[Clinical aspects of amniotic fluid embolism].

An analysis of 456 cases of amniotic fluid embolism of the literature is given. It is reported about age of women, parity, duration of pregnancy, complications in delivery, period of time to death, weight of children and their mortality. Two own cases are reported. A discussion of symptoms, different diagnosis, treatment and the possibility of prophylaxis is included.


[Cesarean-section narcosis using Tricuran (Gallamine as a long-lasting muscle relaxans before delivery of the infant].

The use of long term non-depolarizing muscle relaxants facilitates the carrying out of anaesthesia at caesarean section. We compared the Apgar-score of two groups of 20 newborns after caesarean section, whose mothers got only succinylcholine or succinylcholine and gallamine before delivery by a hexobarbiturate - nitrous oxide - oxygen anaesthesia. The Apgar-score was practically identical in both groups. 70% of infants of the succinylcholine group and 75% of infants of the gallamine group showed an Apgar-score between 7 and 10 after 1 minute. A later decrease was noticed in no case. The use of gallamine is without danger for the newborn.


[Demonstration of an agglutination-like nature of haptoglobins against streptococci with T4-antigen through the examination of umbilical cord sera].

The determinability of haptoglobin types is correlated with the titers of agglutination against streptococci carrying the T4 antigen. If the haptoglobin types in cord-sera cannot be determined (as a result of the physiological binding of haptoglobins) the agglutination reaction fails or the titers are greatly diminished. The dimorphism, which was found in sera of adults, can be demonstrated in cord sera, too, if they can be typed. It is concluded that the observed reaction between Hp 2-2 and Hp 2-1 sera with T4-streptococci is caused by the haptoglobin itself.


[Physiological and pharmacological studies of umbilical cord flow in man].

The results of investigations on physiology and pharmacology of the smooth muscle umbilical cord arteries are presented. In the first part of the investigations it has been found that there is a close dependence between the blood flow and perfusion pressure in the arterial bed of the cord. The pressure flow relationship is linear. The blood vessels of the umbilical cord influence actively the perfusion pressure changes. On the basis of the presented investigations, the possibility of existence of autoregulation in the umbilical cord circulation has been found which testifies to an active but not passive role of the vessels in the circulation between the foetus and placenta. It has been stated that the umbilical cord vessels show a spontaneous contractile activity which may play an important role in the regulation of the umbilical flow. In the case of lack of the smooth muscle spontaneous contractile activity, this could be induced by using active pharmacological substances, as for instance noradrenaline. The reaction of another important pharmacological substance bradykinin (BRS), has been closely associated with oxygen saturation of the perfusion solution. Changes in the sensitivity of the umbilical cord blood vessels to BRS, depending on the saturation with oxygen, have been emphasised, and the role and participation of kinins in closing up umbilical cord blood vessels immediately following labour have been discussed.


[Echographic study in early pregnancy. I. Parameter of the uterus].

The echographic pattern of the growing uterus in normal pregnant women and threatened abortion with analysis of longitudinal, antero-posterior and transverse, the area and volume of the uterus has been studied. There is a significant difference between both groups.


[Echographic study in early pregnancy. II. Amnion cavity parameter].

Ultrasonic B-scanning was used to study 201 patients in early pregnancy. We divided the material in two groups with clinical signs of threatened and a third group of normal pregnancy. The growth of three mean diameters of gestational sac is analyzed. An assesment of gestational sac area and volume is included. The data are represented in terms of regression lines.


[Diagnosis and control of the course of multiple pregnancy using ultrasonic B picture technic].

In this study you find a report about the diagnosis and the control of the course of multiple pregnancy with the help of echoscopy. Out of 513 case studies, 304 female patients were examined with this method. The diagnosis can always be put practically by the experienced examiner as the optimal period for this is stated between the 20th and the 26th week of pregnancy. It is emphasized that the early detection of the multiple pregnancy is clinically uncertain. The ultrasonic control of the course of pregnancy makes it possible to find out the hypotrophy of one or both of the babies. It is also possible to measure the birth weight of the multiple babies exactly clinically. The diagnosis of the prepartal position gives an idea about the expected course of delivery. The diagnosis of a quadriple in the 22nd week of pregnancy and the corresponding ultrasonic control of the course of pregnancy is also dealt casually in short.


[Morphometric studies of the human placenta under the influence of sex steroids].

Placentas of different gestational age from women with oral contraception in the early phase of gravidity were studied morphometrically. An elevated risk for a placental insufficiency could not be found.


TLG medium for pigment detection of staphylococci.

The semidefined medium (TLG) for carotenoid pigment production of staphylococci consists of 0.3% triacetin, 0.1% sodium lactate and 0.1% glucose in nutrient agar. The TLG is used for harvesting of cells for pigment extraction or, with calcium carbonate added, for colour determination of colonies.


[A contribution to purification of staphylokinase (author's transl)].

Optimal production of staphylokinase (SAK) was achieved in a casein hydrolysate yeast extract medium (LO3) containing 0.1 M Na-pyruvate. Addition of the pyruvate reduced significantly the production of protease and facilitated purification of SAK. After concentration of SAK from the culture supernatant by precipitation with ZnCl2 highly purified SAK was prepared successively using DEAE-Sephadex A 25 in a batch-procedure, by chromatography on CM-Sephadex C25, filtration with Ultrogel ACA 54, isoelectric focusing between pH 3.5 and 10 (fig. 2) and refocusing between pH 5-7 (table 1). For fractionation by focusing a device was constructed to record pH and optical density together with the fraction number in one diagramm (fig. 1). The purified SAK-preparation had a specific activity of 16.700 units per mg protein. It proved to be free of hemolysins, coagulase, leukocidin, lipase, nuclease, phosphatase, and protease. It was homogeneous upon analyses by diselectrophoresis, double immunodiffusion and immunelectrophoresis.


[Ultrastructural investigations on anionic surface sites of Brucella canis (author's transl)].

Anionic sites on the surface of Brucella canis were visualized in the electron microscope by staining with positively charged ferric oxide hydrosols in acetic acid (AI-reagent), or propanoic acid (PI-reagent), and with a polycationic ferritin derivative. With the AI-reagent, single or small aggregates of ferric oxide particles were bound to the cell surface of Br. canis, whereas, with the lipophilic PI-reagent, the microorganisms were heavily stained with focal aggregates of iron granules. The polycationic ferritin label was uniformly distributed over the entire cell surface of Br. canis. The ferritin label was not bound on the surface of the organisms after prior treatment with trichloroacetic acid or methanolic hydrochloric acid. Treatment with aqueous acetone, chloroform/methanol, diethyl ether, sodium deoxycholate, pronase, lysozyme, hyaluronidase, and sodium periodate neither influenced the morphology  of the Brucella nor diminished their ionic binding sites. Our results indicate that the anionic sites on the cell surface of Br. canis may be carboxyl and phosphate groups of lipopolysaccharides.


Factor analysis of serogroups botanica and aurisina of Leptospira biflexa.

Factor analysis is performed on serovars of Botanica and Aurisina serogroup of Leptospira biflexa. The results show the arrangement of main factors serovar and serogroup specific, as well as the antigens common with serovars of heterologous serogroups.


[Investigations in taeniasis patients on blood serum immunoglobulins IgG, IgA and IgM and blastic lymphocyte transformation after phytohaemagglutinin (author's transl)].

In 49 patients suffering from taeniasis caused by T. saginata, the serum levels of the immunoglobulins, IgG, IgA, and IgM as well as the blastic lymphocyte transformation due to phytohaemagglutinin were determined. The studies were performed prior to treatment (1st testing) and at day 7 following administration of Yomesan (2nd testing). The results obtained were statistically evaluated by comparison with the results of control studies in 20 healthy persons. A statistically significant lowering of the IgA and IgM levels and of the percentage of blastic cells following lymphocyte stimulation by phytohaemagglutinin was demonstrated to be present in the patients by the 1st as well as the 2nd testing.


Leptospirae: their place in the systematics.

The morphology and electron-microscopic anatomy of Leptospirae, the lack of the presence of leptospiral phages (and probably of bacteriocins), and the absence of phagocytosis as a defence mechanism in leptospirosis, indicate the non-bacteriologie character of this genus. Leptospirae form an evolutionary intermediate bridge between the worlds of bacteria and protozoa. In "Bergey's Manual" they are assigned to the world of bacteria for practical reasons; but it seems to be reasonable to stress more largely the "bacteriological" and "protozoologic" markers of Leptospirae, in the subsequent 9th edition of this Manual.


[Analysis of the biological effect of city smog extract. I. Cytotoxicity of city smog extract from an urban area and of polycyclic aromatic hydrocarbons on mouse macrophages in vitro (author's transl)].

We analyzed the cytotoxic effect of a city smog extract from a large urban area, employing mouse macrophages in vitro. In parallel experiments we tested carcinogenic and non carcinogenic polycyclic aromatic hydrocarbons: benzo(a)pyrene, 7, 12-dimethylbenzanthracene, pyrene and anthracene. City smog extract induced a dose-dependent reduction of cell viability and an alteration in cell membrane permeability. In contrast to city smog extract the carcinogenic and non carcinogenic polycyclic aromatic hydrocarbons produced no detectable cytotoxic effects in the dose range we analyzed. Possible implications of the cytotoxic effect of city smog extract on the lung are discussed.


Effects of lead inhalation exposures alone and in combination with carbon monoxide in nonpregnant and pregnant rats and fetuses. I. Distribution of lead in blood and liver.

Nonpregnant and pregnant rats were continuously exposed for 3 weeks to an aerosol containing 1, 3 and 10 mg lead/m3 air and to a combination of 3 mg Pb/m3 and 500 ppm carbon monoxide. At the two lower lead doses, fetal blood lead levels exceeded those of the mothers. Active transport mechanisms were discussed to be responsible for these differences. A decrease of the fetal blood lead level below the maternal level in the high exposure group was explained by an increasing storage capacity of the fetal livers with increasing lead doses. Lead concentrations of the maternal livers exceeded the nonpregnant values at all 3 doses, probably caused by a higher ventilation and altered pharmacokinetics of lead in pregnancy. Additional CO-inhalation lowered the storage capacity of the livers of the adult animals and raised the blood concentration. In the fetuses additional CO-inhalation raised liver lead concentrations.


Effects of lead inhalation exposures alone and in combination with carbon monoxide in nonpregnant and pregnant rats and fetuses. II. Effects on delta-aminolevulinic acid dehydratase activity, hematocrit and body weight.

