Virilization in Turner syndrome.

A case of gonadal dysgenesis in a phenotypic female associated with neoplastic changes is presented. The patient typified a classic case of Turner syndrome with a 45, XO chromosomal compliment, becoming virilized as a result of the development of bilateral hilar cell hyperplasia in her dysgenetic gonads. The malignant potential of the dysgenetic gonad is stressed in this report. Early diagnosis and appropriate management are emphasized as the two factors that make the difference in the outcome of the patient with gonadal dysgenesis.


A sensitive hemagglutination assay of human chorionic gonadotropin in the diagnosis of ectopic pregnancy.

Hemagglutination assay of human chorionic gonadotropin (hCG) in the urine of patients suspected of having ectopic pregnancies has proved to be a highly sensitive method of detecting the condition. Moreover, the technique is simple and inexpensive. Hemagglutination assays were used in 167 patients with a diagnosis of ectopic pregnancy and in screening 415 patients in whom there was a possibility of ectopic pregnancy. In the former group, hCG titers in urine of more than 500 IU/liter were detected in 136 patients: among the remaining 31, the pregnancies were clinically old and resolving in 22. Low hCG titers were associated with a significantly shorter period of amenorrhea and a protracted clinical course. In the second group, a false-positive rate of 1.7% occurred when the sensitivity of the assay was limited. Increasing the sensitivity of the assay to avoid false-negative results, though also increasing the false-positive rate, would help to reduce the number of cases in which more complex isotope assays are required.


Transabdominal cervical cerclage during pregnancy. A modified technique.

A modified surgical technique for carrying out cervical cerclage by the transabdominal route during pregnancy is presented. It is designed for the patient whose cervix is so short or damaged that the transvaginal procedure is not feasible. Basically, the method consists of a standard laparotomy at which a nylon tape is placed around the uterine isthmus medial to the uterine vessels and fixed to the anterior isthmus, Mackenrodt's ligaments, and to the insertions of the uterosacral ligaments. Results in 10 cases are reported. There were no operative or postoperative complications. One case was terminated by early spontaneous abortion and 2 by hysterotomy at 26 and 30 weeks, respectively, because of placenta previa. Seven cases were terminated by cesarean section at or near term, with delivery of 7 infants who survived. The 7 mothers had had a total of 50 prior pregnancies with only 5 living children; 4 of them had ahd 25 prior pregnancies with no living children. Various aspects of the procedure are discussed.


Evaluation of a dipstick for candida.

Differentiation of the infecting organism is important in determining effective therapy for vaginitis. The utility of a simple, dehydrated culture strip in detecting Candida infections was assessed by culturing specimens from 203 patients, 83 with symptoms of vaginitis. Parallel culture (Sabouraud's medium) and identification were performed in every fourth case by an independent clinical laboratory; KOH preparations for Candida were examined in every case. In 48 of 50 cases, the strip agreed with Sabouraud's culture; one culture was lost due to laboratory error, and one strip did not become positive until after 48 hours' incubation. Only 70% of KOH preparations revealed Candida when the strip culture was positive. Diagnostically superior to the KOH preparation and nearly equal to a Sabouraud's culture, the strip was simple to use, inexpensive, and reliable; as such, it is a useful addition in the ob-gyn office or clinic for routine screening for vaginal candidiasis.


[Level of immunoreactive follicle-stimulating hormone in the pituitary and blood of human fetuses].

The FSH content in the hypophysis and blood serum was determined by means of radioimmunology in 367 human foetuses at the age of 8 to 34 weeks. The immunoreactive FSH was detected in the hypophysis on the 9th week of embryogenesis. The ability of the hypophysis to release FSH in the blood was demonstrated for the female foetuses at the age of 14 to 34 weeks (with the maximum during the 17--18th week) and for the male foetuses at the age of 19 to 31 weeks. Sexual differences in the FSH content were shown in the hypophysis from the 14th till the 34th and in the blood serum from the 14th till the 26th week of development.


[Lipid composition of the gonads of female Strongylocentrotus nudus sea urchins at different stages of development].

Changes in the content and composition of lipids in the gonads of the Strongylocentrotus nudus females during the annual cycle of their development were studied. The qualitative composition of lipids was shown not to change. There were found cerebrosides, sulfatides, free fatty acids, diphosphatidyl glycerine, phosphatidyl ethanolamine, phosphatidyl choline, phosphatidyl inositol, phosphatidyl serine, lysophosphatidyl choline, lysophosphytidyl ethanolamine, phosphatide acid, sphingomyelin and non-identified phospholipids X1 and X2 in the gonads. The relative content of individual classes of phospholipids suffers marked changes. The similarity in the content of total lipids and their individual classes at the 2nd and 5th stages confirms the existence of two generations of oocytes (Gnezdilova, 1971). The relationship between the lipid composition and the morphological state of the gonads with respect to the stage of development is discussed.


[Regeneration of a whole worm from a small fragment of the body of Dugesia tigrina planaria following repeated removal of regenerates].

The ability of restoration of the whole worm from a small body fragment was not reduced after 8 removals of the anterior and posterior regenerates. The polarity of restoring fragments in the most cases corresponded to the initial one. Upon the colchicine effect on the restoring fragments which accompanied the repeated removal of the regenerates, a high percentage of cases of incomplete somatic embryogenesis was observed: the formation of bi- and multipolar forms. The formation of regenerates is realized by neoblasts. Upon the repeated removal of regenerates, the dedifferentiated intestine cells appear to take part in the restorative processes as well.


[Growth of Arabidopsis thaliana embryos following irradiation of the plants during the generative phase].

The flowers and young legumes of Arabidopsis thaliana (phases of development B3--B7) were irradiated by gamma-rays at the dose of 4 kr. The irradiation did not influence the duration of phases of the flower development irrespective of the phase of irradiation. The cytological characteristics of embryos is given for each phase under study. The duration of developmental stages (from zygote till the spheroid stage) in the control and following the irradiation was practically the same. The irradiation induced different developmental abnormalities. The most frequent type: the first transversal division of the apical cell instead of the longitudinal one. The irregular division of the suspensor cells, delay in the apical cell division upon the normal suspensor division, irregular position of septa and irregular form of the embryonic body were also observed. The highest level of abnormalities in the formation of cotyledons was noted following the irradiation of young legumes (phases B6--B7).


[Diagnostic and therapeutic problems in a clinical case of oculoauricular dysplasia associated with mandibule-facial dysostosis (Franceschetti-Goldenhar syndrome)].

The authors present a case of oculo-auricular dysplasia (type Goldenhar) associated with France-schetti's syndrome (mandibulo-facial dysostosis) and complicated by paralytic strabismus and genital malformations. Complete investigation failed to establish a precise aetiology; one suggests an external disturbance in the course of the organogenesis of the branchial arches. Aesthetic improvement was undertaken--removal of epibulbar dermoids, correction of the squint, and ablation of the preauricular appendages; functional orthodontic treatment continues.


[The vitreous in aphakia].

The authors have studied the vitreous in 150 aphakic eyes after uneventful operations. They were examined by the slit-lamp and the Goldmann three-mirror glass. Two types of lesions were revealed: (1) 42% showed rupture of the anterior hyaloid membrane; this is not considered dangerous. (2) 69.3% showed posterior detachment of the vitreous, a more serious lesion. It is often associated with retinal lesions such as haemorrhage, pigmentary anomalies, and retinal tears. In view of such lesions, one cannot consider the aphakic patient as a normal subject and aphakia as a physiological condition. The frequency of retinal detachment in the aphakic bears witness to it.


Malignant melanoma of the lacrimal sac.

A case of malignant melanoma of the lacrimal sac in a 41-year-old woman is reported, which is propably the 12th one in the world literature. Dacryocystectomy is advisable at a localized stage. The importance of early diagnosis is discussed.


Optic nerve changes in chorioidal malignant melanoma.

The optic nerve has been investigated in 11 cases of chorioidal malignant melanoma. 10 cases showed central fascicular degeneration surrounded by a rim of myelinated nerve fibers. Microglia was regularly found demarkating the central changes and often within the demyelinated areas. The changes were found within all quadrants of the nerve and without any apparent correlation with defects in the visual field.


Retinal ischemia (capillary nonperfusion) and retinal neovascularization in patients with diabetic retinopathy.

138 diabetic retinopathy patients with good fluorescein angiograms of the macular areas were studied. Areas of capillary nonperfusion (CNP) were surrounded by other capillary abnormalities and were often based on a larger retinal vessel. A satistically highly significant anatomical relationship was found between CNP and neovascularization. In addition, the frequency of neovascularization increased with the increase in size of CNP.


Orbital plasma cell tumours.

This paper reports two cases of orbital plasma cell tumours, one initially presenting as a localized lesion, but later developing dissemination and proving fatal within 7 months; the other presenting initially as a disseminated disease and apparently cured from that particular disease within 1 year, both on equivalent treatments. The importance of investigations for general disease (for therapeutic reasons) is emphasized as well as possibility of renal involvement and the unpredictability of the clinical course.


Combined operation for cataract and glaucoma.

In cases of cataract and glaucoma, we performed a cataract extraction combined with a Lagrange sclerectomy, a trabeculectomy or a Scheie's cauterization. We obtained the best results with Schie's cauterization.


[Seasonal rhythm of infectious eye disease in North Africa].

The occurrence of infectious eye diseases in a hospital eye department on the island of Djerba in South Tunisia was analysed by mathematical-statistical methods. The seasonal influence was confirmed in accordance with the local traditional opinion and with previous research papers.


Macular hole in diabetic maculopathy.

Three patients with diabetic maculopathy had macular holes. It is suggested that shrinkage or traction of the fibrous proliferation on the edematous and exudative macula led to the formation of these macular holes. Photocoagulation is recommended in patients with macular holes with progressive diabetic retinopathy and visual acuity of less than 0.1.


[Periodic alternating nystagmus].

In this report 2 cases of periodic alternating nystagmus are presented. The most important parameters of this oculomotor disturbance are shown by oculographic tracings. Discussing the literature it is attempted to cast a model of the pathophysiology of PAN.


[Primary choroidal alveolar soft part sarcoma. Ophthalmopathology and histogenesis].

