lipids and fatty acid composition of serum lecithin were studied 8-21 months after delivery in 20 non-pregnant women who during their latest pregnancy had presented signs of CP. These women were compared with normal non-pregnant women (n=18) and with patients with cholestasis of pregnancy (CP) (n=28). In the non-pregnant state women with previous cholestasis of pregnancy (CP) showed in serum lecithin a low relative content of palmitic (16:0) and linoleic (18:2) acids and a high portion of stearic acid (18:0). These findings indicate as a basic defect in CP, a reduction in liver lecithin synthesis via pathway I (Kennedy's pathway) in favour of an increased pathway II (Greenberg's pathway). These data further support the hypothesis of increased estrogen activity as an etiological factor in CP. The basic influence by pregnancy on serum lipids and serum lecithin fatty acid composition was the same in women with CP as in women with a normal pregnancy.


Decrease in the mortality rates for low-birth-weight infants after phenobarbitone treatment. A daily dosage of 100 mg phenobarbitone administered orally to pregnant women for three days or more immediately before delivery has reduced the various mortality rates for low-birth-weight infants by 50% or more. Since it is hardly possible to treat all pregnant women in this way it is recommended to administer phenobarbitone to women with high-risk pregnancies such as former stillborn infant, former premature delivery, pregnancy complications, and planned induction of premature labour before the 37th week and until delivery takes place. If the mothers of low-birth-weight infants have not been adequately treated it is recommended that the newborn infant be given phenobarbitone injections immediately after birth and at 8-hour intervals, 10 injections in all.


Blood flow in myomatous uteri as measured by intra-arterial 133Xenon. Uterine blood flow has been studied using intra-arterial 133Xenon. Compartment analysis was used for calculation of blood flow from the wash-out curves. In 7 myomatous uteri the mean blood flow was 11.6 +/- 1.70 ml-min-1-100 g-1. In 8 control cases the mean blood flow was 20.1 +/- 2.27 ml-min-1-100 g-1. The difference is statistically significant on the 1% level. From the present study it cannot be decided how the uterine blood flow is distributed between myomata and surrounding myometrium.


A prospective study of drugs and pregnancy. I. Psychopharmaca. A prospective study has been performed on the use of psychopharmaca during 6 376 pregnancies and its correlation to certain socio-medical variables and pregnancy outcome. An association between drug use and later miscarriage or legal abortion was demonstrated and is conceivably due to an increased use of such drugs in unwanted pregnancies. No indication of an association between drug use and birth of a dead or defective infant was found. Pregnancies where psychopharmaca were used during the first trimester had, on average, a longer duration than pregnancies where such drugs were not used, but birth weight of full-term infants was not affected.


Disc-electrophoretic protein pattern of cervical mucus in cases of humoral sensitization against spermatozoa. Midcycle cerevical mucus samples from 20 fertile women with negative, and from 6 infertile women with positive serum-sperm agglutinating activity were subjected to a qualitative protein analysis by the Ouchterlony-technique, to polyacrylamide (PAA) discelectrophoresis and after purification on spermatozoa they were also run against rabbit antihuman serum in the Laurell immuno-electrophoretic technique. By the Ouchterlony method the main serum protein fractions were shown to occur also in cervical mucus. No significant differences could be found in the protein pattern of samples from fertile and infertile females as detected by polyacrylamide (PAA) electrophoresis. In all samples a split protein fraction corresponding to serum albumin and a band preceding the protein fraction corresponding to serum preablumin were observed. In 2 samples from infertile females it could be demonstrated that immunoglobulins occurring in the cervical mucus were directed towards antigenic sperm components.


Leucine aminopeptidase activity in maternal, cord blood and placenta of normal pregnancy and in pre-eclampsia. 1) Leucine aminopeptidase (LAP) was determined in maternal and fetal blood and in the placenta of mild and severe pre-eclamptic patients, then compared to the levels of normal pregnancy. 2) The enzyme activity increased significantly in severe pre-eclampsia as compared with the mild type and with normal pregnancy. 3) In mild pre-eclamptic patients LAP activity of maternal and cord blood did not increase significantly as compared with the normal cases but the placenta showed a slight decrease. 4) The enzyme level in cord blood did not increase markedly in pre-eclampsia.


