Phosphoprotein from dentin. New approaches to achieve and assess purity.

Phosphorprotein extracted from rat incisors was purified by passage through a sulfonated polystyrene column. The phosphoprotein that emerged in the void volume contained 54% phosphoserine + serine and 36% aspartic acid and, in contrast to that obtained by DEAE-cellulose chromatography, was devoid of proline, valine, isoleucine, leucine, tyrosine, phenylalanine and arginine. Gel electrophoresis of the material purified on sulfonated polystyrene columns gave one major phosphate-containing band which would not stain with Coomassie Blue. EDTA or acetic acid demineralization yielded phosphoprotein preparations with identical compositions and electrophoretic properties. These data show that purification procedures reported earlier are insufficient.


Rapid delipidation of and particulate removal from human serum by membrane filtration in a tangential flow system.

Approximately 50% of the total lipids and virtually all of the colloids and particulates which impart turbidity to human serum are removed by filtration through 0.1 micrometer-poresize membrane filters in a high-volume tangential flow device. The advantages of the method over solvent extraction are: (a) no organic solvent(s) is added to the serum at any time, (b) filtrations can be performed rapidly at room temperature, (c) unstable lipoproteins and particulates are removed in 1 step, (d) scaleup from hundreds of ml to hundreds of liters is readily achievable, and(e) process time is markedly reduced.


Isolation and characterization of myocytes from the adult rat heart.

Spontaneously contracting myocytes were isolated from ventricles of the adult rat heart. Hearts were perfused retrogradally via the aorta for 30 minutes at 37 degrees C with Ca2+-free phosphate-buffered saline containing collagenase and hyaluronidase. The venticles were divided into pieces and incubated 15 minutes with the enzymes. Dislodged cells were decanted, diluted with cold buffer and allowed to settle. The washed cells were then sedimented through 3% Ficoll. This procedure yielded approximately 50 mg of protein from 1 gm of heart. Viability measured by trypan-glue exclusion is 90-95%. Approximately 80% of the cells were beating. Scanning electron microscopic studies suggest that the isolated myocytes are morphologically intact. The cells oxidize glucose, pyruvate, citrate and palmitate to CO2 and synthesize protein and RNA. Uptake of glucose, 2-deoxyglucose, leucine and taurine was saturable. Glucose uptake was stimulated by insulin. The cells retained LDH and CPK as well as their capacity to oxidize substrates after 24 hours at 4 degrees C or 4 hours at 37 degrees C. After 24 hours at 4 degrees C the cells resume contracting when returned to room temperature. The procedure reported here for the isolation of spontaneously contracting, adult, rat heart myocytes provides cells with a high index of viability and greater yield than previously reported methods. The cells retain metabolic activity and withstand storage for longer periods than other described preparations.


[Covalent binding of acylated trypsin with polymeric carriers].

In order to provide covalent binding of trypsin with polymer carriers, trypsin was activated by an administration of double C=C bond. Thereafter, activated trypsin was polymerized together with a monomer of the acrylic series. Trypsin acylation with an unsaturated acid allowed the enzyme immobilization by means of its copolymerization with a monomer forming a polymer matrix. The specific proteolytic activity of immobilized trypsin decreased in proportion to an increase in the molecular weight of the polymerization product.


[Physico-chemical and enzymatic properties of polymeric trypsin derivatives based on dextran].

The molecular weight distribution, thermal stability during autolysis, resistance to human serum inhibitors as well as temperature optimum of native and dextran-modified trypsin were investigated. The seeming constants of autolytic inactivation and inhibition of native and modified trypsin were calculated. Trypsin polymer derivatives had higher molecular weight than the native enzyme. They also showed higher resistance to autolysis and serum inhibitors. Possible causes of the above effects are discussed.


Anterior dislocation of the radial head in children.

Problems of unilateral isolated radial head dislocation have been reviewed in 28 children. A significant number indicated failure of recognition of the dislocation after injury. Disability due to increasing deformity and instability was consistently noted and indicated surgical reduction. Late reduction required reconstruction of the annular ligament. A modified method of reconstruction using a strip of triceps tendon is described. Good results are recorded in a small number of children in whom this was carried out.


Risk of developing breast cancer determined by mammography.

1) By breast parenchymal patterns one can isolate women at significantly high and low risk for developing breast carcinoma from the general population. 2) Basically the risk classification does not change with aging. 3) Radiographic screening studies should be concentrated in the high risk groups. 4) The highest risk group, DY, should be considered for aggressive surgical ablation of the tissue capable of generating a breast cancer.


Effects of two anxiolytics on distraction, habituation and dishabitiuation.

Rats were engaged in a baseline activity of licking and their distraction to tone stimuli measured by an interruption in licking. Habituation, distraction to a stimulus change and dishabitiuation (the return of distraction to the original tone) were studied. Ethanol (0.4 and 0.8 g/kg) and chlordiazepoxide (7.5 mg/kg) produced significantly faster habituation, a result that cannot be attributed to changes in the baseline response rate, or to differences in the initial distraction to the tone. All groups showed 24 hr retention to the tone when they were tested in the same state in which they were habituated. There was transfer of habituation between drugged and undrugged states for rats injected with chlordiazepoxide, but rats habituated undrugged showed no retention if tested after injections of ethanol. Chlordiazepoxide impaired the specificity with which the physical parameters were coded, whereas ethanol improved the specificity of coding. Neither drug affected dishabituation.


Reduction of the behavioral effects of delta9-tetrahydrocannabinol by hyperbaric pressure.

Delta9-tetrahydrocannabinol in doses of 0.5, 1.0, 2.0 and 4.0 mg/kg was administered to rats under normal (1 ATA) and increased (3, 5 and 7 times normal) atmospheric pressure. Behavior was maintained by a food-reinforced differential-reinforcemnet-of-low-rate (DRL) schedule. Dose-dependent decrements in performance was observed at the 1 ATA conditions, in which response rates increased and the well-established temporal discrimination disintegrated. Under the elevated pressure conditions, however, a reversal of behavioral toxicity occurred during which performance improved as a function of pressure. The behavioral disruptions occurring at the 5- and 7-ATA pressures were minimal compared with those occurring at 1 ATA under equivalent doses of the drug. The present experiment has demonstrated that delta9-tetrahydrocannabinol produces significant behavioral changes at 1 ATA pressure, but when atmospheric pressure is increased the drug effects are reduced.


Inhibition of water intake by ouabain administration in sheep.

Intracarotid infusion of ouabain (1280 ng/min) over 4 1/2 hr virtually abolished water intake of sheep in response to intracarotid infusion of either angiotensin II (800 ng/min) or 4 M NaCl (1.6 ml/min for 20 min. Ouabain treatment did not affect mean arterial pressure either before or during infusion of angiotensin. Neither ouabain nor angiotensin administration affected plasma [Na] or [K] or CSF [K]. During ouabain, but not during control infusion, angiotensin administration significantly decreased CSF [Na]. Ouabain administration also decreased water intake after 23 1/2 or 48 hr water deprivation. In the 23 1/2 hr deprivation experiments, food was made available immediately prior to water presentation and the ingestion of food appeared to ameliorate the reduction in water intake. Food intake itself, was decreased in some animals, during ouabain treatment. Ouabain infused at 960 ng/min resulted in significant, but smaller, reductions in water intake induced by angiotensin, 4 M NaCl, and 48 hr water deprivation. It was concluded that ouabain treatment affected water intake by influence on Na transport either in the thirst receptors or at some other level in the neural system between receptor and effector.


Visual evoked response and behavioral correlates of plasma methadone concentrations in cats.

Twelve cats were implanted with cortical and depth electrodes. After they recovered from the operation, visual evoked responses (VERs) were recorded at 20 min following saline and methadone (0.5, 1, 2, 3, 4 mg/kg) administered IP in a semi-random order to each cat. Four other cats were similarly drugged and plasma was obtained for radioimmunoassay of methadone content. At the three lowest dose levels behavioral excitation and salivation were evident in some cats, while their VER configuration remained essentially unaltered and plasma methadone was barely measurable. Following the 3 and 4 mg/kg doses plasma methadone concentration increased dramatically, behavioral excitation and salivation were evident in most cats and VERs were reliably altered. The VER alterations, consisting of amplitude attenuation and a decrease in some latencies, were restricted to secondary VER components occurring between 50 and 100 msec despite the animals' extreme behavioral excitation. These results suggest that the reticular formation is not a principal site of the drug's effect.


Quantitative determination of stress-induced myocardial damage in rats.

The degree of myocardial damage produced in rats by exposing them to unsignalled, irregular foot-shock stress was determined in three ways: by measuring (1) enzymes (LDH, GOT and GPT) released into the circulation, (2) the rate of release of one of these enzymes (LDH) from isolated perfused hearts into the perfusate, and (3) the cardiac uptake, in vivo, of the radioactively labeled bone-seeking agents, technetium-99m-stannous pyrophosphate or technetium-99m-methylene diphosphonate. The latter two methods permitted quantitative determination of the degree of myocardial damage produced. Determination of cardiac technetium-99m uptake was found to be simple, quantitative, highly sensitive and truly indicative of cardiac damage, and therefore most suitable for studies of the effects of stress on cardiac injury.


Enhancement of sexual behavior in the female rat by nicotine.

The effects of nicotine alone or in combination with mecamylamine, and the effects of both in combination with DA agonists and antagonists and d-LSD (5-HT agonist) have been studied on the sexual behaviour of castrate, estrogen-treated female rats. The results show that nicotine (as low as 50 mug/kg) significantly increases sexual receptivity. The pharmacological analysis suggests this effect to be mediated by a central, nicotine-like cholinergic receptor whose relationship to DA and 5-HT pathways known to exert inhibitory influences on receptivity in the female rat is also discussed.


Self-stimulation of the subfornical organ and lateral hypothalamus: differential effects of atropine and methysergide.

The effects of cholinergic blockade of neurons by atropine or serotonergic blockade by methysergide was investigated in rats responding for brain-stimulation reward. Bipolar stimulating electrodes were placed either in the subfornical organ (SFO) or the lateral hypothalamus (LH). Atropine sulphate and methysergide significantly suppressed self-stimulation of the SFO but not of the LH, suggesting that cholinergic and serotonergic neurons are involved in brain-stimulation reward associated with this site.


