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13182591

The syphilis problem in Asir province, Saudi Arabia.

bined national and international venereal disease team began activities in Saudi Arabia in November 1952, moving from Mecca to Asir province in May 1953, where it remained for two months examining and treating various groups of the population. A total of 309 cases of syphilis among a population of approximately 3,000 at Abha was plete clinical and serological examination and treatment with PAM, in doses varying from 2.4 to 6.0 million units. Serological tests were made on 2,359 blood samples. Only one primary lesion was found; but secondary lesions were mon, amounting to 5.8% of all cases treated, while tertiary lesions represented 12.6% of all cases treated and 67.2% of all clinical cases.Considerable variations in the prevalence of syphilis were noted among the different quarters of the town of Abha and among different tribes and villages. All the age-groups were more or less equally affected, but the females generally showed a higher positivity-rate than the males.All these features-together with the low social, economic, and sanitary standards of the population and many prevalent social habits, such as the use mon eating and drinking implements - would seem to indicate that the syphilis met in Asir, and locally known as "shadjar", "balash", "fringi", "mabrouk", or "wardi", should be included with the endemic treponematoses met with elsewhere in the world.

13182592

Biological modification of rabies virus as a result of its adaptation to chicks and developing chick embryos.

This article describes experiments indicating a change in pathogenicity for laboratory animals of the Flury strain of rabies virus at high egg passages. Factors such as dilution of virus, number of egg passages, age of animals, and route of inoculation are taken into account. The results of the author's investigations indicate that living chick-embryo-adapted virus can be used both as a vaccine administered before exposure to rabies virus, and as an adjunct to antiserum in the protective treatment of animals after exposure.

13182593

Experimental studies on the duration of immunity in dogs vaccinated against rabies.

The results of laboratory investigations on the duration of immunity in dogs vaccinated against rabies are summarized; the experiments demonstrated that dogs vaccinated with phenol-treated killed-virus vaccine show a high degree of immunity at one year after inoculation and that the immunity produced with the Flury-strain live-virus vaccine is superior to, and of longer duration than, that obtained with chemically-treated brain-tissue virus vaccine.

13182594

The control of rabies in Malaya through compulsory mass vaccination of dogs.

A fulminating extension of rabies-which has been enzootic in northern Malaya since 1924-occurred in Kuala Lumpur in April 1952. The outbreak was suppressed by pulsory mass vaccination of dogs, stringent legislation, and intensive stray-dog destruction. Similar measures are being employed in the current campaign, the aim of which is plete eradication of the disease.From an average annual incidence of 112 confirmed canine cases prior to 1952-when a total of 198 cases was reported-the incidence fell to 15 cases (all in unvaccinated dogs) for the period January-November 1953, during the last 5(1/2) months of which no case in either animals or man was reported. It is considered that the extensive publicity campaign and strict enforcement of the control measures have contributed measurably to the present improved position.Statistics relating to confirmed cases in dogs previously vaccinated with (a) phenolized 20% brain-tissue suspension vaccine (buffalo origin) and (b) chicken-embryo vaccine (Flury strain) are quoted and their probable significance in favour of the latter under Malayan conditions is discussed. The hypothesis that the development of rabies may, in many instances, have been blocked by the vaccine is advanced.The plan for a pulsory vaccination campaign in 1954, to consolidate the 1952-3 improvements, is outlined.

13182595

A field demonstration of rabies control using chicken-embryo vaccine in dogs.

This paper reports on a WHO-sponsored field trial of the use, in conjunction with other usual control measures, of modified living-virus vaccine prepared in chicken embryo in a mass vaccination campaign in dogs in Israel with the purpose of assessing the value of the vaccine in an area where rabies was highly enzootic. The mass immunization of dogs with this vaccine was considered to be the decisive factor in achieving the low level of incidence of the disease which has been maintained in this country during the past three years.

13182596

Ecology of rabies in Southern Rhodesia.

The spread of rabies since 1950 in Southern Rhodesia is described, and its probable causes analysed; the outbreak is attributed chiefly to the vast domestic-dog population, but cases have been noted among many other species of animal. The difficulties encountered in enforcing general control measures are discussed; however, the advent of Flury-strain avianized vaccine has allowed of a successful inoculation campaign which, in spite of some failure in immunization, is satisfactorily controlling the disease in most of the areas involved.

13182598

Rabies in Canada, with special reference to wildlife reservoirs.

The course of known outbreaks of rabies in Canada in the 20th century is sketched, and the present extensive enzootic described. Its spread throughout the North West Territories, and in the Provinces of Alberta, British Columbia, Manitoba, Quebec, and Saskatchewan, is attributed to the vast potential reservoirs of infection offered by the density of fauna in these areas-in particular, of foxes and wolves. Control and eradication is being attempted-with some success-chiefly by reducing the wildlife population and restricting the movement of dogs.

13182599

Transmission of rabies by bats in Latin America.

This article reviews the literature dealing with the role of haematophagous bats in the spread of rabies among cattle in Latin America since 1911, when the association between Desmodontidae and rabies epizootics in Brazil was first suspected. Efforts to control the problem by destruction of the vectors and vaccination of bovines are described, and the suitability of chick-embryo vaccine is considered.

13182600

Antiserum in the prophylaxis of rabies.

This paper reviews recent experimental evidence in support of inoculation with antirabies serum, the value of which, as a prophylactic measure, pared with that of vaccine treatment alone. The author concludes that the chief advantages bined antiserum-vaccine prophylaxis lie in the rapid treatment of cases who have suffered severe exposure, and in the possibility of reducing the incidence of plications.

13182601

Phenolized vaccine treatment of people exposed to rabies in Southern India.