Pregnant and nonpregnant rats were exposed for 21 days to an aerosol containing 1, 3 and 10 mg lead/m3 air and to a combination of 3 mg Pb/m3 and 500 ppm carbon monoxide (CO). Pregnant and nonpregnant rats exposed to uncontaminated air served as controls. The activity of the fetal delta-aminolevulinic acid dehydratase (ALA-D) was less inhibited by lead than the maternal activity. Furthermore, the degree of inhibition was highly reduced in the fetuses by additional CO-inhalation, whereas in adult animals the depression of the ALA-D was accentuated by additional CO-inhalation in accordance with epidemiological data. Therefore, it is concluded that the mode of plumbic inhibition of the ALA-D activity differs in fetuses from that in adults. Furthermore, the adaptation to the inhibition of the ALA-D by de novo synthesis of this enzyme was less in fetuses than in adult rats. The high lead aerosol concentration reduced hematocrit and body weight of the fetuses, but it did not influence these parameters in adult rats, thus pointing to a higher lead-sensitivity of the fetal than the adult organism. A stronger inhibition of maternal ALA-D activity than of the activity of nonpregnant animals possibly indicates a higher susceptibility to lead in pregnancy.


[Role of the telencephalon in regulating the electrical activity of skeletal muscles in chick embryos].

On 18-day chick embryos, studies have been made of functional properties of hyperstriatum accesorium (HA) of the telencephalon and that of neck muscles. To investigate the relationship between the HA structure and the EMG in muscles, the former was subjected to unilateral coagulation. Specific levels were established of the energy of oscilatory processes--EEG in the HA and EMG of neck muscles--as well as the relationship between them and possible role of HA structure in regulation of fast movements.


[Localization of the sensory projection areas in the cerebral cortex of the dolphin, Tursiops truncatus].

Using the evoked potential technique, studies have been made on localization of the projectional sensory areas in the cerebral cortex (visual, acoustic and somatosensory) of the porpoise T. truncatus. Distribution of these projectional areas in the porpoise is quite different as compared to that in other mammals. Visual and acoustic areas are shifted to the dorsal part of the hemisphere, all the sensory areas investigated exhibit a direct contact with each other.


[Frequency-threshold characteristics of the subcortical formations of the auditory analyzer of the dolphin Phocaena phocaena].

The evoked potentials (EP) have been recorded in subcortical auditory structures of porpoises exposed to ultrasound stimulation. The magnitude of EP thresholds served as the criterion of auditory centers sensitivity to variations in stimulus frequency. The region of maximum sensitivity occurred within the range 100 to 120 kHz and in some trials additional maximum was observed. Reaction thresholds of "off"-responses invariably exceeded those of "on"-responses. Frequency-threshold curves for both reaction types coincided.


[Prevalence of ornithosis in the Lithuanian SSR].

As a result of immunological examination of 658 domestic ducks of 6 poultry farms and 269 doves caught in Vilnius, antiornithosis antibodies were revealed in 3.1 +/- 0.7% of ducks and in 36.4 +/- 2.9% of doves. They were also found in 20 of 34 wild waterfowl. The causative agent of ornithosis was isolated in virological examination of the organs of a coot. Ornithosis nature of an epizootic outbreak among ducks of a poultry farm was proved by virological examination. The population was examined immunologically (2285 persons) and by intradermal test with the ornithosis antigen (80 persons). Positive specific reactions were revealed in 32.6% of persons engaged in poultry tending, and in 7.6% of other rural population. A case of ornithosis in man engaged in fowling (of doves) for their examination is described.


[Structure-functional features of peripheral nerve elements in oligochaetes].

Histological investigation of the peripheral nervous elements in the earthworm indicates that in 3-projection neurons which are found along the I and III segmentary nerves, one of the projections terminates between epithelial cells, whereas the other produces many ramifications which form multiple terminations in the longitudinal muscles. These polyvalent neurons presumably serve as a morphological basis for the peripheral axon-reflex in the earthworm.


[Etiologic role of bacteria of the genus Providencia in acute intestinal diseases].

A study was made of morphological, cultural, biochemical properties and antigenic structure (by O-antigen) of 59 strains isolated in group acute intestinal affection of children at the pioneer camp. By the combination of biochemical properties (31 tests) all the cultures isolated were referred to Providencia alcalifaciens of biotype 7. Serological typing with the aid of experimental diagnostic agglutinating O-sera showed these strains to be referred to serological group O2. Identity of the O-antigen of the isolated cultures to the standard O2 strain was confirmed by the results of cross reactions of agglutinin absorption. The results of bacteriological and clinico-epidemiological studies offered a possibility of regarding the isolated Providencia alcalifaciens of serological group O2 as the causative agents of the group intestinal disease in children.


[Houseflies (M. domestica L.) as transmitters of the agent of cholera].

The authors present the experimental results of study of the role played by domestic flies in the spread of cholera causative agents. It was found that cholera microbes survived on the external surface of flies for 5 to 7 days, and in the insect organism--in the course of their whole life. Cholera vibrios underwent no sharp changes in the organism of flies. By  means of individual infection method and keeping of flies excluding a possibility. By means of individual infection method and keeping of flies excluding a possibility of repeated autoinfection it was revealed that cholera vibrios could multiply in the organism of domestic flies. The infected insects can discharge cholera vibrios for a long time into the external environment and contaminate food.


[Heterogeneity in phage sensitivity in populations of S. aureus vegetating in patients and carriers].

It was found that the S. aureus populations vegetating in patients and carriers were heterogeneous by phagegroup reference of the strains isolated in 31.1 and 23.9% of cases, respectively, and in 35.9 and 26.9%--phagovars. The frequency and the extent of variability of the populations in the patients depended on the character of the disease, the site of infection and the association of the focus with the external environment, and in carriers--on the localization and the carrier category. S. aureus populations habituating in the patients with the primary purulent processes and mastitis, as in the closed processes and in cases of extrahospital infection consisted, with rare exception, of the strains of one phagovar. In a considerable number of patients with purulent processes after the incision (38.0%), with infected wounds (37.2%), and particularly with burns (78.6%) of the S. aureus population consisted of 2, 3 and even 4 phagovars. Variable were also populations vegetating in patients with open processes (47.1%) and in hospital (26.5%) and mixed infection (52.6%). The phage-type composition of the S. aureus populations in carriers was also characterized by heterogeneity, which was more pronounced in chronic carriers and in case of localization of the processes in the nose. On the basis of the data obtained the minimal number of cultures which should be studied from the microbial focus in order to obtain objective data on the composition of phagovars in the population of various categories of patients and carriers was calculated.


[Serum vibriolytic activity as an index of antibacterial immunity in cholera].

As a result of study of the vibriolytic activity of the serum during the immunity formation in the vaccinated animals in comparison with the specific antibodies titres and nonspecific immunity factors (complement and lysozyme) there was revealed a dependence of the reaction on the vaccine dose and the immunization method; there was also found a relationship between the vibriolytic activity and the serological indices in the sera of volunteers. On the basis of study a conclusion was drawn that the vibriolytic activity of the serum could serve as an index of antibacterial immunity in cholera.


[Protective action of serum RNA-ase in viral infections].

The enzymatic preparations of the RNA-ases from the cells of a continuous line of the sucking pig kidney culture, the blood serum of chicks, and the blood serum of rabbits were isolated and purified. The antiviral action of these enzymes on the homologous culture, chick embryos in infection with the RNA-genom virus of the Newcastle's disease and on rabbits infected with the DNA-genom virus of the Aujeszky's disease was demonstrated. A supposed mechanism of the protective action of "own" RNA-ases is discussed in this work.


[Materials on the serologic study of children inoculated with live measles vaccine].

The results of serological examination of children, residents of Leningrad, vaccinated with live measles vaccine, are presented. A total of 2012 children were examined. Antibodies were absent in children of different age in 4.2--15.8% of cases. The greatest percentage of secronegative children (15) was noted among those vaccinated at the age of under one year. The mean geometrical antibody titres were the greatest in children aged from 7 to 14 years. The values of these mean titres were less in children vaccinated at the age of under one year than in those vaccinated later--6.5--8.6 and 10.6--11.3, respectively.


[Disruption of the mechanisms of natural immunity in the initial stage of adjuvant disease in rats and guinea pigs].

Similar changes in the nonspecific immunity indices were noted in experiments on rats and guinea pigs with adjuvant disease: depression of blood serum bactericidal activity and increase of the lysozyme and complement level, as well as inhibition of the phagocytic activity of leukocytes and production of normal antibodies to O- and Vi-antigens of typhoid bacilli in rats. Changes in disturbances of natural immunity factors in adjuvant disease correlated with the severity of the process in both animal species.


[Primary localization of the pathologic process in amyotrophic lateral sclerosis].

The clinico-electromyographical study was conducted in 120 patients with motor disturbances in amyotrophical lateral sclerosis. Comparing the clinical and electromyographical data in different variants of this disease the authors make a conclusion on the simultaneous damage of peripheral and central mononeurons from the very onset of the disease. Along with this the latter is damaged not only primarily, but secondarily as a result of trans-synaptic degerneration due to pathology of the segmental-nucleus motor cells.


[Interrelationships between the structure of extra- and intracranial arteries, thrombosis, stenosis of their lumina and cerebral infarct].

With the aid of the complex x-ray-anatomo-histomorphometric method in 130 patients who had died due to brain strokes the authors established a statistically reliable correlation between localization of occlusion (stenosis, thrombosis) from anatomical (abnormal) structure of the vessels. A conclusion is made that vessel anomalies are frequently one of the factors which cause brain strokes. They influence not only hemodynamics, but modulate distribution of occlusive process in the lumen of the vessels.


[Secondary stem syndrome following infarcts and hemorrhages into the cerebral hemispheres].

The authors analyse the significance of some factors for the development of a clinical, electroencephalographic and electrocardiographic picture of the secondary dysfunction of stem brain structures in patients suffering from strokes with a hemispheric localization of the focus. A great complexity and different influences of the course of stages of the secondary stem syndrome are stressed. Attention is drawn to the expedience of using repeated EEG recording in the acute phase of a stroke for diagnostic purposes.


[Types of apraxia of the articulation apparatus in afferent motor aphasia].