Interaction of arena size with different measures of amphetamine effects.

The effects of d-amphetamine (0.0, 0.5, 1.0. 2.0 mg/kg) on feeding and activity of male Holtzman rats were investigated in 3 different size test arenas. Differences in the size of arenas significantly altered the drug's effect on ambulatory activity, but not on feeding or rearing. Also, differences in the size of arenas significantly altered the interrelationship (correlation) of amphetamine's effects on feeding and ambulatory activity, but not the interrelationship of the drug's effects on feeding and rearing. These findings suggest that test arena size differentially influences different general measures of amphetamine effects as well as differentially affecting the interrelationship of amphetamine effects. The importance of the interrelationship (correlation) data to the potential incompatability of the drug's effects is briefly considered.


Marijuana and memory impairment: effect on free recall and recognition memory.

The effect of marijuana on memory was evaluated by presenting two groups of 17 male volunteers with lists of repeated or nonrepeated words following administration of a single marijuana cigarette containing 14 mg delta9-THC. An immediate free recall, final free recall and recognition memory test followed. Results indicated that marijuana significantly decreased immediate and final free recall but only slightly influenced recognition memory. Rate of acquisition on the repeated lists was the same for both groups. Long term retention of encoded information was not influenced by marijuana. The shape of the serial position curves departed slightly from those reported by other investigators in that some effects of the drug on the recency portion of the curve were noted. Both internal and external intrusions were elevated under marijuana.


An analysis of nucleotides and catecholamines in bovine medullary granules by anion exchange high pressure liquid chromatography and fluorescence. Evidence that most of the catecholamines in chromaffin granules are stored without associated ATP.

The catecholamine and nucleotide content of chromaffin granules from bovine adrenal medulla was analyzed both qualitatively and quantitatively. Nucleotides were examined by separation on anion exchange high pressure liquid chromatography and ultraviolet absorption, as well as by anion exchange thin-layer chromatography and luciferin-luciferase light emission analysis. CPATHECHOLAMINES WERE QUANTIFIED VIA AUTOMATED CONTINUOUS-FLOW ANALYSIS USING FLUORESCENCE. We found the average catecholamine/ATP ratio to be 8.2:1 with an SD of 1.98 and an SE of 0.50 for 16 separate glands. Relative percentages of epinephrine and norepinephrine were found  to be 79.8 and 20.2, respectively. The granules contained 80.9% ATP, 12.3% GTP, and 6,8% UTP, as well as detectable amounts of ADP, AMP, GDP, and UDP. If we accept the catecholamine/ATP ratio of 4:1 proposed by Hilliarp earlier, then those catecholamines constituting the remainder of our ratio of 8.2:1 should represent a nucleotide-unassociated pool. In view of recent evidence of a direct agonistic function of nucleotides, we propose that the granule-associated nucleotides may act locally as coagonists with certain biogenic amines, and may additionally provide acirculating pool of purines and pyrimidines for use by the heart and lungs.


MAO activity in rat brain stem and cerebral cortex following acute and chronic treatment with L-dopa and ethanol + L-dopa.

This work reports the effects of acute and chronic administration of L-dopa and ethanol + L-dopa on MAO activity in rat brain stem and cerebral cortex using noradrenaline (NA), dopamine (DA), serotonin (5-HT) and tryptamine (Try) as substrates. The results obtained clearly demonstrate that acute and chronic treatment affects MAO activities in the two brain areas examined in opposite ways. Moreover, the two treatments show different effects both according to the substrate used, and, especially in the case of NA and Try, according to the brain area examined.


Catecholamine-induced changes in plasma glucose and insulin levels in the unanesthetized rabbit.

Isoproterenol (ISO) produced dose-related increases in plasma immuno-reactive insulin (IRI) levels in unanesthetized rabbits, whereas epinephrine produced no significant changes. Dose rats of ISO or glucose that produced similar peak increases in glucose levels also produced similar increases in plasma IRI, but the responses to ISO occurred later and were of longer duration than the responses to glucose. Propranolol blocked the increase in plasma IRI produced by ISO, but the ISO-induced rise in plasma glucose was antagonized imcompletely. These data provide supporting evidence for the suggestion that the hyperglycemic activity of ISO in vivo is limited by concurrent ISO-induced changes in peripheral IRI levels.


Effect of acute and chronic morphine treatment on serotonin uptake into rat hypothalamic synaptosomes.

The effect of morphine on uptake of serotonin into hypothalamic synaptosomes was determined following acute and chronic morphine treatment in the rat. The uptake of serotonin was noncompetitively inhibited by in vitro morphine (IC50 = 7 X 10(-4) M) but not by an acute morphine treatment (30 mg/kg s.c.) which produces hypothermia. Uptake of serotonin into hypothalamic synaptosomes derived from rats rendered tolerant to the hypothermic effect of morphine or rats withdrawn from morphine was not altered either in the absence or presence of in vitro morphine as compared to control rats. These data indicate that alterations in thermoregulatory responses of the rat to either acute or chronic morphine treatment do not result from morphine-induced modification of serotonin uptake into hypothalamic neurons.


Norepinephrine-induced reflex bradycardia after central administration of angiotensin II.

Central angiotensin effects may include baroreceptor alterations and/or ventilated, were given angiotensin intravertebrally (10 ng/kg/min), into a lateral cerebroventricle (0.4 microgram/min) or intravenously (10 ng/kg/min). Surgery was completed under methoxyflurane anesthesia; wounds were periodically infiltrated with viscous tetracaine and the methoxyflurane discontinued. The experiments were performed with the brain unanesthetized to optimize detection of an angiotensin effect on the cardioinhibitory component of the baroreceptor reflex. Bradycardia was evoked by norepinephrine injections (2 microgram/kg i.v.). Intraventricular and intravertebral angiotensin increased basal mean blood pressure 16 mm Hg (p less than 0.05); norepinephrine-induced pressor responses and bradycardia were unaffected by the peptide. Intravenous angiotensin did not affect basal blood pressure; a 16 mm Hg increase (p less than 0.05) in the norepinephrine pressor response with no change in bradycardia was observed. Atropine reversed the norepinephrine bradycardia and increased the pressor response in all cats, thus demonstrating the integrity of the reflex. We conclude that centrally administered angiotensin produces no change in the cardioinhibitory reflex to an acute pressor stimulus. The possibility of a peripheral effect of the peptide exists. The hypertensive response observed in the conscious spinal cats after central angiotensin infusions could be due to vasopressin release and/or action of the peptide at cardiovascular sites at high spinal levels.


Role of adrenergic mechanisms in cardiac and respiratory effects of digoxin.

The respiratory and cardiac effects of digoxin the the dog were both markedly reduced by ganglionic blockade and reserpinization, but only the cardiac effects were significantly modified by propranolol. This gives support to our previous hypothesis that digoxin cardiac effects depend, in part, on extra-cardiac mechanisms and its relationship with respiratory effects results from the fact that both effects are dependent directly and reflexly from sympathetic nervous activation.


Lip and laryngeal flaps for reconstruction of the floor of the mouth following glossectomy.

Following glossectomy, the reconstruction of the floor of the mouth is a major problem facing the head and neck surgeon. We have devised split-lip and laryngeal mucosal flaps for this. In selected patients, they have a significant advantage over distant skin flaps. The initial postoperative deformity, from the lip being drawn into the mouth, is corrected by a secondary operation with split-skin graft reconstruction of the vestibule. These lip and laryngeal flaps do not require a delay procedure prior to the cancer surgery, and the operating time is considerably reduced. The cosmetic and functional results have been satisfactory.


Upper lid blepharoplasty.

We reviewed, retrospectively, our upper lid blepharoplasties to critically compare our own postoperative results after (1) conventional blepharoplasty, or (2) fixation of the levator aponeurosis to the lower margin of the orbicularis, or (3) fixation of the levator to the lower margins of the orbicularis and the skin. We found no demonstrable difference in our results with these 3 techniques. It is our opinion that the standard conventional blepharoplasty (including excision of a strip of orbicularis muscle) is preferable for use in most caucasian eyelids. The results are as good, it is simple, and it is less likely to cause problems.


Lateral scalp flaps for instant results in male pattern baldness.

A technique for reconstruction of the anterior hairline, with undelayed lateral scalp flaps, is presented. Unilateral and bilateral flaps have given excellent results in selected patients with a variety of balding patterns. The advantage of gaining instant hair of good density along the anterior hairline is one not provided by the free graft techniques. The continued high patient acceptance and the minimal morbidity encourage further clinical study of this method with cautious enthusiasm.


Correction of entropion in the elderly: a muscle flap procedure.

A method for surgical correction of entropion in the elderly has been described, utilizing a medially-based muscle flap of the orbicularis oculi muscle. The flap is sutured to the periosteum over the lateral orbital rim, thus holding the tarsus and lower lid in a correct position against the globe. The repair is supported further by excising the excess lower lid skin and anchoring the remaining skin to the lateral canthal ligament. The key to this procedure is the ease and accuracy with which the correction can be accomplished.


Treatment of the firm augmented breast by capsular stripping and inflatable implant exchange.

A technique of capsular stripping, removing a gel implant, and inserting an inflatable implant in front of the old capsule, is described for the relief of the firm breasts which sometimes develop after an augmentation mammaplasty. This technique puts all of the old capsule behind the new implant, and it does not require excessive dissection.


Correction of senile (atonic) blepharoptosis during cosmetic blepharoplasty.

Pseudoptosis, caused by skin laxity or by herniation of periorbital fat, can be remedied by the usual cosmetic blepharoplasty. If there is a concomitant mild senile ptosis due to levator weakness, however, we recommend levator muscle plication during the course of the blepharoplasty. While blepharoptosis of significant degree is best treated by resection of the levator, plication works well in a mild degree of senile (or atonic) ptosis (when there is no more than two to 4 mm of droop). It is a simple and effective maneuver, easily performed in association with a cosmetic blepharoplasty.


Photomicrography through the operating microscope.

In summary, the production of high quality photomicrographs through the operating microscope requires considerable attention to detail. The author describes all the details which he has found essential for obtaining good photomicrographs for documentation and/or publication.


Vertical ramisection for prognathism.

