Molecular recognition of nucleotides by means of ionic interaction in hydrophobic media.

Adenosine phosphates, AMP, ADP and ATP were found to be recognized and extracted from aqueous to an organic phase by the newly prepared lipophilic diammonium salt, N,N'-distearyldiammonium dichloride of 1,4-diazabicyclo [2.2.2] octane 1. ADP and ATP were specifically bound by 1 under the condition of no appreciable binding of AMP. The conventional phase transfer reagent, trioctylmethylammonium chloride 2 was far less effective and lacked selectivity fort the binding of adenosine phosphates. This diammonium salt was used as a specific carrier of ADP in the passive transport through a liquid membrane. A high selectivity was observed in the transport rate of ADP relative to that of AMP.


The stereocontrolled synthesis of homo-C-nucleosides.

A facile, stereocontrolled entry to a variety of homo-C-nucleoside derivatives is outlined.


A new synthesis of purine arabinosides by a combination of chemical and enzymatic reaction.

The synthesis of hypoxanthine, 2-chlorohypoxanthine, and 2-methylhypoxanthine arabinoside by an enzymatic transarabinosylation and their chemical conversion to biologically interesting purine arabinosides are described. Some of the synthesized compounds were tested for the inhibition of DNA synthesis in cultured tumor cells.


Synthesis of seleno- and thio-guanine-Pt (II) complexes and their antitumor activity in mice.

Selenoguanine- and selenoguanosine-platinum(II) complexes were synthesized, and their atitumor activities against L1210 in mice and against in vitro tissue culture system were studied. These compounds exhibited antitumor activity of medium strength and showed very low toxicity. The effect of the SeG-Pt (II) complex in mice was retained longer than that of the parent compound SeG because the SeG-Pt (II) complex very slowly released SeG into blood.


Regioselective phenylcarbamoylation of hydroxy-groups of ribonucleosides with bis(tributyltin) oxide--phenyl isocyanate system.

Partial phenylcarbamoylation of ribonucleosides by means of bis(tributyltin) oxide--phenyl isocyanate system is described herein; the reaction was found to occur regioselectively to give the corresponding 5'-, 3'-, and 2'-O-phenylcarbamoyl derivatives due to the conditions used.


Linking of N4-aminocytosine to glutathione by use of bromopyruvate.

N4-Aminocytosine reacted with acetone and acetaldehyde to form hydrazones that were readily revertible to the parent compound. With pyruvate, in contrast, it formed a stable hydrazone. By use of bromopyruvate, N4-aminocytosine was linked to glutathione.


5-(Carboxy-hydroxymethyl)uridine, a new modified nucleoside located in the anticodon of tRNA2Gly from the posterior silk glands of Bombyx mori.

A new modified nucleoside located in the anticodon of tRNA2Gly from the posterior silk glands of Bombyx mori has been isolated and its structure determined as 5-(carboxy-hydroxymethyl)uridine mainly by analyses of its UV, 1H NMR, and FD mass spectra.


Synthesis of cationic cyclo-oligo(ethyleneadenine).

A novel cationic and cyclic oligo (ethyleneadenine) whose main chain has adenine ring was synthesized by the thermal polymerization of 9-(2-bromoethyl) adenine, in the solid phase. The chain extends through N-9 - N-1 and N-9 - N-7 of the adenine rings. Its molecular weight was determined to be 3960 by the sedimentation method. The micro-structure was confirmed mainly with NMR measurements. The cationic and cyclic oligo(ethyleneadenine) interacts with nucleotides and polynucleotides in neutral aqueous solution.


Photochemical reactions on the synthetic polymers containing thymine bases.

Photodimerizations of N-2-isobutyloxyethyl thymine (T-M), bis[2-(5-methyl-1-pyrimidinyl)ethyl]glutarate (T-T), poly-N-2-methacryloyloxethyl thymine (P-MAOT) and poly-N-2-acryloyloxyethyl thymine (P-AOT) were studied in dimethylformamide solution. Quantum efficiencies of intramolecular photodimerizations were determined to be 0.0012 for T-T, 0.0084 for P-MAOT and 0.010 for P-AOT. In the case of T-M, however, intermolecular photodimerization did not occur under the reaction condition used. Quenching studies by using isoprene suggest that the photodimerization of T-T occurs predominantly through an excited triplet state, while that of P-MAOT and P-AOT occur through both singlet and triplet states. For the effect of adding model compounds containing adenine bases on this reaction, adenine derivatives acts as an inhibitor against this reaction by quenching the excited singlet state of thymine. The photodimers of T-T, P-MAOT and P-AOT were concluded to be two syn-fused cyclobutane- type dimers (cis-syn and trans-syn).


Dinucleoside monophosphate having a high anti conformation: the crystal structure of 8,2'-S-cycloadenylyl-(3'-5')-8,2'-S-cycloadenosine hydrochloride.

The crystal and molecular structure of 8,2'-S-cycloadenylyl-(3'-5')-8,2'-S-cycloadenosine (AspAs) hydrochloride has been determined by X-ray method. The conformation of two independent AspAs molecules found in an asymmetric unit are almost identical to each other. The torsion angles concerning the sugar-phosphate backbone are different from those in crystalline dinucleoside monophosphates so far determined by X-rays. Both AspAs molecules are in the sharp bend conformations, i.e. each rotation around P-O bond (omega', omega) is (g-, t) rather than the preferred (g-, g-) or (g+, g+) conformation. There is no intramolecular base stacking or base-pairing but the intermolecular base stacking was found.


Synthesis of 6-O-cyclopyrimidine nucleosides and their physicochemical properties.

Treatment of 5-iodopyrimidine nucleosides with sodium methoxide afforded 6:2'-, 6:5'- and novel 6:3'-O-cyclopyrimidine nucleosides. The rates of cyclization and ring-opening, and the UV-, CD-, mass- and 13C-NMR spectra of the cyclonucleosides were compared with regard to their isomers.


An 15N NMR study of adenine-uracil base pair in a non-aqueous solvent.

[1,3,7,9,10-15N]-2',3',5'-Tri-O-acetyl adenosine (A) and its 8-D and 8-Br derivatives (AD and ABr) were prepared from 95% 15N enriched adenosine obtained from microbial fermentation. The chemical shifts and nuclear Overhauser effects of 15N resonances were measured as a function of the concentration of the mixed 1-cyclohexyluracil. The limiting shift of each 15N resonance was calculated and the structure of the A-U dimer was estimated. From the shifts of 15N-1 and 15N-7 signals it is determined that ABr-U dimers prefer the Watson-Crick type hydrogen bond while the Hoogsteen type pairs are predominant in the A-U dimers.


Effect of divalent metal cations upon the fluorescence and phosphorescence properties of adenosine triphosphate.

The fluorescence and phosphorescence properties of various divalent metal cations and adenosine triphosphate (ATP) dissolved in 1:1 volume by volume of ethylene glycol and water at 77 K have been studied. The present results indicate that Co2+, Ni2+ and Mn2+ quench the phosphorescence of ATP, whereas the fluorescence and the phosphorescence decays are not or only slightly affected. On the other hand, Ca2+ and Mg2+ have no remarkable effect upon the fluorescence and phosphorescence properties.


[Synoviorthesis of the knee joint with 32P-chromic phosphate (author's transl)].

32P-CrPO4 in colloid form has been used for radiosynoviorthesis. There were no acute or subacute side reactions observed. The therapy results were equal to those following 90Y colloid application: 60% very good to good results after 6 months. The substance can be kept on stock since it has a relatively long shelf-life. The cost reduction and the simplification of treatment planning have proved to be the most important advantages of 32P-CrPO4.


[Unilateral pulmonary artery aplasia with special reference to lung scintigraphy (author's transl)].

In a case of unilateral aplasia of one Arteria pulmonalis, i.e. proximal interruption, the diagnostic value of perfusion and ventilation scintigraphy is shown to be simple and non-invasive, exposing the patient to a lower radiation dose than other diagnostic screening methods. When an interruption of a main pulmonary artery is radiologically suspected the scintigraphic examination allows to distinguish between vascular and/or parenchymatous pulmonary diseases, thus clarifying the diagnosis of primary pulmonary malperfusion. The results of other examinations, the relevant literature, the pathogenesis and pathophysiology of unilateral pulmonary artery aplasia as well as therapeutical and prognostic aspects are reviewed.


[Automatic recognition of hemisphere-borderlines in cerebral radionuclide angiography (author's transl)].

The diagnostic value of brain perfusion studies with radionuclides is based upon the careful determination of intracerebral vascular supply areas in sequential scintigraphic frames. This paper describes an automatic algorithm to determine cerebral hemisphere-borderlines (Regions of Interest). In 134 randomized brain perfusion studies, regions of interest were set by three techniques: automatically by a computer program at the beginning of the venous phase, automatically by using all images derived from the total bolus passage (40 sec.), and manual marking with a light pen at the beginning of the venous phase. A good correlation of these different techniques was obtained (r = 0.87). Furthermore, we found the bilateral perfusion index independent within a wide range, from the size of the marked regions and the quality of the injected indicator bolus. Time saving and lesser carefulness, concomitant with higher precision and reliability, in addition to the standardisation of the marking technique increase the diagnostic value of cerebral radionuclide angiography.


[Determination of serum digoxin. A comparison between RIA and EIA (author's transl)].

The results of two radioimmunoassays (RIA, precipitating technique), of a homogenous (EMIT) and a heterogenous (ELISA) enzyme immunoassay (EIA) for ascertaining the amounts of digoxin showed a good correlation in precision and a reasonably satisfying correlation in the recovery. However, there was a clear discrepancy in the amounts of digoxin concentrate in the serum of patients. Only the RIA of Abbott and the EIA of Boehringer showed no significant differences. Particularly noticeable was the tendency towards lower values in the EMIT-technique as well as its liability to unspecific serum changes (lipaemia etc.), which often made the detection of digoxin impossible. The routine use of this technique appears problematic. The need for establishing one's own laboratory and test-specific therapeutical range is pointed out.


Technical parameters of in vivo red blood cell labeling with Technetium-99m.

