Computed tomography of intracerebral hematomas. II. Radionuclide and transmission CT studies of the perihematoma region. Transmission CT studies of 40 patients with intracerebral hematomas were used for an analysis of the perihematoma region. Nineteen of these patients had radionuclide studies. In the brain adjacent to an intracerebral hematoma, the patterns of pertechnetate uptake on scintillation scans and contrast enhancement on transmission CT resemble those observed in cerebral infarctions. The healing of the perihematoma region proceeds similarly to that of infarcts. The brain about the hematoma is ischemic tissue which behaves much like cerebral infarction not related to hematomas.


Diagnosis of isodense subdural hematomas by computed tomography. Subdural hematomas, whose absorption values approximate those of adjacent brain, are not visualized in routine computed tomography. Two clues indicating the presence of such "isodense" subdural hematomas are: (1) unilateral effacement of cerebral sulci on the convexities, and (2) midline shift or mass effect on the ventricles in the absence of abnormal areas of diminished or increased density in the brain. Nine cases were detected on pre- and postcontrast studies in 2,500 CT scans of the brain over a 10 month period. Delayed CT scanning 4-6 hr after intravenous contrast injection showed enhancement of the subdural hematoma in three of seven cases.


Computed angiotomography.

Computed angiotomography. Branches of the anterior and middle cerebral arteries and thalamostriate, septal, and internal cerebral veins can be clearly defined with computed tomography during contrast enhancement with the Ohio Nuclear Delta 25 scanner. Pathologic vessels can also be recognized. Visualization of vessels smaller than 1.5 mm belongs in the province of angiography.


Scleral thickening: a CT sign of orbital pseudotumor. Orbital pseudotumor is a benign inflammatory lesion of the orbit. Computed tomography is a new method for evaluation of orbits. Scleral uveal rim thickening with contrast enhancement was found in eight of 15 patients with pseudotumor (53%). Similar rim thickening was seen in one postoperative patient and two cases of recent trauma. Therefore, the sign presumably represents inflammation. It was not seen in 47 cases of thyroid disease and 66 cases of neoplasm.


High energy fast neutrons from the Harwell variable energy cyclotron. I. Physical characteristics. A high energy fast neutron beam potentially suitable for radiotherapy was built at the Harwell variable energy cyclotron. The beam line is described and results are given of physical measurements on the fast neutron beams produced by 42 MeV deuterons on thick (4 mm) and thin (2 mm) beryllium targets. With 20 muA beam current the entrance dose rate in a phantom 150 cm from the target was about 130 rad min-1 with the thick target and about 60 rad min-1 with the thin target. Therefore, it is possible to use both the thin target and the relatively large target-skin distance of 150 cm to improve depth dose for radiotherapy or radiobiology. With this arrangement the dose rate decreased to 50% at depths in the phantom of 11.3-15.4 cm, depending on the field size. The use of primarily hydrogenous materials for shielding and collimation provided beam edge definition similar to that of 60Co teletherapy units, and off-axis radiation levels of approximately 1% which compare favorably with 14 MeV deuteron-tritium generators. The copper backing of the thin target became highly radioactive and an alterative material may be preferable. Biologic characteristics of the beam are described in a companion paper.


The practical use of thyroid function tests. The diagnosis of thyroid disorders can usually be established by two tests: the serum T4 and the resin T3 uptake (RT3U). The T4 test measures both free and bound thyroxine; the RT3U reflects the number of binding sites available on thyroid-binding globulin. The values of these two tests can be used to calculate a free thyroxine index (FTI), which gives an approximation of the free T4 in the serum. Measurement of thyroid-stimulating hormone (TSH) is useful for the diagnosis of hypothyroidism, while the thyrotropin-releasing hormone (TRH) test may facilitate diagnosis of hyperthyroidism.


Structural changes in porcine xenografts used as substitute cardiac valves. Gross and histologic observations in 51 glutaraldehyde-preserved Hancock valves in 41 patients. Gross and histologic changes are described in 51 Hancock glutaraldehyde-preserved porcine heterograft bioprostheses from 41 patients: 33 valves from 25 patients had been in place for less than 2 months ("early") and 18 valves from 17 patients were examined at later periods up to 75 months ("late") after implantation. The major gross changes were thrombosis (five bioprostheses) and degeneration (three bioprotheses) of the cusps. Major histologic changes observed in 44 bioprostheses (26 early and 18 late) examined histologically were: (1) fibrin deposits on inflow and outflow surfaces of the cusps; (2) inflammatory cell infiltrates; (3) histiocyte deposition; (4) giant cell formation, and (5) focal disruption of the fibrocollagenous structure of the cusps. These observations indicate that porcine bioprostheses are not biologically inert in the human circulation. However, valve failure is rare at the implantation periods studied.


Formazan cells in protein and protein-calorie malnutrition. Formazan cells were less numerous in the peripheral blood of vervet monkeys (Cercopithecus aethiops) receiving a "O" protein-low calorie diet than in animals fed a full or a protein but not calorie deficient diet.


Polymorphonuclear neutrophilic leukocytes in protein deficiency. The number of white blood cells and of polymorphonuclear leukocytes remained unchanged in vervet monkeys (Cercopithecus aethiops) receiving a "O" protein diet. The motility of the polymorphonuclear leukocytes and their phagocytic and killing indices with and without leukokinin stimulation decreased in protein-depleted animals. Acid cathepsin decreased, DNA relatively increased, and peroxidase, alkaline phosphatase, acid phenylphosphatase, and lysozyme reached higher levels in the polymorphonuclear leukocytes of animals on a "O" protein diet.


Sequential changes in body composition during infection: electron probe study IV. Alterations occur in human muscle electrolyte and water composition in response to infection. There appear to be at least two basic mechanisms; the first is an exchange of sodium for potassium without alteration in water content of muscle. The second is an increase in cellular Na and water without a loss of K on a dry weight basis. In a series of studies in monkeys, Salmonella typhimurium sepsis was induced as an experimental model. Both patterns of muscle response to infection were detected. Electron probe microanalysis revealed that the loss of K concentration was due to an accumulation of intracellular saline which dilute the K content. The mechanism of this is unclear; however, a concomitant increase in undertermined osmoles in the serum suggests that there may be an increase in organic osmoles within the cell which leads to the dilution of intracellular K concentration.


Leukocyte electrolytes and sodium transport in protein energy malnutrition. Intracellular electrolytes and sodium transport were measured in leukocytes obtained from malnourished children. In the presence of edema, leukocyte sodium and potassium were raised. The total flux and the glycoside-sensitive portion were increased. Loss of edema was associated with reductions in all these measurements. In marasmus, glycoside-sensitive sodium efflux was reduced compared to recovered values. Sodium was increased and potassium reduced. It is concluded that at least two defects in sodium transport may occur in protein energy malnutrition, an increased passive permeability in kwashiorkor and a reduced active transport for sodium in marasmus.


Infection and iron metabolism.

Infection and iron metabolism. An important component of nonspecific defense of vertebrates against microbial invasion is that of nutritional immunity. Hosts attempt to withhold growth-essential iron from invading bacteria, fungi, and protozoa. Clinical conditions in which hosts are stressed by excess quantities of iron in specific fluids, tissues, or cells result in enhanced susceptibility to infection. Methods for strengthening nutritional immunity are known in theory; research is needed to determine if these would be useful in clinical practice.


Newer products and formulas for alimentation. Adequate nutritional support for the critically ill patient has evolved over the past 150 years from a time when starvation was accepted practice for patients with fever. Three to four thousand calories and other essential nutrients can now be safely provided each day to patients with infection or other critical illness. Nutrients may be provided in meals, administered by specialized enteral feedings, or infused intravenously. Nutrient mixtures with a high proportion of carbohydrate and protein appear the best dietary therapy to maintain body protein and support other organ systems and and cellular functions. New products and formulas offer the physician a wide variety of techniques for providing adequate nutrition to all patients with critical illness.


An experience with total parenteral nutrition in children. Total parenteral nutrition has been used in the treatment of more than 100 children with gastrointestinal illnesses, including 90 under the age of 6 months. The incidence of complications has been reduced markedly as experience was acquired. Total parenteral nutrition has been especially valuable in patients with intractable diarrhea syndrome and it has been used successfully in the management of infants with overwhelming systemic infections.


The energy cost of repleting tissue deficits during recovery from protein-energy malnutrition. Five children with protein-energy malnutrition were were treated with a high calorie, high protein diet and the energy cost of growth in body weight and muscle mass were calculated. Energy expenditures correlated statistically with increases in muscle mass, estimated by [15N]creatine kinetics, but not with gains in body weight.


Failure of postoperative infection to increase nitrogen excretion in patients maintained on peripheral amono acids. Fourteen well-nourished patients undergoing elective major surgery were maintained on intravenous, dextrose-free isotonic (3%) amino acid solution postoperatively. Seven patients developed fevers greater than 100 F due to a variety of mild infective complications. While all patients developed a negative nitrogen balance postoperatively in this ketonemic state, infection did not appear to increase nitrogen loss. This is in striking contrast to the response observed in the fed state. Adaptation to starvation, particulary the effect of ketones on muscle metabolism, would appear to reduce significantly the nitrogen loss during infection.


Effect of deep surgical sepsis on protein-sparing therapies and nitrogen balance. Four patients from a larger group of 18 patients receiving dextrose-free isotonic (3%) amino acid solution as nutritional support, form the basis of this report. An additional seven patients received intravenous isotonic (5%) dextrose as their sole support in the postoperative period following major elective surgery (average nitrogen balance = -12.3 +/- 2.7 g). All patients were well-nourished as determined by anthropometric measurements. The nonseptic patients receiving infusions of isotonic amino acids demonstrated an improvement in nitrogen balance (= delta 8.5 +2, P less than 0.001) when compared to the postoperative use of 100 to 150 g of glucose. However, sepsis produced a decreased net utilization of the infused crystalline amino acids such that nitrogen balance was similar to the intravenous glucose group (- 10.6 +/- 2.1). This septic response was associated with decreased plasma free fatty acid concentrations and the absence of starvation ketosis and ketonuria. While the nitrogen balance was not different in the septic and the dextrose control groups, deficiencies in plasma amino acid concentrations were observed in the group receiving intravenous infusion of glucose.


Protein and energy requirements of young children living in the developing countries to allow for catch-up growth after infections. Children who have lost weight because of infection or other causes of ill-health need to produce catch-up growth after the illness is over. This catch-up growth can be rapid and requires a higher minimum protein intake relative to energy intake than does normal growth. Suitable protein-energy ratios for catch-up growth have been calculated.


