Ethanol consumption and hepatic enzyme activity.

Enzyme activity and ethanol consumption were measured in an F2 generation derived from the C57BL and C3H inbred mouse strains. A significant correlation (0.25) was found between alcohol dehydrogenase activity and ethanol acceptance in the F2 generation. Mass selection from a genetically heterogenous mouse stock, HS/Ibg, has yielded high ethanol acceptance (HEA) and low ethanol acceptance (LEA) lines of mice. The mean ethanol acceptance scores for the fifth generation of these lines are 1.008 and 0.606, respectively. The total liver alcohol dehydrogenase activity was found to be 24% higher in the HEA line than in the LEA line after five generations of selective breeding. No association between cytosolic aldehyde dehydrogenase activity and ethanol acceptance was found in either the F2 generation or the fifth generation of the selectively bred lines.


HPLC determination of biogenic amines in discrete brain areas in food deprived rats.

Norepinephrine (NE), dopamine (DA), 5-hydroxytryptophan (5-HTP), 5-hydroxytryptamine (5-HT), and 5-hydroxyindole acetic acid (5-HIAA) levels in the lateral hypothalamus (LH), ventromedial hypothalamus (VMH), median raphe (MR) and dorsal raphe (DR) were determined in nondeprived and 48 hr food deprived rats. Simultaneous determination of these compounds was accomplished by means of high performance liquid chromatography (HPLC) with electrochemical detection. When compared with controls, food deprived animals showed significant increases in 5-HT and 5-HIAA levels in the raphe nuclei, significant increases in 5-HIAA in the LH, but no changes in either 5-HT or 5-HIAA levels in the VMH. No changes in catecholamine levels were found in any of the brain areas studied. These results show that indoles in the raphe nuclei, as well as in the LH, are affected by food deprivation. The lack of change in indole levels in the VMH indicates that specific nuclei within the hypothalamus are differentially affected by food deprivation.


Etomidate and plasma esterase activity in man and experimental animals.

No hydrolysis of etomidate in plasma in vitro was detected in samples from man, horse, cow, sheep, guinea pig or white rabbit. Brown rabbits showed a moderate degree of hydrolysis and it was marked in plasma from Wistar rats. In this species, a single enzyme, an alliesterase, participated in the hydrolysis in plasma. Etomidate did not interfere with the hydrolysis of procaine by plasma pseudocholinesterase in man.


Pseudoephedrine pharmacokinetics in the rat using a microanalysis technique.

A microanalytical procedure was developed using a gas chromatographic-electron capture technique which is capable of detecting 2 ng pseudoephedrine in 20 microliter plasma samples. Standard curves for pseudoephedrine are linear over the concentration range 0.1--1.6 microgram/ml. Plasma and urine concentrations of pseudoephedrine were followed in 3 rats after intravenous dosing. Derived pharmacokinetics parameters exhibited little inter-animal variation. Average plasma clearance was 67.6 ml/min/kg, with renal clearance averaging 30.3 ml/min/kg. This latter value is approximately 4X the glomerular filtration rate in the rat.


[Repolarisation disturbances in the ECG under antidepressant drugs. A comparison of two drugs, differing in chemical structure and pharmacological profile (author's transl)].

In connection with clinical drug trials we compared the ECG-recordings during application of two different antidepressants. Tandamine (AY 23946) is a tricyclic drug with main effects on the norepinephrine reuptake, Fluvoxamine (DU 23 000) a nontricyclic antidepressant with a selective effect on the serotonin reuptake. No differences were observed regarding both frequency and patterns of the repolarisation disturbances. Thus, it appears that the chemical structure of the drug is not responsible for the "typical" form of the repolarisation disturbances. We further hypothesize that toxic effects and regulatory mechanisms of the cardiovascular system, caused by changes in norepinephrine and 5-hydroxytryptamine levels may be responsible for the areforementioned ECG aberrations.


Epidemiology of hip fracture. A review with implications for the physical therapist.

Patient variables associated with the occurrence of hip fracture are reviewed, with advanced age, the female sex, and the white race being the most notable variables. Findings from studies relating patient variables to treatment results are also presented. The strongest predictors of poor treatment results are 1) age greater than 75 years, 2) cerebral dysfunction, 3) multiple secondary problems, and 4) low prefracture functional status. Relevance of this knowledge for physical therapists engaged in education, research, and clinical practice is discussed, concluding that knowledge of epidemiology is important to physical therapists' general information on hip fracture.


Trends in compensation and benefits provided to physical therapy students during clinical education.

Many facilities offering physical therapy clinical education for full-time affiliation students also provide some sort of compensation or benefits to students. Fiscal policy trends within health care institutions have influenced the extent to which these benefits are provided. The purpose of this study was to examine trends in providing specific benefits, namely, stipend, housing, meals, and uniform laundry, to students in full-time clinical education at the University of Michigan from 1967 to 1977. Data from annual facility information forms showed that, in general, these benefits have decreased during the years examined.


Effect of cold submersion on intramuscular temperature of the gastrocnemius muscle.

This study investigated the effect of a 30-minute, 10 degrees C water bath on the intramuscular temperature of a lower leg and the contralateral lower leg. Intramuscular temperature was measured in 10 subjects using hypodermic thermistor probes inserted 25.3 mm into the lateral head of the gastrocnemius muscles of both legs. One lower leg was submersed in a 10 degrees C cold bath with the water level maintained 5 cm above the patella and with the subject in a nonweight-bearing position. Intramuscular temperature significantly decreased in both lower legs during treatment, although the intramuscular temperature of the treatment lower leg was significantly lower than that of the contralateral lower leg. A temperature difference continued for four hours after treatment; however, the temperature of both lower legs was significantly lower after four hours than it was before the cold bath treatment.


Employment of physical therapist assistants in a residential state school.

Development of a job description for physical therapist assistants in a residential center serving persons with developmental disabilities is presented. Academic preparation and ethical guidelines for the assistant were reviewed to determine appropriate job responsibilities. Assistants had sufficient academic preparation in modalities and bronchial drainage to function effectively and partial academic preparation in other areas related to treating developmental disabilities. Substantial on-the-job training was necessary for the assistant to perform specific tasks competently. Need for additional training was not considered a deterrent to hiring the assistant.


The value of orthoses for patients with Duchenne muscular dystrophy.

We applied knee-ankle-foot orthoses to 17 consecutive patients with Duchenne muscular dystrophy at the time they lost independent ambulation. We judged the value of the orthoses solely by the patients' ability to walk. With the orthoses, 7 patients (41%) became effective ambulators and benefited greatly from the appliances. Four patients (23%) had borderline results. Six patients (35%) were considered failures because they achieved only braced standing. We believe orthoses are indicated for many but not all patients with Duchenne muscular dystropy.


Ipsilateral and contralateral effects of proprioceptive neuromuscular facilitation techniques on hip motion and electromyographic activity.

The effects of two proprioceptive neuromuscular facilitation techniques on increasing the range of hip flexion during active straight leg raising were compared in 30 normal women. Subjects were randomly assigned into contract-relax, hold-relax, or control groups and were tested with the pelvis stabilized. An exercise technique was applied to the right lower extremity in two diagonal patterns while electrical activity was monitored from the contralateral rectus femoris, vastus medialis, semimembranosus, and biceps femoris muscles. Comparison of pretest and posttest measurements of the angle of straight leg raising of both lower extremities indicated that the increase in range of motion of the right lower extremity in subjects in the contract-relax group was significantly greater than that in the hold-relax and control groups. For the unexercised extremity, the increase in motion in subjects in the contract-relax group was significantly greater than that in the control group. Of the 30 subjects, 29 showed evidence of electrical activity in the contralateral limb when the right lower extremity was contracting against resistance.


The 1979 Presidential Address. American Physical Therapy Association.

As I close this address, I do so with a certain sense of sadness about leaving a leadership team in a very exciting time of our professional history. I retire from this office with great faith in the leadership that will follow and with the optimism that the future will hold numerous excitements for our profession. The motivation and interactions that you have provided have caused me to dream of physical therapy in a manner I could have never envisioned on my own. Oh, how I thank you for the pleasures I have derived! I hope my remarks of today will serve to stimulate your dreams, your goals, inasmuch as the combination of our dreams and goals will bring greater fulfillment to the profession of physical therapy in the years that lie ahead.


[Compressive bandages].

Different compressive bandages for chronic venous deficiency and lymphedema, are categorized. These categories are not based on the bandage technique itself, but on its effect. The aims of the compression vary in accordance to whether the case involves a diffuse edema brought on by chronic venous deficiency or by lateral trophic problems following malfunctioning of the perforating veins, or difficulties in transporting tissue from the lymphedemas. These various etiological factors must be taken into consideration in the design and use of compressive bandages.


[Indications for ready-made or custom-made compression stockings].

The author studies ready-made stockings and the techniques of classification by category and by pressure. He examines at the same time, custom-made circular or linear knit stockings. His comments lead to the conclusion that the basic problem is the effectiveness of the stocking, especially in patients whose case is somewhat unusual. Pressure must remain consistently even, and there may be problems in pressure linked to the flexibility of the tissues.


[Retention in edema of the upper limb].

Treatment of lymphedema of the upper limb by the now classical elastocompression technique of Van Der Mollen, provides a reduction time that is followed by retention. The latter is selected and adapted in keeping with clinical elements and is definitive. It is necessary to provide both psychological assistance and to check on proper local tolerance. The elastic arm band assures under these conditions a satisfactory correction of "swollen arm".


[Reduction of edema in the treatment of varicose ulcers].

Patients having ulcers of the two lower limbs underwent the same medical treatment. Yet, the elasto-compressive boot was placed on only one leg after compressotherapy with the Jobst apparatus. Scar formation was more rapid on the leg treated in this way. Applied preventively the treatment of edema by the same method considerably reduced the number of relapses of ulcer, when it was noticed that the relapses occurred during specific periods of the year.


[Proposal with a view to a classification of retention means: stockings and elastic bandages].