On radiation-decreased fibrinolytic activity of vessel walls. Fibrinolytic activity was histochemically determined in biopsy specimens of the walls of human veins (vv. epigastricae superficiales) obtained from 15 patients after irradiation of the lower abdomen because of malignant genital diseases and compared with non-irradiated controls. The activity was significantly lower (p less than 0.001) after radiotherapy.


Growth of the fetal skull, with special reference to weight-for-dates of the newborn child. Two growth curves of the fetal biparietal diameter are presented. One is prospective, based on the last menstrual period, while the other is retrospective, calculated from the date of birth. The prospective curve shows a slight decline in average values following the week 42 of gestation. This is thought not to reflect a true shortening of the biparietal diameter in the single fetus, since serial measurements in single fetuses show growth up to the time of delivery. Individual growth curves, grouped according to the weight-for-dates of the newborn child, show a trend towards longer biparietal diameters in the larger fetuses. Serial measurements, preferably starting before week 30, appear to be a good help in predicting birth weight, but growth rates without regard to the actual measurement values were of little prognostic value in the present material.


Urography and renography in the follow-up of patients with toxemia of late pregnancy. We have studied 129 patients with toxemia of pregnancy two months post partum by urography and renography. The same investigations were performed on 17 healthy parturients post partum. 49 patients (38.8%) had an abnormality either in urography or renography. 20 patients (15.5%) had an abnormal urogram and 42 (32.6%) an abnormal renogram. The findings correlated so that 7 patients had an abnormal urogram with a normal renogram and 13 patients had an abnormality in both investigations. 29 patients had only an abnormal renogram. In the control series 3 patients had an abnormal urogram and the same patients also had an abnormal renogram. We divided the studied patients into groups according to the clinical severity of toxemia. Urographic and renographic findings were divided evenly in the series so that abnormalities were no more common in the severe cases. Renography cannot be considered merely as a screening method when compared with urography in the follow-up of toxemic patients, but these investigations are complementary.


Trisomy-D in a cyclops with cardiovascular defects. A case report of cyclops with trisomy-D in a female infant, associated with cardiovascular defects is presented. A survey of the literature pertaining to other reported cases of cyclopia is presented to establish the probablity of the existence of at least two distinct etiologic groups of cyclopia--those associated with trisomy-D and those associated with other chromosomal aberrations, single gene mutations, or non-genetic factors.


Active pre-term management of severe osteogenesis imperfecta. Some of the advantages of using an intra-amniotic injection of urea combined with prostaglandins for mid trimester termination include an extremely high success rate, a mean time of approximately 10 hours and delivery of a dead fetus. The successful application of this method for the active pre-term management of patients in whom severe fetal abnormality, such as that reported here, suggests this technique of inducing abortion and labour deserves further consideration in those special circumstances where the obstetrician is anxious that the pregnancy should be interrupted despite the gestation length and where a live birth should not occur.


Eardrum displacement following stapedius muscle contraction. Simultaneous monitoring in human subjects on the same ear of eardrum displacement by tympanomanometry, and impedance with the electroacoustic bridge, provided information concerning contraction of the stapedius muscle and its effect on eardrum displacement. Extensive control procedures were employed to elicit only the stapedius reflex; lower intensity auditory stimulation, electrocutaneous stimulation of the homolateral external ear canal, and anesthetization of nerves leading to the tensor tympani. Following these procedures the following results were obtained: (1) Extremely small biphasic and monophasic eardrum movements were seen in the stapedius--only ear to auditory and electrocutaneous stimulation; the form of the response was much less predictable to auditory stimulation. (2) At high sound intensities relatively large inward and biphasic movements of the eardrum occurred in the normal ear, unquestionably due to contraction of the tensor tympani. These results were further validated in a group of stapedectomized ears, without the stapedius but with normal tensor tympani. (3) Biphasic responses did not occur in the tensor tympani--only ear, only monophasic inward responses. (4) Upon air-jet stimulation to the orbit of the eye, these subjects had an accentuated tensor response in that large inward movements of the eardrum occurred as compared with those in normal ears, suggesting that there is an alteration of the tensor response by the presence of the stapedius muscle. Estimates of the actual eardrum displacement were calculated based on a model of the external ear canal and eardrum.