This is the first report on a primary choroidal alveolar soft part sarcoma in a 37-year-old male, who died 1 1/2 years following enucleation secondary to multiple metastases. Histology and differential diagnosis of this tumour are discussed. Histogenetically, because of the localization in the choroid, as far as the origin of these tumour cells is concerned, they supposedly stem from cell systems of the neuroectoderm. Since from these cell systems the malignant melanoma of the choroid arises too, a close relationship of these tumours is concluded.


Practical ptosis surgery. The Wendell L. Hughes Lecture.

The author has emphasized the concept that ptosis surgery should be done in a way that may be modified in the event that the immediate result is not satisfactory. The value of local injection plus fractional anesthesia in the adult allows the surgeon to solicit the aid of the patient to evaluate the result on the table more accurately. A regional block is unsatisfactory because the nerve supply to the levator muscle may be knocked out and titration of the result would not be possible at the time of surgery. The subaponeurotic tunnel without incising the conjunctiva makes a better anatomic dissection of the aponeurosis. The attachment to the tarsus of the advanced aponeurosis 2 to 3 mm from the ciliary border gives the surgeon a leeway of approximately 7 to 8 mm to recess in the event of an overcorrection. In the event of an undercorrection, the aponeurosis is further advanced and reattached by the three vertical mattress sutures.


Giant papillary conjunctivitis induced by hard or soft contact lens wear: quantitative histology.

Both hard and soft lens wearers develop a syndrome of decreased tolerance, increased mucus, mild itching, and giant papillary excrescences in the upper tarsal conjunctiva that resemble a varnal conjunctivitis. In the fully developed syndrome, the upper tarsal plate has an increase in stringy mucus and is covered by large papillae crowded together. The syndrome develops after months to years of otherwise successful lens wear and occurs in users of all types of soft and hard lenses. Histologic examination of tissues from 55 patients with well-developed giant papillary conjunctivitis compared with tissue from 15 normal people showed three findings characteristic of the syndrome: (1) mast cells in the epithelium, (2) eosinophils in the epithelium and substantia propria, and (3) basophils in the epithelium and substantia propria. Plasma cells and lymphocytes per cubic millimeter were not increased in detailed counts of 15 patients and 15 normal individuals. It is proposed that the number of plasma cells and lymphocytes cannot increase much beyond the level already present in normal conjuctiva and further influx of mononuclear inflammatory cells is the impetus for growth of the papillae. It is proposed that giant papillary conjunctivitis is a generalized response of the upper tarsal conjunctiva.


Slow-release artificial tears and the treatment of keratitis sicca.

The slow-release artificial tear (SRAT) is a biodegradable, cellulosic polymer without preservative which is inserted beneath the tarsus of the lower lid, and which provides continuous lubrication and tear film stability to the eye. The SR-AT has been shown to reduce both subjective symptoms and objective signs in patients with keratitis sicca, and is a valuable adjunct to therapy in patients with this disease.


A clinical study of slow-releasing artificial tears.

The slow-releasing artificial tear (SR-AT) is a soluble polymer in solid form. Placed in the inferior cul-de-sac and allowed to dissolve, it is used to treat dry-eye patients. The SR-AT was studied in two phases. The short-term cross-over study of 40 patients was completed in October 1976. The long-term open study is still in progress. Of 37 patients who started the long-term study, 18 are still using the inserts-a study retention of 49%.


Therapy of bovine mastitis: the intramammary tissue compatibility of mastitis remedies administered intracisternally to cows.

Eight different mastitis remedies were administered intracisternally on a rotational basis to the 48 quarters of 12 mastitis negative cows. The resulting intramammary reactions were monitored by determining the Somatic Cell Count (SCC) and Bovine Serum Albumin (BSA) levels in milk. The reactions observed indicate that the intramammary cellular reactions frequently elicited by the local treatments in the treated and sometimes even in the untreated quarters of the treated udders are not necessarily inflammatory in nature. Evaluation of the intramammary tissue compatibility of a mastitis remedy mainly in terms of SCC values therefore seems unreliable. Moreover, it may do injustice to a product unless the SCC values are augmented by BSA or other determinations providing a more accurate indication of truly mastitic reactions. The investigation also implies that the patterns of cellular reactions related to individual mastitis remedies require further elucidation before they can be used as indications of an advantageous or disadvantageous intramammary tissue compatibility of a product. Intramammary tissue compatibility, as such, of mastitis remedies and comparable agents requires definition. It seems more expedient, however, that such a definition and the necessary standardization of mastitis remedies in terms of their intramammary tissue compatibility be attempted by the International Dairy Federation (IDF).


Immunogenicity and pathogenicity of three South African strains of Babesia bovis in Bos indicus cattle.

A strain of Babesia bovis, which has been routinely used in the locally produced babesiosis vaccine for two decades and maintained by needle passage, was of low virulence and therefore safe, but it induced poor protection to challenge with two field isolates. Animals infected with this attenuated strain and subsequently challenged heterologously with a field strain were solidly immune when challenged later with a 2nd field strain. The two field strains, though more virulent, conferred a high degree of immunity to heterologous challenge.


Parasites of domestic and wild animals in South Africa. IX. Helminths in blesbok.

Four blesbok culled in the Rietvlei Nature Reserve during May 1972 were each infested with Trichostrongylus axei and Impalaia nudicollis. Some of these animals also harboured Haemonchus bedfordi, Haemonchus contortus, Trichostrongylus falculatus, Skrjabinema alata and Avitellina centripunctata. Thirty-two blesbok were culled in pairs at approximately 4-5 week-intervals in the Percy Fyfe Nature Reserve from July 1972 to November 1973. Adult H. contortus were recovered in fair numbers from buck slaughtered from August 1972 to February 1973 and during November 1973. Peak numbers of 4th stage larvae were recovered from individual animals slaughtered during October 1972, February and March, and July to October 1973. Peak burdens of T. falculatus were recovered during October to December 1972 and November 1973. The largest numbers of adult I. nudicollis were recorded from January to July and during September 1973. Other helminths recovered were T. axei, S. alata and A. centripunctata. Avitellina centripunctata, H. bedfordi and S. alata are new records for the blesbok.


The micromorphology of the glands of the infra-orbital cutaneous sinus of the steenbok (Raphicerus campestris).

The infra-orbital cutaneous sinus produces a black secretion which is the combined secretion of melanaceous, branched, alveolar, sebaceous and enlarged, coiled apocrine glands. The micromorphology of these glands is described with special emphasis on the sebaceous glands and melanin transfer. The secretion, which may be used for unintentional territorial demarcation, is possibly produced as small black granules and is most likely important for short range communication.


The micromorphology of the apocrine glands of the intermandibular region of the steenbok (Raphicerus campestris).

The histological structure of the newly-discovered intermandibular glandular region in male and female steenbok is described. This region consists of enlarged sebaceous and apocrine glands which secrete a substance used for demarcating grazing territories and for marking females. Migratory lymphoid cells in the epithelium of the apocrine glands resemble Langerhans cells of the epidermis and forestomach epithelium but do not contain Langerhans cell granules. Cells, which are probably of lymphoid origin and resemble sebaceous gland cells, sometimes occur in the apocrine glands.


Wesselsbron disease, pathological, haematological and clinical studies in natural cases and experimentally infected new-born lambs.

This is a report on the clinical signs of Wesselsbron disease in 37 lambs and the pathology of 4 natural and 12 experimental cases. Generally the symptoms were ill-defined. At autopsy 13 of the 14 lambs revealed a mild to severe icterus and a slight to moderate hepatomegaly with discoloration of the liver. No foci of hepatic necrosis were observed macroscopically and, except for petechial and ecchymotic haemorrhages in the mucosa of the abomasum and generalized lymphadenopathy, no other obvious macroscopic lesions were noted. Perforation of the abomasum occurred in one lamb only. Microscopy on the liver showed mild to extensive necrosis of the parenchyma. Degenerated and necrotic hepatocytes were diffusely scattered throughout the liver, but no definite well-circumscribed foci of necrosis were seen. Mitotic figures and hepatocytes with large nuclei indicated that active regeneration of parenchymal cells had occurred in some of the livers. Other changes, for example, Kupffer cell proliferation, sinusoidal leucostasis, bile duct proliferation and infiltration of mononuclear cells in the portal triads, were frequently encountered. Moderate to severe cholestasis was a feature in 66% of the livers examined, while intranuclear inclusions and intracytoplasmic acidophilic or Councilman-like bodies were frequently observed. A complete haematological study was carried out on 4 experimentally produced cases. The gross and histopathological lesions in the liver are compared with those of Rift Valley fever in the new-born lamb.


[Urinary tract infection and vesicoureteral reflux in childhood (author's transl)].

In all recurrent urinary tract infections and fever attacks of unknown origin in children one should consider the possibility of the presence of an vesicoureteral reflux (VUR) and suitable examinations should be carried out. A further indication of the possible presence of a  childish reflux is manifest when enuresis occurs beyond the normal age for this phenomenon. In order to determine whether or not a reflux is present an ad hoc examinational procedure is necessary. There is a definite indication that a VUR operation is called for in cases of pronounced grades of reflux with a corresponding change in the ostia, in the case of marked pyelonephritic changes which are roentgenologically demonstrable and after a conservative treatment of six months.


The development of motor competency in normal and slightly mentally handicapped children.

A study of the motor development and the corporal schema integration was carried out on 60 normal children aged between 6 and 10, and 40 slightly mentally handicapped children of 8 and 10 years of age. The deficiency at the level of manual rapidity is the most important element concerning the motive debility of mentally handicapped children. The tests show that there is no parallelism between the motive retardedness and the level of attainment of the corporal schema. In fact, the motor debility of 8 years old children is emphasized at the age of 10 with reference to normal children. On the other hand, if, at the age of 8, the mentally handicapped children have a lag of the corporal schema acquisition, these children have nearly overcome their retardedness at the age of 10. Therefore one can conclude that the motor retardedness of the slightly mentally handicapped children is not essentially due to a deficiency of the corporal schema integration.


[A testpsychological contribution to the etiology of autism (author's transl)].

The results of two psychological experiments (WURST 1976a,b) with a group of ASPERGER autists and KANNER autists and a parallel group considering age and intelligence show, that neither the belief, autism appears as a possible consequence of a psychoorganic syndrom nor the assumption that autistic behaviour is caused by a perception defect, can be proved with testpsychological methods. However, it seems, that KANNERS point of view, referring to autism as an inborn disturbance of the emotional contact influenced also by negative environment comes closest to the problem.