Forty-four patients with Class III malocclusion, who were operated on for prognathism, have been reviewed. In spite of the associated problems of pain, nausea, fear, relapse, additional orthodontia, lip numbness, lip weakness, and 8 weeks with their teeth wired together, only one patient of the 44 said he (or she) would decline this surgery if it were to be considered anew. The surgeon must make a strong effort to keep the vertical cut in the bony ramus posterior to the lingula, to avoid postoperative lip numbness. He should also keep traction on the soft tissues minimal, to avoid postoperative weakness of the lower lip. A significant relapse was uncommon in this series, and the facial symmetry was greatly enhanced. Most of these 44 patients (66 percent) said the improvement in their self-image and personal appearance was far more important to them than the improvement in their bite.


General anesthesia for rhytidectomy: a review of 100 consecutive cases.

Although local anesthesia will, and should, continue to be the principal method of anesthesia for most face lift operations, we believe that general endotracheal anesthesia, supplemented by local anesthesia with epinephrine, offers significant advantages in a selected group of patients. We review 100 consecutive rhytidectomies done under this combination of anesthetics. These patients had no significant intraoperative or postoperative problems, and the results compare favorably with the usual technique of local anesthesia plus basal sedation. Good cooperation between surgeon and anesthesiologist, and a thorough understanding of the principles involved in such anesthesia administrations (particularly when relatively large volumes of local anesthesia with epinephrine are going to be used) are necessary for the patient's safe course during the procedure.


Method for the prevention of firm breasts from capsular contraction.

The permeability of inflatable silicone implants to water creates a diffusion gradient which may result in a continuous early disparity between the volume of the implant and its fibrous capsule. We submit suggestive evidence that the addition of 50 ml of water to the desired volume of normal saline in an inflatable implant may be a helpful adjunct in the prevention of firm breasts due to capsular contracture.


Marked thinning of the breast skin flaps after the insertion of implants containing triamcinolone.

In 14 mastectomy patients I did bilateral breast reconstruction with double gel-saline implants. In the first two patients we added triamcinolone to the saline solution, and they developed marked thinning and atrophy of the whole anterior surface of each breast--with impending rupture and loss of the cutaneous coverage. The implants were removed, and other implants (not containing any steroid) were inserted. Satisfactory results followed. In 12 other patients I used double implants containing 10 to 20 mg of methylprednisolone (instead of triamcinolone). The above complication has not appeared in this group.


Burn alopecia.

Our experience in managing 117 patients with burn alopecia are presented. Most often we used staged excisions of the scarred scalp areas, and by this means we could cover up to 15 percent of the scalp. When the alopecia involved the anterior portion of the scalp, however, a rotational scalp flap was needed to restore the anterior hairline and/or sideburns. For those with burn alopecia of more than 60 percent of the scalp surface, no surgical treatment was effective; the women would often cover their scalps with hairpieces, but the men in our series preferred not to do so.


Bone dust cranioplasty: case report.

The use of the bone dust technique of cranioplasty, in a case of neglected basal cell carcinoma of the scalp, is described. A minor modification of the technique was the covering of the bone paste with a layer of oxycellulose, to protect it from disruption and to provide a matrix for new bone growth. A rapid restoration of a sizeable portion of the bony cranial vault was achieved.


Single-stage rotation of arterialized scalp flaps for male pattern baldness: case report.

We used the Doppler ultrasonic flowmeter to trace the temporal artery and its branches posteriorly to their anastomosis with the occipital vessels. Then we outlined a scalp flap (one on each side) along the course of these vessels. The scalp flaps were raised and transposed to the anterior hairline in one stage, as treatment for male pattern baldness. There was complete survival of both flaps, with immediate, normal, luxuriant growth of hair--which could be combed to cover the entire scalp.


Persistent tachycardia after nasal surgery as a premonitory sign of thyrotoxicosis: case report.

Persistent tachycardia in a young girl, following nasal surgery, was shown to be due to a cryptic form of thyrotoxicosis. Though unusual as a cause of tachycardia, overactivity of the thyroid should be considered when unexplained tachycardia persists.


Arteriovenous fistula and paralysis of mandibular branch of facial nerve following direct wiring of a jaw fracture: case report.

We present a case in which interosseous wiring of the mandible resulted in an A-V fistula and an injury to the mandibular ramus of the facial nerve. These two complications can serve as a reminder to all who desire to use interosseous wiring in the treatment of mandibular fractures.


A different incision for rhytidectomy in males.

A new incision is proposed for rhytidectomy in males. It uses the existing sideburn as a superiorly-based flap, to preserve the preoperative hair pattern and style.


A method for the evaluation of minor degrees of breast asymmetry.

We have found the study of split-and-reversed photographs useful in the preoperative evaluation of patients presenting for corrective surgery of the breasts. It puts double emphasis on minor asymmetries, and can be used as an objective tool in planning procedures to correct these, and in evaluating the results. Asymmetry in volume is, however, less readily demonstrated by this technique than is asymmetry of shape.


[Therapy and course of alcoholic delirium].

During the past ten years, treatment of delirium alcoholicum was almost exclusively by means of chlormethiazol (distraneurin), an agent which has sedative, hypnotic, and antiepileptic effects. A total of 111 deliriants with single and multiple deliria were subjected to 151 treatments. In the majority of cases the state of delirium was overcome after three days of specific treatment. The case histories of three patients, where the course of disease was extremely severe and additionally complicated by secondary diseases and who died during treatment (the percentage being  0.7% relative to 151 cases of treatment), are discussed in detail. In the case of severe states of delirium accompanied by repsiratory diseases it is necessary that the patient receiving specific treatment be supplied with additional amounts of oxygen because distraneurin, like other  sedatives, trends to reduce the utilization of oxygen under certain conditions. The majority of deliriants were in their third to fourth decades of life. Accordingly, our patients were younger than those included in the reports presented by other authors. Also discussed by the present authors are attacks accompanying the state of delirium as well as concomitant diseases complicating the clinical picture and adverse effects of alcohol on the nervous system.


[Treatment of schizophrenic psychoses with Lyorodin].

Forty-four patients suffering from acute and chronic schizophrenic psychoses were used to obtain, by using Lorr's scale (IMPS) and taking the changes in disease state observed within three months as a base, suggestions or pointers as to the proper treatment of disease with fluphenazine (lyorodin) which is a neuroleptically highly potent phenothiazine derivative. Megalomania, grandiose delusions apathetic and depressive syndromes showed marked tendencies toward major improvement. An "antiautistic" effect was observed in chronic patients. The effective dose was between 6 and 12 mg a day. The drug was well tolerated. In the majority of cases it was also necessary for antiparkinsonian drugs to be administered to patients. After twelve months of treatment, slight to major improvements or even freedom from symptoms could be observed in 28 cases (or 64%).


The relation between acting out and disorders of impulse control.

THE TERM acting out has been used in many different ways and has often been misused. It is frequently applied indiscriminately to behavior, especially antisocial behavior, which is viewed by the observer as difficult to understand or unacceptable. In this misuse, the term sometimes encompasses behaviors which reflect disorders of impulse control. However, acting out and disorders of impulse control differ in many ways and should be distinguished from each other. A previous communication (Frosch and Wortis, 1954) reported on the nosology of the impulse disorders without attempting to differentiate these from acting out in any extensive manner. In the present communication, it is my intention to pursue this differentiation phenomenologically, dynamically, genetically, and therapeutically.


Behavioral treatment of childhood neurosis.

The present study attempted to use behavioral treatment to eliminate the neurotic symptoms of a 5-year-old child. The child's symptoms were assessed on a pre- and post-treatment basis, and in addition, on going observations of the child's symptoms allowed daily evaluation of the treatment program. Behavior therapy focused on altering the current symptom-environment relationships experienced by the child. Follow-ups on the resolution of the child's problems were conducted two months and two years after behavior therapy and indicated that the child was systom free. Therapeutic attempts to resolve the historical conflicts of early childhood and to resolve the contemporary corflicts of current social interaction are discussed as viable but not mutually exclusive therapeutic strategies.


Women and mental health: a review of feminist change efforts.

A CENTRAL CONCERN of the women's movement has been the damage done to women's psychological well-being by traditional views of women and femininity. This paper will review some of the negative effects of social factors on women's psychological well-being and will discuss four areas in which feminists are striving to change the mental health system.


Projective and identificatory illnesses among ex-hunter-gatherers: a seven-year survey of a remote Australian aboriginal community.

THIS article attempts to provide answers from a psychiatric viewpoint to the question posed by Tindale (1974) in the opening paragraph of his Aboriginal Tribes of Australia: "What happens when a few small groups of people of family size are wresting a living from a given area of land by searching for food, over whose presence or growth they have no direct control?" Such very small-scale societies were a necessity in the Australian environment, where the Aboriginals were obliged to live by hunting and gathering. Indeed, the life-style of all manking was similar to this through most of the time span of human existence. The survey on which this article is based examined a community not long removed from that life-style, and found the defense mechanisms of projection and identification, which apparently persist because of their ancient function in assisting the adjustment of the individual and the group in these very small-scale societies. Some clans in this area have been in continuous contact with whites for only 25 years, and the others for about 60 years, so it is unlikely that the modal defenses of the people have changed. The child-rearing patterns that contributed to the defenses, appropriate to a society organized into clans, probably also have not changed significantly. Intensified by stresses of modern origin, these defenses shape the psychiatric illnesses of today.


Psychotic grandiosity.

ALTHOUGH PSYCHOTIC GRANDIOSITY, like delusions of persecution, constitutes a major symptom in paranoid psychoses, it has not aroused investigative attention. Surprisingly little has been added to our understanding of psychotic grandiosity in the past 50 years, and our knowledge of it has not advanced appreciably beyond the early descriptions provided by Bleuler, Kraepelin, Freud, and others. It is indicative of this lack of interest that Psychological Abstracts does not have a heading for grandiosity, and that no articles under the heading megalomania have appeared in the past five years. The goal of this paper, therefore, is to reexamine the phenomenology of psychotic grandiosity in order to ascertain its incidence, delineate the various forms it might take, and discover some underlying causal factors. Toward this end, I shall present empirical data gathered from 100 patients at the Illinois State Psychiatric Institute diagnosed during 1968-1971 as having some form of paranoid psychosis.


The integration of self and significant others.

