[Effects of occupational factors on the natural course of chronic bronchitis in a prospective observation of the industrial population].

Frequence of occurrence and dynamics of chronic bronchitis symptoms as well as barrier syndrome in the examined men in a plant was connected primarily with tobacco smoking and less with the age. Mean values FEV1 depended on the age of examined workers and the rate of spirometric values decrease increased with the age and was connected with smoking habit. It has been ascertained that there is a direct relationship between air contamination with dusts and fluorides and frequency of occurrence of chronic bronchitis symptoms, maintenance of the symptoms for 5 years and decrease of FEV1 value at that period especially in a group of smokers.


[Lower limb varicose veins in textile workers].

441 women working in various textile industry plants were examined to detect possible varicose veins, ulceration of shins, post thrombotic syndrome and active thrombotically inflammable changes. Frequency of the above mentioned changes was evaluated withthe following criteria: age, duration of employment in textile industry and work-post. Additionally, sickness absenteeism analysis was done in patients treated preventively and by operation. Investigations carried out indicate that the frequency of varicose veins in lower limbs, of trophic changes, shin ulceration, thrombotically inflamed processes increases with age and duration of employment in textile industry, resulting in considerable sickness absenteeism. The surgeon working in a given plant should detect varicose veins in lower limbs as early as possible and send his patients for an operation. Operation prevents many complications and shortens duration of disablement for work.


[Evaluation of lens transparency in persons exposed to electromagnetic radiation of 27--30 MHz frequency].

55 women occupationally exposed to lasting electromagnetic radiation at 27--30 MHz frequency and 101 persons from control group were examined with reference to the status of lens transparency. No statistically significant differences between the frequency of lens opacity in the exposed and control group were found. No dependence of opacity on duration of employment was found, either. An increase in lens opacity was proportional to age both in the exposed and control group.


Caloric restriction lowers blood pressure in the spontaneously hypertensive rat.

In the spontaneously hypertensive rat (SHR), caloric restriction without sodium restriction is associated with reduced blood pressure. Four days of fasting lowered blood pressure 19% while 4 days of eating 50% of ad lib intake reduced blood pressure 10%. Similar dietary changes had less effect on blood pressure in normotensive rats of the same strain (Wistar-Kyoto--WKY). These data are consistent with the hypothesis that caloric restriction lowers sympathetic activity.


Galactose and glucose metabolism in the isolated perfused suckling and adult rat liver.

The development of the technique for the perfusion of the immature liver has enabled us to characterize metabolic differences in carbohydrate metabolism in the suckling versus adult rat livers. Livers of fasted suckling and adult rats were perfused with 4 mM galactose or 4 mM glucose. Galactose uptake was the same for both age groups during the first 35 min. The adult liver maintained the initial rate of uptake after this period while the immature liver began to take up galactose more rapidly. By the end of the experimental period, on a weight basis, uptake by the young liver was three times that of the adult. Analysis of the livers at the end of the 90 min perfusion showed hepatic galactose concentrations to be one-half of circulating media levels. Glucose output was observed in each group during perfusion with either galactose or glucose. In the immature liver, galactose perfusion stimulated more glucose output than did the glucose perfusion. In the adult, however, both sugars resulted in the same levels of glucose output. Galactose perfusion resulted in glucose levels in young liver being higher than the media; while in the adult, the level was lower than the media. Galactose perfused livers of the suckling and adult contained significantly more uridine-5'-diphosphogalactose than the glucose perfused livers of each age.


Pyrimidine metabolism in hereditary erythrocyte pyrimidine 5' nucleotidase deficiency.

A patient with hereditary erythrocyte pyrimidine 5' nucleotidase deficiency was studied to determine the mechanism of accumulation of erythrocyte pyrimidine nucleotides. Estimates of the rate of degradation of uridine nucleotides to diffusable products imply that the high levels found in these patients could not be sustained from the degradative pathways alone. Active synthesis of uridine nucleotides was found to occur in erythrocytes from both patient and control blood samples when either uridine or orotate was used as a substrate. The circulating levels of uridine in the blood are such that sufficient nucleotides to account for the high levels seen in these patients could accumulate in the erythrocytes from biosynthetic pathways alone, quite apart from the contribution from degradation of residual ribosomal RNA. This provides scope for new therapeutic approaches; treatment with allopurinol, however, was found to result in an increase, rather than a decrease, in erythrocyte pyrimidine nucleotides.


The metabolism of oleic acid by the perfused rat liver in experimental diabetes induced by antiinsulin serum.

The metabolism of varying quantities of oleic acid was examined in isolated perfused livers from normal fed rats and from animals made diabetic by pretreatment with guinea pig antiinsulin serum (AIS). The data presented reemphasize the fact that the quantity of free fatty acid (FFA) coming to the liver is a necessary, but not the most important, factor affecting the subsequent metabolism of the FFA. Rates of ketogenesis and output of triglyceride and the terminal concentration of hepatic triglyceride were proportional to uptake of FFA in certain concentration ranges. For equal rates of uptake of FFA, ketogenesis was greater, and the quantity of triglyceride secreted or accumulated within the liver was less, with livers from diabetic animals than with livers from normal animals. In confirmation of previous data, the liver was observed to have a maximal capacity to secrete triglyceride. Triglyceride accumulated in livers from normal-fed and diabetic animals only when uptake of FFA was more than sufficient to saturate the secretory process. Since proportionately more FFA was catabolized by livers from AIS treated animals, greater uptake of FFA was required to produce maximal rates of output of triglyceride and accumulation in livers from diabetic than from normal animals. Rates of ketogenesis by livers from normal fed animals increased minimally with increasing uptake of FFA (up to 1.0 mM free fatty acid). Even when uptake increased considerably with FFA concentrations of approximately 2.5 mM, rates of ketogenesis by livers from normal animals were less than half those of livers from diabetic rats, and maximal rates were not achieved by the normal controls. It is evident that changes in hepatic metabolism of FFA in the intact diabetic animal result from simultaneous alterations of supply of FFA and hormonally induced metabolic changes in the liver. Moreover, although hepatic secretion and accumulation of triglyceride is greater in isolated perfused livers from normal rats than from diabetic animals when the livers are exposed to equal quantities of FFA, the diabetic livers can accumulate more triglyceride, secrete more triglyceride, and oxidize more FFA to ketone bodies than can the normal under conditions in which considerably more substrate is available to the diabetic rather than to the normal livers. These differences might also be expected to occur in the acutely insulin deficient intact animal, in which changes in hormonal status and substrate (FFA) availability occur simultaneously, and might, in part, explain the ketonemia, hypertriglyceridemia, and hepatic steatosis often observed in vivo.


Evidence for autonomous secretion of prolactin in some alcoholic men with cirrhosis and gynecomastia.

Prolactin responses to provocative thyrotropin releasing hormone (TRH) stimulation were evaluated in 20 cirrhotic men with gynecomastia. Fifteen of these cirrhotic men had normal responses with a minimum doubling of the prolactin concentration above basal in response to TRH. Five had abnormal (autonomous) responses in that they failed to double their basal level or had a paradoxical decrease from basal in response to TRH. Moreover, these same five men failed to have a sleep-related increase in plasma prolactin. Three of them also failed to respond to chlorpromazine stimulation. Such abnormal responses are generally associated with the presence of a prolactin secreting pituitary tumor. Basal plasma levels of prolactin were measured in all 20 men studied. The five men who failed to respond to TRH had significantly greater basal prolactin concentrations (80.5 +/- 18.7 ng/ml) than did the 15 men who responded normally (33.7 +/- 4.3 ng/ml) (p less than 0.01), although all 20 had increased prolactin levels relative to that of controls (10.8 +/- 0.9 ng/ml) (both p less than 0.01).


Plasma and tumor dopamine-beta-hydroxylase activity in patients with familial pheochromocytomas.

The majority of patients with sporadic pheochromocytomas (pheos) have been noted to have normal plasma dopamine-beta-hydroxylase (DBH) activity. We determined the activity of DBH in the plasma of 8 patients with pheos, secondary to multiple endocrine neoplasia Type 2 (MEN II) (medullary carcinoma of the thyroid [MCT], pheochromocytoma(s), and parathyroid hyperplasia). We also determined the activity of DBH in the pheos of six of the patients. Three of the eight patients (38%) had elevated plasma DBH in the preoperative period. After surgical resection of their pheos, the plasma DBH of two of the subjects, in whom it could be measured, returned to normal. Although two of the other patients had bilateral pheos containing large amounts of DBH and norepinephrine (NE), their plasma DBH was normal in the preoperative and postoperative periods. Despite elevated urinary vanillylmandelic acid (VMA) excretion in all eight patients, their homovanillic acid (HVA) excretion was normal. VMA reflects NE plus epinephrine (E) excretion, while HVA reflects dopamine (DA) excretion. We conclude that the majority of patients with pheos, associated with MEN II, have normal plasma DBH activity.


Glucose metabolism in intact man: the responsiveness of splanchnic and peripheral tissues to insulin.

Man controls his blood sugar concentration within rather narrow limits, despite wide latitude in the content and timing of meals. Man does not eat constantly; rather, he alternates between periods of "feasting" and "fasting." It is a useful generalization that the metabolic environment is altered such that forces promoting substrate storage are dominant during the postprandial period and forces that encourage substrate mobilization are prominent during food-free intervals. In this report, we shall primarily examine the role of insulin, the hormone of carbon storage, in maintaining glucose homeostasis during a 24-hr period. In particular, we wish to highlight (A) possible important differences in the dose response curves of insulin in splanchnic and peripheral tissues and (B) the modulating influences of hyperglycemia and glucagon on insulin's effects across the splanchnic bed.


The effect of ten days of fasting on various aspects of carbohydrate metabolism in obese diabetic subjects with significant fasting hyperglycemia.

Patients with nonketotic diabetes mellitus, who were both obese and had significant fasting hyperglycemia (mean plasma glucose = 310 mg/100 ml), were fasted for 10 days. There was a prompt drop of plasma glucose levels as the result of the caloric deprivation with a mean fall of approximately 200 mg/dl at the end of the fast. The drop in plasma glucose level that occurred during the fast was associated with a drop in plasma insulin level. Fasting plasma glucose concentration rose immediately after food intake was resumed and stabilized within 3--4 days at levels halfway between the initial and the lowest value. At this time, the patients also seemed capable of disposing of an oral glucose load more efficiently. The apparent improvement in carbohydrate homeostasis observed after the fast could not be attributed to an increase in insulin response, but was associated with some amelioration of the insulin resistance that characterizes these patients. Unfortunately, the beneficial effects of the 10-day period of caloric deprivation were transitory and fasting plasma glucose values had returned to prefast levels in most patients within a few months.


