Ureterovesicoplasty: selection of patients, incidence and avoidance of complications. A review of 3,527 cases.

The procedure of ureteral reimplantation has certainly come of age. The incidence of complications can be kept low by careful selection of patients for operation along clear and definite guide lines, by close attention to detail in the surgical procedures and by rigorous followup care. When surgical intervention is deemed advisable the expected cure rate should be more than 94%. While complications do occur resultant damage to the upper urinary tracts should be minimized by its prompt recognition and by institution of appropriate therapy.


Long-term followup of children with colon conduit urinary diversion and ureterosigmoidostomy.

Sixty-four children underwent colon conduit urinary diversion because of a neurogenic bladder owing to myelomeningocele and 39 children required a ureterosigmoidostomy because of bladder exstrophy. The average length of followup was 4.6 years after colon conduit and 5.6 years after ureterosigmoidostomy. Colon conduit diversion was secondary in 3 children and ureterosigmoidostomy was secondary in 5. Of the children with a colon conduit 9.4% and of those with ureterosigmoidostomy 12.8% had postoperative surgical complications. Late surgical complications were encountered after colon conduit in 14.5% and after ureterosigmoidostomy in 20%. Of the children with normal renal function preoperatively 8.3% showed late deterioration after colon conduit and 8.7% after ureterosigmoidostomy. Conversely, only 16.7% with impaired renal function preoperatively did not improve at long-term followup after colon conduit. Of the renoureteral units 91% were normal after colon conduit and 95.2% were normal after ureterosigmoidostomy. The colon conduit halted the preoperative pyelonephritis in 74% of 31 affected kidneys.


Interstitial cystitis in adolescent girls.

Two cases of interstitial cystitis with typical, large bladder ulcerations in adolescent girls are reported. The specific diagnosis was confirmed histologically after full-thickness segmental resection of the bladder wall at the site of the ulceration during subsequent operations. Contrary to other reports based on subjective clinical findings, interstitial cystitis in children is rare when rigid criteria, including careful histological study, are applied. Treatment in children is the same as in adults and should be conservative. A conscientious attempt should be made to exclude infection and tuberculosis as possible contributors to the symptoms of urinary frequency and discomfort, as well as other causes of bladder abnormality. If conservative management fails to relieve symptoms the bladder may be enlarged in some cases by using a segment of intestine.


A case of a giant pheochromocytoma.

A case of a large pheochromocytoma weighing 1,150 gm. is reported. The surgical approach to this massive tumor is discussed. Early recognition of the various clinical and metabolic manifestations of the tumor are important objectives in the cure of this potentially lethal neoplasm.


Traumatic renal injury in pregnancy.

The case is presented of a pregnant woman who had urinary extravasation from the right renal collecting structures after an automobile accident. Treatment was conservative.


An unusual renocolic fistula.

A case of a left renocolic fistula that was caused by a combination of diverticular disease and renal calculi is presented. It is suggested that bowel disease will only produce such a fistula if there is pre-existing chronic renal disease.


Renal vein thrombosis: diagnosis by B-scan ultrasonography.

The substantial morbidity associated with renal vein thrombosis dictates early diagnosis and therapy. While acute renal vein thrombosis may present with symptoms and radiographic features suggestive of venous thrombosis the findings in chronic renal vein thrombosis the findings in chronic renal vein thrombosis are often non-specific. A case of acute renal vein thrombosis is reported in which thrombus in the inferior vena cava was visualized with B-scan ultrasonography. Since nearly 50% of the reported cases of renal vein thrombosis are associated with thrombosis of the inferior vena cava, B-scan ultrasonography may provide a simple method of early diagnosis.


Acute renal vein thrombosis with dextran treatment.

The case of a 35-year-old woman with active ulcerative colitis and acute left renal vein thrombosis is presented. The successful management of this patient with dextran-70 is contrasted with other modes of therapy used currently.


Simple renal cyst manifest by proteinuria in children.

A case of a large renal cyst of the right kidney presenting as persistent proteinuria in a child is reported. The preoperative differentiation and pathogenesis of the proteinuria are discussed.


Renal oncocytoma: a rare case of renal adenoma.

A case of renal oncocytoma is reported. The important pathologic aspects of this rare, asymptomatic, large benign neoplasm are described.


Latent adenocarcinoma in renal cysts.

A case is presented in which repeat examination of a benign cyst disclosed a latent adenocarcinoma near the cyst wall. Since statistically there is a greater incidence of tumor associated with cyst and since there is a 90% accuracy rate in the diagnosis of cystic lesions it appears that reinvestigation seems justified in some cases, especially if there is a change in or new development of symptoms.


Angiographic infarction of a large hypernephroma with a tissue adhesive for control of hematuria.

A case of a large inoperable hypernephroma in a 69-year-old man is presented. Recurrent life-threatening hematuria was controlled successfully by transcatheter embolization and infarction of the tumor using a tissue adhesive called isobutyl 2-cyanoacrylate. The patient remained without hematuria for 18 months until death from extensive metastatic diseases. The advantages and disadvantages of tissue adhesive as an embolization material are discussed.


Needle tract seeding following aspiration of renal cell carcinoma.

A case of tumor implantation along the needle tract 20 months after needle aspiration of a renal cell carcinoma is reported. This rare but possible complication of needle aspiration should not discourage its use in the evaluation of renal mass lesions. Needle aspiration should be reserved for those patients in whom the clinical findings, roentgenograms and sonography indicate a benign process (that is to confirm that the mass is benign).


Avulsion of the ureter caused by stone basket manipulation.

A case of an iatrogenic loss of 18 cm. of the distal ureter owing to attempted basket retrieval of a lower ureteral stone is reported. The defect was bridged by mobilizing the kidney, constructing a Boari flap and fixing the bladder with a Psoas hitch. The complications of stone manipulating are reviewed and discussed.


A spontaneous vesico-ectopic ureterovaginal fistula in a girl.

A case of a spontaneous vesicovaginal fistula through an ectopic ureteral stump in an 8-year-old Japanese girl is reported. A simple nephrectomy had been done when she was 3 years old. The genesis of this fistula is discussed and the diagnostic significance of vaginoscopy is emphasized.


Ureteroileocancerous backflow: a diagnostic radiographic sign for metastatic carcinoma.

Ureteroileocancerous backflow is a radiographic finding representing extravasation of contrast material into venous sinuses of periureteral cancerous tissues. It is suggested that this finding, which has heretofore been undescribed, is diagnostic of recurrent malignancy and that patients may be spared secondary surgical procedures for confirmation of recurrent tumor.


Retroperitoneal struvite calculus causing persistent bacteriuria.

The development of a retroperitoneal struvite calculus that was manifest solely by persistent Pseudomonas bacteriuria is reported. The etiology of the calculus is discussed.


Successful reimplantation of the penis using microvascular techniques.

The second case of traumatic amputation of the proximal shaft of the penis is reported. Microvascular techniques were used for direct anastomoses of the dorsal arteries of the penis. The apparent advantage of immediate restoration of arterial blood supply to the corpora and skin with a reduced amount of skin slough is evident.


Congenital torsion of the penis in father-son pairs.

Congenital torsion of the penis was observed in 5 newborns, 3 of whom had fathers with torsion of the penis. We believe that this common benign condition may be transmitted as an autosomal dominant trait.


Case report: possible diagnostic error: the use of urinary human chorionic gonadotropin tests to differentiate testicular tumor from inflammatory lesions within the scrotum.

A case of a probable falsely positive urinary human chorionic gonadotropin (pregnancy screening) test is reported in association with chronic epididymitis in a patient with a single testis. The urinary human chorionic gonadotropin test was used in an asymptomatic patient to attempt to differentiate a firm mass that was associated intimately with the lower pole of the testis and obliterated the lower pole of the epididymis. The use of currently available tests for human chorionic gonadotropin in the male subject is discussed.


The incidental detection of gallium-67 citrate in a urinoma following a right pyeloplasty: a case report.

An abnormal accumulation of radionuclide was identified within the right juxtadiaphragmatic and juxtahepatic spaces during gallium-67 citrate scintigraphy in a post-pyeloplasty patient. Its mode of presentation, the recent pyeloplasty and the known biologic distribution of gallium suggested that it represented gallium-67 concentration within a postoperatively created urinoma. Diagnosis was confirmed by excretory urography and laparotomy.


An epidermal papilloma of the Atlantic salmon I: Epizootiology, pathology and immunology.

Papillomatosis of Atlantic Salmon (Salmo salar) was studied with regard to epizootiology, gross and histologic pathology, and host response. It was found to be a condition of parr in their second summer, but also occasionally of young adult fish (smolts and grilse) which have adapted to salt water. The lesion was plaque-like to papillomatous and consisted of stratified squamous epithelium with supporting stroma. Immunologic findings tended to support histologic observations that the lesion was ultimately sloughed as a result of a cell mediate immune response.


An epidermal papilloma of the Atlantic samon II: Ultrastructure and etiology.

Ultrastructure of the Atlantic salmon papilloma was studied, and virus isolation was attempted. The papilloma cells were similar to normal epidermis in having interdigitating cell membranes with desmosomes. The nuclei, however, were more regular in shape than normal epidermal nuclei and the chromatin tended to be marginated and clumped. No cytopathic viral agents were isolated.


Spontaneous renal disease in Louisiana armadillos (Dasypus novemcinctus).

Renal lesions were present in 34 (68%) of 50 armadillos (Dasypus novemcinctus) collected for a survey of the prevalence of leptospires in Louisiana wildlife. The renal lesions were not associated with elevations in the renal function tests of blood urea nitrogen or serum creatinine or with consistent serologic or cultural evidence of leptospires.


Prenatal infection of the Rocky Mountain bighorn sheep (Ovis c. canadensis) of Alberta with the lungworm Protostrongylus spp.

First- and third-stage (infective) larvae of Protostrongylus spp. were recovered from the livers of four fetuses of the Rocky Mountain bighorn sheep of Alberta. This record suggests a more cosmopolitan distribution of prenatal infection with lungworms in bighorn sheep than suspected previously.


The immobilization of wapiti with etorphine hydrochloride.

Data and observations on the use of Etorphine hydrochloride (M99) (in combination with Acepromazine) and its antagonist M50-50 for immobilization of captive elk (Cervus elaphus canadensis) are presented. The study period covers 3 years during which 8 adult elk were immobilized 52 times with M99. The average dose of M99 administered for each immobilization was 2.2 mg per 100 kg body weight. Reversal with M50-50 was effected by an average dose of 4.4 mg per 100 body weight. Induction averaged 5.9 minutes while reversal took an average of 4.6 minutes.


