Long-term hemodialysis and nerve conduction in children.

Initial observations in adults revealed that peripheral neuropathy, as documented by reduced conduction velocity is common in chronic renal failure. Critical analysis of this problem in children on long-term dialysis is scarce, consisting of a simgle report which demonstrated that the motor nerve conduction velocities were decreased early and frequently with more severe depression in peroneal nerve velocities. This is in distinct contrast to data from adults, in whom uniform rates of deterioration are encountered. In addition, a direct correlation of the degree of nerve conduction defect with the severity of the renal failure is found in adult patients. The present study showed a relative lack of nerve conduction defects in 11 children on long-term hemodialysis. With rare exceptions, the conduction velocities were normal. To date, no clinical symptoms of neuropathy were evident in our patients. It would seem that, with the short-dialysis schedule of 12--14 h/wk over a period of up to 5 yr, there is no progressive neuropathy as quantitated by nerve conduction measurements.


Fetal lamb lung lavage and its effect on lung phosphatidylcholine.

The lungs of intrauterine 135--136-day-old lambs were lavaged with amnionic fluid, with or without meconium, to determine the effect on lung phosphatidylcholine (PC) concentration, synthesis, and function. No differences were apparent between animals lavaged with amnionic fluid or amnionic fluid with meconium. When lavaged lungs were compared to nonlavaged controls, no detectable differences were observed in histology or the quantity of saturated (SPC) and unsaturated phosphatidylcholine (UPC). However, the lavaged lungs retained a larger fraction of maximal lung volume at 5 cm H2O distending pressure and the incorporation of (32P) orthophosphate into lung PC was significantly reduced. In addition, two lavaged animals who became acidotic (pH less than 7.20) exhibited decreased incorporation of 14C) palmitate into whole lung unsaturated, and saturated phosphatidylcholine. These data indicate that amnionic fluid can reduce lamb lung de novo synthesis of PC and may contribute to the alterations in lung PC found in neonatal syndromes of respiratory distress. Acidosis may accentuate this effect.


The effects of angiotensin II blockade and nephrectomy on the renin-angiotensin-aldosterone system in the newborn lamb.

Six newborn lambs were studied during continuous infusion of saralasin acetate, 5 micrograms/kg/min for 135 min; 40 min after beginning saralasin, furosemide (2 mg/kg) was injected over 1--2 min. In addition, six anephric lambs were studied after injection of furosemide. Plasma renin activity (PRA) increases from 23 +/- 2.7 ng/ml/hr (M and SE) to 85.8 +/- 16.5 (P less than 0.05) during infusion of saralasin alone and remained at this level after injection of furosemide. PRA did not increase above base line after injection of furosemide in the anephric lambs. Blood pressure dropped after saralasin infusion in the normal lambs (P less than 0.05), and after furosemide injection (P less than 0.05) in both groups. Plasma aldosterone concentrations did not increase in response to furosemide in either group. The results suggest that angiotensin II is important in maintaining blood pressure in the newborn and exerts antagonistic effects on the renal renin secretion mechanism. The renin-angiotensin-aldosterone system is activated in the normal newborn. Possible reasons for the activation include decreased circumferential tension of small arteries and salt wasting.


Neonatal mononuclear cell metabolism: further evidence for diminished monocyte function in the neonate.

The metabolic capacity of neonatal monocytes was compared to the metabolic capacity of adult monocytes by two entirely different methods: the selective diminution of monocyte contamination of whole mononuclear cells and the isolation of relatively purified populations of monocytes. Monocyte removal from whole mononuclear cells produced a diminution in the pyruvate kinase (PK) activity (from 28.6 +/- 1.1 to 15.6 +/- 1.2 nmoles/min/10(7) cells) and an increase in adenosine triphosphate (ATP) content (from 7.9 +/- 1.0 to 9.5 +/- 0.8 nmoles/10(7) cells) in adult cells. No change in PK activity (from 13.5 +/- 1.3 to 14.0 +/- 1.3) was observed in cord cells, but the ATP content of cord cells was higher after monocytes depletion (from 4.7 +/- 0.5 to 6.2 +- 0.7). The suggestion of metabolic vulnerability was confirmed by metabolic analysis of isolated adult and cord monocytes. The PK activity of adult monocytes was greater than that of cord monocytes (57 +/- 9 and 25 +/- 0.3, respectively) and the ATP content of adult monocytes (5.7 +/- 0.2) was greater than that of cord monocytes (2.3 +/- 0.1). The data confirm prior observations of diminished energy metabolism in neonatal mononucler cells and suggest that the metabolic perturbations may, in part, correlate with functional immaturity of the neonatal monocyte.


The labeling of lung phosphatidylcholine in premature rabbits.

Lung phosphatidylcholine metabolism was studied in vivo in premature rabbits delivered by cesarean section as early in gestation as compatible with prolonged viability (28.9 days). The newborn rabbits initially required supplemental oxygen and had respiratory distress. The amount of phosphatidylcholine isolated from the lung parenchyma changed little over the first 3 days of life, while phosphatidylcholine in the alveolar wash increased in 3 days from 0.05--3.1 mumol/50 g animal. The phosphatidylcholine of the lungs of the premature rabbits was pulse labeled with isotopically labeled palmitic acid, choline, and phosphate given to the pregnant does 10 min before delivery of the newborns. After the initial incorporation period, the total amount of radioactive precursor palmitic acid, choline, or 32P) incorporated into lung phosphatidylcholine did not change for a period of 4 days. Labeled phosphatidylcholine was detected initially in alveolar wash 3 hr after administration of the three precursors and continued to accumulate for many hours. The biological half-life values for lung and alveolar phosphatidylcholine indicated that phosphatidylcholine was turning over very slowly. However, if the effect of dilution on the measured specific activity caused by phosphatidylcholine accumulation was considered, virtually no labeled alveolar or lung phosphatidylcholine disappeared during the 3--4 days of these observations. These results with premature newborn rabbits were similar to those for term newborn rabbits, but different from similar measurements made in the adult rabbit.


Alternative pathway of complement activation in full term and premature infants.

Classical and alternative pathway complement levels were measured in the cord blood sera of 60 newly born infants, with weights ranging from 1200--4165 g. The impact of maternal illness and infant illness on the complement levels was also evaluated. The mean values for CH50, C3, C4, PH50, factor B, and properdin were all significantly less than normal adult levels (P less than 0.0001). All of the above determinations were significantly correlated with one another except for the relationship between properdin and factor B. CH50, PH50, C4, and properdin levels were significantly correlated with birth weight although there was much residual scatter. Neither maternal illness nor mild to moderate illness in the newborn altered the birth weight-complement relationships. Severe infant illness did significantly alter the relationship between birth weight and complement. However, the impact of this variable on the birth weight-complement relationships was not consistent among the various components. These inconsistencies and the small sample size preclude drawing any strong conclusions about severe illness and complement levels.


Purine and phosphoribosylpyrophosphate metabolism of lymphocytes and erythrocytes of an adenosine deaminase deficient immunocompetent child.

Purine metabolism and phosphoribosylpyrophosphate content of lymphocytes and erythrocytes were studied in an immunocompetent black male child with a total deficiency of erythrocyte and partial deficiency of lymphocyte adenosine deaminase. The partial genetic deficiency of adenosine deaminase was demonstrated in intact lymphocytes, and was approximately one third of the deaminating activity of control lymphocytes. Intact lymphocytes of the patient did not incorporate adenosine at a faster rate than those of control lymphocytes. The patient's erythrocytes deaminating activity was low and adenine ribonucleotide synthesis from adenosine was increased several fold, while adenine incorporation into purine ribonucleotides was comparable to that of control erythrocytes. Transfusion with packed erythrocytes temporarily improved the deaminating capacity of circulating erythrocytes, but did not reduce the elevated incorporation of adenosine into purine ribonucleotides. Phosphoribosylpyrophosphate content of the patient's lymphocytes and erythrocytes was not diminished. Incubation of erythrocytes with adenosine lowered phosphoribosylpyrophosphate content while incubation with phosphate increased phosphoribosylpyrophosphate content to the same extent in mutant and control erythrocytes.


Prospective study of maternal and infantile infection with Chlamydia trachomatis.

We examined the prevalence of chlamydial infection in a population of pregnant women and observed their infants to determine the risk of development of ocular or respiratory infection. We examined endocervical and serum specimens from 322 pregnant women for Chlamydia trachomatis and chlamydial antibody. The cultures were obtained at the first prenatal visit. Six (2%) of the women were infected with C trachomatis. Chlamydial antibody was present in the genital secretions of 47% and 73% of the serum samples. The six infants born to infected women, 61 infants born to women who were culture-negative, but local antibody-positive, and 28 control infants born to culture-negative, antibody-negative women were followed for up to six months. Four of six infants born to infected women developed chlamydial infection: two developed culture-positive conjunctivitis, one had asymptomatic nasopharyngeal infection, and one infant developed pneumonitis. Three of 61 infants born to mothers who were culture-negative and local antibody-positive developed conjunctivitis due to C trachomatis. None of the 28 control infants developed chlamydial infection. Most (79%) of the infants had chamydial antibody in their serum at 2 to 4 weeks of age.  The correlation between maternal and infant serum antibody titer was r=0.71 suggesting that antibody was placentally transferred.


Persistent localized pulmonary interstitial emphysema and lymphangiectasia: a causal relationship?

The mechanism responsible for persistent regional pulmonary interstitial emphysema under tension, which occasionally complicates assisted ventilation, has not been explained. It is difficult to comprehend how interstitial air may cause lobar hyperinflation and not escape to the mediastinum or pleura. Histologic examination of resected emphysematous lung in two neonates with this type of interstitial emphysema revealed air dissecting from the interstitial connective tissue into markedly dilated lymphatics. It is proposed that intralymphatic air dissection causing emphysematous lymphangiectasia may be responsible for fixation of the lung in the emphysematous state.


Familial spontaneous pneumothorax.