Meningococcal bacteremia: clinical and serologic studies of infants with mild illness. We report three mildly ill infants who had meningococcal bacteremia and in whom meningitis or fulminant septicemia never developed. The infants were observed during a three-month period. Two of these infants had pneumonia, as evidenced by infiltrates on chest roentgenogram. The serogroups of the organisms isolated were B, Y, and 135. In none of the infants could specific bactericidal antibody be demonstrated in acute or convalescent serum.


Human complement: onset and site of synthesis during fetal life. The site and onset of synthesis of the various components of complement (C), in man and other mammals, has been studied by incubating fetal tissues in media containing labelled amino acid, and by the analysis of the culture fluids for the presence of newly synthesised proteins. Another useful approach has been that of detecting genetic variants of single components in pairs of maternal and fetal samples. These investigations have shown that all components of human C are produced at an early stage of fetal development and that, in cord blood, the mean level of most components is about half the value detected in samples from normal adults. In agreement with the results observed in man, the maturation of C occurs at an early stage of life in many other mammals.


Differences between sexes in the nasopharyngeal carriage of Neisseria meningitidis. Nasopharyngeal carriage of Neisseria meningitidis was investigated among male and female students sharing similar occupational and living environments at the U.S. Naval Hospital Corps School, Great Lakes, Illinois, in 1972-1973. When students beginning the study without meningococcal carriage were evaluated, meningococcal acquisition, weekly carrier prevalence, number of different serogroups carried, proportion of serogroup Y carriers, and average duration of group Y carriage were approximately equal for each sex. In this comparable group of men and women, there was no evidence of differences in meningococcal carriage associated solely with the sex of the host.


X-linked Hunter syndrome: the heterozygous phenotype in cell culture. Fibroblast cultures derived from the skin of three Hunter heterozygotes have been examined for iduronate sulfatase deficiency primarily by measurement of [35S]-mucopolysaccharide accumulation in the presence and absence of Hunter corrective factor. For each heterozygote, two populations of clones were observed: normal and enzyme deficient, as predicted by the Lyon hypothesis. However, the phenotype of the uncloned cultures was usually normal, presumably because of cross-correction, even after storage in liquid N2. Mixing experiments indicate that the presence of a majority of cells with the Hunter phenotype may be obscured as the result of correction by the minority population of normal cells in the mixture. Variability in the ability to cross-correct was also demonstrated. The unpredictable behavior of uncloned cultures make them unsuitable for diagnosing the Hunter carrier state.


The Hunter syndrome in females: is there an autosomal recessive form of iduronate sulfatase deficiency? Profound iduronate sulfatase deficiency, characteristic of the Hunter syndrome, has been found in cultured fibroblasts, serum, lymphocytes, and tissues of two clinically affected girls. The patients are karyotypically normal and have normal fathers; cloning of the mothers' fibroblasts did not reveal the mosaicism expected of carriers of an X-linked disease. Homozygosity for a previously unsuspected autosomal recessive gene for iduronate sulfatase is considered the most likely explanation, although heterozygosity for the X-linked gene and subsequent selection cannot be completely excluded.


Immunochemical and biochemical investigation of hexosaminidase S. Hexosaminidase S (HEX S), the residual isozyme found in tissues and body fluids of children with the O variant of GM2 gangliosidosis, was purified from tissues of variant individuals and biochemically and immunochemically characterized. This enzyme has an apparent molecular weight of 103,000 with an isoelectric point of 4.2, is heat labile to the same extent as HEX A, and loses most of its activity following heating for 30 min at 50 degrees C. HEX S reacts immunologically with the antisera against either HEX A or B, but the reaction is considerably stronger with the anti-A serum or with antibody preparations which react exclusively with the A isozyme. Results obtained by a radioimmunoassay using the various antisera indicated that there is no antigenically cross reacting material which lacks enzymatic activity in the variant tissues. These findings are in accord with a suggested molecular structure of two subunits, each composed of two alpha chains (alpha2 alpha2) for HEX S; it also implies that alpha and beta chains have some structural similarity which is manifested in antigenic cross-reactivity.


Hypothyroidism and amenorrhea due to hypothalamic insufficiency. A study in four young women. Four women, aged 17 to 23, were evaluated for secondary amenorrhea of 12 to 36 months' duration. All were considered to have hypothalamic hypothyroidism on the basis of low thyroxine (T4) concentrations, inappropriately low thyrotropin (TSH) levels, with a normal TSH response to thyrotropin-releasing hormone (TRH, 500 microgram intravenously) in three, and absence of a pituitary lesion. Nevertheless, menses did not resume after adequate replacement with thyroid hormone. Investigation of the pituitary-gonadal axis revealed a normal increase in both luteinizing hormone (LH) and follicle-stimulating hormone (FSH) following the intravenous administration of gonadotropin-releasing hormone (GnRH). Three subjects received clomiphene citrate, 100 mg/day for five days, but a normal menstrual cycle was not induced. It is concluded that the amenorrhea was not due to thyroid hormone deficiency but, like the hypothyroidism, to a hypothalamic abnormality involving secretion of the appropriate releasing hormone.


Primary hypothyroidism and galactorrhea. Ten of 16 women with primary hypothyroidism and high thyrotropin (TSH) concentrations had high serum prolactin (PRL) concentrations. A positive correlation was observed between the basal TSH and PRL levels in the hypothyroid patients. Five of these patients complained of persistent galactorrhea after delivery. After treatment with triiodothyronine (T3), the elevated TSH and PRL levels fell to within normal ranges, and the galactorrhea disappeared. It is suggested that the elevated serum PRL levels of patients with primary hypothyroidism are mediated by feedback-induced thyrotropin-releasing hormone (TRH) secretion or an enhanced response to endogenous TRH, and that the combination of delivery and the PRL excess may induce persistent galactorrhea in patients with primary hypothyroidism.


The modulating effect of human chorionic gonadotropin on lymphocyte blastogenesis. Human chorionic gonadotropin (HCG) produced by fetal trophoblastic cells was suggested to play a role in the suppression of maternal lymphocyte response against the fetal allograft. Reports supporting this concept have demonstrated a suppressive effect of crude HCG on lymphocyte blastogenesis. However, similar doses of purified hormone preparations were unable to inhibit lymphocyte stimulation with mitogens. A modulating influence of phenol-free and immunoglobulin-free HCG preparation on lymphocyte blastogenesis is presented. Enhanced lymphocyte stimulation with various mitogens occurred in cultures supplemented with HCG at low doses. On the other hand, higher hormone concentration exerted an inhibitory effect on lymphocyte blastogenesis. An increase in lymphoid cell concentrations was demonostrated in cultures supplemented with the hormone preparation. These observations are compatible with the suggested role of HCG in the maternal tolerance toward a histoincompatible fetus.


Elective hysterectomy.

Elective hysterectomy. Hysterectomy is the most frequently performed major operation. Its frequency is increasing due to greater use of elective indications such as uterine cancer prophylaxis, contraception, and menopausal problems. The effects of elective simple hysterectomy are evaluated in terms of morbidity and mortality rates and costs. Among 35-year-old women operated upon, the average over-all gain in life expectancy is only 0.2 years. This is due to the saving of 1.3 per cent of women who would have died from cancer of the cervix or endometrium; they gained 14.3 years of life. In addition, 3 per cent of women are spared the development of and treatment for these two conditions. All women operated upon would be relieved of some undesirable aspects of the menopausal years such as irregular uterine bleeding. There are also economic gains. However, the operation has adverse health effects which could offset any gains from cancer prevention. In addition, each year of life saved would cost about $12,800 and most of the added years would be lived in old age. Delaying the operation to age 45 and including oophorectomy would result in a lower cost per year of life saved-about $9,800-but the risk of adverse health effects probably would be increased very much. Cancer prophylaxis cannot justify elective hysterectomy; we cannot assess whether quality-of-life considerations do.


Immunologic studies on the cystic effusions of ovarian epithelial neoplasms. Cystic effusions from 12 epithelial tumors of the ovary and pooled normal ovarian tissue were studied by immunodiffusion for the presence of immunoglobulins G (IgG), M (IgM), and A (IgA) and free secretory component (FSC). In pooled normal ovarian tissue, IgG was the only immunoglobulin detected. In the neoplastic samples studied, IgG was detected in each of the 12 samples (100%), IgM was found in 10 of the 12 samples (83%), and IgA was detected in 11 of the 12 samples (92%). There was no discernible correlation between the immunoglobulins detected and the composition of the effusions or the pathologic classification of the tumors. FSC was detected in all mucinous samples studied, malignant as well as benign. This substance was not detected in any of the nonmucinous samples or in pooled normal ovarian tissue. The data suggest a correlation between the presence of FSC and the mucinous composition of the tumor effusion. Possible use of FSC assays in the study of mucinous tumors of the ovary is discussed.


Pseudomonas-induced corneal ulcers associated with contaminated eye mascaras. Seven Pseudomonas-induced corneal ulcers were associated with the use of four brands of mascara contaminated with P. aeruginosa. In laboratory studies, preservative systems of three of the four brands were inadequate in comparison with a control mascara of known antimicrobial activity. If the corneal epithelium is scratched during the application of mascara, particularly if the applicator is old, the cornea should be treated immediately and the mascara cultured to detect Pseudomonas. The high incidence of recurrent corneal ulceration in cases of Pseudomonas-induced keratitis indicates that initial chemotherapy should be intensive and maintained until the lesion stabilizes.


The effect of photocoagulation on the choroidal vasculature and retinal oxygen tension. Light microscopy and latex-pigment injection of rhesus monkey eyes studied at varying times after retinal laser and xenon photocoagulation of varying intensity showed that the choriocapillaris was obliterated by a wide range of intensities but that the choroidal arteries and veins remained open. Retinal oxygen tensions acutely increased over the lesion but later subsided to normal. Multiple treatment sessions several days apart may reduce the risk of hemorrhage associated with hypermia secondary to photocoagulation.


Experimental intraocular penetration of dacarbazine. Radioactive carbon (14C)-labeled dacarbazine was used to trace penetration of the drug to the eye after intravenous and subtenon-retrobulbar injection on experimental animals. After subtenonretrobulbar injection of 1 or 2.5 mg of commercial dacarbazine twice daily for two weeks, there were no clinical changes. However, doses of 5 to 7.5 mg per injection produced destructive chorioretinitis, and a proliferative type of retinopathy was confirmed histopathologically.


