Effects of adrenergic and cholinergic agents on ureteral functions in dogs.

The effects of the autonomic nervous system on ureteral functions were investigated by application of stimulating and blocking drugs. These effects were differentiated from those due to a change of urine flow by perfusing the renal pelvis with isotonic saline. Peristaltic frequency was readily increased by higher flow volume, but was rarely affected by blockage of alpha-adrenergic and cholinergic receptors. The ureteral pacemaker could be activated by alpha-stimulation and inhibited by beta-stimulation. During perfusion of renal pelvis at a pressure of 12 mm Hg, transport capacity of the ureter could be significantly increased either by alpha-blockade or beta-stimulation. Stimulation of alpha-receptors decreased transport capacity, whereas stimulation of cholinergic receptors remained ineffective. These experiments suggest that responses of sympathetic stimulators and blockers are brought about by their influence on ureter muscle tone. The therapeutic value of these drugs is discussed.


Influence of pressoreceptor stimulation on electrical activity of the ureter in anesthetized rabbits.

In a previous study, pressoreceptor stimulation was found to augment parasympathetic activity in the bladder. This investigation is a continuum to determine any influence of similar effects on the ureter. With equal urine flow, stimulation of pressoreceptors caused an increase in ureteral peristaltic activity. The exact mechanism of action was not determined.


Scanning electron microscope and microprobe investigation of phosphate phases in uroliths.

In uroliths various phosphate phases can be detected which indicate different formation conditions. Structure and topography of the respective phosphate phases are characterized by scanning electron microscopy and microprobe techniques. Trace element enrichment is investigated and illustrated; for example, sulfur is found preferentially in carbonate apatite. From the distribution of the phosphate phases, conclusions can be drawn concerning the urolith genesis.


Renal fascia: its radiographic importance.

The renal fascia, commonly known as Gerota's fascia, is a collagenous connective tissue sheath which separates the perirenal fat from the pararenal fat. It may be visualized radiographically and is helpful in the precise localization of abdominal masses. It is also useful in the diagnosis of perinephric hematomas and abscesses and in distinguishing them from intrarenal or subcapsular hematomas and abscesses. The anatomy of the renal fascia is briefly discussed, and representative cases are presented.


Rapid and slow-fill gas cystometry. Influence on bladder capacity and diagnosis of hyperreflexic bladder.

Rapid-fill gas cystometry has been criticized for giving a falsely low value of bladder volume and for inducing an "artefact", the hyperreflexic bladder. This study in 72 patients revealed that the average capacity with slow-fill air cystometry was less than with rapid fill. The diagnosis of hyperreflexic bladder was made more often with slow fill than with rapid fill in these 72 patients.


Changing patterns in age distribution of renal carcinoma patients.

A review of 890 cases of renal carcinoma in patients admitted to M. D. Anderson Hospital and Tumor Institute from 1975 to 1976 has revealed a significant increase in the proportion of patients in the age group forty to forty-nine years.


Intrathoracic kidney.

Five cases of intrathoracic kidney are presented, and the literature is reviewed. The diagnosis was made incidentally in 3 patients who had chest radiographs because of upper respiratory tract infections and in 1 infant on a follow-up radiograph after recovery from hyaline membrane disease. The fifth patient had an abdominal mass. All 5 patients had a left intrathoracic kidney, and 2 had a left Bochdalek hernia. An intrathoracic kidney should be considered in the differential diagnosis of a posterior mediastinal mass.


Percutaneous dilatation of ureteroileal strictures and insertion of Gibbons ureteral stents.

A ureteroileal stricture can be dilated through a percutaneous nephrostomy after antegrade catheterization of the ureter. The region of the stricture is kept open with a Gibbons ureteral stent.


Enuresis: evaluation of perplexing symptom.

The child with enuresis is a common problem facing the urologist. We have done a retrospective study of 182 enuretic children seen at our Clinic from January, 1970, to December, 1975. There was a 10.4-per cent incidence of vesicoureteral reflux. In only 58 per cent of the children with reflux were positive urine cultures demonstrated. There were no significant complications in studying these children under general anesthesia. Therefore, we believe an aggressive approach is justified.


Psychogenic urinary retention.

Six cases (5 females and 1 male) of unexplained urinary retention are reported. The diagnosis of psychogenic urinary retention was considered after negative medical, urologic, urodynamic, and neurologic evaluations. This diagnosis was then confirmed by psychiatric consultation. Urinary retention was managed by combining biofeedback-monitored relaxation and specific imagery techniques with intermittent self-catheterization on a fixed schedule. Psychotherapy, pharmacotherapy, and behavior therapy were also utilized with good to excellent short-term results.


Psychosexual problems of aging males: urologist's viewpoint.

Sexual impotency is commonly psychogenic. Any therapist who will take the time to hear out his patient's complaints can readily differentiate etiologies that are likely to respond to simple encouragement and support from those that would require more sophisticated psychology. Key points in the patient's medical history are identified to establish the diagnosis of psychogenic impotency. The diagnostic approach is described herein. Most patients with psychogenic impotency have resumed sexual intercourse within three visits.


Complications of Small-Carrion penile prosthesis.

Seventy-six patients with impotence have undergone insertion of the Small-Carrion penile prosthesis at Duke University Medical Center. Twenty patients experienced postoperative complications. Seven of these 20 patients lost one or both prostheses either by spontaneous extrusion or surgical removal. Although success with this procedure is well documented, complications may be significant when they occur and awareness of these problems is essential for proper management. The benefits of this procedure are reviewed, and reported complications and their management are discussed.


Partial penectomy. Technique to eliminate meatal stricture.

A surgical technique for partial penile amputation is described which prevents meatal retraction and stenosis, and results in a functionally and cosmetically acceptable phallus.


Aligamentous testicle. New clinicopathologic entity in genesis of male infertility and its treatment by orchiopexy.

Absent scrotal ligament or the aligamentous testicle is a clinicopathologic entity which plays an important role in the genesis of male infertility. Twenty-four cases of aligamentous testicle, collected from 300 idiopathic infertile subjects, were studied. Clinical, endocrine, semen, and testicular biopsies were performed. The criteria of diagnosis of the aligamentous testicle are outlined and the role in infertility is discussed. Eighteen infertile patients with aligamentous testicle were treated by orchiopexy aiming to create an artificial scrotal ligament. The technique is described. The results were satisfactory. Failures were due to bad selection of patients.


Multilocular cystic disease of kidney.

A case of multilocular cyst of the kidney with calcification is presented and pertinent literature is reviewed. With our present knowledge, a multilocular cyst cannot be clearly differentiated from a malignant renal tumor by preoperative evaluation. Conservative surgery with operative evaluation of the lesion is suggested.


Crossed fused renal ectopia.

An unusual form of crossed renal ectopia is presented. Both kidneys are at the same level on the same side with fusion throughout their entire lengths.


Asymmetrical gonadal enlargement in adolescent true hermaphrodite with bilateral ovotestes.

A case of gynecomastia and asymmetrical gonadal enlargement in a thirteen and one-half-year-old "male" true hermaphrodite with biopsy-proved bilateral ovotestes is presented. The pathology, genetics, endocrinology, and management of this entity are discussed and compared with instances of hermaphroditism in which there is distinct separation of the ovarian and testicular tissues.


Renal oncocytoma.

Renal oncocytoma is a rare tumor of probable proximal tubular origin characterized by uniform cells with abundant, granular, brightly eosinophilic cytoplasm containing numerous mitochondria. The tumor is benign clinically and can be distinguished from renal cell carcinoma.


Two new, direct, and specific methods of acid phosphatase determination. National field trial.

A national study of the new specific assays for prostatic acid phosphatase was conducted by the National Prostatic Cancer Project. The results of the study have confirmed that the counterimmunoelectrophoretic method is easily reproducible, highly specific, and sufficiently sensitive. Based on tests as performed by different institutions, the counterimmunoelectrophoretic (CIEP) method was also shown to have high reproducibility and was found to be of much greater sensitivity than the conventional biochemical methods for the detection of earlier stages of prostatic cancer. The national study of the radioimmunoassay (RIA) has shown that although being a highly sensitive method, it could not be readily distributed at this time from one specialized center. It requires highly specific, expensive technical assistance and is not yet available nationwide. CIEP is recommended at this time to be used as the preferred method in the evaluation and diagnosis of prostatic cancer. The value of counterimmunoelectrophoresis in detecting early prostatic cancer as a screening method is promising, but still under study.


Correlation of cytology and cystoscopy.

A total of 152 patients had cytology and cystoscopy performed for either initial or recurrent bladder tumors and postoperative control examinations. Positive cytology was found in 97 per cent of patients with pathologically proved bladder tumors. However, 23 per cent of the patients with negative cytology had positive cystoscopic and pathologically proved findings. Without cystoscopic examination a significant number of recurrent tumors may be missed because of a negative cytology.


Renal adenoma -- a misnomer.

Because it is difficult histologically to differentiate between a renal cell carcinoma and a renal adenoma, their differentiation has been based on size. Lesions less than 3 cm. have been called adenomas and those greater than 3 cm. carcinomas. It is a widely accepted concept that adenomas evolve into adenocarcinomas, and it is true that lesions less than 3 cm. rarely metastasize. However, as demonstrated by this case and others, metastasis can occur, therefore, it is suggested that the term renal adenoma no longer be used.


Sertoli cell tumor of testis.

A case is reported of a patient with Sertoli cell tumor of the testis, the second known to have had a lymphangiogram and the third with histopathologic examination of retroperitoneal lymph nodes. Lymphangiography was performed because of extension of the tumor through the tunica albuginea into the adjacent adherent scrotum at the site of previous testicular biopsy. The lymphangiogram proved to be falsely positive following retroperitoneal lymph node dissection. The patient has remained clinically free of tumor for eight years.


Renal phlebography in diagnosis of poorly vascularized renal malignancies.

Eight cases are presented to demonstrate the value and limitations of renal phlebography in the diagnosis of poorly vascularized renal malignancies. Because of the easier compressibility of the thinner venous channels, malignant tumors may cause more pronounced phlebographic changes than seen in corresponding arteriographic studies. Changes include venous compression and amputation, tumor thrombus, and venous neovascularity. It is believed that the supplementary use of renal phlebography at the same time arteriography is being accomplished may increase the chances of preoperatively diagnosing such hypovascular renal malignancies as papillary-tubular adenocarcinomas, metastatic and necrotic malignancies, and invasive transitional cell carcinomas.


