[Results with non-fixed silicone implants in the treatment of blow-out-fracture and fracture of the orbit].

The number of difficult maxillofacial fractures increases with the number of traffic accidents. 80% of all accidents of this kind are accompanied by juries of the head. In the treatment of combined blow-out-fracture and fracture of the orbit, the most important task is a repair of all orbital structures in collaboration of the ophthalmologist with the otolaryngolist and the oral surgeon. A knowledge of all orbital fractures (stages according to Bleeker) is an essential basic requirement. Bigger defects of the orbital walls are closed by me with one, two or three perforated silicon implants in accordance with Whyte. The open repair of the orbital ring with intraosseous fixation is the modern method of treatment of dislocated orbital bones. After a detailed description of my own operative procedure the treatment results of 75 combined blow-out-fractures--among them 4 orbital fractures of the floor, walls, roof and margins--are given. The following complications are listed: 1 case of orbital hemorrhage, 36 cases of persistent lower lid edema, 4 cases of tissue reaction to the alloplast, 3 cases of infection )amoung them one otolaryngolical case) and 5 cases of extrusion of the implant.


Immunopathology of the lens. II. 86Rb efflux and protein leakage from normal lenses exposed to antilens and antiuveoretina antibodies.

Normal rabbit lenses exposed in vitro to heterologous antilens and antiuveoretina antibodies lose control of the intracellular 86Rb and this effect is followed by a late leakage of lenticular proteins; both phenomena take place only in the presence of complement. This antibody-induced complement-dependent membrane damage might be involved in the pathogenesis of complicated cataracts in uveitis and in the self-maintenance of recurrent uveal inflammations.


[Orbital chordoma].

The clinical course, autopsy findings and histological appearance are described in a case of malignant chordoma of the skull base involving the orbits, paranasal sinuses, nasal cavity, and the middle and posterior cranial fossa. Exophthalmos developed early as an unusual symptom in association with ocular pareses, visual detoriation and visual field loss. The clinical and histological characteristics of this rare tumour are briefly reviewed and compared with the findings in the present case.


Orbital involvement of an extramedullary plasmacytoma.

A patient presenting with left-sided proptosis was found to have an EMP primary to the maxillary antrum with extenion into the orbital floor. The patient was in stage II, and myeloma protein was detectable. This protein was found to be the lambda-chain of IgG.


Immunopathology of the Lens. III. The effect of experimental allergic uveitis on the cation balance in the lens.

Rabbit lenses from eyes suffering from experimental allergic uveitis showed a clear enhancement in the 86Rb efflux as compared to the lenses from the fellow normal eyes. Intracellular K+ was also significantly decreased and Na+ significantly increased after several relapses of inflammation.


The disc and the field in glaucoma.

The previous descriptions of the optic nerve head were reviewed. A study was done using discriminant analysis, in which an 85% separation was obtained by means of the discriminant function in a prospective study. The false positives showed a higher incidence of subsequent visual field defects from the true negatives. The pitfalls of the use of the optic nerve head appearance in the recognition of glaucomatous visual field defects were discussed.


Ciliary block (malignant) glaucoma.

A review of the history, recognition, mechanisms, and therapy of ciliary block glaucoma has been given. Cycloplegic therapy is stressed in the susceptible eye.


Dipivalyl epinephrine: a new pro-drug in the treatment of glaucoma.

The dansyl chloride technique in conjunction with thin layer chromatography and autoradiography has shown that dipivalyl epinephrine is a pro-drug in the human eye. Dipivalyl epinephrine appears to be a more effective epinephrine compound, in that it penetrates the cornea approximately 17 times greater than epinephrine.


The pathogenesis of glaucoma in Sturge-Weber syndrome.

What is the cause of glaucoma in Sturge-Weber syndrome? Looking for the answer to this puzzling question, we examined 21 patients with the disease. Sixteen patients had gglaucoma: three bilateral and 13 unilateral. Episcleral hemangiomas were visible in all glaucomatous eyes. In general, the more extensive the hemangioma, the more severe was the glaucoma. During gonioscopy, blood could easily be made to reflux into Schlemm's canal of glaucomatous eyes. Often the canal separated into multiple fine channels. Episcleral venous pressure, which we measured in 11 patients, was high in all glaucomatous eyes. These observations suggest that glaucoma in Sturge-Weber syndrome is caused by elevated episcleral venous pressure. Most likely, veins draining aqueous from the canal of Schlemm are part of an intrascleral or episcleral hemangioma. The canal of Schlemm itself may be part of the hemangioma. Arteriovenous shunts in the hemangioma raise episcleral venous pressure, which in turn elevates intraocular pressure.


The limitations of kinetic perimetry in early scotoma detection.

When tested by Goldmann kinetic perimetry ten patients with glaucomatous optic disc cupping had no visual field defects, but visual field defects were detected when tested by threshold static perimetry on the Tubingen perimeter. To improve the detection ability of kinetic perimetry, we suggest placing the interisopter spot-checks close together or expanding the central 30 degrees plotting area.


Postoperative endophthalmitis. Introduction: incidence and etiology.

Postoperative endophthalmitis (POE) can occur after any type of intraocular surgery including operations for cataract, glaucoma, penetrating keratoplasty, retinal detachment, vitrectomy, and the repair of perforating trauma. Notwithstanding a gradual reduction in the overall incidence of POE, sporadic cases and occasional multiple outbreaks continue to cause the loss of eyes. This symposium is concerned with the incidence, epidemiology, diagnosis, therapy, and prevention of POE caused by bacteria and fungi.


Etiology and diagnosis of fungal postoperative endophthalmitis.

Delayed infections after ocular surgery (especially cataract) are usually due to saprophytic contaminant fungi of relatively low pathogeneicity. About 20 different varieties of fungi have been cultured from such eyes. Thus, as far as the eye is concerned, there is no such thing as a harmless, benign fungus. Mycotic postoperative endophthalmitis is a distinct entity with a typical clinical picture, easily diagnosed once learned. Laboratory tests are often positive. Since the visual result is poor even if the eye is saved, prevention and early recognition are our primary concerns. In this regard, a recent episode of 12 infections from contaminated intraocular lens neutralizing solutions as well as other sporadic instances of fungal infection after lens implantation must be noted.


Experimental aspects and their clinical application.

After laboratory evaluation of nontoxic doses of intravitreal antibiotics, 26 cases of bacterial and fungal endophthalmitis were treated by intravitreal antibiotic or vitrectomy. In 46% of all cases, visual acuity was better than 20/100, whereas 27% had light perception to 20/300 visual acuity, 4% had no light perception, and 23% of the cases were enucleated or eviscerated. Best results have been achieved when the treatment began within 36 hours after symptomatic onset of infection and when the organism involved was not to virulent. We advocate intravitreal antibiotics immediately after intracameral and vitreous tap for culture, to be followed by vitrectomy 24 hours later if the culture is positive. In bacterial endophthalamitis when the vitreous is severely involved and in cases of fungal endophthalmitis, we advocate vitrectomy plus intravitreal antibiotics as the primary procedure.


Prevention of postoperative endophthalmitis.

Prevention of postoperative endophthalmitis (POE) requires (1) environmental control, (2) tissue control, and (3) anticipation of eyes at special risk of infection. Environmental control entails an adequate supply of finely filtered air and absolute sterility of solutions, medications, and objects and materials used during surgery. Tissue control involves degerming the skin of the operative field, inhibition of the flora of the lid margins by an antibiotic ointment use preoperatively, and pretreatment of the conjunctival tear film by soluble antibiotics possessing activity against Proteus and Pseudomonas as well as gram-positive species. Eyes at special risk of infection include those of diabetics, chronic alcoholics, and individuals who have been maintained for long periods of time on systemic or topical corticosteroids. Patients who have had multiple eye operations, recurrent uveitis, and who are scheduled for surgery on the second eye during a single hospital admission should receive special consideration preoperatively.


Survey on the use of intraocular lenses.

A birth of interest in lens implantation occurred especially in the United states in 1974. This coincides with the beginning of four major American lens manufacturers. This interest expoded in 1975 and 1976 and seems to be continuing to grow. Only a few surgeons have stopped implants, most of them after having done ten or less. Half of the surgeons now doing implants have done 25 or less, while 40% have performed a series of 25 to 200. Intracapsular lens styles were the most often used, and the Worst Medallion lens was by far the most popular. Medical Workshop was the leading supplier of lens implants. Accounting for 25%, and European lenses were more often used (61%). The majority of surgeons beginning lens implants after 1974 used either American lenses exclusively or both sources. The majority of lenses used were designed by Binkhorst and Worst. Only 4% of lenses implanted were done secondarily, but one third of the surgeons have performed this procedure; more do them as their experience grows. An overall visual acuity of 20/40 or better postoperatively was found in 83.8% of cases. Significant lens power errors were rare but increased with increasing experience. One third of the surgeons have reported removing a lens implant at a rate of 0.8%, but only 3% of the surgeons have reported removing an eye with a lens implant at a rate of 0.05%.


Surgical correction of far advanced otosclerosis.

The patient with far advanced otosclerosis (a nonmeasurable bone-air gap) may appear superficially to be suffering from profound or total sensorineural impairment. Only by a careful history and examination can a proper diagnosis be made. Stapedectomy has produced satisfactory results in 46 per cent of these cases in our hands.


Sensorineural hearing loss due to cochlear otospongiosis: etiology.

This presentation discusses the most valuable way to correlate specific morphologic changes in cochlear otospongiosis with sensorineural hearing loss. Both biochemical and vascular factors may be responsible for the association of far advanced otospongiosis and histopathologic changes. An enzymatic concept of the disease is proposed on the basis of experimental findings and cytoclinical correlations, and the spread of proteolytic enzymes from the bursting lysosomes in histiocytes of the otospongiotic microfoci of the lateral wall. In addition, according to Ruedi's vascular concept, abnormal vascular connections called "shunts", provoked by active foci breakiny oxygen. Such extensive otospongiotic bone transformation breaking the endosteum of the cochlear is much less frequent than the progressive cochlear component encountered by otologic surgeons in far advanced otospongiosis. It is for this reason that the authors believe that their enzymatic concept of otospongiosis may explain the most important part of the sensorineural impairment in cochlear otospongiosis.