THIS PAPER is a study of self-conception viewed as an interpersonal construct. A relatively simple but flexible and multilevel design used in the study provides an opportunity to observe the relationship between the usually assumed generalized and global sense of self-conception and the self as perceived when in the presence of significant others. Hypotheses derived from theories of the self were formulated to test the postulated importance of significant others, and particularly the mother figure, in the development, stabilization, and integration of self-conception and, specifically, self-evaluation.


Dream content and its relation to self-reported interpersonal behavior.

THE NATURE of the relationship between those psychological processes which influence waking behavior and cognition, and those which influence the content of nocturnal dreams, is a question both interesting and unresolved. Is a person's approach to life similar in both the dream and the waking state? If someone was experiencing conflict in his life, might we expect to find conflictual situations in his dreams? And if, on the contrary, a person's waking expectations and experiences were harmonious, might we expect him to manifest conflict-free dreams? These are the questions to which we addressed ourselves in the present study.


Oedipal distortions in severe character pathologies. Developmental and theoretical considerations.

The oedipus complex is presented as a universal, developmentally determined mental organization that incorporates pregenital factors in a new hierarchic structure. Psychoanalysis with adults who have a variety of disorders, including severe character pathology, demonstrates the role of the oedipus complex and its variants as a dominant theme in these disorders. Recent trends in psychoanalytic theory are reviewed to facilitate our understanding of the newer metapsychological formulations that tend to de-emphasize oedipal constellations. Specific issues of changing emphasis in drive theory, ego organization, developmental levels of anxiety, and the separation-individuation process are considered.


Micropsia and testicular retractions.

Five episodes of micropsia, which were precipitated by oedipal masturbatory fantasies, are described in the analysis of an adult male. Traumatic visual events and testicular retractions during the oedipal and latency years predisposed the ego functions concerned with visual perception to later involvement in conflict. The micropsia itself is seen as defending against castration anxiety by means of a series of unconscious fantasies of denial. These fantasies cause a regression to an earlier mode of visual perception (and to micropsia) characteristic of latency. The defensive modifications of the functions of the ego itself seen in micropsia are closely allied to those seen in the dèjá vu experience and in depersonalization.


Conflict and somatization: psychoanalytic treatment of the psychophysiologic response in the digestive tract.

Somatization of intrapsychic conflicts, as manifested in the mouth, the stomach, the small intestine, the large bowel, and the anus, is described in this long-term study of the psychoanalytic treatment of three patients with peptic ulcer, regional ileitis, and ulcerative colitis respectively. The theoretical and practical aspects of treatment are considered, and the efficacy of and indications for psychoanalysis as the treatment of choice are discussed.


The binding of the son: psychoanalytic reflections on the symbiosis of anti-semitism and anti-gentilism.

Jewish ethno-reliqious history is analyzed as one pole of an interdependent Judeo-Christian system of opposition and symbiosis, in which reciprocal dissociation and projective identification function homeostatically to make history recur and to perpetuate what are ostensibly separate traditions. The nature of identification with the Father and with the Son is explored in the two traditions. Anti-Semitism and anti-Gentilism are seen as mirror images, reflecting what is ego-dystonic and ethosdystonic in Christianity and Judaism. It is argued that the Abraham-Isaac relationship is paradigmatic in Judaism and that throughout Jewish history, the Jewish people have accepted both the sacrificial role of Isaac and the punitive role of Abraham, with the paradoxical consequence that martyrdom is the unconscious symbol of survival.


A syndrome of early recognition of occult hydrocephalus and cerebral atrophy.

A clinical and neuropsychological syndrome for early recognition of occult hydrocephalus and cerebral atrophy is described. Five illustrative patients are reported. The main features of the syndrome are (i) subjective non-specific complaints (headaches, depression and loss of memory); (ii) the tonic foot response of the sole and the grasp reflex of the foot in the absence of the grasp reflex of the hand; (iii) attacks of sudden and transient loss of muscle tone in both lower limbs leading to falls without warning while standing or while walking. These attacks indistinguishable from drop-attacks are termed chalastic fits; (iv) a dissociation between the satisfactory performances on the Ottawa-Wechsler scale and the poor performances on Kohs Block Design test. Clinical and neuropsychological findings could not differentiate between occult hydrocephalus and cerebral atrophy; only radionuclide cisternography and computerized tomography were able to delineate the final diagnosis.


The clinical significance of senile cardiac amyloidosis: a prospective clinico-pathological study.

The heart was screened for amyloid deposits in an unselected post-mortem series of 244 patients over 60 who had been admitted to a geriatric department. Cardiac amyloidosis was found in 121 cases (49-6 per cent) but was limited to minor atrial involvement in 55 (22-5 per cent). The prevalence and severity of cardiac amyloidosis were significantly related to age and sex, females having the higher prevalence (56 per cent compared with 37 1/2 per cent). Cardiac amyloidosis was also significantly correlated with the occurrence of atrial fibrillation and of cardiac failure during the period of admission to hospital. Cardiac amyloidosis showed no significant correlations with other factors studied which included ECG evidence of left ventricular hypertrophy, ischaemia and bundle branch block, pathological evidence of cardiac enlargement or ischaemia, diagnosis of malignant disease, generalized wasting and the occurrence of digitalis toxicity.


Intracranial abscesses: a review of treated patients over 20 years.

A series of 49 consecutive patients with an intracranial abscess treated over a 20 year period is analysed and reported. The overall mortality was 28 per cent. The authors regard this figure as quite unacceptable and stress that the combination of isotope scans and computerized axial tomography (CAT) should allow an immediate reduction in mortality to around 10 per cent. The plea is made that whenever a primary source of infection is present the possibility that an intracranial mass could be an abscess is constantly borne in mind. Under such circumstances the patient should be referred immediately to a neurosurgical department (where computerised axial tomography is usually available) without a preceding lumbar puncture.


The accuracy of mammography: an analysis of 655 histologically verified cases.

The accuracy of the mammography was studied on 655 breasts which were investigated and biopsied or treated surgically shortly afterward. The mammography reports were classified according to the confidence level of the statements. In 279 cases the mammography was interpreted as positive for malignancy. A total of 224 malignant tumors were found. In 30 cases the malignant lesion was missed on the mammograms. The diagnoses made with a high degree of certainty were correct in 90% of the cases. The sensitivity of the mammography was 86.6% at a specificity of 80.7% for malignant tumors. The value of mammography for the diagnosis of chronic mastopathy could not be determined objectively. The sensitivity for solitary benign tumors or cysts was 80%.


The value of computer tomography, orbital venography and carotid angiography in the diagnosis of exophthalmos.

On the bases of 25 patients examined by orbital venography, computer tomography, (CT scanning) and sometimes carotid angiography, the diagnostic value of each of these methods is evaluated. The data obtained are compared with the corresponding information from the literature. In view of the findings it can be stated that CT scanning can be regarded as the primary neuroradiological examination in cases of exophthalmos. Orbital venography gives supplementary information in cases of varices and venous malformations. Angiography is the method which supplies the maximum of information when cavernous sinus fistulae are clinically suspected. With reference to 3 patients it is explained that in such selective angiography of the internal and external carotid and the vertebral artery is indicated.


Methods of transfemoral lumbar epidural venography in the diagnosis of lumbar disc herniation.

This article outlines several ways of achieving adequate visualization of the epidural venous plexus in the diagnosis of lumbar disc herniation. Preference is expressed for simultaneous injection of contrast medium via two catheters selecttively introduced into the lateral sacral segmental veins or into the left and right internal iliac veins. For visualization of the epidural veins, the investigator has a choice of over 20 different procedures. The position of choice of the catheter tip(s) can vary during the examination, dependent on diagnostic problems or technical catheterization problems. Epidural venography should be regarded as a very accurate, relatively simple method of demonstrating disc herniations in the lumbar region. This method is especially recommendable in cases that are clinically suspect but have a negative or dubious caudogram. The risk of complications is very small. It is also a good method for azygography. It is possible to perform the examination on outpatients.


Technique of after-loading interstitial implants.

Interstitial implants are either removable or permanent (and occasionally a combination of both). Permanent implants are generally utilized where tumors are not accessible enough to permit easy removal of sources or where accurate source distribution is less critical. They are useful for cancers of the lung, pancreas, prostate, bladder, lymph nodes, etc. Radon and gold-198 have been largely replaced by iodine-125. Our major interests are in the removable after-loading iridium-192 implant techniques. Template (steel guide) and non-template (plastic tube) techniques are utilized. Templates are preferred where the tumor volume can only be approached from one side and where accurate positioning of sources would otherwise be difficult. They are useful for cancers of the cervix, vagina, urethra, and rectum. Non-template (plastic tube) techniques are preferred where the tumor volume can be approached from at least two sides and where templates are either not feasible or not essential for accurate positioning of sources. The single needle non-template approach is useful for cancers of lip, nodes, and breast (plastic button) and for cancers of the oral cavity and oropharynx (gold button). The paired needle non-template approach is useful for cancers of the gum, retromolar trigone, and base of tongue (loop technique) and for cancers of the palate (arch technique). Procedures for each technique are described in detail.


[Experiences with the early mobilisation of elderly patients with myocardial infarction (author's transl)].

Patients with myocardial infarction undergoing a multi-stage activation programme according to the WHO recommendations, consisting of five basic phases, can be mobilised about 85% of the time within the first 20 days of hospitalisation and about 55% of the time already in the second week after the attack. The average hospital stay is four weeks. In the hospital phase the early mobilised patients showed a decrease in early mortality and complications, e.g., reinfarction, heart rupture, development of aneurysm, cardiac insufficiency, thromboembolism, and heart arrhythmia, compared to 190 patients of the same age, who were under traditional bed rest and anticoagulation therapy. It is particularly interesting to note that patients under bed rest and anticoagulation therapy (risk group II B) far more often incurred complications than patients without cumulative risk factors (groups IA, IIA), and patients undergoing early rehabilitation (group I B).


[Pulse frequency of patients with recent myocardial infarction during ski touring (author's transl)].

During two-day cross country skiing courses for beginners telemetric pulse measurements were carried out on male patients with recent myocardial infarction and middle-aged sportswomen (first day: instruction in techniques; seocnd day: walking tour). The following results were obtained: 1.  The pulse frequency varied little during the different exercises. 2. With the exception of two people the established target pulse rate (work pulse) was not significantly exceeded. 3. In no instance during ski touring was the target pulse rate more than 10% higher than the mean pulse rate (values obtained by pulse counting). The results clearly show that cross country skiing is an extremely suitable sports activity for both preventive and rehabilitative cardiology, as it can be learned easily and carried out at different work loads.