In answer to a need for clarification in the prescribing of support stockings, the author proposes to manufacturers five categories of clinical needs: 1) venous insufficiency that is well offset and is manifested only occasionally in the form of functional problems when there is too much pressure. 2) venous insufficiency with more continuous functional problems and occasional (edema) physical manifestations. 3) non offset venous insufficiency with frequent, if not continuous, vesperal edema. 4) complicated cured venous insufficiency (post-ulcer and post-phlebitis period). 5) lymphedema. A similar classification may be made for elastic bandes, with emphasis on categories 2, 4 and 5.


[Cellulitis, a conjunctive microvascular disease].

While the term cellulitis is incorrect, it is commonly used and deserves a nosological classification. "Cellulitis is a dermohypodermosis and an oedemato-sclerous panniculopathy- It is indeed a true histangiography in which the fibroblastic reaction predominates over capillaro-veinular changes. Adipocytes of exaggerated size interpenetrate into micro- and later into macronodules marked off by more or less structured conjunctive fibrilla, thereby making treatment difficult.


[Hemodynamic relations between capillary and venule].

Following a nosological discussion of the varicose vein, its histological, biochemical and immunological elements are detailed. The hydraulic conditions are described, and attention is drawn to the microvasculartissue consequences of the stasis, the degree of constraint exercised by the interstitial tissue, and the role played by the intricate "micro fiber" network of the microcirculation: only a part of the capillaries reconnect with the veinlet of the same circulatory unit, the others having to flow toward the veinlet of other units and only one initial lymphatic vein contributing to the evacuation of 3 to 4 veinlets. The slightest hydraulic imbalance due to the stasis, sets of a whole series of chain reactions that can rapidly become harmful, with chronic veinous deficiency setting in.


[Influence of LSD and 5-methyoxy-N,N,-dimethyltryptamine on the RNA synthesis in the cell nuclei of rat's brain].

The influence of LSD and 5-methyoxy-N.N.-dimethyltryptamine (MeODMT) on the RNA synthesis was verified in cell nuclei from rat's brain. LSD and 5-MeODMT inhibited the RNA synthesis within the test period of 30 minutes. This inhibition possibly participates in adaptive neuronal processes occurring in the course of psychoses.


[Thromboelastographic and immunologic fibrinolysis determinations in inflammatory-changed and artificial blood stained cerebrospinal fluids using fibrinogen substrate].

In in-vitro long-term tests, the free fibrinolytic activity was determined from inflammatory-changed and blood stained cerebrospinal fluids in which partly fibrinogen concentrations insufficient for the enzyme-catalysed fibrinolytic reaction were present, using after addition of substrate (fibrinogen, plasma) thrombelastography and fibrin degradation products (FDP) recording. The results confirm a free fibrinolytic activity in many inflammatory-changed and blood stained cerebrospinal fluids. The difference in the results obtained with reaction preparations with substrate and those with too low fibrinogen concentrations are discussed.


Psychological reactions to chronic medical illness.

Psychological reactions to chronic medical illness can be categorized as follows: the chronically ill patient is vulnerable, first and foremost, to eight types of psychological stress, all of which have their roots in early childhood. Specifically, chronic illness evokes a threat to the patient's self esteem; fear of strangers; separation anxiety; fear of loss of love, and of the control of developmentally achieved functions; fear of loss of, or injury to body parts; guilt and fear of retaliation; and fear of pain, which cuts across all of these stresses. Other psychological reactions to chronic medical illness include regression, conflict, and inevitable distortions in object relationships. Suggestions for the amelioration of these responses within the matrix of the doctor patient relationship are proposed.


The use and abuse of psychiatry in dealing with pain patients.

The question of real vs. psychogenic pain is considered, and the importance of psychiatric counseling discussed. Hospital staff should also be advised by trained psychiatric personnel how to deal with countertransference. Flexible, eclective, and intensive therapy can certainly help the pain-prone patient.


The chronically ill patient.

Psychiatry's renewed interest in its identity as a medical specialty and its increased therapeutic armamentarium make its involvement with chronically medically ill patients more feasible than ever before. These patients face problems which include economic ones, conflicts between independency and dependency, those connected with self-image, intra-family stresses including sexual ones, social isolation and the threat of death. Patients respond to these stresses with psychological symptomatology which includes depression, suicidal behavior, anxiety, delirium, dementia and psychosis. The treatment of the consequences of these stresses is the daily work of the liaison psychiatrist.


Social networks and schizophrenia.

This artical begins with an introduction to social networks research and its practical importance in the understanding and treatment of schizophrenia, and concludes with a consideration of the experience, the phenomenology, of schizophrenia, from a social network point of view.


Developments in family treatment of schizophrenia.

For the treatment of families of schizophrenics the following issues are discussed: (1) Is there any evidence that families cause schizophrenia? (2) Is it useful to consider the family as a system? (3) What is the aim of family therapy? (4) Does family therapy work for any kind of family? (5) Does family therapy work for families of schizophrenics? The conclusion is reached that systems theory can be applied successfully to some families when the patient suffers from certain conditions.


Ingredients of a psychiatric malpractice lawsuit.

This is a review by two trial lawyers of the practical problems in trying a psychiatric malpractice lawsuit. The substantive rules of law which receive a good deal of attention are found to be most significant in the day-to-day suit than gathering together the facts and medical opinions and presenting them to the jury in a persuasive fashion.


The components of psychic conflict and its consequences in mental life.

This paper surveys current psychoanalytic concepts of drives, unpleasure related to drives, defense and compromise formation, with special attention to the author's contributions to each subject during the years 1950-1978.


A device for teaching the theory of technique.

The usefulness of comparing dream psychology and neurosis psychology is demonstrated in the teaching of a course on the theory of technique at the Pittsburgh Psychoanalytic Institute. Candidates are assigned the task of writing a five-minute segment of free associations using assigned background material, resistances to be demonstrated, and assigned current and past conflicts. The candidates then present their free associations to the class for analysis. Explication of educational and developmental issues is given.


Studies on hysteria--Katharina.

Freud's account of his meeting with the country maid, Katharina, is re-evaluated from a contemporary psychoanalytic perspective. Freud's original explanation of Katharina's hysteria was based on a set of quantitative-economic assumptions and a psychic model based on conflict and defense. A modern analytic perspective would shift the emphasis from the economics of discharge to the aims and objects of sexual activity. The understanding of sensual pleasure focuses more specifically on the related complex of intentions, purposes, meanings, and motives, as well as on the qualities, characteristics, and patterns of interaction with important objects.


Scopophilia and object loss.

The study of a case of voyeuristic perversion and of some previously published cases of simple scopophilia suggests that fear of object loss early in life may be an important factor predisposing one to a propensity for voyeurism. The increased need to maintain visual contact with the object and to incorporate it visually leads to a hypercathexis of the visual function which is at the base of voyeurism. This need later becomes sexualized, while still retaining its pregenital connotations. Although object loss was apparently significant in the case of the patient described in this paper, it is not necessarily a factor in all cases of perverse voyeurism and, when present, may be considered as only one element in its pathogenesis.


On nothing and nobody with an addendum on William Hogarth.

While phase-related traumata are often accepted as sufficient explanation of patients' reporting that they feel like "nothing" or "nobody," it is the thesis of this paper that such feelings often derive from intrapsychic conflict and that the working through of such conflict leads to significant therapeutic benefit. In support of this thesis, two cases are presented, together with an addendum on Hogarth's Mr. Nobody.


[Postoperative radiology of the colon (author's transl)].

The most important surgical procedures are described. Early postoperative control may reveal insufficiency of the anastomoses or stenosis caused by scar formation. Later examinations may reveal anatomic and functional alterations and have to exclude tumor recurrency. In our patients 13% of abdominal surgery concerned the colon. Of 3000 barium enemas, two were complicated by perforations following colonic or pancreatic surgery. Both patients survived.


Evaluation of several sensitometers for use in processing quality assurance.

Sensitometry is becoming a widely used tool to measure and allow correction of changes in the processing of radiographs before those changes become clinically significant. To be effective, the inherent variability of the sensitometer must at least be smaller than the processing variations to be monitored. Results of performance evaluations are given for several commercially available sensitometers. All were found to be useful and dependable quality assurance tools when properly used with life-expectancies of at least five years.


[Radiologic diagnosis of benign and malignant changes occurring at anastomoses following resection of colonic cancer (author's transl)].

Following resection of carcinoma of the colon, local recurrence at the site of the anastomosis must be expected in about 10%. Recurrence diagnosed early can be resected in 50%. Double contrast technique has proven to be most helpful in early diagnosis of recurrence. Therefore, radiographic follow-up examination, in adequate time intravals permit an early differentiation between lesions due to recurrence and due to the surgical procedure or prolonged healing of the anastomosis. Close cooperation with clinical follow-up, especially by endoscopy and biopsy, guarantees reliably good care of patients after resection of cancer of the colon or rectum.


Professional growth and contribution in radiologic technology: can it be taught?

The competency-based education project, as it was carried out in the Radiologic Technology Division at The Ohio State University, describes in some detail the competencies within the contributor role, as well as in technologist, educator, and manager. The domain amplifications of these competencies, giving knowledge, skills, and attitudes, revealed some lacks in the curriculum in the teaching of attitudes and related skills. The response to this lack has been to prepare a plan for incorporating such teaching into the program. It is hoped that this plan will result in strengthening the students' performance in personal and professional growth, and in contribution to the profession over the years.


[The enlarged retrorectal space--indicative of specific pathology or only unspecific symptom of disease in the true pelvis? (author's transl)].

The retrorectal space was measured on the lateral view of the rectum during double contrast barium enema examination in 300 patients in whom no abnormality of the rectum, sacrum or in the true pelvis was demonstrated clinically or radiographically. The measurement obtained is the distance between posterior wall of the rectum and the anterior surface of the sacrum between S2 and S5. The measurements at S5 are considered most accurate, since at this level the rectum will be positively in midline. The normal width at S5 is between 0.2 and 1.5 cm. In connection with other symptoms, a distance between 1.5 and 2 cm should be regarded as suspicious and above 1 cm as definitely abnormal, as was demonstrated in 95 cases with diffuse and localized enlargement of the retrorectal space. An abnormal measurement of greater than 2 cm however is an unspecific symptom and should not by itself be considered indicative of specific pathology, but rather should lend supporting evidence to other abnormal findings in the true pelvis.