The successful hearing aid user.

Improvements and modifications in design, construction, evaluation, and application procedures with the wearable hearing aid have brought the benefits of successful hearing aid use to an ever increasing proportion of the hearing impaired population. Many of today's successful hearing aid users would have been regarded at one time as extremely poor risks for hearing aid use. As a consequence, many of the prognostic principles developed as guidelines in advising for or against hearing aid trial are no longer true and should be discarded. Every person who experiences difficulties related to a permanent hearing impairment, no matter how slight or severe hearing loss, should have access to aural rehabilitation, including the use of wearable amplication.


Identification of hearing loss in infants and young children.

An infant's hearing loss is detectable at any age. In spite of the importance of identifying deafness early, we do a poor job largely because the medical community is neither aware nor convinced that finding hearing loss is worth the trouble. There are two public health strategies for early detection, the high risk register (family history, hyperbilirubinemia, prematurity, rubella, and maxillofacial anomalies) and behavioral screening. The advantages and disadvantages are discussed. The incidence of handicapping hearing loss in newborns is 1 per 380 births and 1 per 61 in babies admitted to an intensive care nursery. This is higher than generally believed and may be one favorable result of using a new automated hearing screening system--the Crib-o-gram. In most deaf babies there is more than one risk factor present. Evaluating a hearing suspect baby demands a high index of suspicion, and taking the parent's suspicions seriously. The chances that a hearing loss exists at one year of age is about 1 in 4 on parental suspicion alone, regardless of what the physician's opinion might be. Immediate referral upon suspicion needs to occur more often than it does.


Viral causes of sensorineural hearing loss.

Many viruses, even the common cold, are capable of producing sensorineural hearing loss. Treatment so far available is ineffective in correcting these losses. However, as the technology of vaccination advances, it is hoped that these can be prevented. Poliomyelitis and smallpox have been virtually eliminated from this country. Measles, rubella, and mumps are coming under control. Perhaps in the future we will be able to completely control influenza and the common cold and thus prevent many of the sensorineural hearing losses that we see today.


Fluid dynamics in sudden sensorineural hearing loss.

A change in fluid pressure in one intracochlear compartment also causes a pressure gradient in the other. Thus, one membrane break is likely to cause a secondary break. We have presented indirect evidence for such double membrane breaks in sudden hearing loss, and argue that one of the two breaks can heal spontaneously while the other remains active.


Viral causes of sudden inner ear deafness.

Clinical, pathologic, and laboratory studies suggesting a viral etiology for sudden deafness have been presented. Although a cause and effect relationship has not been proven, the frequent close association between viral infection and sudden deafness constitutes a strong argument in favor of a viral etiology of sudden deafness in about one of three patients with sudden deafness.


Electric response audiometry: clinical applications.

Electric response audiometry is an exciting new development in the field of otology. At the present time it is the best objective audiometric test for predicting the threshold in infants or uncooperative patients. Brain stem audiometry is a valuable addition to the audiologic test battery for acoustic tumor diagnosis. Electrocochleography offers a means for the study of the function of the inner ear and the differentiation of types of sensorineural hearing impairment.


Sudden Hearing Loss Research Clinic.

There is still a considerable lack of knowledge about the etiology and treatment of sudden hearing loss, despite renewed interest among investigators. There is still no treatment regimen that has been demonstrated to be effective. Other clinics should be established to elucidate the factors surrounding the etiology and to as with sudden hearing loss have another diagnosable disorder, but careful follow-up is necessary. In our series this figure was approximately one-third. Luetic labyrinthitis, perilymphatic fistula, fluctuant hearing loss or endolymphatic hydrops, and acoustic neuroma are among the diagnoses to be considered.


Rupture of the round window membrane.

The mechanism of development of rupture of the round window membrane appears to be an increase in pressure in the cerebrospinal fluid transmitted to the inner ear via the cochlear aqueduct. Two cases of rupture of the round window membrane in divers are described in detail. One diver had ruptures of both round window membranes following difficulty in autoinflating when diving, and the other had a rupture of one round window membrane, having presented with acute prostating vertigo and normal hearing. Surgical repair restored the hearing in the former case and preserved normal hearing in the latter. The  similarity between ruptures of the round window membrane and poststapedectomy fistula is emphasized, and it is suggested that spontaneous healing of ruptures may well occur. A case history supporting this hypothesis is presented. The technique of repair of ruptures of the round window membrane is described as well as postoperative management. Normal nasal function in divers is essential if inner ear barotrauma and ruptures of the round window membranes are to be avoided.


Activation of succinate dehydrogenase from adult Fasciola hepatica (Trematoda).

The succinate dehydrogenase of adult Fasciola hepatica was found to exist in active and in active forms. The enzyme was inactivated by 1 micron oxaloacetate and activated by incubation with compounds which bind to the active site (succinate, fumarate, malonate) or by incubation with anions and certain nucleotides. The activation of the enzyme by succinate followed first-order kinetics. The extent of activation of F. hepatica succinate dehydrogenase depended on the nature and concentration of the activator and on the pH. The rate of activation of the enzyme depended on the temperature. In contrast, the fumarate reductase activity of F. hepatica was not activated by incubation with substrate or anions and was not inhibited by oxaloacetate (100 micron). The significance of these results in the regulation of the tricarboxylic acid cycle in parasitic helminths is discussed.


Strongyloides ratti: the effect of betamethasone on the course of infection in rats.

Rats were treated with betamethasone at different stages of infection with Strongyloides ratti. Treatment caused a diminution in the number of adult worms recovered but this residual population was not expelled as were worms from untreated rats. If treatment was started after expulsion had already begun adult worm numbers increased--suggesting that autoinfection occurred. Treatment throughout a primary infection prevented the development of an immune response which expelled, or killed, a challenge infection. Treatment, just before and just after challenge, prevented the expulsion of the challenge infection. Worm expulsion up to day 35 was prevented by treating rats with betamethasone 4, 6, 8 and 10 days after infection.


Early developmental changes of the schistosomula of Schistosoma mansoni in vitro and in mouse lung.

Fresh (3 h) schistosomula of Schistosoma mansoni were obtained by the skin penetration method and injected intravenously into groups of mice either immediately or after 48 h incubation in tissue culture. Schistosomula were then recovered from the lungs 1 to 2 days after injection. The recovery results showed that the ability of uncultured schistosomula to emerge from lung tissue increased with time, became maximal on the 3rd day and diminished thereafter. In contrast, cultured schistosomula were able to emerge from chopped lung at a much earlier time after injection. Fresh schistosomula, as well as those recovered from mouse lungs, were assayed by indirect immunofluorescence for the presence of parasite and host antigens. Similarly, fresh schistosomula which had been incubated in foetal calf serum, with or without mouse red blood cells, were assayed for parasite and host antigens after 3-24 h of culture. Fresh schistosomula expressed parasite antigen with greater intensity than those recovered from mouse lungs and showed no trace of host antigen. Lung schistosomula, on the other hand, expressed less parasite antigen but more red blood cell antigen with increasing time in the host. Schistosomula cultured in the absence of mouse red blood cells expressed only parasite antigen throughout the period in culture, while those cultured in the presence of mouse red blood cells also expressed parasite antigen during the entire period in culture but, in addition, by 24 h host antigen could also be detected. These developmental and adaptational changes may play a role in determining the survival of parasites in the normal or immune host.


A freeze fracture study of the developing tegumental outer membrane of Schistosoma mansoni.

The freeze fracture technique has been used to quantify changes in the integral components of the double outer membrane of Schistosoma mansoni during the 6-week period of development within the mouse. The intramembraneous particle (IMP) density on the P1 face begins to rise within 6 h of host penetration, reaches a maximum at day 4 and then falls rapidly after day 9, so that it is at a low level between 3 and 6 weeks. The E1 face IMP density follows the same course as that of the P1 face except that maximum particle density is recorded on day 1 and the counts begin to fall on day 5. The IMP density on the P2 face remains at a consistently low level throughout development. The E2 face IMP density rises gradually to a peak at day 4, when the parasites have migrated to the lungs, and remains thereafter at a similar level, so that by 6 weeks the E2 face has a higher IMP density than the other three fracture faces. The E2 face IMP show a marked increase in size on day 4. Morphological studies indicate that a different type of inclusion body makes a transient appearance in the tegument of the lung worms, and immunocytochemical techniques show the lung worms to be nonimmunogenic. It is suggested, therefore, that the E2 face IMP may represent complexes of parasite antigens and acquired host antigens. The tegumental membranes of cultured specimens have also been examined by freeze fracturing and the IMP densities compared with those obtained from in vivo parasites; the cultured schistosomula have a lower E2 face particle density than the in vivo specimens.


Boophilus microplus: rejection of larvae from British breed cattle.

Larvae of Boophilus microplus were labelled with [32P] and used to study the rejection of larvae from British breed cattle with different levels of resistance. On animals of high resistance the loss of larvae due to grooming ranged from 9-54% during the first 24 h of infestation, and more time was spent grooming by these animals. Most of the grooming activity could be attributed to the presence of tick larvae and the presence of older tick stages did not increase the percentage of larvae lost. Grooming was directed to attached larvae and these could be removed. Animals of low resistance did not lose a significant number of larvae as a result of grooming, but all previously infested hosts lost a proportion of the larvae (18-39%) which could not be accounted for by grooming. This loss was greater than the total loss of larvae (11%) on animals not previously exposed to B. microplus.


Decrease of lipase and esterase activities in intestinal contents of newborn infants during test meals.

