[In vitro interaction between sex hormones and lysosomes isolated from rat liver and kidney].

With incubation in vitro of the liver and kidneys lysosomes of castrated rats together with 3H-testosterone and 3H-estradiol in the end concentrations of 2.38.10(-11) M (1 microCu) and 2.8.10(-10) M (2.49 microCu), respectively it was found that the lysosomes can bind labelled hormones. The treatment of lysosomes with membrane-toxic agents (90% aqueous acetone, phospholipase C and 0.1% triton X-100) results in the elimination of labelled steroids from them. In the interaction of 3H-testosterone and 3H-estradiol with lysosomes partake both proteins and lipids of the membranes.


[Comparative intensity of oxidative phosphorylation in different regions of the cerebral cortex of intact animals during anesthesia and hypoxia].

Experiments on 54 dogs with the use of the manometric method of Warburg proved that the level of oxidative phosphorylation in the brain cortex segments differing in the level of their phylogenic development is dissimilar. In the new cortex segment (sensomotor region) the oxygen and inorganic phosphorus uptake as well as the degree of their conjugation, as compared to the energy exchange intensity in the tissues of the old cortex (hippocampus), were found to show a higher level. Anesthetics, such as ether and sodium hexobarbital caused dissociation of the oxidative phosphorylation, more pronounced in the elements of the old cortical segments than in the new ones. The suppression of biochemical processes was especially profound under the effect of sodium hexobarbital and less marked under an ether poisoning. Hypoxia and combined action of an anesthetic and hypoxia produced inhibition of the energy exchange, more intensive in the new cortical segments.


Analysis and exploration of age-related changes in mammalian structure and function.

Although there is a large body of data showing an age-associated decline in the physiological systems of mammals, there is a great need for more descriptive information on the morphological and functional changes that occur with age. A powerful approach for ascertaining the extent to which age-related physiological changes limit the functional capacity of mammals is to study the effects of age on the response to challenges. Food restriction that markedly increases the mean life span of rodents also provides a potentially effective experimental probe of the aging process. Results are reported from our current research on morphologic and functional changes during the total life span of rats and on the influence of food restriction on these age-related changes. The data from our study of the lean body mass, adipose tissue mass, and adipose tissue structure indicate that current dogmas need to be reexamined; moreover, they clearly show the need for and the power of life-long descriptive studies. Our research on the influence of food restriction on age-related changes in functional activity supports the hypothesis that one mechanism by which food restriction increases the life span of rats relates to the delay in time of onset and a change in chronologic course of physiologic decline.


The structural organization of mouse chromatin as a function of age.

Chromatin is organized into a repeating structure (nucleosome) made up of proteins and DNA. Micrococcal nuclease and DNAase I have been used to probe this structure in nuclear populations from three tissues (liver, brain, and heart) of the inbred mouse strain C57BL at different ages. For those parameters examined, for each tissue, chromatin contained essentially the same features of nucleosomal organization, regardless of the age of the mouse. Thus, the rate and extent of nuclease digestion and the size of the DNA repeat unit and nucleosome core are not significantly different as a function of age. However, the accessibility of internucleosomal DNA to micrococcal nuclease, as determined by measuring the DNA size distribution after nuclease cutting, may be partially limited in chromatin of brain (but not liver or heart) of older animals. These results indicate that there are no gross, age-related changes in the conformational state or organization of chromatin in these tissues. The results do not exclude smaller alterations in chromatin that might occur with age, which the current methodology might not be sensitive enough to detect.


Protein synthesis and aging: studies with cell-free mammalian systems.

A cell-free system devoid of polysomes, which translates natural mRNA, has been prepared from rat liver. It contains ribosomal subunits, ribosomes, aminoacyl-tRNA synthetases, tRNAs, and protein factors necessary for translation. Protein synthesis required an energy-generating system, mRNA, and 3 mM Mg2+ concentration, and it was inhibited by 7-methylguanylic acid. The total extent and the rate of protein synthesis were approximately 30% greater when the translating system was prepared from livers of 3-month-old rats, as compared to 30-month-old rats. A ribosome-free fraction containing the protein factors required for translation was also prepared from 3-month-old and 30-month-old rat livers and brains, by extraction with 0.5 M KCl. The high-salt extracts were analyzed for elongation factors EF-1 and EF-2 in a poly(U) translating system. Although the activity of EF-2 was similar in preparations from young and old rats, the EF-1 activity in the 3-month-old rat livers and brains was 30 to 40% greater than in 30-month-old animals. The protein synthesizing activity of high salt-washed ribosomes stripped of endogenous peptidyl-tRNA and mRNA, from livers and brains of young and old animals, was the same.


Age-related changes in function of transfer ribonucleic acid of rat livers.

Changes in transfer ribonucleic acids during aging could be caused by alterations in regulation or mutation and give rise to slower and less accurate protein synthesis. Rodent liver parenchymal cells, purified from disaggregated livers, do decrease in ability to incorporate labeled amino acids during aging. Moreover, old rodents have a rapidly degraded fraction of liver soluble RNA which is absent from middle-aged animals. In addition, tRNAs purified from old unfractionated liver cannot be acylated as well as from young. High speed supernatant tRNAs from old and young liver are quite similar in acylation capacity. Analysis indicates that a defective subfraction of tRNA may be bound to the ribosomal fraction of the liver cell. Some evidence indicates that base modification levels differ in young and old rodent liver. Shifts in the proportions of lysine and serine isoacceptors during aging are consistent with this idea. One isoacceptor change is an increase in tRNAlys4, which is correlated with cell division capacity in other systems.


Influence of controlled dietary restriction on immunologic function and aging.

The underfeeding regimens tested in rodents for life span prolongation and/or immunologic effects result in a complex blend of protein and energy restriction while offering at least adequate amounts of all other essential nutrients. Underfeeding started at weaning and continued throughout life represents the only proved way of slowing the rate of aging in homeotherms. Mounting evidence indicates that underfeeding initiated later in life may also influence life span favorably. Old mice after lifelong restriction, or moderately aged mice (16.5 months) after 4.5 months of restriction, display "younger" immune systems than do age-matched, normally fed controls, as judged by response to mitogens, the mixed lymphocyte reaction, and other determinants. The immunologic effects of underfeeding, when measured quite early in life, are strain-dependent in the mouse. Diets designed to restrict the intake per week of energy (but not protein) produce the same effects on immune response capacity in very young mice as do energy restricted, protein unbalanced regimens. Underfeeding early in life drastically dampens thymic growth and alters the timing of involution. Early restriction also produces a profound lowering of body temperature in young (C57BL/10Sn x C3H/HeDiSn)F1 females. On the other hand, temperature lowering was not observed in males of this hybrid fed normally for the first year of life and restricted for 3 months prior to measurement. The mechanisms behind these various effects of controlled dietary restriction (i.e., undernutrition without malnutrition) are poorly understood at present.


Application of equivalent electrical circuit models to study of sodium transport across epithelial tissues.

An equivalent electrical circuit model for Na transport across epithelial tissues under steady-state conditions, which incorporates the flows and forces across the two limiting membranes and the paracellular pathway, is described. The analysis of electrophysiologic data obtained on rabbit colon within the framework of this model provides information regarding the thermodynamic activity of cell Na and the resistance offered by the mucosal membrane to Na entry. The interpretation of the data dealing with the active extrusion of Na from the cell across the basolateral membrane awaits more detailed information regarding the pump mechanism responsible for this movement; until then, the electromotive force across the basolateral membrane and the resistance of that barrier must be considered phenomenologic parameters that relate the Na current to the observed electrical potential difference.


Hormonal considerations in early normal pregnancy and blighted ovum syndrome.

The hormonal profiles of six pregnancies which terminated in miscarriage with the blighted ovum syndrome have been studied and compared with those of a group of patients similarly studied who had clinically normal pregnancies terminating in live birth at term. The serum chorionic gonadotropin (HCG) values were below normal or at the lowest limit of normal in five of six patients. Three patients had progesterone values within 1 SD of the normal, with normal serum estradiol values. It was concluded that the hormonal profile of early pregnancy is characterized by rising serum HCG and estradiol levels and a declining serum progesterone level from the 5th to the 8th week. The theoretical explanation for the dichotomy seems to be that the fetal adrenal anlagen, even at this early embryonic stage, can produce steroid precursors which are aromatized to estradiol. The production of progesterone, however, does not seem to be possible. Abnormal serum estradiol levels strongly suggest the absence of fetal development and a blighted ovum. However, no single hormonal level will distinguish between blighted ovum and potentially salvagable threatened abortion.


Sequential analysis of spontaneous abortion. II. Collaborative study data show that gravidity determines a very substantial rise in risk.

Evidence from more than 14,000 reproductive histories in the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and Stroke indicates that the risk of spontaneous abortion increases considerably with gravidity. Maternal age, memory errors, and sampling bias related to recurrence risk do not account for the trend. Clustering, or tendency for abortions to follow one another, occurs in histories which include live births.


Lysis of postoperative pelvic adhesions in infertility.

Ovum pickup, sperm transport, and zygote transfer depend on unrestricted contractile, ciliary, and peristaltic mechanisms in the uterine tube and ovary. When adhesions hobble these mechanisms, infertility results. Traditional surgical correction may invite new adhesions thru trauma, disruption of blood supply, and inflammatory reactions from foreign materials. Microsurgery with electrosurgery reduced such surgical sequelae and doubled the term pregnancy rate.


The importance of periadnexal adhesions in tubal reconstructive surgery for infertility.

In only a few studies of reconstructive surgery for infertility has the importance of periadnexal adhesions been examined with regard to the pregnancy rate. In the present study, 101 patients underwent reconstructive surgery for correction of infertility. Subsequent to surgery, 38.6% of the patients conceived, and 72% of the pregnancies terminated in live births. In analyzing the results, attention was focused upon the correlation between the severity of the periadnexal adhesions and the surgical outcome. By classifying the adhesions into four grades, an inverse relationship was noted between the grade of adhesions and the pregnancy rate. This relationship was consistent regardless of tubal condition, and thus became an important prognostic parameter. In the light of these findings it is felt that, in order to improve the results, more effort should be directed to the prevention of adhesion formation, together with the use of microsurgical technique in this particular field.


Hysteroscopy in 100 patients.