Trypanosoma (Herpetosoma) longiflagellum sp.n. from the tomb rat, Taphozous nudiventris, from Iraq.

Trypanosoma (Herpetosoma) longiflagellum sp.n. (Protozoa: Trypanosomatidae) from a bat, Taphozous nudiventris, from Iraq is described. The trypanosome measures 24.0 to 34.2 micron (mean 26.4 micron, SD 2.5) in total length, 13.8 to 18.2 micron (mean 15.2 micron, SD 1.0) in body length, is 1.5 to 2.9 micron (mean 2.0 micron, SD 0.3) in breadth and has a free flagellum of 10.2 to 16.0 micron (mean 11.2 micron, SD 1.6). The nuclear index is 1.4 to 2.1 (mean 1.7 SD 0.1) and the kinetoplastic index is 1.5 to 2.6 (mean 1.9, SD 0.2). This is the second report of a bat trypanosome belonging to the subgenus Herpetosoma and the first report of trypanosomes from bats from Iraq.


Trypanosoma (Herpetosoma) longiflagellum Sp.N. from the tomb bat, Taphozous nudiventris, from Iraq.

Trypanosoma (Herpetosoma) longiflagellum sp.n. (Protozoa: Trypanosomatidae) from a bat, Taphozous nudiventris, from Iraq is described. The trypanosome measures 24.0 to 34.2 micron (mean 26.4 micron, SK 2.5) in total length, 13.8 to 18.2 micron (mean 15.2 micron, SD 1.0) in body length, is 1.5 to 2.9 micron (mean 2.0 micron,SD 0.3) in breadth and has a free flagellum of 10.2 to 16.0 micron (mrsn 11.2 micron, SD 1.6). The nuclear index is 1.4 to 2.1 (mean 1.7 SD 0.1) and the kinetoplastic index is 1.5 to 2.6 (mean 1.9, SD 0.2). This is the second report of a bat trypanosome belonging to the subgenus Herpetosoma and the first report of trypanosomes from bats from Iraq.


Selenium and white muscle disease in woodchucks.

Gross and histologic examination of wood chcks (Marmota monax) trapped on farms in Central New York revealed white muscle disease(WMD). The concentration of selenium in the animal tissues, vegetation and soils in the vicinity of trapping did not consistently correlate with the presence of WMD.


Some blood values of the western diamond-back rattlesnake (Crotalus atrox) from south Texas.

Hematologic values of the western diamond-back rattlesnake (Crotalus atrox) from south Texas were determined by standard techniques. The means of the principal blood measurements were 0.68 +/- 0.20 million erythrocytes/mm3, 31.9 +/- 4.6% hematocrit and 10.0 +/- 1.8 gm% hemoglobin. A comparison of hematologic values of snakes is given.


Fibrosarcoma in a white-tailed deer.

A large, rapidly growing subcutaneous fibrosarcoma was observed on the head of an aged male white-tailed deer (Odocoileus virginianus) from Frederick County, Maryland. Although there was no evidence of distant metastasis, the large neoplastic mass had extensively invaded the osseous supraorbital process, and had several small satellite nodules nearby.


Leptospirosis in small mammals of Iran: II: isolation of Leptospira grippotyphosa from Mus msuculus.

The serotype of Leptospira grippotyphosa, which is most frequently encountered among sheep, cattle and man in Iran, was isolated from the kidney of a house mouse, Mus musculus, by direct culture and animal inoculation. This is the first time that a rodent reservoir of L. grippotyphosa in Iran has been investigated and reported.


Histopathologic alterations associated with Anisakis larvae in Pacific herring from Oregon.

A histopathologic study of Anisakis sp. larvae in Pacific herring (Clupea harengus pallasi) is presented. Tissue alterations included mechanical compression of the pancreas and liver, granulomatous inflammation and necrosis of the liver, and trauma to the muscularis externa of the pyloric caeca. Host exudate in most lesions contained macrophages (histiocytes) and lymphocytes.


Treatment of captive giant Canada geese affected by avian cholera.

In the spring of 1975, an epornitic of avian cholera in Nebraska affected wild waterfowl, common crows (Corvus brachyrhynchos), and a captive flock of guant Canada geese (Branta canadensis maxima). Measures taken to control the disease in the captive geese included flushing the water of their pen with fresh well water, parenteral (50mg oxytetracycline intramuscularly) and feed (tetracycline 500 g/ton) antibiotic treatment, and removing dead waterfowl and crows from the pen, and keeping wild waterfowl and crows out of the pen. Other measures taken to prevent a recurrence of the outbreak included monitoring the area with susceptible sentinel birds and culturing nasal swabs for Pasteurella multocida. Young Canada geese and wood ducks (Aix sponsa) raised in the area also were cultured before release to assure that carriers would not be released into the wild. Presently, ponds in the pen have been dried up so that the area is less attractive to wild waterfowl. Swine feeders and waterers that have been modified to discourage their use by crows are being used to feed and water the geese.


Renal lesions in striped skunks (Mephitis mephitis) from Louisiana.

Renal tissue from 100 striped skunks (Mephitis mephitis) examined microscopically showed evidence of inflammation in 74% of the kidneys. Azotemia was present in 20% of the skunks that had severe renal lesions. The cause of inflammation is unknown, but leptospires were cultured from kidneys or urine of 55% of these skunks.


Dascyllus spp.: new hosts for lymphocystis, and a list of recent hosts.

Lymphocystis disease is reported for the first time from the white-tailed damselfish, Dascyllus aruanus, and the black-tailed humbug, Dascyllus melanurus. Both species are commercially important exotic aquarium fish from the Indo-Australian Pacific. Lymphocystis is recorded again from the copper banded angelfish, Chelmon rostratus. An updated host list for the disease is included.


Studies on pronghorn antelope (Antilocapra americana) as reservoirs of anaplasmosis in Montana.

Twenty-six pronghorn antelope (Antilocapra americana) were collected in an area of eastern Montana where bovine anaplasmosis is enzootic. Their sera were examined for evidence of anaplasmosis by the complement-fixation test. Strong false positive reactions (3+ and 4+ reactors) occurred for 19 of the sera tested; 6 sera were anticomplementary. Inoculation of antelope blood into anaplasmosis, and anaplasma bodies were not found in stained blood smears of antelope or recipient calves.


Seasonal changes in stomach worms (Obeliscoides cuniculi) in snowshoe hares in Maine.

The stomachs of 141 (96.5%) of 146 snowshoe hares (Lepus americanus) collected in the area of East Corinth, Maine between the months of February, 1972 and February, 1973 were infected with Obeliscoides cuniculi. Nematodes were counted in 140 infected adult hares. The greatest intensity of infection occurred during the period from spring into summer (March to July) and at this time the populations of nematodes were mainly adults. During this period, female hares harbored significantly greater numbers of nematodes than males. Lowest numbers of nematodes were seen in late fall and early winter (October to December). The proportions of immature (fourth stage) nematodes in the populations increased appreciably from late summer on into winter and by December these constituted some 60% of the total population. A marked decline in immature nematode numbers was observed after February, with a concurrent increase in numbers of adults. A well-defined cyclical population fluctuation in natural infections of O. cuniculi was evident.


Chronic dermatitis in nutria in Louisiana.

Chronic dermatitis in nutria (Myocastor coypus) in Louisiana was traced to secondary bacterial and fungal infection resulting from the penetration of achene awns of smooth beggartick (Bidens laevis) into the skin.


An elderly case of mixed levocardia with situs inversus including inverted atria and complete transposition of the great vessels--an autopsied case.

We reported on the autopsy of a 35-year-old man who had mixed levocardia with situs inversus including atrial inversion, transposition of the great vessels, and other complex cardiac malformations. Levocardia was discussed.


[An experimental study on canine A-V junctional pacemaker--evaluation of the automaticity by overdrive suppression and autonomic blockade by practolol and atropine].

1. The automaticity of the A-V junction was evaluated in 15 awake dogs with experimentally induced A-V junctional rhythm. 2. The spontaneous heart rate of these dogs ranged from 54 to 112 beats a minute, showing about 1.5-2.5 times slower than that of control dogs with sinus rhythm. The duration of asystole after overdrive in these dogs prolonged significantly in accordance with an increase in the frequency of stimulation for overdrive, and its mean +/- SD attained 4.7 +/- 1.1 seconds after overdrive at a rate of 2.5 times the spontaneous heart rate. 3. By administration of atropine (0.04 mg/kg, i.v.) to 8 dogs, the duration of asystole after overdrive, at a rate of 1.5 times the spontaneous heart rate, decreased from 2.6 +/- 0.8 to 1.5 +/- 0.4 seconds. By administration of practolol (0.5 mg/kg, i.v.) to 7 other dogs, the duration of asystole after overdrive increased from 3.0 +/- 1.1 to 6.4 +/- 2.2 seconds. 4. It should be suggested that, (1) about 5 seconds of asystole might physiologically occur before the initiation of the A-V junctional escape beat during the long-standing sinus arrest, and (2) the sympathetic nerve might play a more important role in regulating the automaticity of the A-V junction than the vagus nerve.


Mechanodynamics at the interventricular sulcus--reciprocal effect of the ventricles on the ventricular function.

The forces acting on IVS were analyzed to delineate reciprocal effects of the two ventricles on the ventricular fucntion as a whole. The resultant force (FT) was dependent on the LV pressure but independent on the RV pressure. But the composite forces (F1 and F2) of FT were affected by the LV and RV pressures. In a normal heart F1 increased with increasing LV and/or RV pressures. But in F2 increase occurred only with increasing RV pressure. In the LV pressure increase occurred only when the RV pressure was 10 mmHg and decrease did when the RV pressure was 50 mmHg, while stable at 30 mmHg. Directions of both the forces (F1 and F2) diverged as the RV pressure increased and the LV pressure decreased. When FRV was hypertrophic, increases of the magnitudes of the forces were decreased when the pressures of the LV and RV were higher. The angle between the forces was also decreased so that the efficiency of the forces was risen. When a portion of the ventricles lost its contractility, FT increased, particularly, when FLV lost its contractility. But these increases seemed to well be within range of compensation.


Preoperative evaluation of the structural lesion of the mitral valve by M-mode scan echocardiography.