Both lipase and esterase activities were present in intestinal contents of all newborns studied, from the first day of life. In adults given a test meal lipase activity increased and esterase activity remained unchanged. In contrast, both activities decreased markedly in infants on feeding. During the digestion of the test meal the lipase activity in intestinal contents of the infants was much lower than in adults (ratio of median values 1:27) and the esterase activity was also several fold lower (ratio of median values 1:1.3). Speculation Newborn infants often absorb lipids less efficiently than adults. One contributing factor may be that their incompletely developed pancreas responds to feedings with comparatively low outputs of lipolytic enzymes. The newborn may be more dependent than adults on auxiliary sources of lipase activity such as the pharyngeal lipase and/or the bile-stimulated lipase in human milk.


High performance liquid chromatography for the detection of homozygotes and heterozygotes of Niemann-Pick disease.

A method is developed for the detection of homozygotes and heterozygote carriers of Niemann-Pick disease type A by employing a high performance liquid chromatography (HPLC) technique for the measurement of sphingomyelin (SP) as well as for the assay of the enzyme sphingomyelinase (SPase) in skin fibroblasts and amniotic fluid cell cultures. A simple, less than 10-min, HPLC of the lipid extract of fibroblasts (about 2 x 10(6) cells) and measurement of the ratio of the area of SP peak to that of other phospholipids present in the cell-lipid extract show accumulation of SP in Niemann-Pick type A fibroblasts compared to normal. The SPase assay was performed by HPLC measurement of the substrate SP before and after hydrolysis by the enzyme. By employing this technique, it was shown that cells from patients with Niemann-Pick disease type A have less than 10% of the normal SPase activity, whereas the heterozygote carriers of this disease have about 50% of the normal activity.


Cystic fibrosis: the prognosis for five-year survival.

Statistical discriminant analysis is applied to 41 concomitant variables obtained during the first year of study of 226 patients with cystic fibrosis. A discriminant function based on six variables is developed which can be used as a predictive index. This index estimates the probability of 5-year survival for an individual patient and can also be used to classify patients into one of two groups: (1) will live for 5 years or (2) will die within 5 years. Speculation A classification rule for cystic fibrosis is presented which correctly assigns 90% of the 5-year survivors and 84% of those who expire. Such a classification scheme is useful for clinical and research purposes.


Care of infants with near-miss sudden infant death syndrome.

The purpose of this study was to evaluate the effectiveness of home management of life-threatening apnea in infants with near-miss sudden infant death syndrome (SIDS). A total of 84 infants were monitored with apnea monitors for an average of seven months (range 1 to 27). A group of 27 infants had episodes of apnea requiring resuscitation during home monitoring, all of whom were successfully resuscitated by their parents on at least one occasion using bag and mask resuscitation, and 17 infants required more than one resuscitation. Subsequent resuscitation was unsuccessful with four infants. Infants who experienced more than ten episodes of prolonged sleep apnea (apnea longer than 20 seconds) during home monitoring had a significantly increased risk of requiring resuscitation than other infants being studied. With the use of home monitoring of these infants and parents trained in cardiopulmonary resuscitation, the survival rate was 93.4%.


Functional immaturity of pulmonary irritant receptors and apnea in newborn preterm infants.

Absence of cough and gag reflexes has been noted in premature infants, but pulmonary irritant reflexes have not been studied. Irritant receptors respond to deflation, direct stimulation, or inhalation of irritant gases, resulting in an increased inspiratory effort. We have studied the responses of 28 intubated infants to direct bronchial mucosal stimulation with a fine catheter. Six of ten infants whose gestation was 35 weeks or more consistently showed a "mature" response, with an increase in inspiratory effort, while only one of 18 infants less than 35 weeks consistently showed this response. The premature infants showed variable responses. Fifty-eight of 93 stimulations produced an increased inspiratory effort, followed by marked slowing or apnea, while 20 stimulations resulted in slowing or apnea alone. These paradoxical responses to irritant stimulation may be related to immaturity of vagal myelination, and may be an important factor in the frequency of silent aspiration and apnea in premature infants.


Reduction of sleep apnea and bradycardia in preterm infants on oscillating water beds: a controlled polygraphic study.

The sleep and respiratory patterns of eight apneic preterm infants were polygraphically recorded for 24 hours. This polygraphic study was designed to test and extend our previous finding that gently oscillating water beds reduce apnea in premature infants. The infants who ranged in gestational age from 27 to 32 weeks and in birth weight from 1,077 to 1,650 gm served as their own controls, off and on the water bed. The 24-hour recordings were divided into four time blocks with the infant being placed on the water bed during alternate six-hour periods. Apnea was significantly reduced while the infants were on the oscillating water beds, with the longest apneic periods and those associated with severe bradycardia being reduced the most. Reduction of apnea was most consistent during indeterminate sleep and most pronounced during quiet sleep. Short respiratory pauses and periodic breathing were not significantly reduced. Reductions of central, obstructive, and mixed apneas were approximately equal.


Prolonged prostaglandin E1 infusion in an infant with cyanotic congenital heart disease.

A small-for-gestational-age premature infant with severe tetralogy of Fallot was treated with prostaglandin E1 to dialate the ductus arteriosus and increase pulmonary blood flow. The infusion was continued for 29 days without complication at which time surgery was performed.


Medium-chain triglyceride feeding in premature infants: effects on calcium and magnesium absorption.

The effect of medium-chain triglycerides (MCT) on the absorption of calcium and magnesium in premature infants was studied in 34 infants with birth weights lower than 2,000 gm. The infants were divided into three groups and fed three formulas similar in nutrient content except for the type of fat, as follows: group 1 (control): corn oil, oleo, and coconut oil (39:41:20); group 2: MCT, corn oil, and coconut oil (40:40:20); group 3: MCT and corn oil (80:20). The infants fed MCT-containing formulas absorbed significantly more calcium than the control group. Magnesium absorption was significantly increased in the 80% MCT group.


Survival of transfused normal granulocytes in a patient with chronic granulomatous disease.

A 5-year-old boy with chronic granulomatous disease (CGD) received four granulocyte transfusions from unrelated HLA-matched donors as part of therapy for a hepatic abscess. Survival studies of transfused granulocytes using the endotoxin-stimulated nitroblue tetrazolium (NBT) test on two occasions demonstrated 19.6% and 16.8% transfusion efficiency and a biphasic granulocyte disappearance curve. These curves were similar whether or not the patient had serum leukoagglutinins directed against donor granulocytes. Transfused granulocytes were present 24 hours after transfusion. Parallel studies demonstrated normal stimulated NBT activity of donor PMNs after overnight storage at 4 C. Kinetic studies of transfused granulocytes in the non-neutropenic recipient with CGD may be performed without radioactive labeling of granulocytes because of the distinctive metabolic abnormality of their cells compared with normal donor granulocytes.


Torsion of normal uterine adnexa in childhood: case report.

A case of torsion of a normal right ovary and tube in an 8-year-old child is presented. True infarction of the adnexa can be prevented only by considering this diagnosis early in the course of right lower quadrant pain. It is recommended that a routine exploration of the pelvis be carried out in any patient explored for acute appendicitis in whom that diagnosis cannot be made at the operating table.


Hereditary late-onset lymphedema.

Two different types of hereditary late-onset lymphedema are presented. In one family the father and one son had recurrent streptococcal lymphangitis beginning in childhood. In the son there was lymphatic hypoplasia in both legs with the infection having only occurred in one. Prophylaxis with penicillin prevented the recurrent lymphangitis. Because of 30 years of untreated lymphangitis, the father has chronic severe lymphedema. The second type, lymphedema associated with extra eyelashes (distichiasis) and a wide spinal canal, occurred in a woman whose lymphedema began at age 12 but in whom the hereditary nature of the disorder was not recognized until she was 29. Both of these types of late-onset lymphedema, lymphedema with lymphangitis and lymphedema with distichiasis, are due to autosomal dominant genes. Both families would have benefited from early diagnosis of the cause of the lymphedema.


Encephalocraniocutaneous lipomatosis.

Two patients with encephalocraniocutaneous lipomatosis have been studied. The main features of the syndrome are unilateral cutaneous and ophthalmologic lesions with ipsilateral cerebral malformations. Seizures beginning in infancy and varying degrees of mental retardation are present in affected patients. The involved tissues are derived from the embryonic ectodermal and mesodermal layers.


Tricuspid insufficiency associated with aneurysm of the ventricular septum.

Because of the anatomic relation of an aneurysm of the membranous ventricular septum (AMVS) to the tricuspid septal leaflet or because of the tricuspid septal leaflet involvement in the aneurysm formation, dysfunction of the tricuspid valve is likely to occur in patients with AMVS. The auscultatory manifestations of the resultant tricuspid insufficiency (TI) could be masked by the systolic murmur of the ventricular septal defect (VSD), which is often present in these patients. The presence of TI is suggested by phonocardiographic findings in five patients with AMVS and is further supported by intracardiac phonocardiography and angiocardiography. After inhalation of amyl nitrite, a pansystolic murmur appeared in three patients, and the intensity of the pansystolic murmur increased significantly in two patients. Inhalation of amyl nitrite reduces the systemic resistance, resulting in decreased systemic pressure and diminished intensity of the murmur of a small VSD. Augmentation of the systemic venous return is responsible for increased intensity of TI murmur.


Sinus node dysfunction in children, adolescents, and young adults.

Thirty children and young adults with electrocardiographic and clinical evidence of sinus node dysfunction (SND) are described. Ages ranged from 3 days to 25 years. Of these, 10 patients had inappropriate sinus bradycardia, 16 had periods of sinus arrest, and 9 had sinoatrial exit block. A total of 22 patients had significant heart disease and SND developed in 13 after cardiac surgery. Eight patients with SND had no obvious heart disease. Seven patients were symptomatic, having either syncopal (three) or near-syncopal episodes (four). The three with syncope have received permanent demand pacemakers. Although significant SND occurs most frequently in children with congenital heart disease, particularly following corrective cardiac surgery, it may occur in otherwise normal individuals.