On the basis of the comparative data on physiology and psychology of speech, as well as applied and comparative linguistics, it is known that apraxia of articulation apparatus in patients with afferent motor aphasia is heterogenous. The study of 3 groups of patients with primary apraxia of either a tongue, lips, or pharynx and larynx allowed one to find that in persons whose native language is Russian, written speech, reading and understanding is disturbed to a lesser degree in primary apraxia of glotis and larynx that are not initial phonemoformation organs in the Russian language.


[Soporous-comatose states in patients with acute pneumonia].

On the basis of a clinical, laboratory and pathomorphological study the author describes soporous--comatose states in 26 patients among 300 with acute pneumonia. In acute lung diseases, there are symptoms of multiple lesions of the nervous system on the background of hypoxia and intoxication which evokes, liquid-dynamical and circulatory brain disorders. Progressive brain oxygen insufficiency conditions appearance of neurological disturbances from general cerebral and functional and as the state becomes more profound up to an occurence of comatose states.


[Long-term l-DOPA therapy for parkinsonism and its pathochemical aspect].

The conducted study of the effectiveness of L-DOPA in its long-term (up to 7 years) continuous administration to parkinsonic patients depicted a high therapeutical action of the drug for the first 6 months of the treatment. L-DOPA administration up to 3 years had an antiparkinsonic action approximately in half of the patients. A further prolongation of treatment period decreased L-DOPA effectiveness even more. The increase of the doses in order to raise a therapeutical effect was impossible due to the appearance of side-effects characteristic of L-DOPA. The longitudinal biochemical studies on biogenic amines in those patients' urine established a correlation with the clinical state. The obtained biochemical data permitted to assume an acceleration of extracerebral metabolism of monoamines in L-DOPA treatment for 1--3 years and further on the decrease of sensitivity of CNS dophaminergic neurons to administered L-DOPA. The methods of increasing the effectivity of L-DOPA use in parkinsonism are given.


[Cerebrospinal fluid melatonin in diseases of the nervous system].

In 66 patients with some diseases of the nervous system (epilepsy, brain tumors, traumatic brain lesions, discorgenic lumbosacral radiculitis) melatonin content in liquor was determined by a fluorimetric method, especially modified for this purpose. The increase of melatonin concentration in liquor mostly significant in frequent epileptic strokes was found. In brain tumors the hormone content depended upon the severity of the patients' state, the existence of epileptic strokes, brain stem and hypothalamus involvement into the process. In traumatic subarachnoid hemorrhages, in the hypothalamic syndrome, the melatonin content was very high. An assumption on melatonin defensive role in conditions of the nervous system pathology and the topico-diagnostical significance of its study in liquor is made.


[Bilirubin and the blood-brain barrier].

The report contains some results of a parallel determination of bilirubin in the blood serum and CSF in 321 patients with different diseases. The bilirubin in the blood serum was studied according to Jendrassik and Cleghorn (1936), in the CSF according to Jendrassik and the spectrophotometrically according to Fleming's and Woolf's (1965) formula. It was demonstrated that bilirubin appears in the CSF only in jaundice of different etiology, cerebral hemorrhages and in blocking the liquor paths. In the absence of such syndromes the haematoencephalic barrier is impassable for bilirubin.


[Methodologic problems in the relationship between psychiatry and psychology (results of a discussion)].

The paper discusses the methodological problems of relationship between psychiatry and contiguous disciplines, psychology in particular. The author sums up the results of the discussion that was held on these problems by the journal. The role and place of pathopsychological investigations in the study of the nature of mental diseases, the range of aims of psychopathological services in the solution of theoretical and practical problems of psychiatric practice are discussed.


[Psychology of relationships as a theoretical concept in medical psychology and psychotherapy].

The theoretical concept called "psychology of relations" (A. F. Lazursky, V. N. Myasishchev) is offered as the basis for a study of a patient's personality and psychotherapy. The author stresses ideological relationship of psychology of relations with phylosophy of dialectical materialism and I. P. Pavlov's studies about conditioned reflexes, its relationship with clinical psychoneurology, its direction to a study of the personality and adherence to primacy of consciousness over unconciousness. The perspectiveness of the evolutionally ontogenetic approach to the analysis of the system of relations and necessity to elaborate working systematizations determined by the research purpose, is stated.


[Relationship between thinking activity and typologic characteristics of personality (material from a study of schizophrenic patients and their relatives)].

The paper presents an analysis of relationships between the expressivity of the change in thinking selectivity and premorbid personality characteristics of schizophrenic patients (242 patients) and the types of personality anomalies in the relatives of the probands with schizophrenia (203 patients). The authors reveal correlation of the expressiveness of the above-mentioned thinking anomaly with definite types of personality anomalies (sthenic, hyperthymic and mosaic schizoids). The circle of the marked personality types according to the analyzed indices are limited both from representatives of the normal population and representatives of other personality types ("model", "deficient", cycloids). The obtained data permit to consider the studied thinking anomaly in the system of typological peculiarities of mental activity.


[States of preadjustment under conditions of prolonged activation according to evoked potential findings in schizophrenic patients].

The paper deals with a psychophysiological study of the states of disposition, expectation with the aid of the method of evoked potentials as one of the indices of peculiarities in activation processes in schizophrenic patients in conditions of active senso-motor activity. The study demonstrated significant differences in the schizophrenic patients in EP changes of cerebral cortex antecentral zones in situations of mental activity associated with expectation, active disposition. Moreover, in conditions of long-term stable activation schizophrenic patients show differences from normals by a character of dynamics of EP changes in the frontal brain areas, as the tension increases. The obtained data can testify to the fact that the given trend of psychophysiological studies may serve as an aspect of search and analysis of factors that are the basis of changes in a selective form of activation in schizophrenia.


[Psychopathology and the dynamics of psychogenic hysterical disorders arising in the presenile period and in old age].

As a result of the study of the nervous-mental state of 45 patients the author revealed considerable peculiarities of the clinical picture and the course of psychogenic hysterical disturbances depending on manifestations in the elderly or old age. It is shown that reactive hysterical states with the onset in the old age are distinguished by more elementariness, stereotypness, monotony of manifestations, absence of inclination for progression and transformation into a pathological development of a personality (what is frequently observed in the debut of hysterical disorders in the old age). The clinico-dynamic differences of psychogenic hysteria with the onset in presenium and old age are explained by different influence of common aged factors, climacteric and cerebro-vascular factors.


[Neuropsychologic characteristics of children with retarded mental development].

The neuropsychological study of 50 children with the diagnosis of mental retardation permitted to devide them into 2 groups according to the character and severity of disturbances. In the first group disturbances of some cortical functions are of a dynamical character, in the second group there is a stable insufficiency. The prevalence of the defect is different: in the first group phenomena of a dysfunction are observed in the zone of verbal tasks and in the second--in the verbal and nonverbal areas. The consideration of these results from the point of view of the conjugate brain activity allows one to state in the first group a dysfunction of the left (speech) hemisphere along with the normal development of the right hemisphere. In the second group there is a dysfunction of both hemispheres which points to a more expressed severity of disturbances. A special neuropsychological study of the functions of the frontal lobes protecting the highest forms of behaviour regulation demonstrates their different insufficiency in children with mental retardation. The first group shows impulsiveness and instability of an arbitrary control, the second group--enertness, perseveration in programming movements and actions. However, the anomaly of mental development in the second group of children may be related to mental retardation, since the marked defects are compensated by the possibility of holding intentions and capability of purposeful activity.


[Several aspects of the psychotherapy of neuroses (value of so-called rational psychotherapy)].

The authors consider neurosis as a disturbed ability of an adequate perception and reaction which must be corrected by the use of psychotherapy. The method of the socalled rational deep psychotherapy is taken as the main therapeutical influence. Other methods and measures are used in the complex with this method. The possibility of a patient's logical judgement in the use of the methods of suggestive therapy is pointed out. The new methods of psychotherapeutical influence are stated.


[Psychological aspects of rehabilitating mental patients under hospital conditions].

The paper summarizes the conducted studies on the investigation of the significance of permorbid aims of mental patients (mainly schizophrenics), their valuable orientations for the process of rehabilitation. Special attention is paid to the results of the socio-psychological studies which are characterized by the interrelations in the system "doctor--nurse--patient" and the analysis of relationships in parent famalies of schizophrenic patients as well.


Effect of vitamin C administration on blood cholesterol level in man.

Vitamin C (1.0 g/day) was administered orally to 20 healthy males for 1 month under controlled conditions. The blood ascorbic acid level rose from 0.76 +/- 0.21 mg% to 1.24 +/- 0.19 mg% in young subjects (20-30 years), and from 0.74 +/- 0.29 mg% to 1.22 +/- 0.22 mg% in middle-aged ones (31-50 years). Simultaneously, the serum cholesterol levels decreased from 204 +/- 16 mg% to 177 +/- 21 mg% in the young and from 256 +/- 11 mg% to 225 +/- 36 mg% in the middle-aged, a statistically significant fall of 10-15%, on the average (P less than 0.01). The effect in normo-cholesteraemic subjects, in particular, supports the cholesterol-lowering action of vitamin C.


Effect of perinatal monosodium glutamate treatment on endocrine functions of rats in maturity.

Rats were injected subcutaneously with monosodium glutamate (MSG); either a single injection of 2 mg/g b.w. was given on the 2nd day of life or repeated daily injections of the same dose were given from the 2nd to the 10th day. Controls received saline. The growth of repeatedly treated females was slightly retarded from day 80. Repeated treatment caused a slight reduction in endocrine organ weights in maturity; however, endocrine functions tested between 120-150 days of life were similar in control and treated animals, e.g., AM-PM difference in plasma corticosterone levels, adrenocortical stress responsiveness and glucose tolerance test (in males) and normal vaginal cyclicity, compensatory hypertrophy of ovaries and presence of pituitary castration cells after spaying (in females). None of these treatments influenced the sexual activity and fertility of either sex. These data indicate that perinatal MSG treatment does not cause hypopituitary syndrome in the mature rat.


Investigation on lichen production of grassland communities of sandy soil II.

Lichen production was investigated on two types of sandy Grasslands over more than two years. Two maxima of production were observed, a minor one in spring and a major one in autumn. The degree of these depended on climatic factors. Path analysis was applied for determining (1) the order of importance of the climatic factors and (2) the role of these factors in the changes of the total lichen production of associations and their influence on the productivity of the two determinant species, viz., Cladonia magyarica and Cl. furcata. Lichen production should be investigated for a period longer than the vegetation period.


