5-hydroxydopamine, unspecific centrally acting false neurotransmitter. Acta Physiol. Pol., 1977, 28 (1): 13-22. 3,4,5-trihydroxyphenetylamine-5-hydroxydopamine (5-OHDA) injected intracerebro-ventricularly decreases the level of noradrenaline, 5-hydroxytryptamine and 5-hydroxyindoleacetic acid in different parts of the rat brain. It does not affect acetylcholine level. 5-OHDA causes dose-dependent hypothermia, transient hypertension and depression of locomotor and exploratory activity in rats. This behavioral phenomena are reversed by central chemical sympathectomy elicited by 6-hydroxydopamine. It is concluded that 5-OHDA is an unspecific centrally acting false transmitter.


Variability of the averaged evoked potentials in healthy subjects after 24-hour sleep deprivation.

Variability of the averaged evoked visual potentials in healthy subjects after 24-hour sleep deprivation. Acta Physiol. Pol., 1977, 28 (1): 61-69. The authors evaluated the effects of 24-hour sleep deprivation on visual evoked potentials in 20 pilots aged 20 to 40 years, clinically healthy and with normal bioelectric cerebral activity. A slight reduction in the latency time of components was observed, mainly in the non-specific part of the visual evoked potentials, and a rise in the P3-N4 amplitude. An analysis of the duration of potential components suggests that sleep deprivation causes disturbances in the equilibrium between the processes of excitation and inhibition from non-specific structures (with increased excitation). All parameters assessed may evidence increased excitation of the central nervous system after activation with insomnia + light flashes, and may be useful for extending the diagnostic possibilities in cases of borderline pathological changes in cerebral bioelectric activity.


Content of vasopressin in the neurohypophysis of long-term dehydrated rats as influenced by carbachol treatment. Acta Physiol. Pol., 1977, 28 (1): 71-75. Rats dehydrated up to 12 days were treated with carbachol given intraperitoneally in daily doses of 20 microng/100 g of the initial body weight. Under extreme dehydration (8 and 12 days) the vasopressin depletion in the neurohypophysis was significantly inhibited in the carbachol-treated animals.


Hormonal regulation of thermogenesis in goslings. The effects of blockade with thiouracil and propranolol. Acta Physiol. Pol. 1977, 28 (1): 51-60. The experiments were carried out on 90 male goslings of White Italian breed. In goslings 5 to 7 and 18 to 21-day-old thiouracil (6 mg/100 g i.p., for 3 consecutive days) diminished the cold-induced increase in the metabolic rate. At the end of 1.5 h exposure to 5 degrees C a small but statistically significant drop of body temperature in the thiouracil-treated goslings was noted. Propranolol treatment (2 mg/kg s.c.) had no clear effect neither on body temperature of cold exposed goslings nor on the cold-induced increase in the metabolic rate. The drug caused a significant decrease in the plasma free fatty acid (FFA) levels only in the goslings kept at thermoneutrality. In those exposed to 5 degrees C the plasma FFA levels rose both in the control and propranolol-treated goslings. This suggests that the cold-induced lipolysis in the goslings may be accomplished without mediation of noradrenaline.


The effects of etorphine, fentanyl and morphine on noradrenaline and dopamine concentrations in the striatum of rat. Acta Physiol. Pol. 1977, 28 (2): 107--112. Dopamine (DA) concentrations were determined after administration of etorphine (M 99--0.008 mg/kg), fentanyl (0.006 mg/kg) and very high doses of morphine (20.0 mg/kg). DA was chosen as a striatal neurotransmitter playing the main role in the extrapyramidal system. The concentrations of noradrenaline (NA) were determined for comparison. Etorphine in therapeutic doses and morphine in subtoxic doses increased the concentration of DA in striatal neurons. Since, under these conditions, the behavior of animals resembles the symptom complex characteristic of the so-called parkinsonian or postneuroleptic syndrome in which a deficiency of absence of DA has been found in striatum, it might be supposed that the cataleptic action of etorphine and morphine may be due to inhibition of presynaptic striatal structures, with consequent disturbances in DA release from its stores.


Isolation of a peptide inhibiting glucose absorption by red blood cells from plasma of healthy subjects performing physical exercise. Acta Physiol. Pol. 1977, 28 (2): 117--125. A peptide inhibiting glucose absorption by erythrocytes was isolated from the plasma of healthy males age 23-24 years subjected to physical exercise of increasing intensity from 1 to 3 W/kg of body weight during 18 min. This peptide was not found in the blood plasma obtained from these subjects before exercise as well as in the initial stage of exercise. It appeared in the plasma at the end of the exercise period when symptoms of fatigue were already evident. In view of this it is suggested to call it "fatigue peptide".


The intestinal calcium and phosphate transport under conditions of experimental hypercalcemia. Acta Physiol. Pol., 1977, 28 (2): 127--134. Intestinal calcium and phosphate transport was examined in various segments of small intestine under two differently processed hypercalcemic conditions. The analysis of the serum calcium and phosphate level changes, showed the increasing serum calcium values without any concomitant change in the serum phosphate concentration during the course of the experiment. The observed discrepancy of the intestinal phosphate transport when compared the in vitro and in vivo studies, suggests the presence of phosphate transport regulatory mechanism acting on the intestinal level.


Entropic properties of the neural signal space, the neurodynamic basis of Weber's and Steven's law. Acta Physiol. Pol., 1977, 28 (2): 113--116. Taking into account the number of neural units, number of their efferent synapses and the average impulse frequency as well as the notion of neural momentum the dependence of neural entropy on neural tonus was examined. Based on the above model the neurodynamic basis of the Weber's and Steven's law was considered.


Radiological method for investigation of the motor activity of the reticulum in sheep. Acta Physiol. Pol., 1977, 28 (1): 85-91. Using a TUR-D 1001 X-ray apparatus, Chirana electronic image intensifier equipped with an Admira 16 film camera the authors studied the motor activity of the reticulum in sheep. The investigations were carried out on 5 young sheep. Barium suspension was used as contrast medium. The successive phases of reticulum contractions were visualized on X-ray films obtained with a seriograph. The authors determined the time of complete reticulum contraction in films obtained at a rate of 16 frames per second. It was found that the mean time of reticulum contractions in sheep is 6 seconds. The high accuracy and usefulness of radiocinematography for studying reticulum contractions in sheep is stressed.


Plasma oxytocic activity after ovariectomy and stilboestrol or progesterone implantation in female rats.

Plasma oxytocic activity after ovariectomy and stillboestrol or progesterone implantation in female rats. Acta Physiol. Pol. 1977, 28 (2): 135--142. The purpose of this work was to compare the oxytocic activity of plasma in the intact rats, after ovariectomy, and in ovariectomized rats after subcutaneous implantation of stilboestrol or progesterone tablets. On the 22nd day after ovariectomy and implantation of hormones 2 ml of blood were obtained under urethane anaesthesia from the cephalad portion of the right external jugular vein. Plasma oxytocic activity was determined by the method of Van Dongen and Hays in Fragments of the rat mammary tissue at the time of lactation. The plasma oxytocic activity of ovariectomized female rats did not differ significantly from that found in the rats with implanted hormones. Cytological analysis of vaginal smears demonstrated stimulation of vaginal epithelium by exogenous hormones which lasted up to 10 days after implantation. Ovariectomy caused a threefold rise in the plasma oxytocic activity as compared with the control values.


Pharmacodynamics and pharmacokinetics of psycholeptic drugs in the course of radiation disease. The effect of premedication with cystamine on pharmacodynamics and Pharmacokinetics of nitrazepam.

Pharmacodynamics and pharmacokinetics of psycholeptic drugs in the course of radiation disease (I). Effect of premedication with cystamine on pharmacodynamics and pharmacokinetics of nitrazepam. Acta Physiol. Pol. 1977, 28 (2): 161--168. In the experiments carried out on rats the radiation disease was evoked by exposure to 600 R. The strongest radioprotective action of cystamine was found on the 3-rd day of radiation disease. The tendency to normalization of both the pharmacodynamics (exploring mobility and anticonvulsant action) and pharmacokinetics of nitrazepam in the animals premedicated with cystamine was described.


Effect of deterlon (DBS) on the electrocardiogram of eel Anguilla anguilla (L).

Effect of Deterlon (DBS) on the electrocardiogram of eel Anguilla anguilla (L). Acta Physiol. Pol. 1977, 28 (2): 179--186. The investigations of the effect of a detergent Deterlon-DBS present in industrial and community sewage on ECG changes in the eel Anguilla anguilla (L) showed that it causes disturbances in the impulse-generating centres and in the mechanism of impulse conduction in the heart. It was found that the threshold concentration of Deterlon-DBS in aqueous medium is 3 mg SA/1 for the eel, the lethal concentration lying in the range of 60--100 mg SA/1.


Effect of fibrinogen degradation products on the rat blood vessels. Acta Physiol. Pol. 1977, 28 (2): 153--159. It was found that fibrinogen degradation products (FDP) exert a slight hypotensive effect and increase the flow of Tyrode's solution through isolated hindpaw of rat. The investigated peptides failed to change significantly the action of noradrenaline and had an additive effect with isoprenaline. Propranolol reduced the effects of FDP and isoprenaline. It is suggested that the described effects may be due to stimulation of the vascular beta-adrenergic receptors by FDP.


Changes in pharmacodynamics and pharmacokinetics of psycholeptic drugs in the course of radiation disease. Effects of premedication with cystamine on dynamics and kinetics of thioridazine.

Changes in pharmacodynamics and pharmacokinetics of psycholeptic drugs in the course of radiation disease. Effect of premedication with cystamine on dynamics and kinetics of thioridazine. Acta Physiol. Pol. 1977, 28 (2): 169--179. The effect of premedication with cystamine (100 mg/kg) applied before irradiation (600 R) on exploring mobility and cataleptic action of thioridazine was investigated in rats. The levels of thioridazine in blood serum, brain tissue and in bile were determined. It was found that cystamine prevents the changes in dynamics of thioridazine action in radiation disease through abolition of disturbances in kinetics of this drug. Half-life period of thioridazine was found to be reduced and its level in the brain tissue was diminished in the irradiated, cystamine-pretreated animals in comparison with the irradiated, untreated ones.


