The anatomical localization of descending pressor pathways in the cat spinal cord.

Functional evidence suggests the location of descending pressor pathways in the bilateral dorsolateral funiculus (DLF). To investigate the anatomical course of these pathways, orthograde degeneration studies were conducted following unilateral lesions of the DLF at the C6-C7 spinal level. Degenerating fiber tracts were localized exclusively in the ipsilateral DLF. Degeneration was also demonstrated in the central portion of the intermediate spinal gray matter, but little or no degeneration in the intermediolateral cell column. This evidence suggests that these descending pathways do not terminate on sympathetic preganglionic cell bodies or their proximal dendrites, but perhaps upon their more distal dendrites or interneurons.


Visually guided reaching in the cat reared in fixed or random frequency stroboscopic light.

The effect of deprivation of visual perception of movement in a visuo-motor task has been tested in cats reared in stroboscopic light since birth. Three cats were reared in light of fixed (2 flash/sec, flash duration 2 msec) and three in light of random (between 0.5 and 3.5 flash/sec) frequency. These 6 animals, together with 6 control cats, underwent (as adults) a test of visual control of reaching for a target with a paw, with operant conditioning. While the cats raised in fixed frequency stroboscopic conditions (FFS) showed no deficit, those raised in random frequency condition (RFS) exhibited significantly less precise guidance than FFS and control animals.


Effects of stimulation of the frontal cortex on identified output VMT cells in the rat.

The neurons located in the mesencephalic ventro-medial tegmentum (VMT) and projecting to the nucleus accumbens, the septum and the frontal cortex were identified by the antidromic activation method. The activity of single VMT cells was extracellularly recorded in Ketamine anaesthetized rats. The effect of the stimulation of the medial frontal cortex on the activity of these identified VMT cells has been studied. The main response observed was an excitation which was followed in some cases by a depression of the spontaneous discharge of the cells.


Distribution of thalamic input to different dendrites of a spiny stellate cell in mouse sensorimotor cortex.

A Golgi impregnated, gold-toned [2] spiney stellate cell from layer IV of mouse SmI cortex was reconstructed in three dimensions from serial thin sections to assess the apatial relationships of the synapses onto its dendrites. The distribution of thalamocortical (TC) synapses with the reconstructed dendrites is presented in this report. Thalamocortical axon terminals were labeled by lesion induced degeneration which, in mouse SmI cortex, may reliably indicate the numbers of thalamocortical axon terminals. Results indicate that thalamocortical synapses, which are distributed over most regions of the dendritic tree, are arranged in a regular, periodic fashion on parts of two of the reconstructed dendrites. In these regions, the necks of spines receiving thalamocortical input attach to the dendrite shaft at intervals of about 5 micrometers. In many other regions of the dendritic tree, two spines receiving thalamocortical synapses are separated by a similar interval. Further studies are expected to determine the extent to which dendrites of spiny stellate cells and of other kinds of cortical neurons are contacted in a periodic fashion by thalamocortical axon terminals.


The role of pattern vision in the increase of visual cortex acetylcholinesterase after first exposure of dark reared rats to light.

Acetylcholinesterase (AChE) activity in homogenates from motor and visual cortex of rats reared for 7 weeks in darkness was compared to levels in normally reared and dark reared littermates exposed to 3-h periods of controlled illumination. AChE levels in the visual cortex of animals fitted with light-diffusing scleral contact occluders, and therefore lacking normally organized visual information, were elevated 17% over dark-reared animals, but were not significantly different from levels in animals exposed to lighting conditions permitting detailed pattern discrimination. There were no differences between conditions in motor cortex AChE. We conclude that higher order perceptual processing is not necessary for the light-stimulated increase in visual cortex AChE in the rat.


Increased utilization of dopamine in the nucleus accumbens but not in the cerebral cortex after dorsal raphe lesion in the rat.

Dihydroxyphenylacetic acid (DOPAC) and dopamine (DA) levels were estimated in the frontal cortex, the nucleus accumbens and the striatum of the rat after electrolytical lesion of the dorsal raphe nucleus. The efficiency of this lesion was tested by measuring the decline in serotonin (5-HT) levels in the striatum. 5-HT levels were reduced by 90% when compared to those of sham-operated rats 11 days after the lesion. As revealed both by the increase in DOPAC levels and in the DOPAC/DA ratio, the rate of DA utilization was markedly increased in the nucleus accumbens, slightly enhanced in the striatum and in contrast remained unaffected in the frontal cerebral cortex 4 days after the lesion. Changes in DOPAC levels in the nucleus accumbens were also seen 11 and 30 days after the lesion but they were less pronounced than those observed at 4 days. These results suggest that neurons originating from the dorsal raphe and projecting to the ventro-tegmental area are regulating the activity of the meso-nucleus accumbens dopaminergic neurons but not that of the meso-cortical dopaminergic neurons.


Lipid composition of sciatic nerve from dysmyelinating trembler mouse.

The amounts and the distribution of the various lipids were studied in the sciatic nerves from normal and trembler mice. When compared to the normal, the total lipidic amount was reduced by 66% in the trembler mouse, and each class of lipid was decreased nearly the same way, except for the cholesterol esters the value of which increased five times. The level of each individual phospholipid was decreased, phosphatidylcholine being the least affected and phosphatidylserine the most altered.


Stimulating effect of angiotensin II on the spontaneous release of newly synthetized [3H]dopamine in rat striatal slices.

Angiotensin II (A II) (10(-6) M, 10(-5) M, 5 . 10(-5) M) stimulated the spontaneous release of [3H]dopamine (DA) continuously synthetized from [3H]tyrosine in striatal slices of the rat. The A II-evoked release of [3H]-DA was prevented when slices were superfused with a calcium-free medium containing EGTA 5 . 10(-4) M. It was also suppressed in the presence of the potent antagonist Sar1-Ile8-angiotensin.


Intracellular recordings from sympathetic preganglionic neurones.

In anaesthetised cats the response of the soma dendritic region of sympathetic preganglionic neurones (SPN) recorded intracellularly in T3 spinal segment was studied following excitation of third thoracic white ramus and following orthodromic inputs. Most cells had action potentials of short duration. Many cells were active. Decreases in membrane potential were relatively short lasting, less than 40 msec and a change of 5 mV was sufficient to discharge the cell. Increases in membrane potential were also evident.


Fluorescence histochemical evidence for decreased noradrenaline synthesis in sympathetic neurones of aged rats.

Measurements of formaldehyde-induced fluorescence of noradrenaline (NA) in sympathetic neuronal perikarya of aged (24-month) and younger (4-month) control rats revealed little or no NA fluorescence in many sympathetic neurones of aged rats: neuronal fluorescence in younger rats was substantially greater. Monoamine oxidase inhibition increased NA fluorescence in all rats, but the increase was greater in the 4-month controls. Reserpine administration caused an almost complete disappearance of NA fluorescence after 12 h. However, normal NA levels were restored in the 4-month controls after 48 h but not for 7 days in the aged rats.


A system of cells in the unstimulated rat brain characterized by preferential accumulation of [3H]deoxyglucose.

An autoradiographic technique using cryostat sections is described which permits visualization of a system of small, probably glial cells accumulating 2-[3H]deoxyglucose (2-[3H]DG). These cells are localized mainly in periventricular regions and in certain parts of white matter. Deoxyglucose uptake of these cells is not influenced by various experimental conditions. An attempt to demonstrate by this technique activation of hypothalamic neurosecretory centers following water withdrawal for 3 days was unsuccessful.


Tremor: role of striatal cholinergic neurons and the effect of intrastriatal kainic acid.

Rats injected intrastriatally with kainic acid (KA) showed increased tremor responses to arecoline and tremorine, but not to harmaline. Since KA significantly reduced both pre- and postsynaptic measurements of cholinergic function in the striatum, the results indicate that integrity of the striatal cholinergic system is not essential to tremor response. Further investigations of cholinergic function in the brains of rats injected with KA did not reveal evidence of cholinergic supersensitivity; thus, the altered responses to cholinergic agents may reflect KA-associated destruction of some pathway normally opposing the behavioral output of cholinergic stimulation. If, as recently proposed, intrastriatal injection of KA produces an animal model of Huntington's disease (HD), then these results may also be relevant to experimental therapeutics of this disorder.


Effects of long-term administration and withdrawal of clonidine on activity of sympathetic efferent nerve unit in spontaneously hypertensive rats.

Daily administration of clonidine for 5 weeks (approx. 300 micrograms/kg/day, p.o.) produced significant decreases in blood pressure and renal sympathetic efferent activity in spontaneously hypertensive rats (SHR). After cessation of clonidine administration, blood pressure and sympathetic nerve activity recovered rapidly from the depressed levels to the untreated control levels. These findings could indicate that clonidine-induced hypotension and its rapid recovery to control after withdrawal of clonidine are caused by corresponding changes in sympathetic efferent nerve activity.


Antinociceptive action following microinjection of methionine-enkephalin in the nucleus raphe magnus of the rat.

The analgesic effect of the microinjection of low doses of methione-enkephalin (20 micrograms in 0.5 microliter) into the caudal brain stem of the unrestrained rat was investigated by means of one vocalisation test. Immediate short duration significant increases in threshold (21%) were seen from sites in the nucleus raphé magnus (NRM). Delayed effects were seen from sites immediately adjacent to this nucleus; sites more lateral produced no significant effect. These results lend further support to the postulated role of NRM in antinociception.


Benzodiazepine binding after in vivo elevation of GABA.

[3H]Diazepam binding was measured in rat cortical membranes. Acute and chronic amino-oxyacetic acid (AOAA) pretreatment greatly increased GABA levels, but did not alter diazepam binding. The GABA normally present was sufficient to maximally stimulate diazepam binding. In in vivo binding studies, acute and chronic AOAA treatment increased the amount of [3H]diazepam in the brain at the time of sacrifice, thus increasing both specific and nonspecific binding and leaving unchanged the fraction of drug specifically bound. Fluctuation of brain GABA may not affect benzodiazepine binding unless the normal concentration is greatly depressed.


Catecholamine turnover changes in hypothalamus and dorsal midline area of the caudal medulla oblongata of spontaneously hypertensive rats.

