Uptake of folate and its analogue-amethopterin by mouse L-cells.

1. The uptake of folate and amethopterin by the mouse transformed L-cells was found to depend on their extracellular concentration and time of incubation. The uptake conforms to Michaelis-Menten kinetics (Km values 10(-4) M and 10(-6) M for folate and amethopterin, respectively) and is temperature-dependent. 2. The observed differential effect of actinomycin D, cycloheximide and pCMB on the uptake of folate and amethopterin and lack of a pronounced transinhibition in the transport of these compounds indicate the existence in L-cells of two separate transport systems for folate and its analogue. 3. Methionine added to the culture medium enhances the uptake of folate, but not that of amethopterin. 4. Under conditions of methionine-dependent increase of folate uptake the activity of dihydrofolate reductase remains unaltered while that of methionine synthetase is markedly reduced. 5. The efficiency of folate uptake seems to be related rather to the modulations of methionine synthetase activity than to changes in the activity of dihydrofolate reductase.


On sulfhydrylation of O-acetylserine and O-acetylhomoserine in homocysteine synthesis in yeast.

Considerable differences in the activities of cysteine and homocysteine synthase (EC 4.2.99.8), and in the ratio of these activities were observed in yeast strains representing different genera and species. This suggests that homocysteine synthesis directly from O-acetylhomoserine may predominate in some strains, whereas in the others homocysteine is formed from cysteine via cystathionine.


Fluorescence of radiation-induced collagen aggregates.

Tropocollagen shows higher ultraviolet fluorescence (emission max, about 305 nm) and lower blue fluorescence (emission max. about 420 nm) than the dimers and tetramers isolated from irradiated collagen. This indicates dityrosine structures in the radiation-induced collagen aggregates.


The presence of serine protease in pea embryo chromatin.

1. It has been shown that chromatin from pea seedlings contains a proteolytic enzyme, similar to that of mammalian chromatin. 2. The protease was isolated from chromatin by acid extraction and partly characterized. It is a serine-type enzyme, sensitive to DFP, of low mol. wt. (about 18 000 - 20 000), with optimum pH at about 8 with [3H]N-acetylated histone as a substrate. 3. In chromatin complex, histones fl and f3 are preferentially degraded.


Circular dichroism of partially purified cytochrome P-450 from rabbit liver microsomes.

The heme related circular dichroic bands of solubilized cytochrome P-450 from rabbit liver and some of its complexes with type I- and type II-substrayes and heme iron ligands were measured in the Soret region. All P-450 dersorption. The positions of the dichroic bands together with their ellipticities vary with ligand substitution and the oxidative state of the iron. The results are compared with CD-date of other hemoproteins and discussed with respect to stereochemical properties of the heme pocket.


[Calcium-dependence of bradykinin-induced contraction in the isolated longitudinal muscle of the guinea pig ileum].

The calcium-dependence of the bradykinin-induced contraction was demonstrated on the isolated logitudinal smooth muscle of the guinea-pig ileum. Using the "La-method" for measuring 45Ca entry into smooth muscle cells we were able to show, that bradykinin significantly increases the intracellular Ca-concentration. This effect of bradykinin was dose-dependent.


Effect of chronic exposure to nitrogen dioxide on collagen fractions content in skin of guinea pigs.

Guinea pigs were exposed to nitrogen dioxide in concentration of 2 mg/m3 (8 hrs. daily, 180 days). Control group inspired fresh air. Collagen fractions were estimated in skin and assayed as hydroxyproline concentration. An increase of total collagen content, due to on increase of salt-soluble collagen fraction was found in the skin of the exposed animals, while a simultaneous decrease of insoluble collagen content was observed.


Remarks on the investigation of sodium nucleinate by means of the limulus amebocyte lysate test.

Results of investigations of sodium nucleinate by means of the limulus amebocyte lysate (LAL) test are described. It was found that the sensitivity of this new pyrogen test to bacterial lipopolysaccharides is nearly the same as to sodium nucleinate, which is prescribed as pyrogen standard in the Pharmacopeia of the German Democratic Republic and recommended as such in the Compendium Medicamentorum.


Stimulation of rat and cat heart adenylate cyclase by triiodothyronine in the presence of 5'-guanylylimidodiphosphate.

Adenylate cyclase activity in particulate preparations from the myocardium of rats and cats was unaffected by 3,3',5-triiodo-L-thyronine (L-T3) added in the absence of, or together with, 5-guanylylimidodiphosphate (Gpp(NH)p), a potent activator of the enzyme. Preincubation of the heart particles with Gpp(NH)p made the cyclase sensitive to L-T3 which then caused, in concentrations of 10(-8) M and higher, additional increases in enzyme activity up to about 50 per cent above the Gpp(NH)p-stimulated level. Similar effects after (GPP(NH)p treatment were produced by low concentrations of 3,3',5'-triiodo-L-thyronine (reverse T3) and 3,3',5-triiodo-D-thyronine, whereas diiodo-tyrosine, 3,5-diiodo-L-thyronine, and 3'-isopropyl-3,5-diiodo-L-thyronine were without significant effect. The stimulatory action of L-T3 on cardiac adenylate cyclase pretreated with Gpp(NH)p may help to explain some of the acute effects of thyroid hormones on the heart that have been reported in the literature.


[Localization of adenylate cyclase in red and white skeletal muscle: a cytochemical study].

An attempt was made to demonstrate adenylate cyclase (ATP pyrophosphate-lyase (cyclizing) EC 4.6.1.1) activity in white and red skeletal muscle (M. psoas and M. soleus) of guinea pigs cytochemically by the lead precipitation technique. 5'-Adenylylimidodiphosphate served as substrate. The free lead ion concentration in the incubation medium was kept below the value that is toxic to the enzyme. An electron dense reaction product, presumably lead imidodiphosphate, was deposited in the soleus muscle (red muscle fibers) at all parts of the plasma membrane and in the psoas muscle (white muscle fibers) chiefly at the membranes of the sarcoplasmic reticulum. The reaction at the latter site was enhanced by adrenaline; the enhancement was prevented by propranolol. These findings are in good agreement with results that have been obtained by other authors in experiments on subcellular fractions of the two types of muscle.


