The effects of a high-fiber diet on bile acid pool size, bile acid kinetics, and biliary lipid secretory rates in the morbidly obese. A high-fiber diet has been suggested as one reason for the low incidence of gallstones in some populations. Therefore the authors tested the effects of a high-fiber diet on biliary secretory kinetics and bile salt kinetics in morbidly obese volunteers. Bile salt pool sizes were reduced by 50%, and their half-lives were decreased 70% after the subjects had spent 6 weeks on the high-fiber diet. Bile acid enterohepatic circulation times also were shortened dramatically. However, the lithogenicity of bile did not decrease, and bile remained supersaturated with with cholesterol. Fasting bile samples tended to be even more lithogenic than before the subjects follwed the diet. In these obese subjects, a high-fiber diet failed to reduce the tendency to secrete cholesterol-saturated bile.


Cutaneous melanoma of the breast.

Cutaneous melanoma of the breast. A study of 115 cutaneous melanomas of the breast demonstrated that these neoplasms follow different metastatic patterns than do primary carcinomas of the breast and require a different therapuetic approach. Lesions located below a 3 cm from the clavicle metastasized exclusively to the axillary nodes regardless of location. None of 19 internal mammary node chains examined histologically contained tumor deposits. Microstaging of the primary lesion correlated closely with prognosis and lymph node metastasis. Treatment by mastectomy (radical, modified, extended radical) offered no advantage over local excision of the primary plus axillary dissection. The latter procedure is recommended for all cutaneous melanomas of the breast which require node dissection. Mastectomy is not indicated unless the breast is in the field of wide local excision. Internal mammary node dissections are not indicated.


The effect of prostaglandin E2, 15-methyl prostaglandin E2, and metiamide on established canine gastric mucosal barrier damage. The ability of two types of gastric acid inhibitor to reverse established gastric mucosal barrier damage was studied in canine Heidenhain pouches. A model of established barrier damage was prepared and validated by perfusing Heidenhain pouches with an acid saline solution containing 20 mmoles of aspirin for 2 hours (damage period) and then perfusing with acid saline alone for a third hour (recovery period). Increases in gastric mucosal permeability to H+ and Na+ produced in the damage period still were present and were significant in the recovery period. In subsequent experiments the effect of topically applied prostaglandin E2 and 15-methyl prostaglandin E2 and intravenously administered prostaglandin E2, 15-methyl prostaglandin E2, and Metiamide on the recovery period permeability was studied. Topical application of the prostaglandins and intravenous Metiamide had no effect on the increased permeability. Intravenously administered prostaglandins returned the permeability to normal and therefore reversed established barrier damage. This effect may have important therapeutic implications in acute gastric mucosal lesions.


Femoral arteriovenous amino acid differences in septic patients. Femoral arteriovenous differences and flux of amino acids across the leg were measured in seven septic patients and compared with those of six nonseptic patients on days 1 and 3 following major surgery. The septic patients were seriously ill and judged clinically to be catabolic. The postoperative patients, although not septic, were expected to have a maximal catabolic response to operation during the first 3 days after operation. Both groups had increased release of phenylalanine from the leg, an index of muscle proteolysis. Septic patients had decreased femoral arteriovenous differences (--20 vs --74 and --60 mumoles/liter) and decreased flux (34 vs 169 and 128 nm/100 gm of calf muscle) of the branched-chain amino acids as compared with the nonseptic postoperative patients on days 1 and 3. The arterial plasmal levels of the branched-chain amino acids and alanine were not different, but phenylalanine was elevated in the septic patients (88 vs 49 and 55 mumoles/liter). The insulin:glucagon molar ratio was lower in the septic patients (2.4 vs 4.4 and 5.5). These findings suggest that in the catabolism of sepsis there is greater oxidation of branched-chain amino acids in muscle than in the catabolism associated with uncomplicated surgery.


Surgical lesions of the colon in the hemolytic uremic syndrome. Hemolytic uremic syndrome (HUS) is characterized by hemolytic anemia, thrombocytopenia, and acute renal failure, usually in children under 10 years of age. Gastrointestinal symptoms, including abdominal pain and bloody diarrhea, frequently precede the onset of renal failure. It has not been generally appreciated that the intestinal disease process may proceed to frank ischemic lesions of the colon requiring surgical intervention. An illustrative patient is presented in whom total infarction of the descending colon occurred. The patient represents the fourth reported case of surgical colonic disease as a consequence of the hemolytic uremic syndrome.


Purification and properties of prothrombin modified by asbestos filtration of human plasma. Filtration through asbestos filter (Seitz) of human plasma modified the prothrombin molecule as previously shown. Factor II could no longer be activated by physiological activators (Ca++ + phospholipid + V and Xa) but reacted readily with staphylocoagulase. The separation and purification of the modified prothrombin allowed allowed the preparation of two fractions:  A small slightly modified accessory fraction, "prothrombin-asbestos-1", lost its ability to be activated by physiological activators, and its ability to be adsorbed by barium citrate, but retained the immunological reactivity of fragment 1, as well as the mobility and molecular weight of unmodified prothrombin. A main fraction, "prothrombin-asbestos-2" appeared to be a modified prothrombin which has lost its N-terminal extremity. It was not adsorbed by barium citrate and could not be activated by physiological activators. It possessed a reduced electrophoretic mobility, as well as a reduced molecular weight (39,000), which are properties similar to those of thrombin. Both fractions 1 and 2 were devoid of thrombin activity. Asbestos was thus able to break the prothrombin molecule non enzymatically, the amputation of the N terminal extremity being responsible for the new functional and physicochemical properties of the molecule. Staphylocoagulase appeared not to need the N terminal extremity of the molecule of prothrombin to form the active thrombin-coagulase complex.


Effect of treatment with activated prothrombin complex concentrate (FEIBA) on factor VIII-antibody level. The influence of treatment with an activated prothrombin complex preparation (FEIBA) on the antibody level was studied in 10 haemophiliacs with an antibody to factor VIII. The antibody level was observed to rise at least once in five patients, while in the remaining five patients no rise occurred. In all, 6 out of 31 treatments were followed by an anamnestic rise of the antibody level, corresponding to 19.4%. A rise of the inhibitor level following FEIBA treatment is likely to occur in patients who show a marked antibody rise after factor VIII treatment (good responders), but have a low antibody level at the time of treatment. High doses of FEIBA and simultaneous of red cells may also enhance the likelihood of an anamnestic response. Stimulation of antibody production is probably due to the presence of small amounts of factor VIII in this preparation.


Fibrin deposition and removal in disseminated intravascular coagulation induced by endotoxin and saline loading: radioautographic findings in rats. In rats a single injection of endotoxin followed by an infusion of normal saline induced the generalized Shwartzman reaction. The presence of disseminated intravascular coagulation (DIC) was demonstrated by measuring plasma fibrinogen, platelet counts, schistocytes, plasma haemoglobin, fibrin(ogen) degradation products, and fibrin thrombi in the glomerular capillaries, 125I-fibrinogen was given after triggering DIC in order to examine the fibrinogen turnover in plasma and the kinetics of fibrin deposition and removal in kidney, liver, and spleen. 125I-fibrinogen turnover was found to be highly accelerated. Early deposition and removal were observed in the kidneys, while a later peak with a more delayed fall of radioactivity was noted in liver and spleen. On histological examination fibrin could be seen only in the glomerular capillaries and only in the early phase of DIC. In radioautographs radioactive material was localized in the glomerular capillaries, the Kupffer' cells of the liver, and in the perifollicular macrophages of the spleen. Comparing the results obtained by scintillation counting to those obtained by light microscopy it can be assumed that radioactivity in kidneys is correlated to fibrin deposition in glomerular capillaries and to an accumulation on fibrin(ogen) degradation products in liver and spleen.


Fibrinolysis in grafted arteries and veins. The fibrinolytic activity in autologous artery and vein grafts was studied in cats during a 4-month period. The fibrinolytic activity in the wall of an aortic segment interposed in the caval vein was increased in comparison to the normal aorta. In the corresponding segment of the caval vein interposed in the aorta, the fibrinolytic activity was reduced during the observation time. Thrombosed segments had a decreased activity. No changes were seen in sham operated animals. The plasminogen activator activity in the vessel wall was found to be influenced by the surrounding milieu.


Platelet functions in relation to dietary fats in farmers from two regions of France. To determine whether the long-term feeding of dietary fats affect platelet functions in man, platelet aggregation (to thrombin ADP, collagen, epinephrine) and clotting activity of platelet-rich plasma (PRP), platelet-poor plasma and of washed platelets were studied in a mobile-laboratory in 44 healthy male farmers (40--45 years) from two French regions Var and Moselle, in relation to lipemia, glycemia, dietary nutriments, and platelet phospholipid composition. In the Moselle subjects, the platelet clotting activity of PRP and of washed platelets, the platelet aggregation to thrombin and ADP, were highly significantly (p less than 0.001) increased as compared to those of Var, but not the plasma cholesterol, which was identical in the two regions. In Moselle, the intake of total calories, total lipids and saturated fats was higher than in the Var. However, it was only with the saturated fat intake (mostly stearic acid) that the platelet clotting activity (p less than 0.01) and the platelet aggregation (p less than 0.001) were highly significantly correlated. The platelet clotting activity was also significantly (p less than 0.001) correlated with the fatty acid composition of the platelet phospholipid fractions phosphatidyl serine + phosphatidyl inositol.


Inhibition of platelet aggregation by a new agent, Ticlopidine. Effect of Ticlopidine, 5-(2-chlorobenzyl)-4, 5, 6, 7-tetrahydro[3,2-C]pyridine hydro-chloride, on platelet aggregation was studied in the rat. Ticlopidine was found to be a potent, long-lasting inhibitor of platelet aggregation. It inhibited the aggregation induced by any of ADP, collagen, thrombin, arachidonic acid and prostaglandin endoperoxides and/or thromboxane A2-like substancee. Ticlopidine was effective at doses as low as 30 mg/kg when orally given to rats, and the effect lasted as long as the life span of the circulating platelets (half time: about 48 hours). Ticlopidine inhibited also nucleotide release from and prostaglandin synthesis in the platelets, but did not significantly affect platelet adhesiveness to glass, platelet factor 3 availability and clot retraction.


