Alterations in lysine transfer RNA during erythroid differentiation of the Friend cell.

The proportion of lysine tRNA represented by the isoacceptor species lysine tRNA4 has previously been shown to be largest in cells with the greatest ability to proliferate. Using reverse phase chromatography (RPC-5), we have analyzed the changes in the relative quantities of lysine tRNA species which occur in different cellular states of the Friend cell, a transformed murine cell infected with Friend erythroleukemia virus complex. This cell undergoes erythroid differentiation when exposed to various chemicals. Lysine tRNA4 comprises 32% of the total lysine tRNA in rapidly dividing, uninduced Friend cells, but only 16% of the total lysine tRNA in uninducase. Friend cells undergoing erythroid differentiation divide more slowly than uninduced cells, and finally cease proliferation, but lysine tRNA4 becomes the major lysine tRNA species (greater than 50%). This does not appear to reflect erythroid properties of the cell, since the lysine tRNA of the mouse reticulocyte contains very little lysine tRNA4. The non-dividing erythroid Friend cell, therefore, represents an exception to the finding that non-dividing cells usually have little or no lysine tRNA4 present.


Modified bases in tRNA: the structures of 5-carbamoylmethyl- and 5-carboxymethyl uridine.

The crystal structures of two nucleosides, 5-carbamoylmethyluridine (1) and 5-carboxymethyluridine (2), were determined from three-dimensional x-ray diffraction data, and refined to R = 0.036 and R = 0.047, respectively. Compound 1 is in the C3'-endo conformation with chi +5.2 degrees (anti), psiinfinity = +63.4 degrees and psialpha = +180.0 degrees (tt); 2 is in the C2'endo conformation with chi +49.4 degrees (anti), psiinfinity -60.5 degrees and psialpha +60.0 degrees (gg). For each derivative, the plane of the side chain substituent is skewed with respect to the plane of the nucleobase; for 1, the carboxamide group is on the same side of the uracil plane vis a vis the ribose ring; for 2, the carboxyl group is on the opposite side of this plane. No base pairing is observed for either structure. Incorporation of structure 1 into a 3'-stacked tRNA anticodon appears to place 08 within hydrogen bonding distance of the 02' hydroxyl of ribose 33, which may limit the ability of such a molecule of tRNA to "wobble".


Xeroderma pigmentosum fibroblasts of the D group lack an apurinic DNA endonuclease species with a low apparent Km.

Apurinic DNA endonuclease activity from cultured human fibroblasts was resolved into two species by phosphocellulose chromatography. The species had sedimentation coefficients of 3.3 S and 2.8 S and apparent Km's for apurinic sites of 5 and 44 nM, respectively. The low Km species was absent from extracts of cell lines XP5BE, XP6BE and XP7BE of xeroderma pigmentosum complementation group D.


Yeast seryl tRNA synthetase: two sets of substrate sites involved in aminoacylation.

Seryl tRNA synthetase from Saccharomyces Carlsbergensis C836 contains two sets of sites for tRNASer, L-serine, and Mg2+-ATP, both of which are involved in aminoacylation. This is based on the following experimental results: (a) at low serine concentrations, second order kinetics in tRNASer are observed; (b) biphasic kinetics result when the amino acid is the varied substrate indicating anticooperative binding of two serine molecules to the synthetase; (c) when two molecules of serine are bound the rate of aminoacylation increases strongly and becomes first order in tRNASer; (d) the involvement of more than one site for Mg2+ and ATP is deduced from systematic variations of the concentrations of Mg2+ and ATP. Implications of the anticooperative binding of the substrates for possible reaction mechanisms are discussed. The results indicate that under normal conditions, the activity of seryl tRNA synthetase is regulated mainly by tRNASer while at high serine concentrations regulation by the amino acid itself prevails.


Conformational states of cowpea chlorotic mottle virus ribonucleic acid components.

The conditions determining conformational changes in the four ribonucleic acid components of cowpea chlorotic mottle virus have been studied. All four components have at least two electrophoretically separable conformers, the occurrence of which can be regulated by both monovalent and polyvalent cations. This phenomenon also occurs, in a much less striking way, in the ribonucleic acids of the two other members of the bromovirus group, brome mosaic virus and broad bean mottle virus. Although specific in some respects, these changes have much in common with effects which have been observed in tRNAs, 55 RNAs and rRNAs. A provisional interpretation of the conformational behaviour of the viral RNAs is given in terms which have been proposed for certain tRNAs which have been studied in great detail.


Analysis of the genome of type 7 simian adenovirus using restrictases.

The effect of the restricting endonucleases R.EcoRI, R.BamI and R.SalI on the genome of type 7 simian adenovirus (SA-7) has been studied. Since the DNA has only one site of R.EcoRI recognition the enzyme cleaves SA-7 DNA into two fragments with the molecular weights 12.0 and 10.0 . 10(6). The restrictase R.BamI cleaves the SA-7 DNA at six sites producing 7 fragments with the molecular weights 6.6, 5.9, 3.8, 2.7, 1.3, 0.7 and 0.6 . 10(6). R.SalI cleavage yields 6 fragments with the molecular weights 8.1, 5.5, 4.3, 2.45, 1.2 and 0.6 . 10(6). The R.BamI and R.SalI fragments are arranged in the orders E-A-D-F-C-G-B and A-B-D-F-E-C, respectively. The only R.EcoRI recognition site is localized in the C fragment produced by R.BamI and in the B fragment produced by R.SalI.


[Studies on renal clearance measurements by nuclear medicine methods (author's transl)].

Two mathematical models are employed to describe and interpret the time-activity course in the human body outside the reno-vesical compartment of a tracer that has been injected intravenously by the single-shot method and is excreted via the kidneys. From the results a method is derived which permits a practical determination of total clearance. The individual clearance of each kidney is calculated using a simplified method of background (EPA) correction.


Ultrasonic evaluation of "silent regions" in the thyroid scintiscan.

35 patients with scintigraphically silent thyroid regions without palpable cold nodules were further evaluated by ultrasonography. In 33 cases the sonographic diagnosis was confirmed by other examinations or the clinical course. 2 cases were misinterpreted right at the beginning of our series. The use of ultrasonography in evaluating silent thyroid regions in the totally decompensated autonomous adenoma, in unilateral thyroid aplasia, thyroiditis and hyperthyroidism is shown to be a reliable and valuable supplement to the clinical and radioisotopic evaluation procedures. When differentiating the totally decompensated autonomous adenoma from unilateral thyroid aplasia a stimulation test need not be performed in most cases. Suspected thyroiditis can be confirmed in a simple way. Being a non-invasive evaluation procedure, ultrasonography should be used before performing a needle biopsy.


Correlations between geometrical parameters measured on liver scintigrams and clinical observations.

Various geometrical data, resulting from anterior scans, of both normal and pathological livers were classified and analyzed statistically from two points of view: Firstly, a static study resulting from observations on pooled scans. This study showed that the frequency distributions of some geometrical parameters in the liver are essentially normal in character. It equally demonstrated that the dimensions of the parameters depend on the degree of the pathology of the liver. Secondly, a study which was carried out on repeated scans recorded on the same patient. It showed that the relative variations of some geometrical parameters of the liver are a function of its degree of pathology, whatever the types of abnormalities considered. The definition of a variable is suggested, the knowledge of which can help to establish the diagnosis.


[Validity of hepato-biliary functional scintigraphy using 99mTc-diethyl-IDA (author's transl)].

99mTc-DAIDA is superior to other cholotropic radiopharmaceuticals. As radiochromatographic examinations with various systems showed, it is secreted by the hepatocytes into the bile as an unchanged anion. In a study of hepato-gastroenterologically selected patients (n = 45) values for liver function parameters such as Tmax' T/2, time of appearance in gall-bladder and duodenum were in the group of patients without any hepato-biliary disease (x +/- S.D.): 15.5, +/- 5.2 min, 30.8 +/- 8.2 min, 13.5 +/- 6.1 min, and 22.0 +/- 10.8 min. The clearance determined after comparison of different defining regions and types of calculation in this group was 323.8 +/- 145.8 ml/min x 1.73 m2 (x +/- S.D.); the renal excretion competitive with the hepato-biliary elimination amounted within 51 min p.i. to 5.15% of the injected activity. The values of the several time-parameters as well as the participation of the kidneys in the 99mTc-DAIDA excretion increased substantially in patients with intrahepatic jaundice, but only slightly in the group of other liver cell diseases. It was not possible to determine the various liver function values in patients with extrahepatic jaundice. Because of their large spread within the different groups these parameters were without diagnostic relevance in the individual case. The hepato-biliary sequential scintigraphy with 99mTc-DAIDA appears to find its main use in morphologic diagnostics.


[Modified biological behaviour of 99mTc-pertechnetate in man as a result of a preceeding administration of tin (tin effect) (author's transl)].

An increased image of blood-filled spaces (Plexus choriodeus, Sinus transversus) was observed in 99mTc-pertechnetate scintigraphy when it had been preceded by the administration of tin (e.g. of 99mTc-Sn-diphosphonate). We have called this behaviour the "tin effect". In vitro studies demonstrated binding of about 80% of the administered activity in the blood with a biological half-life of about 44 hr and an effective half-life of about 5.3 hr. 95% of the blood activity was bound to red cells and 5% to plasma. This resulted in an increased radiation dose to the bone marrow of about 530 mrad/mCi 99mTc-pertechnetate (following tin). The extent of the tin effect decreased with the length of the interval between tin and 99mTc-pertechnetate administration. Because of the tin effect 99mTc-DTPA or 99mTc-citrate should be used for brain scintigraphy if this has to be performed within the first 5 or 7 days following a bone scintigraphy with a tin-containing radiopharmaceutical. The "tin effect" might be taken advantages of when labelling red cells and imaging vascular spaces.


The effect of aliphatic alcohols on certain vitamins of the B-complex group in the liver of the rat.

The effect of the oral administration of a series of aliphatic alcohols (methanol to butanol) in addition to isopropanol on the liver contents of thiamine, riboflavin, pyridoxine, niacin, and pantothenic acid was investigated in rats. It was found the tested alcohols caused a significant decrease in the liver contents of the studied vitamins. This effect was observed after daily oral administration of the tested alcohols in doses of 1 and 2 mg/kg for 7 days. The diminishing effect of alcohols on the liver contents of vitamins was directly proportional to the dose administered.