The in vivo labeling of red blood cells (RBC) using sequential injections of stannous pyrophosphate and 99mTc-pertechnetate has resulted in excellent blood pool images since it was initiated in our laboratory in 1975. Recently certain technical parameters of the procedure have been further researched and clarified. The optimum RBC labeling has been obtained by using 1.43 mg "cold" Sn-PYP/1000 ml blood and a 30-minute lag time prior to pertechnetate injection (15-20 mCi). The binding of 99mTc to RBCs is not instantaneous, but requires several minutes for completion. The "secondary" RBC labeling effect of additional pertechnetate, added after the initial in vivo labeling, demonstrates an initial rapid fall in the labeling efficiency as a function of time followed by a more gradual decrease; the level of baseline (spontaneous) RBC labeling is achieved approximately 8 days after an initial in vivo labeling. Monitoring in vivo RBC labeling over several hours indicates that more than 90% of the initial activity was still in the vascular blood pool at 4 hours, bound to RBCs.


Airborne radioiodine contamination caused by 131I treatment.

Estimation of exposure from 131I inhaled from unsealed sources during laboratory procedures and from that exhaled by patients treated with 131I has revealed that the permissible levels have been exceeded by a factor of 2-5, although the absorbed activity was found to be between 1 and 10% of the maximum permissible absorption of 131I inhaled through the lungs. The fall in 131I concentration in the air exhaled by 19 hyperthyroid patients, to whom 131I was administered in a dose of several hundred MBq, could be expressed by a two-component equation, which reflects the changes in 131I concentration in the blood.


Testicular feminization syndrome: a report of three Ethiopian patients and a brief review.

The clinical features of 3 Ethiopian patients presenting with the complete syndrome of testicular feminization are described. All 3 were seen because of primary amenorrhoea. At laparotomy, one patient had testes located intra-abdominally, a second lodged in the inguinal canals and a third as masses in the labia majora. Also, one of these patients had bilateral inguinal herniae, a usual feature of this syndrome. Since the incidence of malignancy is high among individuals with undescended testes, they were removed in 2 patients. In the third patient, however, the testes were not removed because of delay in development of secondary sex characteristics. The literature on testicular feminization is also briefly reviewed.


The effect of gamma-aminobutyric acid on the content and metabolism of acetylcholine in the rat striatum.

Gamma-aminobutyric acid, 0.6, 0.8 and 1.6 mg/rat, ivc, increased the level of acetylcholine (ACh) in the striatum, and in doses 0.2-1.6 mg/rat ivc, accelerated synthesis of ACh. The former effect commenced 5 min. after the injection, reached its peak 15 min. and declined after 30 min. The ACh synthesis increased 15 and 30 min. after the injection and declined after 60 and 120 min. Gamma-aminobutyric acid increased the activity of choline acetyltransferase but did not affect activity of choline esterase.


The influence of SPC-703 on blood pressure in rabbits and rats and on isolated heart of guinea pigs.

New oral hypoglycemic drug, SPC-703, given in doses of 100 and 200 mg/kg iv rised the arterial pressure in the rat. In the experiments in rabbits, a dose of 100 mg/kg iv was without effect, and the dose of 200 mg/kg rised the blood pressure only temporarily. The cumulative doses of SPC-703 given on the Langendorff isolated heart of the guinea pig, significantly increased the contractile force at the dose 135 mg. The mechanism of inotropic effect of the antidiabetic drugs, derivatives of sulfonylurea is discussed.


Karyometric studies in brains of fetuses from mothers kept under conditions of low methionine supply.

Volumes of nuclei of nervous cells of cortex (C) and caudate nucleus (CN) in brains of fetuses of mothers maintained on methionine--low diet (MLD) or on standard diet (STD) for 2 months before conception and throughout pregnancy were compared acc. to Hintzsche. In both brain areas the class ranges of C and CN nuclei of nervous cells were shifted to the left in fetuses from mothers maintained on MLD and this distribution difference was highly statistically significant. This shows that the nuclei of nervous cells of fetuses of mothers maintained on MLD were retarded in growth.


Some structure-activity relationships of iodophorous iodine complex compounds. Part I. Chemistry.

Five nonionic tensides of a general formula 4-R-C6H4O(CH2CH2O)nCH2CH2OH were prepared by modifying in their structure the nature of the substituent in phenyl group and the length of the ethyleneglycol polycondensate linked with the oxygen of the phenol rest. From the tensides obtained in this way appropriate complexes of iodophorous character were prepared by treating them with iodine solution in hydroiodic acid. Using 131I it was possible to obtain complexes labelled with 131I. This in turn enabled us to determine the degree of iodine complexing in the iodophor solutions by means of a radiometric method.


Interaction of morphine and 5-hydroxytryptamine in the raphe-hippocampus system.

In order to describe the interaction of morphine and 5-hydroxytryptamine (5-HT) in the raphe-hippocampus system we tested the influence on the antinocifensive effect of topic administrations of morphine and serotonergic substances into the dorsal hippocampus and the median raphe nucleus in rats. 5-HT administered into the dorsal hippocampus increased the morphine analgesia. Lysergic acid diethylamide injected into the raphe nucleus antagonized the morphine effect. Morphine given into the raphe nucleus was highly effective, while its injection into the striatum was ineffective. The effect of the intrahippocampal morphine was antagonized by methysergide. The results indicate the important role of the serotonergic raphe-hippocampus system in the mechanism of the morphine analgesia.


[Epidemiological studies for the need of psychotherapy].

Preliminary results obtained in epidemiological studies are reported. The data obtained shows extensive need for psychotherapy, with marked differences between urban and rural communities. Considerations on the present situation in psychotherapy are given and suggestions made for changes in the present system of treatment.


[Hereditary and psychosocial causes of schizophrenia].

On the basis of the examination of patients with endogenic psychosis, indications were obtained that there are forms that mainly develop on a hereditary basis, and forms determined by psychosocial causes. In unsystematic schizophrenia the chief factors are hereditary, above all in periodic catatonia. On the other hand, there are a few indications of a hereditary genesis in systematic schizophrenia although it is just these forms that are distinguished by the severity of their course. By studying twins, cases of schizophrenia in infancy, and the circumstances of brothers and sisters, strong indications of psychosocial causes of systematic schizophrenia were found. Lack of contacts in the course of development appears to the determing factor. In motility psychosis, one of the cycloid psychoses, indications were found that excessive encouragement by other children can be a cause of overstrain and thus may be detrimental. The conclusions drawn are based on concrete findings obtained in a total of 1,114 cases and are for the most part statistically significant.


[Problems and prospects in group psychotherapy research].

The scientific basis of psychotherapeutic findings involves a number of difficulties which are above all connected with the insufficient state of basic research in this field. In this situation, significant advances can only be expected on the basis of a systematic long-term investigation and research programme. This applies in particular to the problems of personality and efficiency diagnostics and to group process research. On the basis of some intermediate results, it is shown that by the combined and systematic use of procedures a number of possibilities for the differentiated recording of the complex processes in therapeutic groups can be obtained.


Effects of inhibitors of steroid biosynthesis on prostaglandin formation in rabbit ovarian follicles.

Rabbit ovarian follicles were incubated without stimulation, with LH and with LH + an inhibitor or steroid biosynthesis. Formation of prostaglandins PGE and PGF and of progesterone and estradiol was measured in these incubates. It was found that aminoglutethimide phosphate (AGP) inhibited the LH stimulated biosynthesis of both prostaglandins and steroids. However U 30870 and Metyrapone, while completely inhibiting the LH stimulated biosynthesis of progesterone and estradiol respectively, had no effect on the formation of prostaglandins. Further, the inhibition of prostaglandin formation by AGP could not be reversed by exogenou steroids. It, therefore, appears that the effect of AGP on prostaglandin biosynthesis may not be related to its effect on steroid biosynthesis. However, the response of rabbit follicles to AGP is contrary to that reported for rat follicles and indicates different control mechanisms for prostaglandin formation in the follicles of the two species.


Perinatal hazards of chronic antenatal tocolysis with indomethacin.

Indomethacin was administered from the 20th to the 34th week of gestation to 51 women (59 fetuses) in whom bed rest and a beta-mimetic compound (ritodrine) had failed to stop preterm labor. No serious maternal side effects were observed. Of the 8 perinatal deaths, 5 were not and 3 were possibly related to the prostaglandin synthesis inhibitor. The sole case of serious neonatal morbidity is not considered to have had a causal relationship with the indomethacin treatment.


Potent constriction of cat coronary arteries by hydroperoxides of arachidonic acid and its blockade by anti-inflammatory agents.

The omega-6 and omega-9 hydroperoxides of arachidonic acid caused dose-dependent constriction of cat coronary arteries in concentrations of 10(-8) to 10(-5) M. Their potency was comparable to that of prostaglandin (PG) E2, and PGF2 alpha and 100 times greater than that of arachidonic acid. The cyclooxygenase inhibitor, meclofenamate markedly reduced constriction caused by the hydroperoxides but potentiated constriction caused by the prostaglandins. The effects of the hydroperoxides were also reduced by indomethacin and dexamethasone but were unaffected by the thromboxane synthetase inhibitor imidazole. Since the hydroperoxides are not substrates for cyclooxygenase, it is suggested that they have a direct effect on the arteries which can be antagonized by anti-inflammatory drugs.


Energetic cost of terrestrial locomotion: biped and quadruped runners compared.

Reanalysis of empirical data relating the energetic ost of running (Erun = cm3 02 g-1 km-1) to body mass (g) indicate the slopes of these regression analyses are indistinguishable when bipeds and quadrupeds are compared. The results agree with previous theoretical conclusions that the cost of transport in all runners scales on body mass (g) raised to the -1/3 power. The comparison also suggests that there is no difference between the energetic cost of maintaining a running posture for bipeds and quadrupeds and this postural cost is much less than original estimates.


[Studies of gastric circulation in the dog. III. Remaining blood flow in the dissected stomach (author's transl)].

After mobilisation of the stomach for high anastomosis between esophagus and stomach, gastric blood flow is maintained by only one gastric artery. Total and regional gastric blood flows are measured in 13 dogs using the microspheres method after ligation of three main gastric arteries. In any part of the stomach blood flow does not decline below 40% of the initial blood flow. Blood flow to mucosa of corpus and fundus is hardly reduced even after this drastic reduction of total gastric blood flow. Blood flow in the muscle layer of the fundus is reduced to about 38% if supplied only by the right gastroepiploic artery. Different operative procedures of replacements of the esophagus are discussed.


[Duodenal lesions produced by pantothenic acid deficiency in animal experiments (author's transl)].