Carbohydrate storage in man: speculations and some quantitative considerations.

Recent information indicates that the capacity of man to store carbohydrate energy by transformation into fatty acids synthetized de novo is very limited in adipose tissue as well as in liver and intestine. This seems to be in contrast to other species such as the rat where de novo fatty acid synthesis can be induced to a high capacity of glucose removal. This leaves man with a limited capacity to store excess carbohydrate. The remaining possibilities are both the main glycogen stores in liver and in muscle. The latter is by far the largest. The capacity of muscle to assimilate glucose is dependent on its glycogen content that in turn is dependent on previous glycogen depletion to supply energy for muscle contraction. Man might, thus, be uniquely limited in the capacity to dispose of extra carbohydrate in the sedentary state. This might speculatively be thought to be an explanation for a carbohydrate excess syndrome in the sedentary state that may well increase the risk for obesity, hyperinsulinemia, and diabetes mellitus. The logical treatment for such a syndrome then is either a decreased intake of energy as carbohydrate or an increased disposal of carbohydrate energy by exercise. Exercise has, indeed, been shown to have such effects both after physical training programs and, perhaps more pertinent to the question, during a few days after a single exercise bout that has consumed a large amount of muscle glycogen.


Pathogenesis of glucose intolerance in uremia.

The pathogenesis of glucose intolerance in uremia was examined with the glucose clamp technique. Hyperglycemic clamp (n = 8): The plasma glucose concentration is acutely raised and maintained at 125 mg/dl above basal levels. Under these steady state conditions the glucose infusion rate, M, equals the amount of glucose metabolized: Predialysis M averaged 4.23 +/- 0.36 mg/kg/min and increased to 7.71 +/- 0.43 postdialysis (p less than 0.001). The plasma insulin response predialysis was 90 +/- 20 microU/ml and decreased to 80 +/- 23 microU/ml following dialysis. Consequently the M/l ratio, a measure of tissue sensitivity to insulin, increased by 80% +/- 25% (p less than 0.001) but still remained less than controls (p less than 0.01). Euglycemic insulin clamp (n = 10): The plasma insulin concentration is acutely raised by 100 microU/ml and the plasma glucose concentration is held constant at the basal level. Predialysis both M (3.37 +/- 0.36 mg/kg/min) and M/l (3.56 +/- 0.33 mg/kg/min per microU/ml X 100) were significantly less than controls (p less than 0.01). Postdialysis both M and M/l increased significantly (p less than 0.01) to a mean that was not significantly different from controls. Basal hepatic glucose production (n = 6), 2.15 +/- 0.09 mg/kg/min, was similar to controls and fell (87% +/- 4%) normally during the insulin clamp. In five uremic subjects in wom insulin binding to monocytes was measured, there was no correlation with tissue sensitivity to insulin (M/l). Significant abnormalities in both growth hormone and glucagon physiology were present in uremic individuals, but no correlation with either the presence or degree of glucose intolerance was demonstrable. In conclusion, glucose intolerance is universally present in uremic subjects and results primarily from peripheral tissue insensitivity to insulin. Insulin secretion is usually enhanced in an attempt to compensate for this insulin resistance but in occasional subjects uremia also inhibits beta cell sensitivity to glucose. Hepatic glucose production is unaffected by uremia. The lack of correlation between insulin binding and tissue sensitivity to insulin suggests that the cellular mechanism accounting for the insulin resistance is probably the result of a defect in intracellular metabolism or in the glucose transport system.


Hyperinsulinemia in obesity syndromes: its metabolic consequences and possible etiology.

Animal models with genetic or experimentally produced (lesions of hypothalamus) obesities are numerous and unlikely to ever be reduced to a single pathophysiologic entity. However, obese animals have many similar traits in common. They are all hyperinsulinemic, an abnormality that occurs early in the development of these syndromes and appears to be of prime importance in producing most of the metabolic changes observed both in the early and late phases of the obesity syndromes. In all instances, obesity is an evolutional syndrome in which the early phase is different from the later one. The early phase is principally characterized by increased hepatic very low density lipoprotein (VLDL) output, increased adipose tissue lipogenesis and VLDL uptake, hence, increased fat accretion and fat cell size. These abnormalities are secondary to hyperinsulinemia and can be reversed toward normal by normalizing circulating insulin levels. The late phase is characterized by the continuation of the disorders of the early one plus a superimposed abnormality, the insulin resistance state, that is detectable particularly at the level of adipose and muscle tissues, and eventually brings about hyperglycemia. Insulin resistance is a multifactorial pathological condition that includes at least: (a) a decrease (more or less marked) in insulin binding to target tissues that is responsible for the decrease in tissue sensitivity to the hormone; (b) intracellular defects that are probably responsible for the decreased insulin responsiveness of target tissues. The origin of hyperinsulinemia in animal obesities is still ill-defined. Lesions of the ventromedial hypothalamus (VMH) produce rapid and lasting hyperinsulinemia. Such lesions produce, in addition, increased secretion of insulin and glucagon and changes in pancreatic insulin, glucagon, and somatostatin content in subsequently perfused pancreases. The locus responsible for these effects is not defined and may actually involve a series of interrelated loci. Whatever the latter may be, one of the routes of CNS influence upon endocrine pancreas is the vagus nerve, although a humoral factor has also been claimed. The etiology of hyperinsulinemia in genetically obese animals is unknown. Genetic inheritance could bear primarily upon some hypothalamic or other CNS sites, with secondary alterations in the endocrine pancreas function, or primarily on the islets of Langerhans with possible alteration in the respective function of the A, B, and D cells with resulting excessive insulin secretion.


Insulin resistance, insulin insensitivity, and insulin unresponsiveness: a necessary distinction.

Insulin resistance may be said to exist whenever normal concentrations of insulin produce a less than normal biologic response. Hormone resistant states may be divided into those due to decreased sensitivity to a hormone (i.e., a shift in the dose-response curve to the right), those due to a decrease in the maximal response to the hormone, and those that are combinations of decreased sensitivity and decreased responsiveness. This distinction is important, since the molecular mechanisms that produce these various forms of insulin resistance may be different. Disorders associated with alterations prior to the interaction of insulin with its receptor are more likely to produce states of decreased sensitivity, where disorders associated with alterations at the intracellular steps in insulin action are more likely to produce decreased responsiveness. Alterations in the insulin receptor itself may produce either, although most frequently changes in receptor affinity as well as in receptor number will be manifest as changes in sensitivity. This is a result of the large number of "spare" receptors for most insulin effects. In many studies, the differential diagnosis between states of altered sensitivity and altered responsiveness is difficult due to the complicated and interrelated nature of the metabolic pathways of insulin action. This is frequently further complicated by incomplete data (usually the result of studying response to only one hormone concentration rather than a full dose-response) and change in rates of basal metabolism in different diseases. The latter is a particularly difficult problem, but it is clear that use of "fold-" or "percent-" stimulation may further obscure the nature of the change when complete data are not provided. With more precise use of these terms and a more complete understanding of insulin action, it will be possible to begin to segregate the roles of the various prereceptor, receptor and postreceptor factors that are involved in producing the differing patterns of metabolism observed in disease.


Ability of circulating insulin to chronically regulate the cellular glucose transport system.

We have tested the idea that the circulating plasma insulin level plays an important role in the long-term regulation, or maintenance, of the cellular glucose transport system, distinct from insulin's ability to acutely accelerate glucose transport. To study this hypothesis, groups of rats were made either hyperinsulinemic or hypoinsulinemic by daily insulin injections or Streptozotocin treatment, respectively. Different levels of hypoinsulinemia were produced by using different doses of Streptozotocin (40 and 55 mg/kg). Isolated adipocytes were prepared from each animal and glucose transport was assessed by measuring the initial rates of uptake of the nonmetabolyzable hexose 2-deoxy glucose. In cells from control animals, the Vmax of in vitro adipocyte glucose transport was 7.1 +/- 0.7 nmole/min/10(6) cells in the basal state and 22.9 +/- 0.9 nmole/min/10(6) cells in the presence of a maximally effective insulin concentration (25 ng/ml) in the buffer. In cells from the experimentally hyperinsulinemic animals, these Vmax values were increased to 11.7 +/- 0.8 and 44.2 +/- 1.1 nmole/min/10(6) cells. Using adipocytes from both groups of Streptozotocin treated (high dose, 55 mg/kg, low dose, 40 mg/kg) insulin deficient diabetic animals, Vmax values were found to be progressively decreased. Thus, in the low dose group, basal and insulin stimulated Vmax values were 1.6 +/- 0.5 and 5.7 +/- 0.7 nmole/min/10(6) cells, as compared to values of 0.9 +/- 0.2 and 1.7 +/- 0.6 in the high dose group. Furthermore, when hyperinsulinemia was induced by feeding rats high carbohydrate diets for 10 days, adipocyte glucose transport Vmax increased 50%. In contrast, when hypoinsulinemia was achieved by fasting rats for 72 hr, transport Vmax decreased by 50%. The apparent Km for 2-deoxy glucose uptake was the same under all conditions. In conclusion, assuming that the Vmax of transport is some function of the number of glucose transport carriers per cell, then these results support the hypothesis that in addition to acute acceleration of glucose transport, insulin is also an important long-term regulator of the number of available adipocyte glucose transport carriers.


Adipose tissue hyperplasia and hyperinsulinemia on Zucker obese female rats: a developmental study.

Obese female Zucker rats show persistent increases in fat cell number compared to lean female Zucker rats from 5 to 52 wk of age. The hyperplastic obesity of the Zucker rat is also accompanied by fat cell hypertrophy and elevated plasma immunoreactive insulin (IRI). Average adipocyte size reaches a peak value at 14 wk of age in the subcutaneous, retroperitoneal and parametrial depots of the female obese rat. Plasma IRI also shows a peak at 14 wk of age. In addition, at this age thymidine kinase activity, a measure of proliferative capacity in tissue, is elevated in obese compared to lean rats, and at 15 1/2 wk of age a bimodal distribution of adipocytes is present in obese rat adipose tissue. The data suggest that attainment of a critical adipocyte size accompanied by maximum levels of plasma IRI may act in concert to potentiate fat cell hyperplasia in Zucker obese rats.