A family is described in which four persons in three generations suffered spontaneous pneumothoraces: a newborn, an infant, an adolescent, and an adult. Review of the literature reveals 61 reports of familial spontaneous pneumothorax in 22 families. The ratio of male to female cases is approximately 1.8. Affected parents and affected children (including affected fathers and sons) are seen in ten families, while affected siblings with unaffected parents are noted in 13 families. Consanguinity has not been reported. Although autosomal dominant inheritance has been suggested as an explanation of familial spontaneous pneumothorax, available pedigree data are not adequate for statistical analysis. Physicians should be aware of the familial occurrence of spontaneous pneumothorax so that members of such families may be appropriately managed when problems arise.


Occult fractures in the production of gait disturbance in childhood.

Trauma to the lower extremities is the principal cause of gait disturbance in early childhood. Three cases are presented to emphasize the relative frequency of children hospitalized for diagnostic evaluation of altered gait who have occult fractures. The cases may refresh the primary physician of the variables that serve as obstacles to accurate diagnosis.


Host defense in infantile osteopetrosis.

Since infants with malignant osteopetrosis often die from infection at an early age, we studied several aspects of host defense in five such infants. No consistent abnormality was found in cellular or humoral immunity. Monocyte cellular chemotaxis and phagocytosis were normal in four tested infants. However, all four of these infants had decreased intracellular bacterial killing by monocytes. Neutrophil function tests in five infants showed that two had defective bacterial phagocytosis and four had reduced cellular chemotaxis, decreased nitroblue tetrazolium reduction, and decreased intracellular bacterial killing. The severity of the decreased bactericidal capacity of granulocytes did not correlate with the number of circulating immature granulocytes. Our data suggest that abnormal function of circulating monocytes and granulocytes may contribute to impaired host resistance to infection. We postulate that this defect may reflect a more generalized inherited abnormality of phagocytic cells and perhaps osteoclasts that plays a role in the pathogenesis of infantile osteopetrosis.


Neonatal signs as predictors of cerebral palsy.

Signs of neonatal neurologic dysfunction, recorded in approximately 40,000 infants, were evaluated prospectively for their ability to predict later motor handicap. Tenfold to 33-fold increases in risk of cerebral palsy (CP) were observed in surviving children with any one of the following characteristics: birth weight less than 2,000 gm, head circumference more than 3 SD above or below the mean, five minute Apgar score of 3 or less, diminished activity or diminished cry lasting for more than one day, thermal instability, need for gavage feeding, hypotonia or hypertonia, single or multiple apneic episodes, or hematocrit less than 40%. Of worse portent, with relative risks exceeding 50, were neonatal seizures or Apgar scores of 3 or less at ten minutes or later. These characteristics were also markers of considerable risk of early death. For 0.5% of surviving infants, an overall impression of abnormality of brain function during the nursery period was recorded by the attending physician; there was a 99-fold increase in CP among these children.


Symptomatic arteriovenous malformation in infants less than 6 months of age.

The symptomatology and sequelae of symptomatic system arteriovenous (A-V) malformations in children less than 6 months old make an early diagnosis possible and early treatment mandatory. A group of 156 infants with systemic A-V malformations involving the CNS (81 infants), liver (61 infants), and lungs (14 infants) were studied to compare symptoms, diagnosis, treatment, and outcome. Congestive heart failure was present in 67% of the patients with CNS A-V malformations. Mortality among the patients with CNS A-V fistulas was 64%. Of those patients with hepatic A-V malformations 67% had abdominal masses, 48% congestive heart failure, and 55% died. Pulmonary A-V malformations presented with congestive heart failure 57%, cyanosis 43%, and resulted in a 43% mortality. Early combined medical and surgical therapy offered the best chance for a successful outcome.


Neonatal intraventricular hemorrhage due to an intracranial arteriovenous malformation: a case report.

A full-term newborn infant with intraventricular hemorrhage due to a small arteriovenous malformation draining into the vein of Galen is presented. Other reported series are reviewed, and differences between this case and the usual pattern of morbidity are discussed. The use of computerized tomography is demonstrated.


Patterns of skin injury in nonaccidental and accidental injury.

The patterns of soft tissue injuries in a group of 154 children reported to protective services for child abuse or neglect were compared with patterns of soft tissue injury found in a group of 91 emergency room patients who sustained an accidental injury and 105 children seen in a pediatric ambulatory clinic. All children in the three groups were 1 to 12 years old. Children in the suspected child abuse and neglect group had significantly more (P less than .01) soft tissue injuries over the cheeks, trunk, genitals, and upper legs. Lacerations were significantly more common (P less than .001) in the emergency room group.


Theophylline pharmacokinetics in the young infant.

The pharmacokinetics of theophylline were investigated in 13 infants, 4 to 18 months of age. An inverse relationship was found between theophylline half-life and age. Volume of distribution did not differ from that reported by other authors in similarly aged infants. Our data suggest that childhood clearance rates of elimination can be achieved by 6 months of age. The decreased theophylline elimination observed in the smaller infant indicates that the usual pediatric dosing recommendations cannot be used routinely. Until more specific data are available in the infant under 6 months, the authors reaffirm individualization of theophylline dosage to maintain therapeutic levels and avoid toxicity.


Motion parallax as an independent cue for depth perception.

The perspective transformations of the retinal image, produced by either the movement of an observer or the movement of objects in the visual world, were found to produce a reliable, consistent, and unambiguous impression of relative depth in the absence of all other cues to depth and distance. The stimulus displays consisted of computer-generated random-dot patterns that could be transformed by each movement of the observer or the display oscilloscope to simulate the relative movement information produced by a three-dimensional surface. Using a stereoscopic matching task, the second experiment showed that the perceived depth from parallax transformations is in close agreement with the degree of relative image displacement, as well as producing a compelling impression of three-dimensionality not unlike that found with random-dot stereograms.


Depth inversion despite stereopsis: the appearance of random-dot stereograms on surfaces seen in reverse perspective.

Inside-out relief masks of faces can be depth-inverted (i.e. seen in reverse perspective) during close-up binocular viewing. If a random-dot stereogram is projected onto such a mask, stereopsis can be achieved for the stereogram, and its depth planes are correctly seen while the mask itself, including the region covered by the stereogram, is simultaneously perceived as depth-inverted. This demonstration shows that binocular depth inversion cannot be explained by a complete loss of stereoscopic information (e.g. through monocular suppression), or by a process analogous to pseudoscopic viewing whereby retinal disparities are incorporated into perception, but with their signs uniformly reversed.


The site of binocular rivalry suppression.

Two experiments were performed to localize the site of binocular rivalry suppression in relation to the locus of grating adaptation. In one experiment it was found that phenomenal suppression of a high-contrast adaptation grating presented to one eye had no influence on the strength of the threshold-elevation aftereffect measured interocularly. Evidently information about the adaptation grating arrives at the site of the aftereffect (presumably binocular neurons) even during suppression. In a second experiment 60 s of grating adaptation was found to produce a short-term reduction in the predominance of the adapted eye during binocular rivalry. These findings provide converging lines of evidence that suppression occurs at a site in the human visual system after the locus of grating adaptation and, hence, after the striate cortex.


Does visual texture discrimination precede binocular fusion?

Various stereoscopic demonstrations are presented which indicate that visual texture discrimination is based on processes which occur after, or at the same time as, the binocular combination of images from the two eyes. Monocularly invisible texture regions can become apparent, and monocularly visible regions can be hidden, by the processes of binocular fusion.


The contribution of colour to three-dimensional ambiguities in paintings and drawings.

This paper is about kinds of visual ambiguity that concern the author as a painter. Some effects of incompatible depth cues on the experience of looking at paintings and drawings are discussed. Particular attention is given to the role of colour as a depth cue. It is suggested that areas of identical pigmentation on different parts of a picture surface tend to be interpreted as being on the same plane. Where this interpretation is incompatible with other depth cues 'visual tension' results, the degree of tension being dependent on the relative strength of the cues involved. This hypothesis is illustrated and elaborated with the help of a number of line drawings.


Adaptation to displacing prisms in human infants.

This research reports a first attempt to study adaptation to laterally displacing prisms in human infants of ages six to ten months. Twenty infants were tested over four days under conditions similar to those used in adult adaptation studies. Evidence was found of vigorous adaptation when infants were exposed to base-right prisms under conditions of active exposure. Detailed consideration is given to the conditions and methods of studying adaptation in infants and implications for adult studies.


The relational determination of length illusions and length aftereffects.

When two lines were presented simultaneously, in an illusion paradigm, the judged length of one of the lines (the focal line) assimilated toward the length of the contextual line. When the lines were presented sequentially, in an aftereffect paradigm, the apparent length of the focal line was displaced away from the length of a previously presented contextual line (i.e. contrast). The largest effects obtained at inverse contextual-to-focal length ratios: 1.67:1 for contextual lines longer than the focal line and 0.60:1 for contextual lines shorter than the focal line. Overestimation of focal length was larger than underestimation for both illusions and aftereffects despite the fact that identical stimuli produced effects in opposite directions in the two paradigms. Results were discussed in terms of a neural length-coding model and were related to visual size constancy.


Bias-free improvement in wine discrimination.

Over three test sessions alternated with two training sessions, accuracy of 'same'/'different' judgments of four dry, white wines improved 14%. Confidence ratings were obtained so that the area under the isosensitivity curve could be computed as a bias-free measure of accuracy while the wine used for same pairs was held constant. An initial bias for 'different' judgments persisted, rather than disappearing as Walk found. While perceptual learning did occur, the problem of attending to irrelevant differences was not overcome.


Sensory conditions for the occurrence of the neon spreading illusion.

The neon effect, i.e. an illusion of light projected onto a homogeneous lattice, may occur in line patterns made up of elements of different color or brightness. Particular luminance relations between the different line elements in the patterns and between these line elements and their background appear to be critical for the occurrence of the effect.


Discrimination of stimulus aperiodicity as a function of temporal patterning: a discrepancy between psychophysical and sensory-neural assessments.