Inflammatory lesions of the duodenal mucosa and duodenal ulcers can be produced in animal experiments by pantothenic acid deficiency. We investigated this model in 30 rats of both sexes aged 2 or 6 months and 1 year. During 3 months the experimental animals were feeded with a diet including all the known nutritional factors except pantothenic acid, while the control animals received a standard diet. Thereafter paraffin and semithin sections of the duodenum showed mucosal changes and lesions (so-called Leistenspitzenerosionen, submucosal oedemas, initial duodenitis) in about three fourths of the experimental animals.--Yet there were no ulcers.--They, however, can be demonstrated when lengthening the experimental period as shown by our investigations using male rats aged 1 year (time for producing ulcers: approximate 5 months).--The duodenal lesions are typical and regularly to be reproduced. In this context their role as a precursor to an ulcer is discussed.


Isoproterenol-induced 45ca uptake into myocardium of rats.

Myocardial lesions induced by isoproterenol (ISP) are similar to those of human "coagulative mycocytolysis" or "myofibrillar degeneration". The localization of tritiated ISP in the damaged myocardium of rats has been recently described. Since H3-ISP was noted in "grooves" along the sarcolemma of ischemic and necrotic fibers, an action on the membrane with exaggerated calcium inflow was suggested. For this reason, the quantity of 45Ca in rats treated with ISP was studied. Thirty rats were given 5 mu Ci of 45Ca. Twenty (Group B) of them were also given ISP 10 mg/kg. Animals were killed at 1 h after the injections. The hearts were sectioned transversally and autoradiography was performed. Serial sections were examined to localize the 45Ca, and its topographic distribution. In Group A (injected only with 45Ca) the myocardium showed + of 45Ca (600 dots in a field x 400) inside the fibers. In Group B (injected also with ISP) 45Ca was deposited +++ (more than 1,200 dots) and related to extensive myocytolysis. These findings confirm that the crucial point in the ISP-induced lesions is the increase of calcium inflow, and if the pathogenesis of human myocytolysis is related to catecholamine effects pharmacological measures may be adopted to prevent these myocardial lesions.


Influence of portocaval anastomosis on lipid parameters in patients with alcoholic cirrhosis.

The effect of portocaval shunt operation on lipid metabolism was investigated in 10 patients with alcoholic cirrhosis. Portocaval shunt operation resulted in a significant decrease of concentration of total serum cholesterol, total serum triglycerides, LDL cholesterol, VLDL cholesterol, VLDL triglycerides, and LCAT activity. The concentrations of free cholesterol, esterified cholesterol, phospholipids, LDL triglycerides, HDL cholesterol, and HDL triglycerides were unaffected.


[A standardized reproducible technique to induce traumatic edema in the rat paw].

A standardized reproducible technique is reported for inducing traumatic edema in the rat paw showing considerable swelling volume and low tissue damage. The edema is measured volumetrically subsequent to squashing the rat paw under standardized conditions in a wringing-machine with two wooden rollers. The technique is compared with other methods.


[The effect of methylprednisolone on the course of the experimental tourniquet-shock in dogs (author's transl)].

In experiments in dogs rubber tourniquets were tied around both hind limbs as close to the hip as possible, and a 4-h acute ischemia was induced. With the removal of the tourniquets the tourniquet-shock was produced. In a control group no therapy of the shock was carried out. The animals were observed for 6 h. In a second group, methylprednisolone 40 mg/kg BW was given immediately after revascularisation. In a third group, methylprednisolone 40 mg/kg was given prophylactically 10 min before the tourniquets were applied and therapeutically as soon as the blood circulation was opened. Hemodynamic parameters and renal function were measured to examine the pharmacological effect of methylprednisolone in acute tourniquet-shock. The mortality rate in the control group was 90%, while it was 50% by therapeutic and/or prophylactic application of methylprednisolone. The prophylactic application of methylprednisolone reduced development of metabolic acidosis, hemoconcentration, and hyperkaliemia during ischemia so that a mitigated course of shock was observed.


[Studies of gastric circulation in the dog, II. Ligation of main arteries (author's transl)].

Following ligation of a single gastric artery total and regional gastric blood flows are measured using radioactive microspheres of 8 mu size. There is no significant influence on total gastric blood flow. Within the depending anatomical region no significant reduction of total wall blood flow can be determined. However, blood flow to the antrum mucosa is reduced to approximately 40% after ligation of any gastric artery. Thus, it can be concluded that ligation or embolisation of a single gastric artery in diffuse gastric bleeding does not necessarily reduce or terminate the bleeding.


Prevalence of HBsAg and HBsAg sub-types in the Canadian blood-donor population.

After 8 years of screening all blood donations in Canada for HBsAg, first by CIEP and later by RIA, the prevalence of HBsAg in the regular panel of "repeat" donors has been reduced from 267/10(5) to 39/10(5). Marked geographic variations exist, but the available data do not indicate whether the high prevalence of HBsAg in young adults, particularly males, may be a factor. The ad : ay subtype ratio across Canada is 2.0, but noticeable geographic differences are present, varying from 3.5 in Quebec to 0.5 in the Atlantic Provinces.


Immune hemolytic anemia associated with anti-Kell and a carrier state for chronic granulomatous disease.

A patient presented with immune hemolytic anemia associated with a strongly positive direct antiglobulin test (IgG and complement). Anti-K was eluted from the patient's red cells, which were shown to be K negative. A powerful complement-binding anti-K was present in the serum together with another antibody(ies) showing characteristics resembling anti-Bg. Leukocyte antibodies were also present in the patient's serum. The anti-K could be adsorbed and eluted from K negative red cells in vitro. It is suggested that either non-specific adsorption of the anti-K may have occurred due to the Matuhasi-Ogata phenomenon; or, the antibody was an auto "minicking anti-K" capable of reacting with a broader specificity within the Kell system. A serendipitous finding was that the patient was a carrier for chronic granulomatous disease. The associations of immune hemolytic anemia, chronic granulomatous disease, and the Kell system are discussed.


Induction of Tk polyagglutination by Bacteroides fragilis culture supernatants. Associated modifications of A B H and I i antigens.

Tk transformed red blood cells were obtained in vitro by treatment with supernatants from cultures of three different Bacteroides fragilis strains. The reactions of these cells with AB sera show that Tk is different from other known types of polyagglutination. Beside the already known modifications of A B H antigens, we found that Tk activated cells have an important modification of I and i antigens: both are reduced, and can even be completely destroyed.


P phenotype observed in two generations of Tunisian family with a high rate of inbreeding.

A p phenotype was discovered in a Tunisian woman and in three of her seven children. This paradoxical result challenges the known hypotheses on this phenotype, which generally recognise that it is determined by the existence of a very rare allele in a double dose. The computation of the coefficient of inbreeding of these subjects showed that repeated intermarriages increased the coefficient of kinship of the propositus and her husband to 0.116 (if unknown women of the ancestry were assumed to be different for each child) through 0,1362 (if unknown women of the ancestry were assumed to be the same for sibs). Therefore inbreeding was proved to be so high as to induce the presence of a recessively defined phenotype in two successive generations. Moreover, the search for probability of origin of genes of the last generation showed that the BCH ancestor was probably the carrier of the p allele.


[Fractures of the facial skeleton].

The radiologist is in the unique position of reviewing the management of facial fractures when interpreting the post reduction films. Many of these patients have other more life threatening injuries so that their facial fractures may have been neglected or treated by individuals unfamiliar with the problem of facial injury. Immobilization following reduction is the key to satisfactory healing. The bony calvarium is the pivotal point and all free fragments should be immobilized to the frontal zygomatic area. Mandibular fractures should be immobilized to the upper alveolar ridge. If the upper alveolar ridge is also a free fragment due to a LeFort type fracture the entire complex of mandible and midface after being wired together should be wired to the stable bony calvarium. Midface fractures (LeFort type fractures) require the same type of treatment as one would apply to a forearm fracture; i.e., the joints proximal and distal must be immobilized. In the midface fracture the mandible is immobilized through the teeth to the upper alveolar ridge and the entire complex to the bony calvarium. The more specific problems associated with individual factors require high quality radiographic techniques for diagnosis and management.


Ultrasonic imaging of the amniotic and chorionic cavities.

This paper presents two cases illustrating separate chorionic and amniotic sacs at 5 to 6 weeks of estimated gestational age. With higher resolution scanning units and higher-frequency transducers, the delineation of the amniotic membrane can be seen before it fuses with the chorionic membrane; this should not be interpretated as an abnormality.


Improved visceral catheterization with reinforced wall Shepherd Crook catheters.

Reinforced polyethylene or polyurethane catheters in the shape of a "Shepherd Crook" have led to improve selective and superselective catheterization of visceral arteries. The technics and potential pitfalls are described.


Report of a case: ultra acute radiation hepatitis.

A case of a patient with neuroblastoma who developed acute radiation hepatitis 3 days after completing 1200 rads ("ultra-acute") is reported. The patient was cured and remains tumor-free 6 years after treatment.


Two unusual causes of ureteric indentation.

Causes for ureteral indentation are legion and mostly well documented. Two unusual cases which are believed to be undocumented are described. One was produced by an inferior vena cava clip and the other by a vaginal tampon. Neither produced significant ureteric obstruction but both resulted in a diagnostic conundrum.


Pulmonary metastases 15 years after removal of an alveolar soft-part sarcoma of the tongue.

Alveolar soft-part sarcoma is a distinct entity. The clinical course is protracted with survival up to 20 years, although the patients eventually succumb to their disease with distant metastases. Because of frequent local recurrences radical surgery is treatment of choice. A case of a 19 year old asymptomatic man with pulmonary metastases discovered 15 years after removal of a primary tumor from the tongue is reported and clinical, radiographic and therapeutic aspects of the disease are discussed.


Galactography.

Galactography is a quick effective means of evaluating nipple discharge. It is especially indicated when the effluent is bloody. A description of the procedure is discussed. The radiographic findings in both normal and abnormal studies are presented. Abnormal findings include filling defects, duct cut-off, duct encasement, extravasation, and duct ectasia. The radiographic diagnosis corresponded with pathologic findings in 12 of 16 cases (75%), although in two cases no radiographic or pathologic abnormality was found to explain the bloody discharge.


[Toxoplasmosis. Clinical, radiological and pathological aspects. Report of 44 cases].

Forty four cases of toxoplasmosis seen in a 20 years span are reviewed. The largest number of cases corresponded to the neonatal group. The most important clinical findings usually involve the central nervous system, reticulum endothelium, skin and eyes. The disease is compared to an equivalent group of congenital lues (Torch complex). Clinical and radiological criteria for the differentiation are established. The most important finding is the presence of intracraneal calcifications. The different patterns and distribution are discussed. The radiologist plays an important role in the diagnosis of this condition, particularly, in the neonatal group of patients where the incidence of intravenous calcification appears to be higher.