Seventy-five infertile patients and twenty-five in whom displacement of an intrauterine device (IUD) had occurred were examined under general anesthesia. The Storz 4-mm hysteroscope was utilized. In all cases Hyskon, high-molecular weight dextran, was used as the distention medium. Concurrent laparoscopy was performed in 80 patients. The hysteroscopic findings were compared with preoperative salpingograms or pelvic x-radiographs. In the infertility group the technique proved to be of special value in locating intrauterine adhesions which had not been detected radiologically. In the "lost IUD" group, hysteroscopy proved to be superior to radiography in determining whether or not a device was located within the uterine cavity, and greatly facilitated removal. Failure to carry out the procedure occurred in four patients. One suffered a serious complication: anaphylaxis to the dextran. It was concluded that hysteroscopy is a simple procedure carrying little risk. It is superior to hysterosalpingography in detecting intrauterine disease which may be a cause of infertility. It is greatly superior to radiology for the detection of lost IUDs.


Spontaneous cure of male infertility.

Four of sixteen couples whose infertility was thought to be due to a male factor achieved a pregnancy without treatment. Pregnancy without therapy, despite compromised sperm counts or motilities, has been documented by a number of other authors. Despite this information many studies concerning the treatment of male infertility neglect to include control groups, and pregnancies which occur are credited solely to the therapy. Such claims of therapeutic success should be viewed with caution.


Epididymal extravasation following vasectomy as a cause for failure of vasectomy reversal.

Twenty-eight men undergoing vasectomy reversal who were found to have no sperm in the proximal vas fluid on one or both sides underwent microscopic epididymal exploration. In 33 of 39 cases so explored, normal sperm were found in the epididymal fluid of the corpus, despite absence of sperm in the vas fluid. Epididymal histology distal to this site revealed extensive interstitial sperm granulomas resulting from rupture of the epididymal duct. Testicular biopsy revealed normal spermatogenesis. Secondary epididymal obstructions were noted when there was copious fluid in the vas deferens proximal to the vasectomy site as well as when there was scanty fluid. It is concluded that persistent azoospermia after an accurate microscopic vasovasostomy results from the secondary epididymal obstruction induced by rupture of the epididymal duct related to the pressure increase after vasectomy.


Is the low fertility rate after vasovasostomy caused by nerve resection during vasectomy?

Cross-sections of human spermatic cords and vasectomy specimens were prepared and the number and cross-sectional area of nerves were determined. On average, about one-half of all nerves in the near neighborhood of the vas deferens were resected during vasectomy. The total cross-sectional area of the nerves along the vasectomy specimens amounted to about one-half of the total area in the spermatic cord samples. The data support the hypothesis that removing nerves to the vas deferens during vasectomy could result in poor functional results after vasovasostomy, i.e., that powerful contraction of the proximal vas deferens and epididymis could be lacking.


Effects of human seminal plasma on fertilizing capacity of human spermatozoa.

Using zona-free hamster eggs and salt-stored human eggs for assessing the fertilizing capacity of human spermatozoa, the effects of human seminal plasma on fertilizing capacity of human spermatozoa were investigated. The persistent presence of seminal plasma prevented sperm attachment to and penetration into the zona pellucida and vitellus. A series of experiments with zona-free hamster eggs revealed that, once the spermatozoa were preincubated in a seminal plasma-free environment known to induce the acrosome reaction, the seminal plasma no longer interfered with sperm-egg fusion. The native seminal plasma appears to interfere with both the acrosome reaction and vigorous motility of the spermatozoa, and this could be the reason fertilization fails when the plasma is consistently present around the spermatozoa. The fertilization-disturbing factor or factors in the seminal plasma appear to be macromolecular substances or substances associated with macromolecules.


Effect of age and estrogen therapy on the immunoreactive human chorionic gonadotropin content of testes.

Levels of human chorionic gonadotropin (HCG) were determined in testicular tissue of young, apparently normal men; older men with carcinoma of the prostate; male transsexuals treated with estrogens; and also in seminal plasma of normal and vasectomized patients. In all samples with one exception (a 76-year-old male with cancer of the prostate), immunoreactive HCG activity could be detected. The immunoassayable HCG content was higher in testicular extracts from young adults as compared with older men with cancer of the prostate. In transsexuals receiving estrogen therapy, testicular HCG levels were also very low. A possible relationship between quantitatively normal spermatogenesis and the testicular HCG level has been discussed. HCG was detected in seminal plasma from both normal and vasectomized men. The origin of this HCG activity may be extratesticular, and the possible role of the prostate and seminal vesicle in the production of HCG-like activity has to be considered.


Mammary tumors and serum hormones in the bitch treated with medroxyprogesterone acetate or progesterone for four years.

After 4 years of a long-term contraceptive steroid safety study, the incidence and the histologic types of mammary dysplasia produced are shown to be similar in beagles treated with medroxyprogesterone acetate (medroxyprogesterone) or progesterone. Serum insulin, thyroid-stimulating hormone (TSH), triiodothyronine, growth hormone, prolactin, 17 beta-estradiol, progesterone, and cortisol were determined by radioimmunoassay on samples collected after 45 months of treatment. Serum growth hormone and insulin concentrations were elevated in a dose-related manner in both treatment groups. Levels of triiodothyronine, cortisol, and 17 beta-estradiol (medroxyprogesterone only) were lowered. TSH and prolactin concentrations were not changed. Pituitary-gonadal hormone interaction in the pathogenesis of mammary neoplasia of the dog is discussed. Prolonged treatment of beagles with doses of progesterone or medroxyprogesterone 1 to 25 times the human contraceptive dose or luteal phase (dog) levels, respectively, results in a dose-related incidence of mammary nodules.


[Cerebral water and electrolytes during changes in the osmolarity and volume of the extracellular fluid].

The increase of osmolarity in the blood serum after administration of polyethylenglycol-400 (PEG) as well as the sharp increase of the renal loss of fluid under the influence of furosemide insignificantly affected the water contents in the white and grey brain substance. A slight dehydration of the grey substance occured on combination of osmotic gradient effect and the renal loss of fluid. Preservation of initial hydration of the brain within the skull on administration of PEG and furosemide is due to redistribution of the fluid phases: dehydration of cells is followed by an increase in the volume of sodium-containing tissue fluid where upon the amount of sodium and calcium in the tissue practically does not change.


[Functional-morphologic analysis of several cortico-caudate connections].

The connections of motor, auditory, vestibular, associative, and visual areas of the cat cerebral cortex with caudate nucleus (CN), their topographical organization and mutual overlapping of their projection areas within CN, were studied. The cortical areas were found to be connected with CN simultaneously with fibers of different diameters, their relation as well as topography of terminals being different within morphologically heterogenous CN. Studies of terminal degeneration in CN after cortical ablations revealed a greater number of cortico-caudate pathways which included the synapses different in their localization, bouton sizes and the degeneration rate. Specifics of the organization of direct connections between functionally different cortical areas with CN in respect to physiological data, are discussed.


[Incorporation of 3H-phenylalanine into the proteins of cerebral neurons and glia during elaboration of a defensive conditioned reflex].

The passive avoidance conditioning enhanced incorporation of 3H-phenylalanine into the total proteins of neurons and glial cells of CA3 hippocampus area and motor cortex, layer V. During the strengthening and maintenance of the reflex (6, 9, and 24 hrs after the learning session), turnover of proteins in the neurons and glial cells of CA3 hippocampus returned (rapidly in neurons, slowly in glia) to the level of active control. In the motor cortex, this decrease did not stop at the evel of active control: protein tureover decreased even below this level in all the cells after 9 hrs while in neuronal nuclei as late as after 24 hours.


[Effect of spinal cord section on extravagal diaphragmatic reflexes].

In anesthetized vagotomized cats breathing under resting conditions, responses of the phrenic motoneurons to tracheal occlusion, and to changes of the lung and chest volumes were studied before and after cordotomy between C6 and T1. The cordotomy did not change the breathing rate whereas the inspiratory period shortened and expiratory one became longer. The cordotomy eliminated the slight shortening of inspiration in response to tracheal occlusion. The slight decrease of inspiratory excitation of phrenic motoneurons and prolongation of the expiration in response to tracheal occlusion remained. After the cordotomy the increase and decrease of chest volumes were not accompanied by any consistent changes in activity of the phrenic motoneurons.


[Analysis of geometric factors determining the parameters of an extracellularly recorded pyramidal neuron action potential].

Calculation of general extracellular field characteristics of a pyramidal neuron during generation of action potential included solution of the Laplas equation for extracellular field and Hodgkin--Huxley equations for electrotonic conduction along dendrites and for excitation of soma. The results were compared with available experimental data. The general factor for action potential amplitude near the soma seems to involve the distance from the soma rather than its size.


[Effect of oxygen supply on isolated rat heart energetics].

The total energy expenditure of the rat isolated heart and the external work of the preparation are positively correlated with the oxygen supply of the heart. A positive partial correlation was revealed between the total energy expenditure of the heart and the oxygen supply of the heart at constant external work of the heart which means that the heart efficiency coefficient decreases on an increase in the oxygen supply. By means of calculation of the partial regression of the heart total energy expenditure on external work at a constant oxygen supply, the "pure" efficiency coefficient of the heart (i. e. the ratio between an increment in the heart work and the corresponding increment of the total energy expenditure of the heart) was found to be about 41 per cent on the average.


[Hemodynamic structure of pressor reactions to vasoactive substances].

In cats, similar changes of the blood pressure had different hemodynamic structures under the influence of catecholamines or angiotensin. Adrenalin was able to evoke a pressor response by means to either caridac or vascular factor. In the former case, the increase in the cardiac output was induced both by an increasing blood flow towards the heart and by an additive outflow of the blood from the minor to the major circulation; in the latter case, the increase in the general peripheral resistance entailed a decrease in the cardiac output in spite of the augmentation of the venous return which determined a delay of the blood in the minor circulation. The latter variant of interrelationships among hemodynamic parameters can occur under the influence of noradrenaline as well. A combined similarly rendered participation of the cardiac and the vascular factors in the increasing the blood pressure occurs under the influence of angiotensin and sometimes of noradrenaline. The participation of cardiac output in the pressor response may depend on hemodynamic shifts in the minor circulation which either limit or facilitate, or leave unchanged the rate of increment of the cardiac output.


[Changes in the respiration of rabbits in a high pressure nitrogen-oxygen mixture].