Shear stress-induced changes in platelet reactivity. We have investigated the effects on platelet function of a physiologic shear stress. The aggregation to thrombin and collagen, the release reaction [(14C) serotonin] and the procoagulant activity of washed platelet suspensions were assayed on samples undergoing laminar oscillatory flow for 20 minutes at 37 degree C in polyethylene tubes, and on paired samples kept at rest. The pulse rate was established at 72 cycles per minute and the shear stress at the wall estimated at 26.2 dynes/cm2. The platelet suspensions were prepared at 37 degree C from blood samples of 15 healthy volunteers and 15 patients with the diagnosis of coronary artery disease proven by angiography. Our results show enhancement of platelet aggregation in samples undergoing oscillatory flow. Furthermore, platelets from coronary patients gained additional procoagulant activity. However, no change was encountered in the rate and speed of the release reaction. It is concluded that exposure to a high shear stress within an oscillatory flow system enhances platelet reactivity; this reaction may take part in the production of platelet and coagulation changes seen in the atherosclerotic patient and after strenuous physical exercise.


[Fowl Cholera. Preventive treatment with antibiotics (author's transl)]. In view of an outbreak of fowl cholera in the duck-and turkey-farming industry, the possibility of instituting long-term preventive treatment of recently acquired birds on the farms involved was studied. Satisfactory results were obtained in Peking-ducks and turkeys when chlortetracycline was administered at a concentration of at least 100 ppm in the feed for three weeks. Satisfactory results were also obtained using a combined preparation of neomycin and oxytetracycline in muscovy ducks or a preparation of neomycin, chloramphenicol and chlortetracycline in Peking-ducks following experimental infection.


[Pentachlorophenol poisoning in nestlings of canaries (Serinus canarius) (author's transl)]. Using binder twine of bales of straw as nesting material for canaries apparently resulted in a reduction of hatchability. However, the outstanding feature was the high mortality rate during the first week after hatching, with a peak on the fourth day and nestlings never growing any older than three months. Other symptoms consisted in marked retardation of growth and poor growth of feathers. The adult birds presented a normal appearance. The most likely cause was the presence of pentachlorophenol (PCP) averaging 285 ppm).


[An interactive system for recording, storage and processing of treatment data (author's transl)]. For correct radiation treatment and evaluation of treatment a complete recording of data is necessary. With this aim an interactive system was developed. Data recording for every patient is started from a terminal assigned to the physician. After completing the patient file with the data of the physical treatment plan, the file may be displayed on the terminal assigned to the particulr treatment unit, and additional data of the particular treatment session added. If a treatment is finished, a hardcopy of all data is generated by the system. Retrieval of patient data is always possible from the physicians terminal. The system is a contribution towards reducing the work in documentation the radiation treatment. It will be possible not only to carry out epidemiological studies, but also to investigate and perhaps optimate the results of treatment methods.


[Determination of the integral dose with a body phantom using Fricke's system and an evaluation by means of potentiometric analysis (author's transl)]. The concept of the integral dose, being correlated with the system of immunity, has got an increased bearing on radiation therapy. Experimental determination of integral doses in a tissue-equivalent body-phantom by means of ferrosulfate dosimetry and potentiometric analysis is described. The results are discussed and compared considering X and Y irradiation techniques and different units for irradiation.


[Determination of the quality of radiation and the dose rate in radiodiagnostics and radiotherapy by means of thermoluminescence dosemeters (author's transl)]. According to article 13, para. 1 of the Röntgenverordnung (regulations for the application of radiology) the dose rate of the useful radiation of radiotherapeutic units must be measured twice a year. The authors demonstrate that it is not absolutely necessary to use very complicated systems for these measurements which can also be performed with LiF thermoluminescence dosemeters. If CaF2 thermoluminescence dosemeters are used simultaneously, it is also possible to obtain an information about the quality of radiation.


[Experimental research on the contrast production of the chemical elements with the atomic number 1-83 in a computer-total-body-tomogram]. The contrast production for the chemical elements with the atomic numbers Z = 1-83 were determined by computer-tomography. With the formula relation of the delta-number and the atomic number can one compute the contrast production of any chosen chemical compound. Iodine-free and inorganic iodine-containing contrast media are examined for their contrast production and compared with presently used organic iodine-containing contrast media. The contrast enhancement of organic contrast media in tissue are discussed.


[Chemotherapy in solid transplantation tumors following synchronization (author's transl)]. In order to examine whether the effects due to cytostatics might be improved by synchronization, cytosin-arabinoside, hydroxyurea or Vincristin were administered to rats bearing solid transplantation tumors, at different intervals following synchronization. The three substances, interfering with the S-phase of the cells, show significantly improved therapeutic results with quickly proliferating Walker-carcinosarcoma after a synchronization by hydroxyurea. Cyclophosphamide on the other hand, being effective through several phases of the cell cycle, furnishes no evidence of any essential therapeutic result. Analogous therapeutic experimentation using slowly growing neurosarcomas yielded no better results after synchronization. The concept of synchronization treatment may be approved, therefore, with certain limitations: firstly, synchronization with hydroxyurea can be maintained for a short time only, and the cancerous cells pass throught the first phases of the cell cycle following synchronization for the most part together with normal cells; secondly, only tumors with an important growth fraction and only cytostatics that do not affect several phases of the cell cycle are appropriate for synchronization therapy.


[Radiation therapy of humeroscapular periarthritis (author's transl)]. The effectiveness of radiation therapy in 233 cases with periarthritis humeroscapularis is reviewed in a prospective study from the Basel canton hospital. The patients are studied with regard to different parameters, such as duration of the anamnesis, importance of the dose, moment of evaluation of the results and influence of a 2-series technique. The total result, comprising 43.3% cases without complaints, 30.9% being better, and 25.8% whose troubles had not changed, is compared with the compiled statistical data of 4957 cases found in literature. The gonadal load is discussed on the basis of our own investigations.


[Comparison of measured relative isodose distributions in tangential stationary fields of Co-60 radiation with calculated isodose plans (author's transl)]. The relative isodose distributions in tangential stationary fields are measured in rectangular phantoms by means of four different methods: film measurements, thermoluminescence probes, ionization chamber, and semiconductor probes. The different measuring methods are compared, and the influence exercised by the part of the field running in the air is examined. Within the scope of their applicability, all measuring methods produce the same values which differ only by +/- 1%. It is possible to reach a better estimation of the dose distribution in the depth of the "partial fields" (a part of which is running in the air) by reducing adequately a "complete field". Furthermore, isodose distributions of measured "partial fields" are compared with calculations from a programme for the irradiation planning (programme COMRAD), and they are discussed. It is shown that the losses due to scattered radiation are not rendered by the calculation.


[Effect of high frequency electromagnetic fields on the processes of transamination in the liver and small intestine tissues of rats]. The influence of electromagnetic waves of metrical and centimetrical range on the transaminoferases activity was studied in the liver and small intestine of 69 rats. The experiment shows that the activity of aspartate and alanine aminotransferases is dependent on the power and duration of the action. It is established that the action of both the short-wave 160 mA diathermy and 30 MW/cm2 microwaves for 20 min is accompanied by inhibition of the liver and small intestine aminotransferases activity. The 20 min action of 12 MW/cm2 microwaves induces an increase in the aminotransferases activity of the liver, small intestine and serum.


[Amino acid metabolism in the human placenta during its functional maturation]. The total content of free amino acids in chorion villi of the 7-40-week human placenta rises from 41 up to 71 mg%, which is mostly due to an increase in the content of replaceable amino acids. In the process of development the intensity of glutaminic acid desamination changes essentially and correlates with changes in its content in the placenta. The aspartate and alanine aminotransferase activity in the placenta during the period under study rises almost twice, that correlates with changes in the content of alanine, glutaminic and asparginic acids in the corresponding periods of development.


[Effect of alpha-tocopherol on phospholipid concentration and lipid peroxidation in rat brain tissue following a burn injury]. Studies of the lipid peroxides and phospholipid content in the rat brain in different periods after burns showed that the total phospholipid content in all the periods is decreased. The daily intraperitoneal administration of alpha-tocopherol in a dose of 100 mg/kg against a background of the burn decreases sharply the phospholipid content. alpha-Tocopherol in a dose of 1 mg/kg, administered immediately after the trauma and then 3, 7, 12 and 17 days after burns restores the phospholipid content to normal. The described changes were connected mainly with the lecithin and phosphatidylethanolamine fractions.


[Correction of nitrogen metabolism in rats with toxic hepatitis by parenteral administration of an amino acid mixture]. The nitrogen metabolism in rats with toxic affection of the liver caused by administration of CCl4 was studied as affected by the amino acid mixture moriamine S-2. It is established that with toxic hepatitis the nitrogen metabolism is sharply disturbed, especially during protein deficiency. The following evidences for this fact: a rise in the depth of the nitrogen negative balance, an increase in the intensity of amine nitrogen and ammonia excretion with urea as well as an increase in the amount of amine nitrogen in blood and tissues with a simultaneous decrease in the content of protein. The parenteral administration of the amino acid mixture for eight days to the animals with a toxic affection of the liver is more effective when nitrogen preparation is combined with the group B vitamin, vitamin C, insulin, nerobolyl and sirepar.


[GABA-transaminase activity in the dog brain visual analyzer following light deprivation during ontogenesis]. The GABA-transaminase activity is the highest in the subcortical formations of the brain visual analyzer in 45- and 90-day dogs. Deprivation of visual impulses at early stages of postnatal ontogenesis lowers sharply this activity in all the studied areas of the brain visual analyzer. Under conditions of deprivation the content of glutaminic acid increases in all the formations of the dog brain visual analyzer to a considerably less extent, especially in the anterior corpora bigemina and lateral geniculate body at the age of 45- and 90-days. Similar regularities are found in the deprivation effect relative to formation of ascorbic acid the content of which lowers sharply in all the formations of the dog brain visual analyzer on the 90th day of light deprivation.


[Serum alkaline phosphatase isoenzymes in rats at different periods after bile duct transection]. Total activity and isoenzymic spectrum of the blood serum and liver alkaline phosphatase were studied with experimental obstructive jaundice beginning from the first hours of its development till 30 days. Changes in the activity of alkaline phosphatase and its isoenzymic spectrum are shown to have their characteristic features at different times of obstructive jaundice.