[Psychodramatic experiences with psychotic patients].

This paper describes an experience carried out at Braulio Moyano Psychiatric Hospital between 1972 and 1976. Two psychodramatic groups were formed. One, according with Moreno's theories; the other, following the doctrines of the "Grupo Experimental Psicodramático Latino-americano". The experience proved to be fruitful. Psychodrama allows, by means of the use of "intermediate objects" the patient to discriminate several entities: reality from dramatization, dramatic spaces from real spaces, inner world from outer world. As soon as the patient is in position to discriminate the images and fantasies that pervade his inner world leading it to chaos, he becomes able to interrelate with other people and to include himself into the real world. Several examples are given of particular cases and the effects of psychodramatic techniques on them, within the limitations of a psychiatric institution. The results show the possibility to lessen psychotic segregation and to improve the possibilities to establish relationships with the outer world.


[The outcome of conflict in psychotherapy].

The authors examine several problems arising from the need to assess the psychotherapeutic processes and their effects, and the difficulties for finding valuable criteria to carry out the assessments. They propose a method centered on evaluation the changes that undergoes the central conflict: [Edipus complex, by means of several psychological tests to be taken at regular intervals during the course of psychotherapy. The tests are: a) House-Tree-Person; b) Wechsler; c) Bender; d) Rohrshach; e) Phillipson. The central thesis is that focal oedipical conflicts envolve necessarily together with defensive systems, objectal inner world, identifications, global structures of the ego, etecetera. That means the focal conflict can be used as an indicator to assess the state, evolution and functionning for the whole psychic apparatus. In support of those theses, several clinical cases are presented, together with some fragments of Phillipson test for each of them. The general conclusions stress the validity of the proposed method.


Birthweights of male and female schizoprenics' offspring.

The live birthweights and the birthweight Z score equivalents based upon state averages of 130 offspring of male and female schizophrenics were compared with state averages and with those of 150 offspring of nonschizophrenic psychiatric patient controls. Offspring of schizophrenics resembled the controls and the state averages with few exceptions. Schizophrenic fathers produced heavier birthweight children and the expected proportion of lower birthweight children. Offspring of schizophrenics born a year or more before onset of the parental disorder were significantly heavier than control offspring, although groups did not differ when birth was near or after breakdown.


Group models, group dynamics, sociological and psychological aspects of group formation and evaluation.

Several group models are defined: a mechanistic model, a model of conflicts, a cybernetic model, a field-theoretical model, an organismic model, an interactionistic model. In all these models the group is a dynamic entity which is based on a mutual dependence of the members. From this sociological-horizontal-interactional point of view the group is therefore an entity. From a psychological-vertical aspect the group is rather a common situation in which the individual members remain in their experience separated from each other. To understand the group therapeutic dynamics it is necessary to keep in mind these two levels. From the sociological aspect, e.g. the frequency and kinds of interactions, the relationship of the inside-distances between the members to the distances of the members to the outside is decisive for group cohesion. The more the total interaction in a group augments, the more the emotionally loaded interactions increase. The significance of group cohesion in the therapeutic process is documented also by means of standardized rating scales. The normative effect of the group, the different roles in it, the group structure have to be considered if the group is to be used as a therapeutic mean. From the psychological point of view five phases of group development can be differentiated: 1) explorative contact, 2) regression, 3) catharsis, 4) insight, 5) social learning. By a factor analysis Lieberman et al. have found out that independent of the method used, the following types of group leaders were successful: the "provider", the "social engineer", the "energizer".


The different kinds of group psychotherapy with patients with different diagnoses.

Group psychotherapy is a treatment method in which in addition to the therapist(s) the participating individuals are, autocentrically, active in attaining a therapeutic effect. The different kinds of group psychotherapy are described: 1) activity group psychotherapy, 2) analytic group psychotherapy, 3) directive-suggestive-group psychotherapy, 4) psychodrama, 5) accelerating/focal methods of group psychotherapy. Group psychotherapeutic techniques with patients of different diagnoses are discussed, e.g. group psychotherapy with drug dependants and alcoholics, in which it is not possible to use a pure analytic method of group psychotherapy. Their oral tendencies and narcissistic desires of undergoing a fusion with the therapist have to a certain degree to be fulfilled. Schizophrenics should encounter is group psychotherapy an unconditioned emotional response  from the therapist. These patients on the one hand expect to be understood in their psychotic experience, but on the other hand they seem to be glad when the measures of the outside reality are maintained in the group. The relatives of schizoprenics wanting to co-operate are taken in a parallel group. Depressives, especially endogenous depressives, need a longer time to be integrated in a therapeutic group than other patients, but if they can be integrated, it helps them to tolerate their sufferings. To the neurotics, group psychotherapy offers insight and a chance to "translate" this insight into a new social behaviour. Analytic self-experience groups with staff members give them an opportunity to recognise from their own experience the conflicts and the behaviour patterns from which their patients suffer.


Traffic accidents involving psychiatric patients. Description of the material and general results.

The present investigation analyzes the characteristics of traffic accidents involving psychiatric patients and comprises all persons who during the period 1970-74 have been admitted to a psychiatric in-patient institution and who during the period 1972-74 have been involved in a traffic accident causing bodily injury. Accidents with psychiatric patients involved constitute about 5.7% of all traffic accidents reported in Denmark. Compared with the total group of accidents, they are characterized by an over-representation of women and of persons in the age group 25-54 years. Accidents with psychiatric patients are over-represented during the period July-September, and in areas densely built up. The accidents tend to be more complicated, and the psychiatric patients are more likely to get injured and be hopitalized due to the accident. The investigation is based exclusively on routinely collected data. The limitations with which the results are encumbered and the problems concerning methodology and comparison of different studies are discussed.


Demographic aspects of functional psychoses in Canada.

Canadian national data for functional psychoses (classified as schizophrenia, effective psychoses, paranoid states and reactive psychoses) are analyzed for age, sex, marital status, expectancy for first admissions and length of stay for discharges. Differences are found such that each psychosis can be distinguished from the others, thus providing indirect evidence supporting the use of the different diagnoses. The demographic characteristics of reactive psychoses from North American data have not been previously described, and are found to be similar to Scandinavian descriptions. Sex ratios for subgroup diagnoses whow similarities between catatonic schizophrenics, manic (bipolar) affectives, and reactive psychoses. Schizoaffective psychoses resemble affectives more than schizophrenia, and paraphrenia is similar to affectives. Total expectancies for functional psychosis (4.4% for males, 5.5% for females) are similar to Scandinavian figures, but the distribution by diagnosis differs, perhaps representing different diagnostic practices, but generally similar sex ratios and high rates in single persons are found.


Three-year follow-up of 100 vagrant adolescent drug abusers in Oslo.

One hundred homeless adolescents were interviewed in 1971 when they still were active drug abusers. The same group was followed-up 3 years later in 1974 with personal interviews. All were traced, with the exception of three individuals residing in foreign countries and four who had died. At follow-up one third were abstinent and were well adapted socially, one third showed an uncertain social adaptation, and one third were still addicted and had a poor social adaptation. The various factors responsible for their psycho-social development and relation to drug abuse are discussed.


Cerebral dysfunction in alcoholism and presenile dementia. A comparison of two groups of patients with similar reduction of the cerebral blood flow.

Fifteen chronic alcoholics and 15 presenile patients were matched in pairs with regard to their mean hemisphere cerebral blood parameters-an index of brain metabolism. The distribution of the regional cerebral blood flow was similar in the two groups. The alcoholics performed significantly better in all psychometric tests than the presenile patients and more alcoholics than presenile patients were still employed and working. Nine presenile patients and one alcoholic showed symptoms indicating brain stem dysfunction. The measurements of the cerebral blood blow were made at rest while the psychometric testings and the evaluation of the social performance gave information about the brain at work. It is suggested that cerebral dysfunction in alcoholics to some extent can be partly overcome by brain activation procedures. In contrast, the defects of higher mental functions in presenile dementia cannot be compensated for.


Influence of temperature on the activity of ciliated cells during exposure to ionizing radiation.

The influence of temperature on the early effects ionizing irradiation has been analysed using the trachea of the rabbit. ATP is assumed to be released by the effect of irradiation on the mitochondrial membranes, which increases the mucociliary activity in the epithelium, registered second-by-second during irradiation performed at 20 degrees C, 30 degrees C, 37 degrees C and 40 degrees C. The early effects of irradiation depended on the temperature, while hyperthermia does not potentiate this condition. A possible explanation is that phosphofructokinase, which is probably stimulated by irradiation, is inactivated at lower temperatures.


Squamous cell carcinoma of the uterine cervix.

The healing among patients with squamous cell carcinoma of the uterine cervix in stages I B and II has been calculated in 189 patients from the 1950's and in 271 patients from 1969 to 1973. The observation period was 2 years. The first material was treated using the Stockholm technique. Extraperitoneal lymphadenesctomy was also performed in 59 per cent. The second material was treated with whole-pelvis irradiation using external high-voltage technique without central shielding, compelemented with intracavitary treatment using modified Stockholm applicators. The frequency of central recurrences, metastases on the pelvic wall after completion of treatment and deaths from carcinoma for stages I B and II were in material I approximately 6 and 20 per cent, approximately 8 and 14 per cent, and approximately 12 and 22 per cent, respectively; and in material II 9 and 20 per cent, 3 and 11 per cent, and 9 and 22 per cent, respectively.


Complications after radiation therapy for cervical carcinoma.

A series of 1 139 patients with invasive carcinoma of the cervix uteri who received a complete course of treatment by means of external irradiation followed by intracavitary curietherapy was evaluated in order to assess the results of treatment and, in particular, the radiation complications induced. Complications developed in 145 instances (12.7%). Severe complications occurred in only 3 per cent. Twenty-four cases had more than one complication. Rectosigmoidal injuries accounted for 72 per cent of all complications, and appeared earlier than did bladder complications and within the first two years after treatment. No apparent correlation between age and the occurrence of complications was found. The rate was higher in early stages. The radiation complications did not adversely affect the survival results.