M-mode scan echocardiographic studies of the mitral valve were performed in order to investigate structural architecture of the diseased mitral valve. Structural lesion of the mitral valve was assessed by the echo-pattern change, an increase in number or thickness of the diastolic mitral echo complex. The echo-pattern was classified into 4 grades according to number or thickness of the mitral echoes. The echo-pattern grade correlated with the degree of the structural lesion of 21 surgically excised mitral valves. Clinically, the echo-pattern grade was compared with subsequent operative procedure in 56 cases with pure or predominant mitral stenosis (42 open commissurotomy, 14 valve replacement). Grade I or grade II echo-pattern was a good indicator for mitral commissurotomy. Grade IV pattern was a reliable criterion for valve replacement. Mitral valve replacement should be also considered in cases with grade III pattern, 38% of whom underwent valve replacement. C-E amplitude of the mitral valve was not a useful parameter in assessing the surgical procedure. Thus, the echo-pattern obtained by M-mode scan technique appeared to be of valve in planning the surgical approach for patients with pure or predominant mitral stenosis.


Vectorcardiograms in aortic and mitral regurgitation -- a comparative study.

Thirteen patients with aortic regurgitation (AR) and 13 with mitral regurgitation (MR) were compared quantitatively from the standpoint of their vector-cardiograms (VCG). Vectorcardiographic parameters were also compared with left ventricular angiographic parameters. The QR time interval was longer and the magnitude of the spatial maximum QRS vector was larger in the AR group, but these differences were thought to be attributed to the differences in length of the left ventricular long axis and the left ventricular end diastolic volume (LVEDV). In the AR group, the ratio of the width to the long axis of the QRS loop in the horizontal plane correlated well with the length of the left ventricular long axis and the angle made by the axis from the middle of the aortic valve to the left ventricular apex and the horizontal axis in the lateral view of the angiogram. In the MR group, these correlations were poor.


Effects of glucagon on the renal hemodynamics in the dog.

The effect of glucagon on the renal hemodynamics in the dog was examined by comparing its effect with that of secretin, a peptide with which glucagon shares a similar chemical structure. An intrarenal infusion of glucagon resulted in increases of RBF and GFR. GFR rose by approximately the same order of magnitude of RBF. The increase in GFR depended on the selective dilation of the afferent arteriole and a consequent rise in the transcapillary pressure difference. On the other hand, secretin infusion produced highly significant and proportional decreases in both afferent and efferent arteriolar resistance, resulting in no change in GFR. A superimposition of acetylcholine to glucagon decreased GFR even though RBF increased significantly. Glucagon infusion did not affect the permeability of glomerular capillary and the distribution of cortical blood flow. These findings indicate that the effect of glucagon on GFR depended on the selective dilation of afferent arteriole, and that as a result of its dilation the net filtration pressure increased without any change in permeability of glomerular capillary and a redistribution of filtration.


[Studies on administration of cephalothin sodium after open heart surgery (author's transl)].

Critical cardiac contamination may occur during extracorporeal circulation in open heart surgery. Prophylactic administration of cephalothin sodium (CET) was studied for their safe and adequate serum concentration after open heart surgery in infants and adults. Methods of administration of CET were discussed for infants and adults.


Pharmacokinetics of dibekacin after intramuscular administration in man.

Pharmacokinetic behavior of dibekacin after intramuscular administration was studied in nine healthy volunteers by cross over administrations of three dosage levels (1 mg(pot.)/kg, 1.5 mg(pot.)/kg and 2 mg(pot.)/kg). Drug concentrations in serum and urinary recoveries were measured and those data were analysed pharmacokinetically. The serum levels of this drug were in proportion to dosage, and the pharmacokinetic parameters were almost the same through the three dosage levels. Then it was considered that the pharmacokinetic behaviors of dibekacin were almost the same within the range of these dosage levels. No significant difference was found between the body clearances calculated from the data of serum levels, and the renal clearances calculated from the data of urinary recovery and serum levels. Therefore it is considered that the elimination of the drug from blood is almost due to renal excretion.


[Studies of sustained release cephalexin (S-6437) in pediatrics (author's transl)].

S-6437 is granule of sustained-release cephalexin which is prepared as longer acting cephalexin. Each gram of the granule contains 200 mg of cephalexin. Absorption and excretion study of this preparation was performed in 8 patients (3 school children, 3 infants and 2 babies). Mean blood levels of cephalexin following a single oral administration of 25 mg/kg in the school children, for instance, were 1.73, 2.47, 3.11, 2.28, 3.84 and 2.86 mcg/ml at 0.5, 1.0, 2.0, 4.0, 6.0 and 8.0 hours, respectively. Fifty-two patients with acute respiratory tract infections were treated with this preparation and out of the 52, 33 were evaluable cases. The daily dose used was 50 mg/kg divided in two doses. Of the 33 patients 29 responded to this preparation showing 87.8% of effectiveness. Four patients who did not respond were 1 with acute pharyngitis, 2 with acute tonsillitis, and 1 with acute bronchitis. No severe side effects due to this preparation were observed.


[Clinical study of S-6437 in pediatrics (author's transl)].

Clinical study of sustained release cephalexin (granules, 200 mg/g, S-6437) was conducted in pediatric patients as follows: 1. For infants under 20 kg of body weight, 25 approximately 50 mg/kg/day of this preparation (or 50 approximately 100 mg/kg/day for severe diseases) were given in two divided doses, and for infants over 20 kg, 1 g (or 2 g for severe diseases) were administered at two divided doses. 2. Patients treated with this preparation were 27 cases with scarlet fever, 3 with acute pharyngitis, 2 with acute tonsillitis, 1 with acute laryngitis, 1 with acute cystitis and 1 with acute enteritis. 3. Out of the 35 patients, 11 showed "very good" response to this preparation, 18 "good", 3 "fair", 1 "poor", and 2 "unknown" indicating 87.9% of effectiveness. 4. Side effects of cheilitis in one patient and vomiting in 1 were observed, and other 2 patients had difficulty in taking this preparation. No other side effects were found.


[Clinical and laboratory studies on S-6437 (a new longacting granule of cephalexin) in pediatric field (author's transl)].

Clinical and laboratory studies on S-6437 were made, and the following results were obtained. 1. Thirty pediatric patients with various types of infections such as tonsillitis, bronchitis, pneumonia, cystitis, pyelitis, lymphadenitis colli and pyodermia were treated with S-6437 at the daily dosage of 50 mg/kg orally, the clinical effectiveness was 89.3%. 2. The peak blood level of cephalexin after a single oral administration (25 mg/kg) was observed after 4 hours and the average peak blood level of 10 cases was 7.4 microgram/ml. 3. The average urinary excretion rate of 5 cases was 71.2%. 4. Mild side effects were noticed in a few cases.


[Study of S-6437 in pediatrics regarding clinical efficacy, blood levels and urinary excretion (author's transl)].

S-6437 was orally given to 29 patients of 3 months to 12 years and 6 months of age who had respiratory or urinary tract infections. The daily dose used was 25 to 60 mg/kg divided in two doses. The following is the results of this study: 1. With 25 approximately 60 mg/kg/day, satisfactory results were obtained for upper respiratory tract infections. In lower respiratory tract infections, however, the effectiveness seemed not to be so good as that in upper respiratory tract infections. 2. Side effects such as diarrhea, loose stool, abdominal pain and eruption were observed but they were temporary. Therefore, the administration of S-6437 was not discontinued due to such side effects. 3. S-6437 was acceptable to elder children but some of children of 2 approximately 4 years of age disliked this preparation because it was not smooth in their mouths. Therefore, the preparation of S-6437 should be further improved. 4. Since it has been recognized that blood levels of cephalexin following the administration of S-6437 last for a longer period of time than regular cephalexin, S-6437 is considered to be a useful preparation. 5. B.I.D. and T.I.D. regimens of S-6437 will give clinical satisfaction to children over 6 years and ones under 6 years, respectively.


[Study of S-6437 (sustained release cephalexin) in pediatrics (author's transl)].

In order to clinically evaluate S-6437, the following study was carried out in pediatric patients. This clinical study was performed in 30 patients ranging from 2 years and one month to 10 years and one month of age. Seven patients had scarlet fever, 3 acute pharyngitis, 4 acute suppurative tonsillitis, 6 acute bronchitis, 2 acute pneumonia, 3 acute pyelonephritis, 1 chronic pyelonephritis, 2 vaginitis, 1 acute gastro-enteritis, and 1 impetigo. The degree of these diseases were all mild or moderate. These patients were orally administered 35 approximately 50 mg/kg/day in two divided doses for 3 approximately 10 days. As a result, effectiveness of this preparation in these patients was 80% and no side effects were observed.


[Clinical studies of S-6437 in pediatrics (author's transl)].

Peak blood level of cephalexin was obtained at 4 hours after the administration of S-6437 as opposed to 2 hours after regular cephalexin. Peak blood level with regular cephalexin was higher than that with S-6437. Blood levels with S-6437, however, stayed for longer period than those with regular cephalexin. Mean urinary recovery within 12 hours after the administration of S-6437 after meal and during meal were 57.1 and 69.3%, respectively. S-6437 was studied in 23 pediatric patients, 7 with acute tonsillitis, 15 with acute cystitis and 1 with cellulitis. They were orally given 400 to 1,200 mg/day of S-6437 in two divided doses at 30 minutes after meal for 4 approximately 12 days. Of the 23 patients, 18 responded to the drug but 5 did not respond. As for side effects, eruption and diarrhea were observed in 1 and 2 patients, respectively. No other side effects were found.


Antitumor effect of seaweeds. II. Fractionation and partial characterization of the polysaccharide with antitumor activity from Sargassum fulvellum.

An almost purified antitumor polysaccharide fraction (SFPP) was obtained by fractional precipitation with ethanol from hot-water extract of Sargassum fulvellum. The fraction showed remarkable tumor-inhibiting effect against sarcoma-180 implanted subcutaneously in mice. The results of chemical and physical analyses suggested that the active substance may be either a sulphated peptidoglycuronoglycan or a sulphated glycuronoglycan.


Studies on the fresh water cercariae in Leyte Island, Philippines. I. Collection of snails.

During the past two years of 1975 and 1976, approximately sixteen thousand specimens of fresh water snails were examined for the presence of cercariae in Leyte Island, Philippines. These snails comprised about 14 species belonging to 7 families, and ultimately 43 species of cercariae were found, namely, 6 species from Oncomelania quadrasi, 13 species from Thiaridae, 9 species from Viviparidae and Pilidae, 8 species from Planorbidae, and 7 species from Lymnaeidae and Bulinidae. As a total, out of 15,925 snails examined, 761 or 4.78% were found infected with cercariae. Up to the present, 22 species of cercariae had been reported from the Philippines, and almost all of them are from Luzon Island only. Therefor, except for the cercaria of Schistosoma japonicum, all of the cercariae in the present study are new discoveries, and most of them are considered as new species. In this paper, the historical review on the cercarial study in the Philippines was made first, then dates and localities of snail collection in the present study were shown in details with some map and table, and general method of cercarial observation was described for the benefit of succeeding reports of this series.