Tactile discrimination of stimulus aperiodicity was investigated in a two-alternative forced-choice task by having subjects report which of two successively presented trains of mechanical pulses, one with complete pulse periodicity and one in which a single pulse was temporally displaced from its regular placement, was temporally irregular or aperiodic. Trains contained three, four, or five pulses and were presented at interpulse intervals of 60, 75, 85, 100, 125, and 150 ms. Aperiodic trains had one pulse, other than the first or last pulse, temporally advanced or receded by 40% of the interstimulus interval. Results showed that: (i) although the percentage of correct reports of aperiodicity decreased as presentation rate increased (smaller interpulse intervals), the amount of decrease was a function of the number of pulses in a train; (ii) the discrimination of aperiodicity was dependent upon the specific location of the irregularity within the stimulus temporal pattern; and (iii) all patterns with complete temporal reversals of their successive interpulse intervals yielded nearly equivalently accurate reports of aperiodicity. These data suggest that central, attentional factors are involved in the discrimination of stimulus aperiodicity.


Optical defocusing reverses perceptual organization.

At a certain point during the defocusing of a reversible figure, the organization of the figure reversed unexpectedly, and the reversal seemed more abrupt than a spontaneous reversal. The critical point is approximately constant over time for a given subject, and a similar point occurs during refocusing. This phenomenon is discussed in terms of inhibition between competing neural structures.


Are black circles attentive fields? A reply to Bross, Blair, and Longtin.

It is argued that the experiment carried out by Bross et al is not a valid test of assimilation theory because they confuse a graphic representation of a constant with the construct itself and assume that changing the former will alter the latter.


Knee disarticulation versus above-knee amputation.

If below-knee amputation is impossible, knee disarticulation should be considered before above-knee amputation, regardless of age and etiology. Knee disarticulation which leaves the femur and patella untoched offers many advantages. The surgical technique is simple and non-traumatic since no bone or muscle tissue is to be dissected. The thigh muscles are completely preserved and thus there is no muscular imbalance. The stump permits total end bearing and its bulbous shape permits easy and firm attachment of the prosthesis. A specially designed double-wall socket and various types of knee joints are presented. Modern prostheses are superior to above-knee prostheses with regard to function, comfort and cosmesis. Results of 72 patients of all age groups are presented and discussed.


Revascularization or amputation.

The factors which determine the choice, revascularization or amputation of an ischaemic leg are very numerous, variable and sometimes also related. They are concerned with the extent and course of the gangrene, the general condition of the patient and the risk of operation, the technical operability in terms of arterial reconstruction, the skill and judgement of the vascular surgeon, the motivation and life expectancy of the patient, as well as the facilities at the limb-fitting centre. In principle, arterial reconstruction should be the primary consideration in all patients with severe ischaemia of a leg, and threatened with loss of the limb. This implies the need for evaluation by a vascular surgeon. If arterial reconstruction is impossible or undesirable and if lumbar sympathectomy is not indicated either, then if amputation is necessary it must be decided, when is it necessary, and whether a below-knee or an above-knee amputation is possible. The patient with severe arterial circulatory disorders is best served when the vascular surgeon who is responsible for the arterial reconstruction, also assumes responsibility for determining the timing and the level of an amputation, and in some hospitals even for doing the amputation. In other words, the same doctor, preferably the vascular surgeon, has to be responsible for the selection of the patients and the judgement whether the patient is a candidate for revascularization or amputation.


Normal human locomotion.

A study of normal locomotion requires an understanding of both the movements and the force actions involved. This is equally true in appreciating the problems of pathological gait. The gait cycle is described in terms of the significant events which occur during both the stance and swing phases. The basic principles underlying the analysis of force actions in walking are briefly described. A simple example of force actions in the elbow joint is considered and the analysis extrapolated to provide a general statement regarding locomotion. This relates to the muscle actions required to resist turning actions at joints due to the force effects in walking and the corresponding forces in the joints themselves. The conventional display of information relating to joing actions is considered and compared with the actual situation, "Stick diagrams" of motion in the sagittal plane are used to identify and discuss the actions at the joints of the leg in walking. Comparisons are made between this and pathological gait--in particular that of the above-knee amputee.


Studies on seminal vesiculitis in the bull. I. Semen examination methods and post mortem findings.

During the ten-year period 1968--1978, about 1500 bulls were examined yearly for possible inflammatory conditions in the genital organs. Thirty-one cases of vesiculitis with or without accompanying ampullitis, and one case of isolated, one-sided ampullitis were recorded. Twenty-three cases (72%) were found in young bulls aged 18 months or less. Diagnosis was based on clinical examination of the pelvic genital organs or examination of semen, or in most cases on both. In 17 (53%) of the cases the diagnosis was initially established in the laboratory. Of the laboratory methods, the most reliable was the demonstration of pus cells in Giemsa stained semen smears. Twenty-five cases (24 + one case of ampullitis) were examined post mortem. Fifteen showed interstitial vesiculitis, Group I (Galloway, 1964). The milder 'catarrhal' type (Group II) was found in 9 cases. The 'potential pathogenic' bacteria isolated from the inflamed vesicular glands were: Corynebact. pyogenes, 8 cases (33%), E. coli, 2 cases; Ureaplasma, 2 cases (one in combination with Corynebact. pyogenes). Four of the bulls were newly imported (stress ?), IN THREE BULLS THERE WAS A HISTORY OF NAVEL INFECTION DURING CALFHOOD, AND IN ONE CASE THE BULL HAD LARGE NUMBERS OF VESICAL CALCULI (ABOUT 300 G). In ten of the sets of pelvic organs examined (40%) rare congenital defects or anatomical variations were found in or around the colliculus seminalis (Blom, 1979b).


Functional additive effect of H blood group alleles on carcass length in Danish landrace pigs.

Previous investigations have revealed statistically significant associations between H blood group genotypes and carcass length in Danish Landrace pigs. The same data were subjected to an analysis aimed at a genetic interpretation of the associations. The regression of the average carcass length (in cm) on the average number of H- alleles for individuals within three genetically characterized classes was 0.725 and the correlation coefficient was 0.995. The results indicate that the associations can be interpreted as being due to an additive effect of the H blood group alleles on carcass length. The additive effect is designated as being functional. A similar effect is expected with respect to any allelic pair exhibiting linkage disequilibrium with alleles at the H locus.


[Diagnosis of cerebral hemorrhages. A report of 247 anatomo-pathological cases (author's transl)].

A series of 247 cases with simple and apparently primitive cerebral hemorrhages selected from the pathological records of Charles Foix laboratory from 1962 to 1977 is reviewed with regard to the accuracy of the premortem diagnosis as a function of the size, the location and the age of the bleeding, the patient's age, the practices of angiography or lumbar puncture and the considered period of death. The clinical diagnosis of cerebral vascular disease was made in 75% of the cases from that serie but the hemorrhagic mechanism was identified only in 50,6% of cases. The diagnosis accuracy was enhanced in large and recent hemorrhages occuring in patients under 70 years old. It seemed better in cerebellar and intermediate locations. It was enhanced in more recent observations (collected since 1974). The practice of cerebral angiography and lumbar puncture rose up (in a somewhat equivalent way) the proportion of accurate diagnoses. The lumbar puncture practice was not associated with a higher rate of cerebral herniae.


[Vascular risk factors in chronic haemodialysis: the role of HDL cholesterol. Correlation with dietary intake and the quality of dialysis (author's transl)].

HDL cholesterol in 53 hemodialysed patients is significantly reduced (p less than 0,001) in front of 34 healthy people. The decrease is more pronounced in male but does not seem influenced by age or ethnical origin of subjects. There is no correlation between alpha cholesterol levels and hyperlipidemia which are in 50% of cases of type IV and more frequent in caucasian than in african: the beta cholesterol is correlated with total cholesterol and increased in type IV (p less than 0,001) but alpha cholesterol negatively correlated with triglyceridemia (p less than 0,001) is in comparable levels in dialysed with type IV or without hyperlipidemia. If for normal value triglyceridemia is correlated with caloric and carbohydrate intake (p less than 0,001), the diet does not seem to influence either the frequence of type IV nor the level of alpha cholesterol. However we found a positive correlation (p less than 0,05) between nervous conduction velocity and HDL cholesterol, this fact can let us hope a decrease in the cardiovascular complication associated with amelioration of the adequacy of dialysis.


[Systematic neonatal screening for Duchenne muscular dystrophy].

More than 15% of cases of Duchenne muscular dystrophy (DMD) may be preventable by the neonatal diagnosis of another affected relative. Systematic neonatal screening seems a more efficient way of getting information for genetic counseling. The principle of the test described is the detection of a specific increase of the activity of Creatine-Kinase (CK) in the blood of newborn children with myopathy. Blood may be spotted on paper and posted to a central laboratory. Furthermore this program can be integrated into the systematic screening of phenylketonurie. The specificity and accuracy of the bioluminescent reaction used for the evaluation of CK suggest that this screening reaction is reliable. A systematic neonatal screening program for DMD such as ours in the Rhône-Alpes area (France) will lead to frequent recourse to prenatal diagnosis now possible through sex fetal determination and which would be possible through in utero blood sampling.


[Hydroxy 9-methyl 2-ellipticinium acetate (NSC 264-137). Toxicologic study and therapeutic effect in 100 cancers (author's transl)].

A new derivative of ellipticine, hydroxy-9-methyl-2-ellipticinium acetate, was found to be a useful anti-tumor drug in advanced cancers which could not be treated any longer successfully by any other procedure. In our series of 100 patients, the best results were obtained with bone metastases from breast carcinomas and with anaplastic thyroid carcinomas. Most patients usually received a weekly perfusion of 80 mg/m2. The main characteristic of this drug is its lack of hematologic, and hepatic toxicity. No renal trouble was observed during the first year, but 2 deaths from renal insufficiency occured during the 18th and 15th month of treatment. The most frequent side effect consists of digestive troubles (nausea, vomiting) which rarely compelled to stop the treatment (4 times in 100 patients).


[Iodine overloads in amniotic fluids (author's transl)].

The mean of total iodine levels in amniotic fluid samples is 7.8 ng/ml during the middle of pregnancy and 4.4 ng at the end. On about 200 samples collected at random from high risk pregnant women, 14% fluid contain iodine load. This iodine excess comes from water-soluble iodinated drugs administrated to the pregnant women; most are less than 300 ng/ml but 24 hours after urography the load reaches 80,000 times the mean value. Biochemical analyses have shown the iodine excess was iodide, easely released. In our study no neonatal hypothyroidism was noticed probably because that degradation. However administration of any iodinated drug to pregnant women may be a risk to the fetus.


