THE R?LE OF THE RETICULO-ENDOTHELIAL SYSTEM IN IMMUNITY : I. THE R?LE OF THE RETICULO-ENDOTHELIAL SYSTEM IN THE PRODUCTION OF DIPHTHERIA ANTITOXIN.

1. Following massive doses of India ink injected intravenously into guinea pigs before a subcutaneous injection of diphtheria toxin-antitoxin mixture, no antitoxin was found in the blood serum for 3 weeks, as indicated by intracutaneous tests, whereas an appreciable amount could be detected in non-blocked, immunized control animals. 2. During the 4th week following immunization, the titer of the serum of blocked animals equaled that of non-blocked controls within the limits of the intracutaneous test dose. 3. The smaller doses of India ink used in these experiments, given before immunization, had no stimulating effect on the production of diphtheria antitoxin but, on the contrary, also inhibited the appearance of this antibody, although to a less extent.     

THE R?LE OF THE RETICULO-ENDOTHELIAL SYSTEM IN IMMUNITY : VII. THE EFFECT OF LOCAL AND SYSTEMIC BLOCKADE ON THE TOXIC ACTION OF HETEROPHILE (FORSSMAN) SERA IN GUINEA PIGS

1. Guinea pigs blocked by intravenous injection of either India ink or trypan blue succumbed with fatal shock after the intravenous injection of heterophile immune serum, although the time of death was somewhat delayed as compared with normal controls. 2. Local blockade of the skin of guinea pigs with trypan blue inhibited completely the development of the characteristic skin reaction following intracutaneous injection of Forssman serum within the blocked area. 3. Infiltration of the skin of guinea pigs with India ink afforded no protection against the full development of the toxic skin reaction.     

THE R?LE OF THE THEBESIAN VESSELS IN THE CIRCULATION OF THE HEART

In summary, evidence has been presented to show a direct connection other than through the capillaries between the coronary arteries and the chambers of the heart. This connection was shown by perfusion, injections and serial sections to be through the Thebesian veins. Communications between the larger coronary veins and the Thebesian veins were also demonstrated by the same methods. Serial sections through Thebesian veins have shown capillaries draining directly into them. Under certain conditions it has been shown that as much as 90 per cent of the arterial flow may escape via the Thebesian vessels. Lastly, in the event of gradual closure of the orifices of the coronary arteries, the Thebesian vessels can supply the heart muscle with sufficient blood to enable it to maintain an efficient circulation.     

THE FACTORIAL STRUCTURE OF THE ARABIC VERSION OF THE REVISED COLLETT–LESTER FEAR OF DEATH SCALE

A sample of 209 volunteer Kuwaiti undergraduates responded to an Arabic version of the Revised Collett–Lester Fear of Death Scale with 4 subscales: Death of Self, Dying of Self, Death of Others, and Dying of Others. Reliabilities of the 4 subscales and of the grand total score ranged from 0.75 to 0.92, which is considered adequate. A 4-factor solution was congruent with the allocation of items to 2 subscales (i.e. Dying of Self and Death of Others), whereas the theorized factor structure of the other 2 subscales were only partially supported by empirical analyses. The intercorrelations between the 4 total subscale scores yielded a general factor of death and dying, denoting good factorial validity of the scale.     

STUDIES ON THE BACTERIOPHAGE OF D'HERELLE : I. IS THE LYTIC PRINCIPLE VOLATILE?

The lytic principle concerned in the phenomenon of transmissible lysis is not volatile. The results which have been taken to indicate volatility are, in our opinion, to be attributed to the transfer to the distillate of minute droplets of the original active filtrate.     

INFECTIOUS CATARRH OF THE ALBINO RAT : I. EXPERIMENTAL TRANSMISSION IN RELATION TO THE R?LE OF ACTINOBACILLUS MURIS

A disease syndrome referred to as infectious catarrh, encountered under natural conditions of exposure in a rat colony, was transmitted to selected animals and maintained for 5 years by nasal instillation or contact. During this period 37 passages were made in 156 rats, the rates of pneumonia, otitis media, and rhinitis being 28, 63, and 87 per cent, respectively. After the 12th passage, Brucella bronchiseptica and Actinobacillus muris (B. actinoides var. muris), which were originally present, were no longer cultivable from infected rats. By reason of the maintenance of infectious catarrh in the absence of the latter and also because of its non-invasiveness on nasal instillation, it is now believed that Actinobacillus muris is of no direct etiological significance.     