In vivo cumulation and discharge of azine, thiazine and xanthene dyes and their effects on the chloragogen cells of Lumbricidae (Oligochaeta).

The in vivo cumulation of neutral red, methylene blue and acriflavine in the body wall, midgut epithelium and chloragosomes of Lumbricus terrestris L. and Octolasium transpadanum Rosa, and the discharge of these dyes by chloragosomes was investigated by spectrophotometry. The chloragosomes cumulated the largest amount of the ingested dyes. Electron microscopy displayed the activation of the chloragogen cells and an increased chloragosome formation on the first days of dye intake. In dye-free environment, the dye content of the chloragosomes decreased rapidly. The above properties of the chloragogen cells indicate the role of these cells in the defence mechanism against the toxic effect of certain cationic xenobiotics ingested via the intestinal tract.


Utilization of kerosene by a hydrocarbon-assimilating strain of Fusarium oxisporum.

Fusarium oxysporum IFO 6384 was grown in three different media, one containing glucose and two containing kerosene as carbon source. One of the kerosene media contained also Tween 60. The harvested dry mats were weighed at various stages of growth. Substitution of glucose with kerosene led to a sharp drop in the production of fungal mycelia. Analysis of the mat samples representing maximum yields indicated that the mycelia grown in the kerosene media were richer in free amino acid and poorer in protein as well as in polymeric and low-molecular weight carbohydrates than those grown in the glucose medium. Treatment of the culture filtrates with three volumes of acetone led to the separation of two fractions. In the first, acetone soluble fraction the free sugars and amino acids were determined, whereas the second, acetone precipitable one, was examined for its proteolytic activity. The gelatinase activity of the acetone precipitable material (APM) obtained from the kerosene media was lower than that from the glucose medium. The former activity, in contrast to the latter reached its maximum and minimum values at pHs 4 and 9, respectively.


Comparison of vegetative anatomy of piperales. I. Juvenile xylem of twigs.

Medullary bundles of Piperaceae resemble those of Ranunculaceae. The nature of tracheary elements of primary xylem suggests that Houttuynia cordata (Saururaceae), Piper cubeba (Piperaceae) and Chloranthus officinalis (Chloranthaceae) are of lower evolutionary status than others. Among these three, P. cubeba shows stratification of secondary xylem, a specialized character. Lateral wall of metaxylem tracheary elements and distribution of bundles of Peperomia, suggest their primitive status and distinctness, supporting separation of "Peperomiacea:" (of NOVAK). Piper cubeba, Houttuynia and Chloranthus bear one important Ranunculaceous character: scalariform perforation in primary vessels. Primitive species of Peperomia carry probably another Ranunculaceous character, i.e., many circles of medullary bundles. Shape and pattern of vascular bundles of Piper cubeba, Houttuynia and Chloranthus are similar. Other species of Piper show modifications. Peperomia represents another distinct pattern.


Comparison of vegetative anatomy of Piperales. II. Leaf.

Many characters of leaf (hair, hypodermal cells, palisade layers, intercellular space, distinction between spongy and palisade parenchyma, "palisade ratio", distribution of collenchyma and sclerenchyma, presence or absence of starch grains, calcium oxalate crystals, number, shape and arrangement of bundles of petiole) are useful distinguishing characters. Reduction of palisade layers seems to be the trend of evolution in Piper and Peperomia.


Changes of erythrocytes due to hyperoxygenation.

After exposure of animals to pure oxygen for an 1--3 hrs daily for 2--8 weeks the reticulocyte concentration increased 1.5--5 times in cats and decreased 2--4 times in rabbits of different age. The hemoglobin affinity to oxygen increased and then returned to normal level in adult rabbits, but only decreased in cats. Blood parameters in newborn rabbits whose mothers were breathing pure oxygen within 4 weeks of gestation up to the parturition were closer to those of adult animals as compared to control newborn rabbits. The hemoglobin affinity to oxygen in hyperoxic animals to normal levels after dialysis. This points to the importance of the salt environment within the erythrocytes for changes of the hemoglobin affinity to oxygen in hyperoxic conditions.


[The pre- and postoperative 2,3-diphosphoglycerate concentration of erythrocytes in children with cyanotic heart disease].

The behaviour of 2,3-diphosphoglycerate concentration (2,3-DPG) of red blood cells of babies and children with cyanotic heart diseases is studied before and after shunt operations. In babies with cyanotic heart diseases at the age of up to 6 months an increase of 2,3-DPG-level and haematocrit (HCT) is seen. Later, the compensation of chronic hypoxia is effected by further increase of HCT at unchanged high 2,3-DPG-level. The 2,3-DPG concentration which is still increased after successfull shunt operations as compared with the normal value is considered as an effective adaptation mechanism to the residual hypoxia presenting only a small load on the circulatory system. The 2,3-DPG concentration alone does not represent a criterion for the assessment of chronic hypoxia.


Characterization of abnormal glucose-6-phosphate dehydrogenase variants.

For characterizing glucose-6-phosphate dehydrogenase variants 10 functional parameters are generally used. As additional tests the determination of Km and Ki at different pH values, the limiting Km for both substrates, isoelectric focusing and electrophoresis of enzyme subunits have been recommended. Most of the variants with favourable kinetic properties do not produce chronic haemolysis. As an exception G6PD Aarau is quoted. Sporadic cases and deficiency conditions with manifest chronic nonspherocytic haemolytic anaemia should be selected for complete enzyme characterization. Individual and public health aspects are of primary importance for screening programs. Among 28,367 blood samples 424 cases with G6PD deficiency have been found in Switzerland.


[Energy metabolism of erythrocytes in pyruvate kinase enzymopathies].

Until now pyruvate kinase enzymopathies have been described only for red blood cells. On the basis of these results special structural properties of the erythrocyte PK was assumed, which are not yet totally established. PK defects may cause a nonspherocytic hemolytic anemia. This enzymopathy is characterized by a polymorphism, which is expressed in more than 5 different pathological variants. Up to now 16 cases of PK deficiency have ben diagnozed in the GDR. The following parameters are used for the characterization of the PK: the PEP-dependance, the inhibition by ATP and alanine, the specificity to nucleotides, the stability to temperature and urea and the maturation dependence. Two pathological variants of the PK with a decreased PEP-affinity are described. Furthermore the differences in the energy metabolism of the red blood cells of these two patients under aerobic and anaerobic conditions are discussed.


Unstable mutants and molecular hybrids in enzyme deficiency conditions.

Multiple molecular forms contribute to various types of enzyme heterogeneity: "Iso(en)-zymes" and "Allozymes" (enzyme variants) are of genetic origin whereas "Metazymes" represent secondary modifications of epigenetic nature. The concept of variability originates from the discovery of a large number of enzyme variants. Structural gene mutations can lead to enzyme variants of low specific activity or reduced stability and can cause enzyme deficiencies. In heterozygous carriers of oligomeric enzyme defects, the formation of hybrid molecules is possible by random assembly of simultaneously synthetized normal and mutant subunits. The study of normal processes as well as enzyme anomalies contributes essentially to better understanding of biochemical individuality and evolutionary events at a molecular level.


Valency hybrids of hemoglobin in red cells of patients with hereditary enzymopenic methemoglobinemia.

Twenty eight patients with hereditary methemoglobinemia have been found and examined. Using the techniques of analytic isoelectrofucossing in polyacrylamide gel and the preparative isoelectrofocussing on a column in sucrose gradient we have managed to disclose an abnormal fraction in hemolysate of the above mentioned patients. It has been proved that the obtained fraction contains hemoglobin valent hybrids, possesses high affinity to oxygen and low cooperativity. Due to the presence of valency hybrids about one-half of the quantity of oxy-Hb fails to participate in the normal function of oxygen delivery, which evidently is the molecular cause of disturbance of oxygen delivery in patients with hereditary enzymopenic methemoglobinemia. This also explains a high degree of cyanosis in them.


[Functional characteristics of normal and pathologic erythrocytes].

Polarographic titration in a closed cell of blood samples and concentrated Hb solutions was used to study the regulation of the release of oxygen by the red cell. The effect of temperature, polyethylenglycol and metabolites normally found in the erythrocyte was determined by spectrophotometric and polarographic methods. Some pecularities of O2-transport and release in beta-thalassemia, functional hypoxia and Cooley-disease are described.


[Uroporphyrinogen-I-synthetase in erythrocytes in acute intermittent porphyria].

The primary genetic defect in acute intermittent porphyria is a decreased uroporphyrinogen I-synthetase [EC.4.3.1.8] activity. As a beginning of a genealogical study of the known families with members suffering from this disease in the People's Republic of Bulgaria, the red cell uroporphyrinogen I-synthetase was determined in 3 families by the method of Mandel et al [8]. Except for the three propositi, an enzyme deficiency was established in 3 latent carriers of the pathological gene, two of whom had normal values of the urinary epsilon-aminolevulinic acid and porphobilinogen. The determination of red cell uroporphyrinogen I-synthetase proved to be a valuable parameter for revealing the latent AIP.


[Electronmicroscopic detection of cation binding sites on the erythrocyte membrane].

Numerous Ca2+-binding sites were localized ultrahistochemically at the inner surface of the erythrocyte membrane and small amounts at the outer surface. La3+-binding sites were demonstrated at the outer surface only. The results were discussed in relationship to the binding capacity of the filamentous matrix and the glycocalyx of the human erythrocyte membrane.


Platelet phospholipids in liver cirrhosis.

In the present study we have investigated and also compared the biochemical nature of the platelet phospholipids in patients with portal liver cirrhosis and in normals. Normal platelets contained 10.88 +/- 0.83 microgram of phospholipid phosphorus per 10(9) platelets whereas the cirrhosis platelets contained 7.63 +/- 1.29 microgramP/10(9) platelets. In cirrhosis there was a 29.87% decrease of phospholipids compared to normal. However the percentage distribution of phospholipids in cirrhosis was similar to normal. But each phospholipid value in cirrhosis was found lower then normal. Estimated as microgram phosphorus per 10(9) platelets decreased amounts of phosphotidyl inositol (PI) (0.29 +/- 0.16), phosphotidyl serine (PS) (0.49 +/- 0.12), phosphotidyl ethanolamine (PE) (2.0 +/- 0.43) and spingomyelin (SPH) (1.42 +/- 0.31) and phosphotidyl choline (PC) (3.25 +/- 0.62) and total lipid phosphorus (7.63 +/- 1.29) were found in the patient group.