The central noradrenaline (NA) and adrenaline (A) turnover in 15--16-week-old stroke prone, spontaneously hypertensive (sp-SH) female rats in an advanced stage of hypertension was found to differ from that of normotensive Wistar-Kyoto (WKy) control rats. The catecholamine (CA) levels were measured after inhibition of dopamine-beta-hydroxylase (DBH) or phenylethanolamine-N-methyltransferase (PNMT). in the hypertensive rats the dopamine (DA) and NA levels and the NA turnover were reduced in the hypothalamus, while in the dorsal part of the caudal medulla oblongata NA levels and A turnover were reduced. Changes in hypothalamic DA and NA mechanisms and in A mechanisms in medulla oblongata may therefore be of importance in the blood pressure regulation of sp-SH rats.


Effects of sulpiride isomers on the control of anterior pituitary secretion in normal man.

The effects of (+)- and (-)-sulpiride on anterior pituitary hormone secretion (LH, FSH, PL, hGH, TSH) have been studied in five normal men. Both (+)- and (-)-sulpiride increase PL and TSH secretion and decrease LH and FSH secretion, whereas they do not seem to affect hGH secretion. These results are discussed in view of the different action of (+)- and (-)-sulpiride on DA receptors in the forebrain with respect to DA receptors involved in the control of anterior pituitary secretion.


A colour-dependent abnormality in human visual detection of stimulus motion and spatial structure.

We have studied the wavelength dependence of visual responses in a single human subject, M.W., who has an unusual visual defect. It is shown that for red stimuli, both spatial resolution for grating patterns and detection of target movement are grossly abnormal. On the basis of these and other [8] experimental data, we argue that M.W.'s response pattern implies interdependent central visual processing of colour, movement and spatial structure. We examine this conclusion in relation to recent anatomical and electrophysiological findings.


Definitive disruption of spatial delayed alternation in rats after lesions in the ventral mesencephalic tegmentum.

Prefrontal system dysfunction are revealed in rats in delayed response tasks. In view of the anatomical projections existing from the ventral mesencephalic tegmentum to the prefrontal system we have done this research in order to determine whether cognitive processes are impaired after mesencephalic lesions. Rats learned spatial delayed alternation in a T-maze. After acquisition they were randomly divided in two groups; the experimental group received lesions in the ventral mesencephalic tegmentum at the level of the A10 cell bodies. These lesions induced definitive disruption of the retention of the delayed alternation and the rats were unable to relearn the task. However, these animals were able to perform normally in an operant conditioning with food reinforcement indicating the specificity of the deficit observed with respect to the delayed alteration task. The possible modulating role of dopaminergic A10 neurones is hypothetized.


Segmental motor innervation of the cat diaphragm.

In ten anaesthetized adult cats, bipolar recording electrodes were inserted in different muscular bundles of each hemi-diaphragm. Both stimulation and section of the phrenic cervical branches were made. The upper phrenic cervical branch innervates both the sternal and lateral portions of the diaphragm whereas the lower phrenic cervical branch innervates both the lateral and dorso-caudal portions.


Significance of presynaptic formations in early stages of cochlear synaptogenesis.

Very early stages of cochlear synaptogenesis are described in inner (IHCs) and outer hair cells (OHCs) of cat foetuses. Ten days before birth (DBB) well-formed synaptic contacts were found between afferent dendrites and both IHCs and OHCs. At the IHC level a preliminary stage before functioning has been proposed. But at the OHC level where the adult cell membrane becomes mainly postsynaptic, we could only formulate hypotheses based on phylogenetic considerations (afferents precede efferents), or on embryology (presynaptic specializations play a role in the arrival and growth of fibers around the hair cell).


An experimental model for the evaluation of vitrectomy instruments.

A scleral window was designed for implantation in human autopsy eyes. This model provides direct visualization of the pars plana, vitreous base and peripheral retina. Using this model, one can directly observe vitrectomy instruments entering the globe, and can evaluate the cutting ability of a variety of instruments. The model can also be used to provide practical experience, analogous to clinical vitrectomy, and is therefore useful as a training device.


Toxicity of antibiotic combinations for vitrectomy infusion fluid.

We have found that gentamicin 8 microgram/ml in various combinations with methicillin 25 microgram/ml, oxacillin 10 microgram/ml, clindamycin 10 microgram/ml and penicillin 80 microgram/ml to be nontoxic to the retina when used in vitreous replacement fluid.


Late vitrectomy in double perforating ocular injuries.

Three double perforating eye injuries were managed satisfactorily with vitrectomy six to twelve weeks after injury. This timing of surgery may be advantageous, in that inflammation may be less and the risk of hemorrhage lower. All eyes in our series had spontaneous posterior vitreous detachment, making surgery technically easier. Serial ultrasonography is essential in these cases, and in the presence of retinal detachment, earlier surgery may be indicated.


A method for recording vitreoretinal relationships.

A method for recording vitreoretinal relationships is described. The system includes designations for the extent and height of posterior hyaloid detachment and for sites of abnormal vitreoretinal adhesions. The method may be used for preoperative evaluation of eyes prior to vitrectomy surgery or for the follow-up of patients with vitreoretinal disease.


Vascular tufts of the pupillary border causing a spontaneous hyphaema.

In 3 patients a spontaneous haemorrhage in the anterior chamber originated from vascular tufts at the pupillary border. These vascular tufts were hardly visible by slitlamp observation, but could be visualized well with fluorescein angiography. The patients were aged 50 years or more and in 2 of them the vascular tufts were found in both eyes. The haemorrhages disappeared spontaneously under conservative therapy and only in 1 case caused a transient glaucoma. Of 115 randomly chosen out-patients, 4 cases were found with the same vascular tufts on the pupillary border, but without any symptom. All the patients who had vascular tufts, with or without haemorrhage in the anterior chamber, were in the sixth decade or older. We think that these vascular lesions are caused by cardiovascular diseases and by elevated venous pressure caused by intrathoracic processes. Diabetes and intraocular diseases were excluded in our patients.


Essential progressive iris atrophy. Report of two cases.

Chandler's syndrome and essential progressive iris atrophy, we believe, are two entities of the same syndrome. We have presented a case which could be considered a perfect intermediate. The mechanical 'stretch' theory of Campbell et al., supported to an extent by the light and electron microscopic findings of Rodrigues et al., is untenable in view of the observation in our patient that the first, and broad, peripheral anterior synechia was opposite the position of the displacement of the pupil. Every case in which corneal abnormality, glaucoma and iris changes are found, should be checked explicitly, with specular microscopy and gonioscopy, for corneal endothelial changes and in order to locate the area of predilection of peripheral anterior synechiae.


Gyrate atrophy of the choroid and retina.

A case of gyrate atrophy of choroid and retina is presented. The serum level of ornithine was 788 mumol/l. The clinical features, the error of metabolism, the inheritance and the treatment of the disease are discussed.


Degenerative apparent anophthalmia with complex choristoma of orbit. A clinicopathological case report.

A case of a peculiar congenital mass in the left orbit is described in a 6-year-old girl from Thailand. The most appropriate name for this malformation, which we have not found described in the literature, seems to be 'degenerative apparent anophthalmia with complex choristoma of the orbit'. Some unknown environmental influence is suggested.


Early morphological changes of the corneal epithelium after burning with hydrochloric acid. A scanning electron microscope study.

The morphological changes of the corneal epithelium after burning with hydrochloric acid were examined using a scanning electron microscope. A drop of hydrochloric acid of differing concentrations (1--0.000001 N HCl) was applied under standardized conditions to normal rabbit eyes for a reaction period of 5 or 30 min. The changes in the cell surface, which are dependent on the concentration of the acid, include a loss of microvilli and microplicae, outlining of the cell nucleus, disruption of the intercellular spaces, cell desquamation and even the most severe damage to the cell membrane and cytoplasm of the corneal epithelial cells.


[Eye manifestations of subacute sclerosing panencephalitis].

A report is given on 10 children with subacute sclerosing panencephalitis (SSPE) whose clinical illness began with visual or mental impairment. All patients showed typical clinical and neurologic features and various ophthalmological manifestations. The latter correspond to lesions generally dealt with in a number of reports and demonstrate for the individual case that ophthalmological manifestation can precede clinical manifestation. The ophthalmologist can give an important contribution to the diagnosis. In some cases the focal retinal lesions can be similar to retinal lesions in the case of toxoplasmosis. A positive antibody titer for toxoplasmosis, which can occur parallel with the typical measles or SSPE virus antibody titer, occasionally causes the misdiagnosis of toxoplasmosis acquisita. In the 10 cases reported on, the diagnosis SSPE was confirmed on the basis of the typical clinical features and elevated measles virus antibody titer. In no case the permission for autopsy was gained. The genesis of SSPE is discussed with reference to a genetic defect, to an autoimmune reaction, or as a result of a measles virus-like infection. In the diagnosis, primarily unclear 'focal retinal lesions' should be at any rate investigated with respect to measles or SSPE virus antibody titer.


Videopupillographic and VER investigations in patients with congenital and acquired lesions of the optic radiation.

In 9 patients with congenital and acquired lesions of the optic radiation, videopupillographic investigations have been employed to determine the pupillographic threshold in the homonymous field defect. The study includes 3 patients suffering from congenital porencephalic cysts. The pupillary response was graded as akinetic, hypokinetic or eukinetic. These classifications yield some diagnostic clues as to the nature of the lesion. An attempt was made using the VER response in these patients to correlate the findings.


[Dissociated ophthalmoplegia of abduction: so-called posterior internuclear ophthalmoplegia in Fisher's syndrome].

The anterior internuclear ophthalmoplegia, a dissociated ophthalmoplegia of adduction secondary to an ipsilateral supranuclear paresis of the internal rectus, represents a well-know clinical picture. The dissociated ophthalmoplegia of abduction, however, sometimes referred to as posterior internuclear ophthalmoplegia, is debated. Such an oculomotor disturbance emerging from an ophthalmoplegic polyneuropathy (Fisher syndrome) is presented and illustrated by oculographic tracings. A secondary finding was a limited range of accommodation. Oculographically, the dissociated ophthalmoplegia of abduction reflects a true mirror image of the anterior internuclear ophthalmoplegia. Because of anatomical considerations the dissociated ophthalmoplegia of abduction cannot be regarded as internuclear ophthalmoplegia, and the terminology of posterior internuclear ophthalmoplegia is not tenable. Discussing the pathophysiology of the Fisher Syndrome, it is reflected upon an infranuclear lesion causing an ocular motility disorder featuring supranuclear aspects, and avoiding limitations of peripheral nerve damage.