[Lactate dehydrogenase isoenzyme spectrum in the myocardium and skeletal muscles of animals under physical stress]. Single physical load (forced run up to fatigue) changes the lactate dehydrogenase activity in the myocardium and skeletal muscles of rats. It is pronounced in a sharp rise of the activity 1 h after the action, in a decrease 6 h after and again in an increase a day later and a gradual fall on the third seventh days. An increase in the portion of isoenzymes typical of the anaerobic metabolism is peculiar to the myocardium and skeletal muscles, that finds its manifestation in both an increase in the lactic acid amount and the lactate/pyruvate coefficient. A regular rise in the LDH2 amount in all periods of the study and LDH5 in the early period after the action is peculiar to the myocardium and the increase in the LDH5 content is characteristic of the skeletal muscles.


[Effect of carbon dioxide on the initial rate of the isocitrate and malate dehydrogenase reactions in rat liver]. The rate of reactions catalyzed by the NADP-dependent isocytrate dehydrogenase and malate dehydrogenase soluble fraction of the rat liver was studied as affected by carbonic acid. The reaction initial rate for both enzymes was determined under normal conditions and at physiological concentrations of carbonic acid. The initial rate of the direct isocytrate dehydrogenase reaction is established to decrease by 20, 35 and 57% at the carbonic acid concentrations 20, 40 and 60 mM. At the same time the initial rate of the malate dehydrogenase reactions increases by 51, 86 and 104% at the same levels of carbonic acid.


[Muscle glycoproteins (soluble in perchloric acid) after denervation and drug stimulation]. Muscle proteins soluble in perchloric acid contain about 75% of carbohydrates presented by neutral hexoses, fucose and hexuronic acids. Three days and two weeks after denervation the content of the glycoproteids protein part is unchanged, a month later it increases by 116%. The content of carbohydrate component following denervation lowers considerably and a month later is on the average 40% higher than in the muscle of healthy rats. Administration of muscular RNA restores the content of the protein component only by the end of a month; administration of pyrogenal normalizes the content of both protein and carbohydrate components.


[Dynamics of orotic acid metabolism in chick tissues]. The processes of pyrimidine nucleotides metabolism were analyzed in cells of chicken small intestine mucosa using the kinetic series-parallel model of the first order equations. The rate constants are calculated for absorption of [2-14C]orotic acid by mucosa cells, its accumulation in blood anc conversion to uridine nucleotides. Stages of uridine nucleotides conversion to cytidine ones and their incorporation into RNA are not described by the system of the first order equations based on the series-parallel model with the single-channel utilization of orotic acid through the pyrimidine pathway. The model into two pathways of free nucleotides metabolism and two individual flows of precursors into RNA corresponds qualitatively to the obtained experimental data. Metabolism of orotic acid along two separate channels might be typical of the chicken liver.


[Effect of histamine and insulin on the sterol composition of gastric secretions in dogs]. The effect of gastric secretion activators with a different mode of action was studied on the qualitative and quantitative composition of sterol in dog gastric juice. Cholesterol was established to be the basic component of the unsaponifiable fraction of both histamine- and insulin-stimulated gastric juice. The presence of unsaponifiable substances and cholesterol was much higher in the histamine-stimulated gastric juice. The data obtained are discussed taking into account the mode of action of the gastric secretion activators.


[Proteins and their reactive groups in the roe and sperm of roach and bream]. The content of proteins soluble in the phosphate buffer in the mature eggs and sperm of the bream is higher than that in the corresponding cells of the roach. The eggs of both the roach and bream is richer in these proteins than the sperm. The amount of SH- and S-S-groups in proteins of sex cells is not the same and varies depending on the fish species. The ionization coefficient value for lateral groups of proteins soluble in the phosphate buffer at 245 and 300 nm is lower for the eggs of the roach as compared to that of the bream and for the sperm of the roach, vice versa, it is higher than for the bream sperm. This index for proteins of the roach and bream eggs at 245 and 300 nm is higher considerably as compared to that established for sperm.


[Polyamine concentrations in the liver and kidney tissues of rats of different ages]. The spermidine and spermine contents in the liver and kidney tissues were determined for rats of different age. The age peculiarities in the polyamine content are revealed in the rat liver and are not observed in the kidneys. Spermidine prevails in the young rat liver, but spermine in the adult rat liver. The spermidine content in the young rat liver calculating per 1 g of fresh weight or per 1 mg of RNA is on the average twice as high as in adult animals. Spermine prevails in kidneys of both the growing and adult animals. The age peculiarities of the polyamine content in the liver are supposed to be connected with its protein-synthetizing function: the spermidine high content may be due to rapid synthesis of extracellular proteins which are necessary to the growing organism.


[Spectrum differentiation as a method of studying protein preparations with a high turbidity level]. The studies on a model of a mixture of fibrin-monomer with glycogen and of fibrin gels of different turbidity show that in the first and second derivatives of the absorption spectra the contribution of turbidity is several orders lower. The derivative spectra are shown to be valuable technique to study the phenomena that are accompanied by substantial changes in turbidity: protein association and self-assembly of supermolecular structure.


[Determination of creatine kinase isoenzymes in rat tissues]. A method is developed for detection and quantitative determination of the creatine kinase isoenzymes during electrophoresis in agar gel. They are found in the agar gel block by formation of fluorescent sites due to combination of the isoenzymes reaction product: creatine with ninhydride in the alkaline medium followed by fluorophore quantitative elution. The method is specific, simple, highly sensitive. It was used to study mobility of creatine kinase of mitochondria and isoenzymes of the rat myocardium mytochondria sarcoplasmic fraction during electrophoresis under different conditions. It is established that mobility of creatine kinase of mitochondria differs from that of isoenzymes. During electrophoresis in agar gel, contrary to polyacrylamide gel, it arranges relative to sarcoplasma isoenzymes depending on the buffer used.


Methods of analysis for backscattering from tissues. Two techniques for tissue characterization by ultrasonic analysis are described. In the first, using narrow-band pulses, the angular variation I (theta) of the ultrasonic intensity back-scattered by vegetal or animal targets is analysed. We examine how it is possible to estimate the surface roughness and the average spatial periodicity d characteristic of the tissues, by calculating the Fourier transform or the autocorrelation function of I (theta). In the second technique the sample is insonified with a broadband pulse at a fixed angle. A value of the mean periodicity can be obtained directly from the frequency spectrum of the echo for tissues of fairly regular structure.


[Urodynamic miction studies--physiological aspects]. In this work, definition and interpretation of different functional parameters, which were obtained through urodynamic investigations, are given. Normal patterns in child age are presented. They were the results of personal studies in patients with normal urinary tract. The pressure curve must be seen as an entity. The so-called after contraction is no detrusor contraction. But possibly it is the result of a determined lapse of contracting and relaxing occurrences in the different parts of the bladder and its outlet at the end of micturition.


Composition of urinary tract calculi from some developing countries. The composition of 142 calculi from Sudan, Thailand, Indonesia and Saudi Arabia has been determined by qualitative and quantitative chemical analysis. Calcium oxalate was the commonest constituent of both kidney and bladder stones, followed by magnesium ammonium phosphate, ammonium acid urate, calcium phosphate, uric acid and cystine in that order. Calcium oxalate was also the main constituent of the nucleus of most kidney and bladder stones, calcium phosphate, magnesium ammonium phosphate, and ammonium acid urate occurring most frequently in the outer layers of the stones. Most endemic bladder stones appear to originate as aggregates of calcium oxalate crystals in the kidney, which subsequently descend to the bladder, where they may acquire secondary deposits of calcium phosphate, magnesium ammonium phosphate or ammonium acid urate.


Epidemiological and clinical significances of urolithiasis in childhood. An epidemiological and clinical study of a sample of 105 children with urolithiasis treated in the period 1965-1974 in a defined population of children revealed a decrease in the rate of incidence of this disease in a municipal infant population with high-ranking care for their health. Serious forms of urolithiasis are on the decrease. There is a higher rate of incidence in schoolboys and schoolgirls, the latter being more often involved than boys. Despite the general lower rate of occurrence, urolithiasis still has such forms as will endanger the life of the organ and the life of the patient. Injury to health of the child by this disease consists mainly in loss of one kidney, ambilateral staghorn stones that proved irremovable in their entirety and pyelonephritis.


Some new results of investigation of tuberous sclerosis. The authors describe the case of a patient with tuberous sclerosis. The occurrence of M-protein with antigenous appurtenance of IgM not only in the patient himself but also in some of the healthy blood relations in the family is pointed out. The question of clinical and biochemical-immunological peculiarities occurring in connection with this disease is discussed.


[Flexible operative nephroscope].

[Flexible operative nephroscope]. Our experiences with a flexible fiberscope for nephroscopy during operation are reported. With high pressure of the irrigation fluid, good judgement of the pelviocaliceal system is possible. Sounds for coagulation and forceps for stone extraction can be introduced. We found nephroscopy helpful after stone extraction and in identification of pyelocaliceal tumours.


[Endoscopic "loop" biopsy].

[Endoscopic "loop" biopsy]. The use of the forceps biopsy has not solved many diagnostic problems of early forms of cancer, and the rate of pseudonegative findings may reach 18 to 60%. The endoscopic biopsy carried out by means of the diathermic loop is free of many drawbacks of the forceps biopsy, as the loop captures a portion of the mucous membrane and submucous layer of the gastrointestinal organs within the diameter of 20--25 mm. Clinical experience with 53 examinations has proved a high diagnostic effectiveness of the method and the necessity of its broad clinical use.


[Analysis of the lethality in cholecystitis and the ways for its decrease]. An analysis of lethality in cholecystitis has been carried out. The main complications, which had resulted in the death of 238 patients, were analysed. Purulent complications served as the most common cause of fatal outcome. The authors came to the conclusion on the necessity to broaden indication for an early surgical intervention in acute cholecystitis in elderly patients.


[Surgical anatomy of the veins as applied to the formation of a renoportal venous anastomosis in the surgical treatment of arterial hypertension]. The possibilities of creating left reno-portal venous anastomoses (RPVA) in man have been studied on 47 fresh human cadavers. The conditions for the formation of anastomoses depended on the shape of the junction of the portal vein branches and their mutual localization against the left renal vein. An adequate, as to its width, anastomosis of the end of the renal vein with the end of the common trunk of the splenic and inferior mesenteric veins was formed in 46.7% of cases. In the rest of cases some other forms of anastomosis were created. RPVA was applied in the clinic in 6 patients suffering from severe and malignant arterial hypertension.