Malignant tumours of the oropharynx.

An analysis of a series of 127 patients with malignant tumours of the oropharynx is presented. All cases of epidermoid carcinoma were retrospectively classified according to the TNM system. Primary treatment consisted in irradiation in all cases of malignant lymphoma and epidermoid carcinoma. The corrected 5-year survival rate for patients with malignant lymphoma was 53 per cent, and for those with epidermoid carcinoma 40 per cent. In epidermoid carcinoma, 60Co treatment seemed to result in a better prognosis than 250 kV radiation therapy. Both in malignant lymphoma and epidermoid carcinoma, the prognosis was definitely related to the spread to regional lymph nodes.


Radiation therapy in Burkitt's lymphoma of the central nervous system.

Involvement of the central nervous system in patients with with Burkitt's lymphoma was treated by superfractionated irradiation. The primary effect in 20 patients is reported. In 3 of 5 patients with paraplegia, complete regression was achieved. Only one patient of 6 with cranial neuropathy and irradiated to the brain improved. In 8 patients with either cranial neuropathy or other neurologic symptoms of signs, the brain and spinal cord were irradiated. Three of these patients, with recurrences after previous intrathecal chemotherapy, responded with complete regression.


75Se-Selenite scrintigraphy in the clinical staging of malignant lymphomas.

The value of 75Se-selenite scintigraphy in clinical staging was investigated in 45 patients with Hodgkin's disease and in 28 patients with non-Hodgkin's lymphoma. Of these, 9 patients had recurrence of previously treated lymphomas. The scintigraphic results were compared with clinical, cytologic, histologic and radiographic findings in different anatomic regions. 75Se-selenite scintigraphy resulted in 6 to 20 per cent false negative findings, 15 to 43 per cent false positive and 12 to 20 per cent equivocal evaluations, the accuracy being least in the abdominal region. The relatively high rediation dose delivered by 75Se-selenite, furthermore, makes it less attractive for use in the primary diagnosis of malignant lymphomas.


In vivo absorption of carbohydrates in rats with gastro-intestinal radiation syndrome.

Absorption of glucose and sucrose by intestine from supralethally irradiated rats was investigated using an in vivo preparation. An activation of glucose absorption one day day after exposure is followed by a marked fall in glucose and sucrose absorption on day 3. Experiments under different conditions of loading indicate that at 20 hours active transport of glucose is already impaired although the maximum velocity is increased. After 3 days maximum velocity and active transport decrease markedly. Inverstase activity increases after 20 hours, but this is not accompanied by an increased sucrose absorption. The defect in sucrose absorption 72 hours after irradiation is paralleled by a decrease in invertase activity.


Retinoblastoma treated with a 60CO applicator.

The 60Co applicator for treatment of retinoblastoma, described in 1963, has the advantage of exact local positioning. It is suitable in cases with solitary small tumours. The complications and the results of treatment in 20 patients followed up for at least 2 years are reported and discussed.


Endocrine influences on the activity ratio of 90Y to 90Sr in the rat skeleton after incorporation of 90Sr.

The quantitative distribution of 90Y to 90Sr was affected after surgical removal of the parathyroids, adrenals, and male and female gonads. The activity ratio of 90Y to 90Sr (Q) and the concentration in bone of 90Sr, expressed in per cent of injected dose per 100 mg of bone ash, were determined. Parathyroidectomy and adrenalectomy reduced while ovariectomy raised the value of Q. Adrenalectomy and ovariectomy increased the concentration of 90Sr in bone. Some aspects of the metabolism of the two nuclides are discussed.


Survival rates for pre- and postmenopausal Danish women with mammary carcinoma.

Survival rates for mammary carcinoma, based on the data of the Danish Cancer Registry for women admitted 1960 to 1966, show about the same values for women aged under 55 in stage I, whether surgical treatment has been combined with radiation therapy or not. For women aged over 55, combined treatment is followed by better survival rates than surgery or radiation therapy alone. For stage II, this applies both to younger and older women.


Phantom measurements of absorbed doses in dental radiography.

Some phantom measurements of absorbed doses from Norwegian dental radiography are presented. The mean bone-marrow dose from a single molar bite-wing projection was assessed to 1 mrad, a conventional full mouth examination (10 exposures) 7 mrad and an orthopantomographic exposure 2 mrad. The population dose from Norwegian dental radiography was estimated to be: mean bone-marrow dose 1 mrad and genetically significant dose 0.012 mrad.


Bone mineral content of the forearm in a healthy population.

The bone mineral content in the distal radius, in the midshaft radius and ulna was measured in 83 healthy males and 89 females from 11 to 87 years old using the 241Am gamma ray attenuation method. The age distributions of different 'density' quantities characterizing bone mineral are presented and the usefulness of these quantities is discussed.


Cervicofacial actinomycosis in man.

Two cases of advanced jaw destruction due to Actinomyces is reported; one with diabetic diathesis and a history of tooth extraction the other had a trauma of the mandible with the fracture; good results were obtained with penicillin therapy.


Two cases of polycystic kidneys in two siblings.

Polycystic disease of the kidneys is a generalized lesion of characteristic clinico-pathological entity. It has two clincial forms: adult and infantile. The adult type is transmitted as a dominant disease where the latter is recessive trait. The infantile form had two pathological patterns. Form "A" in which the kidney is large and spongy, of normal shape and the cysts are numerous. Microscopically the connective tissue is not increased. The cysts are of equal size and shape. The nephrons are not reduced. In the form "B" the kidney may not have a normal shape and is not as large as the form "A". Microscopically the connective tissue is increased intensively. The cysts are of spherical shape and different sizes. The nephrons are reduced in number. We are reporting two cases of infantile polycystic kidneys in two siblings, one of whom represented form "A" and the other was similar to form "B". These two cases are interesting from the genetical point of view. We want to know whether the two forms are different manifestations of one disease with one genetic factor or they are two different diseases with two genetic factors? One can assume that the infantile polycystic kidney is a genetical disease with two different pathological manifestations or two different genetic disorders due to two different genetic factors.


Cyclic hormonal changes in patients with congenital abscence of the uterus.

Our studies have shown normal cyclical patterns of ovarian steroids and pituitary gonadotropines in patients with congenital absence of the uterus. It appears that the life-long abscence of a functioning uterus has no effect on the functional life span of the corpus luterum, but may have some effect in the level of estrogenes in the second half of the cycle.


Birth order and family size in schizophrenia.

In attempt to investigate the relationship of birth rank and family size with the incidence of schizophrenic in an Iranian culture, case notes of 644 schizophernic patient as (432 males and 212 females) admitted to Roozbeh Hospital, University of Tehran were studied. The incidence of schizophrenic appeared to be significantly more frequent among the first-half position of birth orders in the families of 4 children and over; this being more marked in males than in females; and the first and second births comprising the lightest incidence of the illness.


Determination of serum lithium by flame emission spectroscopy.

Lithium can be determined both by atomic absorption spectroscopy and flame emission spectroscopy. We have used the later method with a Zeiss Model PMQII spectrophotometer fitted with ante-chamber atomizer and a potensiometric line recorder. Accurate analysis for the element was accomplished due to a sophistacated measuring instrument.


Locus of control and law knowledge: a comparison of normal, retarded and learning disabled adolescents.

Individualization of instruction of mentally handicapped adolescents may be facilitated by understanding of relevant variables associated with the learning skills required for coping with community life. This study explores the relationship between knowledge of such skills and locus of control (belief concerning the relative contribution of chance or others to outcomes and events which follow one's behavior). Comparisons of scores of 94 high school students on the Bialer-Cromwell Locus of Control Scale and a test of knowledge of law about such matters as credit, theft, and marriage, indicated that: (1) High school students in standard and college preparatory programs were more likely to see outcomes as determined by their own behaviors than were retarded and learning disabled students; (2) High school students in standard and college preparatory programs were better informed about legal matters crucial to community life than were mentally retarded and learning disabled students; (3) Mentally retarded and learning disabled students did not differ in law knowledge or on locus of control; (4) Locus of control was not directly related to IQ within the retarded-learning disabled group; (5) A moderate positive correlation was found between locus of control and law knowledge for the total group. Findings support Rotter's social learning theory. These findings also suggest that educators may need to provide more direct and specific training in critical aspects of layman's law for most retarded and learning disabled adolescents, as well as for average students who manifest external locus of control beliefs.


Paraprofessional treatment of school phobia in a young adolescent girl.

Debbie, a 14-year-old girl, was referred one year ago to a rural mental health center by her parents, essentially due to continued refusal to attend school. It was readily apparent that the symptoms were those of a classic case of school phobia, i.e., refusal to attend school, nausea and/or vomiting on school days but not on weekends, the overprotective mother, the distraught family, and other rather predictable concomitants. Following careful professional assessment, the assignment of a paraprofessional was made (a senior elementary education major taking part in a field experience course in psychology), and treatment was begun. The multiple involvement of a school personnel, and the parents for purposes of resolution of the case is discussed, with particular emphasis on paraprofessional effects. Data concerning school attendance, academic marks, school personnel reaction, peer response, and parental attitude before and after is noted. Though the immediate problem of school phobia was resolved, the underlying problems still remained. An up-to-date summary of the case as it stands today is provided. A brief survey of pertinent literature is also included.


School-age parents: how permanent a relationship?

One hundred eighty school-age girls who registered for care in a prenatal clinic were studied through two years postpartum. At registration, the mean age of the pregnant girls was 15.6 and the putative fathers was 18.5 years. Many of the fathers continued to see the young mothers, to provide financial support, and to visit their children. By 26 months after delivery, however, only 23% of the mothers had married the putative fathers, 23% still were seeing them regularly, 18% saw them occasionally, and 35% either never saw them or had married someone else. Only 25% of the mothers who expected to marry the putative father did so. The study findings have significant implications for the inclusion of putative fathers in programs for school-age mothers.


Graffiti and adolescent personality.