Nonobstructive fragmentation of central renal pyelocalyceal echo complex.

When renal echograms are made, the central renal pyelocalyceal complex (CRPC) is seen as a strongly echogenic oval confluence surrounded by echo-poor renal parenchyma. Fragmentation of the CRPC is abnormal, and this fragmentation is widely known in association with urinary obstruction. But, there are a variety of nonobstructive causes for dispersion of the CRPC; renal duplication, postobstructive atrophy, chronic pyelonephritis, renal sinus lipomatosis, nephrocalcinosis, and renal cystic disease. Patterns of CRPC fragmentation may be correlated with renal parenchymal status to determine the cause of abnormal renal echograms.


Complications of retroperitoneal lymphadenectomy.

Complications found in 47 individuals who underwent radical retroperitoneal node dissection were retrospectively analyzed. Our results indicate no mortality and an over-all complication rate of 29.7 per cent. An increased number of complications was noted in those patients who underwent elective appendectomy and in those node dissection above the renal vessels.


Complications of retroperitoneal lymphadenectomy for nonseminomatous tumors of testis.

We present 4 patients with serious complications after retroperitoneal lymphadenectomy. Chylothorax developed in the first patient; hypertension, blindness, and paralysis of the lower extremities in the second; volvulus and necrosis around an adhesion in the right upper quadrant in the third; and small-bowel obstruction and radiation myelitis in the fourth patient. These complications and modes of treatment and prevention are discussed.


Primary massive reflux in children.

Over a ten-year period, of more than 1,000 children whose primary vesicoureteral reflux was treated surgically, there were 54 children with 80 single ureters which were massively dilated. Primary reconstruction with ureteral tailoring was done in 25 ureters with a success rate of 92 per cent. Forty-five ureters were temporarily diverted because of uncontrolled infection and/or azotemia. In almost half of these instances, temporary diversion resulted in improvement in ureteral caliber to such an extent that nontailored reimplantation could be performed with a success rate of 87 per cent. Six kidneys were removed and four have been maintained in the diverted state with severe renal dysplasia. Eighty-eight per cent of the refluxing megaureters were reconstructed with a success rate of 89 per cent.


Primary nonfunctioning carcinoma of adrenal cortex.

Two cases of nonfunctioning adrenocortical carcinomas are presented. The clinical features, operative findings, and histopathologic appearances are discussed. It is believed that these tumors are difficult to diagnose because of their vague presentation. Intravenous urography with nephrotomography is the most valuable method of detecting these tumors, and surgery remains the best treatment.


Renal artery aneurysm.

More and more renal artery aneurysms are being diagnosed, especially after the introduction of selective arteriography for the evaluation of renovascular hypertension. However, renal artery aneurysm still remains a rare entity. The pathogenesis of renal artery aneurysm is identical to the pathogenesis of arterial aneurysm in other arteries. Symptoms of aneurysm of the renal artery are dependent on a variety of factors, the most important of which are the size of the aneurysm, its location, and whether or not rupture has occurred. The indication for operation on renal artery aneurysm is rupture or threat of rupture. Herein we present a review of the literature and a report of 2 cases which exemplify the capabilities of the surgeon in dealing with such cases.


Catheter-related injuries as cause of acute surgical condition within abdomen.

Three cases of an acute surgical condition within the abdomen secondary to complications of chronic urethral catheters are reported. Common factors in the history and varying mechanisms for the injuries are discussed. Need for including catheter-related injuries in the differential diagnosis of an acute surgical condition of the abdomen is emphasized.


Difference between continuous wave and superpulse carbon dioxide laser in bladder surgery.

Adult exteriorized rabbit bladders were treated with both continuous wave and rapid superpulsed laser energy. A carbon dioxide laser was utilized in these studies. Time and power density were varied, and the effect in both acute and delayed preparations was noted. An additional group of animals treated with the carcinogen dibutylnitrosamine was studied in a similar manner. The depth of tissue ablated was monitored by the operating microscope and varied from 1 to 2 mm., using the power-time grid we employed. Not only could the depth of destruction be controlled, but also re-epithelialization was apparent in one and one-half to three and one-half weeks after destruction. Differences between superpulsed and continuous wave carbon dioxide laser energy are compared.


Treatment of estrogen-resistant stage D carcinoma of prostate with cis diamminedichloroplatinum.

Forty-five patients with rapidly progressive, estrogen-resistant Stage D adenocarcinoma of the prostate were treated with infusions of cis diamminedichloroplatinum (cis platinum) (1 mg./Kg./week) for six weeks initially and every three weeks thereafter. A partial objective response was observed in 13 of 45 patients (29 per cent). This response lasted from two to sixteen months with an average of six months. Eighteen patients (40 per cent) had a significant decrease or disappearance of bone pain and became ambulatory. Six patients (13 per cent) remained stable, and 8 patients (18 per cent) did not respond to treatment and showed progression of their disease. The toxicity of the treatment was mild to moderate. Most of the patients were treated in the outpatient department. Cis platinum appears to be the most effective drug available to date for the treatment of advanced carcinoma of the prostate.


Nondelay in vesicovaginal fistula repair.

Current attitudes toward closure of vesicovaginal fistulas have engendered a period of delay of three to six months prior to surgical closure. We believe that such delay is unwarranted, and describe our experiences with the closure of these fistulas as soon as the diagnosis is made. We consider our success to be good and therefore advocate a more direct approach to these injuries.


Transplacental exposure to diethylstilbestrol in men.

Diethylstilbestrol (DES) was widely prescribed during the late 1940s and early 1950s for complications of pregnancy. Twenty-four men exposed to DES in utero were examined and compared with twenty-four age-matched controls; contrary to previous reports, we found no difference between the two groups in their psychosexual history, medical history, genital examination, or semen analysis.


Seminal zinc and male infertility.

Low seminal plasma zinc is an indication of prostatic secretory dysfunction. We have identified a group of patients referred for infertility evaluation who demonstrated low seminal plasma zinc and decreased sperm motility, in the absence of infection. Treatment of these patients with oral zinc sulfate results in improved sperm motility.


Unusual cause of acute urinary retention in a child.

A five-year-old child presented with a history of acute urinary retention for eighteen hours. Extensive diagnostic evaluation proved the presence of a retrovesical pelvic mass, which on surgical exploration was found to be an acutely inflamed appendix.


Ultrasonographic diagnosis of fetal hydronephrosis in utero.

Ultrasonography offers a noninvasive method to visualize antenatal or neonatal anatomy which will lead to early detection and treatment of abnormalities. In these 2 cases, ultrasound allowed prompt diagnosis of hydronephrosis despite normal physical examination and laboratory values at birth.


Assessment of cavernous hemangioma of bladder by technetium-99-tagged albumin scan.

A case of cavernous hemangioma of the bladder is presented and its endoscopic appearance is illustrated. A scan utilizing technetium-99-labeled albumin has been found valuable in determining the extent of the lesion.


Neurocutaneous syndromes and retroperitoneal tumors.

A patient with multiple basal cell carcinoma syndrome, a symptom complex characteristized by nevoid basal cell carcinomas of the skin, jaw cysts, skeletal abnormalities, and hyporesponsiveness to parathormone is presented. In addition, the patient had a retroperitoneal lymphagiomyoma, a hamartomatous lesion, causing ureteral obstruction. The association of neuroectodermic syndromes and retroperitoneal and intra-abdominal tumors is reviewed.


Testicular tumor in male pseudohermaphrodite with X/XY chromosomal mosaicism.

A case of testicular tumor in an intersex patient is presented. Knowledge of the potential of gonadal malignancy is important in the management of disorders of sexual differentiation. These patients, in whom the fields of oncology, embryology, endocrinology, and genetics intersect, provide a fruitful ground for clinical investigation.


Palatal metastases in renal cell carcinoma.

Renal cell carcinoma may metastasize early in its course and sometimes before the primary lesion becomes apparent. Two cases of renal cell carcinoma with the initial manifestation of metastases to the roof of the mouth are presented. The mode of metastases to the palate is discussed.


Polypoid granulomatous and sclerosing endophlebitis of spermatic cord: new pathologic type of schistosomal funiculitis.

A case of polypoid granulomatous and sclerosing endophlebitis of the spermatic cord due to Schistosoma hematobium is described. The lesion was not due to deposition of ova and is believed to have resulted from death of an incarcerated worm mass upstream. As such, the case represents a hitherto unknown form of schistosomal funiculitis. Vascular changes in schistosomiasis are reviewed and a clinicopathologic classification of schistosomal funiculitis is proposed.


Atypical carcinoma of kidney: possibly originating from collecting duct epithelium.

An atypical carcinoma of the kidney with cellular elements of renal cell and transitional cell carcinoma is presented. The unusual histologic features suggest a lesion originating from the collecting duc t epithelium. Evaluation of atypical renal carcinoma as to origin is advocated.


Primary carcinoid of prostate.

The first case of pure primary prostatic carcinoid is presented. Previous demonstration of the presence of enterochromaffin cells in the non-neoplastic prostate and in otherwise ordinary adenocarcinomas of the prostate furnishes a basis for the origin of this unique neoplasm.


Scrotal scanning: present value and limits of interpretation.

Forty-three testicular scans have been performed on 38 patients presenting with various scrotal symptoms. Scan diagnosis correlated correctly with the clinical findings in 86 per cent of cases. The most common cause of false positive testicular scan was found to be hydrocele. The mechanism responsible for this observation has been explored in a rat model. A false negative diagnosis was made in 2 cases owing to a small retracted scrotum in 1 patient and a markedly late discovered torsion in the second.


Computed tomography of bladder: staging of bladder cancer using low density opacification technique.