[Blood reinfusion in combined and multiple injuries]. The authors present the results of the treatment of 24 patients with multiple and combined traumas. Blood loss in these patients was made up through the reinfusion. Total amount of the reinfused autoblood was 36 litres (from 300 cc to 3 litres per one patient). The authors emphasize that the method of reinfusion is a simple one and very effective.


[Use of the subclavian vein in angiographic studies on children]. The experience with catheterization of the subclavian vein in angiography in children aged from several months to 15 years is presented. 835 angiographies via the subclavian vein were carried out. The puncture of the subclavian vein is a convenient procedure in angiography, particularly in younger children. A relative safety and technical simplicity of catheterization of the subclavian vein allow to recommend it for a broader use in angiography.


[Kidney injury in hydronephrosis in children]. Within the 10 years' period, from 1968 to 1977, 8 children were renal trauma in hydronephrosis were operated upon in the Children's Surgery Clinic in LPMI. 7 patients underwent nephrectomy and one--the plasty of the pyeloureteral segment. The surgical intervention carried out immediately after trauma prevents the occurrence of complications and, sometimes, helps to preserve the kidney. The immediate and late results of the surgical treatment are good, which proves the necessity of an urgent examination and active surgical tactics in case of injury to the kidney in hydronephrosis in children.


[Prolonged peridural anesthesia after operations on the chest cavity organs in elderly patients]. From the analysis of 126 observations of the longlasting peridural anesthesia in elderly patients following operations on the lungs and thoracic organs the author notes a high effectiveness of the method. Anatomical peculiarities of the spine structure in elderly individuals make for a more frequent occurrence of such complications as impossibility to perform the puncture of the peridural space, puncture of the dura mater, drop of the arterial pressure etc. The frequency of complications was 23%; in 7.9% of them the medicamental treatment was needed. The use of the longlasting peridural anesthesia favoured an early motor activity of the elderly patients, a rapid normalization of the bronchial motor function and decrease of the rate of postoperative pulmonary complications. The longlasting peridural anesthesia should be widely applied in geriatric surgery.


[Changes in the circulating blood volume in operations associated with removal of a significant portion of the body]. The changes of the circulating blood volume in patients after amputatio interilioabdominalis (10), amputatio interscapulothoracica (7), amputatio femoris (15) were studied. The blood loss was compensated for in the ratio of 1/1. A relative hypervolemia at the rate per 1 kg of body mass was observed in the early postoperative period.


Mass poisoning in cattle, palm doves and mink caused by the coccidiostat dibutyltin dilaurate. Poisoning caused by dibutyltin dilaurate (DBTD) was diagnosed in cattle, mink, and palm doves. The accidental addition of a DBTD premix to calf concentrates at levels up to 25000 ppm on 18 farms caused poisoning in 1000 cattle, of which 171 died and 287 were slaughtered. High concentrations of tin were found in the cattle tissues and precluded their consumption by humans. Palm doves ingesting concentrates containing 12500 ppm DBTD on one farm were also poisoned and had high concentrations of tin in tissues. Mink were inadvertently fed a vitamin-mineral supplement containing about 1700 ppm DBTD. They appeared the most suceptible of the three species to this compound.


Assessment of the safety of drugs for animals. In summary, the evaluation of the safety of drugs for animals should take advantage of the fact that toxicity can be evaluated in the target species. Acute studies are useful in providing information for dose setting and the possible relevant observations that can be incorporated in the protocol for a longer, more definitive study; however, they are of limited value in the final evaluation of a drug. Longer tests should be conducted to mimic the conditions of use as much as possible, using labeled and exaggerated doses. Flexible protocols should be individually designed for each study. Clinical studies, conducted in several locations at different times of the year if appropriate, should supplement the laboratory studies. New equipment and methodology facilitate measuring even more subtle toxic effects. It is easy to evaluate a compound that kills animals, that causes colic or other gastro-intestinal signs, or that results in serious neurological impairment, such as circling or blindness, shortly after treatment. But the line is blurred between subtle toxic effects and physiological change. When a rise in serum enzymes, an increase in smooth endoplasmic reticulum or a decrease in formed elements of the blood is demonstrated, the significance of the effects produced must be evaluated in the context of the clinical aspects of the proposed usage. A knowledge of medicine and/or drug action and interaction is necessary to make this appraisal. It is incumbent upon the sponsor to discuss thoroughly all aspects of the toxic effects detected, and it is incumbent upon the reviewer to understand them.


[Micromethod of preparing and purifying labeled 4-methyl-5-beta-hydroxyethylthiazole]. A micromethod is developed for production and purification of small amounts (50-60 microgram) of 35S-4-methyl-5beta-hydroxyethyl thiazole(hemineurine)--a neurotropic agent, which is promising for treatment of delirium tremens. 35S-hemineurine was obtained as follows: sulfite separation of it from pyrimidine residues and other reagents py paper electrophoresis and the subsequent elution of labelled 4-methyl-5beta-hydroxyethyl thiazole from electrophoregramms. The purity of the preparation obtained was controlled by chromatographic, chemical and spectrophotometric analysis (using pure unlabelled preparation).


[Effect of triiodothyronine and ICl on protein synthesis in cell-free systems]. Iodine ions exhibited the thyroxin-like effect on incorporation of 1-14C-leucine into proteins of isolated mitochondria and microsomes of thyroidectomized rats in vitro. Thyroxin, triiodothyronine (T3) and ICl increased the incorporation of 1-14C-leucine into proteins of isolated mitochondria of thyroidectomized rats, but did not affect the protein synthesis in microsomes in vitro. Rifampycin and olivomycin abolished completely the stimulating effect of T3 and ICl on incorporation of the label into mitochondrial proteins. The thyroid hormones and iodine ions stimulated protein synthesis in vitro in liver microsomes of thyroidectomized animals only after preincubation with mitochondria or nuclei. In these conditions preincubation with mitochondria elevated the rate of 1-14C-leucine incorporation into microsomal proteins 2--2.5-fold. In similar experiments with nuclei--4--4.8-fold stimulation was detected. Thyroid hormones and iodine ions stimulated synthesis of specific factors in mitochondria (MBS) and in nuclei (NBS) of thyroidectomized rat liver tissue, which increased the protein synthesis in isolated microsomes in vitro. Synthesis of MBS- and NBS-factor required the presence of all the four ribosetriphosphates (ATP, GTP, UTP, CTP) and was inhibited completely by olivomycin; rifampycin blocked only the MBS factor synthesis. NBS- and MBS-factors appear to be RNA (mRNA), synthesized in nuclei and mitochondria, which are transported into the incubation media and translated by ribosomes.


[Sensitivity of hexokinase and glucokinase to hormonal action during hepatocarcinogenesis]. Effects of hydrocortisone and insulin on activities of hexokinase and its isoenzymes and on glucokinase activity were studied in hepatocarcinogenesis, induced in rats by diethyl nitrosamine. After administration during 7 days of hydrocortisone into normal rats the hexokinase was inactivated by 25% due to decrease in activity of the II isoenzyme. In this case activity of glucokinase was decreased by 38% in young animals and--by 23% in older animals. Insulin, administered within 2 days, caused no effect on the hexokinase activity but the glucokinase was activated by 177%. In hepatocarcinogenesis the effect of hydrocortisone on the hexokinase activity (II isoenzyme) was distinctly decreased and with development of tumors the hormone showed a negligible efficiency. Influence of insulin on the glucokinase activity in hepatocarcinogenesis was similar to the effect found in normal liver tissue.


[Trypsin and chymotrypsin activity during early postnatal development in the rat]. Activities of trypsin and chymotrypsin were studied in pancreas as well as in chyme from three departments of small intestine of rats of various age. Distinct decrease in content of chymotrypsinogen and increase in content of trypsinogen were observed in pancreas at first four days of rat life. In pancreas content of trypsinogen and chymotrypsinogen was as high in 4--20 days old rats as that one in 30-days old animals, maintained at definitive diet. Activity of trypsin and chymotrypsin was the same in duodenal contents of rats of both these groups. Activity of pancreatic proteinases was almost unaltered in chyme of jejunum intestine within first 20 days of life; it was twice increased to 30-days age. Trypsin and chymotrypsin were distinctly activated in chyme of ileum intestine with ageing. The highest activity of pancreatic proteinases was observed in chyme of ileum intestine. The data obtained suggest that rather intensive cavitary digestion of milk protein occurs in newborn rats.


[Effect of thyroid hormones on protein synthesis in microsomes in vitro]. I2 and ICl were shown to possess the thyroxin-like effect on protein synthesis in microsomes, isolated from liver tissue of young thyroidectomized rats and incubated in the medium containing 3H-glycine and 1-14C-leucine. Triiodothyronine and iodine-containing substances increased 3.5--3.9-fold the incorporation of these labelled amino acids into microsomal proteins as compared with untreated microsomes from thyroidectomized rats. Olivomycin and cycloheximide abolished the stimulating effect of T3 and iodine ions on the protein synthesis in microsomes. ICl exhibited a distinctly shorter, as compared with T3, latent period of action on the protein synthesis in microsomes of thyroidectomized animals.


[mRNA degradation in membrane-bound and free polyribosomes in rat liver cells after exposure to actinomycin D and cycloheximide]. Actinomycin D caused degradation of mRNA both in membrane-bound and in free polyribosomes from rat liver cells. The rate of mRNA destruction was distinctly higher in free polyribosomes, than in membrane-bound ones. Cycloheximide inhibited the mRNA destruction in both types of polyribosomes. At the same time, the stabilizing effect of cycloheximide on mRNA was less distinct in free polyribosomes. A decrease in specific radioactivity of mRNA from membrane-bound and free polyribosomes was observed after prolonged pretreatment with actinomycin D. The specific radioactivity of mRNA from polyribosomes of both types was not altered after simultaneous administration of actinomycin D and cycloheximide into rats. Occurence of two fractions of mRNA, dissimilar in stability, is possible both in membrane-bound and in free polyribosomes from rat liver cells.


[Extraction of cholesterol from vessel walls by surface-active agents and organic solvents]. Low concentrations (0.1--1.0%) of surface-active substances Tween-20, Triton X-100 and sodium deoxycholate were shown to extract 20--40% of cholesterol from dog vessel wall. Dioxane was effective at high concentrations (80--100%). As contrast to dioxane, ethanol extracted up to 20% of cholesterol at low concentrations (10--20%). The thickened intima of the atherosclerotic vessel is the significant barrier for the extraction of cholesterol.


