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 R?LE OF THE THYROID IN THE REGULATION OF THE BLOOD CHOLESTEROL OF RABBITS

1. The blood cholesterol of rabbits on a normal diet without added cholesterol is increased only slightly (19 per cent) by thyroidectomy. 2. In rabbits with a hypercholesterolemia due to long continued cholesterol feeding, thyroidectomy causes a marked rise (137 per cent) in the blood cholesterol. This rise is usually maintained. 3. When long continued cholesterol feeding has failed to cause a rise in the blood cholesterol of rabbits, thyroidectomy abolishes this resistance and a hypercholesterolemia is promptly produced. 4. A single injection of thyroxin causes a significant drop in the blood cholesterol of rabbits with hypercholesterolemia. This reaction is not influenced by thyroidectomy. 5. Potassium iodide causes an increase in the blood cholesterol of rabbits with hypercholesterolemia. This reaction is not influenced by thyroidectomy in contrast to the effect of KI in preventing a rise in blood cholesterol when given concurrently from the beginning of cholesterol feeding, an effect which is abolished by thyroidectomy. It is suggested that two different mechanisms are involved. 6. A single injection of insulin produces a fall in the blood cholesterol of rabbits with hypercholesterolemia. If anything, thyroidectomy increases the magnitude of this effect.     

THE BIOLOGICAL IDENTITY OF THE FRIEDL?NDER BACILLUS

We conclude therefore that this series of eleven lactose-negative organisms of the Friedländer type, grouped together by Perkins on the basis of fermentation reactions represents a single biological group. It can be distinguished from Bacillus aerogenes and other similar bacilli by cultural, fermentative, and serological reactions. There appears to be a close analogy between this group and Pneumococcus mucosus in the possession of a fixed cultural type, and the behavior toward immune serum. Both represent apparently a single biological group. Unfortunately no immune sera have been developed against the two strains that grew in moist and dry phases; it is possible that with immune sera for these light could be thrown on the relation suggested by Fitzgerald that the capsulated bacilli represent a parasitic development of the Bacillus coli group.     

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 LYMPHOCYTE IN ANTIBODY FORMATION

Following the injection of typhoid antigen or sheep erythrocytes into the pad of the rabbit''s hind foot, lymph from the efferent lymphatic of the popliteal lymph node was collected and analyzed for antibody content. On separating the lymphocytes from the lymph plasma, it was found that the antibody titer of the cell extract was substantially and consistently higher than that of the surrounding fluid. This difference was greatest at the time of greatest rate of increase of antibody titer in the whole lymph, rather than when the antibody titer of the lymph plasma was highest. These results can only be interpreted to mean that the lymphocytes either produce antibodies or take them up from the lymph plasma. Incubation in vitro of lymphocytes containing one species of antibody with lymph plasma containing another showed that antibodies pass from the cells to the supernatant lymph fluid to reach approximate equilibrium; acquisition of antibody from supernatant lymph fluid was not observed. Similar results were obtained when normal lymphocytes were allowed to incubate in vivo in their own lymph fluid to which antibodies had been added. It was again found that antibodies were not absorbed or adsorbed by lymphocytes. These results seem to indicate that lymphocytes are instrumental in the formation of antibodies.     

THE OCCURRENCE OF BACILLUS INFLUENZ? IN THE NORMAL THROAT

1. The frequency of occurrence of Baculus influenzœ in the throats of normal individuals has been as great in the period subsequent to the epidemic of influenza as it was during the period of the epidemic. 2. Bacillus influenzœ may persist in the throats of healthy carriers for a considerable period of time. 3. A considerable proportion of individuals not exposed during the epidemic has been found to carry Bacillus influenzœ in their throats. 4. Oleate hemoglobin agar has been found to be a very satisfactory selective medium for cultivation of Bacillus influenzœ from the throat. To give optimum results it should have a reaction of from pH 7.2 to 7.5.     

THE EFFECT OF EXERCISE AND TIME ON THE HEIGHT AND WIDTH OF THE MEDIAL LONGITUDINAL ARCH FOLLOWING THE MODIFIED REVERSE‐6 AND THE MODIFIED AUGMENTED LOW‐DYE TAPING PROCEDURES

Purpose/Background:

No evidence exits regarding the magnitude of the change in foot posture following the “modified reverse‐6” (MR6) taping procedure, either alone or in combination with the “low‐dye” (LD) taping technique. The purpose of this study was to investigate the change in the height and width of the midfoot after application of the MR6 and the MR6 plus the LD (MR6+LD) taping technique and determine how long those changes last.