Malignant papillomatosis of the intrahepatic bile ducts.

A case of intrahepatic bile duct papillomatosis is reported which recurred several times and finally progressed into a mucin-secreting papillary adenocarcinoma. The paillomatosis predominantly involved the ductal system of the left hypoplastic hepatic lobe. The treatment consisted of a left partial hepatectomy. Hereby, a four-year survival was reached. While the prognosis of solitary papillomas in the distal choledochus and in the gallbladder is considered as good, the prognosis of the intra- and extrahepatic bile duct papillomatosis appears unfavorable. The experience in this case, as well as in the literature, shows that these papillomatoses have to be regarded as low-grade carcinomas.


Jaundice in typhoid hepatitis: a light and electron microscopy study based on liver biopsies.

Light and electron microscopy study of fourteen liver biopsies in typhoid fever disclosed a mild hepatitis in which there is marked reticulo-endothelial hyperplasia, with many lymphoid cells in the hepatic sinusoids. The hepatic cell lesion was non specific, manifested by reticulum endoplasmic dilatation, mitochondrial alteration and biliary canaliculus injury. Such findings were particularly evident in the jaundiced patients. Jaundice was, in our series, a more frequent complication of acute typhoid fever than commonly reported. Usually it is of short duration and the serum bilirubin was not markedly elevated. However, there were instances when the jaundice was so accentuated as to lead the clinician to a first diagnosis of virus hepatitis or leptospirosis. The pathogenesis of the intrahepatic cholestasis in typhoid fever is still obscure, but apparently it is, as has been described in other infectious diseases, due to an injury of the bile secretory apparatus brought out by the bacillary endotoxin.


Ornicetil on encephalopathy. Effect of ornicetil (ornithine alpha-ketoglutarate) on encephalopathy in patients with acute and chronic liver disease.

Di-L (+)-ornithine, alpha ketogluterate infusions were compared with infusions of dextrose water in 27 comatosed patients with acute and chronic liver disease. Of 7 patients with acute liver disease no improvement of conciousness was found in any of these patients. Of 20 patients with chronic liver disease, lowering of blood ammonia level during ornicetil therapy occurred in 8, during the control infusion in 6, and no effect was seen in 4. Improvement of conciousness during ornicetil occurred in 11, during the control infusion in 6 and 3 had no improvement. Among those who improved, 4 in the ornicetil group and 2 in the control group improved after the precipitating causes were controlled or corrected. This study indicated that ornicetil has no beneficial effect on the treatment of coma in various forms of hepatic disease.


The diagnostic value of percutaneus liver biopsy in patients with non Hodgkin's lymphoma - a preliminary report.

Since the presence of the pathological liver process definitely changes the approach in determining clinical staging and therapy of patients with non-Hodgkin's lymphoma, the authors carried out percutaneous liver biopsies in 33 untreated patients with this diseases. The liver biopsies were performed with Menghini's needle and the material was histologically and cytologically examined. Liver involvement was found in 9 (27%) patients. Based on the analyzed biopsies, the authors concluded that percutaneous liver biopsies represent a significant diagnostic approach in clinical staging and therapy of non-Hodgkin's lymphoma. The authors further compared the bioptical findings with physical examinations, biochemical blood tests and liver scintigraphy.


Prophylactic effect of somatostatin on stress ulcer formation in rats.

The aim of the present study was to investigate the effect of somatostatin (growth-hormone release-inhibiting hormone) on ulcer formation during immobilisation stress. This was done in male Albino-rats to study the effect of somatostatin on number and size of ulcers, to calculate ulcer index, to measure pH-value of gastric juice as well as plasma levels of gastrointestinal hormones. Rats treated with somatostatin before and during stress exposition had only the third part of the ulcers compared with the untreated animals. Total ulceration area was less than the tenth of the untreated rats. Normal corticoid plasma levels during stress exposition were found in the lower range of normal values in somatostatin treated rats. Decrease of plasma gastrin during stress exposition exceeded the gastrin decrease of somatostatin treated rats. Rise of plasma glucagon was completely inhibited during somatostatin application. Results of serum glucose paralleled those seen in glucagon.


The assessment of the antipeptic effect of ulcer therapy.

A semi-quantitative method for the analysis of the proteolytic activity of the gastric juice is described. The method is based on the measurement of "lengths" of digested chicken egg-white in fenestrated chlorvinyl tubes. Each tube remained in the stomach of the test subject for 12 hours, either during the day or during the night. During the night, the proteolytic activity of the gastric juice was 30% higher than during the day. A one-week ulcer therapy with atropine and Vikalin (Roter) led to a significant (p less than 0.01) reduction of the nocturnal proteolytic activity. The anticholinergic Chlososil (0.08 g) administered in the evening reduced the proteolytic potential during the night to the level seen during the day. In patients with duodenal and gastric ulcers, the drop in proteolytic activity during ulcer therapy was inversely proportional to the level of the acid output.


Acid releases motilin from human duodenum in vitro.

The effect of hydrochloric acid and sodium hydroxide on motilin release from human duodenal mucosa was studied in vitro. Tissue was incubated in 2 ml chambers continuously perfused with medium and was exposed repeatedly to the stimuli. Motilin released into the medium was determined by a specific radioimmunoassay. Whereas alkalinisation abolished basal motilin release, acidification resulted in a 14-fold increase of peptide secretion. The results indicate that motilin secretion can be stimulated in vitro and that the perfusion system described may be a useful tool in studying the mechanism of gastrointestinal hormone release.


The effect of GIH and Boots secretin and cholecystokinin on duodenal ulcers in the rat.

The effects of two commercially available preparations of secretin and cholecystokinin have been studied on experimental duodenal ulcers in the rat. Pentagastrin and carbachol infused subcutaneously over 24 hours produced a 100% incidence of duodenal ulcers. A dose-related inhibition of these ulcers was found using secretin obtained from the Gastrointestinal Hormone Laboratory, Stockholm (GIH). Boots secretin had no such inhibitory action and may even have aggravated the duodenal ulcerogenesis. Similar results were obtained with both GIH cholecystokinin and Boots pancreozymin.


Comparison between bolus injection and infusion of secretin and pancreozymin in the diagnosis of chronic pancreatic disease (one hour test).

There is no agreement in the literature as regards the carrying out of the Secretin-Pancreozymin test in order to achieve the greatest accuracy in the diagnosis of pancreatic insufficiency. In this study the results obtained by bolus i.v. injection of Secretin and Pancreozymin GIH are compared with those obtained by i.v. infusion of the hormones. The test - always prolonged for one hour - was done in 125 subjects, divided into two groups matched for sex, age and pancreatic or digestive disease. Volume, pH, bicarbonates, calcium and amylase were measured in the juice collected. The results showed that bolus i.v. injection of Secretin and Pancreozymin has greater diagnostic sensitivity (94%) than the infusion method (84%). If infusion is used, it is necessary to protract the test for more than one hour.


Study on lipid absorption in uraemia.

While the occurrence of morphological and functional small intestinal alterations in chronic uraemia is well established, analyses of intestinal lipid utilization are rare. In the present study faecal fat excretion in chronically uraemic humans and rats and the reesterification of a long-chain fatty acid in the mucosa of the small intestine of uraemic rats were investigated. -Reesterification of 14C-palmitic acid in the intestinal mucosa of rats with chronic uraemia produced by 5/6-nephrectomy (BUN 37.8 +/- 12.8 mg/100 ml, serum creatinine 3.0 +/- 0.44 mg/100 ml) was found to be significantly lower (374.2 +/- 166.8 mumol/mg protein x h) than in controls (604.9 +/- 274.2 mumol/mg protein x h) pointing to a disturbance of the intracellular process of absorption of long-chain fatty acids. However, the mean daily fat excretion in the faeces of chronically uraemic rats fed a diet with normal (4.2 per cent) or relatively high fat content (10 and 15 per cent) was not increased. In 20 patients with chronic renal insufficiency (BUN 75.9 +/- 35.9 mg/100 ml, serum creatinine 7.5 +/- 2.8 mg/100 ml) the faecal fat excretion was within the normal range (4.2 +/- 1.2 g/day). These results indicate a sufficient compensation of the impaired intestinal reesterification of fatty acids by the large functional reserve of the small intestine.


Preparation and characterization of Ng-mono-, di- and trimethylated arginines.

A simple procedure is described for the synthesis of N-guanidino methylated ariginines. The yields of all methylarginines exceed those obtained by earlier procedures. Trimethylarginine - an amino acid not found in natural sources - has also been synthesized with this technique. Studies with arginine specific dicarbonyl reagents showed that methylation of guanidino-groups decreases the reactivity of methyl-arginines, only monomethylarginine reacting at a rate comparable to that of arginine.


Kinetic studies on the calcium-dependent potassium transport in human red blood cells.

The kinetics of the Ca-dependent K transport across the human red cell membrane were studied under experimental conditions allowing the separation of this step from the previous membrane events. Net potassium and tracer potassium fluxes were measured and a self-consistent model was constructed for calculating the ionic permeability values. All the experimental results could be interpreted by means of a nonsaturable neutral K selective channel. In net K efflux measurements the accompanying C1 movement was found to be rate-limiting, and the charge-carrying C1 permeability of the red cell membrane could be calculated.


Effect of a biguanide (buformin) on carnitine palmitoyltransferase activity.

Buformin at a concentration of 1--2.5 mM stimulates solubilized carnitine palmitoyltransferase by reducing the inhibitory effect of palmitoyl-CoA. Neither buformin nor metformin inhibits the solubilized carnitine palmitoyltransferase.


On the enhanced catalytic activity of papain towards amide substrates.

According to the scanty literature data papain (EC. 3.4.4.10) reacts with ester and corresponding amide substrates at a similar rate (Glazer, Smith, 1971) despite a considerable difference in the reactivities of the ester and amide bonds. An explanation for the similar rates may be an increased acylation rate of amides relative to that of esters owing to hydrogen bond formation between the amide group of an amide substrate and Asp-158 carbonyl oxygen as it is apparent from the three-dimensional structure of papain. This possibility was confirmed by comparing the second-order rate constants of acylation of papain with the ester and amide derivatives of N-benzoylglycine and O-benzoylglycolic acid. The rate enhancement with amides is not an equally important factor with all substrates of papain: the amides of N-acyl-L-phenylalanylglycine are hydrolyzed at a considerably lower rate than the corresponding esters. It is concluded from the above data that the binding mode is somewhat different with various substrates.