[Systematic deviations of saccadic eye movements in Wallenberg syndrome].

A patient suffering from lateral medullary infarction (Wallenberg's syndrome) is presented, exhibiting a striking bias of all saccadic eye movements toward the side of the lesion. Oculographic tracings demonstrate this oculomotor disorder. Other disturbances of ocular motility which resemble this one superficially are discussed. Interruption of fixation leads to a gliding movement veeringly to the side of the infarction. Since all saccades generated under different circumstances are affected, it is contemplated where the pathological signal is intruded into the prenuclear level, to adulterate all saccades causing lateropulsion of saccadic eye movements.


Genetic study and surgical correction of euryblepharon.

Euryblepharon is a rare congenital anomaly of the palpebral fissure which consists of an increase in its width. A case has been described in which this characteristic is very marked, and associated with ectropion, lagophthalmos, corneal ulcers; also congenital malformations as twisted feet, hypospadia and inguinal hernia. Apart from a limited increase of the palpebral fissure in the mother, the familiar anamnesis is negative, and likewise examination of the cariogram and research of eventual metabolic modifications. An estimation of the various surgical techniques proposed revealed insufficient strictness regarding the standards generally followed in palpebral plastic surgery. Consequently, a technical variation was set up that will satisfy the needs of correct anatomical-surgical practice.


Effect of timolol on the permeability of corneal endothelium.

The effect of short-term administration of timolol on the permeability of the corneal endothelium to fluorescein was measured in normal subjects (single drop) and in a small group of glaucoma patients (one week's treatment). No effect on the endothelium was found in the normal eyes. In the glaucomatous eyes, endothelial permeability was higher than normal when measured after one week without topical medications and normal when measured after one week on timolol treatment. No evidence was found that short-term administration of this drug disturbs the barrier function of the endothelium.


The influence of systemic drugs on tear constituents.

Tears of patients and laboratory animals on systemic medications have been analyzed for the presence and influence of these agents on tear constituents. Antibiotic penetration into tears, drugs stimulating or retarding lacrimation, and effects on tear electrolytes, lysozyme, and immunoglobulins are reviewed from the literature. Important applications to clinical practice such as contact lens wear, general anesthesia, eye infections, and epiphora or dry eye symptoms are discussed.


Interim report: National Registry of Possible Drug-Induced Ocular Side Effects.

Recent data concerning 1%, 2.4%, and 10% topical ocular phenylephrine, topical ocular local anesthetics, carbonic anhydrase inhibitors, diazepam, liquid high-protein diets, sodium fluoride gel, naproxen, and thiabendazole are reviewed. Clinicians are encouraged to report possible adverse drug reactions to the National Registry of Drug-Induced Ocular Side Effects, which has been moved to the Department of Ophthalmology, University of Oregon Health Sciences Center, Portland, OR 97201.


Nabilone: a pressure-reducing synthetic benzopyran in open-angle glaucoma.

Nabilone is a synthesized crystalline benzopyran that resembles the cannabinols but is not a tetrahydrocannabinol. Oral administration of 0.5 to 2 mg to patients with open-angle glaucoma reduced the intraocular pressure from 10% to 54% with an average of 28%. Administration of a topical ophthalmic nabilone solution (0.1 mg/drop) to both eyes of adult albino rabbits (1.5 to 3.5 kg) lowered the IOP an average of 25%. The peak action of the nabilone administered in this manner was 60 minutes, with a return to normal IOP by 180 minutes. Tolerance developed in rabbits after one week of topical administration.


Drug reactions reported in a survey of South Carolina.

A survey of the membership of the South Carolina Ophthalmological Society revealed an average of 3 1/2 patient drug reactions per year per physician using topical diagnostic drugs in the office. The reactions to the drugs included topical allergic responses, acute glaucoma, cardiovascular collapse, and one death. All of the reactions had previous been attributed to these drugs in the literature. Suggestions are presented to prevent these reactions from occurring or to better prepare the ophthalmologist and his staff to manage these problems when they do arise.


Timolol--further observations.

Data from clinical records of patients using timolol confirm the ocular hypotensive effect of the drug in secondary glaucoma, aphakic glaucoma, ocular hypertension, and when used in combination with various other forms of glaucoma therapy. No serious local or systemic side effects were noted. Although many adrenergic agents ultimately produce tachyphylaxis, this effect is infrequent in timolol therapy.


Timolol: its effectiveness in different types of glaucoma.

A study is presented on the effectiveness of timolol maleate in the treatment of 76 cases of various types of glaucoma. Timolol lowered intraocular pressure significantly in almost every diagnostic category, although there was marked variability within the diagnostic categories themselves. The therapeutic trial approach is suggested as an aid in selecting persons who will respond adequately to timolol drops.


Diabetic macular edema and argon laser photocoagulation: a prospective randomized study.

Loss of vision from diabetic retinopathy can result from complications of neovascular proliferation, or frequently, from macular edema secondary to background diabetic retinopathy. Although the benefits of photocoagulation for proliferative diabetic retinopathy have been clarified by the National Eye Institute's collaborative diabetic retinopathy study, those for background diabetic retinopathy with macular edema remain unclear. Several articles have described the visual benefits and reduction of edema following photocoagulation of eyes with background diabetic retinopathy and macular edema, but only Patz's study was prospectively designed utilizing a random assignment of laser treatment for one eye with the other eye remaining untreated. This article reports the two-year results of a similar prospective study in which one eye in each of 39 patients with symmetrical macular edema secondary to background diabetic retinopathy was randomly selected to receive argon laser photocoagulation, while the fellow eye remained untreated.


XXXV Edward Jackson Memorial Lecture. Allergic granulomatous nodules of the eyelid and conjunctiva.

Twenty-two cases of granulomas of the conjunctiva or eyelids were studied, and the clinical and pathologic features were tabled. All cases showed the histologic features of the Splendore-Hoeppli phenomenon, that is a giant cell and eosinophil granulomatous reaction to an antigen-antibody precipitate originally described in relation to parasites or fungi. Seven typical cases were selected for detailed description; in four of these cases, unidentified nematodes were the cause of the condition.


Retinal detachments and topical ocular miotics.

There is increasing suspicion that topical ocular miotic therapy in selected persons may precipitate retinal detachments. This is a rare event and probably does not occur in patients free of retinal pathology. Data supporting a possible cause and effect relationship, obtained from the National Registry of Drug-Induced Ocular Side Effects, a survey of the Retina Society, medicolegal decisions, and a review of the literature, is presented.


Similarity of the intraocular pressure response to different corticosteroid esters when compliance is controlled.

Fifty-four subjects with initial intraocular pressures under 20 mm Hg received a different commercial corticosteroid ester of prednisolone or dexamethasone in each eye for three to six weeks. Compliance was controlled. The intraocular pressure responses of the two eyes of a subject were similar. It was concluded that the absorptions of all four corticosteroids were in excess of the minimum amounts needed to maximally elevate pressure. Subjects complained that prednisolone acetate was irritating. Corticosteroid-induced uveitis developed in 3% (3) of the eyes.


The evolution of the anterior chamber implant up to, and including, the Choyce Mark IX.

Since 1963, the Choyce Mark VIII lens, a quadrupedal, anterior chamber implant, has proved satisfactory following conventional intracapsular surgery in eyes of normal size, but less successful after primary extracapsular procedures and in small eyes. Reducing some of its dimensions by as much as 30% enables the surgeon to treat a much wider range of cataract problems through a smaller incision. The reduced-size version is known as the Choyce Mark IX anterior chamber implant. The quadrupedal principle has been preserved.


Binkhorst Lecture (Part 1). Experimental cataract surgery.

The use of intraocular lenses in cataract surgery leads to a greater corneal complication rate than surgical treatment without such devices. It has been assumed that the predominant reason for this is surgical trauma at the time of lens insertion. A laboratory study to verify and analyze this difference has been carried out, the cat being used as an experimental model. This first report evaluates the effect of the usual steps of cataract extraction on the density of corneal endothelial cells.


Protection of corneal endothelium during intraocular lens implantation using polymacon, a new surgical technique.

A controlled series of intraocular lens implantations on paired cat eyes was performed to determine if a polymacon sheet (Bausch & Lomb plano-T soft contact lens) could protect the corneal endothelium from damage caused by contact with a methyl methacrylate intraocular lens. A new surgical technique has been developed that reduces the endothelial cell loss from 51% (standard implantation technique) to 9% (new polymacon-shield technique).


Retinal detachment and pseudophakia.

A consecutive series of pseudophakic retinal detachments was statistically compared with a matched group of aphakic retinal detachments. Distribution of breaks, anatomic results, and final visual acuities were tabulated. Success in reattachment was equal in the two groups, but final visual acuities were better in the aphakic group. Emphasis was placed on the intraoperative ophthalmoscopic examination of pseudophakic eyes with compromised peripheral fundus visibility.


Early detection of retinal involvement in diabetes by vitreous fluorophotometry.

Vitreous fluorophotometry is a new quantitative method for evaluation of the blood-retinal barrier (BRB). The application of this method to a series of diabetic patients with apparently normal fundi revealed the presence of a significant breakdown of the BRB in the early stages of retinal involvement in diabetes. This alteration of the BRB appears to be the earliest clinically detectable change to occur in the retina in diabetes. Higher vitreous fluorophotometry values, indicating a more marked breakdown of the BRB, occurred in patients who were under worse metabolic control. Higher vitreous fluorophotometry values were also associated with the development of visible retinal lesions.


CO2 laser in vitreoretinal surgery: 1. Quantitative investigation of the effects of CO2 laser radiation on ocular tissue.

Scleral, lens, and vitreoretinal tissue was incised using CO2 laser radiation in a controlled and predictable fashion without producing untoward effects on neighboring ocular tissue. The penetration depth of infrared radiation into normal human vitreous was measured and was found to be exceedingly small. A quantitative correlation was observed between the CO2 laser power and the depth of penetration in scleral-chorio-retinal wall incisions and in lens tissue from human eyebank eyes. The results of this investigation suggest that the CO2 laser may be  useful in intravitreal surgery, full-thickness scleral-chorio-retinal wall resections, transvitreal chorioretinal biopsy, and even dissolution of cataracts.