Increased adipose tissue lipoprotein lipase activity during the development of the genetically obese rat (fa/fa).

Lipoprotein lipase (LPL) enzyme activity in epididymal adipose tissue from obese and lean Zucker rats was measured. At 5, 10, 13, and 20 wk of age obese rats have heavier fat pads, larger fat cells, and more LPL per epididymal fat pad and per fat cell than do their lean littermate controls. Although LPL per fat cell increased as fat cell size increased in lean rats, the increased LPL activity in the obese could not be attributed solely to increased fat cell size. When obese and lean rats had similar cell sizes, LPL per fat cell was still significantly increased in the obese compared to lean. Furthermore LPL activity was increased in "preobese" (fa/fa) rats compared to either lean genotype (Fa/fa or Fa/Fa) during the second postnatal week. The data suggest that early increments in LPL activity in adipose tissue of the "pre-obese" rat may significantly contribute to the early fat cell hypertrophy seen during the development of this genetic obesity. Furthermore, early increased LPL activity may prove useful as a predictor of the onset of obesity.


Insulin response in skeletal muscle and fat cells of the genetically obese Zucker rat.

Isolated fat cells derived from 10-wk-old Zucker obese rats utilized substantially greater amounts of glucose per cell in the presence or absence of insulin than those from lean rats. Initial rates of deoxyglucose or 3-0-methylglucose uptake in fat cells from Zucker obese rats were also 5--10 times greater than those observed in cells from lean rats. However, while 240 microU/ml insulin elicited a maximal response in fat cells from lean rats, this dose of hormone was only about 50% as effective as 24 microU/ml insulin in stimulating glucose metabolism or hexose transport in obese rat cells. This apparent rightward shift in the dose response-relationship could not be adequately explained on the basis of decreased insulin receptors since (125I-) insulin binding per fat cell was increased 2.5--3-fold in obesity, while receptor density on the cell surface in obesity was decreased only slightly. Soleus muscles from obese Zucker rats exhibited decreased basal rates of D(5-3H)glucose conversion to glycogen and H2O compared to those of lean controls. While the percent increase in glucose metabolism due to a supermaximal dose of insulin was similar in soleus muscles of lean and obese Zucker rats, a blunted response to a submaximal insulin dose was observed in muscles from the latter animals. This rightward shift in the dose-response relationship was also observed when deoxyglucose uptake was monitored in soleus muscles from obese rats. Binding of (1251-) insulin to soleus muscles at a medium concentration of 57 microU/ml was significantly decreased in obese compared to lean rats. We conclude that (1) fat cells do not contribute to the insulin resistance of 10-wk obese Zucer rats since glucose utilization is higher in these cells at all concentrations of insulin tested, (2) obese Zucker rat soleus muscle metabolism is defective in two respects--imparied basal glucose utilization and a rightward shift in the insulin dose-response relationship with respect to hexose transport, and (3) this latter defect involving decreased sensitivity of muscle to insulin appears to result from a marked decrease in cell surface receptors for the hormone.


Studies of insulin insensitivity in soleus muscles of obese mice.

The isolated mouse soleus muscle is a suitable system to measure specific insulin binding and insulin effects. Studies in obese mice have pointed to discrete sites of insulin resistance of skeletal muscle in obesity: (1) A decrease in the number of insulin receptors, which may result in diminished insulin sensitivity (i.e., impaired responses to submaximally stimulating doses of insulin); and (2) Alterations that lay apart from, or beyond, the insulin receptor: thus, glucose transport (and/or phosphorylation) appears to be intrinsically altered and the stimulation by insulin of glycogen synthesis is markedly depressed. These alterations are responsible for the marked resistance to maximally stimulating doses of insulin. The serum from a patient with the syndrome of insulin resistance and acanthosis nigricans contains antibodies that inhibit insulin binding and exert insulin-like effects in muscle; this serum is, however, less effective than insulin in maximally stimulating glycogen synthesis, which suggests some differences in their mechanisms of action.


Primary insulin antagonism of glucose transport in muscle from the older-obese rat.

Effects of insulin (1 mU/ml) on diaphragms removed from older-obese (70--110 days, 350--520 g) male Sprague-Dawley rats were compared to responses on muscle removed from younger-lean (27--36 days, 80--150 g) animals. Insulin antagonism on glucose transport (2DG uptake), glucose uptake, glycogen synthesis, glycolysis (lactate production), and glucose oxidation was demonstrated in tissue from the older-obese rats. Extracellular water spaces (measured with inulin-H3) were significantly decreased in these tissue. To determine if insulin antagonism of glucose transport could be secondary to inhibition of a rate-limiting reaction in the Embden-Meyerhof pathway with a subsequent negative feedback on transport, both tissue levels of glycolytic intermediates and oxidation of intracellular lipids were measured. No free intracellular glucose was found in diaphragms from either group of rats. Levels of G-6-P, F-6-P, F-1, 6-diP, PEP, and pyruvate were all lower in muscle from the older-obese animals. Incorporation of C14-FFA into tissue TG was slightly, but significantly, lower in this same tissue. Oxidation of intracellular TG and PL was similar in the two groups. In conclusion, diaphragms from older-obese rats manifest insulin antagonism of glucose transport that is probably responsible for the diminished hormonal effect on glucose uptake and the intracellular pathways of glycogen synthesis, glycolysis, and glucose oxidation. This inhibition of insulin action cannot be accounted for by changes in glycolytic intermediates causing a negative feedback on transport or enhanced lipid oxidation and therefore should be considered primary. The relative effects of age and obesity will need to be evaluated in future studies.


Early changes in gluconeogenesis and lipogenesis following destruction of the ventromedial hypothalamic nuclei.

Young male rats were injected with tritiated water 6 hr after destruction of the ventromedial hypothalamic nuclei (VMN). One hour later they were sacrificed and the incorporation of tritium into liver and carcass lipids, proteins, and glycogen and into plasma glucose and proteins was measured. It was found that lesioned rats showed increased incorporation into carcass and liver lipid, liver and plasma protein and plasma glucose. Conclusions are that the processes of lipogenesis and gluconeogenesis are accelerated within 6 hr after VMN destruction.


Process of consecutive cell divisions and separations in a regular tetrads-forming mutant of Micrococcus lysodeikticus (luteus).

A mutant MT of Micrococcus lysodeikticus (luteus) IFO 3333, whose minimum growing unit is not a single cell, but a tetrad unlike the wild-type divides by binary fission of each monococcus, and then separates first into two daughter tetrads, second into four tetrads and third into eight tetrads. The three planes of either the cell division or the cell separation are equivalent to one another and oriented at right angles in three dimensions, respectively. The process of consecutive cell divisions and separations of the mutant tetrads was schematically illustrated.


Effects of homologous O-antibody on host responses to lipopolysaccharide from Yersinia enterocolitica: neutralization of its pyrogenicity.

The pyrogenic activity of lipopolysaccharide (LPS) obtained from Yersinia enterocolitica was neutralized by the homologous O-antiserum at the optimal antigen/antibody ratio. The level of neutralization in either antigen excess or extreme antibody excess was significantly lower than that at the optimal ratio. These facts suggested that the structure of the so-called "lattice" of LPS/antibody complex might influence the neutralization of pyrogenic activity. Moreover, when LPS was gradually added to the antiserum to reach the optimal antigen/antibody ratio, the pyrogenic activity of LPS was only slightly neutralized by the antibody. The similar event to Danysz phenomenon that has been known in the diphtheria toxin-antitoxin system was also observed in the LPS-anti-LPS system.


Research as an educational tool: experience from Balint groups.

The educational and professional value of research is real but may be deceptive and costly. The history and theory of Balint groups for GPs are reviewed. The value of research in the context of Balint groups is examined and some implications of this experience are discussed in relation to a professional ethos for doctors and their teachers.


A comparison of short and multiple choice questions in the evaluation of students of biochemistry.

Premedical and other undergraduate students were given an examination consisting of a section of short questions and a section of multiple choice questions of the one in five type. After correction for random guessing, the average multiple choice mark was close to the average short question mark. Thus the theoretical 'average' student did equally well in both types of examination. Individual multiple choice marks were plotted against the corresponding short question mark. Although the two sets of marks were highly correlated  (P less than 0.001), there was still a wide scatter around the best-fit, least-square line (r = 0.63). Thus dependence on one type of examination alone could have seriously penalized some students. The least-squares line was extrapolated to determine the multiple-choice mark of a theoretical 'idiot' student, defined as one obtaining zero marks in the short question section of the examination. This student did better than predicted on the basis of random guessing. On the other hand a theoretical 'genius' student, defined as one obtaining top marks in the short question section, did less well than predicted. Thus multiple choice examinations, even when corrected for the random guessing component, may overestimate weaker students and underestimate stronger students.


The interrupted interview: a method for facilitating the development of clinical observational skills.

A teaching technique using videotaped interview data is described which sensitizes students to the verbal and non-verbal data presented by patients. In addition it provides experience of the active, hypothesis-testing posture interviewers need to adopt in order to function effectively.


Videotape recording in the assessment of the history-taking skills of medical students.

The potential of videotape recording in the assessment of student history-taking skills has been explored in a third year general practice undergraduate course. By concentrating on priority areas in history-taking it has been possible to develop a profile of the strengths and weaknesses of individual students and of the group as a whole which should be of value to course organizers.


Measuring clinical competence of medical students.

Evidence of clinical competence for medical students entering the clinical clerkships at the University of Kansas College of Health Sciences is established by passing two different examinations: a 100 item multiple choice examination and a videotaped history and physical examination by each student of a simulated patient, being rated by that patient and two examiners. In 1976 the class of 196 medical students took an average 1.85 written examinations per student. With 70% or better constituting a passing score, 30.6% passed on the first attempt, 55.6% the second, 11.2% the third and 2.5% the fourth. Each student passed the televised practical examination and had the opportunity to review his or her videotape with a critiqued data base and the examiners' and simulated patient's evaluations in hand. Correlation coefficients for all 196 students between scores of written examinations, medicine tutors, examiners and professional patients revealed weak but significant correlations between the assessments of examiners and medical tutors and assessments of examiners and written examination scores, but not between other evaluations. This scheme of proof of competence appears to be objective and direct, and serves the convenience of both students and teaching staff.