Studies on the fresh water Cercariae in Leyte Island, Philippines. 2. Cercariae from Oncomelania quadrasi.

From 1975 to 1976, more than six thousand snails of Oncomelania quadrasi were observed for cercarial fauna in the north-eastern part of Leyte Island, Philippines. Altogether, six species of cercariae including that of Schistosoma japonicum were found, namely two furcocercariae, one monostome cercaria, two xiphidiocercariae and one tail-less cercaria. In this paper a description of their morphology, infection rate, locality, and some remarks on the presumptive life cycle is included with illustrations and photographs.


Toxicological approaches to the metabolites of Fusaria. XI. Trichothecenes and zearalenone from Fusarium species isolated from river sediments.

Fifty isolates of Fusarium species from river sediments were examined on their producibility of mycotoxins such as trichothecenes and zearalenone. The most frequent fungal isolate was Fusarium oxysporum, followed by F. solani and F. lateritium. When cultured on Czapek-Dox medium supplemented with peptone, more than half of these strains were suspected to produce trichothecene mycotoxins through toxicity to mice and reticulocyte assay method. One of toxic isolates, F. lateritium 5036, was proved to produce the following five kinds of trichothecenes; diacetoxyscirpenol, 7alpha-hydroxydiacetoxyscirpenol, 7,8alpha-dihydroxy-diacetoxyscirpenol, 8alpha-hydroxydiacetoxyscirpenol (neosolaniol) and diacetylnivalenol. Three strains produced zearalenone on rice grain culture.


Measurements of the levels of organic solvent vapours by personal air samplers and the levels of urinary metabolites of workers. Part 2. Toluene vapour in a shipbuilding yard (author's transl).

Personal air samplers were applied to shipyard's painters putting on gas masks during the spraying work, and the levels of toluene vapour surrounding the workers were measured. On the other hand, levels of urinary hippuric acid (metabolites of toluene) of the workers were measured, and the levels of toluene vapour inhaled were calculated from the levels of urinary hippuric acid. Then the actual removing-efficiencies of toluene vapours by the use of gas masks were estimated from these two levels (i.e., toluene vapours exposed and inhaled). The values of removing-efficiencies were found to be 65.9-98.1%. The concentrations of hippuric and methylhippuric acids in the urine of workers exposed to toluene and xylene for 3 hours, collected just after the exposure, are valuable indices of these organic solvent vapours inhaled. A minute amount of urinary methylhippuric acid can be determined by means of gas chromatography.


Effects of Russell's viper venom on blood coagulation, platelets and the fibrinolytic enzyme system.

The effects of Russell's viper venom (RVV) on blood coagulation, platelts and fibrinolysis were studied in vivo and in vitro in rabbits and dogs as experimental subjects. RVV was shown to be a strong coagulant, and at the time of manifestation of bleeding due to consumption coagulopathy, the most striking hemostatic abnormalities were fall of fibrinogen level, reduction in platelet count, delayed ADP aggregation of platelets, increased fibrinolytic activity and presence of fibrin degradation products. These findings showed that RVV interfered with blood coagulation, caused abnormalities of platelet function and also activated the fibrinolytic enzyme system.


Surface charge of dengue virus hemagglutinins prepared from infected mouse brains.

Surface charge of dengue virus hemagglutinin (HA) prepared from infected suckling mouse brains was studied by sucrose gradient electrophoresis. The findings were as follows: (1) Both the slow- and rapid-sedimenting hemagglutinins (SHA and RHA, respectively) prepared after streptomycin treatment of the brain homogenate were distributed broadly within the gradient after electrophoresis, while echovirus type 7 HA which was used as a reference migrated narrowly, suggesting heterogeneity of the surface charge of both dengue HAs. (2) Neuraminidase treatment of dengue HA slightly retarded its migration toward the anode but did not alter the broad distribution. (3) Protamine treatment used for purification of HA from the brain homogenate changed the surface charge from negative to positive.


Formation of soluble fibrinogen-fibrin complex in liquid human plasma; reflexion of coagulation process in storage.

Analysis was performed on a high-molecular fraction with fibrinogen antigenicity present in Liquid Human Plasma. This fraction, although seemed to resemble macromolecular FDP (fibrinogen degradation product) derived from stabilized fibrin, has many features not shared with the latter: 1) This fraction is sensitive to sodium dodecylsulfate (SDS) treatment. 2) Degradation products of this fraction obtained by digestion with plasmin, when eluted from a column of Sephadex G-200, exhibited a single peak of FDP-D antigenicity at the position of D-monomer. 3) In SDS polyacrylamide gel electrophoresis in the presence of dithiothreitol (DDT), no evidence for the presence of gamma-dimer was obtained. Thus, it is unlikely that the high-molecular fraction is formed through interchain cross-linking between fibrinogen molecules. The formation of the high-molecular complex was discussed in relation to coagulation process in stored plasma.


Establishement of a rabbit lung cell line (RL-33) and its viral susceptibility.

A new cell line (RL-33) was established from a rabbit  lung tissue. The cells maintained a fibroblastic appearance and a contract-inhibited growth through 180 passages. No latent infectious agent has so far been demonstrated. The cells supported the growth of a variety of viruses, enabling plaque assays for Shope fibroma, rabbit myxoma and types 1 and 2 herpes simplex viruses. They were as sensitive to rabbit interferon as RK-13 (a line from rabbit kidney) cells.


Evaluation of severinghaus' equation and its modification for 2, 3-dpg.

Severinghaus' equation can safely be used for the indirect estimation of oxygen half saturation pressure (P50) on the basis of blood gas parameters in normal subjects. However, 139 blood samples from 65 patients with severe injuries, the estimated P50 values differed significantly from directly measured values. The difference is highly correlated to the molar ratio of 2, 3-diphosphoglycerate to hemoglobin tetramer (2, 3-DPG ratio, [DPG]). Using this correlation, a modified Severinghaus' equation, including 2, 3-DPG molar ratio, was derived: i.e.,deltalog Po2 equals +0.48 (7.4-pH)+0.024 (T-37), +0.0013BE+0.135[DPG]-0.116 where deltalog Po2 is the shift from the standard oxygen dissociation curve, pH is plasma pH, and T and BE refer to temperature and base excess of blood, respectively. The modified equation enables one to indirectly estimate Po2 and oxygen saturation with an accuracy of plus or minus 2.5 mmHg and plus or minus 5 percent, respectively, based on blood gas parameters and 2, 3-DPG molar ratio in most clinical cases. The limitations of the equation was discussed.


Effect of cardiac output on circulatory blood volume.

In anesthetized dogs venous return was drained into a blood reservoir from which blood was pumped to the right atrium at a variable perfusion rate, which was equal to cardiac output in the steady state. When cardiac output was decreased or increased by 25 or 50 percent of the control, the blood volume in the dog's body was changed in the same direction in the intact reflexic state as well as in the areflexic state prepared by hexamethonium and norepinephrine infusion. The volume change in the reflexic state was twice that in the areflexic state when compared 5 min after stepwise changes in cardiac output. When only the flow through the right heart and lungs was changed by-50 percent, with systemic flow unchanged, the decrease in blood volume was about one-fifth of that observed on a 50 percent decrease of cardiac output and not affected by ablation of the reflexes. It is concluded that, on a change in cardiac output, the passive change in blood volume is as large as the active or reflexic change, that the majority of the change in blood volume takes place in the systemic circulation rather than in the pulmonary circulation, and that the receptors for the reflexic change are located in the systemic circulation.


Influence of pulmonary vascular pressure on bronchial collapsibility of excised dog lungs.

The main bronchi of excised dog lobes were obstructed with beads, 5 to 6 cm from their origin so that they did not communicate with the peripheral air spaces. Both pulmonary artery and vein were cannulated and both pulmonary vascular pressures were controlled. With the lobe held at constant transpulmonary pressure, bronchial pressure-volume curves were studied during acute pulmonary vascular engorgement. The bronchial compliance was reduced at higher vascular pressure and the effect of vascular engorgement on the bronchial collapsibility was larger at higher transpulmonary pressure: bronchial compliance at vascular pressure-40 cm H2O at transpulmonary pressure 20, 10, 5, and 0 cm H2O respectively. We concluded that vascular engorgement increased parenchymal radial traction to the bronchi when the bronchi reduced its diameter, although it appeared that vascular engorgement resulted in little change in the lung elastic recoil pressure.


Energy requirement for the maintenance of membrane potential in rat liver cells in situ.

The transmembrane potential of female rat liver cells in situ was-52.4 mV. This was decreased to -42.9 mV by ethacrynic acid (4 mg/100 g), but not by ouabain (1 mg). DL-Ethionine (25-100 mg) caused a decrease in the membrane potential and tissue ATP content. A high dose ethionine (100 mg) increased tissue Na content and decreased K content. By applying adenine (25 mg) to the animals treated with ethionine (100 mg), the membrane potential, ATP content and K content were increased and the Na content was decreased. The repolarized membrane potential in the animals treated with adenine following the ethionine was again depolarized by the administration of ouabain, but not by the administration of ethacrynic acid. These results suggest that two kinds of active ion transport mechanisms, ethacrynic acid-sensitive and ouabain-sensitive mechanisms, may be involved in maintenance of the membrane potential of rat liver cells.


Inhibition and excitation induced by glutamic acid on cerebellar interneurons.

Thin sections of guinea pig cerebellum were incubated in an artificial medium and responses of neurons in the granular layer to glutamic acid were studied. About half of these neurons were inhibited by glutamate administered electrophoretically (GI cells) and others were excited (GE cells). The GI cells were also inhibited in a medium containing glutamate. Gamma-amino butyric acid inhibited the GI as well as the GE cells. The inhibition in the GI cells induced by glutamate was not susceptible to picrotoxin or strychnine medication, and was not blocked in a CI-free medium or in a medium containing CA2+ in low concentrations and Mg2+ in high concentrations. Some GI cells showed high-amplitude spikes which were recordable at distances of tens of micrometer from the cell. These observations indicate that at least some of the GI cells were large Golgi cells and that the inhibition induced by glutamate in the GI cells was not mediated by inhibitory interneurons.


Some properties of late after-potential in frog skeletal muscle fiber.