[Glucose metabolism in different regions of the rat brain under hypokinetic stress influence].

In rats kept under long-time hypokinetic stress influence the glucose metabolism was studied in 7 brain regions. The regional levels of glucose, lactate, glutamate, glutamine, aspartate, gamma-aminobutyrate and the incorporation of 14C from plasma glucose into these metabolites, in glycogen and protein were determined. From the content and activity data the regional glucose flux was approximated guantitatively. Under normal conditions the activity gradient cortex and frontal pole greater than cerebellum greater than thalamus and mesencephalon greater than hypothalamus and pons and medulla is identical with that of the regional blood supply (measured with I131 serum albumin as the blood marker). Within the first days of immobilization a functional hypoxia occurred in all brain regions, and the utilization of cycle amino acids for protein synthesis was strongly diminished. After the first week of stress the capillary volumes of all regions increased, the aerobic glucose metabolism was enhanced (factors 1.3--2.0), and the incorporation of glucose-14C via cycle amino acids into protein was considerably potentiated. The metabolic parameters normalized between the 7th and 14th week of stress. Blood supply and metabolic rate were most increased in the hypothalamus, reaching the value measured for the cerebral cortex in the initial state.


[Asymmetric function of the pes hippocampi in experimental stress-induced arterial hypertension of albino rats].

Relations between a unilateral lesion of circumscribed structures of the Pes hippocampi on the one hand, and stress-induced blood-pressure and learning behaviour, on the other, were studied. An asymmetric functioning of the CNS was analyzed, in which unilateral exclusion of right-hand hippocampal structures stimulates processes of excitation, while lesion of left-hand structures causes prevalence of inhibitory processes. The resulting impairment of the emotional equilibrium potentiates the stress action's contribution to the development of arterial hypertension.


Decreases of local brain temperature due to convection (local brain blood flow) and increases of local brain temperature due to activity.

The influence of local brain blood flow upon variations of local brain temperature in chronical experiments was investigated in cats. It was found that changes of local brain temperature in chronic experiments are esclusively due to changes of local metabolic heat production as long as the temperature of brain inflowing blood remains constant. Decreases of temperature due to convection (increase of local blood flow) are smaller than increases of temperature due to activity.


[Experimentally produced neurogenic-interoreceptive hypertension in the rat].

A hypertension characterized by systolic and diastolic blood pressure rises and increase in heart rate was produced in albino rats by excluding sino-aortal baroreceptors. Cardiac output and peripheral resistance, measured unter barbital narcosis, exhibited no significant changes in the development of hypertension. With the only exclusion of aortal baroreceptors there occurred almost the same blood pressure rises as with sino-aortal deafferentiation. It is concluded therefore that this kind of partial elimination of baroreceptors involving a simplified operational technique and lower risk will suffice for many problems being studied in hypertension research.


[Dynamics of adaptation and maladaptation phenomena in rats exposed to weak chronic stimulation].

Experiments were carried out with rats to study the influence of disturbing artifical light-dark regimens. The findings are consistent with the definition of "relatively weak stress-stimuli" which, according to R. BAUMANN, can be essential in causing regulation diseases. Disturbances in the circadian patterns of spontaneous motor activity are described as an inversion of normal activity maxima and minima, as periodicity step-down and as a dissolution of the day-periodical order. Their occurrence is proportional to the magnitude of the disturbing effect. As vegetative disturbing effects there occurred transient hypertensive derangements, the extent of which is inversely proportional to the magnitude of the stressing stimulus. These differences are discussed basing on a hypothesis of differently synthetized cerebro-visceral regulation mechanisms.


[Use of various statistical procedures for the analysis of biorhythms (periodicities of conditional-reflex processes in the minute range) under emotional stress and physical exercise].

Periodicities of conditional-reflectory processes in the minute range were measured in albino rats kept under various conditions (emotional stress, exercise, normal stall maintenance) and analyzed by different statistical procedures. It was possible in this way to judge by selected parameters of periodical processes the intensity of loads and effects of exercise. The additional use of cluster analysis for scaling the biological effectiveness of different communicative relations of the organisms proved useful.


[Diurnal dynamics of periodicities in conditional-reflex processes in the minute range].

Male adult albino rats living from the 6th week of their lives under conditions of artificial light-dark cycle (16 hrs light, 8 hrs dark) were used to study possible relationships between circadian sensitivity cycles and synchronization of dynamics and the frequency variability of periodicities of reaction times of conditional-reflectory processes with wavelengths in the minute range. The experiments have revealed differences at the time of the activity maximum and minimum of a circadian cycle in the studied parameters of the minute rhythm (mean level of oscillation, mean amplitude, length of period and coupling). In the dark phase (activity maximum) there prevailed an increased level of central-nervous excitation and a tendency towards a higher frequency and diminished coupling of minute periods. In the light phase (activity minumum) the animals showed a balanced level of excitation, reduced frequency and a rigid coupling of periodicities of conditional-reflectory events involved in the process. Relations are shown to exist between central-nervous processes and circadian sensitivity cycles. For the experimental practice it is concluded that the different times of the day should be accounted for in assessing the criteria of minute rhythm and in conditional-reflectory studies in pharmacology and toxicology.


[Studies on the blood pressure effects of various high doses of angiotensin II in depot form in rats under defined conditions].