Graffiti has been studied for many years from many viewpoints. They have been used to explain accounts of people, styles of life, and assumed relationships. The present paper reports an attempt to analyze graffiti as outward manifestations of adolescent personality. Results suggested that different forms of graffiti could be interpreted from five characterizations of early adolescent personality: sexual maturity, self-identity, idealism, iconoclasm, and rebelliousness. Significant differences were found between boys and girls in numbers of inscriptions for each category. Further, the graffiti were analyzed in relation to early adolescent stages of development.


Traditional religious orthodoxy, respect for authority and nonconformity in adolescence.

Broad generalizations regarding youth cultures must take into account the relative impact of conventional beliefs on adolescent behavior. Data obtained from 4,220 boys and girls from grades 8-12, in communities of different socioeconomic status, show that traditional religious orthodoxy and respect for authority represent viable social forces. The general assumption of a drastic decline with age in the commitment to these conventional orientations during adolescence requires some qualification. Beliefs dealing with respect for authority which lack specificity in regard to the institutional lucos of authority remain substantially unchanged with increasing age. Several traditional religious orthodox and respect for authority items either did not show a consistent decline with increasing age or showed only a slight decline. Commitment to these conventional beliefs is inversely associated with nonconforming behavior.


Personality characteristics of black adolescents.

Four hundred and forty-six poor, Black, urban and rural adolescents ages 15-18 enrolled in a summer poverty-work program were administered Gough's Adjective Checklist (ACL) and Holland's Vocational Preference Inventory (VPI). Significant sex differences were found on 12 of the 24 ACL scales with Black females tending to score higher on all differing scales. The VPI scores were compared with Black College students' scores and significant differences were found on most of the 11 VPI scales.


Ideal sex roles for children and acceptance of variation from stereotypic sex roles.

In a sample of 50 child psychology students, 40% preferred that there be no differences between male and female children on 14 personality characteristics, while 60% preferred differences resembling current sex role stereotypes. For the latter students there was some preference for dominance, aggression, autonomy, exhibition, heterosexuality, and achievement to be more characteristic of males, and order, succorance, deference, nurturance, and abasement to be more characteristic of females. Both groups observed male and female peers describing themselves in a manner appropriate or not appropriate to current stereotypes. The students with a stated preference for no sex role difference among children did in fact express a more equal attraction to male or female peers whether they depicted sex appropriate or inappropriate roles.


Ultrastructure of elastin coacervates.

Electron micrographs of negatively stained coacervates of supernatant from sonicated-elastin showed the presence of filamentous structure with the center to center distance typical of tropoelastin, synthetic polypentapeptide as in peptide T1 of tropoelastin, and alpha-elastin. Electron micrographs of negatively stained coacervates of the polypentapeptide, alpha-elastin and sonicated elastin exhibit banded fibers when coacervates are formed, stained and dried at temperatures greater than 50 degrees C.


Chymotrypsinogen D, a new zymogen from porcine pancreas with proelastolytic activity.

During the purification of propancreatopeptidase E, a proATEEase activity is always copurified. The proelastolytic and proesterolytic activities can be separated on a hydroxylapatite column. The zymogen with potential ATEEase activity has a basic isoelectric point, can be activated by trypsin, and can hydrolyse elastin and ATEE but not ATAME. Its molecular weight is about 26,500 and the NH2-terminal sequence indicates clearly that it belongs to the chymotrypsinogen family, but that it is not chymotrypsinogen A, B, or C. We call it chymotrypsinogen D. Although both pancreatopeptidase E and chymotrypsin D can hydrolyse elastin, the synthetic substrate ATAME is attacked only by pancreatopeptidase E. Therefore, the peptide bonds in elastin cleaved by these two enzymes should be different.


Proteolysis of tropoelastin.

The presence of an enzyme associated with tropoelastin is described. The enzyme has a pH optimum between 7 and 9 and trypsin-like specificity. Upon incubation, tropoelastin (72,000 molecular weight) is cleaved into relatively high molecular weight fragments. In addition to the parent molecule, five discrete polypeptide bands are usually observed on SDS gels with molecular weights of approximately 57,000, 45,000, 36,000, 25,000 and 13-14,000.


The fate of intratracheal 14C-guanidinated pancreatic elastase in hamster lung.

Native pancreatic elastase and guanidinated elastase have similar in vitro and in vivo properties and produce emphysema of similar severity in hamsters. 14C-guanidinated pancreatic elastase (16,000 cpm/0.2 mg) was instilled into the trachea of anesthetized hamsters. Within 24 hours the radiolabel found in the lungs rapidly decreases to 12% of the original 16,000 cpm and to 1% after 96 hours. Most of the radiolabel and elastase activity found in the lungs can be removed by bronchopulmonary lavage up to 48 hours after installation. Although seemingly very small, there is a significant amount of radiolabel (1-2%) which cannot be removed from the lungs by extensive bronchopulmonary lavage.


Comparison of the elastolytic effects of human leukocyte elastase and porcine pancreatic elastase.

Porcine and bovine elastins were digested by human leukocyte elastase and porcine pancreatic elastase. The enzymes showed similarities in the extent to which they digested elastin and the pattern and quantitative distribution of N-terminal amino acids in the digests. However, fingerprints of the digests showed differences between the products of leukocyte elastase and pancreatic elastase. Each enzyme produced its characteristic fingerprint irrespective of whether the elastin substrate was obtained from ligament, pleura or lung parenchyma. The enzymes also digested tropoelastin differently. The results suggest that leukocyte elastase and pancreatic elastase should not be considered interchangeable in experimental models of tissue injury.


Evolution of elastin structure.

The aortae of a number of vertebrates and invertebrates were tested for the presence of elastin to determine when this protein first appears phylogenetically. Using several criteria, including amino acid composition, presence of desmosines, and histological characteristics, we found that all representative vertebrate groups have elastin except the primitive jawless fishes (lampreys and hagfishes). All the invertebrates tested, representing most major phyla, were found lackin in elastin as well. Comparison of purified elastins from several vertebrate groups reveals some striking differences in their amino acid compositions and properties, including the arrangement of the elastic fibers in the aorta. The patterns of variations in amino acid composition suggest a mode of evolution which is different from the slow accumulation of point mutations observed with globular proteins.


Ultrastructural studies of developing pulmonary alveolar septal elastin.

Eighteen fetal lambs have been studied at six different gestational ages ranging from 90 days to term. At 90 days gestation, only the microfibrillar component of elastin is present in pulmonary alveolar septal elastic fibers. The amorphous component appears at 110 days and gradually increases in amount, relative to microfibrils. At term (150 days), the composition of the pulmonary alveolar septal elastin resembles that of the adult ewe.


Role of crosslinking in fiber formation.

The synthesis of elastin by smooth muscle cells is demostrated by amino acid analyses and the presence of lysine-derived crosslinks. The data reveal that the ratio of allysine to aldol decreases with time in culture. The presence of insoluble elastin correlates well with the presence of the reduced aldol condensate in these cells. If the formation of the desmosines occurs by the condensation of the aldol and dehyrolysinonorleucine, the presence of the latter may be rate-limiting since the cells display little or no dehydrolysinonorleucine. Several peptides containing the desmosine crosslink were purified and partially sequenced. The data indicate that desmosines crosslink two polypeptide chains and that both desmosine and isodesmosine are present in the same primary sequence approximately equally substituted. A possible role for tyrosine in the regulation of desmosine formation is presented.


Crosslinking profiles of elastin from anatomically defined regions of the lung.

Elastin was isolated and purified by a procedure which sequentially removed lipids, collagen, structural glycoproteins and the microfibrillar proteins. Crosslinking profiles were obtained by column chromatography either after reduction with 3[H]NaBH4 or after reaction with 14[C]NaCN and NH3. Examination of the crosslinking profiles of the elastins from various tissue regions revealed differences in the type, distribution and quality of crosslinks.


Studies on the major fucosylated glycoprotein released into the medium by cultured human skin fibroblasts.

Electrophoretic analysis of the proteins synthesized by cultured human skin fibroblasts demonstrated that the major component released into the medium is a high molecular weight fucosylated glycoprotein (MFGP). Gel filtration chromatography under denaturing and reducing conditions indicated that MFGP has a molecular weight of approx. 250,000; but appears to behave as a disulphide-linked dimer when unreduced. MFGP is further distinguished as the major labelled macromolecule  in the medium after incubation of fibroblasts with [35S]cysteine. The role of this glycoprotein is unknown but it bears a striking resemblance to a presumptive  structural glycoprotein recently shown to be secreted by arterial smooth muscle cells in culture, and may also be related to a group of much studied cell surface glycoproteins.


Studies of the biosynthesis of a soluble precursor of elastin.

A salt soluble protein, isolated from the aortas of copper-deficient swine, has been characterized as a precursor of elastin by its amino acid composition and its incorporation into insoluble aortic elastin in vitro.


The biosynthesis of elastin by an aortic medial cell culture.

A long term culture of aortic medial cells, derived from newborn pig aorta, has been established. The ability of these cells to synthesize soluble elastin has been demonstrated by isolation and characterization of the radioactively labeled protein, using soluble elastin of copper-deficient pig aorta as the carrier. The synthesis of corsslinked elastin was shown by the isolation and identification of the lysine-derived crosslinks after incubating the cultures with [14C]-labeled lysine. The precursor relationship of soluble to insoluble elastin was demonstrated by incubating the [3H]-labeled soluble elastin from copper-deficient pig aorta with the culture and isolating labeled crosslinks from the insoluble elastin residue.


Isolation of lung alveolar walls.

Disintegration of peripheral lung tissue followed by filtration through an 80 mesh stainless steel screen yields a filtrate containing tissue particles with properties consistent with their identification as fragments of alveolar walls. Application of this procedure readily yields large quantities of alveolar wall tissue.


Calorimetric studies of elastin solvation.