Arrhythmias and Stokes-Adams attacks in acute rheumatic fever.

In spite of general complacency about first-degree heart block in acute rheumatic fever, abnormal conduction with dysrhythmias, occasional complete heart block, and, rarely, Stokes-Adams attacks are important early signs of acute rheumatic fever and may precede other signs. Every person with episodic fainting is entitled to an ECG, and frequent ECGs are imperative in any case of rheumatic fever with signs of arrhythmias. Changing atrioventricular block necessitates continuous monitoring for dysrhythmias. A 13-year-old boy who appeared with Stokes-Adams attacks secondary to acute rheumatic fever was successfully treated by temporary pacing.


Antecedents of child abuse and neglect in premature infants: a prospective study in a newborn intensive care unit.

Families of premature and ill newborns admitted to a regional newborn intensive care unit were studied prospectively to assess the incidence of reported child abuse and neglect. Of the 255 infants discharged to their parents, ten were subsequently reported as victims of maltreatment during the first year of life. The high incidence of maltreatment (3.9%) in these premature and ill newborns supports the findings of retrospective studies that there is an increased risk of maltreatment in these special infants. Thirteen family psychosocial characteristics, assessed by admission interview, showed significant association with later maltreatment. These family characteristics included social isolation, a family history of child abuse and neglect, serious marital problems, inadequate child care arrangements, apathetic and dependent personality styles, and inadequate child spacing. Maltreated infants were less mature at birth and had more congenital defects than their nursery mates. There was also less family-infant contact during the prolonged nursery hospitalization in families in which maltreatment eventually occurred.


Flow-volume relationship at low lung volumes in healthy term newborn infants.

To describe the maximum expiratory flow-volume relationship in newborn infants, we simulated forced expiration by transiently applying positive pressure in a chamber surrounding the infant's body. Maximum expiratory flows were reached at any given lung volume when increases in chamber pressure failed to produce increases in flow. Maximum expiratory flows were achieved in seven of nine healthy newborn infants at lung volumes equal to functional residual capacity (FRC) andin all infants at lung volumes below FRC. The volume expired below FRC (6.4 ml/kg) was roughly equivalent to previously calculated values of expiratory reserve volume in newborn infants (7 ml/kg). The maximum expiratory flow volume curves showed that the infants were able to increase expiratory flow rates well above those achieved during tidal breathing. The convex shape of the curves at low lung volumes is compatible with flow limitation occurring in peripheral airways.


Mucocutaneous lymph node syndrome: report of two cases complicated by gallbladder hydrops and diagnosed by ultrasound.

Two patients with mucocutaneous lymph node syndrome are presented. During the course of their illnesses, they developed acute abdominal pain secondary to hydrops of the gallbladder. The diagnosis and management of each case was facilitated by ultrasonography.


Prevalence of hepatitis B in a high-risk setting: a serologic study of patients and staff in a pediatric oncology unit.

The prevalence of serologic markers for hepatitis B virus (HBV) among 188 patients and 158 employees in a pediatric oncology unit was evaluated. Evidence of past or present HBV infection was detected in 33 patients (18%) and in 25 employees (16%). The prevalence was higher among patients receiving chemotherapy (19%) than among those not receiving chemotherapy (7%). The prevalence of HBV serologic markers, while much higher than generally found among healthy children in the United States, was low compared to previously reported prevalences in such settings, and may reflect the use in recent years of blood and blood products screened by "third generation" methods (radioimmunoassay and reversed passive hemagglutination) for hepatitis B surface antigen and the use of all volunteer blood donors. This prevalence suggests that perhaps there is less urgent need for the use of hepatitis B immune globulin and hepatitis B vaccine (when it becomes available) in oncology units than had been anticipated from earlier data in oncology units.


Behavior disturbance, phenobarbital, and febrile seizures.

Of 109 children treated daily with phenobarbital following the first fibrile convulsion, 42% developed a behavior disorder, usually hyperactivity. Daily phenobarbital therapy was prematurely discontinued in 54% of the children with behavior abnormality (20% of those treated). The behavior disturbance usually appeared within several months, was no correlated with high blood barbiturate levels, disappeared in 73%, and improved in all children when barbiturate therapy was discontinued. No characteristics of the child, the initial febrile seizure, or recurrence of febrile seizures were significantly correlated with the occurrence of the behavior disorder except for behavioral abnormality preceding the initial febrile convulsion. Eighteen percent of the children who received no phenobarbital developed behavior disorder, most often hyperactivity. The behavior disturbance spontaneously disappeared in 52%. Among these children not given phenobarbital, the group with normal behavior had a greater frequency of family history of seizures, especially febrile convulsions, and a lower frequency of preseizure behavior disturbance; abnormalities of pregnancy, labor, delivery, and neonatal period; delayed milestones; long seizures; abnormal results of neurological examination; abnormal EEG; and recurrent febrile seizures.


Revision of the Infant Temperament Questionnaire.

The Infant Temperament Questionnaire, originally published in 1970, has been revised to improve its psychometric characteristics. The number of items was increased from 70 to 95, rating options were increased from three to six, more items have high-low reversals, and they are randomized as to content area. The new form was standardized on 203 4- to 8-month-old infants. Good test-retest reliability was maintained and internal consistency of the nine categories was raised to a higher level, thereby assuring a greater reliability of the instrument. These improvements should enhance the questionnaire's use in clinical and research applications.


Evaluation of the expanded newborn screening program in New York City.

Since September 1974, New York State public health law has mandated that all newborn infants be tested for phenylketonuria, maple syrup urine disease, homocystinuria, histidinemia, galactosemia, adenosine deaminase deficiency, and sickle cell anemia in accordance with regulations of the state commissioner of health. During the period from May 1, 1975, to April 30, 1976, a total of 110,180 babies born in New York City were tested for these seven conditions. One year's experience with the screening program demonstrated a paucity of technological problems, low observed rate of both false-negatives and -positives, and the expected incidence of the conditions of highest prevalence, incidentally found during screening: i.e., sickle cell traits, AS and AC. What is equally apparent in reviewing this first year's experience is the extent to which the New York State law, its structure, and implementation have fallen short of the ultimate objective. The major reason for this failure is lack of funds and facilities in the areas of education, case retrieval, continuing medical care, and counseling. This report is presented with the hope that it will benefit all involved in genetic screening and especially those concerned with establishing similar programs.


Child-resistant locks in poison control.

Three child-resistant locks were incorporated into a medicine cabinet, an under-the-sink cabinet, and a vanity box. Three hundred 3- to 5-year-old children were tested against these locks. Only two were able to open the receptacles, whereas all 50 of a group of adults and teenagers similarly tested were able to open all of the containers. The use of adequately protected medicine chests and under-the-sink cabinets is urged as a further step toward the complete prevention of poisoning in children.


Reinforcing effects of prerecorded words and delayed speech feedback on the verbal behavior of a neologistic schizophrenic.

The possibility of using prerecorded words and 2-sec. delayed speech feedback as reinforcement in the reconditioning of intelligible verbal responses in a chronic, neologistic schizophrenic patient was investigated. A test situation was devised which involved daily presentation of 100 stimulus word-picture cards to elicit verbal responses. The results indicated that both singly presented prerecorded words and delayed speech feedback apparently strengthened correct and intelligible verbal responding.


Personality and preference for painting style.

40 university students were asked to choose between the cubist or surrealist from among 15 pairs of slides of paintings according to their aesthetic preference. Their choices were correlated with scores on Rotter's internal vs external locus of control scale. The data support the hypothesis that there is a positive relationship between preference for cubism over surrealism and internal locus control and vice versa.


Relationship between repression-sensitization and word frequency estimates for pleasant and unpleasant words.

College students (45 females and 12 males) estimated the frequency of pleasant and unpleasant English words. 28 subjects estimated how often they, personally, had seen the words (Personal condition), and 29 subjects estimated how often a "language expert" had encountered the words (Kucera-Francis condition). Byrne's Repression-Sensitization scores were obtained for all subjects. In both conditions repressors judged pleasant words to be more frequent, and sensitizers judged unpleasant words to be more frequent (p less than .01). The results may clarify some contradictions in the literature on frequency estimation and may help to explain the relationship between repression-sensitization and perceptual defense/vigilance.


Self-concept correlates in academic placement of secondary school students.

In a large school system in the Southeastern United States 26% of the eighth grade students in the lower distribution of scores on a standardized test in reading and mathematics were assigned to vocational education courses and a career education program. One of the school counselors administered a self-concept inventory, the Me Scale (Yeatts & Morrison, 1974), to a randomized group of 43 students who were in the lower 26% of scores. The same inventory was administered to 91 randomly selected students in the upper distribution of scores. Significant differences were noted for one of five factors in the Me Scale. Lower achieving students perceived themselves as more capable in manual dexterity than higher achieving students.


Handedness and locus of control.

Groups of 15 left-, 15 mixed-, and 39 right-handers were tested with Rotter's Locus of Control Scale. Contrary to prediction, it was found that both left- and right-handers scored significantly higher, i.e., were more externally controlled, than mixed-handers. Primarily these data suggest a complex relationship between handedness and personality and they serve to reinforce the need to include mixed-handers in research on handedness.


An alternate-form instrument to assess vividness and controllability of mental imagery in seven modalities.

A review of the literature concerning assessment of the ability to produce mental images demonstrated that in both the clinical and research areas new instruments were needed. The problem was to produce an alternate-form measure that would enable simultaneous measurement of controllability and vividness on the same test items in seven modalities. The results seem to suggest that for the Survey of Mental Imagery alternate forms are strictly comparable, reliable, have a known factor structure, and combine simultaneous measurement of controllability and vividness in at least six sensory modalities.


Note on preference for stimulus complexity across the life-span.

Preference for stimulus complexity across the life-span was investigated with 175 females ranging in age from 17 to 72 yr. of age. Preference for complexity appeared to be age-invariant and monotonic function. Relationships to previous findings are discussed.