Daily s.c. injections of 0.02--10.0 mg angiotensin in depot form for 14 days caused in rats, under defined conditions, pronounced dose-dependent effects, with an unusual tolerance to the drug being observed. The behaviour of the systolic and diastolic blood pressure and heart rate allowed to define 4 dose ranges. In the lowest dose range of 0.02 mg angiotensin-II a lasting borderline hypertension with only straight-line changes of diastolic blood pressure and bradycardia were observed. The doses of 0.15--1.25 mg angiotensin-II caused a continual blood pressure rise and led, between day 4 and 6 of the experiment, to a pronounced lasting resistance high-pressure without appreciable changes in heart rate. The strongest resistance high-pressure, which occurred as early as on day 3, with pronounced tachycardia was achieved with a dose of 2.5 mg angiotensin-II. Higher doses produced pronounced tachycardia but no significant effects on blood pressure. The varying dose-dependent effects of depot angiotensin are discussed, and the possibility is pointed out to study by the angiotensin-II hypertension model various mechanisms of a long-time hypertensive dysregulation.


[Effect of angiotensin II depot administration on bioelectric functional processes of the central nervous system].

Using the average evoked potential technique, angiotensin-II depot effects (1 mg implantate = 3--4 mg/kg body weight angiotensin-II) were studied neuroelectrophysiologically in reticular, hippocampal and neocrotical structures of albino rats. A multivariate variance and discriminance analysis program revealed differentiated changes of the bioelectrical processing data of the CNS. Evidence was obtained for a varying structural sensitivity of central-nervous substructures under depot administration of angiotensin-II. In later phases of angiotensin-II action, the hippocampus was characterized by an electrographic synchronization phenomenon with high-amplitude average evoked potentials. The reticular formation, and to a lesser extent the visual cortex, showed an angiotensin-induced diminution of bioelectrical excitation. However, the intensity of the change in functional CNS patterns did not always correlate with maximal blood pressure rises. The described changes of afference processing to standardized sensory stimuli, especially in hippocampal and reticular structures of the CNS foll owing angiotensin depot action, point to a central-nervous action mechanism of angiotensin-II.


N-terminal amino acid sequences of pepsinogens from dogfish and seal and of bovine pepsinogen B.

The N-terminal amino acid sequences of dogfish pepsinogen (8 residues), seal pepsinogen (26 residues) and bovine pepsinogen B (25 residues) have been determined. The primary structures of all three pepsinogens show considerable homology with those of zymogens of gastric proteases sequenced previously.


Review of 1,375 cases of vascular reconstruction for ischemic disorder of the lower limbs Statistical analysis of late postoperative thromboses with evaluation of the effect of an anti-platelet agent[tauthor's transl)].

The authors are presenting 1.375 cases of arterial reconstruciton of the lower limbs, those patients having undergone 1.562 operatons between 1963 and 1974. Although mention is made of long-term postoperative morbidity (false femoral aneurysm, infection, amputation), the study is mainly centered on the problem of late thromboses, calculated in percentages per year and classified according to the time lapse since the initail operation. Comparison is made between the percentages before and after 1972. Since 1972, Dipyridamol, an anti-platelet agent, has been administered systematically to all vascular reconstructions of the lower limbs. The action of this type of drug on the platelet adhesivenss is briefly treated. In this respect the numbers calculated suggests a decrease of about 25 % in the numbers of late thrombosis, all other treatment remaining unchanged for the past 11 years. In conclusion, operative indication and surgical skill remain primordial in this type of surgery. However, the anti-platelet treatment, associated with fat-free diet, no tobacco, vasodilators or anticoagulants, seems to bring a further guarantee to permeability of arterial reconstructions.


[Treatment of spontaneous pneumothorax and prophylaxis of relapses (author's transl)].

This study reports the treatment of 192 consecutive cases of spontaneous pneumothorax observed in 99 patients. Relapses are frequent, but it could be shown that their number can be reduced by more aggressive therapy. Conservative treatment led to 99 % of relapses, whereas they were reduced to 32 % by continuous pleural suction, as shown in 76 cases. Pleurodesis with glucose 40 % or 50 % solution followed by continuous suction for 7 days, is advertised by the authors for every first episode of spontaneous pneumothorax. Under this treatment relapses were observed in only 19 % of the cases. If however after this treatment a recurrent pneumothorax occurs, thoracotomy has to be considered for parietal pleurectomy and occasional resection of emphysematous bullae. This procedure was successfull in all 13 cases where it had been applied.


[Diaphysal pseudarthrosis of the tibia (author's transl)].

The authors analyse the etiology and treatment of 18 pseudarthroses of the tibial diaphysis occurring in a series of 320 fractures of this bone. This complication seldom appears in simple fractures treated by a plaster cast (two cases out of 144). In addition to classical and well known factors, it appears that pseudarthrosis occurs more frequently after traction-immobilization (10 cases out of 73), when the fragments had to be repositioned on many occasions under plaster cast, or in cases of open fractures. The treatment by bone grafting, principally in-lays, with or without plates and visses, yield satisfactory results.


[Surgery for chronic non neoplastic diseases of the pancreas (author's transl)].

The authors analyze the surgical indications and procedures for cases of chronic pancreatites. There were but few cases and the procedures were chosen for minimal harm ; there were : 4 external marsupialisations, 1 resection of a true cyst, 5 cystoanastomoses, 2 biliary bypasses, 4 left pancreatectomies. Postoperative courses were normal in 12 patients; 2 had recurrent pancreatitis because of alcoholism. Our attitude towards chronic pancreatic lesions is thus as follows: 1. Cautions and reserved indications. 2. Ad minima procedures.


[Ulcer of the colon and Mallory-Weiss syndrome (author's transl)].

A 71 year old man presents with a high and low hemorrhage with no signs of associated shock. Endoscopy shows a laceration of the cardia (Mallory-Weiss syndrome). The low hemorrhage is attributed to a left colic lesion that appears to be an ischemic colitis. Colonoscopy in addition to baryum enema is useful in the differential diagnosis of colon lesions.


[Classification and operative tactic in the treatment of the small ptotic breast (author's transl)].