In the course of computed tomographic (CT) evaluations involving 200 patients with suspected pelvic disease we have found that scan quality is often suboptimal. A preliminary report employing a low density bladder opacification method is presented whereby an indwelling catheter is inserted to control bladder volume and facilitate the instillation of low density iodinated contrast agent (0.6% Renografin-60). The patient remains supine throughout the twenty-five-minute procedure. Observations during the CT staging and follow-up of a controlled group of 8 patients undergoing immunotherapy and/or radiation therapy for bladder carcinoma indicate that this is a simple, safe, and effective staging procedure. We have obtained reliable clinical-radiologic-pathologic corrlation as a result of careful surgical staging and biopsy, followed by open surgery and full pathologic examination. It is hoped that this information will help initiate other similar studies to determine the diagnostic accuracy of this method and thus its use in pretherapeutic evaluation of the bladder lesion and its subsequent response to treatment.


Cystometry and periurethral striated muscle electromyography using cold and room temperature fluid.

In evlauating patients with neurologic lesions of the spinal cord and voiding abnormalities, it would appear from this study that distention is a more physiologic stimulus to bladder contraction than relatively smaller amounts of cold fluid. While the ice water test has speed and simplicity to recommend it, it should not be used as a sole means in determining whether or not a detrusor reflex is present. It may not uncover those patients with detrusor hyperreflexia or may fail to reveal a detrusor reflex. If iced contrast medium is to be used for voiding cystography, the volumes should approximate those used for regular cystometry.


Anal stimulating electrodes in electromyography.

The Continaid pelvic floor stimulating electrode is useful in reception of electromyographic signals, a use for which the device was not originally conceived. I believe there is money to be saved and some clinical problems can be avoided when this plug is substituted for some others now in clinical use.


Ureteral endometriosis.

Ureteral endometriosis poses a problem to the clinician because of its nonspecific clinical presentation and its possible confusion with ureteral tumor. To facilitate early diagnosis and the application of appropriate treatment, the gynecologist should obtain an excretory urogram on all patients with pelvic endometriosis advanced enough to require surgery, and the urologist should suspect the disease when a premenopausal woman presents with distal ureteral obstruction of unknown cause.


Morbidity of pelvic lymphadenectomy.

A retrospective review of 100 patients undergoing pelvic lymphadenectomy alone or with additional surgery was done to assess the morbidity and to help identify factors contributing to a high wound morbidity. Major wound morbidity occurred in 8 per cent of patients, while 16 per cent had minor wound problems. Factors contributing to wound morbidity included urinary tract infection, altered metabolic states, and the use of wound drains. Other morbid events are tabulated.


Transitional cell carcinoma of bladder in patients under thirty years of age.

Seventy-nine cases of transitional cell carcinoma of the bladder in the age group under thirty years have been reviewed. The diagnosis and treatment are the same as in the older age group. The tumors are usually of low grade and low stage, but they can become more aggressive and more malignant. Contrary to previously held beliefs that transitional cell tumors in the younger age group rarely if ever recur, this series had a recurrence rate of 13.9 per cent with several patients having multiple recurrences. Therefore, the follow-up care of these patients must be vigilant and persistent.


Insulin-induced growth hormone responses in patients with prostatic carcinoma.

Insulin-induced pituitary growth hormone (GH) response was studied in 12 patients with prostatic carcinoma. Three patients demonstrated significant abnormal GH release associated with concentrations which remained on a high plateau during the study. The patients subsequently presented clinically with rapidly progressing disease. Such observations are compatible with the viewpoint that abnormally high or low GH levels systemically present, may be associated with a particularly bad clinical prognosis. Further studies will clarify this relationship.


Partial tears of prostatomembranous urethra in children.

Five boys having sustained a pelvic fracture were found to have incomplete tears of the prostatomembranous urethra. Three patients were treated with suprapubic cystostomy drainage alone and fared better than 2 who were treated with urethral catheter stenting and drainage. A recommendation is made for the "hands-off" approach to the evaluation and management of membranous urethral injuries.


Peyronie disease: surgical treatment with muscular aponeurosis.

A new method for surgical correction of Peyronie disease by grafting autologous muscular aponeurosis was tried in 4 patients. Early results were encouraging, with disappearance of penile curvature and of pain on erection. The urologist can perform the operation without the assistance a plastic surgeon must usually give when dermal grafts are used.


Insufficient penile erection due to abnormal drainage of cavernous bodies.

Four men were referred for incomplete erection of the penis. All had abnormal venous outflow from the cavernous bodies: 1 iatrogenic fistula from the cavernous body to the glans, 1 congenital fistula from the cavernous body to the glans, 1 with several congenital large veins connecting the interior of the cavernous body to the outer veins, and 1 who suddenly lost the ability for erection was found to have a venous leak through scar tissue in the tunica albuginea. They were all operated on and the visible leaks closed. Three of them were functionally greatly improved.


Double-ended pigtail ureteral stent: useful modification to single end ureteral stent.

A newly created ureteral stenting catheter of double-ended pigtail design is introduced. The pigtail design at both ends maintains the catheter in place by serving as a solid anchoring device, both intravesically and within the renal pelvis; upward or downward migration of the stent is thus prevented. It is designed also to minimize trigonal irritation. The catheter can be introduced easily either cystoendoscopically or through a percutaneous antegrade route, or by a combination of both methods. It offers the additional advantage of being readily available from an inexpensive stock source; it may be quickly and easily custom made and shaped for any ureter by the physician immediately prior to its insertion. It thus avoids having to have premanufactured, more expensive ureteral stents of different lengths. Open surgery for upper urinary tract decompression can thus be avoided.


Transvesical intussusception (Lich) ureterectomy.

Intussusception ureterectomy has been used to excise prophylactically the distal ureter in 10 patients with carcinoma of the renal pelvis. The procedure has proved safe and expeditious, as well as permitting more precise excision of the surrounding vesical mucosa.


Renal arteriovenous fistulas secondary to bilateral renal cell carcinoma.

Arteriovenous fistulas commonly occur in cases of renal cell carcinoma, but they rarely produce sufficient left-to-right shunting to cause decompensation of the cardiovascular system. A case of refractory hypertension and congestive heart failure secondary to arteriovenous shunting in bilateral renal cell carcinoma is presented. Renal blood flow studies at the time of staged nephrectomy, together with measurements of cardiac output, established parenchymal arteriovenous shunting as the cause of the patient's cardiovascular symptoms. Subsequent nephrectomy achieved a marked clinical and symptomatic improvement. The causes, diagnosis, and treatment of arteriovenous fistulas are discussed. Although nephrectomy offers dramatic resolution of clinical symptoms, long-term survival depends on the behavior of the neoplasm.


Vasovasostomy: evaluation of success.

Our review of 2,685 cases of vasovasostomy reported between 1948 and 1977 shows that many different surgical techniques can be successful. However, various reporting practices have made case comparisons difficult. We suggest a standardized method for reporting vasovasostomy results.


Alteration of semen quality in dogs after creation of varicocele.

A left vein varicocele was created in male dogs by partially obstructing the left renal vein medial to the entrance of the left internal spermatic vein. Eight dogs had semen parameters determined preoperatively (2 times/week for five weeks) and postoperatively (2 times/week for twelve weeks). Semen quality was altered by the experimental varicocele. A significant decrease in sperm count, motility, per cent viable, and per cent oval sperm were noted. Semen volume was not affected. The possible chemical influence of serotonin is mentioned. Testosterone levels were unchanged by the varicocele. Histologic findings in the left and right testicles are mentioned before and after creation of the varicocele.


Urinary tract obstruction secondary to cerebrospinal fluid cysts.

Bilateral hydroureteronephrosis secondary to mechanical kinking of the ureteral-conduit anastomosis or ureteral compression caused by a large intra-abdominal cerebrospinal fluid cyst should be considered in patients who have ventriculoperitoneal shunts, abdominal ascites, and deteriorating upper tracts. Therapy directed at correction of the cerebrospinal fluid cyst should be sufficient to correct the urologic dysfunction.


Retrocaval ureter in Turner syndrome.

Turner syndrome is commonly associated with urinary tract anomalies. A second case is reported of its unusual association with retrocaval ureter and massive hydronephrosis.


Leg edema as complication of bladder overdistention.

A case of massive leg edema resulting from overdistention is described. Remission of symptoms followed bladder decompression. Venous obstruction as the etiologic factor is supported by impedance plethysmography data before and after bladder decompression.


Ureterocele--a familial congenital anomaly.

Nonidentical twins with ectopic ureteroceles, and duplication of the urinary collecting system in two more members of the same family are described. This incidence may indicate that inborn anomalies of the urinary tract may have a genetic background.


Bladder and ureteral displacement complication of total replacement hip arthroplasty.

An unusual case of bladder and lower ureteral displacement owing to extruded cement in the pelvis through the acetabulum after total hip arthroplasty is described. The literature is reviewed.


Transitional cell carcinoma: cause of refractory cancer of prostate.

Four cases with a diagnosis of adenocarcinoma of the prostate are presented in which a histologic pattern of adenocarcinoma mixed with transitional cell carcinoma developed subsequently. Suggestions are made regarding the pathogenesis and diagnosis.


Bronchogenic squamous cell carcinoma metastatic to kidney. Detection by urine sediment cytology.

A fifty-seven-year-old man with bronchogenic squamous cell carcinoma is described. There was clinical suspicion of metastatic involvement of the kidneys. Urine sediment cytology revealed neoplastic squamous cells consistent with metastatic squamous cell carcinoma. Subsequent autopsy confirmed the renal involvement. In the right kidney the tumor had invaded and breached the renal pelvic wall. It is suggested that urine sediment cytology should be considered a useful diagnostic procedure in this clinicopathologic setting.


Leiomyosarcoma of urinary bladder.

Leiomyosarcoma of the bladder remains a rare diagnosis with poor therapeutic results. The available data continue to support surgical intervention as the mainstay of therapy, although other modalities have been employed with varying success. A case report and review of the literature with current treatment alternatives are presented.


Pararenal pseudocyst (urinoma) as complication of percutaneous nephrostomy.

Percutaneous nephrostomy is a well-recognized procedure utilized by the radiologist both as a temporary drainage method for urinary tract obstruction and as the elective therapeutic modality in selected pathologies of the urinary tract. We report a complication not previously mentioned in the literature, urinoma formation.


Renal pseudoenlargement due to masses in posterior pararenal space.

Two patients presenting with acute flank pain had unilateral smooth enlargement of a kidney on excretory urography with associated attenuation of the collecting system. This presentation suggested intrinsic renal disease, but sonography showed the urographic findings to be due in each case to a mass in the posterior pararenal space. By displacing the kidney anteriorly and away from the x-ray film, such masses will result in radiographic enlargement of the renal outline, i.e., renal pseudoenlargement. The distinction between true renal enlargement and pseudoenlargement may be made by sonography.