[Tubular secretion of phosphate in the human kidney (author's transl)].

There are a few scattered publications on primary tubulopathies, where a net secretion of phosphorus by renal tubules, a mechanism usually not existing in man, is shown. By means of a further case, we are able to demonstrate a 30% increase of phosphate excretion over filtration after a phosphate load. The mechanism of action will be discussed. Under certain conditions like a rapid increase in serum phosphorus or after volume expansion a tubular secretory mechanism of phosphate can be unmasked. As this secretory mechanism goes into action only beyond a certain serum threshold of phosphorus and a transport maximum cannot be shown it is most likely that passive transport by means of an increased diffusion cell to lumen is the proposed mechanism involved.


[Anaphylactoid purpura in infancy and childhood (author's transl)].

The clinical picture and the laboratory data of 40 patients with anaphylactoid purpura as well as its etiology and pathogenesis are discussed. The clinical expression and the rate of complications does not differ from that described in the literature. 45% of the patients showed renal involvement, three patients had severe glomerulonephritis. Up to now there is a lack of typical laboratory tests to confirm the diagnosis of anaphylactoid purpura. This study suggests neutrophilia and initial creased fibrin/fibrinogen split products in serum and decreased C3 levels are poor prognostic criteria correlating with appearence and severity of a complicating glomerulonephritis.


[Katamnestic study regarding patient-physician role in urban pediatric practice (author's transl)].

Criteria of patient-physician relationship are reported and give interesting results, so far to our knowledge not published in pediatric literature. Intrafamilial needs are registered out of a talk between doctor and visiting patients in a doctor's office. General functions of the pediatrician for his patients are analysed and found to exceed organic problems, a trend to increase in future. The role of the pediatrician is seen to include psychohygienic and psychosomatic knowledge in order to fulfill the patients needs in the face of social medicine and increasing psychological knowledge of childrens development.


[Cervicomediastinal cystic hygroma invading the pericardium (author's transl)].

A case of a huge congenital cystic hygroma of a newborn is reported. A onestage operation of the cervicomediastinal tumor was impossible and only the cervical part could be removed. The baby died because of unrelievable inflow obstruction of the right heart.


[Extrapyramidal signs as side-effect with metoclopramid-medication (author's transl)].

4 cases of extrapyramidal disturbances, observed in children with Metoclopramid-medication, are reported. These side-effects may occur already at normal therapeutic dosage, especially in the young patient. The side-effects are reversible, and respond easily to i.v. injection or peroral application of anti-parkinsonian drugs, less severe cases may subside by withdrawal of the drug. The therapeutic use in the pediatric field must be strictly indicated because of the special disposition of children to the side-effects described above.


A review of intra-uterine diagnosis of genetic disorders.

In this review the different methods of antenatal detection of congenital abnormalities are briefly outlined. Modern techniques developed in recent years for the diagnosis of genetic disorders by studying the amniotic fluid are considered in detail. The technique of amniocentesis, its indications, complications and the methods of investigation of amniotic fluid are discussed. The indications for chromosomal analysis of amniotic fluid cells for detecting fetal abnormalities and possible pitfalls are reviewed. The major inborn disorders of lipid and carbohydrate metabolism which can be detected in early pregnancy are tabulated and briefly discussed.


Distribution of nodules in thyroid lobes.

Frequency of berign nodules in each lobes of the thyroid gland was determined in 214 consecutive patients who underwent thyroid operation. All cases had thyroid scintiscans. The right lobe was involved two times more than the left. In order to determine if this higher frequency was related to the naturally-occurring greater mass of the right lobe, fifteen normal thyroid glands from consecutive autopsy cases were bisected into halves and the weight of the two segments were compared. Although in 13 glands the right lobe was the larger one, the average weight difference was only seven percent.


Secondary amyloidosis complicating rheumatoid arthritis; report of a case in an eight-year-old girl.

Secondary amyloidosis can complicate any long-standing suppurative infection, such as tuberculosis, osteomyelitis and disorders of connective tissue, i.e., the so-called "collagen diseases". Rheumatoid arthritis is known to be a notable precursor of amyloidosis. The fact that a long-standing process is often necessary to produce the changes in the ground substance, makes Juvenile Rheumatoid Arthritis (J R A) an interesting challenge to that hypothesis. The decreasing incidence of secondary amyloidosis, complicating rheumatoid arthritis, is attributed to better management of patients and the use of more effective anti-inflammatory therapy.


Athletic injuries in adolescents.

In a survey of adolescent patients treated in the University of Rochester Section of Athletic Medicine, injuries to adolescent athletes comprised 12 per cent of all athletic injuries during an 18-month period. The incidence among boys was much greater than among girls, and injuries to the lower extremity--particularly the knee--were most common. Sprains and strains, fractures, chondromalacia of the patella, contusions, and internal derangements of the knee accounted for 80 per cent of the 161 injuries studied. Participation in athletic events has many positive aspects for the adolescent, but it does carry the risk of injury. It is important for the pediatrician to promptly determine the nature and extent of the injury so that appropriate care can be given and the risk of permanent disability lessened.


The growth rate of the human cranial base between nasion and inion.

The growth rate of the human cranial base between nasion (N) - tuberculum sellae (Ts) and tuberculum sellae - internal occipital protuberance (= Twining's line (Tw)) were calculated in proportion to nasion - inion (N - I) distance and expressed in two cranial base ratios: (see formulas) The growth rate of the whole cranial base showed a notable stability and a given ratio apparently prevails through into later life.


Cervical metrizamide myelography by lumbar puncture.

Cervical myelography with metrizamide administered by a lumbar puncture is described. Diagnostic information in the cervical region was obtained in 8 of the 8 patients studied. No major complications were encountered.


Radiologic evaluation of the thymus in juvenile myasthenia gravis.

Clinical records and chest radiographs of nineteen patients with juvenile myasthenia gravis treated by thymectomy were reviewed retrospectively. Correlation of radiographic findings, clinical data, and pathologic observations were sought to determine the value of radiography in the pre-operative assessment of juvenile myasthenia gravis patients. Although the vast majority of patients had normal plain films and tomographic chest radiographs the thymuses in seventeen of the nineteen patients were pathologically abnormal. The pathologic abnormalities consisted of hyperplasia and/or the presence of germinal centers within the glands. Despite these histologic abnormalities, the weights of the surgically removed thymuses were generally in the range of normal for patients of this age. None of the nineteen patients had a thymoma. In our series, there was no apparent benefit from radiographic examination of the thymus gland in consideration of thymectomy for patients with juvenile myasthenia gravis.


Improved plainfilm diagnosis of right aortic arch anomalies with high kilovoltage-selective filtration-magnification technique.

In the pediatric patient, the presence of a right aortic arch is an important roentgen observation. It may be associated with vascular rings and cyanotic heart disease and may complicate the repair of tracheoesophageal fistula. It may be missed on conventional low KVP radiographs but is easily detected on high kilovoltage-filtered films with air gap magnification.


The width of the common bile duct in childhood.

The maximum diameter of the common bile duct was measured on 85 normal intravenous cholangiograms carried out on children between the ages of 1--14 years. There was a close correlation between bile duct width and the patient's age, but a poor correlation with weight. The range of bile duct widths in each age group is tabulated as a guide to diagnosing biliary dilatation in childhood.


Renal abscess in children. A rare but important radiological diagnosis.

As in adults, renal abscess in children mimicks a tumoral syndrome. Renal abscess, although infrequent, should however be kept in mind because it is important to make an early diagnosis. The reason is simply that the treatment fo the two conditions is so different. Furthermore, an early accurate diagnosis avoids unnecessary investigations, such as arteriography, as well as unnecessary surgery. Four cases are reported in which the diagnosis of abscess was obtained by correlating both clinical and radiological findings. In only one case was arteriography performed and this was after treatment and it was normal. For an early diagnosis intravenous urography is of paramount importance. It shows a tumoral radiological pattern; in the context of clinical signs of suppuration (high fever, high leucocyte count and variably a urinary tract infection). The radiological findings suggest the diagnosis of abscess. On treatment the rapid regression and disappearance of the various clinical, laboratory, and radiological findings confirms the diagnosis of renal abscess.


A method for calculating acetabular anteversion in children.

A method of calculating the degree of anteversion of the acetabular fossa is described. A posterior-anterior projection of the prone pelvis with a long focus film and focus object distance is used. The distance between the anterior and posterior rims of the fossa as projected on the films is measured and then divided by a distance equivalent to the diameter: this yields the sin of the anteversion angle. The angle is rapidly calculated with a pocket calculator.


Pulmonary and hepatic echinococcosis in children.

Eighty children suffering from pulmonary and/or hepatic echinococcosis are reported. The epidemiological and parasitological aspects are reviewed, and the importance of the radiological signs and differential diagnosis are emphasized.


Radionuclide evaluation of a communicating bronchopulmonary foregut malformation.

A boy with a communicating bronchopulmonary foregut malformation is presented. Since arteriography failed to demonstrate systemic or pulmonary blood supply to the lesion, 99M Tc-macroaggregated albumin was injected into the aorta at the conclusion of the arteriogram. This procedure documented the existence of a systemic blood supply which at surgery arose from the ninth left intercostal artery. Administration of 99M Tc-pertechnetate prior to surgery demonstrated gastric mucosa in the lesion.


Resolution of Hodgkin's induced ivory vertebrae.

This case demonstrates that, as part of a favourable response to therapy, the "ivory" vertebrae of Hodgkin's disease can revert to a normal radiographic appearance.


Childhood sarcoidosis with fatal cor pulmonale.

A 14 year-old white girl who developed fatal cor pulmonale from severe pulmonary sarcoidosis had a previous clinical diagnosis of cystic fibrosis. Chest radiographs demonstrated marked pulmonary fibrosis without the changes of severe bronchiectasis that would be anticipated with cystic fibrosis.


A severe form of metatropic dwarfism.

The clinical and radiological manifestations of a lethal case of metatropic dwarfism are presented. Two radiological signs present in our case are regarded as particularly useful in making the diagnosis. Moreover other findings, unusual in this condition, are described.


Searching for molecular abnormalities in genetic diseases by the use of a double labeling technique. I. Rationale, techniques, and initial evaluation.