[Deviation in cortisol metabolism induced by rifampicin. Therapeutic consequences in adrenal failure (author's transl)].

Deviation of cortisol metabolism in favour of its 6 beta-hydroxylated derivative was demonstrated in two patients with adrenal failure receiving substitution corticosteroid therapy and rifampicin. The existence of a frank increase in the metabolic clearance antipyrin was in favour of an hepatic enzyme induction. After rifampicin treatment was stopped, the 24 hour urinary excretion of 6 beta-OH-F returned to normal, demonstrating the responsability of the drug. This enzyme induction results in a need to increase the dose of hydrocortisone substitution therapy in patients with Addison's disease treated with rifampicin.


[Computerized tomography: physiological reheightering of the images by sugars (author's transl)].

During experimental utilization on the dog (per os) of several types of materials capable to be modified by the liver after digestive absorption, sugars appeared naturally opaques in the gastric cavity and so they could substitute in C.T. to the habitual materials of contrast, we also notice some belated modifications on intra hepatic density that might be in relation with the metabolism of intra hepatic glucose.


[Hydatic cyst of the thyroid. One case (author's transl)].

Thyroid localisation of an hydatic cyst is a rather rare phenomenon. Therefore, the occurence in our region of a thyroid hydatic cyst is noteworthy. In the present observation, the needle aspiration of an hypofixating nodule assured the diagnosis. Further more, this technique was harmless.


[Bacterial endocarditis due to Staphylococcus epidermidis. Two cases (author's transl)].

Bacterial endocarditis due to Staphylococcus epermidis is rare and severe. In a first patient, a 58-year-old-man, it developed 40 days after the insertion of a double prosthesis (mitral and aortic). Cure was obtained by medical treatment using a combination of vancomycin and gentamicin, followed by pristinamycin and tobramycin. The second patient, a 50-year-old-woman, suffering from cirrhogenic hepatitis and treated with corticosteroids. Staphylococcus epidermidis endocarditis developed without any portal of entry being discovered. After the failure of various antibiotic combinations (even though bactericidal in vitro), a mitral Starr valve was inserted which resulted in cure. None of the patients showed any sign of valvular mutilations or disinsertion of prosthesis.


[Corticosteroid osteoporosis (author's transl)].

Otseoporosis is a common and sometimes severe complication of all prolonged corticosteroid therapy. After reviewing the clinical, radiological, histological and biological features, the authors discuss the various physiopathogenic mechanisms: anti-anabolic effect of corticosteroids and decreased bone formation, and hyperparathyroidism secondary to the calcium deficiency induced by corticosteroids (fall in intestinal calcium absorption). Treatment should be preventive, based upon great car in the prescription of corticosteroids (absolute indication, minimal effective dose, alternate administration in certain cases) and upon improved calcium balance (calcium, vitamin D or its derivatives).


[Study of the effect of dopamine on renal excretion in chronic renal failure (author's transl)].

The effects of dopamine on renal excretory function were studied in 20 patients with chronic renal failure (plasma creatinine higher than 30 mg/i). Effects were marked at a dose of 2 micrograms/kg/mn and were no greater at a dose of 5 micrograms/kg/mn (10 subjects in each case). In general, creatinine clearance increased by 28%, urea excretion by 45%, urine output by 77% and urinary sodium output by 164%. In ten patiens with terminal renal failure (plasma creatinine greater than 100 mg/i), the effects of dopamine were maintained. In these individuals, furosemide (250 mg by single intravenous injection) resulted in a higher total urine and urinary sodium output but had a less favourable effect upon creatinine.


[Automaton resuscitation (author's transl)].

The aim of the Automaton Resuscitation is execution, watching and maintenance of a programme of intricate resuscitation tying for the first time the therapeutic to extemporaneous outflow of biological spoliation. This apparatus executes permanently and automatically the taking of biological fluid, estimates its outflow, amounts its total and realizes or the reinstillation of the fluid in the digestive tract or the order of intravenous perfusion tied to fluid spoliation according to an adjustable connection. A first self acting regulator for the juice intestinal reinstillation has been made in 1974. The second one with 4 units of continuous aspiration, data integration, reinstillation and perfusion tied with security had waked for 6 months. Moreover it allows with fiability the reinstillation of the gastric, duodenal, bilious, pancreatic or intestinal juice, on the other hand an intravenous perfusion tied to spontaneous spoliation (digestive) or instigated spoliation (provocated diuresis) and in a fundamental way simplifies the work of the physicians and the nurses.


[Acute fatty infiltration of the liver in pregnancy. One case (author's transl)].

Acute fatty infiltration of the liver in pregnancy is characterised by microvacuolar fatty infiltration, without necrosis, occuring at the end of pregnancy. This syndrome, defined by Sheehan in 1940, remains rare. The authors were able to find 62 authentic cases in the french, english and german literature. The course is fatal in 75% of cases for the mother and 70% for the child. The gravity is related to hepatocellular failure, but also to extra-hepatic complications (renal failure, haemorrhagic syndrome, infectious complications, acute haemorrhagic and/or necrosing pancreatitis). When the course is favourable, the hepatic lesions disappear in a few weeks and there is no recurrence during subsequent pregnancies. The histological lesions of acute fatty infiltration of the liver in pregnancy are identical to those of fatty infiltration of the liver induced by cyclines and of Reye syndrome.


[Complications of digestive involvement in CRST syndrome. 3 cases (author's transl)].

In CRST syndrome, latent oesophageal involvement is common but not usually associated with any clinical manifestations. Involvement of the small intestine is rare. In three patients there occurred severe complications related to digestive involvement in the condition. In one case, involvement of the small intestine was associated with functional obstruction. In the other two patients, oesophageal involvement progressed to very tight stenosis of the lower end of the eosophagus. The generally accepted bening nature of this form of scleroderma must therefore be questioned.


[Cervical sprains and cervical herniated discs (author's transl)].

The cervical spine, containing twenty-articulations, is particularly exposed to sprains. Benign cases are those in which both spinal stability is not affected and only subjective neurovascular complaints are present. Management essentially involves constant volontary immobilization of the cervical spine with or without apparatus (Postural training). The severity of the sprains results from the possibility of either vertebral instability or objective neurovascular complications. Bony instability can be detected on dynamic radiographs based on precise criteria defined by physiologic study of normal spinal movements. When a persistant vascular syndrome involving the vertebro-basilar arteries is observed, vertebral arteriography may be indicated. Likewise, the presence of a thoracic outlet syndrome may required sub-clavian arteriography. Metrizamide myelography is used to explore neurologic lesions. The author concluded that only severe cervical sprains required surgical intervention. A prolapsed cervical disc, revealed by discography and especially metrizamide myelography, most often requires an anterior approach to surgery.


[Factors influencing the elimination of the migration of inhaled mineral particles (author's transl)].

The reaction of the body to inhaled mineral dust brings into play physiological and pathological mechanisms in which immunological processes may be involved. An analysis is made of phagocytosis by alveolar macrophages, of the transport of dust to the lymphatic system, of dust aggravation in lymphoid tissues on lymph glands and of the resulting lesions. The part played by dust in immunological disturbances is put forward in the cases of tubercular infections, experimental arthritis and tumors.


[Gaseous aerocontaminants and phagocytic defence of the respiratory tract. Cytotoxicity of NO2, of ozone and acrolein for alveolar macrophages in gaseous phase (author's transl)].

A new method of survival in vitro of alveolar macrophages in gaseous phase, ensuring direct contact between the cells and the surrounding atmosphere may be used for the qualitative and quantitative study of the cytotoxicity of gases under controlled experimental conditions. Exposure to nitrous oxide (0.1 to 6 ppm), ozone (0.65 to 3.25 ppm) and to acrolein (4 to 35 ppm) for 30 minutes results in a significant untoward effect on the cells which is proportional to the concentration of the toxic agent. This method offers the possibility of a new approach to study of the mode of action of gaseous aerocontaminants on the respiratory tract and particularly upon phagocytic defences.


[Thyroid nodule secondary to subacute thyroiditis. 8 cases (author's transl)].

This description of 8 cases of thyroid nodules secondary to subacute thyroiditis serves to emphasise the relative prevalence of the circumscribed forms. These nodules, variable in size, firm and painful, developed after a period of cervical discomfort and pain. A contrast between a raised or normal blood hormone level and a very low uptake of I131 was found in five cases. It was all the more valuable when there was no iodine overload. Scintigraphy showed the nodule to be cold in 6 cases, isofixing in one and hot in one case. An essential diagnostic criterion is the rapidly favourable course: 4 nodules disappeared completely, 3 regressed in less than 6 months and one persisted, justifying excision with histopathological examination since localised thyroiditis of this type may be the presenting feature of a carcinoma.


[Raynaud's phenomenone: prospective study of 100 cases (author's transl)].

A prospective study of 100 consecutive patients hospitalised with a Raynaud phenomenone is presented. In 82 patients, a precise etiology was pound, most often a collagen disease (50 cases) and amongst this group generalised scleroderma was the most commun (n = 37). Other etiologies were very divers: inflamatory artertis, atheroma, local mecanical causes, emboligenic. In 18 patients, no etiology was found: the age, the sex, the context and the benign cours in this patients was such that a diagnosis of idiopathic Raynaud's phenomenone. This results lead to the suggestion of a method for the investigation of Raynaud's phenomenone. The consequences are therapeutic, the etiological context foring the base of the treatment prescribe.


[Revascularisation of the intestinal arteries from the suprarenal aorta (author's transl)].

Amongst procedures for revascularisation of the intestinal arteries, bypass implanted in the suprarenal aorta by a purely abdominal approach, with section of the right crus of the diaphragm, would appear to be the most satisfactory procedure. For the superior mesenteric, in particular, the pre-pancreatic anterograde course avoids any bending or kinking. Nine patinets undergoing surgery with venous or goretex grafts confirmed the quality of the results obtained by this technique.


[Results of emission computerised axial tomography of the liver in 113 patients (author's transl)].

Transversal emission computerised axial tomography (ECAT) was performed in addition to bioptic examination in 113 patients with solid tumours and lyphomas. In 69/113 (61%) patients the results of conventional scintigraphy and ECAT were in agreement. In 44/113 (39%) patients additional information was obtained. Correct positive and correct negative results were found in 86.3% (63.6% and 22.7%, respectively), while in 13.6% the results were false positive or false negative (6.8% both).


