[Changes in the nervous system of patients with acute occlusive processes in the subclavian artery system].

The report is concerned with clinico-electrophysiological studies of 36 patients with acute occlusional processes in the system of the subclavian artery. The causes of acute occlusions were mainly cardiac disorders and anomalies in the development of bone-muscular systems in the upper apperture of the thorax. Diffucilties of diagnosis during the initial peroids can be explained by a prevalence of symptoms of irritation with wide zones of distribution of pain and acroparesthesia. The amount of supplementary methods of studies, including angiography, predetermine the second period which is characterized by symptoms of desintegration of the peripheral nervous system functions and typical signs of arterial ischemia. An early detection of causes of acute arterial ischemia is a basis for determining the level and volume of surgical operations and measures leading to the restitution of functions of the peripheral nervous system.


[Causes of premorbid vascular insufficiency in patients with facial neuritis].

In 110 patients with facial nerve neuritis of different etiology, the author studied diseases which were accompanying the main disorder and those which were in the past history. In most of the cases there were infectious diseases and accompanying disorders of a vascular, endocrine character, diseases of the gastrointestinal tract and chronic tonsillitis. In some of the patients accompanying disorders were of a physiological condition (pregnancy, climacterium). On the basis of the specific traits of the above-mentioned diseases and physiological states which can accompany or lead to structural of functional changes of the vegetative nervous system and because of a vascular nature of some of them the author assumes that these diseases are the cause of permorbid vascular insufficiency in patients with facial nerve neuritis.


[Recurrent meningococcal menigitis and congenital cerebrospinal fluid rhinorrhea].

In a 20-year old patient there were 5 relapses of meningococcus meningitis during a period of 14 years following the first illness. The development of the last relapse was atypical. A congenital cranio-nasal fistula and liquorrhea was found, inflammatory changes in the lumbar and nasal, an expressed cystic-adhesive membrane process during pneumoencephalography. Frequent relapses are connected with a congenital cranio-nasal fistula and a formation of the focus of infection in the membranes of the cerebral base.


[Diagnostic value of the palmomental reflex].

On the basis of a study of the palmomental reflex in 100 children (from new born to 3 years) and in 73 adult patients with organic lesions of the CNS the author makes a supposition of a connection between its appearance and a lesion of the caudate nucleus. The highest level of the CNS related to the mechanism of the formation of the palmomental reflex is most likely the paleostriatum. The appearance of the palmomental reflex was not connnected with the occurrence of other symptoms of the CNS lesions.


[Functional state of the suprasegmental structures of the brain in experimental secondary contracture of the facial muscles].

For the first time the model of secondary contractures of facial nerves was used to study by long-term sterotaxic implanted electrodes the state of the cortex, amygdal complex, reticular formation of the middle brain, reticular nuclei of the pons and nuclei of the facial nerves. The experiments were accomplished on 31 rabbits. The experiments confirmed a close functional connnection of the VII pair of cranial nerves with the limbico-reticular complex. In secondary contracture there were factors facilitating the influence of pons reticular structures on the deficient system the facial nerve--facial muscles. The achieved data are used to explain the origination of the main symptom of secondary contractures--a stable increase of the muscular tone.


[Effect of lithium on the serotonin and kynurenine paths of tryptophan metabolism].

Lithium carbonate in dosages from 50--100 mg/kg leads to an increase of tryptophanepyrrolase activity in the liver of rats from 50--80%, 5 hours following a single-time intraperitoneal administration and does not exert any influence after 1,3 and 20 hours. The same dosages (50 and 100 mg/kg) of lithium lead to an increase of II-hydroxycorticosteroids in in the blood plasma of rats to 2.5 times and could be prevented by a preliminary administration of dexametasone. A chronic administration of lithium (50 mg/kg) during 10 days did not exert any influence on the triptophanepyrrolase activity and the level of 11-hydroxycorticosteroids in the blood plasma of rats. These data permit of assume that an increase of tryptophanepyrrolase activity by lithium is moderated by an increase of II-hydroxycorticosteroids in the blood.


[Effect of lithium salts on the ultrastructure of isolated cerebral mitochondria exposed to the serum of schizophrenic patients].

The author studied the influence of lithium chlorous on the ultrastructure of isolated brain hemispheric mitochondria of cats, subjected to the action of the blood sera of schizophrenic patients and normal donors. The data demonstrated similar changes in the mitochondria structures under the action of schizophrenic patients and normals. Lithium to a certain extent prevents disorders in the mitochondria structure which appear in an incubation with the blood serum. This effect of lithium is expressed in the same way in the presence of the blood serum of schizophrenic patients and normal donors and is considered to be nonspecific.


[Treatment of depressive states with lithium salts and its importance for the understanding of manic-depressive psychosis].

It was possible to demonstrate a certain positive effect in the prophylaxis and lithium treatment of 25 patients with periodical unipolar depressions and in 16 patients with depressive phases of a bipolar manic-depressive psychosis. No difference between the unipolar and bipolar depressions from the point of view of lithium action was detected. Lithium treatment is considered as a symptomatic, similar to other forms of medicative treatment, because it is impossible to completely eliminate with its aid the phasic disease. The authors recommend to use lithium salts in patients who are in need of prophylactical treatment partially instead of NaCl.


[Role of clinical and pharmacokinetic parameters in predicting the effectiveness of lithium salts in patients with affective psychoses].

Prophylactic treatment with common preparations of lithium carbonate and in its retarded form was given to 44 patients. The studies demonstrated an inverse correlation between the level of negative changes in the patients and the effect of treatment. The use of different methods of mathematical models demonstrated that in the group of patients who received lithium carbonate the most informative was the index of the half-life period and the period of half-elimination of lithium. It was demonstrated that the higher the indices, the better the effect of treatment. In administration of retarded lithium the most informative was the integral index of elimination of the preparation from the organism (an inverse correlation with the effectiveness of therapy).


[Prognostic factors in preventive therapy with lithium salts].

As a result of prophylactic therapy with lithium salts in 250 patients who were treated for approximately 4 years and who demonstrated distinct phasic affective disorders the authors established the following facts: factors of the nosological affinity of the affective psychoses, polarity in its development, the age of the patients and the duration of the therapy did not exert a significant influence on the results of prophylactic therapy with lithium, and therefore cannot be considered as prognostic factors.


[Long-term observation of patients taking lithium and relationship between prognosis and the course of the disease].

The authors evaluated the results of lithium therapy in 70 patients with manic-depressive psychosis and endogenous depressions. The achieved results do not confirm the idea that patients with singular phases have a better prognosis in lithium therapy compared to the prognosis in patients with more frequent attacks. The conclusion is made that atypical signs during the development of an affective psychosis diminish the hope of a successful prophylactic use of lithium.


[Analysis of characteristics of the course and genealogic findings in patients with manic-depressive psychosis having a favorable outcome with lithium treatment].

With the aid of questionnaires it was established that among the patients who had begun long-term treatment with lithium since 1974, 85% of them continued to be treated prophylactically for at least 2 years. Favourable results in such treatment were considered to be in 91% of the cases. Some of the patients at the same time continued to take antidepressive and ataractic drugs. A study of the morbidity risk for relatives of the first degree of kinship in the group of patients treated only with lithium and in the group of patients receiving combined treatment did not demonstrate significant differences.


[Possible prediction of the preventive use of lithium in affective psychoses based on a study of the erythrocyte index].

In 70 patients with affective psychosis, who were prophylactically treated by lithium carbonate (the mean duration of treatment was 1692 days) the authors studied the erythrocyte index (the ratio of lithium content in the erythrocytes to its content in the serum). It was found that the highest index was in the depressive phase and the lowest one in remissions. The success of prophylactic treatment during remissions positively correlated with the increase of the erythrocyte index. The lithium index is of interest only with consideration of the phase of the disease.


[Experience with the use of lithium salts in the treatment of chronic alcoholism].

Lithium salts were given to 88 patients with chronic alcoholism and affective disorders in the clinical picture (32 of the patients received lithium for more than 3 months). Positive results were seen in those cases where pathology of the affective sphere was marked in the premorbid period of alcoholism and was only aggravated in the formation of alcoholism. The absence of any affect was found in those cases where affective disorders first appeared at the remote stages of alcoholism (II-III and III stages). About in 1/3 of the cases there were side-effects, more frequently in the form of dyspeptical disorders.


[Clinical aspects of lithium prevention of endogenous phasic-affective psychoses].

The report deals with the results of a long-term (up to 7 years) therapeuticoprophylactic use of lithium salts in 80 patients with manic-depressive psychosis and attack-like schizophrenia. It was possible to confirm the nosological predictiveness of this method in manic-depressive psychosis. The authors show some indications for the use of lithium in periodical schizophrenia with affective and affective-delusional attacks. A study of the pathomorphosis of clinical signs permitted to distinguish 2 types in the dynamics of the disease development during lithium treatment and correlating with different therapeutical effects. The authors analyze the changes of psychopathological structures in the attacks (phases) during lithium salt treatment.


[Effect of lithium on the course of endogenous psychoses (several clinico-statistical relationships)].

In 75 patients with a phasic development of endogenous psychoses the course of the disease before lithium treatment was characterized by statistically valid and successively increasing from attack to attack phenomena such as lengthening of attacks (phases) with a stable duration of the remissions and more frequent double phases. All of these phenomena were regarded by the authors as an unfavourable medicative pathomorphosis. The influence of lithium was expressed in the following symptoms: 1) prevention of hospitalization (56% of the cases); 2) significant shortening of the attacks (phases) and in some of the cases (19%)--their arrest; 3) transition from psychotic syndromes to cyclothymic; 4) a significant drop of double phases and a corresponding rise in the number of "pure" subdepressive states.


[Clinical and diagnostic characteristics of brain tumors in children in the 1st year of life].