Neuro-ophthalmology update.

One source of ophthalmologic concern today is the normal computed tomography (CT) scan. The most important tests in any patient with visual loss are the history, fields, and office visit findings. A visual field examination should be obtained before a CT scan. The importance of aiming the CT machine by the history is stressed, and conservative approach to optic nerve sheath meningiomas is advised.


Surgical lesions of the intracranial optic nerves and optic chiasm.

Compressive tumors and vascular lesions affecting the intracranial optic nerves and optic chiasm are of interest to both the neurosurgeon and the neuro-ophthalmologist. Common types of tumors that occur in the chiasmal and parasellar regions are discussed in terms of their course, neuro-ophthalmologic implications, and surgical treatment by the transsphenoidal approach as opposed to the standard subfrontal approach. Vascular lesions that cause visual distrubances, including intracranial aneurysms and arteries acting as compressive lesions of the chiasm and nerves or in conjunction with tumors, are discussed.


Presumed phlebitis of the optic disc.

The clinical picture of unilateral disc edema suggests the presence of ocular, orbital, or intracranial disease. This report focuses on a poorly appreciated and often overlooked cause of unilateral disc edema, presumed phlebitis of the optic disc, along with a review of the  literature. Typical case presentations are reviewed, and emphasis is placed on the neurophthalmologic approach to this entity. An appropriate diagnostic evaluation and indications for treatment are presented. Awareness of this syndrome can eliminate extensive neurodiagnostic procedures for the patient with a typical clinical picture.


Results of excision of advanced epithelial downgrowth.

Advanced epithelial downgrowth was excised in 14 patients. The technique involved excision under direct observation of the epithelium found as bands in the anterior chamber and as membranes in the front and back of the iris, over the ciliary body, on the front and back surfaces of intraocular lenses, and over the vitreous face. In the first nine cases, cryoapplication was used to destroy the epithelium on the back of the cornea. In three patients, in spite of repeated applications, the epithelium was unaffected by freezing. In these cases the epithelial downgrowth was excised by scraping it free from the back of the cornea. In four eyes the whole cornea was removed both for visualization of the extent of the growth of the epithelium throughout the anterior and posterior chamber and to scrape the epithelium free. Thereafter the cornea was replaced. Eleven of the 14 eyes have remained free of epithelial downgrowth from 18 months to eight years postoperatively. Penetrating corneal transplantations were performed in six eyes because of corneal edema; these have remained transparent. Although two eyes have vision better than 20/40, the majority have 20/200.


Extended wear of CAB contact lenses in aphakic patients.

In order to assess the applicability and safety of cellulose acetate buterate (CAB) contact lenses for extended wear in aphakia, 139 lenses were fitted in 102 aphakic patients. These lenses were removed periodically for cleaning only. There has been an average follow-up of 24.75 months on 99 patients (135 lenses), with a success rate of 80%. No serious complications or corneal vascularization have occurred. The major problems encountered were due to lack of tint, increased tendency to accumulate mucus, and the need for periodic insertion and removal.


Applied optical principles: keratometry.

The optical correction of the aphakic eye requires the addition of a significant amount of vergence power to the corneal interface by one of three modalities: spectacle, contact lens, or intraocular lens. No matter which modality is chosen, based upon Gullstrand's parameters, the corneal interface provides approximately 74% of the effective vergence power of the eye; therefore, it is essential to understand the principles underlying the clinical assessment of the refracting power of the cornea. This presentation briefly reviews selected principles underlying the determination of corneal curvature and toricity by keratometry, as well as their relationship to the correcting spectacle lenses, and emphasizes the necessity of surveying the topography of the cornea for the greatest accuracy in these measurements.


Defects of vision through aphakic spectacle lenses.

The following defects of aphakic vision will be reviewed: (1) magnification, which causes false orientation (due to excessive overall magnification of aphakic spectacles, resulting in false depth, and false projection) and distortion (due to excessive peripheral magnification of aphakic spectacles, resulting in pincushioning and concave contracture of the peripheral visual field); (2) swim; (3) image aberrations due to defects of focus through the periphery of aphakic spectacle lenses, resulting from radial astigmatism, curvature of image plane, spherical aberration, coma, and chromatic aberration; (4) restricted peripheral visual field due to small lens size, the roving ring scotoma, and the unrefracted area outside the field of view of aphakic spectacle lenses; (5) near vision problems; (6) weight, thickness, and cosmetic appearance of aphakic eyeglasses; and (7) inaccurate spectacle prescription due to faulty measurement of vertex distance, inaccurate lens duplication, pantoscopic tilt, turning of head during refraction, and rotation of eye during refraction.


Newer designs of aphakic spectacle eyeglasses.

This paper discusses the four available types of plastic aphakic spectacle lenses, which include (1) nonaspheric nonlineticular, (2)hardly aspheric lenticular and moderately aspheric lenticular, (3) mildly aspheric nonlenticular, and (4) highly aspheric nonlenticular in much larger eye size but adjusted closer to the eye to produce an enlarged visual field and suppress the "jack-in-the-box" phenomenon. Absolute size of the refracted peripheral visual fields through these types will be compared for the stationary eye in primary fixation. These visual fields were performed on the Amark projection perimeter. Helpful hints will be presented on how to determine if the patient has obtained the types of lenses prescribed and how to best prescribe each of these lenses.


Physiology of monocular aphakia.

The refraction of the unilateral aphakic patient has been aided by recent improvements in the ophthalmometer. New techniques simplify retinoscopic assessment of the patient. Choice of the type of correction, ie, spectacle, contact lens, contact lens-spectacle combination, or intraocular lens, depends on several factors. One factor is image size difference in aphakic and phakic eyes, particularly if removal of a second cataract is not imminent and vision is good in both eyes. Simple approaches that allow approximate size correction and effective restoration of binocularity are described. The current status of correction of vision in unilateral aphakic infants and young children is also discussed.


Soft lens design in aphakia.

Because of their size and mass, weight is a major concern in the fitting of soft gel lenses. Lenticular design is necessary, and there are essentially two lens designs for aphakia: the spin-cast lens of Bausch & Lomb and the lathe-cut lenses of the other manufacturers. A solution to the problem of weight in a single cut soft contact lens is presented.


Prolonged wearing contact lenses and preliminary results.

Extended wear contact lenses are sure to gain approval sometime during 1979. Four such lenses are briefly described, and the author's experience with one of them is discussed. The characteristics that differentiate these lenses from daily wear lenses are the high water content and the thinness.


The eye movement disorders of progressive supranuclear palsy.

In addition to the gross disturbances of vertical gaze, patients with progressive supranuclear palsy may show abnormalities in the saccadic and pursuit subsystems of horizontal gaze. Saccades are slower and smaller than normal. An attempt to elicit a large amplitude saccade will often result in a series of "fractionated" saccades. Pursuit eye movements become saccadic. The quick phases of vestibular and optokinetic nystagmus are of low amplitude. In the study presented, eye movements of 13 patients were recorded clinically and by electro-oculography, and data from the two methods, compared.


Infant vision testing by a behavioral method.

A behavioral method of screening binocular infant vision called forced choice preferential looking (FPL) has been developed. Clinical trials of the FPL test for young infants are reported here. The test aids nonspecialized personnel in early identification of bilateral ocular abnormalities and anomalies of binocular cooperation (strabismus). It is not possible to screen for monocular eye disease or amblyopia with this test. Modifications of the FPL test may offer new ways of assessing other aspects of visual function early in life.


Laser scotometry in drusen and pits of the optic nerve head.

Laser scotometry is an accurate means of detecting dense blind spots. A small low-energy spot is guided across the fundus from nonseeing to seeing areas. Patient responses are recorded on fundus photographys, allowing direct correlation with fundus pathology. Accuracy to less than 1 degree is feasible. All typical optic nerve drusen tested with this technique had field defects. In cases of optic nerve pits, dense scotomas correlated with the shape of visible nerve fiber defects rather than with the shape of serous retinal detachments.


Self-injected retinal emboli.

Twelve patients with bilateral intraretinal talc emboli were examined. Each patient had self-injected large doses of methylphenidate (Ritalin) for one or more years. All fundi showed yellow-white particles in the macular area, and two eyes had reduced vision secondary to retinal vascular occlusion. The clinical syndrome, ophthalmoscopic appearance, and fluorescein angiographic findings of self-injected retinal emboli are presented, and the pathogenesis is discussed.


Argon laser trabeculotomy:long-term follow-up.

A five-year follow-up of argon laser trabeculectomy in a group of 28 male patients with bilateral patients with bilateral primary open-angle glaucoma showed an overall mean pressure drop of 10.3 mm Hg in treated eyes. Twenty percent of the treated eyes had a pressure less than 20 mm Hg up to two years after treatment. No specific laser parameters were associated with pressure lowering. The pressure drop appears more patient dependent than treatment dependent. A randomized clinical trial is suggested.


Unilateral tonsillar enlargement.

Unilateral tonsillar enlargement may result from infection, chronic inflammatory response, or neoplasm. Neoplasms that commonly produce a unilaterally enlarged tonsil include lymphomas (lymphocytic and histiocytic types) and squamous cell carcinomas. Rarer tumors include extramedullary plasmacytomas, Hodgkin's disease, leukemia, and metastatic neoplasms. Sixteen cases of unilateral tonsillar enlargement owing to causes other than squamous cell carcinoma are reviewed. When examining a patient with unilateral tonsillar enlargement, diagnosis of a neoplastic disease must be considered.


Synovial chondromatosis of the temporomandibular joint.

Synovial chondromatosis is an uncommon disease of cartilaginous transformation of synovial membrane with formation of loose bodies within the joint space. A case involving the temporomandibular joint (TMJ) is presented. In the TMJ, this disorder occurs more often in females and is usually on the right side. Symptoms include preauricular swelling, pain, and tenderness. Radiographs of the TMJ may be normal, but frequently show multiple, partially calcified loose bodies within the joint. Treatment consists of removal of the loose bodies together with all affected synovium. If the meniscus is excised, reconstruction with a Silastic prosthesis is recommended.