The records of antirabies treatment given under the auspices of the Pasteur Institute of Southern India, Coonoor, to 412,800 persons between 1907 and 1951 are analysed. The results of treatment with dried-cord, Högyes, and 1%, 2%, and 5% Semple vaccines are assessed, taking into consideration the various factors in their preparation. An account is given of an enquiry which has been in progress since 1946 parative mortality among untreated bitten persons and those treated with 5% Semple vaccine.

13182602

Prevention of human rabies; treatment of persons bitten by rabid wolves in Iran.

TREATMENT BY THE CLASSIC METHODS OF PERSONS BITTEN BY RABID WOLVES GIVES RESULTS, BUT THESE RESULTS ARE UNSATISFACTORY: the case-fatality-rate is decreased, but only to an inadequate extent. New and more effective methods are indisputably required.

13182603

Treatment of wounds inflicted by rabid animals.

This paper describes a series of experiments in which guinea-pigs were inoculated intramuscularly with a strain of fixed-virus rabies, and their wounds treated, after intervals of varying duration, with different viricidal substances. The authors found that cauterization with fuming nitric acid gave no greater protection against the development of rabies than did irrigation with a 20% soap-solution; a cationic detergent, Zephiran, was found to be the treatment of choice for wounds artificially contaminated with rabies virus.

13182604

Recent advances in the preparation of antirabies vaccines containing inactivated virus.

This paper describes experiments undertaken to determine the usefulness of 15 nitrogen-mustard and mustard-like drugs in inactivating fixed rabies virus for the preparation of experimental antirabies vaccines. One or more of the five agents eventually selected gives promise of practical value in rendering rabbit-brain fixed rabies virus and duck-embryo fixed rabies virus noninfective for mice, at the same time allowing of successful antirabies immunization.

13182605

Avianized rabies virus vaccination in man.

This paper describes the results of three experiments in which 98 volunteers were inoculated intramuscularly with living avianized rabies virus of the Flury strain, modified by adaptation to chick embryo; their reactions pared with those of 31 other persons either inoculated with normal-embryo material, or undergoing Pasteur treatment. Immune response was estimated by determination of the development of neutralizing antibodies. These observations show that Flury-virus vaccine can be used without untoward effects for the immunization of man against rabies, but give no clear indication as to the best method for the administration of this vaccine.

13182606

Experimental allergic encephalitis in animals, and its bearing upon the etiology of neuroparalytic accidents following antirabies treatment in man.

In an attempt to throw light upon the etiology of neuroparalytic accidents following antirabies treatment in man, the author analyses the process and effects of experimentally induced allergic encephalitis in various animals. He concludes that the two conditions are apparently identical, and suggests that the solution to the problem of plications be sought in either the elimination of the encephalitogenic factor or the use of an antirabies vaccine which does not contain brain tissue.

13182607

Can man be protected against rabies?

The literature dealing with the protection of man against rabies over the past 70 years in many parts of the world is reviewed, and the salient problems of our present state of knowledge analysed. The author discusses the measures currently in use for eliminating canine rabies by quarantine, regulation of the dog population, and-in particular-mass vaccination of dogs, with a detailed survey of the questions of immunological research which this method raises. Measures for suppressing the disease in other vectors are also described. It is concluded that, given effective education of the public and the widespread use of canine mass vaccination, human rabies is a preventable disease.

13182609

Therapeutic studies in hyperthyroidism; use of radioactive iodine.

Of 112 patients with hyperthyroidism who were treated with radioactive iodine, 110 were relieved of the disease. Nine had transient hypothyroidism. Twelve had permanent hypothyroidism. No other adverse effects that could be attributed to radioactive iodine were noted.

13182608

Consequences of the widespread use of antibiotics.

Great quantities of antibiotics are used each year. A direct result has been the appearance of large numbers of infections caused by organisms that are resistant to the action of one or more of these drugs. A new syndrome, that of superinfection by bacteria resistant to an antibiotic being administered, has mon. Its recognition is of great importance. The control of resistant infections requires the development of new antimicrobial agents and new knowledge about the use of older ones bination. The medical profession must be circumspect in its use of these important drugs or the time e when the control of many serious infections may e impossible.

13182610

Snorkel tracheotomy tube for respirator use.

The Snorkel tracheotomy tube, a simple modification of the standard tube, es many of the mechanical inconveniences usually encountered in the care of patients with tracheotomy who have to be kept in respirators. With it in place, it is not necessary to use special devices to hold the collar of the respirator away from the site of the tracheal incision. Nursing care of the patient is made easier.

13182612

Treatment of the inadequate endometrium in infertility.

In many cases of sterility in women, the usual routine investigation does not reveal abnormality sufficient to be considered the cause of the condition. In such cases thorough study of the endometrium is indicated, for in some it will be noted that there is not a consistently good secretory development and conditions are not conducive to indation. Intensive hormonal therapy with chorionic gonadotropin, estrogens and corpus luteum preparations may prove helpful where endometrial defects are found, both in sterility and, preconceptionally, in habitual abortion.

13182611

Antibiotic anaphylaxis.

Anaphylactic reactions following the injection of penicillin or other antibiotics have increased greatly during the past several years. These untoward reactions to penicillin were infrequent during the first nine years of penicillin therapy and there can be no doubt that hypersensitivity to these drugs is developing in many people. Therefore promiscuous use of them is to be condemned. It is safer not to use antibiotics parenterally in patients with allergic conditions such as bronchial asthma. The further use of a particular antibiotic should be avoided if the patient has previously shown any hypersensitivity to that drug.A questionnaire was answered by more than 1,000 California physicians who reported that over 300 patients had severe anaphylactic reactions from parenteral penicillin and streptomycin. There were seven deaths. Since the antibiotics should still be used when needed, prevention of anaphylaxis is of fundamental importance. The frequency of these reactions can be greatly reduced by the use of antihistaminic bined with the antibiotics. Treatment of these shock-like reactions demands the prompt administration of epinephrine intramuscularly, antihistaminic solutions intravenously and oxygen.