Studies on heart isophosphorylases by means of immunotitration.

Anti-phosphorylase produced in cocks against phosphorylase from rabbit skeletal muscle inhibits phosphorylases isolated from mammalian heart and skeletal muscle to different degrees. On the basis of the differential inhibition observed an immunotitration method was developed to determine isophosphorylases in crude heart extracts. It was found that the ratio of isophosphorylases is different for every mammalian species investigated and characteristic for the given species.


Studies on human tonsillar lymphocyte membranes. I. Isolation and characterization of a membraneous glycoprotein fraction from human lymphocytes.

A microsomal fraction containing high amounts of plasma membrane has been isolated from human tonsillar lymphocytes. The subcellular fractions were characterized on the basis of their chemical composition and enzyme activities. A glycoprotein fraction solubilized by lithium-diiodo-salicylate (LIS) was purified by ion-exchange chromatography. The purified glycoprotein was analyzed by various methods and its carbohydrate content was determined. The glycoprotein contained large amounts of hexoses and sialic acid and this fraction represented 3--4% of the whole plasma  membrane protein. The fraction was shown to consist of three individual proteins (4 X 10(4), 4.6 X 10(4) and 4.8 X 10(4) daltons) determined by SDS-polyacrylamide gel electrophoresis.


Vinblastine inhibition of microtubule assembly in vitro.

The effect of vinblastine on the in vitro polymerization of tubulin was investigated. It has been shown that the presence of VLB prevents the assembly of tubulin in rat brain extracts, and the addition of VLB to assembled microtubules results in their rapid depolymerization. The polymerization was monitored by viscometry and electron microscopy.


Bound water in biology.

A detailed investigation of the spin-diffusion coefficient Ds of water protons in skeletal muscle has been studied by pulsed nuclear magnetic resonance (NMR) methods. Skeletal muscles of mature male rats were placed in a sample holder in which the diffusion coefficient (Ds) of water could be determined as a function of fiber axis theta. The value of Ds(theta) was determined for theta = 0 degrees, 45 degrees, and 90 degrees. The measured anisotropy Ds(O)/Ds(90) was 1.39, and the value of Ds(O) was 1.39 X 10(-5) cm2/sec. These results are interpreted within the framework of a model calculation in which the diffusion equation is solved for a regular hexagonal network similar to the actin-myosin filament network. The large anisotropy, and the large reduction in the value of Ds measured parallel to the filament axes lead to three major conclusions: (1) interpretations in which the reduction in Ds is ascribed to the effect of geometrical obstructions on the diffusion of "free" water are ruled out; (2) there is a large fraction of the cellular water bound or otherwise associated with the proteins in such a way that its diffusion coefficient is substantially reduced; and (3) cellular water cannot be considered to be equivalent to a dilute solution.


The role of shortening and tension in the heatproduction of muscle.

The dependence of the heatproduction of muscle on shortening was examined. An inverse relation was found between heatproduction and shortening as well as tension and shortening, while there was a close positive correlation between heatproduction and tension. The results emphasize the primary importance of tension as compared in the heat production of muscle, to shortening.


Electrical properties of the cardiac muscle cell membrane and its role in the excitation-contraction coupling.

During extracellular stimulation, the electrical properties of the cardiac muscle cell membrane were investigated by means of intracellular microelectrodes. The current-voltage characteristic was S-shaped, and showed non-linearity over given voltage ranges in hyperpolarizing and depolarizing directions as well. The space constant of the membrane was 1.7 +/- 0.1 mm, which decreased after treatment with Ca-free or hypertonic solutions. The mean membrane time constant was 70 msec. and the input resistance was about 8 Mohm. The specific membrane resistance (Rm) and capacity (Cm) were 20 000 ohm.cm2 and 5--6 muF/cm2, respectively. After glycerol treatment the Rm decreased to 10 000 ohm.cm2 and the Cm to 4--4.5 muF/cm2. On the basis of our results it seems reasonable to suggest that the functional relationships between muscle cells might be realized through low resistance junctions, and the effectiveness of these junctions appears to be weakened both by Ca-free solution and glycerol treatment. The specific membrane capacity was lowered by 20 per cent, after treatment with a hypertonic solution, however 60 per cent of the contractility remained unchanged. Thus, we conclude; 1. a part of the Cm originates from the infoldings of the surface membrane, and 2. the snail heart muscle cells are insensitive to glycerol treatment. Since the excitation-contraction (E-C) was not affected by the glycerol treatment it can be assumed that in snail heart the coupling of the E-C is a "direct coupling" similarly to other heart, smooth and slow muscles.


[Transient agraphia due to a left parieto-occipital glioma in a right-handed patient: amnesic or "pure" agraphia? (author's transl)].

The authors investigate a case of agraphia induced by a left parieto-occipital tumor (glioma) in a right-handed 67 year-old patient. After three successive neuropsychological examinations it still proves immensely difficult to determine whether defects of spontaneous writing, dictation and copy are due to apraxia, alexia or motor disturbances. The authors discuss whether the clinical findings indicate a "pure agraphia" syndrome or "amnesic agraphia". Finally, problems of aetiology and lesional localisation are examined in the light of the literature. (Acta neurol. belg., 1977, 77, 321-330).


[New possibilities of anatomo-clinical correlation in aphasia using cerebral tomodensitometry (author's transl)].

The authors present a method using cerebral tomodensitometry to establish anatomo-clinical correlations in aphasia. They confirm, in their broad lines, the results of previous studies. They stress the importance of the material that could be studied by this method and define the ideal conditions in which future work should be carried out. (Acta neurol. belg., 1977, 77, 351-362).


Transendothelial vesicular transport of protein in brain edema induced by ultraviolet irradiation.

Focal vasogenic brain edema was induced by ultraviolet irradiation of the exposed cerebral cortex of 16 cats. In 5 animals horseradish peroxidase was intravenously injected at times varying from 30 min to 24 h following irradiation and allowed to circulate for 45 min. Fixation was carried out by perfusion and immersion with glutaraldehyde. The tissue, part of it incubated for peroxidatic activity, was treated for electron microscopy. The UV-irradiation leads to a shallow coagulation of the superficial cortex from which a wide zone of edematous tissue spreads to the deep white matter within 24 h. Arterioles, capillaries and venules of this zone show enhanced pinocytotic activity and a concurrent rise in permeability for horseradish peroxidase which is found in micro- and macropinocytotic vesicles, in tubular vesicle-like structures, in endothelial wall invaginations and apparently not membrane-bound. These changes are most pronounced in venules which after 48 h allow penetration of reaction product though the base membrane into the surrounding neuropil. There is no evidence for the penetration of tight junctions which appear intact.


Generalized giant axonal neuropathy: a filament-forming disease of neuronal, endothelial, glial, and schwann cells in a patient without kinky hair.

The process of Giant Axonal Neuropathy (GAN) is not restricted to the peripheral nerves, but also involves the central nervous system. In a 25 year old man  with normal hair, abundant axon swellings and spheroids were observed in the spinal cord, brain system, and cerebral cortex. The findings in the sural nerve have already been published by Boltshauser et al. (1977). Accumulations of filaments in the axons and in the perineural cells were accompanied by Rosenthal fibres. The ultrastructural pattern of GAN differs clearly from that of Neuroaxonal Dystrophies.


Effects of chronic styrene inhalation on rat brain protein metabolism.

Adult male rats were exposed to 7.9 mumol/1 (300 ppm) of styrene for 2--11 weeks 6 h daily excluding Saturdays and Sundays. The exposures caused a marked styrene accumulation in brain and perinephric fat, and the accumulation tended to increase upto the 4th week. The body styrene content decreased thereafter gradually towards the end of the experiment to reach half of the styrene content of the 4th week. Serum creatine kinase activity increased at the initial stage of the exposures while serum non-specific cholinesterase was below the control range at the same time. Earliest biochemical changes were detected at the 9th week of exposure, and they included increased activity of lysosomal acid proteinase. Increased enzyme activity prevailed to the end of the exposures. Simultaneous minor alterions could be detected in spinal cord axonal protein pattern whereas water-soluble protein composition in cerebellum did not change. Biochemical alterations in brain were not accompanied by significant changes in serum enzyme activities. It is concluded that marked metabolic adaptation to inhaled styrene takes place. Serum enzyme determinations may prove valuable in the adaptation period whereas they may not reflect beginning chronically neurotoxic effects.


Paranodal myelin retraction in protein deficient and normal rats: a morphometric study.

Young rats, submitted to severe protein restriction were studied concerning the width of inter-myelin gaps at the nodes of Ranvier in peripheral nerve fibres. The results gave no proof of increased paranodal myelin retraction in lumbar spinal roots or the sciatic nerves of low-protein rats. Malnourished rats as well as controls showed great interindividual differences as to the presence of nodes with wide inter-myelin gaps.


Striated muscle cells in the leptomeninges in cerebral dysplasia.

Non-neoplastic foci of skeletal muscle cells are rarely noted within human central nervous system. This report describes two children with developmental anomalies and striated muscle in the leptomeninges. Embryological displacement of notochordal or prechordal mesoderm in certain types of cranio-vertebral-cerebral dysplasia may account for the origin, the restricted sites and the infrequent observation of leptomeningeal striated muscle cells.


[Enterogenous cyst of the spinal cord associated with mucomyelia (author's transl)].

A woman of 22 years developed heavy pain in the neck and arms with weakness and paresthesia. She died two days after a myelography which was normal. At autopsy an enterogenous extra- and intra-medullary cyst of the cervical cord (C3, C4) was found. In addition the cervical cord apart from the cyst and the uppermost thoracic cord presented central clefts which were filled with mucilage. These findings are named mucomyelia and have not been reported previously.


The effect of salbutamol and terbutaline in the management of premature labour.

A comparative study concerning the effect of salbutamol and terbutaline in the management of premature labour with intact membranes has been performed. Each group included 34 patients between 27-36 weeks gestation. The drugs used were given by intravenous infusion. Salbutamol arrested labour activity in 33 of 34 patients and terbutaline in 32 of 34 patients. Delivery was postponed for more than one week in 74% of the patients receiving salbutamol and in 80% of the patients receiving terbutaline. No significant difference in effect was found between the drugs used. The effect was equally good independent of the gestational age. Dilatation of cervix beyond 2 cm was associated with successful treatment (delay of delivery more than one week) in 27% compared to 91% if cervix was dilated 2 cm or less. In 12 patients with ruptured membranes a temporary arrest of labour activity (1-7 days) was obtained in 7 patients, and in 1 patient the delivery was delayed for 6 weeks. In the dosage used an increase in maternal and fetal heart rate was observed, more frequently in the patients receiving salbutamol compared with those receiving terbutaline. No serious side-effects were observed, neither in the salbutamol nor the terbutaline group. It is concluded that both drugs are well tolerated and effective in the treatment of premature labour.