Vasodilating agents in augmentation of skin flap survival.

Skin flap necrosis is a serious problem in reconstructive head and neck surgery. Currently, the only clinically effective means of preventing flap necrosis is delay. Hypothesized mechanisms of delayed and experimental methods of increasing flap survival are discussed. Investigative data supporting the use of phentolamine to augment flap survival are presented.


Mucocele of the sphenoid sinus: report of a case.

A case is presented in which a sphenoid sinus mucocele was indicated by rapidly progressive blindness in the left eye. Recognition and extension of the mucocele was made possible with a computerized tomographic (CT) scan and tomograms, which outlined its boundaries and the involvement of the maxillary sinus, the ethmoid, and the left orbit. Immediate decompression and marsupialization of the cyst through the left maxillary sinus, using the Caldwell-Luc approach, gave excellent results. Immediate improvement of vision was noted and almost complete return of vision occured within six weeks.


Mucosal tattooing in oral cavity carcinoma.

Tattooing provides accurate localization for tumor surgery following radiation therapy. This paper describes studies done on tattooing technique and instruments available currently. Procedures tested included hypodermic needles and three types of surgical instruments. Chemical tested included india ink, iron oxide, and colored pigments. India ink and iron oxide used with the Spaulding-Rogers Outliner gave satisfactory tattoos.


Thyroid carcinoma in a patient with a coexisting functional adenoma.

Fourteen case reports have been published in which "hot" nodules have been documented as carcinoma, with or without coexisting adenomas. The diagnosis of these lesions is difficult, since hot nodules usually represent benign disease. These carcinomas are not functional, but represent coexistence of a functional area or a malignant degeneration. Hot nodule carcinomas should be suspected in high-risk patients. A euthyroid, 31-year-old woman who, as a teenager, had radiotherapy for acne is reported. She was followed up with yearly scans for a hot nodule in the right lower lobe of her thyroid. When she was 36, a node was discovered in the right side of her neck, and carcinoma was suspected. Surgical excision revealed a papillary-follicular carcinoma adjacent to an adenoma with metastases to regional lymph nodes.


Infectious and noninfectious complications in major head and neck surgery.

The Hemovac drainage system was required postoperatively for 156 patients who had undergone major head and neck surgical treatment. This study distinguishes infectious complications from noninfectious complications by the aerobic and anaerobic cultures that were taken from the Hemovac line drainage and any subsequent complications. The 33% complication rate included only those of the head and neck and excluded general medical complications. Of the 52 patients having complications, 19 had infectious, 24 had noninfectious, and nine had both infectious and noninfectious complications.


Endoscopic nomenclature for bronchopulmonary anatomy.

Development of the flexible fiberoptic bronchoscope (FFB) has allowed visualization of the peripheral tracheobronchial tree to the level of fifth-order bronchi. Examination of this area requires an extended anatomic nomenclature to describe the pathology of findings. A system of description is presented that combines the concepts of Jackson and Huber, Boyden, Ikeda, and Weibel into a practical endoscopic shorthand lettering designation for endobronchial anatomy. Using the system, a sub-sub-subsegmental (fifth order) bronchus in the right lung could be designated RB1b1 alpha. The principles are described and illustrated.


Squamous metaplasia of the middle ear mucosa during vitamin A deprivation.

Adult and juvenile albino rats were maintained on a vitamin A-free test diet for 2 to 28 weeks. Histologic study of the middle ear and eustachian tube mucosa of these animals showed extensive focal squamous metaplasia when compared with the control group. Keratinization of large areas of normally columnar, ciliated epithelium was observed without frank keratoma formation. In over half of the most vitamin A-deficient animals, acute otitis media with effusion was found. It is hypothesized that vitamin A deficiency disrupts the mucocilliary clearing mechanism in the middle ear and eustachian tube, which may lead to effusion and otitis media.


The significance of lysosomal enzymes in middle ear effusions.

Although lysosomal enzymes have been demonstrated in middle ear effusions by several investigations, the exact source of these enzymes and the role they play in the maintenance and progression of otitis media with effusion have not been thoroughly studied. The source of lysosomal enzymes in middle ear fluids and their possible role in the inflammatory process in otitis media with effusion are explored.


Antigenicity of the guinea pig's tympanic membrane.

The immunogenicity of the middle ear constituents is a matter of prime importance. In this work, the authors were interested in the antigenicity of the guinea pig's tymphanic membrane. They reached the conclusion, after developing an antiserum (IgG), that the tympanic membrane of the guinea pig can be antigenic in the rabbit. After purification and absorption, a cross-reactivity remains between the tympanic membrane and the mucosae of the upper respiratory system.


Electron microscopic findings in presbycusic degeneration of the basal turn of the human cochlea.

Three human temporal bones with presbycusis affecting the basal turn of the cochlea were studied by light and electron microscopy. Conditions in two ears examined by light microscopy were typical of primary neural degeneration, with a descending audiometric pattern, loss of cochlear neurons in the basal turn, and preservation of the organ of Corti. Ultrastructural analysis revealed normal hair cells and marked degenerative changes of the remaining neural fibers, expecially in the basal turn. These changes included a decrease in the number of synapses at the base of hair cells, accumulation of cellular debris in the spiral bundles, abnormalities of the dendritic fibers and their sheaths in the osseous spiral lamina, and degenerative changes in the spiral ganglion cells and axons. These changes were interpreted as an intermediate stage of degeneration prior to total loss of nerve fibers and ganglion cells as visualized by light microscopy. In the third ear the changes observed were typical of primary degeneration of hair and supporting cells in the basal turn with secondary neural degeneration. Additional observations at an ultrastructural level included maintenance of the tight junctions of the scala media despite loss of both hair and supporting cells, suggesting a capacity for cellular "healing" in the inner ear. Degenerative changes were found in the remaining neural fibers in the osseous spiral lamina. In addition, there was marked thickening of the basilar membrane in the basal turn, which consisted of an increased number of fibrils and an accumulation of amorphous osmiophilic material in the basilar membrane. This finding supports the concept that mechanical alterations may occur in presbycusis of the basal turn.


Hearing aid performance relative to site of lesion.

This study investigated hearing aid acceptance and use as functions of the probable site of a lesion: conductive, cochlear, neural, and central as determined by an audiometric test battery. Results indicate significantly better acceptance of aids in conductive and cochlear disorders than in more central neural and central disorders.


Detection of middle ear disease in cleft-palate patients.

A prospective study of 17 cleft-palate patients under the age of 37 months was performed. The otoscopic findings, as reported by the primary physician and otolaryngologist, were compared with the results of tympanometry. Preoperatively, all tympanograms were abnormal. Ears with an AS pattern were not described as abnormal by any physician, and postoperatively, these ears all progresses to a more advanced stage of disease.


Evidence for intracochlear impedance changes following ethacrynic acid administration.

The effects of intra-arterial 30-, 40-, and 50-mg/kg doses of ethacrynic acid upon cochlear function in guinea pigs were studied for periods of three to five hours. Cochlear potentials recorded in the first turn included the endocochlear potential, whole nerve response, cochlear microphonics, and summating potentials in scala media, scala tympani, and scala vestibuli. Evidence of organ of Corti damage at 50 mg/kg was found in addition to electrical impedance changes in the cochlear membranes at all dose levels.


The penetration of gentamicin and neomycin into perilymph across the round window membrane.

Many commonly employed otic drops contain aminoglycoside antibiotics that may be toxic to the inner ear. A variety of chemicals such as ionic solutions, certain anesthetics, and epinephrine have been shown to diffuse across the round window membrane into the perilymph. Twelve adult cats were studied in this experiment. The auditory bulla was exposed and solutions containing gentamicin or neomycin concentrations similar to that commonly used in otic drops were applied to the round window niche for 15 minutes and washed with saline solution. The gentamicin and neomycin concentrations in the round window niche wash and the perilymph were then assayed by a radioenzymatic method. Concentrations of both antibiotics were observed in the perilymph. Thus, the round window membrane is a route through which these ototoxins may gain access to the inner ear.


Perilymph fistulae: variability of symptoms and results of surgery.

A perilymphatic fistula of a labyrinthine window may initially present with various cochlear or vestibular symptoms. Vestibular perilymph leaks can occur spontaneously with or without hearing loss and are most readily diagnosed by a positive Hennebert's sign. Surgical correction is indicated and should initially consist of grafting of the perilymph leak. A significant incidence of recurrence warrants further investigation of grafting materials and techniques.


The freeze-injection method of hypertrophic scar and keloid reduction.

Hypertrophic scars and keloids continue to plague the head and neck surgeon as an unpredictable consequence of trauma or incision. The myriad suggested methods of revising such lesions indicate that no one method is foolproof. The application of conventional cryotherapy to the lesion, followed by the dilute intralesional triamcinalone injection, offers several advantages over other methods.


Virtual image of the incus from a saline lens: an aid to safe dissection of the mastoid antrum.

Dissection of the antrum requires judicious visualization of the tegmen, horizontal canal, incus, and facial nerve. Inadvertent contact with the incus by the power drill may cause significant acoustic trauma. An effective "early warning device" accurately predicting exposure of the incus may be constructed with the saline irrigation fluid. The formation of the meniscus at the antrum permits visualization of the image of the incus around the corner of the bony canal wall overhang. A thin-lens model of this phenomenon has been created for first-order analysis of the optics, and it provides useful criteria for using this image. Image minification, displacement, and distortion were analyzed. A more complex model was then created to assess the impact of changing meniscus shape. The latter helped in understanding an added "swinging-door effect" noted as the meniscus was altered. The model predicted accurately the phenomena as observed in the temporal bone preparation. Illustrative examples of the optics and photographic demonstrations of the phenomena are presented.


[Eventration of the diaphragm in infancy and childhood (author's transl)].

31 children with eventration of the diaphragm were observed at the surgical department of the University Children's Hospital in Zürich from 1960 to 1975. 27 of the 31 children were less than one year old. In 14 of the cases the eventration was caused by a congenital hypoplasia of the diaphragm, in 12 by a traumatic paralysis of the phrenic nerve and in 3 cases it occurred postoperatively. 2 children had acquired the eventration later on in childhood. 18 of the 31 children were operated upon, 13 were treated conservatively. All except one survived and were examined again 3 to 15 years later. The various pathological anatomical forms, the clinical picture, signs and symptoms and the indication for conservative or operative treatment are discussed and illustrated by typical cases of the present series.