The interaction of ox ligamentum nuchae elastin (native, purified and soluble) with four different solvents was investigated by Differential Scanning Calorimetry. The freezable solvent content was determined, at different total solvent contents, from the melting endotherms, and the amount of unfreezable solvent was obtained by extrapolation. For two bifunctional solvents, water and ethylene glycol, the molar ratio "bound solvent/elastin residue" was the same for all the elastin samples investigated, and very close to 1.5. This result is identical to that obtained by other workers for the "water/CO-NH group" of synthetic amorphous polyamides, and it can suggest that the hydration of elastin is interpretable on the basis of a similar model. The model is based on a direct interaction of water with the peptide group, and suggests that 0.5 moles of water are strongly bound, and 1.0 moles are loosely bound to the CO-NH group. The ratio "bound water/elastin residue" is larger for the soluble beta elastin. Different molar ratios are also obtained for monofunctional solvents such as methanol and trifluoroethanol.


A 13C magnetic resonance study of embryonic chick aorta.

13C nmr spectra of defatted aorta, obtained  from chick embryos, ranging in age from 13 to 20 days, showed that linewidths were independent of the age of the embryo, this, in spite of the fact that crosslinking increases with age. As expected the dipolar decoupled spectrum of defatted aorta had a larger C-H signal intensity than the scalar decoupled spectrum, since collagen in the sample contributes signal intensity only in the former case. Significantly, the dipolar decoupled spectrum of autoclaved aorta also had a larger C-H signal intensity. This result indicates that ca. 30% of the carbons in the tissue, swollen by 0.15 M NaCl, has restricted motion at 37 degrees. Preliminary data indicate that tissue culture techniques can be used to enrich specific amino acids in chick aorta with 13C, thereby affording a means to study possible differences in molecular structure of the chemically distinct regions in elastin.


The morphogenesis of elastic fibers.

Elastic fibers have been shown to contain two proteins, insoluble elastin and the elastic fiber microfibril, a glycoprotein. The microfibril has been suggested to play a morphogenetic role in determining the presumptive shape and direction of the forming elastic fiber. The principal alteration seen in individuals with the disease Pseudoxanthoma Elasticum is in insoluble elastin which loses its amorphous appearance and affinity for anionic stains, and takes on a finely granular appearance and shows increased affinity for cationic stains. Normal elastic fiber microfibrils are sometimes associated with this material; although, in general, these structures are not present in the elastic fibers that are markedly altered in this disease.


The ultrastructure and mechanics of elastic ligaments.

The major central part of elastic ligaments is constituted by longitudinally orientated elastic fibres, each surrounded by a sheath of spirally orientated collagen fibrils with an intervening thin layer of microfibrils. In the terminal region of such ligaments the orientation of the collagen fibrils is longitudinal and the elastic fibres end within the ligament without any attachment to bone. The ligament response to a first, unphysiologically high load produces a continuous stress-strain curve. On the other hand the curve becomes biphasic after repeated application of such loads. It is suggested that three factors are involved in this mechanical response, namely, frictional forces between elastic fibres and their sheaths, compressive forces exerted upon elastic fibres by their sheaths, and intre-sheath friction due to rearrangement of the constituent collagen fibrils.


[Testing of the "retinal acuity" with the laser interference apparatus as a routine clinical method].

The retinal function may be tested by laser-interference-fringes formed on the retina independently of the refraction status of the eye. The perception of these fringes is a subjective test for the retinal function even in case of moderate opacities of the optical media. Experiences with a new apparatus described here showed that the determination of this "retinal acuity" is very simple to perform. The comparison of retinal acuity and visula acuity of several hundred cataratous eyes and the measurement before and after cataract extraction in about 100 cases are discussed. The method gives useful prognostic and diagnostic information to the ophthalmologist.


Prostaglandins and ocular trauma.

Laser irradiation of the iris in rabbits causes miosis, a rise in intraocular pressure and an increase in the protein content of the aqueous humour. These effects on intraocular pressure and the blood-aqueous barrier are partly due to the release of prostaglandins of the E type and can be very much reduced by pretreatment with prostaglandin synthetase inhibitors such as indomethacin. The miosis and part of the rise in intraocular pressure and breakdown of the blood-aqueous barrier may be due to antidromic stimulation of sensory nerves, and they are reduced by nerve-blocking drugs. A combination of indomethacin and local anaesthetic can block the miosis and rise in intraocular pressure and greatly reduce the increase in protein content of the aqueous humour. It is probable that the human eye reacts in a similar way to laser irradiation of the iris, but so far the rise in intraocular pressure has not had serious results clinically in the treatment of glaucomatous eyes.


Q-switched ruby laser damage of the rabbit eye lens.

Results on Q-switched ruby laser damage to lenses of Chinchilla grey rabbits are reported. Threshold irradiances of about 10(10)W/cm2 are shown to be necessary for lens damage. The minimal lesions consist of empty bubbles about 1 mm in diameter. Energy consideration as well as histologic investigation of the lesions indicate a mechanical damage process following a light-induced absorption in the focus. Retinal damage accompanied lenticular damage in all cases


The new glaucoma research laser.

This new pulsed argon laser has only been in use for a comparatively short time. Thbrefor, this information can only be valued as a preliminary study. But due to its high efficiency and its good steering possibilities, it offers new vistas and aspects in the application of laser.


Benign paroxysmal positional vertigo and rotatory-induced nystagmus.

The study of 25 cases of 'benign paroxysmal position vertigo' showed us that irrigation of the ear opposed to the injured side inhibited this nystagmus. In these patients, it is difficult, not to say impossible, to provoke rotatory nystagmus, either by the caloric test (Brünings position II) or by the rotatory test in frontal plane. The significance of these observation is discussed and ascribed to a central compensation system.


Cochlear otospongiosis etiology, diagnosis and therapeutic implications.

First, the authors discuss the most valuable way to correlate specific morphological changes encountered in cochlear otospongiosis with sensorineural hearing loss. They think that biochemical factors may be responsible for this association of cochlear otospongiosis and histopathologic changes, and they explain their enzymatic concept resulting from experimental findings and cyto-clinical relationship. Second, the authors analyze clinical, audiometric and X-Rays investigations enabling the diagnosis of cochlear otospongiosis, in its pure pereceptive form as well as in the perceptive component added to the conductive loss in far-advanced mixed audiometric types in surgical otospongiosis. They present two typical cases of cochlear otospongiosis: one combines clinical history, audiometric test and post mortem investigations;-the other shows the passage from a pure cochlear otospongiosis to a secondary stapedial fixation, ten years later, thus confirming by audiometric data and by stapedectomy the otospongiotic etiology of this previous pure sensorineural loss. Finally, they insist upon the great interest of establishing an early diagnosis in cochlear otospongiosis on account of its therapeutic implication, particularly from the enzymatic point of view.


[Pregnant teenagers - what do they know about health? (author's transl)].

399 pregnant women have been interviewed for their attitudes towards pregnancy. The group of teenagers (up to 18 years) has some pecularities, e.g. mostly unmarried, apprenticeship or other professional training not completed, no own home, excessive smoking, only few interested in courses of mother and child-health, stronger wishes for an interruption of pregnancy. It is important therefore, to help them not only by medical care and health-education, but to give them more self-consciousness and social integration.


[The importance of height of parents for correct estimation of growth of their children (author's transl)].

Linear dependence was found between the height of children and average height of both parents in the group of 100 619 children and parents (Fetter et al. 1951). Equations of regression lines are recorded for every age-class of both boys and girls from 6 to 18 years. Decisive deviations of children's height in individual groups of parents in every class do not significantly differ from standard deviations of the whole class. Decisive deviation valid for the whole class may therefore be used for height standards of children of equal class in all height groups of parents. Age difference between standards of children with equal body height but different average height of parents from 152,5 cm to 180,0 cm is at ages from 6 to 8 years in both sexes, at least 1 year in boys between 9 to 12 years, and in girls from 12 to 18 years up to 4 years. Per 1 cm difference of average parental age from average standard height of adult population either in the positive or negative sense there exists the shift in children height from given class standards. In boys from 6 to 8 years and in girls from 6 to 9 years it makes 4 mm. In boys from 9 to 16 years and in girls from 10 to 14 years it is 5 mm. In boys from 17 to 18 and in girls from 15 to 18 it makes 6 mm in equal sense. The validity of the conclusions may be presumed for both the contemporary generation and groups from other European states as well. Eventual incorporation of assessing criteria after standard parental height into some existing aids used in estimating the growth of children may be anticipated.


[A nomogram for determination of "midparents height" and for correction of the height of children refering to the stature of their parents (author's transl)].

A monomgram is given to find graphically the mean between the stature of the father and the stature of the mother (midparents height) and to correct (in an additive or reducing manner) the height of children of a certain age refering to their midparents height. Using such correction terms may be an approximative method to exclude the genetic factors of growth if one wishes to compare groups of children growing up in different environments.


[A map on recent menarcheal age research in Europe (author's transl)].

Publications on menarcheal age from 1965 to 1974 are reviewed. The menarcheal data are shown on a map, in comparison to a former map, published 1967. It seems, that presently socio-economic conditions are more strongly modifying the action of genetic factors of sexual development than "natural" factors of environment as climate, level of height a.s.o.


[Group therapy of obesity in children and youth (author's transl)].

There are social, family-bound and individual factors as a cause of obesity. Changes of weight in 326 pupils are demonstrated as results of a longitudinal control during their school-life. The need of prevention and therapy of obesity in children and youth is stressed. The author deals with the effect of a group therapy in 19 boys and 24 girls. She has proposals to help solving the social problems of obesity.


Oral hyposensitization of children with pollinosis or house-dust asthma.

25 years of experience have proven oral hyposensitization to be an effective and safe method for specific treatment of respiratory allergies in children up to the age of 10-12 years. For pollinosis aqueous extracts or pollen powder are used. Results after at least two cures are comparable to those observed after subcutaneous hyposensitization. In house-dust asthma oral hyposensitization is performed either with commercially available extracts or with extracts prepared from the patient's own house-dust. The way to collect such dust samples, their use in testing and the preparation of extracts from it are described. Long-term results with oral hyposensitization of children with house-dust asthma are good.


Surgical diseases of the adrenal gland.

Abnormal levels of adrenal hormones, or their metabolities, in the urine or blood are found in most patients with surgical diseases of the adrenal gland, including neoplastic and some hyperplastic states. Neuroblastomas and nonfunctioning adrenocortical tumors often present as abdominal masses. Surgery is required for the majority of these disorders, particularly for the malignant tumors.