Spinal hematoma compressing cauda equina.

Epidural and subdural spinal hematomas are unusual complications of diagnostic lumbar punctures. A renal allograft recipient on anticoagulant therapy underwent lumbar puncture. Urinary retention and evidence of an S2, S3, and S4 neurologic deficit developed subsequently. A myelogram showed a defect of the posterior lumbosacral spinal canal. Urodynamic investigation demonstrated normal sympathetic innervation of the proximal urethra and impaired parasympathetic and pudendal innervation of the detrusor and external urethral sphincter, respectively.


[Characteristics of clinical picture, diagnosis and surgical treatment of hypoplasia of the thoracoabdominal portion of the aorta].

The experience with diagnosis and surgical treatment of 10 patients with a rare disease--hypoplasia is set forth in the article. According to the author's data this disease is always complicated with aortoarteritis with the involvement of the renal and visceral arteries. It is suggested to subdivide hypoplasia into several types: infrarenal hypoplasia, interrenal and supradiaphragmatic ones; hypoplasia with preseved orthograde blood flow and without the latter, with unilateral and bilateral involvement of renal arteries. 8 patients were operated upon. Errors of surgical tactics made when operating the first 3 patients are discussed. The other 5 patients showed a good effect of the operation. There were no fatal outcomes.


[Perforation of gastroduodenal ulcers and pulmonary tuberculosis].

17 observations of the perforation of gastroduodenal ulcer in pulmonary tuberculosis cases are analysed. Most of the patients were males, aged over 50, with protracted chronic forms of tuberculosis. In all cases the suturing of perforation was carried out. 9 patients died. The conclusion has been drawn that a massive antibacterial therapy, which should be carried out in specialized medical institutions, is imperiable.


[Etiology of acute gastric perforations following suturing of gastroduodenal ulcers].

Data concerning 6 patients who underwent suturing of perforating ulcer and developed an acute stomach perforation postoperatively (4 cases) and acute necrosis of the stomach wall at the site of the suture (2 cases), are analyzed. Besides, the results of experiments on 10 animals are set forth. The author has come to the conclusion that acute thrombophlebitis of the subserous stomach veins constitutes the cause of the above-mentioned complications.


[Late results of surgical treatment in carcinoma of the cardia of the stomach].

The author studied the findings obtained in 27 patients operated upon for carcinoma of the cardia of the stomach with/without involvement of the esophagus, who survived more than 5 years after radical operations. 16 patients survived more than 10 years, 4 of them--20 years. The common prognostic factors, i. e. metastases, anatomic type of the tumor and its size are analysed.


[Surgical treatment of vasorenal hypertension in non-specific aorto-arteritis].

An injury to the renal arteries was found in 119 patients with non-specific aorto-arteritis and high arterial hypertension by means of angiography. 66 patients were operated upon (75 operations). The reconstruction of one renal artery was carried out upon 31 patients, 30 patients underwent the reconstruction of both renal arteries. 6 patients were subjected to the primary nephrectomy, and 6 others to the secondary one. The blood flow along the aorta and visceral arteries was restored in 31 cases in one-stage operation together with the reconstruction of the renal arteries. In recent years the postoperative mortality has constituted 4.3%. Excellent and good results have been obtained in 83.6% of cases.


[Laser therapy in surgical diseases].

Laser therapy proved to be effective in the treatment of patients with trophic ulcers, deforming arthrosis of the I and II degree, and particularly, in early stages of inflammatory processes (infiltrative stage) and in some surgical diseases, as well. So, there are all the grounds for further and more broad and profound experimental and clinical study of laser therapy in various diseases, surgical ones, in particular.


[Early postoperative peritonitis].

Data concerning immunologic changes in postoperative peritonitis and the most common causes of their occurrence are set forth. The report is grounded on the observation over 112 patients and on the experiments on 60 dogs. The depression of the immunoreactivity and sensitization of the organism and its autoallergization with tissue decay products against the background of postoperative peritonitis have been found. It is advisable to use the desensitizing and detoxicating therapy together with relaparotomy and correction of metabolic disorders in postoperative peritonitis.


[Preoperative care and accumulation of non-active hemoglobin derivatives in blood of patients].

A study of the concentration of met- and sulfhemoglobine in patients on admission to the clinic and at the end of the preoperative management and treatment was carried out upon 35 surgical cases. The medicamentous therapy included the drugs favouring the restoration of methemoglobin (10.20% and 40% glucose solutions, ascorbic acid etc.). Therewith the concentration of non-active hemoglobine derivatives dropped at the end of the preoperative management and treatment.


[Surgical treatment of multiple pulmonary echinoccocosis].

Clinical observations concerning the surgical treatment of multiple pulmonary echinococcosis in 54 patients are set forth in the paper. Various surgical interventions were carried out upon 46 patients: 16--for unilateral multiple echinicoccosis, 30--for bilateral multiple echinococcosis; in 8 patients pulmonary echinococcosis was combined with liver injury. From the authors' experience the surgical treatment of multiple pulmonary echinococcosis is an effective method. Good clinico-roentgenologic results were found in 44 out of 46 patients operated upon. 2 patients died from cardio-pulmonary insufficiency in the early postoperative period.


[Effect of orotic acid on regeneration of the lungs].

The effect of orotic acid on the development of compensatory pulmonary hypertrophy has been studied in the clinic and in the experiments (71 patients, and 349 rats) carried out with the use of morphologic, biochemical cytochemical, immunologic and clinical methods, and also through autoradiography. The results of the study prove the effect of the drug upon the pulmonary regeneration. Experimental findings have shown that behind the stimulating effect of the drug there is the activation of the synthesis of nucleinic acids, the rise of the mitotic activity of the interalveolar membranes cells of the lung remnants. An essential increase of the lymphocytic dehydrogenase activity of the peripheral blood occurred in response to the effect of the drug.


[Ectopia cordia].

9 children aged from 40 hours to 7 years were operated upon. The peculiarity of the surgical intervention in a newborn consists in the difficult arising at the correction of the position of the heart. Both newborns died to the heart defects incompatible with life. The operations carried out upon elder children (7) were successful, the difficulty derived from the necessity to form a thoracic frame over the transposed heart. The late results are good.


[Status of the cardiovascular system in children with acute diffused peritonitis].

67 patients with acute diffused peritonitis aged from 2 to 15 years were examined. The arterial and central venous blood pressure, contractile function of the myocardium, peripheral and central blood flow were estimated. It has been found that functional shifts of the cardiovascular system occur at the early stage of the disease and advances as it develops.


[Radioisotopic diagnosis of Meckel's diverticulum in children].

The serial scintiphotography following intravenous injection of Tc99m-ertechnetate was used for examination of 50 children aged from 11 months to 14 years. The method is founded on the Tc99m-pertechnetate property of selective accumulation in the gastric mucous membrane and in Meckel's diverticulum when the latter contains the ectopic gastric mucous membrane. The inflamed diverticulum can accumulate the radionuclide, as well. Meckel's diverticulum was suspected in 7 children during examination; in 6 of them Meckel's diverticulum was found peroperatively, and in one case there was enterocyst of the ileum.


[Failure of anastomosis after resection of the small intestine in children].

The authors observed the described complication in 25 out of 350 children who had underwent and urgen resection of the small intestine (7.1%). 18 children died (72%). An analysis of the clinical picture of the anastomosis failure is set forth. The errors admitted at the repeated operation and treatment are discussed. Some practical recommendations are suggested.


[Diversion of the venous blood from the adrenal gland and the kidney into the portal system in the treatment of malignant arterial hypertension].

A method of the portalization of the adrenal and renal blood has been devised in the experiment on 47 cadavers. The method consists in the formation of the left renoportal venous anastomosis combined with contralateral adrenalectomy. The method was successfully applied in the clinic upon 9 patients with severe and malignant arterial hypertension of various etiology. The technique of the operation is described. A detailed description of one observation of a successful use of the method, applied in malignant clinical course of arterial hypertension, illustrates the effectiveness of this operation. The indications for this operation are set forth.


[Functional and morphological changes in the nerves following injury due to traction mechanism (experimental and morphological studies)].

In acute and chronic experiments on 52 animals (rabbits and dogs), carried out by means of neurophysiologic and neurohistologic methods, the authors have studied functional and histologic changes in the nerves following a one-step forced traction. Traction injuries have been found to cause early trophic disorders, persistent and long-lasting alterations of the nerve conductability and excitability. Some considerable retrograde changes in the nerves and related segments of the spinal cord have been noted together with the delay of the resorption of the decay products of the axons and the myelin sheath in the peripheral nerve fragment. The severity degree of the alterations depends on the degree of the traction.


[Renin activity and functional status of the adrenal cortex in surgical intervention during ketamine anesthesia].

The renin activity and gluco- and mineralocorticoid adrenalocortical function were studied in 22 patients operated mainly on abdominal organs under the conditions of ketamine anesthesia. As noted, the ketamine injection followed with hypertension and tachicardia does not give rise to the renin activity and to the 11-OKS and aldosterone blood levels, as well. An evident trend to the increase of the concentration of the adrenocortical hormones, together with the occurrence of hypokemia and progressive hyperglycemia have been traced throughout the anesthesia and operation.


[Characteristics of combined nitrous oxide nacrosis and premedication with phentanyl and droperidol or phentanyl and seduxen in patients with pain syndrome caused by blood vessel diseases of the lower extremities].

66 patients were subjected to nitrous oxide narcosis after various types of premedication. The premedication with phentanyl and seduxen or droperidol proved to be more effective than the routine premidication. The authors consider endotracheal narcosis with nitrous oxide combined with fractional injections of phentanyl and seduxen of phentanyl and droperidol to be a method of choice.


[Diagnostic value of thermography in stomach diseases].

According to the authors' data positive thermographic findings have been noted in gastritis and gastric and duodenal ulcer cases, mostly in complicated forms of the disease or in aggravation of the inflammatory process. Malignant neoplasms of the stomach are most often mirrored in the thermograms as zones of increased radiation adequate to the localization and spreading of the focus of the lesion (77%). A stable character of the pathologic thermoasymmetry in malignant neoplasms, as it is found in repeated studies, allows to make a differential diagnosis with inflammatory diseases subsiding with the treatment, which gets confirmed through the decline or vanishing of pathologic thermographic signs found in the repeated studies.