[Isodose curves for the tangential application to the breast].

The auxiliary collimating device furnished by Atomic Energy of Canada Ltd is constituted of a metalic base with a acrilic plate at the end and is fixed at the trimmer. This device is generally used in the irradiation of the breast in order to minimize the dose to the lung. Since only one isodose curve was furnished, the construction of others field sizes became necessary. Two systems of measurements were used. Isodose curves were obtained by decrement lines and scanning semi-conductor detector techniques. The problem associated to the measurements are also discussed.


Premature closure of the foramen ovale as a cause of intrauterine fetal ascites.

Fluid collections are readily evaluated by ultrasound. Intrauterine fetal ascites is a rare abnormality particularly suited to evaluation by ultrasound. Premature closure in utero of the foramen ovale is an unusual cause of fetal ascites. This report illustrates and discusses premature foramen ovale closure causing intrauterine fetal ascites.


Rupture of a non-rheumatoid popliteal cyst: a syndrome mimicking thrombophlebitis.

Rupture of a popliteal cyst and dissection of its contents into the calf may produce pain, swelling, a positive Homan's sign and other findings closely resembling thrombophlebitis of the calf. The correct diagnosis is not often made, and the patient is subjected to needless long term anticoagulant therapy with its potential complications. To avoid this, it is essential that this possibility be kept in mind in all patients in whom the diagnosis of thrombophlebitis is considered. The history of preexisting arthritis of the knee, joint effusion and popliteal cyst are strongly suggestive of a ruptured popliteal cyst. This diagnosis can be verified by arthrography, ultrasonography, computed tomography and radionuclide scanning. Arthrography is preferred because it reveals superior anatomic detail thereby making differentiation between an encapsulated calf cyst, with smooth walls, and rupture, with irregular feathery margins, possible. Three illustrative cases are presented and the literature is reviewed.


Dynamic scintigraphy in renal arteriovenous fistula.

Radiographic contrast aortography and radionuclide dynamic scintigraphy were used to diagnose a congenital renal arteriovenous fistula in a 33 year old woman who presented with hypertension, cardiac decompensation and abdominal bruit. Since dynamic scintigraphy is a noninvasive, nontraumatic, low risk and easily repeatable procedure, it is invaluable for the diagnosis of the fistula and for monitoring patients who are managed without surgery.


The differential diagnosis of supratentorial enhancing lesions on computed tomography.

One hundred and fifty-one surgical, autopsy or clinically confirmed supratentorial lesions evaluated by Computed Tomography at Mount Sinai Medical Center were reviewed to determine if their etiology could be predicted by their pattern of enhancement after the intravenous bolus injection of an iodine containing contrast agent. Meningiomas, gliomas, metastases, primary lymphomas, cerebral infarcts, intracerebral hematomas, arteriovenous malformations, aneurysms and abscesses were evaluated. The different patterns of enhancement were defined as homogeneous, ring-like, vermiform and mixed. The differential diagnosis of each pattern of enhancement is presented. In addition, the different etiologies are also discussed as to the relative distribution of their patterns of enhancement, i.e.: homogeneous, ring, vermiform or mixed.


Current trends on diagnostic work up of pulmonary thromboembolism.

This report describes a six month prospective double blind study of 30 consecutive patients who were evaluated at Jackson Memorial Medical Center for pulmonary emboli. In this series, 77 per cent of the patients with lung scans interpreted as high probability for pulmonary emboli had angiographic confirmation of emboli. In 90 per cent of the patients with lung scans interpreted as low probability for pulmonary emboli, angiography confirmed the absence of pulmonary emboli. Five patients had radionuclide scans that were interpreted as nondiagnostic. Although pulmonary arteriography remains the gold standard for the diagnosis of pulmonary emboli we feel it should not be used in the low probability category because of the accuracy of the ventilation perfusion scans. It should be used in the indeterminant group and in the high probability category when anticoagulation therapy is contraindicated; prior to embolectomy or Mobin-Uddin umbrella insertion.


Radiographic manifestations of gastrointestinal tuberculosis.

Barium studies of a gastrointestinal tract and chest radiographs of 109 patients with gastrointestinal tuberculosis were investigated. The type and site of the tuberculous lesions in the bowel, as well as its association with pulmonary tuberculosis and surgical complications, were reviewed. The ileocecal region is the portion of the gastrointestinal tract most frequently involved. The ulcerohypertrophic type of tuberculous lesion was the most common. Thirty-two percent of the patients had a normal chest radiograph. Nineteen patients had a significant surgical complication. Fistulous tracts and intestinal perforation are rare. The radiographic differential diagnosis with regional enteritis and other forms of inflammatory bowel disease is discussed.


Hazards of straight catheter aortography in the tortuous abdominal aorta.

Twenty abdominal aortograms utilizing a straight-tipped catheter were evaluated for catheter tip motion during the injection of contrast media. The catheter tips were stable in 15 patients but showed downward recoil in the remaining 5 patients. These 5 patients had marked tortuosity of their abdominal aortae which was felt to be the etiology of the catheter tip instability. Based on this finding, the use of a straight-tipped catheter is to be discouraged in patients with extreme tortuosity of the abdominal aorta.


Secondary achalasia in esophagogastric carcinoma:re-emphasis of a difficult differential problem.

Six cases of esophagogastric junction carcinoma are reviewed, with emphasis placed on differential diagnosis between achalasia and carcinoma. All six had abnormal motility with aperistalsis being the most common finding. Three patients demonstrated tapering of the distal esophagus simulating achalasia. Patients over 40 with recent onset of esophageal symptoms and radiographic signs suggesting achalasia should be suspected of harboring carcinoma.


Malignant polypoid lesions of the esophagus: review and case reports.

Polypoid lesions of the esophagus occur infrequently and may be benign or malignant. Polypoid pedunculated malignancy of the esophagus is still a rare lesion. We report three additional cases in this paper, two associated with tumor-related hypercalcemia, and review the recent literature on malignant polypoid lesions of the esophagus.


[Segmental portal hypertension caused by volvulus of the spleen].

Volvulus of the spleen is a complication of a previous congenital anomaly consisting basically in the absence of supporting structures of the spleen. Clinically, it is an extremely rare complication. It may present as an acute abdomen. The search of the literature that we conducted does not show any such case being the cause of portal hypertension. This motivated this case report. The patient was treated surgically and this cured the patient.


[Modern urography].

An IVP optimum quality should be tailored to the particular needs of a given case and consequently most be supervised by the radiologist when it is being performed. The most meticulous technique is needed, the adequate amount of contrast medium should be used, compression of the ureters should be performed and under optimum conditions tomography during the nephrographic phase should be performed whenever the circumstances should require it. With only very few exceptions no significant differences between different contrast media exist. The use of medium speed high contrast x-ray films as well as the use of rare earth intensifiers screens avoid the need for extremely powerful generators that are very costly. Film processing is a critical step in obtaining a good study and should be automatic.


An analysis of the dosimetry for mantle field therapy using 4 MV X-rays and its routine application.

There are several different methods in vogue at present in determining patient midplane doses in the "mantle" treatment for Hodgkin's disease and malignant lymphomas. A method of determining midplane doses in individual cases using thermoluminescent dosimetry is presented. It shows excellent agreement with the midplane doses measured in an Alderson-Rando phantom treated as a hypothetical "mantle" patient.


Pseudo-obstruction of the colon.

Pseudo-obstruction of the colon is a rare form of diffused or segmental dilatation of the colon nonassociated with an obstructive lesion. It usually accompanies or follows other major illnesses in elderly patients. The abdominal radiographs are very helpful in differentiating this form of ileus from a chronic mechanical obstruction of the colon and in evaluating its complications. The abdominal radiographs of 14 patients with pseudo-obstruction of the colon were reviewed, and the radiographic findings associated with this condition were evaluated.


Submucosal tumors of the stomach and duodenum.

We present several cases from our teaching file of submucosal lesions of the stomach and duodenum with emphasis upon the differential diagnosis between the extramural, intramural submucosal, and mucosal location. Difficulty is sometimes found with intraluminal masses. Differential diagnosis has been presented with possible hints to narrow the differential diagnosis for an intramural submucosal mass.


Duodenal pseudolesions: the key hole sign.

Pseudolesions in the duodenal bulb are produced by barium surrounding and entrapped in contiguous parallel duodenal folds. A typical defect with a "key hole" sign identifies the majority of these pseudolesions allowing for the radiological exclusion of true polypoid masses in the duodenal cap. The filling defects disappear with peristalsis or with distention of the duodenal bulb with air.


Carcinosarcoma of the esophagus: report of two cases.

Carcinosarcomas are malignant tumors containing both epidermal and mesodermal components. They are rare in the esophagus, but when present frequently have a characteristic radiographic appearance presenting as a bulky, intraluminal, polypoid filling defect. Although capable of metastatic spread, their usual indolent nature offers a relatively favorable prognosis.


Circumscribed eosinophilic gastroenteritis.

A case of eosinophilic gastroenteritis with peripheral blood eosinophilia and typical histology is described. The location, radiographic appearance, and gross pathologic appearance of the lesion were unique in that they resembled eosinophilic granuloma of the stomach. Also unique was the fact that the distal esophagus as well as the stomach was involved. This case demonstrates that eosinophilic gastroenteritis may involve any portion of the gastrointestinal tract and that the radiologic distinction between eosinophilic gastroenteritis and eosinophilic granuloma may not be as clear cut as previously thought.


[Localization of aphasic symptoms: preliminary observations with C.T. scanner (author's transl)].

Twenty patients with aphasia and left-hemisphere damage were examined with a standard language battery, and Computerized Axial Tomography. Patients were divided into fluent (N = 9) and nonfluent (N = 6) on the basis of the language examination; 5 patients who could not be classified in either category were excluded. Lesions were retrorolandic in 8 out of 9 fluent aphasics while extending anteriorly in all 6 nonfluent aphasics. Some unexpected lesions were also found. Five cases -- 3 fluent and 2 nonfluent -- are discussed in detail.


[Some problems of psychiatric care unit in a general hospital I: Concerning decision of admission to hospital (author's transl)].