Enzymatic changes in peripheral blood leukocytes in rats in subacute benzene vapours poisoning.

The activity of acid phosphatase (AcP), its intracellular distribution in peripheral blood lymphocytes and the activity of lysosomal isoenzyme of acid phosphatase (AcPL) in serum of rats exposed to benzene vapour in the concentration 27 000 mg/m3 for 6 hours daily through 10 consecutive days were investigated. The statistically significant fall in the number of lymphocytes affecting AcP-positive and AcP-negative lymphocytes, reduction in the percentage of granular lymphocytes and increase in the percentage of granular-diffusive and diffusive lymphocytes were found. The increase in the activity of AcPL in serum was statistically insignificant. According to the authors opinion the phenomenon observed results from a damage to lymphocytic lysosomes by benzene.


Platelet aggregation and adhesiveness as well as blood lipids level in dogs treated with di-(1-isoquinolinyl)-di-(pyridyl-2')-butane and carbocromen.

The effect of di-(1-isoquinolinyl)-di-(pyridyl-2')-butane (S-147) on platelet aggregation and adhesiveness as well as on blood lipids level (total lipids, triglycerides, total cholesterol) was tested in mongrel dogs, in comparison with carbocromen. The compounds administered iv (2 mg/kg/day) over 7 days inhibited ADP-induced aggregation, being without depressive influence on platelet adhesiveness. S-147 exhibited slightly stronger effect than carbocromen. The inhibition of platelet aggregation was accompanied by the decrease of serum lipids level.


A sensitive and specific determination of gamma aminobutric acid in brain.

A sensitive and specific method for the determination of gamma aminobutyric acid in small (30 mg) brain samples is described. It is based on preparation of the dansyl-butyrolactam (DBL), subsequent separation by thin layer chromatography and measurement of fluorescence after elution. Recovery is checked by routinely adding 14C labelled GABA.


n-alkanes as a substratum for riboflavin production. I. Investigations of the dynamics of the flavinogenesis in chosen yeasts of the genus candida.

For the first time the flavinogenic abilities of Candida flareri on a simple, fully defined medium with hydrocarbons were demonstrated. C flareri and C. guilliermondi on a synthetic medium with biotin and n-alkanes (n-decane and hexadecane) overproduce riboflavin with a considerable but varying efficiency. Among the two hydrocarbons examined n-hexadecane proved to be a more favourable source of carbon for the biosynthesis of this vitamin than n-decane. The quantities of riboflavin accumulated by C. flareri in an aerated culture are twice higher than those for C. guilliermondii (50.5 microgram/ml on hexadecane) in analogous conditions.


Search for potential psychotropic agents. Part II. N-benzylidene derivatives of 4-arylpiperazine-1-acetic acid hydrazides.

The authors in all have snythesised 24 new N-benzylidene derivatives of 4-arylpiperazine-1-acetic acid hydrazides as potent psychotropic agents. Six compounds subjected to pharmacological activity failed to show any significant activity.


3-(p-tolyl)-4-aminobutanoic acid synthesis, resolution into enantiomers and pharmacological activity.

Racemic 3-(p-totyl)-4-aminobutyric acid was obtained, resolved into enantiomers and their absolute configuration was determined. Both the racemic acid and two enantiomers were screened for CNS activity. R (+) enantiomers is 14--27-fold more effective than the S(-) one and 1.2--2.1 fold more effective than the racemate.


Reduced analgesic effects of morphine after bilateral lesions of the locus coeruleus in rats.

Noradnenaline-depleting lesions involving the locus coerulcus markedly reduced morphine analgesia. Rats were tested for analgesia using the tail-compression method. The results indicate that locus coeruleus plays an important role in analgesic action of morphine.


When "lymphoma" is not lymphoma: diagnosing immunoblastic lymphadenopathy.

Immunoblastic lymphadenopathy, a newly described disease, is clinically similar to lymphoma but has a specific histologic picture. It usually does not have malignant potential and is best treated initially by corticosteroid in high doses. Chemotherapy is used when corticosteroid fails or when malignant conversion occurs.


Case report: metal fumes fever.

A young male foundry worker had headache, nonproductive cough, orthopnea, formication, rigor, fever, and substernal pain after exposure to concentrated metal fumes. Examination revealed bilateral basal rales. Serial spirometry suggested a transitory restrictive impairment with persistent mild to moderate obstructive impairment. Leukocytosis, hypoxemia, and the other symptoms resolved with no therapy other than the patient's removal from the polluted area.


Treating gout: successful methods of prevention and control.

For control of acute episodes of gout, administration of a full course of colchicine is the preferred method of therapy. This drug also is useful in prophylaxis of recurrent attacks, taken daily in combination with one or more drugs that influence uric acid metabolism. Weight reduction if the patient is obese, a balanced diet with restriction of foods high in purine content, and high fluid intake also are recommended.


Pregnancy testing. 1. Immunoassays and radioimmunoassays.

Immunoassays have virtually replaced bioassays for detection of pregnancy. Slide and tube tests are applicable in most clinical situations. Because of its sensitivity, radioimmunoassay is ideal for diagnosis of early and ectopic pregnancies.


Diagnosing ascites: the value of abdominal paracentesis.

Abdominal paracentesis is a useful and safe technique in the evaluation of ascites. The withdrawn ascitic fluid should be routinely analyzed for appearance, blood cell count, and amylase and total protein concentrations; examined cytologically; and cultured. Results should either substantiate the clinical diagnosis or alert the clinician to the presence of previously unsuspected disease.


Case report. Evolution of cerebral abscess: disparity between radionuclide and CT scans.

The course of frontal lobe cerebritis in a teenage boy was followed with serial radionuclide and CT scans. During treatment with high doses of dexamethasone and antibiotics, the radionuclide scans became normal, whereas the CT scans remained abnormal and ultimately demonstrated an encapsulated abscess that was successfully drained. In patients receiving steroid therapy, the radionuclide brain scan may not be a reliable technique in demonstrating an intracranial abscess.


Computed body tomography: how useful is it?

Computed tomography (CT) of the body is becoming as well established a diagnostic procedure as CT of the head, often yielding information not available by other techniques and sparing patients unnecessary surgery. To take proper advantage of CT, physicians should understand the full potential and practical applications of this new technique. Properly used, it can expedite diagnosis and decrease the number of procedures needed per patient.


Iatrogenic factors in acute renal failure: can vigilance equal avoidance?

Physicians can aid substantially in reducing morbidity and mortality from acute renal failure by exercising particular care when using potentially nephrotoxic procedures or agents, by identifying patients at high risk before undertaking elective surgical procedures, and by acting promptly to correct predisposing conditions.


[Value of isotope study with ytterbium-169 citrate in the diagnosis of pulmonary opacities of cancerous nature].

Out of 60 observations, the authors deduct the value of the isotopic study with Ytterbium169 citrate in the diagnosis of cancerous pulmonary opacities. Ytterbium169 is a radiolanthanide with a period of 32 days. Patients receive intravenously 500 muCi of Ytterbium169 citrate. Recordings are made on the 2nd, 7th and 14th day. Valuable information on the data of the fixation rate on the 2nd and 14th day can be obtained from drawing a curve of fixation. As shown by the dosimetric study the radioactive pollution is minimal; nevertheless the dose of irradiation should not be underestimated and not recommended for young patients. Reliability of the examination is great: the percentage of true positive results is satisfactory (87%) and above all the percentage of false positive results (7.7%) much below that of other isotopes (30-40%). Results are excellent for peripheral opacities which escape the usual diagnostic mean. The main failure of the examination is the relatively frequent lack of fixation, not prejudicial in itself as it has no diagnostic value. Indications and limits of this examination are drawn from this study.


[Apropos of a fatal case of poisoning by household aerosol].

The authors present a case of abusive use of nitrogen in aerosol. It produced an acute edema primarily toxic bringing a hypoxemia amidst the coronarian network already partially occluded. It is rapidly followed by a subendocardiac infarct of the myocardium with left ventricular failure. The abnormal gas exchanges (alveolo-capillary block) taking place on the 15th day are discussed. Autopsy revealed a typical "cardiac lung", the presence of hyalin membranes and an early fibroblastic proliferation. These abnormalities corroborate the hemodynamic character, perhaps toxic, of pulmonary lesions.


Isolation of viral double-stranded RNAs using a LiCl fractionation procedure.

A general procedure for the isolation of virus-specific double-stranded RNA (ds-RNA) is discribed. The procedure is based on the differential solubility of different types of nucleic acids in LiCl. Principal advantages over conventional methods are simplicity, avoidance of enzymatic treatment, and relatively good yields of undegraded ds-RNA while permitting separation of several main groups of cellular and viral nucleic acids from the same batch of tissue. The method has been successfully applied in tissues infected by several representative plant RNA viruses. The virus-specific ds-RNAs obtained have been identified by their resistance to ribonuclease and comparison of their electrophoretic mobilities with those of the corresponding single-stranded RNA (ss-RNA) in polyacrylamide gels. The molecular weights of the ds-RNAs of tobacco mosaic virus, turnip yellow mosaic virus, alfalfa mosaic virus, and peanut stunt virus fit the curved log molecular weight-migration relationship constructed from a set of known marker ds-RNAs.


Large scale preparation of pure hog kidney renin.

The complete purification of renin raises difficult problems due to its extremely low concentration in kidney (less than 1/50,000 of total proteins). The complete purification of hog kidney renin has been realized on a large scale, starting from 300 kg of fresh hog kidneys. 14.6 mg of pure renin were obtained with an overall yield of 4%. The purification procedure involved 14 steps. The enzyme was extracted at pH 3.5. Subsequent purification steps were performed in the presence of protease inhibitors to decrease renin proteolysis. These steps included an ammonium sulfate precipitation and a batch-chromatography on DEAE-cellulose. The major purification step was an affinity chromatography on Sepharose-hexamethylene-diaminopepstatin. The enzyme obtained was further purified by molecular sieving gel filtration and isoelectric focusing.


[Absence of hydroxyindole O-methyltransferase, the terminal enzyme in melatonin synthesis, in the rat intestine].