[Liver function disorders and hepatic insufficiency in diseases of the abdominal cavity organs].

The tissue respiration and oxidative phosphorylation in mitochondrial preparations of the liver were studied by means of the polarography in 14 cases of peptic ulcer localised in the stomach and the duodenum and 46 cases of cancer of the stomach. The deterioration of the indices of oxidative phosphorylation in the liver (decrease of the respiratory control, desintegration of the respiration and phosphorylation processes) has been found to occur with the development of the tumor process.


[Effectiveness of cryogenic action in experimental liver resection].

The traditional ligature methods were added with freezing of the left hepatic lobe resection line in order to block up parenchymatous bleeding and cholerhagia in atypical resection of the liver. Alterations in the enzymatic activity (alaninic and asparaginic transaminases alkaline phosphotase, lactate dehydrogenase and ribonuclease) in the blood serum and liver of the rabbits allowed to judge about the character of inflammatory and destructive changes in the liver following the use of the abovementioned methods. The rise of the activity of the enzymes under study within the first days after operation and its normalization by the 7th to 14th days in all the studied variants of hemo- an cholestasis have been established.


[Phytobezoars of the stomach].

Literature data and the own authors' observations (76 cases), concerning the recognition and treatment of stomach phytobezoars following vagotomy and stomach resection are set forth in the paper. All these formations in the stomach were removed by means of the conservative procedures. Knowledge of the specificity of the phytobezoars manifestations in an operated stomach allows for better understanding and evaluation of the state of the patients who have been subjected to stomach resection of vagotomy.


[Surgical treatment of pancreatic cysts].

The authors observed 103 cases of pancreatic cysts caused by acute pancreatitis, aggravation of chronic pancreatitis (81.0%) and trauma to the pancreas (12.0%). The posttraumatic cysts were more common in children and young adults (86.0%). The use of the complex method of diagnosis (x-ray examination of the gastrointestinal tract, celiacography, and upper mesentericography, endoscopic pancreatography, ultrasound echolocation of the pancreas) allowed to establish the diagnosis in 91.6% of cases. The external drainage of the cysts was carried out in cases of infected cysts with poorly formed walls. In case of a dilated and deformed main pancreatic duct with disorder of its patency (21 cases) the longitudinal cystopancreatojejunostomy was performed. The lethality after internal drainage constituted 2.4%. 80.8% of patients showed good long-term results of the treatment and 14.4%--showed fair results. 2 patients (2.1%) developed the recurrence of the cyst.


[Regional blood redistributions after experimental laparotomy].

The authors studied regional redistribution of the blood in the experiments on 12 white male rats adapted to the experimental conditions. There were no postoperative complications in the laparotomy model. The main direction of the postoperative regional blood redistributions has been considered as one of the typical redistribution reactions associated with the mobilization of the intravascular blood reserve and its use in the organs with an intense function.


[Vertical stereophlebography and the results of its use in the diagnosis of venous diseases of the lower extremities].

The described method of vetrical streophlebography, added with the contrasting of the limb surface, allows to reveal the space interrelationship between different veins, veins and bones and also between the limb and the body surface. The authors believe that due to the spacious image of the venous system of the lower limbs, stereoplebography is a more informative angiographic method as compared to a routine phlebography.


[Stability and the biodestruction of polymer compositions for joining and replacing bone tissue].

Ethylcyanacryl-based compositions were subjected to gravimetric studies with the use of standard specimens in numerous laboratory tests and in 60 experiments on rabbits. Compositions with various fillers were studied. A relatively high elimination rate or orotic acid, microcapsulated in dextrane, from polymerized blocks was found. The results of the studies have shown the expediency of further improvement of the composition for the alignment and replacement of the bone tissue.


[Early complications after a gastric resection for peptic ulcer combined with the late phase of opisthorchiasis].

The paper is grounded on the analysis of 243 case histories of the patients with opisthorchiasis operated upon for gastric and duodenal ulcer. Various modifications of Billroth II operation were carried out upon 174 patients and Billroth I operation--upon 66 patients. 33 patients developed various complications in early postoperative period, in 10 of them there was a pathogenetic association of the complication with a parasitogenic disease. 7 patients died.


[Severe injuries of the neck].

An analysis of the surgical tactics in 15 patients with severe combined neck traumas was carried out. All the patients recovered. There were 3 injuries to the trachea, 2 injuries to the larynx, 3 injuries to the pharynx and 2 injuries to the thyroid gland. 10 patients sustained traumas to the large vessels. Surgical tactics and results of the treatment are described.


[Problems of the diagnosis and therapeutic procedure in traumatic aneurysms].

Some problems, concerning the diagnosis and treatment of peace-time traumatic aneurysms, are considered here. The authors treated 30 patients, using mostly plastic operations, 28 of them showed excellent and good results. The amputation of the femur was carried out in one case. One patient died from infected arterio-venous aneurysm.


Comparative pathology of glomerulonephritis in animals.

Glomerulonephritis constitutes an important category of renal diseases in animals and has been recognized with increasing frequency in the last decade. We report here the comparative morphologic aspects of glomerulonephritis as a naturally occurring disease of animals. We briefly review the immunopathogenesis of glomerulonephritis. The morphology of renal lesions occurring in glomerulonephritis in dogs, cats, cattle, sheep, horses and swine has been reviewed with emphasis on the range and specificity of various glomerular lesions and on the comparison of lesions between various species. A distinction was made between glomerulonephritis as a primary disease entity and glomerulonephritis associated with other disease processes. Primary idiopathic glomerulonephritis occurred in all species but was most commonly recognized as a clinically important disease in dogs and cats. Glomerulonephritis also occurred in association with other diseases such as equine infectious anemia, chronic hog cholera, canine pyometra, dirofilariasis, feline leukemia virus infection and canine systemic lupus erythematosus.


Histological and electron microscopic studies of endemic ethmoidal carcinomas in cattle.

In five cases of endemic ethmoidal carcinoma in cattle from the Dominican Republic three tumor types could be classified: undifferentiated carcinoma (3), adenocarcinoma (1), and squamous cell carcinoma (1). Electron microscopy showed that the tumor cells in undifferentiated carcinomas closely resembled the cells of the normal olfactory mucosa. This was especially true for the dark cells of Bowman's gland. Ultrastructurally, the lymphoid cells of the undifferentiated bovine carcinoma resembled the lymphoid cells of human nasopharyngeal carcinoma being closely associated with Epstein-Barr Virus. This and epidemiological observations suggested a viral cause of endemic ethmoidal carcinoma.


Intracardial mesotheliomas and a gastric papilloma in a giant grouper, Epinephelus itajara (Lichtenstein).

A giant grouper, Epinephelus itajara (Lichtenstein), was found dead in its tank. The principal necropsy findings consisted of multiple tumors in the ventricle of the heart, a tumor mass in the stomach, and protozoa-like organisms in the heart tumor, bile ducts and kidney collecting ducts. The heart tumors were identified as mesotheliomas the stomach tumor as a papilloma. The morphology of the protozoan-like organisms was similar to that of Rhabdospora thelohani (Languesse).


The nomenclature of periodontal epulides in dogs.

Epulides of periodontal origin are seen frequently in dogs. The classification of these tumors in the literature varies greatly and leads to much confusion when trying to compare reports from different sources. Our article reviews the literature regarding these tumors and suggests a standardized nomenclature. Three types of epulis are described. These are fibromatous epulis, ossifying epulis, and acanthomatous epulis, all of which are of periodontal origin. The three are grouped together because all have a stroma closely resembling normal periodontal ligament. The acanthomatous epulis has the potential to infiltrate locally into bone, whereas the other forms are not invasive.


Feline histiocytic colitis. A case report with electron microscopy.

A 5-year-old cat with clinical colitis had histiocytic inflammation of colonic mucosa. Light and electron microscopy demonstrated bacilli, 0.7 x 3.0 micrometers, in various stages of degradation within macrophage cytoplasm. The disease is similar to histiocytic granulomatous bowel disease of other species. The cat responded to long-term treatment with antibiotics.


Transitional cell carcinoma in the domestic cat.

In 17 cases of transitional cell carcinoma in cats the most common site for primary neoplasia was the urinary bladder; metastasis was recorded in five of the cases. Nine of the cases have been reported previously; the eight additional carcinomas from the files of the New York State College of Veterinary Medicine were highly invasive and had a desmoplastic response. According to WHO guidelines they were classified as nonpapillary, infiltrating; papillary, infiltrating; and variants of transitional cell carcinoma.


The pathogenesis of Trypanosoma congolense infection in calves. IV. The kinetics of blood coagulation.

Blood coagulation studies showed there was a pronounced thrombocytopenia and hypofibrinogenemia in Holstein calves infected with Trypanosoma congolense TREU 112. There was also ineffective thrombopoiesis characterized by an increased megakaryocytic mass, reduced uptake of 35S-methionine into peripheral blood platelets and a normal platelet lifespan. There was an increased uptake of isotopic label into fibrinogen and a shortened half life indicating a consumptive error with increased peripheral use of fibrinogen. No consistent abnormalities were found in ethanol gelation, partial thromboplastin time, clot retraction and lysis or plasminogen assay. Fibrin split products were rarely detected. These findings suggest that in the chronic form of bovine trypanosomiasis there is a partially compensated consumption coagulopathy.


Vascular malformations and hemangiomas of the canine spinal cord.

An arteriovenous malformation and two hemangiomas in the canine spinal cord were found in three dogs. The malformation was ventral, extramedullary and largely subdural. Chronic hypoxia, consequent upon the shunt, had led to extensive local edema, necrosis and hemorrhage at T13-L1. Prominent intramedullary perivascular fibrosis, mineralization and obliteration were the presumed consequences of the hemodynamic insult. The hemangiomas, one of which was multiple, were deep lesions that produced compressive changes in the adjacent cord tissue. The masses were regarded as benign neoplasms with central sclerosis. These conditions appear not to have been reported previously in the dog.


Placental lesions in habitually aborting cats.