13182613

Measles encephalitis; a successful method of treatment with typhoid vaccine.

During a 12-year period 50 patients with measles encephalitis were treated with typhoid vaccine-45 of them not until they were in a vegetative state. There were no deaths in the treated cases. All except one were clinically normal after treatment was ended. Late in the series it became apparent that after the clinical normal is attained and the electroencephalogram es normal, treatment should still be continued until the cortex has been "challenged" repeatedly and the electroencephalogram shown to remain normal. The "shock" element in the treatment with typhoid vaccine was prevented by anticipating and circumventing the unfavorable reactions to the vaccine. It may take 20 to 50 treatments or more with typhoid vaccine to return a patient to normality. Each individual is different and responds in a different period of time.

13182614

Lumbar sympathectomy in older patients.

Of 43 older patients (aged 65 to 83 years) with arteriosclerosis obliterans treated by lumbar sympathectomy for one or both limbs, 19 had excellent result, 13 had fair result and four had poor result. One died postoperatively and six later. Results were better than prognosticated from response to sympathetic block. Thirty-four patients considered the operation worth while and twelve, after unilateral sympathectomy, requested operation for the other limb also. Twenty-four after operation could walk farther without claudication.

13182616

Psychological aspects of atomic disaster.

Increasing attention to the psychological aspects of atomic disaster will help improve the ability of the citizens of this country to withstand attack and survive as a free people. Since an enemy may be expected to exploit any internal weaknesses it can find, preparation must be made against the onslaught. The ability to deal effectively with any situation, even the most awesome, depends on knowledge of what to expect, and there is no reason to believe that facts about atomic disaster are an exception to this time proven truth. The psychological aspects need to be considered from two points of view, namely, the effect on masses of people and on individuals.

13182621

Spinal puncture headache.

Headache is plication of spinal puncture. There is no significant difference in the incidence of headache after lumbar puncture, whether or not the puncture is followed by injection of an anesthetic agent. The sequence of events leading to postlumbar puncture headaches is probably (1) decreased volume of cerebrospinal fluid with lowered pressure; (2) increased differential between the pressure of the cerebrospinal fluid and the intracranial venous pressure; (3) dilation of venous structures with increase in brain volume; and (4) production of tension on the pain sensitive areas in the cranium. Prevention of postlumbar puncture headache consists largely in attempts to avoid the development of the pressure differential between that of the cerebrospinal fluid and intracranial venous pressure. Treatment consists of analgesics, hydration and attempts to restore normal cerebrospinal fluid pressure.

13182622

Treatment of carcinoma of the uterine cervix; a commentary on current methods.

A monograph on Cancer of the Female Genital Tract published by the American Cancer Society seems to put greater than warranted stress on the value of operative treatment pared with radiotherapy of "small" or "early" lesions of the uterine cervix. The terms themselves may be misleading in that many readers may mistakenly take them to mean Stage I lesions. A diagnosis of Stage I is no assurance that extension has not occurred (as it had in 23.5 per cent of 17 cases of Stage I carcinoma observed by the author). In addition, there is suggestion in the monograph that the extent of operation may be reliably determined on the basis of frozen section examination of the obturator and iliac nodes. This overlooks the considerable possibility of metastasis that skips these groups and extends to others beyond (as it did in one of the 17 cases).Moreover, preoperative diagnosis of the stage of a lesion is not wholly reliable. In a series of 37 cases observed by the author in which the preoperative diagnosis was Stage I carcinoma of the cervix, pathological examination of tissues, after total hysterectomy of the Wertheim type, revealed that in nine cases the growth was actually at a more advanced stage. Upon further examination of tissues it was noted also that the excision was inadequate in 33 of the 37 cases.

13182623

Isoniazid therapy in chronic ulcerative colitis; a preliminary report.

Uniformly good response to isoniazid therapy was observed in five cases of chronic ulcerative colitis during an initial period of 3 to 6 months of treatment. In all cases the disease was in relapse at the time administration of the drug was started. There was both subjective and proctoscopic evidence of improvement. Isoniazid has little significant or serious toxicity.

13182624

Postmenopausal bleeding of nonmalignant origin.

A study was made of the medical records of 102 patients hospitalized because of postmenopausal bleeding. Diagnostic procedures used included vaginal examination, Papanicolaou smears, curettage and cervical biopsy. The major associated pathological conditions (possibly etiological factors) in the series were chronic cervicitis, fibromyoma of the uterus, endometrial polyps, cervical polyps and adenomyosis of the uterus. Sclerosis of the uterine vessels was suggested as another possible cause of this type of bleeding. Neither the amount and type of bleeding nor the pattern of associated symptoms were of diagnostic value.A history of hormonal therapy prior to the onset of bleeding is not sufficient evidence to establish that as the cause of the bleeding and the patient should be pletely investigated as if this history were not present. In over 61 per cent of cases in this series, uterine curettage with or without cervical biopsy, cauterization, conization or trachelorrhaphy, was the only treatment required for both diagnosis and therapy.

13182625

Thyroid carcinoma; an approach to management of the disease.

A clinical and pathological study was made of a series of 34 consecutive patients with thyroid carcinoma. Carcinoma occurred only in nodular goiters, and in the majority of cases was found in a gland with a solitary nodule. The degree of firmness to palpation of a thyroid nodule is unimportant in the diagnosis of carcinoma of the thyroid since hardness was an infrequent finding. In the diagnostic use of radioactive iodine, scintigram studies of a nodular goiter usually revealed an area of decreased function at the site of a thyroid carcinoma.Twenty-three per cent of the 34 patients with thyroid carcinoma died within five years. The duration of survival for various patients pared with the type of treatment administered. It is believed that solitary thyroid nodules are best treated by lobectomy. Total thyroidectomy is indicated in cases of large thyroid carcinoma and also for smaller tumors if papillary adenocarcinoma. Radical neck dissection is warranted if lymph node metastasis is present and limited to the neck; and also in the absence of metastasis if the tumor is papillary in histologic pattern. Surgically inaccessible metastatic lesions are best palliated by radioactive iodine or external irradiation.