The clinical picture and diagnosis of tumors of the brain in infants of the first year of life are analyzed. Supratentorial tumors predominate (60%) at this age; 76% of the tumors were localized on the midline of the brain and grew into the ventricular system. The tumours were large and always induced the development of concomitant hydrocephalus. The disease was most frequently encountered among boys. The syndrome of progressive hydrocephalus comes to the forefront in the clinical picture and does not differ in clinical signs from that encountered in progressive hydrocephalus of nontumorous genesis. That is why every infant under the age of one year with hydrocephalus should be examined for tumor of the brain to exclude it as the cause. The diagnosis of brain tumors in infants of this age is extremely difficult and is possible only with use of a complex of additional radiocontrast methods of examination.


[Ultrasonic skull trepanation].

Experimental ultrasonic cranial trepanation was performed on 60 albino rats by means of a semi-automatic device, Y3T-1. The trepanation is altraumatic and does not need any considerable physical effort. A histological examination showed that the zone of bone necrosis along the edge of the cut surface was one third to one half that developing with the use of electric and pneumatic surgical instruments. The Y3T-1 device was used in operations on the skull in 78 patients. Resection trepanation of the skull was carried out in 55 patients, osteoplastic in 23. With the use of the ultrasonic device the time of the operation is shorter, a good hemostatic effect is produced, and no considerable physical effort is required on the part of the surgeon. A special catch incorporated in the device ensures safety of the operation. In reimplantation of an osteoperiosteal flap or in primary-delayed cranioplasty the use of an ultrasonic chisel for punctate osteosynthesis creates good conditions for bone tissue regeneration.


[Changes in cerebrospinal fluid pressure in neurosurgical patients during hexenal and thiopental-sodium preanesthesia].

Before undergoing operation on the brain, 30 neurosurgical patients were examined to determine the effect of hexenal (in 15) and thiopental sodium (in 15) central venous pressure were taken. Arterial pressure was measured by Korotkov's method. The cerebral perfusion pressure was calculated. Both anesthetics caused reduction of CSFP: hexenal by 91 +/- 12.1 mm water, thiopental sodium by 108 +/- 21 mm water. A smallrise of cerebral perfusion pressure was noted at the same time.


[Cranioplasty in severe craniocerebral injury in children (a clinical and morphological study)].

The work deals with "delayed" cranioplasty in children with severe craniocerebral trauma employing a bone graft preserved under the skin or fascia of the thigh. On grounds of a morphological examination of bone grafts the most favourable terms for performing cranioplasty are indicated.


[Circadian rhythm of the free 17-hydroxycorticosteroid content in the blood plasma of neurosurgical patients before and after the surgical intervention].

Study of the daily thythms of free 17-oxycorticosteroids in blood plasma of patients with tumors of the spinal cord and spine, discogenic pain syndrome, and of those who underwent plastic surgery for cranial defects revealed disturbances in the biorhythms of the adrenal cortex in patients with tumors of the spinal cord before operation. The postoperative period in all patients was characterized by the development of a stress reaction and paradoxical-type curves of the daily content of these hormones on the 3rd day with complete restoration of adrenal cortex biorhythms by the 15th day. The patients examined did not require special hormonotherapy.


[Combination of aneurysm and primary echinococcosis of the brain].

Aneurysm of the supraclinoid portion of the left internal carotid artery with rupture of its wall and a primary calcified echinococcus of the left frontal wall were discovered in a patient who had a history of general epileptic seizures. Death occurred from massive subarachnoid hemorrhage due to rupture of the aneurysm.


Iatrogenic perforation of the esophagus.

The treatment of iatrogenic esophageal perforation is still today subject of discussion. The present work relates our experience on 16 cases seen between 1955 and 1976, and compares the results with the 1,310 collected by French and English literature. The etiology of perforation is: endoscopy (50.5%), dilatation (19.5%), foreign bodies (14%), surgery and other causes (16%). The mortality rate of cervical perforations is 14.5% (7.3% with medical treatment, 18% with drainage, 12.6% with suture). In the thoracic esophagus it is 32.5% (50% with medical treatment, 40% with drainage, 18% with suture). The data demonstrate that the best results are obtained with surgical treatment, that may be simple drainage when the perforation is cervical, but must be the suture in the thoracic esophagus. We must emphasize that the operation must be performed within 24 hours, because, in the cases operated on after 24 hours, the mortality rate is nearly double.


[Intestinal lesions after radiotherapy (author's transl)].

The authors present a series of 50 patients for which a laparotomy was performed following a lesion of the intestines due to radiotherapy. Resection and anastomosis is indicated only in localized lesions in patients with a good general state. In more extensive bowel lesions it is safer to perform by-pass procedures as the morbidity and postoperative mortality are lower. However, by-pass is inadequate to stop profuse haemorrhages: in such cases resection is mandatory.


[Iatrogenic lesions in a series of 1 250 mediastinoscopies (author's transl)].

Forty-seven complications occurred as a consequence of 1,250 mediastinoscopies, a rate of 3.8%. There were 17 hemorrhages, 7 of which necessitated thoracotomy. One of these died of laceration of the pulmonary artery. Mediastinoscopy was a factor in the death of 6 other patients.


Treatment of alkaline reflux gastritis. A report of twenty cases.

The surgical treatment of twenty patients operated for postoperative alkaline reflux gastritis is discussed together with the pathogenesis of this syndrome as a late postoperative surgery syndrome. Diagnostic procedures and results of investigations and treatment were compared with data of the literature. Surgical treatment is of great benefit. The different surgical technics should be used according their own indication.


[Digestive lesions caused by radiotherapy after surgery (author's transl)].

Between 1968 and 1972, 33 patients with carcinoma of the colon or the rectum underwent a radical surgical procedure followed by adjuvant irradiation therapy. One month after surgery, 6,000 rads were delivered in 6 to 7 weeks. Five of these patients presented later a radiotherapy ileitis, colitis or rectitis. One of them developed a rectitis of the anastomotic area with important diarrheas treated by drugs only; a second presented bowel subobstructions induced by a radiotherapy ileitis and died in cachexy a few months later. The 3 other patients underwent surgery again; one of them for adhesions in the anastomotic area: a definite left colostomy was realized for a stenosic rectitis in the second patient; the last patient underwent surgery 4 times again and died from a rupture of the iliaca artery. Discussion on the observations made at surgery and on the surgical pathology data could explain the high rate of these iatrogenic lesions induced by radiotherapy.


Iatrogenic chylothorax. Etiologic and therapeutic considerations, with presentation of two clinical cases.

A case of mediastinal sclerosis after radiotherapy is presented as a curiosity in iatrogenic etiologies of chylothorax. After 7 weeks of conservative treatment, an operative pleurodesis was successful. In a second clinical case, the hazardous intra-thoracic coagulation of the chyle is illustrate. Etiology and therapeutic mangements of iatrogenic chylothorax in the literature are briefly reviewed.


[Use of acrylic prosthesis for the repair of large defects of the chest wall (author's transl)].

The experience of the authors is based on 17 patients 28 to 76 years old. The defect was always too large to be filled by the surrounding tissues. Six resections were on the sternum or the sternum with ribs. In 4 cases there was also a large resection of skin and muscles and in 3 cases pulmonary resection was associated. Prior to 1971 the authors used a crinoplate 3 times, a thin Marlex plate once and a thick one 5 times. Since 1971, 11 prostheses of methyl methacrylate were fixed with a double metal mesh (3 cases) or a Marlex mesh (8 cases). The authors insist on the interest of the latter prosthesis, made concurrently, easily and solidly fixed, and immediately and indefinitely well tolerated. In cases of large resections of muscle and skin the greater omentum can be used as described by Kiricuta to protect skin flaps from the plate prosthesis.


Cardiac herniation following intrapericardial pneumonectomy.

Cardiac herniation is a rare, highly lethal complication of intrapericardial pneumonectomy, demanding urgent treatment. The condition presents in the immediate or early postoperative period. Cardiovascular collapse is invariably present. Elevation of the jugular venous pressure and cyanosis in the drainage area of the superior vena cava are frequently noted. ECG may demonstrate the abnormal position and some ischemia of the heart. The effects of cardiac herniation are due to a combination of cardiac malposition, with subsequent torsion of the great vessels, obstruction to the outflow of blood from the heart and strangulation of the prolapsed ventricles by the borders of the pericardial defect. The diagnosis rests on an awareness of this condition, its clinical manifestations and radiological examination. Urgent reduction of the herniated heart gives the only possibility of survival. Prevention of possible recurrence must be considered.


Rupture of the posterior wall of the left heart at the atrio-ventricular groove following mitral valve replacement.

The authors report 8 cases of left heart rupture at the insertion of the posterior leaflet of the mitral valve out of 693 mitral valve replacements. Special attention is paid to the anatomy of this area and to the technique of removal of annular calcifications, when present. In reviewing the literature, the authors analyze the cases reported up to now with particular reference to the age of patients, number of valves replaced, size and amount of calcifications, volume of the left ventricular cavity, type and size of the prosthesis employed, supra- or subannular insertion, time between valve application and rupture of the heart, techniques of repair with cardiopulmonary by-pass with a beating or arrested heart. The authors maintain that this dramatic iatrogenic complication can be avoided in most instances with some modifications of the surgical technique which has been adopted in the last 200 mitral valve replacements.


The femoral artery-predilection site for iatrogenic vascular injuries. Causes and therapy.

The study evaluates the number of cases, the causes and therapy of iatrogenic injuries to the femoral artery during and after the transfemoral angiographies, which were performed (1968-1975) in the Klinikum of RWTH Aachen. Total rate of complications was 0.15%. Operative indications were as follows: 1 degree hemorrhage in 4 patients, 2 degrees acute ischemic syndrome in 5 patients, 3 degrees a false aneurysm with intermittent claudication in 2 patients. The pathomorphological substrate of the lesions is reviewed and related to corresponding etiological factors. Therapeutic procedures are considered in relation to recent vascular surgical aspects. With the exception of a hemodynamically effective stenosis, reconstructive surgery involved no complication. Principles to be observed in preventing iatrogenic damage to the femoral artery while performing surgical diagnostics are discussed.


[Arterial lesions caused by the Fogarty catheter (author's transl)].