[Formation of a heparin-prothrombin complex]. Formation of complex between heparin and prothrombin was shown using a spectral method. A method is developed for production of active complex heparin-prothrombin with the ratio of components as 1 : 6. The heparin-prothrombin complex obtained exhibited the anticoagulant and antipolymerization properties as well as the nonenzymatic fibrinolytic effect on instabilized fibrin both in absence and in presence of such blocking agents of enzymatic fibrinolysis as epsilon-aminocapronic acid and soybean inhibitor of trypsin. The increase in the anticoagulant and nonenzymatic fibrinolytic properties of blood occurred after intravenous administration of the complex into animals. The heparin-prothrombin complex acted in circulation within 1.5--2 hrs.


[Determination of fibrinogen concentration in blood plasma by the sulfite precipitation method]. Two methods using thrombine and sulfite were compared for estimation of fibrinogen concentration in blood plasma. Both methods produced the same results in estimation of fibrinogen in donor blood plasma. If blood plasma contained high amount of products of fibrinogen and/or fibrin degradation, the efficiency of thrombin method was decreased; on the other hand, final concentration of sulfite did not precipitate fragment D of fibrinogen from human blood plasma. Presence of heparin did not influence on the sulfite method but the polysaccharide might interfere in the thrombin method. Some experiments require to use both these methods for evaluation of fibrinogen in blood plasma.


[Experimental vitamin D deficiency with different dietary calcium-phosphorus ratios]. Excess of phosphorus (the ratio Ca : P = 1 : 2) in a diet of growing rats strengthened such manifestations of vitamin D insufficiency as hypercalcemia and inhibition of animal growth. The data obtained suggest that excess of phosphorus is apparently important for pathogenesis of rachitis and the optimal ratio Ca : P should not be ignored in child diet.


[Vitamin K-dependent inhibitor of thrombin formation]. Activity of thermostable inhibitor of thrombinoformation was decreased in blood serum after administration of pelenthane into animals. Simultaneous administration of vicasol limited this effect. Decrease in the activity of the inhibitor was also observed after partial hepatectomy and poisoning with CCl4. Correlation was not found between total coagulation activity, content of prothrombin and the inhibitor activity. The inhibitor was inactivated markedly in exogenous thromboplastinemia and lesser--in hyperheparinemia. The data obtained suggest that self regulation of blood coagulation system occurs at the level of synthesis of its biochemical components.


[Biometric studies in  the cytological diagnosis of soft tissue tumors]. Introducing of quantitative signs (the number of cells on the given area, size of cells, nuclei, optic and spectral characteristics) makes the cytologic diagnosis much more objective. Karyometric studies conducted by the author (the determination of nuclei volume) on cytological smears, obtained from 16 patients with soft tissue tumors, indicated some difference in nuclei size of various histotypes. The studies have evidenced that the method of karyometry associated with cytophotometry will offer the pre-conditions for using karyometry in the practice of pathocytologists and facilitate the finding of algorithms for computing analysis of soft tissue neoplasms.


["Pathomorphosis" of skin melanomas in the comprehensive treatment using hyperthermia]. The writers examined histologically and histochemically the melanomas removed in 40 patients, subjected to general and local hyperthermia associated with radiation and chemotherapy. In such cases it was found that melanoma tissues exhibit grave destructive changes characterized by the morphological features, which are manifested by microcirculatory disorders in the tumor and metastases and are associated with extensive injuries of the neoplastic tissue.


[Classification of tumors of the thymus gland]. The authors have analysed the data of clinical and pathoanatomical (biopsy) investigations in 41 patients, operated upon for the true tumor of the thymus (thymoma) without any signs of malignant miasthenia. Based on the literature materials and personal observations, it is considered necessary to provide for a rational clinico-anatomical classification of thymomas, which may allow certain prognostication of the results of surgical treatment. An attempt is made to work out a preliminary uniform working scheme of the histological nomenclature for thymomas.


[Immune reactions in assessing the disease prognosis in soft tissue sarcomas]. Under examination were 60 patients with local forms of soft tissue sarcomas of various histological structure. By means of skin delayed hypersensitivity test for dinitrochlorobenzene (DNCB) and tuberculin as well as cell immunity reaction in vitro the immune response was shown to be of value in estimating the prognosis of the disease. The dynamics of immune reactions 2-3 months following the operation proved to be of greatest prognostic value. Among the employed immunological tests the skin test for DNCB and the reaction of spontaneous rosette-forming provided the most comprehensive information as to the control over the clinical course of malignant lesion.


[Diagnosis and treatment of mediastinal teratomas]. Among 221 operated patients with primary tumors and cysts of the mediastinum teratomas were observed in 54 (24.4%). The diagnosis of mediastinal teratodermoids should be complex. Clinically in benign teratomas the localization and character of the process were determined precisely in 94%, histogenesis--in 35%, in malignant teratomas--the proper localization was determined in 90%, the tumor character--in 78%, histogenesis--in 26%. For malignant tumors the combination therapy with intensive telegamma therapy prior to and after surgery was employed. Resectability in malignant teratomas made 73%, the postoperative mortality--in 5.5%. A five-year survival following radical surgery in patients with malignant teratoma was 37%. In inoperable teratoblastomas it seems rational to use intensive split course telegamma therapy with a total focal dosage of 5,500-6,500 rad.


[Clinical morphological characteristics of seminomas]. Two hundred patients with seminomas were under observation in the urological clinic of the N.N Petrov Research Institute of Oncology. The histological characteristic of 3 groups of seminomas is presented; spermatocytic seminomas (Masson seminoma)--in 9 patients, Chevassu seminomas (dysgerminomas)--in 95, and dysgerminomas with the syncytio-and cytotrophoblast elements--in 86. Observations over the patients indicated that Chevassu seminomas (dysgerminomas) metastases are highly sensitive to radiotherapy and sarcolysin, while Masson seminoma metastases and dysgerminomas with the trophoblast elements would show resistance to the therapy of this kind. The experience has shown that including of olivomycin and cyclophosphane in the chemotherapy for spermatocytic seminomas and of methatrexate and dactinomycin for dysgerminomas with the trophoblast elements enhances the effectiveness of the treatment. Also, it seems rational to include retroperitoneal lymphadnectomy in the complex of measures against dysgerminomas with the trophoblast elements.


[Fibrillar structures in poorly differentiated human soft tissue sarcomas]. Electron-microscopy examination of 13 soft tissue tumors in human subjects has revealed in four of them, diagnosed histologically as polymorphous-cellular sarcoma, fibrosarcoma, monophase and biphase synovioma, the ultrastructural features allowing them to be classified as rhabdomyosarcomas.


[Criteria for the "early diagnosis" of breast cancer]. Studies have indicated that the appearance of metastases in regional lymph nodes is not dependent on the tumor size. The probability that the tumor may be local is the greater the less its size. The term "early diagnosis" referred to prophylactic examinations in the up-to-date diagnostics remains to be unwarranted, without distinct boundaries, and the true tumor proliferation may be judged only after a histological assay of lymph nodes.


[Morphogenesis of cervical cancer].

[Morphogenesis of cervical cancer]. The origination and development of cervical cancer occurs in the tumor field, which includes cellular and non-cellular components of the connective tissue and vessels adjacent to the epithelium. During each of these phases of cancer growth alterations in these components may be observed within certain boundaries which widen with the tumor progression. A removal of the neoplasm within the limits of the unchanged, as compared with the normality, components of the stroma and vessels would guarantee against the recurrence and is a reliable criterion of the radicality of surgery being a minimum for preinvasive and microinvasive cancer. The data obtained support the fact of a sufficiently full coincidence of the rate of stromal and vascular changes with the true boundaries of the tumor field.


[Cytogenetic study of peripheral blood lymphoid cells in children with lymphogranulomatosis]. In 6 untreated patients the chromosome set of lymphoid cells in the peripheral blood was studied. It was shown that there were quantitative and structural changes of the karyotype arising yet at the early stage of the process. This offers an opportunity to use the cytogenetic test for establishing the differential diagnosis between lymphogranulomatosis and reactive lymphadenitis.


[Standardization of the cytological conclusions in the diagnosis of cancer of the lung, stomach, breast and thyroid gland]. Based on a correlation of the results of cytological and histological assays in 1213 patients, the authors have analysed the correct and erroneous verifications of the cancer pattern according to cytological preparations. Under consideration are the possibilities and limitations of the cytological verification of different histological patterns and degree of differentiation of cancer of the lung, stomach, breast and thyroid. Standard cytological conclusions in accordance with the suggested cytological classifications of cancer of these organs are discussed.


[Liver regeneration in tumor-bearing animals under the action of x-ray irradiation]. The growing tumor in the organism causes the inflammatory, dystrophic and necrotic changes in the liver and stimulates its regeneration. During X-irradiation there is a summation of the tumor and X-ray effects. The rate of the reparative regeneration is sharply inhibited in later stages of the tumor growth, moreover this inhibition is reduced by irradiation. During X-irradiation poliploidization (the appearance of uninuclear poliploid and increase of binuclear hepatocytes) and sharp proliferation of stroma elements but not proliferation of the parenchyma cells predominate in the mechanism of the liver regeneration.


[Treatment of the early stages of cancer of the lower lip]. 464 patients with the lower lip cancer were treated; stage I--in 292, stage II--in 150, stage III and IV--in 22 patients. The vast majority of patients in the stage I and II were given close focal roentgenotherapy on the primary focus. 123 Wanakh operations for the stage I revealed metastases in lymph nodes in 2 patients, 113 Wanakh operations for the stage II showed metastases in 9 cases. The clinical recovery for a 3-year period was noted in 99.4% of cases in stage I without the Wanakh surgery, for a 5-year period--in 92.7%. In the stage II without the surgery the clinical recovery for a 3-year period was noted in 93.8%, for up to 5 years--in 92.7%. In the stage I the Wanakh surgery should be denied, and in the stage II the combination therapy to a full extent is recommended.


[Late results of the surgical treatment of esophageal cancer]. Of 60 patients, subjected to resection of the esophagus for cancer, 12 patients died (the mortality being 20%). Among the followed up patients after radical esophagectomy 17 patients survived for 5 years (39.5%--in the followed up subjects, 37.8%--in those discharged from the hospital, and 29.8%--in the operated ones).