The deceiving results obtained by the single implantation of mammary prostheses in the treatment of the small ptotic breasts are the consequence of faulty judgment and lack of recognition of the various anatomical elements involved in the deformity and which bear an incidence on the operative technique and the final esthetic result. By studying the three inseparable elements -ptosis, skin and hypoplasia -a classification into three types of small ptotic breasts is proposed, based mainly on the origin of the ptosis and the hypoplasia and on the static qualities of suspension and coverage of the skin : Type I : primary small ptotic breast. Type II : secondary small ptotic breast with normal skin. Type III : secondary small ptotic breast with skin of bad quality. The respective indications and prognosis of the classical methods of treatment are reviewed according to this classification. The single implantation of mammary prostheses has only restricted indications : when the ptosis of the nipple and/or the lower pole of the breast does not exceed 1 tot 1,5 cm. In all the cases where the ptosis is more pronounced, the single implantation is contraindicated and a reshaping operation will be performed. In cases where the reshaping operation does not give enough volume to the breast, a two-stage procedure is strongly recommended by the author : a reshaping operation, followed in a second stage by the implantation of the adequate prosthesis as soon as the local conditions are favorable.


[Reimplantation of severed fingers (author's transl)].

Finger reimplantation is actually feasible. Two cases of complete amputation and three of partial amputation are presented. There were four successes out of five. A partial reimplantation failed on the 12th postoperative day. The technique and the postoperative care are presented. Success does not depend solely on technique. Physiopathology of the microcirculation at the level of the anastomoses, not well known at present, conditions vascular patency and survival of the reimplanted finger.


[Prophylaxis of postoperative deep vein thromboses by means of weak doses of subcutaneous heparin (author's transl)].

The authors intend to control with the marked fibrinogen test, the real frequency of postoperative deep vein thromboses (DVT) and the eventual prophylactic effect of subcutaneous heparin in weak doses. Heparin was administered 2 hours before the operation and every 8 hours during 6 days thereafter, each time at the dose of 5,000 U subcutaneously. Ninety-nine patients undergoing major surgery were randomized into two groups of 55 control operated patients and 44 operated patients treated with heparin. The radioactive fibrinogen test was used in 27 patients of the control group and in 23 of the treated group. In the control group of 55, 7 DVT were clinically recognized : the isotopic test was positive in 17 patients. In the treated group of 44 no DVT was clinically diagnosed : 6 DVT were recognized by the marked fibrinogen test. There were no noticeable hemorrhagic complications in the treated group. Low dose of subcutaneous heparin is an efficient and safe prophylactic method in postoperative thromboembolic accidents.


Renal artery stenosis and occlusion.

Renovascular hypertension caused by renal artery stenosis was a coincidental discovery in 5 of the 6 patients presented. They did not have any comlaint and it was by routine bloodpressure measurement that hypertension was diagnosed. In one patient without hypertension stenosis of both renal arteries was seen on the aortography for an infrarenal aortic occlusion. Depending on the extent and localisation of the stenosis unilateral renal artery stenosis was treated by a saphenous vein graft interposition, or by an aortorenal vein patch. In a man with bilateral renal artery stenosis a venous bridge was constructed. Once an unilateral nephrectomy was necessary, the kidney being atrophic and a vascular correction impossible.


Ontogenetic factors in the retrieval of memories.

Although rats may show extensive forgetting if a long interval is interpolated between an aversive-conditioning episode and a retention test, this forgetting can be alleviated by a variety of reactivation treatment. This paper reports several experiments analyzing the consequences of one reactivation treatment - noncontingent presentation, between conditioning and testing, of the unconditioned stimulus - when applied to rats which differ in the age at which they are given their conditioning episode. After a long retention interval, both paradigms tested using this reactivation treatment are relatively ineffective for animals conditioned when 16--17 days of age, although both paradigms markedly alleviate forgetting when such immature animals are tested after relatively short retention intervals (a similar effect seems to occur with very old rats). Implications of this finding are tested and discussed.


Meptazinol: I.M. use in postoperative pain.

In a population of 39 patients, the new analgesic drug Meptazinol was tested in postoperative period at a dose of 100 mg I.M., administered only on request of the patient. Cardiovascular and respiratory parameters were not altered significantly. The onset of analgesia was rapid (+/- fifteen minutes) with a maximum reached after thirty minutes; the provided analgesia was good for about two hours as evaluated by the anesthetist and the nurse. The patient asked for a new dose only after about five hours.


First experience with a new analgesic drug: buprenorphine.

Buprenorphine, a new analgesic drug, was used for treatment of immediate postoperative pain in a group of 30 patients. A standard dose of 4 mug/kg was given IM. Onset of action occurred 10 to 20 min. later; pain relief was very good to good in 73%, fairly good in 23% and insufficient in 3%. Duration of action was very long (Mean + SEM: 360 +/- 32 min.) Side effects were few.


Etomidate, a new short acting, intravenous hypnotic.

Etomidate can be recommended for short procedures combined with fentanyl and for the induction of neuroleptanesthesia. It has advantages in poor risk patients because it has only negligible effects on the heart and the peripheral circulation. It has to taken in consideration though, that etomidate has only hypnotic and no analgesic action.


Clinical use of etomidate, influence on blood pressure and heart rate. Comparison with thiopentone and methohexital.

This study deals with blood pressure and heart rate measurements during the use of etomidate after premedication; the injection of etomidate is always preceded by 0.10 mg of fentanyl. Etomidate is compared with thiopentone and methohexitone. There appears to be no gross difference between the drugs as far as the blood pressure is concerned: it is decreased by 15-20%. The influence on the heart rate is typical for each drug: whereas thiopentone causes a rise of 23%, and methohexitone of nearly 40%, the rate remains constant in the etomidate series.


Clinical use of etomidate.