[Experiences with non-swimmers in the rehabilitation of adult clients (author's transl)].

The experiences with 595 adult non-swimmers receiving swimming instruction during the years 1974-1976 are discussed on the basis of selected and cited tape interviews. Theoretical reference systems are described against this background of empirical observations, e.g., Alfred Adler's interpretation of individual psychology - that one's style of living is influenced by early childhood experiences, human indifference or hostility. Recent works of brain physiologists are mentioned, which deal with the two forms of human consciousness: the verbalisation of linear, logic and abstract thoughts in the left hemisphere (in the case of right handed persons), and the specialisation of the right hemisphere in the perception of symbols, pictures and irrational feelings. The helpful effect of a non-directive, client-centered atomosphere is discussed. The behavioural changes in patients who learned to swim are compared with the hypothesis formulated by Hoppe - that psychosomatic diseases might be caused by a functional disconnection of the two hemispheres.


[Some considerations on the goals of rehabilitation (author's transl)].

Has not the term "rehabilitation" been very frequently used lately to describe exclusively vocational rehabilitation? If, however, "rehabilitation" does not cover all aspects of rehabilitation including the efforts made to provide  the severely handicapped with the opportunity of developing their potential to the fullest then the severely handicapped are automatically considered segregated. What we do for them can only be described in a negative way. We are unable to integrate them vocationally but we do not want to leave them their fate, either. Without a positive exression for the efforts made for these fellow-citizens alone from the way we think and talk this part of rehabilitation implies inhuman tendencies.


[Some considerations on the goals of rehabilitation - as seen from the viewpoint of social insurance agencies (author's transl)].

1. The final goal of rehabilitation is - according to & 39 cap. 3 BSHG (Federal Law on Social Assistance) - the integration of the disabled person into society. This goal is reached as soon as the disabled person has been resettled into employment and professional life through adequate measures and when it is possible for him/her to participate in community life. Through his resettlement into employment and professional life the disabled person's integration into society is thus achieved in part. 2. The responsibility for the various phases of the rehabilitation process is divided among different social security agencies. Comprehensive rehabilitation is guaranteed through the close cooperation between these agencies.


Identification of metahydroxyamphetamine as a metabolite of amphetamine in the rat.

m-Hydroxyamphetamine (mOHA) was found as a metabolite of amphetamine in rat urine, liver perfusate and bile. The identity was established with a gas chromatograph-mass spectrometer (GC/MS) by its retention time, mass spectrum and selective-ion-monitoring of fragments representing both the side chain and the aromatic moiety. Furthermore, deuterium-labelled amphetamine was used in order to circumvent the possibility of interference by substances with similar structure of endogenous or exogenous origin. The amount of mOHA was low, about 10% of the ring hydroxylation could be accounted for as metahydroxylation.


High pressure liquid chromatographic determination of sulfisoxazole in plasma.

A high pressure liquid chromatographic method for the separation and quantitative determination of sulfisoxazole in plasma was developed. Plasma samples were vortex-mixed with acetonitrile and centrifuged to obtain clear supernatant solutions. The supernate was chromatographed on a reverse phase column using acidified aqueous ethanol as mobile phase to effect separation. The separated components were detected by UV absorption at 280 nm and the peak height measurement was used for quantitative determination. This assay is simple and rapid. Each assay takes less than 8 minutes to complete and can be carried out on as little as 10 microliter plasma samples to accurately measure 2.0 microgram/ml of sulfisoxazole in plasma. This method can be used for an efficient monitoring of sulfisoxazole in plasma during the chemotherapy of bacterial infections, and also for the bioavailability study of the drug from dosage forms.


Multiple factors affecting excretion of warfarin in rats.

Dialysis studies showed that the binding of warfarin by rat serum decreased in the presence of either tolbutamide or oxyphenbutazone. A combination of tolbutamide and oxyphenbutazone decreased the binding of warfarin more than either of the drugs separately. The binding of warfarin by serum from fasted rats was less than in controls, presumably from competition between free fatty acids (FFA) and warfarin for the same site(s) on albumin. The binding of warfarin further decreased under the combined effect of fasting and the presence of tolbutamide than under either condition alone. The binding of warfarin was less at 37 degrees C than 23 degrees C and even less at 37 degrees C in the presence of a combination of tolbutamide and oxyphenbutazone. When tolbutamide or oxyphenbutazone was injected 60 min after iv injection of 14C-warfarin there was an increase in the rate of biliary flow, the amount of radioactivity, and its excretion rate in bile. Injecting both drugs at 60 min further increased these variables.


A concise method for study of the binding of thrombin to human platelets.

A rapid and sensitive technique is described for use in the study of the binding of 125I-thrombin to human platelets. The procedure involves the separation of free thrombin from platelet-bound thrombin by passage of this mixture through a discontinuous sucrose density gradient at low centrifugal force (1,500xg). Results obtained by this method are shown to be comparably to data obtained by two other conventional methods. This technique may facilitate further kinetic study of the binding of thrombin to human platelets.


Protective effect of ethanol against epinephrine-induced myocardial necrosis in rats.

Myocardial necrosis was produced in rats by the subcutaneous injection of a single dose of epinephrine (3 mg base/kg). The severity of the cardiac injury produced was assessed by visual inspection, determination of the release of LDH, CPK, GOT, and HBDH from isolated perfused hearts, and measurement of cardiac uptake of technetium-99m-methylene diphosphonate in vivo. Ethanol, given in doses of 0.5 to 6.0 gm/kg 15 minutes or two hours prior to epinephrine administration protected the hearts against the epinephrine-produced injury, the degree of protection increasing with dose. Investigations of possible mechanisms of action of ethanol indicated that the protective action of the latter does not appear to be due to a lowering of plasma free fatty acid levels, a reduction of cardiac contractility, a non-specific caloric effect, an interference with epinephrine-induced platelet aggregation, or ethanol-induced analgesia.


Failure of the N-oxodized metabolites of some carcinogenic amines to induce tumors in normal and wounded rat skin.

The skin of Osborne-Mendel and Sprague-Dawley rats was treated by repeated topical application of 1- and 2-naphthylamine, 4-biphenylamine and their corresponding N-arylhydroxylamine and nitroso derivatives for 52 weeks. In addition, the possibility of enhancing the susceptibility of the skin to the tumor induction by periodic wounding at the site of compound application was investigated in the Sprague-Dawley strain. The animals were observed for an additional year after which all survivors were sacrificed. No skin tumours were elicited in any of the rats although a small number of systemic tumors at sites distant from the area of application were observed in the Osborne-Mendel strain. No discernable increase in the sensitivity of the skin as a consequence of wounding to the carcinogenic effect of the compounds tested were observed.


Disulfiram-induced acetonemia in the rat and man.

Disulfiram treatment caused marked elevations of circulating blood acetone levels in rat and man. In the rat, disulfiram (0.59 g/kg, p.o.) given singly or for three consecutive days increased the fasting blood acetone levels 5- and 25-fold, fespectively. Circulating acetone levels were also estimated noninvasively in man by measuring acetone in the expired air. A 15-fold increase in the expired air acetone levels was observed in a group of five male non-fasting subjects taking disulfiram (250 mg daily) for a minimum of one month, when compared to control subjects.


Effect of mineralocorticoids on the paradoxical glucose-induced hyperkalemia in nondiabetic patients with selective hypoaldosteronism.

Intravenous infusion of hypertonic glucose induced a transitory paradoxical serum potassium elevation in 3 nondiabetic patients with selective hypoaldosteronism. The abnormal serum potassium response developed in spite of a normal insulin release and was abolished by pharmacological doses of mineralocorticoids in two. It is apparent that in certain patients with aldosterone deficiency normal insulin production alone cannot reverse completely the hyperosmolality-induced transfer of potassium from the intracellular to the extracellular fluid.


Effect of dietary ingestion of oxalic acid on growth and reproduction in male and female Long-Evans rats.

Male and female Long-Evans rats placed on a diet of Purina laboratory chow supplemented with 2.5 and 5.0% oxalic acid for a period of 70 days revealed decreased body weights and restricted growth rates. Ingestion of 5.0% oxalic acid depressed absolute organ weights of several visceral and endocrine tissues but enhanced the organ/body weight ratios of both male and female rats. Vaginal smears indicated disrupted estrous cycles.


In vitro oxidation of 6-MP and its metallo complexes by xanthine oxidase.

Xanthine oxidase oxidized pure 6-MP, and its bismuth complex to 6-thiouric acid, in vitro. The enzyme did not oxidize the palladium complex of 6-MP under identical conditions.


Heat and water loss from the airways and exercise-induced asthma.

Exercise-induced asthma was studied in 8 asthmatics using various conditions of inspired air during exercise. The exercise consisted of walking on a treadmill for 10 min, with a speed and grade elevation adjusted to achieve the target heart rate of approximately 90% of predicted maximum. Pulmonary function tests were performed pre- and post-exercise to determine exercise-induced asthma. With inspired air at 23 degrees C and 15% relative humidity (RH), the post-exercise forced expiratory volume in a sec (FEV1), maximal mid-expiratory flow rate (MMEF), and specific airway conductance (SGaw) decreased to an average of 69, 59 and 38% of the pre-exercise baseline, respectively. In contrast, the exercise-induced asthma was clearly prevented in all subjects by using inspired air at 37 degrees C and 100% RH, when the post-exercise FEV1, MMEF, and SGaw were 99, 100 and 91% of the baseline, respectively. Inspiration of warm, dry air or humid, room air reduced but did not prevent exercise-induced asthma. The results indicate that the primary stimulus for exercise-induced asthma may be heat loss and/or water loss from the airways during exercise.


Bronchial reactivity to prostaglandins F2alpha, E2, and histamine in different types of asthma.