[Results of hepatic scintigraphy with a new colloid (99mTc-Sn-Antipyrine D 77 1268) compared with 99mTc-Sn-phytate (author's transl)].

Liver scans were performed on 84 patients, using a new colloidal substance 99mTc-Sn-Antipyrine colloid, and compared with 36 liver scans with 99mTc-Sn-phytate under identical conditions. The following differences were found: 99mTc-Antipyrine uptake in the spleen was higher in comparison with 99mTc-phytate, renal excretion was twenty times lower. The tin content was less then one fifth in the Sn-Antipyrine preparation. Antipyrine yields simultaneous imaging of liver and spleen even in normal patients.


[Effects of venous compression for blood sampling on the results of in vitro tests of thyroid function (author's transl)].

In a group of subjects with a normal as well as pathological thyroid function there was a significant increase in RT3U, serum-thyroxine-concentrations and TSH-levels but there were no significant changes in the T4-RT3U-indices and ETR-tests after 5 min of venous compression. The discordant results were obtained in 21 cases (26.9%) with the RT3U-test and in 4 cases (5,1%) with the T4-serum-level-determination, which may cause diagnostic errors. The non-standardized venous compression time causes a widening of the euthyroid zone which reduces the discrimination capabilities of these function tests. With TSH-determinations these deviations may be of diagnostic importance in the evaluation of TRH-TSH-test results. A standardized and minimum compression time when drawing blood samples is recommended in order to eliminate this potential source of diagnostic error.


Radioiodide treatment of pulmonary metastases of differentiated thyroid cancer. Results and prognostic factors.

Pulmonary metastases were found in 123 out of 840 patients with thyroid cancer between 1955-1977, 87 patients with pulmonary metastases of differentiated cancer were studied in detail, including an evaluation of prognostically important factors. In 66 of them, the induction of 131I uptake in metastases was attempted, in half of them successfully. Uptake was achieved more frequently in younger subjects, in papillary cancers and in patients with fine pulmonary metastases on chest films. Survival (not corrected for age) was evaluated 10 and 15 years following the diagnosis of thyroid cancer and was found to be 29,1% and 12,2%, respectively. Significantly higher survival rates were seen in younger patients, in patients with the fine type of pulmonary metastases, in the absence of bone metastases and, particularly, in patients with induced 131I uptake in metastases. Papillary cancers were found to have higher survival rates in males and in young subjects only, in the whole group the survival rates were independent of either microscopic type or sex. It is believed that biologic behaviour of distant (pulmonary) metastases may be influenced by radiodide therapy.


[The diagnosis of cerebrospinal rhinorrhea with the 131I-hippuran swab test].

The report deals with the 131I-hippuran swab test and its effectiveness as compared with other methods (X-ray techniques, Clinistix) in 123 patients with rhinoliquorrhea. Results in 32 patients with rhinoliquorrhea are correlated with those of various methods of examination and with the surgical reports. In frontal and ethmoidal lesions and in those of the middle part of the face the liquorrheas can be demonstrated with a greater probability and even in cases where other methods are ineffective. An exact diagnosis was made in 88% of the cases. This semi-quantitative method is also suitable for follow-up control since, in contrast to other techniques, even discrete liquorrheas can be identified considering that a subjectively observed cessation of flow may not be equated with an occlusion of the liquor fistula as shown by the 131I-hippuran swab test, which continues to be positive.


Outpatient oral anticoagulation: guidelines for long-term management.

The experience with outpatient anticoagulation services (ACSs) in two municipal teaching hospitals has been reviewed. These two ACSs have provided therapy with a major hemorrhagic morbidity of 4.1% based on patient treatment years and with no anticoagulation-related mortality. Their major goal has been to provide safe, efficient monitoring of anticoagulation control for the patients of a wide variety of primary care physicians in the hospital clinics. With careful patient selection and education, monitoring of the duration of therapy, and close communication among patient, primary care physician, and pharmacist, this goal has been achieved.


The importance of significance and the significance of importance.

This article has attempted to illustrate the following principles of statistical significance. 1. An investigator must state the hypothesis to be tested beforehand, so that a null hypothesis can be constructed and validly tested using standard statistical techniques. 2. A statistically significant difference does not prove that a difference exists. It merely establishes that if no difference exists, there is only a small chance that the results obtained would have occurred. A small chance is traditionally and arbitrarily defined as 5% or less. However, even 5% may be too large when important decisions depend on the results. 3. Failure to establish a statistically significant difference does not prove that no difference exists. Chance alone or the small numbers used may have prevented the investigators from rejecting the null hypothesis. 4. A statistically significant difference may be too small to be clinically useful. Statistical significance can be demonstrated for even the most inconsequential of differences if the number of individuals used in the study is large enough. 5. The clinical usefulness of a statistically significant difference may be limited by the degree of overlap. This is reflected in the standard deviation around the averages. In answer to the questions posed at the beginning of this article: If it is statistically significant, it might be true. If it is statistically significant, it might be important. If it is statistically significant, it might be clinically useful.


Genetic causes and workup of male and female infertility. 3. Details of the clinical evaluation.

In the evaluation of male and female infertility the history, family history, physical examination, and endocrine and gonadal functional evaluations are the most informative measures. The cause of the infertility is never found in some 17.5% of couples and in almost one fourth of males. In over one third of cases male infertility is attributed to varicocele. In 40% of women infertility can be attributed to ovulatory or cervical factors, uterotubal disease, endometriosis and other pelvic disease, or a combination of these factors. For couples with primary infertility the fertility rate after seven years is only 36%; in such cases the neonatal death rate, frequency of low birth weight, and incidence of major malformations are several time greater than in the normal population.


Mania: the common symptom of several illnesses.

A clinical picture of mania can have many causes, including amphetamine or cocaine use, acute schizophrenia, manic-depressive illness, and viral encephalitis. Accurate and complete history--of both the present episode and past experiences--is most valuable in the differentiation, along with mental status examination, physical examination, and selected laboratory tests. It is advisable to withhold drug therapy, if possible, until the initial evaluation is completed, for it may obscure the diagnosis.


Nasal skin cancer:hazard to a uniquely exposed structure.

The nose is one of the most common sites of malignancy on the face, probably because of its unique position of exposure to environmental damage. By far the most common type of nasal tumor is basal cell carcinoma. Squamous cell carcinoma is less common but considerably more aggressive, with a tendency to fast growth and metastasis. Tumors of either type are more likely to invade easily and resist treatment if they are in certain "danger zones." Nasal skin cancer in general has a relatively good prognosis, regardless of the type of treatment selected, ie, surgery, radiotherapy, cryotherapy, or electrodesiccation and curretage. However, tumors that are not eradicated have a long history of recurrences before proving fatal. When ablative surgery is performed, some type of reconstructive procedure is usually necessary.


A clinical look at the aging skin.

The aging Caucasian skin becomes yellow, dry, wrinkled and inelastic. Deterioration increases its susceptibility to malignant neoplasms, pruritus, and candidal infection. In addition, psychosomatic problems vascular disease, "little strokes," and chronic malnutrition may precipitate or exacerbate skin disorders in the elderly. Treatment with "strong" medications should be taboo because of the fragility of senile skin. The risk of toxic reactions or of allergic sensitization is great. Because healing is retarded in old tissue, time is an indispensable component of successful treatment.


Unusual mucocutaneous infections in immunosuppressed patients with leukemia.

Patients with leukemia may become severely infected with usually nonpathogenic organisms and are also prey to infection in unusual sites and by unusual organisms.. Every organism isolated from such a patient must be considered a potential enemy, regardless of its pathogenic reputation, and evidence of infection must be sought.


Alcohol, caffeine, and nicotine as factors in pregnancy.

Use of alcohol, caffeine, and nicotine during pregnancy can have serious consequences for the fetus, such as low birth weight, congenital anomalies, or even death. Recent epidemiologic and animal studies indicate that these drugs may exert their effect by a number of metabolic and endocrine mechanisms, which are described here.


Who gets gallstones and why.

Gallstone formation is a heterogeneous disease for which supersaturation of bile with cholesterol and hemolysis of RBCs are major driving forces associated with initial formation and growth. Specific risk factors are superimposed on the gradually increasing prevalence of gallstones with age in most populations. Major risk factors associated with cholesterol gallstone formation are American Indian ancestry, female sex, obesity, and ingestion of lithogenic drugs, such as estrogen-containing preparations and clofibrate. Hemolysis and cirrhosis are risk factors for pigment stones.


Gram-negative bacteremia. Two cases in adults with chronic otitis media.

Chronic otitis media was the cause of septicemia in two hospitalized men. The organisms involved, K pneumoniae and B fragilis, are not usually associated with primary infections of the middle ear and would not have been traced to this site had proper cultures not been performed. In adults, the true incidence of bacteremia arising from the middle ear may be higher than suspected.


The fallacy of free extrapolation.

In determining the meaning of a study for other populations or situations, the investigator and the reviewer must be leery of extrapolating beyond the range of the data. They must beware of the ecological fallacies which can occur when population data are not linked to individual data. They must be conscious of the underlying assumptions to avoid drawing invalid conclusions about one population from valid studies on another. Finally, they must take into account the differences between the study population and the general population.


Autoimmune hemolytic anemia. 2. Drug-induced type.

A variety of commonly prescribed drugs can produce a positive direct antiglobulin test, but the incidence of actual drug-induced hemolytic anemia is low. Of the four mechanisms which may be responsible, only one involves autoantibody production; the others include drug-RBC interaction of the hapten type, immune complex formation, and direct alteration of the RBC membrane.


Pulmonary heart disease: pathophysiology, diagnostic signs, and therapy.

The anatomy and physiology of the pulmonary vasculature has been described with emphasis on several types of pulmonary hypertension and their pathophysiology. Treatment of pulmonary hypertension may be successful, especially when disease is related to emboli which respond to anticoagulant therapy. Relief of mitral valve obstruction is usually beneficial. Patients with abnormalities of blood PO2 and pH (especially in chronic obstructive lung disease) may be spared increased pulmonary pressure or may reverse existing pulmonary hypertension by giving up smoking, learning more efficient ventilatory methods, and when indicated, using supplemental oxygen, bronchodilators, digitalis, diuretics, or a combination of these.