Etomidate and methohexital were administered for induction of anesthesia in 45 patients who had to undergo open heart surgery. The anesthesia technique was otherwise standardised. Measurements of blood pressure and heart rate were obtained during a period of ten minutes after injection of the induction agent, and in a selected group of 16 patients cardiac index and stroke volume index were obtained by impedance cardiography. In the group of 45 patients, blood pressure one minute after induction was unchanged with Etomidate, but decreased (-6%) with methohexital. During intubation, important variations of systolic blood pressure occurred, specially with Etomidate (+ 36%) and less with methohexital (+ 21%). Heart rate increased in both groups during intubation (+ 41%) and returned towards starting value after ten minutes. In the group of 16 patients, cardiac index varied with Etomidate, decreasing during intubation (- 21%), increasing to + 32% and then returning to starting value afterwards. Heart rate increased with intubation (+ 39%) and was still somewhat elevated at ten minutes. Stroke volume index decreased with intubation (- 36%) and was still lower than the initial value at ten minutes (- 14%). With methohexital, cardiac index variations were less pronounced (+ 11%). Cardiac index was lower than the initial value at ten minutes (- 14%). Stroke volume index decreased with intubation (- 36%) and was still lower than the initial value at ten minutes (- 14%). This was compensated by an increase in heart rate. These measurements made during induction reflect the complex interaction of drug administration and technical manipulations. Blood pressure lowering one minute after the injection of methohexital can be ascribed to vasodilatation and myocardial depression. The important blood pressure and cardiac index variations observed with Etomidate are probably due to the short action and the lack of analgesic properties of this agent.


Influence of etomidate, a new short acting anesthetic agent, on cerebral blood flow in man.

Cerebral blood flow was measured by means of a ten channel cerebrograph. This investigation was done after a corotid angiography; 2 to 3 miCi of Xenon133 was injected in the internal carotid artery. Beside CBF we measured arterial bloodpressures, heart rate, stroke volume, cardiac output, central venous pressures, blood gases and glucose in arterial blood, blood gases and glucose in the bulbus of the internal jugular vein and blood gases in mixed venous blood. In most regions CBF decreased significantly after Etomidate. The other parameters did not change. Only the heartrate slowed significantly.


Etomidate and tonsillectomy.

Tonsillectomy under general anesthesia, one of the most commonplace operations there are, is more of a problem for the anesthetist than for the surgeon. Once intubated, the child or adult will be protected from any operative risks by correct ventilation and the protection of his upper airways. The only problem is that arising from the anesthesia required to carry out this intubation and from the consequences of this anesthesia on the waking period, which should be brief in order to avoid, after detubation, any reactions which might induce excessively deep sleep at that moment. In this respect we found etomidate, with its short duration of action, even after reinjection, just as interesting as methohexital. We should mention, however, that his product presents certain disadvantages the most troublesome of which seemed to be the pain provoked when this substance is injected. A new solution (of basic etomidate) still hardly presented this disadvantage.


A comparative study of etomidate and methohexital as induction agents for analgesic anesthesia.

Two hundred current surgical procedures were done in adult patients using neuroleptanalgesia with either methohexital (1 mg/kg) or etomidate induction (0.3 mg/kg) in half of the cases. The cardiovascular function was less altered with etomidate (less occurrence of tachycardia, blood pressure drops or systolo-diastolic pinching). The etomidate dosage chosen more often gave an immediate satisfactory sleep. However, with methohexital induction, less signs of awakening were observed during the surgical procedure. The frequent postoperative somnolence also points, although indirectly, to a longer residual effect of the barbiturate. Both drugs sometimes gave erythema. The injection of etomidate was more frequently painful in the arm. On the other hand, hiccups occurred with methohexital induction only. Etomidate induced myoclonia in one-third of the cases premedicated with diazepam and after preliminary injection of a minimal amount of fentanyl. Without these precautions, myoclonia can occur in two-thirds of the patients. However, these myoclonia are bothersome and of prolonged duration in rare instances and would be of real annoyance only when this drug would be used alone for surgical procedures of short duration where perfect patient immobility is required. We therefore conclude and confirm that etomidate is a good induction agent for neuroleptanalgesia anesthesia procedures.


Clinical study of althesin and hypnomidate.

A simple clinical and a more elaborate instrumental study are presented on the cardio-circulatory action of Althesine and Etomidate (Hypnomidate) compared to thiopental (Pentothal). Statistically is Althesin not significantly worse than thiopental but significantly worse than Hypnomidate. Hypnomidate is less aggressive than thiopental although non significantly. Succinylcholine (1 mg/kg) aggravates the heart depressant actions of the tested drugs, while the intubation of the trachea produces sometimes a serious pressor response which can not be always blocked by prior administration of a low dose (0.1 mg i.v.) Fentanyl.


Cardiovascular effects of various anesthetics in man. Four short-acting intravenous anesthetics: althesin, etomidate, methohexital and propanidid.

Four groups of 15 patients without any cardiovascular or pulmonary pathology received an intravenous injection of one of the 4 studied anesthetics, Althesin (0.07 ml/kg), Methohexital (1.6 mg/kg), Etomidate 0.15 mg/kg) or Propanidid (6 mg/kg). Arterial pressure, heart rate, stroke volume and cardiac output were measured every thirty or sixty seconds. Stroke volume decreased and heart rate increased with all of them, but most of all with Propanidid. The only statistically significant reduction of cardiac output was observed with Althesin. Arterial pressures did not vary. Under the conditions of the present study and at the dose levels mentioned, Etomidate produced the least changes in cardiac parameters.


Study of the cerebral blood flow in patients with brain lesions under anesthesia.

The influence of thiopental (Pentothal) on cerebral blood flow was studied by means of ten scintillationcounters in man on occasion of a carotid angiography. The patients received a basic anesthesia with 30% oxygen, 70% nitrous oxide and pancuronium bromide. When the anesthesia was stabilised, thiopental was given (4 mg/kg). The influence of barbiturates on autoregulation is discussed.


Cardiovascular effects of different anesthetics in man. Study of two volatile anesthetics: enflurane (ethrane), halothane (fluothane).