The two-stage concept of rhytidectomy.

The two-stage concept is a plan for the management of rhytidectomy patients. Preoperatively, all patients are told that they may need a minor secondary temporal tuck-up procedure 6 to 12 months after surgical treatment. Although only 20% of patients require this secondary surgical procedure, the possibility of its need encourages all patients to return for follow-up and removes a source of patient discontent. The indications for the secondary procedure are significant gravitational jowling and malar sagging developing 6 to 12 months after the primary surgical treatment. The technique is described in detail.


[Experiences about ductus arteriosus closure with congenital diaphragmatic hernia (author's transl)].

Ten cases of posterolateral diaphragmatic hernia have been operated upon the last two years. Three cases of these have successfully been operated in conventional way. In seven cases ductus arteriosus was closed. Only two cases survived. A preoperative evaluation is to be done. Depending on the blood-gas-analysis, the cases can be divided into cases belonging to the survival zone and cases belonging to the fatal zone according to Boix-Ochoa. If it is possible to increase the oxygen uptake and to expire the carbonic acid, the results seem to be good after conventional operation. If it not will be possible to increase the oxygen saturation and not even possible to reduce the CO2 pressure with a ventilator with 100 per cent oxygen, the cases are to be considered inoperable. In fatal zone cases, where a reduction of PCO2 is possible, but there are no possibilities to get an increased oxygen saturation, an operative closing of ductus can be tried if heart anoxia is treated with the aid of an oxygenator.


[Epidemiology of measles and mumps. 1st part: measles (author's transl)].

Measles morbidity is seen to follow a cyclic pattern with peaks and ebbs every 2--3 years. The maximum in the annual course is found in the second quarter, the peak of the age-specific morbidity in Central Europe in the 4th year of life. At 15 years of age, seroconversion is practically 100%. Complications can be expected in 6,7% of cases, mortality in about 1:10,000. Encephalitis occurs in about 1,2% of cases and is often followed by neurological and psychical damage.


Office organization and experiences with hearing aid dispensing.

Roles of the otolaryngologist and the audiologist in providing hearing health care are expanding as a result of current trends in amplification technology, legislation, and patient populations. Within clinic dispensing of hearing aids has become a part of this role expansion. Requirements for setting up a dispensary, fitting procedures, fee analysis, and statistical results of 4 1/2 years' experience are discussed. On the basis of the benefits described, direct dispensing is advocated.


[Epidemiology of measles and mumps. 2nd part: mumps (author's transl)].

Similar to measles, mumps morbidity is also seen to follow an undulating course with a 2--3 years rhythm as well as having an annual peak in the second quarter. The peak of the age specific morbidity, however, is found in the 7th--8th year of life and consequently part of the infections only appear later in adulthood. Most of the infections remain subclinical and only about 12% are recorded. Morality is about 1 : 100 000, meningitis occurs in about 1,5% of the infections and is benign in most cases. Encephalitis occurs in about 0,9% of cases and frequently leads to brain damage.


A new approach to measure restlessness.

A new method to measure restlessness is described. It consists mainly of recording thoracic electrical impedance and measuring the amount of movement artifacts appearing in the pneumographs. Technical equipment and data evaluation are described; an example of typical data is given together with proposals as to how the method may be automated. Potential applications in different fields of interest are described.


[Newborn cardiotoxicity after tocolysis with fenoterolhydrobromide].

In the clinical treatment of imminent premature birth, sympathomimetic amines have greatly increased in importance as an interruptor of labor pains. The purpose of this report is to discuss the clinical findings on the basis of 30 newborns admitted to our hospital (between April 1977 and June 1978) after long-term treatment of the mother and Fenoterol (Partusisten). The predominant clinical findings were: tachycardia, paroxysmal dyspnea, cyanosis, metabolic acidosis, congestive heart failure and, in the ECG, cardiac arrhythmias and T-wave inversions in the left precordial chest leads. A high correlation was found between the clinical degree of alteration and changes in both the ECG and the VCG. In all patients these changes have normalized within 8 weeks. The histological findings of 3 deceased newborns revealed typical although not specific features such as: polyploid cells especially in the subendocardial region and a streamlined fatty degeneration of the myocardium. These findings, however, cannot prove with certainty the cardiotoxic effect of Fenoterol on the myocardium, but it appears possible that an especially high dosage of Fenoterol given i. v. can cause myocardial complications. Our findings suggest that catecholamin derivates should be applicated only with extreme caution.


[Experiences with aldactone in pediatric cardiology (author's transl)].

In Pediatric Cardiology for many years the usage of spironolactone (Aldactone) and Canreonat-K+ (Aldactone pro injectione) had been experienced. The efficiency of aldactone was controlled by clinical parameters, electrolytes, discontinuity of the drug and in some cases by radioimmunologic measurement of the plasma aldosterone concentration. The treatment with aldactone in combination with digitalis gave good clinical results in cases with and without signs of secondary hyperaldosteronism. The recommended dosage i. v. and orally was for infancy 2--3 mg/kg/die the first 2--4 days and afterwards 1,5--2 mg/kg/die, for later childhood 4--5 mg/kg/die for 3--5 days and afterwards 2--3 mg/kg/die. Special attention should be paid to hyperkaliemia, over 6 mval serum K+ the aldactone administration was interrupted.


[The risks involved in the heart catheter examination. A retrospective evaluation of the complications after 700 examinations. I. Method, patients, diagnoses (author's transl)].

A retrospective study is undertaken in order to assess the kind and frequency of complications which occurred in 700 heart catheterizations performed in 539 infants and children. This paper deals with the distribution of age groups and diagnoses. The percentages of the different age groups resemble closely those of the "Cooperative Study" of Braunwald and ass. (1968) with the exception that newborns and infants are represented in greater number. This id due to a more active approach to investigation of cardiac malformations in infancy. With regard to the diagnoses those malformations are highly represented which are susceptible to low-risk surgery (Ductus Botalli, atrial septal defect, coarctation, pulmonic and aortic stenosis) and those where surgery is inevitable (tetralogy, transposition of great arteries). Aortic stenosis, too, shows a higher than real incidence because the exact degree of severity can be ascertained only by use of invasive methods. On the other hand there are relatively few ventricular septal defects, because many of them diminish spontaneously in size and do not need catheterization. The rare anomalies are represented in small numbers.


[The risks involved in the heart catheter examination. A retrospective evaluation of the complications after 700 examinations. II. Complications (author's transl)].

The author reviewed the complications of 700 heart catheterizations in infants and children performed between 1970 and 1978 with a frequency of 55 to 113 investigations per year. Arrhythmias occurred on 70 occasions (10%), death within 24 hours: 14 (2%), extravasation of contrast media: 11 (1,6%), perforation by catheter: 6 (0,9%), cyanotic spells 5 (0,7%), myocardial ischemia: 4 (0,6%), respiratory arrest: 4 (0,6%), convulsions: 2 (0,3%), wound infection: 2 (0,3%), icterus 2 (0.3%), lung atelactasis: 1 (0,15%), bacterial endocarditis: 1 (0,15%), pyrexia: 1 (0,15%), exanthema: 1 (0,15%), pulmonary edema: 1 (0,15%), meningitis purulenta and hepatitis as possible complications: 1 (0,15%) each. The mortality figue of 2% lies well within the range of rates reported by Ho and ass. (1972): 1,5%, Stanger and ass. (1974): 3,0%, Rowe (1978): 0,95%, and Graham (1978): 2,9%. Mortality mainly occurs in sick neonates and infants with complex cardiac malformations. It could be lowered by a more aggressive approach to diagnostic work-up of suspected cardiac disease, as well as by using more sophisticated catheterization techniques and material and by introducing intensive care principles on the infant ward. Catheter related mortality (e. g. by perforation, severe arrhythmia) could be reduced to zero during the last three years. Myocardial staining by contrast media and electrocardiographic alterations suggesting myocardial ischemia occurred comparatively often but were never followed by serious or long lasting sequelae. Their occurrence was not related to the diagnosis or to the age of the patient. Respiratory arrest and convulsions could only be observed in sick infants. The seizures were not directly related to angiocardiography. All other complications were incidental events. Arrhythmias and vascular complications are discussed in separate papers.


[The risks involved in the heart catheter examination. A retrospective evaluation of the complications after 700 examination. III. Irregularities of heart (author's transl)].

Disturbances of heart rhythm, observed during 700 heart catheterizations in infants and children, are discussed. Paroxysmal supraventricular tachycardia has been observed in 25  investigations (3,6%), sinus bradycardia in 18 (2,6%), junctional rhythm in 10 (1,4%), second degree AV-block in 9 (1,3%), ventricular fibrillation in 8 (1,1%), sinus tachycardia in 7 (1%), complete block in 7 (1%), asystole and atrial flutter in 2 (0,3%) each, and ventricular tachycardia in 1 (0,15%). Supraventricular tachycardia occurred equally in all ages without preference of a special malformation. The two patients with WPW-syndrome, however, showed this disorder in each of three catheterizations. Propranolol and verapamil succeeded in terminating the attacks. Junctional rhythm and sinus tachycardia presented equal behavior and benignity. Sinus bradycardia, second and third degree AV-block, and especially ventricular fibrillation occurred mostly in neonates and infants, many of them cyanotic and suffering from complex malformations and therefore needing multiple catheter manipulations. Bradycardia was in two, asystole in one of the very sick neonates associated with subsequent death within 24 hours. Once asystole resulted in immediate death after pulmonary angiography in a child with severe pulmonary hypertension. Ventricular fibrillation could be terminated promptly by DC countershock in all patients, but three of the children died subsequently. Complete block occurred only in children with systemic right ventricular pressure, 4 of the 7 patients having pulmonary hypertension, too. In two instances the block subsided spontaneously, the rest could successfully be treated with orciprenaline (Alupent R). Life threatening arrhythmias became less frequent as a consequence of earlier investigation, if severe heart disease was suspected, and by closer control of cyanosis, acidosis and temperature before, during, and after catheterization.