The absence of hydroxinol-o-methyltrapherase, the terminal enzyme in the chain of melatonin biosynthesis in the gastrointestinal tract of rats was revealed by means of radioisotopic biochemical methods. A high endogenous methylation in the mucosa of the small intestine of rats with the participation of S-adenozylmethionine, differing from melatonin synthesis in the epiphysis, was revealed during this study.


[Placental ultrastruct in rats with experimental diabetes mellitus].

The placenta of Wistar rats with various forms of diabetes mellitis was studied by electron microscopy. Metabolic disturbances characteristic of alloxan diabetes mellitus failed to derange the trophoblast ultrastructure during the existence of placenta and produced no changes in the ultrastructure of the fetal vessels similar to the changes in the capillary ultrastructure of other organs and tissues in this pathology.


[Gonadal tumors in the testicular dysgenesis syndrome].

Morphological study of the gonads in 84 patients with the testis dysgenesis syndrome demonstrated the presence of the tumours in 26 (31%) of cases. They were mostly microscopic, benign, could affect both gonads simultaneously, and, in asymmetrical differentiation of the gonads, the connective tissue band as well. Two types of the tumours were revealed: gonadoblastomas (different variants) and dysgerminomas. No specific clinical signs of the tumour changes of the gonads accompanied the syndrome under study.


[Electroencephalogram of patients with the idiopathic edema syndrome].

Patients (45) aged from 19 to 52 years with the syndrome of idiopathic edema were examined by the electroencephalographic method. The great majority of the patients displayed a distinct increase of the theta-activity with some reduction of the alpha-activity. Such shift in the frequency composition could be interpreted as a reflection of the involvement of diencephalic structures into the pathological process. An extreme irregularity of the frequency and the amplitude of the main rhythm was revealed in 14 of 45 patients on the EEG; this, in combination with clinical symptoms, led to a supposition that the regulatory functions of the hypothalamus were disturbed.


[Somatotropic function of the adenohypophysis in juvenile (pubertal) goiter].

Patients (86) with pubertal goiter were examined. There was an increase of the somatotropic function of the adenohypophysis. The functional acitivity of the thyroid gland is not disturbed. Observation results indicated that physiological thyroidin doses (0.03--0.05 g per 24 hours) were of expedience in pubertal goiter for the purpose of replacement therapy.


[Regularity in the extreme character of the ontogenetic development of ovarian activity in the reproductive function self-regulation system].

Opposite conclusions were drawn depending on the sex hormones which different authors used to assess the functional condition of the ovaries at various age periods. A new index--reception coefficient (RC)--is suggested proceeding from the systemic approach to find the way out from this inconsistency. This coefficient represents the ratio of the peripheral hormone value and the gonadotropin level inducing it. Regularities of the extreme character in the ontogenetic development of the ovarian activity were established by means of RC: the maximum ovarian function under normal conditions fell on the age group of 20--29 years, and the minimum--on the age groups of under 7 and over 50 years. A sharp decline of the ovarian function began in the age group of 40--49 years.


[Circadian rhythm of ornithine decarboxylase activity in the rat epiphysis].

A distinct 24-hour rhythm of the ornithindecarboxylase (ODC) was revealed in the epiphyses of rats kept under controlled illumination regimen (14 hours illumination and 10 hours darkness). ODC was an enzyme playing, according to modern views, a significant role in the regulation of the rate of protein biosynthesis at the level of transcription and translation. The maximum ODC activity was observed during the darkness period, and the minimum--during illumination. The 24-hour rhythm of the enzyme activity was levelled in the animals kept under constant illumination and in blinded animals. This indicated that the ODC rhythm was not oxogenous, but endogenous, circadian, whereas the external stimulus (the illumination regimen) synchronized the circadian changes in the enzyme activity with the time of the 24-hour period. The data obtained open one of the possible ways of analysing the mechanism of the pineal rhythms formation.


[X-ray diagnosis of the osteoarticular changes in diabetes mellitus].

Changes in the osteo-articular apparatus of the type of degenerative-dystrophic affections with a cystoid reconstruction, deforming osteoarthrosis, osteoartrhopathy, etc. were revealed in roentgenological examination of 60% of 65 patients suffering from diabetes mellitus examined. Changes in the osteo-articular apparatus were mostly revealed in elderly patients with diabetes of moderate severity and severe in combination with angio- and neuropathies and sensitivity disturbances. The detected changes, except diabetic osteoarthropathy were apparently nonspecific and subject to further study.


[Effect of sulfonylurea preparations on the course of pregnancy and the state of the fetuses of female rats with alloxan prediabetes, latent diabetes and mild forms of manifest diabetes].

The influence of antidiabetic sulphanylamides, used before the occurrence of pregnancy, on the weight of fetuses and placentae was revealed in rats with alloxan "prediabetes", latent diabetes, and manifest diabetes. Diabetes compensation before the occurrence of pregnancy in rats with "prediabetes" and latent diabetes by means of chlorpropamide, and in rats with manifest diabetes with chlorpropamide together with biguanides led to a significant reduction of the weight of fetuses and prevented their death.


[Correlation of the changes in the calorimetric indices of energy metabolism and of the morphofunctional changes in the thyroid gland of rats with various forms of experimental obesity].

Changes in heat exchange were compared with the morphofunctional changes of the thyroid gland in rats with various forms of experimental adiposity. Reduction of the hormone-forming function of the thyroid gland proved to correlate with the changes in heat formation and thermoregulation, and corresponded to the degree of adiposity observed.


[Comparison of the morphological changes in the capillaries and the state of the renin-angiotensin-aldosterone system in diabetes mellitus].

Microangiopathies were the earliest and most frequent complications of diabetes mellitus; however, their pathogenetic mechanisms are still obscure. Electron microscopic study of the capillaries of the gastrocnemius was conducted in 11 patients with diabetes mellitus at the state of decompensation and in 8--of clinical compensation; blood aldosterone level and the plasma renin activity were determined by the radio-immunological method. A marked thickening of the capillary basal membrane (the most marked sign of microvascular affection) was revealed in all the patients under study; there was also an increase in the aldosterone level and renin activity. The mentioned changes were to the greatest degree (statistically significant values) expressed in the patients at the state of decompensation. Analysis of the data obtained revealed a direct correlative relationship of these changes.


[Insulin-like substance in the submaxillary glands of mice normally and in alloxan diabetes].

The content of an insulin-like substance, revealed in the submaxillary glands of mice by means of the radioimmunological method proved to decrease in alloxan diabetes, still remaining higher than in the blood serum of the same animals. Cells of the granular portions of the salivary ducts underwent some ultrastructural changes in this disease. The exogenous 125I-insulin was capable of being included into the cells of the salivary ducts. The percentage of labeled cells in these portions considerably exceeded such in acini of the submaxillary and the pancreatic ducts, and also in the islar cells. Incorporation of 125I-insulin into the salivary ducts proved to diminish in alloxan diabetes.


[Variants in the catecholamine effect on renal hemodynamics].

It was shown in experiments on dogs that intravenous injection of adrenaline or noradrenaline in a dose of 2 microgram/kg per min was accompanied by an increase of resistance of the renal vessels with unchanged general renal circulation, and administration of adrenaline against the background of obsidan action--by an increase of resistance and reduction of blood flow, and--against the background of phentholamine action--by a reduction of resistance with unchanged circulation. On the basis of these data and those obtained by the author earlier a supposition is put forward on a possible mechanism of a combination of functions in the systems of circulation and excrection in the control of general water-salt homeostatis in extraordinary hemodynamic shifts with the participation of the humoral factor--renin-angiotensine system.


Chemical carcinogenesis.

The first step in the generation of a malignancy seems to be a transformation in the genetic apparatus of a single cell. The ultimate nature of the cancer which appears is a result of the interaction of that change with the control and regulatory apparatus of the whole animal. It appears that the primary cellular change which may be induced by physical, chemical or biological agents (or a combination of them) may be something which is common to all carcinogenesis. The nature of that primary change and how it may result from the action of viruses, chemicals, and radiation (or interaction between them) is the subject of this discussion.


Carcinogenic bioassay of the herbicide, 2,4,5-trichlorophenoxyethanol (TCPE) with different 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin) content in Swiss mice.

The carcinogenic effect of a herbicide trichlorophenoxyethanol (TCPE) was investigated. The substance always contains 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin) as a trace contaminant. Outbred Swiss-H/Riop mice were treated for 1 year with different doses of the various admixtures of the two compounds and those of dioxin alone to determine whether their carcinogenic effects are dose-dependent. Observation time after TCPE treatment was 1 and 2 years. The maximum tolerable dose of TCPE (70 mg/kg) with a dioxin concentration of 7.10(-6) mg/kg doubled the number of liver tumours as compared to the controls. The occurrence of liver tumours decreased at the administration of lower doses of the two compounds. No change in tumour frequency could be detected when the level of dioxin as a trace contaminant was raised, either (10 ppm). According to our preliminary results, dioxin has a more toxic than carcinogenic effect. The use of TCPE as a herbicide in accordance with the proper factory regulations and the consumption of products treated with it does not seem to bear a carcinogenic risk for the consumer.


Myoelectrical and mechanical activity of isolated canine stomach perfused in vitro with fluorocarbon. Role of glucose, phosphate, calcium and strontium in the perfusate.

Myoelectrical and mechanical activities were recorded from whole isolated canine stomachs perfused, intravascularly, with fluorocarbon emulsion, oxygenated in vitro. The perfusate was composed of an oxygen carrier, fluorcarbon, emulsified with a surfactant added to a simulated physiological solution. Bipolar electrodes and a strain gauge were used for recordings. Stomachs perfused as above for 5 h displayed normal electrical and mechanical activities. 'Normal' meaning identical with those observed under in vivo conditions or during perfusion with homologous blood. Normal response to electrical stimulation of a vagus nerve branch or to intraarterial injection of methacholine or pentagastrin were also observed. These functions of smooth muscles were not altered when glucose-free or glucose-and phosphate-free perfusate were used. In calcium-free perfusate, electrical and mechanical activities were absent and no responses to stimulants used were recorded. When calcium was added to the perfusate, these functions were restored to normal. Strontium was found to be an adequate substitute for calcium in fluorocarbon perfusate. Gastric secretions were alkaline and contained fluorocarbon emulsion.


Effect of C 21 524-Su (pirprofen) on spontaneous osteoarthrosis in the mouse.

