[Experience with sonographically controlled fine-needle punctures with permanent visual control (author's transl)]

With our new biopsy-device it is now possible to perform fine-needle punctures of lesions in the abdomen, thoracic cage, cervical region and extremities under continuous visual control. This intervention can easily be done with low risk for the patient and can be repeated whenever necessary. It has proven its advantages for amniocentesis as well, especially in cases with a low amount of amniotic fluid. Moreover, our new device allows the combination of sonographical and radiological interventions, for example of the kidneys.

Generation of an electrochemical proton gradient in Streptococcus cremoris by lactate efflux

Recently an energy-recycling model was proposed that postulates the generation of an electrochemical gradient in fermentative bacteria by carrier-mediated excretion of metabolic end products in symport with protons. In this paper experimental support for this model is given. In batch cultures of Streptococcus cremoris with glucose as the sole energy source the maximal specific growth rate decreased by 30% when the external lactate concentration was decreased from 50 to 90 mM. In the same range of external lactate concentrations the molar growth yield Y for glucose as measured in energy-limited chemostat cultures also showed a 30% drop. From Y max lactose values of S. cremoris grown in the presence and absence of added lactate it was calculated that the net energy gain from the lactate efflux system was at least 12%. Lactate efflux from de-energized cells loaded with lactate could drive the uptake of leucine. This uptake was sensitive to carbonylcyanide p-trifluoromethoxyphenylhydrazone and was only partly inhibited by dicyclohexylcarbodiimide (DCCD). The limited inhibition by DCCD of lactate-induced leucine uptake indicates that ATP hydrolysis was not the driving force for transport of leucine. Uptake studies with the lipophilic cation tetraphenylphosphonium demonstrated that lactate efflux increased the electrical potential across the membrane by 51 mV. The generation of an electrical potential by lactate efflux and the demonstration of a potassium efflux-induced uptake of lactate indicates that lactate is translocated across the membrane by a symport system with more than one proton.

[Ultrasonically guided percutaneous fine needle aspiration biopsy of pancreatic tumours under permanent visual control (author's transl)]

Using a new method of ultrasonically guided fine needle biopsy under permanent visual control it is now possible to biopsy tumour-suspect changes of the pancreas and other abdominal organs reliably. The risk for the patient can thus be reduced to a minimum. The method leads to considerable improvement in obtaining biopsy material and is easily performed and may be repeated. The correct diagnosis could be established in all of 18 patients with pancreatic disease by cytological investigation. Sonographic interpretation of space occupying pancreatic lesions was successful in only 16 patients.

Guided puncture under real-time sonographic control

A new method of percutaneous thin-needle biopsy is presented. The needle is guided sonographically under visual control. This method is safe, economical, and tolerated well by the patient.

Antistreptococcal antibodies, rheumatoid factors and haptoglobin in apes and monkeys

Sera of 157 baboons (Papio hamadryas and P. anubis) 21 chimpanzees (Pan troglodytes) five orang utans (Pongo pygmaeus) three mountain gorillas (Gorilla gorilla beringei) and three gibbons (Hylobates lar lar) were examined for the content of antistreptolysin O, antidesoxyribonuclease B, for the presence of rheumatoid factors as well as for the level and type of haptoglobin. The mean antistreptolysin O titer (AST) in baboons was 106 ASU +/- 18 in dextransulfate absorbed sera ("real" AST) and 182 ASU +/- 34 in non-absorbed sera. The mean decrease after absorption was 20% (i.e., 20% inhibitor + 80% antistreptolysin O), a value that is lower than previously found in rhesus monkeys (55%) or in man (40%). Raised values of anti-DNase B were found in two baboons only, and none of the sera of that species displayed presence of rheumatoid factors. In chimpanzees, the mean AST was 68 +/- 29 in absorbed and 87 ASU +/- 57 in non-absorbed sera. Anti-DNase B was raised in three animals, and in two cases the increase was correlated with raised AST. Of 19 chimpanzee sera examined, 13 were found to contain antigammaglobulins ("rheumatoid factors") the titers of which reached 1:64 or more. All primate sera tested so far showed haptoglobin type 1-1 or Hp 1-1-like patterns. The haptoglobin level in chimpanzees and baboons was comparable to that established in man; in rhesus monkey, on the other hand, much lower values (40-62 mg/100 ml) or ahaptoglobinemia were observed. The sera of all monkeys and apes tested so far showed a very low (undiluted, or up to 1:10 titer at most) agglutinating activity against T4-antigen-carrying streptococci. This is in agreement with our observations made previously which indicated that human or animal sera of haptoglobin type 1-1 agglutinated streptococci to a much lower degree than type Hp 2-2 or type Hp 2-1 sera.