Bronchial reactivity to prostaglandins F2alpha (PGF2alpha), E2 (PGE2) and histamine has been studied in 27 patients with aspirin-sensitive asthma and in 28 asthmatics without this sensitivity. Of the latter group, 13 patients had atopic, 9 infectious, and 6 mixed type of asthma. Atopic patients were characterized by vivid reactivity to low doses of both PGF2alpha and histamine. In patients with infectious asthma significantly higher doses of both PGF2alpha and histamine were necessary to induce bronchoconstriction as compared to atopics. Aspirin-sensitive patients responded quickly with bronchial spasm to similar doses of histamine as atopics, but tolerated significantly higher doses of PGF2alpha. There was no difference in reactivity to PGF2alpha between patients with aspirin sensitivity and those with infectious asthma. 5 and 10 min after administration of 60 microgram PGE2 significantly better improvement in ventilation occurred in aspirin-sensitive patients than in those of either atopic or infectious groups. The results obtained point to differences in bronchial reactivity to prostaglandins and histamine depending on type of asthma and severity of its symptoms.


[Effects of O2 inhalation on the partial arterial-alveolar pressure of CO2 in healthy patients and in patients suffering from chronic bronchitis (author's transl)].

The increase in arterial-alveolar CO2 difference (D[a-A]CO2) on 100% O2 breathing was studied in healthy subjects and in chronic bronchitic patients with or without hypoxemia. This increase in D(a-A)CO2 showing the enhancement of the dead-space effect (i.e. of the ventilation/perfusion ratio; VA/Q,), resulted from increase in PaCO2 or/and from decrease in PACO2 and was only found in hypoxic bronchitic subjects. In such subjects D(a-A)CO2 increased by about 50%. This phenomenon seems to arise from the vasomotor effect of pure O2 on pulmonary circulation and the role played by the Haldane effect in increasing PaCO2 and thus D(a-A)CO2 in some subjects is very weak. In subjects where inhalation of pure O2 produced the greatest increase in D(a-A)CO2 and in VA/Q, the calculated value of the venous admixture (QSh/QT) after measurement of D(A-a)O2 at the 30th min of hyperoxia was overestimated. Indeed D(A-a) O2 was enlarged by increasing the dead-space effect under 100% O2 breathing.


Fatty acid metabolism in hypoxic rat liver.

Fatty acid metabolism was investigated in adult male albino rats exposed to hypobaric hypoxia at 25,000 ft simulated altitude for 6 h at 32 degrees C. Oxidation and esterification of palmitic acid-1-14C and de novo lipogenesis from acetate-1-14C were studied. Palmitic acid-1-14C oxidation in liver slices was normal while acetoacetate formation was increased. In vivo esterification of palmitic acid-1-14C to form triglycerides was increased while formation of phosphatidylcholine and phosphatidylethanolamine was observed to decrease. Decreased incorporation into plasma phosphatidylcholine with unaltered total activity in plasma triglycerides was observed. The incorporation of acetate-1-14C was observed to remain unaltered in triglycerides and phospholipids of liver with a similar pattern in the plasma indicating unaltered de novo lipogenesis. There appears to be increased esterification of fatty acids with probably impaired release of triglycerides into plasma while fatty acid biosynthesis remains unaffected.


Nomenclature proposal for postsegmental bronchi.

The use of flexible fiberoptic bronchoscopy has given a chance to deeper visualization of the bronchial tree. For this reason, the classical bronchial nomenclature becomes much more annoying when denominating pathological processes located in the most peripheral bronchi. The authors suggest a new nomenclature for an easier and more practical use.


Effects of single breath lung inflation on the pattern of subsequent breaths.

In rabbits, on release of lung inflations 0.4 to 3.3 times control VT and lasting 1 to 30 sec, VT, peak diaphragmatic activity (Ep) and inspiratory duration (Ti) increased, whereas expiratory duration (Te) decreased relative to pre-inflation values. Similar changes occurred between pre- and postinflation occluded breaths. These changes lasted from a few breaths up to 30 sec, and were positively correlated with magnitude and duration of inflations. Postinflation changes of pulmonary stretch receptor activity were relatively small and limited to 1-3 breaths. At chemical drive close to control: (a) postinflation VT vs Ti relationship moved to the right without changing its slope, Ti occluded eventually exceeding Ti after vagotomy; (b) the Te vs Ti relationship moved downwards, its slope being decreased and eventually abolished; (c) the average rate of rise of E was decreased. An increase of VT, Ep and Ti, and a decrease Te also occurred on release of stimulation of the central ends of the cut vagi producing apnea at FRC in mono- and bilateral vagotomized rabbits. Postinflation effects were mainly of central origin and tentatively explained as rebound phenomena within the respiratory center.


A mathematical expression to describe the ventilatory response to hypoxia and hypercapnia.

A mathematical expression has been developed to describe the ventilatory responses to changes in arterial oxygen saturation (SaO2) and arterial carbon dioxide tension (PCO2). The derivation is based on the experimental observations: (1) that ventilation is a linear function of PCO2 under isoxic conditions, and (2) that ventilation is a linear function of SaO2 under isocapnic conditions. It is assumed that all functions are continuous and single valued, with the implication that for any given SaO2 and PCO2 there is a unique ventilatory response. The analysis following from these three assumptions has enabled us to derive the following expression for ventilation: VI(SaO2, PCO2) = alpha1 - SaO2 - PCO2 + alpha2 - SaO2 + alpha3 - PCO2 + alpha4 where the alpha's are constants for an individual. This equation, which follows uniquely from the assumption stated, is simpler and contains fewer parameters than previous expressions used to describe ventilation.


Conditions for equivalence of gas exchange in series and parallel models of the lung.

The Fick principle was applied to series and parallel compartmental lung models to determine whether conditions existed under which their differentiation was theoretically possible. Respiratory and inert gases were examined under assumptions of steady-state gas exchange, continuous ventilation and bloodflow, perfect mixing within each compartment and alveolar-endcapillary diffusion equilibration. Algebraic analyses allowing broad generalizations were possible for inert gases but not for O2 and CO2, for which numerical methods were required. For trace amounts of inert gases present in venous blood but absent from inspired air, a given series model always had an exact parallel equivalent. When inert gases were then inspired, equivalence was lost if more than one 'resident' gas (inert or respiratory) was soluble, but the discrepancies were two orders of magnitude smaller than current experimental errors in inert gas measurements. Consequently, steady-state trace inert gas exchange cannot in practice be used to differentiate series from parallel models, but by the same token, if series gas exchange occurs, equivalent parallel analysis is possible.


The respiratory gas exchange of sea turtle nests (Chelonia, Caretta).

Sea turtles lay about 100 leathery-shelled eggs in a 25 cm diameter chamber carefully excavated about 50 cm deep in a nesting beach, where the eggs exchange gases (at approximately 28 degrees C) during their 60-day incubation period. The sand surrounding the spherical nest chamber restricts the diffusion of gases into and out of the nest so that as embryonic development progresses, PO2 decreases and PCO2 increases in the gas inside the nest. PO2 falls to 80-100 torr and PCO2 rises to 40-60 torr inside 100-egg man-made Chelonia and Caretta nests. The change in gas tensions in the nest during development is very similar to that seen in the air cell of the chicken egg. Gas tensions inside the turtle nest and in the sand surrounding the nest can be described by a radial steady-state diffusion model. The rate of diffusion of gases in the sand is 30-50% of the rate found in the nest and 6-12% of the rate found in an equal volume of air. The sand surrounding the turtle nest appears to determine the gas exchange of the eggs in the nest and is functionally analogous to the shell surrounding the chicken embryo. The female sea turtle may construct her nest so as the maximize its gas exchange and minimize gas partial pressure gradients inside the nest.


A comparison of central venous pressure and pleural pressure in supine dogs.

Respiration induced changes in central venous pressure were analyzed and compared with intrapleural pressure changes in dogs. During normal breathing intrapleural pressure changes were transmitted to the vena cava with distortion consisting of attenuation, addition of cardiac and mean pressure components, and a slight temporal delay. Attenuation and temporal delay increased in a regular manner as mean central venous pressure increased. Cardiac components could be removed by electronic filters. The presence of these distortions suggest the need for caution in interpreting intrapleural pressure changes from central venous pressure.


Effect of chest cage restriction on perception of added airflow resistance.

The effect of restricting chest expansion on the detection of resistive loads added to inspiration was assessed in 6 healthy male subjects. Restriction was accomplished using an adjustable chest clamping device. Load detection scores obtained with and without chest clamping were plotted against deltaR and the Weber Fraction (deltaR/Ro), where deltaR is the added load and Ro is the initial resistive load (i.e. subject's R plus minimal R of the apparatus). Results indicate that restricting chest expansion does not alter the ability of healthy subjects to detect added inspiratory resistive loads. It is concluded that perception of such loads is not dependent upon sensory information from the chest wall.


Alteration from apneusis to more regular rhythmic respiration in decerebrate cats.

In spontaneously breathing or paralyzed, ventilated, decerebrate cats. bilateral pneumotaxic center lesions and bilateral vagotomy resulted in apneusis characterized by a marked prolongation of inspiratory duration (TI) and, concomitantly, an elevation of tidal volume (VT) and reduction of respiratory frequency (f). Subsequent placement of medial or lateral lesions in the caudal pons or medulla reduced TI and VT, increased f, and restored a more regular rhythmic respiratory pattern. Placement of these pontile or medullary lesions in animals with pneumotaxic center lesions prevented the development of a typical apneustic pattern upon vagotomy. Large rostral pontile lesions did not change apneusis in spontaneous breathing animals whereas, in paralyzed, ventilated cats, these lesions resulted in some decrease of TI. It is concluded that apneusis generation is not equatable simply with a summation of caudal pontile respiratory unit activities. Rather, activity inherent to intrapontile and/or pontomedullary feedback circuits is considered as a necessary requisite for apneusis development. Interaction of these circuits with an inspiratory off-switch mechanism is considered probable.


[Neuropathologic and toxicologic study of 12 cases of bismuth encephalopathy].

Examination of twelve cases of bismuth encephalopathy showed a constantand marked elevation of the bismuth levels in autopsy cerebral tissue (ranging from 2-8 mg/kg to 25 mg/kg). These values were found to be much higher than the last-measured Bismuth venous blood values. In every case, periveinular lymphocytic infiltration and abundant intra-cytoplasmic lipofuscin were seen. The microanalysis with Castaing's electrode revealed the presence of focal areas of bismuth in the leptomeningeal spaces. The significance of the lesions is not fully established and it will undergo further investigations.