Specific and varied practice of motor skill.

To assess the potential effect of specific and varied practice on the development of motor schema, 64 children in two age groups (8 yr. and 12 yr.) were tested on a simple throwing task at the beginning and end of a 12-wk. physical education program. For the throwing test the children were assigned to either a specificity or a schema group (varied practice). The task was performed without visual feedback, but knowledge of results was given after each trial. Prior to both tests at the criterion target, the specific group was given practice throws using the criterion target distance, whereas the schema group practiced on two other targets. No differences were found between the two groups at the beginning of the program but on the posttest those children receiving a variety of practice on the throwing task performed significantly better than the specific-practice group. Thus it was suggested that a varied practice schedule may facilitate the initial formation of motor schema, and this process may be enhanced by participation in a physical education program.


Kindergarten predictors of three aspects of reading achievement.

Kindergarten measures of intelligence, auditory perception, visual perception, and associative learning were used to predict three aspects of reading achievement (word attack, word recognition, and comprehension) at the end of Grades 1,2, and 3 for 79 subjects. The predictability of each measure was a function not only of grade, but also of the aspect of reading achievement being predicted. Multiple correlations of the predictors tended to increase across grade levels and were highest for the comprehension aspect of reading. The Number Facility subtest of the PMA was the over-all best predictor or reading achievement. Possible reasons for this and other findings are discussed.


Sensitivity to laterality as a function of handedness.

This study tested the hypothesis that left-handed individuals are more aware than right-handed individuals of others' handedness. 18 left-handed and 18 right-handed college students were shown a drawing of 8 children at a party. Seven children held objects in the left hand, while one held an object in the right hand. After 2 1/2 min. the drawing was removed and subjects answered 15 questions about its contents. Included were 2 questions asking how many children were holding something in the right or left hand. Compared with right-handed subjects, left-handed subjects reported significantly more children holding something in the left hand and significantly fewer holding something in the right hand. The two groups did not differ on any other questions.


No evidence for relationship between biorhythms and industrial accidents.

According to the popular biorhythm model accidents are more likely to occur during the "critical days" of three sine wave-like cycles that display periodicities of 23 days, 28 days, and 33 days. Analyses of 400 mining accidents from two separate industries demonstrated that the number of employees who were involved with accidents on their individual critical days of the different cycles did not differ significantly from chance expectancy. Furthermore the number of employees involved in accidents when their cycles were in ascending phases (presumably associated with positive behaviors) did not differ significantly from the number of employees who were involved in accidents when their cycles were in the descending phases, presumably associated with negative behaviors. We have found neither empirical nor theoretical support for the biorhythm model.


Lateral differences in habituation of ipsilateral head-turning to repeated tactile stimulation in the human newborn.

Lateral differences in habituation of ipsilateral head-turning to repeated tactile perioral stimulation following midline head restriction was studied in 44 full-term neonates. Left-sided stimulation had a significantly greater and faster decremental effect than right-sided stimulation. Even in the absence of tactile stimulation (Control Group), head-turning to the left decreased systematically whereas head-turning to the right did not. The transient efficacy of prior midline head restriction for the elimination of lateral differences in both spontaneous head movements and responsiveness to tactile input suggests that behavioral asymmetry is already well-established in the newborn.


Field independence and performance on ball-handling tasks.

Subjects were administered the Children's Embedded Figures Test and four ball-handling tests. Pearson product-moment correlations were low between the measures. Girls scored significantly higher than boys on the embedded figures test while boys scored significantly higher than girls on the striking and throwing tests.


Individual differences in reported visual imagery and cognitive performance.

Selected on the basis of their scores on the Vividness of Visual Imagery Questionnaire, 16 High Visualizers and 14 Low Visualizers (equally divided by sex) completed various cognitive tasks thought to involve visual (Space Relations, Watch Rotation) and non-visual (Verbal Reasoning, Abstract Reasoning, Numerical Ability) processes. Although Low Visualizers (particularly males) were superior to High Visualizers in Numerical Ability, both groups performed equally well on the other tests. Since correlational analyses indicated that scores on the vividness questionnaire and the Gordon Controllability of Imagery Questionnaire were not independent, particularly for females, it was suggested that questionnaires ought to be developed better to differentiate the abilities to generate and control visual images.


Letter discrimination as a function of culture, orthography and dimensionality of letters.

46 4-yr.-old children from the United States and 80 from Bangalore, India made fewer discrimination errors when letters were three- rather than two-dimensional. More errors were made on Kannada (Indian) than on English orthographic tasks, but there were relatively fewer errors made by Indian than American children. Younger subjects and boys made relatively more errors than other groups. The findings suggest visually perceived depth may activate the young child's enactive system dominant during the preoperational period and serve to increase accuracy of letter discrimination.


Relation of dance skills to body cathexis and locus of control orientation.

33 subjects provided measures on extent of dance training, dance performance, locus of control orientation, and three measures of body cathexis. Pearson product-moment correlations yielded significant, though modest, positive relations between three measures of body cathexis and performance, and between time dancing and the Levenson Internal scale; and a negative relation between body cathexis and the Levenson Chance scale.


Assessment of field dependence in young children.

In a series of exploratory studies to develop instruments for measuring field dependence in young children, a total of 312 Japanese middle-class children, ages 5 to 6, served as subjects. Without changing the essential nature of the original test, the geometric embedded-figures test attained relatively high internal consistency (KR-20 in the .80's) and stability (R = .83 to .52, at intervals of 1.5 to 13 mo.). Correlation pattern between the Embedded Figures Test and Wechsler subscales similar to that of older subjects was influenced by the speed factor in embedded figures and Wechsler performance scales. Correlation between Kato's portable Rod-and-frame test and embedded figures was significant only in boys. In addition, the correlation pattern between the rod and frame and the preschool Wechsler was not consistent with Witkin's conceptualization. A newly developed darkroom Rod-and-Frame Test correlated with embedded figures for both sexes. Additional analyses indicated the need for more refined instructions to subjects regarding the concept of upright. Some children had more than one anchoring point for responding. Nyborg's scoring method and the relationship of Piagetian spatial concept to rod-and-frame performance are discussed.


Field dependence and reaction time in senior tennis players (65 and over).

Rod-and-frame errors and speed of response are both thought to reflect, in part, differential ability in selective attention, or one's ability to focus on the salient perceptual factors of a given environment. The present study involved an investigation of 18 "super-senior" tennis players aged 70 yr. and over who participated in the national championship tournament. Their data were compared with the data from a similar aged heterogeneous group. The super-seniors were significantly more field independent and had much more rapid simple reaction times and total-body response time than their counterparts.


Authoritarianism and social distance attitudes towards offenders released from prison.

It was hypothesized that authoritarian individuals maintain attitudes of greater social distance towards (a) violent offenders, (b) violent young offenders, (c) non-violent offenders, and (d) non-violent young offenders released from prison. Correlations of scores on Boehm's Legal Attitudes Questionnaire for the offender groups supported the hypothesis. Subjects were 48 students in management science. Apparently high authoritarians would like to maintain attitudes of greater social distance from violent offenders than non-violent offenders released from prison.


Perceived exertion and the field-independence--dependence dimension.

Perceived exertion responses were compared between field-independent and field-dependent perceivers at three cycle-ergometer pedalling rates. 50 male subjects were classified according to mode of field approach on the basis of their performance on an embedded-figures test. Power output was held constant at 840 kpm/min., while pedalling rate was randomly set at 40, 60, or 80 rpm. Significant differences between the field-independent and -dependent groups were not found at the three pedalling rates for any of the physiological variables or for over-all, legs and chest ratings of perceived exertion. The extent of differentiated psychological functioning did not account for individual differences in perceptual reactance during muscular exertion.


Future orientation, perception of population problems and birth planning behavior.

A measure of the strength of future orientation in a sample of 350 college students correlated positively with the perceived seriousness of the U.S. and world population problems as well as the likelihood of using a variety of birth control techniques. Correlations were low (.20 to .30).


The Cognitive World Structure Game.

The Cognitive World Structure Game is a social psychological measure of individual differences, originally developed within the framework of an occupational research model. The purpose was to develop a non-diagnostic tool to distinguish among individuals and sets of individuals within various organizations. The game is briefly described and can be distinguished from traditional personality measures by its underlying assumption as well as its methodological components. Although primarily a research tool, an example of its use in a counseling situation is included to illustrate its use in analysis of the multidimensional complexity of personality.


On the validity of hypotheses derived from the Rorschach: III. The relationship between shading and anxiety.

Research was reviewed in an attempt to assess the validity of the hypothesis that shading on the Rorschach is related to anxiety. This research turned out to be replete with inconsistent and contradictory findings. The reasons for this are discussed. However, as a consequence of the kind of research that has been conducted in this area, we are unable to draw any conclusions except that we need more research. The methodological and epistemological issues in this research are discussed with the hope of providing some direction for that new research by correcting for the errors in the research done to date.


The Torrance Tests of Creative Thinking and the Rorschach Inkblot Test: relationships between two measures of creativity.

The purpose of this study is to determine whether there are any significant correlations between the subscores and total scores of the Torrance Tests of Creative Thinking and the Rorschach Inkblot Test, as scored by the Rorschach Index of Repressive Style. Twenty-six teachers of Grades 3, 4, and 5 and 51 fourth grade students were given, by group administration, the Torrance Tests of Creative Thinking and the Rorschach Inkblot Test. Results show that although neither the Total Verbal, Total Non-verbal nor Over-all Torrance scores correlate significantly with either the Rorschach Human Movement score or with the Rorschach Total Movement score (HM + FM + m), there are significant relationships between the Total RIR, m score and the Over-all Torrance score. The main conclusion is that the Rorschach HM and Total M score measure artistic, associative, intuitive creativity, while the Torrance Tests of Creative Thinking and RIR Total score measure divergent thinking.


Delayed auditory feedback and the speech of stuttering and non-stuttering children.