[The risks involved in the heart catheter examination. A retrospective evaluation of the complications after 700 examinations. IV. Vascular complications (author's transl)].

The review of 700 heart catheterizations in infants and children revealed arterial occlusion in 30 instances after 175 catheterizations (17,1%), but 29 of them after 88 arteriotomies (32,9%) and only 1 after 87 percutaneous arterial catheterizations (1,1%). In two cases thrombectomy of the femoral artery was necessary, brachial artery occlusion was never felt to indicate surgical intervention. Since percutaneous sheath catheterization is used in combination with systemic heparinization no obvious occlusion occurred after about 80 investigations. This may be due to a minimum of intimal damage by the sheath and prohibition of thrombus growth at the site of puncture. Occlusive thrombosis of the femoral vein has been assessed clinically and sometimes angiographically in 7 cases out of 468 (0,4%). In two older children the vein was explored and thrombectomy performed. All other were cyanotic infants; in two of them femoral vein occlusion became manifest as late as two days after investigation by venous cutdown. Thrombosis of inferior vena cava has never been observed neither early nor late. Venous bleeding occurred in 6 infants after vessel disruption and 1 arterial hematoma in a boy because of incomplete compression of puncture site. In 4 instances the catheter could not be inserted because the vessels were too small or too spastic. One time a spring guide entered a small artery in the groin or small pelvic region. Forceful withdrawal stripped the arter. -- This study reveals that the most frequent complication, i. e. arterial occlusion, after adoption of modern techniques does not occur more frequently than in institutions with a larger number of catheterizations per year.


[Renal upper pole calyceal obstruction: clinical and radiological significance (author's transl)].

Obstruction of the superior renal calyces due to intrarenal vascular compressions is assumed on the basis of a characteristic sharply defined oblique filling defect with or without blunting of the fornices. Scintillation camera renography shows prolonged retention in the superior collecting system of the involved kidney. 11 out of 23 children had a symptomatology of recurrent hematuria, other origins of hematuria were excluded. 5 patients had urinary tract infection, the remaining 7 had normal urinary findings. Renal function was always normal. There is no correlation between severity of blunting and hematuria. In contrast to other studies which included only patients with blunting and ectasis even cases without blunting of the fornices have a clinical symptomatology. Deterioration of radiologic appearance and kidney function was not found. Any idiopathic hematuria should be investigated for calyceal obstruction. Uncomplicated cases require no therapy, long term follow-ups with regard to complications such as urinary tract infection and urolithiasis are indicated.


[Computerized tomography in hydrocephalus of infancy (author's transl)].

Prior to invention of computerized tomography, the coincidence of hydrocephalus and brain tumors in early infancy resulted in diagnostic problems, frequently. Two cases with primarily insufficient diagnosis are reported. In spite of the necessity of deep sedation or general anesthesia at the present, computerized tomography has turned out to be highly perferable to other common methods.


[Pediatric pharmacology of azlocilin (author's transl)].

Pharmacokinetic investigations of acylureido-penicillins azlocillin in newborns, infants and school shildren showed age dependend results. The differences were especially evident in a prolongation of the serum half-life to 2,56 hours in newborns compared to 0.94 hours in school children. On the basis of our pharmacokinetic results and of the dosages resulting from the data the antibiotic was used clinically in twenty eight patients with Pseudomonas aeruginosa infections and one patient with a Proteus mirabilis infection. The results were much better in infections of the urinary tract than in infections of the respiratory tract. This might be due to an observe bacterial presistence in spite of highly effective levels of azlocillin in bronchial secretion. The tolerance to the antibiotic was good.


[Plexus paresis and smallpox vaccination (author's transl)].

Paresis of the left side upper plexus brachialis is diagnosed to a boy of 2;8 years. The trouble appeared after a smallpox vaccination, which had been carried out successfully. There are no symptoms of CNS-disturbance. serumneuritis and virogenic radiculatis are discussed as pathogenic variants. Although postvaccinal peripheral nervous lesions very seldom occur, it does seem possible that the ailment in question could be a consequence of the smallpox vaccination.


[Salmonella-cholecystitis (author's transl)].

Gastroenteritis due to Salmonella enteritis is an endemic disease in our region, extraintestinal manifestations however are rare. We report a 8 years old girl who presented after 4 days of an unspecific diarrheal disease with watery liquid stools, vomiting, abdominal cramps, fever above 39 Grad C and symptoms and signs of an acute abdominal emergency. Mid abdominal laparotomy disclosed a cholecystitis with reactive peritonitis. Cultures of bile showed Salmonella group B as the causative organism. Cholecystectomy was performed, postoperatively Gentamycin later Chloramphenicol was administered. The postoperative course was unremarkable. Cholecystitis is a rare disease in pediatrics. Gallstones don't seem to play a roll in the etiology unlike in adults. It usually follow serious systemic infections or postoperatively after unrelated abdominal surgery due to overgrowth of the biliary system and organisms contaminating the upper gastrointestinal tract (biliary stasis, dehydration). Salmonella enteritidis as a cause of a cholecystitis is a rare event.


[Septic arthritis and osteomyelitis as a complication of neonatal intensive care (author's transl)].

In a prematurely born infant of a diabetic mother a purulent arthritis with osteomyelitis of the elbow occurred 18 days after an enterobacter aerogenes-septicemia was proved. Enterobacter (aerobacter) aerogenes is a nosocomial gramnegative germ, that is more and more regarded responsible for infection of the newborn in intensive care units. In accordance with the literature recording a high rate functional loss after septic arthritis also our patient suffered from a mobility deficiency in his right elbow a year after the onset of the disease.


Chronic pain: which patients may a pain-management program help?

To ascertain whether chronic-pain patients who are likely to benefit from a pain-management program can be identified before treatment, we studied for differences discernible at the beginning of treatment a group who succeeded and did well at 1-year follow-up (n = 34) and a group who failed (n = 35). The two groups differed significantly (P less than 0.01) in regard to duration of pain, work time lost, number of operations, subjective pain level, and drug dependency. Deviations on the MMPI were greater in failures than in successes; but the differences were not statistically significant. A 7-item rating scale based on these data differentiated a favorable group (including 71% of the successes) from an unfavorable group (including 86% of the failures). This scale should be helpful in selection of candidates for a pain-management program, even though it needs further validation.


Signal detection theory and pain research.

Rollman [13,14] has clearly raised important questions about the application of signal detection (TSD) procedures to the study of the perceived painfulness of stimuli. Researchers have often failed to realize that the discriminability of two usually painful stimuli need not be related to their reported painfulness. Thus indices of discrimination accuracy derived form TSD are logically (though not necessarily empirically) independent of the analgesic properties of any treatment. However, Rollman misleadingly gives the impression that he is questioning the general validity of the application of TSD to answering questions in pain research. This is not the case. Procedures derived from TSD may play an important part in answering questions of interest to pain researchers especially as Rollman has exaggerated the practical difficulties associated with TSD experiments. It must be emphasized that there is no one TSD model as Rollman often seems to imply but a variety of models [5,9]. The usefulness of any model in any situation is a matter for experiment. Rollman has certainly criticized effectively one dubious analogy to TSD procedures which pain researchers have used. That is not the same as questioning the general usefulness of TSD models.


The effectiveness of tricyclic antidepressants in the treatment of coexisting pain and depression.

A group of moderately to severely depressed individuals with moderate anxiety were studied to determine the frequency and nature of pain complaints and their response to doxepin. It was discovered that 100% of these subjects had chronic pain complaints, most of which paralleled the course of depression. Headache was most commonly noted. Doxepin's analgesic effects were intimately associated with its antidepressant effects. There was a highly significant relationship between improvement of depression and reduction of pain on doxepin (P less than 0.005). Conversely, patients who obtained minimal antidepressant effect also obtained minimal analgesic effect. Psychophysiologic and biochemical hypotheses of this association of pain and depression are discussed.


Pain and the marital relationship: psychiatric distress.

Psychologic assessment and treatment of the family of the chronic pain patient has been thought to be of benefit in the outcome of pain therapy. The present study was designed to determine the presence of psychologic symptoms in the spouses of pain patients and the relationship of distress levels between the marital pair. Forty-four couples were studied. Demographic data was collected and each individual completed the SCL-90, a widely used and validated measure of psychologic symptom severity. There was a significant correlation (P = less than 0.001) on psychiatric distress scores between pain patients and their spouses particularly when pain patient distress scores were high. Distress levels tended to decrease with age and were highest among the unemployed and lowest in the retired. In addition spouses were significantly higher than nonpatient norms on most symptom subscales. These data underline the importance of conjoint assessment of the chronic pain patient and the spouse, and have implications for treatment.


The internal structure of the McGill pain questionnaire in dysmenorrhoea patients.

The McGill pain questionnaire (MPQ) was administered to 166 women attending Gynaecology Clinics complaining of dysmenorrhoea. Responses were subjected to factor analysis with 4 dimensions emerging. These reflected sensory qualities of the pain experience and factors related to the reaction component of the pain. These results are considered in relation to factorial analysis of the MPQ among back patients and in terms of treatment implications.


The nature of pain that may accompany cancer of the lung.

The pains that may accompany cancer of the lung vary from relatively benign to very severe. Careful clinical observation will establish that the pains occur in distinct syndromes (patterns). Six syndromes have been identified and described. When a syndrome has been established it tends to persist, although a second syndrome may be added. Recognition of the syndromes helps the clinician to make a prognosis and to plan for management of the pain.


The origin of multinucleate giant cells in myeloma kidney from mononuclear phagocytes: an ultrastructural study.

Ultrastructural examination of a biopsy of a myeloma kidney has shown structural relationships between the multinucleate giant cells which characterize this condition and macrophage polykarya. On the other hand, no evidence was found of any resemblance to renal tubular cells. Moreover the electron microscopic observations indicate that these multinucleate giant cells, in common with the mononuclear phagocytes, attempt to ingest the cast material which in addition becomes fibrillar in the zones of endocytosis. No such phenomena were observed in the vicinity of tubular cells. In conclusion the ultrastructural evidence suggests that the multinucleate giant cells of myeloma kidney are derived from mononuclear phagocytes.


Prostatic aspiration cytology.