[Duplications of the gastro-intestinal tract (author's transl)].

Duplications of the stomach, small and large bowel are rare. In cases of communication with the lumen of the GI-tract, a reliable diagnosis can be made by radiography. Without direct communication these duplications present as fluid filled cystic mass lesions and therefore are difficult to specify radiographically.


Effect of kilovoltage and milliamperage on focal spot size.

Producing radiographs of the best possible quality is the responsibility of every radiologic technologist. Many factors affect the finished radiograph, yet the effect of kilovoltage and milliamperage on a selected focal-spot size is almost always overlooked. With the selection of appropriate milliamperes and kilovolts, one can maintain high radiographic quality, reduce radiation absorbed dose to the patient, and prolong equipment life. Supporting data based on laboratory research are provided.


[Localized interstitial calcinosis (author's transl)].

Case report of an unusual case of soft tissue calcification in the lower leg of a 50 year old patient examined for compensation problems for a gunshot fracture suffered in World War II. The differential diagnosis "localized interstitial calcinosis", "myositis ossificans" and "myositis ossificans progressiva" is being discussed.


[A comparison of the readings of film- and pocket dosimetry (author's transl)].

An inquiry to compare the readings of film- and pocket dosimeters worn by the same individual at the same time showed similar results, a fact which was found to be very satisfying. Of the 2132 dosimeters compared, only 46 (2.2%) were outside the standard error of -30/+50% permitted for film dosimetry. The majority of these (37) can be explained to be due to the different type of energy dependence of these 2 dosimeter types. The total dosis measured reflected an even better, conformity, differing only by 11.3% to 14.4% depending on the mode of calculation, the difference being partially due to the better sensitivity of the film dosimeters to low energy beta radiation. An additional result of the study is the conclusion to recommend more careful use and recording of pocket dosimetry.


[Radiobiological aspects of preoperative radiotherapy (author's transl)].

Radiobiological considerations suggest the use of preoperative radiotherapy with subcurative doses in malignancies known for frequent local recurrence or for easy metastatic spread during surgery. Clinical experience with this form of preoperative radiotherapy on esophageal cancer is being analyzed in regard to its radiobiological significance.


[Technique and management of double contrast studies in the intestinal tract. Experience with a new barium suspension (author's transl)].

Competition of endoscopy has brought forth development of new roentgenographic procedures in gastroenterology. Besides modern fluoroscopic equipment, examination of the gastrointestinal tract was mainly improved by double contrast technique. Contrast media which guarantee the coating of mucosal folds enable better visualization of the intestinal wall. Examples of routinely done gastrointestinal tract examinations demonstrate possibilities to obtain diagnoses by double contrast technique with a new barium suspension (Topcontral). It is shown that only combined radiologic, endoscopic, microscopic, and possibly cytologic examinations guarantee greatest diagnostic accuracy in gastrointestinal disease.


Factors influencing false negative rates in xeromammography.

Xeromammographic false negatives were analyzed to ascertain the cause of the errors and determine what corrective measures could be taken. Of 52 cancers miscalled, 52% were not visualized and 48% were categorized as misinterpretations. The causes of these errors are discussed. The error rate in all but 8% of the former group appears to be irreducible, yet errors discussed in the latter group are thought to be correctable in a high percentage of cases. Recommendations to reduce the number of false negatives in this group are presented.


Annular pancreas: etiology and diagnosis using endoscopic retrograde cholangiopancreatography.

A case of annular pancreas diagnosed by endoscopic retrograde cholangiopancreatography (ERCP) is described and the etiology of the abnormality considered. Annular pancreas is an anomaly of the ventral pancreas, and probably due to the persistence of the left ventral bud; the dorsal pancreas plays no apparent role in its development. In the diagnosis of annular pancreas, it appears that ERCP provides unequivocal evidence in some, quite possibly all, cases.


The value of simethicone in abdominal preparation.

The effectiveness of simethicone in reducing the amount of gastrointestinal gas was investigated with abdominal radiographs in a double-blind study of 169 patients receiving either simethicone or a placebo randomly. There was no statistically significant difference between the two groups. Although simethicone may relieve clinical symptoms and accelerate the transit time of gas, it does not reduce the amount of gas in the gastrointestinal tract. This study indicates that simethicone is not helpful in preparing the patient for radiological examination of the abdomen.


The value of plain radiographs prior to oral cholecystography.

The diagnostic significance of a routine preliminary plain radiograph of the right upper abdominal quadrant prior to oral cholecystography was evaluated retrospectively. The plain radiograph was decisive in the diagnosis in only one case out of 1,022 consecutive cholecystographic examinations (0.1%) (95% confidence limits: 0.00-0.55%). The sensitivity of oral cholecystography, now approximately 90%, would drop by only 0.43% (95% confidence limits: 0.01-2.14%) if the routine plain radiograph were omitted.


Angiographic assessment of lymphatic metastasis from gastric cancer.

Lymph node metastasis was evaluated angiographically in 151 patients with gastric cancer. In 20% of the patients with nodal metastases, abnormally staining masses were demonstrated by angiography. Superselective angiography is useful in confirming the presence of lymph node involvement.


Involvement of the inferior vena cava in patients with renal cell carcinoma.

Inferior vena cavography plays an important role in the staging of renal cell carcinoma. The renal angiograms and inferior vena cavograms in a series of patients with renal cell carcinoma were reviewed to determine which patients require cavography. Our findings show that renal angiography is of great value in suggesting tumor involvement of the renal vein or vena cava, and that the decision to do cavography can be made from the angiographic findings. In the series of 172 patients with renal carcinoma, 15 or 9% had inferior vena cava involvement.


Giant aneurysms of the renal arteries: an unusual manifestation of fibromuscular dysplasia.

Diffuse areas of narrowing and dilatation involving the main renal artery are the most common angiographic findings in fibromuscular dysplasia (FMD), together with the presence of renal artery stenosis. The development of false aneurysms of the renal artery and arteriovenous fistulas are uncommon manifestations. Large, partially thrombosed and calcified renal artery aneurysms are described and their differential diagnosis is stressed.


Laryngeal sarcoid.

Involvement of the larynx is an unusual complication of sarcoidosis. Clinical and laryngographic findings are reviewed and a differential diagnosis is given. Unlike the pulmonary and hilar manifestations of the disease, laryngeal lesions do not respond well to systemic steroids, although local injections may alleviate the need to perform a tracheostomy for airway obstruction.


Antefemoral dissecting cysts in rheumatoid arthritis.

Five cases of an antefemoral synovial cyst in rheumatoid arthritis were confirmed by arthrography. Communicating with the suprapatellar bursa, these rarely observed cysts may be considered an anterior analogy to dissecting Baker cysts.


Advances in radiologic reporting with Computerized Language Information Processing (CLIP).

Computerized Language Information Processing (CLIP) is a system of radiologic reporting in which the user interacts with a computer keyboard and cathode-ray tube terminal to generate coded reports. The hierarchical medical classification on which the code is based permits rapid on-line compilation of reports of any degree of complexity. The system provides organized sets of pre-assembled statements that are rapidly accessed and modified for each examination. Although the reports are printed in English, they are held in the computer as a succinct code that is eminently suited for permanent storage and rapid retrieval.


Variability of unilateral epiphyseal dysplasia (dysplasia epiphysealis hemimelica).

Nine cases of dysplasia epiphysealis hemimelica (Trevor disease) are reviewed. This osteocartilaginous process arises from the epiphysis and most commonly involves the ankle and knee. While usually mild, 3 cases of greater severity were found with associated arrest of the growth plate. One mild and 2 severe cases are presented in greater detail. The term unilateral epiphyseal dysplasia is proposed as the condition may involve the upper extremity and often involves more than half the epiphysis.


Cerebral embolic disease: a complication of carotid aneurysms.

Thrombus formation in large aneurysms is well recognized. However, thrombi in small aneurysms with subsequent embolization into intracranial vessels is infrequently identified or suspected. A series of cases in which this phenomenon has occurred is documented. Since many of these examples present embolic disease without suspicion of aneurysm, definitive diagnosis can only be accomplished by angiography. The importance of this study should be emphasized since embolic disease is usually assessed only by computed tomography which fails to delineate the embolic source.


Arteriovenous malformation simulating a cyst on computed tomography.

Three cases are described in which an intracerebral arteriovenous malformation (AVM) was accompanied by a cystic component probably resulting from hemorrhage. The 3 patients gave a history of headaches. In cases of low-attenuating nonenhancing CT processes, an AVM must be considered.


Enlargment of the hypoglossal canal in the presence of a persistent hypoglossal artery.

Enlargement of the hypoglossal canal with preservation of its cortical margin is described as a normal variant when a persistent hypoglossal artery is present.


Evaluation of mucoceles of the paranasal sinuses with computed tomography.

Eighteen patients with mucoceles of the paranasal sinuses were studied by plain radiography, pluridirectional tomography, and computed tomography (CT). Sixteen of the lesions had a homogeneous appearance on CT but demonstrated variable absorption characteristics, with acutely infected mucoceles showing rim enhancement. Plain radiography and pluridirectional tomography were usually sufficient for making a diagnosis and defining the extent of the lesion, but CT more accurately demonstrated orbital and intracranial extension. Both transverse and coronal CT are essential for adequate evaluation.


Evaluation of retroperitoneal hemorrhage by computed tomography before and after translumbar aortography.

Twenty patients were prospectively studied by computed tomography (CT) before and after undergoing translumbar aortography (TLA). Changes indicative of retroperitoneal bleeding were depicted by CT in all 20 patients despite the predominantly small size of the hematomas. CT scans obtained within two hours after TLA demonstrated: (a) thickening of the diaphragmatic crura, (b) enlargement of the left psoas muscle, and (c) obscuration of the aortic outline by soft-tissue density. Follow-up scans at 24 hours (10 patients) and one week (3 patients) revealed marked decrease in abnormalities, suggesting rapid resorption of the hematoma.


Computed tomographic guided liver biopsy using the Menghini needle.

CT guided biopsies of the liver using the Menghini needle were performed in 42 patients. The recovery of diagnostic tissue was successful in 86% of focal lesions. Advantages over the blind liver technique include better recovery of diagnostic specimens, while advantages over the ultrasonic guided techniques include greater amount of tissue obtained and better occuracy in guidance. This technique is indicated in those patients with a small number of focal defects in the liver in whom a diagnostic histologic specimen is desired.