The authors report 7 cases of arterial wound consecutive to the use of the Fogarty catheter: 1 rupture, 1 perforation, 2 arteriovenous fistulae. They investigate the mechanism and stress the importance of preoperative angiography to minimize the risk of unknwon anomalies. Also they indicate the ease and efficiency of the surgical correction when needed.


[Repair problems of infected iatrogenic lesions of the femoral trifurcation. Review of 7 cases (author's transl)].

The authors report on seven cases of infected iatrogenic lesions of the femoral trifurcation. One case was a false aneurism consecutive to a femoral vein catheterization. In 5 cases an arterial lesion followed angiography according to Seldinger. In the last case aetiology was undetermined. Local symptomatology was always associated to systemic infection. The causative germ was a pseudomonas in 3 cases an a staphylococ in 4 others. Operation was performed in emergency in all cases because of a fissure or a rupture of the artery. The authors performed: one simple arterial suture, one resection with plastic graft, one resection with venous graft and 4 resections with double vein graft. This last procedure appears useful for lesions situated at the femoral division.


Complications following cava catheterization.

The employment of cava catheterization in intensive care and emergency-treatment has dramatically increased. On the basis of our patients in the Surgical Clinics of the RWTH Aachen risks and complications of the central venous catheterization are explained. Six hundred and eighty-four cases have been examined--categorized according to the method of insertion and according to the technique. In a small randomized study, 60 cava catheters were individually examined bacteriologically.


[Vascular iatrogenic lesions in surgery (author's transl)].

The authors report 93 cases of iatrogenic vascular lesions. Thirty-one were secondary to catheterizations and angiography, 10 resulted from accidental intra-arterial or intravenous injections of irritant chemicals, 15 resulted from various operations mainly vascular surgery. Visceral or pelvic ischemias after surgery on the aortic bifurcation are analyzed for symptoms and treatment.


[False aneurysm of the external iliac artery. A late complication of hip surgery (author's transl)].

The authors report one case of false aneurysm of the right external iliac artery following perforation of the acetabulum by a Böhler nail, which was placed twenty-two years before. Clinical signs were a no-pulsating tumor of the right fossa iliaca, deep venous thrombosis of the right leg and severe anemia. Treatment included resection of the false aneurysm, suture of the arterial wound and removal of the Böhler nail. The authors report the place held by vascular lesions in bone surgery, and diagnostic difficulties due to the delayed clinical manifestations.


[Osteoarthrosis of the knee joint, a predictable consequence of meniscectomy in patients with angular deformity of the knee (author's transl)].

The load-bearing function of the menisci is now well established. Meniscectomy increases the load per unit area in the operated femorotibial compartment; this may result into accelerated wear and osteoarthrosis. This is even more likely to occur if meniscectomy is performed on a knee-joint which presents with a mechanical imbalance secondary to angular deformity in the frontal plane. Often, in such cases, the meniscus only displays secondary, degenerative changes, which do not justify meniscectomy. Through a better knowledge of the load-bearing function of the menisci and a more thorough clinical and roentgenological preoperative study in painful knees, undue meniscectomy could be avoided in a number of cases and the frequence of iatrogenic postmeniscectomy osteoarthrosis of the knee-joint could be reduced.


Femoral artery occlusion caused by percutaneous angiography. Mechanisms and management.

Forty-two patients developed signs of acute arterial insufficiency following percutaneous femoral angiography. Three responsible mechanisms were recognized: 1. Occlusion of the femoral artery due to stripping off of thrombus formed on the intra-arterial catheter (22 cases). 2. Distal embolization of thrombus formed at the puncture site in the femoral artery (12 cases). 3. Subintimal dissection of an atherosclerotic plaque with secondary thrombosis (8 cases). Vasospasm was not an adequate explanation for the resulting symptoms and signs of ischemia. Such a diagnosis caused delay in proper surgical therapy. Early heparinization and thrombectomy were necessary. It was successful in all but one of 35 cases. Of seven delayed cases there were complications in three.


[Tracheal resection for correction of stenosis following prolonged intubation. Review of 2 cases (author's transl)].

Longterm tracheal intubation is a safe procedure given technical precautions and intensive care. Tracheotomy causes many more complications among which is tracheal stenosis. Be it after intubation or tracheotomy, tracheal stenosis can nearly always be treated by segmental resection.


Surgical treatment of post-intubation lesions of the trachea.

One hundred and fifty-six patients with post-intubation lesions of the trachea were treated surgically. Of these patients 14 had cuff lesions as a result of ventilatory assistance with endotracheal tubes only. Cuff lesions predominated in those who had tracheostomy tubes. There were six tracheo-esophageal and one tracheoarterial fistulas. The majority of the patients were repaired by end to end anastomosis through the cervical route, most of the others through the cervico-mediastinal route with only five patients by the transthoracic approach. Ninety-one percent have achieved either a good or satisfactory result to date.


[Laryngeal and tracheal stenoses after intubation and/or tracheotomy. A review of 32 cases including 39 lesions and 33 operations (author's transl)].

After reviewing their cases of scarr-stenosis of the upper airway between 1966 and 1976 the authors compare laryngeal to tracheal lesions: Laryngeal and laryngo-tracheal stenoses are long and difficult to repair and all too often yield poor results. These stenoses are usually due to technical faults (tracheotomy after prolonged intubation, forced intubation, tracheotomy through the first ring). They are most often avoidable. Pure tracheal stenoses nearly always result from ischemic destruction from the pressure in the balloons of the tubes and cannulae. They are difficult to prevent when resuscitation requires high pressure ventilation. Their treatment however is simple: resection and anastomosis yields excellent results though it should only be performed in pure scarr-tissue stenosis. Endoscopic dilatations may be a necessary preparation.


Superior mesenteric artery and aorto-iliac blood flow after surgical reconstruction in the aortic bifurcation.

In order to evaluate the possibility of a redistribution of blood from the superior mesenteric artery to the iliac-femoral region, as a cause of intestinal gangrene after surgical reconstruction in the aortic bifurcation, 149 patients operated upon during the last 10 years were reviewed. Aorto-iliac blood flow was studied in all the patients. Blood flow measurements on the superior mesenteric artery before and after release of the aortic clamp and after intra-arterial injection of a vasodilator were made in seven patients. No intestinal complications were found in the present material. The superior mesenteric artery blood flow showed little or no variations and a redistribution of blood from the mesenteric artery to the iliac-femoral region can hardly explain intestinal necrosis.


The place of profundaplasty in surgical treatment of lower limb atherosclerosis.

Fourty-five reconstructions of the profunda femoris artery were performed in 41 patients during the period from 1972 to 1974. 78% were operated upon for pain at rest or distal gangrene. Three patients died postoperatively and in 5 cases the reconstruction failed to save the limb. In 1 additional case the operation probably lowered the amputation level to below knee. There was only 1 late occlusion. In the present material profundaplasty alone or combined with iliac reconstruction could relieve rest pain and save limbs when no other possibilities except amputation existed. However, when significant obstruction of the profounda femoris artery is demonsrated by angiography, profundaplasty should probably be perferred to femoro-popliteal reconstruction in most cases since it represents a minor operation with encouraging long-term results. Lateral angiograms of the deep femoral artery should supplement conventional angiography or lower limb atherosclerosis.


A follow-up study of patients after treatment for bleeding duodenal ulcers by selective vagotomy and drainage (4-8 years observation time).

From 1966 to 1972, 92 patients with bleeding duodenal ulcers were treated acutely by oversewing, selective gastric vagotomy and drainage. Seven patients (8%) died within the postoperative period. Subsequently 22 others have died, but from causes not associated with duodenum or stomach. One patient developed a pyloric cancer 4 years after the original operation. 53 patients could be follow-up with an observation time between 4 and 8 years. Six patients had undergone further surgery, three with duodenal ulcer recurrence six months, two years and four years, respectively, after the primary operation. One, after five years with an ulcer of the corpus of the stomach, and two others, eight months and four years, respectively, after primary operation, on suspicion of ulcer recurrence, which could not be confirmed. Three patients had severe dumping, and one, in incapacitating diarrhoea. 62% of the patients were graded in Visick group I, 19% in group II, 4% in group III and 15% in group IV. (Table III). No patient presented with recurrent bleeding, and no patient died from ulcer disease after discharge from hospital. The value of selective versus truncal vagotomy in treatment of bleeding duodenal ulcer is discussed, and it is concluded, that the procedure, which has to be performed, depends on the surgeon's experience in the vagotomy concerned.


Gardner's syndrome. Report of three cases and review of the literature.

Three cases of Gardner's syndrome are reported. Two patients had one and two carcinomas in the colon respectively. Postoperatively the two patients developed desmoid tumours in the abdominal wall, and one of them also an intraabdominal desmoid. The literature is briefly reviewed with respect to diagnosis and treatment of the components of the syndrome. A special section is devoted to the differentialdiagnostic problems. The reports from the last years concerning this problem are surveyed, and the rationale for maintenance of Gardner's syndrome and familial polyposis of the colon as two different genetic entities is questioned.


Aorto-iliac arterial thrombosis in young women. Report of 3 cases.

Three cases of young women with thrombotic arterial occlusion in the aorto-iliac region are described. All were smokers and used oral contraceptives. Both these factors must be regarded to be of etiological importance.


Fluid absorption and capillarity of suture materials.

The fluid absorption and capillarity of different suture materials commonly used were investigated in saline and blood plasma. Linen and silk have high fluid absorption in plasma (92.2 +/- 1.3%, 65.2 +/- 0.7% of dry weight), and polyamide twisted with cover together with polyester considerably lower absorption (27.0 +/- 0.8%, 16.0 +/- 0.3%). Monofilament polyamide has fluid absorption ability in spite of its homogeneous structure (10.1 +/- 0.2%). Capillary properties were demonstrated in all multifilament synthetic and natural materials but were effectively eliminated by waxing treatment. The fluid transport rate constant varied considerably between different materials and was highest for polyamide with cover. Fluid absorption and capillary properties are presumed to be of significance for the impact of contaminating bacteria.