Methods:

Eleven individuals (2 female and 9 male) were recruited for this study and were tested under each of two experimental conditions, the MR6 and the MR6+LD taping technique. The order of testing for the two conditions was randomly determined. For each condition, the height and width of the midfoot at 50% of each subject''s foot length was initially measured and then again immediately following the application of the tape. These measurements were repeated four hours later immediately prior to running two miles on a treadmill, again immediately after running, and finally after another four hours.

Results:

The dorsal arch height increased significantly with both the MR6 and MR6+LD taping, but only the MR6+LD remained statistically greater after four hours, a bout of exercise and again at the end of the day. The mean width of the midfoot significantly decreased with both taping procedures. The change in the width of the midfoot remained significantly decreased in both taping conditions after exercise and throughout the day.

Conclusions:

Both taping procedures are able to significantly change the height and width of the medial longitudinal arch of the foot, but the change lasted longer when the two taping procedures were combined.

Levels of Evidence:

Level 3, Prospective Cohort Study     

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.     

THE R?LE OF THE RETICULO-ENDOTHELIAL SYSTEM IN IMMUNITY : II. THE COMPLEMENT TITER AFTER BLOCKADE AND THE PHYSIOLOGICAL REGENERATION OF THE RETICULO-ENDOTHELIAL SYSTEM AS MEASURED BY REDUCTION TESTS.

1. Intravenous injections of India ink into guinea pigs caused a decided drop in the complement titer which set in as early as 15 minutes after the injection, but did not reach its maximum for 3 hours. This drop was followed by a return to normal within the first 24 hours following the injection. 2. India ink mixed in vitro with guinea pig serum adsorbs the complement almost immediately to its full extent. 3. By means of reduction tests (methylene blue and nitroanthraquinone) it was shown that the respiration of the cells of the liver and spleen of guinea pigs was markedly impaired for the first 8 hours, following an intravenous injection of ink. Evidences of a return to normal functional vitality, however, became apparent by the end of the 1st day after the injection.     

THE R?LE OF THE RETICULO-ENDOTHELIAL SYSTEM IN IMMUNITY : VI. THE EFFECT OF ENDOTHELIAL BLOCKADE ON THE STORAGE AND DISTRIBUTION OF NEOARSPHENAMINE

1. Blockade of the reticulo-endothelial system by means of a single injection of India ink caused a marked retention of neoarsphenamine in the blood of guinea pigs during the first twenty minutes of observation after intravenous injection, as contrasted with the rapid disappearance of the drug from the blood of normal controls. 2. Rabbits blocked by a single dose of India ink showed a slower elimination of the drug from the circulation following the first few hours after intravenous injection than corresponding controls. 3. The arsenic content of the liver of mice, which received neoarsphenamine intravenously after a preceding blocking injection with India ink, was appreciably lower than the arsenic content of the normal organ under similar experimental conditions.     

THE R?LE OF THE RETICULO-ENDOTHELIAL SYSTEM IN IMMUNITY : III. THE PRODUCTION OF ACTIVE AND PASSIVE ANAPHYLAXIS IN THE BLOCKED ANIMAL.

1. Guinea pigs injected intravenously with massive doses of India ink before active sensitization exhibited occasionally a more or less marked, decreased sensitiveness to the reinjection of the antigen. 2. The serum of rabbits which had received massive doses of India ink before the sensitizing injections, showed approximately the same titer of anaphylactic antibodies as that of sensitized normal control animals, as demonstrated by the degree of passive sensitization induced in guinea pigs. 3. The precipitin titer of sensitized rabbits blocked with massive doses of India ink was somewhat lower than that of sensitized normal controls. In one instance, the intravenous injection of smaller doses of India ink was followed by a higher precipitin titer. No uniform relation was found between the height of the precipitin titer and the anaphylactic power of the antiserums. 4. One blocking injection of India ink given to guinea pigs before passive sensitization did not interfere with the occurrence of anaphylactic shock nor alter its nature.     

STUDIES UPON EXPERIMENTAL PNEUMONIA IN RABBITS : V. THE R?LE OF THE LEUCOCYTE IN EXPERIMENTAL PNEUMONIA. THE RELATION OF THE NUMBER OF ORGANISMS INJECTED TO THE MORTALITY.