Auto-immune haemolytic anaemia in childhood: follow-up in 29 cases. We describe 29 children with auto-immune haemolytic anaemia (AIHA). The patients could be followed up for long periods of time. The auto-antibodies, responsible for the AIHA, are described as well as the associated diseases that could be diagnosed, the clinical course and some clinical aspects of special importance. Finally, the treatment given to these patients and its results are discussed.


A 'new' allele, Kpc, at the Kell complex locus. Four Kp(a-b-) Japanese sisters, the product of a consanguineous mating, have otherwise normal Kell antigens. Kpc, a 'new' allele of Kpa and Kpb is the most probable background.


The red cell antigen once called Levay is the antigen Kpc of the Kell system. The antigen corresponding to the 'new' allele Kpc postulated in a Japanese family is the low frequency antigen Levay recognized in England 33 years ago.


A new red cell phenotype I-i-: red cells lacking both I and i antigens. When blood samples from 5,864 healthy Indian blood donors were tested with anti-I, seven samples failed to react or reacted only weakly. Further studies with a number of anti-I and anti-i sera suggested that these samples had the phenotype I-i- and reacted weakly with anti-IT. In one family, the I-i- phenotype was present in three generations.


Transsphenoidal hypophysectomy in the treatment of metastatic breast and prostate carcinoma. The cases of 70 consecutive patients having a transsphenoidal hypophysectomy for metastatic carcinoma of the breast or prostate are reviewed. In half of the patients with cancer of the breast an objective remission was obtained. In 30 percent of the patients with cancer of the prostate there were objective signs of tumor regression and in 75 percent there was relief of pain. The operative mortality was 1.4 percent and the morbidity of the procedure was gratifyingly small. There is some indication that hypophysectomy may be preferred to adrenalectomy in patients with hormone-responsive metastatic mammary cancer.


Nosocomial varicella. Part I: outbreak in oncology patients at a children's hospital. Twenty cases of varicella occurred in patients or siblings of patients in a 41-day period in a children's hospital. Most cases were among oncology patients, with transmission occurring in both the inpatient and outpatient areas. One patient died after visceral dissemination of varicella. Neither pooled immunoglobulin nor zoster immune plasma was effective in preventing clinical varicella, although zoster immune plasma appeared to ameliorate the illness. Recommended control measures included strict isolation or discharge of infected patients, and respiratory isolation or discharge of exposed susceptibles. Although apparently too late to be effective in this outbreak, similar measures are warranted should nosocomial outbreaks of varicella occur elsewhere.


Skin and soft tissue polymicrobial infections from intravenous abuse of drugs. Skin and soft tissue infections were studied in 21 seriously ill narcotic addicts who had been admitted to hospital. Subcutaneous abscesses were present in 14 patients; cellulitis was noted in 3, pyomyositis in 2 and necrotizing fasciitis in 2. In four patients there was septicemia. Infections in 14 patients (66.6 percent) were associated with anaerobic bacteria, which were the exclusive isolates in 6 patients. In seven patients (33.3 percent) isolates were exclusively aerobic bacteria and in eight both aerobes and anaerobes were present. The anaerobic isolates were clostridia (six), peptostreptococci (five), bacteroides (five), peptococci (three), and one of each of Veillonella, Propionibacterium, Eubacterium, Fusobacterium and Actinomyces. Staphylococcus aureus, generally thought to be the most common cause of subcutaneous infections in addicts, was found only in four (19 percent) patients. The other aerobic isolates were Klebsiella (five) and Enterobacter (four) species. When clinical features or the Gram stain of pus suggest that anaerobic bacteria may be present, antibiotic therapy should be directed against both aerobic and anaerobic bacteria until culture results are available.


Adult respiratory distress syndrome.

Adult respiratory distress syndrome. Many causes for the adult respiratory distress syndrome (ARDS) have been reported, all with common pathologic, pathophysiologic and biochemical end results. The final common pathway may involve changes in lung content of a critical enzyme, superoxide dismutase, or alterations in surfactant metabolism, or both. The early assumption that the disorder is partially due to oxygen toxicity from inspired oxygen concentrations greater than 60 percent is consistent with findings of recent biochemical studies. Although the lung normally maintains its alveoli dry, during ARDS increased permeability of small pulmonary vessels results in primary pulmonary edema, in contrast to edema from increased vascular pressure. These data have been obtained mainly in animals; whether they apply to humans with ARDS is not certain. Tissue oxygenation is improved by increasing end-expiratory pressure in an animal model of ARDS, more effectively during spontaneous breathing than during mechanical ventilation. During spontaneous breathing, adverse ventilatory effects were caused by stimulation of pulmonary reflexes.


Health hazard appraisal counseling--continuing evaluation. A program of annual health examinations was expanded to include counseling based on a computerized appraisal of individual patients' specific health risk factors. Data obtained from a specially designed questionnaire, laboratory tests and a physical examination yielded a health hazard appraisal showing a number of weighted risk factors and their relation to ten leading causes of death as determined for that patient. From all of this information, a "risk age" was developed which could then be compared with the patient's "true age." The results were reviewed with each patient, and methods of correcting health hazards were stressed. The first annual retesting of a group of 107 examinees showed a net risk age reduction of 1.4 years (formerly reported in this journal). The longer term follow-up reported in this paper showed a net risk reduction of 2.38 years in a group of 26 examinees. The net risk age reduction in the two groups represented 32 and 40 percent, respectively, of the achievable risk age reduction when patients comply with suggestions made during risk reduction counseling. These findings indicate that health hazard appraisal counseling is an effective method of altering priorities of health practices.


[Diagnostic value of ultrasonography in aneurysm of the abdominal aorta (author's transl)]. A case of aneurysm of the abdominal aorta is presented. The clinical picture was suggestive of a pancreatic cyst, but the correct diagnosis was made on abdominal ultrasonography. Early diagnosis of the condition allowed removal of the aneurysm and implantation of a femoral by-pass. The value of ultrasonography in diagnosing aneuryms of the abdominal aorta is discussed. This completely safe procedure appears to supersede the reliability of invasive methods as a diagnostic tool and is recommended in cases of doubtful aneurysm since with early diagnosis and surgical intervention severe complications, including rupture, can be avoided.


[Combination therapy of local tumour recurrence in patients with breast cancer (author's transl)]. Treatment of 54 patients with extensive loco-regional recurrence of breast cancer is reported. Combined radio-chemotherapy was given to all patients with the aim of reducing the irradiation dosage and also decreasing the side effects of chemotherapy by reduced drug dosage. In this way a significant improvement in the quality of life could be achieved. The remission rate in patients with their first recurrence was 87.5%, while for subsequent recurrences the rate decreased to 50%. The median time of remission in both groups of patients was 7 months. There was complete loco-regional tumour control in 51% of all patients (with and without distant metastases). A significant prolongation of the survival time was not accomplished by this treatment.


[Angiocinedensitometric assessment of a case with persistence of a primitive trigeminal artery (author's transl)]. This report is concerned with an evaluation of cerebral angiocinematography by means of densitometrical measuring equipment. The advantages of accuracy offered by this procedure, the temporal and spatial resolving capacity of angiocinedensitometry and the problems involved in the measuring technique are discussed. The case report is presented of the clinical symptoms and, particularly, the haemodynamics of the cerebral blood supply in a 32 year-old female patient with a persistent primitive trigeminal artery. Evaluation of angiocinematography with respect to overall and regional determinations is discussed.


[Angiographic diagnosis of ovarian cancer (author's transl)]. The methods of examination which are usually used in cases of tumours of the lower abdomen are mostly not able to determine the site of origin of the lesion of its histology unequivocally. Angiographic examination techniques enable the definition of such tumours and very often allow the differentiation between benign and malignant lesions. Both hypogastric arteries are selectively or semiselectively catheterized using Seldinger's technique. Additionally, in most patients, aortography and selective catheterization of the inferior mesenteric artery is performed. So far the diagnosis of an adnexal tumour was made by angiography in 6 out of 30 patients. The typical angiographic criteria of ovarian carcinoma are cited and discussed. Our results show that in selected cases of suspected ovarian tumours angiography offers good results and, therefore, it deserves an important place among the different available clinical examination techniques.


[The research programme "Artificial Heart" at the 2nd Department of Surgery, University of Vienna: a ten year review (author's transl)]. The experimental and clinical results are presented of the research programme "Artificial Heart" carried out by the 2nd Department of Surgery, University of Vienna. In particular, an assessment of the clinical experience in 177 patients with the intra-aortic balloon pump is documented and it is concluded that only limited cardiac support is possible by this pump. In view of this fact more efficient methods of mechanical circulatory support, such as the interaortic auxilliary ventricle, the aortic "Windkessel" ventricle with guiding balloon, and two types of ventriculo-aortic bypass ventricle were tested with regard to their haemodynamic and long-time efficacy. The transatrio-aortic auxilliary ventricle (E-LVAD) was also clinically tested in 11 patients. In conclusion the problems of total mechanical heart replacement are discussed.


[Problems of a stage-based therapeutic approach to surgery in breast carcinoma (author's transl)]. A therapeutic concept dependent on staging of breast carcinoma is presented: 1. Stage T0-T1 N0 M0: wide local excision or quadrant resection with axillary lymph-node excision. 2. Stage T2 and T3 N0-N1: simple mastectomy (Patey). 3. Stage T4 or N2: radical mastectomy (Rotter). 4. Stage N3 or M1: tumour excision according to the T-stage, lymph-node excision, local excision of affected distant lymph nodes. With equal therapeutic results the smaller and cosmetically-preferable surgical procedure is to be recommended.


[Modern functional and physiological techniques in abdominal surgery (author's transl)]. The increasing importance of physiological and functional surgical procedures in the surgical therapy of benign abdominal disease is implied. Positive results were achieved at the 2nd Department of Surgery of the University of Vienna following parietal cell vagotomy in hypersecretory gastroduodenal ulcer, latero-lateral pancreatico-jejunostomy according to Puestov-Mercadier in chronic relapsing pancreatitis, distal splenorenal shunt according to Warren in portal hypertension and following peritoneo-venous shunt according to Warren in portal hypertension and following peritoneo-venous shunt according to Le Veen in ascites and cirrhosis of the liver.