The workshop concept in training of health personnel.

A description is given of the planning, conduct and evaluation of four workshops for health personnel. Components common to all programmes are used to derive a basic model which could be used for educational training training. The results indicate that participants found their workshop experience valuable and relevant to education in the health sciences.


A follow-up of the career preferences of Manchester and Sheffield graduates of 1972 and 1973.

Pre-registration house officers who answered enquiries in 1973 and 1974 about career preferences were written to again in 1976. This yielded 205 comparisons, in which 134 (65.5%) doctors retained their original first choice of career, thirty-five (17%) opted for their previous second or third choice and thirty-six (17.5%) gave a completely new choice. The most common reasons for a change in career choice were reappraisal of aptitudes and abilities, altered domestic circumstances, additional knowledge of promotion and career prospects and additional experience of the new choice of career.


A postgraduate course in community paediatrics.

Community paediatrics is assuming increasing importance but is rarely taught as an entity. We have recently organized a course in community paediatrics for general practitioners, doctors working in the area child health services and hospital paediatricians. Features of this day release course are self-instruction at home with specially prepared material, discussion between doctors from different disciplines, discussion with non-medical professionals and the undertaking and presentation of a project. The course is flexible, and once set up can be run without extensive facilities and resources.


A school of community paediatrics.

Medical graduates need a new kind of instruction in the health care of children. The practice of general practitioners, clinical medical officers and paediatricians can be improved by it. The nature of a school, created for this purpose, its teaching programme, it first year of operation and its possible future are described.


Hypernephroma treated by nephrectomy, excision of tumour, and autotransplantation.

A patient developed a hypernephroma in his only fuctioning kidney. This was treated by nephrectomy, bench surgery which involved excision of the tumour and repair of the kidney, and autotransplantation. The patient remains well with good renal function, and no recurrent or metastatic disease.


Preliminary report on ten patients with spinal cord injuries treated with hyperbaric oxygen.

A preliminary report is presented on 10 patients with spinal cord injuries who were treated with hyperbaric oxygen. The results suggest that by supporting injured spinal cord tissue with oxygen under pressure, improvement in nerve function may occur. No deterioration of motor power or sensation was evident during or after hyperbaric oxygen treatment in any of these patients. The possible contribution of ischaemia to the pathology of spinal cord injury should encourage further experimental research and clinical trials with hyperbaric oxygen.


Hyperbaric oxygen and acute spinal cord injuries in humans.

Clinical assessment of a regime of hyperbaric oxygen within 12 hours of acute spinal injury in humans suggests that further study of this method of treatment is indicated. For statistical proof of the efficacy of this form of treatment study of a large number of patients is necessary and an Australia-wide study is suggested. A recommendation is made for early referral to the spinal unit.


Funnel chest: results and description of an improved operative technique.

An improved operative technique for funnel chest is described in detail. The results of operation with this procedure on 229 cases over the past 10 years are compared with those obtained, using an earlier technique, on 319 cases over the preceding 16 years.


Cardiac arrest after cervical spine mobilization.

This case report describes cardiorespiratory arrest which occurred in a 38-year-old man immediately after a mobilization procedure of the cervical spine without anaesthesia.


Tonsillar hypertrophy and chronic hypoxia.

Three patients with hypertrophied tonsils presented in the Mater Children's Hospital with chronic hypoxia and congestive cardiac failure. The clinical features and physiological basis of this unusual syndrome are discussed. The condition is potentially fatal, but may be completely cured by adenotonsillectomy.


Sudden death in infancy in Tasmania, 1970--1976.

A series of 155 sudden infant deaths in Tasmania for the period from 1970 to 1976 gives an incidence rate of 2.94 deaths per 1000 live births. This abnormally high State figure is composed of significant internal regional variations. The seasonal, age, and sex distributions are, however, similar to those generally reported elsewhere. If "pneumonitis", as defined in this paper, is also included, the over-all rate of sudden infant deaths becomes 3.79 per 1000 live births.


The age of the menopause of Australian women.

The mean age of the menopause by probit analysis in a group of apparently healthy Australian women was 50.4 years. No relationship was found between this value and the age of the menarche or the number of children born or the age at the time of birth of the first child. The mean duration of the menstruating life was 26.3 years with a range of from 17 to 44 years.


Elastofibroma dorsi.

A case of bilateral subscapular elastfibroma dorsi in a 60-year-old woman is described. The striking clinical and pathological features of this rare benign tumour-like lesion are described and illustrated.


A needle biopsy would be quickest.

A case of a benign intrathoracic thyroid adenoma which was biopsied percutaneously is described. Except for a routine posterior-anterior (PA) and lateral chest X-ray examination, no preliminary investigations were performed. This resulted in several unnecessary procedures.


Sudden infant death syndrome related to position in the cot.

It is suggested that partial respiratory obstruction may be the precipitating factor responsible for the age distribution in sudden infant death syndrome.


[Iron absorption after gastrectomy following oral application of tardyferon].

Iron absorption was studied in 35 volunteers following oral application of Tardyferon during 21 days. In 25 patients a total gastrectomy and in 5 patients a subtotal gastrectomy have been performed, whereas 5 persons served as controls. The following parameters have been determined: Serum iron, iron binding capacity, hemoglobin, hematocrit, red blood cells and reticulocytes. The following results were obtained: Serum iron is markedly reduced in the patients with total gastrectomy during the first postoperative year, increases steadily and reaches normal values after the third postoperative year. Following oral application of Tardyferon an improved absorption is observed during the postoperative course. Because of the excellent absorption of Tardyferon it can be recommended for the oral application during the first two postoperative years.


[Combination of a hiatal hernia and a transpyloric prolapse of gastric mucosa].

During the past 5 years we operated 13 cases of combination of a hiatal hernia and a transpyloric prolapse of the gastric mucosa. These represent ca. 7% of all operated hiatal herniae. In addition we treated 9 cases conservatively, at that the combination of a loose cardia and a labile pylorus was diagnosed through endoscope. Results of these both treatments are satisfactory. 12% of operated hiatal herniae are combined with duodenal ulcer but only 4% with gastric ulcer. It may be concluded that gastric entrance (cardia) and exit (pylorus) have a close connection.


[Overlooked osteochondral fractures of the knee-joint area among juveniles].

Osteochondral fractures among juveniles are the subject being reported. Thereby it is emphasized that the fractures in the early stages could often be overlooked. The existing pains, the effusions of blood as well as the mechanism of the accident often lead to the term "distorsion" as a wrong diagnosis. X-ray examinations can be unsatisfactory in the early stages. In 3 up to 4 weeks it is recommendable to repeat the X-ray examinations in the case of sustained pains. After that tomographies and tangential roentgenograms of the patella are also valuable. In early cases the therapy can be carried through conservatively as a general rule. Later on a surgical treatment is advisable. Cases of illness which are not treated lead to degenerative effusions of the joint and in the long run they lead to degenerative alterations of the joint.


[Cardiomyopathy in Duchenne muscular dystrophy. Part 2: serum enzymes, vector-cardiography, and echo-cardiography in 143 patients (author's transl)].

To diagnose a possible latent or manifested cardiomyopathy, 143 male patients between 2 and 21 years of age with confirmed Duchenne muscular dystrophy were examined for serum enzymes, by electrocardiography, vector-cardiography, and echo-cardiography. The results contain information on 1. the quantitative cellular myocardial degeneration process, 2. the disturbed cellular depolarization and nerve-conduction processes in the area of the right and left ventricular myocard, and 3. the disturbed left ventricular function which, in the initial state, is only documented by a discrete decrease of contractility caused by a manifested decreased ejection output. The pathological contraction and relaxation process of the heart muscle cell and its dependency on calcium ion transport as pathogenic background is discussed.


[Mesenteric venous thrombosis and oral contraceptives (author's transl)].

Primary mesenteric venous thrombosis seldom occurs in young women. As a complication of oral contraceptives it is uncommon as well. Based on an own observation (39 year old female patient) pathogenesis and problems in diagnosis of this aspect of thrombosis are discussed. Involvement of the veins being segmentary and peripheral, small bowel resection is the effective treatment.


[A questionnaire for early recognition of digitalis intoxication (author's transl)].

The diagnostically relevant data of 1164 patients under digitalis were stored in a computer and compared statistically for toxic and nontoxic patients. Resulting from this a questionnaire was developed in which each item was weighted according to its own diagnostic value. In a prospective study 77 suspected cases of digitalis intoxication were classified according to their scoring in the questionnaire. In 92% of the patients this classification was confirmed by the final diagnosis (after withdrawal of the glycoside). Mean score and mean serum digoxin concentration (SDC) of the toxic patients were significantly higher. There was a high consensus between the final diagnosis, the classification by the questionnaire and the SDC. The questionnaire proved to be a useful aid in the bedside diagnosis of digitalis intoxication.


[Pacemaker-Twiddler's Syndrome (author's transl)].

A case of Pacemaker-Twiddler's Syndrome is presented. Rotation of a permanent pacemaker can result in a capstan effect, and the lead is drawn out of the right ventricle. Fixing thouroughly the pacemaker and the lead should be an useful prophylactic measure.


[Frequency and appearance of depressive syndromes in chronic hemodialysis patients (author's transl)].

83 chronic hemodialysis patients of a dialysis-transplantation program were investigated psychopathometrically by various self-rating scales on their emotional and subjective somatic state. It was found that at the time of the investigation 20% of the patients had depressive syndroms which were characterized by complaints about various somatic disturbances. Suicidal tendencies were seen in 8% of the patients. In the personality inventory (FPI) 3 psychopathologically different groups could be found: 1. anxious, more retarded depressive patients (16%), 2. dysphoric, more out-acting depressive patients (14%), 3. euphoric patients with lack of criticism (35%). A fourth emotionally normal group was only somatically disturbed (25%). Various pathogenetic aspects are discussed.


[Dialysis dementia: case report (author's transl)].

A case of dialysis dementia, a disorder with psychiatric-neurological symptoms and a fatal outcome is reported. Possible etiological factors are discussed.


[Intractable renal and enteral loss of potassium in a case of Turner's syndrome (author's transl)].