[Paraplegia and bilharziasis. A propos of 4 cases (including 2 confirmed cases of bilharzial myelitis].

Four observations of paraplegia of bilharzians are presented. In two of them the anatomical proof of medullar localization of parasitosis was obtained, once in vivo, only once after a post-mortem. Medical study enables us to spot 55 cases of bilharzian paraplegia, of which 25 sufficiently explicit on the clinical point of view, indicated medullar parasitosis. A parasitosis diagnosis must especially therefore be sought out with the greatest care so that the specific and remarkably active treatment may be started as soon as possible.


[Hepatic encephalopathies; hemodynamic and metabolic study of the influence of ammonia and levodopa].

The authors present the results of a study of cerebral blood flow and energy metabolism carried out in 19 subjects, 12 of whom had hepatic cirrhosis and hepatic encephalopathy (HE). The spontaneous changes and those noted after intravenous administration of ammonium chloride and of L. Dopa, shows that the signs of hepatic encephalopathy are not directly related to the reduction in energy metabolism and that this metabolic disorder does not depend on a blocking of the dopaminergic synopses. The results of this study emphasize the complexity of HE and raise up the hypothesis of the creation of intra-cerebral arterio-venous shunts in cirrhotic patients.


[Rhythmic quadriceps myoclonia related to sarcomatous involvement of the crural nerve].

A case of rhythmic myoclonus of the quadriceps related to involvement of the crural nerve by a schwann-cell sarcoma of the thigh is reported. The rhythm of involuntary contractions varies between 35 and 300 per minute. The myoclonic jerks occur rhythmically in the quadriceps only during full extension of the knee. The jerks are inhibited during lengthening of the quadriceps by active or passive flexion of the knee. Clonazepam is very effective in controlling the myoclonus. It is suggested that the myoclonus is the consequence of a response of alpha-motoneurons of the spinal cord to the excitation of Ia fibers of the crural nerve by the tumor. This activation appears to be enhanced by descending excitation pathway and inhibited by activation of Golgi tendon organs of the quadriceps.


[Torsion dystonia of the left upper limb probably due to a head injury. Calcification of the head of the right caudate nucleus discovered by tomodensitometric examination].

A young man (30 years) suffered a head injury in the course of a road accident. Four years after the accident, there was progressive development of hypertonia of the muscles of the left shoulder in association with certain movements, with torsion dystonia of the left upper limb. The presence of minimal neurological signs differentiated this cases from so-called idiopathic torsion dystonia. Tomodensitometry revealed an opacity of the head of the right caudate nucleus which was invisible on standard skull films. The authors discuss the physiopathology problems raised by this special case.


[Transitory dyslexia related to hematoma of the left temporal lobe in a 14-year-old adolescent].

A hematoma limited to the median region of the second left temporal convolution was the factor of an involvement of written language which rapidly set in in a 14 years old adolescent. The type of disorders observed are quite superimposable on dyslexia in children. After evacuation of the hematoma, the reading disorders disappeared, as was proved by normalization of the leximetric test.


[Properties of and information about a new preparation of immunoglobulins (IgGAM) enriched in IgA and IgM].

A new immunoglobulin preparation, called IgGAM, has been obtained from fraction III. Fraction III obtained during large scale fractionation is used as starting material and caprylic acid for the precipitation of most proteins other than the immunoglobulins present in fraction III; the immunoglobulin concentrate is finally obtained by ethanol precipitation of the supernatant. The IgGAM preparation contains IgG,IgA and IgM in various proportions according to the modifications of the initial technique, and we can obtain fractions more specially enriched in IgA or in IgM. The clinical results obtained with IgGAM preparation are summarized; different types of antibody deficiency syndromes have been successfully treated. It can be injected once à week IM, at a dose of 0.5 ml/kg. No side effects, nor appearance of anti IgA antibodies have been observed.


[Antigen Fyx: quantitative study of subjects FybFyx, FyaFyx and FyxFyx from two new families].

Two new families are described in which multiple examples of antigen Fyx are found in homo-and heterozygous states. The expression of the antigen is evaluated by conventional methods (agglutination scoring) and HD50 assays using a polybren-citrate autoanalyzer technique. Individuals from both families are tested in parallel with those from the family of the first known examples of homozygous FyxFyx described by Cedergren and Giles [2], and with 59 known FyaFyb and FybFyb controls. No consanguinity is found in the two families reported. Quantitative study of anti-Fyb absorption by red cells reveals that the expression of Fyb in individuals considered to be FybFyx is weaker than in FybFyb and even FyaFyb controls. HD50 assay data obtained in the control donors population seem to indicate that, in contrast to the admitted opinion, intermediate degrees of antigenic strength do exist between "normal" Fyb and Fyx the definition of which, based on quantitative criteria, remains unprecise. Using a new potent anti-Fy3 (AR), the expression of Fy3 displayed a slight and variable decrease in FyxFyx samples investigated.


[Clinical effects of the transfusion of leukocytes isolated by filtration from continuous flux].

The present work studies clinical effects of leukocyte transfusions to patients with medular aplasis. Leukocytes were collected by filtration on a continuous flow, according to the technique earlier described in this review [9]. Two major points are stressed on tolerance by the patients of the injected products and clinical efficiency. Seventy eight suspensions were prepared and transfused to 30 patients in the course of 36 incidents of myeloid insufficiency. All patients but two evidenced by the time of transfusion a number of polynuclears inferior to 500 per cubic millimeter. The infection was quite serious with increased gravity despite the antibiotherapy. Intolerance was noticeable in about one third of the cases, half of which consisted only in chillis by the end or after transfusion. Only one accident consisting in acute respiration troubles and shock was observed. This however does not occur by chance. It involves sensitization which may be related to HLA system but may also be of different nature, although not clearly identified. Nevertheless is efficiency of the injected products demonstrated by recirculation of the transfused leukocytes. This was noticed within an hour following transfusion for more than 50 percent of the cases. Furthermore it lasted for 16 hours in more than one fourth of the patients. In addition following results are in favour of real clinical efficiency. Certainly in the course of 16 aplasic incidents, no improvement was observed. For most patients however transfusions were late and not renewed or the patients were highly immunized. Conversely the infection state did improve in 8 patients, the disease responsible for aplasia running its course on its own. Lastly in the course of 12 aplasic incidents, infection and acute aplasia did cure. All these observations should lead one to study with great care the immunological state of the recipient. Instructions being known, the number of transfused leukocytes should be sufficient and renewals frequent enough. Under these conditions leukocyte (filtered and eluted) transfusions appear safe and reliable.


[Preparation of leukocyte-free blood by a method of sedimentation-filtration].

After centrifugation of 450 ml-CPD-whole blood, 125 ml of packed red cells are diluted to 50 percent with saline (pH 7, 2). To remove leukocytes the diluted blood is filtered at room temperature through a newly devised column packed with cotton wool disks. 200 ml of red blood cells suspension are recovered and contain less than 5.10(6) leukocytes. Appropriate controls show that: 1. The filtered blood contains no pyrogen; 2. The red blood cells have a normal osmotic resistance; 3. The suspension can be maintained at 4 degrees C up to 5 days before transfusion without cellular damage.


[Technics for the study of a total leukocyte dialysate and its fractions].

The crude dialysate extracted from human white blood cells from a thousand unselected donors were studied by leukocyte migration inhibition test with measles antigen. This dialysate and its fractions eluted from Biogel P4 and P6 chromatography were compared towards rosette restoration test and nucleotide composition.


Rhinomanometry in myocardial infarction.

In the curves obtained from rhinomanometry a mid-cycle rest (M.C.R.) is sometimes found to occur. The aim of this study was then to analyse the frequency of the M.C.R both in normal subjects and in subjects who had had a myocardial infarction. Rhinomanometry was therefore performed on 3 different groups of people, viz. 1 .32 normal subjects without any respiratory, cardial or any pathological problems. 2. 44 subjects who had had a myocardial infarction. 3. 34 subjects without any cardial problems. Rhinomanometry revealed that 50-60% of the second and third group had a poor nasal respiration. In the first group no M.C.R. was found in any of the subjects. In the second group over 50% of the subjects had a M.C.R. In the third group less than 50% of the subjects had a M.C.R. The x2 test was used to analyse these results as to their statistical significance. The x2 parameter was 3,84 with a significance of 95%, and 6,64 with a significance of 99%. Our result was x2=5,34 which seems to justify further study.


Inspiratory nasal obstruction.

Inspiratory nasal obstruction or collapsing alae is caused by a sucking in of the candal cartilaginous parts of the nose; this is followed by a partial or complete stoppage of the inspiratory air. The nose usually assumes a pinched appearance together with a widening of the nostrils during the inspiratory phase, in cases where the collapse is confined to the upper laterals. Weakening of the upper laterals can results from development anomalies, or atrophy of the tissue with aging. Fractures of the nasal framework may cause displacement or buckling, with subsequent thickening or scar formation. This will again result in poor function. In other cases both the upper and lower lateral cartilages become involved with a resulting collapse of the lobule, producing a silit-like appearance of the nostrils. Examination of patients with inspiratory nasal obstruction will often reveal poor support of the upper laterals, deformity of the lower nasal cartilage, columella and nasal spine or dislocation of the candal parts of the septal cartilage, all of which cause obstruction to the inspiratory air. Collapsing alae should be treated by nasal reconstruction, with removal of the obstruction and stabilization of the nasal framework. In children, it has been possible to enhance symmetric growth, and at times, increase growth-potentials by re-alignment of the cartilaginous structures of the nose.


A nasal functional test: the opeining of mouth during physical effort.

Apart from rare exceptions (cf Voydeville's Thesis, Nancy 1951), nasal airflow resistance has so far been estimated irrespective of variations in air intake needs. The object of the test presented here is to offer a quick, simple and objective method for determining the level of muscular effort at which a given subject spontaneously switches from nasal to buccal respiration. A thin flexible tube (1,5 mm across) is stuck at one end on to the subject's lower lip and the other into a carbon dioxyde analyser. The subject is then made to pedal at a speed at least 30 rev./min. on an ergometric bicycle, while a braking force increasing by 20 W ever two minutes is applied. The emission of carbon dioxyde starts being detected, and graphically recorded, only when the subject starts breathing through his mouth. Results obtained so far show that this threshold can vary as widely as from 80 to 180 W among healthy individuals. Further aplications of this test to both healthy subjects and patients with impaired nasal function would contribute towards throwing light on the still obsure notion of "nasal comfort".