An ovariohysterectomy was done on five female cats with a history of habitual abortion in the 3rd to 4th week of pregnancy and the foetuses and placentas examined. Histologic and electron microscopic examination showed multifocal placental necrosis which was deduced to begin in the syncytial trophoblastic cells and to extend to all the cells of the labyrinth. This lesion was followed by foetal autolysis. No bacterial, viral or mycoplasmal agents could be incriminated in the disease.


Uremic gastropathy in the dog.

Stomachs of four dogs with uremia  and four normal dogs were examined. Uremic stomachs represented four types of disease: atrophic, amyloidotic, ulcerative and necrotic gastropathy. Pathologic changes common to all uremic stomachs were expansion of the lamina propria, atrophy of gastric glands, and submucosal arteriopathy; lesions were limited to body and fundic zones. Lamina propria was markedly expanded by edema, mastocytosis, deposition of acidic mucosubstances, fibroplasia and mineralization. Capillaries in lamina propria had swollen endothelium and calcium salts were present extracellularly as amorphous granular laminae. Gastric glands were distorted and irregular and had fewer cells per unit of tissue. Parietal cells were swollen and had fragmentation of cytocavitary network and mitochondrial swelling with calcification. Chief cells were shrunken, agranular and atrophic with foci of glycogen and dilation of endoplasmic reticulum. Argentaffin cell content was diminished. Muscular arteries of submucosae had segmental degenerative lesions characterized by myocyte necrosis, calcification, and deposition of acidic mucosubstances and fibrin; thrombosis and obstructive arteriopathy were common. These studies suggest that uremic gastropathy is a disease of mucosal lamina propria and that lesions were due to anoxia caused by diffuse vascular injury and to altered parietal cell function.


Mycobacterium avium abortion in a sow.

A 2-year-old sow aborted her entire near-term litter of 11. Gross and histologic examination of a fetus suggested a tuberculous infection, and a yellow-pigmented Mycobacterium avium serotype 1 was subsequently isolated from the fetal tissue. Efforts to rebreed the sow were unsuccessful. She was anergic to skin tests with purified protein  derivative of M. avium on two occasions but had M. avium specific in vitro lymphocyte immunostimulation. Gross granulomatous lesions were found in the liver, kidneys, and endometrium when the sow was necropsied 5 months after the abortion. Histologic examination showed diffuse and focal non-encapsulated granulomas in lymph nodes, tonsils, kidney, liver, spleen, lung, and uterine and vaginal walls. There were a few encapsulated calcified foci in the endometrium. The centers of some granulomas in the tonsils, liver, kidneys, and some lymph nodes were caseated. The yellow-pigmented M. avium was isolated from the reproductive organs and from 11 of 12 other tissues cultured.


Morphology of spontaneous brain tumors in the rat.

In lifespan studies of 2,242 rats of three strains, 32 neoplasms were identified in brain, meninges and pineal gland. They were astrocytoma (16 Wistar, three Sprague-Dawley), ependymoma (four Osborne-Mendel), meningioma (two Osborne-Mendel, one Wistar), pinealoma (two Osborne-Mendel), reticulosis (two Wistar), oligodendroglioma (one Wistar), and gliomatosis (one Wistar).


Canine granulomatous meningoencephalomyelitis.

In 27 adult dogs with a distinctive chronic granulomatous meningoencephalomyelitis there were locomotor problems, cervical meningitis and blindness. Lesions were widespread, but most severe in cerebral and cerebellar white substance and in the cervical spinal cord. Lesions were characterized by the development of epithelioid cell granulomas arising from mononuclear cuffs. There were secondary edema and necrosis in severe cases and eventual fibroplastic repair in chronic cases. The cause is unknown.


The pathogenesis of Trypanosoma congolense infection in calves. V. Quantitative histological changes.

Calves infected with Trypanosoma congolense TREU 112 had generalized microvascular dilation which was most prominent in the liver and the mesentery; there also was increase in cellularity in the lung with significant alveolar thickening and accumulation of hemosiderin-bearing cells in the alveolar septa, focal accumulations of lymphocytes primarily at the corticomedullary junction of the kidneys and a well developed glomerulonephritis, likely membranoproliferative. Reticuloendothelial changes were marrow hyperplasia with an erythroid shift, moderate hemosiderosis and moderate dysthrombopoiesis, marked thymic cortical atrophy, hypersplenism and enlarged nodes with reduced cellular density, paracortical atrophy and medullary sclerosis.


Treatment of methapyrilene toxicity with physostigmine.

Methypyrilene, 40 mg/kg, was administered to male mongrel dogs, resulting in both central and peripheral anticholinergic effects. Physostigmine in doses of 0.5 to 1.0 mg was effective in reversing the central effects completely and the peripheral effects to a limited degree.


[Subfractional composition and structural characteristics of G immunoglobulins in pathological states].

Physico-chemical properties of gamma-globulin fraction and immunoglobulins G (IgG) were studied, using temperature-perturbational differential spectrophotometry and ion exchange chromatography on DEAE cellulose, in blood serum of 118 patients with impairments of thyroid gland and of 28 patients with chronic pneumonia. Amount of tyrosine residues, perturbated by temperature, was decreased and an alkaline subfraction was increased in IgG of patients with toxic goiter and chronic pneumonia; the increase in the alkaline subfraction was more distinct in impairments of thyroid gland. The data obtained suggest that the alkaline subfraction is characterized by an increased rigidity and apparently by altered structural properties in toxic goiter. The tyrosine residues in IgG enable to evaluate effectively the availability of a cavity between variable domains (antigen-antibody site) of the immunoglobulin.


[Extraction of crystalline L-threonine(serine)-dehydratase from rat liver].

Isolation on a preparative scale of crystalline pyridoxal phosphate-dependent threonine dehydratase (responsible for threonine deamination) from rat liver tissue is described. The enzyme was purified by stepwise salting out with (NH4)2SO4, two precipitations with acetone, gel filtration through Sephadex G-25, chromatography on DEAE cellulose, repricipitation with ammonium sulfate and crystallization. The ratio of threonine to serine dehydratase activities was altered only slightly through all the steps of the purification procedure. Both enzymes proved to be similar in their chromatographic properties; this suggests that a single enzyme is responsible for dehydrative deamination of both hydroxyamino acids in rat liver tissue. Stability of the enzyme preparations was distinctly increased after DEAE cellulose chromatography. The yield of crystalline threonine (serine) dehydratase was about 3%; the enzyme was purified 1500-1800-fold.


[Chemiluminescence of blood plasma in the presence of hydrogen peroxide].

Chemoluminescence arised after incubation of diluted blood plasma with hydrogen peroxide. A typical pattern of the luminescence development, similar to that obtained on addition of H2O2 to other biological objects, was observed: quick increase and gradual decrease to a steady-state chemoluminescence level. The increase in chemoluminescence, which was noted in some experiments, might be due to elevation in content of both initiators of peroxidation and activators of the chemoluminescence in blood plasma. Kinetics of the chemoluminescence did not correlate with concentration of oxygen in media.


[Antivitamin activity of thiaminase from B. thiaminolyticus with different routes of administration into animals].

Effect of bacterial thiaminase was studied in vivo after subcutaneous and intragastric administration of either the enzyme or of suspensions of intact and inactivated with an antibiotic bacterial cells, producing thiaminase. Activity of the thiamin-dependent enzymes (transketolase and alpha-ketoglutarate dehydrogenase) was distinctly decreased in liver and kidney tissues within 2 and 7 days after a single subcutaneous administration of 0.015 IU of the enzyme. Repeated administration of the enzyme within 4 days inhibited activity of thiamin-dependent enzymes in other tissues (heart, spleen, muscle and blood). Activity of thiamin-dependent enzymes in liver, kidney, heart, spleen, brain, muscles and blood was decreased more distinctly after administration of intact bacterial cells into mice stomach as compared to the effect of inactivated cells. Old animals were more sensitive to administration of intact bacterial cells than the young ones. The data obtained suggest that, besides the known thiamin-degrading effect of bacterial thiaminase in the intestinal contents, the enzyme exhibits functional activity within the animal tissues after the parenteral administration.


[Keto sugars in the urine of patients with chronic pancreatitis].

Simultaneously with fructose and sucrose, five oligosaccharides, containing fructose residue and exhibiting reducing properties, were found in urine of patients with chronic pancreatitis and with liver impairments caused by ethanol intoxication. Four of the oligosaccharides were trisaccharides, containing fructose residue and two residues of glucose as well as one tetrassaccharide, comprizing a residue of fructose and three residues of glucose. The fructose residue occupied the terminal position in all the oligosaccharides. The oligosaccharides found in urine of the patients were dissimilar in the types of link between residues of glucose and between residues of fructose and glucose; these oligosaccharides exhibited different chromatographic mobility.


[State of the external secretory function of the pancreas in chronic enterocolitis].

Activities of main pancreatic enzymes as well as activity of trypsin inhibitor were studied in blood serum, duodenal contents and urine in course of investigations of the exocrinic function of pancreas in patients. The exocrinic function of pancreas was found to be impaired in chronic enterocolitis. The impairment of the gland secretion, caused by inflammatory and atrophic alterations in intestine, might be one of the factors responsible for alterations in the enzymatic activity and in activity of trypsin inhibitor. Complex examination of the pancreatic enzymes and of trypsin inhibitor supplied an adequate information on the state of exocrinic function of pancreatic gland in the patients with chronic enterocolitis.


[Effect of insulin and hydrocortisone on pyruvate kinase from the medullar and cortical layers of rabbit kidney].

Activity of M2-pyruvate kinase from medullar layer of rabbit kidney was studied in diabetes, in starvation within 1 day and 10-16 days and in long-term starvation of rabbits after administration of glucose or hydrocortisone and protamine-Zn-insulin. The enzymatic activity was increased in diabetes and decreased in long-term starvation and after administration of insulin. A correlation was observed between low activity of pyruvate kinase in kidney medulla under conditions of long-term starvation of rabbits and deficiency of the enzyme substrate. The data, obtained after study of the enzymatic activity in kidney medulla as compared with that of rabbit kidney cortex, demonstrate various adaptability of cells from these kidney layers to regulatory effects of hormones on the pyruvate kinase activity.


[Superoxide dismutase activity in the blood of children with iron deficiency anemia].