25 male stutterers and 25 male non-stutterers matched by age and speaking task, read or recited under normal and 113-, 226-, 306-, 413-, 520-msec. delayed auditory feedback conditions. Changes in speaking rate and disfluency count from normal to each delayed auditory feedback condition were calculated as indicators of reaction to delayed auditory feedback. Using an analysis of variance of difference scores for speaking rate, no significant differences were found between stutterers and non-stutterers or among the delays. An analysis of variance of disfluency difference scores showed no differences between stutterers and non-stutterers. Significant differences in disfluency reaction among delay times were found.


Creative thinking and interests of eleven- and twelve-year-olds.

Scores on What I Like To Do were not shown practical for predicting creative thinking in 100 11- and 12-year-olds from low-income backgrounds. Interests did account for a significant proportion of the variance (36%) in common with Torrance's total creative thinking score in the 50 girls. Suggestions for research are offered.


Perceptual versus mediational learning in a total change concept-shift paradigm.

The experiment investigated the effects of language acquisition by children in Grades 1 to 4 on performance in a concept-shift task in which the relevant stimulus attributes were either the colour of ink in which a word was written or the meaning of the word. Both English stream and French Immersion children served as subjects. The results indicated a developmental sequence from perceptual learning to verbal mediation. This process was demonstrated at an earlier stage in the French Immersion students who formed a more highly selected group, and intellectual or socio-economic explanations for these differences may be feasible. The relative speed of acquisition of intradimensional and extradimensional shifts interacts with the perceptual/mediational process.


Visual short-term memory, age, and imaging ability.

Visual short-term memory of young and older adults was studied in relation to imaging ability. Both recall and recognition memory tasks were used and additional variables included stimulus complexity and response delay (recognition tasks) and stimulus complexity and visual masking (recall tasks). Young and older participants were matched on visual discrimination, verbal intelligence, and imaging ability. Stimuli consisted of abstract visual patterns. Age-related decrements in recognition and recall were observed but performance was related to imaging ability only with recall tasks and only for older adults. The results were discussed with reference to mediational strategies and locus of occurrence of age-related decrements in short-term memory.


Sex differences in the perception of touching.

Sex differences in the perception of touching were investigated by having 25 male and 25 female college students rate how likeable a touch would be under different conditions. The women produced a more favorable affect than the men when they touched, and women were perceived as liking to be touched more than men. Perception of touching in general was correlated positively with Self-esteem for men, negatively with Machiavellianism for women, and positively with Trust for women. Results were discussed in terms of traditional sex-typing of touching behavior.


Physiognomic perception and educational-vocational preference.

The purpose of the present study was to determine whether physiognomic perception influenced community college students' selection of a variety of educational-vocational goals. Physiognomic perception, a cognitive style dimension through which people imbue objects with varying degrees of affect, was measured by a standardized and validated instrument known as the Stein Physiognomic Cue Test. The subjects were 183 community college students classified according to their stated choice of major field on a brief questionnaire. The hypothesis that students selecting various major fields of study would differ as a function of physiognomic tendencies was supported. The expectation that females would have greater physiognomic tendencies than males was not confirmed for the present sample.


Reaction time to accelerating lines and dots on a cathode-ray tube.

Two experiments recorded the simple RT of 13 and 10 airline pilots, respectively, to accelerating lines and dots on a cathode-ray tube. In Exp. 1, dotted lines of six lengths moved in-line or frontally, and downward or to the right. Exp. 2 compared seven different in-line-moving solid lines with dot pairs of corresponding separations, and with single dots. RT increased with the length of in-line-moving solid lines but not when dotted lines were used. RT decreased with frontal movement of dotted lines. RT to dot pairs was shorter than to solid lines or single dots. Results indicate the importance of three factors: amount of movement information, visual angle, and inhibition of the retinal area stimulated.


Effect of individual, small group, and large group method of presentation on modal performance in college men and women.

The present study investigated individual, small group, and large group methods of presentation in inter- and intra-modal functioning within auditory and visual modes along a temporal dimension. Subjects were 52 men and 70 women, ranging in age from 17 to 36 yr. Auditory and visual stimuli were presented by electronic means in a same-different matching task. Four separate conditions were investigated: auditory-auditory, visual-visual, auditory-visual, and visual-auditory. An analysis of variance, conducted for three methods of presentation, indicated no significant differences. Thus, group testing is feasible in modal research.


Effects of counselor's eye contact on student-clients' perceptions.

This study investigated the effects of amount and direction of eye contact with the counselor on a student's perceptions. 48 undergraduate and graduate education majors were randomly assigned to one of six conditions in a 2 x 3 factorial design representing two levels of eye direction (eye-to-eye and eye-to-nose/mouth) and three amounts of eye contact (high = 85%, medium = 50%, low = 15%). Subjects had 10-min. standard interviews that differed only according to the six experimental conditions. Interviews were videotaped to assess maintenance of experimental conditons. Following the interview, subjects rated (5-high to 1-low) the interview on seven variables (comfort, attention, interest, ease, helpfulness, eye contact, and willingness to return). Interrater reliability for maintenance of experimental conditions was .87 on amount of eye contact and .03 for direction. Scheffé comparisons showed high and medium eye contact produced significantly higher ratings by student clients on attention, interest, eye contact, and willingness to return than low eye contact. There were no differences for direction of eye contact.


Cautionary note on the use of short state-anxiety measures.

The report noted that the use of high item-remainder coefficients as the sole criterion in the selection of items for short state-anxiety scales from full scales can lead to inaccurate interpretation of results. It was demonstrated that the use of a four-item state-anxiety scale from the State-Trait Anxiety Inventory A-State scale based on high item-remainder coefficients changed relationships in a previously reported study which used full-scale scores. It was proposed that such changes in relationships were the result of selecting four items which happen to load on only one of three dimensions of the A-State scale. The criterion of high item-remainder coefficents alone may be inadequate in the formation of short state-anxiety scales.


Neuropsychological and MMPI correlates of patients' future employment characteristics.

Previous research has suggested that patients' neuropsychological test scores correlate not only with neurologic status but also with their success in coping with some of the demands of daily living. This study investigated the utility of such laboratory test scores in predicting several vocational variables. Patients who had recieved neuropsychological evaluations were recontacted and questioned about their employment over the previous 6 mo. Of the 78 individuals who participated, 25 had been chronically unemployed. The remaining 53 were asked about job stability, hours worked, and wages earned, and were administered the Minnsota Job Requirements Questionnaire. Patients' scores on the Halstead-Reitan Battery, the WAIS and the MMPI were highly correlated with employment status (employed or chronically unemployed), income, and skills required on the jobs held. The results suggest that these tests may have clinical utility in assessing patients' employability, as well as the types of jobs for which they are suited.


Effects of differentially modeled stimuli on vicarious autonomic arousal.

The present study examined effects of variations in modeled pain cues on level of vicarious arousal, using heart rate and blood-volume amplitude as psychophysiological measures. Students were assigned randomly to one of four groups in which they either (a) underwent directly the cold-pressor test, (b) observed a model exposed to the cold-pressor test and expressing pain by facial and bodily movements, (c) heard only the modeled verbal expressions of pain, or (4) observed the model express neither verbal expressions nor physical movements while undergoing the painful stimulation. The results show aversive stimulation increases heart rate whereas vicarious aversive stimulation produces reductions in heart rate. The deceleration of heart rate was not found in response to all three forms of modeling. Both direct and vicarious aversive stimulation produced decreases in the amplitude of vasomotor responses. The size of the decrement between direct stimulation and the minimal modeling condition of vicarious arousal showed significant differences, but differences between direct stimulation and the maximal modeling condition were not significant. The vasoconstriction was found in response to two forms of modeling.


Transformation of visual neural signals into psychological information.

A theory is proposed which transforms visual neural signals into the psychological information and which explains visual illusions. As an example, Poggendorff's illusion is explained.


A hypothetical construct to evaluate intracranial stimulation as a source of motivation.

An explanation is offered for the excessive continued responding found when intracranial stimulation is the primary source of motivation for learning. A response pattern which appears cannot be easily broken.


Age differences in visual and kinesthetic short-term memory.

30 elderly subjects were matched with 30 young subjects and tested on a kinesthetic short-term memory task which required the replication of criterion moves after a variable retention interval under conditions of either rest, differing interpolated movement tasks, or mental activity. A visual control condition was used. Differing interference and temporal decrements were observed. Both old and young subjects differed significantly between sighted and blindfold conditions; however, there was no difference between the performance of the old and the young in the blindfold (kinesthetic) condition. These findings were discussed with respect to practical implications for the retraining of old subjects on certain motor tasks.


[Fluorescent thyroid scanning and intrathyroidal iodine quantification: study in 140 patients (author's transl)].

The system consists of twenty individual sorces of one Ci of 241Am and a high resolution lithium drifted silicon detector. A dual channel analyser permits to measure intrathyroidal stable iodine. The scan requires only 13 minutes and can be made with a very low radiation dose (less than 10 mrads). It provides good quality images and remains available in cases of flooded iodine pools or iodine induced thyrotoxicosis. It is of great interest to follow up subacute thyroiditis and to diagnose autonomous nodules without TSH stimulation. Thyroid stable iodine was measured in vivo in 104 patients. Normal female thyroid glands contained 5,5 +/- 1 mg stable iodine. In hyperthyroidism (10 patients), iodine values are low or elevated. An inverse relationship exists between thyroidal stable iodine and values of T4 or T3.


[The estimation of parathormone in primary hyperparathyroidism (author's transl)].

In a recent series of 110 cases of primary hyperparathyroidism, estimations of plasma immuno-parathormone (PTH) were carried out in fifty two patients. This estimation proved reliable, making possible the confirmation of the diagnosis. In the absence of renal insufficiency, there was a highly positive relationship between PTH levels and plasma calcium. The relationship between PTH and the weight of the parathyroid tumour was less significant. For technical reasons, this long and difficult estimation cannot be used on a routine basis. However, it is most useful in cases in which other laboratory findings are not typical.