To meet the challenge of unravelling the molecular pathology of the ever expanding number of known genetic diseases in man, new efficient investigative techniques have to be designed. A procedure is presented for detection of protein defects in genetic diseases on the basis of structural rather than functional alterations. The technique is based on double labeling of normal and diseased fibroblast proteins followed by extensive fractionation and analysis. The rationale, advantages, and limitations of the procedure are discussed and the technical aspects of its use explained.


The effect of iron supplements and blood transfusion on iron absorption by low birthweight infants fed pasteurized human breast milk.

Using serial metabolic balances, iron absorption was measured in six preterm infants (mean gestational age 29 weeks), and two fullterm small for gestational age (SGA) infants, between day 10 and 70 after birth. They were all fed breast milk. Iron supplements (2.5--13 mg/kg day) were given from day 30. Three preterm infants received blood transfusions for anemia. During the first 30 days of life iron balance was negative in the preterm infants (mean +/- SEM = -0.10 +/- 0.02 mg/kg day) and positive in the full term SGA infants (mean +/- SEM = 0.098 +/- 0.02 mg/kg day). In infants who were not tranfused, absorption of supplementary iron was a linear function of iron intake, and corresponded closely to 34% absorption. An iron intake of 5--6 mg/kg day resulted in the absorption of amounts of iron close to those being laid down in utero. Blood transfusion was followed by a reduction in iron absorption; in two cases it became negative, becoming positive again as the hemoglobin fell below about 12.0 g/100 ml. These data show that a mechanism exists in preterm infants for the control of iron absorption which does not operate at the hemoglobin concentrations that prevail in such infants, unless they are transfused.


Identification of small cells in fetal and infant adipose tissue.

In developing adipose tissue, cells of size less than 25 micron may make a major contribution to adipose tissue  cell populations. This study reports the separation, identification, and sizing of infant and foetal adipose tissue small cells. Subcutaneous adipose tissue was taken from the anterior abdominal wall of children aged 2 months and 22 months. Subcutaneous tissue was also obtained from a paraumbilical site in 4 fetuses of gestational age 16 weeks. Tissue samples were fixed in buffered osmium tetroxide solution containing collidine. Aliquots of cell preparations suspended in saline on microscope slides were viewed and separated using a dissecting microscope. A diameter distribution of particle size was obtained using at least 200 cells for each preparation. There was a substantial number of cells that were smaller than 20 micron. Their modal cell size was remarkably constant in fetuses and in 2-month-old and 22-month-old infants. Ultrastructural studies show that the tissue is composed of a relatively uniform population of cells within sparsely collagenous connective tissue. Although some of the cells show no intracytoplasmic aggregates of lipid material, others show variable amounts of lipid material which can occupy a very large part of the cell volume.


The growth and development of fat cells in infancy.

Studies on the development of adipose tissue in infancy would seem essential to test the hypothesis that adult fat stores relate to the numbers of fat cells developed during early childhood. Thirty infants aged from 1-28 months and 13 fetuses of approximately 11-16 weeks of gestation obtained at therapeutic abortion and two preterm infants of 28 weeks of gestation were studied. The cells of both fetal and infant adipose tissue were separated from connective tissue and fixed by treatment with osmium tetroxide in buffered collidine using a method modified from Hirsch and Gallian (J. Lipid Res.,9:100(1968) for estimation of cell size and number. In fetal and early infancy there are two populations of cells in adipose tissue. Small cells found in tissue before birth and the first months of postnatal life do not contain fat. The larger cells, which are fat containing, represent maturing fat cells. They are cells which include fat cells recognized by previous workers but up to 24.6% were found to be less than 25 micron in diameter. Small cells in the early stages of fat accumulation may make an important contribution to the cell population of fat mass. It is apparent that increasing fat accumulation in the first 6-12 months of life, as demonstrated by increased skinfold thickness measurements, is associated with increasing fat cell size and that this association bears a linear relationship.


Aspirin-induced hemolysis: the role of concomitant oxidant (H2O2) challenge.

Studies were conducted in an attempt to determine the hemolytic potential of acetylsalicylic acid (ASA) on normal intact red blood cells (RBCs). ASA (25 mg/100 ml) did not impair RBC G-6-PD, glutathione peroxidase or catalase activity, glutathione stability, or hexose monophosphate shunt activity. Hemolysis was not observed after incubation with ASA alone but was quickly noted after exposure to ASA (25 mg/100 ml) and H2O2 (1.2%). Hemolysis did not occur with H2O2 alone but was directly proportional to the ASA concentration. Hemolysis was preceded by peroxidation of membrane lipid and was inhibited by the presence of the antioxidant, thymol. With ASA and H2O2 a marked reduction in membrane phosphatidyl ethanolamine occurred with oxidation of 20:4 and 22:6 fatty acids. No effect on phospholipids or fatty acids occurred with either ASA or H2O2 alone. Salicylic acid, singly or with H2O2, does not exhibit these effects.


Effects of neonatal stunting on the development of rats: early and late effects of neonatal cortisone on physical growth and skeletal maturation.

Cortisone acetate, 1.25 mg, was given im to each pup of eight eight-pup litters; saline was given to each pup of eight litters. At 21 days body weight, stem length, and length of long bones was less in the treated animals (P less than 0.001). The number of ossification centers was greater in the treated animals (P less than 0.05). Brain weight was less in the treated animals (P less than 0.001). For 84-day-old animals body weight (P less than 0.02) and length of most long bones (P less than 0.05) were less in the treated females. Body weight (P less than 0.01), stem length (P less than 0.01) and some bones (P less than 0.02) were smaller in the treated males. There was no difference in the number of epiphyseal fusions. The brains of the treated males weighed less than those of the controls (P less than 0.01). The effect on linear growth is in conformity with observations in children but the accelerated skeletal maturation was unexpected. The effect on skeletal maturation was less persistent than that on bone length.


Fetal growth retardation: femurs, fontanels, and follow-up.

Sixty-three term newborn infants with fetal growth retardation were evaluated within three days of birth. They were classified by length and head circumference. In group 1, both length and head circumference were less than the tenth percentile; in group 2, either length or head circumference was less than the tenth percentile; and in group 3, both length and head circumference were greater than the tenth percentile. Ponderal index (weight/length ratio), anterior fontanel size, and amount of epiphyseal ossification were also determined. Significantly lower birth weights and decreased ossification were found when groups 1 or 2 were compared separately with group 3. These differences were most marked when the weight/length ratio was less than 2.25. When the ponderal index was less than 2.0, epiphyseal ossification was usually absent (suggesting a chronic process). Epiphyseal ossification was positively correlated with birth weight and length but was unrelated to anterior fontanel size. Ossification was more often absent in males than females. There was a negative (inverse) correlation between birth weight and anterior fontanel size. Follow-up of 32 of these infants at age 1 year showed marked individual variations, but there were significant differences in incremental linear growth between groups 1 and 3, a finding which supports results of animal studies showing that catch-up growth may be related to skeletal immaturity. Physical measurements at birth in the individual baby with fetal growth retardation do not reliably predict subsequent growth.


Mechanical and chemical damage to lung tissue caused by meconium aspiration.

We investigated the effects of meconium on the lungs of an adult rabbit model to distinguish between mechanical obstruction of airways and chemical pneumonitis. After the rabbits were anesthetized and intubated, 20% human meconium in saline was instilled into the trachea. Arterial and mixed venous blood gases, functional residual capacity, cardiac output vascular pressures, calculated venous admixture, and pulmonary vascular resistance were measured. Sections of affected lung tissue were examined microscopically. The results were consistent with an early mechanical obstruction of airways with gradual development of chemical pneumonitis over 48 hours.


Skin oxygen permeability in premature infants.

While 24 newborn infants (ages, 2 to 48 hours; gestational ages, 24 to 42 weeks) breathed various concentrations of oxygen, the PO2 values on their unheated skin surface were measured by an unheated microcathode electrode for transcutaneous PO2 monitoring. In infants with arterial PO2 values in the range of 50 to 100 torr and with similar skin temperatures, the mean surface PO2 of unheated skin was inversely related to birth weight: 27.2 torr in infants weighing less than 1,500 gm, 14.3 torr in infants weighing 1,500 to 2,500gm, and 2.9 torr in infants weighing more than 2,500 gm. In the smallest infants, the skin surface PO2 was significantly related to arterial PO2: it was about one third of arterial PO2 as estimated by a second electrode for transcutaneous PO2 monitoring heated to 44 degrees C. Phototherapy, crying, or blood transfusion increased the surface PO2 of unheated skin, but not the tcPO2 measured at 44 degrees C. These findings suggest that blood flow to the skin in excess of its metabolic needs due to immature control of cutaneous circulation, along with low resistance to oxygen diffusion, determines the high oxygen permeability of skin in premature infants.


Violaceous discoloration in pneumococcal cellulitis.

Two patients with periobital cellulitis, one of whom also had buccal cellulitis, had violaceous discoloration of the skin. Blood cultures from both patients yielded Streptococcus pneumoniae. Therefore, pneumococci should be considered, in addition to Haemophilus influenzae, as possible causes of cellulitis with violaceous or bluish-red discoloration.


Amniotic fluid infections, neonatal hyperbilirubinemia, and psychomotor impairment.

A large prospective study found that infants born with evidence of recent amniotic fluid infections subsequently had an increased frequency of mental, motor, visual, and hearing impairment. These infections also potentiated the neurotoxicity of neonatla hyperbilirubinemia. This potentiation of bilirubin neurotoxicity of neonatal hyperbilirubinemia. This potentiation of bilirububin neurotoxicity increases with the severity of the amniotic fluid infections. With or without such infections, an increased frequency of long-term mild mental retardation started at peak neonatal bilirubin levels of only 7 mg/dl in both term and preterm infants. Significant neurologic abnormalities began at peak bilirubin levels of 12 to 13 mg/dl.


Urinary tract infection in high-risk newborn infants.

The prevalence of neonatal urinary tract infection (UTI) was studied in 1,762 high-risk neonates. Symptomatic bacteriuria was found in 1.9% and asymptomatic bacteriuria in 0.5% of these neonates. Male preponderance was 5:1. Clinical manifestations were extremely variable--vomiting, weight loss, and diarrhea being the prominent symptoms. Bacteremia was associated with UTI in six infants. The organisms identified in the urine obtained by suprapubic aspiration were Escherichia coli, Klebsiella, and Proteus. A mixed infection was found in four patients. Roentgenographic examination of the urinary tract showed abnormalities in 44% of the symptomatic patients. It is conclued that symptomatic high-risk newborn infants should be screened for bacteriuria, and that radiological investigations be preformed in those with proven infection.