In the first part of this paper we report the effects of 4 short acting intravenous anesthetics (althesin, etomidate, epontol, brietal) on the cardiovascular effects due to ethrane. In the second part we learn with the same induction anesthetic (etomidate) the cardiovascular effects of ethrane and fluothane. We have proved that: 1 degree althesin least potentiates the variations in the cardiovascular parameters under the action of ethrane, 2 degrees halothane 2% decreases more the blood pressure than ethrane 1%.


Cerebral blood flow under enflurane anesthesia.

Cerebral blood flow was measured, under controlled conditions of stable ventilation and PaCO2, in 11 patients suffering from cerebro-vascular lesions. Comparing the results under N2O-enflurane 1% anesthesia with those under N2O-fentanyl anesthesia shows an average 8.4% decrease of blood flow. In 5 cases, a third measurement was performed under N2O-enflurane 2% anesthesia. This caused an average 8.5% complementary decrease. Whereas most inhalational anesthetic agents produce an increase of cerebral blood flow, this is not observed with enflurane, the tendency rather being towards a decrease.


Influence of enflurane on blood loss from the pregnant uterus.

Uterine blood loss was measured in women undergoing therapeutic abortion during the first trimester of pregnancy. A first group, operated under paracervical block anesthesia, had a mean blood loss of 17 ml. The second group, anesthetized with pentothal, nitrous oxide and enflurane 1%, had a mean loss of 41 ml. The difference is statistically highly significant, but absolute blood losses remained small in both groups.


Impaired early insulin response to glycemic stimulus during enflurane anesthesia in dogs.

We assayed glucose tolerance and insulin secretion in unanesthetised dogs and during enflurane anesthesia. When compared to the awake control animals, enflurane administration induced glucose intolerance with mild hyperglycemia resulting from decreased basal insulin secretion. Moreover, insulin secretion in response to a glycemic stimulus (intravenous glucose tolerance test) was impaired. Comparison between the net incremental insulin responses and the cumulative insulinogenic indexes suggests impaired insulin secretion is mainly related to a deficit in secretion from the acutely releasable insulin storage pool.


Study of the renal function during anesthesia with halothane and enflurane.

In this work, the renal function of ten patients has been studied during an anesthesia with halothane (5 patients) or enflurane (5 patients), a new volatile anesthetic agent. Before and during the anesthesia, the patients were perfused with Lactate Ringer solution. Blood and urine samples were regularly collected to allow the measures of the various parameters of the renal function. Halothane decreases the glomerular filtration rate, the renal plasmatic flow; the filtrated fraction remains stable. Enflurane decreases the glomerular filtration rate but increases the renal plasmatic flow; besides the filtrated fraction decreases. As far as water and electrolytes are concerned, halothane mainly decreases the urine output, the osmolar clearance and the fractional excretion of sodium. This suggests that it chiefly acts on the proximal tube of the nephron. Enflurane mainly decreases the urine output and the free water clearance. This suggests an effect on the distal tube of the nephron.


Ocular tonometry in the child under general anesthesia with IM ketamine.

In the young child, the ocular tension cannot be taken without general anesthesia. Most of the anesthetic drugs lower the ocular tension which may give false low results in glaucoma. Ketamine is the only practical drug elevating the ocular tension. To determine the amount of the change in ocular tension under ketamine, the ocular tension was measured under I.M. ketamine 5 to 10 mg/kg in 30 children without ocular disease. The ocular tension before the anesthesia has not been measured. As soon as the child fell asleep, the ocular tension was recorded between 15 to 20 minutes. We  noticed that the ocular tension remains stable in the beginning, but that it tends to rise after eight minutes of narcosis. So the ocular tension must be measured as soon as possible after induction, as soon as the child does not react to stimuli. Abnormal ocular tensions under ketamine are discussed. The ocular tensions under two different types of anesthesia (ketamine and methohexital + Thalamonal) are compared. Some examples of ocular tensions in glaucoma under ketamine are presented.


Post-traumatic and postoperative treatment of severe brain injuries with controlled hyperventilation.

Controlled hyperventilation has shown to be an effective method of treatment in patients with pronounced brain edema and high ICP caused by accidental or surgical damage. This treatment has to be started as early as possible after the injury to avoid secondary changes and spreading cerebral edema leading to the impact of the brain-stem and thus irreversible brain damage. If conducted consequently, controlled hyperventilation will diminish mortality rate and increase the rate of valuable recoveries in all sorts of brain injuries.


The prevention of irreversible lung changes following reversible phrenic nerve paralysis.

Phrenic nerve paralysis frequently follows operations on the neck such as resection of a cervical or first rib. It all too often passes unrecognised or is incorrectly treated, leading to permanent lung damage which may be severe enough as to result in a functional pneumonectomy. This is particularly unfortunate since the phrenic nerve paralysis is usually temporary. Three case histories are described of reversible paralysis of the phrenic nerve in which, due to prompt diagnosis, the ensuing lung changes were either prevented or immediatley treated. Intermittent assisted respiration with a Monaghan respirator was used to provide nebulised inhalations of Mesna several times a day. The method is applicable via a tracheostomy, an endotracheal tube or a simple mouthpiece. The latter is illustrated. The therapy is not hindered by immobilisation of the head and neck and the level of consciousness of the patients is of no importance. Many chest X-rays demonstrate the rapid clearing of the lungs achieved. All three patients were discharged with perfectly normal lungs.


Management of potentially fatal alcohol intoxication.

Severely alcohol intoxicated patients pass through all stages of anesthesia according to the Guedel classification. Additional illnesses or injuries might be present, however. These require careful investigation. Blood alcohol levels are no criterion for the degree of intoxication. The treatment varies and is based on clinical symptoms. In our series of more than 100 alcohol intoxicated patients the treatment generally consisted o Apomorphine, unless unconsciousness was present, and peripheral vasopressors, if necessary. Occasionally endotracheal intubation was required. On gastric aspiration via nasogastric tube only minimal amounts of alcohol could be recovered. With correct diagnosis and effective treatment the cure rate of acute alcohol intoxication should be as high as that of other intoxications.