Mice of the C57 Black strain, aged 11-12 weeks, were treated once daily on 5 days a week for 4 months with C 21 524-Su (pirprofen) in doses of 10 and 30 mg/kg p.o. In this genetically predisposed strain of mice, increases in the incidence of gonarthrosis have been observed after the administration of certain anti-inflammatory agents such as acetylsalicylic acid. Radiography and in particular exact histological examination of the knee joints revealed, however, that neither the overall incidence nor the severity of osteoarthrosis was greater in the mice treated with C 21 524-Su than in the controls. On the contrary, in the treated animals there was a tendency for the incidence and the intensity of gonarthrosis to be lower.


Relations between hepatotoxicity and pharmacokinetics of paracetamol in rats and mice.

A dose-dependent increase of paracetamol serum half-life (t1/2) was found after oral and intravenous application in rats and oral application in mice. The hepatotoxic effects of paracetamol were not correlated with this prolongation of t1/2. Dithiocarb protected rats against paracetamol liver damage but did not change paracetamol t1/2. Paracetamol t1/2 was not influenced either by a hepatotoxic dose of carbon tetrachloride. In conclusion, the dose-dependent prolongation of paracetamol serum half-life is not due to paracetamol-induced liver damage but merely the consequence of saturated elimination processes.


Neurobehavioral studies of tremorgenic mycotoxins verruculogen and penitrem A.

Verruculogen (V) and penitrem A (PA) represent a group of toxic secondary metabolites of mold contaminants of foodstuffs known as 'tremorgenic mycotoxins', which produce a unique neurotoxic syndrome characterized by sustained tremors, limb weakness, ataxia and convulsions. In the present study the intraperitoneal median tremogenic dose in mice for V was found to be 0.92 mg/kg and that for PA, 0.19 mg/kg. Behavioral and neurochemical parameters were assessed following acute exposure to varying neurotoxic and subneurotoxic doses of these mycotoxins. Measures of spontaneous motor activity (photoactometer) and exploratory reflex behaviors (open field) were markedly depressed by both V and PA. Notably, at dose levels of V or PA that were not accompanied by any overt signs of neurotoxicity, significant neuromotor depression was still observed. Acquisition of a conditioned avoidance shuttle response was disrupted, but only at a high neurotoxic dose level of V. Neurochemical analyses revealed no clear catecholaminergic or cholinergic involvement in the neurotoxic syndrome of eigher V or PA.


Stimulation of "regulatory" dopamine receptors by bromocriptine (CB-154).

Bromocriptine produces long-lasting hypomotility and decreases brain dihydroxyphenylacetic acid (DOPAC) in mice. These effects are obtained with doses much lower than those which produce hypermotility. The decrease of brain DOPAC is correlated to the hypomotility both on a dose and on a time basis. Potent DA receptor blockers as pimozide, benzperidol and droperidol antagonize the hypomotility and the decrease of brain DOPAC produced by bromocriptine. These effects are obtained with very low doses (0.05-0.3 mg/kg) of neuroleptics which per se do not affect motility or brain DOPAC. The maximal decrease of brain DOPAC produced by bromocriptine is similar to that produced by apomorphine and the combination of these drugs does not result in a further decrease. On the basis of these results it is postulated that bromocriptine decreases DA turnover and produces hypomotility by acting on "regulatory" DA receptors different from the postsynaptic ones of the "terminal" dopaminergic areas.


Evaluation of the central effects of ergot alkaloids by means of electroencephalography.

The effects of some ergot derivatives on the electroencephalogram and behavior of laboratory animals (mice, rats, rabbits) have been surveyed. The interference of bromocriptine on the dopaminergic central systems has been studied using behavioral (interference with the effects induced by L-dopa, 5HT, TRF or neuroleptic drugs) and electrophysiological (EEG) methods. While no clear effects of bromocriptine could be evidenced in mice, EEG recordings from the dorsal hippocampus of the rabbit showed a slight disruption of epsilon-waves after administration of 2 mg/kg i.v. of the drug or more.


Effects of 2-bromo-alpha-ergocryptine on the ultrastructure of anterior pituitaries in different experimental conditions.

The morphology of anterior pituitaries has been investigated by electron microscopy after administration of 2-bromo-alpha-ergocryptine (CB-154) in different experimental conditions. These include: a 1- to 5-week treatment (1 mg/kg BW, daily) to rats and a 5-week treatment (0.3 mg/kg BW, daily) to dogs, a single injection (2.5 mg/kg BW, 4 h before autopsy) or a 15-day treatment (1 mg/kg BW, daily) to hypophysectomized rats bearing an ectopic pituitary, a single injection (10 mg/kg BW, 4 h before autopsy) to rats bearing the experimental MtW 15 tumor and an in vitro experiment with fragments of a human GH producing adenoma incubated for 2 h in a medium containing CB-154 (1 microgram/ml). Some possible explanations for the structural changes observed after CB-154 treatment are offered.


Effect of bromocriptine on acetylcholine output from the cerebral cortex.

The effect of bromocriptine on acetylcholine (ACh) output from the cerebral cortex was investigated in anaesthetized rats. Bromocriptine caused a brief decrease in ACh output at the dose of 0.1 mg/kg i.p. and a dose-related long-lasting increase at doses from 1.25 to 10 mg/kg i.p. Apomorphine elicited an increase in ACh output when injected intraperitoneally at doses from 0.1 to 10 mg/kg. When bromocriptine was administered to rats in which a septal lesion had been made 12 days prior to the test, no increase in ACh output was observed. Bromocriptine seems therefore to stimulate a cortical cholinergic pathway originating from or passing through the septum.


Bromocriptine and hydergine: a comparison on striatal or hypothalamic adenylate cyclase activity.

We compared the effects of bromocriptine and of hydergine on striatal and hypothalamic adenylate cyclase activity. Rats treated with bromocriptine (5 mg/kg) or with hydergine (3 mg/kg), showed a stimulation of adenylate cyclase activity in the striatum, but not in the hypothalamus. Furthermore, we considered the competitive action bromocriptine and hydergine had on the dopamine-stimulating effect of the adenylate cyclase activity. There was a definite inhibition of the dopamine-stimulating effect both in the striatum and in the hypothalamus of the rats treated with bromocriptine. In those treated with hydergine we observed an inhibiting effect on the striatum and an increased dopamine stimulation on the hypothalamus.


Dihydroergotoxine(Hydergine) and ethanol-induced aging of C57BL/6J male mice.

The residual effects of dihydroergotoxine (Hydergine), ethanol, and Hydergine-plus-ethanol were investigated in old male mice of the C57BL/6J strain. Prolonged 10% v/v ethanol, concomitant with adequate nutrition, produced a significant decrease in life-span, decreased spontaneous locomotor activity and reduced lipofuscin accumulation in neurons of the reticularis gigantocellularis. These effects were not apparent in mice treated with Hydergine or alcohol combined with Hydergine.


Effect of ergot alkaloids on growth hormone and prolactin secretion in humans.

The effects of ergot alkaloids (mainly bromocriptine) on the secretion of GH and PRL in normal subjects and in pathological conditions (i.e. acromegaly and hyperprolactinemic states) are discussed. In the normal subjects, bromocriptine releases GH whereas in about 50% of acromegalics it causes a marked and long-lasting inhibition of the hormone secretion. PRL release is reduced by the drug both in normal subjects and in hyperprolactinemic states. Physiopathological studies in the humans indicate that, according to the experimental data, bromocriptine inhibits GH release in acromegaly and PRL secretion through a dopaminergic mechanism of action playing at the pituitary level. Data are reported on the effectiveness of bromocriptine in the medical treatment of acromegaly and of hyperprolactinemic states.


Effects of hydergine on aging neuroblastoma cells in culture.

Exposure of mouse neuroblastoma cells in culture to low pH for 8 days caused a sixfold increase in cell lipofuscin pigment. Pigment content was measured as the percent of cells having clumps of acid phosphatase-staining material. Hydergine, between 0.1 and 3 microgram/ml, caused a concentration-related decrease in pigment content. Hydergine also stimulated neurite formation in cells in regular pH medium and was slightly toxic to cells in low pH medium. These results support the use of neuroblastoma cells as an in vitro model for age pigment studies.


Ergometrine and its biphasic action at dopaminergic receptors in the nucleus accumbens of rats.

Bilateral administration of ergometrine into the nucleus accumbens of rats pretreated 40 min earlier with apomorphine (0.9 mg/kg, s.c.) resulted in a shift from a predominant licking score to a predominant gnawing score. Bilateral administration of ergometrine or (3.4-dihydroxyphenylamino)-2-imidazoline into the brain of rats treated 20 min later with apomorphine (2.0 mg/kg, s.c.) resulted in a shift from a predominant licking and gnawing score to a predominant walking and sniffing score. These and related data suggest a biphasic action at a certain group of dopamine receptors within the nucleus accumbens of rats: a short-term activation and along-term inhibition following this initial activation. The predictive value of the behavioural profile triggered by ergometrine for the evaluation of antidepressant effects of centrally acting drugs is discussed.


Open study with bromperidol (C-C 2489), a new neuroleptic, for the determination of the neuroleptic threshold and the neuroleptic-therapeutic range.

In an open study involving 30 schizophrenic patients the neuroleptic threshold dose (measured via Haase's graphopathological test), the maximum dose, and the maintenance dose were determined. The neuroleptic threshold dose was 5.6 mg/day (0.08 mg/kg body weight); the maximum dose was 11 mg/day (0.16 mg/kg body weight); and the maintenance dose was 6 mg/day (0.09 mg/kg body weight). With reference to the effectiveness, good to very good results were obtained in 19 cases. Regarding side effects 15 patients complained of extrapyramidal disturbances, this was to be expected in view of the study design aiming at the determination of the maximum dose level. When administered in one single dose in the evening, bromperidol influenced the night sleep positively, so that sleep-inducing drugs could be reduced, and, in some cases, even dispensed with.


Object reconstruction from focused positron tomograms.

A major problem with the reconstruction of three-dimensional object distributions from focused tomographic images using Fourier transforms is the amplification of statistical noise in certain frequency components. This paper describes the use of a generalised matrix inversion technique to limit noise amplification to a level related to the spatial resolution of the imaging system. The reconstruction method is applied to a simulated positron camera, and results are presented on the imaging of an extended, three-dimensional object distribution. A significant improvement in the elimination of the background is achieved.