Iron content of pigmented villonodular synovitis detected by computed tomography.

Pigmented villonodular synovitis is a rare lesion in which iron is accumulated. A CT scan performed on one such lesion demonstrated significantly increased attenuation values. We have calculated the amount of iron which would have to be added to muscle tissue in order to produce this increase in density. We have also measured the iron content directly. The close agreement of these two figures suggests that the observed density increase is due to the iron content of the lesion.


Ultrasonography of peritoneal tumors.

Peritoneal masses arising from different types of primary carcinoma were studied ultrasonographically in 34 patients as well as with computed tomography in 3 patients. In shape, the masses were nodular, mantle- or sheetlike, or irregular. The peritoneal line was usually obliterated unless the mass was very small. When a considerable amount of ascites was present, peritoneal implants as small as 2-3 mm could be delineated.


Gallbladder wall sonolucency in acute cholecystitis.

The usual ultrasound findings in acute cholecystitis include diffuse hyperreflective wall thickening, hazy wall delineation and gallbladder distension. In 11 patients with acute cholecystitis, an additional sign was seen consisting of a hyporeflective or sonolucent layer, continuous or interrupted, within the hyperreflective, thickened gallbladder wall. Anatomic-pathologic correlation, comparative CT scans and clinical follow-up studies showed subserosal edema and necrosis to be the most probable cause of this finding.


Cholecystosonography--the junctional fold.

Three cases are presented in which a fold occurred along the posterior wall of the gallbladder at the junction of the body and infundibulum at cholecystosonography. On the initial supine scans, this finding suggested a small polyp in 1 case and a calculus in the other 2. Familiarity with this normal variant as well as adherence to correct scan methodology should help to further reduce erroneous diagnoses.


Ultrasonographic evaluation of chemotherapeutic response in hepatic metastases.

Three hundred and thirty-four hepatic ultrasonograms were obtained in 93 patients to evaluate the chemotherapeutic response of their metastatic lesions. Four patterns of response were noted. The ultrasonographic results were correlated with those of other diagnostic modalities and found to be extremely accurate when lesions were judged to have improved, worsened, or remained unchanged. However, a fourth type of response, a change in the initial ultrasonographic pattern, was difficult to evaluate, and its significance is discussed.


Megalocytic interstitial nephritis: ultrasonic and radiographic changes.

The radiologic and ultrasonic findings are presented in a case of megalocytic interstitial nephritis, a very rare condition, in many ways similar to renal malacoplakia. The role of ultrasound in the interpretation of the radiographic changes is discussed. Excretory urography will demonstrate a nonspecific renal mass effect and angiography may rule out evidence of tumor. Ultrasonic correlation can be highly suggestive of an interstitial parenchymal lesion.


The decidual cast of ectopic pregnancy: a confusing ultrasonographic appearance.

The appearance of the central uterine cavity was analyzed in 39 cases of ectopic pregnancy. In nearly 20% of cases, a fluid collection surrounded by an echogenic ring was present which could be mistaken for a normal early intrauterine pregnancy. When ectopic pregnancy is suspected clinically, and there is fluid in the cul-de-sac or an adnexal mass on ultrasound, a fetal pole should be evident within the central fluid collection before a definitive diagnosis of intrauterine pregnancy is made.


Bicornuate uterus with incomplete vaginal septum and unilateral renal agenesis. Ultrasound demonstration in two patients.

Ultrasound studies in two patients revealed identical anomalies consisting of unilateral renal agenesis, bicornuate uterus, communication between the two uterine cavities at a level just above the cervix, and incomplete vaginal septum with a blind hemivagina filled with purulent material. One patient was 28 weeks pregnant at the time of diagnosis and was managed surgically.


The relationship of information density to pre-set counts obtained in brain, lung and liver scintigraphy.

The total number of counts required per view for brain and lung scintigraphy to achieve information or count density (CD) of 1 000 counts/cm2 and 2 000 counts/cm2 for liver scans was examined. To achieve these CDs, 600 000 counts per view are required for brain scans. For the lung, 500 000 counts in anterior and posterior views are required; 400 000 counts in the lateral view are sufficient. For 2 000 CD in the liver scan, 600 000 counts should be obtained in the anterior view and 500 000 in the right lateral. This number of counts assures the desired CD in 97% of cases.


Dose to the liver and spleen in pediatric patients undergoing technetium-99m sulfur colloid scans.

Quantitative conjugate view external counting techniques were applied to determine radiation dose to the liver and spleen in pediatric patients undergoing 99mTc-sulfur colloid (Tc-SC) liver scans. The effective half-life of 99mTc-SC was 5.8 +/- 0.23 hours and 5.2 +/- 0.68 hours in the liver and spleen, respectively. Dose per administered activity ranged from 0.34 to 0.63 rad/mCi (92 to 170 muGy/MBq) for the liver and 0.35 to 1.96 rad/mCi (95.0 to 530.0 muGy/MBq) for the spleen. The spleen to liver dose ratio ranged from 1.0 to 4.9. These values are compared with results extrapolated from published adult data to the pediatric population.


Utility of bone scanning in detecting occult skeletal metastases from cervical carcinoma.

Bone scans were obtained in 100 patients with carcinoma of the cervix in order to search for occult skeletal metastases. Scans revealed metastases in 4 patients with advanced stages of disease, but the scans in 79 patients with Stage 0, I or II disease were negative. The scans in 14 patients showed renal asymmetry; 11 of these had obstructive uropathy due to tumor invasion or radiation therapy. Bone scanning does not seem warranted as a screening test in asymptomatic patients with Stage 0, I, or II carcinoma. If the test is done, renal symmetry should be carefully evaluated.


Rapid clearance of advanced pelvic carcinomas by low dose rate 252Cf neutron therapy.

Californium 252 low dose rate intracavitary neutron implants combined with conventional external beam therapy for advanced pelvic tumors produced better local response than 137Cs in pelvic brachytherapy. Greater tumor regression was achieved by applying 252Cf while the maximum amount of tumor was present preceding or shortly after starting external beam therapy (12/14 or 86%). This schedule was more effective than similar neutron doses given after external beam irradiation.


Computed tomography applied to radiotherapy treatment planning: techniques and results.

In order to assess the role of computed tomography (CT) in radiotherapy treatment planning, tumors were localized by conventional techniques and with CT using an EMI CT5005 scanner. CT scans were obtained under conditions simulating radiotherapy. A comparison between the two localizations was made, and detailed results are given. Forty-seven of 123 patients had their treatment plan altered, implying that, provided information is obtained and used correctly, CT can play a significant role in radiotherapy treatment planning.


A mammography quality assurance test program.

The design and implementation of a program to investigate remote quality assurance testing for film mammography is described. The measurements included tube output, x-ray machine and processor stability, and film quality. Mammography phantoms and film sensitometric strips were distributed monthly to 24 regional hospitals. Most of the hospital processors and x-ray machines performed in a stable manner during the 12-month test period. It was found that x-ray machine useful beams could be reliably measured using nonscreen films. The main utility of the phantom was to identify cases of poor image quality. The measurements performed on the phantom image could not be used to diagnose specific causes of poor images.


Correlation between computed tomography and intracranial pressure monitoring in acute head trauma patients.

A preliminary retrospective correlation between computed tomographic scans and intracranial pressure (ICP) monitored was performed for 21 patients. No patient with a normal CT scan had elevated ICP. The lowest correlation was noted with slit ventricles; the highest, with dilatation of the contralateral temporal horn.


Polyvinylpyrrolidone contrast enhancement: abscess imaging.

Rabbits with thigh abscesses received an intravenous solution of polyvinylpyrrolidone (PVP) and metallic salts, resulting in a dense ring of contrast enhancement as determined by computed tomography (CT). Enhancement increased during the first two weeks, stabilized, then decreased to control levels at eight weeks. After antibiotics the ring of enhancement appeared to mark the abscess perimeter as it regressed. Normal muscle density did not change. The magnitude and duration of enhancement would improve CT detection of small lesions and be useful in evaluating the efficacy of therapy.


Development and testing of new hypoxic cell radiosensitizers.

Several new electron-affinic compounds have been shown to possess radiosensitizing ability in hypoxic mammalian cells. The correlation between chemical structure and biological activity can aid in the design and synthesis of new agents with potentially greater hypoxic cell radiosensitizing ability.


Radiographic techniques for balloon-occlusion pulmonary angiography.

Pulmonary angiography was performed in 125 patients with suspected pulmonary embolism. Standard angiographic techniques were combined with balloon occlusion of pulmonary arterial branches using a double lumen catheter and contrast material injection distal to the occlusion. Vessel opacification was fluoroscopically monitored and images obtained with either a conventional cut-film camera, a spot-film camera, or cineangiography. Balloon-occlusion angiography improved image quality and contributed substantially to the radiographic diagnosis of pulmonary embolism in most patients. The technique is useful in patients too ill to undergo conventional angiography and may be performed at the bedside.


Dose reduction in xeroradiography--application to chest tomography.

Exposure and image quality in xeroradiography were studied in a test object and in patient tomographic examinations of the chest. With increased tube voltage and added copper filtration, skin exposure was reduced up to a factor of 10 without loss of image quality.


Magnification radiography of the temporomandibular joint: technical considerations.

The design, application, and advantages of a temporomandibular joint (TMJ) positioning unit adapted to the RSI microfocus manigification system are described. The reasons for improved TMJ images with this system are discussed and the rationale for film-screen choice presented. The issue of patient radiation exposure is also considered. This system provided superior TMJ images at acceptable levels of exposure.


Routine fluoroscopy using minispot cameras.

Routine fluoroscopy was performed using 100- and 105-mm spot film cameras. Radiation dose was reduced to between 30% and 43%, and cameras were acceptably reliable. Cost for film and holders was high.


A new approach to ultrasound image recording using a video disc recorder.

A system utilizing a multi-image capacity video disc recorder rather than a photographic camera for the initial recording of ultrasound images id described, as well as the resulting benefits.


Radiology management: the advantages of the dedicated mini-computer.