[Investigations concerning bovine gastro-intestinal strongyles. III. Faecal egg output in the 2nd grazing period (author's transl)].

Parasitological examination was made on 5065 faeces samples from about 850 cattle, mainly heifers during their 2nd grazing season. The cattle, the majority of which were apparently in good health, were included in a study on weight gains as related to different grazing systems. The samples, which were examined by a modified McMaster technique, were taken through the period April--October in four consecutive years (1971--1974). The monthly occurrence of positive samples (EPG less than or equal to 50) was rather low but fairly stable during the period concerned (Fig. 2 A). The average daily production of trichostrongylid eggs could not be determined exactly (Fig. 2B), but was estimated at about 1.5 million per animal. Larval cultures were made on randomly selected faeces samples. Ostertagia accounted for 58.4% of the identified larvae, and tended to increase in predominance as the grazing period progressed (Fig. 3). Cooperia, constituting 29.4% of the larval population, and other genera, constituting maximum 7% each, showed a declining representation during the grazing season.


[Deliberate self-overdose with propranolol. Changes in serum levels (author's transl)].

Suicidal attempt using beta-blockers are rare. Overdose by the ingestion of a large number of tablets rarely exceeds the high therapeutic doses suggested for the treatment of certain resistant cases of hypertension. The case described is that of a 65-year-old patient who took 800 mg of propanolol. Observation of plama levels showed that the half-life propanolol in the case of overdose is prolonged: 8.6 hours in this case, with a maximum plasma level of 1536 ng/ml. Plasma renin activity levels were low during the phase of intoxication and showed evidence of a rebound effect at its end. Treatment is above all that of the circulatory insufficiency produced: isopropylnoradrenaline or glucagon. Indications for extra-renal dialysis should take into account knowledge concerning the pharmacokinetics of these drugs and their prolonged physiological action.


[The doppler effect applied to the study of the vertebral arteries (author's transl)].

Results and correlation with arteriographic findings in 25 cases. The methodological criteria essential to the reliability of this examination are described, as well as the special conditions of recording which may influence interpretation. The respective values for systolic and diastolic circulatory rates obtained on ultrasound curves led the authors to classify the results into five groups. There was satisfactory correlation between the latter and the anatomical data provided by arteriography of the vertebral arteries. Such a quantitative approach provides an assessment of the functionally normal or pathological state of the vertebral arteries and of circulatory assymetry.


A case of partial cerebellar hypoplasia in a cat.

A case of spontaneous ataxia accompanied by partial cerebellar hypoplasia in a two month old siamese kitten is described. The cause of cerebellar hypoplasia is unknown but the feline panleucopenia virus is number one to be suspected.


A study of skin diseases in dogs and cats. III. III. Microflora of the skin of dogs with chronic eczema.

The microflora of the skin was studied in 10 dogs with chronic eczema without clinical signs of secondary infection (Table I). The skin surface was swabbed at 7 different sites, making a total of 70 swabs, 25 of which were taken from visibly inflamed areas and 45 from apparently unaffected skin (Table II). Staph. aureus, Staph. epidermidis, micrococci, alpha-hemolytic streptococci, and Acinetobacter spp. were found consistently. Ten different Gram-negative bacteria, 3 different Gram-positive bacteria, and 2 yeasts were found to occur sporadically (Table III). Compared to a group of 10 healthy dogs a more prolific growth of aerobic microorganisms, a greater number of sites carrying Staph. aureus, and a higher recovery of Gram-negative transients were found in dogs with eczema (Table IV--VII). Within the group of dogs with eczema the growth of Staph. aureus was significantly heavier from eczematous skin areas than from clinically normal skin (Table VIII). In dogs with non-infective dermatitides the colonization of the skin by potentially pathogenic microorganisms may have to be considered in the clinical handling of these diseases.


[Prolonged exposure (flooding) in phobic and obsessive compulsive patients: 21 cases (author's transl)].

A first appraisal of 21 patients with phobic (n = 15), obsessive-compulsive (n = 5) and bereavement problems (n = 1) is carried out after a flooding procedure (prolonged exposure). One case is reported in detail. The actuarial rate of improvement amounts to 73% at a follow up between 6 and 9 months. The failures and relapses take place in the first month following the treatment. Two psychotic subjects show a significant improvement. The importance of the patient's expectations and motivation and the interpersonal aspects are underlined.


[Pulmonary oedema after late revascularisation of the lower limbs (author's transl)].

In the two cases reported, pulmonary oedema developed immediately following revascularisation of the lower limbs after prolonged ischaemia. Without it being possible to formally exclude the possible role of a haemodynamic factor, the authors suggest the hypothesis of a predominantly lesional mechanism. The "reconnection to the circuit" is the provoking factor in this oedema, the alveolo-capillary membrane being previously altered by the prolonged ischaemia, infection and massive transfusion. The pulmonary manifestations would seem to enter within the classification of somatolysis.


[Extramembranous glomerulitis associated with visceral tumours. Clinical and histological study based upon 10 cases and a review of the literature (author's transl)].

The frequency of the association between extramembranous glomerulopathy and a visceral tumour suggests the responsibility of various antigen-antibody systems related to malignancy, at the origin of the nephropathy. In a number of special cases, the role of these systems has been more precisely demonstrated. The cases reported here emphasise the need to seek a visceral tumour when the onset of extramembranous glomerulitis occurs after the age of 40 years, in particular since the onset of proteinuria may precede the first clinical signs of the tumour by several months. The presence of polynuclear cells in the glomerular capillary loops, associated with extramembranous deposits, is an additional element of orientation in the direction of neoplastic aetiology.


[Hereditary antithrombin III deficiency causing recurrent thrombo-embolic problems (author's transl)].

A marked deficiency in antithrombin III (AT III) was demonstrated in a 39-year-old man suffering from recurrent thrombo-embolic problems. The patient's father had died following a thrombo-embolic disorder. A certain number of members of the family also showed evidence of a marked decrease in AT III levels. Although it was not possible to study the patient's parents, it would seem reasonable to conclude that the diagnosis was one of hereditary deficiency in AT III. The various aspects of this disorder discovered by Egeberg are reviewed: early onset, in several members of the same family, or recurrent thrombo-embolic problems, accompanied by a decrease in functional activity of one of the principal inhibitors of thrombin (AT III), with autosomal dominant transmission and treatment based upon anti-vitamin K agents.


[Psychologic regression in patients treated in an intesnsive care unit (author's transl)].

Regression occurs frequently in patients in Resuscitation Units. It is a desirable phenomenon so far as it leads to better acceptance of the treatment by patients, yet it can be harmful since it may lengthen the course of illness. Thirty patients were studied via a questionaire centered around six main points. The results and their correlation with the degree of regression are reported. Regression leading to a worsening of the course of illness, may have its origin in the patient himself or in the treatment team. Training of the latter would mainly aim to establish a treatment team - patient relationship fostering autonomy as early as possible.


[Transplacental infection by lymphocytic choriomeningitis virus. Results of a retrospective serological study in France (author's transl)].

A study was made on the presence of antibodies against lymphocytic choriomeningitis virus in 452 children in the Lyon area who had suffered from either a major pathological condition or a congenital malformation at birth. Of 34 cases of congenital hydrocephalus, only one could be definitely attributed to a maternal infection with the virus, occurring between the 5th and 6th months of pregnancy. Lymphocytic choriomeningitis virus should thus be added to the list of those which are potentially teratogenic for the human species.


[Acute non-septicaemic broncho-pulmonary aspergillosis. One case in a patient with no obvious immune deficiency (author's transl)].

A 55-year-old man, alcoholic, and with a past history of tuberculosis, suddenly suffered a pneumococcal pneumonia which favourised the onset of predelirium tremens and then generalised convulsions. The latter, in combination with the administration of sedatives, resulted in acute respiratory insufficiency. Assisted ventilation proved necessary. After a brief improvement, fever recurred and extensive pulmonary necrosis developed. The patient died 32 days later, all aetiological studies having proved negative. The diagnosis was made at autopsy which revealed the presence of multiple pulmonary aspergillus abcesses and a purulent bronchitis due to the same fungus. Aspergillus serology had not been done.


[Inappropriate secretion of anti-diuretic hormone in a case of intermittent acute porphyria (author's transl)].

The authors report the case of a patient who presented, during two exacerbations of intermittent acute porphyria, a grave psychiatric syndrome secondary to severe hyponatraemia. The later was due to inappropriate secretion of anti-diuretic hormone confirmed by laboratory tests and the stimation of anti-diuretic activity in the urine. The course was favourable under the effects of symptomatic treatment including sodium supplements and fluid restriction. The anti-diuretic syndrome disappeared on each occasion without sequelae at the time of regression of the exacerbation of porphyria.


[Revascularisation of the arteries of the digestive tract by retrosternal bypass from the left subclavian artery (author's transl)].

This technique of revascularisation of the digestive arteries is suggested when the infrarenal aorta cannot be used. The hepatic artery is reimplanted in the coeliac region. The vein graft is passed in the root of the transverse mesocolon and anastomosed with the superior mesenteric artery. The subclavian artery, frequently used in the revascularisation of the neck vessels, was felt to be preferable to the axillary artery. Passage of the graft retrosternally avoids any kinking or compression in the abdominal wall. The patient's own saphenous vein is the most suitable material. If this is not possible, a varicosity preserved by cold was felt to be preferable to a dacron tube.


[Essential hypertension in the child and the adolescent. Epidemiological study in schools (author's transl)].