A proposal concerning the absorbed dose conversion factor.

New definitions of the absorbed dose conversion factors Clambda and CE are proposed. The absorbed dose in water is given by the product of absorbed dose conversion factor, exposure calibration factor, ionisation chamber reading, cap displacement correction factor and perturbation correction factor. At exposure calibration the material of the build-up cap must be the same as that of the chamber wall. An ionisation chamber of which the wall material is water-equivalent or air-equivalent may be used. In the latter case the wall must be thin. For these two cases absorbed dose conversion factors are introduced and it is recommended that either of the two sets should be adopted. Furthermore, if the chamber wall is neither water- nor air-equivalent, the factor by which these currently defines values should be mutliplied is also given: again the wall must be thin. The ICRU definitions of Clambda and CE are inconsistent, as recently pointed out, while the definitions presented here are consistent.


In vivo measurement of calcium by the 37Ar method: a study of the effect of recirculating breath collection systems on the exhalation rate.

A study has been made of the effect that different methods of breath collection have on the measurement of calcium in vivo by the 40Ca(n,alpha) 37Ar method. The effect of open and rebreathing breath collection methods has been examined by using intravenous injections of 133Xe. This study has indicated that comparison of calcium measurements between individuals and between centres is likely to be accurate only if breath is collected on 'open circuit'.


A computer driven photoscanner for medical imaging.

A novel and versatile instrument for producing high quality monochrome and colour hard-copy of medical images from an array of digital information is described. Images are produced on standard photographic print paper mounted on the bed of a conventional X-Y plotter by scanning a time-modulated light source over the paper using a computer driven raster. A matrix board gives control of both greyscale and colour attribution. Examples of NMR images produced by the system are presented. A refinement of the technique which allows two variables to be displayed on one image is also described.


A new dosemeter for the measurement of natural ultraviolet radiation in the study of photodermatoses and drug photosensitivity.

The production and optical properties of a dosemeter for natural ultraviolet radiation are descirbed. The physical form of the dosemeter is a thin polymer film which incorporates 8-methoxypsoralen as the chromophore. The dosemeter responds to ultraviolet radiation at wavelengths up to 380 nm and is suitable for quantifying the UV exposure of patients suffering from some idiopathic photodermatoses or drug photosensitivity.


Effect of ultrasonic irradiation on mammalian cells and chromosomes in vitro.

Human peripheral blood and HeLa cells were irradiated in vitro at the ultrasonic frequency of 65 kHz. The whole blood and HeLa cell suspensions were exposed to continuous and pulsed ultrasonic power levels of 0.12, 0.16, 0.72, 1.12 and 2.24 W for a period of one minute. The method of ultrasonic irradiation was carried out with the whole blood or HeLa cell suspensions coupled directly to a cylindrical transducer while heating of the cell suspensions in excess of 41 degrees c was avoided. Irradiated and unirradiated peripheral blood lymphocyte chromosome cultures were prepared and scored for selected numerical and morphological abberrations. There was no significant difference in the frequency of chromosomal aberrations between irradiated and unirradiated cells. The fraction of cells S surviving after an exposure to an ultrasound dose of D can be represented by S = exp (-D/Do). Further, Do is shown to depend on the time after exposure at which survival is assayed.


The effect of deep heat on isometric strength.

The effect of a 20-minute treatment of short-wave diathermy on isometric strength of the quadriceps muscle group was studied in 12 subjects over a 2-hour period. The heat treatment caused an initial decrease in isometric strength followed by an increase 30 minutes after the heat was terminated. Strength remained significantly above the control level for two hours following heat. The findings of this study suggest that the relationship between the application of short wave diathermy and the optimal time which should elapse between the heat treatment and therapeutic exercise should be examined.


Effects of electromyographic feedback training on motor control in spastic cerebral palsy.

Electromyographic feedback training may play a special role in increasing active range of motion in spastic cerebral palsied individuals. The effects of electromyographic feedback training were documented on four persons with spastic diplegic cerebral palsy within a single subject design. Subjects received immediate auditory and visual feedback twice daily during ten consecutive days. Electromyographic feedback training resulted in increases in the active range of motion of the ankle joint of from 20 percent to 500 percent in the limbs trained during the first five days with electromyographic feedback and of from 33 percent to 450 percent in the limbs trained in the last five days. The acquired active range of motion was maintained by two of the subjects over intervals of from four to nine weeks.


Use of augmented sensory feedback to achieve symmetrical standing.

Ambulatory patients with hemiparesis were given auditory feedback of weight bearing on the involved leg in order to achieve symmetrical standing. A device for augmented sensory feedback, the Limb Load Monitor, was used for the training. Patients who could correct their limb loading pattern during the first treatment session learned to achieve symmetrical standing. Results are also related to the magnitude of weight bearing on the involved limb and the side on which the lesion occurs. These findings suggest that the patients utilized the feedback signal to control an inherent activity.


Characteristics of physical therapy role models.

This study examined the personal and technical characteristics used in an investigation of role modeling in physical therapy. Recently graduated physical therapists performed a forced-choice Q sort composed of 49 physical therapist characteristics to describe 1) themselves, 2) their model academic instructor, and 3) their model clinical instructor. A significant difference between the frequency of personal and technical characteristics placed in the Most Descriptive section resulted for the self sort. The 10 characteristics ranked by highest mean values were all personal for self sorts, the majority were personal for the clinical model and combined sorts, and were equally divided between personal and technical for the academic model sorts.


Successful replantation of two avulsed scalps by microvascular anastomoses.

Two cases of immediate replantation of avulsed scalps by microvascular anastomosis are presented. This method of treatment seems to offer significant economic, social, and psychological advantages over split-skin grafting of the calvarium, or other presently used treatments. The need for secondary reconstructive procedures after a successful replantation is minimal, or nil. The mechanism of scalping is reviewed, and it is related anatomically to the structure of the galea aponeurotica. Specific recommendations are made regarding the immediate care of the avulsed scalp and the denuded calvarium, the value of a team approach in replantation, and various technical aspects of the procedure and postoperative management. The more frequent use of interpositional vein grafts is urged.


Treatment of a lacrimal bulge in blepharoplasty by repositioning the gland.

We advise a simple solution to the problem of the bulging and ptotoic lacrimal gland in a blepharoplasty. A pocket is dissected above and behind the gland, and the gland is fixed there to the orbital periosteum. This technique safely produces a normal contour in the lateral third of the upper eyelid, where a bulge has been present before.


Lymphedema of the eyelids.

Lymphedema of the eyelids is a relatively rare condition whose main effect is to obstruct vision, and it is unsightly. We present 3 cases in which the edema was treated by excision and skin grafting of the eyelid, with satisfactory functional and cosmetic results. It is suggested that a split-skin graft be used for the upper eyelid and a full-thickenss graft for the lower eyelid. The lower eyelid skin can be "de-fatted" and used as a graft, but in the more severe cases we suggest a postauricular skin graft be used.


Use of an encircling silicone rubber string for the correction of lagophthalmos.

We describe a modification of Arion's technique for the correction of lagophthalmos by a circle of silicone rubber string placed subcutaneously near the lid margin. We have operated on 14 cases by this technique, with good results observed in 13 after a two-year follow-up.


A study of the evoked electromyography of the superior orbicularis oris muscle in man.

A study was made of the impulse conduction speed by moving recording electrodes at 5 mm intervals, successively, after stimulating facial nerves on one side in normal subjects. The findings showed that the speed of the potentials was fast and the amplitude was large, up to a distance of 0.5 cm across the midline. This makes us believe that there is an intermingling, of approximately one cm, of the left and right superior orbicularis oris muscles. Evoked potentials were recorded up to 1.5 to 2.5 cm across the midline--but as the speed reduced abruptly and the amplitude became small, we believe these potentials were conveyed by volume conductors. Six patients with facial palsy were studied, but in none were these findings indicating any reinnervation from the normal side. However, the conduction speed was delayed in them (as compared to normal subjects).


Staged reconstruction of flexor tendons with a silicone rod and a "pedicled" sublimis transfer.

We report the results in 11 cases of secondary flexor tendon reconstruction, employing a silicone rubber rod and a sublimis/profundus tenorrhaphy in the first stage, then hinging out the sublimis tendon on the profundus motor at the second stage. Achievement of a healed proximal tenorrhaphy before the second stage allows (1) inspection of the proximal tenorrhaphy (with assessment of its location, apperance, and strength) and (2) early postoperative motion in a controlled range (with greater confidence in the proximal tenorrhaphy, as rupture after free tendon grafting is not uncommon. The functional results attained were comparable to those in other series of secondary flexor tendon reconstructions.


Silicone prostheses and anti-tumor immunity: an in-vitro rat study.

We believe we have demonstrated that there is no difference in the immune responsiveness in normal animals which undergo sham surgery (as compared to those unoperated). With the addition of a simple placement of a silicone prosthesis, there was an increase in the lymphocyte cytotoxicity--but this was equalized by a blocking effect at both the target cell and the lymphocyte levels. This response appeared to be of short duration. The presence of tumor, as previously documented produces an increase in lymphocyte cytotoxicity with a concomitant increase in the target cell and the lymphocyte blocking effect. Importantly, we found no significant difference in the immune response when prostheses were placed as an adjunct to surgical excision of transplanted tumors in this rat model.


[Suicide and its ethical and legal evaluation].

Suicide is--considering general principles to be judged both from ethical and legal viewpoints. Moreover special attentions has to be paid to the particularities of a single case and to the fact that these particularities do not recur. This is also true of the attempt to commit suicide. The "suicideprophylaxis" is of great social important. Attention has to be paid to the problems of a fellowman, who is possibly frightened of a think or who is ill and sees no wayout from his hopelessness. The author discusses regulations of the criminallaw such as indemniti in a case of suicide--if there was no "suicide and also a putting death against another person without there own consent" and the duty of help according to paragraph 119 StGB in an accident or represent a general danger. ("erweiterter Suicid")


[Quantitative analysis of the electromyogram using triggered correlation].