When planning to automate management functions, a department must choose between using a dedicated mini-computer and the hospital's large central computer facility. Rapid response times and ease of program modification are important advantages of the dedicated mini-computer; moreover, limitations on transmission speeds and the variety of terminals available are disadvantages of the central computer facility. The substantial reduction in the cost of computers coupled with the availability of well designed data-base management systems which allow communication with other systems are additional reasons for selecting the mini-computer. In selecting systems that are already programmed, the department minimizes risks and implementation difficulties.


Basal level of human platelet prostaglandins: PGE1 is more elevated than PGE2.

Radioimmunoassays of platelet prostaglandins E1 and F1 alpha in platelet rich plasma or platelet suspension, demonstrate that both PGE1 and PGF1 alpha are present at higher concentrations than prostaglandins E2 and F2 alpha. Gas chromatography--mass spectrometry determinations of prostaglandins E1 and E2 in resting washed platelets confirm this difference. Lastly, there is a greater incorporation of [1--14C] acetate into prostaglandins E1 and F1 alpha compared to that into prostaglandins E2 and F2 alpha.


Prostaglandins and congeners XXIII (1). Synthesis of 15-deoxy-16-hydroxy-16-methylprostanglandins. The importance of the C13--C14 trans double bond for bronchodilator activity.

The synthesis and bronchodilator activity in the guinea pig of several 15-deoxy-16-hydroxy-16-methylprostaglandin analogs is described. The E2 (VIa) and E1 (VIb) analogs are potent bronchodilators comparable in activity to the natrual prostaglandins, but possessing a longer duration of effect. Replacement of the C13--C14 trans double bond by a cis double bond or an ethylene linkage causes a substantial diminishment of this activity.


Prostaglandin and thromboxane production by human and guinea-pig macrophages and leucocytes.

The ability of partially purified human and guinea-pig haematogenous cell populations, when cultured in vitro, to metabolise arachidonic acid (AA) has been studied. Supernatants from 24 hour cell culture have been subjected to analysis for products of AA metabolism by gas chromatography with electron-capture detection. The cell types studied were human peripheral blood monocytes (both glass adherent and non-adherent), neutrophils, eosinophils and leukemia leucocytes; thoracic duct lymphocytes and lung alveolar macrophages. From the guinea-pig, induced and non-induced macrophage or neutrophil enriched peritoneal exudate populations, lymph node cells, peritoneal eosinophils and peripheral blood platelets were examined. Supernatants were assayed for the presence of PGE2, PGD2, PGF2 alpha, TXB2 and 6-keto-PGF1 alpha. In all types studied PGE2 and TXB2 were the major products formed. The identification of PGE2 and TXB2 was confirmed by GC/MS with multiple ion monitoring. The results have been compared with other reports and their possible significance discussed in relation to the proposed role of prostaglandins as mediators and modulators in immunopathology.


Light and electron microscopic studies on the pineal tract of rainbow trout, Salmo gairdneri.

The pineal tract of rainbow trout from the pineal end vesicle to the posterior commissure was studied by light and electron microscopy. Five types of nerve fibres (photoreceptor basal process, ganglion cell dendrite, electron-lucent fibre and synaptic vesicles, myelinated and unmyelinated axons) and two modes of synapses (photoreceptor basal process ganglion cell dendrite and axon terminal with synaptic vesicles-photoreceptor basal process synapses) are distinguishable in the proximal region of end vesicle. The two distinct synaptic associations with the photoreceptor basal process suggest two different (excitatory and inhibitory) control of pineal sensory activity. At the distal portion of stalk about two thousand nerve fibres converge into dorsal and ventral bundles. Posterior to the habenular commissure several small branches run out laterally from the ventral bundles to the basal margin of the ependyma, but not into the habenular commissure. The dorsal bundle passes through the dorsal side of the subcommissural organ and runs ventral to the posterior commissure. The pineal tract is composed of unmyelinated axons, electron-lucent nerve fibres and myelinated axons. The number of fibres increases throughout the stalk and reaches the maximum number at the opening of pineal lumen to IIIrd ventricle, however, the number of fibres then decreases through the subcommissural organ and posterior commissure. This increase and decrease of nerve fibres suggest the continuous participation of axonal fibres of pineal nerve cells and the ramification or branching of pineal tract, respectively.


Ultrastructural correlates of luminescence in Porichthys photophores. I. Effects of spinal cord stimulation and exogenous noradrenaline.

Light emission induced by electrical stimulation of the spinal cord is associated with ultrastructural alterations of the varicose endings, photocyte organelles and membranes in Porichthys photophores. Changes in nerve profiles appear first and include alterations of the shape, number and distribution of synaptic vesicles, as well as invaginations of the axolemma and mitochondrial swellings. Protocyte vesicles become markedly coalesced and their membranes are incorporated inside vesicular pools, whereas photocyte microvilli become sharply reduced at the cell periphery. Luminescence obtained by administration of noradrenaline is accompanied by similar, but more acute changes in the ultrastructure of photocytes, whereas no marked alteration of nerve profiles is noted after this treatment. These and other observations, such as the presence of specialized synaptic contacts, are discussed in terms of neural activity and processes within the photocytes which may lead to light production.


Ultrastructural correlates of luminescence in Porichthys photophores. II. Effects of metabolic inhibitors.

Prolonged, bright luminescent glows in Porichthys photophores are elicited by administration of 2,4-dinitrophenol (DNP) and potassium cyanide (KCN). Ultrastructural alterations of varicose nerve endings precede photocyte changes during such luminescent activity. Common alterations of nerve profiles include mitochondrial disruptions, flattening and depletion of synaptic vesicles, formation of large vacuolar cisternae, and invaginations in the contour of axolemma. Protracted luminescent activity in response to DNP results in depletion of photocyte vesicle material while vesicle and ER membranes accumulate and coil inside coalesced vesicle pools, and photocyte microvilli disappear completely. Although similar photocyte alterations are initially observed in KCN treated luminescing photophores, the early extinction of the response to KCN is related to deleterious, irreversible effects of this chemical on photocytes. These observations, along with some pharmacological manipulations, indicate that at least DNP acts initially and primarily on neural structures, probably the mitochondria, to induced transmitter release and consequent photocyte activity. Based on this and earlier studies, a chain of subcellular events leading to light emission of Porichthys photophores is proposed and discussed.


[Current problems in thoracic injuries].

The authors stress the increased frequency in the recent years of single thoracic trauma and of thoracic trauma in the frame of polytraumatic lesions. The fact is stressed that the severity of thoracic trauma is usually determined by pathophysiological syndromes generated sometimes by minor anatomical lesions. An original classification is presented, of thoracic trauma, the present etiopathogenetic concept is discussed, as well as pathophysiologic syndromes consecutive to thoracic trauma. The major types of lesions are illustrated by clinical cases. The treatment of thoracic trauma should respect in the first place the principle of re-equilibration of vital functions that have been disturbed. Only after this has been achieved integrity of the anatomic structures of the organs involved should be attempted. Surgical indications are justified only if the anatomical lesions are the origin of a cardio-respiratory imbalance that cannot be eliminated but by surgical procedures. An original procedure is presented, that of Prof. C. Coman, which achieves immobilization of the flaps with the aid of blades, and the advantages of this system are stressed.


[Bipolar approach to biliobronchial fistulas].

On the basis of 4 cases (three bilio-bronchial fistulae of hydatic origin, and one post-traumatic fistula), the authors review the problems of etiology and of pathological physiology. After an interpretation of the results obtained they recommend the bi-polar approach (pulmonary and biliary) in the same surgical intervention. In relation with the condition of the patient the second stage of the intervention will be performed after 14 to 21 days (the abdominal stage being carried out after the thoracic stage).


[Possibilities of early detection of postoperative venous thromboses].

The use of labelled fibrinogen in 106 patients with thromboembolic risk led to the detection of thrombosis of deep veins of lower limbs in 25 patients (23,58%) as compared with a single patient (0,94%) who showed all the clinical signs. The thromboses were identified more frequently (in 60% of the cases) in patients whose age was above 60 years. In 80% of the cases the thromboses were detected in the first 24 h after surgery. Most frequently involved were the veins of the leg (64%), and especially in the IV-th area, corresponding to the upper third of the leg (23,80%). Surgery performed in the pelvic area gave a high percentage of thromboses. Advanced age, the existence of varicose veins, the presence of diabetes, of obesity, as well as previous surgical interventions, increase the risk of thrombosis and of embolies. Due to existing possibilities for an early diagnosis of thromboses in deep veins following surgery, for detecting latent clinical thrombosis, as well as for assessing the evolution of an already formed thrombus, it appears that the test with labelled fibrinogen is a highly useful clinical investigation.


[Treatment of duodenal stress ulcer by means of chemical sclerosis of the gastric mucosa induced with a 60 percent glucose solution (results after 1--5 years)].

Sclerosing of the gastric mucosa with a 60% fresh sterile solution of glucose was applied in 60 selected patients with chronic conflictual duodenal ulcers, hyperacidic gastritis by vagal neurogenic hyper-reactivity, associated with ischaemic gastropathy developed on an sympathico-adrenergic background. The immediate operatory results were good. The late results (between 1 and 5 years) were as follows: the clinical, radiological and metabolic results were good in 57 patients. Gastric chemical analysis, the values of the hourly basal output remained high in 16,6% of the patients, and those of acidity stimulated by histamine administration remained high in 13,3% of the patients. No peptic recidive was recorded. Unsatisfactory late results were noted in 3 patients (of which forced indication of the method in one patient and non-association of drainage in two patients).


[Rapid arthrodesis of the ankle by verticalization of the articular interline, using a cylindrical piston drill (original surgical technic. Results)].

An original technique is presented for tibio-tarsal arthrodesis, that can be achieved in 8--10 minutes with the aid of a cylindrical bore equipped with an expulsion piston, under Rx-TV control. Since 1974 a total of 22 patients have been operated and 21 remarkably good results were obtained, evaluated both clinically and radiologically. The technique is indicated in posttraumatic arthrodeses or after inflammatory affections of the ankle and in paralytic affections of the foot, when there are severe displacements in the foot-leg axis.


[Determination of optokinetic reactivity by a sudden supra-optimal acceleration of the stimulus (author's transl)].