In 14 unanesthetized rabbits, the parameters and the work of respiration, the electrical activity of respiratory muscles, the oxyhemoglobin content in the arterial blood, and the oxygen available in the cerebral cortex were studied in conditions of nitrogen-oxygen mixture (PO=0.2 kgc/cm2) under increased pressure: 6, 10, 20, 30, and 40 kgc/cm2. The 6 kgc/cm2 pressure decreased the lung ventilation, intensified the work of respiration and the electrical activity of external intercostal muscles. The 20--30 kgc/cm2 pressure entailed a gradual drop of the oxyhemoglobin content in the arterial blood and of the oxygen available in the cortex. The 40 kgc/cm2 pressure stopped the breathing in rabbits within 10--30 min. The data obtained reveal a limit of the increase in the density of inspired gas which for rabbits seems to be about 51.29 g/l.


[A simplified direct radioimmunoassay for urinary aldosterone (author's transl)].

A simplified direct radioimmunoassay for urinary acid labile aldosterone was developed. One ml of urine was hydrolysed with 2 ml of 0.2N HCL at 30 degrees C for 16hrs. One tenth ml of hydrolysed urine diluted 10 times with charcoal treated aldosterone-free calf serum was used for the radioimmunoassay. The radioimmunoasssay was done with a specific antibody, 125I-aldosterone, as the labeled antigen and polyethylene glycol for bound-free separation. There were excellent correlations between the present methods and other methods, i.e., i) a method using dichloromethane extraction before the assay as well as pre-extraction before hydrolysis and ii) a commercial kit using 3H-aldosterone. The intra-assay coefficient of variation was 5.8%, and the inter-assay coefficient of variation was 9.5%. The normal value of urinary aldosterone was excretion was 3.7 plus or minus 2.5 micrograms/day by the present method, and values of patients with primary aldosteronism were between 24 to 43 micrograms/day.


[A study on the biological action of hypothalamic tridecapeptide, neurotensin (author's transl)].

Investigations on various kinds of biological actions of a newly purified hypothalamic tridecapeptide, neurotensin, were performed both in vivo and in vitro by utilizing experimental animal models. The effect of neurotensin on pituitary gonadotropin release was studied in ovariectomized estrogen-progesterone-treated rats by the measurement of serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH) and prolactin (PRL) in radioimmunoassays. Neurotensin (340 mg/100 g BW) significantly increased serum LH and FSH 30 minutes after an intravenous injection (p smaller than 0.05) and lowered serum prolactin concentrations significantly (p less than  0.025). Bradykinin and substance P showed on significant effect on serum LH and FSH release. Intraperitoneal or intravenous administration of 0.5 n.mole neurotensin lowered blood pressure in intact mature rats from the range of 90 approximately 100 mmHg to 50 approximately 60 mmHg; however, tachyphylaxis was observed after repeated injections of the same dose of this peptide. Neurotensin was as potent as bradykinin in inducing rat duodenum relaxation and guinea pig ileum contraction in vitro. Theses effects on neurotensin and bradykinin on the intestines were not inhibited by the pre-treatment of phentolamine, propranolol, methysergide and pyribenzamine. Bradykinin induced contractions of the uterus in proestrous rats, but neurotensin induced no marked contraction. These results suggest that neurotensin in not hypothalamic releasing or inhibiting factor but possess the nature of kinin.


[Psoriasis vulgaris--decrease of serum immune complexes following photochemotherapy (author's transl)].

By means of a polyethylene glycol precipitate method [6] circulating immune complexes were examinated in increased concentration in 56 percent of the sera from psoriatic patients. The effect of photochemotherapy with external administration of 8-methoxypsoralen followed by irradiation with UVA was investigated. In 12 of 13 cases the serum immune complex concentration after the therapy was normal.


[Catamnestic study about the fertility of the man (author's transl)].

Collective investigations of fertility in childless married couples were carried out in 9 andrological health centres of the GDR. Analysis of 1937 spermatograms in comparison to fertility after 1 to 2 years shows: (1) Fertility decreases significantly at sperm density nearly 10 million per ml. (2) Motility below 60 per cent caused reduced fertility. Normal motility is more important than normal density of spermatozoa. (3) Fructose level doesn't correlate to motility or fertility of man.


[Re-interviews improve source-training in Gonorrhoea (author's transl)].

A sample should be given to improve the intensity of contact-tracing. Therefore three re-interviews were performed in two groups of patients suffering on gonorrhoea (Group A=1000;Group B=110 persons) with the aim to find out, how many persons could be traced more by re-interviews and could be found infected with gonorrhoea too. By re-interviews 12.0% more contacts could be traced, of whom 55.5% were infected.


Werner's syndrome: seven cases in one family.

7 cases of Werner's syndrome in one family of northern Sardinia (the female : male ratio being 4:3) are reported. A 9-year-old girl affected with Cooley's anemia is reported too. The typical complete pattern of the syndrome was observed in patients in the fourth decade of their lives, whereas in the two youngest ones, some features were missing. 1 patient died of gastric carcinoma, 1 of cachexia. Consanguinity was established in two generations. The genealogical tree suggests an autosomal recessive mode of inheritance. Genealogical, clinical, biochemical, and histopathological studies were performed. As far as we know, this is the largest number of patients with Werner's syndrome reported in one family.


[Palmar and digital varicosis - recurrent thrombophlebitides (author's transl)].

Venectasias of palms and fingers, more or less developed, occur relatively frequently in elderly people. Other terms are palmar and digital varicosis. This abnormality is rarely observed, but it is clinically important in the case of thrombophlebitis, appearing as small, painful, palpable nodules.


Treatment of basal cell carcinoma of the skin with 5-fluorouracil ointment. A 10-year follow-up study.

During the period 1966-1968, 88 patients with a total of 95 basal cell carcinomas were treated with 5% 5-fluorouracil ointment. A follow-up study carried out from November 1977 to January 1978 revealed a total of 12 recurrences in 56 surviving patients with 56 basal cell carcinomas. The recurrence rate is thus 21.4%. It is concluded that there is hardly any indication for using 5-fluorouracil in local treatment of nodular basal cell carcinoma.


Premature multiple Bowen's disease in poikiloderma congenitale with warty hyperkeratoses.

A constant gradual malignant degeneration of verrucous hyperkeratoses was observed in a now 16-year-old poikiloderma congenitale patient although topical immunotherapy of the warty lesions was partially successful and led to an improvement of T-cell functions.


[Primary disseminated herpesvirus hominis type 2 infection in a healthy adult].

A healthy 26-year-old patient presented a primary herpetic type 2 infection. The infection disseminated to the skin, the mucosa and the liver. The clinical course of the infection had a favorable issue.


Human articular cartilage in relation to age, A morphometric study.

The cell density of the weight-bearing area of normal femoral head cartilage was investigated in 65 cases of both sexes ranging from 6 to 90 years of age. In the maturing cartilage (until about the third decade), the cell density decreases, while in aging cartilage (30-90 years) it remains constant. Our results are in agreement with the main trend of earlier and similar investigations. The reason for contradictory reports is suggested to be due to differences in the selection of criteria for defining 'normal' cartilage. This problem is particularly acute with advancing age, where a great part of the available material shows degenerative changes.


Potentiation of leukemogenicity and infectivity of Rauscher leukemia virus by an enhancing factor present in egg fluids.

Sequential intraperitoneal administration of a low molecular-weight-enhancing factor, isolated from egg fluids, in mice infected with Rauscher leukemia virus (RLV) significantly stimulated viral replication. This was evidenced by elevated levels of viral DNA-polymerase in mouse sera. This stimulation of viral replication correlated with aggrevation of viral leukemogenicity, as reflected by increment of splenomegalic response and shortening of survival time. The in vivo potentiation of replication and leukemogenicity of RLV is achieved at least partly by the enhancing factor at the cellular level, since RLV replication was found to be stimulated also in an in vitro system. We assume that the stimulatory effect of the enhancing factor on viral replication is connected with its stimulatory effect on the synthesis of cellular DNA.


Selected morphological immunocytochemical and growth characteristics of three experimental rat gliomas and of their cells in vitro.

Tumors of the nervous system were induced in Sprague-Dawley and Long-Evans rats by weekly administrations of 6 mg/kg N-methyl-N-nitrosourea in the drinking water. Three of these tumors, a grade 2 mixed glioma, a grade 2 to 3 astrocytoma and a grade 1 to 2 oligodendroglioma, were established in culture and propagated in vitro. The mixed glioma strain (75SD-G-376) and the astrocytoma line (75SD-G-420) were repeatedly subcultured, cloned at passage 90 and 120 and designated as 75SD-G-376C and 75SD-G-420C clone, respectively. The growth rate of the oligodendroglioma cell strain (77LE-G-180) was very low and the cells died off after the 5th in vitro passage. The glial nature of all lines was ascertained by demonstrating the presence of the S-100 protein in the culture cells. 2 1/2 years after the establishment in vitro of the 75SD-G-376 and 75SD-G-420 primary cultures, mass cultures as well as clones derived from them are still producing S-100 and thus are clearly comparable to the primary cultures, at least in this respect. From a morphological standpoint based on light microscopy, cells of clonal lines with relatively few and short processes differ, however, from cells of primary cultures and their uncloned lines. Therefore, the cell morphology of these clones can be viewed upon as a form of adaptation to the in vitro conditions. It can be concluded that permanent cell lines with well-defined properties can be grown from experimental brain gliomas successfully established in culture and maintained in vitro.


Effects of murine tumor necrosis factor on heterotransplanted human tumors.

A partially purified glycoprotein fraction (the G-200 II fraction) obtained from sera of CD-1 mice sensitized with Corynebacterium parvum and treated with endotoxin was designated as tumor necrosis factor (TNF). Human melanoma cells exposed to this factor in vitro had decreased tumorigenicity when injected into nude mice. Human melanoma, embryonal adenocarcinoma of the testis and colon carcinoma heterotransplanted in nude mice exhibited regressions in size following intraperitoneal injections of TNF. The responses were related to dose and duration of exposure.


A new concept regarding the origin of the junctional and crevicular epithelium in rat molars.

