Anorexia nervosa. An affective disorder?

Follow-up data on 26 patients hospitalized during adolescence for anorexia nervosa are presented. The mean length of follow-up was 4.9 years. There were no mortalities. Only one patient at the time of follow-up was still possibly anorexic. However, a substantial number of the patients did have other eating difficulties. Most striking was the clinical psychopathology present at follow-up, particularly the incidence of affective disorder. A large number of patients manifested depressive symptomatology in both the premorbid and the postmorbid states, as well as at the time of follow-up. A family history of affective disorder was particularly common in the mothers of the anorexic patients. Data from this study are consistent with the hypothesis that there is a strong relationship between anorexia nervosa and affective disorder.


Water intoxication, psychosis, and inappropriate secretion of antidiuretic hormone.

A review of the literature and the three presented cases indicate that multiple factors are often involved in the development of water intoxication in the psychotic. Although the syndrome of inappropriate secretion of antidiuretic hormones (SIADH) is one of these factors, it is usually associated with other causes of the SIADH. Evidence is lacking that the SIADH is an essential feature of a psychotic illness.


Psychologic and neuroendocrine response to methylphenidate.

The value of neuroendocrine techniques for providing information regarding the pathophysiology of psychotic disorders is largely dependent on clarification of the relationships among psychologic state, neural activity, and neuroendocrine regulation. This study presents a strategy for examining the interface between neurochemical activity, psychologic state, and neuroendocrine regulation. Psychologic state and serum growth hormone (GH) and cortisol were monitored following administration of methylphenidate hydrochloride, a drug that appears to preferentially affect central dopamine regulation. While individuals varied in both their endocrine and psychologic responses to methylphenidate, the general effects were GH elevation, euphoria, and activation with elation, the most pronounced psychologic effect. Subjects who showed GH elevation became elated while those who did not show a GH response did not become elated. Elation and GH release following administration of methylphenidate may be mediated by the same neurochemical events.


[Extraneural metastasizing oligodendroglioma (author's transl)].

A 40-year-old man suffered from a right parietal oligodendroglioma. Two months after the onset of clinical symptoms complete removal of the tumor was attempted. At second craniotomy four years later the tumor was found to invade the falx cerebri. The patient died seven years after the first admission to the hospital. Necropsy revealed the right parietal oligodendroglioma invading the sagittal sinus and the left hemisphere as well as metastases in the lung, the lymph-nodes, the vertebra, and the femur.


[Comparative investigation of somatosensory spinal and cortical evoked potentials in children (author's transl)].

Somatosensory spinal (spinEP) and primary cortical evoked responses (ssEP) to median and tibial nerve stimulation (at forefinger, wrist, and ankle respectively) were investigated by means of summation techniques in 23 normal children aged 6 to 14 years. Amplitude recovery functions of cervical spinEP were tested by paired stimuli and short tetanic stimulation at the wrist; spinEP amplitudes were unchanged for stimulus intervals down to 5 ms. The amplitudes of the cervical spinEP after strong stimuli to the finger were only a quarter as great as those obtained by stimulation of the wrist at motor threshold strength. In one patient with the Brown-Séquard syndrome cervical spinEP were absent for stimuli on the side of position sense impairment, but were unaffected for stimuli on the side of dissociated sensory loss. The normal latencies of spinEP (to the onset of the negative potential) and ssEP (to first negative peak) are presented as functions of body height. The difference between these two latencies yielded a central latency from the lower cervical spinal cord of about 9--10 ms. The spinal afferent conduction velocity, calculated from the difference between the lumbar and cervical latencies after tibial nerve stimulation at the ankle, was found to be 74m/s.


[Psychophysiologic processes in pyrovasy (fire walking) (author's transl)].

1. Using the model of pyrovasy (fire walking) we investigated human psychophysiologic processes, possible 'paranormal' human efficiency, and the scientific principles connected with the latter. The introduction is a field study description of the historical background and the cultic character of pyrovasy as a religious rite of invulnerability. 2. The psychophysical process during the ceremony of fire walking was investigated neurologically and psychiatrically with polygraphic recordings from four Greek fire walkers in a Greek village. 3. We did not find any pathognostically relevant results. The conditions of pyrovasy were also simulated in a thermophysical laboratory experiment. All results of the investigation support the hypothesis that fire walking lies within the scope of human efficiency. 4. The hypalgesia experienced during pyrovasy has, among other things, a psychologic component with specific effects on the physical regulation of temperature, and is also partly due to a special technique of walking.


[Cortical blindness, clinical, psychologic, and localizatory findings (author's transl)].

Description and evaluation of a case in which both occipital lobes of the brain and adjacent temporal and parietal areas were heavily damaged by malignant meningiomas. Loss of simple and complex visual functions resulted. During a 5-year period the clinical, neurologic, ophthalmologic, and psychologic findings could be completed by self-observation by the highly intelligent patient and compared with findings from three operations. Postmortal neuropathologic analysis  showed loss of both left and right areas 17 and 18 and of right area 19. The localizations of elementary and complex visual functions in the brain are discussed.


Choledochoduodenostomy in the treatment of benign biliary tract disease.

Recurrent surgical interventions on the biliary system for benign biliary tract diseases carry high morbidity and mortality. Choledochoduodenostomy creates a large and easily performed biliodigestive anastomosis enabling good drainage of the biliary system. Among 27 patients undergoing choledochoduodenostomy for benign biliary tract diseases, recurrent cholangitis occurred in only one patient, in whom a stenosed anastomosis was probably the culprit. The other patients have been free of abdominal complaints, cholangitis, or pancreatitis for follow-up periods of from six months to eight years. There was no operative mortality; morbidity was 45%, but hospital stay averaged only 14.7 days. The traditional objections to this procedure do not seem valid where choledochoduodenostomy is rightly indicated, the common bile duct is dilated, and a wide enough anastomosis is constructed. Our favorable results mark choledochoduodenostomy as a safe, simple, and effective procedure in the management of benign biliary tract disease, particularly in the high risk patient.


Primary intrahepatic gallstones.

Caroli's disease is characterized by congenital segmental dilation of the intrahepatic bile ducts producing a variety of symptoms and, usually, primary intrahepatic gallstones. We are reporting five new cases of Caroli's disease in addition to the 91 reported in the literature. The diagnosis is made by intrahepatic cholangiography; techniques are emphasized. The diagnoses were confirmed by the surgical specimen of the left lobe of the liver in cases 1 and 2, by autopsy in case 3, and by intrahepatic cholangiogram in cases 4 and 5. The treatment resulted in leftsided lobectomy of liver in cases 1 and 2. Cholecystectomy, removal of common duct stones, choledochoduodenostomy or, preferably Roux-en-Y choledochojejunostomy, were done in cases 3, 4, and 5. Two patients died more than five years after their original surgery, and three are alive at six months, six, and 13 years, respectively. This is a more encouraging outcome than is usually reported.


Pancreatic pseudocysts communicating with the stomach: demonstration by endoscopic retrograde pancreatography.

The use of endoscopic retrograde pancreatography (ERP) provides important information in the management of pancreatic pseudocysts unavailable by other methods. When the pseudocysts communicate with a hollow viscus, the surgeon is better able to deal with the problem if aware of this fact prior to operative intervention. A pancreatic pseudocyst communicating with the stomach was demonstrated by ERP in each of four patients. One of these patients had pancreatic ascites and the other had left-sided pleural effusion, and both were treated successfully by distal pancreatectomy. The other two patients responded to nonoperative treatment. This report emphasizes the potential diagonstic value of ERP in determining the presence and the fate of pseudocysts.


Inguinal herniorrhaphy under local anesthesia. A prospective study of 100 consecutive patients with emphasis of perioperative morbidity and patient acceptance.

For various reasons, repair of inguinal hernias under local anesthesia is not well accepted. The purpose of this study is to evaluate the effectiveness of local anesthesia in inguinal hernia repairs. One hundred consecutive inguinal herniorrhaphies are reported. The selection of patients, surgical technique, and incidence of intraoperative and postoperative complications are reported. Patient acceptance and their immediate postoperative course are also described. The study demonstrates that inguinal hernias can be easily repaired under local anesthesia, complications are minimal, and patient acceptance, excellent. We strongly recommend thath this form of anesthesia be used in the "routine" repair of inguinal hernias in cooperative patients.


Patency of venous grafts in small veins: influence of aspirin and warfarin sodium.

Venous autografts were prepared in jugular veins of rabbits as a test model to determine the usefulness of antiplatelet and anticoagulant agents (aspirin and warfarin sodium) alone or in combination for maintaining patency in the reconstruction of small veins. Graft patency was determined by periodic venography and postmortem examination. The grafts clotted in all of the untreated controls, five of six animals receiving aspirin, and three of four receiving warfarin, but in none of the animals receiving the combination of aspirin and warfarin.


Total hip arthroplasty: an editiorial comment.

Total hip arthroplasty has become an accepted method of management of severe painful problems of the hip. It has undergone some dramatic changes, the major thrust now being to more nearly match the mechanical characteristics of the implant to the bone and cartilage they replace.


Status of total shoulder arthroplasty.

Some patients with degenerative, rheumatoid, and traumatic diseases of the glenohumeral joint require treatment primarily to relieve pain. In the absence of complete knowledge of basic mechanical requirements, clinical trials with both constrained and resurfacing prosthesis were initiated. Three types of constrained prostheses were placed in 23 patients. Pain relief was satisfactory, but six reoperations were necessary and motion greater than 90 degrees was rarely achieved. Twenty-five prostheses that were used to replace the glenohumeral articulation, but were not stable by virtue of design, were implanted. Again, pain relief was excellent; mechanical problems were not present, and motion was almost always greater than 90 degrees. Achieving stability by capsular-muscle cuff repair has not been as great a problem as anticipated. These results suggest that more emphasis should be placed on repair of the glenohumeral stabilizing structures than on their replacement.


Total replacement of the elbow joint.