The authors describe a new method of optokinetic stimulation. The stimulus is applied during 3 successive sequences: the first and third include displacement of 1 to 2 black or white bands per second (apparent mean speed of 16 degrees/sec), while the second sequence comprises the sudden acceleration of 6 black or white bands per second (apparent mean speed of 59 degrees/sec.). Each sequence lasts 4 to 10 seconds. However many times the stimulus is repeated the optokinetic response becomes hyposynchronous at the frequency at which the bands are passing when the speed is increased, whereas the amplitude of the ocular responses is multiplied two to three times. The increase in the amplitude appears to be proportional to the reduction in frequency. In this way, optokinetic reactivity is tested when the subject looks in the three principal directions: horizontally, vertically, and obliquely. Particular types of reaction are observed in pathological conditions where they are either unadapted or incomplete, while absence of optokinetic reactivity can be found in all directions, several directions, or in one direction only.


[Clinical and electroencephalographaic aspects of seizures due to electrolyte and water disturbances in infants (author's transl)].

Clinical seizures, or subclinical EEG discharges, were observed in sixteen new-born babies or infants under one year of age admitted to hospital. Clinical observation and initial biological tests showed that: --seizures occurring during rehydration of infants with salt retention are not associated with severe neurological lesions,--in dehydrated babies, a dissociation between electroencephalographic and clinical manifestations (electrical discharges without clinical signs or vice versa) and large abnormalities in the intercritical tracing are bad prognostic elements;--in new-born babies with severe dehydration and meningeal hemorrhage, the occurence of clinical and electroencephalographic seizures does not imply that there will be an unfavourable evolution. The authors discuss the physiopathological correlations arising from the study of this series.


[Photosensitivity and colour filters (a systematic study on 1500 subjects) (author's transl)].

The reinforcing, activating, inhibiting or negative action of yellow, orange, red, green, and blue filters was studied in 1500 patients. A reinforcing action is seen much more frequently in subjects photosensitive to white light who are under twenty years old, while an inhibiting or negative action is more frequent in those over twenty. Two other factors seem to play a role in the reinforcing action of orange and red filters in subjects under twenty years old: epilepsy and cerebral immaturity. None of the non-epileptic subjects who developed a photo-convulsive response to yellow, orange, or red filters only, became epileptic during the two-year follow-up period.


[Posterior theta rhythms during waking state activity in man (author's transl)].

Telemetric recordings were made of 44 subjects divided into 4 groups according to age and occupation (35 and 50 years--skilled workers and university personel), during a period of 8 hours working activity. Short sequences of posterior theta rhythms were observed in all cases. They appear mainly during continuous work activity and diminish or disappear when work ceases. They are more frequent in the 50-year-old subjects than in those aged 35 years. They are neither pathological nor related to immaturity or emotion, and their etiology is related to visual perception and attention.


[Experimental study of the toxic convulsant properties of commercial preparations of essences of sage and hyssop (author's transl)].

Commercial preparations of essences of sage and hyssop have caused poisoning of human beings and were found to possess a convulsant action of central origin in animals. The convulsant effect of hyssop essence appears to be more powerful than that of sage in non-anaesthetized rats. The dose limit, below which the cortical phenomena are subclinical, is 0.08 g/kg for hyssop, while above 0.13 g/kg convulsions appear and become lethal above 1.25 g/kg. The same doses for essence of sage are respectively 0.3, 0.5 and 3.2 g/kg. The neurotoxicity of hyssop appears to be related to the presence of two terpene ketones, pinocamphone and isopinocamphone, the former of which has powerful convulsant properties, and is lethal at doses above 0.05 ml/kg. The toxicity of essence of sage is due to the presence of camphor which is well-known to possess convulsant properties.


[Soleus muscle reflexes evoked by stimulation of the posterior tibial nerve compared to tendon reflexes in man (author's transl)].

The characteristics of the reflex response evoked in the soleus muscle after stimulation of the posterior tibial nerve at the ankle were contrasted with the achilleus tendon reflex in 14 healthy volunteers and in a group of selected neurological patients. The following features were examined: conditions of stimulation including stimulation frequency; appearance of reflex activity in muscles other than soleus, effect of the vibratory stimulation, interactions with voluntary contraction. Moreover, a reflex response is described in the soleus following stimulation of the sural nerve. The results have shown a marked jitter in latencies of the responses, a pattern of coactivation of antagonistic muscles, a clear increase of amplitude under vibration or voluntary contraction, normal responses both in spasticity and in S1 radiculopathy with achilleus areflexia. All these data differ from those observed with the tendon jerk of the same amplitude and differentiate the two responses. It is concluded that the reflex evoked by stimulation of the tibial nerve at the ankle is a polysynaptic response of cutaneous origin.


[An acute meningo-encephalitis with a favourable prognosis and occasional severe electrical and clinical changes; infectious mononucleosis meningo-encephalitis (author's transl)].

Four cases of severe meningo-encephalitis in patients with infectious mononucleosis (IMN) are reported. In three cases the clinical context suggested a mononucleosis. In the other case there was fever but only isolated neurological signs, which demonstrates the importance of serological diagnostic tests because of the benign prognosis of this affection. In fact, neurological complications of IMN are considered to be reversible even though deaths have occurred from respiratory failure, from polyradiculoneuritis, or bulbar involvement. In the cases reported, the onset of a deep coma with loss of reflexes and pauses in respiration required resuscitation therapy, which enabled vital functions to be restored and complete recovery to be obtained. Electro-encephalographic changes were marked by the severity of the initial changes in the tracings with very slow delta waves and prolonged electrical silences which were, however, reversible. The prognostic value of the EEG has to be stressed as improvement in the EEG always preceded clinical improvement.


[Effects of therapy (diazepam, phenobarbital) on the E.E.G. in new-born babies during the first 24 hours of treatment (author's transl)].

The poor prognostic significance of inactive or paroxystic E.E.G. recordings in new-born babies appears to be well established (Monod et al., ibid., 1972, 32, 529-544). However, some cases have been described as having a favourable evolution even though such tracings had been proesent during the neonatal period. The authors studied, therefore, the effects of anticonvulsants (diazepam, phenobarbital) to see if they produced inactive or paroxystic tracings. A total of 19 new-born babies with convulsions of various etiologies were treated with phenobarbital and diazepam and recordings were made less than 24 hours after the beginning of treatment. Plasma levels were measured at the time of recording and varied from 3 to 26 micrograms/ml for phenobarbital and 0 to 2.75 micrograms/ml for diazepam. No paroxystic tracings were noted, but 2 inactive tracings were seen in infants who had been severely asphyxiated at birth, and in whom the plasma levels of the anticonvulants was found to be low. The injection of diazepam during the E.E.G. recording caused suppression of electrical discharges without notably altering the inter-seizure E.E.G. activity. The authors conclude that in the 19 cases studied the changes noted in the E.E.G. were related to the severity of the condition and were not secondary to therapy.


[Objective immunological and clinical data observed during an altitude cure at Briançon in asthmatic children allergic to house dust and dermatophagoides (author's transl)].

In 42 asthmatic children with positive intradermal skin tests to Dermatophagoides pteronyssinus and domestic dust, assays of total and specific IgE were done at regular intervals during a prolonged (9 months) stay at high altitude (Briançon 1300 m). Geometric mean of total IgE (1047 UI/ml at the beginning) dropped to 40% (p less than 0,001) after the stay. In the same way, specific IgE to dermatophagoides, to domestic dust and to grass pollen dropped during the stay (p less than 0,001). On the other hand, other immunoglobulins (IgG, IgA and IgM) did not undergo any significant variations. Clinical improvement of asthma in these allergic children was observed at the first week of stay and could be maintained without drugs during all the 9 months in altitude. Rather than a consequence of an aspecific effect of altitude on the biosynthesis of reaginic antibodies, it would seem that the very consistent fall in total and specific IgE and the clinical improvement should be interpreted as the result of removal from antigenic provocation into a hypoallergenic atmosphere.


[Contribution of functional respiratory exploration to the etiological study of spontaneous pneumothorax (author's transl)].

In order to specify the etiology of primary spontaneous pneumothorax, lung function studies were performed on 14 patients after one pneumothorax without any set. All the patients showed at least one disturbance. 4 patients revealed a decrease of maximal expiratory flow, a decrease of lung recoil, a hyperinflation and a reduction of lung transfer factor. In 6 other patients decrease of elasticity, hyperinflation and decrease of transfer factor were observed, but maximal expiratory flow was normal. One patient showed an obstructive syndrome. It is difficult indeed to connect physiological findings and anatomy, but these disturbances are often observed in lung dystrophy. Perhaps, these disturbances are in connexion with the proximity of accident; so, a long term study is required in order to know the etiopathogeny of this disease.


[Comparison of chronic respiratory diseases in an agricultural versus urban environment (author's transl)].

A longitudinal investigation was conducted simultaneously in Normandy and in the West-Paris region. Based on more than 2000 subjects in Normandy and 1500 in the Paris (St. Lazare) area, the frequency of a bronchial syndrome was established as 21 and 26% respectively; obstructive respiratory failure, 4 and 2% respectively; and restrictive respiratory failure, 1%. The typical elements of risk (tobacco, age, socio-professional sphere) reappear in this study. Alcoholism also seems to be a contributing factor. In a longitudinal investigation, the study of new cases which are in progress will help to identify the onset of the disease and its facilitating circumstances. In the future, the study of the flow-volume curve should be included in epidemiological investigations.


[True and false problems in surgery of pulmonary aspergilloma. Study of 220 cases (author's transl)].

Different problems involved in the surgery of 220 cases of pulmonary aspergilloma are analyzed. The operatory blood loss, which was more abundant than usual, did not bring about any complication. The authors believe that pleural cavities were observed for only 6% of the partial excisions, probably because of the complementary thoracoplasties they performed. The true problem is raised by the patients suffering from respiratory failure for whom techniques of direct approach are the only solution.


[Study of pulmonary leucostasis by measurement of the alveolo-arterial CO2 difference (author's transl)].