The effect of beta-receptor-stimulating agents on the utero-placental blood flow.

The influence of salbutamol, a beta-2-receptor-stimulating agent, on the blood flow through the utero-placental unit was evaluated in the human. Serial placenta scintigrams were analysed quantitatively, after injection of 0.5 mCi Indium-113m, by means of a gamma-camera connected on line to a computer. The examinations were performed in the third trimester of pregnancy. No sedation was used. Uterine contractions were not present. Salbutamol caused an increase in activity over the placental region, corresponding to a 15% increase in blood volume. The rise time of the initial phase of isotope accumulation (calculated from 5 to 95% of final activity) was prolonged by 100% during salbutamol infusion. As the rise time is proportional to the volume/flow ratio of blood in the uteroplacental region, our data indicate that salbutamol infusion causes a decrease in blood flow in the absence of uterine contractions.


The influence of pressure upon the fetal head during labour.

In contracted pelvis, moulding of the skull bones is caused by the force of the amniotic fluid pressure and the resistance of the pelvis. In normal labour and abnormal uterine action the moulding of the skull bones is caused by the head to cervix pressure, as has been demonstrated by intra-uterine tokometry. By contrast, in the contracted pelvis there are no mouldings between the two parietal bones. In breech presentation during the first stage of labour the moulding of the skull bones is explained, by the differing resistance of the various skull bones against the amniotic fluid pressure.


Maternal deaths in Iceland 1911-1975.

Death certificates for all deaths in Iceland are available since 1911. In this report on maternal deaths, all women who died after the 28th week of pregnancy, during delivery and during the first eight weeks after delivery are included, irrespective of the cause of death. Out of 225 891 women who delivered during the 65-year period, 321 women died. Maternal deaths per thousand deliveries have declined from 3.89 to 0.09 from the first 5-year period (1911-1915) to the last 5 years of the observation time (1970-1975). The three main causes of maternal deaths, puerperal fever, haemorrhage and toxaemia, are discussed. Since the new Maternity Clinic at Landspitalinn opened in 1949 it has been the main department for obstetrics and gynecology in Iceland, to which a great majority of complicated cases in pregnancy and delivery are referred. Since 1949, 39411 women have delivered at this department. There have been 15 maternal deaths at the clinic or 0.4 per thousand. A separate table (Table III) shows the age, parity and causes of death in the 15 cases. Maternal deaths in Iceland during the last decade occur in one per 11 000 deliveries. This is a problem of communication as well as a medical problem.


Maternal mortality in Australia 1964-72.

Statistics covering deaths directly due to pregnancy in the Commonwealth of Australia have been available since the turn of the century. However, those for deaths associated with pregnancy have not. Over the past two decades each State in the Commonwealth has set up Maternal Mortality Committees to collect confidential information on each maternal death, both direct (where the death is directly attributable to pregnancy or childbirth) and associated (where the death is associated with but not directly due to pregnancy or childbirth). New South Wales had set up the first such Committee in the 1930's, and this has since been followed by the other States. Most of the States have published reports from time to time but, owing to the small numbers involved, these reports have been limited in the conclusions that could be made. Confidential information on each maternal death is obtained and is considered by the State Maternal Mortality Committee. The cause of death is confirmed and classified. A necropsy is usually performed in each instance, the pathologist travelling to the town where the death has occurred, if requested.


Danazol: an antigonadotrophic agent in the treatment of recurrent pelvic and intestinal endometriosis.

Six cases of pelvic endometriosis were treated with Danazol 400 mg daily for six months. In four of these cases, intestinal endometriosis of varying severity was also present. The initial results were very satisfactory except in one case with adenomyosis and continuous spotting. Follow-up after cessation of treatment suggests that in some cases a further period of treatment will be necessary.


Estriol concentrations in urine and serum in patients with various intestinal diseases.

Pregnant women with ulcerative colitis shows frequently low estriol values in both serum and urine. 18 patients with ulcerative colitis, 4 patien;s with mb. Crohn, and 3 patients with a by-pass operation were examined. Low estriol concentrations were seen only in the patients with ulcerative colitis especially in patients, where an operation has been performed. In one patient with severe diarrhea the estriol concentration in serum was low until the intestinal function normalised and the estriol concentration went up exactly when the diarrhea stopped. However, no unequivocal connection between low estriol concentrations and diarrhea could be demonstrated.


The effect of various doses of oral oestradiolvalerate and oestriolsuccinate on urine calcium/creatinine, serum FSH and endometrium in castrated women.

The effects of various doses recommended for clinical use of oestradiolvalerate and oestriolsuccinate on urine calcium/creatinine, serum FSH and endometrium were investigated in two castrated women. Oestrogen treatments were given in 6-week periods separated by 2 weeks without treatment. After various oestrogen treatments, serum FSH generally decreased clearly and urine calcium/creatinine slightly. The proliferative effect on endometrium was investigated histologically. In no period was a hyperplastic endometrium found.


Changes in serum lipids during treatment with norgestrel, oestradiol-valerate and cycloprogynon.

The serum concentrations of triglycerides, cholesterol, and free glycerol were determined in 23 climacteric women, before and after the administration of three different steroid drugs. Each drug was given within a period of 12 weeks (3 cycles). Period I: Norgestrel, 0.5 mg daily from the 12th to 21st day of each cycle. Period II: Oestradiol-valerate (Progynon) 2 mg daily from the 2nd to 21st day of each cycle. Period III: Oestradiol-valerate 2 mg from the 1st to 11th day followed by oestradiol-valerate 2 mg+0.5 mg dl-norgestresl from day 12 to 21 of each cycle (Cycloprogynon). A significant decrease in triglycerides was observed following the administration of norgestrel and Cycloprogynon, whereas oestradiol-valerate had no effect on the triglyceride levels. On the other hand, oestradiol-valerate, following a period of norgestrel, produced an increase in serum cholesterol levels.


Uterine activity in diabetes insipidus.

In two nonpregnant women with cranial diabetes insipidus, myometrial activity under different hormonal conditions was studied by intrauterine pressure recording. Recordings were performed when the women were under the influence of their regular treatment with desaminocys1-D-arg8-vasopressin (DDAVP), and when they had fully developed symptoms of their disease. Uterine activity was similar to that found in normal women under the same hormonal conditions, and generally did not change when symptoms of lack of vasopressin appeared. Both DDAVP (15-20 microgram), given intranasally, and lysin vasopressin (0.2 IU), given intravenously, stimulated uterine activity, particularly in late secretory menstrual phase. It is suggested that endogenous vasopressin is of minor importance for the induction of spontaneous uterine activity in nonpregnant women.


Pubococcygeal repair ad modum Ingelman-Sundberg. A retrospective investigation with 10-20 years time of observation.

Fifty-one women operated on for stress incontinence with pubococcygeal repair ad modum Ingelman-Sundberg between 1955 and 1965 were investigated urogynecologically. The time of observation was accordingly at least 10 years in every case. An evaluation was made of this operation method, the distribution of recurrences during the postoperative period and possible side effects. Eight women had symptoms of at least degree I stress incontinence and thirteen showed signs of incontinence at the examination. Only four had both symptoms and signs of incontitinence. The cure rate from a symptomatic point of view was 84% and from the technical aspect 75%. Most fo the severe recurrences occurred in the first postoperative year. Thereafter the recurrences were evenly distributed. The only side effect in the long run was a tendency to rectocele.


Ingelman-Sundberg operation for urinary incontinence. Our experience.

The authors analyse the indications for the Ingelman-Sundberg operation considering pelvic anatomy, previous surgery and the age of the patient. The operation is described with pre- and postoperative management. Associated operations, such as perineorraphy and the amputation of the uterine cervix are mentioned. Finally, a study is made of the experience of the Gynecologic Clinic of the Catholic Faculty of Medicine presenting the postoperative problems that have arisen and the results obtained in the cure of urinary incontinence. The surgical treatment of urinary incontinence due to lesions of the pelvic floor, presents several difficulties, with a high incidence of recurrence of symptoms.


Results of operative treatment of stress urinary incontinence with special reference to preoperative clinical and radiological evaluation.

Operative results of stress urinary incontinence are discussed on the basis of a follow-up study made 3-5 years after the operation. The series consisted of 301 patients operated on during 1969-1971. The most significant anamnestic feature was the great number of multiparas: 67% of the patients had given birth to at least 4 children. The choice of the operative method was based on Green's urethrocystographic classification into type I and type II. The healing was complete or satisfactory in 85% of the total material. In the group operated on according to type I the outcome was good in 88%, while in the type II group it was good in 84%. Incontinence of degree I was cured in 89% of the cases, while patients of degree III in only 72%. If there was a significant urgency component observable in the incontinence symptoms preoperatively, a good outcome was only attained in 64%. In pure or dominant stress incontinence the corresponding outcome was 88%. Hysterectomy combined to the operation seemed to improve the results. Age, parity, duration of the incontinence symptoms, weight and changes of weight after the operation had no significant effect on the healing. The authors emphasize the importance of careful differential diagnosis based on the anamnesis and examinations in choosing the therapeutic method for incontinence patients.


Is there a changing epidemiology of premalignant lesions of the cervix? Results of cytologic screening of pregnant women.

The selection of women approached for cytologic screening is based on previous studies on age distribution and prevalence and consequent considerations on the risk of developing invasive carcinoma. In order to check if this is appropriate the results of the screening of pregnant women being selected irrespective of their age has been studied for two periods, 1961-64 and 1972. The frequency of lesions was remarkably high among the teenagers of both periods. A significant increase in the incidence of lesions was noted for the period 1972. This increase is most evident in the ages 21 to 30. A shift to more severe lesions was found among the teenagers and in the groups between 31 and 40. In conclusion more effort should be made with respect to cytologic screening of young women, particularly when pregnant. The increased frequency of cytologic atypias among women between 21 and 30 should focus the attention to the possibility that the epidemiology or premalignant lesions of the uterine cervix is changing.