Size and duration of inhibition in the medial geniculate body in unanesthetized cats. A method which allows repeated micro-electrode recordings from subcortical structures without using any drugs is described. This method was adopted in combination with convential implantation techniques to study click-evoked potentials and inhibitory processes in the auditory system of the cat. The click-evoked potentials in MG were hardly affected by moderate doses of barbiturate and only to a minor degree in the auditory cortex. In the unanaesthetized animal the most significant contribution to the click-evoked inhibition in the auditory system was due to mechanisms in the MG. The inhibition was diminished both in size and duration as compared with the situation in anaesthetized cats. The MG cells showed a tendency to cyclic inhibition in the unanaesthetized cat, but not so regularly as following administration of sodium pentobarbital. The action of barbiturates on the auditory system is discussed.


Advanced Meniere's disease. A study of 356 severely disabled patients. A selected material of 356 patients with Meniere's disease, all severely disabled by paroxysmal vertigo, was analysed. The question under study was to what extent and in what way the severe vertigo is reflected in the caloric reaction and in the level of hearing. The caloric response, expressed as differences in right/left sensitivity, was reduced in 59% and exaggerated in 1% of the patients; in the remaining 40% it was normal. The median values for pure tone audiogram, speech reception threshold and speech discrimination score were 56 dB,60 dB and 54%, respectively. The hearing deteriorated considerably in the early stage of the disease, but the hearing level stabilised with time. A parallelism between acoustic and vestibular dysfunction was demonstrated. Reduction of the pure tone threshold was accompanied by a progressive decrease in caloric response. The frequency of bilateral cases increased with lengthening duration of illness. All patients included in this investigation have since undergone operation.


Ultrasound treatment of Meniere's disease. Long-term follow-up of 356 advanced cases. Twelve years' experience of ultrasound treatment of 356 patients is presented. For evaluating the results a new multifacetted scoring system was developed, where each individual patient was evaluated on the basis of four parameters. According to this evaluation 71% of the patients improved after the operation, while 29% remained unchanged or deteriorated. Because of lack of improvement, 42 patients underwent reoperation by different methods; in half of them ultrasonic irradiation was again used. The hearing deteriorated in about 40% of the patients, to which result the long observation times also contributed. The caloric response became reduced in 70% of the patients. Marked depression of the caloric response characterized the patients who were relieved of vertigo. Transient facial paralysis in 4 patients was the only complication.


Radiosialometry. II. The diagnostic accuracy of different evaluation parameters. The temporal course of 99TcmO4 accumulation in the parotid gland after fast intravenous injection of the radionuclide was measured quantitatively by radiosialometry in 32 patients suffering from inflammatory or neoplastic diseases of the parotid glands. The diagnostic accuracy of five different evaluation parameters was compared. It was found that without reducing diagnostic accuracy, the method used could be simplified by omitting three of the five evaluation parameters. This implies a shortening of the measuring time from 18 to 10 minutes. The diagnostic accuracy of radiosialometry in 14 cases with a general engagement of the parotid parenchyma (irradiation damage, collagen sialosis and chronic recurrent parotitis) was high. Thus, all these 14 cases had abnormal radiosialometric values. Parotid tumours not causing extensive destruction of the parotid parenchyma were not detected by this method.


Radiosialometry. 1. A method for evaluation of salivary gland disorders. The temporal course of the total 99Tcm40 acumulation in the parotoid glad after fast intravenous injection of the readionucleotide, is studied by examination with quantitative radiosialometry.  The method adopted is based on the use of two collimated, symmetrically located and opposite placed NaI-detectors.  The normal ranges of five evaluation parameters are obtained from a control material of 100 parotoid glands in 50 individuals without disorders of the parotoid glands.  The reproducibility of these five evaluation parameters is estimated and the sensitivity and the detectability of the parameters as well as different sources of variation are discussed.  Classification boundaries between normal and abnormal valves values are arbitrarily chosen form the normal ranges.


A topographic quantitative analysis of the post-natal bone formation in the auditory ossicles of the dog. The amount and distribution of the post-natal bone deposition in the auditory ossicles and in the left tibia of dogs of varying ages were studied by means of alizarin labelling. The relative amount of fluorescent new-formed bone was expressed as a percentage ratio NB/(NB+PB) of new bone (NB) on the pre-existing bone (PB). The result was that the post-natal bone deposition (1) was larger in the tibia than in the incus, malleus and stapes; (2) significantly decreased with age both in the ossicles and in the tibia; (3) in the stapes it stopped at 3 months, while it was present in the tibia, incus and malleus even at 12 months. In the ossicles the post-natal bone deposition takes place both on the periosteal surfaces of the ossicles and on the internal surfaces of the haversian systems. The first process produces an appositional growth that stops in all three ossicles within the 1st month of post-natal life, the second one produces an internal growth that continues until the age of three months in the stapes, while in the incus and malleus it occurs in small amounts, even in the 12th month of life. In the ossicles all the new-formed bone tissue, periosteal and osteonic, is built up by primary bone (addition bone). In the tibia from 50 days of age the primary bone is gradually replaced by secondary haversian systems as a consequence of remodelling processes.