DOES THE INGESTION OF ALCOHOL INFLUENCE THE DEVELOPMENT OF ARTERIOSCLEROSIS IN FOWLS?

The effect of alcohol ingestion upon the development of naturally occurring and stilbestrol-induced arteriosclerosis was studied in the domestic fowl. In two experiments, a 15 per cent ethyl alcohol solution was used for drinking purposes, and in a third experiment wine containing 12 per cent of it was administered. The caloric intake of both food and alcohol was carefully controlled by pair-feeding, a glucose solution being used for drinking purposes to equalize the caloric intakes of the control birds with those of the alcohol-treated birds. A total of 224 cockrels was studied, and the period of observation for each experiment lasted 12 months. The degree of arteriosclerosis in the thoracic and abdominal aortas was determined in the gross and microscopically, and the degree of lipide infiltration was determined microscopically. The gross grading of arteriosclerotic lesions agreed closely with the microscopic analysis of intimal thickening and lipide infiltration of the arterial wall. The gross gradings were subjected to a critical statistical analysis which allowed precise statements to be made on the probability that a real effect would be overlooked. This analysis yielded no evidence that alcohol or the wine used had affected the degree of gross arteriosclerosis or lipide infiltration.     

THE FACTORIAL STRUCTURE OF THE REVISED COLLETT–LESTER FEAR OF DEATH SCALE

In a study of 144 college students, the factorial structure of the Collett–Lester Fear of Death Scale matched the face content of the subscales quite closely, ameliorating the criticism of the scale by R. A. Neimeyer et al. (2003) Neimeyer, R. A., Moser, R. P. and Wittkowski, J. 2003. Assessing attitudes toward dying and death. Omega, 47: 45–76. [Web of Science ®] , [Google Scholar].     

THE THERMAL INACTIVATION TIME AT 41.5°C. OF THREE STRAINS OF HERPES SIMPLEX VIRUS

1. The thermal inactivation time at 41.5°C. of the H. F. and Frank strains of herpes simplex virus, under the conditions described, was 80 hours. 2. A strain of herpes virus recently recovered from a patient treated with a physically induced fever had a thermal inactivation time of 50 hours at 41.5°C. 3. The neurotropic factor of the H. F. and Frank strains of virus was more resistant to a temperature of 41.5°C. than the dermotropic factor. There was little difference in the thermostability of these two factors of the Go strain.     

STUDIES OF CALCIUM AND PHOSPHORUS METABOLISM : V. A STUDY OF THE BONE TRABECUL? AS A READILY AVAILABLE RESERVE SUPPLY OF CALCIUM.

1. Bone trabeculae are easily depleted by the prolonged administration of parathormone, long continued negative calcium balance and growth. 2. A long continued high calcium diet results in a rapid accumulation of the trabeculae. 3. Alizarin red, as has previously been shown in the literature, is deposited in newly formed bone. Its use has made clear that easily mobilizable calcium is not deposited in the shafts of adult animals, but in the trabeculae of bone. 4. The bone trabeculae therefore serve as the storehouse of readily available calcium. 5. The shafts have a slow progressive exchange of inorganic salts and are not influenced except in the case of unusual body demands. 6. It is suggested that the absence of trabeculae in premature infants and their depletion at the end of 4 months in a normal baby might well be an etiological factor in rickets. 7. In our observations, parathormone administration to growing or adult cats has been without effect. 8. Daily injections of parathormone in growing rats results in an increased number of trabeculae and smaller bones.     

THE PRACTICE OF GOOD LEADERSHIP WITHIN THE MEDICAL PROFESSION

My university studies and postgraduate training equipped me to be a competent doctor and medical specialist,but in 1976 when I was 30 years old,I was invited to come to Melbourne to establish a Neonatal Intensive Care Unit in an university teaching hospital and to be its Director.I had never taken any leadership or management course to equip me to be a leader.Now over 30 years later,on the eve of my retirement from medicine,I look back to reflect on what kind of leader I was over the course of my medical career.What wisdom did I gain over the past 30 years on becoming a good leader,based on learning from the mistakes I had made in exercising the leadership roles I was given within the hospital and university,as well as in the national and international professional arenas? This essay begins with a general principle of good leadership followed by an examination of aspects of pride,power and submission,which if misused or abused,constitute a trilogy of harmful influences on the character of leaders and their wise exercise of good leadership.     