Over a thousand patients a year request hospitalization at the Psychiatric Admission Unit of the Region General Hospital of Santa Maria Nuova in Florence. About five hundred are actually hospitalized, less than half. Decision to hospitalize depends on several factors: a) factors relating to the patient (the psychopathological picture, the severity of his condition, his family background etc.); b) factors relating to the doctor on duty (degree of experience, attitude toward the patients, theoretical view toward hospitalization etc.); c) practical and administrative factors (service situation, day of the week, time of the day etc.). On the other hand the doctor's attitude may be that of undertaking care of the patient's psychiatric needs or not. This behaviour is largely independent from the decision to hospitaliz or not. Hospitalization does not necessarily mean taking care of the patient from a psychiatric point of view (hospital seen as a parking place, for example) and, vice versa, treatment can be planned without hospitalizing the patient who asks for it. Thus, there are four possibilities in a Psychiatric Admission Unit: a) hospitalization and care of the patient; b) no hospitalization but care of the patient; c) hospitalization without care of the patient; d) no hospitalization and no care of the patient. These four situations discussed with appropriate examples. The emotional attitude of the psychiatrist in his relationship with the patients who request admission is viewed as the most important factor for a correct decision.


[Idiopathic unilateral calcification of basal nuclei (author's transl)].

A case of idiopathic unilateral (left) idiopatic basal ganglia calcification with associated extrapiramidal controlateral symptoms is described. The patient, a 20 years old man, showed since childhood a progressive motor impairment of his right limbs more obvious in his arms. Neurological examination showed hypertonia, distonia, motor and other extrapiramidal impairments of his right limbs. Skull X Ray and CT scan revealed left basal ganglia calcification. Laboratory investigations excluded all the common diseases with basal ganglia calcifications: tumors, tiroid and paratiroid disorders, parassites, vascular, inflammatory or degenerative diseases. Psycodiagnostic tests did not reveal relevant abnormalities. We cannot say with certainty that this is a sporadic case as we were unable to examine the whole family. Slight improvement of symptoms was obtained using orfenadrine and diazepam.


On the dual action of ascorbate and erythorbate on rat liver lysosomes.

Low concentration (0.1--1 mM) of ascorbate and erythorbate (isoascorbate) caused lipid peroxidation and lysosome labilization ("cofactor" action). In addition, they acted additively on microsomal NADPH oxidase-induced lipid peroxidation at the low concentration. The "cofactor" action, however, was dependent reciprocally on the density of lysosomes; the more dilute was the lysosomal fraction, the more susceptible the lysosomes were. On the other hand, ascorbate and erythorbate at concentration more than 1 mM inhibited microsomal NADPH oxidase-induced lipid peroxidation and lysosome labilization. Their antioxidant effect was revealed to be clear especially when the "cofactor" action was eliminated by such a basic protein as protamine. Considering that the "cofactor" action was observed only at the lower density of lysosomes and might be inhibited by physiologically occurring basic proteins, ascorbate and erythorbate may mostly act as antioxidant on lysosomes in vivo. Ascorbate- or erythorbate- induced lysosome labilization was certified to be mediated by lipid peroxidation.


A study on acid glycosaminoglycans in pleural diseases.

1. Pleural fluid contained protein-bound hyaluronic acid, protein-bound chondroitin sulfate, hyaluronic acid, chondroitin sulfate, undersulfated chondroitin sulfate and dermatan sulfate. The composition of acid glycosaminoglycans in pleural fluid seems to reflect the rate of biosynthesis and degradation of these polysaccharides at some sites which are closely related to the pleural cavity. 2. A possibility was suggested that hyaluronic acid was synthesized in pleural tissue and was excreted shortly thereafter into the surroundings, as evidenced by experiments with rabbit pleural tissue. 3. In human, hyaluronic acid, chondroitin sulfate, dermatan sulfate and heparan sulfate were found in thickened pleurae caused by lung cancer, in those caused by asbestosis and also in tumor tissues of pleural mesothelioma. The molecular size of hyaluronic acid from pleural mesothelioma was found to be larger than that from human unbilical cord. 4. Quantification and histochemical study of acid glycosaminoglycans demonstrated that the quantity of hyaluronic acid in tissue specimens of mesothelioma by far exceeded that in non-mesothelioma cases (statistically significant). 5. Thus a possibility was suggested that histochemical investigation together with microquantitation of hyaluronic acid in pleural tissue may prove to be an efficient means of differential diagnosis of pleural mesothelioma. 6. Definite conclusion on the relationship between the fluctuation with time in quantity of acid glycosaminoglycans of the effusions and etiology of pleurisy awaits further investigations.


[Influence of a tributyltin oxide oily aerosol on the exploratory behaviour toward the mouse (author's transl)].

Inhalation of an oily aerosol of bis (tributyltin oxide) (TBTO) after single or repeated expositions (1 hour) disturb the exploratory behaviour in the mouse. Weak concentrations (42 and 84 ppm) stimulate exploratory activity while large doses (170 and 340 ppm) significantly decrease it. Modification in brain amine levels may appear but the observed perturbance seems to be more dependent from oily vehicule than TBTO itself.


[Bromide encephalopathies (author's transl)].

Bromide encephalopathies are frequently reported in Northern America and Great Britain. There is no characteristic clinical pattern, the neurological symptoms are multiple, this is readily explained by the diffusion of bromide ions to all regions in the central nervous system. An accurate history (bromide intake, followed by the slow onset of digestive and neuropsychiatric symptoms) as well as an apparent hyperchloremia are of the greatest aid in suggesting the diagnosis. The incidence of this type of intoxication is greater in women over 50. The association of a salt free diet to bromide therapy favors the onset of clinical symptoms because of the competition between bromide and chloride at the choroid plexus and at the renal tubule.


[Photoprotection by psoralen-UVA therapy: experimental and clinical results (author's transl)].

Studies on minimum erythema doses, histological investigations and quantitative determination of DNA repair synthesis of epidermal cells revealed that a tan induced by the oral administration of 8-methoxy-psoralen (8-MOP) and subsequent UVA irradiation gives protection from the erythemogenic effects of sunlight, diminishes UVA-induced cellular injury in the epidermis and, possibly, also shields DNA from incident UV radiation. In a study of 14 patients with severe polymorphous light dermatosis the 8-MOP-UVA induced tan proved to be a clinically effective sunscreen. The uncontrolled use of this method for UV protection of normal individual is, however, not recommended.


The first night effect revisited with age as a variable.

The EEG records of 15 younger females and 40 older females were analyzed in an effort to reevaluate the effects of the first night of laboratory sleep, and to determine to what extent age may be a variable in the First Night Effect. These records substantiate earlier findings that sleep latency is longer, there is more wakefulness, and the REM cycle is disrupted on the first night of laboratory sleep. In addition, there is some evidence that older subjects show a greater First Night Effect. These effects adapt out by the second night of sleep.


[Intolerance to acetylsalicylacid and food additives in patients suffering from recurrent urticaria (author's transl)].

Ninety patients suffering from recurrent urticaria were orally exposed to 500 mg acetyl salicylic acid (ASA). 36.6% proved to be ASA intolerant in this group. 26 ASA-positive and 18 ASA-negative probands were selected to take part in an additional provocation test with 8 different food additives (preservative and colouring matters). Altogether 31 tests sheets were exaluated. Urticarial reactions were seen after administration of p-hydroxybenzoic acid methylester (5), p-hydroxybenzoic acid propylester (6), benzoic acid (9), sodium benzoate (6), tartrazine (6). Ponceau rouge (5) and indigo carmine (3). Detailed research was carried out on the occurrence of the tested substances. With a diet avoiding salicylates, benzoates and colouring matter 20% of these patients recovered spontaneously and became symptom-free, whilst a further 55% of cases showed marked improvement.


An automatic spindle analysis and detection system based on the evaluation of human ratings of the spindle quality.

An evaluation of the spindle quality ranked by experienced human raters is described. The pattern discriminating criteria obtained from this evaluation are used for an automatic system based on the complex demodulation method. The performance of this automatic system is compared with both the human visual scoring and with a second automatic system employing phaselocked loop techniques. The performance of the complex demodulation is satisfactory. It also detects spindles buried in slow waves. It is not sensitive to the age of the subject. This method opens possibilities for research of either temporal or chemical (drugs etc.) effects on the characteristics of rhythmic activity, without being hampered by the arbitrary EEG jargon "alpha" or "sigma".


[Treatment of common warts with topically applied DNCB (author's transl)].

Twenty-one patients suffering from multiple common warts were treated by topically-applied dinitrochlorobenzene (DNCB). After an average treatment period of 8.7 weeks, the warts had completely disappeared in twelve patients. Therapeutic failure must be admitted in five patients, whereby, sensitization to DNCB was not possible in two of these cases. Four patients did not complete the therapeutic regimen. Indications, advantages, disadvantages and side effects of this therapeutic method are discussed and an attempt is made to explain the underlying mechanism of this form of treatment.


[Lupus erythematosus panniculitis (author's transl)].

Lupus erythematosus panniculitis is a rare clinical variant of lupus erythematosus. In this report we described a 38 year-old female patient who had suffered from chronic discoid lupus erythematosus for several years before developing widespread inflammatory, sclerotic and ulcerative lesions, which were first diagnosed as Weber-Christian panniculitis. It was only when the patient developed other signs and symptoms of systemic lupus erythematosus that the subcutaneous lesions were recognized as lupus panniculitis. A combined regimen of tetracyclines and chloroquine resulted in a remission, both with regard to regression of the lesions and suppression of the serological parameters of disease activity. The findings in this particular patient and similar reports in the literature form the basis for a discussion of the entity of lupus panniculitis.


[Unusual variants of blue naevi--a report of four cases (author's transl)].

This paper presents four unusual variants of blue naevus: a giant-sized blue naevus, a blue naevus assuming the clinical and histological appearance of a histiocytoma, a plaque-type blue naevus, and a pedunculated cellular blue naevus. Two of these lesions were studied at the ultrastructural level: in one case the dermal melanocytes contained malanosomes of all stages, thus documenting active melanin synthesis. In the other lesion, melanocytes of identical appearance were found in the superficial portions, whereas inactive melanocytes, densely packed with mature melanosomes, predominated in the deeper portions. It is concluded that blue naevi may vary considerably, both clinically and in histological appearance, as well as in regard to melanin synthesis activity.


Sleep of depressed patients with hypersomnia: a 24-h polygraphic study.

Sleep of 6 depressed patients with hypersomnia was studied during their depressed phase and their remitted phase using 24-h polygraphic recording. Nine normal subjects were studied as the controls. The latency to sleep onset of the depressed patients was significantly shorter than that of the remitted patients and that of the control subjects. The total sleep time of the depressed patients was significantly longer than that of the remitted patients as well as that of the controls. This increase in sleep time of the depressed patients was mainly due to the increased sleep in day time. The intervals between sleep onset and start of each sleep stage, the relative percentage of individual sleep stages, REM latency and REM density of the depressed patients were not significantly different from those of the remitted patients.