Acetylcholinesterase activity in the chinchilla organ of Corti in normal and acoustically overstimulated animals. The distribution of acetylcholinesterase (AChE) positive nerve fibers and endings in the organ of Corti of normal and acoustically overstimulated chinchillas is described. The strongest activity was located in the inner spiral bundle, ane remained almost unchanged even after all the outer and the majority of the inner hair cells had degenerated as a result of intense exposure. In the chinchilla even the apical coil had three rows of AChE-positive nerve endings under the outer hair cells.


Toxic effects of gentamicin on the basilar papilla in the lizard Calotes versicolor. A surface study. Gentamicin in a dose of 100 mg and in some cases 150 mg per kg bodyweight and day was given intraperitoneally to healthy lizards, belonging to the species Calotes Versicolor. The animals were injected for 7, 14 and 21 days. After completed injections the animals were sacrificed and their hearing organ, the basilar papilla, was processed for scanning electron microscopy. Animals treated for 7 days did not show any significant surface damage in the basilar papilla. When gentamicin was administered for 14 days the normal appearance of the surface structure was lost. The ventral (apical) type A cells were relatively intact while the type B cell-population in the dorsal (basal) part of the organ showed sensory hair fusions and cytoplasmic herniations. Lizards treated for 21 days showed a severely damaged basilar papilla. The ventral (apical) type A cells still only were moderately damaged with some hair fusions and cytoplasmic herniations while the dorsal (basal) type B cells were more or less destroyed. Only occasional cells were left and some of these were severely damaged. The surface of the dorsal (basal) part of the organ instead was covered by supporting cells thus forming a sort of scar tissue.


Aminotransferases in post-mortem cochlear fluids. Aspartate and alanine aminotransferase (ASAT, ALAT) activities were measured in human post-mortem sera, cerebrospinal fluid (CSF), perilymph and endolymph. Due to heart and/or liver morbidity during a terminal illness, the ASAT and ALAT serum activities were considerably increased as compared with normal and both were 20--30 times higher (p less than 0.001) than in CSF or inner ear fluids. CSF and inner ear fluids showed mutually similar values.


The syndrome of renal tubular acidosis with nerve deafness. Two brothers with renal tubular acidosis and nerve deafness are described. Studies of the physiopathological characteristics of the renal acidification defect show that the defect is limited to the distal tubule. Renal tubular acidosis with nerve deafness is a distinct nosologic entity that is determined by an autosomal recessive trait.


[Electrophoretic examination of protein distribution in guinea pig perilymph]. Perilymph and serum of guinea pigs were investigated using immunoelectrophoresis and polyacrylamide gel electrophoresis. The molecular weights of the perilymph proteins were estimated by electrophoresis in a linear polyacrylamide gel gradient (3-20%). The immunoelectropherograms and the polyacrylamide gel electropherograms of equivalent amounts of perilymph protein and serum protein are nearly the same. The immunological detection of the perilymph proteins indicates that they are serum proteins. The clear identification of the individual proteins fails because of missing monospecific antisera against the individual proteins of guinea pig. High-molecular proteins (range of the molecular weight estimation 67 000-290 000) are also detectable in the perilymph according to the molecular weight estimation.


Interaction between the saccules and the vertical semicircular canals. For the experiments 39 cats were used. Selective sectioning of either the anterior or the posterior vertical ampullar nerves was performed bilaterally. Additionally in some cats the utricular nerves were cut, or the saccule extirpated on one or both sides. The otolith organs were stimulated by tilting around the bitemporal axis of the animals. Bilateral sectioning of the anterior ampullar nerve induced vertical nystagmus upwards, which disappeared, if the animals were tilted upside down. When the posterior ampullar nerves were cut bilaterally a vertical nystagmus downwards was obtained, and if the animals were tilted upside down there was a large increase in nystagmus frequency. After unilateral extirpation of the saccule, vertical nystagmus downwards was observed in 50 percent of these experiments. This nystagmus was modulated by tilting. However, if the saccules on both sides were extirpated, no nystagmus could be elicited. The cause of these results is discussed.