Total replacement of the elbow joint has been performed on 86 elbows at the Mayo Clinic, all but 15 in patients with rheumatoid arthritis. The Mayo design, which replaces both radiohumeral and humeroulnar joints, was used in 41 elbows, almost all in rheumatoid patients, with 71% good results. The Coonrad hinge with polyethylene bushings was used in 34 elbows; it was successful in 64% of rheumatoid patients, but failed in 46% of posttraumatic patients with bone loss. Previous designs have failed because of humeral loosening. Total elbow replacement is a technique still to be perfected in medical centers before general release.


New concepts in arthroplasty of the hand and wrist.

Clinical trials with cemented polyethyiene and metal total joint arthroplasties were initiated in 1973. Replacements have been developed for the wrist, carpometacarpal joint of the thumb, metacarpophalangeal joints of the thumb and fingers, and the proximal interphalangeal joints of the fingers. Results, evaluated by pain relief and joint stability, were excellent at all sites. Motion, however, averaged only 50% of normal. Significant problems included abnormal posture in the wrist, roentgenographic evidence of loosening in the finger metacarpophalangeals, extensor lag in the metacarpophalangeal of the thumb, and lack of motion in the proximal interphalangeal joint of the finger.


Current status of total knee arthroplasty.

Total knee arthroplasty has become an acceptable method of surgical management for severe, disabling gonarthropathy. The three major biomechanical classifications of total knee prostheses are minimally constrained, partially constrained, and fully constrained. The major indication for total knew arthroplasty is pain, followed in a much lower frequency by instability, loss of motion, and deformity. The principal contraindications for the various types relate solely to the residual or restorable ligamentous stability of the knee and the degree of bone loss. In general, the greater the instability and bone loss, the more constrained the prosthesis must be Theoretically, loosening rates increase with increasing shear stresses, which are generally highest with the most constrained prostheses. The major complications are sepsis, loosening, and instability. Various prostheses have incorporated patellofemoral resurfacing as the final dimension in producing a total knee arthroplasty. Knee arthroplasty is very effective in preserving functional knee motion, with relief of pain as an alternative to arthrodesis.


Total ankle joint replacement.

The ankle is an inherently stable, kinematically simple joint that bears tremendous compression forces with relative ease because of a large load-bearing surface area. Disabling disease of the ankle is less common than at the hip or knee joints, but is not rare. Ankle arthrodesis seems less than ideal as a technique of surgical treatment. Total ankle joint replacement seems to be a clinically possible alternative on the basis of experience with 76 procedures performed during a 31-month period. Continuing clinical experience is resulting in more gratifying results by the avoidance of technical errors and better selection of patients.


Can and should the ethics of a cottage industry survive?

In an era of rapidly escalating costs of health care, government and the consumer can be expected to play an increasingly active role in determining the character of health care systems. In this setting, professional behavior will become increasingly conspicuous. In reviewing a physician's responsibilities to his patient, to his community, and to himself, emphasis is placed on the pivotal qualities of integrity, selflessness, professional commitment, communication, and continued intellectual and personal growth. Underscroing this a code of ethics that is flexible, comprehensive, and sensitive to the needs of contemporary society.


Detecting complications of direct arterial surgery: the role of intraoperative arteriography.

Intraoperative arteriography was carried out using a specially constructed operating table and long x-ray film changer that permitted rapid serial exposure of the arterial reconstruction and the distal arteries. During a ten-year period, this method was applied in 1,810 arterial reconstructions, with technical problems being detected in 82 (4.6%) of these patients. The incidence of problems was highest in patients undergoing endarterectomy, where 16.7% of the patients were found to have either residual debris in the cleared segment or areas of stenosis. When bypass grafts were used, technical problems were found in 2.2% of patients and included embolism or thrombosis, graft torsion in vein grafts, stenosis of the distal anastomosis, and the creation of an intimal flap. In the entire series, five patients needed reoperation in the early postoperative period. In three of these, the operative arteriograms had been initially misread.


Axillary lymph node biopsy.

We describe a technique that facilitates excisional biopsy of the axillary lymph nodes. The arm is suspended anterior to the chest in an adducted position that displaces the pectoralis major muscle medially and positions the axillary lymph nodes immediately deep to the hair-bearing area of the skin. This position permits biopsy of the lymph nodes with a relatively short incision and a minimum of dissection.


Coronary-subclavian steal.

Of 450 patients undergoing internal mammary artery grafts for coronary artery bypass, proximal subclavian artery stenosis with reversal of flow in the internal mammary and vertebral arteries ("coronary-subclavian steal") subsequently developed in two patients. Carotid-subclavian bypass successfully reestablished antegrade blood flow in the ipsilateral internal mammary and vertebral arteries in both patients. Arch aortography is indicated preoperatively in myocardial revascularization patients in the presence of cerebrovascular symptoms, upper extremity blood pressure gradients, and carotid or subclavian bruits. Should subclavian artery stenosis develop subsequent to myocardial revascularization, carotid-subclavian or acillary-axillary bypass can effectively restore antegrade blood flow and reverse the coronary-subclavian steal.


Carotid embolization presenting as total monocular blindness.

Blindness suddenly developed in the right eye of a 55-year-old man. There had been no antecedent illness suggestive of cardiovascular disease. Funduscopic examination eight hours later showed findings consistent with central retinal artery thrombosis. After an arteriogram showed an ulcerated plaque at the bifurcation of the right common carotid artery, the patient underwent thromboendarterectomy. The specimen contained an ulcer, presumably the nidus of an embolus to the central retinal artery. The patient's vision did not recover. This case demonstrates that, although it is rare, total monocular blindness may be caused by a large embolus from a carotid artery plaque.


Gray-scale ultrasound: utility preoperatively and postoperatively in a patient with obstructive jaundice.

We present a case of obstructing calculi of the common bile duct diagnosed by ultrasonography. Postoperatively, a sterile abscess due to bile leakage at the distal common bile duct developed, and was also diagnosed by ultrasound Ultrasonography was useful in following the course of clearing of the bile collection. Preoperative ultrasound evaluation of the jaundiced patient should be followed by postoperative sonography, especially if complications occur.


Pancreatic fistula: management guided by endoscopic retrograde cholangiopancreatography.

A patient with a persistent external pancreatic fistula was studied by endoscopic cholangiopancreatography (ERCP). The ERCP demonstrated the probable site of the fistula and a high-grade, main pancreatic ductal stricture. This information prompted early, successful surgical correction of the pancreatic fistula by drainage into a Roux-en Y jejunal loop.


Multiple lipomas of the ileum with volvulus.

We describe a patient with symptomatic multiple lipomas with volvulus. He complained of gradually increased abdominal pain and distention. Preoperative roentgenograms showed many rounded filling defects of the small intestine. Operation was performed to reduce intestinal obstruction and ileal resection was performed. The dilated ileum was rotated 720 degree clockwise and it contained 115 submucosal and 26 subserosal lipomas. Histologically, the lipomas were benign and consisted of well-developed fat tissue. The patient's postoperative course was satisfactory, and neither residual lipoma nor recurrence were found at barium enema examination two years after operation.


[Age and individual characteristics in the structure of the celiac trunk in man].

The individual and developmental features of the structure of the celiac trunk were studied in 155 human corpses of either sex, age and habitus. The method used was the dissection preceded by the injection of vessels with roentgen-contrast masses and roentgenography. The individual and developmental features of the level of branching the celiac trunk off from the abdominal part of the aorta have been revealed, as well as the angle of its branching, the length and diameter of the celiac trunk and the form of its ramification.


[Adaptation of the limb bones of inbred rats to physical stress following 60 days of hypokinesia].

Under study were the alterations in the extremity bones of inbred animals during 60-day-long hypokinesia. Variations of the correction of hypokinesia by physical loadings associated with the linear kind of animals were found and tested. Hypokinesia was shown to have inhibiting effects on the morphometrical parameters of flat (scapula, pelvic) and tubular (humeral, femoral, tibial) bones, the calcium and phosphorus content in blood serum being increased. Interlinear distinctions of the parameters studied under hypokinesia were revealed. The physical loading given against the background of restricted mobility normalizes the growth of bones, the level of calcium and phosphorus in the blood serum. The correction degree is dependent on the linear kind of animals speaking in favour of genotypical nature of adaptation of bones to physical loadings during hypokinesia.


[Influence of preliminary conditioning to gravitational overloading and subsequent exposure to a series of extreme factors on the intra-organ blood flow of the intestine].

The intraorganic blood circulation bed of the intestine was studied in 21 rabbits subjected to training to gravitation stresses (according to special schedules) and then to maximum endurable gravitation stresses, hypokinesia for 4 weeks and repeated stresses of the direction and character similar to those at the beginning of the experiment. The direction of stresses was different: head--pelvis, pelvis--head, chest--back. Injection of the intestine blood vessels with the Gerota's mass followed by clearing after A. M. Malygin, histological staining after Van Gieson and method of luxmetry were used. Preliminary training to stresses considerably prevented anatomical alterations in blood vessels of the intestinal coats. The most favourable morphological picture was observed in the cases when the stress was of ventro-dorsal direction. Blood vessels of the large intestine were more inert in their transformation than those of the small intestine coats.


[Structure of the tunica vaginalis of the human testis and its microcirculatory bed during the pubertal period].

The microvascularization of the layers of the tunica vaginalis propria testis in juveniles and youths is different in morphological parameters which is responsible for their participation in metabolic processes. The distribution of vessel diameters is based on the regularity of random variation. The number of classes for each link of the microcirculatory bed in the tunics studied practically coincide. In any microvascular part of the parietal and visceral layers of the vaginal tunic of the testis a class (a leading functional group of vessels) may be established which has substantially greater density than that of other classes of the variation line presented. The results of morphometry show the prevalence of the venular portion over the arterial one in each of the layers under study. However, the difference between the venular and arterial portions of the microcirculatory bed is more considerable in the parietal layer which is sure to influence the degree of its outflow from the microvascular system.


[Anatomy of the connective tissue framework of adult human lymph nodes].