The substitution of the internal enamel epithelium by a squamous epithelium during tooth eruption has been studied histologically in rat molars. Just prior to eruption, cytolysis of the connective tissue covering the cusp tip determines hyperplasia in the oral epithelium. A conspicuous infiltration results. Infiltrated undifferentiated cells form distinct cords which seem to be attracted by the internal enamel epithelium. They reaggregate when they come into its contact and form an underlying epithelium. The process starts in the superficial part and progressively extends towards the cervix. Finally, the internal enamel epithelium is expelled when desquamation begins. The lack of mitoses in both stratum intermedium and internal enamel epithelium and the pyknosis observed in the former, clearly show that the cells of the embryonic dental bell do not take part in the formation of the squamous epithelium as some authors still suppose.


Serum theophylline levels in asthmatic children after oral administration of a slow-release aminophylline preparation (Phyllocontin Continus tablets).

Twenty-seven asthmatic children aged 3--14 years who were considered to need continuous treatment were studied. Fifteen received a low dose of slow-release aminophylline and fifteen a high dose. There was a wide range of serum theophylline levels between individuals for similar doses. Fourteen of twenty children who had five or more levels measured throughout the day had differences between maximum and minimum levels of greater than 4 microgram/ml. The peak levels occurred between 2 and 6 hours after the dose. Only four children had levels exceeding 20 microgram/ml and none was symptomatic. We suggest a dose of 14 mg/kg/dose twice daily which should be reviewed after peak serum theophylline levels are measured.


The problem of the bronchitic patient.

Chronic bronchitis is probably associated with two distinct processes, 'hypersecretory chronic bronchitis' and 'obstructive chronic bronchitis'. These, however, have common causes and typically chronic bronchitis develops as a result of several factors in conjunction. Smoking, air pollution and infection all predispose to chronic bronchitis and elimination of these hazards can slow the progress of the disease.


A comparison of controlled-release aminophylline (Phyllocontin Continus tablets) and sympathomimetic bronchodilators.

In a crossover trial on twenty-four patients with reversible airways obstruction the rise in FEV1 on Phyllocontin Continus tablets (15%) was comparable to that achieved with Alupent tablets (14%). The usage of inhaled salbutamol and frequency of attacks of wheeziness were both greater when the patients were taking Alupent tablets. In a second study the effect of Phyllocontin tablets and Ventolin tablets both in combination with inhaled Ventolin and alone were examined. It was found that on Phyllocontin tablets alone patients showed a similar improvement (22%) in FEV1 to Ventolin tablets alone (19%). When inhaled Ventolin was added to Phyllocontin tablets a further rise in FEV1 was seen but not when inhaled Ventolin was added to Ventolin tablets.


A comparative assessment of three bronchodilator preparations in general practice.

Phyllocontin Continus tablets and Ventolin Spandets were compared in a crossover study in eighteen patients with reversible airways obstruction. Results showed that Phyllocontin Continus tablets produced a highly significant (p less than 0.002) improvement in PEFR compared with Ventolin Spandets. A further comparison of Phyllocontin Continus tablets and Choledyl tablets in nineteen patients with reversible airways obstruction showed that Phyllocontin Continus tablets brought about a greater improvement in PEFR and gave better protection from breathlessness than Choledyl tablets.


Theophylline levels in patients receiving a controlled-release aminophylline preparation (Phyllocontin Continus tablets).

The author describes a study which was designed to establish the blood theophylline levels in patients taking a constant dose of controlled-release aminophylline tablets.


General principles in the management of asthma in childhood.

The author draws upon his extensive experience as a paediatrician to describe the assessment and management of the asthmatic child. The role of various drug therapies is discussed.


Long-term effects of propylthiouracil-induced neonatal hypothyroidism.

Hypothyroidism was induced in neonatal Sprague-Dawley rats by adding propylthiouracil to the lactating female's food and water. Behavioral evaluation on a 6-item battery occurred from 70 to 114 days of age. Results indicated long-lasting behavioral changes in the neonatal hypothyroid animals characterized by increased activity and decreased performance on avoidance and escape learning. Serum thyroxine levels were reduced in the hypothyroid animals throughout the 120-day period. Experimental animals also had fewer synaptic contacts in the cerebellar cortex when analyzed at 90 days of age.


Developmental and genotypic effects on pituitary-adrenal function and alcohol tolerance in mice.

Lactating females of 2 lines of mice selectively bred for long (LS) and short (SS) ethanol-induced sleep time (a measure of alcohol tolerance) consumed either tap water or 10% ethanol in tap water on Days 2-14 postpartum. Effects of genotype and neonatal treatment on offspring open-field behavior, alcohol-induced sleep time, and adrenocortical responsiveness to alcohol or saline injection were studied. The LS mice had higher ethanol-induced sleep times than SS mice, and also higher plasma corticosterone levels following alcohol challenge. The LS mice also responded more to saline injection and to novelty stress, suggesting that they were generally more responsive to stressors than SS mice. Significant genotype-dependent effects of neonatal treatment on (1) adrenocortical responsiveness to injection stess and (2) alcohol tolerance were noted. However, these 2 effects did not appear to be causally related. Neonatal treatment had no effect on open-field activity or defecation in either genetic line.


Development of the acoustic startle response in the rat: ontogenetic changes in the magnitude of inhibition by prepulse stimulation.

Three experiments examined the development of the acoustic startle reflex and its modification by a preliminary stimulus in the infant rat during the 2nd and 3rd postnatal weeks. The 1st experiment employed a white noise S1 (20 msec, 70 dB), the 2nd a cutaneous S1 (.5 msec, .5 mA and 1.0 mA shock), and the 3rd identical S1-S2 pairs (20 msec, 10 kHz, 110 dB tones). The results demonstrate a similar maturation of the prepulse modification pattern over days in the 3 experiments, evidenced mainly in the growth of inhibition. The findings indicate peripheral and central mechanisms that are maturing during the period of life under observation and that contribute to the developmental patterns of modification.


Influence of neonatal injections of testosterone propionate on sexual behavior and plasma testosterone levels in the male house mouse.

The effects of neonatal testosterone injections on adult male sexual behavior and plasma testosterone levels were investigated in several strains of male house mice. Both sexual behavior and plasma testosterone levels were increased in the testosterone-treated groups from some strains, but the 2 variables did not change concomitantly.


Behavioral effects of rotation between lactating and nonlactating females.

Rat pups stunted by housing only 8 hr daily with lactating females and 16 hr with nonlactating foster mothers showed a delay in returning to their nest from other parts of the home cage. This delay was not due to changes in activity level or to lack of attraction to the nest, but appeared to be perceptual in nature. Both lactating and nonlactating females caring for stunted litters tended to be more maternal than those caring for control pups. After nutritional rehabilitation, the adult experimental animals showed no deficits in learning a series of visual discrimination problems in a modified version of the Lashley jumping stand procedure with a nonappetitive reinforcement. We compared the results with those obtained when other methods of stunting animals are employed and concluded that different methods of stunting may result in both common and divergent effects on behavior. Although many methods of stunting may produce similar behavioral deficits during the period of food deprivation, after rehabilitation behavioral deficits reported with other techniques of stunting may be due to extranutritional causes rather than to reduced food intake per se.


Effects of dichloroacetate on lipid metabolism in isolated rat liver cells.

Administration of dichloroacetate (DCA) to normal rats resulted in a fall in serum glucose and triglycerides and a rise in ketone bodies. Insulin and cholesterol levels were unchanged. The effects of DCA on lipid metabolism were examined in isolated rat hepatocytes. At 10 mM DCA, the incorporation of tritiated water into fatty acids (saponifiable lipids) was inhibited by 33 +/- 4% (mean +/- SEM, N = 5). No effect on incorporation into cholesterol (measured as nonsaponifiable lipids) was observed. DCA inhibited the incorporation of 14C-glucose into lipid but had no effect on glucose oxidation. Fatty acid oxidation was increased by 76 +/- 7% (mean +/- SEM, N = 6). However, DCA had no effect on the recovery of newly synthesized lipid. Thus, inhibition of tritiated water incorporation into fatty acids represents decreased synthesis rather than increased turnover. DCA did not affect the incorporation of 14C-palmitate into triglycerides or phospholipids. Cell viability, as assessed by incorporation of 3H-isoleucine into protein and trypan blue exclusion, was not affected by DCA. These results suggest that DCA lowers serum triglycerides through inhibition of fatty acid synthesis and stimulation of fatty acid oxidation by liver.


Downregulation of insulin receptors in obese man.

In an attempt to determine whether the decreased number of insulin's receptors in obesity is a result of downregulation of the receptors, diazoxide (5 mg/kg/d) was given to 10 obese subjects. Insulin's suppression by diazoxide in these 10 subjects resulted in a mild glucose intolerance and an increase in insulin's receptors in seven of the 10 subjects. The subjects could be divided into three groups by analyzing the Scatchard plots of their insulin receptor studies before and after diazoxide. Four subjects exhibited an increase in both high affinity and low affinity receptors, three showed an increase only in high affinity receptors, and three failed to demonstrate any change in receptors in response to diazoxide. These studies support the concept that the decreased number of insulin's receptors observed in obesity is a result of the downregulation of the receptors and is not the primary, underlying cause of insulin resistance in obesity, although a contributory role cannot be ruled out.


Malformations in infants of diabetic mothers occur before the seventh gestational week. Implications for treatment.

In the present study we used a developmental morphologic approach to fix the latest time in development at which the malformations commonly reported in infants of diabetic mothers could occur. Developmental morphologic dating shows that the significantly more common congenital malformations in infants of diabetic mothers occur before the seventh week of gestation. This suggests that any therapeutic intervention aimed at decreasing the incidence of congenital malformations must be instituted during the critical early period.


Circulating glucagon antibodies in children who have insulin-dependent diabetes mellitus. Clinical significance and characterization.

A substance present in the sera of diabetic children that interferes with the radioimmunoassay for glucagon was found in six of 66 children who were participating in an inpatient study of diabetic control. Detailed studies documented unequivocally that this glucagon-binding substance is a specific antibody to glucagon and is located in the immunoglobulins. In a survey of diabetic children in the outpatient diabetes clinic and in a diabetes summer camp, antibodies to glucagon were found in about 12% of those evaluated. However, no children who had had diabetes for less than three years were found to have antibodies, and there appeared to be an increase with increasing duration of disease of up to greater than 20% at eight years' duration. The presence of glucagon antibodies may be of pathologic significance in that the patients have a greater tendency to develop hypoglycemia than do diabetic children without glucagon antibodies.


Factors related to diabetes mellitus in Puerto Rican men.