Activity of superoxide dismutase was studied in blood of children with various types of iron deficiency anemia. The enzymatic activity was increased in all the types of iron deficiency anemia studied (typical form, infectious anemia of premature children). This increase was especially distinct, when calculation was made per 1 mg of hemoglobin or 1 billion of erythrocytes. Alterations in superoxide dismutase activity and in content of blood hemoglobin were reciprocal in the anemias studied. Correlation was observed between the alteration in the enzymatic activity and a decrease in content of hemoglobin in prematurely born children with anemia.


[Effect of methotrexate on the activity of DNA-dependent RNA polymerases (A and B) in the spleen of mice infected with Rauscher leukemia virus and on the development of virus-induced leukemia].

Methotrexate was shown to inhibit development of Rausher's leukosis and growth of spleen. Activity of DNA-dependent RNA polymerases A and B was distinctly altered. The activity of RNA polymerase B was increased two-fold within the first days of the leukosis development; RNA polymerase A was activated five-fold in the course of subsequent progression of the impairment. Methotrexate inhibited the RNA polymerase activity in leukemic spleens. As suggested by correlation between weight of the spleen and the activity of RNA polymerases A and B, the enzymatic activity may be considered as a marker of the leukosis development.


[Thrombotic complications in the blocking effect of protamine sulfate on nonenzymatic fibrinolysis in the blood of animals during activation of the anticoagulation system].

Protamine-sulfate blocked non-enzymatic fibrinolysis not only in vitro but also in vivo through binding of heparin and dissociation of its complexes, which are of great importance as humoral components of the anticoagulation system. Almost complete blocking of humoral agents of the anticoagulation system, caused either by a single intravenous administration of protamine-sulfate at large doses or by repeated administration of the substance at moderate doses within 14 days, led to death of the animals as a result of thrombotic complications related to appearance of additional thrombin in blood circulation. In these cases thrombosis occurred into coronary blood vessels. The non-enzymatic fibrinolytic effect was not observed in extracts from lungs, auricula atrii and liver tissue of experimental animals, treated with protamine-sulfate, as compared with the controls, administered with physiologic solution.


[Modeling the oxidative detoxication function of the liver using electrochemical oxidation reactions].

An electrochemical system is developed, which permits to simulate oxidative reactions, processing in presence of cytochrome P-450. The system, combined with a dialyzing apparatus, may be used for oxidation and elimination of various hydrophobic substances of exoand endogenous origin from animal and human organisms.


[Disorders of oxidative deamination of biogenic amines in the myocardium in experimental atherosclerosis].

Statistically significant inhibition of oxidative deamination of several biogenic amines was found in mitochondrial fraction of heart muscle from rabbits and rats with experimental atherosclerosis and hypercholesterolemia, caused by various methods. Sensitivity of oxidative deamination of tryptamine to inhibitory effect of clorgyline (selective inhibitor of mitochondrial monoamine oxidases) was unaltered in rats with experimental hypercholesterolemia. The rate of oxidative deamination of beta-phenyl ethylamine, tryptamine, benzylamine as well as histamine and putrescine was inhibited after treatment of the mitochondrial fragments from healthy rabbit and rat heart muscles with preparations of oxidized linoleic and linolenic acids, concentration of which was increased in tissues under conditions of atherosclerosis.


[Activity of glycosidases in amniotic fluid cell cultures].

Deficiency of glycosidases is a fundamental feature of the hereditary diseases of glycoconjugate accumulation. The data obtained on activity of glycosidases in cell culture of normal amnionic fluid might be used as standards in prenatal diagnostics of hereditary glycolipidoses and glycoproteinoses. Use of cell culture of amnionic fluid for prenatal diagnosis of Tay-Sachs disease is described.


Ischemic heart disease. Precarious coronary lesions and prognosis.

Coronary arteriograms in 113 patients whose cases were followed for 2 to 12 years were analyzed in an attempt to discover why in some patients with angina pectoris there are long stable clinical courses and in others the courses proceed rapidly to death. It was found that patients with completed coronary occlusions, usually with distal portions reconstituted by collateral, had favorable prognoses with prolonged longevity. Patients with multiple high grade narrowings of the coronary arteries, on the other hand, had poor prognoses with high attrition rates. The more stenotic lesions present in the coronary arteries, the higher the attrition rates. Completed coronary occlusions, therefore, have been classified as nonprecarious while local coronary stenoses greater than 50 percent of the lumen diameter have been classified as degrees of precariousness according to the number of lesions present. When compared with classification by number of diseased vessels and by arteriographic score of Friesinger, the nonprecarious cases had better prognoses than the precarious.


Nosocomial varicella. Part II: suggested guidelines for management.

Because of the potential severity of varicella among patients with compromised immunity in hospitals, a case of nosocomial varicella demands immediate attention. Patients with varicella should be discharged or placed in strict isolation. Other patients in the hospital should be screened for varicella exposure and susceptibility, and isolated as necessary. Exposed staff members must also be screened for susceptibility. Prompt institution of these measures should prevent or reduce transmission of nosocomial varicella.


[Intraoperative diagnosis in vascular surgery (author's transl)].

The different methods of intraoperative diagnosis in vascular reconstructive surgery are described. Intraoperative angiography is of importance in the morphological assessment of reconstructive procedures, whilst functional assessment is based on pressure difference and basic and peak flow determination. The peripheral resistance can be calculated from these parameters. With intraoperative diagnosis the immediate postoperative occlusion rate is lowered and the haemodynamic state in the reconstructed part can be better judged, which is of prognostic value in long-term functional terms.


[Surgery of the mitral valve (author's transl)].

A report is given on the results of different forms of mitral valve operations in 866 patients. Closed mitral valvulotomy was performed in 519 patients and mitral valve replacement in 291 cases. Open mitral valve anuloplasty was performed as reconstructive surgical procedure in 15 patients. The overall mortality was 10.4%. Follow-up of the surviving patients showed that the long-term results of mitral valve replacement are significantly worse than those of mitral valve reconstruction.


[Surgery of extracranial carotid artery occlusion (author's transl)].

A report is given on the results achieved in 197 procedures undertaken for extracranial cerebrovascular insufficiency in 186 patients. Patch angioplasty of the common carotid and internal carotid artery were performed in 162 cases, whilst in 30 patients kinking or looping of the internal carotid artery was corrected by means of arteriopexy, segmental resection of the common carotid artery or by means of reimplantation of the transected internal artery proximal to its origin. Neurological deficits with incomplete recovery were observed in 2 cases (1%). The mortality rate was 3%.


[Endoscopic sphincterotomy and removal of a gallstone from the common bile duct (author's transl)].

Twenty-one patients with an average age of 69 years were subjected to endoscopic sphincterotomy of the papilla of Vater over the past six months. This therapeutic approach was successful and without ensuring complications in 20 of these patients. Hence, endoscopic sphincterotomy can be recommended in the case of elderly or high-risk patients as an alternative form of therapy to surgery with the attendent dangers of anaesthesia and, in particular, duodenotomy. However, it is unlikely to become a routine procedure since a team of highly-experienced specialists in endoscopy is mandatory with the close cooperation of radiologists and surgeons. The technique, indications and complications are mentioned.


[Peripheral pulmonary stenosis due to tumour compression (author's transl)].

A report is presented of the occurrence of peripheral pulmonary stenosis due to tumour compression in a 12 year-old boy. The tumour was identified as a liposarcoma of the mediastinum, which caused complete occlusion of the left pulmonary artery and stenosis of the right pulmonary artery. This was followed by an extreme increase in prestenotic pressure with right heart failure.


[Rickets prophylaxis by daily administration of vitamin D tablets (author's transl)].

The efficiency of a daily vitamin D prophylaxis with tablets ("Laevovit D3"), containing 1000 I.U. cholecalciferol was studied in newborn babies (most of them "prematures") over a period of about 5 weeks. The blood-values of 25-hydroxycholecalciferol were taken as parameter and determined 1 week and 5 weeks after the start of vitamin D prophylaxis. The data obtained were--with very few exceptions-- in a range considered to be protective against development of vitamin D deficiency. No significant difference could be found comparing vitamin D prophylaxis with these "microtablets" vs. liquid vitamin D preparations.


[Application of vasopressin in diagnostic radiology (author's transl)].

Vasopressin is demonstrated in 100 selected patients as a suitable drug to remove intestinal gas in diagnostic radiology. After subcutaneous injection of 10 IU Vasopressin only slight side-effects occurred in 35% of the patients. Under strict attention of the contraindications the use of Vasopressin is nearly without risk and leads to partially excellent results.


[Hospitalisation of patients with pulmonary tuberculosis (author's transl)].

The clinical symptoms of patients with pulmonary tuberculosis, transferred from other hospitals to the Pulmological Center of Vienna, were analyzed. Among 373 transferred patients there were 113 cases (30.3%) of pulmonary tuberculosis. A significant change in the range of symptoms between the examined period (1976/77) and former periods could be shown. By a more accurate regard of the symptoms a primary admission to pulmonary center should be possible in about half the cases and the interval between the primary symptoms and the initial treatment would be shortened in this way. It seems, that tuberculosis of the lung as common sickness only has historical significance, as acute illness of single patient it is still important.


[Treatment of osteoporosis with a new retard-preparation of sodium fluoride (author's transl)].

25 female patients with different forms of osteoporosis (progredient form in elderly patients, steroid osteoporosis, involutive osteoporosis) treated during a period varying between 1 to 24 months with a new compound preparation containing 25 mg sodium fluoride and 200 mg L-ascorbic acid per tablet. The daily dose amounts to 2 tablets. Clinical success was observed in 18 patients, X-ray controls showed increase of bone density in 8 patients. In 3 cases it was necessary to discontinue treatment because of side effects (2 patients with pains in the bones and joints, 1 patient with stomach troubles). Late side effects have not been observed. At present the treatment of certain forms of osteoporosis with sodium fluoride is the only effective therapy of this disease.


Effect of temperature on alanine uptake by membrane vesicles isolated from a psychrophilic marine bacterium.