Activity of single medial geniculate units in response to single and double clicks. The discharge pattern to clicks and the time course and pattern of the click-induced inhibition in the medial geniculate body have been studied by single unit recording technique. The medial geniculate neurones showed a tendency to fire at preferred latencies after a click. A conditioning click caused a reduced number and increased latency of the discharges to a subsequent test click.  Provided conditioning click of a certain strength was employed, the inhibition was often cyclic, each period lasting for about 100-150 ms. Clicks could also trigger barbiturate spindles with synchrony between the activity of the medial geniculate body and the primary auditory cortex. Interaction experiments suggest that the triggered and spontaneous spindle activity operate with the same neurones.


Premature adrenarche in indentical twins. Monozygotic female twins with premature adrenarche are reported. Endocrine work-up excluded the existence of an endocrinopathy or a tumor.


D-glyceric-acidaemia and non-ketotic hyperglycinaemia. Clinical and laboratory findings in a new syndrome. The clinical and laboratory findings in a 2 1/2-year-old boy with non-ketotic hyperglycinaemia are reported. Except for a somewhat impaired liver function there was a picture similar to the cases previously reported in the literature. The patient deviated from the classical description, however, in the excretion of large amounts of D-glyceric acid in the urine. The same compound was also repeatedly found in the serum. It is suggested that the large amounts of glycine found in various body fluids are secondary to a hitherto undescribed enzymatic defect in the degradation of D-glyceric acid.


Immunoglobulin levels in children with homozygous beta-thalassemia. Patients with hereditary hemolytic anaemias have been known to have immunoglobulin alterations related to an increased susceptibility to infection. In the present series, immunoglobulins, G, A and M have been estimated in 50 thalassemic children aged 10 months to 13 years. No significant difference was found in any of the immunoglobulins between patients and age-matched controls. No correlation could be shown between immunoglobulin levels and (a) the severity of anaemia, (b) the degree of hemosiderosis, and (c) the frequency of febrile infections per year. Against clinical impressions patients did not shown any increased susceptibility to infections.


Myocardiopathy in Duchenne progressive muscular dystrophy. In a retrospective study of hospital and autopsy records of 19 male subjects with the Duchenne type of progressive muscular dystrophy the incidence of cardiac involvement of the heart almost invariably develop heart failure; an early sign may be persistent tachycardia and, possibly, electrocardiographic changes, in case of which institution of digitalis treatment should be considered. Cardiac and pulmonary complications were equally frequent causes of death (42%) but, death from cardiac complication occurred only patients with Duchenne progressive muscular dystrophy very often develop cardiac complications, and when relating the available information on treatment to the autopsy findings it should be stressed that early and intensive therapy of the cardiac symptoms is of the greatest importance to the patient.


Alport's syndrome. A report of three Swedish families. Three families with hereditary nephritis of Alport's type have been studied with particular emphasis on the occurrence of symptoms and signs in different sexes and age groups. Part of the material was tested for impaired hearing or eye anomalies which may be the sole manifestation of Alport's yndrome. The youngest patients were 3-4 years of age, and the proportion of diseases individuals increased with age. In two of the families about half of the investigated males or females were affected whereas in the third family all but one of 16 investigated individuals were affected. In this last family the kidney disease was exceptionally severe, but no differences in the histopathology of the kidney lesions were seen between the families. In all the families renal symptoms progressed more rapidly in males than in females. Affected as well as unaffected sons and daughters were born to healthy as well as to diseased mothers. In contrast, healthy fathers produced only unaffected children. Diseased fathers produced only daughters, two-thirds of whom were affected. It is concluded that Alport's syndrome in these three families most probably is transmitted by autosomal dominant inheritance with variations in expression and penetrance.


The osteodystrophy of prolonged obstructive liver disease in childhood. Mild rickets was present in 7, and 3 others with severe bone disease developed widespread skeletal demineralization and multiple fractures. The intake of vitamin D was apparently loosely related to the severity of the osteodystrophy. The latter however, was closely linked to both the serum inorganic phosphate and the calciumXphosphate product. The serum calcium was directly related to the infant's gestational maturity, hypocalcaemia being present in those born before 35 weeks. Pathogenetic factors have probably included reactive hyperparathyroidism and nutritional deprivation associated with preterm delivery. Five of the infants who had biliary atresia developed radiological evidence of osteoporosis from about twelve months of age. This may be related to protracted calcium malabsorption, but its true nature remains to be elucidated.