1. The importance of the leucocyte in the resistance of animals to experimental pneumonia is emphasized by the fact that animals treated with benzol, a leucotoxic substance, rapidly succumb to the disease, while animals treated in like manner with toluol, a very similar chemical substance causing no leucopenia, show no decreased resistance. 2. The rôle of the leucocyte in the resistance of animals to experimental pneumonia is further emphasized by the fact that animals that respond to the pneumococcus infection with a leucocytosis, as occurs after the repeated injection of toluol, are more resistant to the pneumonia. Further, the hyperleucocytosis produced by repeated injection of nutrose before the production of pneumonia likewise seems to increase the resistance of the animals. 3. Experimental pneumonia is not necessarily fatal in rabbits. The factors determining the outcome of the disease are numerous; among these is the number of bacteria inoculated. Animals receiving small doses usually survive, while those receiving comparatively large numbers usually succumb.     

THE DIAGNOSTIC VALUE OF THE PLACENTAL BLOOD FILM IN ?STIVO-AUTUMNAL MALARIA

1. The placental blood film examination is worthy of routine application wherever æstivo-autumnal malaria is endemic. This type of malaria when associated with labor and the early days of the puerperium can be more easily and certainly diagnosed by the use of this film and a polychrome stain than by employing the usual films made from the mother''s peripheral blood at the time of labor. The placental film in such an infection offers an abundance of adult parasites and far more evidence of the presence of pigment, while the peripheral blood film frequently offers but a scant number of the small ring or discoid forms of a parasite. The examination of the present series revealed positive placental films in nineteen cases, while but eight of these same cases were positive in the peripheral blood film examination. On the other hand, no peripheral blood films were found positive in which the associated placental films did not reveal a far more abundant evidence of the infection. 2. The early days of the puerperium can by this method be protected many times from a malarial outburst, and, as a rule, puerperal sepsis can be differentiated. 3. The intricate vascular architecture of the mature placenta rivals that of the spleen, liver, and bone marrow as a harbor for adult malarial parasites of this type and as a storage for pigment. 4. The localization of parasites in the placenta is unique. Here is the one vascular system which particularly favors the development of the parasites but which at the same time is so situated that it may be spontaneously discarded by the body at the climax of the attack. By this simple act late in pregnancy the prognosis for both mother and child may be improved. 5. The pregnant state encourages attacks of malaria by lowering bodily resistance and by furnishing an additional harbor for the development of parasites. A tenable theory in regard to most attacks of this nature, occurring in cases under professional care, would appear to be the development of latent malaria (malarial carriers) into acute attacks toward the close of the pregnant state. The women who expose themselves (as the negroes in this series) offer favorable conditions to the introduction of a primary infection. Malaria frequently interrupts the late stages of pregnancy and sometimes causes the death of the mother and the fetus, more often the latter. The records at Ancon indicate that it more frequently exerts a harmful influence than other types of infectious diseases in this locality. 6. Most of the children in this series that were delivered while malaria was present in the mother, were of a race that seems to possess a relative immunity to the ravages of malaria. This may account for the fact that the negro fetus more nearly approximates the full term of development when associated with this disease and is comparatively subjected to a less number of the accidents of pregnancy. Many of them revealed evidence of prematurity and were jaundiced, but, as a rule, they developed rapidly. The commonest mishap is miscarriage late in pregnancy. Occasional still-births occur and sometimes there is a fatal issue to both the mother and child. 7. Cases diagnosed as congenital malaria probably indicate that some accident occurred to the placenta, because it practically never happens that fetal blood is positive at the time of birth, regardless of the degree of infection in the mother. Many of the cases now reported in the literature as congenital malaria suggest immediate postnatal infection as their history, as our pathological and clinical records testify. 8. The size of the intervillous spaces of the placenta and their adaptability in the localization of parasites seem to disprove to a certain extent the old idea that the localization depends on the smallness of the capillary caliber. If this were the case the brain should be more often the seat of an extensive localization than the spleen, bone marrow, and placenta, yet our anatomical records will not support that theory. A sluggish blood sinus with a large endothelial surface, a higher internal body temperature, and red blood cells burdened with parasites of a certain age beyond the ring form seem to be important factors in the localization and development of the æstivo-autumnal parasite. 9. The racial disparity of malarial infections shown in this series is believed to be due to local conditions and a wrong impression is apt to be given by our statistics in regard to the relative immunity of the negro race. The white women on the Canal Zone avail themselves of all the opportunities the sanitary system affords; they live well and place the entire course of their pregnant state under competent professional care, while the negro woman is indifferent to her pregnant state, works as a domestic servant, and lives in the cheapest unprotected quarters that can be rented in the suburban divisions of Panama City where the malarial rate is highest and the sanitary control is difficult. It should be noted that these negro women can carry an infection with little manifestation of its presence that would produce serious results in the white women brought from the temperate zone regions of Europe and the United States.