Hypersomnia with sudden sleep attacks ("symptomatic narcolepsy") on the basis of vertebrobasilar artery insufficiency. A case report.

Report of a 56-year-old patient with a one-year-history of uncontrolable sleep attacks occurring at daytime and episodes of unsteadiness, dizziness, diplopia and dysarthria. The clinical evaluation revealed evidence of vertebrobasilar artery enlargement and insufficiency. He has become symptom-free under appropriate treatment. This raises the question of "symptomatic narcolepsy" caused by vascular brain stem disorder.


[Acute febrile neurophilic dermatosis (Sweet's syndrome)--report of two cases (author's transl)].

Acute, febrile, neutrophilic dermatosis (Sweeet's syndrome) is an uncommon, distinct disease of unknown origin. It is characterized by typical skin lesions and systemic symptoms such as fever and leucocytosis. Ultrastructural data suggest a primary vascular process as the initial pathogenic mechanism. In this paper two patients are described and the clinical variability, incidence and pathogenesis of this syndrome are discussed.


[Epidemiology of breast cancer in Austria (author's transl)].

In cooperation with the Austrian National Institute for Statistics the incidence-rates of breast cancer in Austria in the period of 1971-1975 were investigated. The incidence-rate of breast cancer (50 new cases/year/100,000 women) is higher than the incidence-rate of cervical or endometrium carcinoma. The increasing risk of the higher age-groups, which is especially expressed by the incidence-rate of 145 in the age-group of 70 or more years, is pointed out. This findings are of great consequence to the system of preventive medical care. In urban areas the incidence of breast cancer seems to be higher than in rural district.


Salt tolerance of Rhizobium species in broth cultures.

Salt tolerance of five rhizobia strains was examined in broth cultures. Five levels of NaCl concentration were used and the optical density was taken as a measure for the vigour of bacterial growth. Rhizobium leguminosarum and R. meliloti were tolerant to high levels of salinity and growth curves in saline broth showed a similar pattern to the control level. Rhizobium japonicum, cowpea Rhizobium, and R. trifolii were intolerant to salt and showed a strong growth retardation with increasing salt concentration. Growth was inhibited at high levels of salinity. It is suggested that rhizobia sensitivity to salts may be partly responsible to the inhibition of nitrogen fixation by legumes growing under salt stress.


[Steroid-transforming enzymes from microorganisms. XII. Induction characteristics of the 4-en-3-oxosteroid: (acceptor)-1-en-oxidoreductase in Nocardia opaca].

17 alpha-Methyltestosterone and the corresponding 1(2)-dehydrocompound (Dianabol) are efficient inducers of the 4-en-3-oxosteroid: (acceptor)-1-en-oxidoreductase from Nocardia opaca. After a lag period of 4 hours the enzyme activity increases rapidly. During the induction the steroids are completely metabolized causing a drastical drop of specific enzyme activity. Using a fixed induction time the optimal steroid concentration and the temperature characteristic were found out. The influence of the concentration of the steroid water suspension on the induction effect is discussed to be dependent on the velocity of the dissolving of the steroid particles. Chloramphenicol and streptomycin are powerful inhibitors of the induction process.


How do elder people live in the GDR?

The improvement of housing conditions for all citizens including the elder population is the gist of the socio-political programme of the Party of the Working Class, the Council of Ministers and the Confederation of Free German Trade Unions (FDGB). Their activities establish the necessity of starting from the differentiated needs of the population in realizing the complex housing programme. The main substance of geriatrics and gerohygiene makes it imperative to preferably care for those citizens who are in the greatest want of a satisfactory solution of the housing problem. The preferred persons are among others: from the pensioners' 6-8% persons needing care, 10-15% persons who should live in small flats being adequate to elder people, and 6% persons accomplishing the evening of life in apartment houses. The remaining groups should live in their hitherto existing rooms. But this requires services rendered such as neighbourhood assistance, informative advice, medical, social and cultural attendance. The basic principles of a solution of the housing problem until the year 2,000 are as follows. Realization of the fundamental requirements of elder people respecting health, safety, shelter as well as full integration, participation and appreciation of the forming of life of the individual on behalf of the society.


Toe temperature change: a measure of sleep onset?

In an attempt to provide a more "physiological" measure of sleep onset, temperature of the great toe was monitored for 166 sleeper-nights in both insomniac and control groups. All subjects were women between 21 and 45 years of age. Earlier published reports had suggested that toe temperature elevation was the result of lowered sympathetic tone and marked a "vegetative preparedness for sleep." More recently, elevation of the toe temperature has been used to denote a level of chemical anesthesia sufficient for major surgery. In this study, however, the mean latency of the time course of the temperature elevation of the toe was uncorrelated with sleep onset determined by EEG criteria. Temperature elevations were frequently of large magnitude but were not uniformly observed across all subjects and all nights. It is suggested that the toe temperature elevation is reflective of metabolic adjustments which coincide with the onset of the night's first period of slow wave sleep.


Psychohygiene and sanitary education for elder people.

Psychohygiene and sanitary education must help to be incorporated in the complex attendance to elder people as immanent ingredients. A healthy style of living involves salubrious behaviour and facilitates the health promoting shaping of living conditions. The psychic health and the psychic efficiency are accessible to a sphere of influence in the same way as the physical efficiency assumptions. Psychic training covers both thinking, speaking and deciding as well as adaptation, change-over and creative activity. Psychic health in old age is principally possible and can be supported by psychohygienic measures.


Criteria for the dispensary care of elder workers.

The dispensary attendance of old people in the production process is deduced as the means and necessities of a purposive medical, social and cultural care. The dispensary attendance is the highest step of the socialist health protection and reflects its prophylactic fundamental trend. It was the object of our activities to specify the criteria of the dispensary attendance to elder workers, which we designate as gerodispensary attendance in order to furnish the pre-conditions that both effort and efficiency can be adequately proportioned for the benefit of elder workers.


[Partnership and sexuality in the latter half of life. The partnership situation and sexual behavior of the working woman in the change of life].

The problem of partnership and sexuality is of great importance also in the second half of life. It is necessary for the consultation centres on marriage and sexuality to take these facts into account, both with respect to organisation and content.


[The problem of leisure in old age (author's transl)].

In his leisure time man is ridden from social requirements. The leisure time has in the single periods of life different problems and figurations. It is a part of life-span and is formed by the individuality and by the society. Labour and leisure time are not in contrast to each other, they involve one another. Our study of leisure time of older people (n = 245) let notice that 7% live more or less isolated, 64% are middling or much engaged by homework, and 30% take always care of relatives. The chance of a subjective contentment in life in all the more since the own activity is more extensive. It contains the orientation about the future with desires and plans.


[Current problems of the control of neoplasms in later life (author's transl)].

The author gives a survey of current problems regarding the control of neoplasms in patients of advanced age. He deals especially with cancer of the lung, stomach, large bowel, breast and cervix uteri.


[Recording the case history from the geriatric point of view (author's transl)].

Emphasizing the significance of the case history for medical care, the authors discuss major points to be taken into account when interviewing elderly patients. They describe in detail both the emotional situation in later life and particularities regarding symptoms and the course of diseases in advanced age.


[Investigation of the excretory function of the pancreas in later life by means of secretin and pancreozymin (author's transl)].

The investigation of the excretory function of the pancreas in subjects of various age groups has shown that digestive activity can be assessed only by means of secretin and pancreozymin. Stimulation with secretin (dose: 2 international units per kilogram of body weight of the subject) done twice within 60 minutes or a twofold combined secretin-pancreozymin test yield the most reliable data on the excretory functional capacity of the pancreas and its secretory reserve in elderly people. The data from subjects of various age groups--young, old and very old--can be used as a guideline for setting up standards for various age groups. They are also important for functional diagnosis and for differentiating between age-dependent functional changes and pathological conditions of the pancreas.


[Postoperative intestinal absorption in old age (author's transl)].

The function of intestinal absorption was analysed in elderly patients before and after cholecystectomy by the help of the modified D-xylose-absorption test. A characteristic dependence upon the age for the process of intestinal absorption was demonstrated in the elderly not only preoperatively but also postoperatively. The effective intestinal absorption of D-xylose normalized postoperative by in freshly operated older patients more slowly than in younger ones.


[Intra-articular surgery in the treatment of chronic articular rheumatism (author's transl)].

On the strength of his own case material, the author presents a phased programme for intra-articular surgery (synoviorthesis with corticosteroids and radionucleids, synovectomy) for the treatment of the chronic articular rheumatism.


[Fat consumption, blood lipids and age (author's transl)].

The serum lipid values (total lipids, cholesterol) and the amounts of fat components (total fat, cholesterol, saturated and multiply unsaturated fatty acids) in food were determined for 1000 subjects of primary obesity and 200 subjects having normal weight. The age of the subjects included in this study was between 18 and 60. From the second to sixth decades of life, obese subjects showed increases in hypercholesterolemia and hyperlipidemia from 2.3% to 22% and from 4.6% to 26%, respectively. Lower percentages were determined for the controls. The consumption of total fat, cholesterol, saturated and multiply unsaturated fatty acids in food was lower in subjects of obesity than in normal-weight subjects. Problems of the dynamic and static phases of obesity, hyperphagia, hypophagia, and longitudinal behavior are discussed with particular reference to the causes thereof. With males, the intake of all fatty substances contained in food decreased with increasing age. Possible causes of this include changes in environmental and working conditions as well as nutritional consciousness.


[Changes of pulmonary and bronchial vascularisation in disseminated lung diseases (author's transl)].

Pulmonary and bronchial artery angiographic pictures were evaluated in 14 patients with pulmonary disseminations. Diffuse fibrosing alveolitis was present in 4 patients, in 4 other patients secondary pulmonary fibrosis and in 6 patients pulmonary sarcoidosis. Most changes of pulmonary vascularisation were found in the lobular and terminal branches of the pulmonary artery. They consisted in their narrowing and even occlusion. Different degrees of the reduction of pulmonary perfusion could be observed. The most morbid alterations were in fibrosing alveolitis. They were less pronounced in cases of secondary fibrosis, showing a localized character, and in sarcoidosis in which the upper pulmonary parts were involved. Bronchial artery vascularisation was showing hypervascularisation of various degrees. Increased and dilated vessels strongly winding and even reticularly arranged could be regularly found. These alterations were very pronounced in patients with sarcoidosis. After transgressing of the pathological process to the state of fibrosis the vessels were showing a striped course presenting a greater number of broncho-pulmonary anastomoses.