Suture material and bacterial transport. An experimental study.

The transport of bacteria and spreading of infection by suture materials was studied. An in vitro experiment showed that immobile bacteria can propagate inside multifilament materials. The spreading was correlated to the capillary properties of the threads. A similar result was obtained in an in vivo study in the muscle of the rat. The bacterial transport inside the thread was found to be of significantly greater importance for the spreading of wound infection than that on the surface of the material.


Strength of knots in surgery in relation to type of knot, type of suture material and dimension of suture thread.

The 12 commonest types of suture material in dimensions 7/0, 5/0, 000, 0 and 2 (USP, 1965) were tested in 16 types of knot with regard to tensile strength of knot using the loop method. The results are given in tabular form as the strength of the loop for alltypes of knot tested, and as the mean knoe efficiency for certain groups of knots. The knot efficiencies are compared with regard to the different types of knot, the various types of suture material, and the different dimensions of thread using statistical methods including variance analysis. The strength of unknotted thread within a given dimension showed considerable variations for different suture materials: a given material could be more than twice as strong as the weakest material of the same dimension. With very few exceptions, the knot was the weakest point in a suture loop subjected to disrupting forces. The knot efficiency depended very largely on the type of knot and the strength of different types of knots varied from 3% to 99% of the corresponding unknotted thread. With the exception of two types of steel thread and both types of catgut, the efficiency was low for most simple crossed knots and for many simple parallel knots, and here considerable variations were recorded. Knot efficiency was clearly highest and showed least fluctuation with complex and particularly complex knots, and was closely similar for these. The dependency of knot efficiency on the type of suture material (mean for 16 knots) varied from 44% (polyethylene) to 90% (multifil steel). The variations in dependency on material were greatest with simple knots and with certain materials, and decreased with increasing knot complexity. The dependency of knot efficiency on the dimension of any particular suture material was apparently of much less importance than the type of knot and type of material.


Effect of dextran and induced thrombocytopenia on the lysability of ex vivo thrombi in dogs.

The lysability of thrombi and clots was studied in intact and thrombocytopenic dogs. The thrombi were formed in ex vivo in rotating. Chandler loops, the clots were formed in plastic tubes. Infustion of dextran 70 to the intact dogs was followed by a significant increase in the lysability of the thrombi but not of the clots. Thrombocytopenia caused an increase in the lysability of both thrombi and clots. After infusion of dextran to thrombocytopenic dogs a further increase was noted in the lysability of thrombi but not of clots. The results indicate that dextran and induced thrombocytopenia increase the lysability of thrombi by different mechanisms. The different behaviour between thrombi and clots is probably due to the difference in structure between them particularly with regard to the distribution of platelets. It is suggested that dextran decreased the thrombus statility by impairing the platelet surface function.


Craniofacial development of the rat with respect to vestibular orientation.

The vestibular orientation was applied in the present work. Its purpose was to contribute to the knowledge of the craniofacial development of the growing rat. Sagittal cuts were made in 91 crania from Wistar rats (44 males and 47 females) at 8, 15, 30 and 60 days of age. The x and y coordinates of the sagittal points were determined. The sagittal intersection of the vestibular plane was employed as the abscissa and its perpendicular at the mid point of the external semicircular canal (mesovestibion) as the ordinate. Cranial diagrams were constructed in which the length of the sagittal projection of each bone and its angulation with respect to the abscissa were measured. It was confirmed a progressive evolution towards orthocrania due to the bone rotation complexes, which characterized three cranial regions: the anterior region (frontal-ethmiodal-facial complex) with trigonometric rotation; the mid region (parietal-sphenoidal complex) remained stable, and the posterior region (interparietal-occipital complex) with clockwise rotation. Each complex had its own pattern of rotation. The causal factors reside in the differential increment between the functional components: (a) neurocranium-splanchnocranium, (b) neurocranium-cervical column, (c) dorsal neurocranium-basilar neurocranium and (d) dorsal splanchnocranium-basilar splanchnocranium. Its etiology obeys to the functional requirements induced by the adaptation of the modern rodents.


Electron-microscopic study of collagenous fibers of cultures of bone marrow from healthy children.

Bundles of collagenous fibers have been detected by means of the electron microscope in the intercellular space among hematogenic and stromal cells of 9- and 13-day cultures of bone marrow of two 6-year-old healthy children in course of formation of fibroblast-like cells. Detection of the latter in the cultures during growth gives rise to the suggestion that collagen-producing cells (true fibroblasts) may be formed in vitro. The data obtained are discussed in connection with the question of fibroblast-like cells transformed in vitro to true fibroblasts.


Mitotic index of the Langhans' cells in the normal human placenta from the early stages of pregnancy to the term.

The mitotic index of the Langhans' cells of the normal human placenta has been evaluated from the 6th week of pregnancy until the term. The index is very high from the 6th to the 10th week, and afterwards it decreases quickly. However, some dividing cells are present also in placentas of 30-32 weeks. The high number of mitotic cells is considered to be related to the increase of the syncytial layer more than to the HCG production. This latter would be independent of the proliferative activity of the Langhans' cells and is probably affected by some humoral factors.


Relation between collagen fiber orientation and age of osteon formation in human tibial compact bone.

The predominant collagen fiber orientation in newly formed osteons was determined by polarized light microscopy. Osteons were classified into five categories according to the proportion of their cross section formed by dark lamellae. In dark lamellae most fibers run longitudinally or on a step spiral while they follow a circular or shallow spiral course in light lamellae. Types 1 and 2 are 'light' osteons; types 4 and 5 are 'dark', and type 3 is 'intermediate'. A significant correlation was found between the predominant collagen fiber orientation in osteons and the age at which their formation occurs. Significant differences were found also in the collagen fiber orientation in osteons among the different quadrants of the same bone.


Fine structure of canine thymus.

Normal thymuses of young-to-adult healthy dogs have been studied with light and electron microscopy. Two well-defined zones are observed both in the medulla and in the cortex. In the outer cortex including the subcapsular region, reticular cells and mitotic lymphoblasts are more numerous than in the inner cortex, whereas in the central portion of the medulla the small proportion of free lymphoid cells is more evident than in the outer medulla. Reticular cells can be classified into two main groups according to some morphologic features: epithelial and mesenchymal. Epithelial reticular cells seems to undergo a gradual transformation from the subcapsular region to the medulla, and finally they may become heterogeneous Hassall corpuscles. Mesenchymal reticular cells are represented by macrophages and dendritic-like cells. The latter cells are located in the inner medulla and fill the intercellular spaces with their long cytoplasmic processes. In some occasions these processes appear degenerated and plasma cells and eosinophilic leucocytes are found. This fact suggests different functional stages and a possible participation of the normal thymic medulla of the adult dog as a peripheral lymphoid organ.


Definition of the stages of the cycle of the seminiferous epithelium of the opossum (Didelphis azarae, Temminck, 1825).

Spermatogenesis of the opossum (Didelphis azarae, Temminck, 1825) as revealed by the ferric hematoxylin technique is described. The spermiogenesis is subdivided in 15 steps characterized by changes observed in the nucleus and in the acrosomic structure of the spermatids. Using the morphological changes during the spermatids' maturation, a classification into 10 stages is proposed for the various cellular associations during the cycle of the seminiferous epithelium of the opossum.


Histogenesis of colon glands during postnatal growth.

The development of colon mucosa during postnatal growth was analyzed in male BD IX rats using histological and radioautographic methods. Newborn animals already exhibited clearly recognizable crypts of Lieberkühn. DNA synthesis activity predominated in the lower two thirds of those crypts, as it constantly did during subsequent growth and in adult colons. The height of crypts at birth was already half the adult size. There was, in contrast, a dramatic increase in their number (more than 1,000% from birth to the 10th week, as observed on transverse sections). The mechanism by which new glands derive from the mucosal epithelium implies a longitudinal fission of preexisting glands.


The taste buds of Suncus murinus (Indian musk shrew).

Taste buds were generally found on the posterior side of the tongue. Neural elements (nerve fibres, mainly thick myelinated, and ganglia arranged in a chain-like fashion) participated in the innervation of the taste buds. Cholinesterase activity was much marked in the bottom of the taste buds, while the marginal surface showed no such activity.


[Blood supply of the scaphoid bone of the hand].

For investigation of the vascular supply of the os scaphoideum we produced post mortem injection specimens of hands with latex milk. The estraosseous vessels were prepared macroscopically and microscopically. The intraosseous vascular distribution was represented by cleared specimens (Spalteholz technique). A branch of the arteria radialis or of the ramus dorsalis arteriae radialis enters the dorsal face in the middle and distal third by several foramina nutricia. This artery effects the blood supply almost completely. Other vessels entering the navicular bone are small calibrated and only sometimes demonstrable. The proximal third of the scaphoideum shows no artery entrance.


Radioautographic study of the effect of malononitrile dimer on RNA synthesis in mice.

The drug malononitrile dimer (1,1,3-tricyano-2-amino-1-propene) was administered intraperitoneally to groups of mice at 20 mg/kg body weight, either as a single injection or as chronic 2-month injections. To study the effect of malononitrile dimer on RNA synthesis in the brain, it was necessary to choose a precursor that would pass the blood-brain barrier. Animals were injected with 14C-formate, then sacrificed 1 h later. RNA synthesis in the brain, liver and kidney of the drug-injected and control animals was determined by the amount of 14C-formate incorporated into newly synthesized RNA. A new method involving the comparison of RNase-extracted with non-extracted slides is described for determining the proportion of 14C-formate incorporated into RNA radioautographically. The results show that RNA synthesis was significantly increased as a result of both single and chronic malononitrile dimer injections in all tissues studied. In most cases, malononitrile dimer nearly doubled the percentage of 14C-formate incorporated into newly synthesized RNA. The effect of the chronic injections was most pronounced in the brain. The mechanism of malononitrile action on RNA synthesis are mediated by thyroxine is discussed.


[Postnatal cellular reactivity of the optic nerve after enucleation in the rat. Quantitative aspects in relation to myelinization].