[Ultrasonically guided percutaneous fine-needle biopsy (author's transl)]

A new method is described of doing fine-needle biopsies, under continuous visual control with real-time ultrasonic guidance, of the neck, thoracic and abdominal regions. The method decreases the risk of needle puncture and improves the yield of material obtained. It is simple and hardly stresses the patient, pain being only slight and momentary. It can be easily repeated. It is particularly useful for amniocentesis in obstetrics because it employs the shortest possible pathway.

[The problem of the multifocal breast neoplasm]

Nowadays, it is accepted that mammary cancer does not represent a localized tumor only, but a bilateral disease of breast tissues. During a period of 6 years, bilateral manifestations of infiltrating cancer have been observed in 12.7% of all cases. 23.2% of all breast cancer patients had a unilaterial multicentric tumor. The implications of this phenomenon with regard to control and therapy are as follows: As early diagnosis of malignant breast tumors often is possible by means of mammography, this examination should be performed regulary in high-risk patients, especially in cases of known earlier malignancy of one breast. More radical surgery should have priority, in view of the frequently observed multicentricity of breast cancers.

[Sonography and retrograde endoscopic cholangiopancreatography in unclear upper abdominal complaints]

Real-time scanning is of great importance as a screening method for the examination of parenchymal organs in the pigastrium and allows rapid evaluation and exact diagnosis of lesions in the biliary duct system and the pancreas. Sonographic findings are expanded by endoscopic cholangiopancreatography (ERCP). The two methods are complementary tools.

[Erroneous diagnosis in superficial course of the aorta. Demonstration using ultrasound]

In hyperlordosis of the lumbar spine, the abdominal aorta becomes well palpable and behaves like a pulsating tumor in the lower abdomen. This normal finding often cannot be differentiated from pathologic changes by clinical investigation alone. Sonography offers a simple method, without risk, for the definitive diagnosis of the abdominal aorta.

Variable phenotypic expression of an X-linked recessive lymphoproliferative syndrome

Investigation of a family with cancer in boys revealed that at least 20 males had the X-linked recessive lymphoproliferative syndrome. A variety of phenotypes occurred: aproliferative phenotypes consisted of aplastic anemia, agranulocytosis or acquired hypogammaglobulinemia; and proliferative phenotypes of B cells included disorders associated with the Epstein-Barr virus, American Burkitt's lymphoma, immunoblastic sarcoma of B cells, fatal infectious mononucleosis or plasmacytoma. The lymphoproliferative disorders observed in males could have resulted from an immunodeficiency to Epstein-Barr virus. The variable phenotypic expression could have resulted from individual differences in the viral dose, duration of exposure and age at which the boys were exposed to the virus. Aproliferative phenotypes such as acquired hypogammaglobulinemia could have ensued from excessive suppressor-cell activity on B cells, whereas proliferative phenotypes such as Burkitt's lymphoma or fatal infectious mononucleosis could have resulted from infection by Epstein-Barr virus and failure to stop proliferation of B cells.

[Possibilities and limits of xeroradiography. A statement (author's transl)]

Xeroradiography has proved to be of particular use for the examination of soft tissues. Due to great latitude and edge enhancement effect alterations of the splanchnocranium, the breast and the juxtaosseous soft tissues are especially well recognizable. Also for examination of larynx and trachea as well as certain soft tissues in the region of the neck this method is advantageous and proves its facilities to demonstrate diseases of the lungs and hilar region. On the contrary, alterations of the vertebral column, the basis of the skull and the abdomen cannot be examined by means of xeroradiography because of not justified radiation dosage. Xeroradiography offers no advantage for arthrography, angiography and examination of bones and skeletal parts of joints.