A computer module for the continuous monitoring of cardiac output in the operating theatre and the ICU.

A new pulse contour method to determine stroke volume and cardiac output continuously in patients on a beat-to-beat basis from the aortic pressure wave has been implemented in the form of a simple, inexpensive, fully automatic computing module for a commercially available patients monitoring system (Philips Medical Systems). Its reliability has been tested and shown in a computer analog, in experimental studies in 10 dogs (not reported here), in 22 hemodynamic studies on 20 young healthy volunteers and during 41 days in 20 postsurgical patients in the ICU, the most important result being that erros figures (15 and 19% respectively in the two human studies) are of the same order as when two standard methods, Fick and dye dilution are compared. The clinical studies have further indicated the easy applicability of the module 1 degree in the monitoring of critically ill patients in ICU's, 2 degrees as a monitor of the systemic circulation during anesthesia, and 3 degrees as a tool for studying the hemodynamic effects of pharmacological agents. The instrument consitutes no burden to the patients and has, several times during the course of the evaluation, provided an early warning of a deteriorating hemodynamic status of the patient to the physician.


Study on peroperative bleeding in ear, nose and throat surgery.

Some interventions in ENT surgery are very difficult or are even impossible if the slightest bleeding occurs. Microsurgery of the ear is the best example. For this reason we choose this particular intervention to test different anesthesia techniques. Bleeding in the surgical field is followed, while simultaneously respiratory, venous and arterial pressure tracings are recorded. These parameters are followed and changes can be attributed directly to observations by microscope of the surgical field. Successively neuroleptanalgesia in its pure form or with help of several drugs (trimetaphan, furosemide, enflurane) is studied. One conclusion can probably be made of the analysis of our series: an anesthesia with "light" analgesia gives better results than an anesthesia protecting completely the patient.


Controlled hypotension induced by sodium nitroprusside. A practical approach.

Although known since 1849 and introduced in medical practice 1955, sodium nitroprusside is used mostly in large medical centres fully equipped with monitoring equipment. This attitude has contributed that sodium nitroprusside is not as popular as it should be. An attempt is made to show that single banded practising anesthesist may and should use sodium nitroprusside to produce controlled hypotension, provided certain "safeguards" are followed. These safeguards are based on information got from the literature and own experience with sodium nitroprusside in obtaining controlled hypotension during anesthesia using sophisticated equipment as well as simplified monitoring, which is fully explained in the article.


Some experience of the use of etomidate in children.

Etomidate 0.2 mg/kg was used as an intravenous hypnotic to induce anesthesia in 198 children. If proved to be a safe and effective agent, with no appreciable side-effects on the cardiovascular or respiratory systems. The main problems in use were a high incidence (27%) of pain after injection, and a 10% incidence of significant myoclonia. In addition, 0.2 mg/kg was assessed as an inadequate induction dose of etomidate in unpremedicated children.


Cerebral malformation associated with metabolic disorder. A report of 2 cases.

A clinical and neuropathological study is presented of two cases each of which showed neuronal heterotopia. Microgyria was also present in one case. One patient was suffering from a degenerative disorder affecting the white matter. The other was a case of Menkes' disease. It is suggested that the antenatal damage may have been caused by an imbalance of the maternal metabolism, the predisposing factor being the mother's carrier state for a metabolic defect. This is the first report of teratogenesis in a case of Menkes' disease. It is also noted that in this case there is interference with the postnatal as well as the antenatal development of the brain.


Anthrax meningitis. Report of two cases with autopsies.

The authors report two cases of occupation-related anthrax meningitis; one was direct contamination from a diseased animal; the second was due to handling of bone powder imported from India. The pathological pattern of involvement of the meninges and brain is described and discussed.


Sequence of morphological alterations in the nervous system of metachromatic leucodystrophy. Light- and electronmicroscopic observations in the central and peripheral nervous system in a prenatally diagnosed foetus of 22 weeks.

Light and electronmicroscopic findings are reported in a case of metachromatic leukodystrophy diagnosed prenatally who died after iatrogenic abortion during the 23th week of gestation. The brain of this foetus was not yet myelinated while the spinal cord showed early, and the peripheral nerves advanced myelination. The onset and the degree of myelination were similar as in a normal foetus of the same age. Ultrastructurally there was evidence of sulphatide storage before the beginning of myelination. During myelination lysosomal storage material, staining metachromatically in acid cresyl violet preparations, appeared in oligodendrocytes and Schwann cells. Besides sulphatide storage material, prominent amounts of neutral lipids were found in oligodendrocytes. Myelin breakdown was encountered very seldom.


Cerebral "radiation necrosis": vascular and glial features.

Glial and vascular abnormalities in brain, simulating intracranial neoplasia, are described in a patient who received radiation to the pituitary region for treatment of an adenoma, 13 months before death. In addition to the expected changes of cerebral radionecrosis, four interesting features are cited: 1. Diffuse hyperplasia of capillaries in the cerebral cortex with marked endothelial hypertrophy; 2. abundant, large multipolar bizarre cells in the perivascular connective tissues; 3. focal astrocytic proliferation with many cells resembling either Alzheimer type I astrocytes or neoplastic cells, and 4. radiation changes in the non-irradiated brain.


Nucleic acids in human normal and osteoarthritic articular cartilage.

During operations on joints of patients with osteoarthritis, specimens of severely degenerated cartilage of the femoral head were removed and cartilage from knee joints taken at meniscectomy was used as control material. DNA and RNA concentrations were reduced in advanced osteoarthritis, while the synthesis of DNA and RNA was increased in relation to the number of cells in the tissue. The result showed that in advanced osteoarthritis the remaining chondrocytes are metabolically very active.