A case of Turner's syndrome is presented; many congenital defects were detected. Predominant clinical findings were cheilognatoschisis, respiratory distress, caused by congenital bronchiektasis and chronic hypokalemia with paroxysmal attacks of paralysis and tetania. Hypokalemia was mainly due to gastrointestinal losses as a consequence of permanent vomiting in the presence of stomach atonia and hiatus insufficiency or because of "third space losses", while a subileus persisted chronically. Furthermore also a renal loss of serum potassium was evident in the patient's predialytic time. Basic renal diseases were pyelonephritis, renal damage from phenacetine abuse, or probably even a nephropathy due to potassium depletion. Uraemia was controlled by dialysis treatment and by a dialysate consisting of 7 and 6 mmol/l potassium respectively. The result of this intense therapy was physical rehabilitation and the patient finally could resume her professional work again.


[Comparison of clofibrate and bezafibrate in type IIa and type IIb hyperlipoproteinemia].

In a randomized block-trial the comparative efficacy and side-effects of clofibrate (2 X 1 g), placebo and bezafibrate (3 X 150 mg) were tested in groups of 24 patients each with hyperlipoproteinemia type IIa and IIb. Each period of treatment was 2 months. Both bezafibrate and clofibrate as compared to placebo were associated with a significant lowering of triglycerides and cholesterol: triglycerides by 30% in type IIa and a 41% reduction in type IIb, whereas clofibrate lowered triglycerides by 23% in type IIa and 28% in type IIb. Bezafibrate reduced total cholesterol by 18% in type IIa and 12% in type IIb as opposed to clofibrate reducing cholesterol by 16% in type IIa and 8% in type IIb. Bezafibrate compared to clofibrate was shown to be significantly more effective in lowering triglycerides in type IIa correlating to a significant reduction of VLDL- and LDL-triglycerides in this type. Both substances significantly lowered LDL-cholesterol in type IIa; in type IIb only bezafibrate was effective. HDL-cholesterol increased significantly with bezafibrate. The effect of clofibrate raising LDL-cholesterol in dependence on the initial concentration of the VLDL-triglycerides was seen less frequently after bezafibrate and only with higher initial VLDL-concentrations as compared to clofibrate. Patients tolerated both bezafibrate and clofibrate equally well. It should be considered that bezafibrate was not given in the optimal dose of 3 X 200 mg.


[Diabetic control with a portable insulin infusion pump for 7 weeks (author's transl)].

A portable insulin infusion pump was used to achieve diabetic control over a period of 7 weeks in a juvenile onset-type diabetic. Insulin was infused at a basal rate and further doses could be triggered externally by the patient. Insulin requirement had been previously determined by means of an artifical beta-cell (Glucose Controlled Insulin Infusion System). This method of insulin administration resulted in a clear improvement in diabetic control. Some problems did arise in connection with materials from which the instrument and catheter were constructed. However, it was shown that a portable insulin pump can be used with out-clinic patients for a number of weeks and is also justified for at least certain cases.


[Report on the clinical manifestations of toxoplasmosis (author's transl)].

The clinical symptoms of toxoplasmosis in man are very various and often uncharacteristical. Until now there are no statistical evaluations on the frequency of different clinical appearances of the disease. A comparison of the clinical symptoms and the results of serology was made on 14 618 patients with suspected toxoplasmosis, who were divided into groups in regard to their age and clinical symptoms. Suggestions for the diagnosis of toxoplasmosis are given by this evaluation.


[Bacteriemia due to acinetobacter calcoaceticus var. anitratus (author's transl)].

A serious bacteremia caused by Acinetobacter calcoaceticus var. anitratus could be observed. From the clinical point of view the most important symptoms were shivering, high tempeature up to 41 degrees C and clinical signs of acute hepatitis. There were pathological changes in the EEG. Certain signs of an outlayer damage of the heart could be seem in the ECG. The pathogenic microorganism isolated from the blood culture media was classified. Specific antibodies--agglutinines and precipitines--were demonstrated in the patient's serum. A contamination could be excluded so that the bacterium was the causative agent. The diagnostic value of finding antibodies in patient's serum having this type of bacterial infection is discussed.


[Determination of creatine kinase and CK-MB in heart failure (author's transl)].

Serum activity of creatine kinase and creatine kinase-MB have been investigated in 129 patients of various etiology in overt heart failure. Elevations in CK-MB were found in 19 patients, most frequently in patients with inflammatory heart disease. We found no correlation between CK-MB activity in serum and the severity of heart failure. CK-MB elevation in patients with chronic heart failure may be interpreted as a sign of progressive as well as regressive processes in the myocardium.


[A contribution to the psychopathology of patients with open heart surgery (author's transl)].

The results of a larger study of psychopathological disorders in relation to pre-operative and post-operative examined heart surgery patients, where the heart-lung machine was used, will be shown, to begin with, on 20 patients. Pre-operative examination showed quite clearly, among other things, that patients suppress obvious operation risks. General mental disorders were seen post-operative in 4 patients, and these were diagnosed as organic psychosis. A comparison between psychotic and other patients shows, among other things, that somatic predictors such as cerebral sclerosis and atrophy, or a cerebral trauma tend to promote post-operative psychosis. A releasing cause could be a cerebral hypoxia brought about by the extracorporeal blood circulation. In our opinion psychological factors can only be found in the contents of psychosis.


Cervical bacterial flora in infertile and pregnant women.

The cervical bacterial flora in early pregnancy, labour, and infertility was assessed qualitatively. The cervix harboured several types of bacteria in both pregnant and infertile women. In the latter group, however, fewer species were found. The incidence of a mixed aerobic and anaerobic flora differed significantly between patient categories as did the frequency with which only aerobic isolates were obtained. There was also a significant difference between patient groups with regard to the incidence of anaerobic isolates. Among the anaerobic bacteria, peptostreptococci and bacteroides species were the dominating ones whereas coagulase-negative staphylococci were the most prevalent aerobic bacteria. Lactobacilli constituted 29--44% of the anaerobic bacteria found in the pregnant cervix and 52% of those found in the infertile cervix. The distribution of different aerobes as well as anaerobes was similar in pregnant and infertile patients.


Evaluation of microdilution trays (sensititre) for antimicrobial susceptibility testing of Bacteroides fragilis.

Microdilution trays (Sensititre) for antimicrobial susceptibility testing of Bacteroides fragilis has been compared for accuracy with the standard agar dilution method. The microtrays were found to be reliable for all antimicrobials tested (benzylpenicillin, clindamycin, doxycycline, chloramphenicol, fusidic acid, cefoxitin, and cephalotin) but not for metronidazole.


[Serological confirmation of the two subspecies of Neisseria mucosa Véron et al. 1959 (author's transl)].

The two subspecies of N. mucosa (subsp. mucosa, subsp. heidelbergensis) can be separated not only on the basis of pigment production, type of growth and enzymatic activities, but also by their antigenic composition. This could be demonstrated by the immunodiffusion with absorbed antisera.


Vaccine against hepatitis B--18 months prevention in a high risk setting.

The development of a vaccine against hepatitis B prepared with purified and inactivated HBs Ag is described. This vaccine has been applied in patients and staff members of haemodialysis centres. Safety and efficiency of the vaccine are very satisfactory. The response of patients to immunisation was significantly lower compared to the response of the staff members. None of the volunteers who had a primary response to immunisation developed signs of clinical or biological hepatitis.


Growth of some attenuated influenza A viruses in hamsters.

The replication of three attenuated influenza viruses in SPF hamsters inoculated by aerosol was investigated. Strains A2-Eng, A2-Victoria, ts-1-[E] A2-Victoria recombinant, and the RIT 4050 strain all multiplied to high titers in hamster lungs and induced both primary and secondary serological responses. Recombinant strain, A/AA/6/60-A2-Vic (CR22) multiplied to lower titers in hamsters. Differences were observed between the infectivity of different strains for hamsters, the wild-type viruses A2-Eng and A2-Vic being the most infective.


The use of a measles latex reagent for the determination of measles antibodies and in a specific test for multiple sclerosis.

Measles virus antigens covalently linked to latex spheres were used for measuring measles-specific antibodies in a direct agglutination test either in microtitre plates or as a rapid slide-agglutination test. The titres were compared to that obtained by conventional assays. The measles-latex spheres were also used as the antigen for a radio-immuno assay. By incorporating a 14C-radioactive marker into the measles-latex spheres their interaction with lymphocytes from multiple sclerosis and control patients was determined. Lymphocytes from multiple sclerosis patients reacted with a higher percentage of beads at low bead/lymphocyte ratios compared with controls, whereas the reverse was found when the ratio of beads was increased.


Surveillance of hepatitis in laboratory staff: a seven year study.

Enquiry by questionnaire showed that the attack rate of hepatitis in clinical laboratory staff in Britain had fallen to 35 per 100,000 person-years in 1975--76 from 111 in 1970--72 and 143 in 1973--74. This suggests that increased awareness and application of safety precautions have been effective.


High risk groups for hepatitis B virus infection in a university hospital staff as determined by detection of HB antigens, antibodies, and Dane particles.

The prevalence of HBsAg and anti-HBs has been determined by solid-phase radioimmunoassay in 1815 university hospital employees and compared with the results obtained by investigating 131 metal workers and 86 laboratory technicians. Hospital personnel and here especially dialysis staff members and laboratory workers is at higher risk to acquire a hepatitis B virus infection than population compartments without contact to patients or blood. Electronmicroscopic studies revealed that a considerable number of the blood samples of HBsAg-positive staff members contained Dane-particles. These employees have to be considered infectious and possibly present a hazard to the patients they take care of.


Influenza surveillance in Israel, 1976--77.

An influenza surveillance program developed and conducted in three districts in Israel during winter 1976--77, was based mainly on morbidity data in the general population, corroborated by sero-epidemiologic surveys on selected groups. This information was supplemented by data on mortality organized according to specific age groups. During the period under study, similar results were observed in each of the three districts surveyed. Two successive waves of influenza were recorded: an early wave due to B/Hong Kong/5/72 followed by an A/Victoria/3/75 outbreak. Both waves were of moderate extent, with the highest frequency of clinical influenza occurring in the youngest group, age 0--14 years. The age-specific mortality rates were highest and rather similar in the extreme age groups 65+ and 0. The search of A/New Jersey/8/76 antibody revealed a considerable proportion of positives with a higher titer in the older age groups. A special serologic survey among Yemenite Jews over 50 years of age, who immigrated to Israel in 1949, showed that the 1918 influenza pandemic also reached that isolated country. The surveillance program provided an early warning system as well as a rather accurate measurement of influenza impact in Israel.