[The diagnosis of soft tissue alterations of the knee by means of xeroradiography (author's transl)]

Xeroradiography is a useful screening-method for the evaluation of soft tissue alterations in the region of the poplitea. It proves that recognition of Baker's cysts, aneurysms, and even tumours is possible due to morphological criteria which allow for differentiation to a degree. The conformation of a lesion by means of arthrography or angiography is not to be dispensed with, but xeroradiography permits the objective demonstration of a clinically uncertain alteration. This method has demonstrated its usefulness especially for the rheumatologist in the evaluation of Baker's cysts.

Growth of Hansenula polymorpha in a methanol-limited chemostat. Physiological responses due to the involvement of methanol oxidase as a key enzyme in methanol metabolism

Hansenula polymorpha has been grown in a methanol-limited continuous culture at a variety of dilution rates. Cell suspensions of the yeast grown at a dilution rate of 0.16 h-1 showed a maximal capacity to oxidize excess methanol (QmaxO2) which was 1.6 times higher than the rate required to sustain the growth rate (QO2). When the dilution rate was decreased to 0.03 h-1, QmaxO2 of cells increased to a value of more than 20 times that of QO2. The enzymatic basis for this tremendous overcapacity for the oxidation of excess methanol at low growth rates was found to be the methanol oxidase content of the cells. The level of this enzyme increased from 7% to approximately 20% of the soluble protein when the growth rate was decreased from 0.16 to 0.03 h-1. These results were explained on the basis of the poor affinity of methanol oxidase for its substrates. Methanol oxidase purified from Hansenula polymorpha showed an apparent Km for methanol of 1.3 mM in air saturated reaction mixtures and the apparent Km of the enzyme for oxygen was 0.4 mM at a methanol concentration of 100 mM. The involvement of an oxygen dependent methanol oxidase in the dissimilation of methanol in Hansenula polymprpha was also reflected in the growth yield of the organism. The maximal yield of the yeast was found to be low (0.38 g cells/g methanol). This was not due to a very high maintenance energy requirement which was estimated to be 17 mg methanol/g cells X h.

S-formylgluthathione: the substrate for formate dehydrogenase in methanol-utilizing yeasts

Formaldehyde dehydrogenase and formate dehydrogenase were purified 45- and 16-fold, respectively, from Hansenula polymorpha grown on methanol. Formaldehyde dehydrogenase was strictly dependent on NAD and glutathione for activity. The Km values of the enzyme were found to be 0.18 mM for glutathione, 0.21 mM for formaldehyde and 0.15 mM for NAD. The enzyme catalyzed the glutathione-dependent oxidation of formaldehyde to S-formylglutathione. The reaction was shown to be reversible: at pH 8.0 a Km of 1 mM for S-formylglutathione was estimated for the reduction of the thiol ester with NADH. The enzyme did not catalyze the reduction of formate with NADH. The NAD-dependent formate dehydrogenase of H. polymorpha showed a low affinity for formate (Km of 40 mM) but a relatively high affinity for S-formylglutathione (Km of 1.1 mM). The Km values of formate dehydrogenase in cell-free extracts of methanol-grown Candida biodinii and Pichia pinus for S-formylglutathione were also an order of magnitude lower than those for formate. It is concluded that S-formylglutathione rather than free formate is an intermediate in the oxidation of methanol by yeasts.

[Bronchial carcinoids (author's transl)]

Of 35 patients with bronchial carcinoids seen at the Kantonsspital Zürich during 16 years, 33 underwent an operative resection. The endoscopic resection is not recommended because of the risk of hemorrhage recurrence, and that this operation results in only partial removal of carcinoids which develop extrabronchially. It is concluded that bronchial carcinoids are potentially malignant tumours and that resection should be most radical if they show recurrence, invasive growth or metastases. Controls are necessary for a long period of time because even in presence of metastases the growth is very slow.

[Malignant peritoneal mesothelioma]

A case of diffused malignant mesothelioma of the peritoneum in a 64-year-old man is presented. This mesothelioma, of the papillary type, was complicated, after a year without significant clinical symptoms, by the development of ascites and obstructive upper bowel ileus. Physiological-anatomical and clinical aspects, as well as special radiologic findings and therapeutic regimens, are discussed in the light of the literature. It is recommended that all patients with malignant mesothelioma of the peritoneum be treated by total abdominal irradiation and intreperitoneal instillation of colloid P32.