The morphometrical investigation of thin histological sections taken from the profound inferior cervical, apical axillary, superior and inferior tracheobronchial and ulnar lymph nodes of adult man has demonstrated the amount of the connective tissue in the nodes to be increased with age. At the same time, the amount of parenchyma in the node is somewhat decreased, the correlation between the medullary and cortical substance being also changed. There are some sex differences in the connective tissue construction. The amount of the connective tissue in the lymph node in men is 2-3% more than that in women. Women have more adipose tissue than men. The developmental transformation and seasonal changes in the connective tissue correlate with the cytoarchitectonics of lymph nodes and the changes of their parenchyma.


[Ultrastructure of collagen fibers and basic substance of the human dermis].

Histological and histochemical methods and fluorescent and rastral electron microscopy were used for complex investigation of intercellular connective tissue components of the human skin derm (collagenous and elastin fibres, basic substance). The structure of collagenous fibres in different levels of their organization was studied. The structure of periods and differently directed combination of fibrils in the fibre were revealed by different methods. Five types of ruthenies--positive structures in the basic substance and fibres--were found. A supposition is made and substantiated that two interconnected and diverse mechanisms take part in sustaining the structure--function integrity of the collagenous fibre. One of them prevents from rapprochement of fibrils (different direction of fibres, amorphous substance) and the other connect them (adhesive properties of the amorphous substance).


[Structural aspects of the decrease in several renal functions in old rats].

The proliferation, size and ultrastructure of the renal cells was studied in 32-38-month-old rats. At this age no dividing epithelial cells were found and their size was enlarged (in proximal areas of the nephrons by 30,2%, in the collecting tubes by 22%). The decreased rate of glomerular filtration in aged rats in dependent on the disturbance of hemodynamics in the glomerular capillaries, for which, to certain extent, the hypofunction of the rhenin-secreting complex is responsible. The reduction of microvilli, hypoplasia of the basal folds, changes in the orientation and size of the mitochondria are considered to be the structural basis of the decreased reabsorbtion in the proximal part of the nephron. In the distal part of the nephron the organization of the plasmalemmal-mitochondrial sodium pump is disturbed. In the collecting tube the number of dark cells becomes less, they shrink and disintegrate, which is considered to be responsible for disorders in the function of the hydrogen ions secretion. The decreased level of the physiological regeneration of cells is likely to underlie the disorders in renal functions in aged rats. The lack of proliferation gradually results in a deficiency of epithelial cells, their hypertrophy, functional stress and wear.


[Changes in the lymphoid organs of rats during space flight].

The thymus, spleen and inguinal lymphatic nodes of rats flown for 19.5 and 22.5 days on board of the Earth artificial satellites Cosmos-605 and Cosmos-782 were examined histologically. It was shown that prolonged space flights brought about accidental involution of lymph organs due to a decrease of the lymphocytes amount. It is suggested that hypoplasia of lymph organs resulted from stress effects of space flight factors. The mass disintegration of lymphocytes and accumulation of nuclear detritus in the thymus as well as neutrophil infiltration of the spleen can be attributed to the acute stress of the reentry and weightlessness--1 g transition stages. It is emphasized that inhibition of erythroid hemopoiesis in the spleen cannot be ascribed to stress effects of space flight factors. Possible contribution of the changes found in lymph organs to the immunological state of the animal body is discussed.


[Adaptive-compensatory reaction of the brain to irradiation].

In totally irradiated chick and rat embryos, young chicks and rats structural functional activity of the subcellular reparative processes in the brain cortex was studied. The animals were given an irradiation dose of 600 and 1,200 rad. In embryo-genesis and in early postnatal period, the adaptive compensatory response in shown after X-ray irradiation to be characterized by subcellular changes and organell hypertrophy of the neurons in the CNS accompanied by disturbances in metabolic and synthesis processes. Ultrastructural regeneration goes side by side with the destructive processes in them.


[Effect of adrenomimetics and sympatholytics on the adrenergic neural fibers and mast cells of the dura mater].

The effect of noradrenaline, dophamine and rausedyle on the adrenergic nervous apparatus and on the labrocytes of the dura mater in white rats was studied by means of Falk's and Glenner's methods and under light electron microscopy. The adrenergic nerve fibres and labrocytes are stated to respond to the injection of adrenomimetic and sympathomimetic drugs with increase or decrease of deposited monoamines on the background of corresponding clinical and vessel phenomena. The data obtained makes it possible to consider the adrenergic nerve fibres and labrocytes to be a single adrenergic apparatus of the dura mater.


[Perspectives of using the probability principles for the study of the problems of normal and pathological morphology].

On the literature available and the author's data the prospects on application of probability principles for the study of certain problems of normal and pathological morphology are discussed. Short consideration is given from the theory of probability and information with theoretical grounds for their possible application in morphology. From this standpoint some problems of morphological bases of homeostasis, adaptation, compensation and pathological processes are reviewed. Certain points of the probability theory of atherosclerotic morphogenesis and informative characteristic of malignization in stratified epithelium of laryngeal mucosa illustrate the article. General principles for further development of quantitative morphology are shortly elucidated.


[Histochemistry of glucosephosphate dehydrogenase and lactate dehydrogenase of the neural cells of chick embryo].

A high intensity of the reactions to lactate dehydrogenase and glucous-6-phosphate dehydrogenase was demonstrated histochemically in the neural anlage of the chick embryos after 15, 20, 24, 30, 44, 48 and 72 hours of incubation. At early stages of the development cranio-caudal gradient of enzymatic reactions was distinctly traced. A high intensity of the reactions was observed in certain cells of the neural groove in 24-hours' embryos and in the neural tube of 48-hours' embryos. These cells are supposed to develop into neuroblasts.


[Study of the central representation of the posterior nerve of the lateral line in dwarf sheatfish].

Applying the axon-terminal degeneration method, the representation of the lateral line posterior nerve in acustico-lateral area of the dwarf sheatfish medulla oblongata was studied. The connections of the lateral line posterior nerve were demonstrated to be topically organized within the medial nucleus of the acustico-lateral area, however, within the limits of the nucleus the projections were not evenly distributed. The greatest degree of localization of the degenerated terminals was revealed in the dorsolateral area of the medial nucleus on the ipsilateral side, where previously, under adequate stimulation of the organs on the lateral line of the dwarf sheatfish, the greatest amount of responses was registered.


[Problem of thickening of the adrenal cortex in acute thermal stress].

The problem was studied on albino rats: five rats served as controls; five--were overheated in a thermochamber at 45 degrees C up to the state of motor excitation (the first series); five--up to the heat stroke (the second series). By means of cytometry it was statistically stated that the cross section area of the fascicular zone spongiocytes of the adrenal cortex in the first series decreased by 14,77% in comparison with the control. The cross section area of the adrenocorticocytes of the reticular zone in the animals of the second series decreased by 7,91%. The vascular reaction of the adrenal cortex in the animals of the first series was manifested in hyperemia, which increased in animals of the second series. Hence, the adrenal cortex thickness is the result of blood congestion rather than derived from real hypertrophy; an abrupt vasodilatation disturbs the parallelism in spongiocytes arrangement, that gives a semblance that the thickness of the reticular cortex zone goes at the expense of the fascicular zone.


[Effect of acute and chronic hypoxia on the structure of the neural elements of the brain].

In rats subjected to the effect of 10 000 m "altitude" for 2 h, numerous nerve cells in different areas of the brain (cortex of both cerebral hemispheres, cerebellum, optic thalamus, hippocamp, pons varolii) had morphological features peculiar to a reversible and irreversible dystrophic process. Similar changes were not observed in the brain of rats subjected to the effect of 9000 m "altitude" for one hour. Nerve cells in all brain areas are rich in substance of Nissl. In the rats adapted to hypoxia, as in the rats from the first experiment, the nerve cells are enlarged in their dimentions, the substnace of Nissl in their cytoplasm is seem increased. The destructive changes in neurons are scarce. Many neurons of the cortex have signs pointing to an increased activity of nucleus and nucleolus. Satallitosis and quantitative augmentation of glial cells is noted.


[State of the nerve cells of the cat spinal ganglia transplanted into the mesentery].

The survival of the mature differentiated neurons from the spinal ganglia under the conditions of autotransplantation into the colon mesentery of the cat was studied in chronic experiments. For two months, one-third of the neurons from the peripheral parts of the grafts survived and, as the normal ones, had a pseudounipolar form. However, their initial glomeruli had excessive overgrowth in the form of perivascular plexus, in its formation both the main axonal segment with its fine lateral branches and the finest offshoots from the neuronal bodies take part. These regenerating nerve fibres together with growth cones make terminals in the form of buttons, rings and loops. Such terminal structures in the capsular plexus around the neurons and in numerous Nageotte's cells present receptor terminals which are abundantly produced under the condition of the spinal ganglia transplantation.


[Effect of gravitational loads (+Gx) of the training schedule on the structure of the main arteries of dogs].

In dogs subjected to gravitational overloadings (+Gx) according to a special training schedule the wall structure of the main arteries (carotid, humeral, femoral and aorta) was studied by histological methods. The amount of catecholamines (adrenaline and noradrenaline) in the venous blood plasma and in the adrenal tissue was the index of the sympathoadrenal system condition. It was demonstrated that in trained animals the tolerance threshold to continuously increasing overloadings (+Gx) rose. It was accompanied by an elevated amount of catecholamines in blood and the adrenals In the walls of the main arteries studied a moderate hyperelastosis and a slight collagenization of the adventitia was noted. All parts of the microcirculatory bed were moderately dilated, which favoured a better blood outflow. The data obtained demonstrate adaptational changes, which can be interpreted as indices of training and reliability of the organism.


[Intracortical and juxtamedullary nephrons of the kidney during postnatal ontogenesis in rats].

Intracortical and juxtacortical nephrons from the kidney of the male rats (Wistar) at the age of 5-30 days were isolated by means of microdissection technique. In the rat kidney, besides superficial and juxtamedullar nephrons there are 5 more populations of the intercortical nephrons. The development of these nephrons during postnatal rat ontogenesis is accompanied by a considerable increase both of their general length and the length of their segments. Correlation changes between different nephronal segments during the first month of life is determined by their uneven development, that is seen in a relative decrease of the distal segment, a considerable increase of the nephronal loop, its distal segment in particular, at a practically constant length of the proximal segment.