A study has been made to determine the usefulness of triggered correlation as a method of automatic quantitative analysis of graphic representations of the somatic electric currents associated with muscular action. Although an electromyogram is neither a normally distributed nor a stationary random process, the method has been found to be suitable for clinical electromyography. The method is easy to use, with measuring values that may be used for diagnostic purposes being obtained within a few seconds. In the case of normal subjects and patients with neuromuscular diseases, parameters of triggered correlograms are compared with those of visuamanually analyzed or digitally averaged potentials of individual motor units.


[Hemispheric dominance in schizophrenics as determined on extrapyramidal side effects of neuroleptics].

Phenomena observed during treatment with neuroleptics were clinically measured in an attempt to determine the difference in vulnerability of the two hemispheres and the relation between this difference and schizophrenic diseases. In the group of systematic schizophrenias the increase in tonus was significantly higher in the dominant hemisphere. This finding is considered a verification of the nosological hypothesis of schizophrenias.


[Fibrin(ogen degradation product concentration (SFP) as a diagnostic parameter for the differentiation of artifical and essential blood in cerebrospinal fluid].

The fibrin(ogen) degradation product concentration is another differential-diagnosis parameter for distinguishing between artificially blood-stained and essentially blood-stained CSF. Determination of the fibrin(ogen) degradation product concentration has been found to be a reliable method of recognizing natively and artificially blood-stained CSF as being different.


[Hospital legislation in the Federal Republic of Germany and its effects on psychiatric hospitals (author's transl)].

The article discusses the hospital laws of several land governments enacted subsequent to the hospital financing law of the Federal Government, in respect of the influence exercised by these laws on the internal structure of the hospital. The fact that the laws apply to all kinds of hospitals, and hence also to big psychiatric hospitals, is considered a disadvantage for psychiatric care. Such care is obviously hampered, on the one hand, by the legislative demand for departmentalization of the individual fields according to specialist subjects, representing a setup which is opposed to the realization of patient care in accordance with the requirements of the communities and citizens who expect to be cared for on an individual and not on a schematic basis, whereas, on the other hand, the new structures of management stipulated by the law do not provide for the inclusion of representatives of the new groups of professions now engaged in psychiatric activities. The model of regrouping the hospital structure into sectors instead of medical specialist departments, is presented and contrasted with the proposed model. It is recommended to arrange for representation of the non-medical and non-nursing professions in the managing boards, as well as to take into account the sociotherapeutico-rehabilitative interests as forming part of the conceptual approach to care in psychiatric hospitals, via special hospital committees.


[Steps toward a therapeutic community in a psychiatric hospital (author's transl)].

The psychiatric hospital is conceptualized as a social organism with its own development. Every important change or new development follows certain laws. When those steps of phases of development are known their unfolding can be guided more easily. Resistance must be expected and tends to hinder the planned development. There is also a risk of wrong or defective development, endangering the overall goal. The different systematic phases, resistances or risks in changing a psychiatric hospital from a traditional-custodial to a milieu-active institution are summarized in a table. The described milieu therapy is that of a therapeutic community; its conceptualization is briefly discussed. Milieu therapy as a term is at the same time understood in a inclusive and in a complementary way: Inclusive in so far as all therapeutic procedures in a hospital are coordinated via milieu therapy; complementary in the sense that all activities which take place beside the classical therapies (pharmacotherapy; psychotherapy, etc.) are understood as therapeutic activities.


[Crisis and crisis therapy (author's transl)].

A psychic crisis is defined as a reaction to external events where the individual is unable to cope with these events by means of his usual adaptive mechanisms and earlier experiences. Examples of a traumatic crisis is the death of a near relative, the sudden onset of a severe illness, a sudden infidelity in marriage etc. So called transitional life situations may also elicit crisis reaction, i.e. the birth of a first child, retirement from work etc. A psychic crisis is often overdetermined from experiences in early childhood. The more "pure" crisis reactions are often seen in medical or surgical clinics while the psychiatrists usually meet the overdetermined crisis reaction. Four different phases of the crisis reaction are described. The goal of crisis therapy is to support the individual's and his surroundings own resources. It is not to replace the loss or to help the individual deny the emotional impact of what has happened. The function of the therapist can often be described in terms of "containing function" and "vicarious hope". Listening to a client in acute crisis often evokes feelings of anxiety and helplessness in the therapist. He often feels seduced to behave omnipotently, helping the patient to suppress the feelings of sorrow and anger. He may also be overprotective or may avoid discussing the pertinent feelings. The antitherapeutic risks of crisis psychotherapy are discussed and also illustrated with examples from the author's research on reactions of mothers to the birth of stillborn children.


[Definitive contraception and contraceptive responsibility (on the psychic situation in voluntary sterilization in men and women--results of psychologic-psychiatric research) (author's transl)].

Definitive contraception or voluntary sterilization in men and women has become more and more common as a final and permanent contraceptive measure. This family planning method combines all advantages of contraceptives under the psychological prerequisites: independent and free decision, clear motivation regarding the renouncement of reproduction, agreement between the partners, balanced partnership and personality, detailed advice before the operation. These prognostic criteria are derived from the author's evaluation of 73 psychologico-psychiatric series of catamneses of the past five decades in international literature.


[Psychiatric treatment under unfavorable conditions (author's transl)].

This paper reports on the first 12 months during which a large psychiatric hospital was undergoing reorganization and reform, resulting outwardly in a reduction of the number of occupied beds from 870 to 730, and in an increase in the number of admissions from 2100 to 2800. Despite sociopsychiatric orientation of the reformatory measures, medical and biological steps were taken first. Second in importance were the matters concerning reorganization in the sense of a differentiation between the various treatment groups. This was associated with the parallel development of initial socio-therapeutic approaches.


[On the importance of the geographical position of psychiatric hospitals for the admission rates and hospitalization period (author's transl)].

Rates of admission, duration of hospitalization, chances of discharge and legal basis of admissions are analyzed with reference to the distances between the patients' domiciles and the hospital, basing on the figures which apply to the district hospitals Gabersee in Upper Bavaria. More patients from nearby are admitted, and also given long-term treatment, than from the more distant zones; in the long run, chances of discharge are not more favorable for patients living nearby; there is no variation regarding the share of voluntary admissions in relation to the distances between the respective domiciles and the hospital. These results show that there must be increased cooperation between hospitals or wards for inpatients, partial inpatients, and outpatients, in view of the expected increased hospitalization frequency in future psychiatric practice located in the immediate vicinity of the individual districts. Under no circumstances should it happen that instead of the expected saving in the number of hospital beds, the overall capacity of the hospitals is increased.


[Experiences with small groups in a psychiatric hospital (author's transl)].

The author reports on her experience collected over a period of almost three years with psychoanalytic groups in an open ward of the Psychiatric (Land Government-financed) Hospital at Düren. The special feature of this study is that the groups remained together for a short period only (10-12 sessions), so that it was necessary to limit the subjects covered. The problems which came up in these groups were partly due to the specific character of groups made up of in-patients, and partly due to the structure of such short-lived groups. An attempt was made to take advantage of the opportunity of the dual function of the head of an in-patient group, namely, to be the object of reference and transference for the small group and a member of the team for the entire ward, to offer a chance to the group members of focusing conflicts based on the Oedipus complex. In this connection, it was found to be very useful to enlist the help of the nurse or male nurse as co-leader of the group. Patients with a subsiding psychosis derived the greatest benefit from participating in such groups, whereas in the case of patients suffering from depression, participation in such a short-lived group should be discouraged.


[Rare malpositions of the colon (author's transl)].

3 unusual cases of colon malposition are presented which were detected primarily radiologically. The clinical and diagnostic significance in adults is discussed. These rare anomalies can be explaned by embryology. Previous results presented in the same issue are discussed also.


[Duct pattern of the breast. An indicator of patients with increased risk of breast cancer development? A histological and mammographic study with 160 cases of breast cancer (author's transl)].

In 1975 John Wolfe proposed a classification of mammographic findings concerning the distribution of the duct pattern to select patients with high cancer risk. In a retrospective study we classified 160 patients with breast cancer according to the duct pattern classification. Our findings support well the results of Wolfe. Type N (normal duct pattern) is found in only 8,9% of all cancer patients whereas breast cancer was combined in 80% with the P2-DY-type. Our investigation confirms the classification of the duct pattern according to Wolfe as a valuable addition to the mammographic diagnosis of breast cancer.


The patient-care gap.

Although adequate attention is paid to technical principles and equipment in the radiologic technology classroom and supporting literature, little if any is devoted to the patient. The humanity of the patient and his primacy in the profession demand that in radiologic technology education and practice he be given the consideration he should and must have whenever he is in the hands of radiologic technology personnel.


[Extracranial and intracerebral vascular obstructions (author's transl)].

Different types of extracranial and intracerebral vascular occlusion and their etiology are described. In infants the cause for cerebral vascular occlusion is infection or embolism in endocarditis. In women contraceptives evidently cause arterial thrombosis. After the fourth decade especially in men arteriosclerosis is prevalent. The results of vascular reconstruction are described.


[Radiolucent filling defects of the ureter (author's transl)].

Ureteral filling defects and their differential diagnosis are discussed. Excretory urography including late films and especially endoscopy in combination with retrograde ureterograms might clarify doubtful ureteral lesions.


[Radiological diagnosis and differential diagnosis of calcifications of the basal ganglia (author's transl)].

The radiological appearance and main features of calcifications of the basal ganglia in metabolic, toxic and hypoxemic disorders, degenerative and systemic diseases, tumors as well as infectious and parasitic lesions are described and demonstrated by typical radiographs. The roentgenological differential diagnosis and etiological classification are debated on occurence, incidence, localization, and topography with regard to individual structures of the basal ganglia, distribution pattern and according to the dimension, shape, margin and density pattern of these calcifications.


Radiologic technologists can communicate clearly.

To improve professional communications skills of students, a pilot course in "Scientific Communications" was included as a requirement in the new baccalaureate program in the Department of Radiological Sciences, School of Related Health Sciences, University of Health Sciences/The Chicago Medical School, in 1973-74. During four years, the course has been revised to meet recognized needs of students. Learning objectives and course content are described as an encouragement to other schools to train radiologic technologists in professional communications.


[Roentgenological differential diagnosis of calcifications of extremities (author's transl)].