Bacterial shock.

Bacterial shock due to Gram-negative bacilli is best managed by prompt control of the infection with appropriate antibiotics and surgical drainage or excision. Corticosteroids for purposes of controlling systemic reactions to bacteria and their toxins constitute adjunctive therapy. Volume repletion and respiratory support may be of the greatest importance for temporary support of these critically ill patients. Vasoactive drugs including dopamine and isoproterenol should be used very sparingly and only as very temporary expedients.


Accelerated atrioventricular conduction during acute myocardial infarction.

Three cases are described in which accelerated atrioventricular conduction occurred during an acute myocardial infarction. The first patient, an 82-year-old woman, developed a WPW syndrome suggesting posterior right ventricular preexcitation, a pattern which persisted for four months until her death. An accessory bundle was found on autopsy. Fibrotic changes, associated with acute lesions (hemorrhage, polymorphonuclear infiltrates) were present in the atrioventricular node and His-Purkinje system. Two men, of 47 and 74 years, developed a short PR interval associated with supraventricular tachycardia during the course of an acute myocardial infarction. The PR interval returned to its initial value in one case and remained unchanged for three months in the other. Accessory atrioventricular connections which became functional during myocardial ischemia may explain the various electrocardiographic patterns of preexcitation.


Pulmonary valve fluttering in subpulmonic ventricular septal defect.

Three patients with subpulmonic ventricular septal defect and pulmonary valve fluttering by echocardiography are presented. The echographic changes appear identical to that reported with infundibular pulmonic stenosis and the mechanism causing this fluttering is probably similar.


The value and limitations of echocardiography in recording mitral valve vegetations.

The echocardiographic findings and case reports of three patients with active Streptococcal endocarditis and severe congestive heart failure are presented. All three had pathologically proven vegetations on the mitral valve; however, only the two with calcification of the vegetations were successfully demonstrated on echocardiography. Clinical and pathological differences are highlighted and prior case reports in the literature are reviewed. The nonspecific nature of echoes recorded from valvular vegetation is stressed and factors in their echocardiographic detection are discussed.


Influence of test site on ventricular fibrillation threshold.

An influence of VFT test site location on measured values of VFT was demonstrated in dogs with coronary occlusions, in dogs with localized areas of short recovery properties induced by warm thermal lesions, and with a computer simulation of fibrillation threshold. Under these experimental conditions VFT did not significantly change from control values when the measurement was made at a site distant to the lesion. Differences in the temporal relationship of time of recovery following application of VFT test stimuli to various locations are probably responsible for the observed differences in effects of lesions on VFT measured at these sites.


Clinical toxicity of furosemide in hospitalized patients. A report from the Boston Collaborative Drug Surveillance Program.

Of 17,068 hospitalized medical patients monitored in a drug surveillance program, 2,367 (13.9 per cent) received furosemide. Of these patients, 53 per cent were hospitalized with a primary (first) diagnosis of cardiovascular disease; many other patients had cardiovascular disorders coincident with other diseases. In 78 per cent of cases the indication for furosemide therapy was congestive heart failure. Adverse reactions were attributed to furosemide in 239 patients (10.1 per cent), but in only 14 instances were the unwanted effects considered life-threatening. The most common adverse reactions were: intravascular volume depletion (4.6 per cent of furosemide recipients), hypokalemia (3.6 per cent), and other eletrolyte disturbances (1.5 per cent). Many patients experienced more than one manifestation of toxicity. The over-all frequency of adverse reactions increased progressively with higher daily doses of furosemide, but was not correlated with total furosemide dose. Among furosemide recipients who also recieved potassium-supplements or potassium-sparing diuretics, hypokalemia was less frequent, less severe, and of slower onset. Coadministration of other diuretics with furosemide was associated with a higher frequency of volume depletion. The findings indicate that furosemide is a relatively safe diuretic in a wide range of clinical situations. Serious adverse reactions are uncommon, and occur primarily in the seriously ill.


The thoracic windows for electrical ventricular defibrillation current.

The thoraces of dogs were mapped out to identify those areas where defibrillating current gains easiest access to the heart. Of all of the transchest and chest-to-back electrode locations, the lowest current dose (0.6 amp. per kilogram of body weight) was found with one electrode over the apex-beat area with transchest electrodes and slightly anterior to the apex-beat area with chest-to-back electrodes.


Pulmonary and left atrial hemodynamics in mital stenosis.

A laboratory model has been utilized to evaluate left atrial and pulmoanry hemodynamics while comparing atria of three different compliances, five valve orifices, four pulmonary complicances, two venous pressures, and a predetermined pulmonary vascular resistance. The data demonstrate significant relationships between these variables and cardiac output, pulmonary artery pressure, and left atrial pressure and between the variables themselves. The complexity of these interrelationships is consistent with the lack of simple linear relations between current clinical measurements and emphasizes the need for measurements of compliance if the hemodynamic consequences of mitral stenosis are to be better understood.


Measurements of right ventricular volumes in man from single plane cineangiograms. A comparison to the biplane approach.

An area-length expression for RV volume determination from single plane cineangiograms has been developed and verified against the biplane volumes with the aid of the RV human casts. A close correlation was found to exist between the two methods (r = 0.93). Ten patients with normal hearts were subsequently studied. Biplane and single plane RV cineangiogrpahic analyses yielded virtually identical results. The single plane expression was equally valid in the end-systolic and the end-diastolic volume analysis.


Double outlet left ventricle associated with situs inversus and atrioventricular concordance.

A case is described in which the ventriculo-arterial connection of double-outlet left ventricle was associated with situs inversus and atrioventricular concordance. The case additionally exhibited l-malposition of the aorta, a subaortic ventricular septal defect, and valvar and subvalvar pulmonary stenosis. Originally diagnosed as transposition of the great arteries, a Rastelli type correction was attempted. This was not successful, owing to hypoplasia of the morphological tricuspid valve orifice.


Pre-excitation of the ventricle associated with total intra His bundle block.

A case with total intra-His bundle block and intermittent pre-excitation syndrome is presented. During A-V conduction there was a P-delta interval of 130 msec. with a P-A interval of 20 msec., an A-H interval of 60 msec. and an H-V interval of 50 msec. During rapid atrial pacing the P-delta interval increased primarily due to an A-H1 prolongation and a Mobitz type 2 block and total A-V block occured at increasing rates showing H1 following every A spike. The escape beats showed a normal width of the QRS complexes with preceding H2 spikes. After administration of Ajmaline the bypass tract was blocked and constant total A-V block occurred. It was concluded that there was a constant total intra-His bundle block and a nodoventricular or fasciculoventricular bypass tract with prolonged conduction to the ventricle. This bypass tract blocked sometimes spontaneously and could also be blocked by rapid atrial pacing and administration of drugs. The close anatomic proximity of the His bundle and Mahaim fibers is responsible for the simultaneous block resulting in total atrioventricular block.


Risk-benefit analysis for industrial and social needs.

This study develops a decision method for evaluating the social acceptability of industrial controls on hazardous materials. Decisions are based on a "multiple criteria approach" that jointly considers measures such as risk-benefit tradeoff, minimum reducible health risk, maximum acceptable cost and implicit value of human life. Health risks are calculated by combining separate estimates of production and usage patterns, emissions to air and water, effectiveness of controls, pollutant dispersion and human susceptibility. Economic benefits consider employment, trade and consumer impacts, as well as direct costs of controls. The analysis focuses on asbestos as an example hazard. Relative values of hazard reduction alternatives are examined for asbestos manufacturing exhaust filters and for asbestos substitutes in brake linings. Preliminary calculations indicate risk reductions of these alternatives cannot justify their social costs.


Performance characteristics of the 10 mm respirable mass sampler: Part II--coal dust studies.

The 10 mm cyclone respirable mass sampler was evaluated to determine the flow rate which best matched the BMRC and the LASL-ACGIH criteria, and to determine effects of pulsating flow, particle charge, mass loading, and sampler orientation. Part II, this paper, presents the work with coal dust. There is no significant difference between results obtained, for normal ranges of airborne dust concentration and size distribution, due to particle charge, sampler orientation or position (except upside down, which was not investigated), dust concentration, and ambient air velocity.


Nonideal collection characteristics of single stage and cascade impactors.

Experimental studies of single stage and cascade impactors showed that bounce was severe for dry particles on dry solid surfaces. Oil drops on dry surfaces or dry particles on oil coated surfaces were collected as predicted by theory. While glass fiber media collection surfaces reduced particle bounce, the impactor collection efficiency characteristics were changed.


Thermal stress: the need for an international standard.

There is a universal need for a single index of heat stress. Such an index would make it possible to standardize thermal working conditions on a global basis. It is proposed that the WBGT index, corrected for energy expenditure and airflow, can fill this need. A review of available indices suggests that for all practical purposes the WGBT index is most likely to find universal acceptance.


Metrication and AIHA.

AIHA supports a planned orderly national program for conversion to the metric system and will cooperate with other technical societies and organizations in implementing this voluntary conversion. The Association will use the International System of Units (SI) as modified by the Secretary of Commerce for use in the United States in all official publications, papers and documents. U.S. customary units can be presented in parentheses following the appropriate SI unit, when it is necessary for clarity.


Improvements in the validity of charcoal tube sampling by the use of a unique low flow true total volume sampling pump.

Standard methods of determining toxic vapor exposures rely heavily on charcoal tube sampling. The validity of results depends critically on accurate determination of the total air volume and avoidance of saturation breakthrough. The difficulty of substantiating sampling validity has stimulated a search for more absolute methods. A novel pump will be described which fulfills the requirement of true total volume measurement and has a flowrate capability down to 1 cc/min. This low flow feature lends itself to a variety of new detection techniques which will be outlined together with a detailed description of the unit's function.


Air sampling and analysis in a rubber vulcanization area.

Results of sampling and analysis of air in a rubber vulcanization area are described. Organic compounds were collected on activated charcoal, desorbed with carbon disulfide and analyzed by gas chromatography. Several previously identified substances were quantitated, including styrene, toluene, ethylbenzene, and several oligomers of 1,3-butadiene. Concentrations ranged from 0.007 to 1.1 ppm.