The effect of systolic hypertension on rhesus monkey eyes after ocular sympathectomy. Systolic hypertension was induced in rhesus monkeys by obstructing the thoracic aorta and by ocular sympathectomy obtained with the retrobulbar injection of 6-hydroxydopamine. During the late phase of fluorescein angiography, fluorescein leaked from the choroidal circulation into the retina. The retinal vessels did not leak fluorescein. The effect was not permanent since fluorescein did not leak into the retina after the blood pressure returned to normal.


Glial cell proliferation in human retinal detachment with massive periretinal proliferation. By transmission electron microscopy we studied 38 epiretinal membranes obtained from human eyes by vitrectomy operation in rhegmatogenous retinal detachment. Two of the membranes were composed of closely packed glial cell processes. The cytoplasm of the glial cell processes in both membranes contained little besides loosely packed filaments and microtubules. Microvilli protruded from the cells at the vitreal surface of one of the membranes. Junctional complexes were present between the cells only at the vitreal surface. In the other glial membrane, microvilli extended into a duct-like structure with junctional complexes sealing the lumen. A discontinuous basal lamina was laid down by cell processes at the retinal side of the membranes. Similar glial membranes, formed by migration and proliferation of astrocytes from the retina, were seen in owl monkeys with experimental and naturally occurring retinal detachment. A new epiretinal membrane (reformed in one of the eyes from which a dense glial membrane had been removed three weeks previously), was composed primarily of single large cells with extensively developed rough endoplasmic reticulum. The new cells were surrounded by collagen, fine fibrillar material, and fibrin. The new membrane also contained free pigment granules and pigment-containing macrophages. Additionally, we observed spicule-like crystals between the cells in the glial membrane specimens, identified as calcium phosphates by energy-dispersive x-ray analysis.


On the safety of long-term treatment with lithium. Thirteen patients with bipolar affective illness who had received lithium therapy for 1-5 years were tested retrospectively for evidence of cortical dysfunction. Data on patients younger than 55 show no abnormalities on the Halstead-Reitan Neuropsychological Battery and suggest that chronic lithium therapy is relatively safe. Significantly elevated Halstead Impairment indexes were observed among elderly patients, but these data are difficult to interpret.


Pituitary thyrotropin response to thyrotropin-releasing hormone in affective illness: relationship to spinal fluid amine metabolites. The authors studied pituitary thyrotropin, i.e., thyroid-stimulating hormone (TSH), response to thyrotropin-releasing hormone (TRH) in patients with primary affective disorder. There were no overall differences between either depressed or manic patients and normal controls; however, the TSH response was significantly lower in the unipolar depressed patients than in either bipolar depressed patients or normal subjects. Bipolar patients in the manic phase tended to have a lower response than bipolar depressed patients. In the unipolar group, the TSH response showed a significant negative correlation with the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) in the CSF. These neuroendocrine responses may constitute markers of specific monoamine dysfunction in subgroups of patients with affective illness.


Tardive dyskinesia in young adults.

Tardive dyskinesia in young adults. The authors describe two cases of tardive dyskinesia in which severe axial dystonia and intense facial grimacing produced marked discomfort as well as social and physical disability. Both patients experienced the onset of psychiatric symptoms as young adults, showed a prompt response to antipsychotic drug therapy, and were subsequently left on maintenance treatment for indefinite periods. The severity of this frequently irreversible and disabling condition warrants careful consideration in the use of long-term antipsychotic drug treatment in the young psychiatric outpatient population.


Pediatric nurse associates in a large official health agency: their education, training, productivity, and cost. During 1974, 29 pediatric nurse associates and 15 pediatric nurse associate trainees worked in the child health care system of the New York City Department of Health. All of these nurse associates, formerly public health nurses from the Department of Health, were trained in a one-year, intensive, closely supervised didactic and clinical course. Within the child health units the nurse associates  assumed clinical roles in the care of well and sick preschool children according to the written guidelines and protocols of the Department. In addition, they continued to function in the traditional role of the public health nurse for their own patients, rendering counseling, referral, and follow-up services as indicated. Physicians acted as consultants to the pediatric nurse associates. Comparisons are made between pediatric nurse associate-physician staff versus public health nurse-physician staff in terms of productivity and cost.


Life support systems in intensive care: a review of history, ethics, cost, benefit and rational use. This paper outlines the development of life support systems, i.e. artificial support systems for failing essential organs such as heart, lungs, kidneys and gastrointestinal tract. The current status of organ support is discussed, particularly in relation to intensive care units. Ethical problems posed by the availability of these systems are presented, cost and cost/benefit ratios are discussed, and proposals are made for the rational use of life support systems in the intensive care situation.


An electron microscope study of the perfusion-fixed spleen. II. Fine structure of the sinus lining cells with respect to filamentous structures in monkey spleens. In the perfusion-fixed spleen of monkey (Macaca mulatta) were studied with the electron microscope the cytoplasmatic structures of the sinus lining cells. The particular interest find the contractile filaments in this cells, which are important for the cell contraction. The connections to the smooth endoplasmatic reticulum are very strong as in the muscle fiber or muscle cell.


Sperm/egg interaction: the specificity of human spermatozoa. Human spermatozoa display unusually limited affinities in their interaction with oocytes of other species. They adhered to and, when capacitated, penetrated the vestments of the oocyte of an ape--the gibbon, Hylobates lar--both in vivo and in vitro. On the other hand, human spermatozoa would not even attach to the zona surface of sub-hominoid primate (baboon, rhesus monkey, squirrel monkey), nor to the non-primate eutherian oocytes tested. Among the apes the gibbon stands furthest from man. Thus, although the specificity of human spermatozoa is not confined to man alone, it probably is restricted to the Hominoidea. This study also suggests that the evolution of man and perhaps the other hominids has been accompanied by a restrictive change in the nature of the sperm surface which has limited and made more specific the complementary surface to which their spermatozoa may adhere. For the failure of human spermatozoa to attach to the zona surface of all non-hominoid oocytes stands in contrast to the behaviour of spermatozoa of the several other mammals studied which, in most combinations, adhered readily to foreign oocytes, including those of man. Taxonomically, the demonstration of a compatibility between the gametes of man and gibbon, not shared with cercopithecids, constitutes further evidence for inclusion of the Hylobatidae within the Hominoidea.


Treatment of chronic perennial allergic rhinitis: a double-blind trial of cromolyn sodium. In a double-blind, crossover study to determine the efficacy of cromolyn sodium in chronic perennial allergic rhinitis five of 12 patients with significant sneezing problems and four of 12 patients with significant rhinorrhea showed major improvement after a four-week course of the drug. Nasal eosinophils disappeared in five of six patients after a course of cromolyn sodium.


[Fast immunochemical assay of proteins with Gemsaec centrifugal analyser. Application to serum transferrin and IgA assay]. An automated method for measurement of specific proteins on a centrifugal analyser is reported. Based on the immunoprecipitin turbidimetric reaction enhanced by polyethylene-glycol, the technique, simple and fast, gives precise and accurate results with following cautions: the antigen and antibody concentrations must be carefully chosen according to defined specific antiserum, and two dilutions of each serum sample must be assayed to control quite satisfactory determination and exhibit any antigen excess error. Large series of serum transferrin and IgA assays were studied and compared with radial immunodiffusion and continuous-flow immunonephelometric method: good correlations prove the value of the reported method.


[Protein assay by immunoprecipitation with Centrifichem centrifugal analyser]. The authors present an automatic technic of estimation of ten serum proteins (albumin, alpha-antitrypsin, orosomucoid, alpha-1-macroglobulin, haptoglobin, C'3 complement, transferrin, IgM, IgG, IgA) by immunoopacimetry on a Centrifichem centrifugal analyser. This technic is derived from an immunonephelometric method, with the following differences: --the use of two concentrations of polyethylene glycol permitting one to obtain for all proteins, a constant levelling-out of the reaction within 3 minutes; --by a first reading at 3 seconds avoiding the prior determination of blank reagents and sera; --by the use of two dilutions of serum permitting calculation of all concentrations. The results are reproducible and are satisfactory: 95% of the coefficients of variation are less than +/- 5% in the case of all the proteins. The correlation with IDR is good. The coefficients vary from 0.91 to 0.99.


[Meningitis due to "Listeria monocytogenes": small postnatal outbreak (author's transl)]. Four cases of "Listeria monocytogenes" serotype 4 neonatal meningitis are reported. In all, the study of maternal antecedents and the circumstances of their outcome as small epidemy suggest a raisonable evidence that postnatal contamination within the early twenty-four hours of life happened. A proper treatment succeded in complete healing without sequelae in all cases.


Association of ocular, cervical, and cardiac malformations. Association of ocular, cervical, and cardiac anomalies is discussed. A case with severe congenital heart disease, unusual Duane's retraction syndrome, classified here as atypical typical, and Klippel-Feil anomaly is described. To alert the physicians to such an association of congenital malformations and for nosological purposes this entity may be called oculo-cervico-cardiac syndrome. Importance of the association of heart and eye abnormalities is stressed and syndromes with associated ocular and cardiac anomalies are briefly discussed.


The use of fluorescein angiography to study oxygen toxicity. This study was designed to test whether oxygen toxicity results in retinal damage that could be documented by the technique of fluorescein angiography. Three squirrel monkeys lived in 100% oxygen environments for periods ranging from 50 to 117 hours. Two of the monkeys incurred damage as evidenced by early multifocal leakage and subsequent accumulation of dye in the retina. All monkeys survived the exposures and were followed for several weeks thereafter. The pathology appeared to be reversible since later angiograms were either normal, or approaching normality, when the animals were sacrificed. Subsequent histopathologic examination revealed no abnormalities.


[Isolation and characterization of "Listeria monocytogenes" bacteriophages (author's transl)]. Fifteen L. monocytogenes phages are isolated from lysogenic strains without induction and are selected for phage-typing. Four of these phages are produced by strains belonging to serotype 1/2a and 1/2b, eight by strains 4b and three other phages respectively by strains 4ab, 4g and 3c. Electron micrographs of 5 of these phages show isometric heads with non contractile tails. They belong to morphological group B of Bradley. Rabbits are immunized with 7 bacteriophages and all the phages are studied by neutralization tests with these 7 antisera. This study seems complex nevertheless it is possible to distinguish four antigenic groups: A, B, C, and D. The lytic spectrum of each phage is usually restricted to strains of the serotype from which that phage is obtained. It appears that a good correlation exists between phage sensitivity and serological type of the strains. With this first set of fifteen phages, 159 of 214 (74,3%) strains of L. monocytogenes can be classified in more than 21 types but it appears that some new phages obtained from strains of serotype 1/2 must be isolated in the future. Our data indicate that these phages can be used as a phage-typing scheme for L. monocytogenes.