The use of an experimental procedure based upon progressive postoperative delays allowed the quantification of the effects of enucleation performed at the ages of 2, 8 and 20 days, corresponding to key stages of the postnatal maturation of the optic nerve, namely premyelination, myelination and postmyelination. Two main events were noteworthy regarding cell reactivity. The higher the age of the animals at operation, the lower was the proliferation, and the larger was the time lapse between operation and the peak of proliferation. The interferences between reaction gliosis and myelination gliosis depended upon the developmental stage of the optic nerve. This reflects a progressive loss of plasticity.


Cytochemical study on the mechanism of secretion of catecholamines.

Adrenal medulla and carotid body of cats are studied with acrylic aldehyde-dichromate and glutaraldehyde-dichromate methods for catecholamines. The frequency of dark vesicles and the mean diameter of the cores obtained by these specific methods are compared with those found by the standard glutaraldehyde-osmium method in normal and reserpine-treated animals. In the samples of normal organs fixed with aldehyde-dichromate methods, the number of dark-cored vesicles is significantly higher than in the controls. On the contrary, in the adrenal gland of reserpine-treated specimens the specific methods demonstrate reductions in the frequency of dark vesicles that can be semiquantitatively compared with the known diminution in the content of catecholamines produced by the drug. In the carotid body it was not found a so strict relation, nevertheless the specific methods give a consistently lower frequency of dark vesicles in reserpine-treated than in control animals. It is suggested that the discrepancy between standard and specific methods in the carotid body is due to substances existent in the dark cores contrasted by the former procedure but not by the latter. The constancy of the mean diameter of the cores even in glands that have lost 93% of their granules confirms the suggestion of an all-or-nothing exocytotic mechanism of discharge of the secretory vesicles. The inverse relation shown between the frequency of dark and clear vesicles indicates that membranes emerge in the cytoplasm after exocytosis as clear vesicles.


Pars nervosa hypophyseos in chronic audiovibratory stress.

In the nervous part of the hypophysis, significant decrease in the quantity of neurosecretion, hypertrophy, and frequent findings of mitosis of adenopituicytes occur under the influence of noise and vibrations. In chronic audiovibratory stress, the phenomenon of hyperplasia of adenopituicytes and intracytoplasmic presence of structural elements of neurosecretory fibres in disintegration are noticeable. Heterogeneity of neurosecretory fibres is characteristically manifested in the presence of dilated Herring bodies with preserved structure, occurrence of nerve swellings very variable in structure, with numerous polymorphous inclusions and autolytic bodies, or with large vacuoles, few secretory granules and few mitochondria. There are some endings of neurosecretory fibres with many clear microvesicles and few granules, as well as the endings abounding only in clear microvesicles, particularly in pericapillary spaces. The results obtained point to strong stress-inducing effects of noise and vibrations upon the nervous part of the hypophysis.


Effects of mitomycin C in postnatal tooth development in mice with special reference to neural crest cells.

Neural crest cells in the pre- and postnatal development of mice showed a specific sensitivity to mitomycin C. In mice injected with mitomycin C 24-48 h after birth and surviving up to the 9th day, a free or attached denticle in the pulp and a fibroma or excessive cell proliferation in the dental follicle or the periodontal ligament were seen; further, a dentinoma developed.


Successive stimulation of major cell groups in bone marrow. A preliminary approach to the problem of stem cell competition.

The existence of pluripotential haemopoietic stem cells raises the possibility of stem cell competition when two or more differentiating stimuli are given either simultaneously or in close succession. The experiments now reported deal with the effects on guinea pig bone marrow of successive stimulation and they fall into two groups. In one group, erythropoiesis was first stimulated by means of hypoxia, after which granulopoiesis was stimulated by the intraperitoneal injection of typhoid vaccine. In another group, these two stimuli were given in the reverse order. Bone marrow changes were evaluated both quantitatively and by differential counts. The experimental animals were compared with controls given only one stimulus, either hypoxia or vaccine, and also with normal untreated animals. As judged by the output of granulocytes or erythrocytes, no stem cell shortage developed in the experimental animals. A marked fall in transitional cells in the bone marrow of the experimental animals is consistent with the view, though not affording actual proof, that the pluripotential stem cells are to be found in the transitional cell compartment.


Ultrastructure of the human pyloric glands with emphasis on the mucous cell component. Part I.

The human pyloric glands are simple or branched tubular glands which spiral through the connective tissue of the lamina propria. They are comprised of three cell types: the pyloric gland (mucous) cell, the parietal cell, and endocrine cells. The mucous cell is the most common cell type in the human pyloric glands and is characterized by an abundance of secretory granules. The secretory granules are usually round in shape and vary considerably in diameter. They are membrane-bound and comprise a heterogeneous population. The larger granules contain a light staining amorphous material and often possess an area of increased electron density near the limiting membrane of the granule giving them a mottled appearance. A smaller, more electron-dense secretory granule also is found both in relation to the Golgi complex and cell apex. The morphological observations indicate that the mechanism of mucin production by the mucous cells of the human pyloric glands may be similar to that reported in other mucin-secreting cells.


Sexual dimorphism in metacarpal dimensions and body size of Mexican school children.

The hypothesis that patterns of sexual dimorphism in transverse dimensions of the metacarpal only reflect sex differences in body size was investigated in a sample of 324 Mexican school children 6.00-10.99 years of age. Several patterns of sexual dimorphism in second metacarpal dimensions are seen with regard to stature and weight. Sex differences in medullary diameter and percent cortical area are not related to sexual dimorphism in body size, while sex differences in cortical thickness are related to, but not fully explained by, differences in body size. Dimorphism in metacarpal diaphyseal diameter is related to differences in body size, but, at a constant body size and age, boys still have significantly larger diaphyseal diameters than girls. Finally, sexual dimorphism in cortical area is closely associated with sex differences in body size.


Absence of mitral cells in monolayer in monotremes. Variations in vertebrate olfactory bulbs.

An invariant feature of the olfactory bulb in placental and marsupial mammals is the arrangement of the perikarya of mitral cells in a monolayer. Contrasting with this is the arrangement found in the olfactory bulbs of the monotremes, platypus and echidna, where the large perikarya are not only absent from the position of a monolayer (usually forming the external boundary of the internal plexiform layer) but occupy a region which would characterize them as tufted cells. In other classes of amniote vertebrates, reptiles and birds, the placement of large perikarya in the olfactory bulb ranges from a compact layer to a broad band. Such an overview among several vertebrate classes suggests that a monolayer of mitral cells may be a specialized subset of the tufted-mitral cell population. The accessory olfactory formation among mammals also exhibits variation in the compactness of the large perikarya: a broadband in most but a compact layer in a few others such as the chinchilla and the capybara. Such specialized alignment of perikarya (and, consequently, of their dendritic and axonal elements) may enable more refined signal processing than does random alignment of these elements. Such speculations can be tested using appropriate phylogenetic sampling, and monotremes provide particularly advantageous test cases.


Histochemical and ultrastructural study of the parafollicular (C) cells in the thyroid of the gerbil, Meriones unguiculatus.

A histochemical and electron-microscopic study has been done on the parafollicular (C) cells of the thyroid in the gerbil. Histochemical tests revealed the characteristic presence of alpha-glycerophosphoric dehydrogenase and the presence of phenolic groups and indoleamines. Acid phosphatase levels were similar to those observed in the apical cytoplasm of the follicular cells. Electron microscopy revealed characteristic presence of noncisternal rough endoplasmic reticulum, well-developed Golgi apparatus, numerous prosecretory granules and a few electrondense mature secretory granules. Most characteristic of these cells was the presence of numerous, large, electron-lucent vesicles which often were packed in the cytoplasmic processes that were located subjacent to the follicular cells and close to the blood capillaries. Significance of these histochemical and ultrastructural findings is emphasized particularly in regard to the presence of monoamines and their possible role in the release of calcitonin and thyroxin.


Effects of X-rays on the spermaries and ovaries of Xenopus tadpoles.

The results show that irradiation affects both the size of the gonads and the number of germ cells they contain. At stage 64, gonads from irradiated animals were smaller than those from unirradiated ones. The reduced length and thickness of gonads of the test animals were probably due to cell killing. The variation in size of gonads of different test animals and the difference between the left and right ovary of a single individual are indicative of the degree of radiation sensitivity.


Endocardial surface structures of the feline heart observed with a scanning electron microscope.

Internal surface structures of the auricular and ventricular chambers were studied with scanning electron microscopy. We observed vascular connections between the ventricular chamber and the coronary vessels, including cords and papillary muscles covering the lining of the endocardium. The endothelial cells covering the inner surface of the endocardium appeared to be functionally active with many microvilli similar to pinocytic microprojections of other endothelial cells. The pinocytic microprojections ranged between approximately 100 and 300 A in diameter. The epicardium contained mainly bundles of collagenous fibers.


Differences in the osteoinductive potential of transplanted isogeneic dental structures of the rat.

Pulp tissue, enamel and incisal and basal dentine of the mandibular incisor were taken from one litter of rats and transplanted subcutaneously or intracerebrally to sex-matched, 5-day-old animals of the subsequent litter of the same parents. As sham-operations the mere transplantation instrument was inserted into the transplantation sites. With some exceptions, the host animals were killed 4, 32, 128-138 and 210 days after the operation and the transplantation sites were examined either grossly or microscopically or both. The pulp tissue transplantation had resulted in formation of osseous tissue observed 128 days post-operatively. Bone was found in association with many of the basal dentine transplants 128-210 days after their insertion whereas no such tissue was observed with the transplanted enamel of incisal dentine. The sham-operation seemed to have elicited intracerebral bone formation in two animals. The osteoinductive activity of the transplanted tissues seemed reduced by their mineral phase. Further, in contrast to demineralized hard tissues, the non-demineralized inductive agents do not seem to possess bone morphogenetic properties.


Rate of growth of lower incisor teeth in the adult white rat.