13182626

Acne conglobata; use of cortisone and corticotropin in therapy.

Six patients with acne conglobata were treated with cortisone and adrenocorticotropic hormone. Definite immediate improvement was observed in all of them. In three cases control of the disease was maintained on relatively low doses of steroid. In one case there was response to superficial x-ray therapy after the acute phase of the disease had subsided in response to steroids. Resistance to steroid therapy apparently developed in one patient after approximately 18 months of treatment. One patient responded to treatment and then remained well (for two months when last observed) although steroids and all other treatment were discontinued. bined use of antibiotics and steroids in the patients treated gave the best results.

13182627

Proctologic disorders in sex deviates; a study of sixty-eight cases of sodomy.

Sixty-eight patients, 50 of them in penal institutions, who practiced passive sodomy were studied by interview and examination with regard to type of homosexuality, appearance, age at onset, frequency of practice, techniques, and proctologic findings.A high incidence of anal cryptitis was observed. A sign observable on digital examination, possibly peculiarly indicative of the practice of sodomy, was noted in many cases. Particular care is needed in the examination and treatment of anorectal diseases in sodomists and certain precautions must be taken as to hospital modations.

13182628

Unusual abdominal cysts in infants and children.

In a 20-year period at the Los Angeles Children's Hospital, 46 infants and children have had operation for cysts within the abdomen. The age range of patients was from newborn to 13 years. Most of them were under four years old. There were four general groups of these cysts. (1) About one-half were cysts of the ovary, some of them serous and some dermoid. These cysts are attached by a stalk that often twists, causing gangrene or rupture with acute symptoms simulating appendicitis. (2) Next in frequency were cysts arising in the mesentery of the intestine. They usually caused little trouble until by their size (up to a 2-quart capacity) they created pressure and obstruction in the intestine. (3) Enteric cysts were found in four patients. (4) Cysts of the pancreas were present in three of the children.X-ray examination was helpful in diagnosis. Usually the type of cyst was not determined until operation was done. Transection of the intestinal tract sometimes was necessary for removal of the cyst. Surgical correction was satisfactory in 44 of the 46 cases.

13186830

Stability and absorption spectrum of malononitrile.

1) Spectra in the ultraviolet and visible regions have been obtained on samples of malononitrile under different conditions. The samples were manufactured by panies in America and Sweden. 2) The spectral analysis has demonstrated that pound used by Hydén and Hartelius is not the same as that employed by American investigators. If, however, an aqueous solution of the American product is allowed to stand at room temperature for a long enough time, it develops the same spectral characteristics as the Swedish solution. 3) Future studies will concern themselves with attempts to identify, the active substance and to examine its effect on neuronal nucleoproteins.

13186846

Reduction of serum lipides and lipoproteins by ethionine feeding in the dog.

(i) The effects of daily oral administration of 125 mg of DL-ethionine upon the serum lipides and lipoproteins of dogs were studied. (ii) The feeding of the ethionine resulted in a prompt reduction in the levels of serum fatty acids, phospholipides, and cholesterol. See PDF for Figure At the end of 25 days, negligible amounts of these lipides remained in serum. (iii) A reduction in the levels of low- and high-density lipoproteins also resulted from the feeding of ethionine. In general, the extent of reduction in all lipoprotein fractions paralleled that observed in lipides. (iv) The removal of ethionine from the diet led to a prompt restoration of the concentrations of all lipide and lipoprotein constituents to normal.

13190428

Refractory heart failure.

Any patient with so-called "refractory" heart failure should be looked upon as suboptimally handled. The patient should be studied for possible development of new disturbances, either inside or outside the vascular system, which, at the same time, have a bearing upon the heart failure.The entire therapeutic program should be reviewed to be sure that all aspects of therapy have been evaluated satisfactorily and established optimally. If diuretics, especially mercurial diuretics, have been given, the plications of such therapy, particularly in terms of electrolyte imbalance, should be considered. It is only through a general survey of the patient for an evaluation of these factors that they may be found and therapy instituted to minimize or eliminate them.

13190429

Emesis and hiccough; treatment with chlorpromazine.

Thorazine was very effective in the control of vomiting, regardless of cause, in 20 cases in which it was used. It stopped hiccough in five of seven patients treated and partially controlled it in the other two. The drug was more effective when given intramuscularly than orally. Use of the drug intravenously was observed in one case; shock occurred soon after injection.

13190430

Dystocia due to soft tissue.

In dystocia caused by abnormal conditions of the soft parts, the etiologic changes may be either in the genital tissues or in adjacent soft structures. Broadly, the conditions causing the difficulty may be grouped as follows: (1) anomalies or congenital modifications; (2) tumors; (3) modifications due to age, accident or surgical operations; (4) modification of the expulsive forces; (5) abnormalities of the products of conception. Often in such circumstances cesarean section is necessary. Sometimes when tumor is present it can be removed before it interferes with delivery, but decision to excise the growth must be guided by such factors as the location of the lesion and the stage of gestation. This would determine to what extent the maintenance of pregnancy would be jeopardized by surgical intervention before term.

13190431

The use of silicones in dermatology.

A cosmetically acceptable lotion containing a silicone protectant, a keratolytic, a bacteriocidal agent and antipruritic substances, was clinically tested in 208 persons with various dermatoses.Twenty-four-hour closed patch tests on humans and intradermal tests in laboratory animals indicate the lotion not to be a sensitizer. Subacute and chronic housewives' eczema and contact dermatitis of the hands, plicated "diaper rash," periaural dermatitis due to excessive moisture, and certain hyperkeratotic dermatoses responded satisfactorily to the use of the lotion.

13190432

Management of resectable lesions of the small bowel.