Some properties of late after-potentials which appear following a train of impulses were examined in frog skeletal muscle fiber. The decay of the late after-potential followed a simple exponential time course. The time constant of the decay was larger in a viscous solution than in normal Ringer solution. It was proved by physical experiments that the diffusion of K ions was delayed in the viscous medium at the same rate as the decay. The effect of temperature on the decay was low and the Q10 for the time constant was 1.2. When the late after-potentials were recorded at membrane potentials variedly controlled by the polarizing current, the reversal potential shifted in the positive direction with the increase of impulses. These results suggest that the late after-potential may be dependent on K ions accumulated in the T system. During the initial 300 msec period immediately after the onset of the decay, the amplitude was smaller than expected by a simple exponential time course. This effect was especially apparent in the sucrose hypertonic Ringer solution in which the decay was extremely extended. The cause of this non-exponential component was discussed with respect to the K accumulation hypothesis.


Impairment of acquisition of learning by inhibitors of RNA or protein synthesis.

The effects of inhibitors of RNA or protein synthesis (cycloheximide, puromycin and actinomycin D) on acquisition of learning in mice were investigated using various types of shock avoidance tasks. Mice having uniform and superior learning ability were used as subjects. Drugs were injected into the lateral ventricle 1 hr before training for avoidance tasks in three different shapes of maze and in a one-way shuttle box and for those based on light-dark discrimination. In all cases of training, the drugs were found to impair the acquisition of learning. The impairment was pronounced in a relatively complicated task such as H-maze learning as compared to a simple task such as T-maze learning. The drugs never affected the performance of pretrained animals. During the discussion, the acquisition of learning would be related to some specific process of RNA and protein synthesis in the brain.


Functional properties of peripheral sensory units in hairy skin of a cat's forelimb.

The properties of peripheral cutaneous units in the hairy skin of cat's forelimb were studied by single-fiber recordings with tungsten microelectrodes. The response properties and receptive field (RFs) of total 193 units in superficial branch of radial nerve (SRN) were studied. The SRN sample included the following five major types of mechanoreceptive units; two types of low-threshold units (type I and II, slowly adapting), two types of hair units (G and D, rapidly adapting) and field units (F, responding principally to slow skin movement). Afferent conduction velocities of these units ranged from 9.0 to 56.0 m/sec. D hair fibers conducted much slower than other types of afferents and their conduction velocities were between 9.0 and 23.3 m/sec. Most of the smaller RFs of G, D and F units were found in the paw and digits. The disto-proximal increase of the mean size of RFs was marked in D hair units. The distributions of the RFs of simultaneously recorded paired units, which were supposed to be adjacent fibers, were examined. Among 23 paired units, more than half of them were homonymous combinations of unit types and there were no marked prevalence of particular types in heteronymous combinations. The RFs of paired units were close to each other, but showed little overlaps and some were separated by up to several cm over the skin surface. Some functional properties of cutaneous afferents from the forelimb were discussed.


Tetanic contraction and tension-length relation of frog ventricular muscle.

Complete tetanic contraction was generated in frog ventricular muscle by repetitive electrical stimulation. The maximum stimulus was a transverse alternating current at 10 Hz and 17-20 V/cm in peak to peak voltage in an external solution containing 9 mM Ca2+. The maximum isometric tension thus obtained was twice or more than that of the twitch tension at 20 degrees C. The tetanic tension and its rate of rise declined with decreasing external Ca2+ concentration and less than half of the maximum tension was generated at 1.8 mM Ca2+. Various tetanic tensions less than the maximum were obtained in the partially depolarized muscle in excess K+ solution by reducing the stimulus intensity. Adrenaline (5X10(-6)g/ml) potentiated the submaximal tetanic tension as well as the twitch tension, although no effect was observed for the maximum tetanic tension. The tension-length relation for the tetanic contraction of ventricular muscle was similar to that of the skeletal muscle, but the tension fell almost linearly at shorter lengths than 0.9 Lm, where Lm is the optimum length at which the maximum tension, Fm, was generated. Fm was 4.6 g/mm2, while the sarcomere length at Lm was 2.0-2.2 mum.


Effects of diltiazem and lanthanum ion on the potassium contracture of isolated guinea pig smooth muscle.

Effects of diltiazem on K-induced contracture of the smooth muscle were examined in the isolated taenia coli and stomach strip of the guinea pig. Results were compared with those of lanthanum ion (La(3+)). K-contracture was evoked by isotonic K-Krebs solution. La(3+) inhibited K-contracture of the taenia coli and effects on the phasic response were found to be more remarkable than on the tonic response. After the removal of La(3+), the phasic response almost regained its normal magnitude, whereas the tonic response was significantly augmented. In contrast to the effects of La(3+), diltiazem inhibited the tonic response more markedly than the phasic response in both taenia coli and stomach strip. Inhibition of the phasic response was elicited, in association with decrease in the frequency of spike discharge during rapid depolarization of the membrane. The effects of diltiazem were completely reversed after washing out the compound. It is assumed that although both La(3+) and diltiazem inhibit the transmembrane influx of Ca(2+), additional mechanisms may differ.


Effects of diltiazem on electrical and mechanical activities of isolated guinea pig taenia coli.

Effects of diltiazem on electrical and mechanical activities of isolated guinea pig taenia coli were studied by means of the double sucrose-gap method. In the spontaneously active preparations, diltiazem (2.2 X 10(-6) M) suppressed both electrical activity and isometric contraction, while electrical and mechanical activities evoked by the depolarizing current pulse were not affected at the concentration of 2.2 X 10(-6) M. In the presence of 2.2 X 10(-5) M diltiazem, the evoked contractile force and the number of repetitive firings during depolarization were reduced, whereas the single spike was almost unchanged or somewhat inhibited. At 2.2 X 10(-4) M diltiazem, both electrical and mechanical activities were almost abolished. The contractile force and single spike suppressed by diltiazem were partly reversed by the addition of 5 mM CaCl2. There was little significant change in membrane potential and membrane resistance. Similar but somewhat weaker effects were observed when NaCl was replaced with sucrose. In some preparations, 2.2 X 10(-4) M diltiazem reduced the contractile force without significant influence on the electrical activity in Na+-free Locke solution. CoCl2 (3 mM) inhibited the evoked activities in both normal and Na+-free solutions. Possible mechanisms for the relaxing effects of diltiazem on isolated guinea pig taenia coli were discussed.


Non-cholinergic, excitatory junction potentials in smooth muscle of chicken rectum.

Muscle strips from the longitudinal or circular muscle of the chicken rectum were used to determine changes in membrane potential during field stimulation as recorded using the sucrose-gap method. Stimulation with single square pulses (0.1 msec duration) evoked junction potentials elicited by transmitter released from nerve endings. Facilitation in amplitude of excitatory junction potentials (EJPs) was seen during repetitive stimulation in the longitudinal muscle, but in the circular muscle, EJPs reduced. Neither atropine nor hyoscine (up to 10(-5) g/ml) reduced EJPs. These drugs abolished the depression of EJPs in the circular muscle produced by repetitive stimulation. Anticholinesterases (2 X 10(--8)-2 X 10(-6) g/ml) reduced the EJPs. The inhibitory effect was produced without affecting the membrane resistance of smooth muscle and was completely antagonized by atropine (1-(-6) g/ml). Drugs that abolish the adrenergic functions did not affect the EJPs. These results suggest that nerves involved in the EJPs are non-cholinergic and non-adrenergic in nature, and the motor transmission to the smooth muscle may be inhibited by cholinergic nerves, presumably presynaptically.


Hemolysis and morphological changes in rat erythrocytes with mercurials.

Effects of mercurials on rat erythrocytes were studied morphologically using an electron microscope. In the scanning study, the normal biconcave shape of the erythrocytes was changed to rugged surface spherocytes when mercuric chloride was added to the erythrocyte suspension. Methylmercuric chloride produced an irregularity of cell shape with spicules including the final stage of spherocytes. p-Chloromercuribenzoic acid formed crenated cells with protrusion, then spherocytes. By a carbon replica technique, it was revealed that control erythrocytes had a granular surface structure; however the surface of mercuric chloride-treated and methyl-mercuric chloride-treated erythrocytes appeared less granulated. By a negative staining technique, severe damage was observed on the erythrocytes lysed by mercurials. As a decrease in content of reduced glutathione, inhibition of glucose-6-phosphate dehydrogenase activity and formation of methemoglobin in erythrocytes treated with mercurials to induce hemolysis were not observed, it was concluded that the hemolysis induced by mercurials was not due to a disturbance in erythrocyte metabolism but rather to the direct action of mercurials on the cell membrane.


Effect of fluorescent products from reaction of malonaldehyde with phosphatidylethanolamine on lipids in plasma and liver of rats.

Effect of fluorescent products from the reaction of malonaldehyde with dipalmitoyl phosphatidylethanolamine on the content of lipids in plasma and liver of rats was examined, and the results are as follows: Growth of rats was suppressed by daily intraperitoneal administration of fluorescent products (10 or 50 mg/kg) for 7 days. Levels of triglycerides and total cholesterol in the plasma tended to decrease but that of phospholipids increased significantly by the administration of fluorescent products in a dose of 50 mg/kg/day. On the other hand, content of triglycerides in liver decreased by about 26% at a dose of 10 mg/kg and 23% at a dose of 50 mg/kg. Total cholesterol and phospholipids showed a slight diminution. Free fatty acid content in the liver was almost constant. Thiobarbituric acid values in the plasma and liver increased significantly by treatment with the fluorescent products, especially the values at a rate of increase were higher in the plasma than in the liver. No significant changes were observed in the relative fluorescence intensity between control animals and groups treated with fluorescent products. Serum lipoprotein patterns after Agarose gel electrophoresis revealed diffuse bands in the pre-beta and beta-regions.


Cardiovascular changes induced by large doses of clonidine in mice.

Clonidine at doses of 0.5-1.0 mg/kg i.p. produced an initial rise followed by a sustained fall in blood pressure. The initial pressor response became more marked and the onset of hypotensive effect was delayed as the dose was increased to large doses such as 10-50 mg/kg given intraperitoneally. The heart rate was markedly reduced soon after clonidine administration and the bradycardia lasted for more than 2 hours. Both the initial pressor and subsequent hypotensive effects of clonidine were reduced by pretreatment with phentolamine, the initial pressor effects were suppressed by propranolol which did not affect the hypotensive effects. This initial pressor effect was potentiated while the hypotensive effect was reduced after bilateral vagotomy and pretreatment with either 6-hydroxydopamine or atropine. The bradycardia was significantly reduced by propranolol, atropine and bilateral vagotomy. Central sympathetic as well as parasympathetic mechanisms may be involved in cardiovascular changes after large doses of clonidine in urethanized mice.


Pharmacological actions of intracerebrally administered polyamines in mice.