Urban-rural comparisons of the prevalence of diabetes were made in a cohort of 2567 rural and 6190 urban participants aged 45 to 64, in the Puerto Rico Heart Health Program. The prevalence of diabetes in the urban population was more than double that in the rural. Consistent with this, blood glucose concentrations were significantly higher in urban than in rural populations. The prevalence of diabetes increased with age and relative weight. It was associated with elevations of serum cholesterol, blood pressure, and fasting serum triglycerides. A positive family history was found more commonly in diabetics than in nondiabetics. If there was a history in both a sibling and a parent, there was at least a threefold increased prevalence over those with no family history. The reason for the higher prevalence of diabetes in the urban than in the rural area is elusive. In obese men, the urban and rural prevalence rates are the same, but, among relatively lean men, the prevalence in the urban area is twice that of the rural men.


The effect of age on insulin-degrading activity in rat tissue.

Insulin-degrading activity was measured in the 100,000g supernatant fraction of muscle, liver, and kidney from rats of varying ages. Young animals (four weeks old) had the highest activity in all three tissues. By seven weeks of age the activity in both muscle and liver had decreased significantly as compared with four-week-old animals. A slight but nonsignificant decrease occurred in kidney. In animals over one year of age the insulin-degrading activity in all three tissues was significantly less than the activities at either four or seven weeks. In contrast the effect of age on degradation of albumin and parathormone was much less marked.


Glycosylated hemoglobins: increased glycosylation of hemoglobin A in diabetic patients.

The components of the hemoglobin-A1 fraction--hemoglobins A1a--c--arise from nonenzymatic glycosylation of hemoglobin A at the beta-chain N-terminal amino groups and can be resolved from hemoglobin A by cation exchange chromatography. Glycosylation can also occur at the alpha-chain N-terminals as well as the epsilon-amino groups of lysine residues of both alpha- and beta-chains; this results in glycosylated species appearing in the hemoglobin-A fraction. In this study, we determined the extent of hemoglobin-A glycosylation using a colorimetric chemical method specific for the detection of ketoamine-linked hexoses in proteins. We demonstrate increased glycosylation of the main hemoglobin-A fraction in diabetic patients, which correlates significantly (r = 0.72, P less than 0.001) with the hemoglobin-A1 percentage determined by column chromatography in the corresponding hemolysates. This finding provides the basis for the application of this chemical procedure to the measurement of total glycosylation of hemoglobin.


Theophylline: potentiation of arginine-induced somatostatin release from the isolated rat pancreas.

Somatostatin's release from the isolated rat pancreas was studied using a perfusion technique. Arginine at a concentration of 19 mM produced a biphasic increase in somatostatin release from the perfused rat pancreas. Both first and second phases of somatostatin's increase are significantly higher in the presence of 1 mM theophylline than in the absence of the drug. These results indicate the possible inclusion of the adenylate cyclase--cyclic AMP system in the regulatory mechanism of rat pancreatic somatostatin secretion.


Fatty acid desaturation in experimental diabetes mellitus.

Microsomal fatty acid desaturation is defective in streptozotocin-induced experimental diabetes. This defect is correctable by insulin treatment. The electron transport chain needed for microsomal fatty acid desaturation was studied in liver microsomes of streptozotocin diabetic rats, and the defect was localized to the terminal desaturase enzyme. Cytochrome b5 levels were elevated in the face of decreased fatty acid desaturation and returned to normal after 48 h of insulin treatment; 2 U of regular insulin every 6 h for 24 h repaired the fatty acid desaturation defect, while 0.5 U failed to correct the defect. Both the delta 6 and delta 9 desaturase defects (linoleic acid and stearoyl-CoA desaturation) required similar amounts of insulin and periods of time for correction, although these are different enzymes. This is consistent with the desaturation defect being due to a protein synthetic effect. Diabetic rats treated twice daily with injections of 4 U of NPH insulin showed a "super" repair of their desaturase defect by 48 h: delta 9 desaturase activity increased eight times over control activity, while delta 6 desaturase activity increased two and one-half times over control activity. This, together with the fact that delta 6 desaturase activity in diabetes (64% of control) is altered less than is delta 9 desaturase activity (22% of control), indicates that delta 6 desaturase enzyme activity is less responsive to insulin than is delta 9 desaturase enzyme activity. The physiologic significance of altered fatty acid desaturation in diabetes mellitus is unknown.


Splanchnic metabolism of alanine in intact man. Effects of somatostatin and somatostatin plus insulin.

We examined splanchnic metabolism of alanine in 15 normal males under three sets of conditions: infusion of saline (control studies); infusion of somatostatin (SRIF) (bihormonal deficiency of insulin and glucagon); and infusion of somatostatin plus insulin (selective glucagon deficiency). Net splanchnic alanine uptake (NSAU) remained stable over 2 h during infusion of saline. Infusion of SRIF was associated with a fall in estimated hepatic plasma flow (EHPF) whether or not insulin was infused concomitantly. With SRIF only, arterio-hepatic venous alanine differences increased such that NSAU remained stable over 2 h, despite the fall in EHPF. In contrast, with selective glucagon deficiency, NSAU fell significantly after 2 h, an effect consequent on a fall in EHPF and a delayed fall in arterio-hepatic venous (A-HV) alanine differences. Our studies are compatible with a role for basal glucagon in maintenance of splanchnic extraction of alanine in normal man. However, the SRIF-initiated fall in EHPF may exert an influence on A-HV alanine differences independent of changes in pancreatic hormone secretion.


Bile acid metabolism in benign recurrent intrahepatic cholestasis. Comparative studies on the icteric and anicteric phases of a single case.

Bile acid compositions in the serum, urine, bile, and feces were examined in a typical case of benign recurrent intrahepatic cholestasis for a period of 3 yr. The serum cholesterol level remained almost constant. The serum and urinary levels of total bile acids increased markedly during the icteric phase but returned to normal toward the anicteric phase. Daily fecal excretion of bile acids in the anicteric phase was about three times the normal value. Bile acids in the bile and feces, and in the serum and urine, mainly consisted of chenodeoxycholic and cholic acids, with little deoxycholic acid even in the anicteric phase. Scarcely any coprostanol was found in the feces. These observations suggest that metabolism by intestinal bacteria was altered in this patient. The ratio of cholic acid/chenodeoxycholic acid in the serum was above 2.0 in the icteric phase but was reduced to 0.9 in the anicteric phase. At least three unusual bile acids, designated as peak 7a, 11, and 13, were detected in the feces. The amount of bile acid in peak 7a reached about 10% of the total in the anicteric phase.


Erythromycin ethylsuccinate-induced cholestasis.

A 52-year-old Caucasian female developed abdominal pain, fever, and jaundice after erythromycin ethylsuccinate administration. Similar symptoms followed the administration of the same drug 5 mo earlier. It is believed that this is the first published case of erythromycin ethylsuccinate-induced cholestasis.


Small intestinal biopsy in a patient with Crohn's disease of the duodenum. The spectrum of abnormal findings in the absence of granulomas.

The case is reported of a patient who presented with an occult anemia that was due to Crohn's disease of the duodenum. The initial evaluation revealed low serum levels of iron, folate, and carotene, and a small bowel series was abnormal but not diagnostic of Crohn's disease. Numerous small intestinal biopsy specimens were obtained from the duodenum and proximal jejunum in an unsuccessful attempt to make a diagnosis. It was shown by radiography and laparotomy 2 yr later that the patient had Crohn's disease of the proximal small intestine. This report provides a detailed analysis of the spectrum of abnormalities found by peroral mucosal biopsy in this patient. These abnormalities were patchy and included flattened mucosa, an abnormal surface epithelium which was infiltrated by large numbers of polymorphonuclear leukoyctes, increased plasma cells and polymorphonuclear leuckocytes within the lamina propria, crypt abscesses, erosions, granulation tissue, and pyloric gland metaplasia, all in the absence of granulomas. Crohn's disease should always be considered in the differential diagnosis of a proximal small bowel mucosal disease, especially when a constellation of acute inflammatory changes is present.


Adrenal corticosteroids cause gastrin cell hyperplasia.

Chronic exogenous high dose adrenal cortical steroid administration to dogs resulted in a 137% increase in G-cell mass with an associated enhancement of peak serum gastrin levels. Adrenalectomy caused a halving of G-cell numbers without significant changes in serum gastrin levels. Adrenal cortical steroids appear to have an important trophic role for the G-cell.


The role of intraluminal junction potentials in the generation of the gastric potential difference in man.

Using flowing isotonic NaCl or flowing molar KCl electrodes, the magnitude of liquid junction potentials between the electrode tip and gastric juice was measured directly, and calculated from electrolyte concentrations in gastric juice according to standard formulas. Gastric transepithelial potential difference was obtained by subtracting the junction potential from the measured gastric potential difference. Junction potentials by direct experiment correlated closely with calculated values. The magnitude of the junction potential was shown to depend on the level of gastric acidity as well as on the nature of the flowing intraluminal electrode. However, transepithelial potential difference was always the same with the two electrode solutions. It is impossible to measure junction potentials with an intraluminal KCl agar electrode, but they must exist because these electrodes did not accurately measure transepithelial potential difference when gastric acidity was high. Pentagastrin caused a transient decline in transepithelial potential difference; this was not observed in patients with pernicious anemia. We conclude that accurate measurement of transepithelial potential difference must include correction for liquid junction potentials, which are sizable when gastric acidity is high. This can best be done with a flowing intraluminal electrode.


Effects of prolonged administration of metiamide on serum gastrin, gastrin content of the antrum and gastric corpus, and G-cell population in the rat.

The effect of prolonged metiamide administration on serum gastrin, gastrin content of the antrum and gastric corpus, and G-cell population was studied in the rat. A single subcutaneous injection of metiamide (200 mg/kg) at the onset of 16 days of continous treatment with three daily injections was followed by a fivefold increase in serum gastrin level at 4 hr in fasted and at 4 and 6 hr in fed rats. After 16 days of metiamide, the fed rats showed a peak in serum gastrin level of the same magnitude as on day 1, but only at 4 hr. Two hours later, the levels decreased rapidly to basal values. In the fasted animals, the response to metiamide was reduced to a threefold increase at 2 hr. There was no difference in gastrin content of the antrum and gastric corpus nor in volume density of the G-cells after the prolonged treatment compared with the controls. It is concluded that in spite of rises in serum gastrin, prolonged metiamide medication has no effect on the gastrin content of the antrum and gastric corpus nor on the G-cell population in the rat. Furthermore, after prolonged treatment, metiamide-induced gastrin release is diminished.