Broncholithiasis: current concepts of an ancient disease.

Broncholithiasis, associated most frequently with tuberculosis and histoplasmosis, usually presents with acute onset of cough and hemoptysis. Visible stones are coughed up in fewer cases than was previously believed. The disease may be accompanied by obstructive symptoms, bronchiectasis, and occasional fistula formation into either the esophagus or the aorta. The prognosis of these patients is generally excellent; however, a significant number require surgery because of persistent symptoms or a complication of the disease.


The atypical pneumonias: a diagnostic and therapeutic approach.

Mycoplasmal pneumonia, tularemic pneumonia, Q fever pneumonia, psittacosis, and Legionnaires' disease are the most frequently encountered treatable atypical pneumonias. Mycoplasmal pneumonia, the most common, is often accompanied by nonexudative pharyngitis, conjunctivitis, or otitis. The nonproductive cough is characteristic. Tularemic pneumonia is characterized by substernal chest pain, bloody pleural effusion, and bilateral hilar adenopathy. Although the clinical presentation is mild, roentgenographic findings are impressive. Q fever pneumonia resembles psittacosis but is less serious; it may be accompanied by subacute bacterial endocarditis, hepatitis, or both. Psittacosis is characterized by prominent headache, bloody sputum, and relative bradycardia. Tetracycline is the drug of choice for either. In Legionnaires' disease, pneumonia is accompanied by prominent extrapulmonary symptoms. The most important diagnostic clues include diarrhea and mental confusion. Relative bradycardia and laboratory abnormalities are also helpful. Erythromycin is the drug of choice unless doubt exists as to the diagnosis.


Effect of domperidone on gastric emptying and secretion.

Domperidone (5 mg i.v.) was given singly or together with apomorphine (0.25 mg i.v.) to healthy volunteers. The gastric emptying rate of a test meal of 750 ml of water was then measured using a dye dilution and double sampling technique. The effect of domperidone on gastric secretion was evaluated in patients with duodenal ulcer who received domperidone (5 mg i.v.) prior to continuous aspiration of the stomach contents for 120 minutes. Domperidone markedly increased the rate of emptying of the test meal. Following apomorphine the gastric emptying rate decreased and domperidone antagonized this slowing effect. The composition of gastric juice was not affected by an intravenous dose of domperidone. Domperidone appears to modulate gastric contractile activity without affecting gastric secretion.


The effect of domperidone on pyloric activity in dog and in man.

In a study in dogs using ultrasonic transducers to measure degree of pyloric dilatation, it was found that i.v. domperidone (0.35 and 0.7 mg/kg) significantly increased the diameter of the pyloric lumen without affecting the frequency of pyloric relaxations. A subsequent study involving 59 patients referred for upper digestive tract endoscopy, confirmed this increase in diameter of the pylorus which indicates a potential use of domperidone (either i.v. or oral) in the treatment of some forms of dyspepsia characterized by delayed gastric emptying.


The effect of darkness on vitamin D in adults.

Circulating 25-hydroxy vitamin D measurements were made on Caucasians in the Antarctic. Following a period of 3 months' complete darkness there was a significant fall in 25-hydroxy vitamin D values. These results emphasize the importance of u.v. light on skin synthesis of cholecalciferol and support the view that the geriatric and immigrant population should be adequately exposed to sunlight to prevent vitamin D deficiency.


The clinical pathology of heart failure and atrial fibrillation in old age.

The factors associated with the development of heart failure and of atrial fibrillation in elderly patients were studied in a prospective clinico-pathological series of 171 cases. Multiple logistic analyses allowed the contributions of multiple factors to be assessed simultaneously. Senile cardiac amyloidosis, ischaemic heart disease and atrial fibrillation were significantly associated with heart failure and had additive effects. Senile cardiac amyloidosis, ischaemic heart disease, mitral valve ballooning and higher age were significantly associated with atrial fibrillation but their additive effects were modified by significant interactions between ischaemic heart disease and mitral valve ballooning (whose effects were multiplicative) and senile cardiac amyloidosis and age (the age effect being confined to those without amyloidosis).


Comparison of two coronary prognostic indices.

Two coronary prognostic indices for patients treated in a coronary care unit, namely the Norris Index and the Chapman-Gray Index were compared. Both were found to be reliable but the Chapman-Gray Index with its ready reckoner was more convenient and was subject to fewer subjective data.


The incidence of postoperative pulmonary perfusion defects.

The incidence of postoperative thromboembolism was studied using radioisotope lung perfusion and ventilation scanning. 26% of patients had defects on their pre-operative scans and 8% developed new unmatched perfusion defects postoperatively, indicating possible pulmonary emboli. This latter figure was much lower than some previously recorded results and was similar in 2 groups of patients--one receiving dextran 70 prophylaxis during operation and the other a control group who received saline.


Hip fracture after hemiplegia.

In a series of 57 hemiplegic patients who subsequently fractured their hips, it was found that hip fracture occurred significantly more often on the hemiplegic side. Hip fracture was equally common in right- and left-sided hemiplegia, and often occurred within one year of the stroke. Two factors seem to be important in the genesis of hip fractures in hemiplegic patients: the tendency of stroke patients to fall to the affected side as a result of impaired locomotor function, and the development of disuse osteoporosis in the hemiplegic limb.


Idiopathic pulmonary haemosiderosis: report of two cases and review of the literature.

Idiopathic pulmonary haemosiderosis (IPH) is a rare disorder affecting mainly children and adolescents, and is usually fatal. However, there is increasing evidence that the aetiology of this condition is immunological, and that immunosuppressives may prolong remission. Two cases are reported, one of which has the atypical feature of a malabsorption syndrome. This has not been previously reported. The literature is reviewed and current ideas on the postulated immunological basis to IPH are discussed.


Pneumopericardium and pneumomediastinum complicating endotracheal intubation.

Pneumopericardium and pneumomediastinum have been described as complications of endotracheal intubation and assisted ventilation in neonates and children. Here the occurrence of these complications in an adult is described and the possible mechanism discussed.


Colonic tuberculosis.

A case of tuberculosis of the colon is described. Attention is drawn to the similarity between this and other inflammatory diseases of the bowel. Colonic tuberculosis is now a rarity even where mycobacterial infection is endemic, and may mimic other inflammatory diseases of the bowel with important consequences for treatment and prognosis. Such a case is now described.


Levamisole in the treatment of cyclical neutropenia.

A child with cyclical neutropenia was observed before and during treatment with levamisole. Marked clinical improvement occurred while on levamisole. Deterioration occurred after stopping treatment. The improvement was not associated with changes in the neutrophil or monocyte counts, nor did tests of phagocytic cell function convincingly demonstrate improvement while the child was on treatment.


Epsilon aminocaproic acid (EACA) myopathy.

Two female patients developed a severe, painful proximal myopathy after taking 18--30 g of epsilon-aminocaproic acid daily for 5 weeks. Marked elevations of serum aminotransferases, creatine kinase and aldolase levels were found and the first patient had electromyographic and muscle biopsy changes of an acute monophasic, necrotising myopathy at the height of the illness. Resolution occurred in both cases on stopping the drug and the second patient had no electromyographic or muscle biopsy abnormalities 3 weeks later. Only 2 recognized cases of the condition have been reported previously but a review of the literature revealed several other possible examples.


Central circulatory responses in normotensive and hypertensive pregnancy.

Haemodynamic responses in normotensive pregnancy in the antenatal phase show that cardiac output is elevated by the end of the first trimester, and remains elevated throughout pregnancy, although it may fall very slightly at the end of the third trimester of pregnancy. Heart rate remains virtually static throughout pregnancy, although it may fall very slightly at the end of the third trimester of pregnancy. Arterial blood pressure remains virtually unaltered. During labour in patients with traditional anaesthesia, cardiac output is elevated by 40% overall at the end of the labour, and this rise may be as much as 60% in the immediate post-partum period. Patients with epidural analgesia show no overall rise in cardiac output throughout labour. Following Caesarean section there may be massive rises in cardiac output. In patients who become hypertensive as a result of pregnancy, there are marked individual patterns. These different groups show patients with elevated levels of cardiac output, patients with a pure elevation of systemic vascular resistance, and a third group in which there is elevation of both resistance and output. It seems certain that different syndromes are occurring, the theoretical explanations for which are discussed.


Cardiac disease in pregnancy.

The problems encountered in the management of pregnant patients with valvular, congenital and ischaemic heart disease are described with the help of illustrative cases. The increased incidence of cardiac dysrhythmias in pregnancy is also discussed.


The management of thyroid disease in pregnancy.

The management of hyperthyroidism and hypothyroidism in pregnancy is discussed and illustrated with appropriate cases. The dangers of the usage of high doses of antithyroid drugs and of propranolol are described.


Clinical aspects of diabetes in pregnancy.

The introduction of insulin produced a rapid improvement in the maternal prognosis in pregnancy associated with diabetes mellitus. Within years, maternal mortality fell from 50% and has become a rarity. Improvement in fetal survival was less dramatic until the work of Pedersen (1952); Peel and Oakley (1950) and White (1949) demonstrated that with determined antenatal control of diabetes the fetal outcome was greatly improved. Further improvement in the care of the fetus of the pregnant diabetic with fetal monitoring, both ante- and intra-partum, together with modern neonatal expertise, had brought the perinatal and neonatal morbidity and mortality for this group of patients close to that of the non-diabetic. An account is given of the author's present day practice in this group of patients.


[Pulmonary mucormycoses (author's transl)].

Mucormycoses are rare, acute infections, most often fatal, occurring usually in a host with decreased immunity. The agents are ubiquitous fungi belonging to the Mucoraceae family, an ordinary saprophyte becoming pathogenous in patients with a severe disease (malignant hemopathy, diabetes) or treated by immunosuppressive drugs. Pulmonary localizations remained exceptional (128 cases found in the literature). The observations reported draws its originality from: -- the etiological circumstances: an aged patient with no hemopathy or diabetes, without immunosuppressive treatment but undergoing a prolonged antibiotic therapy; -- the clinical signs: discovery on X-ray of excavated infiltrates in a background of a severe infection with a very poor physical condition; -- the diagnosis criteria with the demonstration of the responsible mucor in the sputum, the endobronchial aspiration and transparietal puncture; -- the great efficiency of Amphotericin B at rather small doses. A review of the literature underlines the exceptional character of the cure.