Amongst a group of 819 children and adolescents aged between 10 and 18 years and attending a public school, the distribution of blood pressure was determined in relation to age, sex, height-weight ratio and family history. Mean blood pressure values increased with age both sexes for both systolic and diastolic levels. Children outside the norms, blood pressure 2SD, should be considered to be hypertensive and be followed up. The prevalence of systolic hypertension was 3.95 per cent amongst the boys and 3,83 per cent amongst girls. That for diastolic hypertension was 7.33 per cent for boys and 6.97 per cent for girls. Obesity appeared to be the major factor associated with hypertension since half of the hypertensive individuals were overweight. Individual prevention is thus possible. The existence of a family history of hypertension and of obesity more particularly in obese hypertensive children should lead to steps aimed at the familial prevention of hypertension.


[The value of gallium 67 citrate in the diagnosis and localisation of deep-seated abdominal abscesses (author's transl)].

Six French Departments of Nuclear Medicine have pooled their results of Gallium 67 citrate scanning, carried out with the aim of demonstrating an abcess. Two hundred and thirty five examinations were performed. During the postoperative period, an abcess was correctly localised in 83 cases out of 89. For the 188 patients undergoing the examination, the reliability was 92%. In cases of suspicion of a subphrenic abcess, precise diagnosis was obtained in 19 cases out of 21. In 35 patients with an infectious syndrome in the absence of surgery, scanning gave an accurate diagnosis in 33. In 12 patients who had recently had a renal transplant, scanning revealed a purulent collection in 5 cases. By virtue of the affinity of Gallium for any inflammatory process, echotomography must always be performed after the isotope scan in order to confirm the presence or absence of a fluid collection in the region of the zone of increased uptake. These atraumatic techniques, easy to carry out, should provide clinicians with precious information when an infectious process within the abdomen is being sought.


[Corticotrophic adenomas with melanoderma (Nelson's syndrome). Two cases clinical and laboratory studies before and after spontaneous intercurrent necrosis (author's transl)].

Two cases of Nelson's syndrome (macroscopic cortico-melanotropic pituitary adenoma developing after bilateral total adrenalectomy for Cushing's disease) are reported. The unusual feature was spontaneous necrosis of the adenoma, as indicated by the rapid disappearance of melanoderma, the normalisation or decrease in plasma ACTH level, retraction in the diaphragm of the sella at air encephalography and autopsy findings in one case.


[Why, when and how dietary fiber will be used in gastrointestinal disorders (author's transl)].

This paper reviews the current status of knowledge with relation to the effects of dietary fiber on intestinal physiology and pathology. Vegetable dietary fiber is a physical complex acting principally in the colon. Fibers have water-holding, cation exchange and absorptive properties and important effects on bacterial activity. Data on transit times, colonic intraluminal pressure and colonic motor activity, favour the view that fibers are interesting in the therapy of constipation, irrtable colon and diverticular disease. High residue diet must be recommended in this colonic disease. Indications are given for the choice, dosage and administration of dietary fibers.


[The influence of rifampicin upon the metabolism of isoniazid (author's transl)].

The authors sought to determine whether the combination of rifampicin and isoniazid altered the rate of acetylation of the latter drug by possible hepatic involvement. INH inactivation and transaminase levels were studied in 36 patients with tuberculosis, before and after 30 days of treatment with a combination of INH in a dose of 5 to 7 mg/kg/day and rifampicin in a dose of 600 mg/day. The results failed to confirm such a hypothesis since, whatever the phenotype of inactivation, no significant difference was seen between residual INH levels at 3 and 6 hours, before and after treatment, nor any significant increase in transaminases.


[The duodenum : a psychosomatic organ? (author's transl)].

A pressure-captor tube was inserted into the duodenum close to the ampulla of Vater in 15 surgical patients. The authors present a selection of 12 pressure curves under different circumstances : sleep, awake, meal, psychological agression, physical agression, pharmacological agression. The curves indicate that the duodenum reflects a psychosomatic structure in terms of its motricity, which could explain various aspects of gastric or biliary pathology.


[Leydig cell tumours of the testis. Two cases presenting opposing sexual features : gynaecomastia, precocious virilisation, and revealed by study in vitro of aromatisation activity].

Two Leydig cell tumours presented with changes in sexual characteristics. The first patient was a child with precocious puberty whilst the second was that of an adult with recurrent gynaecomastia. Histochemical examination in vitro of tumour tissue from the second patient made it possible to explain the synthesis of oestrogens by a primary tissue destined to an essentially androgenic activity.


[Pleuro-pulmonary infections : importance of anaerobic bacteria and therapeutic consequences (author's transl)].

A prospective study of bacteriology and therapeutic outcome in 14 cases of pleuro-pulmonary infections is reported. Bacteriologic results are based on transtracheal aspirates and empyema fluid. Appropriate anaerobic bacteriologic methods were employed. Anaerobic bacteria were recovered from 11 patients, and were the only pathogens isolated in 6 patients. Patients were treated by penicillin G. This was judged satisfactory in all cases, although 1 patient died from pneumococcal septicemia few hours after his admission to the hospital. The results indicate that with reliable specimen (pleural fluidand transtracheal aspirates) and optimal anaerobic culture methods, bacteriologic diagnosis can be established. Since anaerobes play a key role in most cases of pleuro-pulmonary infections, penicillin G is the prefered initial drug.


[Cerebral ischemia, treatment by vascular micro surgical technique: intra-extra cranial anastomosis (author's transl)].

The introduction of vascular micro-surgical techniques has allowed to treat cerebral ischemia, through extra-intra-cranial anastomosis, when the causative arterial lesions have a surgically unfavorable location. Thirty patients underwent brain revascularization through extra-intra-cranial micro-anastomosis between the superficial temporal artery (branch of the external carotid artery) and a cortical branch of the middle cerebral artery. Twenty five patients had definite sensitive and motor deficits. Five patients, on the other hand, underwent preventive surgery because of transient cerebral ischemia. In our series, the global rate of the microanastomosis patency is 78%. When the anastomosis is patent, 85% of the cases with motor deficits are cured or improved. The results are even more favorable in case of transient cerebral ischemia, for the anastomosis in such cases was always patent. None of these later patients had ischemia attacks with a one-year follow-up.


[Perhexilline maleate: relationship between side-effects, plasma concentrations and rate of metabolism (author's transl)].

In three individuals (2 male and 1 female) with severe side-effects apparently related to the regular ingestion for a period of at least 5 months of perhexiline maleate, the authors studied the rate of fall in plasma levels of the drug, of its monohydroxylated metabolite, blood transaminase and glucose levels following the interruption of therapy. The relationship between these data would indicate two hypotheses which could be tested during future studies: the manner in which the body metabolises the drug would appear to vary in relation to plasma concentration and/or hepatic involvement.


[The radiological exploration of renal tumour syndromes [author's transl)].

Four radiological examinations are available to the clinician for the diagnosis of renal tumour syndromes: intravenous pyelography with vascular nephrotomography is used to make an initial classification. Hypervascularised masses, usually malignant, remain the indication of choice for renal arteriography. Apparently avascular or doubtful masses should first be studied by ultrasound echotomography which offers the possibility of a second classification into fluid-filled tumours, the cystic nature of which may be confirmed by translumbar puncture followed by kystography, and solid or doubtful tumours, suggestive above all of a necrosed carcinoma. In this latter case, the indications for renal arteriography with the use of angiotensin, translumbar puncture or immediate exploratory lumbotomy must be decided in the light of individual cases and local preferences.


[External drainage of the common bile duct. A new transcystic drain (author's transl)].

The authors present a new transcystic drain which offers the possibility of per-operative cholangiograms of excellent quality and provides an highly satisfactory means of external drainage of the common bile duct.


[The MB Iso-enzyme of creatine phosphokinase in myocardial infarction (author's transl)].

CPK and its MB iso-enzymatic fraction were measured in 240 patients, 180 of whom suffered from myocardial infarction. MB iso-enzyme was expressed as a percentage of total CPK and a minimum figure of 4 per cent of MB isoenzyme was taken as indicative of a diagnosis of myocardial infarction. In the 180 patients with an infarction, the average MB level as a percentage of total CPK was 12.1 +/- 5.4 per cent. Five patients with a proven infarct had an MB iso-enzyme level of less than 4 per cent. Amongst the 60 patients without a myocardial infarction who were included in view of a pathological level of CPK, the average maximum level of MB was 1 +/- 2.5 per cent. Five of these 60 patients (false positives: 8.3%) had an MB iso-enzyme level of greater than 4 per cent. It is concluded that the estimation of MB iso-enzyme of CPK using a chromatographic technic is a highly valuable laboratory method for confirming or eliminating a diagnosis of myocardial infarction in the numerous clinical circumstances when such a diagnosis is difficult or even impossible on the basis of standard data.


[Scintigraphic appearance and particular arteriographic aspects intrahepatic cholestasis].

Based on one case history, it is reviewed here that prolonged cases of obstructive jaundice can take on deceiving appearences, and all the more so when they fall within the framework of a "biological gap". Extensive distension of the extra and intrahepatic bile ducts are at the basis of images with multiple, radiating hilar gaps on scintigraphy, and of "chicken nests" and "Swiss cheese" at hepatographic times in selective hepatic arteriography. These rather uncommon images should lead to a diagnosis of a surgical cholestatic liver.


DNA-binding nonhistone proteins: DNA site reassociation.

The DNA-binding nonhistone proteins (NHP) have been demonstrated to fractionate the rat genome into protein-bound and unbound DNA sequences. Twenty percent of highly sheared rat DNA [approximately 350 base pair (bp)] can be retained on membrane filters as protein complexes. When extracted from the filter and retitrated with the NHP, a 4- to 5-fold enrichment of binding sites is present in the bound DNA with few, if any, sites detected in the unbound DNA. Rat DNA restricted by EcoRI endonuclease can be fractionated by its DNA-binding NHP retention characteristics. Reassociation kinetics of the bound restricted sequences indicate that 45.6% is a subset of total single-copy sequence of the rat genome an 26.9% is repetitive sequences. Cross hybridization studies indicate the repetitive sequences of the bound DNA are not enriched as much as the slow component of the rat genome. Thus a 4-fold enrichment of a subset of the rat genome has been observed via NHP-DNA interactions.