Evaluation of the growth hormone exercise test in normal and growth hormone-deficient children.

A group of 168 short but otherwise normal children (group A) and 25 children deficient in growth hormone (GH) (group B) wwere studied with an exercise stimulation test to determine the expected error of this method. In group A, 125 (74.4%) had maximum GH responses greater than 15 ng/ml, 23 (13.7%) had responses between 10 and 15 ng/ml, and 20 (11.9%) had responses less than 10 ng/ml. The mean +/- SD values were 8.4 +/- 0.4 ng/ml at 0 time, 26.3 +/- 15.0 at 20 minutes, and 10.7 +/- 8.3 at 40 minutes. The mean maximum response was 27.7 +/- 14.3 ng/ml. In group B, 22 (88%) had maximum responses less than 10 ng/ml and 3 (12%) had responses between 10 and 15 ng/ml. Patients with maximum responses less than 10 ng/ml have a high probability of being GH-deficinet, whereas patients with responses between 10 and 15 ng/ml are less likely to be GH-deficient. No patients with responses greater than 15 ng/ml were GH-deficient.


Neonatal osteomyelitis.

To evaluate current conservative therapy and document the existence of a recent shift in etiologic agents, we reviewed the records of 45 infants who developed osteomyelitis within the first ten weeks of life and who were admitted to Babies Hospital (New York) from 1951 through 1976. Emphasis was placed on characteristics and course of the disease, etiologic agents, therapy, and outcome. Illness was diagnosed within the first two weeks of life in 34 of the 45 infants (73%). Only six had been delivered normally after normal pregnancy and led a normal life before development of ostemyelitis. Infected sites were distinctive in frequency of involvement of multiple foci (21), of facial bones (10), and of joints contiguous to infected long bones (22 of 29). Conservative therapy (nonsurgical) seems reasonable for the majority of patients. Of particular interest is documentation of a shift from Staphylococcus aureus as predominant etiologic agent before 1965 to beta-hemolytic streptococci, commonly group B, from 1965 through 1976. Data collected from the literature of the 1930s indicate that such shifts have occurred before.


Vertebral osteomyelitis in children: report of four cases.

Four children had vertebral osteomyelitis due to Staphylococcus aureus. Abdominal signs and fever were frequent clinical manifestations. Back pain was an uncommon symptom except as a late manifestation in one patient. The portal of entry of the organism generally was not apparent. Location of infection was in the lower thoracic and lumbar spine. Diagnosis was based on roentgenographic changes, radionuclide imaging, and bacteriologic corroboration. We conclude that symptoms and signs of vertebral osteomyelitis in children can be atypical and that a diligent attempt to rapidly diagnose and promptly treat this condition will prevent orthopedic and neurologic sequelae.


Pyogenic hepatic abscess in infancy and childhood.

Five cases of childhood pyogenic hepatic abscess at Milwaukee Children's Hospital and 61 cases in the literature were reviewed. Hepatic abscess occurred most often in infants who had sepsis or umbilical infection. Cases in older children were associated with underlying host defense defects, particularly chronic granulomatous disease (CGD) and leukemia. Common clinical findings were fever, abdominal pain and hepatomegaly. Radionuclide scan was useful in diagnosis of lesions larger than 2 cm. Small or microscopic lesions were diagnosed at autopsy. Staphylococcus aureus was the most common etiologic agent. Mortality in all evaluable cases was 27% in patients with CGD and 42% in those without CGD. Open drainage and appropriate antibiotic therapy is the treatment of choice and should lower the mortality of this infection.


Increased lead burden in children of battery workers: asymptomatic exposure resulting from contaminated work clothing.

Lead transmitted into the home via contaminated parental work clothing was the probable source of excessive lead exposure among 69% of 58 children whose mothers worked in a battery factory in Raleigh, North Carolina. Blood lead levels were highest in children less than 3 years old, and declined with age. All children were asymptomatic, and all had normal findings on physical examinations. Dust samples from the homes of children with the greatest lead burden demonstrated gross contamination of the home environment. Although maternal employment was short, young children spent a significant portion of their lives exposed to lead. Certain parental occupations can sufject children to considerable risk from lead exposure.


Usher syndrome in four hard-of-hearing siblings.

Retinitis pigmentosa (RP) and congenital deafness comprise the autosomal recessive Usher syndrome. The four affected siblings discussed here have audiometric curves characteristic of the 10% of patients with the syndrome who are not profoundly deaf. The oldest already has RP. Even though the younger three siblings have no visual symptoms, they do have auditory signs of the syndrome; they almost certainly will develop RP and become deaf-blind adults. Electroretinography indicates that the second oldest boy has early evidence of rod dysfunction. Special audiometric tests and electronystagmographic results support previous reports of a peripheral rather than central auditory lesion. The heterozygote parents show unilateral high-frequency hearing losses with normal retinal and vestibular function.


Congenital rectal stenosis: a sign of a presacral pathologic condition.

Congenital rectal stenosis may be detected in the newborn during the initial physical examination. Failure of conservative therapy (dilatation) should alert the physician to the presence of an associated pathologic condition in the presacral space. Presacral teratoma, anterior sacral meningocele, or bony anomalies may be the underlying extrinsic causes of congenital rectal stenosis. Prompt recognition and appropriate operative management directed at the presacral lesion will relieve obstructive symptoms and minimize morbidity.


Hypertension associated with the Guillain-Barré syndrome.

Guillain-Barré syndrome (GBS) is frequently complicated by hypertension, which has been ascribed to sympathetic nervous system hyperactivity. We report the case of a child with GBS and hypertension that appeared to be related to increased renin-angiotensin activity. Urinary catecholamine excretion was normal. Propranolol therapy successfully controlled the hypertension. Evaluation of the renin-angiotensin system and catecholamine excretion is indicated in patients with GBS and hypertension.


Bromacil and diuron residue levels in Florida citrus soils.

The widespread use of herbicides in Florida citrus groves raises the possibility of residue accumulation following repeated applications. To determine residue levels of commonly used herbicides, soil samples were taken from large experimental plots in commercial groves in Polk and Hardee Counties. Bromacil and diuron had been applied in combination at both locations for 7-8 years. Analyses of samples showed low levels of both herbicides at various soil depths to 60 cm. Only a small amount of bromacil was detectable one year after applications, but diuron levels were higher. Continuous applications at recommended rates and frequencies have resulted in maximum bromacil and diuron levels of 3.9 percent and 13.1 percent, respectively, of their total application.


DDT residues in butter and infant formula in India, 1977.

Samples of commercial brands of butter and infant formula from different parts of India were examined for DDT residues. All 18 samples of butter representing nine brands were contaminated. Levels of DDT residues ranged from 0.42 to 11.36 ppm and exceeded the Food and Agriculture Organization/World Health Organization practical residue limit of 1.25 ppm in 90 percent of the samples. All four brands of infant formula contained DDT residues above the practical residue limit. Most DDT residues were in the form of p,p-TDE in both commodities. This contamination of milk with excessive amounts of DDT residues seems to be widespread in India.


A study of skin diseases in dogs and cats. V. The intradermal test in the diagnosis of flea allergy in dogs and cats.

A group of 143 dogs and cats with pruritic skin disease was tested by intradermal injection of a dilute whole cat flea extract. The test results were correlated with the clinical diagnosis (Table I, III), with previous or present findings of fleas on the animals (Table II, III), with the presence or absence of blood eosinophilia (Table IV), and, in animals with clinical flea allergy, with the histological findings in a skin biopsy excised from a clinically affected skin site (Fig. 1). The predictive value of a positive and a negative outcome of the test was assessed graphically by means of calculations described in the Appendix (Figs. 2, 3). It is concluded that the test is sufficiently specific to justify its use in animals where flea allergy is suspected but cannot be proved by routine clinical examination. The histological findings and the nature of the skin reactions suggest that a positive outcome of the test is indicative of an immediate, type I hypersensitivity towards components of the oral secretion of fleas and that this hypersensitivity is mediated by reaginic antibody which to some extent is produced by plasma cells located in skin areas where flea saliva is deposited.


[Pharmacokinetic study of antibiotics in human respiratory tract (author's transl)].

We report the results of the study of the bronchial concentrations of several antibiotics. The experiment included 280 patients and the concentrations achieved in bronchial secretions were measured for 11 antibiotics. The samples of bronchial secretions were taken in situ by fibroscopy or through the tracheostomy cannula. The results of the study show that the rate of penetration is variable according to the different drugs; even in the same antibiotic family such as beta-lactam antibiotics the rate of penetration is variable. The bronchial levels of aminoglycosides, macrolides and tetracyclines are worthwhile, and are often superior to the MIC of the infecting organisms; the penetration is also dependant of the inflammatory conditions of the bronchi. Otherwise the sampling conditions were the best possible since samples taken by fibroscopy or by tracheostomy are not contaminated by saliva which is a factor of dilutional error. The methodology used in this study is an approach of pharmacokinetics of antibiotics in respiratory tract.


[B virus chronic hepatitis in the haemodialysed uraemic patient. Correlation between hepatic lesions and the presence of antigen e in 12 patients (author's transl)].

Twelve patients on haemodialysis for 6 months to 3 years contracted AgHBs positive hepatitis, 9 being also Ag e positive. They continued to carry the same antigens. Histological surveillance was begun from the 6th month of the disease onwards, with 2 to 4 repeated biopsies in 1,5 to 3,5 years in 9 patients, the last 3 having only one biopsy between the 8th and the 15th month. In 6 patients, the first biopsy revealed chronic persistent hepatitis (CPH) and in other 6 (5 male and 1 female) chronic aggressive hepatitis (CAH). Subsequent biopsies revealed cirrhosis in a patient treated with alphamethyldopa (Ag e +), the absence of any changes in 7 other patients (4 CPH including 3 Ag e +  and 3 CAH including 2 Ag e +), and an improvement in the last. Long term surveillance of hepatitis B by repeated biopsies in haemodialysed patients reveals that histological lesions are stable at 2 years, that certain drugs may have an aggravating role and that Ag e has no prognostic value.


[The association of a digestive carcinoma and subacute endocarditis. 4 cases (author's transl)].