[Body constitution of growing inbred animals under hypo-, normo- and hyperkinetic conditions].

The work was carried out in inbred mice C57BL/6, CBA, CC57Br/M strains, interstrain hybrids of the first generation FF1 and in rats of August and Wistar strains. Only one-month-old male animals, which were kept for two months under the conditions of hypo-, normo- and hyperkinesia were used in the study. Statistically significant relation between underloading, overloading and habitus changes was demonstrated. It was stated that habitus changes under the conditions of hypo-, normo- and hyperkinesia were genetically determined. Hereditary predisposition of the reactionary norm and the phenomenon of heterosis manifest themselves under different motor regimens.


[Influence of considerable athletic training on the foot condition of young athletes at a boarding school with a cross-section of sports].

The present day sport inevitably causes enormous physical loading on the locomotor system of the sportsman, and in particular on his foot. To obtain best results in any sport is closely connected with participation of children in systematic purposive training, therefore a necessity arises to study the influence of different time-limited loadings on the locomotor system--foot of young sportsmen. The work represents the data on changes of different parameters of the foot under time-limited loading for 18-30 h per week of the children attending a boarding-school of sporting type, which is a new type of going in for sports for children and teen-agers. We have stated that at the age of 10-11 years some undesirable changes in the longitudinal foot vault (its flattening) are observed, especially in children going in for skiing or gymnastics. Inclusion in training lessons special exercises contributing to fixation of the foot muscular ligamentous system prevents it, to a great extent from overloading and undesirable anatomical disturbances.


[Effect of ski racing on the skeleton of the hands and feet of young sportsmen].

To evaluate the influence of skiing races on the locomotor system of young skiers, a group of 32 sportsmen at the age of 12 years, who attend a sporting school, was examined roentgenologically. Ten children of the same age who do not go in for sports were taken as controls and examined in the same way. One hundred and sixty-eight roentgenograms were prepared and measurements were made. The data obtained were biometrically processed with a computer. The analysis of the results revealed that the hand and foot skeletal bones of the young sportsmen were much longer than those of the controls. Thickness of the growth zones of some bones prevail in young skiers. To reveal specific peculiarities of the skeletal changes in the locomotor system of children we calculated indices for hands and feet. The indices expressed in figures make it clear that more specific changes are seen in the hand bones and especially in the foot bones of the young skiers. All these changes are of progressive character.


[Influence of dynamic and static loads on femoral growth in white rats].

The aim of the work was to elucidate experimentally the influence of different in intencity and character physical loadings on the growth of the femoral bones in 110 albino rats. A positive, but not synonymous, influence of dynamic and static loadings on the growth of the femoral bones in the experimental animals was proved. Long-lasting dynamic loadings stimulate the increment of mass, length and massivity of the femoral bones in the albino rats, the phenomenon was especially prominent in the experimental group under training regimen every other day. Static loading contributes to the femoral bone growth only at the first stage of the experiment. Prolonged static loading inhibits the growth of the femoral bones throughout all the parameters studied.


[Age dynamics and correlation of pulmonary trunk and pulmonary artery parameters].

In 70 cadavers of the persons at the age of 15-92 external and internal diameters and radiuses, wall thickness, cross section area of the pulmonary stem and the left pulmonary arteries were measured. Increase of all the parameters with age was stated. For each size regressing equations were introduced. By means of dispersion analysis the effect of the age factor on the diameters and thickness of the vessel walls was determined. Radius/cross section relations of the pulmonary stem and those of both pulmonary arteries were studied. Indices of the relative vessel wall thickness were calculated and their comparison with the arteries of the systemic circulation was done.


[Classification of cerebral arteries].

Proceeding from the requirements of neurosurgical clinic, the author substantiates the necessity of a new classification of the brain arteries and suggests a scheme according to which all the brain arteries are divided into intracerebral and extracerebral. The latter, in their turn, are subdivided into intracranial, cranial and extracranial. Extracranial arteries, due to their topofraphic differences, the author suggests to sub-divide into the arteries of the upper thoracic and cervical regions.


[Fascial-cellular sheath of the superior mesenteric artery and its branches].

Fascial-adipose tissue sheaths of the superior mesentery artery consist of: a proper fibrous tunic separated by a paravasal fissura from the external layer of the arterial wall; an adipose tissue coupling with vascular and nervous plexus--around the vessels, and a fascial case which isolates the adipose tissue coupling from the surrounding adipose tissue. The fascial case is more dense around the trunk and less dense around the branches of the superior mesentery artery. The work presents the data of the development of the fascial-adipose tissue sheaths and their age-dependent changes which result in a considerable exhaustion of these sheaths at an old age, in deposition of adipose tissue between the fascial plates. The thickness of the fascial-adipose tissue sheath of the superior mesentery artery varies, depending on age, from 5 to 12 mm. It is considerably more developed than similar fascial-adipose tissue sheaths of the celiac trunk and the inferior mesentery artery, is of great applied importance for novocain blockade of the paraarterial nervous plexus.


[Standard linear x-ray densitometry as a method of intravital determination of the mineral saturation of bone tissue].

The method of standard linear roentgenodensitometry represented in the work in comparison with other methods of photo- and densitometry eliminates, to a certain extent, the influence of many side factors affecting the investigation results and allows to establish a real intravital content of phosphorous calcium salts in the bone tissue. The method in question gives an objective quantitative information on the condition of mineral saturation in the human skeleton, can and must find a wide application both for elucidation of the limits of, so called, normal mineral saturation of human bones at different ages and to study bone system adaptation for different environment influences.


[Retrograde changes in the giant pyramids of the motor area of the isolated cortex].

Retrograde changes in the giant pyramids of the layer V in the motor area of the cortex isolated neuronally at different dates after operation were followed by Nissl method. The cortex isolation was surgically performed by sectioning projection fibres which connect the cortex with subcortical structures after M. M. Hananashvily method (1961). Characteristic retrograde changes appeared in the giant pyramids on the third postoperative day: moderate swelling of cellular bodies, chromatolysis and nuclear displacement towards the periphery. In the following days the retrograde changes progressed rapidly and by the 10th day resulted in a partial destruction of the giant pyramids. One month later in the layer V, only separate cellular shadows were visible; from one month to one year period the giant pyramids in the layer V disappeared completely. Neurons of other layers in this area, as well as small and middle size neurons of the layer V are preserved and show no signs of pathological changes.


["Mixed" follicles in the rat thyroid gland (electron microscopic findings)].

The thyroid gland of the rats 3, 5, 7, 11 days and 1 month old has been studied by electron microscopy method. Mixed follicles with walls consisting of usual thyrocytes and unusual stratified epithelium have been observed. Particularly large cells containing glycogen are described in stratified zones. Structural relation of basal cells with marginal cells has been traced. Mitosis of basal cells has been demonstrated. The origin of mixed follicles is discussed and some doubts arise as to their ultimobranchial nature.


[Methods of intravital study of the microcirculatory bed and assessment of vital dye transport in the pericardium].

The method of vital microscopy was used to obtain new data on the features of blood microcirculation in different links of the vascular bed in the pericardium. The work of dynamic structures of microcirculation pathways controlling processes of redistribution of blood streams is shown such as arteriolar anastomoses, zones of branching of resistance microvessels, the pathways of magistralization of the capillary blood stream, venular anastomoses and microvalves. By means of calorimetric study of the serous fluid obtained from the pericardium cavity, after a preliminary intravenous injection of the vital dye a quantitative evaluation of the transcapillary transport of the dye was made under conditions of a normal and altered permiability.


[Blood vessels and tissue structures of the pituitary in the presence of ischemia].

Modelling of the brain ischemic hypoxia, the hypophysis including, by ligation of the left internal carotid artery in dogs results in weight enlargement of the hypophysis, marked edema of the parenchyma, discomplexity of the cellular elements of the anterior pituitary lobe with morphological signs of hypofunctional condition of the increting cells in the organ studied. Ischemic hypoxia produces lumen augmentation of blood vessels in some areas of the anterior pituitary lobe with resulting increased circulatory capacity in the anterior pituitary lobe. Comparing with the data available in the literature, we conclude that blood circulation manifests a nonspecific reaction to different hypoxic models, while cellular reaction is more specific.


[Demonstration of the noradrenaline-and adrenaline-secreting cells of the adrenal medulla in laboratory animals and man].

A comparative study of four histochemical methods of estimation of noradrenaline- and adrenaline-secreting cells in the adrenal medulla of laboratory animals and man was carried out at different terms after death and depending on the temperature of tissue storage before their histochemical treatment. It was stated that light histochemical method of Honoré and luminescent method of El-Badawi and Schenk are highly specific and make it possible to estimate the amount and location of catecholamines in the adrenal medulla of man and animals. The advantage of honorés method is that it allows to differentiate, at light level, noradrenaline-secreting cells from adrenaline-secreting ones and consider their structural peculiarities. /ence, this method can be recommended for differential study of catecholamines in the adrenal medulla of laboratory animals and man.


[Ultrastructural changes in the ovaries of chickens following exposure to x-rays].

Changes in the ovaries of chicken embryos (17th day of incubation) and in 2-day-old chickens at different terms (2, 24, 72 h) were studied by light and electron microscopic methods after x-ray irradiation in the doses of 606 and 1200 rad. In oocytes of 17 embryos x-ray irradiation acts as an additional factor, enhancing and increasing the degree of chromatin condensation and producing earlier appearance of pachynema stage. In the ovarian oocytes, at diplonema stage, in 2-day-old chickens after irradiation, condensation of chromosomal substance is observed; in this case, irradiation produces a reverse action to that of normal despiralization. Ultrastructural changes in cellular organelles, in nuclear membrane, in particular, depend on the degree of oocyte differentiation and the irradiation dose applied. Within the terms of investigation, x-ray irradiation does not produce any considerable ultrastructural changes in the oocytes, but its disturbes the contacts between them and follicular cells, which is supposed to be the cause of oocyte destruction.