A STUDY OF THE PROTEOLYTIC FERMENTS OF THE LARGE LYMPHOCYTES IN A CASE OF ACUTE LEUK?MIA

The leucocytes of the blood of normal individuals and of patients showing a marked polymorphonuclear leucocytosis contain enzymes capable of digesting coagulated blood serum in neutral, alkaline or acid solutions. The cells in pus that is composed principally of polymorphonuclear leucocytes and the leucocytes of the circulating blood in myelogeneous leukæmia contain similar proteolytic enzymes, which act best when the reaction is alkaline. The leucocytes of the circulating blood and of the enlarged lymph nodes from a case of large cell, acute, lymphatic leukæmia contain proteolytic enzymes that act qualitatively in much the same way as the leucocytes of pus and as the white corpuscles of the blood in myelogenous leukæmia. These large lymphocytes in acute lymphatic leukæmia can be differentiated biologically from the small lymphocytes in chronic lymphatic leukæmia which possess no proteolytic enzymes, and from the large endothelioid cells of the hyperplastic lymph glands which are proteolytic only in the presence of acid. These results seem to show that the large cells of the so-called acute lymphatic leukæmia are not true lymphocytes, but are nearly related to the granular myelocytes and should probably be considered as the forerunners to these cells.     

STUDIES ON THE MECHANISM OF THE FORMATION OF THE PENICILLIN ANTIGEN : III. THE N-(D-α-BENZYLPENICILLOYL) GROUP AS AN ANTIGENIC DETERMINANT RESPONSIBLE FOR HYPERSENSITIVITY TO PENICILLIN G

An excess of D-benzylpenicillenic acid (BPE) was reacted with human γ-globulin, human serum albumin, gelatin, and poly-L-lysine in aqueous solution buffered at pH 7.5–8.0. Under these conditions, BPE reacted predominantly with lysine ε-amino groups of the proteins to form the mixture of diastereomers of ε-N-(D-α-benzylpenicilloyl)-lysine groups (Di-BPO-Lys). BPE reacted also, but to a considerably smaller extent, with cystine disulfide linkages of human γ-globulin and human serum albumin to form D-benzylpenicillenic acid-cysteine mixed disulfide groups (BPE-SS-Cys). Conjugates containing large numbers of BPE or D-penicillamine mixed disulfide groups were prepared by reaction of BPE or D-penicillamine with thiolated human γ-globulin under mild oxidizing conditions. Anti-penicillin antibodies were produced in rabbits by immunization with either potassium penicillin G (PG) or a preincubated mixture of PG with normal rabbit serum (PG-NRS) in complete Freund''s adjuvant. Specific precipitation analyses in aqueous and gel media (Ouchterlony), PCA analyses, and specific inhibition of these reactions with haptens were carried out on the rabbit anti-PG and anti-(PG-NRS) sera, using the above conjugates as antigens. The anti-penicillin antibodies were found to be directed against the diastereomeric mixture of N-(D-α-benzylpenicilloyl) groups, predominantly the Di-BPO-Lys groups. By these techniques, no antibodies directed against the BPE-mixed disulfide or the D-penicillamine mixed disulfide groups were detected. Three out of six patients with histories of allergic reactions to PG responded with wheal-and-erythema reactions to the N-(D-α-benzylpenicilloyl) (BPO) groups contained in BPE-human gamma globulin conjugate. Another such patient exhibited serum antibodies specific for the BPO group. One patient being treated with 25 gm per day of PG showed the presence of non-dialyzable antigenic BPO-conjugates in his serum. These results demonstrate that the diastereomeric BPO groups (predominantly Di-BPO-Lys groups) are major antigenic determinant groups responsible for PG hypersensitivity in rabbits and human beings. The possible clinical usefulness of multivalent Di-BPO conjugates and univalent Di-BPO haptens is discussed.     