Treatment of sarcoidosis by old tuberculin, blood and BCG. I. Results.

Treatment of sarcoidosis by subcutaneous injections of a mixture of old tuberculin and blood of a highly tuberculin sensitive donor of an appropriate bloodgroup and by additional vaccination with BCG is described. All patients exhibiting x-ray stage I of the disease were cured without any relapse. The evaluation of these results as being due to our therapy is difficult, because of high frequency of spontaneous healing, however, during our treatment of the patients we never observed a progression of this stage into a more severe one. Of 60 patients exhibiting sarcoidosis of x-ray stage II and III treated by us, 54 were cured within an average time of therapy of 28 months as judged by clinical and x-ray parameters including 8 cases with sarcoidosis stage III, who at the end of the therapy showed only some residual scars, 5 of the 6 patients who did not respond to the therapy, had been unsuccessfully treated with corticosteroids before, or suffered from concomitant disease like extrinsic allergic alveolitis. In contrast to other methods of treating sarcoidosis, during our therapy we did not observe any harmful side effects.


Treatment of sarcoidosis by old tuberculin, blood and BCG. II. Case reports.

The immunological therapy of sarcoidosis is composed of subcutaneous injections of a mixture of old tuberculin and blood of a highly tuberculin sensitive donor of an appropriate bloodgroup and additional vaccination with BCG. By presenting 3 sarcoidosis patients with typical clinical courses of disorder under our therapy, it is demonstrated that chronic sarcoidosis by this treatment is cured without any relapse, and that an acute sarcoidosis can be shortened in its duration.


[The dynamics of the diseases of hilar and mediastinal lymph nodes as seen by fluorography (author's transl)].

Fluorographic anamnesis of patients with sarcoidosis and lymphogranulomatosis was studied. The fluorograms carried out prior to the discovery of diagnosis of sarcoidosis were found normal in 21 out of 25 cases, they showed signs of pathologic changes in 4 patients. On the other hand, in patients with Hodgkins disease the preliminary fluorogram was normal in 13 cases, abnormal in 13 patients. Differences were found in the form of radiologic picture as well: sarcoidosis caused symmetrical enlargement of the hilar lymph nodes, in lymphogranulomatosis enlargement of the paratracheal ones could be observed.


[Smoking habits by pupils in a district of village schools (author's transl)].

An interview with pupils of the classes 8-12 was made in order to find out the frequency, the begin and the motivation of smoking in a rural district. Simultaneously the consumption of cigarettes in relation to the learning-results were examined among smokers and nonsmokers.


[Nonsmoking on workingplace--an inquiry of smokers and nonsmokers in the traffic service (author's transl)].

3000 workers of different age and vocational groups in the plants and institutions of the Deutsche Reichsbahn (German Railways) were interviewed concerning their attitudes to smoking. The results of this inquiry are summarized in a table and evaluated. It is concluded that in general smokers are not against sensible measures for reducing smoking in public life. As a result a new programme of measures for reducing smoking in the sector of traffic is presented.


[The frequency of intravital not detected tuberculosis in autopsies (author's transl)].

The analysis of 41 576 autopsies in the years from 1962 till 1978 revealed a total amount of 872 cases of active tuberculosis. In this time the percentage of tuberculosis mortality decreased from 3.3% (1962) to 0.9% (1978) of all autopsies. An increase of ante mortem not detected cases of tuberculosis with a high rate of generalised miliar tuberculosis could be demonstrated in our observations. Especially in high age patients exacerbations of tuberculosis should be considered. In diseases with clinical symptoms of the hematopoetic system tuberculosis should be taken into considerations of differential diagnosis.


[Development of an experimental animal model of aerogenic immunization with bacterial antigens (author's transl)].

Gnotobiotic piglets once aerogenically vaccinated with a avirulent strain, B10, of live Erysipelothrix rhusiopathiae (E.r.) showed no signs of illness when exposed to 100 LD50 of the highly virulent E.r.-strain FFA two weeks later. Mice vaccinated in the same manner were not fully protected. Various serological assays provided no indication for an actual protection mechanism against the challenge infection. On the other hand preliminary evaluation of the reactivity of lymphoid cells from various organs showed remarkable differences in the response to the vaccinating antigen and to various mitogens between vaccinated and non vaccinated piglets. Developmental phases of the model system and its advantages and disadvantages are presented.


[A new method for the stabilization of cervical spine fractures - calculations of the safety of devices under experimental conditions].

After a short comparison of the usual methods we present an own development for the stabilisation of cervical spine fractures. Principle and construction were described. The major part of the publication consists of static calculations concerning the stability of construction part and the interaction to the vertebral substance. We took away the mechanical characteristics from a hitherto unpublished advertisement about the load capacity of cervical vertebral bodies. Detailed calculations will be permitted to be claimed by the author.


[Basic studies on the pathogenesis and treatment of fat embolism. I. Fracture mechanism and fat embolism].

We examined the amount of fat that can be forced into the circulation by compression of femora and of heads of the tibia in the very moment of injury. By fractures of diaphyses no considerable reduction of the intraosseous space was achieved and no fat was expelled through the foramina nutritia before the hard cortical bone was splintered. However, considerable amounts of fat were expelled into veins, when the epiphyses of the femora or when the head of the tibia was compressed from medially and from laterally. Even by a purely manual compression some fat was forced to leave the spongiosa by the foramina nutritia. This is explained by the higher elasticity of the spongious bone, permitting a marked space reduction by compression even before a fracture sets in. The mechanism resembles the procedure of opacification of veins by contrast media, injected into the bone cavity under pressure. The significance of these findings for the pathogenesis of clinical fat embolism is discussed.


[Chronic osteomylitis in the standard animal model on the tibia head of rabbits].

The making of a standardized model of a chronic osteomyelitis is represented. The standardized cavity in the tibia head of 7 x 12 x 5 mm is attainable by trepanation. A plastic body was inserted in the cavity. The cavity was inoculated with staphylococcus aureus after 4 weeks. The model is suitable for the assessment of different therapy methods and for the clarification of other questions, because of the control possibility of healing by exact methods.


[Use of the ball-dent method to determine the firmness of cervical vertebra spongiosa].

The check of mechanical indexes of vertebrae spongiosa is showed on the example of vertebral bodies C3 and C4. We make a new method to a subject for discussion after the statement of foundations for the one-axial resistance attempt. The mechanical indexes of macerate as well as fresh spongiosa is be able to find out with the so-called ball dent method.


[Fluid crystals of cholesterol-a new aid in the study of circulation].

A measuring method for model investigations is described. It is suitable for the velocity measurement and for evidence of strong local distortions of the velocity profile. The basis for this method are the regularities of the heat transport in streaming fluids. It was tested on silicone tube branches with a straight main branch. Clinically interesting induced flows can be produced if the flow is interrupted in one branch. A limited fluid exchange takes place in the closed branch then. This is important for the diagnostic and the planning of vascular surgery measures.


[Comparison of the dog's vena jugularis and the human vena saphena magna].

The present contribution compares the histologic and mechanic qualities of the vena saphena magna in man with the dog's vena jugularis. Both venae have a similar histologic structure and an analogous enzymatic equipment. The dog's vena jugularis has a smaller mechanic resistance, however, it is fast enough to resist the artery pressure. The dog's vena jugularis is therefore suitable for experiments with venae transplants which are reproducible in the clinical application.


[Measurements of bone conditions with ultrasound. IV. Changes in 2 indices of bone echograms in models of untreated and of fixed fractures].

Measurements on the lower leg of a corpse and on fresh human tibiae were carried out in the diaphysis with the ultrasonoscope GA 20 by using a frequency of 1 MHz. The maximum possible transsound distance of the tibia was much smaller hitherto supposed. No alteration of the ultrasound debilitation could be observed in the model test even if a complete severance of the tibia was in hand in case the fracture crack was filled up with fluid. Changes of the transfer speed proved to be extremely small. The measuring methods with 1 MHz in order to check the process of the fracture healing are very problematic.


[Oxygen partial pressure, oxyhemoglobin saturation and the oxygen content of blood in endotoxic shock].

Our research showed in the endotoxic shock no fundamental and durable changes with reference to oxygen partial pressure and oxyhemoglobin saturation of the arterial blood within the first two hours. On the other hand the oxygen contents of the arterial blood decreased progressively in connection with the progressive decrease of hemoglobin. In detail the arterial oxygen partial pressure decreased within the first 30 minutes after the endotoxin injection and normalized itself by the sixtieth minute, afterwards it remained stationary. Statistically significant divergences of the oxyhemoglobin saturation were not existing during the whole examination. The oxygen contents of the blood decreased progressively in consequence of lower hemoglobin values.


[Effect of protein-containing cerebrospinal fluid on ventriculo-auricular drainage].

Elevated protein level in liquor still prohibits ventriculo-auricular drainage methods. Spitz-Holter valves and Pudenz-Heyer valves were therefore tried in model tests using plasma-containing fluids. The quantities of flow depending on time were presented on graphs. A considerably reduced flow through the Spitz-Holter valve was observed after brief perfusion already, with tendency to complete occlusion. Similar results were obtained from trials on the Pudenz-Heyer valve.


[Measurement of polymerization heat of the tissue adhesive Fimomed (alpha-n-butylcyanoacrylate) reduced in the GDR].

The authors describe a method for measurement of temperature that originates from the polymerisation of the adhesive Fimomed (alpha-n-butylcyanoacrylate). The intravascular application of the adhesive is taken as a basis of the measurement. This kind of application is applied by the authors for the closure of arterio venous fistulae. The measurement of the temperature with this method did not show both in the centre of polymerisation and in the surroundings any doubtful value if not more than 3 ml adhesive was applied. However the measurement of the temperature which originates from the polymerisation is recommended in all cases before any plane sticking is applied.


[The pre-ejection-period of the human fetal heart: patterns of change during labour and heart-frequency alterations (author's transl)].