[Rib duplication].

Fluorographic examination under roentgenographic control of 400,000 persons revealed rib doubling to be the rarest anomaly--3 cases (approximately, one case per 133,000 examined) and semi-doubling ribs--2 cases (1:200,000); in literature only one case of the right third rib doubling (P. V. Yashunin, 1936) is described. Our cases of rib doubling are: the third, left; the fourth, left and the only case of neighbouring ribs doubling--the first and second, left; semi-doubling: the third, left (demonstrated) and the fifth, left.


[Morphofunctional basis of joint typology].

Everincreasing needs of practice (medical, sporting, etc.) demand to reconsider the existing articular classification according to their similarity to geometric "rotation bodies". Every joint can be regarded as highly-, moderately- and stiffly-mobile, according to the degree of relative shift of the connected links. Swing correlation of the opposite movements makes it possible to demonstrate the existance of ordinary joints, as well as joints with a preferable movement which exceeds considerably average normal swing. Kinematic expression of the articular type is a maximum swing of passive movings in it. Morphologic base of the type is the degree of curvature and congruence of the articular surfaces, location and form of the movement restrictors in the bone, size and differentiation of ligaments, "passive insufficiency" level of muscles-antagonists. Percentage correlation of every articular type depends on age.


[Patterns in changes in the dimensions of the nucleoli of human cardiac neurons during postnatal ontogenesis].

Morphometric studies of the neuronal nucleoli from the hearts of 157 healthy persons at different age, revealed certain regularities in their size changes, which demonstrate a strict quantitative organization--bilogical "quantumness"--of intranuclear synthesis processes and excretory processes into cytoplasm. Five more stable aliquot, as well as less stable, intermediate nucleolus volumes were demonstrated, their percentage content depending on the degree of differentiation, activity and cardiac neurons aging during postnatal ontogenesis.


[Development of collateral circulation following an experimental gunshot wound to the shoulder].

Peculiarities in the development of collateral blood circulation and skin temperature of the foreleg were studied in two series of experiments (38 dogs) after gunshot wound of the humeral area, lesion of vessel-nervous bundle (first series) and humeral artery resection with section of medial and ulnar nerves (second series). In animals of the first series, the blood circulation was states to restore within a month at the expense of the arteries of the posterior humeral muscles, mainly. Further circulatroy improvement develops due to anastomoses in the anterior humeral muscles, as well as some intrasystemic roundabout ways in humeral area and shoulder girdle. Three months later, the humeral vessels network increases, it does not prevent, however, trophic ulceration of the ulnar skin. Skin temperature of the distal extremital parts raised to normal by 19--20 day of the experiment. The animals from the second series demonstrated retarded development of the roundabout ways in the operated extremities during the whole follow-up period (180 days). Skin temperature was lowered during the first 3--4 days, gradually reached the temperature of the contralateral extremity.


[Use of colchicine in studying the proliferative activity of chicken embryos].

Manifestation of mitotic activity of colchicin in 4- and 5-day-old chick embryos was studied under different modes of colchicin injection into the eggs. Three methods were tested: colchicin solution was injected into the serous-amniotic cavity (1) and into the yolk sac (2) and also by dripping on the serous membrane over the enbryo (3). Perfect metastatic effect was observed only when colchicin was used in concentration of 1 X 10(-4) g/ml and injected by the third mehtod. Increase in the solution volume over 0.1 ml resulted in a greater percentage of embryo death. Lack of a definite inhibitory action after colchicin injection into the serous-amniotic cavity might be explained by decrease of the substance concentration as a result of its dilution by the cavity fluid. A complete lack of blocked mitoses in the embryo tissues after colchicin injection into the yolk sac can be explained, according to the authors, by the presence, in the yolk, of a great number of ovoflavins capable to inhibit mitotic activity of colchicin.


[Quantitative assessment of catecholamine fluorescence detected by the Falck method].

While using Falck's method, a number of simple and handy additional ways were suggested to carry on quantitative estimation of the fluorescence change of noradrenergic and dopaminergic terminals in a number of nuclei of the central nervous system. A device was used, which allows to obtain samples of brain of a given size and in a definite plane. The method we used makes it possible to treat simultaneously a great number of material at all the stages of work. Fluorescence intensity was measured by means of fluorometric device with the stop of a large diameter. Tests with the substances lowering the content of catecholamines showed that at the content of catecholamine less than 60% one can observe linear dependance between fluorescence intensity and the content of catecholamine in tissues. In the sphere of high concentrations such linearity does not exist.


[Interrelationship between the enterochromaffin and several connective tissue cells in the wall of the small intestine following sensitization with an organotropic antigen].

The problem of main cell elements in the intestinal mucosa and their interrelations at different terms of sensibilization (7, 14, 21, days), anaphylactic shock and during post-shock period (3, 7, 14, 21 days) are considered in the work. Some data on quantitative interrelations of enterchromaffine cells, macrophages, labrocytes and plasma cells in the control animals are presented. The amount macrophages under the organotropic sensibilization and during post-shock period increases, their functional activity is growing; the quantity of enterochromaffine cells correlates with that of labrocytes; the amount of plasma cells increases under sensibilization and decreases during the post-shock period.


[Development of senile plaques in the human brain].

In 100 persons, the development of senile plaques in 8 different parts of the brain was studied by means of Bielschowsky, Miagawa-Alexandrovskaja, phase contrast and morphometric methods. Appearance, within an unchanged brain tissue of a fine fibrillar structure, of a ball-shaped body (average diameter of 8.9 mcm) with a marked peripheral radiancy is believed by the author to be the first morphological stage of the senile plaque formation. Around this central focus, brain tissue necrosis separated from the normal brain tissue by a demarcation zone further develops. At final stages, desintegration and resolving of the central focus, and then of the whole senile plaque is observed.


[Fibromuscular dysplasia of the renal arteries].

Thirty-two cases of fibrous-muscular dysplasial of renal arteries (including one autopsy case) were studied. Sections of renal arteries removed at reconstructive operations from patients suffering from renovascular hypertension were examined. Two morphological variants of the process were distinguished: medial dysplasia (perimedial fibroplasia, medial fibroplasia, and dissecting aneurysm) and intimal proliferation. Morphologically, fibrous-muscular dysplasia is a manifestation of proliferation of smooth muscle cell which appears to have various forms and stages. Diagnostically, fibrous-muscular dysplasia should be differentiated from atherosclerosis, nonspecific arteritis, proliferation of the intima due to hypovolemia, and perivascular sclerosis of different etiologies.


[Wound healing as an autoregulatory process].

A hypothesis of autoregulation of the reparative growth of the connective tissue based on the inverse relationship between degradation and collagen biosynthesis is suggested. At the ultrastructural level such homeostatic mechanism is realized in two stages: (1) resorption by macrophages of collagenic fibrillae of the tissue necrotized as a result of trauma and inflammation, induction of collagen genesis by cell contacts between macrophages and fibroblasts, enhanced fibrillogenesis; (2) the inhibiting effect of collagen fibers of a mature tissue contacting with fibroblasts on collagen biosynthesis with simultaneous induction of fibroclasia.


[Histogenesis of dermatofibrosarcoma protuberans].

In order to specify the histogenetic appurtenance of dermatofibrosarcoma protuberance, the ultrastructure of cells from three tumors was studied. The similarity between the ultrastructure of the tumor cells and normal fibroblasts suggests the fibroblastic origin of the tumor.


[Ultrastructure of leiomyoma of the ciliary body].

Leiomyoma of the ciliary body of the eye was studied with the help of optical microscope at the ultrastructural level. The tumour was characterized by 4 types of cells: micro immature myoblasts, macro differentiated myoblasts, dystrophically changed muscle cells with lipofuscin inclusions, and fibroblasto-like cells. At the luminous level the differentiation of pigmental granules of melanin and lipifuscin was impeded. At the ultrastructural level they had different morphology, and therefore the differential diagnosis of a slightly pigmented melanoma and leiomyoma is possible.


[Mitotic division of the nuclei of the human heart myocytes after healing of myocardial infarct].

Mitoses of nuclei of myocytes of the left ventricle of the heart observed in two elderly people who had died of extensive relapsing infarction are described. All the mitoses were pathological (delaying and dispersing of chromosomes in metaphase multipolar mitosis) and apparently they were completed by formation of multiple micronuclei.


[Rare congenital heart valve defects].

The article contains excerpts from case records and autopsy protocols for two children who had died of congenital valvular heart diseases. Both were full-term infants, with good weight who initially developed normally. During the first month of life, however, they developed respiratory disease which provoked the development of decompensation of the malformed heart. Moreover, both patients showed clinical signs of congestion not only in the greater circulation but in the lesser circulation as well. The latter was conditioned by anatomic features of the valvular defects. In the first case all the valves of the heart turned out to be malformed, in the second case there was observed a combination of Ebstein's anomaly with corrected transposition of the ventricles and major vessels of the heart and as a result the right ventricle with a malformed tricuspid valve was found to be on the place of the left ventricle.


[Cerebrospinal fluid in the healthy preterm newborn infant].

The cerebrospinal fluid (CSF) composition was studied in 54 premature infants. The pregnancy was normal and the delivery normal and non traumatic in all of them, and the 5 minutes Apgar score ranged from 6 to 9. No abnormalities were found on physical examination including neurological examination. Blood cell countings and blood gasometry were normal. CSF composition was studied as to: total cell count and total protein, glucose, bilirrubin and hemoglobin concentrations. Data found permit to stablish as physiologic the following values: leucocytes, until 16 per cumm; erithrocytes, until 1,280 per cumm; total protein content until 300 mgm/100 ml; bilirrubin until 80 micrometer/1; hemoglobin until 8 micrometer/1; glucose, two thirds of the concentration found in the blood. Protein, bilirrubin and hemoglobin are significantly increased as compared to values found for the CSF of 79 fullterm normal newborn babies evaluated previously. Hemoglobin was not detected in the CSF of any full term newborn baby. The differences found are probably due to a less efficient blood-CSF barrier in premature infants as compared to full-term newborn babies.