[Femoro-crural reconstruction in preference to amputation (author's transl)]. 22 cases of arterial occlusion below the branching of the popliteal artery and 1 case of traumatic subtotal amputation of the calf were revascularized by autogenous femoro-crural vein bypasses. All patients had pain at rest and/or gangrene. So far, with an average bypass patency of 15 months in two of three equal parts of the operated legs, the decision to try reconstruction instead to amputate has met with successful results. The operative technique is described in detail and the speical problems of this group of patients and the particular difficulties of this technically sophisticated bypass procedure are discussed.


[Late results of tracheal resection (author's transl)]. 17 cases of tracheal stenosis following prolonged endotracheal intubation are reported. Resection of the stenotic segment and anastomosis were performed in all patients. The clinical result was classified as good in 15 patients and as satisfactory in one patient. One patient died from wound dehiscence and mediastinitis. Results of pre- and postoperative respiratory function tests are presented and the validity of these tests for objective evaluation of operative results is discussed. Diagnostically most informative is the quantitative and qualitative evaluation of airway resistance and MEFV curves.


[Results of a long-term clomiphene citrate therapy in women with normogonadotropic menstrual disturbanes (author's transl)]. A total of 72 pregnancies was achieved in 59 women with menstrual cycle disturbances (WHO Type II) by administration of clomiphene. 27 of these pregnancies (34.7%) occurred only after more than three courses of cloimphene. A secondary classification of the patients was based on the symptomatic severity of the menstrual disturbance. Clomiphene (100 mg) was administered on the fifth day after the onset of menstruation for five days, whereby in one or two cases up to 19 courses had to be given. The group consisted of women who had rejected HMG-HCG therapy because of the possibility of multiple pregnancy. 59 pregnancies went to full term; 2 tubal pregnancies and 11 cases of miscarriage were recorded. The commencement of pregnancy was evaluated and the time of ovulation and the length of the luteal phase determined in women requiring up to three courses of clomiphene and those requiring over three courses. The investigation demonstrates that clomiphene therapy can be successful even after more than six courses of the drug. Side effects are minimal.


[Local immunotherapy. Alternative therapy for malignant cutaneous lesions (demonstration on 30 patients with malignant melanoma) (author's transl)]. Experimental data in animal models and clinical experience with a systemic immunotherapeutic approach in patients with tumours were the determining factors in the decision to test the local effect of this form of therapy on primary and secondary malignant lesion of the skin. The antitumour effect of local immunotherapy seems to be based on the induction of a cell-mediated immune challenge reaction in close contact with the malignant neoplasm. A trial of local immunotherapy was undertaken in 30 patients with melanoma with local recurrence of the primary tumour or multiple metastases involving the skin. The therapeutic indications and clinical response are discussed.


[Results of hyposensitization in children (author's transl)]. The results of specific hyposensitization in 160 children (121 boys) were evaluated using a questionnaire. In 54% complete remission or clear-cut improvement without additional need for medication was achieved. In a further 34% improvement was demonstrated when compared to the pretreatment period. The main initial complaints were allergic rhinitis or allergic asthma. Treatment was pursued for at least 3 months and for a maximum of 3 years. There were no differences in the success rate as regards sex and offending allergen.


[Results of systemic treatment of lichen planus with a new aromatic retinoid (RO 10-9359) (author's transl)]. 24 patients suffering from generalized lichen planus were treated systemically with a aromatic retinoid (RO 10-9359). Initially a dose of 100 mg retinoid per day was administered for 2 to 3 weeks, then the daily intake was reduced slowly. The average duration of treatment was 72 days. This therapy produced a significant improvement in all patients. Lesions recurred during reduction of administered retinoid in 3 patients and after stopping treatment in 5 cases. Initially side effects consisted of cheilitis and exfoliation of the skin over the palmar and plantar regions; later 50% of the patients developed an effluvium. The results of the present study indicate that the aromatic retinoid can be considered as an alternative drug to systemic steroids in the treatment of lichen planus.


[HLA B13, B17, B37 and Cw6 in psoriasis vulgaris: relationship to age of onset (author's transl)]. The frequency of HLA B13, B17, B37 and Cw6 was investigated in 77 patients with psoriasis vulgaris (57 patients with an onset of the disease between 10 and 20 years of age and 20 patients with an onset between 35 and 45 years). A highly significant increase in the frequency of the four HLA antigens tested was found. The highest relative risk was calculated for Cw6 (RR = 8.28). Furthermore, a significant positive association was observed between the presence of Cw6 and an early onset of psoriasis vulgaris.


[Recurrent subarachnoid haemorrhage due to upper cervical A. V.-angioma associated with metameric naevus flammeus (author's transl)]. The case is presented of a recurrent subarachnoid haemorrhage caused by an angiographically-proven spinal A. V. angioma of glomus type II at the C 1--2 level supplied by both vertebral arteries. The angioma was accompanied by a median naevus flammeus over the occipito-cervical region. The clinical differentiation between subarachnoid haemorrhage of cerebral and spinal origin is discussed and emphasis is placed on the significance of complete cerebral angiography for the detection of the sources of recurrent subarachnoid haemorrhage of undetermined origin.


[Treatment of herpes simplex of the lid margin with vidarabin ointment (author's transl)]. Twenty cases of herpes simplex of the lid margin were treated with vidarabin ointment applied topically 4 to 5 times daily together with an antibiotic ointment 2 to 4 times per day. Healing of the skin eruptions was observed within 3 to 12 days (average 6 days). Vidarabin eye ointment was well tolerated in all cases. A comparison with other locally-applied virustatic preparations is drawn.


[Renal failure and carbon monoxide diffusing capacity of the lung (author's transl)]. Reduced carbon monoxide diffusing capacity of the lung (DLCO) is reported in patients with impaired renal function. Since DLCO also depends on the pulmonary capillary blood volume the role of renal anaemia was evaluated. Measurements were carried out in 43 azotaemic patients [serum creatinine (SKr) 1.5 to 14.0 mg/100 ml], without evidence of cardiovascular or pulmonary complications of uraemia, of SKr, haemoglobin concentration (Hb) and steady state DLCO. In the case of DLCO values allowance was made for body surface area and thoracic gas volume. The relation was studied of the corrected DLCO to SKr and to Hb. There was a higher statistical correlation between DLCO and Hb than between DLCO and SKr. After additional correction of DLCO for Hb, no correlation to SKr was found. It is concluded that the reduction in DLCO in uraemia is due largely to a low Hb and, hence, to renal anaemia rather than to uraemic damage of interstitial lung tissue.


[Digitalis therapy in practice: correlation between clinical evaluation and plasma digoxin concentration (author's transl)]. In a prospective study 73 patients on maintenance digitalis treatment at the Paracelsus Institute, Bad Hall, were clinically examined and the dosage of the drug was adjusted according to cardiac symptoms. The clinical effects were correlated to digoxin concentrations measured on the day following admission to hospital and on the 21st day of treatment. The following practical conclusions were reached: 1. More than 50% of the patients were underdigitalized. 2. There is often no indication for digitalis therapy in patients with a low daily maintenance digoxin dosage and normal renal funciton. 3. The usual recommended maintenance dosage of digoxin provides serum digoxin levels in the lower region of the therapeutic range. 4. Patients with symptoms of decompensation taking an average dosage of digoxin need more digitalis. There is generally no danger of toxicity when the dosage is increased. 5. The serum digoxin concentration in patients with slightly reduced renal function lies in the upper region of the therapeutic range with usual doses of digoxin.


[Aneurysm of Valsalva's sinus (author's transl)]. An aneurysm of Valsalva's sinus is one of the rarest malformations of the aortic root. The case of a non-ruptured aneurysm is reported and the possible pathogenic mechanisms of the congenital and the acquired forms of this aneurysm are discussed, as well as the clinical symptoms and the diagnostic procedures. Finally, the necessity of surgical treatment of the aneurysm is pointed out.


[Perinatal mortality at the gynecological hospital in Wels (author's transl)]. From 1970 to 1976 301 from 14,033 children died in the perinatal period. The perinatal mortality decreased clearly during this 6 years. A further decrease is to be obtained only by more intensive maternity care and prevention of premature birth.


[Clinical experience in the diagnosis and therapy of plasmacytoma (author's transl)]. 8 patients with plasmocytomas were treated with Endoxan and compared with 5 patients without any considerable treatment. Diagnosis, therapy and prognosis of plasmocytoma are discussed. Particularly mentioned are 3 patients with secondary tumours during cytostatic treatment, a plasmocytoma without paraprotein, a tumorous plasmocytoma with double paraproteinemia and a gammopathia with further development into a plasmocytoma 10 years later.


[Oral cephalexin therapy of osteomyelitis (author's transl)]. 40 patients with chronic osteomyelitis were treated per os with the bactericidal beta-lactam-antibiotic cephalexin during 3 to 60 weeks. In 16 patients, who were operated simultaneously, bacterial spreading was prevented by a combination of cephalexin and parenteral cephaloridin during operation and in the postoperative period. In these patients no recurrence occurred during the follow up time (2 to 5 years). In 34 patients general and local signs of inflammation diminished under cephalexin therapy and a complaint-free interval of at least 6 months followed. No serious side effects forcing a stop of therapy were observed. According to the gained experiences oral cephalexin in combination with perenteral cephaloridin is indicated for prevention of bacterial spreading during operations in chronic bone infections and in patients with acute febrile recurrence of chronic osteomyelitis refusing a surgical intervention.


[Enteral resorption and tumor cachexia]. The rapid loss of the body weight of oncological patients in the advanced stage of the carcinomatous disease is caused by numerous pathophysiological mechanisms. With the help of the modified D-xylose absorption test was investigated which value have disturbances of the enteral absorption in the complex of causes for the development of a tumour cachexia. For the patients in the stage of generalisation of the carcinomatous disease clear disturbances in the enteral food intake could be proved in contrast to patients with carcinoma without general tumour symptomatology and healthy persons. The influence of chemo- and radio-therapy on the enteral absorption of patients with carcinoma was discussed. The forced alimentation of oncological patients with unspezific tumour symptoms must be regarded as a firm constituent in the treatment of patients with carcinoma.


[Hypoxia and internal intensive medicine. I. Clinical aspects of acute hypoxia]. The treatment of the topic acute hypoxia and internal intensive medicine with description of the fundaments--classification and definition of hypoxia and its forms, clinic, therapeutic possibilities and oxygen therapy--becomes necessary in order to get in the entity of hypoxia and to find a common language among specialists for intensive medicine. The knowledge of a differentiated treatment of different forms of hypoxia and thus also of clinical pictures seems to be necessary under the aspect of a highly developed respirator technique and the knowledge of anaesthesiology in this field. Application of the first report is the description of the factors of the oxygen transport. Respiratory, stagnation, anaemic and histotoxic hypoxia are defined and possible causes mentioned. The clinically relevant hypoxia will mostly be a mixed form, among which the respiratory insufficiency in shock lung plays an important role in intensive medicine.