A single dose of 14C was given to adult rats and the animals were sacrified 4 days later. The thickness of dentine formed during this period was measured in radioautographs of incisor teeth. It appeared that the thickness of dentine laid down per day was 15 microns. This rate was about one seventh of the rate of growth in immature incisors. No new dentine formation was observed in molar teeth.


Structure and postnatal organization of heretofore uninvestigated and infrequent ossifications of the sella turcica region.

A heretofore unreported spine, which protrudes into the pituitary fossa, has been described and recorded. Complete and incomplete 'sella bridges', their angle formations with the planes of the head, dimensions and sutures have been detailed and their origin postulated. The development and formation of the carotico-clinoid foramina have been exhibited and interpreted. Development stages of the ophthalmic canals have been elicited. An ossified trigeminus bridge has been measured and its origin elucidated. The supracochlear cartilages have been traced from their appearance in the new-born to their supposed fate (os suprapetrosum).


Somata of feline extra-ocular muscle proprioceptors.

The somata of proprioceptive fibres in extra-ocular muscles have been localised to the trigeminal mesencephalic nucleus in twelve cats. This has been achieved by the demonstration of unequivocal changes of chromatolysis in the neurons of this nucleus following selective orbital resection of extra-ocular muscles. The localization of the somata has been shown to be bilateral, and a topographical subdivision in the nucleus in which different muscle groups are represented in different areas of the nucleus has also been demonstrated.


Regeneration of the tail of X-irradiated Xenopus tadpoles.

The effects of X-rays on the regeneration of the tail of Xenopus laevis tadpoles have been studied. Larvae of stage 52 were exposed in groups to irradiation either of the head or the body region with doses of 3,000 and 4,000 r. In both cases, the animals have regenerated the lost parts of their tails.


Aging in the human brain stem. A study of the nucleus of the trochlear nerve.

As a part of a continuing study of the relationship between age and neuronal population within the human brain stem, the nucleus of the trochlear nerve was examined in a total of 20 brains from newborn to 87 years of age. The cell count in the newborn was 1,830, and in the 87-year-old 2,010, while the mean number for all the specimens examined was 2,115. It is apparent that there is no cell loss in this nucleus in the normal aging process, which is in accord with the findings in five other brain stem nuclei examined by various investigators. This is in contrast to the findings in cerebral and cerebellar cortex which show significant cell loss with advancing age. Based on this and previous studies of the brain stem nuclei, it appears that neuronal loss is not a concomitant of the normal aging process in the brain stem. The anatomical basis of this selectivity in neuronal loss with aging in certain parts of the brain is not known at present.


Functionally induced alteration of adult scapular morphology.

The dependence of the growth and development of the scapula on its functional matrix has been clearly defined by a number of experimental studies. Early modifications of this functional matrix may result in an altered scapular morphology [Howell, 1917]. Further, extreme developmental muscular hypofunction results in an increase in scapular breadth and a decrease in length [Riesenfeld, 1966; Doyle, 1976]. However, these studies have been confined to the scapular growth period and no findings have been published on the effect of scapular hypofunction in adults. The present paper addresses this problem. Adult scapular hypofunction in the rat was produced by unilateral amputation of the upper arm. Statistically significant (p less than 0.001) differences in intraindividual scapular breadth dimensions are reported. Further, an increase in the relative instability of the scapular length dimension was observed. No differences in gross scapular morphology resulted from the hypofunctional condition. It is concluded that the functional matrix of the scapula determines a unique morphology during the course of development. Once established, scapular morphology is relatively fixed and only unstable dimensions such as breadth are predictably responsive to a changed matrix.


A scanning electron-microscopic observation on the rat embryo with the frozen resin-cracking method.

The early embryos at the embryonal cylinder stage in rats were studied by scanning electron microscopy, employing the frozen resin-cracking method. An embryo at 15:00 o'clock on day 7 of pregnancy (L6-15) was exposed in the frozen resin-cracked surface. It was located at the antimesometrial side of the uterus and constructed of the embryonic node and trophoblasts, enclosing the blastocele. The embryonic node consisted of the primary ectodermal cell mass and the primary entodermal cells, surrounding the former. The ectodermal cells, forming a solid mass, are polygonal in shape and contain each a comparatively very large nucleus having a significant nucleolus. The entodermal cells are simple columnar or cuboidal in shape, contain numerous vacuoles of various sizes, in which threadlike structures forming a network are seen, and surround closely the ectodermal cell mass; they continue at the ectoplacental cone to the distal entodermal cells, which are very flattened, simple squamous in shape and line the inner surface of Reichert's membrane. In this specimen, the endometrial luminal epithelium has disappeared completely; the narrow blastocele is observed, but the primary amniotic cavity is not.


The roll of the antagonistic muscles in the calculation of muscle moments during trochlearthrosis work.

From the biomechanic point of view, the osteo-myo-articular system works as a physical pulley instead of working as a simple closing and opening of the angle formed between two arms of lever turning around the same point of support. The vector which expresses the force of muscular flexion being always 'sliding'; its moment is constant independently of the angular value between the bone segments which are in flexion.


Excision and localisation of the avian (Gallus domesticus) carotid body.

The anatotopography of cranial thoracic inlets, the carotid body and associated structures in the caudal pole of the thyroid gland are described. The source from which the various groups of fowls (n = 65) were obtained as well as the varied localisation of the carotid body are indicated. In this investigation, the carotid body was found to be situated mostly (49 cases) either on or in the immediate vicinity of blood vessels (carotid and inferior thyroid artery) and only in 14 cases in close association with the parathyroids.


Blood supply to the testis of a Brazilian marsupial (Didelphis azarae) and its abdominotesticular temperature gradient.

The testicular arteries of Didelphis azarae originate from the abdominal aorta either independently from each other or by way of a common trunk. Accessory testicular arteries may be found. At the spermatic cord they form a rete mirabile having 26.8 +/- 5.0 and 29.3 +/- 4.9 slender branches on the right and left sides, respectively. The arterial branches are intermingled with veins of similar caliber and number. Near the testis the branches of the rete reunite in a single vessel which then penetrates the parenchyma of the testis. Inside the testis the artery divides usually into two main branches that course toward the caudal pole. The rectal, scrotal and testicular temperatures were 32, 28.5 and 30.4 degrees C, respectively, appearing than an abdominotesticular gradient temperature exists in this animal. Whether this mechanism is thermoregulatory for the normal spermatogenesis cannot be inferred from the present work.


Microscopic anatomy of the scrotum, testis with its excurrent duct system and spermatic cord of Didelphis azarae.

The authors give a description of the microscopic anatomy of the scrotum, testis and its excurrent duct system and the structures of the spermatic cord. The scrotal skin of Didelphis azarae is hairy with the surface marked by shallow grooves and spotted with black pigmented areas. Clear cells and mitotic figures are frequently seen in the basal region. The sweat glands are tubular, apocrine, with alcian-blue- and PAS-positive secretion, presenting large myoepithelial cells. The tunica dartos is poorly developed. The tunica vaginalis is constituted by three layers, presenting patches of melanocytes in variable extensions. The tunica albuginea is composed preponderantly of collage and thin elastic fibers without muscle fibers. The interstitial tissue presents connective cells and a large number of Leydig cells. Mast cells were not observed. The tunica propria of the seminiferous tubuli is fibroelastic with two or three layers of elongated cells. The straight tubuli are divided into three different portions lined by epithelium with variable height. These tubuli at the mediastinum join each other to form a single duct near the cranial pole of the testis. The extratesticular segment of the efferent duct divides initially into two and then into three or four smaller flexuous ductuli to constitute the head of the epididymis. The spermatic cord shows a well-developed cremaster muscle. A collagenous fibrous band separates the muscle from the deferent duct and vessels. Mast cells are observed among the muscle fibers of the cremaster and the tunica adventitia of the blood vessels.


Studies on human coronary arteries. I. Branch pads or cushions.

The chronology of branch pad development in fetal coronary arteries, their topographic and structural particularities as well as some observations on their evolution in succeeding age-groups are presented. A peculiar emphasis is given to the microarchitecture and functional significance of longitudinal muscle columns as a prevalent structural component of branch pads.


Lymph macrophages enter the germinal center of lymph nodes of guinea pigs.

To determine the fate of macrophages within the afferent lymph stream, the popliteal lymph nodes at various times (3 h to 6 months) after subcutaneous injection of india ink into the footpads of guinea pigs were examined. Two types of cells which had phagocytized india ink were observed in the germinal centers. A small number of type I phagocytes (engulfing india ink as small particles which were often found together with tingible bodies in their cytoplasm) were scattered through the germinal center. A large number of type II phagocytes (packed full of india ink) presented preferentially in the medullary portion of the germinal center, together with many pyroninophil lymphoblastoid cells. In the second experiment, the afferent lymphatics of the popliteal lymph node were ligated 15-20 min after india ink injection. Although the type I phagocytes were distributed as in the first experiment, the type II phagocytes were scanty. In the third experiment, the afferent lymphatics of the popliteal lymph node were ligated 7 days after india ink injection. The type II phagocytes disappeared rapidly from the germinal center, whereas the type I phagocytes remained and were not affected by ligature. These results suggest that the type I phagocytes are the fixed macrophages or tingible body macrophages in the germinal center, and that the type II phagocytes are the macrophages migrating from the peripheral tissues. It was also shown that many macrophages reaching the regional node via afferent lymphatics entered the germinal center through the medullary pole where the cap of small lymphocytes became thinner or disappeared.


Effects of corticosteroid hormone on the epiphyseal growth center of immature pregnant mice.

Immature pregnant mice treated with glucocorticoid hormone (triamcinolone hexacetonide) were killed 1 week following delivery. The epiphyseal growth plates of the humerus and their cellular constituents were analyzed quantitatively. It became evident that pregnancy per se evokes a marked suppressive effect upon young cartilage cells, thus interfering with the normal process of endochondral bone formation. Pregnant mice treated with glucocorticoid hormone experienced an even higher degree of chondrocytic derangement, however, to a lesser extent than chondroxytes of nonpregnant mice treated with the hormone. It therefore appears that pregnancy-induced elevation of systemic estrogens and progesterone provides some kind of a protection against the antianabolic activity of glucocorticoids upon chondrocytes.