In order to study pulmonary leucostasis in 18 leukemic subjects, the ventilatory flow from ventilated nonperfused zones (VFVNZ) was measured using alveolo-arterial CO2 difference (28 times). This method proved to be simple and accurate in the follow-up of the patients. The number of white cells necessary to increase the VFVNZ by 1% is very different from one histologic type to another. These results are in agreement with in vitro observations.


[Pericarditis in bird raiser's disease (author's transl)].

The authors report the case of a 53 years-old male who was presenting signs of a chronic interstitial pneumonitis. A pericarditis was found and the ECG abnormalities first disappeared, then reappeared with new exposure to birds, before making the diagnosis of bird raiser's lung on the history and the immunologic findings. The possibility of pericardial involvement during bird raiser's lung or farmer's lung is found in 4 previously reported cases.


[Use of a flexible laser-beam (Yag) for endoscopic treatment of some tracheobronchial lesions (author's transl)].

After the use for several years of an endoscope which enables electro-coagulation in the treatment of some tracheo-bronchial lesions, the limitations and accidents of this method were compared with clinical results and experimental research. Results seem to indicate that the flexible laser beam can considerably improve therapeutic possibilities. This beam, conducted by a flexible fiber, could easily be used by medico-surgical teams who already possess the suitable endoscopic material, or material that could readily be adapted to this method.


[Should the lung cancer of iron-miners in Lorraine be considered an occupational disease? (author's transl)].

The occupational group composed of the iron-miners working at the bottom of the mines in Lorraine makes up a high risk population for lung cancer (The carcinogenic index is 5 to 12 times as high as that of the population of non-miners). The authors report a new series of 270 cases in support of this assertion. The cancers have few particular characteristics. Their genesis appears to be related with the action of many co-factors: tobacco, various gases and noxious dust, iron particles. Our findings are similar to those of the Swedish, British and Russian authors. The occupation of iron-miner at the bottom of the mine appears then to favorize the manifestation of lung cancer. So it would be fair to consider this tumor an occupational disease, as with asbestosis.


[Pleural aspergillosis. One case of giant mycetoma (450 g) (author's transl)].

Pleural aspergillosis is an uncommon localization; only about 60 observations have been previously reported and two-thirds of them in France. A new case characterized by the presence of a giant mycetoma (450 g) is reported. It should be kept in mind that this lesion develops in the residual cavity, resulting from a therapeutic pneumothorax. Conservative surgery is therefore required and enables (as shown in this case) a satisfactory recovery of the underlying parenchyma.


[The rupture of the pleura: a serious complication of hydatid cyst of the lung in children (author's transl)].

The authors report 5 cases of rupture of hydatid cyst into the pleural cavity observed among 336 patients operated for hydatid cyst of the lung during a 13-year period. Three cases were spontaneous ruptures and two were the result of repeated pleural tappings. One case among the spontaneous ruptures was presented with a picture of acute surgical abdomen. There were no death among the five patients.


[Clinical approach of asthma (author's transl)].

The identification of asthma is based on the analysis of clinical data. The integration of such individual and subtle information into the field of epidemiology requires that these data be comparable, collective, and suitable for statistical use. With this in mind, only a broad conception of the asthmatic condition, with a specific definition, would eliminate the possibility of not recognizing an asthmatic subject in a given group. A fundamental basis is given in a general questionnaire which enables a qualitative and quantitative evaluation, the establishment of a scale of severity, and a nosologic classification of asthma. This questionnaire should eventually include specific questions adapted to the objectives of the investigation to be carried out.


[Medico-social consequences of asthma in children (author's transl)].

The author proposes a study of the medico-social consequences of asthma. Having shown the impossibility of a monolithic conception of asthma, he shows how much it is conditioned in the child by his social and family surroundings. Different levels of consequences are considered: restraints linked to the therapeutics of a chronic disease, effect on physical activity and leisure, importance of the repercussions on school life (absenteeism and slowness). In conclusion, the author stresses both the importance of these consequences on the personal and professional future of the child and the need to define high risk groups corresponding to criteria based on seriousness and social environment for whom the prevention of these repercussions must have priority.


[Evaluation of the frequency of asthma among the adolescents attending school in the Bas-Rhin (author's transl)].

The frequency of asthma in a population including all the adolescents attending school in the department of Bas-Rhin (29 138) in May and June 1976, is 4,1%. This rate is 4,9% in boys and 3,4% in girls. The frequency of asthma is higher in urban areas (5,0%) than in rural areas (3,8%). Asthma is related to respiratory symptoms and is related to more school absenteeism (26%) than in non asthmatics (13,7%). These findings are confirmed by the data given in other medical surveys.


[Epidemiology of adult asthma (Socio-economic effects) (author's transl)].

A study of the prevalence of adult asthma (subjects over 18 years of age) has been carried out in the Puy-de-Dôme area over the past two years by means of a questionnaire sent out to all the doctors in the area. 1,130 asthmatics have been inventoried to this day (547 males and 583 females). A study of the geographical distribution carried out in terms of demographic data on thhe present time, but is certainly underestimated. Correspondence analysis shows up the influence of age on the severity of the attacks. Frequency calculation and the cumulated frequency of the answers to the question concerning the date of the onset of asthma, leads to the conclusion that there will probably be an important increase of cases of late asthma in the next few years. The socio-economic and professional (sick leave, change of job) effects of this type of asthma in adults are analysed.


[Prevalence of childhood asthma in Corsica (author's transl)].

Several evaluations of cumulative prevalence (c.p.) of childhood asthma (dyspnoea with wheeze) were made from 1970 to 1976 in all the 6 and 12-years old children living in Corsica. In the 6-years old children c.p. was: 1.56% (1970), 1.34% (1971) and 1.72% (1976). In the 12-years old children c.p. was 1.77% (1970) and 1.57% (1971).


[Asthma and professional life (author's transl)].

In world industry and agriculture as a whole, the number of people with asthma and complex pneumopathies related to chemical and organic pollution seems important. Indeed, subjects with an atopic inclination are often the first to be jeoparized. However, it must be stressed that occurrence of asthma in relation with work should always lead to investigate an anomaly in professional hygiene. For other workers this latter eventuality constitutes in the long run a threat of precipitin pneumopathy, chronic bronchitis, pulmonary fibrosis, or even cancer (in the case of nickel). Selection upon hiring is an unsatisfactory measure. The improvement of the atmospheric conditions at work should always be sought for. In some professional asthma cases, we were able to confirm that medication provides efficient protection. This solution, however, seems only slightly satisfactory since the subject is still left in contact with substances which have harmful effects other than asthma. It is therefore important that doctors track down and explore the cases of professional asthma, declaring their existence to social security and work inspection organizations, in order to establish an epidemiological knowledge, regularly updated, which would provide an indispensable basis for any prevention through improvement of working conditions.


[Medico-social consequences of asthma in adults (author's transl)].

The evaluation of the medico-social consequences of asthma in adults encounters difficulties that are inherent to a chronic disease with varying clinical pictures. Overall statistical analyses, particularly concerning mortality, provide little information in a socio-economical perspective, especially in France. However, based on the results of fragmentary but varied analyses, the study of this disease in relation to the working careers of asthmatic subjects underlines the importance of the repercussions at the very start of professional life (choice of profession, recruitement in a company). The study of absenteeism and inaptitude reveals to what degree these consequences are related to the seriousness of the disease and to the asthmatic person's social sphere. The same is true for family and social life which is more difficult to evaluate. Systematic analyses alone will be useful in determining whether asthma is considered a "social disease" with its eventual implications on a public health program.


[Respiratory symptoms related to asthma in young adult males (author's transl)].

A survey performed in young adult males (military recruits) showed that 14.1% had wheeze in the chest, 8.9% had attacks of dyspnoea at rest with wheeze in the chest and 6.2% had asthma.


[Role of IgE in the study of the allergic risk of the young child (author's transl)].

Cord blood IgE were determined by using the PRIST and the RAST techniques in 123 cases. The RAST assay was never positive. Total IgE were detectable in 34% of the samples; statistically increased levels were found in babies born from allergic mothers and/or when the mothers were treated with progesterone during their gestation.


[Total and specific IgE concentrations for early diagnosis of respiratory allergy in children less than four years old (author's transl)].

Serum total IgE concentrations were determined according to paper-radio-immunosorbent test (Prist, Phadebas) in 73 infants aged 2 months to 4 years, with recurrent asthmatoid bronchitis. Specific IgE against multiple inhalant allergens (Dermatophagoides pteronyssinus d1, house dust h3, pollens, moulds) were quantified by radio allergosorbent test (Rast, Phadebas). Normal total IgE values were determined in a control group of 111 infants aged 0 to 4 years. Total IgE were slightly elevated in 8 cases, strongly in 35 cases (id. e in 47% of the patients' group). Serum IgE are significantly higher in infants whose first degree relatives are atopics. Specific IgE against d1 are detected in 44% of our cases. Fourteen infants with dl-specific IgE have had an "ecologic treatment" by Paragerm AK. The clinical results are good in twelve of these patients. Total IgE and d1-specific IgE decrease in 5 cases at the end of the Paragerm application.


[Study of the links between functional and clinical data in 212 asthma patients from 14 to 30 years old at a health spa in La Bourboule (author's transl)].

212 asthma patients, who attended their first health spa at La Bourboule, are studied. The functional data are statistically compared to those obtained from clinical examination. In this group of patients, it is found that: 1. Most of the functional tests are perturbed in proportion to the seiousness of the disease (determined by the number of days of attack per year). On the contrary, the other clinical criteria, and in particular the evolution time, do not affect the functional values. 2. The different ventilatory parameters studied are correlated two by two, for instance V 50 on the one had, FEV1, FEV1/VC or LR on the other. Finally the authors discuss the interest of V 50 and LR measurement in order to localize the bronchial obstruction in asthma at the level of either the large trunks (LR) or the small bronchii (V 50).


[Medico-social consequences of asthma in the adult. Information gathered from hospital consultation (author's transl)].

The socio-professional consequences of asthma are studied in 80 patients with more or less serious asthmatic conditions. The professional repercussions are important since 27% of the asthma patients who work have had important changes in their professional life due to their disease. Work interruptions are frequent and seem to be longer than for workers who belong to the primary and secondary sectors. The family consequences are more difficult to determine, however 17 out of 80 patients think that their disease has interfered in their relationship with their spouse.