The intestinal microvillus. Ultrastructural variability in coeliac disease and cow's milk intolerance. In 8 patients with coeliac disease, 2 patients with cow's milk intolerance and 10 patients with other gastrointestinal disturbances, intestinal biopsies were examined in order to compare the extent of alteration of surface vs. crypt microvilli (MV). In those diseases associated with the ingestion of a noxious agent, namely coeliac disease and cow's milk intolerance, a marked and abrupt difference between the severely damaged surface epithelium and its MV, and the preserved crypt epithelium was noted. The results of the examinations give reason to suppose that these morphological variations are caused by the higher gliadin or milk protein concentration over the avillous surface epithelium as opposed to the lower one in the elongated crypts.


Hemoglobin-oxygen affinity in hypophosphatemic rickets. In 14 patients with simple X-linked hypophosphatemic rickets, 5 were below the third percentile in height and 9 were between the third and twenty-fifth percentile. Although the mean serum inorganic phosphorus level was only 2.01 +/- 0.65 (normal range for all age groups is 3.8 to 6.0 mg/100 ml), both the mean values for red cell 2,3-diphosphoglycerate (2,3-DPG) and adenosine triphosphate (ATP) were normal at 4.78 +/- 1.23 and 1.02 +/- 0.17 mumol/ml of red blood cells respectively. Moreover, the mean P50 value was normal at 26.4 +/- 0.9 mmHg. These normal oxygen transport data make unlikely any proposal that short stature seen in these patients is secondary to chronic tissue hypoxia. They also indicate that the intra-erythrocytic organic phosphate levels are maintained at normal levels despite profound chronic hypophosphatemia.


Cytophotometric studies of the DNA, nucleic acid and protein content of liver cell nuclei from patients with virus hepatitis. Cytophotometric studies of the DNA, nucleic acid and protein content of liver cell nuclei from patients with virus hepatitis. Acta path. microbiol. scand. Sect. A, 84: 1-8, 1976. With a view to investigating some of the causes why the size of liver cell nuclei increase in virus hepatitis, the nuclear size and the nuclear contents of DNA, nucleic acid and protein were measured by cytophotometry. The liver cell nuclei could be grouped in classes according to their contents of DNA, nucleic acid, and protein and, as in control livers, diploid nuclei were always most frequent. Nuclei with intermediate DNA values, probably S-phase nuclei, were more frequent in hepatitis livers than in controls. The average size of nuclei from patients with hepatitis was significantly larger than that from controls, whereas the DNA content was the same. A significant, positive correlation between nucleic acid content, protein content and nuclear area was found. The high correlation between nuclear protein content and nuclear size simultaneously with the increased nuclear size during hepatitis is assumed to reflect an increased nuclear function.


Foetal rhabdomyoma. Case report of a patient with two tumours. A case report of a girl with two foetal rhabdomyomas is presented. One tumour was a small cutaneous lesion present at birth in the left thigh and the other was located in the chest wall deeply in the subcutaneous tissue and attached to the adjacent intercostal muscle. The patient also had the naevoid basal cell carcinoma syndrome which lends credence to the opinion that foetal rhabdomyoma is a malformation rather than a true neoplasm.


Renin inactivation in vitro in non-pregnant rabbit uterine and kidney tissue. In slices of non-pregnant rabbit uterus, renin was gradually inactivated during incubation in vitro at 37 degrees C, for 44 hours. The percentual rate of inactivation (40 per cent/44 hours) was, however, only about half of that found in uterine slices from pregnant and post-partum animals despite the fact that the endogenous renin concentration was much lower in the non-pregnant uteri. In control experiments with kidneys with the same high renin content as in the pregnant uteri only about 30 per cent of the renin was inactivated in 44 hours.


The alveolar lining layer in experimental paraquat poisoning. Rats were injected with paraquat, 35 mg/kg, and killed 8 or 12 hours later. Electron microscopic studies of the lungs revealed degenerative changes in alveolar epithelium and alveolar capillary endothelium after 8 hours. After 12 hours, the alveolar lining layer was contaminated with cellular debris from disintegrating alveolar epithelium. This contamination is probably responsible for the inactivation of lung surfactant that can be demonstrated in early stages of experimental paraquat poisoning.