Telencephalon cytoarchitecture in Serranus scriba.

Cytoarchitectural analysis of the telencephalon in Serranus scriba fish enabled us to differentiate a rather specialized morphological structure. Nerve cells identified in this structures cannot be classified following classical categories met in higher vertebrates neither be related to the isodendritic type of nonspecialized neurons. A centripetal orientation of dendrites and exons from all regions to the striatum is clearly expressed. Numerical prevalence of large cells is remarkable for similar structures in mammals in their prenatal and postnatal ontogenesis.


The pineal complex and its relationship to other epithalamic structures.

The pineal complex of rodents is made up of a pineal gland which developmentally always originates from the area between the habenular and posterior commissure and a pineal sac which is continuous with the choroid plexus of the third ventricle. At the light-microscopic level, this sac appears to be identical to the choroid plexus. The pineal sac abuts the deep and superficial pineal glands of the golden hamster. In the PET mouse, gerbil, kangaroo rat, and Chinese hamster, the sac is contiguous with only small areas of the pineal gland. This sac never abuts true pineal parenchyma in the albino rat. The variability of the relationship between this sac and pineal parenchyma indicates that the sac may not be the main physiological route of pineal secretion. Venous drainage of the pineal gland consistently seemed to be into the superior sagittal sinus by means of the vena cerebri magna.


Limited fat absorption in the large intestine of mice. A morphological study.

A limited fat-absorbing ability of the epithelial cells in the cecum and colon of mice was demonstrated light- and electron-microscopically. After injection of predigested donor fat into ligated segments of the large intestine and after massive gastric intubation of fat, fat droplets, predominantly of extremely large diameter, were visible in the cecum and colon. Comparison with fat absorption in the proximal and distal small intestine was undertaken. The large intestine, similar to the distal small intestine, is capable of absorbing lipids; however, the subsequent processing of fat appears considerably less effcient than in the proximal segments of the small intestine.


Effect of vincristine on the histological structure of taste buds.

10 adult rabbits were arranged in five batches, 2 animals of nearly the same body weight in each group. 1 animal in each group was injected with vincristine sulfate whereas the other animal was similarly injected with the dissolving medium and used as a control. The animals were sacrificed 2 days after the last injection, and the areas containing the circumvallate and foliate papillae were examined. Injection of vincristine was followed by a decrease in number and in cell contents of vallate and foliate taste buds. Most of the taste buds which persisted after vincristine injection were full of necrotic debris which represented the remnants of degenerated cells. Possible reasons for degeneration of taste buds after vincristine injections were put forewards.


The effects of zinc and copper salts on Cyprinus carpio and Ctenopharyngodon idellus.

The effects of zinc and copper salts on the survival of the two species of freshwater fish, common carp, Cyprinus carpio, and grass carp, Ctenopharyngodon idellus, were investigated. It was discovered that the levels of tolerance to the concentration of the metals were species-specific. Cyprinus carpio was found to be more susceptible to copper, whereas Ctenopharyngodon idellus was more susceptible to zinc. In general, copper was more toxic than zinc, as revealed by the survival times. The body and the gills of dead fish seemed to be covered by a veil-like film which looked like coagulated mucus and which was formed by the heavy-metal ions reacting with some constituents of the mucus and which was formed by the heavy-metal ions reacting with some constituents of the mucus secreted by the gill. The histopathological assessment of the gill and liver of Cyprinus carpio was also carried out. Particles were observed around the gills of the dead fish treated with zinc and copper salts, although no other major changes were found in the gill. Several histopathological changes were observed in the livers, including the presence of particles. The symptoms of the liver suggested that the internal injury was also an important feature of the intoxicants.


[Studies of enzyme distribution in carbohydrate metabolism in humeral periosteum in rats from different age groups].

In the periosteum of newborn, 8-, 30- and 60-day-old albino rats, beta-glucuronidase, beta-galactosidase and succinate dehydrogenase were found. The enzymes of the investigated age groups show remarkable differences in reaction. beta-Glucuronidase reacts distinctly in the cells of the cambium layer of 8- and 30-day-old animals. beta-Galactosidase reacts very differently in the cell layers of the periosteum of albino rats in all age groups. The reaction of succinate dehydrogenase we found above all in the cambium cells, the preosteoblasts and the osteoblasts.


Ultrastructure of the uterine epithelium of mice treated neonatally with estrogen.

In neonatally estrogenized mice, uterine epithelial cells possessed a few microvilli on the fuzzy-appearing apical surface, regardless of the presence or the absence of estrogen. The cells showed well-developed rough endoplasmic reticulum and a large number of mitochondria, suggesting that the cells were actively functioning. At 13 months of age, the uterine epithelium of neonatally estrogenized mice was sometimes stratified and squamous. Spherical basal cells like those appearing in cancerous vagina in estrogen-treated mice made their appearance. These cells may have the capacity of autonomous proliferation.


Myelination and cholinesterase activity of chick embryo spinal cord.

This work was undertaken to study the myelination and cholinesterase activity of the developing white matter of chick embryo spinal cord from the 6th day of incubation until hatching. Myelination of the white matter was always preceeded by the aggregation of neuroglial cells. The sequence of myelination in the cervical and thoracic segments was from before backwards, whereas in the lumbosacral segments it was from behind forewards. Myelination of the ventral column extended craniocaudally, whereas in the posterior column is extended caudocranially. True cholinesterase activity was encountered in the spinal white matter only before and during the process of myelination and was closely associated with the sites of neuroglial aggregations. No pseudocholinesterase activity could be seen in the white matter before myelination. However, during the period of active myelination, enzymatic activity was seen only at the sites of formed myelin and after myelination of all tracts; the whole white matter reacted positive for the enzyme. The significance of these findings is discussed.


Persistent hypoglossal artery in the fetus.

The hypoglossal artery in a human fetus studied by post mortem angiography and microdissection is described. In contrast to the fetal form of the trigeminal artery which differs from the adult form by possessing branches supplying the pons and anastomotic branches to the cerebellar and internal auditory arteries, there were no major anatomical differences between the fetal and the adult form of the hypoglossal artery. The incompetence of the vertebral arteries in the presence of a hypoglossal artery is also emphasized.


Gas chromatographic separation and mass spectrometric identification of polyols in human cerebrospinal fluid and plasma.

Seven polyols, erythritol, arabinitol, anhydroflucitol, mannitol, sorbitol, myoinositol and possibly ribitol were identified in human cerebrospinal fluid by means of gas-liquid chromatography and mass spectrometry. Quantitative data were obtained for five polyols, arabinitol, anhydroglucitol, mannitol, sorbitol and myoinositol, by screening of 205 CSF samples. These five polyols represented 90-95 per cent of the polyol-concentration which was 340 +/- 105 mumol/1 in the total series. The concentration of polyols in the CSF was two times higher than that in the plasma (148 +/- 30 mumol/1), where only anhydroglucitol and myoinositol could be quantitated. The variations noted were not associated with age, sex or the plasma concentrations of polyols. The polyols of the CSF most likely originate from brain tissue and/or spinal cord since penetration from the plasma against a gradient seems unlikely.


Polyols in the cerebrospinal fluid and plasma of neurological, diabetic and uraemic patients.

Five polyols, arabinitol, anhydroglucitol, mannitol, sorbitol and myoinositol, normally present in the cerebrospinal fluid (CSF), were studied. Quantitative gas-liquid chromatographic analysis of 211 CSF and 112 plasma samples indicated significantly altered concentrations in several clinical conditions. All five polyols were decreased in the CSF of patients suffering from meningitis, cerebral atrophy, sepsis, and in patients receiving intrathecal cytostate therapy. Equilibration between plasma and CSF may explain the changes in sepsis and meningitis, while decreased total number of functioning cells may cause the decrease in cerebral atrophy. Intrathecal cytostates seem to have a destroying effect on the cell metabolism of the central nervous system. Renal failure causes accumulation of polyols in the plasma. Alterations in the metabolism of sorbitol, myoinositol and anhydroglucitol seem to be present in diabetes. The plasma concentration of anhydroglucitol is decreased in renal failure.


Clinical, neurophysiological and morphological findings in Eaton Lambert syndrome.

Two patients with maysthenic syndrome apparently not associated with carcinoma were studied in detail with repetitive stimulation of motor nerves, single fibre electromyography and histology. One patient showed signs of widespread autonomic dysfunction and the other patient had multifocal CNS symptoms of unclear etiology. Both cases showed a marked improvement with guanidine treatment which could be documented by the electrophysiological investigations. Due to severe adverse effects of the guanidine treatment on kidney, pancreatic and bone marrow functions the drug had to be withdrawn. Edrophonium given intravenously caused a marked and longlasting improvement of the muscle weakness and of the neurophysiological parameters. The mechanism of action is suggested to be different from that seen in myasthenia gravis. Single fibre electromyography showed a marked increase of neuromuscular jitter and blockings which decreased with increasing innervation frequency. The morphological study showed a selective affection of type II (fast twitch) fibres, a finding which is suggested to be secondary to an impaired neuromuscular transmission in the type II motor units.


Correlation between single fibre EMG jitter and endplate potentials studied in mild experimental botulinum poisoning.

To study the correlation between single fibre EMG jitter and endplate potential amplitude we examined neuromuscular transmission in rats paralysed with botulinum toxin type A with single fibre EMG (SFEMG) in vivo and with intracellular microelectrode techniques in vitro. In muscles that were not completely paralysed SFEMG showed an increased neuromuscular jitter on nerve stimulation and in these muscles endplate potentials were of reduced amplitude. When the nerve stimulation frequency increased the jitter decreased. Intravenous injection of drugs that increase the acetylcholine release and endplate potential amplitude markedly reduced the jitter and the frequency dependence disappeared.


Disability and progression in Parkinson's disease.