THE INFLUENCE OF CHOLINE,CYSTINE, AND OF α-TOCOPHEROL UPON THE OCCURRENCE OF CEROID PIGMENT IN DIETARY CIRRHOSIS OF RATS

1. Five per cent l-cystine in a stock or low protein diet produces ceroid deposits in rat liver. This effect of l-cystine is much greater in low protein than in stock diets. 2. One per cent choline has an inhibiting effect on deposition of liver ceroid resulting from a low protein diet containing excess cystine. 3. The occurrence of ceroid pigment in the livers of rats on a low protein diet, with or without the addition of excess l-cystine, is transiently inhibited by the administration of α-tocopherol. Five per cent cod liver oil in the diet did not prevent this effect of α-tocopherol. 4. On low protein, vitamin E-deficient diets, there occurs after 4 months, a rapid and progressive weight loss. This does not happen when α-tocopherol is added to the diet.     

SOME OBSERVATIONS ON THE LYMPH AND BLOOD VESSELS OF THE RABBIT TRACHEA : WITH PARTICULAR REFERENCE TO THEIR R?LE IN THE PATHOGENESIS OF EXPERIMENTAL LOBAR PNEUMONIA.

1. Winternitz, Smith, and Robinson have offered as experimental evidence in support of the lymphatic path of infection in lobar pneumonia, a series of injection experiments of the rabbit''s tracheal submucosa. What these investigators supposed to be lymphatics are shown by us to be an unusual type of venous supply consisting of short, wide, and richly anastomosing vascular channels. 2. There is little homology between the structure and distribution of the lymph and blood vessels in the human and rabbit trachea. 3. Injections of pneumococci by the tracheal route to produce lobar pneumonia in the rabbit include an intravenous administration of these organisms when the mucosa is pierced or injured.     

STUDIES ON INFLUENZAL MENINGITIS : II. B. INFLUENZAE—THE PROBLEM OF VIRULENCE AND RESISTANCE

1. By a suitable bactericidal technique, it can be demonstrated that the virulent S influenza bacillus is completely resistant to the bactericidal action of diluted normal unheated serum. In contrast, the R organism is easily killed when subjected to the action of diluted normal serum. Although this is not a true virulence test, it promises to be a useful substitute when a susceptible animal is not available. 2. The S culture filtrate contains a substance with a strong antibactericidal effect, but the R culture filtrate does not contain this substance. 3. It would appear probable that this antibactericidal substance is identical with, or closely related to the precipitinogen (or soluble substance) which is present only in the culture fluid of the S influenza bacillus. In view, however, of differences in heat stability of the two substances, this question must remain in doubt until a supply of purified precipitinogen is available. 4. Quantitative agglutination, precipitation and bactericidal comparisons between (a) R-absorbed anti-S serum and unabsorbed anti-S serum and (b) anti-S serum and anti-R serum indicate that the agglutinogen is a separate antigen, and the agglutinin a separate antibody, taking no part in the bactericidal action of the antiserum. They also indicate that the precipitin, which is present only in the anti-S serum, is identical with the bactericidal antibody. 5. The relation of the precipitinogen (or soluble substance) to virulence and of the precipitin to resistance is discussed.     

ETIOLOGY OF YELLOW FEVER : XIII. BEHAVIOR OF THE HEART IN THE EXPERIMENTAL INFECTION OF GUINEA PIGS AND MONKEYS WITH LEPTOSPIRA ICTEROIDES AND LEPTOSPIRA ICTEROH?MORRHAGI?.

1. Slowing of the heart occurred in monkeys and guinea pigs during the febrile period of the experimental infection due to Leptospira icteroides. A similar reaction took place in animals inoculated with Leptospira icterohœmorrhagiœ. 2. The mechanism of slowing was usually due to slowing of the whole heart. 3. Once incomplete heart block was seen. Changes in the ventricular complex occurred four times.     