Abortive poliomyelitis or minor illness as a clue to genetic susceptibility.

The model of genetic susceptibility to poliomyelitis has been used to examine minor illness caused by poliovirus infection. It is suggested that persons who are genetically susceptible but who have not converted to phenotypic susceptibility are those who develop minor illness. The overall rates of the sum of paralytic and minor illness are close to the predicted 26%. For families with a case of illness, the prediction that 58%--71% of the children become ill has been examined. The rates of illness in children of different ages in the same families should be similar. Data from a number of epidemics is shown to be consistent with the predictions of the model.


Modulation of the lung local immune response by systemic immunization.

The present study describes the respiratory immune response of mice to locally administered antigen, and the modulation of this response by systemic immunization. Intranasal immunization of mice with the A/PR/8/34 strain of influenza virus evoked local antibody response of the IgA type. The titer of the IgA antibodies declined to a nondetectable level in 40--50 days. If at that time a second intranasal dose was administered, a secondary IgA response was evoked. On the other hand, administration by the intramuscular route resulted in a mixed population of IgA and IgG antibodies. The relevance of this finding to problems of immunization against respiratory viral infections is discussed.


A contribution of cellular immunity to protection against influenza in man.

The degree of lymphocyte transformations and leukocyte migration inhibition (LMI) in the presence of inactivated A/Scotland/74 (H3N2) influenza virus vaccine was measured in blood samples collected from 56 medical student volunteers. At the same time the volunteers were skin tested, using the same vaccine. Using the antigenically similar WRL 105 (H3N2), recombinant influenza virus, the level of haemagglutination-inhibiting (HI) antibodies in serum, and neutralizing antibodies in nasal washings collected from the volunteers, were also determined. Each volunteer was then inoculated with live, attenuated WRL 105 influenza virus vaccine and infections demonstrated by virus isolations and serology. Correlations between the ability to infect the volunteers and the various parameters of humoral and cellular immunity were then determined. The results showed a good correlation between the level of serum HI antibody and infection. Thus 16 of 20 volunteers with serum HI antibody titres of 1:10, but only 6 of 20 volunteers with antibody levels of 1:30, showed evidence of infection. No direct correlation was observed between any of the other parameters measured and infection by WRL 105 virus. However, when the LMI and serum HI antibody levels were considered together, a contribution of cellular immunity, as measured by the LMI test, could be found. Of 19 volunteers with low serum HI antibody and low LMI levels, 16 were infected, whereas of 13 volunteers with low HI antibody, but with high LMI levels, only 6 showed evidence of infection with WRL 105 influenza virus.


Generation of virus-specific cytolytic activity in human peripheral lymphocytes after vaccination with vaccinia virus and measles virus.

Human peripheral blood lymphocytes (PBL) harvested after vaccination with vaccinia or measles virus showed a specific activity against virus-infected target cells. This activity peaked on day 7 and was specific for the target cells infected with the virus used for the vaccination. The cytotoxic activity was not related to HLA markers. The cells involved in the cytolytic process were lymphocytes bearing Fc receptors. In addition, the cytotoxic activity was abrogated by more than 90% by rabbit Fab'2 anti-human IgG. It is therefore likely that two subpopulations of lymphocytes are involved: an antibody-secreting cell providing specific antiviral antibody and an effector cell bearing Fc receptor (K cells). Finally, these experiments suggest that antibody-dependent cell cytotoxicity may play a major role in the recovery from virus infection in man.


Trials of live influenza A recombinants in man during natural antigenic change in 1971-1976.

A long-term study is described of human trials with live recombinants derived from A/PR/8/34 (H0 N1) and successive virulent H3 N2 viruses. A/PR/8/34 was noninfectious for man and the H3 N2 strains all induced similar influenza-like illness. In each recombinant experiment, some of the progeny were adequately attenuated and potentially immunogenic. In addition, there appeared to be evidence of probable cross-protection against viruses with related but non-identical haemagglutinins. However, the degree of cross-protection depended upon the time interval between the appearance of the epidemic and vaccine viruses. Recombinants of A/PR/8/34 and a human Hsw1 strain of low virulence did not function satisfactorily, and it seemed that the suitability of A/PR/8/34 as a 'master' parent depended upon the presence of standard genetic properties in the wild parents. The replacement of A/PR/8/34 with the partially virulent virus, X-31 (H3 N2), produced a live vaccine which was infectious but poorly antigenic. A universal master strain for live influenza vaccine recombinants is probably not yet a practical possibility.


Central nervous system tumors of childhood treated with CCNU, vincristine, and radiation.

CCNU was used in the treatment of 18 patients with childhood tumors of the CNS. Severe bone-marrow toxicity was noted. The initial dose was 130 mg/m2 given every 6 weeks, but it was often necessary to reduce the dose and prolong the interval between doses. The toxicity appeared to be much the same whether previous radiotherapy had been given to the whole CNS or to the brain only. In assessable patients with pur medulloblastoma, three out of three showed marked responses to CCNU. In those with a mixture of medulloblastoma and other tumor components, two out of two showed responses to CCNU. In children with astrocytomata of various types, only two out of six showed responses to CCNU, and in these the degree of response was slight. The results suggest that CCNU is a useful treatment for medulloblastoma but its value in the treatment of childhood astrocytoma is uncertain. In 6 patients who received both radiotherapy and CCNU, the contribution of the CCNU was not assessable.


Sarcoma with myelophthisic anemia: report of two cases.

Two cases of sarcoma complicated by pathologically confirmed myelophthisic anemia are presented. Although marrow involvement may occur in childhood rhabdomyosarcoma, complete marrow replacement in adult patients with sarcoma has not been previously described.


Normal urinary excretion of catecholamine catabolites in children with retinoblastoma.

Urinary catecholamine catabolites, homovanillic acid, vanillylmandelic acid, total metanephrines, and total catecholamines were assayed in 12 patients with newly diagnosed retinoblastoma prior to surgery and treatment. These values were within normal limits for the ages of all 12 patients, including one with metastases to brain, liver, lymph nodes, and bone marrow. The predictive value and efficiency of these tests in the diagnosis of retinoblastoma are insufficient to warrant their continued use on a routine basis.


Alpha-hemolytic streptococci: clinical significance in the cancer patient.

Alpha-hemolytic Streptococci were associated with 29 episodes of sepsis (12 polymicrobial) in 27 patients with cancer during a nine year period. Only two patients had dental manipulation prior to the onset of sepsis, but each had received chemotherapy and 75% were granulocytopenic (PMN less than 500/mm3) at the time of the infection. None of the patients developed bacterial endocarditis. Unlike the normal host in whom a transient bacteria with alpha-hemolytic Streptococci may occur following dental extraction or periodontal procedures, the cancer patient is at risk for more clinically significant sepsis. This risk is probably related to the presence of chemotherapy-induced oral mucusitis and granulocytopenia, and our results suggests that isolation of alpha-hemolytic Streptococci in febrile cancer patients should not be dismissed as a contaminent.


Safe, rapid administration schedule for cis-platinum-mannitol.

Cis-diamminedichloroplatinum (II) cis-plastinum, 25--75 mg/m2, with 40 gm mannitol and fluid were given over 1--2 hours to 40 patients with no evidence of elevated serum creatinine levels. Cis-plantinum was administered every 28 days at a dose of 50 mg/m2 to 22 patients, and 75mg/m2 to 6 patients. Patients received from one to eight courses of therapy with no change in their serum creatinine level. A safe, simple method of cis-platinum administration has been achieved.


Comparative studies on human and bovine nasal cartilage proteoglycan complex components.

Human and bovine nasal proteoglycan complex components were prepared in parallel. Some molecular properties of human and bovine proteoglycan subunits (PGS) were compared. Two major human "link-like proteins" have been characterized and purified; their compositions and molecular weights were very similar to those observed for the previously described bovine "link proteins".


Color vision testing: an alternative 'source' of Illuminant C.

The objective of this project was to evaluate an alternative procedure for administering reflective-type color vision tests. In this procedure, the tests are illuminated by a low color-temperature, 100 W, incandescent lamp (i.e. an improper illuminant) and the patient then views the illuminated test elements through an inexpensive gelatin filter placed before his eye (e.g. a Wratten 78AA costing about $4). Since the relative transmittance of this filter is quite similar to that used in the Macbeth Easel Lamp, the tests should still be valid. In fact, this alternative procedure yields test performances for normal and deficient subjects on the 100-hue, panel D-15, and AO H-R-R tests that are virtually identical to those obtained using a standard Macbeth Easel Lamp.


Optimization of stimuli for trit-anomaloscopy.

Free-choice colour matches were made by 50 young normal trichromats on an anomaloscope. Six equations, of the kind 'blue' + 'green' = 'cyan' + 'yellow', were used in which the stimuli were defined by narrow-band well blocked interference filters. The stimuli were selected so that the instrument controls, which varied the quantities (blue/green), (cyan/yellow) and (cyan + yellow), were nearly independent controls for hue, saturation and brightness respectively. 'Yellow', 'green' and 'cyan' were fixed at 589, 499 and 480 nm, respectively, and the least interindividual variation in blue/green was found for 'blue' in the region 430-439 nm. This and a similar finding in the pilot study of Moreland and Young agree with expectations based on the density spectrum for macular pigment measured by Ruddock. Matches made by a few selected subjects, when the saturation control was locked at a position for the population mean, in the presence of large but typical saturation differences, were the same as when all three controls were used.


Colour discrimination under C and high-pressure Na illumination in normals and patients affected by various diseases.

Under illumination produced by a high-pressure sodium lamp, colour discrimination, compared to C illumination, is found to be impaired. In particular, young diabetic patients, without signs of retinal involvement, show the expected decrease in total score as age proceeds from 10 to 25 years under C illumination. This is no longer the case under Na illumination.


Colour discrimination in the frame of illuminating engineering. Effects of C and high-pressure Na sources at different illuminances.

Nowadays, people are encouraged to utilize colour information. In turn, the sources employed for both indoor and outdoor installations show a variegated gamut of spectral distributions. The colour rendering factor refers to the average observer, representative of the normal, young, adult, healthy population. In order to have an idea of the deviations from this ideal case, we have been undertaking a population study. The results up-to-date obtained by the use of the high pressure Na source are now briefly reported.