Destaining effects of immersion oils on Giemsa-stained chromosomes (R-bands). In 24-48 hours, immersion oils without PCB (polychlorinated biphenyl) destroy Giemsa-stained chromosomes (R-bands) on uncovered slides. We can recommend yellow paraffin oil as immersion oil. It has a preserving effect on the chromosomes like immersion oils containing PCB.


[GH secretion induced by continuous infusion of insulin (4 u/hour) in 9 insulin treated adult diabetics before and after CB 154 (2.5 mg/24 h) (author's transl)]. Continuous infusion of insulin (4 u/h) was performed in 9 insulin treated adult diabetics before and after CB 154 (2.5 mg/24 h). In 4 patients GH secretion do not exist under insulin infusion before CB 154 in spite of mean blood glucose level decrease of 1.5 g/l. In the same group GH secretion appears after CB 154. In the 5 others patients CH secretion is induced by blood glucose level decrease and became higher after CB 154.


Neonatal endotoxin encephalopathy.

Neonatal endotoxin encephalopathy. Telencephalic white matter of the neonatal kitten frequently contained diffuse astrogliosis or focal necrosis (sometimes including the thalamus and the caudate) following a single intraperitoneal injection of Escherichia coli lipopolysaccharide. No evidence for a disseminated intravascular coagulopathy was found. Telencephalic lesions in neonatal monkey and rabbit were also hemorrhagic. Enhanced karyorrhexis of glial nuclei was presented in the telencephalic white matter of the neonatal rat. In the kitten, a delay in the generation of macrophages and hypertrophic astrocytes occurs following transient neonatal endotoxemia. Marked weight loss and temperature fluctuation are prominent systemic effects. Large hemispheric cavitary lesions are not accompanied by obvious neurological deficits in the kitten.


Immunoassay of enzymes.

Immunoassay of enzymes. Antisera against purified human placental alkaline phosphatase (PAP) and crystallized creatine kinase (CK) isoenzyme from human skeletal muscle (MM) were raised in rabbits. The PAP antiserum was shown by radial immunodiffusion not to react with purified alkaline phosphatases from human liver and intestine, nor with the alkaline phosphatase in sera from patients with osteoblastic bone disease. CK antiserum also demonstrated no cross-reaction and was precipitated quantitatively by its homologous antisera. A "rocket" electroimmunoassay for PAP and CK is described. The method is simple, reproducible and uses small volumes of antiserum. The isoenzyme patterns were compared with those developed by several electrophoretic methods. These techniques share with other immunoassay the advantages of specificity for the antigen and enhance the quantitation of isoenzyme assays.


Periodic lateralized epileptiform discharges (PLED's) and nystagmus retractorius. A 57-year-old diabetic woman presented with focal right-sided seizures and hyperglycemia. She later showed periodic lateralized epileptiform discharges (PLEDs), originating in the left hemisphere, which were temporally associated with nystagmus retractorius. It appears that the left hemisphere epileptiform activity diffusely excited brainstem structures via polysynaptic pathways to produce the nystagmus.


Antimicrobial activity of amine oxides: mode of action and structure-activity correlation. The effect of N-alkyl derivatives of saturated heterocyclic amine oxides on the growth and metabolism of microorganisms has been studied. 4-Dodecylmorpholine-N-oxide inhibited the differentiation and growth of Bacillus cereus, of different species of filamentous fungi, and of the yeast Saccharomyces cerevisiae. For vegetative cells, the effect of 4-dodecylmorpholine-N-oxide was lethal. Cells of S. cerevisiae, after interaction with 4-dodecylmorpholine-N-oxide, released intracellular K(+) and were unable to oxidize or ferment glucose. The functions of isolated yeast mitochondria were also impaired. 4-Dodecylmorpholine-N-oxide at growth-inhibiting concentrations induced rapid lysis of osmotically stabilized yeast protoplasts, with the rate of lysis a function of temperature and of amine oxide concentration. A study of the relationships between structure, antimicrobial activity, and cytolytic activity was made with a group of structurally different amine oxides involving a series of homologous 4-alkylmorpholine-N-oxides, 1-alkylpiperidine-N-oxides, 1-dodecylpyrrolidine-N-oxide, 1-dodecylperhydroasepine-N-oxide, and N,N-dimethyldodecylamine oxide. Disorganization of the membrane structure after interaction of cells with the tested amine oxides was primarily responsible for the antimicrobial activity of the amine oxides. This activity was found to be dependent on the chain length of the hydrophobic alkyl group and was only moderately influenced by other substituents of the polarized N-oxide group.


Auxotypes and penicillin susceptibilities of Neisseria gonorrhoeae isolated from patients with gonorrhea involving two or more sites. A system of auxotyping described in 1973 is based on the differing nutritional requirement patterns of Neisseria gonorrhoeae strains. Our ongoing evaluation of the reliability of auxotyping has involved a study of the constancy of characteristics of gonococci isolated at one time from two or more sites of a given subject. The auxotypes and minimal inhibitory concentration (MIC) of penicillin G were determined for 181 isolates obtained from 84 patients with uncomplicated gonorrhea, for 16 isolates from 8 couples with uncomplicated gonorrhea, and for 21 isolates from 12 other patients, 9 with disseminated gonococcal infection and three consorts. The penicillin MIC served to distinguish between many members of auxotypes 1, 2, and 3, which are commonly involved in uncomplicated gonorrhea. Thus, for proline-requiring gonococci (auxotype 2) the MIC ranged from 0.01 to 1.2 IU of penicillin per ml. The profile of gonococcal responses to seven other antibacterial drugs provided useful additional information where the extent of phenotypic similarity was in doubt. In all but seven instances, the gonococci isolated from different sites of the same patient, or from a consort, had the same nutritional requirements and penicillin MIC. The gonococci isolated from one patient with disseminated gonococcal infection and from one of her two sexual contacts had nutritional requirements for arginine, hypoxanthine, uracil, and thiamine pyrophosphate, whereas the strain isolated from her second contact differed in having no requirement for thiamine pyrophosphate. The paired cervical and rectal isolates from one patient with uncomplicated gonorrhea differed only with respect to a requirement for hypoxanthine. Pairs of isolates from three patients differed slightly in degree of susceptibility to penicillin. In the remaining two instances, however, numerous differences between the isolates from the endocervix and the anal canal of a given patient indicated the presence of concomitant infections with different strains of N. gonorrhoeae.


Transferable plasmids mediating multiple-antibiotic resistance in Streptococcus faecalis subsp. liquefaciens. In strain HK187 (Streptococcus faecalis subsp. liquefaciens) four plasmids were isolated. The molecular weights, as analyzed in neutral sucrose gradients and by electron microscopy, were found to be about 36 x 10(6), 31 x 10(6), 26 x 10(6), and 4 x 10(6). Plasmid 3, also designated pFK14, with a molecular weight of 26 x 10(6), was found to be responsible for resistance to chloramphenicol and erythromycin and also for high-level resistance to streptomycin and lincomycin. In mixed cultures these four resistances could be transferred with high frequency to a plasmid-free recipient, S. faecalis strain JH2-2.


Transfer of plasmid-borne beta-lactamase in Neisseria gonorrhoeae. Neisseria gonorrhoeae strain GC82 contains a plasmid specifying a beta-lactamase (beta-Lam(+)). Mixed incubation of strain GC82 with a penicillin-susceptible (beta-Lam(-)), streptomycin-resistant mutant of strain GC9 results in the expression of beta-lactamase activity and streptomycin resistance in the transcipients. The frequency of transfer of the plasmid-specified resistance to penicillin seems to be proportional to the initial input ratio of the mating mixture of donor to recipient and to correlate positively with bacterial density. Cell-to-cell transmission of the deoxyribonucleic acid (DNA) appears to be by a conjugal mechanism or, alternatively, by an as yet undescribed transducing phage. Additionally, whole-cell DNA from a beta-lactamase-producing strain could be used to transform streptomycin-resistant recipients, resulting in the expression of both beta-lactamase activity and streptomycin resistance in the transformants, and purified gonococcal plasmid DNA transformed Escherichia coli but not the gonococcus. Circular DNA extracted from donor GC82 comprised three molecular species (approximately 2.7, 4.8, and 25 megadaltons [Mdal]), whereas the recipients GC9-S (Str(r)) contained only the 2.7-Mdal cryptic DNA species. DNA from the GC9-S82 (Str(r), beta-Lam(+)) transcipient contained a 4.8-Mdal species in addition to the cryptic molecular species (2.7 Mdal). The finding that the transcipient will not retransfer beta-lactamase is consistent with the hypothesis that the 25-Mdal plasmid promotes mobilization of the smaller 4.8-Mdal R plasmid.


Temperature effects on minimum inhibitory and bactericidal concentrations of cell wall antibiotics in Streptococcus faecalis. The minimal inhibitory and bactericidal concentrations were determined at 30 and 37 degrees C for several antibiotics affecting cell wall biosynthesis. The test organism, Streptococcus faecalis ATCC 9790, possesses a single autolytic enzyme and does not produce penicillinase. Penicillin, methicillin, and, possibly, bacitracin appeared more effective at 37 than at 30 degrees C. Vancomycin, ristocetin, and phosphonomycin appeared equally effective at both temperatures, and cycloserine appeared consistently more active at 30 than at 37 degrees C.


In vitro activity of rosamicin against Neisseria and Haemophilus, including penicillinase-producing strains. Rosamicin was significantly more active against Haemophilus and Neisseria than are many antibiotics currently used to treat or prevent infection caused by these organisms. This enhanced activity was also observed against penicillinase-producing strains.