[Directions for mammography from a radiological viewpoint]

A significant decrease in mortality due to breast cancer is feasible only by earlier diagnosis. The decisive screening method is mammography, which permits identification of a malignancy in its earliest stages. Indirect and direct signs of malignancy exist whose detection necessitates biopsy. Radiological examination of the tissue sample permits evaluation of the adequacy of excision and thus renders possible specific histological examination of the region of interest. Pneumocystography is a method for simultaneous diagnosis and therapy of benign cysts.

[The place of xerography combined with routine conventional mammography (author's transl)]

Xeroradiography is a valuable supplement to conventional mammography, especially in cases with dense glandular structure. In our patient material this new procedure was necessary for clarification of findings on conventional mammography in 16% of cases and improved diagnostic yield. Indirect and direct signs of carcinoma were more easely recognized with xeroradiography, since more detail is visualized because of greater latitude and edge contrast enhancement. Moreover the area visualized is considerably greater. The soft tissue structures can be seen to the level of the thoracic wall. Viewing the films is less tiring than reviewing conventional mammography films. A relatively greater exposure latitude and short exposure times are further advantages of this method.

Oxidation of methanol, formaldehyde and formate by catalase purified from methanol-grown Hansenula polymorpha

Catalase has been partially purified from cell-free extracts of methanol-grown Hansenula polymorpha and its peroxidative properties were studied. It was shown that the enzyme is capable of oxidizing methanol, formaldehyde and formate in the presence of hydrogen peroxide. The physiological significance of these reactions in the transduction of energy from the oxidation of methanol in yeasts is discussed.

Correction of transposition of the great vessels with previous Baffes procedure

Twenty-four patients with transposition of the great vessels who underwent a Baffes procedure in infancy were totally corrected by a modified Mustard procedure. There were three postoperative deaths and one major complication. All survivors have been followed from 2 to 8 yr and have done well except for one patient who required a tricuspid valve replacement because of tricuspid insufficiency. It is our conclusion that this group of patients can be corrected with a relatively low mortality and a favorable outcome.

[Normal antistreptolysin titres and demonstration of rheumatoid factors in rhesus monkeys (Macaca mulatta) (author's transl)]

Rhesus monkeys are often used as experimental animals. Many clinical and biochemical parameters are known but there are only few papers dealing with the normal values of antistreptolysin O (ASL). Informations about antistreptococcal antibodies are necessary in order to follow the course of immunization and infection experiments. When non-absorbed sera were used, the mean value of antistreptolysin O in clinically healthy rhesus monkeys (Macacus rhesus) amounted to 178 +/- 52 ASU. After absorption with dextran sulphate, the mean value was 90 +/- 20 ASU. Absorption with dextransulphate is a necessary prerequisite to exact determinations of antistreptolysin titres because it removes unspecific inhibitors of streptolysin O. In the sera of rhesus monkey more inhibitors were present than in human sera. On an average, in monkeys 55% of the material reacting with streptolysin O was an inhibitor, compared with about 40% in human sera. As a result of common infections with streptolysin O-producing streptococcal groups C and G antistreptolysin titres can frequently be seen to increase above the average normal value. Using non-absorbed and dextran sulphate absorbed sera, respectively 350 and 200 ASU must be regarded as the normal upper limits for serum antistreptolysin-titres.

[A comparison of xero-tomography of the lung hilum with conventional tomography (author's transl)]

Because of its particular photoelectric properties, xero-tomography is particularly suited for the investigation of abnormalities in the hilar regions. It is superior to conventional tomography because of the improved edge contrast, which emphasises details of relatively non-opaque structures, and because of its high exposure latitude. This justifies its use despite the higher radiation dose that is necessary. The demonstration of relatively dense and of more transradient tissues on the same picture by xero-tomography, and the ability to read it by ordinary light, makes it less tiring to interpret than the translucencies of conventional radiographs.

Xeroradiography examinations in orbitonasal surgery. Preliminary report

The use of xeroradiography for graphic visualization of both the bony and soft tissue structures of the head is presented. The advantages and indications are discussed.

[Pulmonary echinococcus cysticus]

A 23-year-old Spanish male presenting with hemoptysis, fever and radiologic signs of lung tumor was found to have hydatid disease of the lung with rupture into the bronchial system. Diagnosis was possible only by demonstration of scoleces in the sputum. The cyst was totally enucleated by surgery. The epidemiology, diagnosis and treatment of this quite rare disease are briefly reviewed with special reference to immunology, radiology and cytology.