Pharmacological actions of spermidine (SPD) and spermine (SPM) in mice given these polyamines by intracerebral injection (i.c.) were investigated. The spontaneous motor activity (SMA) assessed by the photocell counter method did not change immediately following injection of 80 mug SPD, but was enhanced 24 hours after the injection of 40 or 80 mug. A significant decrease of SMA was not immediately evident after the administration of 40 mug SPM but was demonstrated 24 hours later. Mice given single doses of 20 mug SPD exhibited increase in weight gain and those given 40 mug showed no significant difference, whereas a conspicuous decrease in weight occurred in mice given 80 mug of SPD. The body weights of mice given single doses of 10 mug SPM remained much the same, while significant weight losses occurred in both the SPM 20 mug and 40 mug dosed groups. There was a significant prolongation of pentobarbital induced sleep 6 days after the injection of high doses of SPD or SPM. Similar prolongation of sleeping time was also evident 30 minutes after the injection of SPM. A maximal hypothermic response with a fall by about 1 degree C was observed immediately following injection of 80 mug of SPD and 24 hours after the injection of 40 mug SPM, respectively.


[Binocular summation in the perception of Landolt-ring presented at brief durations (author's transl)].

Landolt-ring identification accuracy of brief durations was determined under monocular presentation. Dichopic presentation to corresponding retinal areas was studied when the same Landolt-ring was presented simultaneously and successively. Both simultaneous and successive dichopic presentation gave identification accuracy significantly above the level expected from two independent chances to perceive at SOAs shorter than 60 msec. Performance under dichopic simultaneous stimulation to non-corresponding areas was slightly lower than that predicted level. Identification performance under monocular successive presentation was better than that under dichopic successive presentation to corresponding areas though these conditions were given the same amount of energy entering the visual system. Laterality and anisotropy in the perception of Landolt-ring were also considered in connection with binocular summation.


[Clinical studies on endoscopic electromyogram of gastric cancer (author's transl)].

Endoscopic gastroelectromyograms were obtained from 8 patients with gastric cancer, which was located at the gastric antrum. These cancers include 6 cases of advanced cancers and 2 cases of early cancers with mucosal invasion. On healthy volunteers, the gastroelectromyograms from the gastric antrum showed spike bursts with equal intervals. On the other hand, in the patients with advanced cancers on which muscular layer was completely destroyed by the cancerous invasion, the gastroelectromyograms from the cancerous lesion showed no spike bursts. However, in the patients with mucosal cancers in which the cancerous invasion destroyed neither muscular membrane nor muscular layer, the gastroelectromyogram from the cancerous lesion showed spike bursts similar to those of healthy volunteers. From these results, it is proved that the deeper cancerous invasion disturbed the local motility at the cancerous lesion. In future, endoscopic lead of gastroelectromyogram will become useful for the diagnosis of the degree of cancerous invasion and infiltration.


[Effects of loperamide on the motility of the isolated intestine in guinea pigs, rats and dogs (author's transl)].

Effects of Loperamide on the motility of the isolated intestine in guinea-pigs, puppies and rats were examined. The spontaneous contractions of the small intestine and colon in puppies were inhibited at relatively high concentration of the agent (10(-5) g/ml). The peristaltic reflex in the guinea-pig ileum was slightly inhibited at concentrations of 10(-8) to 10(-7) g/ml, and was completely abolished at 10(-6) g/ml. The agent (2X10(-7) g/ml) inhibited the longitudinal contraction of the guinea-pig ileum elicited by transmural electric stimulation. The agent (10(-5) g/ml) inhibited the acetylcholine-induced contraction of the colon and small intestine in puppies, and induced the hyperpolarization of the membrane potential and the abolition of spike potentials of the intestinal muscle in rats.


[Chronic influences of transection of extrinsic nerves to dog's stomach on the fluctuations of intragastric pressure (author's transl)].

15 adult dogs fasted over night were used under Ketalar anesthesia. Experiments were undertaken during 3 months on 3 groups of animals vagotomized, splanchnicotomized and transected both extrinsic nerves. The intragastric pressure was measured by balloon-strain gauge method. The intragastric pressure was elevated in a way of filling with 200 ml of Ringer's solution within 1 minute every 2 minutes till a total of 800 ml. Following results were obtained: 1) The intragastric pressure at the initial period of gastric fullness and the average intragastric pressure during 2 minutes after filling of Ringer's solution in 3 groups were maintained in a higher level compared to that of the control dogs at every time after operation and every stage of gastric fullness. Their pressure gradients were shown sharp slopes compared to that of the control dogs. 2) The amplitude of the peristaltic movements in 3 groups was larger than that of the control dogs at every time after operation and every stage of gastric fullness. 3) The results in the chronic experiments were almost the same with that in the acute experiments of the present author (Ikeda, 1976 a b).


[Manometric studies on antireflux effect of fundic patch operation].

Antireflux effect of various operations for achalasia of the esophagus was investigated with the use of the manometric study. Operative procedures subjected to the present comparative study were proximal gastrectomy with end-to-end esophagosgastrostomy, Wendel procedure, Heller procedure and Fundic patch operation, each prepared in four mongrel dogs. Incidence of postoperative reflux with possible esophagitis was greatest in proximal gastrectomy followed by Wendel and Heller procedure. Fundic patch operation well prevented the reflux with greater values of pressure as well as dimension of the lower esophageal sphincter than those of the control series. In other series of experiments in dogs, an attempt was made to reveal the rationale of the effective valvular mechanism of the Fundic patch operation preparing various sizes of the valve. When compared by the manometric study, Fundic patch procedure with an incision of 6 cm in length, formation of the artificial mucosal valve and two thirds enclosure of the distal esophagus with the fundus like fundoplication sufficiently prevented the reflux. Preparation of the valve smaller in size accelerated the incidence of postoperative reflux.


Physiologic profiles in circulatory support and management of the critically ill.

An automated system has been developed for measuring hemodynamic, oxygen transport and tissue utilization functions. Rapid measurement and data analysis of physiologic profiles by paramedical personnel allow prompt evaluation of altered cardiovascular function. Evaluation of physiologic function allows therapeutic interventions to be instituted on a timely basis, appropriately directed toward improvement of the measured cardiovascular abnormalities. Physiologic profile studies were performed on 1016 occasions in 580 patients during a three-year period and form the basis of this report. Although utilized on hospitalized patients, there are implications for use in evaluating and treating all critically ill patients.


Treatment of second degree burns: nitrofurazone, povidone-iodine, and silver sulfadiazine.

Nitrofurazone (N), povidone-iodine (P), and silver sulfadiazine (S) were compared in the emergency department outpatient treatment of 84 patients suffering second degree burns over less than 15% (adults) or 5% (children) of their total body surface area. Indices of healing were percent of healing, degree of dryness, crust separation, eschar separation, tissue granulation, and wound pain. Statistical analysis indicates that healing in N-treated patients was superior to that in S-treated patients: tissue granulation began sooner, crusts separated more rapidly, wounds were dryer, and the amount of healing at two weeks was greater. Results in P-treated patients were equivalent to those in N-treated when cases with complications were excluded from analysis. Among patients with less serious burns, N-treated patients suffered less pain than S-treated, but there was no significant difference in pain between N and P or between P and S. In patients with more serious second-degree burns there was more pain with P than with N, but neither P nor N differed significantly from S in this regard.


Accidental hypothermia: a review of 62 cases.

A retrospective review of all patients seen in an urban city-county emergency department over a 32-month period with a primary or associated diagnosis of hypothermia was performed using the emergency department encounter form and the inpatient chart of 62 cases (59 patients) with core temperatures of 35 C (95 F) or below. With this relatively large population, a general conclusion was reached about the presentation and natural history of this interesting entity. This permitted a defensible treatment regimen which is currently employed a this institution and which is offered for institutions in similar settings. The variance in clinical signs, laboratory values, electrocardiographic findings and complications encountered in this study are detailed against the background of a review of the findings of the current literature.


The fiberoptic bronchoscope.

The fibertopic bronchoscope was used in 14 cases in the emergency department between September 1974 and September 1976 at Lock Haven Hospital, Lock Haven, Pennsylvania and St. Charles Hospital, Toledo, Ohio. It was used successfully to remove foreign bodies from the trachea and esophagus; in difficult or hazardous endotracheal intubation; intubation in a victim of cardiac arrest with a cervical deformity; evaluation of laryngeal and tracheal injury; localization of bleeding from the posterior nose; evaluation of hemoptysis, and evaluation of thermal injuries from smoke inhalation.


Cardiac contusion and right bundle branch block.

In a case of transient right bundle branch block due to nonpenetrating chest trauma, this abnormal electrocardiographic finding was the sole manifestation of cardiac contusion. There is a high frequency of occult cardiac contusion and routine electrocardiography is recommended in the evaluation of nonpenetrating chest trauma.


Effect of dithiothreitol on mercuric chloride- and uranyl nitrate-induced acute renal failure in the rat.

The current study was undertaken to examine the effects of dithiothreitol (DDT), a sulfhydryl-reducing agent and heavy metal chelator, on the course of heavy metal-induced acute renal failure in the rat. Groups of rats in metabolic cages received uranyl nitrate (UN) alone, UN plus DTT, mercuric chloride (HgCl2) alone, and HgCl2 plus DTT. UN injected alone produced azotemia, decreased creatinine clearance, and rising fractional sodium excretion over the 48 hr of study. These effects of UN on renal function were not observed when DTT was administered 30 min after UN injection. Qualitatively similar results were obtained with HgCl2-induced acute renal failure. Groups of rats were killed at 6 hr after UN plus DTT, HgCl2 alone, or HgCl2 plus DTT; and determinations of plasma renin activity (PRA) and renin activities of the superficial and deep juxtaglomerular apparatus (JGA) were performed. PRA's and JGA renins were increased in animals receiving either UN or HgCl2 alone, but not in the rats receiving both DTT and UN or HgCl2. The effect of DTT on distribution of 203Hg was also examined. Treatment with DTT did not alter the renal accumulation of 203Hg, suggesting that this agent does not act by limiting renal exposure to the heavy metals. Thus, DTT ameliorates the course of heavy metal-induced ARF, and this effect is associated with prevention of heavy metal-induced alterations in sodium excretion and renin-angiotensin system activity.


[Irvine-Gass-syndrome (author's transl)].

Cystic edema or the macula of Irvine-Gass syndrome, accompanied by a diminution of the central vision, is observed in 5% of the patients who have been recently operated for cataract. Only the fluorescin angiography can confirm the diagnosis with certainty. The inflammatory and vitreous theories explain most satisfactorily the pathogenesis of the condition.