THE EFFECTS OF ANTICIPATION ON THE MECHANICS OF THE KNEE DURING SINGLE‐LEG CUTTING TASKS: A SYSTEMATIC REVIEW

Background

ACL injuries are common in sports, which has resulted in the development of risk screening and injury prevention programs to target modifiable neuromuscular risk factors. Previous studies which have analyzed single‐leg cutting tasks have reported that the anticipation status of the task (pre‐planned vs. unanticipated) has a significant effect on the mechanics of the knee.

Hypothesis/Purpose

The purpose of this systematic review is to assess the effect of anticipation on the mechanics of the knee in the sagittal, frontal, and transverse planes during tasks which athletes frequently perform during competition.

Study Design

Systematic Review

Methods

The following databases were searched using relevant key words and search limits: Pub Med, SPORTDiscus, CINAHL, and Web of Science. A modified version of the Downs and Black checklist was used to assess the methodological quality of the articles by two independent reviewers.

Results

284 articles were identified during the initial database search. After a screening process, 34 articles underwent further review. Of these articles, 13 met the criteria for inclusion in this systematic review.

Conclusions

It appears that tasks which do not allow a subject to pre‐plan their movement strategy promote knee mechanics which may increase an athlete''s risk of injury.

Clinical Relevance

Clinicians involved in the development and implementation of ACL injury risk screening and prevention programs may want to consider incorporating tasks which do not allow time for pre‐planning. These unanticipated tasks may more closely mimic the demands of the sports environment and may promote mechanics which increase the risk of injury.

Level of Evidence

Level 1b     

THE R?LE OF THE MUCOID POLYSACCHARIDE (HYALURONIC ACID) IN THE VIRULENCE OF GROUP A HEMOLYTIC STREPTOCOCCI

1. A quantitative turbidimetric method for the estimation of hyaluronidase activity, based on the ability of the enzyme to decrease the capacity of the polysaccharide to precipitate acidified protein has been developed. Two units of hyaluronidase, by this method, are equivalent to one viscosity-reducing unit. 2. Hyaluronidase added to a phagocytic system containing defibrinated human blood, immune or non-immune, greatly increases the rate of phagocytosis of group A streptococci. Phagocytosis of Type I pneumococci is not affected by hyaluronidase under the same conditions. 3. The bactericidal activity of non-immune blood against group A streptococci is increased by hyaluronidase; the activity of immune blood is, however, somewhat inhibited by the enzyme. Killing of pneumococci is not affected by the presence of the enzyme. 4. Mice can be protected against group A streptococcal infection by frequent treatment with 200 turbidity-reducing units of hyaluronidase; the protective action of the enzyme is removed by heating at 60°C. for 1 hour. Mice infected with Type I pneumococcus and treated with hyaluronidase die somewhat sooner than the untreated controls.     

STUDIES ON THE BIOLOGY OF STREPTOCOCCUS : II. ANTIGENIC RELATIONSHIPS BETWEEN STRAINS OF STREPTOCOCCUS H?MOLYTICUS ISOLATED FROM SCARLET FEVER.

1. Hemolytic streptococcus has been found in 100 per cent of the throats of patients with scarlet fever during the 1st week of the disease. 2. The average length of time that these organisms are present in the throat varies from 10 to 20 days. 3. No morphological or cultural characteristics peculiar to the hemolytic streptococcus from scarlet fever can be demonstrated. 4. Ten immune sera have been prepared from different strains of scarlet fever streptococci and each of the sera agglutinated more than 80 per cent of the strains isolated from scarlatinal throats. On the other hand, scarlatinal streptococci are not agglutinated by immune sera prepared from hemolytic streptococci isolated from other pathological sources. 5. Serum from patients convalescent from scarlet fever agglutinates weakly or not at all the homologous strain of hemolytic streptococcus. 6. The specificity of the agglutination reaction of scarlatinal streptococci is confirmed by absorption experiments. 7. Scarlatinal antistreptococcic serum affords some degree of protection against virulent scarlet fever streptococci but has no protective power against hemolytic streptococci from other diseases. 8. In a small epidemic of scarlet fever a healthy carrier of hemolytic streptococcus was detected; the organism carried was identical in its serological reactions with strains of hemolytic streptococci isolated from active cases of scarlet fever. 9. In a study of a number of contacts with a case of scarlet fever, in only one instance was a scarlatinal type of hemolytic streptococcus recovered from the throat.