Aging of impregnated charcoal studied by powder x-ray diffraction.

The effects of aging, naturally and artificially, on the cyanogen chloride capacity of copper and chromium impregnated charcoals were demonstrated by means of an x-ray technique. The results reveal that crystallite growth of water soluble impregnants seems to be the primary cause of the capacity loss.


Analysis of the polycyclic aromatic hydrocarbon content of airborne particulate pollutants in a Søderberg paste plant.

A method of enrichment and separation of polycyclic aromatic hydrocarbons (PAH) in air samples is described. Airborne particulate samples from the work atmosphere of a Soderberg carbon-paste plant were collected on glass fiber and Acropor filters using high volume samplers. The filters were Soxhlet-extracted using cyclohexane and extractable matter was subject to a liquid/liquid separation. The PAH-fraction was concentrated and separated on a gas chromatographic system with the possibility of mass spectrometric identification. More than 40 PAH compounds and some heterocyclic compounds having from 3-6 rings have been separated and identified. Quantitative determinations show that some of the PAH-components are 2-3 decades more abundant than recently reported data from urban air samples. The results are presented as a PAH-profile. It is suggested that the PAH-profile may be a characteristic of the process involved. Furthermore, the profile has a potential use of the profile in evaluating potentially hazardous risk of the PAH's.


Pulmonary valve vegetations detected with echocardiography.

In a patient with pseudomonas endocarditis a pulmonary regurgitant murmur developed. Sequential echocardiography demonstrated the initial absence of vegetations, the evolution of pulmonary valve vegetations with relapse and finally the apperance of vegetations on all cardiac valves. The findings were confirmed at autopsy. Echocardiography, a useful technique for evaluating mitral, aortic and tricuspid vegetations, can also detect pulmonary valve vegetations.


Clinical significance of the V wave in the main pulmonary artery.

Among 68 patients with mitral insufficiency who had right and left cardiac catheterization and left ventriculography, 6 had retrograde transmission of the left atrial V wave into the main pulmonary artery. All of these patients had mitral insufficiency of acute onset. The remaining 62 patients had chronic mitral insufficiency that was considered severe in 17. Pulmonary vascular resistance was lower in the group with acute insufficiency (mean 139 dynes sec cm-5) than in the group with chronic severe insufficiency (mean 631 dynes cm-5) (P less than 0.005). Nondistensibility of the left atrium and low pulmonary vascular resistance were the two factors favoring retrograde transmission of V waves. Because both factors are present in acute mitral regurgitation, this finding is helpful in differentiating patients with acute mitral insufficiency.


Fine structural features of adrenergic nerve fibers and endings in the pineal gland of the rat, ground squirrel and chinchilla.

The ultrastructural features of the adrenergic nerve fibers in the pineal glands of the rat, ground squirrel and chinchilla are described. Frequency distribution histograms of diameters of granulated and non-granulated vesicles in the adrenergic nerve endings demonstrate that the pineal nerve endings in the chinchilla contain a considerable number of large granulated and non-granulated vesicles, in contrast to those in the rat and ground squirrel. Synaptic ribbons seen in the pinealocytes of the ground squirrel were often localized near that plasma membrane which lay in close proximity to the axolemma of adrenergic nerve fibers. This observation may indicate that the synaptic ribbons are involved in the functional interconnection between pinealocytes and adrenergic nerve fibers. Localized dilations of the adrenergic nerve fibers were commonly observed in the pineal glands of all species examined. In addition to a variety of axonal constituents, various forms of inclusion bodies were tightly packed within these axonal dilations. The accumulation of the inclusion bodies may represent degenerative changes which occur in the pineal adrenergic nerve fibers in relation to the functional activity of the pineal gland.


The thyroid in the spontaneously hypertensive rat: a light and electron microscopic study.

The present study was undertaken to seek ultrastructural changes in the thyroid gland of the spontaneously hypertensive rat which would contribute to the understanding of previously reported abnormalities in thyroid function. Light and electron microscopic observations and measurements of plasma T3 and systolic blood pressure were recorded from a colony of Wistar Kyoto rats (WKY) and of spontaneously hypertensive rats (SHR). The systolic blood pressure of SHR was significantly higher than that of WKY but the plasma T3 levels of the two groups did not differ significantly. After administration of propylthiouracil (PTU), serum T3 levels and systolic pressure of both groups decreased. The size of the thyroid follicles in SHR was highly variable throughout the gland, and the colloid contained unevenly dense areas and cell debris. The follicular cells contained slightly dilated rough surfaced endoplasmic reticulum (ER) and numerous pleomorphic bodies of uneven density. After treatment with PTU, the vessels between the follicles of SHR did not become as dilated as those in WKY but the fine structure of follicular cells in SHR was similar to that of WKY and was characteristic of the typical thyroid response to PTU administration. We suggest that the thyroid in SHR does not respond adequately to the elevated TSH levels reported to be present in these animals, although it can respond to the highly elevated TSH levels which occur with PTU administration. This impairment most probably involves defects in synthesis and/or secretion of thyroid hormones in response to TSH stimulation.


Disposition of 14C-nicotine in the fertilized chick egg.

14C-Nicotine-HCl (4.5 mg) was injected into the air space of chick eggs after one day of incubation and the distribution of radioactivity measured on days 3, 5, 7 and 12. By day 3, 98% of the dose had passed from the air space into the egg, proper. The quantity of nicotine in the yolk was highest on day 3 (74% of dose) and decreased steadily until day 12 (52%). The quantity in the albumen increased from 16% on day 3 to a maximum on day 7 and remained constant at 34% until day 12. The embryo contained 0.03% of the nicotine on day 3, and this level increased to 5% by day 12. Nicotine in the allantois increased throughout the study period (0.01% on day 3 to 3% on day 12). Although only 5% of the dose was present in the embryo, the highest concentrations within these components of the embryo ranged from a minimum of 0.85 microng nicotine/mg dry wt in the heart to a maximum of 2.00 microng nicotine/mg dry wt in the carcass. These levels within the embryo were two to five times higher than the greatest concentrations in the yolk and albumen. The dynamics of nicotine passage from the air space into other components of the fertilized chick egg were clarified. Whereas the conventional expression of teratogenic doses of drugs in chick eggs (i.e., ppm of egg weight) assumes that the compound is distributed uniformly, this study indicates that such expressions are inaccurate.


The assessment of prenatal age from the crown-rump length determined ultrasonically.

Crown-rump lengths determined ultrasonically in vivo and in utero in cases of known postovulatory age (33-86 days) agree well with those in length/age tables in current embryological usage. Within the embryonic period proper, however, for a given age, the ultrasonic lengths are usually 1 to 5 mm longer than those of fixed specimens. The probable reasons for this are discussed.


Determination of zinc availability in foods by the extrinsic label technique.

The absorption of intrinsic 65Zn and extrinsic 65Zn from corn and liver was measured in rats. No significant difference between the absorption of intrinsic- and extrinsic-label was observed. These results indicate that endogenous zinc and exogenous 65Zn enter a common pool prior to being absorbed from the intestine. Since extrinsic 65Zn enters a common pool with intrinsic zinc, whole-body absorption of extrinsic 65Zn can be used to obtain an accurate estimate of the availability of zinc in food. The availability of zinc in human breast milk, in cow's milk, in infant formulas, and in reconstituted dry milk was analyzed by use of the extrinsic label. The zinc in human breast milk was most available (59%) while the zinc in the infant formulas was the least available (26 to 37%). Zinc from both raw and cooked corn was more available than zinc from either cooked or uncooked rat liver.


The relationship of zinc to protein utilization in the preadolescent child.

The effects of zinc intake on nitrogen utilization was investigated during a 20-day balance study with 23 preadolescent girls. The children were fed a diet which provided 4.17 g of nitrogen and 5.5 mg of zinc daily; the diet was supplemented with a combination of 5 mg of zinc and/or nitrogen supplied from either amino acids or nonspecific nitrogen. Complete collections of excreta were made throughout the study. Neither the supplementation of amino acids nor zinc improved the retention of nitrogen. Urinary excretion of urea nitrogen, uric acid, and creatinine were not different as a result of zinc supplementation. Subjects consuming the lower level of zinc were in negative zinc balance, but the subjects consuming 10.5 mg of zinc were in positive balance. The supplementation of this low protein diet with amino acids did not improve nitrogen retention.


Amino acid maintenance requirements of young women and of adult rats fed different dietary amino acid patterns.

Adult rats were fed isonitrogenous diets (5% protein equivalent) providing indispensable amino acids either in the whole-egg protein pattern or in the adult rat maintenance pattern of Smith and Johnson (S & J. Brit. J. Nutr. 21:17, 1967). In two separate experiments the threonine and the methionine (total sulfur amino acid) requirements were assessed. Similar responses were obtained with rats on the threonine experiment independent of the pattern of indispensable amino acids fed. In the methionine experiment the rats fed the S & J pattern showed a lower need for this amino acid than the rats fed the egg pattern. When the latter group was switched to the S & J pattern, they too required less methionine. In the experiment with college students (female) fed 7 g of nitrogen/subject per day, the lysine requirement on the whole-egg pattern was compared to the requirement on a pattern equal to twice the previously published requirements for young women. No evidence was obtained over the relatively short experimental period that the lysine requirement differed substantially with change in the pattern of indispensable amino acids.


Nitrogen balance studies with normal children.

A total of 1148 nitrogen balance studies were conducted in 100 boys and 23 girls 1 to 11 years old. Mixed, customary diets supplied between 8.9 and 21.4% of calories from protein. Duration of balance studies ranged from 72 hr in the youngest subjects to 120 hr in older children. Regressions and 95% confidence intervals of nitrogen retention on nitrogen intake are presented. The slope of the regression was significantly greater for children 12 to 18 months old than for children of other age groups. Correlation coefficients between various parameters of nitrogen balance and energy intake are presented. Although variability in results of nitrogen balances within subjects appears to be rather large, a significant difference between subjects was observed.