[Megadolichobasilar anomaly: apropos of 5 cases diagnosed angiographically].

After brief considerations on the symptomatology and ethiopathogeny of megadolichobasilar, five cases of this vascular anomaly are presented. Agreeing with the majority of the papers on the subject, the age of the patients was between the fourth and the sixth decades, all of them presenting arterial hypertension of long duration and advanced atherosclerosis; the neurological findings were varied, having in common the fact of an abrupt (ictal) beggining. The angiographic study of the vertebrobasilar system was basic in the diagnosis in every case.


[Neurosurgical aspects of fronto-ethmoidal osteomas; report of 6 cases and review of the literature].

The cases of six patients with fronto-ethmoidal osteomas which have produced intracranial complications are reported. The patients have been divided in two groups depending on their clinical aspects, from cranio-facial deformities to exophtalmus, rinorrhea, pneumocephalus, meningitis and mucocele. A review of the literature is made and the importance of such lesions is stressed together with a critical analysis of the methods proposed for their surgical treatment. The results obtained with a frontal approach and a plastic closure of the dura were uniformelly good with restoration of functions in all patients.


[Status epilepticus in Lennox-Gastaut syndrome; therapeutic aspects].

Therapeutic aspects of convulsive and non convulsive status epilepticus observed in fourteen patients with Lennox-Gastaut syndrome were studied. A temporal relationship between the status epilepticus onset and the beginning of treatment with chlonazepam and diphenylhydantoin was observed; these drugs withdrawal was followed by suppression of symptoms. The possibility of treating status epilepticus by altering the orally administered therapy and leaving parenteral therapy for such cases with progressive impairment of consciousness and/or neuvoregetative disorders was indicated.


[Frequency of potential anastomoses in the posterior communicating branches of the circle of Willis].

This neuroanatomic study has been performed to establish the frequency of potencials anastomosis in the posterior portion of the cerebral arterial circle in 87 brains from northeasterner brazilians without any aparent clinical manifestations of neural dysfunction. The fetal pattern of the posterior communicating branch was present in the 46% (40/87) of the cases. The frequency with regard to side was the following: 21,8% (19/87) on the right side; 12,8% (12/87) on the left side and 10,4% (9/87) bilateral. The bilateral and unilateral potencials anastomosis at level of the posterior communicating branches, with fetal pattern or with gross caliber (Padget, 19483), were present in the 71,2% (62/87) of the arterial circles. The bilateral potencials anastomosis were formed by two posterior communicating branches with fetal pattern in the 10,4% (9/87) of the cases, by two of those vessels of gross caliber in the 11,5% (10/87) of the circles, and by one fetal posterior communicating branch, and one contralateral posterior communicating branch of gross caliber in the 13,8% (12/87) of the cases. Unilateral potencials anastomosis constituted by fetal posterior communicating branch (21,8%) or by posterior communicating branch with gross caliber (13,8%) ocurred in the 35,6% (31/87) of the arterial circles.


[Cellulose acetate electrophoresis of cerebrospinal fluid: normal values].

Determinating the total protein contents by the Meulemans method and using strips of celulose acetate "Cellogel" for electrophoresis the authors have studied the CSF of 19 patients between 10 and 54 years old. Total proteins was found between 10 and 28 mg%. The proteins were separated in six fractions with the following results: preé-albumin 4.3%; albumin 54.8%; alpha1-globulin 5.9%; alpha2 globulin 8.3%; beta-globulins 15.5% and delta-globulins 11.2%.


[Myotubular or centronuclear myopathy; report of a case and review of the literature].

A case of centronuclear or myotubular myopathy in a 13-year-old boy who was admitted with hypotonia and congenital ptosis is reported. Clinical, electromyographic and pathologic studies are discussed. A review of the electron microscopic features and comparison with out findings is included. Review of the literature disclosed near 50 cases of centronuclear myopathy. The diferential diagnosis is discussed.


[Idiopathic arterial occlusive disease (moyamoya); report of 4 cases].

Four cases of the occlusive arterial disease "moyamoya" type, are reported with comments on the clinical, roentgenological and embriological aspects. The clinical onset in all four cases was of isquemic type, in spite of different ages (2 adult male, one young adult female, 1 child female). Some particular symptoms are analysed, mainly the constant complaint of episodes in which the patient is, suddendly, extremely tired. The causes of this episodes are thought to be due to suddendly lowering of the cerebral perfusion in the disease. The importance of the radiological appearance is emphasyzed. The plain roentgenographic films, the site of the occlusion, the associated vascular malformations, the collateral circulation and the site of the vascular nest, are discussed. Some embriologic aspects of the etiology including the variable time onset of the pathologic process are also discussed.


[Subdural abscess at the level of the cauda equina; report of a case].

A case of staphylococcal subdural abscess at cauda equina level region in a 42 year old male patient is reported. The neurological signs presented in this condition are discussed briefly and it is pointed out the importance of laminectomy associated to antibiotic treatment to achieve good outcome.


A systematic method of drawing corneal pathologic conditions.

We describe a method of indicating corneal pathologic conditions in the patient record by color-coded frontal and slit sketches. The practice improves biomicroscopic skill, provides an easily reviewed record of the disease's course, helps monitor observations of ophthalmologists in training, and creates a standardized method of notation.


Retinal arterial occlusive disease in systemic lupus erythematosus.

Four patients with systemic lupus erythematosus (SLE) developed an unusual form of occlusive retinal arterial disease. The most prominent clinical features of this disorder were deposition of yellow-white material in retinal arterial walls and evidence of multifocal retinal arterial occlusion. Fluorescein angiographic findings included nonperfusion of the obstructed arteries and the retinal capillary beds fed by them, and fluorescein leakage at the sites of involvement of the retinal arteries. This ocular complication of SLE is presumably a manifestation of the widespread systemic vascular problems seen in this disorder. It may be more common in patients with lupus involving the CNS.


Isolated inferior oblique paresis.

The clinical features of eight patients with inferior oblique palsy are described and the differential diagnosis discussed. Six of the eight patients were treated by unilateral superior oblique tenotomy; the conditions of all six improved postoperatively.


Ultrastructural abnormalities in a Marfan's syndrome lens.

The surface ultrastructure of the posterior of the Marfan's syndrome lens was studied by scanning electron microscopy. All aspects of the architecture and construction of the capsule, the zonules and their insertions, the epithelium, and the lens fibers showed a sharp deviation from normal. The capsular fibrils were abnormally large and grossly granular. The zonular fibrils, similar in size and granularity to those of the capsule, contained numerous large aggregates and showed a lack of parallel orientation. The epithelial cells displayed a coarser than normal surface granularity and a lack of regularity of form and orientation. The cortical and nuclear lens fibers displayed a relatively normal surface pattern but showed poorly defined borders and interdigitating processes.


Revision of filtration surgery.

Forty-one procedures were performed to revise malfunctioning filtering blebs in 37 eyes. Thirty-two procedures were undertaken on underfiltering blebs, seven on overfiltering blebs, and two on normally functioning but otherwise unsatisfactory blebs. Revision procedures were successful in 24 of 32 underfiltering blebs, four of seven overfiltering blebs, and one of two normally functioning but unsatisfactory blebs.


No-touch technique for intraocular malignant melanomas.

Large variations in intraocular pressure occur during enucleation, scleral depression, 32P testing, and vigorous rubbing of an eye. Data from animal studies show that during a critical phase of an intraocular malignant melanoma, ocular massage significantly decreased longevity due to increased metastastic disease. We report "no-touch" technique to prevent tumor spread from occurring secondary to ocular manipulation during enucleation. This technique avoids IOP elevations above 50 mm Hg before freezing completely around the tumor, thereby preventing flow of fluid and blood to or from the tumor prior to the manipulation necessary for enucleation. Theoretically, the patient with an ocular tumor should be warned against vigorous rubbing of his eyes and hard lid squeezes or diagnostic techniques that elevate IOP. The ophthalmologist should perform enucleation with gentieness and avoid pressure on the globe. Patients who are being followed up with a suspected ocular tumor should be warned not to rub or vigorously squeeze their eyelids.


Short fascial strip--what next?

A surgical technique has been developed that effectively utilizes a short fascial strip to obtain the required length needed for frontalis fixation. The technique is simple and the tensile strength adequate.


Topical antibiotic therapy of staphylococcal keratitis.

The in vivo antibacterial effectiveness in the rabbit cornea of a number of commercially available ophthalmic antibiotic preparations was determined against a single strain of penicillinase-producing Staphylococcus aureus isolated from a human corneal ulcer. Each antibiotic was instilled topically at hourly intervals, and the number of residual viable organisms in the cornea subsequently was ascertained. In vivo measurements demonstrated that five antibiotics--neomycin sulfate, gentamicin sulfate, erythromycin, tetracycline hydrochloride, and chlortetracycline hydrochloride--were equally effective in suppressing growth of the strain of S aureus studied. Therapeutic results were the same whether the corneal epithelium was present of absent for each of the drugs studied. With one exception (chloramphenicol), there was excellent correlation between in vivo and in vitro findings.


Validity of tympanometry for middle ear effusions.

The findings on paracentesis and aspiration of the middle ear were compared with preoperative tympanometry. From the results obtained, it was found that if tympanometry alone is used to determine the presence or absence of fluid the best discriminant is a compliance of 0.21 or a gradient of 0.04 equivalent volume units. The average failure rate with either or these criteria is 20%. A numerical estimate of the validity of tympanometry may be made for individual cases.


Effects of nasal packing on eustachian tube function.

Eustachian tube function was assessed by tympanometry in 47 patients (94 ears) with anterior nasal packing placed after nasal surgery and in 12 patients (24 ears) requiring anterior and posterior packing for epistaxis. Twenty-four of the 94 ears (25.5%) in patients with anterior packing exhibited reductions in middle ear pressure (greater than or equal to --100 mm H2O), whereas 12 of 13 ears (92.3%) ipsilateral to and six of 11 ears (45.4%) contralateral to the posterior pack demonstrated comparable reductions in middle ear pressure. The observation that posterior packing is associated with a greater incidence of eustachian tube dysfunction than anterior packing suggests that the mechanism of this dysfunction may be related to stasis in the peritubal lymphatic plexus rather than to nasal obstruction per se.