[Results of lamellar keratoplasty for recurring pterygium (author's transl)].

Although difficult, recurrent forms of pterygium are seldom seen in central Europe, they cause considerable therapeutic problems because they cannot be cured by simple dissection and conjunctivoplasty. A useful method of treatment in these cases is the marginal, lamellar keratoplasty, which, according to the type of involvement, can take the shape of a sector, ring, horseshoe, or semicircle. If the pterygium is extensive and affects the center of the cornea, a subtotal, lamellar keratoplasty can be performed. The rate of recurrence in the group of 35 lamellar keratoplasties which we performed amounted to a satisfactory 31%. Only rarely did a pronounced astigmatism cause a decrease in the visual acuity postoperatively. Essential for the success of the procedures are exact surgical techniques and local use of atropine and cortison postoperatively. Just as with other surgical procedures, however, the lamellar keratoplasty cannot be considered the perfect method for all pterygiums.


[A dirofilaria granulom of the lid and the orbid (author's transl)].

A 66-year-old woman of the northeastern USA developed suddenly a tumefaction of the lid and the orbit. After the excision a granuloma was found which was caused by a dirofilaria conjunctivae. This worm occurs in North-America mainly in racoons and is transmitted to humans by a fly or a mosquito. This infestion is usually found in the warm zones. Our case is an exceptional one as it occurred in the temparate zone.


[Inflammation of the uvea--the cellular immune response in the iris (author's transl)].

Ultrastructural analyses of iris biopsies in 17 cases of uveitis with different etiology revealed that all cells involved in immunological reactions are present. Many plasmacells and lymphocytes, but also macrophages and mastcells are found. Destruction of cells and even necrosis as well as damage of blood vessels are run. No specific germs could be demonstrated and etiology was not further elucidated. But there remains no doubt on the immunological nature of uveitis.


[Exudation into the anterior chamber following intraocular surgery (author's transl)].

Purulent exudation into the anterior chamber with a hypopyon on the first or second day after intraocular surgery is the alarming sign of intraocular bacterial infection. The manifestation of an intraocular mycosis takes 4 to 5 weeks, the exudation into the anterior chamber increases slowly; however, a hypopyon may also develop. In cases of early postoperative cloudy exudation in the pupillary area without hypopyon a sterile aqueous humour is found. Consideration of this symptomatology leads to the correct diagnosis of a harmless reaction, which may be related to the protein content of the aqueous humour in a hypotonic eye.


[Destruction of the posterior hyaloid membrane in rhegmatogenous detachment of the vitreous body (author's transl)].

As a rule there are two pre-formed holes at the posterior hyaloid membrane in cases of recent rhegmatogenous posterior detachment of vitreous body. This finding remains stationary only in some patients. In others an extensive denudation of the posterior surface of the vitreous body occurs by progressive destruction of the posterior hyaloid membrane, the causes of which are unknown.


[Results of transpupillar vitrectomy (author's transl)].

Vitreous prolapse in cataract surgery or during the extraction of a dislocated lens; corneal dystrophy in aphacic eyes due to corneo-vitreous contact and vitreous invading the anterior chamber following perforating injury proved to be valid indications for partial transpupillary vitrectomy. In malignant glaucoma, in postoperative wound rupture following cataract extraction, in open-sky-surgery of the anterior segment of aphacic eyes and in other particular conditions, transpupillary vitrectomy may also be considered. The transpupillary approach is not indicated in retinal detachment, unless prepupillary vitreous incarceration pulling up of the retina is obvious. Transpupillary vitrectomy can be performed without much harm to the eye even in children, if indicated (congenital cataract, congenital on traumatic lens dislocation, perforating lens injury). In general the results of transpupillary vitrectomy are good. Longterm complications are relatively rare. Experiences on 208 eyes are reported in particular.


[Lasermicrosurgery of the flattened anterior chamber (author's transl)].

The method of laser-microsurgery for restoration of lost anterior chamber in aphakic pupillary block and malignant glaucoma is once more reported. The problems of the flattened anterior chamber are discussed. Principle, technique, and indication of laser-coagulation of the iris are demonstrated. A short discussion of the method, description of late observations and instructions for postoperative treatment are given. In each of the 23 eyes this dangerous postoperative complication could be abolished in a simple manner without any risk. This operation must be considered as the method of choice.


[Gold drainage as a glaucoma operation (author's transl)].

A glaucoma operation is described in which a piece of gold leaf 0.05 mm thick, 1.5 mm wide and 4 mm long is laid into a trepanation opening or into an anterior chamber angle incision after preparation of a scleral flap. The tendency of rejecting of large gold leaves was considerable. A diverticulum of the anterior chamber formed round all gold leaves through the scarred walls of which a reasonable regulation of pressure by drainage of the aqueous was apparently not possible. A real wick or drainage effect was not seen in any case.


[The early diagnosis of glaucoma as a social medical problem (author's transl)].

Tonometric mass screening for industrial nations is not recommended. Amongst the reasons against mass screening is to be emphasized the sufficient prevention of glaucoma blindness, if the reading glasses are prescribed by the ophthalmologist and if he measures the intraocular pressure in each patient over 40 years of age. In developing countries the programmes are completely different since here no medical treatment is possible. The cost benefit calculation is presented for such mass screening, which should be directed to the early recognition of simple glaucoma and which should combine tonometry and Friedman Analyzer field study. Pilot studies should show, whether it is useful or not to include the inspection of the optic disc. Glaucoma teams could be associated with the cataract eye camps. Their work must be coordinated by a center, which evaluades the results of the examination teams and changes directives accordingly.


[Operation for retinal detachment caused by holes in the posterior pole area, simple, long-tolerated silver span and cerclage (author's transl)].

A method for treatment of retinal detachments caused by macular holes or by holes at the posterior pole of the eye is presented. A simple silver clasp is sutured on the sclera. The silver clasp usually is well tolerated for many month and has remained on several eyes for more than 4 years, nevertheless removal of the instrument 6 months after the primary operation is advised. Lasting indentation by the clasp is provided by an additional encircling silicon band. In 10 out of 11 cases of a total or subtotal retinal detachment caused by a hole at the posterior pole, the retina could be reattached; in one case of massive pre-retinal retraction the puckering focus was successfully tamponed. The method is especially suited for the treatment of detachments in globes with posterior staphylomas.


[Treatment of retinal detachment with macular hole: scleral buckling with an absorbable fibrin sponge (author's transl)].

In 21 patients with macular hole and retinal detachment a macular buckling procedure was performed including diathermic or cryogenic coagulation. An absorbable fibrin sponge (Fibrospum) was used as a new buckling material, which needs not to be sutured to the sclera at the posterior pole. In comparison to other procedures the use of fibrin sponge seems to be more simple and at least of the same results.


[Eosinophilic granuloma of the orbit (author's transl)].

A case of a tumor of the upper lid involving the bons in a 6 1/2 year old body is reported. Histology revealed a solitary eosinophilic granuloma. The classification of this systemic disease which almost always shows an orbital manifestation is discussed.


[A colour-television-system for lectures and clinical training in ophthalmology (author's transl)].

First experiences with a new Colour-TV-System in the University Eye-Clinic Munich are reported. The system is described in detail and special problems of fitting the TV-cameras to the ophthalmological instruments such as operation microscopes, slit lamps and fundus cameras are described.


[Supplementary instrument for lens removal (author's transl)].

A combination of a sponge holder and a squint hook is described as a supplementary instrument for intracapsular lens cryo-extraction with this instrument. Quick changes of manipulations during lens removal and other surgical manoeuvres are possible.


[Impression of a partial eclipse of the sun on the macula after observation of the sun (author's transl)].

The picture of the grey retinal coagulation focus after light coagulation due to observation of an eclipse of the sun corresponds to the picture of the sun's disc not covered by the moon.


Reversal of "one kidney" to "two kidney" tipe of Goldblatt hypertension in a patient with bilateral artery stenosis.

A 32-year old hypertensive woman with bilateral renal artery stenosis of more than 50% on both sides was studied. Renal vein renin levels were low (0.3 ng/ml/h on the right side and 0.42 on the left) before surgical correction of the left renal artery. Thereafter, blood pressure was only temporarily reduced. Four months later a repeat angiography demonstrated a widely patent left renal artery and the stenosis on the right side was unchanged. Renal vein renin was 5.12 on the left and 11.2 on the right. Subsequent operation on the right side lead to normalization of blood pressure. Thus, our patient seems to demonstrate in sequence the characteristics of the tow types of experimental renovacular hypertension known as "one kidney hypertension" and "two kidney hypertension". Our findings usggest that the pathomechanisms of these experimental models are operative in man too.


[Compromized myocardial perfusion in arrhythmias (author's transl)].

In 7 patients with arrhythmias of various origin the myocardial scintigram displayed either a diffuse or circumscript defect of the perfusion. The coronary arteriogram was normal in all patients. The localized defect of the perfusion in 2 patients was in the region of the upper part of the interventricular septum. Both had a left bundle brunch block. A correlation between the perfusion defect and the electrophysiological abnormality seems probable. The perfusion defect in one of the patients is most probably caused by a previous myocarditis followed by fibrous changes. In the other 6 patients the cause for the perfusion defect is not obvious. A history of myocarditis is missing. The presence of "small vessel disease" in those patients has however to be considered. Our results point to the relation between an abnormality of the microcirculation and arrhythmias in younger patients.


[Hemodynamic effects of sar1-ala8-angiotensin in patients with renovascular hypertension (author's transl)].

In 7 hypertensive patients with renal artery stenosis and in 1 patient with hypertension and unilateral pyelonephritic nephrophthisi the influence of the angiotensin II antagonist, saralasin on systemic hemodynamics was studied. In the patients with normal renin infusion of saralasin produced an increase in total peripheral resistance, in patients with elevated renin a decrease in peripheral resistance was observed. In 3 patients who had extremely high renin levels while under sodium saralasin produced a dangerous drop in blood pressure concomitant with a marked decrease in cardiac output and in central venous pressure, heart rate remained unchanged or increased just slightly. The findings suggest that in patients with high plasma renin peripheral resistance, venous tone, venous retrun, and cardiac output are to a large extent controlled by circulating angiotensin II.


Radiation injury in the neonatal canine kidney. I. Pathogenesis.