[Conservative therapy of CNS-tumors in children. I. Intrduction (author's transl)].

A successful conservative therapy of brain tumors presupposes an early diagnosis as well as radical tumor removal as far as possible. The previously unisatisfactory results of treatment are still often attributable to late diagnosis. With new diagnostic methods of low risk, e.g. computerized tomography, an earlier begin of therapy should be attainable. Improved results of treatment can be expected only by the cooperation of all regional centers in prospective therapy studies and continuous cooperation of all faculties involved.


[Irradiation therapy of central nervous system tumors in children (author's transl)].

Tumors of the central nervous system (CNS) in children mostly need irradiation therapy often in combination with surgery and intensive drug therapy. The tumor dose is age-dependent and maximally 6000 R. Metastasing tumors require irradiation of the whole skull and the spinal axis. The individual prognosis depends on the type of tumor involved. Altogether up to 50% of CNS-tumors can be eliminated.


[Interim results of the SIOP study (author's transl)].

Since 1975, the International Society of Paediatric Oncology has been carrying on a cooperative therapeutic trial, the aim of which is to find out whether adjuvant chemotherapy with vincristine and CCNU, added to standarized radiotherapy of the whole central nervous system, can improve life expectancy in medulloblastoma and high-grade ependymoma. Up to 1st July, 1977, 164 patients from 14 different countries had been entered into the trial. Up to now, results do not yet permit a statistically valid conclusion as to the superiority of one method of treatment over the other.


[Bronchodilators in babies with wheezy bronchitis (author's transl)].

In 16 babies aged one month to 11 months, lung mechanics were studied before and after subcutaneous injection of a bronchodilator; in addition, total serum IgE and various Virus-Complement-Binding Reactions (CBR) were determined. All the babies showed the clinical signs of bronchial obstruction, but the total lung resistance and the dynamic lung compliance were not significantly altered after the injection. No relationship existed between the height of the serum IgE-value and the results of the Virus-CBR. It could not be confirmed that babies with wheezy bronchitis and a raised IgE-value reacted any better to the bronchodilator than babies with bronchial obstruction and a normal IgE-value.


[Diffuse, telangiectatic arteriovenous anastomosis in the lung as the cause of cyanosis in an infant with persistent ductus arteriosus (author's transl)].

Compared to the discrete, solitary or multiple pulmonary arteriovenous fistulas, the type of diffuse telangiectatic arteriovenous anastomoses occurs less frequently. Pathogenetically an association with the morbus Rendu-Osler-Weber and with chronic liver diseases is discussed. Based on the literature, and an own case with an additional patent ductus arteriosus, the clinical features are described. Diagnostic results of pulmonary angiography are less helpful than the dynamic radionuclide perfusion scintigraphy which is of great value in following up the disease. There is no successful therapy.


[Cystomanometric investigations in children with enuresis and chronic urinary tract infection (author's transl)].

Ninety one patients with urinary tract infection, infection with enuresis or enuresis alone, but without any malformation of the lower urinary tract have been examined clinically as well as by cystomanometric und uroflow-metric studies. It could be shown that the most important parameters to evaluate blader function were the bladder compliance and the detrusor contraction during the filling of the bladder. The bladder compliance was estimated from the volume pressure relationship under resting conditions, at the first urgency to voide and at the moment when the maximal bladder capacity was reached, Concerning the detrusor contraction we distinguished partial isovolumetric detrusor contractions with an amplitude of 1--8 mm Hg and uninhibited detrusor contractions with an amplitude of more than 10 mm Hg. According to these two parameters it was possible to differentiate cystomanometrically seven different types of irritable and non irritable bladder, and to introduce a new theory of the pathogenesis of enuresis. According to this theory we suppose that enuresis in childhood is mostly caused by neurovegetative psychogenic disorders similar to anorectal sphincter achalasia in patients with overflow encopresis.


[Prevention of neonatal apnea with theophylline (author's transl)].

To the well known methods for prevention of neonatal apnea like stimulation, CPAP, and mechanical ventilation the treatment with theophylline has been added recently. We studied the efficiency of theophylline therapy in 10 premature infants with apnea. The initial dosage was 6 mg theophylline/kg body-weight, followed by a dosage of 2 mg/kg for the next 12 h. The frequency of apnea thereby was significantly reduced. Only in two cases the heart rate rose above 180/min as a side effect. In no case an additional therapy was necessary.


[Campomelic syndrome (author's transl)].

A female premature infant with dwarfism, peculiar facial features, cleft palate and bone anomalies including bowing of the lower extremities with pretibial skin dimpling, the so called "campomelic syndrome" is presented. Other symptoms were hypotonia and respiratory distress. The radiological and autopsy findings in this child are described. The lack of known teratogenic factors during the pregnancy and the available data about the familial occurance of this malformation syndrome suggest the possibility of an autosomal recessive mode of inheritance in this patient. This is the first case of campomelic syndrome reported from Iran.


An effect of cell-cycle position on ultraviolet-light-induced mutagenesis in Chinese hamster ovary cells.

Using synchronous populations obtained by selectively detaching mitotic cells from cultures grown in monolayer, we demonstrate here that Chinese hamster ovary (CHO) cells exhibit a differential sensitivity to mutation induction by UV as a function of position in the cell cycle. When mutation induction to 6-thioguanine (TG) resistance is monitored, several maxima and minima are displayed during cell-cycle traverse, with a major maximum occurring in early S phase. Although cells in S phase are more sensitive to UV-mediated cell lethality than those in G1 or G2/M phases, there is not a strict correlation with induced mutation frequency. Fluence-response curves obtained at several times during the cell cycle yield Dq values approximating 6 J/m2. The primary survival characteristic which varies with cell cycle position is D0, ranging from 2.5 J/m2 at 6 h after mitotic selection to 5.5 J/m2 at 11 h afterward. Based on studies with asynchronous, logarithmically growing populations, as well as those mitotically selected to be synchronous, the optimum phenotypic expression time for induced TG resistance is 7--9 days and is essentially independent of both UV fluence and position in the cell cycle. All isolated mutants have altered hypozanthine-guanine phosphoribosyl transferase (HGPRT) activity, and no difference in the residual level of activity was detected among isolated clones receiving UV radiation during G1, S, or late S/G2 phases of the cell cycle. Changes in cellular morphology during cell-cycle traverse do not contribute to the differential susceptibility to UV-induced mutagenesis.


Spontaneous chromosomal aberration levels in human peripheral lymphocytes.

Spontaneous levels of structural chromosomal aberrations in human peripheral lymphocytes were studied cytogenetically in 49 female and 56 male subjects. With a total of 16 267 metaphase spreads examined, 191 cells were found to contain chromosomal aberrations, giving a rate of 1.17%. The rates of individual aberration types were as follows: chromatid fragments, 0.39%; chromosome fragments, 0.71% dicentrics, 0.06%; symmetrical and asymmetrical chromatid exchanges, 0.01%; and rings, 0.006%. There were significant differences in aberration yields between females aged 20--29 yr. and 60--70 yr., whereas males aged 20--50 yr. showed no difference. The two sexes differed significantly in chromatid fragments, chromosome fragments and aberrants cells.


Do present levels of air pollution outdoors affect respiratory health?

A sensitive lung function test does not show difference due to air pollution between lifetime residents in a rural area and those in a small industrial town in Connecticut. Also, there is no evidence that higher air pollutant concentrations elsewhere have any marked effects on the lungs. Severe pollution is dangerous and must be avoided, but at present, air pollution control outdoors does not deserve priority as a means of preventing chronic lung diseases.


Molecular structure of a double helical DNA fragment intercalator complex between deoxy CpG and a terpyridine platinum compound.

The crystal structure of a complex containing deoxy CpG and a terpyridine platinum compound (TPH) shows a DNA double helical fragment with TPH intercalated between two Watson-Crick GC base pairs. The DNA unwinding angle is 23 degrees and the pucker of the deoxyribose rings differ at the 3' and 5' ends.


Mycoplasma capping on lymphocytes.

When mycoplasmas infect lymphocytes they behave as multivalent ligands and cap on the lymphoid cell surface in the absence of added specific antibody. There is an apparent high correlation between mycoplasma capping and blast transormation of the infected lymphocytes. Mycoplasma caps are shed from the surface of cells as an aggregate containing host membrane vesicles. This novel interaction may suggest a physiological role for the phenomenon of capping and may play a part in mycoplasma pathogenesis.


Degenerate perturbations of protein structure as the mechanism of anaesthetic action.

The interaction of the n-alkanols with lipid bilayers and excitable membranes shows that there is no simple correlation between conduction block and any of the perturbations of bilayer structure currently proposed as unitary mechanisms of local anaesthetic action. We propose instead that the n-alkanols act by direct interaction with target proteins to cause perturbations which depend directly on the precise structure of the alcohol.


The intestine as source of immunoreactive substance P in plasma of the cat.

1. Substance P (SP) was measured in acid acetone extracted plasma of cats using a sensitive radioimmunoassay. The immunoreactive material was submitted to ion exchange chromatography and at least 90% of immunoreactivity co-chromatographed with synthetic SP. 2. The level of immunoreactive SP (I-SP) in extracted plasma of the cat was 69.3 +/- 9.8 fmol/ml with values ranging from 2.5 to 165 fmol/ml. Evisceration of the cats caused a decrease of I-SP levels from 70.8 +/- 30.8 fmol/ml to 20.8 +/- 9.9 15 min and to 26.8 +/- 19.7 fmol/ml 60 min after the operation. 3. Ligation of intestinal blood vessels led to a fall in I-SP levels from 58.7 +/- 11.5 to 25.9 +/- 4.1 fmol/ml within 15 min. 4. No difference between I-SP values in portal (71.8 +/- 11.2 fmol/ml) and peripheral plasma (68.3 +/- 12.1 fmol/ml) was found under the conditions in which these experiments were performed. 5. It is concluded that a major part of circulating immunoreactive SP originates from the intestine.


Benzodiazepine receptor binding: the interactions of some non-benzodiazepine drugs with specific [3H] diazepam binding to rat brain synaptosomal membranes.