The results of cytological examination of 1280 transrectal fine needle aspiration biopsies of the prostate from 1122 patients over a period of 10 years are given. The technique was used for the diagnosis of prostatic carcinoma. The microscopic appearances including classification according to differentiation are described and illustrated. Of the 1280 aspirates examined 467 were diagnosed as carcinoma. In 469 cases, it was possible to compare the cytology with the results of histological examination. In this group, 255 cases of prostatic carcinoma were diagnosed: 53% by both cytology and histology, 20% by cytology alone and 27% by histology alone. The findings show that the Franzen needle biopsy technique has an important role to play in the diagnosis of carcinoma of the prostate.


Quantitative studies of Hb Bart's levels and red cell indices in alpha thalassaemia trait in Mediterraneans.

Haemoglobin Bart's was detected and quantitated in 42 babies during a survey of cord blood from neonates of Mediterranean origin. The distribution of Hb Bart's levels for the group appeared to be bi-modal, with modes at 2.0% and 5.5%. Haematological data obtained from 21 babies during the first week of life showed a highly significant reduction in average MCV (86.3 +/- 7.7 fl) and MCH (27.8 +/- 6.0 pg) in comparison with a control group of babies. However, there was no significant correlation between these parameters and Hb Bart's levels. Haematological data were available on 57 parents of the Hb Bart's babies and HbH preparations were positive in 28 cases (49%). Examination of red cell indices showed a highly significant reduction in the average MCV and MCH of parents with positive HbH preparations, and a diagnosis of alpha-thalassaemia (based on the presence of HbH inclusion bodies and reductions in MCV and/or MCH) was made in at least one parent in the majority of couples with both partners tested, suggesting that alpha-thalassaemia trait in people of Mediterranean origin is generally associated with detectable haematological changes.


Low-calcium/high phosphorus rickets in rats. I. Mast cell changes.

Weanling rats were given a low Ca (0.003%)/high P (0.64%) diet with and without vitamin D for periods up to 5 weeks. This was associated with hypocalcaemia, rachitic bone changes and increased bone resorption. These changes preceded the accumulation of large numbers of mast cells in long bone metaphyses. Mast cells did not increase in the epiphyses of long bones or in caudal vertebrae, tooth pulp, skin and other organs. A light and electron microscopic study showed that most mast cells had raised secretory activity, as evidenced by variability in the structure of granules and loss of granule contents, particularly in animals with the lowest serum calcium levels. It was not possible to relate the position of a mast cell to an area of active bone formation or resorption. The increase in mast cells might be related more to the maintenance of connective tissue integrity in areas of rapid bone remodelling.


Visceral oedema and increased vascular permeability in early experimental hypertension.

Increased vascular permeability and visceral oedema without significant hypertension or arterial damage was found in clip-nephrectomized rats dying in the first post-operative week. Increased vascular permeability was demonstrated by intravenous colloidal carbon labelling, and was restricted to capillaries and venules. Rats surviving the first week became hypertensive, and visceral oedema with predominantly venular and capillary labelling continued, although carbon was now present in arteries also, associated with smooth muscle necrosis. These results suggest that the pressor and permeability effects of renal artery constriction are independent.


The effects of temporary fluid restriction in clip-nephrectomized rats.

Constriction of the remaining renal artery in unilaterally nephrectomized rats is associated with a high mortality in the early post-operative phase before hypertension has developed. The high mortality is accompanied by increased vascular permeability, mesenteric and pancreatic oedema. Temporary post-operative water restriction reduces this mortality and also modifies subsequent blood pressure elevation, heart weight and cardiac index in surviving animals.


A functional parathyroid gland adenoma of transitional oxyphil cells. A light and ultrastructural study.

This report describes light and ultrastructural features of a functional parathyroid gland adenoma, principally composed of transitional oxyphil cells, in a 64-yr-old hypertensive black woman. She was hospitalized for repeated episodes of headaches, lethargy, and dizzy spells. Her serum calcium level was 2.92 mmol/l and immunoassay for parathormone was 390 pg/ml. On neck exploration, the left lower parathyroid gland was found enlarged and therefore removed in toto. The serum calcium and phosphate levels returned to normal following parathyroidectomy. Microscopically, the diagnosis of functional oxyphil adenoma was made. On ultrastructural examination, the tumour was composed principally of transitional cells, occasional typical, and degenerating oxyphil cells. The predominant transitional cells were rich in mitochondria and contained multiple active Golgi complexes, stacked profiles of rough endoplasmic reticulum, and a few secretory granules. On the other hand, typical oxyphil cells were tightly packed with mitochondria at the expense of other organelles. It appeared that neoplastic oxyphil cells were chief cells transformed in response to some unknown oncogenic stimulus.


Adenocarcinoma of the uterine cervix of probable Wolffian origin.

An unusual type of adenocarcinoma involving the endocervix and the lower segment of the uterus resulting in a vaginal vault recurrence 7 years after hysterectomy is discussed. Features of the tumour which suggest a probable Wolffian duct (or mesonephric) origin are outlined.


Empirical description of effects of exercise on mood.

18 experienced joggers showed altered Mood Adjective Check List responding after jogging 12.5 miles, highlighted by increased pleasantness. Results support a broad-spectrum, unipolar approach to quantification of exercise-induced mood change.


Relationships among selected perceptual-motor tests and teachers' rankings as a function of children's age and sex.

28 third grade (M = 8.4 yr.) and 28 sixth grade (M = 11.8 yr.) children were administered the Body Coordination Test and Gross Motor Skill Test to assess the relationship between these measures as a function of age, sex, and the subjective ratings (ranks) of their physical education teacher. Scores were significantly correlated (.76) for all as were scores within each grade and sex. The teachers' subjective ranking of younger subjects on their general physical performance was significantly related to scores on both tests but only moderately related to general coordination and unrelated to somatic development. Significant correlations were observed for the older subjects for all ranks on the Gross Motor Skill Test but were only moderately related or unrelated on the Body Coordination Test. These tests may have utility in evaluating motor developmental differences among children.


Differentiated perceptions of exertion: part I. mode of integration of regional signals.

The mode of sensory integration of differentiated perceptions of exertion from the legs and chest was determined during sub-maximal cycle ergometer exercise. 50 male subjects performed three separate cycle ergometer tests. Power output was held constant at 840 kpm/min., while pedalling rate was randomly set at 40, 60, or 80 rpm. The over-all rating of perceived exertion was significantly lower than the rating for the legs and higher than that for the chest at each pedalling rate. Local signals from the legs dominated the sensory process. Central signals were less pronounced. The mean of the ratings for the legs and chest was slightly but significantly higher than the over-all rating at each pedalling rate. Therefore, the integration process at the superordinate level of sensory processing appeared as a weighted average of the involved regional signals.


Differentiated perceptions of exertion: part II. relationship to local and central physiological responses.

Differentiated ratings of perceived exertion in the legs and chest were compared to local and central physiological adjustments during submaximal cycle ergometer exercise. 50 male subjects performed three separate cycle ergometer tests. Power output was held constant at 840 kpm/min., while pedalling rate was randomly set at 40, 60, or 80 rpm. Differentiated reports of exertion from the legs were considered to be local signals and reports from the chest to be central signals. Ratings of exertion for the legs, chest and over-all body were each significantly higher at 40 rpm than 60 or 80 rpm. Heart rate, oxygen uptake, ventilation and respiratory rate were also higher at 40 rpm. Lactic acid, pH, and pCO2 were similar between pedalling rates. Lactic acid did not operate differentially to influence local perceptual signals from the legs. Central measures of respiratory and aerobic metabolic adjustments were consistent with the more intense regional report of chest exertion at 40 rpm.


Monocular and binocular visual evoked potentials before and after cataract surgery.

Visual evoked cortical potentials (VEPs) were recorded from an individual with a mature cataract in one eye. Stimulation was both monocular and binocular and VEPs were obtained from three occipital scalp sites. Comparisons of recordings taken prior to cataract removal and after removal showed a dramatic increase in amplitude of potentials derived through stimulation of the affected eye. Slight differences in hemispheric amplitude prior to surgery suggest a greater degree of opacity in one portion of the affected lens.


Responsiveness of pre- and non-delinquents to incentive aspects of a reinforcing event.

A learning task, a six-position modification of a Fellows (1967) sequence, was used to examine the differences in responsiveness to symbolic and tangible incentives with 24 pre-delinquent and 25 non-delinquent 15-yr.-old boys. Under the low-incentive condition, only the symbolic incentive was available while under the high-incentive condition a symbolic and material reinforcer was employed. The high-incentive condition had no significant effect on the non-delinquents but did significantly affect the delinquents. Also, the high-incentive delinquent group performed similarly to both non-delinquent groups. Recommendations for research are given.


Body perception in athletes and non-athletes.

20 male athletes and 20 control subjects were required to make estimates of the length of their body dimensions and of external comparison objects. Athletes were more accurate in judging body dimensions than comparison objects while the reverse pattern was demonstrated by non-athletes. The results are discussed on the basis of the possible influence of sports activities on body perception.


Pupillary responses to pictures and descriptions of sex-stereotyped stimuli.

An attempt was made to replicate Hess and Polt's (1960) report of sex differences in pupillary responses to sex-stereotyped pictures. Some methodological refinements were used that seem desirable for future studies. College men and women were either shown or told they would be shown pictures of a semi-nude man, a semi-nude woman, a baby, and a landscape. With resting pupil size as covariate, a three-factor analysis of covariance did not show sex differences in response to visually presented stimuli. Men responded more to verbal than visual mode of presentation and more than women to verbal stimuli. Contrary to previous results, men responded as much or more than women to verbal or visual presentation of baby stimuli. The verbal or anticipatory mode seems to be at least as sensitive as the visual and eliminates problems of control of visual materials.


Hemispheric superiorities on a unilateral tactile test: relationship to cognitive dimensions.

Subjects, 30 male and 30 female, were administered a unilateral tactile test, which requires the subject to judge line orientations. More field-independent individuals in the sample perceived line orientation significantly more accurately with their left hand than with their right hand, while more field-dependent individuals showed no significant lateral difference. However, a similar pattern was observed when a verbal comprehension measure was used as a criterion. The results are discussed as they relate to the hypothesis of a link between psychological differentiation and cerebral specialization.