During a 12-year period at the Los Angeles County General Hospital there were 364 cases of resection and anastomosis of the small intestine which were classified and studied. Particular attention was paid to the methods of anastomosis. There were more wound infections, fistulas and otherwise faulty anastomosis with the open than with the closed technique. In the presence of a peritoneal cavity not previously contaminated by bowel content, a closed anastomosis is better and safer than an open anastomosis.

13190433

Intravenous administration of fat emulsions; metabolic and clinical studies.

Fat emulsions alone or in alternation with amino acid mixtures were administered by continuous intravenous infusion to human subjects. Adequate nutrition was maintained thereby, without untoward effects. Upon too rapid administration of such emulsions, toxic manifestations occurred, apparently referable to an "overload" of the enzyme systems concerned with fat catabolism and storage.

13190434

Progress in blood preservation.

Disodium ethylenediamine tetraacetate (Na(2)EDTA) is a powerful anticoagulant for blood. It preserves the cellular elements of the blood better than the monly used. It is practically atoxic and pletely excreted. Blood preserved with the disodium ethylenediamine tetraacetate is useful for transfusion after storage of three to four weeks. The addition of glucose and raffinose increases the survival time of the erythrocytes for from four to six weeks. The disodium plex may be used for the preservation of whole blood. It pletely atoxic. Ethyl alcohol-saline-sugar solutions preserve erythrocytes for at least 150 days; they are excellent preservatives for the agglutinogens. Whole blood preserved with glycerin-raffinose-glucose may be frozen at -20 degrees C. for at least two months, and probably for a longer period, without excessive hemolysis after thawing.

13190435

Prevention of infections hepatitis by gamma globulin.

Infectious hepatitis, a viral disease, has e increasingly more important in recent years. It is believed that the great increase in reported cases is not due entirely to better reporting, but that there has been an actual increase in the incidence of this disease. paratively long incubation period in infectious hepatitis, the high incidence in persons in close contact with patients who have the disease, and the fact that in most instances contact between persons is the mode of spread, makes this disease particularly suitable for the use of an immunizing agent which would be administered after exposure. From the studies reviewed it is apparent that gamma globulin is of value in preventing hepatitis both when administered as mass prophylaxis in an epidemic, and when given to persons in close contact with a person who has the disease. Widespread use of gamma globulin prophylactically among persons who have been in close contact with the occasional patients with infectious hepatitis seen by practicing physicians might often obviate the need for mass immunization. It should be stated that there is little evidence for the effectiveness of gamma globulin in the therapy of infectious hepatitis. In a study in which very large amounts (average dose 45 cc.) of gamma globulin were given very early in the disease, no significant difference was observed between those injected and a control group.

13190436

Infectious hepatitis; report of an outbreak of 24 cases.

In an epidemic of 24 cases of infectious hepatitis in a small munity, the majority of cases occurred in children. Sixteen of them were pupils in one school. The school apparently was the focus for the spread of infection, which is thought to have been through contact between persons. Five multiple case households with eight secondary cases were observed. With one exception, gamma globulin was not used for the prophylaxis of infectious hepatitis in families in which one member had the disease.

13190437

Diagnosis and treatment of glaucoma; a review of recent developments.

Tonography is helpful in the diagnosis of doubtful cases of chronic simple a. If also gives a good indication of the status of the disease in a given eye. The most useful miotic in the treatment of a is still pilocarpine. Carbachol is more potent but must be used in an anhydrous base ointment or in a solution of a wetting agent. DFP (diisopropyl fluorophosphate) produces undesirable side effects because of the hyperreactivity of the ciliary body and iris sphincter which it causes. These can be partly e by using pilocarpine first. Diamox is a carbonic anhydrase inhibitor that is effective when given orally. In many cases it produces at least a temporary lowering of tension in atous eyes, apparently by reducing the secretion of intraocular fluid. Its ultimate value in a remains to be seen. The cyclodiathermy operation which has been modified somewhat by Weekers has had a recent increase in use but the long-term results have been somewhat disappointing. The importance of early operation in narrow angle a is ing more and more apparent. Following iridectomy the wound should be tightly sutured to insure the prompt reformation of the anterior chamber.

13192249

Chemical structure of steroids in relation to promotion of growth of the vagina and uterus of the hypophysectomized rat.

In the hypophysectomized albino rat which is protected from contact with steroids in the ration and environment the uterus and vagina are highly atrophic but are sensitive indicators of activity of substances which promote their growth. Both the pituitary growth hormone and certain steroids have mon property of inducing growth of these tissues. The vaginal epithelium consists of 2 layers of cells which differ profoundly in their growth in response to steroids, depending on the molecular structure of pounds. The differential response to modifications of chemical structures of steroids permits evaluation of the importance of the ponents for the process of growth. The number and site of functional groups, the geometry of the molecule and the state of oxidation are of high importance in determining physiologic activity of steroids in the androstane series; these features are less specific in the estrane series. Side groups at positions C(3) and C(17) are of importance in the promotion of growth by steroids in the androstane series, but these active centers are not equivalent in their physiological influence. As a generalization, hydrogenation of the oxygen function at C(17) (but not at C(3)) and dehydrogenation at critical areas of the ring structure increase the quantitative efficacy of steroids in promoting growth. The position of double bonds and the state of oxidation at both C(3) and C(17) determine the qualitative type of growth-cellular pattern, which pound in the androstane series induces in the vaginal epithelium.

13192250

Significance of the hydroxyl groups of steroids in promoting growth.

The presence of a 17beta-hydroxyl group endows the simple androstane molecule with the ability to produce growth of the uterus, vagina, and prostate of the female hypophysectomized albino rat. It appears that hydrogen atoms at position 17 are of critical importance since pounds with a ketone group at this site are inactive. Monofunctional steroids with a hydroxyl or a ketone group at position 3 likewise are devoid of activity. If a phenolic A-ring is present in monofunctional steroids the 17beta-hydroxyl group is not obligatory for growth. Proliferation of the uterus and vagina were found to follow the administration of 17-desoxyestradiol.