Current status of PCB toxicity to mink, and effect on their reproduction. Experiments were conducted from 1968 to 1974 to investigate reproductive complications and mortality in mink fed Great Lakes coho salmon and to ascertain the effects of polychlorinated biphenyls (PCB's) on this fur bearer. The results of mink feeding trials indicated that coho salmon, as such, were not responsible for the loss of reproduction in the adult, or the kit mortality. Mink diets that contained other species of Great Lakes fish caused similar reproductive complications, but to a lesser degree. Rancidity, mercury poisoning and chlorinated hydrocarbon pesticide contamination of the fish were all discounted as being responsible for the problem. The clinical signs and lesions noted in mink that died while receiving diets that contained Lake Michigan coho salmon were very similar to those observed in mink fed on rations that contained supplemental PCB's. These included anorexia, blood stools, fatty liver, kidney degeneration, and hemorrhagic gastric ulcers. Analyses of tissues from mink that died when fed 30% Lake Michigan coho salmon or 30 ppm supplemental PCB diets showed similar PCB residues. PCB toxicity experiments revealed that mink are very sensitive to these compounds and that the lethal dose varied inversely with the chlorine content of the PCB's although only Aroclor 1254 exerted a detrimental effect on reproduction when fed at a low level (2 ppm) for 8 months. The reproductive failure encountered in feeding mink Lake Michigan coho salmon and Aroclor 1254 was shown to be of a non-permanent nature.


Insecticides, polychlorinated biphenyls and metals in African lake ecosystems. I. Hartbeespoort Dam, Transvaal and Voëlvlei Dam, Cape Province, Republic of South Africa. Concentrations and distribution of chlorinated hydrocarbon insecticides, polychlorinated biphenyls (PCB's) and some metals were determined in two South African lakes, Hartbeespoort Dam and Voëlvlei Dam. Water, bottom sediments, aquatic plants, aquatic insects, fish, fish-eating birds and their eggs were collected. Insecticides and PCB's were analyzed by thin layer and gas chromatography and mass-spectrometry. Analysis of metals was accomplished with atomic absorption spectrophotometry. Metals included arsenic, cadmium, copper, mangenese, lead, zinc, and mercury. The insecticide residue most commonly found in both dams were DDE, DDD, DDT, and dieldrin. Hartbeespoort had higher levesl than Voëlvlei of insecticides and PCB's in all types of samples common to both lakes. Concentrations of PCB's in all types of samples common to both lakes. Concentrations of PCB's having six or more chlorines increased with an increase in the trophic level. Concentrations of PCB's in the brains of the African birds were greater than the average total concentration of insecticides while the opposite was true for carcasses. Biological magnification of insecticides and PCB's occurred in both lakes. Hartbeespoort Dam had higher levels than Voëlvlei for all metals examined in bottom sediments and birds, except for copper in bird carcasses. Mercury levels in bird carcasses ranged from 2- to 5-fold greater than in fish while lead concentrations ranged from 2- to 10-fold greater.


The knees and ankles in sport and veteran military parachutists. 112 actively parachuting sport (free fall) parachutists with more than 200 descents each and 109 veteran military parachutists no longer active returned a postal questionnaire about their parachuting activities, injuries, and current and past musculoskeletal symptoms. A high frequency of fractures and injuries was reported by each group, both in relation to parachuting and to other activities. 58 sport parachutists aged 23 to 57 years (mean 33 - 3 years) had weight-bearing anteroposterior and lateral radiographs taken of each knee. These showed a prevalence of radiological osteoarthrosis of 10 - 4% which was mild in degree in all but one knee in one subject. 46 ex-military parachutists aged 50 to 70 years (mean 55 - 2 years) had weight-bearing anteroposterior radiographs taken of both knees and showed a prevalence of radiological osteroarthrosis of 41 - 3%. Moderate and severe changes were found in 10 - 9%. In both groups of parachutists six of the eight knee joints showing either moderate or severe radiological osteroarthrosis had been subjected to a previous meniscectomy. Forty ex-military parachutists had anteroposterior radiographs of the ankles (talotibial articulation) and showed a prevalence of osteoarthrosis of 17 - 5%, with the majority showing mild changes. There was a poor correlation between radiological osteoarthrosis, ankle symptoms, and previous fractures. With the reservation that the great majority of the sport group are still young (95% aged less than 50 years), it is concluded that parachutists as a group do not show an increased prevalence of radiological osteoarthrosis of the knee or ankle.


[Left bundle of His branch block in stages 3 and 4 with conduction in the right branch only in a super-normal period]. The authors report a case of chronic second degree atrio-ventricular block with permanent right bundle branch block. Intracavitary electrophysiological recordings allowed them to delimit the refractory period of the left branch, which was affected by a block during phase 3 but also during phase 4. They showed that there was possible conduction by the right branch during the extremely fine time limits of a supernormal period; using an atrial stimulation rate of 150/mn, it is therefore possible to obtain 1/1 conduction in the presence of a left bundle branch block.


[Phonomechanographic evaluation of the severity of pulmonary stenosis]. External phonomechanographic methods allow us to obtain a fairly precise estimate of the degree of obstruction to the pulmonary outflow, whether such an obstruction is a single entity or associated with another intracardiac malformation. The greatest precision in this field is obtained with the cases of pure pulmonary stenosis. The findings on phonomechanographic investigation of 54 cases with pulmonary stenosis have been compared with the results of the haemodynamic tests (catheterisation and angiography) as well as with the anatomical findings after a surgical cure had been effected in a certain number of cases. This study has allowed us to pick out five phonomechanographic criteria of severity of pulmonary stenosis: an increased reduplication of the second sound, lenghening of the interval between the Q wave of the electrocardiogram and the maximum portion of the systolic murmur, an increase in Furuta's ratio and also in the amplitude of the jugular venous a-wave as a function of the total height t (the a/t ratio), but most especially the "corrected" Furuta ratio as a function of the length of the ejection phase of the right ventricle, as this has been shown to possess the best correlation with the right ventricular systolic pressures.


[An attempt to estimate the value of myocardial contractility in left ventricular aneurysms]. Using monoplanar angiography at 30 degrees, the authors have attempted to quantify the effectiveness of the non-aneurysmal myocardium in 50 patients (17 of them having undergone surgery) with an aneurysm of the left ventricle. Having fixed the position of two points during systole and diastole, they first delimit the aneurysmal zone and/or neighbouring dyskinetic zones in relation to the zones which are still 'healthy'. By a method of integration based on the formula of the three levels, they first measure the global volume of the left ventricle and its ejection fraction, and gain an idea of the size of the aneurysm. They then evaluate the ejection fraction and the volumes of each of the other zones. They have shown that the prognosis depends upon the ejection fraction and the end-diastolic volume of the ventricle which is presumed to be healthy, these measurements being corrected according to the size, expressed as an ejection volume, of the adjacent dyskinetic zone, which can be assessed by an index (volume of the dyskinetic zone as a proportion of the total 'healthy' and dyskinetic zones, in turn expressed as a ratio of the ejection fraction). The application of this work is to be found in seeking a limit of operability for extensive left ventricular aneurysms with cardiac failure.


[Vasodilator treatment of left ventricular insufficiency in the acute stage of myocardial infarction]. The haemodynamic effects of two vasodilators (phentolamine and nitroprusside) have been studied in 11 patients who developed acute left ventricular failure during the acute phase of a myocardial infarction. The dose was adjusted to the highest level failing to cause tachycardia (phentolamine: 0.19 to 0.76 mg/mn; nitroprusside: 0.07 mg/mn), and the treatment was maintained for between 5 hours and 8 days. Under these conditions, after one hour a diminution in mean arterial pressure can be observed (from 94 to 82 mmHg, p less than 0.005), as can a decrease in pulmonary arterial diastolic pressure (from 21 to 14 mmHg, p less than 0.001); the cardiac index rises slightly (from 3.1 to 3.51/mn/m2(NS), and the systemic and pulmonary vascular resistance are decreased by 20% and 30% respectively. The index of systolic work does not increase to a significant degree (30.7 to 32.9 g-m-syst-m2), the same work being carried out with smaller filling pressures. Together with the lessened resistance to ventricular ejection, and also, it seems, to a dedrease in venous tone, this beneficial effect has been particularly marked in a case of posterior papillary syndrome with mitral incompetence. As the response varies from individual to individual, constant monitoring of arterial pressure and cardiac rate is vital if the maximum therapeutic effect is to be achieved, particularly in hypertensive patients, in whom tachycardia in response to lowering of the arterial pressure occurs more readily.


[Sinus dysfunction and nodo-hisian conductive disorders. Indication for definitive cardiac stimulation]. A consecutive series of 80 patients has been the object of intracavitary electrophysiological studies, including a study of sinus function and of node/His conduction, before implantation of a definitive cardiac pacemaker. Investigation of the sinus yielded normal or insignificant results in 32 cases. It revealed certain criteria of "major" sinus dysfunction (TRSC 1000 ms; more than compensatory return cycles where there was SAP) in 39 cases, made up of 18/20 in group I (documented evidence of sinus malfunction), 10/14 in group II (sinus bradycardia less than or equal to 55/mn), 9/44 in group III (A-V conduction defects), and 2/2 in group IV (paroxysmal supraventricular tachycardia); criteria of "minor" sinus dysfunction (TRSC between 550 and 1000 ms, TECASA greater than 210 ms) were found in only 9 cases (group I--1; group II--2, group III--6). The association of sinus malfunction with node/His conduction defects was found in 29 cases, the site of the AV block being nodal in 7 cases, intra-His in 2 cases, infra-His in 10 cases, and a combination of nodal and infra-nodal in 10 cases. In 59 cases, the severity of the AV block (40 cases), of the sinus malfunction (17 cases) or of the sinus bradycardia (2 cases) was already obvious, and investigation of the sinus was not critical in determining the indications for a cardiac pacemaker. In 21 cases, however, this investigation was a determining factor, and most especially in 12 cases from group II. Sinus investigation seems to represent, in addition, a valuable indicator for the decision to install a pacemaker in a certain number of litigious cases.


[Echocardiographic criteria of obstructive cardiomyopathy]. In defining the characteristic abnormalities of obstructive cardiomyopathy (OCM), the echocardiogram appears to offer an excellent method. We have used this technique in 22 adults presenting with this condition, and have compared the results of echocardiography with those taken from 17 normal subjects. All those with OCM had asymmetrical hypertrophy of the septum (meaning hypertrophy of the septum without proportional thickening of the posterior wall of the left ventricle); certain other facts were noted: an undilated left ventricular cavity, good systolic function, and indications of poor diastolic compliance. In addition, from the thickeness of the posterior wall and the movement of the mitral valve complex during systole, it has been possible to draw a distinction between the patients with and those without obstruction while they were all at rest. These results confirm that it is possible to identify obstructive cardiomyopathy and the frequently associated defects of ventricular function by an echocardiographic method.