[Respiratory signs linked to passive inhalation of tobacco smoke in infants (author's transl)].

Thirty observations done on infants formed the base of a review of the literature on the epidemiology, the clinical signs and the physiopathological mechanisms of passive smoking (PS). The main signal was a chronic cough but in infants under 12 months, PS also provoked, as well, an "asthmatoid bronchitis", progressing relentlessly since the coming out of maternity ward, in relation with the maternal tobacco addiction. In these patients, examinations failed to disclose the different causes of recurring respiratory infections. Among the granulocytic tests, only the spontaneous migration of neutrophil polykaryocytes in the absence of chemotactic stimulus was significantly lowered, by comparison with the controls. The authors did a review on epidemiological surveys done to this day; they revealed a direct relationship between the parent's addiction to tobacco and the frequency of recurring respiratory disorders. It was particularly evident when the mother smoked and the child was under 12 months. At this age it was independant from the infection eventually transmitted by the parent's cough. The constituants of tobacco smoke probably have a depressive action over the regional or perhaps the general means of immunitary defense as it is suggested by the decrease of leukocyte migration noted in parents with PS. It is therefore necessary in our country to define the true risks of PS in infants thanks to well organized epidemiological surveys and to obtain the means of an efficient preventive policy.


[Prevention of thrombo-embolic accidents after pneumonectomy (author's transl)].

The authors analyzed the progress in the prevention of thrombo-embolic risk in 550 pneumonectomies divided chronologically in 4 groups : without anticoagulant treatment, with post-operative anti-vitamin K, with post-operative calcium heparinate, with pre and post-operative calcium heparinate. This study revealed the necessity of a pre-operative systematic preventive treatment : systematic, as there is no biological reason enabling the prevention of thrombosis risk. Pre-operative, because venous thrombosis and pulmonary embolism can occur very early.


[Dystrophic hyperlucent lung (author's transl)].

Emphysematous bullae isolated on a healthy lung and primitive progressive dystrophic emphysema all belong to the dystrophic hyperlucent lung and are surgical cases. Having recalled the excellent prognosis of isolated bullae, the authors analyzed the surgical indications in the progressive dystrophic emphysema concerning 66 observations of which 52 cases were operated. They showed that surgery provided many improvements and that making a pleural adhesion during the intervention limited the bullous evolution of the disease. Results plead in favour of early interventions and wider indications.


[Value of vascular tests in the diagnosis and therapeutical indications of pulmonary embolism on a pneumological background (author's transl)].

The diagnosis of mislaying forms of pulmonary embolism, where even angiography was not pathognomonic, induced the use of a phlebography on lower limbs in patients where this diagnosis was suspected. The revelation of a distal thrombo-phlebitis and even more so an iliocaval one, becomes a major value when the clinical and paraclinical data remained arguable. The comparative study of diagnostic usual clinical and paraclinical elements (radiographies, E.C.G., gasometries and scintigraphies) confirmed, in 22 patients, the value of phlebography. On a pneumological background, it is useful to perform this examination, most of the time : a) on patients over 55, when a cardiorespiratory decompensation remained unexplained in a patient with chronic respiratory insufficiency, or even an unproved hemoptysis; b) but mostly before 55, in case of painful pneumopathy above all if it is bilateral and recurring, or in case of paroxysmal bronchospasm without atopic ground, when a belated asthma could be thought of. Finally vascular tests induced the fitting in situ of a clamp or "umbrella" in the vena cava in 7 patients out of 22.


[Broncho-pulmonary amylosis (about two cases) (author's transl)].

The authors reported two recent cases of broncho-pulmonary amylosis with monoclonal gammapathy. The first observation concerned a diffuse amylosis characterized by a bilateral pulmonary infiltration with pleural effusions and secretion of IgGlambda with  a Bence Jones proteinuria. Pleural and pulmonary biopsies will provide the proof of amylosis. Evolution will rapidly be fatal in case of renal insufficiency. Post-mortem sampling will confirm the amyloid involvement (muscle, liver, kidney). The second observation described a localized amylosis developed in contact with a mediastino-pulmonary lymphoplasmocytic lymphoma with tumoral secretion of IgMlambda. Although pneumonectomy brought out the disappearance of the abnormal paraportein, death occurred within a few months, linked either to the spreading of the lymphomatous process or to the onset of a bacillary surinfection. The authors then recalled the main clinical and diagnostic data of the broncho-pulmonary amylosis. They underlined the importance of GLENNER'S work who, by proving the immunoglobulinic nature of amyloid, explained that in both cases, amylosis appeared as the consequences of an abnormal immunoglobulins synthesis.


The amino acid and energy requirements of broiler breeder hens.

Three trials, involving 1000 broiler breeder hens each, were conducted under rather uniform conditions in order to test the applicability of two models for calculating the amino acid requirements of broiler breeders, and to evaluate their energy requirements. The birds fed diets based on Model A (which assumes that all of the egg white and shell membrane proteins are synthesized during albumen formation and secretion at the expense of tissue proteins) produced at a rate greater than the planned target, whereas Model B (which assumes that only ovoglycoproteins and shell membranes are thus produced) supported a production close to the anticipated performance. This indicates the validity of Model B, developed for egg layers, to predict the requirements of the most limiting amino also for broiler breeder hens. The resulting practical diets contained considerably lower protein levels than customary. According to Model B, minimal amino acid requirements for broiler breeder hens producing a daily egg mass of 52.7 g. having a body weight of 3.5 kg and gaining weight at a rate of 4 g/day, calculated to be as follows (g/hen/day): methionine, .57; sulfur amino acids, .83; lysine, .76; arginine, 1.11; threonine, .72; valine, .92; isoleucine, .85; leucine, 1.25; tryptophane, .19; histidine,


Interrelationship between dietary pyridoxine and free plasma amino acids in chicks.

The interrelationships between dietary pyridoxine and free plasma amino acids in young chicks were studied with two different diets. Chicks fed isolated soybean protein supplemented with less than 1.0 mg pyridoxine-HCl/kg diet had reduced body weight gain and feed consumption and a higher mortality rate (19%) than those fed 1 or 5 mg pyridoxine-HCl/kg. A casein diet required greater supplementation (2.0 mg pyridoxine/kg) to prevent reduced body weight gain and depressed feed intake. The concentrations of free plasma taurine, threonine, and serine were significantly lower in chicks fed the isolated soybean protein diet supplemented with less than 1.0 mg pyridoxine-HCl/kg, while those of isoleucine, valine, glycine, and ornithine were significantly higher than in chicks fed greater levels of pyridoxine. Supplementation of casein diets with less than 2.0 mg resulted in a significant accumulation of threonine, glycine, cystathionine, and ornithine. Valine was significant higher in chicks fed casein supplemented with only .6 mg pyridoxine-HCl/kg. Feeding isolated soybean protein or casein diets without any pyridoxine supplementation resulted in the dealth of 95% and 100% of the chicks, respectively. Pair feeding a group fed the isolated soybean protein diet supplemented with 1.0 mg to a group receiving .5 mg pyridoxine-HCl/kg resulted in a similar body weight gain and concentration of amino acids in the plasma.


Studies on duck nutrition. II. Calcium and phosphorus requirements of mule ducklings.

Experiments were conducted to determine calcium and phosphorus requirements of mule ducklings. Two-day-old, straight-run mule ducklings were fed diets containing graded levels of calcium or phosphorus for three weeks. Weight gain, feed consumption, tibia ash content, and levels of serum calcium and phosphorus were used as criteria for the determination of the optimum dietary calcium and phosphorus levels required by the ducklings. The minimum calcium requirements were .48% and .58%, respectively, for maximum growth and optimum tibia ash content as determined by regression analysis of body weight gain and tibia ash content against calcium level in the diet. The minimum available phosphorus requirements were .26% and .34%, respectively, for maximum body weight gain and optimum tibia ash content as determined by the same method.


Phosphate and heat treatments to control Salmonella and reduce spoilage and rancidity on broiler carcasses.

Broiler chicken carcasses were inoculated with about 300 cells of a naladixic acid resistant strain of Salmonella typhimurium, then treated for 3 min with highly agitated water with or without 6% phosphate added, at 65, 70, 75, 80, 85, or 90 C. Other broiler carcasses were inoculated with about 60 cells, then similarly treated at 65 or 70 C. All carcasses were chilled after the hot water treatment in a system simulating commerical chilling. When inoculum was 300 cells, at least 5% of the carcasses remained contaminated with Salmonella, even when hot water treatment was at 90 C. When inoculum was 60 cells, Salmonella were eliminated by hot water treatment at 65 or 70 C. Carcasses showed a partially cooked appearance after hot water treatment. Total bacterial counts on carcasses treated at 70 and 90 C, with or without added phosphate, and then chilled were lower than on control carcasses throughout storage at 2 C for up to 26 days. Phosphates did not consistently or significantly affect either Salmonella survival or total bacterial counts. Oxidative deterioration as measured by the thiobarbituric acid test was significantly retarded throughout 26 days of storage by the addition of 6% phosphate to a 70 or 90 C hot water treatment.


The effect of early treatment with methyl-CCNU on the lymphoid organs and the humoral immune response in chickens.

Presented are data upon the effect of a single or muliple administration of methyl-CCNU (a nitrosourea derivative an alkylating agent, and anticancer drug) to newly-hatched chicks. Lethal and sublethal doses of methyl-CCNU caused temporary damage to the lymphoid organs, of which the bursa was apparently the most sensitive. The decreased weight and the morphological changes observed in the bursa of treated chicks were accompanied by a parallel decrease in serum gamma-globulins level. The humoral immune response of animals treated with me-CCNU to sheep red blood cells and to killed Brucella abortus organisms was impaired in about 30% of the treated animals examined 8-10 weeks following 2 injections of 3 mg me-CCNU (given at the day of hatching and the next day). The thymus recovered rather rapidly from treatment. The time schedule of mortality and the early and late toxic manifestations of the drug as observed in chickens, in this study, are similar to previous reports obtained in mammals. Prolonged effects, however, were noted to some extent on body and spleen weight, and most dramatically, on testicular weight, morphology, and function.