Comparison of acid secretion rates measured by gastric aspiration and by in vivo intragastric titration in healthy human subjects.

In nine healthy subjects acid secretion rates, measured first by gastric aspiration and then by in vivo intragastric titration to pH 5, were compared. In vivo intragastric titration was initiated by instilling 50, 100, or 700 ml saline (pH 5) into the stomach, followed by a continuous intragastric saline infusion at 3.3 ml/min. Irrespective of the volume of saline used to initiate in vivo intragastric titration, acid secretion rates during titration were two to three times greater than secretion rates during gastric aspiration (P less than 0.005). This difference was not due to transpyloric acid losses during aspiration, since such losses were corrected for by nonabsorbable marker recovery; nor was the difference due to a higher intragastric pH during in vivo titration, since significant differences in acid secretion rates between aspiration  and titration persisted when in vivo titration was performed at an acid pH. These findings suggest that in vivo intragastric titration leads to higher measured acid secretory rates than gastric aspiration because the titration method is associated with gastric distention and even small degrees of gastric distention stimulate gastric acid secretion.


Liver collagen synthesis in schistosomiasis mansoni.

We determined collagen synthetic rates and utilization of key amino acid precursors of collagen in slices of wedge liver biopsy specimens obtained at required surgery from 9 patients with hepatosplenic schistosomiasis and from 4 control patients. The liver specimens from the patients with schistosomiasis showed advanced fibrosis, with histologic evidence of schistosomiasis alone in four, and both schistosomiasis and chronic active hepatitis in five cases. Liver slices were incubated with radioactive proline, arginine and glutamine, using quantitative assay conditions validated earlier for murine schistosomiasis. Collagen peptide synthesis in slices from all nine fibrotic liver specimens was 4- to 25-fold greater than normal and correlated positively with liver collagen content, which was 2- to 5-fold greater than normal. Free proline, an amino acid that may contribute to regulation of collagen peptide synthesis, was increased in six of the nine fibrotic liver specimens, and proline was actively formed from arginine in liver slices from all specimens. These measurements of the initial steps of collagen biosynthesis in fibrotic human liver are quantitatively similar to those previously made of the same processes in experimental animals.


Biliary mannitol clearance and bile salt output before and during secretin choleresis in the dog.

The clearance of 14C-mannitol in the bile before and during intravenous secretin was measured in anesthetized dogs receiving a constant infusion of taurocholate. During secretin, bile flow (+80%) and bicarbonate output (+140%) both rose while bile salt output was unchanged (+2.4%). Mannitol clearance increased significantly by 20 +/- 8% (P less than 0.05). The ratio of bile salt output to mannitol clearance fell significantly after secretin by 14 +/- 7% (P less than 0.01). Secretin caused, therefore, a significant rise in mannitol clearance in this canine preparation. This may be due either to a rise in the bile salt independent fraction of canalicular bile or to tubular entry of mannitol.


Permeability of the diaphragm and fluid resorption from the peritoneal cavity in the rat.

The ability to remove fluid from the peritoneal cavity is greatly impaired in rats after sealing the diaphragm (abrading such that fibrous tissue forms). The in vivo resorptive capacity of rats with sealed diaphragms was significantly reduced from 12.3 +/- 1.77% . hr-1 in controls to 5.05 +/- 2.53% . hr-1 in rats with sealed diaphragms. The in vitro permeability of isolated diaphragms for mannitol, inulin, and dextrans of mol wt 16,000 and 75,000 was 4.69 +/- 0.74, 1.16 +/- 0.22, 0.54 +/- 0.11, and 0.22 +/- 0.04 cm . sec-1 . 10(-6) for controls, and 0.54 +/- 0.24, 0.19 +/- 0.19, 0.09 +/- 0.03, and 0.08 +/- 0.02 cm . sec-1 . 10(-6) for sealed diaphragms, respectively. The reduction in the permeability of the fibrosed diaphragm to larger molecules could account for the reduced resorptive capacity.


Hepatitis B e antigen, DNA polymerase activity, and infection of household contacts with hepatitis B virus.

To determine if the presence of hepatitis B e antigen (HBeAg) and elevated DNA polymerase activity in the serum of chronic HBeAg carriers indicate increased contagiousness in a household setting, the household contacts of 74 carriers were prospectively evaluated for serologic evidence of hepatitis B infection. Thirty of the HBsAg carriers had HBeAg and 44 had anti-HBe. Twenty-eight HBeAg-positive carriers regularly demonstrated elevated DNA polymerase when serially drawn serum samples were analyzed. None of the anti-HBE-positive carriers demonstrated elevation of DNA polymerase activity. Both household contacts of HBeAg-positive and anti-HBe-positive carriers demonstrated serologic evidence of hepatitis B infection (HBsAg, anti-HBs, and anti-HBc). However, infection was significantly more frequent among spouses and sexual partners of carriers who had either HBeAg (P less than 0.001) or elevated DNA polymerase activity (P less than 0.001). Thus, the data indicate that a particular subpopulation of spouses and sexual partners of hepatitis B carriers are at significantly greater risk for acquiring infection.


Histometric and serial section observations of the intrahepatic bile ducts in primary biliary cirrhosis.

Histometric examinations, based on the assumption that hepatic arterial branches and bile ducts run parallel within the portal tracts, suggest that in primary biliary cirrhosis bile ducts with a lumen (the smallest diameter between the subepithelial basal membranes) below 70--80 micron are destroyed. The smaller the ducts, the more they destroyed. Extensive destruction of the ducts was seen more frequently in the nonfibrotic stage of primary biliary cirrhosis than in later stages. Serial sections of the intrahepatic bile ducts in primary biliary cirrhosis revealed three types of periductal lesions preceding the disappearance of bile ducts: (A) periductal cellular reaction including features of chronic nonsuppurative destructive cholangitis, (B) periductal edema, and (C) periductal fibrosis. In the nonfibrotic stage, types A and C were frequent, whereas in the fibrotic stage types A and B were increased, and type C was predominant in the cirrhotic stage.


Leukocyte migration inhibition in response to biliary antigens in primary biliary cirrhosis, sclerosing cholangitis, and other chronic liver diseases.

The leukocyte migration inhibition test has been used to investigate cellular immune responses to antigens in a protein fraction (BPF) of normal human gallbladder bile in patients with a variety of intra- and extrahepatic diseases. Inhibition of leukocyte migration in the presence of BPF was observed in 30 (81%) of 37 patients with PBC, in 8 (80%) of 10 patients with sclerosing cholangitis, and in 7 (26%) of 27 patients with chronic active hepatitis. Only 1 of 31 patients with other liver diseases or with uncomplicated ulcerative colitis showed a similar response to BPF. The BPF was found to contain three antigens which were distinct from plasma proteins. Immunofluorescence studies revealed that one of these antigens appears to be derived from that part of the hepatocellular membrane which forms the bile canaliculus and that a second appears to be associated with the epithelial cell membranes of interlobular and septal bile ducts. The site of origin of the third antigen could not be established. It is suggested that cellular immune responses to biliary antigens could be involved in the progressive bile duct destruction of chronic biliary disease.


Intact hepatocyte theory of impaired drug metabolism in experimental cirrhosis in the rat.

The elimination of propranolol by perfused livers of rats made cirrhotic by chronic carbon tetrachloride inhalation during phenobarbital treatment has been compared with control animals receiving only phenobarbital. Cirrhosis reduced propranolol clearance at a constant flow of 20 ml/min from 1.43 +/- 0.08 to 1.12 +/- 0.08 ml/min/g liver (P less than 0.025). In addition, an increase in intrahepatic shunting of 15-micron microspheres from 0.41 +/- 0.01 to 9.4 +/- 4.1% was found in cirrhotic livers (P less than 0.05). Finally, in cirrhotic livers, reducing blood flow did not produce the normal rise in hepatic extraction ratio, which actually fell from 0.873 +/- 0.021 at 20 ml/min to 0.836 +/- 0.025 at 15 ml/min and 0.823 +/- 0.026 at 10 ml/min. At each flow the observed extraction was significantly lower than that predicted to result from a reduced enzyme activity alone, consistent with the development of functionally significant intrahepatic shunts. An operational model is proposed that explains impaired drug metabolism in cirrhosis on the basis of the development of intrahepatic shunts which perfuse nonfunctioning tissue, while the remaining blood flow is exposed to a reduced mass of hepatocytes with an apparently normal amount of drug metabolizing enzyme (the intact hepatocyte theory).


Iodipamide hepatotoxicity in the rat.

Iodipamide meglumine (Cholografin) has been implicated in several cases of liver injury in patients. The present study was designed to assess the hepatotoxic potential of this drug in rats. Iodipamide administered intraperitoneally or intravenously caused a characteristic type of necrosis which began in the midzonal area and spread to the centrilobular region. Only rats weighing 400 g or more developed necrosis when the dose administered was 2 mmol/kg. Rats weighing 200 g failed to develop liver necrosis even when given 3 mmol/kg. Selenium deficiency and pretreatment with 3-methylcholanthrene protected against liver necrosis due to iodipamide. Phenobarbital pretreatment provided little or no protection. Kidney tubular necrosis was also observed but occurred in young rats and in selenium-deficient rats which developed no liver necrosis. These results indicate that iodipamide is a hepatotoxin in rats. There are a number of factors, age being the most striking, that modify its hepatotoxicity.


Complement alterations in inflammatory bowel disease.

A prospective evaluation of the activity of the complement system was undertaken in 32 patients at the time of diagnosis of inflammatory bowel disease, before the onset of therapy. Serum classical pathway components and function were normal, while significant abnormalities of the alternative pathway were found. Depressions of serum properdin and properdin convertase were noted in association with diminished consumption of C3--C9 after reaction with cobra venom. These abnormalities of alternative pathway integrity were most significant in regional enteritis and in ulcerative colitis with extraintestinal complications. Sequential studies extending into clinical remission revealed resolution of all significant abnormalities.


Enhanced colonic carcinogenesis with azoxymethane in rats after pancreaticobiliary diversion to mid small bowel.