[Coronary circulation in abnormal left coronary artery arizing from the pulmonary artery trunk, before and after correction]. Two patients, both of them young girls, aged 14 and 15, had this condition and were studied by haemodynamic methods preoperatively and during the seventh postoperative month. In both cases, the retrograde perfusion of the left coronary vascular tree was shown up well, demonstrating the "coronary steal" and a left-right shunt of 2 volumes. In both cases also, the postoperative coronary arteriogram showed a return of the left coronary circulation to normal, disappearance of the large anastomatic vessels, and above all a return to normal dimensions of the right coronary artery, previously extremely tortuous and dilated. The 30 or so cases of total correction published in the world literature have been reviewed in the light of these two new cases.


[Valve replacement in case of a partial atrioventricular canal. A propos of 17 cases]. In 17 patients with a partial form of atrioventricular canal, at least one valve was replaced. The mitral valve was the most commonly affected (16 cases), sometimes in association with the tricuspid valve (5 cases) or the aortic valve (1 case); the tricuspid valve alone was replaced in one case. 7 cases were ranked as operative deaths, and the longer term mortality was of 4 cases. The factors leading to this high mortality figure are discussed. The future treatment policy for this condition is discussed.


[Progressive external ophthalmoplegia and disorders of ventricular conduction. Apropos of 3 recent cases]. The authors report 3 cases with an association of progressive external ophthalmoplegia (OEP) and disordered intracardiac conduction. These cases, and the twenty or so similar ones reported in the literature, show that this association is important for two reasons:--there is a therapeutic importance in that the condition affects young patients, who are at risk from sudden death due to the conduction defect; for this reason electrocardiographic follow-up must be regular, and an intracavitary pacemaker must be introduced definitively at the least indication;--there is a physiopathological importance in that the effect of the myopathies on the myocardium is well known, but most information relates to the diffuse cardiomyopathies, and in only 10% of cases are there conduction defects. By contrast, the conductive tissue appears to be involved in all cases of OEP, while cardiac failure is rare. It seems likely, therefore, that cases of OEP have a pathogenesis different from that of the diffuse myopathies, whether or not these involve the external occular muscles.


[The risk of hemorrhage versus the thromboembolic risk in patients with prosthetic valve]. 376 adults were followed up for between 2 and 153 months after surgery (mean: 3.8 years); all of them, with the exception of 8, received anticoagulant treatment. The results were subjected to statistical analysis using several tests. Thromboembolic complications occurred in 16 per 100 after 5 years, and 8.5. per 100 of them were fatal. Among the factors favoring this complication are the type of valvular disorder (the rate of throembolism being 4 times greater with mitral valve defects), the type of prosthesis, and the efficiency of the anticoagulant therapy (the risk of thromboembolism being four times greater in those patients whose treatment has been inneffective). Against the vitamin antagonists must be set the haemorrhages: the incidence of lethal haemorrhage in this series was 6.4 per 100 patients per treatment year. There was a proven hypoprothrombinaemia to below the desirable level in two thirds of these cases, and in one case out of four an additional predisposing factor could be demonstrated. Haemorrhage and thromboembolism are together responsible for one in four of the late deaths. In order to reduce the mortality, several solutions are considered, one of which is to utilise anti-aggregation treatment. However, the vitamin K antagonists remain an essential part of treatment in the majority of cases; it can only be justifiable to withhold them in those patients in whom the risks of haemorrhage are for various reasons considered to be too high. The introduction of biological valves or of valves with a lessened risk of embolism is highly desirable in such cases.


[Karyovolumetric studies on possible central-nervous-system action sites of the positive estrogen feedback]. In adult, progesterone-pretreated female rats, the medial preoptic and ventral premamillary nuclei of the hypothalamus, and the medial amygdaloid nucleus of the limbic system exhibit a significant karyovolumetrically measurable activation of their neurons after the subcutaneous administration of an ovulation-inducing dose of oestradiol benzoate. The finding suggests that these nuclear regions are sites of action of the positive oestrogen feedback and are involved in the induction of ovulation. The infundibular and lateral septal nuclei, and the bed nucleus of the stria terminalis were also investigated karyovoumetrically but failed to reveal, at the time of testing, any quantifiable morphokinesis that might have been attributable to the administration of the hormone.


Persisting symptoms in schizophrenia predicted by background factors. A social worker's Home Inquiry was conducted for 75 schizophrenic males as soon as possible after hospitalization. A standard set of items based on this inquiry was scored in terms of nine factors. These Home Inquiry factor scores were found to have modest but statistically significant correlations with specific symptom ratings conducted two years after admission. In the present sample, an interpersonally uncomfortable childhood home and low premorbid self-esteem have untoward implications for the remission of symptoms.


Total parenteral nutrition using peripheral veins in surgical neonates. A new program of total parenteral nutrition (TPN) for surgical neonates has been described an investigated. The program is based on the use of fat emulsion as the major source of calories and infusion of large volumes of the solution via peripheral veins. This program has three main advantages over conventional hyperalimentation using a central venous catheter: (1) it avoids complications such as septicemia, thrombosis of large vessels, and metabolic complications such as hyperglycemia or osmotic diuresis; (2) it provides physiological nutritive elements containing a normal composition of glucose, protein, and fat; and (3) it is easy to start and manage the TPN using a peripheral vein. Thirty-four neonatal surgical patients with life-threatening gastrointestinal anomalies have been placed on this TPN program. Infusion of fat emulsion and large volumes of fluid were well tolerated and all patients gained weight during the period of observation.


Vitamin requirements in patients receiving total parenteral nutrition. This study represents an initial attempt to define intravenous vitamin requirements in adult patients receiving total parenteral nutrition (TPN). We have investigated two different vitamin formulations for their ability to maintain normal circulating blood levels of vitamins A, C, E, B12, folic acid and riboflavin. Administration of 1.1 ml of Multi-Vitamin Infusion (MVI) solution supplemented with 100 microgram of folic acid, 10 microgram of vitamin b12, and 100 mg of vitamin C, per liter of TPN infusate (patients received an average of about 3 liters/day), maintained normal or higher than normal levels of vitamins C, B12, and riboflavin, but resulted in less-than-normal levels of vitamins A, E, and folic acid. Increasing the amount of MVI to 1.4 ml and the folic acid to 200 microgram, and decreasing the ascorbic acid to 70 mg and vitamin B12 to 5 microgram/liter of TPN infusate, resulted in normal blood levels of all tested vitamins within two weeks after initiating TPN therapy, and normal blood levels were then maintained at this dosage for additional periods of time up to three weeks.


[Ultrastructure of "villose cells" in the early stages of their formation in the process of chemical carcinogenesis in the CNS]. Early stages of redistribution of cellular elements around the pill of carcinogenic agent DMBA introduced into the right hemisphere of the brain of female SHK albino rats were studied. Precursors of the ciliated cells were established to appear in the perivascular tissue within 12 h. Within 24 h they accumulate around the pill bed, and within 48 h a cellular edging is formed around DMBA. The cytoplasm of ciliated cells become richer in organelles. The main marker in identification of cells in all periods of experiment were lipoid inclusions in the cytoplasm which are different from lipids of usual macrophages occurring both in experiments and in control, in a polygonal shape and sinuous contour. Within 48 h the cytoplasm of ciliated cells form long lancet-shaped spiculae with upright walls. The cytoplasm of macrophages gives only short, somewhat sinuous processes.


[Comparison of the field formation in the frontal area during prenatal period in Macaca (Macacus rhesus, S. Macaca mulatta) and man]. A developmental comparison of the fields 8, 9, 10, 11, 12, 47 during prenatal life in macacus rhesus and man was performed. Cytomyeloarchitectonic and morphometric methods of investigation were applied: the areas of the fields in question, the transverse thickness of the cortex, separate cortical layers, neuronal dimentions were measured. Alongside, general regularities in the development of these fields in both species (the frontal cortex is laid earlier than other parts of the cortex, the terms of the field differentiation coincide, uneven development of the fields with different phylogenic origin) some important differences are demonstrated. They are seen a) in the rate of the frontal field maturation--in man it takes longer time, b) in a more complex organization of the frontal part in man--during prenatal life new structural features of the fields, 44, 45, 46 and subfields in the field 47 appear. During prenatal life of monkey and man in the development of the frontal area the phenomena of heterochrony (common for both species) and anabolia (peculiar for man only) are observed (the appearance of new more complex structures). These phenomena display themselves in the shift of the laying of the frontal area towards earlier stages of embryogenesis.


[Quantitative characteristics of the systems of truncal auditory and visual brain formations in Artiodactyla and perissodactyla]. On the ground of cytoarchitectonic investigation and planimetric measurements a volumetric comparison between the systems of truncal formations of auditory and optical analysers were made in the representatives of artiodactyla (deer, elk, gazelle, sheep, wild boar, hippopotamus) and perissodactyla orders (horse). The data obtained demonstrated a great quantitative predominance of the system of optical formation in comparison with that of auditory, which correlates to the leading role of the optical system in these animals. In non-ruminants, according to other environmental conditions, vision looses its biological importance, such as in ruminants. In the former, therefore, a much less predominance of the optical formations comparing with the auditory ones was revealed. Comparisons with the previous results of the author obtained in other mammal orders, demonstrated quantative changebility--plasticity of corresponding truncal auditory, optical and vesitbular formations in response to ecologically stipulated changes of leading afferentation in different mammals.


[Blood vessels of the epiphysis in comparative-anatomical aspect]. The structure of the epiphysis and its inner blood vessels were studied in the representatives of nine orders of placental mammals and in man by means of injection of stained masses into the arteries and veins and subsequent preparation of histological sections. Not only form and topography of the organ differ in the representatives of different orders, but histological picture of the epiphysis is specific for each of them. In insectivores and chiroptera the loops of the inner three-dimensional capillary network are stretched along the longitudinal axis of the organ. In the epiphysis of carnivores, ungulata and monkey, the intraorganic vessels are situated in stromal trabeculae and the loops of the capillary network have polygonal shape. The intraepiphyseal vessels in man are arranged in peculiar baskets which envelope parenchymal lobules. The intraorganic veins beginning from the loops of the capillary network do not follow the arteries penetrating into the organ, but independently go to different surface parts of the organ where they flow into extraorganic veins.


[Anatomy of the lymph vessels and nodes of the head and neck in green marmosets]. In 50 mature green monkeys, the lymphatic system of the skin on the hairy part of the skull (occipital, parietal, frontal) and on the face was studied. The lymphatic vessels of cranial and cervical organs flow into submental, submandibular (anterior, medial, posterior) lymph nodes and into profound cervical (cranial, medial, caudal) lymph nodes. Lymph nodes together with efferent lymphatic vessels form lymph collectors of the neck which follow the blood vessels branching: superficial jugular, profound jugular and paratracheal network.