The interaction of several non-benzodiazepine drugs with [3H] diazepam binding to benzodiazepine receptors in rat brain synaptosomal membranes was investigated. Baclofen, benzoctamine, hydroxyzine, chlorpromazine, haloperidol, imipramine, and amitriptyline displace specific [3H] diazepam binding, but the concentrations needed are too high to explain pharmacological effects of these drugs by an interaction with benzodiazepine receptors. The most potent non-benzodiazepine drug for inhibiting specific [3H] diazepam binding was methaqualone (IC50 value of 150 micrometer). It is suggested that interactions with benzodiazepine receptors may account for the anxiolytic and anticonvulsive side effects of this drug. The analeptic drug pentylenetetrazole interacts with benzodiazepine receptor binding with an IC50 value of about 1 mM, which is possibly too high to explain its convulsive properties by an antagonism at the benzodiazepine receptor.


Differences in the metabolic fate of noradrenaline released by electrical stimulation or by tyramine.

Strips of canine saphenous vein were loaded with 3H-noradrenaline (1.4 micrometer) and perifused with Krebs solution and either subjected to field stimulation or exposed to tyramine 40 micrometer. 3H, noradrenaline and its metabolites were determined in the perifusion fluid. Stimulation caused an increase predominantly in noradrenaline, followed by DOPEG, whereas tyramine release DOPEG in larger amounts than noradrenaline. Tyramine had more sustained effects than stimulation. Cocaine (1.6 micrometer) drastically reduced DOPEG efflux due to stimulation, but had no effects on the pattern of release by tyramine. It is concluded that tyramine releases noradrenaline which is deaminated before it reaches the synaptic gap, whereas after stimulation deamination of the transmitter occurs after re-uptake.


Genotype dependent response of morphine and methionine-enkephalin on the electrically induced contractions of the mouse vas deferens.

Analgesia and locomotor activity are genetically differentiated in C 57 and DBA mice. In fact, DBA strain, unlike C 57, is very sensitive to the analgesic effects of morphine. On the contrary, morphine elicits an increase of locomotor activity only in C 57 mice. We have used this genetic approach to study the in vitro response of vas deferens contractions to morphine and methionine-enkephalin. The results obtained are the following: 1. The percentage of morphine inhibition of the electrically evoked contractions of the longitudinal muscle of the vas deferens is greater in DBA strain, which is sensitive to the analgesic effects of morphine, than in C 57 mice in which morphine exerts a stimulating effect of the locomotor activity; 2. Met-enkephalin has been found to be more active than morphine on the same preparation; 3. The inhibitory effects of Met-enkephalin appear to be greater in C 57 than in DBA mice; 4. Different doses of Naltrexone are required to reverse the effects of morphine and Met-enkephalin; 5. Cumulative doses of Met-enkephalin and morphine induce different responses in the vas deferens of C 57 and DBA mice. The results emphasize the usefulness to study analgesic activity in these strains of mice.


PGE-release, blood flow and transmucosal water movement after mechanical stimulation of the rat jejunal mucosa.

1. The influence of weak mechanical stimulation of the jejunal mucosa in vivo on PGE-release, on intestinal blood flow and transmucosal water movement was studied in rats. 2. Mechanical stimulation of the mucosa increased PGE-release into the venous outflow and into the gut lumen. This increase is followed by an increase in intestinal blood flow and transmucosal movement of tritiated water in both directions. 3. Pretreatment of the rat with indomethacin reduced the effect of mechanical stimulation on PGE-release. Indomethacin further reduced the increase in blood flow and in secretion of tritiated water. Absorption of tritiated water was not changed in these experiments. 4. Pretreatment of the rat with atropine (1 mg/kg, i.p.) or perfusion of the gut with methysergide (10 microgram/ml) did not influence the increase in intestinal blood flow after mechanical stimulation. 5. It is suggested that enhanced intestinal blood flow and transmucosal movement of tritiated water after mechanical stimulation are mainly provoked by a preceding release of PGE. 6. It is further supposed that such a mechanism may be physiologically involved in regulation of intestinal blood flow and transmucosal water movement during food intake.


[Dynamics of the spike activity of association cortex neurons in awake cats during elaboration and reinforcement of a defensive conditioned reflex].

Neuronal responses of association field 5 during elaboration of defensive conditioned reflex to sound were studied in chronic experiments on cats. Neuronal activity at the reflex elaboration was usually observed in the first 50 ms after sound stimulation, i.e. it was connected with the action of signal stimulus, but not with the display of the conditioned movement. The most essential changes in neuronal responses of the association cortex were seen at the initial stage of conditioning. In some neurons under conditioning the reaction was stabilized, in others a decrease in both the background impulse activity and intensity of the responses was observed, in some cases the response to either of the applied stimuli disappeared. The latter circumstance allows suggesting the transition from polysensory to monosensory specialized neuronal reaction during conditioned reflex elaboration.


[Mechanisms of interaction between the parietal association and projection areas of the cat neocortex].

The pecularities of evoked potentials changes in the first visual, first somatic and parietal cortical areas locally cooled under nembutal anesthesia, as well as in the association thalamic nuclei (pulvinar and posterolateral) were studied in cats. Two types of interaction between these cortical structures were distinguished. Type I interaction was observed between all the studied cortical areas; type II--took place only between the parietal and each of the projection areas. Type I is suggested to be formed by cortical connections, type II--by direct and indirect subcortical ones. The peculiarities of involving the association parietal area into type I and II interactions according to its activation by different modality signals are discussed.


[Neuronal activity in an epileptic focus formed as a result of the effect of tetanus toxin on the motor area of the cat cerebral cortex].

Activity of single neurons was recorded intracellularly in the cortical epileptic focus produced by tetanus toxin. The activity of all studied neurons correlated positively with ECoG during the interictal period. A group of neurons was found with continuous background activity. The membrane potential of these neurons gradually decreased and the frequency of discharges increased during the interictal intervals. The neurons with continuous background activity during the interictal intervals revealed paroxismal depolarization without the following hyperpolarization. In some neurons with random background spikes hyperpolarizing shifts after paroxismal depolarization were observed. The mechanisms of the organization of the neuronal "epileptic aggregates" as well as of inhibition of these functional structures are considered.


[Participation of interoceptive afferent signals in the polymodal reactions of superior colliculus neurons in cats].

Stimulation of the vagal nerve in unanesthetized immobilized cats evoked marked responses in 43% of neurons of the superior colliculus. In 60% of the responses the changes in the spike activity were of tonic character. After stimulation with single stimuli inhibitory effects prevailed; in half of cases distinct initial inhibition of discharges lasting for 180-1700 ms was observed. Phasic responses with an initial period of activity occurred only in 9-11% of neurons. On the contrary somatic stimuli provoked mainly phasic reactions of activation type. Most of the investigated neurons were bimodal and often the time pattern of the responses depended on the modality of stimulation.


[Change in the concentration of RNA in the cytoplasm of cells of the inferior colliculus in cats during monaural and binaural stimulation].

The method of cytospectrophotometry of the gallocyanin-chromatium stained sections was used to show that the 2-hour monaural and 1.5-hour binaural stimulation with rhythmical noise signals result in a pronounced increase in cytoplasmatic RNA content per cell in the principal and large multipolar neurons. The increase in cytoplasmatic RNA amount in the principal cells both from ipsi- and contralateral central nuclei of the inferior colliculus with monaural and binaural stimulations allows to suggest a uniform distribution of the binaurally converging connection from the lower auditory nuclei to the principal cells. The increase in cytoplasmatic RNA in the large multipolar cells of the contralateral central nucleus following monaural stimulation shows predominant contralateral projections to these cells. A conclusion is made on patterns of binaurally converging connections on the principal and large multipolar cells of the central nucleus of the inferior colliculus.


[Correlation between conduction velocities in fibers of the optic nerve and optic radiation in cats].

The responses of dorsal lateral geniculate body units to striate cortex and optic chiasm stimulation were examined in cats immobilized with d-tubocurarine. A high correlation between antidromic responses to striate cortex and orthodromic responses to optic chiasm stimulation was found (r=0.895; P=0.01). 9% of neurons responded antidromically to optic chiasm stimulation indicating the existence of centrifugal fibres in the optic nerve. The functional significance of time dispersion of the afferent volley in visual system is discussed.


[Comparative characteristics of neuronal response in the vagus and facial nerve lobes of carp medulla oblongata to chemoreceptor stimulation].

The unit activity in the vagal lobe of medulla oblongata in response to stimulation of the mouth cavity and gills chemoreceptors with solutions of hydrochloric acid and sodium chloride was studied in immobilized carps and compared with those in the facial lobe in response to skin chemoreceptors stimulation. The firing rate in the vagal lobe is lower and the latent period is longer than in the facial lobe. The level of the chemical stimuli gradations analysis is different in two parts of the chemoreception primary centre. In the vagal lobe units responding to the impulses from both receptive fields as well as those responding selectively to stimulation either of the mouth cavity or the gills were found. Activity of a firing pattern was predominant in the vagal lobe units in response to stimulation with sodium chloride solutions.


[Ionic mechanisms of the excitatory action of transmitter, exogenous acetylcholine and serotonin on neurons of the superior cervical ganglion in rabbits].

Ionic mechanisms of EPSP and depolarization evoked by iontophoretically applied acetylcholine (Ach) and serotonin (5-hydroxytryptamine, 5-HT) in the neurons of the rabbit isolated superior cervical ganglion (ACh-potential and 5-HT-potential, respectively) were studied using intracellular electrodes. Reversal potentials of EPSP (EEPSP) and Ach-potential (EACh) were -14.4 +/- 1.6 mV and -16.5 +/- 1.2 mV, for 5-HT-potential they were close to these values. More negative values of EEPSP and EACh were obtained in a group of neurons (about 1/3) using the extrapolation method, probably due to an increase in their membrane resistance during hyperpolarization. A decrease in external sodium or potassium concentration made EEPSP and EACh more negative, and an increase in external potassium concentration made them more positive than in normal solution. Changes in external chloride concentration do not influence EEPSP and EACh. It is concluded that excitatory transmitter and exogenous ACh (as well as probably 5-HT) increase membrane permeabilities to sodium and potassium ions.


The small frontolateral approach for the microsurgical treatment of intracranial aneurysms.

The authors describe a new approach (the Small Frontolateral Approach) for the elective microsurgical treatment of aneurysms of the rostral part of the circle of Willis, including those arising from the carotid siphon. This approach provides the advantage of permitting an easy, direct and "protective" attack to such aneurysms through a small and merely osteoplastic craniotomy.