Vaccination of chickens through the drinking water with a live, Pasteurella multocida, vaccine.

Broiler-type chickens were vaccinated orally at several ages with various dilutions of the Clemson University (CU) strain of Pasteurella multocida vaccine and then challenged orally with virulent strain P-1059 or strain X-73 of P. multocida to determine the degree of protection produced by vaccination. When vaccinated at 8 and 12 weeks of age for 2 consecutive days with a 1:133 dilution of the vaccine and then challenged at 17 and 19 weeks of age with strain X-73 and P-1059 P. multocida, respectively, no significant levels of protection were elicited in the vaccinates. Significant levels of protection were elicited in the vaccinates for 2 consecutive days at 9 weeks and at 13 weeks with 1:133 and 1:50 dilutions of the vaccine respectively, and then challenged at 16 weeks with strain X-73 and at 20 weeks with strain P-1059. Broilers vaccinated at 12 and 16 weeks for 3 consecutive days and then challenged at 20 weeks with strain X-73 showed a highly significant level of protection upon challenge when compared to the controls.


The effects of the northern fowl mite, Ornithonyssus sylivarium on egg production and body weight of caged White Leghorn hens.

Egg production of caged White Leghorn hens with heavy (greater than 1000) populations of the northen fowl mite, Ornithonyssus sylviarum (Canestrini and Fanzago), was 5 to 15% less than egg production of control hens. Body weight was depressed in hens infested with mites before the hens came into full egg production but not when hens were infested after that time. Feed consumption was not affected by mite populations.


Structure of the germinal centers in the chicken caecal tonsil: light and electron microscopic and autoradiographic studies.

The light and electron microscopic structure of the germinal center of chicken caecal tonsils were studied. Two kinds of germinal centers were revealed; the first was located deep in the lymphatic tissue close to the muscle layer of the caeca. These germinal centers frequently have an incomplete capsule, and are not, therefore, separated from the diffuse lymphatic tissue. The second kind of germinal center was located closer to the epithelium and had a complete capsule separating it from the diffuse lymphatic tissue. Both germinal centers possessed an outer dark cortical zone which contained smaller lymphoblasts (of less than 10 micron in diameter) and a central medullary area which contained larger lymphoblasts (up to 16 micron). Autoradiographic studies revealed that the small lymphoblasts of the outer cortical zone are concerned with cell generation and that the large lymphoblasts of the medullary area may have derived from the small lymphocytes. Within the medullary area of the germinal center are cells which are embedded in an intercellular substance of high density. We propose that the intercellular substance may be a product of this cell. For discussion purposes we have called this cell a secretory cell. The secretory cell may originate from a small lymphocyte-like cell.


Plasma concentrations of progesterone and corticosterone during the ovulation cycle of the hen (Gallus domesticus).

The observation that injections of either ACTH or corticosterone induced ovulation in the hen has prompted speculation which implicates the adrenal gland in the mechanisms controlling ovulation. In this study, the role of the major adrenal steroid in birds was further examined by measuring the plasma concentration of corticosterone during the 24 hr period preceding mid-sequence ovipositions and the 28 hr period preceding terminal ovipositions. Progesterone, which is an accurate index of preovulatory ovarian activity, was also measured in the same samples. An increase in plasma progesterone preceded mid-sequence ovipositions which are accompanied by an ovulation. This preovulatory surge in plasma progesterone began approximately 7 hr before ovulation, reached a maximum of 6.9 ng/ml 3 to 2 hr before ovulation, and returned to baseline concentrations at the time of ovulation. A major preovulatory peak of progesterone was not observed during the interval between sequences, although a small but statistically significant rise in progesterone was observed between midnight and 0600 hr on the day of the last oviposition of the sequence. The concentration of corticosterone increased approximately two-fold during the dark portion of the photoperiod regardless of the position of the oviposition in the sequence. Baseline concentrations during the illuminated portion of the photoperiod ranged between 1 and 4 ng of corticosterone per ml of plasma whereas during the period of darkness, they ranged between 2 and 6 ng of corticosterone per ml of plasma. It was concluded, therefore, that the circulating concentration of corticosterone was regulated by a circadian rhythm which operates independently of follicular maturation.


The effect of photoperiod and feed restriction on semen production in the turkey.

In Experiment 1, 72 yearling Broad Breasted White Turkey males were induced to molt under either stimulatory (16L:8D) or nonstimulatory (8L:16D) light used concurrently with a short period of feed and water deprivation, and followed by periods of daily feed restriction (50% of full feed). One-fourth of the males wer killed at intervals of 4, 8, 12, and 16 weeks and their testes weighed. In Experiment 2, 40 yearling Broad Breasted White males were killed at 2-week intervals during an 8-week period of 8 hr light per day followed by a 10-week period of 16 hr light per day. Testes were removed, weighed, and fixed in Bouin's solution for histological preparation. In Experiment 1, birds kept under 16 hr light and given different periods of feed and water deprivation, followed by 8 weeks of feed restriction, failed to terminate semen production, although their testes were reduced substantially in size and function. Other groups of males given 8 hr light per day with concurrent regimens of feed deprivation and daily feed restriction, terminated semen production within 4 weeks. When returned to 16 hr light, the testes were twice as heavy as those of males kept in production during the entire test. In Experiment 2, the testes of birds induced to molt under 8 hr light per day regressed by 73% and 89%, respectively, after 4 and 8 weeks of exposure. When given 16 hr light per day, some spermatogenic activity was noted at 4 weeks, and complete spermatogenesis, with maximum semen production, occurred after 6 weeks. There was evidence that a successful rejuvenation of the testes requires a period of complete quiescence.


Description and surgical removal of the cranial cervical ganglia in 3- to 5-day-old chicks.

The cranial cervical sympathetic ganglion (CCG) provides the primary innervation of the pineal gland in several gallinaceous species. The CCG is located at the base of the skull near the exoccipital bone, dorsal to the level of the vagus and glossopharyngeal nerves. It occupies a much larger volume and appears pinkish-gray, instead of white, when compared to the petrosal ganglion. To surgically remove the CCG, chicks were anesthetized with halothane vapor. Following a small skin incision, blunt dissection was used to expose the CCG lying adjacent to the internal carotid. The ganglion was grasped with small forceps and pinched free of its fine neural connections to adjacent nerves. The success of the surgery was confirmed visually and by complete adrenergic dennervation of the pineal gland. The entire surgical procedure required approximately 20 min per bird. Mortality was less than 20% overall.


Morphological and histochemical observations on the primordial and early growing oocytes of crow (Corvus splendens) and myna (Acridotheres tristis).

A morphological and histochemical study has been made of the primordial and early growing oocytes in the ovaries of crow (Corvus splendens) and common myna (Acridotheres tristis). The primordial oocytes in the myna ovary are loosely arranged in groups or nests, whereas in crow they form compact nests surrounded by highly vascularized connective tissue bands or lie in layers beneath the surface epithelium. The primordial oocytes in both the species are surrounded by flat granulosa cells whose number, shape, and cytochemical properties change with the initiation of growth. The oocyte nucleus shows a single basophilic nucleolus and thick diplotene chromosomes. With the initiation of growth, the number of nucleoli increases; simultaneously the chromosomes attain lampbrush configuration. Crescent-shaped Balbiani's vitelline body consists of ribonucleoproteins, lipoproteins, and phospholipids. The amount of these substances increases with the oocyte growth. The nature of proteins and lipids in the ooplasm and follicular epithelium also changes with the oocyte growth. Some randomly distributed protein bodies are also present in the ooplasm of primordial follicles. They disappear with the initiation of oocyte growth. The enzyme activities of acid phosphatase, NADP-diaphorase and NAD-diaphorase, also increase in the Balbiani's vitelline body with the oocyte growth. Alkaline phosphatase and delta 5-3 beta-HSDH activities are not seen. The possible functional significance of these morphological and histochemical changes has been discussed in relation to the initiation of growth in quiescent oocytes.


Arprinocoid evaluation in broiler chicken pen trials in Europe.

The effect of arpinocid (9-[2-chloro-6-fluorophenyl)methyl]-9H-purin-6-amine) on artificial and natural coccidial infections in broiler chickens was evaluated in a series of pen trials conducted in England, France, and Germany. In trials with induced infections, mortality attributable to coccidiosis did not occur at 50, 60, and 70 ppm although it ranged from 3.2 to 9% in unmedicated groups. At 7 to 8 weeks of age, birds receiving arprinocoid in feed at levels of 40, 50, 60, and 70 ppm had improved body weights and feed conversion compared with unmedicated birds, the differences being significant (P is less than .05) in 4 out of 5 trials. Productivity of birds on arprinocid was equivalent or significantly superior (P is less than 0.5) to those on halofuginone (3 ppm), monensin (100 ppm), nicarbazin (125 ppm), and PANCOXIN (165 ppm). Based on the results of these pen trials, arprinocid at levels of 50 to 70 ppm in feed is a highly efficacious compound for the prophylaxis of coccidiosis, preventing mortality, and permitting good growth and feed conversion under conditions of both mild and severe infection pressure.


Ultrastructure of the turkey's basilar papilla and the damping elements in the scala media.

The ultrastructure of the turkey's inner ear was investigated by use of scanning and transmission electron microscopes. It was shown that hair cells of the basilar papilla are separated from each other by microvilli of the supporting cells. Organized compartments in the lower surface of the tectorial membrane of the turkey are arranged in polarized fashion as are the hair bundles. Kinocilia were not identified in the hair bundles examined in this study. Well-organized filamentous elements were observed in the cutucular plates. The continuation of these filamentous elements into the stereocilia indicates that the theory of adjustable resistor in generating cochlear potential may be closely associated with these elements. Membrane bound homogeneous material was found in the scala media between the tegmentum vasculosum and the tectorial membrane. The presence of this homogeneous damping material is believed to be essential in offsetting the sensitivity and enhancing the time resolution ability of the relatively short avian cochlea.