13192251

Interference between poliomyelitis viruses in tissue culture.

The inhibition of multiplication of one poliomyelitis virus by a poliomyelitis virus of another immunologic type has been established by using tissue cultures of monkey testes. The degree of interference varied from none, to partial, plete, depending upon the time between inoculation of the interfering and the challenge viruses, and the amount of each virus inoculated. Reciprocal interference was demonstrated between Types 1, 2, and 3 poliomyelitis viruses. Under conditions which resulted plete suppression of the growth of one poliomyelitis virus by another, interference by poliomyelitis virus with the multiplication of four antigenically distinct "orphan" viruses and of three antigenically related strains of Coxsackie virus could not be demonstrated. Poliomyelitis virus rendered non-infective by formalin or by irradiation with high energy electrons or with ultraviolet light, or treated so that only traces of residual active virus remained, failed to interfere with the propagation of active homologous virus.

13192252

Studies on the transfer of lymph node cells. III. Effects of variation in the interval between the injection of antigen into the donor and collection of its lymph node cells.

At various intervals, from 10 minutes to 21 days, after the injection of dysentery bacilli into the hind foot pads of rabbits the popliteal lymph nodes were excised. The cells of the lymph nodes were teased free, washed, and injected intravenously into normal rabbits. In each case aliquots of the same cell suspension were either incubated at 37 degrees C. for 24 hours or heated at 52 degrees C. for 20 minutes and then injected into other normal rabbits, as controls. In the case of lymph node cells obtained 4 or 3 days after the injection of antigen, antibody was found in the serum of recipients on the 1st day after the transfer of untreated cells. The titer increased until the 3rd day and then began to decline after the 5th or 7th day. In the sera of recipients of incubated cells antibody was not found, except on occasion after the 4th day and in low titer. This late appearance of antibody was attributed to the presence of small amounts of antigen in the original cell suspension. As the interval between injection of antigen and collection of cells was increased beyond 4 days the effectiveness of the transfer decreased progressively until at 14 days no transfer effect was obtained. When cells which were obtained 2 days after the injection of antigen were transferred, antibody appeared on the 2nd day after transfer and then followed the characteristic curve, whereas in the case of incubated cells antibody did not appear until the 3rd day after transfer. After the transfer of untreated 1 day cells antibody did not appear in the recipient until the 3rd day, and then followed the type of curve seen with 2, 3, and 4 day cells. Following transfer of incubated 1 day cells antibody also appeared on the 3rd day. To establish the possibility of eliciting the cell transfer effect as early as 1 day after the injection of dysentery bacilli, recipient rabbits were x-irradiated 24 hours prior to the injection of cells. It was found that in the sera of such recipients of untreated cells antibody appeared on the 3rd day following transfer, while irradiated recipients of incubated cells did not develop any measurable amounts of agglutinin for the first 10 days. It was concluded that a total of 3 days was required between the injection of antigen into the donor and the appearance of measurable antibody in the serum of the recipient, regardless of the fraction of that time spent by the cells in each of the animals involved, donor or recipient. Following the transfer of untreated cells removed from lymph node as early as 10 minutes after the injection of antigen distal to them, antibody could be found in the sera of x-irradiated recipients 4 days later, whereas antibody did not appear following the transfer of heated cells to such recipients.

13192253

Studies on the transfer of lymph node cells. IV. Effects of X-irradiation of recipient rabbits on the appearance of antibody after cell transfer.

Cells of the popliteal lymph node were teased 3 days after the injection of Shigella paradysenteriae into the hind foot pads of rabbits. These cells were transferred to normal and x-irradiated recipients. It was noted that the serum titers of dysentery agglutinins in irradiated recipients were higher than in normal recipients. This was represented both in a higher peak: titer and a tendency to remain higher for a longer period than in normal animals. Recipients were x-irradiated within 1 hour after receiving cells of the lymph node prepared as indicated above. The serum titers of these recipients were markedly reduced parison with those of non-irradiated control animals. If the irradiation of the recipients followed the transfer of cells by a day, however, this difference was much smaller and in the case of a 2 day interval after the transfer of the lymph node cells the irradiation appeared to have no effect on the resulting serum titer.

13192254

Structure and development of viruses observed in the electron microscope. II. Vaccinia and fowl pox viruses.

Vaccinia and fowl pox viruses were visualized by the electron microscope in sections of infected chorioallantoic membrane of chicken embryos. The viruses were of similar structure and size, averaging 200 x 300 mmicro with considerable individual variation. Intracytoplasmic viral particles contained a dense, nucleus-like body (nucleoid) separated from granular material (viroplasm) by a zone of lesser density. They were enclosed by a single membrane. Near the surface of the host cell and in the extracellular space the particles consisted of a central body of variable shape and density enclosed by a double membrane. The initial sites of development were confined to the cytoplasm of the host cell. Before release from the host cell the viral nucleoids appeared to enlarge and to occupy a central position within the particle, which became enclosed by a double limiting membrane. The brick-shaped forms found after removal of the embedding plastic from thick sections indicated that drying caused characteristic distortion of certain viral particles.

13192255

The selective localization of murine pleuropneumonia-like organisms in the female genital tract on intraperitoneal injection in mice.

Acute oophoritis and salpingitis monly observed in weanling mice injected intraperitoneally with murine pleuropneumonia-like organisms of the catarrhal type (4 strains). Organisms of the injected strain were regularly recovered in cultures from the ovary or uterus during the 3rd to the 5th week but not after the 12th week. They were also obtained from the vagina through the 5th week and with varying results, depending on the strain, from the heart's blood through the 1st week. PPLO injected into the vagina survived for some weeks but did not migrate inwardly nor were they transmitted outwardly to exposed mice. In male mice peritoneal abscesses were sometimes present but the genital organs were normal and free from PPLO. Otitis media, with positive exudate cultures, occurred more often in females and varied in rate with the strain of PPLO. PPLO of the conjunctival type failed to survive in the abdominal cavity of mice and produced no reaction in either the genital or the respiratory tract.