[French mesothelioma register 1965-1978 (author's transl)].

A mesothelioma register was initiated in France in 1975 to record pathologists, cases diagnosed since 1965. These cases have been accepted as definite mesothelioma after histological reexamination by the mesothelioma panel. Histories of asbestos exposure have been recorded using a standardized questionnaire. Among 699 cases reported, 296 were confirmed and 79 excluded by the panel. Twenty per cent of cases were females. Tumour was located in the pleura in 96% of cases. Age at death was lower for the mesothelioma group than for the general population. A linear increase of annual incidence since 1965 has been observed. Mapping of cases showed irregular distribution with areas without any case. Distribution of cases according to asbestos exposure was the following: definite occupational history 50%, definite non-occupational 3%, possible occupational 31%, undiscovered 16%. Distribution of cases according to the latency period showed a two peaks-curve, median being 36 years. The obvious under-reporting of cases and the absence of control group greatly affected the validity of some results.


Effects of muscle relaxants on catecholamine release from adrenal medulla.

Bovine adrenals were perfused with secretagogues in the presence or absence of muscle relaxants. On a molar basis, Dially-nor-toxiferine was as potent as tubocurarine in inhibiting the catecholamine release induced by carbachol; pancuronium was about 100 times less potent than tubocurarine, whereas gallamine and succinylcholine produced no inhibition whatsoever. KCl-induced catechoamine release was not affected by any of these compounds. Nicotine-induced catecholamine release was inhibitedby diallyl-nor-toxiferine, tubocurarine and pancuronium, but not by gallamine or succinylcholine. Muscarine failed to stimulate the adrenal medulla to release catecholamines. The results show that the inhibition of catecholamine release is based on the specific block of the nicotinic receptor, whereas gallamine and succinylcholine possess no blocking action, and that diallyl-nor-toxiferine and tubocurarine might affect clinical symptoms under conditions in which catecholamine release from the adrenal is increased by a compensatory mechanism.


Effects of N-dimethyl propranolol (UM-272) on isolated cardiac mitochondria and microsomes.

N-dimethyl propranolol (UM-272) has been shown to protect the heart from injury produced by ischemia. In the present study we examined the effects of UM-272 on the function of isolated rabbit cardiac mitochondria and microsomes. Concentrations of 13 micrometers or below were without effect on these organelles. UM-272 (130 micrometers) significantly decreased respiratory control of mitochondria utilizing glutamate plus malate, or succinate, as substrates. At 1.3 mM, UM-272 increased the initial rate of basal oxygen consumption, and decreased the rate of ADP-stimulated respiration. UM-272 was slightly more potent than d,1-propranolol. At a concentration of 1.3 mM, UM-272 significantly decreased the rate and maximum amount of 45CaCl2 accumulated by microsomes in the presence of ATP and oxalate. Concentrations of drug that suppress cellular metabolism are close to those required to prevent ischemic injury. We suggest that sarcolemmal and intracellular actions of the drug which help to depress oxygen demand and ATP utilization may account for part of the drug's protective effects.


Plasma and central nervous system kinetics of gamma-hydroxybutyrate.

Sodium gamma-hydroxybutyrate was administered to dogs in dosages of 200 to 1000 mg per kg with continuous EEG and temperature monitoring. Based on these studies, pulsed doses of 500 mg/kg of GHB were given and timed serum, cerebrospinal fluid (CSF) and brain samples obtained. In addition a group of animals were sacrificed 60 minutes after GHB administration and the regional distribution of GHB determined. The CSF kinetics of GBH suggests a passive diffusionof GHB into CSF but brain concentration peaked very early. Highest concentrations of GHB were found in cortical white matter with lower concentrations in subcortical areas.


[Epidemiological study of asthma in school age children at Bordeaux. Investigation by questionnaires and functional respiratory examinations by flow-volume curves (author's transl)].

The first results of a survey involving 1950 children from 6 to 12 years old living in Bordeaux are presented here. For 280 of them, who had attacks of asthma or showed other closely related signs, a questionnaire was filled out by the parents. On this basis, the main features of the disease, as well as the ORL bronchial and allergological course, were specified for a representative epidemiological population (with a distinction between actual asthma and disappeared asthma, distribution according to sex and age of the first attack). A functional examination by flow-volume curve for 111 of the children showed, using maximal flow measurement (particularly V 50 and V 25), the existence of modifications of the bronchial paths that were not detected by classical spirometric parameters.


[Evaluation of the medical and therapeutic theorical cost of bronchial asthma during the first year of its treatment (author's transl)].

The medical and therapeutic cost of type II allergic asthma, was determined during the first year of its diagnosis and its treatment. The cost ranges from 4 000 up to 10 000 French francs. In every case, the basic treatment represents about three quarters of the total cost; whereas the initial assessment doesn't exceed one fifth. The most changing modules according to the patient and the physician (symptomatic contribution treatment, antibiotherapy, corticotherapy), are as well and by far the cheapest.


In vitro effect of levamisole on oxygen consumption and survival of platelets.

Levamisole at a concentration of 10(-3)M inhibits the oxygen consumption of resting platelets, the thrombin induced burst and the platelet aggregation induced by ADP. At the concentration of 10(-7)M it exerts still an inhibitory activity of the thrombin induced burst, but it does not inhibit neither the basal oxygen consumption nor the platelet aggregation. At every tested concentration platelet survival in the presence of levamisole is comparable to that of controls. Levamisole moreover, together with theophylline and glucagon, shows a synergistic inhibiting influence toward the burst of oxygen consumption. Our data suggest that levamisole may act by producing an enzymatic block of cyclo-oxygenase.


Induction of hepatic microsomal cytochrome P-448 by 3,3',4,4'-tetrachloroazobenzene and the corresponding azoxy and hydrazo analogs.

3,3',4,4'-Tetrachlorazobenzene (TCAB) has been found to pose occupational health hazards among chemical workers as a consequence of its contamination in commercially important herbicides. The induction of hepatic microsomal cytochrome levels in male rats treated with TCAB or its azoxy and hydrazo analogs were examined in several short-term experiments. Five daily consecutive administrations of TCAB or 3,3',4,4'-tetrachloroazoxybenzene (TCAOB) at doses of 25 mg/kg/day yielded maximal stimulation of cytochrome levels. Both compounds induced cytochrome P-450 with absorption maxima (reduced, CO complex) at 448 nm to 2.7 times control levels. In contrast, cytochrome P-448 levels were enhanced less than twofold relative to controls in animals treated with 3,3',4,4'-tetarchlorohydrazobenzene (TCHB) under identical conditions. Cytochrome inductions arising from these chemicals are dose dependent. Parallel increase of the liver to body weight ratios was also observed in these studies. Further experiments using different regimens indicated TCAOB as being the most potent and persistent inducer among these three analogs. A twofold enhancement of cytochome P-448 levels was observed 14 days after a single ip injection of TCAOB at doses as low as 10 mg/kg.


Hepatic microsomal enzyme induction by trifluoromethyl compounds and some halogenated and nonhalogenated analogs.

Trifluoromethyl derivatives of toluene, phenothiazine, benzimidazole and DDT were administered ip to male rats for 5 days and induction of hepatic microsomal enzymes catalyzing the metabolism of EPN, p-nitroanisole and aminopyrine measured. The addition of a trifluoromethyl substituent to toluene, phenothiazine and benzimidazole increased the inducing capacity of the parent molecule on p-nitroanisole metabolism. Dihalogenation of benzene with trifluoromethyl groups, regardless of position, resulted in induction of p-nitroanisole metabolism whereas halogenation of benzene with trichloromethyl groups did not. For these compounds, the size and electron-inducing capacity of the halogenated substituent may be relative to microsomal enzyme induction.


The effect of lead on aminopyrine N-demethylation.

The effect of various lead salts on "in vitro" aminopyrine N-demethylation was investigated. Lead was administered to male rats as a 1% solution in the drinking water. After seven days of lead treatment it was found that lead chloride and lead acetate had no effect on microsomal aminopyrine N-demethylation while lead nitrate increased aminopyrine metabolism. Intraperitoneal administration of either lead chloride or lead nitrate at a dose of 20 mg./kg. decreased metabolism. Lead chloride by oral administration did not suppress phenobarbital induction of aminopyrine metabolism in rats.


[Phytohemagglutinin (PHA) skin tests: its relevance in carcinology (author's transl)].

The skin response to 1 microgram Phytohemagglutinin (PHA) was studied in 359 subject including 235 cancer patients and 124 without cancer. Responses to PHA, tuberculin, candidin were compared. A positive skin response to PHA was observed in 88% of patients without malignancy. This percentage remained almost equal in older patients (more than 70 years). Among patients with advanced malignancies, there was a fall down to 64.5% of the percentage of positive responses. A negative response to both PHA and tuberculin was observed in 6% of patients without malignancy and 28% of cancer patients. 38 +/- 5 days was the average survival of this last group. The arguments favouring the fact that PHA induces cutaneous basophilic hypersensitivity are reviewed. An advantage of this test is that no presensitization is required.


Toxic effects of peroral o-cresol intake on rat brain.

Male Wistar rats were given o-cresol in their drinking water (0.3 g/l) for 20 weeks. The ingested cumulative dose exceeded the acute LD50 at the fourth week of the experiment. O-cresol induced an increased drinking rate initially which decreased significantly below the drinking rate of the controls at the end of the experiment. The biochemical effects in the cerebral homogenate were inconspicuous, and they included increased RNA content initially, and reduced glutathione concentration and azoreductase activity at the end of experiment. Glial cells displayed significant increases in the acid proteinase and 2',3'-cyclic nucleotide 3'-phosphohydrolase activities at the 20th week of exposure.


[True and false problems in surgery of pulmonary aspergilloma. Study of 220 cases (author's transl)].

Different problems involved in the surgery of 220 cases of pulmonary aspergilloma are analyzed. The operatory blood loss, which was more abundant than usual, did not bring about any complication. The authors believe that pleural cavities were observed for only 6% of the partial excisions, probably because of the complementary thoracoplasties they performed. The true problem is raised by the patients suffering from respiratory failure for whom techniques of direct approach are the only solution.