Positive Hennebert's sign in Meniere's disease.

A positive Hennebert's sign was found in 24 of 81 (30%) of ears with Meniere's disease and in none of 22 cases of vestibular schwannoma or 100 normal controls. Negative pressure applied to the external auditory canal was the required stimulus in 14 of 24 (58%) ears. The character of induced eye motion was variable, although horizontal nystagmus was found in 22 of 24 (92%) ears. A positive Hennebert's sign is seen in a variety of labyrinthine lesions and gives corroborative evidence for a cochlear site of hearing impairment with hydrops and vestibulofibrosis are the underlying pathophysiologic condition.


Composite hyoid sternohyoid muscle grafts in humans. Its use in reconstruction of subglottic stenosis and the anterior tracheal wall.

Successful results were achieved in three of four human cases of glottic, subglottic, and tracheal stenosis by using composite hyoid bone-muscle pedicle. A technique is used to create and interposition the grafts to widen the lumen and to provide structural support. The vital composite hyoid bone-muscle graft interposition technique offers a promising method for the solution of difficult cases of glottic, subglottic, and tracheal stenosis. Abandonment of previous long-term dilations is recommended in favor of early surgical restoration of a widened airway.


Simplified protocol for treatment of malar fractures. Based on a 1,220-case, eight-year experience.

A simplified protocol of approach has evolved from the treatment of approximately 1,200 malar fractures in an eight-year period in the private practice of one of us (R.S.M.) and at the Los Angeles County/University of Southern California Medical Center. The method begins with the Gillies incison for reduction and routinely uses internal wire pin fixation tailored to the mechanical requirements of the malar fracture. It advances only if necessary to brow and infraorbital incisions, direct wiring, orbital exploration, or Caldwell-Luc. Antrostomy with antral packing. Occasionally, a transcutaneous wire or small bone screw may be inserted for headcap or halo vector traction if indicated by the judgment of the surgeon. The internal wire pin protocol has produced hundreds of satisfactory reductions and fixations of malar fractures in our experience, with shortened operating time and reduced complications. It has been installed as the primary method of treatment for this type of facial fracture in a residency program that has many of these patients.


Effect of ethacrynic acid on the stria vascularis.

The stria vascularis of young albino guinea pigs was examined by scanning electron microscopy at intervals of 30, 60, and 240 minutes after the intracardiac administration of ethacrynic acid (70 mg/kg). Results from this study showed that the appearance of large intercellular spaces in the intermediate region of the stria vascularis was due to acute separation of these cells rather than atrophy, as described by previous investigators. It was probable that these spaces were due to an accumulation of extracellular fluid. In some marginal cells, extrusions of cytoplasm into the endolymphatic space were noted in the 240-minute group of animals. The importance of these extrusions is not apparent at this time.


Intradermal sutures in facial lacerations. Comparative study of clear monofilament nylon and polyglycolic acid.

A blind study comparing the clinical inflammatory response of intradermal clear monofilament nylon sutures with polyglycolic acid sutures was carried out on 106 patients with facial lacerations. There were no clinically apparent infections in either group of sutures. Intradermal monofilament nylon was associated with significantly less inflammatory response than similarly placed polyglycolic acid sutures. The lesser inflammatory response, the tolerance to infection, and the greatly prolonged tensile strength of monofilament nylon are factors that lend support to its being the superior intradermal suture in facial lacerations.


Thyroid surgery in children and teenagers.

From 1961 to 1976 62 patients under age 20 underwent thyroidectomy for various thyroid disorders. Twenty-four thyroid lobectomies and eight subtotal or near-total thyroidectomies were performed for benign nodular goiter. Eight near-total thyroidectomies and two thyroid lobectomies were performed for carcinoma. Two patients also had a radical neck dissection. Twenty patients with hyperthyroidism underwent near-total thyroidectomy. Postoperative complications occurred in six patients-all with hyperthyroidism. Operative mortality was zero. Two indications for thyroidectomy in our series were nodular goiter (to rule out carcinoma), and hyperthyroidism (that was not well-controlled medically or where surgery was chosen as primary therapy). In patients with nodular goiters that required surgery, a minimal complication rate occurred. By contrast, surgery for hyperthyroidism was associated with a high postoperative complication rate, six of 20 patients or 30%, which must be anticipated by the surgeon.


Cervical adenopathy secondary to toxoplasmosis.

Toxoplasmosis is not a rare disease. Infestation occurs in 75% of the general world population and in 35% of the US population. Lymphadenopathy, primarily of the cervical type, is one of the most common signs of acquired toxoplasmosis. During the past 15 years a great number of reports have appeared in the medical literature regarding toxoplasmosis. However, it seems that most clinicians do not consider this disease as a possibility when they encounter patients with unexplained cervical adenopathy in whom the usual tests for infectious mononucleosis are negative. In fact, the majority of such patients come to the operating room with a suspected diagnosis of malignant neoplasm, particularly of malignant lymphoma. Thus, a great deal of unnecessary anxiety is generated and, at times, unnecessary surgery is performed. These may be avoidable. A total of 38 cases of acquired toxoplasmosis manifested by lymphadenopathy (82% in the cervical region) are analyzed with respect to symptomatology, differential diagnosis, clinical and laboratory diagnosis, and treatment. Toxoplasmosis should be included in the differential diagnosis of patients with cervical tumors.


Massive hemorrhage from perforated thyroid complicating tracheostomy. Report of two cases.

Two cases of unusual hemorrhagic complication of tracheostomy involved perforation of the thyroid gland as the cause of hemorrhagic episodes. In one case, massive hemorrhage complicated the postoperative course of a 62-year-old man with dissecting aortic aneurysm. In the other, fatal hemorrhage occurred after tracheostomy through the thyroid gland in a 6-month-old boy. A major branch of the thyroid artery was ruptured adjacent to the tracheostomy wound. This is the sixth reported case of fatal hemorrhage from perforation of thyroid artery after tracheostomy, to our knowledge.


Value of the isolated tensor tympani muscle reflex elicited by electric lingual stimulation.

A bilateral reflex contraction of the isolated tensor tympani muscle has been obtained in man by bipolar electric stimulation of the edge of the tongue (DC generator). The avoidance of the elevated and variable body electric resistance and of the variable contact resistance from the hand to the ground plate, represents an appreciable improvement of this method in comparison with the unipolar method described in a earlier paper. A further improvement has also been achieved by applying the electric stimulus to one inferior aspect of the tongue near the floor of the mouth, nearer to the lingual nerve. An analysis has been subsequently conducted in normal subjects and in patients affected by pathologies of the tympano-ossicular system; otosclerosis, tympanosclerosis, unilateral complete suprastapedial facial paralysis, interrumption of the ossicular chain; in cases of interruption of the afferent arc: section of the unilateral lingual nerve; involvement of its central portion: cerebello-pontine angle tumour, brain stem tumour. A chiasma-like central nervous pattern is suggested.


Cochlear events and whole-nerve action potentials.

For proper interpretation of electrocochleographic recordings, it is essential to know how the activity of primary auditory neurons is reflected by the whole-nerve action potential (AP). It is easy to show theoretically that for stimulation with tone bursts the latency of the AP decreases with increasing stimulus intensity as a result of cochlear frequency selectivity. It is less easy to show that the phenomenon of saturation as shown by primary auditory neurons is almost equally important in this respect. The proof centers around a peculiar property: theoretically, latency effects will be absent when the input-output relation of auditory neurons can be described by a power law. APs evoked by clicks also show latency changes as a result of variations in stimulus level. These changes can also be interpreted as the result of frequency selectivity and saturation. Here the main factor is that the whole-nerve AP reflects the activity of neurons sensitive to high frequencies far better than those sensitive to low frequencies.


Auditory nerve and brain stem responses to sound stimuli at various frequencies.

The responses of the auditory nerve and brain stem auditory nuclei have been recorded with ear lobe and scalp electrodes in response to unfiltered click stimuli which excite mainly high-frequency nerve fibers. In order to overcome this limitation, normal subjects and patients with hearing loss were stimulated with third-octave filtered clicks with center frequencies of 250, 500 and 1 000 Hz. Analysis of the responses suggests that these lower-frequency stimuli excite lower-frequency cochlear nerve fibers. It is concluded that low-frequency filtered clicks can be used to complement unfiltered clicks in order to obtain a more complete objective audiogram.


Clinical electrocochleography in the diagnosis and management of Meneère's disorder.

Patients with a fluctuating hearing loss, episodic vertigo and tinnitus with no known aetiological cause were investigated as cases of Menière's disorder. Transtympanic electrocochleography was found to be helpful in reaching the diagnosis of an inner ear disorder. In 65% of the patients, a large DC potential was recorded which caused an apparent widening of the summating potential/action potential (SP/AP) waveform. This potential was thought to be an SP which enhanced relative to the AP component, and believed to be related directly to the presence of endolymphatic hydrops. A method is described which 'scores' the clinical history with respect to certainty of the diagnosis of Meieère's disorder. It was found that the more certain cases, with high scores, were statistically more likely to show an abnormal SP/AP waveform. The results of endolymphatic sac surgery were also assessed over 1 year in 28 cases, and it was found that those patients whose ECochG had revealed an abnormal SP/AP waveform prior to surgery benefitted in a statistically significant manner more from the operation.


alpha-chain sequence of newt haemoglobin (Taricha granulosa).

The amino acid sequence of the alpha-chain of the major haemoglobin of a newt, T. granulosa, has been determined. The chain is 142 residues long and has an extra methionine at its N-terminus when compared with human alpha-chain. Most of the tryptic peptides were sequenced by a combination of the subtractive Edman method and by deduction from the compositions of overlapping fragments produced by various enzymic treatments. The sequence of two 'core' regions was obtained by automatic sequencing of large peptides produced by trypsin cleavage at arginine residues only after blockage of lysine residues by citraconylation; by cleavage between aspartic acid and proline residues with 70% formic acid, and by cyanogen bromide cleavage at methionine residues. The sequence of T. granulosa alpha-chain is compared with those of representative species from the other classes of vertebrates. The differences in alpha-chain between the classes of vertebrates are compared with the differences in this protein between an equal number of orders of mammals. This comparison allows us to conclude that the major functional and conformational features of alpha-chain have been conserved since the divergence of the classes of jawed vertebrates.