Disability and progression in Parkinson's disease prior to levodopa treatment was investigated in a random group of 442 patients representing 91 per cent of all known cases with Parkinson's disease in a defined area. Almost half the patients were totally independent, 27 per cent needed help occasionally, and 25 per cent were dependent on other people. Ten per cent of the patients had only unilateral symptoms, 57 per cent had bilateral involvement with mild disability, 20 per cent had a moderately advanced disease, and 13 per cent were severely idsabled. A great variation was found in progression rates. In individual cases, however, the progression rate seemed to be relatively fixed. Concurrent arteriosclerosis was found to worsen the prognosis, whereas the beginning of the disease with tremor and the occurrence of prominent tremor promised a slower progression. Twenty-six patients with only unilateral symptoms 10 years after onset of the disease were found to correspond to postencephalitic patients in age structure, and in such cases a history of preceeding viral infection of the central nervous system was observed on four occasions.


Evaluation of the red blood cell cytopherometric test for the diagnosis of multiple sclerosis.

The effect of linoleic acid on the electrophoretic mobility of red blood cells from both MS patients and normal subjects was studied. An extensive statistical evaluation of the data clearly demonstrated that there was no difference in behaviour of red blood cells from patients and normal subjects in the presence of linoleic acid. Even a tendency for the mobility of erythrocytes to be decreased in patients and increased in normal subjects after addition of linoleic acid was not observable.


EEG in presenile dementia related to cerebral blood flow and autopsy findings.

EEG, regional cerebral blood flow (rCBF) and neuropathological autopsy data were studied in 17 patients with presenile dementia. RCBF was measured in 14 cases using the intra-arterial-133-Xenon clearance technique. The neuropathological study included semi-serial whole brain microscopical sections in which the severity and regional distribution of the neuronal degeneration was studied, particularly in the cortex and the brain stem. There were two main diagnostic groups, seven cases of Alzheimer's disease and five cases with a cortical atrophy of the Pick (DFT) type. Both groups showed fronto-temporal cortical degeneration. In addition the Alzheimer group showed severe postcentral and posterior-temporal loss of neurons. There were also three cases with degenerative changes, suggesting Jacob-Creutzfeldt's disease. The Alzheimer cases had EEG abnormalities which progressed slowly. In contrast, the Pick (DFT) patients had normal EEGs which remained so even late in the course when the signs of dementia were marked. A positive correlation between rCBF reduction in postcentral areas (as evidence of neuronal loss in these regions) and an increase of EEG abnormality could be established. Degenerative changes confined to frontal and anterior-temporal cortical regions with concomitant flow reduction, on the other hand, appeared to leave the alpha rhythm essentially undisturbed. Finally, the relationship between bifrontal delta-episodes in EEG and neuropathological evidence of brain stem lesions was confirmed.


Electron microscopic studies on the cerebral lesions of rats in experimental chronic disulfiram poisoning.

Following chronic administration of disulfiram to rats, changes of the brain were examined electron-microscopically. Pathological findings were observed in the nerve cells of the cerebral cortex and hypothalamus at later stage and synaptic changes in the hypothalamus from initial stage. On the other hand, changes of myelinated fibers, neuroglias and capillaries were very slight. It was considered that neurons were affected more predominantly than other neuronal elements by the cytotoxic action of the drug, and that the synaptic changes of the hypothalamus might reveal chronic disturbance of noradrenergic transmission by inhibition of dopamine-beta-hydroxylase. These ultrastructural findings might relate to the pathogenic mechanism of the disulfiram psychosis.


The significance of atypical mitoses in malignant meningiomas.

A group of 5 selected malignant meningiomas was studied in relation to the incidence and morphology of the mitoses. Beside a high mitotic rate many structural chromosomal abnormalities were observed. In agreement with other malignant onco-types previously studied, the authors suggest that atypical mitoses together with a tissue and cytological undifferentiation may be assumed to be an important prognostic criterium for meningiomas. The problem of malignancy in meningiomas has not been, so far, satisfactorily resolved, so that, in our opinion, the definition of even minimal details may be of some interest. For example, as it clearly appears from reviewing the literature on this sugject, no particular attention has been paid to the mitotic features. Referring to previous studies on the mitotic abnormalities in different malignant cerebral onco-types, the authors aimed to examine the various mitotic aspects in a limited group of tumors selected on the basis of clinical and histological malignancy.


[Fatal cerebral apoplexy as the first manifestation of immature infantile leukemia (author's transl)].

Among 93 clinical cases of mature and immature leukemia among children in the last 10 years only 3 showed massive cerebral hemorrhage as the first manifestation. The children--aged 5 3/12 yr., m., 2 1/12 yr., f., and 10 3/12 yr., m. died within 40, 48 and 7 h, respectively. Characteristically, an extreme hyperleukocytosis of immature cells with 8999000, 585000, and 360000 cells/mm3, respectively was found. Morphologically the quantitatively varying occurrence of blasts in veins and arteries, basically of hemodynamic origin, is notable, while locally pronounced variations in the venous involvement apparently are strongly dependent upon endovasal growth periods of the blasts. The blasts penetrated extravasal areas not only via passive but also via active migration. The mainly round to oval shape of the perivascular infiltrates of blasts is determined especially by the Virchow-Robins' spaces. The abscence of growth disrupting hemodynamics and texture structures in the unhindered areas of the cerebral ventricle system and retinal detachement favors the formation of leukemic nodules. Neurological symptoms accompanying a high blast count point to a diagnosis of intracerebral hemorrhage.


Congenital intramedullary spinal dermoid cyst associated with an Arnold-Chiari malformation.

Clinical and neuropathological studies of a case of congenital intramedullary spinal dermoid tumor in a patient with typical Arnold-Chiari malformation have been presented. The bulk of the tumor mass was located at C7 level and extended downward for about 3 cm. Numerous well formed hairs were grossly noted within the lesion. Microscopic examination revealed the presence of keratin squams, hair and hair follicles in chronic inflammatory granulation tissue. These histological features suggest that the dermoid has ruptured and therefore the cyst walls could not be identified as such but the content induced prominent chronic inflammatory granulomatous reaction. The rarity of the lesion, especially at the cervical and upper thoracic level and its unique association with an Arnold-Chiari malformation are discussed.


Multiple layers of basement membrane around myelinated and unmyelinated fibers in cellular blue nevus.

Concentric multiple layers of basement membranes around Schwann cells in cellular blue nevus are reported.


Skin and conjunctival biopsies in adrenoleukodystrophy.

Conjunctival and skin biopsies were performed in an 11 1/2 year-old caucasian male affected by adrenoleukodystrophy (ALD). In Schwann cells surrounding myelinated axons in conjunctival and dermal nerve bundles, empty clefts and few arrays of lamellae were discovered. The vacuolization in the eccrine glands of the skin, another striking feature, has not been reported previously in ALD. The obtained results suggest that ALD can be diagnosed in skin specimens precluding major surgery for biopsy. They provide support to the hypothesis of Schaumburg et al. (1975) that ALD is a generalized metabolic disorder.


Focal abnormalities in mitochondrial distribution in muscle. Two atypical cases of so-called "central core disease".

Describing two new cases of so-called Central Core Disease, the authors revealed certain atypical features: The cores were formed in central as well as in peripheral position; they were observed in some apparently type II fibers; typical "structured" and "unstructured" cores coexisted with "reversed" core. Starting from this pictures a cycle of core formation was imaginated supposing to be initiated as the consequence of abnormal functional interrelationship between muscular and neural components in early myogenesis.


Establishment and characterization of 5 human cell lines derived from a series of 50 primary intracranial tumors.

A series of 50 human primary intracranial tumors were cultivated in vitro in an attempt to establish cell lines with the trypsinization technique. During the in vitro adaptation period, cultures were maintained at high cell density to avoid rapid over-growth by connective tissue. Five lines were established from 5 tumors including 4 malignant gliomas (SA4, SA44, SA45, SA101) and 1 meningeal sarcoma (SA39). These 5 lines were compared for the following investigations and criteria: light and electron microscopy, chromosomal patterns, saturation density, plating efficiency, doubling time, synthesis of collagen, S-100 and GFA proteins, response to d b-c AMP and tumorigenicity into nude mice. For one or more of the characteristics mentioned above each line was distinct from the others. None of the growth parameters that serve to define the abnormal state in vitro correlated consistently with cellular tumorigenicity in athymic nude mice. The nature of lines derived from gliomas remain uncertain and the collagen synthesis in vitro is not sufficient to affirm that these lines are mesenchymal rather than glial.


[Gliomesenchymal scar formation and senile retinoschisis (author's transl)].

In senile retinoschisis microfibrillary bundles and basement membrane material were observed within a nearly formed scar tissue on the inner side of the outer layer which were similar to the gliomesenchymal scar formations of the CNS.


Glial and nerve cell changes in rats with porto-caval anastomosis.

Nuclear size and density were determined in brain regions with different glial--neurone composition in rats up to 35 weeks after porto-caval anastomosis. In the white matter, i.e. corpus callosum, both the total cell count and the percentage of astrocytes and oligodendrocytes were unchanged. In the corpus striatum, where the glial/neurone ratio is about 1, the number of nuclei registered as astrocytes increased, and after 35 weeks astrocytes comprised 29% of glial cells (compared with 15% in controls). However, the number of oligodendrogial nuclei decreased simultaneously, leaving the total glial number unchanged. In the animals with longest experimental period there was a 15% loss of neurones. In a region with higher glial/neurone ratio, i.e. the Purkinje cell layer, the neurones showed a similar reduction, whereas the number of Bergmann astrocyte nuclei increased less than striatal astrocytes. A small group of animals with pronounced signs of encephalopathy had a higher loss of neurones and, furthermore, the glial number in corpus striatum and callosum was reduced, due to loss of oligodendrocytes. Despite the use of perfusion fixation, the size of astrocyte nuclei increased, this was reversible, as only slight changes were seen after 35 weeks. A possible explanation of the increase in astrocyte nuclear count and decrease in oligodendroglial count could be that nuclei normally considered to be oligodendroglial are transformed into nuclei with morphological characteristics of astrocytes.