Effect of alkoxyglycerols on the frequency of injuries following radiation therapy for carcinoma of the uterine cervix.

The incidence of injuries following intracavitary and external radiation therapy is markedly decreased in all stages of the disease by the administration of alkoxyglycerols. Complex injuries (due to radiation injury and tumour growth in combination) were reduced to about 1/3 in a group receiving alkoxyglycerols prophylactically, i.e. before, during and after radiation treatment, when compared with a control group. Using non-prophylactic administration of alkoxyglycerols, i.e. during and after radiation treatment, no effect was observed on complex injuries, while--as for the prophylactic group--the injuries due to radiation only, were significantly decreased. The use of so called "increased amount" of radium in the intracavitary irradiator was followed by an unexpectedly high incidence of radiation injuries, which was considerably reduced, however, by alkoxyglycerols, especially when administered prophylactically.


The change of alkaline phosphatase binding conditions with trophoblast membrane at different stages of human placenta.

Alkaline phosphatase was brought into solution from microsomal fractions of placentas of varying gestational age by using gradually increasing concentrations of proteinase papain. When the activity of the soluble alkaline phosphatase (S) was compared with that of the non-soluble residue (R), the S/R ratio rose as pregnancy progressed. The electrophoretic pattern showed that in serum from pregnant women the papain-soluble alkaline phosphatase corresponded to the heat-stable one. These results indicate that the cytoplasmic membrane of the trophoblast changes with the growth of the placenta so that this enzyme is easily dissolved by papain. It is probable that alkaline phosphatase molecules easily enter the maternal blood stream in late pregnancy.


Hyperthyroidism during pregnancy treated with propylthiouracil. The significance of maternal and foetal parameters.

Hyperthyroidism during pregnancy may be dangerous to the infant. The major risks are prematurity and neonatal thyrotoxicosis. The latter may be due to placental transfer of thyroid stimulating immunoglobulins from mother to fetus. Of two siblings of a previously thyrotoxic mother the first had marked symptoms of neonatal thyrotoxicosis after a pregnancy where no antithyroid treatment was given. The second child had only minimal thyrotoxic symptoms but almost as high levels of thyroid hormones as the first. During the second pregnancy propylthiouracil was given to the mother from 26 weeks' gestation, because of increased fetal movements and fetal tachycardia. Fetal movements and fetal heart rate were considered to be most valuable indicators of thyroid function in the fetus. Intense control is necessary from the beginning of the second trimester.


The effect of dexamethasone therapy in prolonged pregnancy.

Fifty-six patients, chosen by random sampling from a total group of 120 post-term women, received dexamethasone (Decadron, "MSD" 2 mg 3 times a day for 4 days, the other 64 patients acting as controls. The evolution of uterine activity was evaluated using pelvic score (PS) and a modified low dosage oxytocin sensitivyt test (OST) before (T1) and after (T2) the treatment. During the interval from the second to the 6th day inclusive after T1 35 women of the dexamethasone group and 15 of the control group had a spontaneous onset of labour (SO) (0.001 less than P less than 0.01). Five patients in the dexamethasone group with primary rupture of membranes started labour spontaneously within 12 hours after membrane rupture, 7 patients in the control group with primary rupture of membranes received oxytocin as labour did not start within 24 hours. Excluding patients artifically induced, the mean interval from T1 to SO was 6.8 days in the control group and 5.2 days in the dexamethasone group (P less than 0.001). In both groups PS and the sum of Montevideo units (MU) during OST increased from T1 to T2, the increase was significantly greater in the dexamethasone group than in the control group. We found no correlation between the results of OST and the T1--SO interval. Dexamethasone, as used in this study, may promote labour in prolonged human pregnancy. Due to its low potency, it is not a substitute for oxytocin in the induction of labour. The lowered placento-fetal quotient in the dexamethasone group warrants further study of the effects of steroid hormone on placental function.


The immediate effect of a beta-adrenergic agonist (salbutamol) on carbohydrate and lipid metabolism during the third trimester of pregnancy.

The responses of plasma insulin and the C-peptide of proinsulin, glucose, lactate, free fatty acids (FFA), glycerol, D-beta-hydroxybutyrate and alanine to a beta2-adrenergic agonist (salbutamol) were determined in 5 patients during the last trimester of pregnancy before labor. Salbutamol was given as an infusion in the same dosage as is used to inhibit uterine contractions in cases of premature labor and in obstetric emergencies. The influsion of salbutamol was given for 45 min, accompanied by repeated sampling of arterial blood. All patients developed moderate tachycardia and exhibited metabolic effects following salbutamol infusion, implying marked increases in plasma levels of insulin, C-peptide, glucose and lactate. An increased rate of lipolysis was evident from the rises of FFA, glycerol and D-beta-hydroxybutyrate. Plasma levels of alanine declined, possibly due to stimulation of gluconeogenesis. It is unlikely that these acute maternal metabolic changes would have significant adverse effects on the fetus.


Outcome of pregnancy in the presence of intrauterine device.

The outcome of 196 pregnancies with Lippes Loop in situ was studied. In 102 cases with inaccessible thread, the IUD was left in place. Ninety-four women had the IUD removed when the thread was still visible. The incidence of spontaneous abortion and premature delivery was 56.8% in the group of 102, and was significantly higher than in those women whose loop was removed. No serious complications occurred in any of the cases. The results suggested that the IUD should be removed early in pregnancy when the string is still accessible.


Scintigraphic studies of uterine and placental growth and placental migration during pregnancy.

Placental scintigraphy with 113mIn (Indium) combined with cervical marking with a shielded 57Co (Cobalt) radioactive source was used to study uterine and placental growth in human pregnancy and placental location and migration in a total of 176 patients. Uterine length measurements can be used for selecting growth retarded fetuses. There was an approximately constant ratio between placenta diameter and uterine length (0.68 +/- 0.03). When the placenta was located on the ventral uterine wall, low implantation occurred in 61%. The corresponding figure for low implantation when the placenta was located on the dorsal uterine wall was 30%. The difference was highly significant. Placental migration was studied in 20 patients. Significant migration occurred in 11 cases. The placental margin closest to the internal cervical os migrated outwards about 3 cm on average.


Feto-maternal bleeding. During pregnancy and at delivery.

Blood samples from pregnant women and from mothers before and after delivery were tested for the occurrence of feto-maternal bleeding (f.m.b.) using Kleihauers acid-elution technique and a counting technique described by Schneider. It was assumed that f.m.b. had occurred, when there was a clinically significant difference between the values of hb-F cells per million cells in two blood samples. F.m.b. had occurred in nearly 2/3 of the mothers after pregnancy and delivery. The f.m.b.'s were most often less than 0.1 ml and only a few per cent had f.m.b.'s between 0.1 and 1 ml. Abortion, complicated pregnancies, amniocentesis, pre-eclampsia, caesarean section and other kinds of complicated deliveries increased the risk of especially larger f.m.b.'s.


Serum HCG and HPL in twin pregnancies.

Serum HCG and HPL levels were determined in 154 samples derived from 39 twin and one triplet pregnancies. Compared with singleton gestations, these levels were respectively 2.5 and 1.5 times higher throughout gestation. Analysis of these data in terms of predictive accuracy for the existence of a twin indicates that neither assay can serve for screening purposes though simultaneous determination of HCG and HPL may provide a fair index of suspicion.


The cervical balloon method for induction of labor.

The cervical balloon (Embrey & Mollison) was used to induce labor in a study group of 87 patients. The control group included 97 patients, where induction of labor was performed using oxytocin-drip. In the study group oxytocin-drip was added in 34 patients. The cases of the study and control groups were classified as "favorable" cervix. The patients classified as "unfavorable" cervix showed a shorter mean induction-delivery interval in the study group, and a shorter mean duration of oxytocin-drip in the cases of the study group where it was needed. It was concluded that the cervical balloon is a convenient method for the induction of labor, for its effectivity, simplicity and innocuity, especially in the "unfavorable" cervix cases.


Evaluation of a feto-pelvic scoring system in the management of breech presentations.

A feto-pelvic scoring system comprising maternal pelvimetric data, estimated fetal weight, type of breech presentation and previous obstetric history was used in selecting patients for cesarean section of vaginal delivery. A maximum score of 20 points was possible. Twelve points or less indicated cesarean section. During 1973-1975 224 singleton breech deliveries were evaluated. In 29.5% cesarean section was performed and in 83% of these it could be planned in advance. In 70.5% of cases, patients were allowed to deliver vaginally under continuous electronic monitoring of the fetal heart rate. There was one intrapartum death and only one early neonatal death of a small premature child. In two cases intrauterine death had occurred already in the antepartum period. The uncorrected perinatal mortality was 17.9 per 1000 but not significantly different from the uncorrected perinatal mortality of 8.0 per 1000 for all patients delivered at the Danderyd's Hospital during the period 1972-1975 (12832 births). The corrected mortality resulting from breech presentation was 8.9 per 1000. The infants exhibited similar and excellent 5 min Apgar scores whether delivered vaginally or by cesarean section or matched with a randomized control series of 1000 cephalic presentations.


Immediate post-partum insertion of the Antigon.

The results of intrauterine contraception using the Antigon inserted into 364 women immediately post partum are submitted. The patients were followed for 24 months, total number of woman months 5225. The follow-up was 96.7% after 3 months, 92.9% after 12 months, and 89.7% after 24 months. Four types of Antigon were used, having surface areas from 785 to 2740 mm2. Type I and the wing model (type IV), which have the smallest surface area, proved best suited. The continuation rates for types I and IV after 12 and 24 months were 77.4--59.2 and 76.4--54.5 respectively. These rates are on a level with those for Antigon inserted 6--8 weeks post partum. It is notable that the expulsion rates (12.8 and 12.7 after 12 months) were no higher than those for Antigons inserted 6--8 weeks post partum. The incidence of puerperal complications was not increased, and no perforations occurred.


Incidence of sterility in women operated on in childhood for perforated appendicitis.

Of 80 women who had appendicectomy in childhood 78 were reviewed with reference to sterility. Thirty-nine of them had been operated on for acute perforated appendicitis (APA) and 39 for acute non-perforated appendicitis (ANPA). There was no statistically significant difference in the incidence of sterility between the two groups. In the APA group the incidence of sterility differs from that in sterility models with the same age composition. It may therefore be advisable for young girls to have appendicectomy at at the least indication.