The effects of radiation on the developing canine kidney were investigated. Beagles were exposed to 330 R 60Co gamma-radiation on the 2nd postnatal day of life. The kidneys were examined at 2 days (6 hours after irradiation), 4, 8, 14, 22, 70, and 200 days of age with qualitative and quantitative light microscopy and scanning electron microscopy. The primary result of the radiation injury was a failure to form the normal number of nephrons. The kidneys of irradiated dogs had 42 per cent fewer nephrons (260,000) than the control dogs (445,000). In addition, extensive damage to forming nephrons produced dysplastic renal corpuscles and other corpuscles which were arrested in their development. Three mechanisms of radiation injury were identified. First, there was extensive mitosis-linked cell death in the nephrogenic zone. Second, mitotic delay resulted in only one-fifth of the normal mitotic activity in the nephrogenic zone through 2 days postirradiation. Third, there was an immediate and permanent cessation of nephron formation. The extensive injury in the outer renal cortex was compounded by the development of intercapillary glomerulosclerosis in some middle and inner cortical corpuscles by 200 days of age.


Pilocarpine stimulation of the bronchiolar Clara cell secretion.

Fasted rats were given a single cholinergic subcutaneous injection of pilocarpine and sacrificed from 30 minutes to 24 hours later. Secretory granules were extruded by Clara cells as early as 30 minutes after pilocarpine administration. Simultaneously and thereafter, Clara cells displayed dilated cisternae of endoplasmic reticulum and active assembly of secretory granules at the Golgi complex. After 1 to 2 hours, new secretory granules reached the cell surface and were discharged into the bronchiolar lumen by exocytosis. At 4 hours the Clara cell organelles appeared quiescent. Complete cell recovery apparently occurred by 12 to 24 hours after pilocarpine administration. The accelerated secretion by Clara cells with pilocarpine provides an evidence of their exocrine character and the exocytotic secretory mechanism. The morphologic data indicate that the production and secretion by Clara cells may be controlled by neurohumoral mechanism.


The effect of chronic low level lead intoxication on the Haversian remodeling system in dogs.

The greatest portion of lead ingested by human beings or experimental animals is stored in bone. Once in bone, lead is difficult to remove. It may have a half-life of 20 years or more and could interfere with bone metabolism. The effects of lead intoxication on the production of intercellular matrix have been reported previously but the effects of lead on bone turnovers rates were not reported. In this paper we reported the results of a study of the effects of lead on bone turnover in dogs. Differences between experimental and control dogs were found when measuring appositional rates, radial closure rates, activation frequencies, osteon formation times, and bone formation rates. We found that dogs subjected to a low dose (1.3 mg. per kg. per day) of lead over a long period of time (201 days) showed a statistically significant decrease in bone formation activity at the cell (90 per cent), tissue (85 per cent), and organ (78 per cent) levels when compared to controls. Although these observations were made on a small experimental and control sample (four dogs), they suggest that chronic low dose lead intoxication does alter normal bone physiology.


Uptake and transport of Imposil by the glomerular mesangium in the mouse.

The mesangial uptake and transport of particulate material has been studied using an iron-dextran complex, Imposil, as a tracer particle. The tracer was given as a single dose into the tail vein of the mouse, and animals were killed at intervals from 5 minutes to 48 hours. Light and electron microscopy showed that the iron-dextran complex was initially taken into the matrix channels of the mesangium from which it progressed over the course of 8 hours to the matrix of the juxtaglomerular apparatus and intercellular spaces of the macula densa. This delineated a continuous functional pathway from the glomerular capillary lumen to the macula densa cells of the distal tubule for material taken up by the mesangium. It is suggested that the products of inflammatory lesions in the glomerulus could affect the secretory function of the granular cells of the juxtaglomerular apparatus as it would appear that such products must circulate in the immediate environment of these cells.


The reliability and validity of the comfort level method of setting hearing aid gain.

The comfort level method (Carhart, 1946) probably is the most widely used procedure for setting the acoustic gain of hearing aids. A series of experiments were conducted to determine the test-retest reliability of the comfort level method and the relationship between the comfort settings established in a clinical test suite and the comfort settings utilized in more realistic daily listening situations. Adults with bilateral sensorineural hearing impairments were subjects. The results suggest that the comfort level method has good test-retest reliability for most clinical purposes. Further, clinically established comfort settings may accurately represent typical daily-use settings if the input level used to establish the comfort settings in the clinical environment is 70 dB SPL.


A cineradiographic investigation of children's w/r substitutions.

Articulatory positioning and movement characteristics were compared between /w/ and intended /r/ productions in three children exhibiting w/r substitutions and one normal control subject. High-speed lateral-view cineradiography was utilized. It was found that only the control subject demonstrated significant differences in lip, jaw, and tongue positioning for /w/ compared to /r/. However, systematic patterns of articulatory variability within and between subjects suggested that the experimental subjects were possibly differentiating between /w/ and intended /r/ even though the articulatory target configuration appeared to be nondiscriminatory. Perceptual judgmnets of the tape-recorded utterances mirrored the physiological data in that only those intended /r/ productions involving articulatory positioning clearly different from that of /w/ were perceived as /r/.


The verbal environment of a language-impaired child.

A child with a language handicap presents a potential conflict for the adults with whom he interacts. In terms of age and physical development, he may present cues that ordinarily elicit complex speech from adults. His language performance, however, may be comparable to that of a much younger child. This study involves a detailed analysis of the speech addressed to a 4.7-year-old language-impaired boy and to his normal-speaking female cousin (4.6 years) by the boy's mother, father, and baby-sitter. Each adult interacted with each child in a five-minute free play and a five-minute story-telling situation. Quantitative measures of the speech of the adults included word rate, disfluencies, type-token ratio, and mean length of response. There was a strong tendency to present the language-impaired child with fluent, short, and simple sentence patterns, as compared to his peer. Qualitative analyses of sentence types again showed that simplifications were made in speech to the boy, and that the adults used sequential sets of sentences with the language-handicapped child that were similar to those used by mothers of normal, but much younger children.


Time-compressed speech discrimination in central auditory disorder: a pediatric case study.

Audiological data are presented for an 11-year-old aphasic girl with confirmed left-hemisphere damage. Pure-tone audiometry, impedance measurement, and speech discrimination testing were completed. Discrimination testing included presentation of the Word Intelligibility by Picture Identification (WIPI) test at 0 and 60% time compression. Results indicated significantly poorer speech discrimination in the ear contralateral to the site of lesion at 60% time compression. This case study supports the use of time-compressed speech discrimination testing in the assessment of central auditory function of children and as a diagnostic tool for determination of site of lesion.


Tympanometric assessment of eustachian tube patency in children.

Eustachian tube patency was assessed tympanometrically in a group of otologically normal children at a pediatric outpatient clinic. A pressure-swallow technique of assessing eustachian tube patency was administered. The results indicated the importance of the examination of both middle ear pressure and function changes in the evaluation of eustachian tube test results.


Patterns of dysfunction in schizophrenic patients on an aphasia test battery.

Twenty-seven schizophrenic patients free of any known neurologic deficit were tested with an aphasia test battery. The objective of the research was to derive a profile of schizophrenic language performance to permit its comparison with the profiles characteristic of aphasia, apraxia of speech, generalized intellectual impairment, and confused language. Results indicate that schizophrenic patients exhibit a profile of language performance distinctive from those found in aphasia, apraxia of speech, confusion, or generalized intellectual impairment and demonstrate that the disruption of language in schizophrenia is not aphasic in nature.


Clinical acoustic reflex threshold measurements in infants.

Acoustic reflex thresholds elicited using clinical acoustic impedance techniques were obtained on normal infants between one month and one year of age. Reflex activating signals of 500, 1000, 2000 Hz, low-pass, high-pass, and white noise were used. Less intensity was required to elicit the acoustic reflex to the noise than to the pure tones, with the 500-Hz tone requiring the greatest intensity. Inference of auditory thresholds from the acoustic reflex indicated the presence of normal hearing in the infant group.


Reliability of hearing-impaired children's responses to oral and total presentations of the Test of Auditory Comprehension of Language.

The Test of Auditory Comprehension of Language (TACL) (Carrow, 1973) was administered on two occasions to two groups of hearing-impaired children. The test was administered in the usual manner (face-to-face, spoken) to children who were being educated by oral methods. The test was also simultaneously spoken and signed to children who were being educated by total-communication methods. Reliability of responses was high for both groups (r = 0.96 for oral-aural and 0.90 for total-communication children) and error patterns were similar. The TACL appears to be an appropriate and reliable instrument for use with hearing-impaired children.


Effects of sophistication on four tests for nonorganic hearing loss.

Three groups of 15 normal-hearing subjects were asked to simulate a hearing loss in one ear. Each subject was then tested on four measurements often used in determining the presence of pseudohypacusis (a comparison of the SRT to the pure-tone average, ascending vs descending pure-tone tests, the Stenger test, and pure-tone delayed auditory feedback). Results showed that as practice and sophistication on each of the procedures increased, there tended to be more improvement in the subjects' ability to "beat" some of the tests than others.


Disorders of nonverbal communication.

The idea that nonverbal communication can be disordered is explored, and several types of nonverbal communication disorders are described. The characteristics of these disorders and a number of possible explanations for their acquisition are offered. Finally, suggestions for therapeutic procedures are made.


Aphasia testing: a second look at the Porch Index of Communicative Ability.

It has been claimed that the Porch Index of Communicative Ability (PICA), through its multidimensional scoring system, corrects for lacks in other tests for aphasia. Specifically, the PICA is said to specify the details of the response and indicate the nature of the response; detect and describe small changes in the patient's responses; indicate the patient's level of communicative ability; and eliminate the subjectivity and bias present in descriptive methods of scoring. It is argued here that the PICA does none of these things and that the multidimensional scoring system as applied in the PICA is invalid.


Blissymbolics-a nonverbal communication system.

Until recently, speech-language pathologists have shown little interest in seeking alternate forms of communication when functional verbal communication is not attainable. There is a paucity of literature dealing with nonverbal communication systems for people lacking functional verbal communication for reasons other than deafness. Blissymbolics is a logical, visual language that has provided functional communication for nonverbal cerebral-palsied children. The full potential and application of Blissymbolics has only begun to be realized, and there is much need for experimentation and research. This paper describes the system and suggests areas for future application and development.


Women and men problem drinkers. Sex differences in patients served by Iowa's Community Alcoholism Centers.

The development of and recovery from alcoholism was examined in 3132 men and 395 women alcoholics. Drinking by the women was more often a response to crises and emotional stress, while more men gradually drifted into ever greater dependence on alcohol to cope with everyday problems.


A longitudinal analysis of alcohol use, environmental conduciveness and normative structure.

The social environment and normative structure surrounding drinking have a reciprocal relationship in determining adolescent drinking patterns in high school and college.