Calcifications of extremities are frequently encountered in radiological practice. Their etiology, localization and differential diagnosis related to topography, distribution, shape, and dimension of calcifications are discussed. The roentgenological appearance of different diseases is demonstrated by typical radiographs.


[The Nelson syndrome. Early diagnosis of minimal alterations of the sella turcica (author's transl)].

In Nelson Syndrome it is most important to reveal minimal alterations of the sella turcica in an early stage of the disease with pigmentation of the scar and light exposed areas of the skin. The lateral hypocycloidal tomography should be preferred. The early diagnosis may give information about the indication of a medical supressor treatment.


[Different roentgenographic structures in ameloblastoma of jawbone (author's transl)].

The ameloblastoma is a benign, but locally invasively growing tumor with different radiographic structures. These structures may well be explained by typical development of the tumor. Occasionally differential diagnosis appears difficult. Various roentgenographic techniques do facilitate surgical planning if the diagnosis is confirmed microscopically.


[Unusual angiographic technic in a ruptured aortic aneurysm (author's transl)].

In a 65-year-old patient with amputation of both legs, a life-threatening acute abdominal hemorrhage necessitates aortography. Following surgical dissection of the right femoral artery a catheter could be inserted through the thrombosed vessel into the aortic lumen. This approach made the diagnosis of a perforated aortic aneurysm by angiography possible.


[Differential diagnosis of gallbladder distention by angiography (author's transl)].

The angiography alterations of 42 cases with gallbladder distention in inflammatory or malignant disease are compared with 44 those of gallbaldder distension in distal occlusion of the common bile duct. Branches of the cystic artery were more frequent and wider in patients with gallbladder disease than those with distal common duct occlusion. In the first group, there is more often accumulation of contrast medium in the gallbladder wall, and the opacified wall is wider than in common duct obstruction. Tumor vessels are observed in 50% of malignant gallbladder disease, significant difference in the diameter of the cystic artery trunc could not be found.


The spectrum of radiologic findings in allergic bronchopulmonary aspergillosis.

Early diagnosis of allergic bronchopulmonary aspergillosis (ABPA) is important. Initiation of corticosteroid therapy in ABPA is essential to prevent progressive destruction of lung parenchyma. The earliest radiographic manifestations of the disease may be present only on bronchograms. In addition to the classic radiographic findings (infiltrate, massive homogeneous consolidation, tram-line shadow, parallel line shadow, ring shadow, toothpaste shadow, glove-finger shadow), perihilar infiltrates simulating adenopathy (pseudohilar adenopathy) and air fluid levels were frequently demonstrated.


Pulmonary changes in paraquat poisoning.

Paraquat is a commonly used herbicide. A case study of ingestion of paraquat is described. Chest radiographs showed coarse nodules, interstitial fibrosis, and pleural effusion. Pathological changes resembled hyaline membrane disease.


Sarcoidosis and mediastinal emphysema.

Mediastinal emphysema developed in a 13-year-old boy with diffuse interstitial pulmonary disease, later proved to be sarcoid. No previous report was found.


The air-fluid level in cavitary pulmonary tuberculosis.

Pulmonary tuberculosis has long been associated with the formation of cavities in the lung. Many reports in the literature indicate that the occurrence of air-fluid levels in tuberculosis is unusual. The authors present 18 cases of proved active cavitary tuberculosis where air-fluid levels occurred during the active phase of the disease. The consideration of tuberculosis in the differential diagnosis of an air-fluid containing pulmonary cavity is emphasized and the pathogenesis of cavity formation is discussed.


The state of radiographic technique in the examination of the colon: a survey.

The results of an extensive, multiple choice questionnaire sent to 113 leading medical centers in the world (100 centers responded) were analyzed and compared to those of a similar survey from 1968: single-contrast and double-contrast barium enema procedures are still the standard methods of radiographic assessment of the colon; the double-contrast, barium enema examination is now used more frequently, especially in conjunction with the single-contrast barium enema; preparation of the colon is now more meticulous; and drugs are added more frequently to the barium enema. Equipment has become more sophisticated through increased use of image intensifiers, television, and remote controls. More use is made of videotapes. Water-soluble contrast media are administered more frequently. The use of special radiographic procedures to evaluate the colon has decreased.


Radiologic evaluation of the continent (Kock) ileostomy.

The continent ileostomy is a solution to the persistent difficulties of leakage, odor, and skin irritation produced by the conventional permanent ileostomy in patients who have had proctocolectomy. Patients with continent ileostomy do not use ileostomy appliances, have complete fecal continence, and need empty the ileal reservoir only 2 to 4 times a day. Radiographic examination is often of great value in assessing patients with continent ileostomy. Radiographic features of the normal continent ileostomy and complications of continent ileostomy are discussed with regard to plain film and contrast examinations.


Persistence of the dens as the body of C1. A case report of a rare anomaly.

A patient with persistence of the dens as the body of the first cervical vertebra is described. This is an extremely rare anomaly and in this patient was associated with instability of the first cervical vertebra. Embryologic considerations and the clinical implication- of this anomaly are discussed.


Nevoid basal cell carcinoma syndrome: radiographic manifestations including cystlike lesions of the phalanges.

The radiographic findings in 25 patients with the nevoid basal cell carcinoma syndrome are presented. Cystlike lucencies of the phalanges, a previously unreported finding, were seen in 46% of the patients in whom hand films were obtained. Mandibular cysts, present in 42% of cases, and exuberant intracranial calcifications were also characteristic features. Brachymetacarpalia, and rib and spine anomalies were also associated with the syndrome but are less specific findings.


Isolated clustered microcalcifications in the breast: radiologic-pathologic correlation.

Thirty-one consecutive cases of mammographic isolated, clustered microcalcifications which prompted breast biopsy were studied by radiologic and histopathologic methods. Isolated, clustered microcalcifications were sensitive, but nonspecific cancer markers; 35% of the lesions were malignant and half of these were noninvasive. Radiologic and histopathologic similarities, and overlap between benign and malignant disease, prevented accurate differentiation. Breast biopsy is indicated when isolated, clustered microcalcifications are discovered by mammography.


Breast pattern classification and observer error.

Using the Wolfe breast pattern classification, a study was conducted to test the reproducibility of this classification in view of its likely significance for breast screening and rescreening programs. The results are highly encouraging, and there was good agreement. Reclassification from low risk occurred in 1% of the cases; reclassification from high risk to low risk occurred in 1.4%. There was a variance of 2.4% in the low-risk group and 0.6% in the high-risk group.


Renal vein valves: incidence and significance.

Although autopsy studies have demonstrated valves in 28-70% of right and 4-36% of left renal veins, they have rarely been detected or described during life. In an analysis of 98 renal venograms, valves were found in 16% of patients on the right side and in 15% on the left, without predilection for any particular location. Angiographically, they appeared as thin, web-like structures which may block passage of the catheter or of contrast material, and hence cause poor venographic filling. Rarely, valves produce total obstruction to the retrograde flow of contrast material.


Evaluation of the left renal vein in candidates for splenorenal shunts.

The authors describe 4 patients who had functioning distal splenorenal shunts despite obstruction of the left renal vein at its insertion into the inferior vena cava. The angiographic technique and findings of left renal vein evaluation in 40 shunted patients are reviewed. There were two important findings. First, no correlation existed between the degree of portal hypertension and the degree of filling of collateral tributaries of renal veins. Second, obstruction of the left renal vein does not impair a splenorenal shunt if good collateral pathways are present.


Recognition of renal artery spasm during renal angiography.

During the performance of routine angiography in a community hospital, three different forms of renal arterial spasm were encountered. Renal artery spasm may involve either large or small arteries of the kidneys. The temporary nature of the spasms may be demonstrated by additional angiography which shows no defect. Either a sufficient waiting period for the spasm to relent or the employment of a vasodilating drug through the catheter will usually suffice for this demonstration. Differentiation of spasm from fixed, organic disease is essential to prevent diagnostic error and improper therapy.


Liver metastases discovered during high-dose excretory urography.

Liver metastases were discovered in 4 adults during high-dose excretory urography with upper abdominal tomograms. Previous reports in the English literature have noted incidental discovery of hepatic cysts or abscesses during urography, but no documented cases of liver metastases were found. All metastases were visualized as round, lucent, hepatic filling defects during total body opacification. Radiologists performing high dose excretory urography with tomography should routinely scrutinize the hepatogram, because metastases, cysts, or abscesses may be visualized. Final diagnosis of these masses usually depends on additional diagnostic modalities.


Radiation dose in hysterosalpingography: modern 100mm fluorography vs. full-scale radiography.

Radiation doses of modern 100mm fluorography and full-scale radiography were compared experimentally and applied to hysterosalpingography. It was determined that 100mm fluorography reduced the doses by 28-29% per exposure and 37-47% per examination compared with full-scale radiography performed with fast tungstate screens in identical conditions (70-80 kV, 400 mA). The dose during one minute of videofluoroscopy was equivalent to the doses produced by one exposure in full-scale filming and three to four exposures in 100mm filming. Although electronic magnification in 100mm fluorography increases the doses by two or threefold, these are still less than the doses in full-scale radiography.


Computed tomographic measurement of the xenon brain-blood partition coefficient and implications for regional cerebral blood flow: a preliminary report.

The calculation of regional cerebral blood flow requires, in addition to the measurement of the clearance, a knowledge of the regional brain-blood partition coefficient. The usual 133Xe washout techniques do not measure this latter parameter but use published values for normal brain tissue. This may lead to large errors in pathological tissue because the partition coefficient changes significantly in brain tumors. Investigations have begun into the use of CT and stable xenon to produce a cross sectional view of the brain in terms of its brain-blood partition coefficients. Results of experiments using an iodine phantom and xenon inhalation in animals are presented.


Computed tomography of shearing injuries of the cerebral white matter.

Changes secondary to shearing injury of the cerebral white matter can be demonstrated on CT. These consist of eccentric hemorrhage in the corpus callosum, diffuse cerebral swelling, subarachnoid hemorrhage and less frequently, hemorrhage around the third ventricular region and in the cerebral white matter. These CT findings are associated with acute severe neurologic deficits and sequelae. Eight cases with this injury pattern were encountered in 286 acute head injuries. All 8 patients were involved in automobile accidents.


Tuberous sclerosis. Comparison of computed tomography and conventional neuroradiology.