Attention has recently been drawn to the association of digestive carcinoma and streptococcus bovis endocarditis. The authors studied 130 records of patients with endocarditis and an association with a digestive tumour (3 neoplasms, one villous tumour) was found in four. Streptococcus bovis was demonstrated in one case, streptococcus faecalis in two and streptococcus durans in one. The association of carcinoma and subacute endocarditis would thus seem to not solely relate to digestive commensual organisms. The question of common factors favourising carcinoma and endocarditis is raised.


[The persistence of foetal circulation. Neonatal pulmonary arterial hypertension. Favourable action of tolazoline (author's transl)].

Alongside reversible secondary pulmonary arterial hypertension accompanying neonatal respiratory distress, there are primary PAH leading to the persistence of the foetal circulation. This is a true functional neonatal heart disease which may occur alone or be seen in association with another form of neonatal distress such as respiratory distress secondary to the inhalation of amniotic fluid. Any neonatal hypoxaemia irreductible by classical methods should suggest the possibility of persistent pulmonary arteriolar vasoconstriction and lead, in the absence of systemic hypotension, to the administration of vasodilators. These data remain in the preliminary stage and further studies, in particular pharmacological, of these drugs are necessary.


[Transperitoneal supra-mesocolic approach to the inferior vena cava in the prophylaxis of pulmonary emboli (author's transl)].

An immediate approach to the inferior vena cava is depicted. By this way, it is easy to place a serrated clip under the renal veins, to face the problems of possible caval abnormality, and to review the whole abdominal cavity.


[Comparative studies on the action of aminoglycosides and cephalosporins on the proximal tubule of the human kidney (author's transl)].

Tubulo-toxic effects of drugs can be recognised by the elimination of portions of brush border membrane in the urine. An integral constituent of the brush border membrane is an alanine aminopeptidas (AAP). It is measurable in the urine enzymatically and immunologically with great reliability. The AAP activity was determined in the 24-hour urine of test subjects. Fifteen subjects received 3 mg/kg gentamicin, sisomicin or tobramycin on 3 consecutive days and 10 subjects were given amikacin (15 mg/kg). In addition, 15 subjects received cephacetrile (8.0 g), cephazolin (6.0 g) or cephalothin (8.0 g) on 3 consecutive days. It was shown that all aminoglycosides have a cumulative effect on the brush border membrane, amikacin is the strongest and tobramycin the weakest. The cephalosporins cephalothin and cephazolin were indifferent to the tubule membranes and had no effect on the excretion of AAP. There were responders and non-responders to cephacetrile. The application of cephalothin and cephazolin immediately before the administration of gentamicin prevents the membrane effect of gentamicin.


[Prediction of aminoglycoside nephrotoxicity (author's transl)].

The intrarenal distribution characterisitcs of tobramycin were evaluated in 76 normal canine kidneys during various states of hydration and urine pH. The intrarenal gradient paterns of the drug were also evaluated in 18 severely diseased kidneys obtained from 14 patients undergoing pre-transplant nephrectomy. The results were compared with our earlier data evaluating gentamicin accumulation characteristics in 54 healthy canine and 12 diseased human kidneys. Renal cortical drug accumulation, a matter of potential nephrotoxic importance, was significantly lower in the tobramycin studies. Similarly, cortical tissue binding of tobramycin was 59% (+/- S.E. 4) and for gentamicin was 85% (+/- S.E. 3). The presence of severe disease drastically reduced the renal drug concentration of both compounds. However, in such tissues tobramycin demonstrated slightly higher tissue concentrations in renal cortex (p less than 0.05), medulla (p less than 0.01) and papilla (p less than 0.01) than those measured for gentamicin. The results indicate that there are important differences in the renal disposition of tobramycin and gentamicin in health and disease which relate to matters of toxicologic and therapeutic importance.


Hypertension in renal insufficiency: a major therapeutic problem.

Hypertension and a high incidence of cardiovascular morbidity and mortality often accompany end-stage renal disease. Causes of the hypertension include abnormalities of extracellular fluid volume, increased activity of the renin-angiotensin system, dysfunction of the autonomic nervous system, and deficiency of vasodilator substances. Treatment is not detrimental to residual renal function and may enhance the quality of survival. Several types of therapy are available that may be used sequentially or in combination. New antihypertensive drugs and improved blood-cleansing devices allow a more optimistic outlook on long-term survival in end-stage renal disease.


Renal osteodystrophy in end-stage renal failure.

Renal osteodystrophy has many skeletal pathologic features, eg, fibroosteoclasia (osteitis fibrosa), osteomalacia, osteopenia, pseudofracture, cyst formation, and osteosclerosis. Many of these are caused by the secondary hyperparathyroidism that usually accompanies renal failure. Derangements in parathyroid hormone secretion, calcium and phosphate metabolism, and renal production of 1,25-dihydroxycholecalciferol (the most active form of vitamin D) are all interrelated and pathogenetic features of renal osteodystrophy. Types of abnormalities detected radiologically vary with patient age, type of management, and duration of hemodialysis, as well as with techniques and type of film used and interest of the radiologist. An x-ray film of the hands should always be made--it will show subperiosteal resorption in a large number of patients on dialysis. Prevention and management of renal osteodystrophy hinge on control of hyperphosphatemia and hypocalcemia.


Drug use in renal failure.

The spectrum of interaction between drugs and the kidney is broad. Most drugs are excreted at least partially by the kidney, and renal function affects drug bioavailability, volume of drug distribution, and drug metabolism and rate of drug elimination. Drug therapy not only is potentially hazardous in patients with renal failure but also can cause a number of renal diseases. The clinician should be familiar with the pharmacologic and potential toxic effects of any drug used in a patient with uremia and should monitor creatinine clearance or at least serum creatinine level as a gauge of renal function. The drug regimen can be modified according to these measurements, either by administering a constant dose and varying the interval or by varying the dose and keeping the interval constant.


Electrolyte studies. 2. Potassium, chloride, and acid-base.

Hypokalemia plus elevated carbon dioxide (CO2) content usually indicates renal or gastrointestinal potassium (K+) loss. Hypokalemia plus decreased CO2 content usually means intestinal K+ loss. Hyperkalemia is common in metabolic acidosis and oliguric renal failure. With hemolysis or thrombocytosis, serum K+ concentration may be elevated while plasma concentration is normal. A CO2 value less than 18 mmole/liter suggests metabolic acidosis; a value greater than 30 mmole/liter suggests metabolic alkalosis.


Urography in children: when should it be done? 2. Conditions other than infection.

Conditions that are often associated with an increased incidence of renal anomalies include imperforate anus, congenital vertebral abnormalities, and Fanconi anemia; excretory urography should be done if such a condition is present. Urography is also useful to provide baseline data in conditions associated with later development of urinary problems, such as myelodysplasia, prune-belly syndrome, and exstrophy of the bladder. In addition, urography serves as a periodic check for complications of treatment (hydronephrosis, obstruction) in patients with urinary diversion. Certain signs, eg, dribbling, hematuria after mild trauma, unexplained pneumothorax or pneumomediastinum in a neonate, and neonatal abdominal mass, call for immediate urography. In many conditions that were formerly thought to be associated with major urinary abnormalities, urography is not called for. Such is the case in hypospadias, deformities of the external ear alone, and undescended testes. Dehydration is the only absolute contraindication to urography.


Hemophilia: a guide for the primary care physician.

The hemophiliac knows when he is bleeding. When such a patient is aware of bleeding and consults a primary care physician, the episode usually has been of sufficient duration and is severe enough to demand prompt treatment with high-potency materials. Needless delay results in further complications and additional costly treatment. The type of deficiency can usually be ascertained from the patient or family member. If there is no history of an inhibitor, replacement therapy should be initiated promptly.


Pathogenesis of the uremic syndrome.

Uremia is the last of four progressive stages of renal disease. Symptoms are referable to major organ systems and appear to be intensified by high intake of crude dietary protein. In many respects uremia resembles systemic poisoning from a toxic substance, and many chemicals are now suspected, but not proved, to be causative agents. The hypometabolism and low body temperature commonly seen in advanced uremia could result from alterations in cellular sodium transport. These changes can be reversed by hemodialysis or renal transplantation.


Metabolic and endocrine alterations in end-stage renal failure.

Many alterations in metabolic and endocrine function occur in end-stage renal disease. Glucose intolerance is almost always present with uremia; it improves shortly after institution of regular hemodialysis. Hyperlipidemia (type IV) is prevalent, and atherosclerotic cardiovascular disease causes death in about 50% of patients receiving long-term hemodialysis. Although plasma levels of growth hormone usually are elevated, children with chronic renal failure show growth retardation. The occurrence of thyroid disorders is difficult to determine, since many clinical features of uremia are similar to those of hyperthyroidism and hypothyroidism. The incidence of duodenal ulcer is high, possibly due to high gastrin levels. Sex hormone disturbances are common. Anemia is a constant feature of chronic renal failure; patients usually tolerate it well.


[Risk of general anaesthesia (author's transl)].

95 506 patients who received general anesthesia during the period of 1964--1977 were studied. The account of all actual or possible life threatening complications during the anesthesia is given: oedema of the glottis, air embolism, accidental injection of the wrong drug, respiratory insufficiency, hypoxia, pulmonary oedema, airway occlusion by the cuff, vomiting and aspiration, anaphylactoid reaction, death within 24 hours, death on the table. Deaths not attributable to anaesthesia are listed separately. We have found that in one of every 139 anaesthetics given there was a life threatening complication to the patient. In every 197th anaesthetic there was a clear connection with the anaesthetic technique used. In contrast with the great number of near fatal complications the rate of irreversible damage or mortality connected with general anaesthesia was low.


[Risks associated with regional anaesthesia (author's transl)].

The risks attendant on regional anaesthesia derive from the condition of the patient, the technique employed and the skill, or lack of skill, on the part of the anaesthetist. Patient-determined risk factors are: existent diseases and pathological conditions which in many cases cannot be rectified pre-operatively. The main difficulties and complications of regional anaesthesia arise from mechanical, pharmacodynamic and toxic factors and infection. Each technique carries its own specific risk. With due care many of the complications can be prevented.


[Death on the operating table (author's transl)].

Inquests following death on the table present the expert with a number of problems: he has to assess not only the causal connection between therapeutic or surgical procedures and death of the patient, but also the part played by anaesthesia in the fatal outcome. A number of cases are reported and an attempt is made to provide some objective guide-lines for the expert.