Studies on metatherian sex chromosomes. III. The use of tritiated uridine-induced chromosome aberrations to distinguish active and inactive X chromosomes.

The paternal X inactivation system of kangaroos has been investigated in this study by using tritiated uridine-induced chromosome aberrations to distinguish the active from the inactive X. Previous work in eutherian mammals has demonstrated that constitutive heterochromatic chromosome regions are less susceptible to breakage by tritiated uridine than euchromatic regions. The results of a comparison between the paternal X chromosome of a wallaroo X red kangaroo hybrid female and the two X chromosomes of a red kangaroo female suggested that the facultative heterochromatin of the X is also less susceptible to breakage by this treatment. However there were significantly more breaks of the paternal X in fibroblasts than in lymphocytes of the hybrid female, which agrees with biochemical findings suggesting activation of the paternal X in fibroblasts. Our results strengthen the suggestion of other workers that the reduced number of aberrations in heterochromatin occurs because such breaks occur principally when the DNA and labelled RNA are in apposition during transcription. Some evidence was found of an apparent toxicity effect of the tritiated uridine solution on the cells.


A test-retest reliability study on clinical measurement of masking level differences.

Measurement of binaural release from masking was studied in 30 normal and 10 hearing-impaired subjects to determine the test-retest reliability of masking level differences measured with a clinically feasible technique on generally available clinical equipment. The instrumentation/methodology was found to elicit reliable, consistent, rapid measurements for both 500-Hz and speech (spondaic) stimuli which were comparable with those generally reported in the literature as laboratory-conducted experiments.


Studies on metatherian sex chromosomes. IV. X linkage of PGK-A with paternal X inactivation confirmed in erythrocytes of grey kangaroos by pedigree analysis.

Pedigree and population data are presented for erythrocyte phosphoglycerate kinase A (PGK-A) allozymes in the two species of grey kangaroo. The pedigree data confirm the hypothesis that PGK-A is X linked, the paternally derived X chromosomes being inactive in nucleated erythroblast precursors of the enucleate erythrocytes in females. The existence of different allozyme variants in eastern and western grey kangaroos further supports their division into separate species.


Heterozygosity of the sheep: Polymorphism of 'malic enzyme', isocitrate dehydrogenase (NADP+), catalase and esterase.

In contrast to other reports, it is found that the sheep has approximately as much enzyme variation as man. Most of the genetically interpretable enzyme variation in heart, liver, kidney and muscle from 52 sheep (Merinos or Merino crosses) is in the NADP-dependent dehydrogenases [two 'malic enzymes' and the supernatant isocitrate dehydrogenase (NADP+)] and in the esterases. Ten different loci for NAD-dependent dehydrogenases are electrophoretically monomorphic, as are five different NADH diaphorases from heart muscle and 15 different major proteins from skeletal muscle. It is highly statistically significant that NADP-dependent dehydrogenases and esterases are polymorphic but representatives of several other major classes of enzymes are not. The physiological significance of this polymorphism may be related to the role of these enzymes in growth and detoxication, sheep having been selected by man for faster growth, of wool or of carcass, and for grazing a wide variety of plants.


The effects of microphone spacing on auditory localization.

The localization ability of 10 normally hearing adults was determined under varying microphone separations and varying sound source azimuths. The stimuli (white noise busts) were prerecorded, after being transduced through 'body' hearing aids and then played to the subjects over headphones. Results indicated that there was an improvement in localization ability for all azimuth conditions when the microphones were spaced wider than 12.7 cm apart (15.2-30.5 cm). The smaller the separations (5.5-12.7 cm), the poorer the localization. Localization was always poorer at 30 degrees azimuth (the smallest used) than at any of the other azimuths (0 degree, 30 degrees, 60 degrees, 90 degrees right and left), regardless of microphone spacing. Implications are made about the relation of these findings to the use of binaural body aids on infants and young children.


A thermodynamic assessment of possible substrates for sulphate-reducing bacteria.

A thermodynamic feasibility study was applied as a means of predicting suitable energy-yielding substrates for growth of sulphate-reducing microorganisms. The average free energy release per electron pair for a substrate-sulphate oxidoreduction may be more or less than the energy requirement for ATP synthesis from ADP and Pi. Substrates were divided into two groups on this thermodynamic basis and the division was shown to accord with previous experimental reports; those substrates which released an average of at least 8-4 kcal per electron pair (35-2 kJ per electron pair) were able to support growth whilst those releasing less than 8-4 kcal were unable to do so. It is proposed that the thermodynamic assessment could be applied to a wide range of possible substrates to predict the likelihood of their serving as sole substrates for growth of these organisms. The literature concerning the use of hydrocarbons by sulphate reducers is confused and indefinite, but inclines toward the idea that use of long-chain hydrocarbons by these organisms is possible. In contrast, however, thermodynamic analysis showed that the highest energy release is from the short-chain alkynes.


Factors in the appreciation of a prosthetic rehabilitation.

6 months after the prescription of a hearing aid, the appreciation of the aid was judged in a group of 160 patients by a questionnaire. The analysis of the answers in combination with the audiometric features is reported. The answers given in a questionnaire have a good interrelation and agree with the score given for the aid. The audiometric features also showed a good correlation for every one but only a weak relation was found with the subjects' appreciations of the aid. The implications of this hearing aid evaluation for the improvement of the fitting procedure are discussed.


Dithionite reduction in the presence of a tetrapyrrole-containing fraction from the desulfoviridin of Desulfovibrio gigas.

Low-molecular-weight fractions obtained from the desulfoviridin of D. gigas and from the growth medium of Desulfovibrio sp. 10455 promoted the reduction of sodium dithionite to sulphide in the presence of reduced methylviologen. These fractions contained a tetrapyrrole of the isobacteriochlorin type which was not complexed with iron, nor was it complexed with protein. The observations are discussed in relation to the function of sulphite reductases in the sulphate-reducing bacteria.


Re-examination of the effects of periodic and aperiodic stimulation on the auditory-evoked vertex response.

It has been hypothesized that aperiodic stimulation will produce larger auditory-evoked vertex responses than periodic stimulation. Attentiveness toward an acoustic stimulus by human subjects has been shown in the past to enhance the auditory-evoked response. The unpredictability of aperiodic intersignal intervals has been assumed by previous investigators to produce more attentive listening behaviour and has therefore been used clinically to obtain 'enhanced' evoked responses. In order to examine this question further, auditory-evoked vertex responses were obtained with variable-interval (aperiodic) and with fixed-interval (periodic) schedules of stimulus presentation that had geometric mean intersignal intervals of 5 or 10 s. The evoked responses were obtained from normally-hearing adults while they were engaged in a counting task and while they were reading. Tone bursts were presented at 30 and 60 dB sensation level. No significant differences in peak-to-peak amplitude measures of components with latencies shorter than 300 ms could be attributed to aperiodic stimulation. When the time-base on the signal averager was extended to include components with latencies longer than 300 ms, no significant changes in component amplitudes could be attibuted to aperiodic stimulation, even though peak-to peak amplitudes during an attentive state (counting) were nearly double those obtained during an inattentive state (reading). It was concluded that aperiodicity in intersignal intervals is not a useful technique to employ in order to produce larger and more identifiable evoked responses for clinical diagnosis.


Amino acid sequence of the smaller subunit of conglutin gamma, a storage globulin of Lupinus angustifolius.

The amino acid sequence of the smaller subunit of conglutin gamma, the simplest of the three globulins from the seeds of Lupinus angustifolius cv. Uniwhite, has been determined. The subunit was homogeneous and contained 154 amino acid residues, including five sulphur-containing amino acids--a considerably higher content than is found in most other legume storage proteins. There was no indication of the complexity experienced in studies of many other legume storage proteins. This is perhaps the first sequence of a subunit of a legume storage protein to be determined.


Sulphur-selenium studies in sheep. I. The effects of varying dietary sulphate and selenomethionine on sulphur, nitrogen and selenium metabolism in sheep.

Sulphur, selenium and nitrogen metabolism were studied in Merino wethers fed for 35-day periods on semipurified diets in which the sulphur content was increased to either 0-07 or 0-20% by the addition of sodium sulphate. At both levels of sulphur, additions of selenium as DL-selenomethionine increased the basal level of selenium (0-02 microgram/g) to 0-06, 0-09 and 0-67 microgram/g. Both levels of dietary sulphur supported positive sulphur balances but a reduction in sulphur intake per se resulted in a significant depression in dry matter digestibility (P less than 0-05), apparent nitrogen digestibility (P less than 0-05), nitrogen balance (P less than 0-01), sulphur balance (P less than 0-05) and plasma sulphate-sulphur (P less than 0-05) and wool (P less than 0-01) selenium levels. Selenium balance was not affected by differences in sulphate-sulphur intake. Selenium balances (P less than 0-001), plus the selenium levels in plasma (P less than 0-001), and wool (P less than 0-001) were significantly different at the different levels of selenium supplementation. A positive selenium balance was achieved when the selenium intake was approximately 37 microgram/day, regardless of sulphur treatment. The validity of using plasma and/or wool selenium levels as indices of the selenium status of sheep is questioned.


Does pop music cause hearing damage?

Relatively few investigations have so far reported on the hearing in pop musicians. In summary, these have shown a sensorineural hearing loss in 5%. This study was carried out on 83 professionals working with pop music. Depending upon how hearing loss is defined, we found a sensorineural loss in 13-30% of the pop musicians. Hearing losses were slight. It appears that the risk for hearing damage for the audience is small. A limit for presentation of the music at 95 dB (A) is suggested as a compromise satisfying both audiologists and audience.