Nasal glands in newborn infants.

The entire mucosa of the nasal septum from four newborn infants was removed, stained by the PAS-alcian blue whole-mount method, and the density of mucous glands was determined in 12 different localities. The interindividual median density was 30.7 glands/mm2 and the median count 13,500 glands. The glands were regularly distributed over the entire respiratory region, but with a significant decrease in density in the posterior half. It has been demonstrated that all glands are laid down before birth, that their density decreases with increasing age until it reaches 8.4 glandss/mm2 at an adult age, and that acute or recurrent acute catarrhal or inflammatory changes of the nose do not lead to the newformation of glands.


Macrophages in immunobiology.

Macrophages are now known to be important not only in resistance to infection but also in immunoregulation, in resistance to tumours and as secretory cells. Among problems requiring further investigation are the ways in which they destroy intracellular organisms, the ways in which they recognize and destroy tumour cells and the extent of their heterogeneity.


The true choanal polyp-a case report.

Whether one could distinguish if a large polyp occupying the nasal pharynx derives from the mucosa of the posterior superior wall of the antrum, ethmoids, or the choanae is a matter not clearly understood. Existing literature is somehow confusing on this subject. One definite fact is that these polyps, whatever the site of their origin, are rare. From the histologic point of view, the general opinion among pathologists is that choanal polyps do not differ histologically from the simple mucous polyps of the nose. The case we are reporting concerns a 65-year-old caucasian male, who for many years had a sensation of fullness behind the nose. Examination revealed a polypoid growth protruding below the margin of the soft palate. Surprisingly roenthenograms were not contributory. This polyp was removed by threading a long soft wire over a regular nasal snare. The free loop of the wire was passed through the anterior nose down to the pharynx where the polyp was threaded into this loop, and by pulling the free end of the wires, the polyp was totally removed without any bleeding whatever. A pathology report is attached as well as a picture of the polyp.


Testings of the ostial patency and penetrance.

In the present study, consisting of 118 cases of maxillary sinusitis with retention of secretion, ostial patency and penetrance were examined three times during each examination, natively, postsuctionally and postirrigationally, by using consecutive measuring technique. Results indicate that, when both ostial respiratory patency and sniff/blow penetrance were tested in these afore-mentioned three phases at each examination that the information gained about ostial patency and penetrance is most representative when the most normal of these results, i.e. the optimal result, is taken as the finding. This is particularly important when testing the ostial penetrance. Observed inconsistencies between the results of the patency and penetrance tests are apparently due to the different pressures used in testing ostial patency and penetrance.


A clinical evaluation of the Cottle rhinomanometry "flow" nozzle.

A clinical study was undertaken to establish what changes in values were caused by the nozzle used in the Cottle flow-pressure technique of rhinomanometry. Cottle rhino-sphygmo-manometry was performed over seven hundred times, half with the nozzle and half without and the results analyzed using pattern, rate, amplitude, work co-efficient and four breath factor as outlined by Cottle. In many instances marked changes did occur but were unpredictable by examination prior to testing. It is suggested that Cottle rhino-sphygmo-manometry be carried out routinely with and without this nozzle in order to better evaluate results of flow-pressure relationship in which this nozzle is used.


Eustachian tube permeability during the nasal provocation test.

The results of manometric study on the permeability of the Eustachian tube after a crisis has been produced by exposing 26 cases of perennial nasal atopy to the threshold-dose of the responsible allergen are reported. In 73% of the cases a reduction of the permeability (16 cases) or a stenosis (4 cases) of the ipsilateral tube were found. The importance of inquiring and specifically treating a nasal allergy in patients suffering from secretory otitis is underlined.


Pathogenesis of nasal polyps.

On the basis of studies on the glands of the nasal mucosa and polyps as well as the structure of the latter, some previous pathogenetic theories are analysed. The authors advance their own theory of polyp formation: Infiltration and oedema in the nasal mucosa result in rupture of the epithelium and formation of granulations which gradually become lined with pseudostratified columnar epithelium. During growth of the polyp there occurs formation of mucous glands which owing to growth of the polyps become long and stretched.


The timing of ovulation by a method of direct basophil cells count.

The variation of the basophil cells number during the menstrual cycle was studied by the method of Shelley and Parnes, slightly modified. The study comprised 29 women diagnosed as primary or secondary amenorrhoea (first group) and 38 women with normal menstrual cycle, twenty of them being fertile and 18 diagnosed as secodary sterility (second group), including also two women in the second month of pregnancy. The radioimmunological measurement of luteinizing (LH) and follicle-stimulating (FSH) hormone was applied for the second group. The data obtained on 34 women of the second group showed the precipitous decrease of the number of basophils from the level of 20--50/mm3 in the follicular phase, or even their disappearance. This decrease corresponded to the LH increase. Moreover, the morphologic examination of the basophils during the menstrual cycle allowed to classify these cells into three categories: intact, partially degranulated, and firing, the number of the latter type increasing on the day of ovulation at the expense of the first two types.


The serum and pituitary prolactin variations under the influence of a pesticide substance in the male rat.

Prolactin was measured in the serum and hypophysis of the male rat after five days of oral administration of malathion in suspension (200 mg/kg body), alone or associated with pimozide (a psychotropic drug). The release of prolactin observed in the group treated with malathion was lower (19.97 +/- 7.27 ng/ml) than in the groups treated with malathion and pimozide or pimozide alone (26.65 +/- 3.17 and 26.49 +/- 2.57 ng/ml, respectively) but significantly higher than in the control group (10.08 +/- 5.82 ng/ml). The administration of two dose levels of pure malathion solubilized in alcohol/water (v/v) failed to reproduce the same results. The discussions are focussed upon: 1) the mechanisms involved in the release of prolactin under the influence of malathion (vagomimetic action) and 2) the lack of cumulative effects of malathion and pimozide (presumably different levels of their influence).


The release of LH and FSH during the thyroid surgery for hyperthyroidism.

Serial blood samples, collected from 21 females and 9 males through the thyroid surgery procedures were assayed for LH and FSH by a radioimmunoassay (RIA) technique. During thyroid surgery the serum LH increased significantly in the male patients from the preoperative levels 20.66 +/- 11.67 to 45.49 +/- 18.50 mIU/ml (p less than 0.01), being unchanged or slightly lower in the female group. The serum LH progressively fell towards the end of the surgery, remaining over the preoperative levels i4 hrs after surgery; occasionally very high levels were observed. The release of LH seemed to be more precocious during the surgery in both sexes in patients belonging to the age group under 40 years by comparison to the older group. The serum FSH showed nonsignificant changes during and after surgery in both female and male patients excepting two menopaused female hyperthyroid patients and a woman of 60 years under laborious surgery for a cervicothoracic polynodular goiter. The data are suggesting the dissociated secretion of LH and FSH in both sexes excepting some cases of menopaused women.


Medullosclerosis, contralateral adrenalectomy and splanchnicosympathectomy in severe essential arterial hypertension and thromboangiitis. Part II.

Operations were performed in 58 patients with severe essential hypertension and in 105 patients with Buerger's thromboangiitis. No postoperative deaths were recorded. The mean adrenalinemia value decreased by 70.91% and that of noradrenalinemia by 10.34%. Systolic pressure decreased by about 30--50 mm Hg and the diastolic pressure by 10--30 mm Hg. The delayed results (1--20 years) were good in 62% of the patients with IIIrd-degree eye lesions and in 17% of the patients in the organofunctional stage II, in 17% of the patients in stage II--III of restricted necrosis, and in 4% of the patients in gangrenous stage III.


A statistical and pathological correlative study of 434 thyroid carcinomas observed between 1967 and 1975.

The authors studied 434 cases of thyroid carcinoma. The sex distribution showed a strong predominance of women (67%). The highest percentage (47%) appeared between 30 and 49 years. Histologically the folliculo-papillary aspect predominated. Thyroid cancer was associated with the following thyreopathies: in 75% of the cases with an anisofollicular adenomatosis, in 12% with a chronic thyroiditis, and in 0.4% with Graves's disease. Only in 13% of the cases no association was found with other thyreopathies. Between 1967 and 1975 no increase of the number of thyroid carcinomas was found.


Influence of a thymus polypeptide extract (TP1) on immunogenesis and on experimental influenza infection in x-rayed animals.

The thymus polypeptide extract TP1 administered to X-rayed animals shows a protecting effect on the level of serum anti-influenza antibodies in the rats inoculated with A2 influenza vaccine and reduces the haemagglutinating titres in the mice inoculated with the A PR8 influenza virus.


Obstructive uropathy in chronic inflammatory bowel disease.

On the basis of intravenous pyelography the frequency of ureteral obstruction was elucidated in retrospect in 140 patients with Crohn's disease and 88 patients with ulcerative colitis. The findings were related to X-ray examination of the gastrointestinal tract and to the clinical condition at the time of examination. 19% of the Crohn patients had ureteral obstruction, typically affecting the right ureter on a level with the linea terminalis. There was a close topographic relationship between radiologically demonstrated intestinal changes and a mass in the homolateral iliac fossa. There was no relation to duration or activity of the disease, urinary tract infections, surgery, or steroid medication. 14% of the patients with ulcerative colitis had ureteral obstruction of varying localization and nearly always arising after colectomy. Renal calculi were found in 13% of the patients with Crohn's disease and in 18% of those with ulcerative colitis. I.v. pyelography is recommended before and after intestinal resection in chronic inflammatory bowel disease to demonstrate the relatively common and often fairly silent urinary tract complications.


Elevated fecal levels of endogenous pancreatic endopeptidases after antibiotic treatment.

Feces from normal and antibiotic-treated persons were analyzed for the content of immunoreactive trypsin and elastase. In the control group the mean concentration of immunoreactive trypsin was 13 microgram per g feces as compared to 147 in the antibiotic-treated group. Elastase was demonstrable in only 3 of 30 samples in the control group but in 20 of 26 in the antibiotic-treated group. The decreased inactivation of pancreatic proteases must depend on an altered intestinal microflora. The results suggest that reestablishment of a normal enteric flora may take months after the short time oral administration of antibiotics.