13192256

Studies on entry and egress of poliomyelitic infection. VII. Early lesions in peripheral ganglia after simple feeding; with comments on the possible value of immunization in preventing neural entry.

At 56, 60, and 72 hours after simple feeding of poliomyelitis virus, typical, discrete lesions were found in the ganglia supplying the mouth and pharynx, which were most numerous and severe in the Gasserian ganglia. Lesions were also found in the nerve bundles adjacent to the infected ganglia. The character, localizations, and time of appearance of lesions point to nerve-conducted entry of infection from the mucosa of the mouth and pharynx. The possibility is suggested that under natural conditions of exposure, in which only small amounts of virus are involved, artificially induced immunity, active and probably passive, may block primary neural entry at the oropharyngeal portal by virtue of antibodies in the overlying mucus.

13192311

Photosynthetic efficiency of marine plants.

Multicellular marine plants were collected from their natural habitats and the quantum efficiency of their photosynthesis was determined in the laboratory in five narrow wave length bands in the visible spectrum. The results along with estimates of the relative absorption by the various plastid pigments show a fairly uniform efficiency of 0.08 molecules O(2) per absorbed quantum for (a) chlorophyll of one flowering plant, green algae, and brown algae, (b) fucoxanthol and other carotenoids of brown algae, and (c) the phycobilin pigments phycocyanin and phycoerythrin of red algae. The carotenoids of green algae are sometimes less efficient while those of red algae are largely or entirely inactive. Chlorophyll a of red algae is about one-half as efficient (phi(o2) = 0.04) as either the phycobilins, or the chlorophyll of most other plants. These results as well as those of high intensity and of fluorescence experiments are consistent with a mechanism in which about half the chlorophyll is inactive while the other half is fully active and is an intermediate in phycoerythrin- and phycocyanin-sensitized photosynthesis.

13192312

The mercury-hydrogen peroxide system as an analogue of nervous transmission.

The construction and behavior of a system exhibiting all-or-nothing propagation of an electrochemical disturbance are described. Detailed measurements of the distribution of electric current and potential are given and the device pared with nerve and with the Lillie model in respect to structure, electrical and chemical activity, and energy relationships.

13192314

The position of the cell nucleus in pathways of hydrogen transfer: cytochrome C, flavoproteins, glutathione, and ascorbic acid.

A study has been made of calf thymus and liver tissue to ascertain the position of the nucleus with respect to mechanisms capable of hydrogen transfer. Although previous work had shown that reduced pyridine nucleotide coenzymes are produced in the course of nuclear metabolism, it has now been established that the flavoprotein system of cytochrome c reductase, cytochrome c, and most, if not all, of other flavoproteins are absent from nuclei. Metabolites capable of cytochrome c reduction, notably ascorbic acid and glutathione, have been demonstrated in the nuclei. Glutathione reductase has been found present in nuclei only to a minor extent, suggesting that nuclear glutathione might function largely in a capacity other than that of hydrogen carrier in the nucleus. Although no enzymatic relation could be established between ascorbic acid and hydrogen transfer in nuclei) it was possible to demonstrate a close association between ascorbic acid concentration and the mitotic process in lily anthers. The significance of the anaerobic character of nuclear metabolism to chromosome function is discussed.

13192313

Hexokinase activity from eggs of the sea urchin Arbacia punctulata.

1. The hexokinase activity of homogenates of eggs and embryos of the sea urchin Arbacia punctulata has been measured. Expressed as micrograms glucose consumed at 20 degrees C., per hour per milligram of protein the following values were obtained: unfertilized eggs, 67; fertilized eggs, 72; 24 hour plutei, 94; 48 hour plutei, 226. The concentration of the enzyme in the eggs is small and may be calculated to be about 0.001 per cent of the dry weight of unfertilized eggs. 2. The hexokinase activity of the egg homogenate was virtually all recovered in the supernatant fraction when the homogenate was centrifuged at 20,000 x g for 30 minutes and was found to have the following properties: The concentrations for half maximal hexokinase activity with various substrates were, approximately: Glucose, 0,00003 M; fructose, 0.00075; mannose, 0.00007; 2-desoxyglucose, 0.00025. The relative rates of phosphorylation of various sugars by the supernate fraction when saturated with substrate were, approximately: Glucose, 1.0; mannose, 1.2; fructose, 1.8; 2-desoxyglucose, 2.0; glucosamine, 0.6. Adenosinediphosphate and glucose-6-phosphate inhibited the enzyme. No evidence for more than one hexokinase in the Arbacia extracts was found.

13192315

Interactions between magnesium, pyrophosphate, and the contractile elements.

1. If glycerol-extracted muscle fibers are alternately immersed in solutions of inorganic pyrophosphate (PP) or ethylenediamme tetraacetate (EDTA) and KCl two to three times, PP no longer increases extensibility. The original condition is restored by solutions containing Mg. EDTA pletely the softening action of PP, but has no effect in the presence of an excess of Mg. These observations are explained by assuming that PP and EDTA remove bound Mg. Evidently PP has no softening action without Mg. 2. If PP is washed out from muscle fibers by solutions containing Mg, the softening action of PP persists for many minutes, but washing out with KCl solution promptly abolishes the effect of PP. Also, if fibers which have been made refractory to PP are immersed into a solution of PP and then into a KCl solution free of PP for several minutes, the addition of MgCl(2) alone increases extensibility. It is concluded that PP forms plex with protein. The formation of plex, however, has no influence on the mechanical properties, unless Mg also is present. 3. In the presence of PP and Mg the viscous resistance of muscle fibers drops with diminishing temperatures.