[The role of the physician in assessing fitness for surgery (author's transl)].

The decision regarding fitness of a person to undergo surgery and anaesthesia is made by the surgeon and anaesthetist according to agreed criteria. The physician takes part in the decision only in those cases where additional information regarding the type and extent of the disorder is required or when doubtful findings need further clarification. Closer co-operation between anaesthetist and physician regarding the indications for pre-operative tests and investigations is desirable.


[The technical risk of anaesthesia (author's transl)].

Improper anaesthetic practice is caused among other things, by technical failure of apparatuses used in anaesthesia. An attempt is made to classify the technical hazards involved in anaesthesia, especially with regard to symptomatology and causes, to enable rapid detection and correction of technical errors or breakdowns.


[Misadventures in anaesthesia and the law (author's transl)].

In order to establish liability there must be a causal connection between an objectively erroneous action and the ensuing damage. Criminal negligence presupposes that failure on the part of the anaesthetist to exercise the necessary care, including neglect properly to choose and supervise his assistants, is responsible for the mishap. Since anaesthesia constitutes a trespass to a person's body the consent of the patient has to be obtained. Such consent is valid only if the patient has been apprised of the nature, significance and risks of the anaesthetic method to be used. The anaesthetist must inform the patient whether general or regional anaesthesia is planned. The extent to which such information must be supplied and proof that it has been given may present difficulties. A practical approach is to provide the patient with as much information as will enable him to ask relevant questions and then to decide whether or not he wants further explanations.


[Air embolism; a complication during neurosurgery in the sitting position (author's transl)].

Neurosurgery in the sitting position not only puts a strain on the cardiopulmonary system, but also carries the risk of venous air embolism. Special monitoring procedures as well as prophylactic measures greatly contribute towards the safety of the patient. The pathogenesis, pathophysiology and the symptoms of venous air embolism are reviewed, and various monitoring methods are discussed, with special reference to their reliability, sensitivity and practicability. The analysis shows that the Doppler ultrasound method, continuous capnography during the duration of the operation, intra-arterial measurement of blood pressure, recording of the central venous pressure and of electrocardiographic changes are essential means of routine monitoring. Suspected air embolism must be promptly dealt with not only by ligation of the severed vein but also by attempts at aspiration of the air bubbles via the atrial catheter. The latter, therefore, plays an important role both as a diagnostic parameter and a therapeutic agent. Although the suggested prophylactic measures do not absolutely protect against complications they will markedly reduce the incidence of venous air embolism.


[Cardiocirculatory arrest due to hyperkalaemia following i.v. Imbretil for muscular relaxation (author's transl)].

The muscle relaxant Imbretil was investigated in 10 patients for initiating anaesthesia and for a prolonged artificial ventilation. In 50% of the patients a rather quick and drastic rise of the serum potassium-level was found. A cardiac arrest occurred in one patient due to a hyperkalaemia but fortunately was reversible. Consequently we do not use Imbretil in our Hospital anymore. Today better and less dangerous drugs are available instead--Imbretil must be placed as an obsolete drug.


[Rupture of the aorta complicating multiple injuries (author's transl)].

A case of subtotal circumferential rupture of the aorta is described which involved a woman who had sustained multiple injuries in a traffic accident. The rupture was discovered only during autopsy. As this type of injury is generally not diagnosed until after death, knowledge of some of the characteristics signs of rupture of the aorta is important, especially to the physician in charge of an intensive care unit. If there are suspicious signs aortography is essential. The only treatment likely to succeed is surgery, but postoperative mortality is still as high as 20--40 per cent.


[Antacids for preventing aspiration pneumonia (Mendelson syndrome) in obstetric anaesthesia (author's transl)].

The risk of aspiration pneumonia attendant on obstetric anaesthesia and the importance of the pH value of the aspirated gastric juice in the development of aspiration pneumonia are emphasized. The use of antacids and other agents as a preventive measure is reviewed.


[Cardiovascular effects produced by prophylactic digitalization during introduction of anaesthesia (author's transl)].

The narrow field of non-controversial indications concerning the application of digitalis glycosides is pointed out. Problems of routine digitalization of older patients not suffering from cardiac insuffiency are discussed with special regard to preparing them for operations. Up to now, from the viewpoint of anaesthesiologists no benefits of prophylactic digitalization have been found. In a retrospective computerized study, clinical hemodynamic parameters during introduction of anaesthesia have been investigated by means of anaesthetic data recorded during three years. Nondigitalized patients older than fifty years showed satisfactory cardiac functions, whereas prophylactically digitalized patients--compared with the control group--have been treated with plasma expanders earlier and at a double rate. Furthermore, higher heart frequencies and greater tendency to arrythmias were observed. Consequently, prophylactic digitalization cannot be recommended in general.


[EEG tracings in cerebral death (author's transl)].

In diagnosing electrocerebral silence (isoelectric tracing) the investigator must be sure to exclude the possibility of an artefact. With the methods available up to now for testing the proper functioning of electroencephalographic equipment it has not been possible entirely to avoid errors. A new method is described for the rapid and quantitatively exact testing of EEG equipment including electrodes and cables and the correct recording of isoelectric tracings.


[Cardiac arrest and hydrothorax as a complication of anaesthesia following subclavian catheter (author's transl)].

The present case report describes a case of intrapleural infusion by means of a subclavian catheter. The clinical situation together with the signs of posteroinferior infarction in ECG led to a wrong diagnosis. During an emergency oepration the intrapleural infusion caused cardiac arrest which could be mastered by successful reanimation. After drainage of the intrapleural infusion the patient recovers without further complications. Prior to every infusion subclavicular catheters should be tested by blood aspiration.


[Temporary paresis of the phrenic nerve as a complication of subclavian vein puncture (author's transl)].

A case of phrenic nerve paresis as a complication of puncture of the right subclavian vein in local anesthesia is reported. The paresis and phrenoparalysis disappeared after 90 minutes. Possible reasons are discussed.


Preparation and spectral properties of 12-hydroxyl eicosatetraenoic acid (HETE).

A convenient method for the biosynthesis of 12L-hydroxy-5,8,10,14-eicosatetraenoic acid (HETE) from archidonic acid with human platelets was developed, and milligram quantities were made for biological and spectroscopic characterization. This compound has only weak activity in two of five biological prostaglandin assays and no activity in the other three. The 13C and 1H NMR spectra of HETE were obtained and the signal due to each carbon atom was assigned.


Synthesis of S-behenyl coenzyme A.

The synthesis of behenyl CoA by the reaction of coenzyme A with N-hydroxysuccinimide ester of behenic acid is reported. This method gives better yields of behenyl CoA when compared to the acid chloride or mixed anhydride method where side reactions seem to cause a decrease in yield.


Nalpha-(pteroyltetra (gamma-glutamyl))-lysine as a ligand for the purification of thymidylate synthetase by affinity chromatography.

Nalpha-(pteroyltetra (gamma-glutamyl))-lysine Sepharose was synthesized and shown to be a stable high capacity affinity matrix capable of bringing about the purification of Lactobacillus casei thymidylate synthetase to maximum specific activity from crude extracts in high yield. Under conditions optimal for binding of thymidylate synthetase, dihydrofolate reductase was not bound.


Fractionation of water-insoluble protein using sephacryl S-200 in formamide.

The ability of Sephacryl S-200 to fractionate water-insoluble protein by gel permeation chromatography was investigated. Elution of protein standards from colums of Sephacryl S-200 equilibrated with formamide, an excellent solvent for both hydrophobic and hydrophilic proteins, was molecular weight dependent. Advantages of chromatography of water-insoluble proteins using Sephacryl S-200 include rapidity, recovery of protein free of detergent or solvent, safety, ability to purify large amounts of protein, and ability to separate proteins as large as 100,000 daltons. Separation of water-insoluble polypeptides in a crude preparation of gliadin in formamide demonstrated the practicality of the method.


Purification fo cathepsin D by AH-sepharose affinity chromatography.

A rapid and reliable method for coupling the protease inhibitor pepstatin to AH-Sepharose 48 was developed. The matrix prepared was used to purify cathepsin D from rat liver. The enzyme was eluted in one fraction and proved to be pure by gel electrophoresis, two types of ion exchange chromatography, molecular sieve chromatography, and immunologically homogenous by immunoelectrophoresis. This method is more rapid and gives a higher yield than previous techniques. The possibility to use this technique for the purification of other enzymes inhibitable by pepstatin should be considered.


Purification of antibiotics from Physarum gyrosum by high pressure liquid chromatography.

A family of five antibiotic substances was isolated from the slime mold Physarum gyrosum by high pressure liquid chromatography (HPLC). For this purpose, mold was cultured for two weeks in a liquid medium. Soluble products were harvested by rotary evaporation of medium and extraction with 1-butanol. Paper chromatography in ethyl acetate:pyridine:water (2:2:1 v/v) was used for preliminary fractionation. Active components were separated by HPLC with a reverse-phase column packed with Bondapack C18/Porasil B (Waters Associates) and were eluted with a linear gradient of methanol:water increasing from 70 to 100% methanol over 90 minutes. Purification was completed by rechromatographing individual fractions. Purity of the active components was verified by HPLC and thin layer chromatography. Activity assays against Bacillus cereus showed these materials to be bacteriostatic rather than bacteriocidal.


The interaction of mammalian interferons with immobilized cibacron blue F3GA: modulation of binding strength.

Mouse, hamster, rabbit, horse, and human interferons bind to immobilized Cibacron Blue F3GA under appropriate solvent conditions. Three forms of the immobilized ligand have been investigated: Cibacron Blue F3GA-Sepharose 4B, Blue Dextran-Sepharose 4B and Blue Sepharose CL-6B. The strength of binding of an interferon depends critically on the sorbent: Cibacron Blue F3GA-Sepharose 4B is the weakest in the series and Blue Sepharose CL-6B the strongest. The use of Blue Dextran-Sepharose 4B--a sorbent of intermediate binding properties--allows the complete separation of hamster, mouse and human fibroblast interferons in a single chromatographic step. Indeed, both the resolution, as well as the recovery, of those interferons is complete--regardless of the relative complexity of the chromatographed preparation (containing either crude or purified interferons). Thus, these ligands should prove of considerable use when a facile chromatographic evaluation, both qualitative and quantitative of mammalian interferons is required.


Velocity sedimentation in isotonic saline and sucrose buffer as a possible method of fractionating normal erythrocytes.