Sixty-two patients with tuberous sclerosis were studied by skull radiography. In addition, 16 had CT scanning, 26 had air studies, and 5 had cerebral angiography. Both subependymal and parenchymal tubers were shown on CT; all had a higher density than the brain and none were enhanced by contrast material. CT showed tubers in 13 of 16 patients, including 4 of 6 patients with glioma and hydrocephalus. Air studies showed subependymal tubers in 12 of 26 patients. Four other patients had intraventricular gliomas but no tubers. Skull radiographs showed spotty calcification, compatible with tuberous sclerosis, in 30 cases. Four patients had calcification compatible with tumor. Angiograms were nonspecific, showing intraventricular masses but no tubers.


Detection of myocardial ischemia in vitro by computed tomography.

The applicability of CT in the delineation of ischemic myocardium is defined. Twenty-six dogs had their left anterior descending coronary artery occluded, and radiolabeled microspheres were injected into the left atrium to measure myocardial blood flow. From 30 minutes to 7 weeks after coronary occlusion the hearts were excised and scanned in a CT head scanner. An unbiased observer divided selected CT scans slices into normal, abnormal, and borderline areas of attenuation coefficients; these were correlated with blood flow measurements and a progressive decrease in flow from normal to borderline and borderline to abnormal segments was found. As early as 2 hours after coronary arterial occlusion, areas of reduced attenuation coefficient, corresponding to regions of reduced blood flow, were seen. Areas of increased attenuation were seen in regions containing microcalcifications and fibrosis in several longer term experiments. Areas of reduced blood flow were visible immediately after coronary arterial occlusion with intravenous iodinated contrast material (1 ml/kg). CT detection of regions of reduced blood flow defined by radiolabeled microsphere is a promising means of detecting and sizing myocardial infarcts.


Measurement of left ventricular cast volume by computed tomography.

Angiocardiographic methods available for cardiac-chamber volume measurements are neither consistently accurate nor precise. To explore the capability of computed tomography for left ventricular volume measurement, Silastic casts of 24 normal human left ventricles were measured by a displacement method, a conventional angiocardiographic biplane volume method, and computed tomography. The displacement method used degassing to remove air trapped in the casts; displacement was measured by Archimedes' principle. Cast volumes measured by biplane methods displayed spread around the regression line, caused by the chamber's irregular shape and its variations in orientation. Computed tomographic measurements were independent of chamber orientation and significantly more accurate.


A quantitative clinical comparison of three 99mTechnetium labeled brain imaging radiopharmaceuticals.

In a comparison study of three commonly employed 99mTc brain imaging pharmaceuticals, 16 patients with proven brain lesions had imaging performed with DTPA, glucoheptonate, and pertechnetate over a short interval of time. Lesion detectability was assessed by a data processing system which evaluated average lesion-to-background activity ratios for each patient examination. Statistical analysis of the resultant data demonstrated a significant improvement (20%) in lesion-to-background ratio in favor of one hour delayed DTPA images versus two hour delayed pertechnetate images. Comparison of one hour delayed DTPA images with one hour delayed glucoheptonate images did not reveal a significant difference in lesion-to-background ratio. The authors conclude that both Tc-DTPA and Tc-glucoheptonate are superior alternatives to pertechnetate when employed in the manner described.


Correlation between intracoronary 201Tl myocardial scanning, coronary angiography and left ventriculography.

One hundred and six patients with angina pectoris who underwent routine coronary angiography and left ventriculography were given intracoronary injection of thallium 201. The myocardial images had excellent resolution because of lack of interference from the background activity. The myocardial images and the left ventriculograms showed 94% correlation. Correlation between scans and EKG was lower. There was no correlation between the degree of coronary artery stenosis and 201Tl scan. Currently, the intracoronary injection of 201Tl at rest does not yield additional information to coronary angiography and left ventriculography.


Diffuse pulmonary hemangiomatosis.

The authors describe three pediatric patients with diffuse pulmonary hemangiomatosis. Virtually identical clinical, radiographic, and pathologic findings were observed in each case. The combination of diffuse interstitial pulmonary infiltration and bloody pleural effusion in a child is pathognomonic. Early recognition of hemangiomatosis can allow more effective evaluation of therapeutic measures.


Aicardi's syndrome; radiologic manifestations.

Features of Aicardi's syndrome include infantile spasms associated with pathognomonic chorioretinopathy, abnormalities of the corpus callosum with heterotopia of gray matter, and characteristic electroencephalographic findings. Vertebral abnormalities are also part of the syndrome, which is apparently limited to female infants. Subnormal mental development appears in all cases. It was first described in 1969 in French. Isolated cases in the literature have been associated with facial asymmetry, plagiocephaly, and the Dandy-Walker syndrome. Experience with two patients suggests that a search for cases among patients with chorioretinopathy and infantile spasms will show the syndrome to be more common than currently reported.


An unusual location of an esteochondroma.

An unusual hip tumor was seen in a 13-year-old youth following a brief history of discomfort. The osteochondroma was differentiated from dysplasia epiphysealis hemimelica by its location.


Adrenal ultrasonography.

The adrenal gland was evaluated prospectively in 59 patients using gray-scale ultrasound. 95% accuracy was achieved. Recent modifications of this technique which affect the approach to the right adrenal gland are described, and the limitations of the technique as well as the role of ultrasonography in relation to other noninvasive imaging modalities are discussed.


Ultrasonography of adrenal masses: usual features.

Gray-scale B-scan was successful in delineating adrenal masses in 40 patients, all confirmed pathologically. Two patients with extra-adrenal pheochromocytomas, two calcified cysts, and two patients with bilateral adrenal hyperplasia are demonstrated. The usual ultrasonographic features are presented in this paper; they correlated well with urographic, angiographic, CT, and pathological findings. The smallest mass demonstrated was an aldosteronoma (1.3 cm in size).


Ultrasonography of adrenal masses: unusual manifestations.

Forty patients with pathologically-proved adrenal masses, and two patients with extra-adrenal pheochromocytomas, were examined with gray scale B-scan. The authors describe unusual echo patterns of adrenal masses due to necrosis or hemorrhage, variations in the effects of large adrenal masses on surrounding organs and vessels, and the differential diagnosis. The complementary role of computed tomography is also discussed.


Parathyroid ultrasonography.

Gray-scale ultrasound was used to evaluate patients with primary hyperparathyroidism. Twenty-one of the 25 parathyroid glands shown pathologically and anatomically to be greater than 5 mm in diameter were identified and varied between 6 and 15 mm. Although the nosological sensitivity was poor, the false-positive rate was low. Important anatomical limitations and pitfalls are described. The role of ultrasonography is compared to that of other noninvasive diagnostic modalities and related to specific clinical situations and surgical approaches.


A two-dimensional echoaortocardiographic approach to dissecting aneurysms of the aorta to prevent false-positive diagnoses.

Two patients with dissecting aneurysms of the aorta of Debakey type I and II, 10 healthy subjects, and 2 patients with signs mimicking aortic-root dissection were studied by two-dimensional echoaortocardiography, standard echocardiography, and M-mode scanning. In both electrocardiographically gated and nonelectrocardiographically gated two-dimensional echoaortocardiograms of each patient, aortic-root dissections were clearly visualized. Because of the possibility of a false-positive diagnosis of an aortic-root dissection by previously reported criteria (including cases in the authors' experience and in the literature), the authors are convinced that the combination of two-dimensional and standard echoaortocardiography provides the most reliable echo diagnosis of this disease.


An experimental "trans-molybdenum" tube for mammography.

Possible mammographic advantages of "trans-molybdenum" anodes (atomic number greater than ZMo) are decreased dose because the fluorescent radiation is more penetrating, and increased useful output; contrast degradation is known to be tolerable. The output per mAs, the HVT in Al, and the penetration in Lucite were measured spectroscopically for an experimental Rh-anode tube and also for Mo- and W-anode mammographic tubes. The trans-molybdenum tube was shown to have output and dose advantages over Mo anodes, and output and contrast advantages over normal and selectively filtered W anodes. Possible applications in areas other than mammography are briefly discussed.


Optimization of electrostatic imaging systems for minimum patient dose or minimum exposure in mammography.

The x-ray photon energies that give the highest signal-to-noise ratios per unit of exposure or average dose in mammography are significantly greater than those used in current film/screen systems. Optimum photon energies for detection of calcifications in a range of thicknesses of water and fat were calculated. Soft-tissue targets were also considered. Comparison of the theoretical results and those obtained experimentally with the Stanton mammography phantom indicate that operation at less than optimum photon energies is a major cause of inefficiency in film/screen mammography. On the other hand, electrostatic imaging systems, because of their processing flexibility, can operate at the optimum photon energy levels, thus minimizing either dose or exposure.


Edge enhancement of ECG-gated cardiac images using directional masks.

ECG-gated images were processed by a computer using a nonlinear digital filter and directional masks to improve delineation of cardiac chamber boundaries and identification of the aortic and mitral valve planes. This technique proved to be satisfactory in 30 patients with documented coronary or valvular heart disease.


Development of a method of evaluating cardiac performance using interactive computer graphics.

The authors discuss an objective method of analyzing local wall motion to detect and measure the pattern of contraction of the left ventricle using computer graphics. The method's advantages include: (a) the use of modular hardward and software, which can be extended and upgraded; (b) a minimal expenditure of time and money; (c) uniformly calculated results; and (d) a graphic and legible report.


Simultaneous detection of myocardial perfusion and wall motion abnormalities by cinematic 201Tl imaging.

A method for simultaneous acquisition of static and ECG-synchronized 201Tl myocardial images is reported. The ECG-synchronized images are then displayed continuously in cinematic format. In studies of 37 patients, the cinematic technique provided detection of regional wall motion abnormalities and improved distinction of cardiac borders without losing perception of perfusion defects. Cinematic display is a useful addition to 201Tl myocardial imaging.


General purpose digital display system for computed tomography images.

The authors describe a microprocessor-based digital image display system utilizing a solid-state image memory with a high quality television-type monitor for display of computed tomography images. It is an alternative to a commercially available display system, and offers the potential for research in digital image display. It is now under clinical evaluation. Image input to the stand-alone display system is via 9-track magnetic tape common to almost all CT machines, and it may be programmed to accept digital tapes from any type of CT machine and display them in a common format.