Since biliary excretion of metabolites might determine the pattern of intestinal neoplasms induced by azoxymethane, the number and distribution of tumors were studied in rats after pancreaticobiliary diversion to the mid small bowel. Pancreaticobiliary diversion was performed either immediately before the first of 16 weekly injections of azoxymethane or 10 days after the last. Seven months after pancreaticobiliary diversion, persistent ileal hyperplasia was manifested by higher levels of mucosal RNA and DNA compared with controls (34--102%: P less than 0.001), while there was little residual adaptation in the colon. Qualitative and quantitative analysis of fecal bile acids 6--26 wk after pancreaticobiliary diversion showed few differences. Pancreaticobiliary diversion doubled the incidence of colonic tumors, whether operation preceded (P less than 0.005) or followed (P less than 0.02) the course of azoxymethane. Suture-line tumors were common in the small bowel, particularly in the transposed duodenal stump. Despite intense ileal hyperplasia as a consequence of pancreaticobiliary diversion, the ileum remained resistant to chemical carcinogenesis. The potentiation of colonic neoplasms by pancreaticobiliary diversion probably depends on the stimulation of colonic mucosal proliferation.


Esophageal scintigraphy to quantitate esophageal transit (quantitation of esophageal transit).

None of the tests employed currently to investigate esophageal transit is quantitative. The purpose of this study was to evaluate normal subjects and patients with a variety of esophageal disorders using a scintigraphic technique to quantitate esophageal transit. After oral administration of a bolus of water labeled with 99mTc-sulfur colloid, isotopic count rates were measured over the esophagus employing a gamma-camera on line to a digital computer. Esophageal transit was expressed as the percent emptying for each of the first 15-sec after the initial swallow and for 15-sec intervals after serial swallows. Sixty-two subjects were studied, including: normal volunteers; patients with motor disorders of the esophagus such as achalasia, diffuse esophageal spasm, and scleroderma; and patients with symptomatic gastroesophageal reflux both with and without esophageal motor dysfunction on manometic testing. Esophageal transit was decreased significantly after single and multiple swallows in patients with motor disorders of the esophagus. In addition, esophageal transit was abnormal in patients with reflux disease accompanied by abnormal motor function. In contrast, esophageal transit was normal after a single swallow, but incomplete after serial swallows in patients with reflux associated with normal esophageal motor function on manometry. We conclude that esophageal scintigraphy may be used to evaluate esophageal transit.


Mechanism of lower esophageal sphincter stimulation by bombesin in the opossum.

Effect of intravenously administered bombesin has been studied on the in vivo and in vitro motor function of the lower esophageal sphincter (LES) of the opossum. Intraesophageal pressures were monitored by an assembly of polyvinyl catheters attached to pressure transducers and a recorder. The catheters were continuously perfused with bubble-free water. Intravenous administration of 5, 10, 30, 50, and 100 ng/kg bombesin stimulated the LES 4, 34, 106, 148, and 130%, respectively, above control values. Atropine and hexamethonium did not antagonize the response of the LES to bombesin. Tetrodotoxin, phentolamine, and reserpine all significantly antagonized the response of the LES to bombesin. The LES stimulatory effect of bombesin injected locally in the left gastric artery (LGA) was antagonized significantly by local administration of phentolamine in the LGA. Experiments performed in vitro (25 ml baths containing oxygenated Krebs solution) showed that bombesin (10(-9) M) increased the tone of LES strips, and the effect was antagonized by phentolamine (10(-6) M). Serum gastrin concentrations increased significantly only 15 min after bombesin administration. It is concluded that bombesin is a potent stimulant of the LES. The mechanism of stimulation involves a direct effect on the smooth muscle as well as an indirect one by an effect on the postganglionic adrenergic neurons releasing norepinephrine.


Antroduodenal motor response to solid-liquid and homogenized meals.

The effect of the physical state of food on antroduodenal motor activity and the pattern of the emptying of an aqueous phase marker were examined in 6 healthy volunteers using an intestinal perfusion technique and intraluminal pressure transducers. Ingestion of a solid-liquid meal produced marked phasic changes in pressure in the distal antrum, lasting 92 +/- 10 min (mean +/- SE), while, in contrast, ingestion of the same nutrients in a homogenized state resulted in complete absence of distal antral changes in pressure lasting 133 +/- 12 min. The motor responses of the proximal antrum and duodenum were similar for the two meals. Both meals emptied during a 3-hr period, the pattern of emptying of the aqueous phase marker being similar for the two meals except for the first 40 min, when emptying was more rapid after the solid-liquid meal. The homogenized meal emptied despite the absence of changes in distal antral pressure. The gastrin response was similar for the two meals and is therefore not responsible for the different patterns of antral motility and gastric emptying.


Epidemic gastritis with hypochlorhydria.

Seventeen of 37 healthy volunteers participating in studies of acid secretion and 1 patient with Zollinger-Ellison syndrome became rapidly and profoundly hypochlorhydric. A mild illness with epigastric pain occurred in 9 subjects, usually several days before detection of hypochlorhydria. Gastric mucosal biopsy specimens taken from subjects during hypochlorhydria revealed severe fundal and antral gastritis; however, even when acid secretion was severely depressed, parietal cells were abundant and appeared normal histologically. During hypochlorhydria, gastric permeability to hydrogen, sodium, and lithium was normal in 4 subjects. Serum gastrin concentrations were usually normal, whereas serum pepsinogen concentrations were invariably elevated. Serum parietal cell antibodies were not present. Acid secretion returned to near baseline levels in 14 of 17 subjects after a mean of 126 days (range 53--235); severity of gastritis diminished concurrently in 7 of 10 subjects on whom biopsies were serially performed. An infectious etiology is suspected, although serologic studies and bacterial and conventional viral cultures of stool and gastric juice have not identified a candidate agent.


Mesenchymal hamartoma of the liver.

The case of a 19 yr-old female with abdominal pain, jaundice, and hepatomegaly is reported. A large mass replacing the left hepatic lobe, detected by scintigraphic and angiographic studies and also by means of ultrasound and transhepatic radio-opaque filling, proved to be cystic. A left hepatic lobectomy was performed. Pathologic examination revealed a mesenchymal hamartoma, a rather rare event in view of the patient's age. Prompt recovery followed surgery, and the patient is well and symptomless 1 yr after operation.


[On spasm of the bladder sphincter in a case of herpes zoster (author's transl)].

Report on a 64-year old patient with extensive Herpes zoster of the trunk. The patient presented with urinary retention which stopped after 4 tablets of the chemotherapeutic agent Flumidin. This effect of Flumidin was unknown to the manufacturer and reports on this effect in the literature were not located.


[Discussion of a spontaneous uretero-colonic fistula with stone formation in the rectum (author's transl)].

The unusual course of a vesico vagino-rectal fistula with spontaneous development of a uretero-colonic fistula in a patient with carcinoma of the cervix is presented. After a double-barrel colostomy had been performed kidney function remained normal for many years. Because of incontinence of the anal sphincter the urinary drainage has been undisturbed inspite of stone formation in the rectum.


[Malacoplacia of the vagina, a rare cause of vaginal bleeding (author's transl)].

In a 74 years old woman who developed bleeding per vaginam following a paroxysm of cough colposcopic inspection revealed a yellowish-brown soft tissue of the mucous membrane of the upper vaginal vault. Microscopical examination showed a typical Malacoplacia of the vagina. Bleeding per vaginam resulted from ruptured vessels of this granulation tissue. This seems to be the 2nd case of a Malacoplacia of the vagina, as far as we are informed.


[Endometrial carcino-sarcoma in a young woman with Turner syndrome (author's transl)].

Endometrial carcino-sarcoma is a rare rapidly growing mixed muellerian tumor. The pathogenesis of this tumor is not definitely known. However, the current explanation favors the theory of the growth of this tumor from pluripotential sub-epithelial cells. The incidence of the tumor is increased in post-menopausal women. Many of these women have a history of radiotherapy of the genital organs for benign gynaecological disease. A causal relationship between occurence of carcino-sarcoma and estrogen treatment as in carcinoma of the endometrium is not mentioned in the literature. The clinical signs and symptoms are non-specific as in many other malignant tumors of the uterine body. The prognosis is very bad. The average survival from the onset of the first symptoms is only a few months. The treatment of choice appears to be total abdominal hysterectomy and bilateral salpingo-oophorectomy. Radical operations and ancillary radiotherapy and chemotherapy do not appear to improve the survival rate. The extremely rare coincidence of a carcino-sarcoma in a young woman with Turner Syndrome gonadal dysgenesis after five years of treatment with estrogen led to the present case report.


[Serial determination of hormones in pregnancies following induction of ovulation with clomiphene and gonadotropins (author's transl)].

The HCG, HPL, progesterone and oestriol levels in the serum were determined in 33 pregnancies following induction of ovulation with clomiphene and in 7 pregnancies following induction of ovulation with gonadotropins. During these pregnancies bleeding, premature labour and toxaemia occurred more often in women who became pregnant after induction of ovulation with clomiphene. The progesterone and oestriol levels were increased up to the 12th week of gestation, whereas the HCG and HPL levels remained normal. After induction of ovulation with gonadotropins the progesterone levels remained elevated until the 19th week of gestation whereas the levels of HCG and HPL and oestriol remained normal. The course of the pregnancy in a patient who had Meigs-syndrome after treatment with gonadotropins was presented. Our results show that the hormonal evaluation of pregnancies after induction of ovulation is best accomplished during the first three months by HCG and HPL titres and during the second half of the pregnancy according to the same criteria as in other pregnancies.


[Relation between endometritis post abortum and oestrogen levels in the plasma (author's transl)].

In 13 patients with abortion in the second to fourth months of pregnancy the variation in oestrogen levels in the plasma was determined before and after abrasion of the abortus, using the radioimmunoassay method, and correlated with the results of histological examination of the abraded parts. Seven women without endometritis revealed high oestrogen concentrations before and after the abrasion (mean (1734 pg/ml or 397 pg/ml, respectively). On the fifth day after abrasion the levels corresponded with those of the proliferation phase of the normal menstrual cycle (mean 115 pg/ml). In six women with histologically established endometritis low oestrogen levels were found before and after the abrasion, the mean values being 101 pg/ml and 36 pg/ml, respectively. On the fifth day the values continued to remain low (average 25 pg/ml). The difference in oestrogen concentrations of both groups was significant and correlated well with the results of histological examination of the abraded parts.