On velocity sedimentation in isotonic saline and sucrose buffer, normal human erythrocytes could be fractionated into many different populations. The fastest sedimenting cells consisted entirely of normal discocytes, had a tendency to form clusters of eight to ten cells, were less fragile, and seemed to be separable into two distinct groups of different buoyant densities. The slowest sedimenting cells were echinocytes, did not clump, showed extreme fragility, and were of similar density.


Isolation and characterization of membrane vesicles from human and boar spermatozoa: methods using nitrogen cavitation and ionophore induced vesiculation.

A method for isolation of plasma membrane vesicles from human and boar spermatozoa using nitrogen cavitation is described. The purity of the preparations were assessed by electron microscopy, marker enzyme assay and the sedimentation characteristics of fused plasma membrane-acrosomal membrane vesicles in sucrose gradients. PAGE-SDS profiles of plasma membrane polypeptides from boar spermatozoa were significantly different from those of human spermatozoa. Differences in electrophoretic profiles of polypeptides from different regions of the spermatozooon were also observed.


Effects of chronic experimental liver dysfunction and L-tryptophan on behaviour in the rat.

Rats with chronic experimental portocaval anastomosis were hypoactive as indicated by diminished activity in the home cage, during habituation in red light to an observation box and during exposure in white light to an open-field. Food intake and responsiveness to electric shock were also decreased. However, there was an abnormally high frequency of social activity when anastomosed rats were paired together after having been caged singly for 3 weeks. Also, sham-operated rats interacted more with anastomosed rats than they did with other sham-operated animals. Anastomosis also raised brain concentrations of tryptophan, 5-hydroxytryptamine and 5-hydroxyindoleacetic acid. Administration of tryptophan to sham-operated rats increased shock threshold and decreased ambulation in an open-field. Thus, while anastomosed rats are not comatose they do have considerable behavioural abnormalities for which brain tryptophan changes may be in part responsible.


An analysis of normeperidine's contribution to the rate-decreasing effects of meperidine.

The effects of normeperidine (1-17.5 mg/kg) alone and in the presence of naloxone (1 and 10 mg/kg) were studied in pigeons responding under a multiple fixed-ratio 30 response, fixed-interval 5-min schedule of food presentation. Naloxone only potentiated the rate-decreasing effects of normeperidine. The effects of meperidine also were studied after pretreatment with SKF-525A (25 and 50 mg/kg), an inhibitor of drug metabolism. SKF-525A had no effects on responding when administered alone, but it potentiated the rate-decreasing effects of meperidine. It was concluded that meperidine's rate-decreasing effects cannot be due to normeperidine, the metabolite, but rather that both of these drugs have non-narcotic actions which produce decreases in schedule-controlled responding.


Disapearance and excretion of labeled alpha-MSH in man.

Despite the considerable evidence for the CNS actions of alpha-melanocyte-stimulating hormone (alpha-MSH) in man, little attention has been given to its half-time disappearance from plasma and urinary excretion in normal individuals. In the first experiment, a healthy man was given 15 muCi of tritiated (3H)-alpha-MSH as a rapid IV injection. A plot of the disappearance time in plasma was characteristic of a multiexponential curve, the linear components of which were resolved by the subtraction method and half-time disappearance calculated directly from the slope of the regression line. The half-time disappearance was 1 min for the first component and 25 min for the second component. After the IV adminisration of 50 muCi of 125I-alpha-MSH in the second experiment, the two components showed halftime disappearances of 1 min and 4.8 min respectively. These times were not changed by precipitation of the plasma with 10% trichloroacetic acid. Thirty-eight percent and 42% of the label appeared in the urine 4 hr after the injection of either 3H-alpha-MSH or 125I-alpha-MSH. The results suggest that the persistence of high levels of alpha-MSH in the blood after injection in man may be too short to fully explain the CNS effects of alpha-MSH.


Effects of extended training on rats depleted of central and/or peripheral catecholamines.

Thirty-two Wistar rats were used to investigate the effects of extended training on avoidance performance of rats depleted of Catecholamines. They were injected with 6-hydroxydopamine either (i) intracisternally, (ii) intraperitoneally, or (iii) both IP and IC, and trained on the two-way shuttlebox avoidance task. The results on peripheral noradrenaline depletion led to the conclusion that extended training ameliorates the observed behavioural deficit significantly back to the level of controls. The conclusion that is indicated by the present central catecholamine depletion are: (i) central catecholamine depletion has long term effect on behavioural deficit, (ii) central depletion is more detrimental to avoidance learning than peripheral depletion, and (iii) plasma corticosterone plays no significant mediating roles.


Lack of behavioural effects following intraventricular infusion of somatostatin in the conscious goat.

The effect of IV or intracerebroventricular (ICV) administration of somatostatin was studied on the behaviour of conscious goats. The doses of somatostatin infused IV were 100 and 300 microgram for 30 min and 600 microgram for 6 min. The doses infused ICV were 10 and 100 microgram for 30 min and 600 microgram for 6 min. In contrast to earlier reports on experiments with rats ,no behavioral effects whatsoever were seen in goat. IV infusion of 100 to 600 microgram and ICV infusion of 600 microgram of somatostatin caused a difinite reduction in the secretion of insulin and growth hormone, but had no effect on the concentration of blood glucose. The reason why neither IV nor ICV administration of somatostatin had any behavioural effects in the conscious goat, in contrast to the effects in rat, cannot be explained with certainty. This may be due to species specificity, to the amount of somatostatin reaching the central nervous system, or to some metabolic changes in rat but not in goat.


Effects of repeated injections of naltrexone on antagonism of rate decreases by morphine in the pigeon.

Responding of three pigeons was maintained under a multiple schedule of food presentation in which key-pecks produced access to grain under a fixed-interval schedule in the presence of one stimulus and a fixed-ratio schedule in the presence of another stimulus. Repeated daily injections of 1 mg/kg naltrexone had no systematic effect on overall response rate during either schedule component, and the naltrexone continued to antagonize rate decreases of periodic single injections of 10 mg/kg morphine for seven weeks. Tolerance did not occur to the antagonistic effects of naltrexone on rate decreases generally produced by morphine.


Effects of catecholamine manipulations on three different self-stimulation behaviors.

Rats with self-stimulation electrodes in the medial part of lateral hypothalamus (LH) or in the lateral part of LH were trained to bar press, to run in a continuous, square-shaped runway, and to move their tails from side to side while otherwise restrained, all using LH stimulation on an FI 2 sec schedule as the reinforcement. At low doses of pimozide (a dopaminergic blocker) or of FLA-57 (a dopamine beta-hydroxylase inhibitor) different effects on rates of responding were observed on each of the 3 tasks at the 2 electrode placements, indicating that the rate reductions were not the results of specific performance effects of the drugs. The patterns of rate changes suggested that the effects of LH stimulation on behavior in the runway were primarily, but not exclusively mediated by a dopaminergic system; that the effects of LH stimulation on tail movement were primarily, but not exclusively mediated by a noradrenergic system; and that the effect of LH stimulation on bar pressing was mediated by both, or either of these substrates. These results suggest that the reinforcement of behavior by LH stimulation is flexibly mediated by at least 2 different neural systems.


Control of polydipsic drinking by a taste aversion procedure.

Rats were given daily sessions with free access to food and saccharin flavored water. After fluid consumption had stabilized food was delivered once every minute. Water was always available in the home cage. All rats showed the marked increase in fluid consumption known as schedule-induced polydipsia. The rats were then poisoned with lithium chloride after each of three sessions in an attempt to condition a taste aversion to the saccharin. On recovery from the toxicosis all rats showed first a reduction and then a recovery in saccharin intake. To establish the nature of this effect, the rats were poisoned after saccharin consumption in the home cage. Again there was a marked reduction in polydipsic drinking in the experimental chamber. These results indicate that common incentive mechanisms govern normal and polydipsic drinking and stand in contrast to published results pointing to different drive systems in the brain mediating normal and polydipsic drinking.


Effects of central nervous system accumulation of tellurium on behavior in rats.

Rats were treated for 112 days with daily injections of 2 mg/kg potassium tellurite in Sorensen's phosphate buffer or with the buffer vehicle only. At sacrifice, the cerebral gray matter of the animals treated with tellurite was grossly darkened. The presence of tellurium in cerebellum was confirmed by atomic absorption spectrophotometry. Growth of the tellurite-treated animals was significantly impaired when compared with control animals. However, in a T-maze the activity level of the tellurite-treated animals was increased. On a simple delayed response task, the performance of the tellurite-treated animals was more consistent than that of the buffer-treated animals.


Sex and strain differences in the visual evoked potentials of albino and hooded rats.

Visually evoked potentials were recorded n male and female rats from albino and hooded strains. Recordings were made at 4 different flash intensities in unanesthetized animals. Clear sex and strain differences were observed. Females had larger amplitude P1-N1 and N1-P2 components and shorter latency N1 peaks than males. Albino rats had larger amplitude P1-N1, N2-Pe and P3-N3 components and longer latency P2 and P3 peaks than hooded rats. Variations in flash intensity produced greater alterations in latencies and N1-P2 amplitudes in hooded rats than in albino rats, but greater alterations in N1, N2 and P3 latencies in albino rats than in hooded rats. Hooded rats are recommended as more valuable for studies of chemically induced change in the visual evoked potential.


A reappraisal of scopolamine effects on inhibition.

A series of related experiments was conducted to examine the effects of scopolamine on discrimination performance in the presence or absence of a stimulus signalling non-reinforcement. In Experiment 1, rats trained to respond on 1 of two levers in the presence of a 1000-Hz tone and on the other lever in the presence of a 3000-Hz tone were not reinforced when white noise was added to 1 of the tones. Pairing white noise with the other tone during an extinction session demonstrated that the white noise had become a conditioned inhibitory stimulus. In Experiment 2, scopolamine decreased responding and discrimination accuracy on the excitatory (reinforced) trials, and increased responding on the inhibitory (non-reinforced) trials. The magnitude of the drug's effect was similar on excitatory and inhibitory trials. Using combination of visual and auditory discriminative stimuli, Experiment 3 confirmed the results of Experiment 2. These experiments show that scopolamine disrupts animals' ability to discriminate, and that scopolamine-induced increases in non-rewarded responses cannot be attributed solely to a disinhibitory effect of the drug as Carlton (1969) and others have claimed.