The Pre-ejection period (PEP) of the cardiac cycle, fetal heart rate, and uterine contractions were monitored in a series of 115 unselected fetus sub partu. PEP was detected by a new on-line technique using EKG and DKG. This method permits a continuous registration of PEP patterns simultaneously with the fetal CTG. Any change in PEP was related to fetal status and fetal heart rate patterns. Absolute PEP was prolonged and relative PEP (PEP/cardiac cycle) did not alter during decelerations due to a fetal head compression. The absolute PEP and the relative PEP were prolonged (rarely relative PEP was shortened) during alterations of fetal heart rate patterns based on the alteration in hemodynamics of fetal circulation. A first increase of the PEP was followed by a second increase of the PEP during severe variable decelerations conducting to a secondary chemoreceptor-reflex caused of fetal hypoxemia and acidosis; the duration between the two prolongation peaks of the PEP is directly correlated of fetal blood oxygenation: hypoxemia decreases this duration. These changes are essentially independent of heart rate and therefore PEP can be considered as an independent parameter for fetal assessment.


[Comparative study of pre-ejection period and trans-cutaneously measured pO2 sub partu (author's transl)].

Transcutaneously measured pO2 (tc pO2), Pre-ejection-period (PEP) fetal heart rate (FHR) and intrauterine pressure were registered simultaneously in 5 cases of fetuses having umbilical cord complications. In addition a punctual measurement of acid-base-status was performed during intra partal registration and after delivery. In each fetus there is a relative correlation of basic PEP and basic tc pO2. An almost parallel pattern of PEP and tc pO2 occurred during uterine contractions, while both parameters are strictly correlated. There is always a prolongation of the PEP and a rise in tc pO2 of the fetal scalp during deceleration and uterine contractions. PEP changes due to a decrease of preload and increase of afterload of the fetal heart, the relative better oxygenation of the fetal scalp during uterine contractions and decelerations due to a redistribution of circulating blood volume caused by a selective peripheral vasoconstriction.


[Adrenalin and cardiac output in pregnancy (author's transl)].

The heart rate performance, cardiac output and catecholamine excretion were observed at rest in the ergometer test (40 min at 50 watts) in a group of 8 pregnant women whose case history and clinical record did not reveal any abnormal findings, during the course of pregnancy (20th, 28th and 36th weeks of pregnancy) as well as 2 and 12 weeks post partum. It was found that the cardiac output increased, dependent upon the heart rate, the stroke volume remaining approximately constant (max. + 60%) during pregnancy, compared with the controls post partum. There is a close linear correlation (r = 0.983) between the measured heart rates and the corresponding excretion of epinephrine (adrenalin) with the urine at rest and under load. It may be assumed that there is a causative link between the increase in secretion of catecholamine by the mother and the well-known change in cardiac output during pregnancy.


The effect of locally administered estrogens on the human cervix.

A randomized study to evaluate the effect of natural estrogens on the unripe uterine term cervix was conducted. One hundred and five term gravidas were studied, of whom 70 were treated with 180 mg 17 beta-estradiol or 250 mg estriol (treated women) and 35 were treated with gel only (control group). In all subjects the distented Foley catheter used for the instillation was left in situ. Twelve hours after the instillation there was no apparent difference in mean cervical progress between treated women and controls and the rather unexpected degree of cervical ripening is atributed to the intra-uterine balloon catheter. The procedure could not be shown to have any untoward effect on the mother or the fetus.


[Adenoma of the nipples].

The adenoma of the nipple (syn.: erosive adenomatosis, papillary adenoma, florid papillomatosis) is a benign tumour of the major nipple ducts and presents chiefly as an eroded oozing and crusted lesion with serous or sanguineous discharge of the nipple or as an indurated nodule. The lesion can be mistaken clinically for Paget's disease of the nipple. The correct diagnosis, however, can easily be established by an incisional biopsy. Pathohistologically, the tumour displays adenomatous and papillomatous proliferation of the milk sinus epithelium. An outer myoepithelial and inner columnar epithelium layer can mostly be distinguished. Atypical cellular features are lacking. Keratin cysts near the mostly eroded epidermal surface are are additional characteristic signs. The resection of the nipple is the therapy of choice. The adenoma of the nipple is no precancerous condition. A typical case of adenoma of the nipple from a 54 year old woman is presented.


[Innervation of the small intestinal mucosa of laboratory animals. II. Ultrastructure of neuro-cellular connections].

In addition to our light microscopic contribution (Stach, Hung 1978) giving an insight into the density, architecture, histochemical variety and relations between plexus mucosus and Lieberkühn's glands the herewith presented electron microscopic results reveal mainly neuro-cellular relations from the lamina propria. This means that the plexus mucosus has mainly the function to innervate blood vessels and lymphatics as well as smooth muscle cells and connective tissue cells (mast cells, histiocytes, plasma cells) of the small intestine mucosa.


[Behavior of the superior cervical ganglion after total isolation of its contralateral homologue].

When the superior cervical ganglion of one side isolated from its neuronal and vascular connexions is held in situ, the contro-lateral one shows early modifications which are maximal at 15th day. Recuperation of the initial structure is definitively obtained during the 2nd month. Hypotheses are suggested to explain this phenomenon.


Nerve endings in the heart of teleosts.

The nerve endings in the heart of fishes were studied using silver impregnation techniques. The heart chambers are profusely innervated by the sympathetic, parasympathetic (vagal) and postganglionic fibers of the intracardiac ganglia situated at the sinuatrial and the atrioventricular junctions. The plexuses are composed of medullated and nonmedullated fibers. The nerve fibers generally end freely and are slightly branched or unbranched terminations of myelinated and unmyelinated fibers. Moreover, a few nerve fibers end redundant in the form of end-rings, bulb-like, bush-like, club-shaped end end-coil like structures. The complex unencapsulated types of endings are also found in the myocardium of the atrium and the ventricle. The encapsulated endings (Vater-Pacinian; Krause end-bulb) could not be observed.


[Secretory phenomena at the ependyma of the sulcus hypothalamicus Monroi of the fetal rat. A histochemical and electron microscopic study].

In a localized area above the sulcus hypothalamicus Monroi ventriculi tertii of the rat ependymal structures are observed, which only occur between the 18th and 20th day of gestation. They were investigated with the aid of lightmicroscopic, ultrastructural and histochemical technics. The surface of the ventricular wall is rendered irregular by protrusions and deposits. Neurosecretory stains and histochemical examination give no positive results. Apical parts of the ependymal cells are fingershaped, dome-like and of spheric appearance. The equipment of the protrusions with organels is variable. Some of them contain a fine granular ground plasma, polyribosomes and occasional profiles of the endoplasmatic reticulum. Others are impacted with optic empty or substantial vacuols. Vacuols merging in the cellular membrane evacuate their content into the ventricular space. Multivesicular bodys engorged with vesicles are together with those, which lie empty in the ventricular cavity. Empty, buddle like and frequently folded membrane protrusions suggest that cellular content has been delivered into the ventricle.


The hypothalamo-neurohypophysial system in Indian fresh-water goby, Glossogobius giuris (Ham.).

The hypothalamo-neurohypophysial neurosecretory system in Indian fresh-water goby, Glossogobius giuris (Ham.) has been described. The tractus preoptico-hypophyseus serves the function of a morphological and physiological connection between the hypothalamus and pituitary gland. In addition to main mass of the nucleus preopticus cells (cystine/cysteine bearing), a group of few cells in the hypothalamus has also been observed. These cells are situated posterior to the position of the nucleus preopricus and are CH Ph + ve and AF + ve. The neurosecretory material in the cells of nucleus preopticus is in the form of fine granules. The nucleus lateralis tuberis is absent in the fish under study. The disposition of neurosecretory material is heaviest along the fibres of the neurohypophysis in the region of pars intermedia with which it forms a profuse interdigitation. The fibres usually terminate over the blood vessels. The Herring bodies are noticeable at different levels in the neurohypophysis and pars-distalis. Besides the neurosecretory fibres, Herring bodies, non-stainableneurosecretory fibres and blood vessels, the pituicytes are also present in the neurohypophysis (SAKSENA 1974a, b). The intraaxonal flow of neurosecretory material, the vascularization of the nucleus preopticus and hypothalamo-hypophysial regulatory mechanism have been also discussed.


Types of neural cells in the spinal ganglia of human embryos and early fetuses.

Spinal ganglial of human embryos and fetuses ranging in C.-R. length from 15 to 74 mm and in age from 6 1/2 to 11 postovulatory weeks were studied by light and electron microscopy. A sequence of events in differentiation and maturation enabled five types of cells to be distinguished: 1. apolar, undifferentiated neuroblasts are the main cells at 6 1/2 to 7 1/2 weeks; 2. early bipolar neuroblasts (strictly speaking, types 2 to 5 are immature neurons) predominate at the end of the embryonic period proper (8 postovulatory weeks); 3. intermediate bipolar neuroblasts are characteristic of the early fetal period; 4. late bipolar neuroblasts, in which two proceses arise separately from one pole of the cell, appear at about 10 postovulatory weeks; 5. unipolar neuroblasts are found within another week and, by that time, cells of types 1 and 2 are no longer present.


[Clinical aspects and treatment of acute kidney failure].

It is reported on haemodialyses which were carried out in the period from 1959--1978 in 157 patients with acute renal failure. Here in 25 cases developed exogenic intoxications. The surgically conditioned cases of acute renal failure were subdivided into 7 groups according to the basic diseases. The lethality of about 47% significantly differs in the individual surgical noxes from the data of literature. It is dealth with the general principles of treatment in these acute pictures of disease, which 1. consist in a basic treatment--maintenance of vital functions--and 2. in an elimination of the damaging noxe--elimination of the exogenic poison and removal of the surgical basic diseases and tiding over of the temporary deficiency of the renal function. Of the deceased patients about 16% came ad exitum in uraemia. The others died of the basic disease which could not be controlled. Thus the prognosis depends on the prognosis of the basic disease. In the intoxications the prognosis mainly depends on the dialysability and the quantity of the poison as well as on the time interval between intake of poison and beginning of the treatment.


[Vascular connections for hemodialysis with reference to thromboses and infections].

A survey of the at present possible vascular accesses and their valency for acute and chronic haemodialyses depending on age and body weight is followed by a comparison of the two most essential possibilities of access Scribner-shunt and fistula Brescia-Cimino. Thei main complications thombosis and infection are discussed and therapeutic directives are shown.


[Melanocytoblastoma in urology].

On the basis of special literature presence and frequency of autochthonic melanomas in the uro-region are described. It is referred to 1 own case. The sequels of metastasizing are given in the chapter "secondary localisation" with the comprehensive reason for the decision, again to remove again an already functioning renal graft, when it becomes known, that a metastasising melanocytoma was present in the donor of the organ.