The effect of temperature on the membranes of Ant-300, a psychrophilic marine bacterium, was studied by measuring alanine uptake by isolated membrane vesicles. Uptake was observed from 0 to 35 degrees C. The maximum initial rate of uptake occurred at 25 degrees C although more alanine was ultimately taken up at temperatures from 10 to 20 degrees C. An ARRHENIUS plot of these data shows a single infection point at 7.8 degrees C. Within 10 min, over 50% of the alpha-aminoisobutyric acid taken up by whole cells at 5 degrees C was lost after a temperature shift to 25 degrees C. Vesicles preloaded with alanine at 5 degrees C did not become leaky when shifted to 25 degrees C. In addition, exposure of the vesicles to 25 degrees C for 30 min did not affect subsequent alanine uptake at 5 degrees C. The data obtained suggest that the loss of the uptake and permeability control functions of membranes from psychrophilic bacteria at elevated temperatures is not due to degeneration of the membrane itself, but rather to a control or regulatory mechanism associated with whole cells.


Serum mineral changes due to exogenous ATP and certain trace elements in experimental diabetes.

The intravenous injection of zinc or manganese chloride immediately before and 15 minutes after alloxan or dithizone prevented the usual hyperglycemia observed 24 hours after induction of diabetes. Injection of zinc chloride in alloxan diabetes led to normalization of sodium while zinc, copper, iron and magnesium remained high and calcium and potassium remained low as in alloxan. In case of dithizone diabetes, the administration of zinc salt led to an increase in serum zinc, magnesium and potassium and to a decrease in serum calcium while the sodium level returned to normal. Manganese plus alloxan led to a normalization of serum zinc, copper, potassium and sodium. In the case of dithizone plus manganese only magnesium was raised while the other elements were unchanged when compared to animals injected with dithizone only. Chromium and cobalt lowered the blood glucose to a certain extent however it did not affect most of the elements. The same changes occurred in all elements as with alloxan or dithizone alone. Pretreatment with ATP led to a normalization of serum zinc, copper, magnesium, sodium and potassium, while in case of iron it remained high and calcium remained low as that found in alloxan diabetic rats.


[Fructose tolerance and utilization in healthy and chronically diseased liver].

In 12 patients with liver cirrhosis (LC) and 11 normal subjects (N) equimolar (0.75 g/kg/h for 4 hrs.) 14C-(1)-glucose and 14C-(1)-fructose infusions were administered. When given fructose, N and LC showed only a small increase of serum-glucose and -fructose concentrations in steady state. In N and LC the total fructose clearance was significantly higher than the total glucose clearance. No differences were found between N and LC. The metabolic clearance was equal in both groups when given fructose, whereas during glucose infusion lower in LC than in N. 30% of the infused 14C-fructose were recovered in 14C-glucose. The renal loss in both groups was higher for glucose than for fructose. A more extensive renal 14C-excretion during infusion of 14C-fructose was due to a higher 14C-lactate excretion.


[Sulfites in infusion solutions].

9 commercially available high-calorie carbohydrate solutions were investigated for their sulfite content. It became evident that 6 manufacturers of infusion solutions add varying amounts of sulfite to their solutions. We consider such an addition to be unnecessary and risky from the toxicological point of view.


[Effect of caffeine on motor reactions and visual-mental processing time].

The effect of coffee without and with caffeine (200 mg) on the performance of "awake" respectively "fatigued" subjects was proved. 5 females and 7 males (22 to 32 years) were chosen for the cross-over double-blind study. Motor reaction time, visual-mental processing time, reading-speed and reading-errors were recorded. Further experiments under aggravated conditions were carried out. In the morning ("awake") caffeine increases the efficiency of all parameters excepted the reading errors. At night ("fatigued") the increase by caffeine is insignificant. Even in some subjects caffeine decreases the speed of reading and increases the number of errors. Under test-conditions, which were aggravated by strong acoustical disturbance, caffeine does not improve efficiency, compared with caffeine-free coffee. Overriding into the range of decreasing performance in spite of increasing central activity was not found under any test-condition.


[Nutritional states in a medical clinic].

The nutritional state of 168 patients in a medical clinic was determined with the following parameters: Weight/height index, triceps skin fold, arm muscle circumference, creatinine/height index, albumin, prealbumin, transferrin and cholinesterase. Using these parameters we found that 51.2% of these patients were suffering from malnutrition (26.2% marasmus, 7.7% kwashiorkor-like syndrome, 17.3% marasmic kwashiorkor). Triceps skin fold, arm muscle circumference and creatinine/height index were the most precise parameters to confirm marasmus. Prealbumin and cholinesterase are especially recommended to determine acute protein deficiency, albumin to confirm chronic protein deficiency. It was also possible to demonstrate the deleterious effect of malnutrition on the immunological system of the patient through determination of the absolute lymphocyte count in peripheral blood and intracutaneous testing with streptokinase-dornase, mumps skin test antigen and candida vaccine.


Chemical and biological studies on banana fruit.

Chemical and biological evaluation of both the edible and nonedible portion of banana fruit was carried out. The possibility of using the nonedible portion (peel) as animal feed was also explored. The results showed a remarkable difference concerning the chemical composition of both the edible and nonedible portions. The amino acid contents were proved to vastly deficient with regard to the indispensable amino acids with exception of phenylalanine which was found in good amounts in the edible portion (pulp). The biological results demonstrated that neither the pulp nor the peel portions yielded good P.E.R. values when used at 6% protein level. The P.E.R values showed negative values which amounted to -1.75, -5.85 and -4.67 for the pulp and peel diets respectively. Incorporation of the stock diet to the peel diet resulted in a slight increase which amounted to 6% in both male and female rat groups.


[Diaplacental transfer of verapamil in guinea pigs (author's transl)].

Verapamil (1--50 mcg/kg/min) was given to guinea pigs by intravenous infusion for 30 minutes. The average clinical dosage amounts to 1 (0,5--2) mcg/kg/min. At doses of 1--10 mcg/kg/min we could not find pharmacologically effective concentrations of verapamil in plasma, although concentrations in mother rose corresponding to administered doses. Only at dosage 50 mcg/kg/min we found comparatively to the mother low, but clearly measurable concentrations also in fetal plasma. That means: Verapamil, administered to guinea pigs--hemomonochorial placentation like man--in dosage, given for tocolysis does not appear in fetal plasma with pharmacologically effective concentration.


[The maternal and perinatal mortality and morbitity in attendance to Caesarean section in the period from 1956--1976 at the UFK-Jena (author's transl)].

In the period from 1956--76 1 468 caesarean sections were accomplished at the UFK-Jena. 44 043 children were delivery during the 21-year period. The number of caesarean sections rose from 1,08% to 1956 to 10,8% in 1976. The fetal indication in 1956 was zero, on the other side it amounts to 34,3% in 1976. First place of the maternal indication in the 21-year period took in the cephalo pelvine disproportion. In the same time the maternal mortality in attendance of caesarean section was 12,3%. Considering the period between 1969--76, the maternal mortality fell to 2%. Maternal morbidity diminished from 1965 and obtained 23% in the period between 1974/1976. The feverish childbed took in the first place of the maternal morbidity (30%). The perinatal mortality fall from 28,57% in the period between 1956/1958 to 3,71% in the period between 1974/1976. The perinatal morbidity we could'nt state certainly. In 8,3% we found perinatal morbidity by acidosis. 5,5% of children, delivered by caesarean section needed medical care. 16,4% of all children were either small for gestational age or immature. The problem of caesarean section as an important method for termination of labor is discussed.


[The inhibition of coagulation in cord plasma (author's transl)].

203 Plasma samples from the umbilical vein were tested for their inhibitory activity in coagulation. Disturbance of the assay by the presence of thrombocytes, fibrin(ogen) degradation products and by storage was avoided by an improved preparation method of the plasma. The mean inhibition was dependent on the way of delivery (spontaneous, by vaginal operation or by caesarean section). The mean inhibition was also dependent on birth weight and on the duration of gravidity. A possible mechanism for the generation of the inhibition is discussed.


[Anatomy of cervical changes at the end of pregnancy (author's transl)].

The problem of anatomical changes in the uterine cervix at the end of pregnancy is discussed and contrasted to the anatomy of the uterine corpus during pregnancy. The muscles of the uterine cervix have proven functionally unimportant in contrast to earlier held views. However, the function of the myometrium of the uterine corpus has its well known significance. Very important changes appear, on the other hand, in the connective tissue of the cervix. The collagen and the ground substance are metabolized completely. As a consequence, the resulting structural transformation allows rapid dilatation of the cervix during delivery. We have to admit that, unfortunately, we have no causal explanation for the overal control of this connective tissue transformation either by hormones or by the autonomic nervous system.


[New possibilities of drug therapy for herpes simplex infections of the skin].

Jodo-desoxyuridine (IDU) of different concentrations in different vehicles can shorten the duration of primary infections and recurrences of herpes simplex virus (HSV) infections to about one third. Therapeutical failures can be due to the development of IDU resistence. Ethyl-desoxyuridine (EDU) in a gel base was found to reduce the mean duration of acute herpetic lesions to about 50%. 42 recurrences of 16 patients with herpes labialis and 36 recurrences of 10 patients with herpes genitalis were observed and statistically evaluated. In cold sores 0,3% EDU-gel had similar effects as the 2,0% EDU-gel, what shortened significantly (0,001 less than p less than 0,01) the duration of skin lesions. In herpes genitalis both concentrations had good effects. 0,3% EDU-gel reduced the healing time significantly (p less than or equal to 0,05). Remarkable was the quick disappearence of subjective complaints in all treated patients. Side effects were not observed.


[Pharmacokinetics of lidocaine after intramuscular injection in patients with acute myocardial infarction (author's transl)].

The kinetics of lidocaine after i.m. injection (M. deltoideus) of 300 mg were studied in patients with acute myocardial infarction in the course of 4 hrs.; another patient received this i.m. dose after being pretreated with 100 mg lidocaine i.v. The antiarrhythmically effective threshold concentration in plasma (1.5 mg/l) was reached after an average time of 5.5 min by 9 out of 10 patients. The mean value of maximum concentration after 30 min was 3.6 mg/l in 10 patients and the mean duration for exceeding the threshold (1.5 mg/l) was about 2 hrs. The elimination half-life for lidocaine valued 1.77 hrs. The toxic threshold concentration of 6 mg/l was exceeded for a short time by 3 patients without any side effects; in three other patients suffering from side-effects no relation to high plasma levels of lidocaine was observed.