[Seasonal fluctuations in the sex ratio of new borns and the influence of the declining birth rate on the sex ratio (author's transl)].

Seasonal fluctuations in the sex ratio of new borns are investigated. The largest predominance of male deliveries over female deliveries was found to be during the conception months May-June with an almost constant number of deliveries. The highest value was in June. Seasonal maximum of the male to female sex ratio is concomitant to the seasonal maximum of conceptions. The investigation of the yearly sex ratio from 1958-1978 showed changes in the secondary sex ratio concomitant to the increase or decrease of the delivery rate. When the delivery rate decreased below 10 deliveries by 1000 population a reverse in the sex ratio was noted and the lowest number of male deliveries was found. This occurred although the number of first deliveries increased further with the decrease of multiparities. The reasons for this reverse trend in the sex ratio are discussed and a possible relationship to preceeding oral contraception is mentioned.


[A case of superfetation (author's transl)].

A case of superfetation is reported. A 23 year old gravida 3, para 1, aborta 1 had a D & C and partial left salpingectomy for ruptured left tubal pregnancy. The microscopic examination of the curettings and the left fallopian tube revealed two pregnancies. The tubal pregnancy was obviously older than the intra-uterine pregnancy and the two fertilized eggs had to result from different ovulations.


[Suppurative parotitis in newborns (author's transl)].

Neonatal suppurative parotitis is described in 6 patients followed by a review of the literature. About 30-40% of the patients were premature, dehydration constitutes a predisposing factor. Infection occurs usually by bacteria ascending the duct. In 5 of our 6 patients infection had been caused by staphylococci; E. coli was found in 2 patients and pseudomonas in 1 patient. The parenteral therapy with antibiotics is usually sufficient.


[Contemplations on demographic theories (author's transl)].

All demographic theories make statements on the relationship between population developments and economic developments. The demographic teachings of Adam Smith, Thomas Robert Malthus, and Karl Marx are embedded in their specific economic theories and contain ideologic statements which are not detrimental to demographic and economic sciences but a stimulus for research. The demographic theories which developed with the onset of the industrial revolution of the 19th century are all sceptical of too high populations independent of their analysis of the market mechanisms or of capitalistic production relationships. This has remained unchanged to date. The statistical evaluation of the 1980's underlines this problem. The reproductive behaviour and demographic theory of a highly industrialized economy can not be based on experience alone but must also be based on rational findings. The rejection of the prestige value of children on the reproductive behaviour which is independent of circumstances must be recognized.


[Anaesthesia in gynaecological outpatient treatment with particular reference to methohexital and enfluran (author's transl)].

Minor operations in gynaecology requiring anaesthesia can often be effected on an outpatient basis if the basic conditions for low-risk narcosis are complied with, such as selection of patients, availability of the necessary facilities in respect of drugs and equipment, professional qualification of the anaesthesiologist. General and specific problems involved in outpatient narcosis and patient care subsequent to anaesthesia. Basing on practical experience, the authors recommend to use the ultra-short acting anaesthetic methohexital to induce anaesthesia, and the inhalation anaesthetic enfluran in combination with a nitrous oxide-oxygen mixture to maintain the anaesthetic condition.


[Ovarian function and vegetative complaints after hysterectomy in normally cycling women (author's transl)].

The assessment of the hormonal cycle after hysterectomy by means of radioimmunological determination of FSH, LH, Progesterone and Estradiol-17beta in serum and BBT-measurement revealed no obvious difference to a corresponding control-group of preclimacteric and climacteric women. The vegetative climacteric syndrome is much more frequently connected with the stable hypergonadotropic type than with the fluctuating hypergonadotropic or normogonadotropic type. Within the last two groups there is no correlation between vegetative complaints and the exent of ovarian function.


[Infusion therapy after vaginal hysterectomy (author's transl)].

The applicability of a complete solution containing amino acids, electrolytes and calories for post-operative infusion therapy after vaginal hysterectomy was investigated. In the 16 patients examined it was found that using this solution it is possible to maintain a smooth nitrogen balance to a large extent. In a control group of 6 patients who only received an infusion of electrolytes and calories, the nitrogen balance was clearly noncompensated. As even with the complete solution compensation of the nitrogen balance is not achieved until the second day, it is recommended that for patients at risk the infusion treatment should be commenced on the day prior to operation.


[Unexpected findings in laparotomy. Clinical and morphological aspects of the malignant hemangiopericytoma (author's transl)].

A case of hemangiopericytoma with a component of fibrosarcoma is reported. The tumour was diagnosed three years prior to the first operation which was done for increasing growth of the tumour. Three years after the first operation and radiotherapy a local recurrence was removed. Histology of the tumour showed a pure fibrosarcoma. The patient remains well for more than one year after the second operation. Because of the prolonged course without general spread is questionable that retroperitoneal tumours show the same biological propensities as other fibrosarcomas.


[Single vaginal vault recurrences following endometrial carcinoma stage 1 treated by operation (author's transl)].

From 1950--1975 201 women had total abdominal hysterectomies and bilateral salpingoophorectomies for stage 1 carcinoma of the endometrium, out of a total of 280 endometrial carcinomas. All patients had post-operative external radiation. A prophylactic vaginal radium insertion was not done. Of 191 follow-up cases from between 2 and 10 years following the operation 2 patients had recurrences of the vaginal vault and 2 patients had single vaginal metastases. Based on a study of the literature and the personal results, it is suggested that a prophylactic vaginal radium insertion is justified only in cases of undifferentiated endometrial carcinomas stage 1 group I type G3 with 50% or more tumour invasion of the myometrium.


[The diagnostic value of lymphography in invasive carcinoma of the cervix stage 1B (author's transl)].

In invasive carcinoma of the cervix stage 1B our investigations showed 19% lymph node metastases (n = 47) which were verified by operation and microscopic examination. In all of these patients no lympographic evidence of metastases was observed. The value of lymphography in stage 1B invasive carcinoma of the cervix is limited. Since we found 19% false negative results and 0% false positive results, the operation of invasive carcinoma stage 1B of the cervix should therefore include a lympadenectomy which is not dependent on the results of lympography.


[A case of carcinoma of the cervix in Turner-syndrome (author's transl)].

A case of carcinoma of the cervix in a patient with Turner-Syndrome is reported. The possible causes of the rare coincidence of these two diseases are discussed.


[Application of computer tomography (CT) as an additional means of follow-up gynecologic neoplasms-a case documentation (author's transl)].

The application of CT represents an important progress not only in diagnostic and therapeutic planning, but also in the evaluation of the effectiveness of follow-up procedures in gynecologic cancer therapy. The evaluation of the results of some follow-up procedures in a case of leiomyosarcoma uteri shows significance and importance of CT as a new radiologic method. Inspite of preliminary negative results of extensive radiologic, myelographic, laboratory investigations and of technetium- and gallium-scintigraphy, CT proved a solitary metastasis located at S-1 in the os sacrum. The diagnostic aspects of follow-up examinations in patients undergoing cytoreductive surgery or radiotherapy are discussed. CT should not be placed at first rank position, but be considered as an helpful additional means for special cases.


[Folate- and iron-deficiency in pregnancy (author's transl)].

In an open study the influence of a pure iron-therapy (Aktiferrin) and a combined iron-folic-therapy (Aktiferrin F) on the blood and the folate levels in the serum of 60 anaemic pregnant women was compared. The prophylactic administration and the therapy of iron and folate acid in pregnancy is demanded because of the results of this examination.


[Pregnancy and parturition in multiparae (retrospective study in 203 patients) (author's transl)].

It is a well-known fact that pregnancy and parturition, as well as the post-partum period and puerperium, present special problems in multiparae. Hence, we compared 203 of our multiparae with the total group of 3251 parturients in respect of these parameters in a retrospective study. The results were as follows: Pregnancy of multiparae is characterized by an increased incidence of monosymptomatic or polysymptomatic EPH gestosis and by diabetes mellitus. In multiparae it was considerably less often necessary to induce labour than with the other parturients. There was in increased incidence of premature rupture, meconium-stained fluid, funicular complications, vagino-operative birth and delivery in sectio. Reduced desire to nurse the baby was significant sign in multiparae. There was also a significant increase in stillbirths and in the delivery of children with a birth weight of more than 4000 g. There was no increased incidence of monstrosities.


[Ultrasonographic examinations of the true conjugate (author's transl)].

The sonographic examination of the true conjugate is described. The results are compared with intraoperative and radiologic measurements. There is a good correlation between these data. In a number of 39 cases the true conjugate was 12.1 cm (MV) intraoperatively and 11.9 cm (MV) echographically. With ultrasonographic measurements during the last month of 776 pregnancies a mean value of 12.0 (+/- 0.8 cm SD) was found. Based on these results one may conclude, that in correlation to the acceleration of the human body growth there is in this material also an increase of the true conjugate, which usually is quoted in the literature to be 11 cm.


[Pregnancy and delivery combined with hereditory angioneurotic edema (author's transl)].

Two deliveries in a patient combined with hereditory angioneurotic edema are reported. Although even the smallest trauma can lead to life threatening edema the tendency to edema is reduced during pregnancy. Neither in the vagina nor the vulva the deliveries caused edema. The episiotomy did not cause a concomitant edema of the vulva, despite the predilection of the external genital organs for edema. It is possible that a correlation between the gonadotrophin level and the tendency to edema exists in hereditory angioneurotic edema.


[The increasing number of extra marital deliveries a sociological phenomenon (author's transl)].

Recent statistical results show an increase in extra-marital life birth. The number of older women between 26 and 28 years of age who have extra-marital deliveries has especially increased. The number of single parent families has more than doudled in the last three decades. The number of 26--28 year-old women who married following conception and then had marital deliveries has markedly decreased. Does monogamy no longer appear to offer a measure of personal happiness to the older working women? Is the social prestige of marriage and maternity within marriage less attractive to the emancipated woman?


Aldolase activity and cross-reacting material in lymphocytes of aged individuals.

Aldolase activity was determined in human lymphocytes from 21 donors aged 18-84 years. The lymphocyte extracts contained exclusively aldolase A isozyme. No significnat difference in enzyme activity between adult (18-41 years) and old (56-84 years) age groups was observed. There was also no significant decrease with age of 'cross-reacting material' as determined with monospecific anti-aldolase A antibodies.