Optic disc edema in raised intracranial pressure. VI. Associated visual disturbances and their pathogenesis. The pattern and pathogenesis of nonlocalizing visual disturbances, associated with optic disc edema (ODE). raised cerebrospinal fluid pressure, and intracranial space-taking lesions were investigated experimentally in rhesus monkeys with simulated progressive brain tumor and clinically in patients with benign intracranial hypertension. The visual disturbances occurring in one of both eyes were of three types: recurrent attacks of transient obscuration, permanent blindness, and various types of visual field defects. The studies indicate that the visual disturbances are usually due to two mechanisms. The most common is ischemia of the optic disc secondary to ODE. The other, rarer mechanism probably consists of the space-taking lesion causing downward herniation of the parahippocampal gyrus into the tentorial notch, producing compression of the lateral geniculate body and optic tract.


Hearing patterns in Morquio's syndrome (mucopolysaccharidosis IV). The hearing status of 18 patients with Morquio's syndrome (mucopolysaccharidosis IV) was evaluated. All three patients under age 8 years had a conductive hearing loss. Fourteen of 15 patients 8 years of age and older had a mixed or sensorineural hearing loss; one had normal hearing. Six patients wore hearing aids. By the end of the first decade of life, most persons with Morquio's syndrome may be expected to have either a mixed or sensorineural hearing loss. Amplification may be required.


Factors determining the effects of chronic protein-deficiency on antibody responses to sheep red blood cells and Brucella abortus vaccine in mice. Chronic protein-deficiency in weanling mice caused variable suppression of the humoral plaque-forming cell (PFC) responses to sheep erythrocytes. This was most prominent at high antigen doses and did not increase when mice were maintained on the diets for longer periods. Antibody responses produced by deficient mice were often short-lived and involved high levels of IgM. Total PFC counts were depressed slightly more than were circulating antibodies. Antibody responses to Brucella abortus were slightly decreased by protein-deficiency at high antigen doses but were normal or elevated at lower doses, the proportion of IgM produced was increased and the splenomegaly response to B. abortus was severely depressed. These results suggest that the depression of antibody production by protein-deficiency is not simply due to an impairment of helper T cell function, but a reduction in the availability or effectiveness of macrophage and regulatory or suppressor T cells may be important.


Cardiopulmonary vagal afferents in the monkey: a survey of receptor activity. A survey was made of vagal afferents whose endings originated in cardiopulmonary areas of the Rhesus monkey. Recordings of action potentials from single fiber preparations of the left cervical vagus were made in both open and closed chest monkeys. A total of 425 receptors were identified in sixteen animals. These consisted of 347 pulmonary stretch receptors (one of which increased its discharge during expiration), 42 aortic baroreceptors, 4 ventricular pressure receptors, 1 epicardial ventricular receptor, 7 type A atrial receptors and 24 type B atrial receptors. The response of each cardiovascular receptor was tested by altering the stimulus for their discharge. Aortic and ventricular baroreceptors increased their discharge in response to an increase in blood pressure induced by intravenous norepinephrine. Type A atrial receptors did not increase their discharge in response to an increase in atrial pressure during intravenous administration of isotonic saline, while type B atrial receptors did. The discharge of the latter became continuous following the intravenous administration of veratridine sulphate (20 microgram). It is concluded that the basic types of cardiopulmonary afferents exist in the non-human primate and that they respond similarly to those which have been demonstrated in lower species.


Comparison of the cardiovascular effects of phentolamine, sodium nitroprusside and nitroglycerin in anaesthetized cats (comparison of vasodilators). The effects of phentolamine (PH), sodium nitroprusside (NP) and nitroglycerin (GTN) were compared in experiments on anaesthetized cats. All three agents diminished vascular resistance and lowered blood pressure, although they differed in the intensity of their effects (NP greater than PH = GTN) and in the steepness of their dose-response curves (NP greater than PH greater than GTN). NP and GTN did not cause consistent changes in heart rate and dP/dt, whereas PH produced marked, dose-dependent increases in these two variables and in cardiac output, which was augmented to a lesser extent by NP and not affected by GTN. It is concluded that whereas the beneficial therapeutic effects of NP and GTN are presumably due exclusively to the reduction of preload and afterload, PH has an additional cardiostimulant action.


Effect of toloxatone on behaviour of primates. 1. The effects of (3-methyl)-3-phenyl-5-hydroxy-methyl-2-oxazolidinone (toloxatone) were studied on the behaviour of three species of primates: baboon, rhesus monkeys and chimpanzee. 2. The activity against reserpine-induced depression is observed in baboon as in rodents. 2. The administration of toloxatone induces three effects which probably have the same origin: suppression of feeding inhibition of the subordinate baboon, improvement of escape reaction in the conditioned chimpanzee, increase in general activity and the active component of social behaviour in grouped rhesus monkeys. These three effects can be interpreted as resulting from the stimulating effect of toloxatone, or more precisely from a disinhibiting effect. 4. Contrary to amphetamine, toloxatone does not induce, even at high or repeated doses, behavioural disturbances.


Antibacterial and anthelminthic properties of visnaginone and khellinone derivatives. The compounds tested, derivatives of visnaginone and khellinone, showed antibacterial activity on gram negative and gram positive micro-organisms. Some of the compounds possess an antibacterial activity on some pathogenic bacteria, i.e. Brucella abortus, for which there is no remedy as yet. All the chalcones tested were inactive except Ib, which showed antiparasitic broad spectrum.


Comparison of two dosage schedules of gold salts in the treatment of rheumatoid arthritis. Relationship of serum gold levels to therapeutic response. Two doses of gold sodium thiomalate were compared for their effect on rheumatoid arthritis. Thirty-seven patients with active disease for longer than 6 months were treated with 25 mg of gold sodium thiomalate for an average of 29.6 weeks, then at biweekly or monthly intervals to complete 2 years of treatment. Thirty-eight patients were given more than twice as much gold salt at the same intervals on a flexible dose schedule that produced serum gold levels which averaged 332 microgram/dl during the weekly injection phase. No differences were observed in the therapeutic responses of the two groups. Therefore the minimal dose of gold sodium thiomalate required to induce a response in rheumatoid arthritis is 25 mg or less per week. Serum gold levels in the steady state varied between 95 and 386 microgram/dl and were not related to response. Serum half-life for gold was calculated for patients who had an excellent response and for those who were treatment failures. The rate at which gold disappeared from serum was not related to therapeutic responses.


Postinjection nonvasomotor reactions during chrysotherapy. Constitutional and rheumatic symptoms following injections of gold salts. During gold sodium thiomalate (GST) therapy, 15% of 100 unselected patients described recurring postinjection reactions (PIRs), consisting of transient stiffness, arthralgias, myalgias, and constitutional symptoms. Six patients with more severe reactions requested discontinuation of chrysotherapy and for these, gold thioglucose (GTG) substitution abolished or amelioriated the reactions. The major significance of the PIR is that it may be a frequent cause of unwarranted premature abandonment of chrysotherapy.


Amino acid sequence of normal (microheterogeneous) porcine immunoglobulin lambda chains. The partial amino acid sequence of pooled, microheterogeneous pig immunoglobulin lambda chains was determined previously (Franĕk, F. (1970), FEBS Lett. 8, 269; Novotný, J., and Franĕk, F. (1975), FEBS Lett. 58, 24). In the present study, citraconylated pig lambda chains were digested by trypsin under conditions in which some of the epsilon-amino groups of lysine residues unmask. The resulting fragments were purified by gel filtration and ion-exchange chromatography at pH 3.0  in buffers containing urea; some of the fragments were found to be of intermediate size (i.e., larger than normal tryptic peptides but smaller than "citraconyl" peptides), thus permitting overlap information and amino acid sequences of all the 14 tryptic peptides to be deduced from amino acid compositions and partial amino acid sequences of selected fragments. In addition to completing the major amino acid sequence of pig immunoglobulin lambda chains, the present study demonstrates that it is possible to sequence microheterogeneous proteins with a suitable fragmentation strategy.


Acetylation of prostaglandin synthetase by aspirin. Purification and properties of the acetylated protein from sheep vesicular gland. We previously presented evidence that aspirin (acetylsalicylic acid) inhibits prostaglandin synthetase by acetylating and active site of the enzyme. In the current work, we have labeled the enzyme from an aceton-pentane powder of sheep vesicular gland using [acetyl-3H]aspirin and purified the [3H]acetyl-protein to near homogeneity. The final preparation contains protein of a single molecular weight (85 000) and an amino-terminal sequence of Asp-Ala-Gly-Arg-Ala. The [3H]acetyl-protein contained 0.5 mol of acetyl residues per mol of protein based on amino acid composition but only a single sequence was found.


Molecular characterization of limulin, a sialic acid binding lectin from the hemolymph of the horseshoe crab, Limulus polyphemus. The sialic acid binding lectin, limulin, was isolated by gel filtration and ion-exchange chromatography from the hemolymph of Limulus polyphemus. When the purified protein was characterized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis in the presence of beta-mercaptoethanol, two major protein bands were observed. These two bands, subsequently found to contain carbohydrate as well, corresponded to molecular weights of 25 000 and 27 000. Amino acid sequence analyses were performed on both the intact protein and isolated cyanogen bromide fragments. The following primary structural features were noted in the amino-terminal region of limulin: (1) the absence of histidine and alanine from the NH2-terminal 50 residues; (2) the presence of five of the total eight prolines of the molecule between positions 13 and 30; and (3) a possible carbohydrate attachment site consisting of only the amino acids proline and serine between residues 13 and 19. The resultsof cyanogen bromide cleavage studies confirmed the presence of 2 methionine residues per subunit, at positions 25 and 58 respectively. No sequence heterogeneity was observed in this study. While it is quite possible that limulin plays some role in the defense mechanisms of the horseshoe crab, there is no obvious sequence homology between this invertebrate lectin and vertebrate immunoglobulins.