[Hypoxia and internal intensive medicine. II. Normobaric oxygen therapy]. The second report on the topic "acute hypoxia and internal intensive medicine" deals with the fundaments of the normobaric oxygen therapy. It consists of indication, forms of application and their effectiveness in different etiopathogenetic forms of acute hypoxia. Side effects of prolonged and highly concentrated oxygen application are described.


[Radioimmunologic determination of serum digoxin. Methodological and 1st clinical experiences]. The tested quality signs of the digoxin-RIA (Medica) correspond to other RIA-test methods. The digoxin-RIA (Medica) is, therefore, well suited for clinical examinations. In the dilanacin- (digoxin-) long-term therapy with the maintenance dose of 0.5 mg digoxin a day 75.4% of the patients examined (n = 65) were within the therapeutic field. In each case 12.3% were underdigitalised or overdigitalised, respectively. In the 8 patients in the toxic region only the half showed signs of digoxin intoxication. It is referred to the importance of creatinine and potassium in the serum, the digoxin clearance depending on age, the body weight and the body surface, respectively, in very obese patients for the height of the serum digoxin level and for the compatibility of this heart glycoside.


[Morphological and clinical liver changes after taking oral contraceptives]. In 155 women of the age group 16-45 years after intake of oral contraceptives in 68.4% (106 cases) histologically provable liver changes were found. Sinusoidal ectasias of different size and drug-conditioned hepatitides most frequently occurred. An isolated intrahepatic cholestase only rarely existed. Increases of transaminase are the most frequent reference to a lesion of the liver parenchyma after intake of oral contraceptives. The author adopts a definite attitude to the differential diagnosis and its difficulties between a drug-conditioned hepatitis and the usual virus hepatitis.


[Diabetes mellitus and coronary disease--common problems in long-term care]. With the help of a comparative analysis of the cardiovascular risk profile of 150 patients with diabetes mellitus, 62 patients with condition after myocardial infarction and 50 control patients of a rural district with 30,000 inhabitants was established that the spectre of the risk factors widely corresponds. According to a point valuation the diabetics on an average reached 3.36 points and the patients with a condition after myocardial infarction reached 2.66 points. In comparison of the curves a nearly identical course with "a shift to the right" of the patients with diabetes mellitus about the factor of the disturbance of the glucose metabolism could be proved. Concluding from this a general conception of the treatment was described. In this case the aim is a balanced therapy of the factors of risk and a preventive physical conditioning of diabetics with a high risk of infarction. In our investigations was furthermore conspicuous, deviating from literature, a very large proportion of patients with a hyperuricaemia (33.3% of the diabetics, 41.9% of the patients with infarction).


[Recognizing epicardial lipomas].

[Recognizing epicardial lipomas]. Three own observations of oscillating miniature lipomas of the epicardium are a cause to doubt the extreme rareness of this form of tumours. Pediculation and vascular proliferations facilitate the morphological delimitation of fat rumps. The possibility of a removal of infarcted lipomas of the epicardium is taken into consideration.


[Aetiology of chronic aggressive hepatitis in Vienna, a contribution (author's transl)]. In 32 patients with clinically, biochemically and histologically proven chronic aggressive hepatitis, HBsAg, HBsAb, HBcAb and HA-Ab were determined by radioimmunoassays and HBeAg and HBeAb were estimated by immunodiffusion. HBsAg was positive in 18 patients [57%], HBcAb were found in 23 patients [72%], HBsAg and/or HBcAb were detected in 26 patients (82%). The incidence of HA-Ab was 88%, similar to the frequency of HA-Ab found in healthy blood-donors. The aetiology of chronic aggressive hepatitis was associated with hepatitis B in 82%, and with autoantibodies in 6% of our patients, while in 12% the aetiology remained cryptogenetic.


[A tapeworm infection with fatal outcome (author's transl)]. Parasitoses of the intestinal tract are rare in Europe. Their diagnosis is difficult since the general symptoms are frequently only little pronounced or completely lacking. On the other hand, the course of the disease may be fatal. Such cases from the literature and our own observations are intended to call to memory the differential diagnosis of intestinal parasitosis.


[Intravenous leucine load in patients with cirrhosis of the liver (author's transl)]. In 6 patients with cirrhosis of the liver and in 6 healthy controls the elimination half life of the serum leucine level (t 1/2 Leu) was determined after intravenous administration of 50 mg leucine per kg bodyweight. Examinations were repeated with simultaneous administration of 0,33 g glucose per kg bodyweight and during a continuous infusion of 500 microgram somatostatin over 60 minutes. The following results were obtained: 1. In cirrhotics and in healthy controls the t 1/2 Leu was shortened during the additional glucose administration compared with the t 1/2 Leu after leucine administration alone and was prolonged by inhibiting insulin secretion by somatostatin. 2. In spite of significantly higher serum insulin levels the t 1/2 Leu in patients with cirrhosis of the liver was significantly prolonged compared with healthy controls after leucine administration as well after leucine and glucose administration. Therefore we conclude, that in patients with cirrhosis of the liver in spite of elevated serum insulin levels leucine as well as glucose are metabolized slower. These results are indicating peripheral insulin resistance regarding the assimilation of glucose and leucine (at least in patients with portocaval shunts).


[Plasmaperfusion through activated charcoal and amberlite XAD-7 in dogs with liver failure induced by yellow phosphorus (author's transl)]. Various sorbents were tested in-vitro for their ability to support hepatic excretory and detoxification functions, and their in-vivo perfusion with plasma was studied in an animal experiment. Amino acids, particularly phenylalanine and tyrosine, were strongest bound by activated charcoal, while Amberlite XAD-7 removed conjugated and unconjugated bilirubin and bile acids from plasma. Using a cell-separator plasma of dogs, in whom acute liver failure was induced by yellow phosphorus, was perfused through a combination of charcoal and Amberlite XAD-7 without major complications. Platelet counts remained nearly unchanged, platelet aggregation was inhibited reversibly, and circulating platelet aggregates occurred late only. It is concluded that using the method described, therapeutic trials in patients with fulminant hepatic failure can be performed.


[Correlations between the diminished secretion of export proteins from the liver and the plasmatic activity of liver cell enzymes (author's transl)]. For the evaluation of certain differences in the diminution of export proteins of the liver we examined some exactly defined groups of liver diseases with the aim of further differentiation of the pathogenetic mechanisms. We measured the activity of glutamate-oxalacetate transaminase, glutamate-pyruvate transaminase, glutamate dehydrogenase, lactate dehydrogenase, alkaline phosphatase, cholinesterase and lecithin-cholesterol acyltransferase, the Quick value, the coagulation factors I, II, V, VII, VIII, IX and X. Clotting factors were determined by a Schnitger-Gross Coagulometer. Prothrombin, antithrombin III, plasminogen, factor VIII associated antigen and activated factor XIII were measured by immunoelectrophoresis according to Laurell. Lipoprotein electrophoresis in agarose gel was performed to evaluate changes in lecithin-cholesterol acyltransferase activity. Except of the rising diminution of export proteins in the course of liver disease from acute hepatitis to cirrhosis we found also specific changes of the patterns of the plasma specific enzymes. These proteins were diminished dependent on their half life time and the inflammatory activity--measured as the height of the transaminases. Lecithin cholesterol acyltransferase and factor VIII did not participate in the general diminution of the most export proteins; some details were found to explain this differing behaviour. Results are critically discussed with regard to new aspects in the biochemistry of the damaged liver cell.


[Biochemical maturation of organs in the foetus and its induction (author's transl)]. Several biophysical and biochemical changes are prerequisites for the adaptation of the newborn to extrauterine life. Enzyme induction is the mechanism on which this adaptation of metabolism is based. The theoretical fundamentals of enzyme induction are presented, and the perinatal origin of enzymes explained by means of the example of PEP carboxykinase. Among the mose frequent disturbances of the maturing of organs are hyperbilirubinaemias and the respiratory distress syndrome of newborn. The biochemical and physical concepts underlying these disease pattens are explained, and possibilities of enzyme induction and hence acceleration of maturity are shown. On the grounds of clinical experience, enzyme induction appears to be safely established as a membrane prophylaxis.


[Diagnosis of poor intrauterine fetal growth in twin pregnancies (author's transl)]. In 11 cases both twins were of normal weight. In 7 cases one twin and in 12 cases both twins were underweighed (the growth retardation was classified according to the intrauterine growth curves after Hohenauer applicable to our area). The determination of total 24 hours urinary estrogens and serial ultrasonic measurements of biparietal diameters appeared in our study to be the best parameters for the detection of intrauterine growth retardation. Serum HPL determination was unreliable. In addition 2 types of growth retardation in twins could be recognized from the estrogen values. In one, a dysfunction of the fetoplacental unit existed; in the other, the etiology of the growth retardation could not be determined by the methods used in the study (genetic origin?).


[Creatine kinase and creatine isoenzyme activities in newborn. Development of the organ-typical isoenzyme pattern during the fetal period (author's transl)]. The activity of the creatine kinase isoenzyme was measured in the serum of 133 healthy newborn. In contrast to the conditions in the adult, a normal range of 0-45 U/1 was found. No creatine kinase BMB activities were established. The increased creatine kinase-MB activities in newborn could be explained by means of an examination of the creatine kinase isoenzyme pattern in the skeleton muscle of foetuses and newborn. Depending upon the gestation age, creatine kinase-MB activity levels were found amounting to as much as a multiple of ten of the adult levels. Due to the deviation of the creatine kinase isoenzyme distribution in the organ tissue of newborn, identified in this study for the first time, creatine kinase-MB activity seems to be unsuitable as an indicator of myocardial damage during the neonatal period.


[Determination of renal function during pregnancy via renal sequence scintigraphy (author's transl)]. Following a detailed description of the technique of examination and evaluation used in nuclear medicine, the article reports on first results obtained with renal sequence scintigraphy in pregnant women with normal kidneys. Attention is drawn to the diagnostic possibilities offered by this method, basing on a discussion with reference to the published literature, with particular emphasis on pregnancy and on the monitoring of risk pregnancies.