13192316

Changes in the permeability of ascospores of Neurospora tetra-sperma during germination.

The respiration and germination of activated ascospores of Neurospora tetrasperma have been shown to be pletely inhibited by concentrations of ethylene diaminetetraacetic acid (EDTA) as low as 0.0035 M. In contrast, however, dormant ascospores are insensitive to this chelating agent. At any time up to about 150 minutes after activation Ca(++) or Mg(++) pletely reverse this toxicity but Cu(++), Co(++), and Mn(++) only partially reverse it. After this time, the minerals of the Neurospora "minimal" medium taken singly, or in binations cannot reverse this effect. Adding EDTA at 120 minutes after activation eliminates the lag period associated with its effect upon respiration. Inhibition occurs even though the cells seem to be impermeable to EDTA. Cationic exchange resins, as another example of a non-penetrating metal-binding agent, gave effects similar to those noted with EDTA. Of the resins used the H(+) form of IR-120 and the Na(+) and K(+) forms of amberlite IRC-50 were the most toxic to activated ascospores. On the other hand, dormant ascospores were entirely unaffected by the resins. The release of Ca(++) from activated ascospores coincided with the period of maximum sensitivity to EDTA. More than 60 per cent of the cell's content of K(+) is released by EDTA-inhibited ascospores. A low pH decreased the effectiveness of EDTA as a poison. The data are consistent with the possibility that non-penetrating metal-binding agents are toxic because of the irreversible removal of essential cations from the cell. The kinetic data for the inhibitory effects, and for the release of Ca(++) establish that the permeability of germinating ascospores to minerals changes drastically as a result of activation.

13192318

The inactivation of dilute solutions of crystalline trypsin by x-radiation. I. Kinetics and characteristics.

The activity of dilute solutions of crystalline trypsin is destroyed by x-rays. The inactivation is an exponential function of the radiation dose. The reaction yield of inactivation is independent of the intensity at which the radiation is delivered or the quality of the x-rays. The reaction yield increases with increasing concentration of trypsin, varying from 0.06 to 0.7 micromoles per liter per 1000 r for trypsin solutions ranging from 1 x 10(-7) to 2 x 10(-4)M.

13192317

The behavior of isolated hearts of the grasshopper, Chortophaga viridifasciata, and the moth, Samia walkeri, in solutions with different concentrations of sodium, potassium, calcium, and magnesium.

1. The blood of Chortophaga viridifasciata was analyzed. The average concentrations of inorganic cations expressed as milligrams per cent are: sodium, 250.66; potassium, 13.52; calcium, 11.40; and magnesium, 51.15. The osmotic pressure of the blood at 0 degrees C. is 10.7 atmospheres. Protein and non-protein nitrogen, expressed as milligrams per cent, are 253.4 and 140.0, respectively. 2. The blood of Samia walkeri has an osmotic pressure of 13.36 atmospheres at 0 degrees C. Its protein nitrogen is 628.58, and its non-protein nitrogen, 441.20 milligrams per cent. 3. The effects of isotonic chloride solutions of sodium, potassium, calcium, and magnesium and of distilled water on the heart beat of these two species were determined. The heart of the grasshopper failed to beat in isotonic solutions of KCl, MgCl(2), or in distilled water. For both insects, sodium was found to be the least toxic ion. In the case of the grasshopper, calcium ranks next in order. In the case of the moth, potassium ranks next after sodium and is followed by calcium and magnesium. 4. The ratio of sodium to potassium in milligrams per cent, necessary for maintaining the normal heart beat of Chortophaga viridifasciata is 3 to 1, but it may be increased to at least 34 to 1 without any appreciable effects. The ratio of potassium to calcium necessary for maintaining the normal heart beat of this insect is 1 to 1, and may be increased to as much as 3 to 1. 5. The ratio of sodium to potassium, in milligrams per cent, necessary for maintaining the normal heart beat of Samia walkeri was found to be equal to or to exceed 1 to 13.8. The sodium content may be increased so that the ratio of sodium to potassium is 34 to 1 without any toxic effects. The ratios of potassium to calcium required for normal heart beat in this insect may be 1 to 1, 2 to 1, or 3 to 1. 6. The hearts of the grasshoppers beat normally in isotonic solutions having an osmotic pressure of 10.7 atmospheres. They beat equally well in solutions having an osmotic pressure of 13.4 atmospheres. The hearts of the cynthia pupae beat normally in isotonic solutions having an osmotic pressure of 13.36 atmospheres. However, they also beat normally in solutions having an osmotic pressure of 10.02 atmospheres. Therefore, although the blood of the cynthia moth and of the grasshopper have different osmotic pressures, their hearts are tolerant to solutions having the same tonicity. Because of this, and since the ratios of potassium to calcium necessary for maintaining normal heart beats of both insects are the same, solutions favorable to the grasshopper may also be favorable to the cynthia moth.

13192320

Relation of function to diameter in afferent fibers of muscle nerves.

1. A method of isolation of individual afferent fibers from muscle has yielded a representative sample of the fibers prise groups 1 (12 to 20 micro) and II (4 to 12 micro) of the afferent fiber diameter distribution of muscle nerves in cat. 2. Afferent fibers from muscle stretch receptors account for groups I and II of the afferent diameter spectrum of muscle nerves to soleus and medial gastrocnemius. Fibers from tendon organs are largely confined to the diameter range above 12 micro. This fiber group, which has a simple one-peak diameter distribution, is termed group IB. Fibers from muscle spindles show a bimodal diameter distribution and account for the remainder of fibers in the 12 to 20 micro group (termed IA) and substantially all of group II (4 to 12 micro). 3. No significant difference has been found in the receptor characteristics of the large (group IA) and intermediate sized (group II) spindle afferent fibers other than a slightly higher threshold of the latter to steady external stretch.