Photosynthetic activity of diimidoester-modified cells, permeaplasts, and cell-free membrane fragments of the blue-green alga Anacystis nidulans. On treating the blue green alga Anacystis nidulans with dimethylsuberimidate up to 70% of the free NH2 of the photosynthetic membrane is amidinated, and presumably inter- and intramolecular cross-links are established in the membrane proteins. Amidination destroys the ability of A. nidulans to photoreduce HCO3(-) but leaves the photochemical activities of Photosystems II and I nearly intact. With added electron acceptors, photosynthetic O2 evolution can be demonstrated both with permeable cells (permeaplasts) prepared by digestion of the cell wall of dimethylsuberimidate-reacted A. nidulans with lysozyme, as well as with heavy membrane particles (36 000 x g) prepared from dimethylsuberimidate-reacted cells. Permeaplasts prepared from dimethylsuberimidate-reacted cells resist damage in hypoosmotic medium, whereas those prepared from unreacted cells are induced to release C-phycocyanin. On the other hand, the former are inactivated more easily by heat stress than the latter. On this basis, it is concluded that cross-linking with dimethylsuberimidate confers functional instability to photosynthetic membranes.


Studies on DNA repair in Bacillus subtilis. III. Identification of an exonuclease which enhances the priming activity of gamma-irradiated dna by "cleaning' damaged ends. An enzyme which enhances the priming activity of gamma-irradiated DNA for type I DNA polymerase (EC 2.7.7.7) was identified and partially purified from extracts of Bacillus subtilis cells. The enzyme preferentially degraded gamma-irradiated DNA into acid-soluble materials. DNA preparations treated with heat, ultraviolet light, pancreatic DNAase (EC 3.1.4.5) or micrococcal DNAase (EC 3.1.4.7) were not susceptible to the enzyme. However, sonication rendered DNA susceptible to the enzyme to some extent. From these results, it is supposed that this enzyme may function by 'cleaning' damaged terminals produced by gamma-irradiation to serve as effective priming sites for repair synthesis by the type I DNA polymerase.


The influence of micelle formation on lipoxygenase kinetics. The effects of a series of n-alcohols and n-carboxylic acids on lipoxygenase activity was studied. It was shown that to a large extent the effects of these compounds could be ascribed to physiochemical interaction with the substrate solution rather than a direct action on the enzyme itself. The effect of better substrate analogues such as stearate and oleate could also be ascribed to this effect. A type-2 lipoxygenase was found to have a very unusual velocity-substrate relationship which could be normalized by addition of calcium chloride in amounts stoichiometric with the substrate. An excess of calcium inhibited the enzyme. By comparison of results with linoleoyl sulphate/linoleoyl alcohol mixed micelles, an explanation for this unusual velocity-substrate activity is presented.


[Effect of chemical modification on thermal stability of horseradish peroxidase]. Soluble preparations of horse radish peroxidase are obtained by means of its amino groups modification with glutaric aldehyde, maleic anhydride and inert proteins including albumin. The enzyme activity is found to decrease under the modification with glutaric aldehyde and to be unchanged at all other cases. Thermal stability of the enzyme preparations obtained is studied within the temperature range from 56 to 80 degrees C. Thermostability of glutaric aldehyde-modified peroxidase is approximately 2.5-fold decreased at 56 degrees C. Thermostability of other preparations exceeds the stability of native peroxidase in 25--90 times at 56 degrees C. Thermodynamic parameters of activation for the process of irreversible thermoinactivation of native and modified enzyme are calculated. A strong compensation effect between activation enthalpy and entropy values is observed, which were changed in 1.5--2 times, while the free activation energy is changed by 2--3 kcal/mol only. Possible mechanism of the change of the enzyme thermal stability under its chemical modification is discussed.


Is taurine essential for the neonates?

Is taurine essential for the neonates? Serum amino acid concentration measurements in infants with low birth weight fed on human milk or on two humanized formulas and in infants on total parenteral nutrition showed that taurine was significantly decreased in the three groups on artificial diet. Infants weighing more than 2,000 g on total parenteral nutrition perfused with a solution containing no taurine and little cystine showed a low taurine concentration despite a significant increase of cystine. These results favor the hypothesis of Sturman et al., that the human infant cannot synthetize in adequate amount of taurine from cystine and methionine precursors and may be dependent on its diets as a taurine source.


Theoretical conversion yields for penicillin synthesis. The efficiency of conversion of the carbon-energy source to product is of primary importance in many fermentation processes. In order to assess the efficiency of a process, one must know how close the actual conversion yield is to the theoretical maximum. Theoretical conversion yields are useful, therefore, as guides in improving a process. This knowledge is particularly important today because the cost of raw materials is rapidly rising. In this study, the biochemical pathway of penicillin synthesis was used to estimate the theoretical yield of penicillin from glucose, ammonia, and sulfate. These values are compared with experimental data from the literature. An analysis of the role of glucose in the synthesis of cell mass and penicillin and in the maintenance of cells makes it possible to assess the efficiency of carbon-source utilization and to direct further advances in penicillin fermentations.


[Characteristics of the interaction of 9,10-dimethyl-1,2-benzanthracene with the hairy cells in the central nervous system]. The implantation of a pill containing carcinogen DMBA into the right hemisphere of the rat brain induces the formation of a capsule, the innermost layer of which is composed of "hairy" cells. Two principally different mechanisms of carcinogen penetration into the "hairy" cell were distinguished: ordinary phagocytosis and biochemical interaction of carcinogen with the cell membrane. It is supposed that in the second case there occurs formation of secondary carcinogenic products in the form of steroid hormone which could be morphologically identified as lipid-like structures of the "hairy" cell.


[Differentiation of type D virus from continuous human cells (Il'in-Bykovskiĭ virus) and Mason-Pfizer monkey virus by the antigens of the viral envelopes]. For differentiation of Ilvin-Bykovsky virus (IBV) and monkey Meson-Pfeizer virus (M-PMV) the method of virus neutralization with antibodies against the envelope virus antigen was used. The viruses were cultivated in similar human embryo cells. The results of the virus neutralization were determined by presence or absence of the gs-antigen in the infected cells. The antiserum to M-PMV envelope antigens did not neutralize the IBV antigen. It has been concluded that IBV and M-PMV differ by their envelope antigens and should be regarded as different viruses.


Agonist and antagonist properties of buprenorphine, a new antinociceptive agent. 1. Buprenorphine is a highly lipophilic derivative of oripavine. In rodent antinociceptive assays (writhing, tail pressure), buprenorphine had an action which was rapid in onset and of long duration; it was 25-40 times more potent than morphine after parenteral injection and 7-10 times more potent after oral administration. 2. The log dose-response relationship for buprenorphine was curvilinear in mouse and rat tail flick tests with the antinociceptive effect decreasing at higher, non-toxic doses. 3. Tolerance developed to the antinociceptive activity of buprenorphine in mice. 4. No signs of abstinence were observed on naloxone challenge or after abrupt withdrawal in monkeys receiving buprenorphine chronically for one month. 5. Buprenorphine antagonized the antinociceptive actions of morphine in mouse and rat tail flick tests but was an ineffective antagonist in the rat tail pressure test. 6. Buprenorphine precipitated signs of abstinence in morphine-dependent mice and monkeys but not in morphine-dependent rats. 7. Buprenorphine produced Straub tails in mice. This effect was not antagonized when the animals were pretreated with naloxone. However, in the rat tail pressure test high doses of diprenorphine antagonized established antinociceptive effects of buprenorphine. 8. It is concluded that buprenorphine represents a definite advance in the search for a narcotic antagonist analgesic of low physical dependence potential.


The animal pharmacology of buprenorphine, an oripavine analgesic agent. 1. The general pharmacology of buprenorphine, a potent analgesic agent derived from oripavine, is described. 2. After cute administration of buprenorphine, the spontaneous locomotor activity of mice was increased; rats displayed stereotyped licking and biting movements; behavioural depression was marked in guinea-pigs but mild in rhesus monkeys. The behaviour of cats was unchanged. 3. In general, buprenorphine reduced heart rate but had no significant effect on arterial blood pressure in conscious rats and dogs. 4. In anaesthetized, open-chest cats buprenorphine (0.10 and 1.0 mg/kg, i.v.) caused no major haemodynamic changes. 5. Buprenorphine (0.01-10 mg/kg i.a.) and morphine (0.30-30 mg/kg, i.a.) increased arterial PCO2 values and reduced PO2 values in conscious rats. With doses of buprenorphine greater than 0.10 mg/kg (a) the duration of respiratory depression became less, (b) ceiling effects occurred such that the maximum effects produced were less than those obtained with morphine. 6. Buprenorphine was a potent and long-lasting antagonist of citric acid-induced coughing in guinea-pigs. 7. At a dose level 20 times greater than the ED50 for antinociception (tail pressure), morphine suppressed urine output to a greater extent than the corresponding dose of buprenorphine in rats. 8. Over the range 0.01-1.0 mg/kg (s.c.), buprenorphine slowed the passage of a charcoal meal along the gastrointestinal tract in rats. After doses in excess of 1 mg/kg, the meal travelled increasingly further such that the distances measured at 10 and 30 mg/kg did not differ significantly from control values. In contrast, the morphine dose-response relationship was linear.


Avoidable factors contributing to death after head injury. We reviewed 116 patients, known to have talked before dying after head injury, to discover factors which had contributed to death but which might have been avoided. All the patients were admitted to a neurosurgical unit and had a neuropathological post-mortem examination. One or more avoidable factors were identified in 86 patients (74%); an avoidable factor was judged certainly to have contributed to death in 63 patients (54%). The most common avoidable factor was delay in the treatment of an intracranial haematoma; others included poorly controlled epilepsy, meningitis, hypoxia, and hypotension. Changes in the management of patients with head injuries which reduce the incidence of avoidable factors should decrease mortality from this condition.


An experimental study of the efferent connections of the superior cerebellar peduncle in the rhesus monkey. Unilateral electrolytic lesions were made in the right superior cerebellar peduncle immediately lateral of its decussation or in the dentate nucleus of 6 monkeys. The course of the contralateral ascending and descending degenerated fibers and sites of preterminal degenerated fibers were studied in material stained by Fink-Heimer, Nissl and Weil methods. Major thalamic sites of preterminal degeneration were in the rostral part of VPLo, and in VPI, VLo, VApc, CL and PCn. In other thalamic nuclei or subdivisions, no preterminal was observed or was questionable. No degenerated fibers entered the internal capsule or corpus striatum. There was abundant preterminal degeneration in the rostral part of the nucleus ruber and adjacent reticular formation. The descending degenerated fibers of the superior cerebellar peduncle led to massive preterminal degeneration in the central part of the nucleus reticularis tegmentalis and in nuclei raphe pontis and magnus. The most caudal site of preterminal degeneration (minimal) was in the nucleus reticularis gigantocellularis adjacent to the median longitudinal fasciculus.