Anemia in urban underprivileged children. Iron, folate, and vitamin B12 nutrition.

The prevalence and type of nutritional anemia was investigated in 344 children aged 1 to 16 years of mixed race and living in a poor urban setting. Iron deficiency anemia was common in 1-year-old children (23%) as was biochemical evidence of iron deficiency (53%). Anemia rates were minimal in older children and the prevalence of iron deficiency decreased with age. Folate deficiency did not appear to contribute to the etiology of anemia, and nutritional vitamin B12 deficiency was not present. No-relationship could be found between a number of familial variables and hematological nutritional status. It is suggested that to identify families whose children are at risk for nutritional anemia new approaches will be needed to define their characteristics.


Effect of income and geographic region on the nutritional value of diets in Brazil.

The nutritional quality of dietary patterns in Brazil was examined as influenced by income level, region, and urbanization by calculating nutrient to calorie ratios and amino acid scores. In general, income level had only a minor influence on diet quality. Riboflavin and calcium were generally low in the low income groups in all regions, especially in urban areas. Thiamin intake was marginal in urban areas at all income levels. Protein quality appeared to be relatively independent of income, with two exceptions. These were the dietary patterns of the lowest income groups in the rural Northeast and the City of Sao Paulo which were somewhat limiting in methionine and lysine, respectively. In contrast, the total availability of calories and protein was greatly dependent on income and the lowest income families were seriously short of food. Income, therefore, appeared to be more important in determining the total amount of food available to a family in Brazil than in affecting the nutritional quality of the diet.


Prospects of cure in lymphocyte-predominant Hodgkin's disease.

This report concerns a particular benign histologic variant of Hodgkin's disease, the lymphocyte-predominant category of the Rye classification. The group of 24 cases, all involving localized disease, was first reported in 1960, and is now reappraised, incorporating subsequent data. The interpretations of the original findings are confirmed and elaborated. A characteristic feature had been the long relapse-free and symptom-free survival period, which gave a false impression of security but was followed in some instances by disseminated disease, usually after 5-15 years. The proportion of such cases is now shown to be greater, and the possible quiescent period extended. Cure was suspected in some instances, and can now be considered likely in about half of the cases. The present results include a substantial number of patients who have survived for very long periods and who must be regarded as cured, though careful confirmatory autopsies are still unavailable.


Hodgkin's disease of the thymus (granulomatous thymoma) and myasthenia gravis: a unique association.

A 19-year-old girl who had myasthenia gravis was found to have thymic Hodgkin's disease or "granulomatous thymoma." The myasthenia regressed completely following surgical removal of the thymic lesion. This association of Hodgkin's disease of the thymus and myasthenia appears unique. Possibly pathogenetic implications are discussed.


An improved procedure for quantitation of platelet factor 4.

Platelet factor 4 (heparin neutralizing) activity shortens the thrombin time of a heparinized plasma. In the proposed procedure (I) a heparin thrombin time curve is constructed by adding gradually increasing amounts of heparin to a commercial plasma substrate and determining thrombin times, (2) a suitable concentration of heparin that gives highest reproducible thrombin time is selected and added to the substrate, (3) thrombin times are determined for the heparinized substrate before and after addition of a test material containing platelet factor 4. The two thrombin times are converted to heparin concentration by reference to the heparin thrombin time curve. The difference in heparin concentrations represents platelet factor 4 activity. When lyophilized commercial plasma is used as substrate larger quantities of heparin can be employed in the system, resulting in improved sensitivity and precision.


Epitheloid germinal centers: an acquired immunologic deficit?

The histologic structure of lymphoid tissue in cases of fatal infection was reviewed, and epithelioid germinal centers, completely devoid of the usual dark zone of rapidly dividing blast cells, were found in 16 infants and children, one of whom also had Reye's syndrome. Epithelioid change has been previously reported to occur in various childhood infections and in the sudden infant death syndrome. All reported cases have been fatal. In four additional cases there was toxic follicle alteration, or massive necrosis of germinal center cells. Toxic follicle alteration and epithelioid change have been found in childhood infections and sudden infant death syndrome, and some evidence of a pathogenetic relationship between the two was found in this study. It is concluded that epithelioid change represents a definite pathologic alteration of germinal centers associated with total destruction of a whole population of cells. It probably represents an acutely acquired immunologic deficit and therefore may well contribute to the thus far uniformly fatal outcome of the associated diseases.


Microgranulomas in grossly normal rectal mucosa in Crohn's disease.

Rectal biopsies of sigmoidoscopically normal mucosa from 99 patients with Crohn's disease of the ileum, colon, or both were studied histologically, with particular reference to the presence of granulomas. Among the 14 cases of granulomas, some were of the usual sarcoid type and could easily be detected. Other microgranulomas were less well defined and were found only by mid- or high-power microscopic screening of serial sections. The morphologic characteristics, the relationship to ordinary Crohn's-disease granulomas and the possible significance of microgranulomas are discussed.


Leydig-cell tumor of the testis with gynecomastia and elevated estrogen levels.

A normally-virilized 24-year-old white man who had gynecomastia was found to have a Leydig-cell tumor of the testis, without demonstrable metastases. Hormonal evaluation revealed negative serum and urine tests for human chorionic gonadotropin, and normal steroid excretion. Prior to orchiectomy, serum estradiol was elevated and serum testosterone depressed; postoperatively these values reverted to normal. Attempts to quantitative the estradiol content of the tumor failed to show a significant increase over normal testicular tissue, however. Histologically, the tumor showed classic Reinke crystalloids, the nature of which remains undefined. Electron-microscopic studies showed these crystals to have a regular hexagonal pattern.


Measurement of urinary and serous-fluid glycosaminoglycans and urinary hydroxyproline.

Although analytic measurements of connective tissue components in biological fluids would frequently be useful in diagnosis and/or management of many inflammatory, neoplastic and metabolic diseases, such information is often unavailable due to the methodologic problems posed by these natural products. This report outlines relatively simple procedures leading to the colorimetric measurement of glycosaminoglycans in urine and other body fluids and to measurement of hydroxyproline in urine. Normal values and potential applications are presented.


Steroid profile in a case of adrenal carcinoma with severe hypertension.

The case of a young boy who had Cushing's syndrome and severe hypertension in association with metastatic adrenal carcinoma is described. Marked elevation of the mineralocorticoid 11-deoxycorticosterone was demonstrated in the plasma. 11-Deoxycortisol, 17alpha-hydroxyprogesterone, and urinary tetrahydro-11-deoxycortisol and pregnanetriol were also elevated. Aldosterone excretion was low. The data implicate defective 11beta hydroxylation and suggest that excessive 11-deoxycorticosterone production may have been responsible for the hypertension.


Evaluation of clinical chemistry laboratory performance in twenty Veterans Administration hospitals.

Twenty highly automated Veterans Administration (VA) Hospital laboratories participated in a study to evaluate their performances of routine chemistry tests. Ten of the laboratories had been identified as "superior" on the basis of previous College of American Pathologists Surveys. Several aspects of proficiency surveys were simultaneously examined: use of masked vs. unmasked survey specimens, methods of ranking, and comparison of medically useful performance criteria. The laboratories were found in general to be performing at the level of the state of the art and, more importantly, realistically meeting the criteria for medical needs for most routine tests. There was no difference between results obtained with masked and unmasked specimens. The ten "superior" laboratories showed slightly greater precision than the others, but were not more accurate, and two of them performed very poorly in the present study. The sum of squared SDI's was found to be a helpful technic for ranking and identifying outstanding and poor performances.


Evaluation of transbronchial biopsy of the lung.

Transbronchial biopsy of the lung through the fiberoptic bronchoscope is becoming a widely utilized clinical diagnostic technic. The authors reviewed the histologic features of 109 consecutive cases. The primary problem is the small size of the pulmonary tissue samples obtained, which is further compounded by an apparent mechanical inability to enter the biopsy forceps into dense nodules of neoplastic tissue. The diagnosis of carcinoma can best be made by examining the periphery of the cancer for microscopic extension into adjacent pulmonary parenchyma; however, multiple levels of the tissue block are needed to find such foci. A second problem reflects the use of transbronchial biopsy in the early clinical evolution of various infectious diseases in which pulmonary tissue may contain organisms without a fully developed inflammatory response, which would ordinarily provide the clue to the infective agent. The latter problem appears in cases of infections by Pneumocystis carinii. Close cooperation between the clinician and the pathologist is particularly important in all of these clinical situations.


The perilobular hemangioma. A benign microscopic vascular lesion of the breast.

Vascular tumors of the breast are rare, and reports in the literature suggest that most are malignant. The present study is concerned with a benign vascular tumor of the breast, a lesion generally known as perilobular hemangioma. This microscopic lesion consists of a meshwork of thin-walled, dilated vascular channels that may be situated within a breast lobule or in the extralobular mammary stroma. Hemangiomas of this type were found in seven or 1.2% or 555 mastectomies performed in 1974 in female patients who had mammary carcinoma. There was no association with a specific type of mammary carcinoma. Similar hemangiomas were observed as often in a series of breast biopsies performed for benign conditions. None of the angiomas showed any significant atypia or anaplasia.


Comparison of the reaction-rate and clot-density methods for determination of plasma fibrinogen.

The reaction-rate (Dade) and clot-density (Sherwood) methods for determining plasma fibrinogen were compared. Both require small sample volumes, are economical, and may be performed using commercially standardized instruments and reagents. Equivalent times were required for sample preparation. The results of the fibrinogen determinations were similar for plasmas of normal subjects, reference plasmas, those from patients with and without disseminated intravascular coagulation, and solutions of bovine fibrinogen. Both procedures could be made more economical by adjusting the amounts of certain reagents in the kits. High fibrin degradation product levels had no effect on the fibrinogen determination by either method. Advantages of the Sherwood method included digital readout (obviating further calculations) and the fact that the change in clot density could be plotted. The Dade method had the advantages of being less affected by high concentrations of heparin, being applicable to either citrated or oxalated plasma, requiring considerably less time (especially for certain abnormal plasmas), and requiring less technical sophistication.