Effect of indomethacin on fracture healing in rats.

The healing of closed, non-immobilized femoral fractures in rats was seriously impaired by indomethacin given orally at a dose of 2 mg/kg daily. The fracture haematomas were larger and disappeared later in the animals receiving indomethacin. Mechanical strength testing of fracture healing showed that maximal tensile strength, elastic stiffness and maximal bending moment between fragments were significantly diminished in the indomethacin-treated animals. Radiological examination showed a smaller amount of mineralized callus and a more pronounced angulation between the fragments in these animals than in the placebo-treated ones. Hsitological examination showed bridging between the fragments by callus tissue 24 days after fracture in placebo-treated animals, whereas indomethacin treatment was followed by histological findings resembling those seen in early pseudarthrosis development.


Effect of fracture on longitudinal bone growth in rats.

The growth rate in proximal tibia and distal radius in rats was investigated by the tetracycline method after femoral fracture, tibiofibular fracture, and metatarsal fracture. Up to 1 to 2 weeks after the fracture, a higher growth rate was recorded on the fractured side than on the unfractured side. This effect occurred later after tibiofibular fracture than after femoral and metatarsal fracture, but was almost of the same size and about 8 per cent of the normal growth rate. This difference in growth rate was caused partly by a general group retardation compared with the normal growth rate, and partly by a local growth stimulation in the fractured extremity. The growth retardation was pronounced after tibiofibular fracture, but was insignificant after femoral and metatarsal fracture. The growth rate on the fractured side after the latter two types of fractures was higher than under normal conditions. Thirty days after all types of fractures, the growth rate was normal, both in fractured extremity and in other growth regions.


Muscle blood flow after amputation with special reference to the influence of osseous plugging of the medullary cavity. Assessed by 133 xenon and histamine. An animal experiment.

The muscle blood flow (MBF) in rabbits subjected to amputation of the crus was assessed by means of 133 Xenon and Histamine. It was shown that after the operation the flow in the amputation stump was initially reduced. MBF in the stump increased more rapidly and stayed at a higher level after closure by myoplasty than after amputation without myoplasty, and it was still further stimulated after osseous plugging of the medullary cavity.


An unusual case of subluxation of C.3-C.4.

A case is reported of spontaneous subluxation of C.3 on C.4 in a 6-year-old boy due to an upper respiratory infection after surgical treatment for muscular torticollis.


Fracture of the first rib.

Fifteen cases of isolated fracture of the first rib are submitted. The mechanism of the fracture is discussed. It proved compatible with the descriptions in the literature, caused either by direct trauma to the shoulder, a sudden violent contraction of juxtacostal muscles; or else it was a chance finding, without any history of trauma and as such interpreted as a fatigue fracture. A case of Horner's syndrome complicating a fracture of the first rib is also described.


Pelvic strength after major amputation of the sacrum. An exerimental study.

Major sacral resections up to the level of S 1 and even higher have been performed. This has raised the question of the degree to which such operations weaken the pelvic ring. Fifteen cadaver pelves, including the fifth lumbar vertebra, were loaded to failure, five unresected, five after resection of the sacrum between S 1 and S 2, and five after resection about 1 cm below the promontory. The weakening of the pelvic ring amounted to approximately 30 per cent with the former type of resection and 50 per cent with the latter. Taking into consideration the calculated normal load on L 5 in upright standing it seems safe from this study to allow patients to stand with full weight-bearing at an early stage postoperatively after submaximal resection of the sacrum.


Wear of the polyethylene head of the Oscobal prosthesis.

Ten hemiarthroplasties were performed with the Oscobal (Daubenspeck) his prosthesis, which consists of a metal stem and a nonrotating ployethylene head. Five patients died 1-150 days after the operation. Signs of massive wear of the polyethylene head were demonstrated in four out of the five patients still alive 16-28 months after the operation. We can therefore not recommend the Oscobal system for hemiarthroplasty of the hip.


Bifurcation of the distal femur.

Bifurcation of the femur has previously b-en reported in the literature in only 12 cases. Two more cases are added, and the etiology of this congenital anomaly is discussed.


Old total rupture of the adductor longus muscle. A report of seven cases.

Seven cases of old total rupture of the adductor longus muscle are described. Five patients were referred with the suspicion of a soft tissue tumour. Six patients reported an adequate trauma when thoroughly questioned; four of them had sustained the injury while playing soccer; the seventh patient could not recall any trauma. The diagnosis of this lesion is discussed.


Knee instability. An orthoradiographic study.

An orthoradiographic method for preoperative assessment of mediolateral instability and varus/valgus deviation in gonarthorsis is presented. A special definition of the varus/valgus deviation is given. The examination technique has been tested on 15 young, healthy subjects with no clinical signs or symptoms in their knee joints. To test the accuracy of the method, seven of the subjects were re-examined at a later date.


The incidence of osteochondritis dissecans in the condyles of the femur.

The incidence of osteochondritis dissecans in the condyles of the femur was studied in a defined population and was found to be twice as common in men as in women; the maximum incidence in both sexes being between the ages of 10 and 20. The site of the lesion in the condyles did not differ between age groups. The indicence of diagnosied cases has increased somewhat in recent years but only in men. The incidence in the population is less than has been suggested in the past.


Strontium-85 uptake in knee joints with osteochondritis dissecans.

The uptake of Strontium-85 in the distal end of the femur and in the immediate vicinity of the lesion was measured in 12 young ment with ostoechondritis dissecans. The uptake was significantly but only slightly increased. It was confined to the area of the lesion, was less than observed in early cases of gonarthrosis and an order of magnitude less than in cases of osteonecrosis. It is concluded that the repair process of osteochondritis dissecans is very slow and involves only minor part of the bone tissue surrounding the lesion.


Distal disinsertion of the patellar ligament combined with avulsion fractures at the medial and lateral margins of the patella. A case report and an experimental study.

A 12-year-old boy presented with a proximally retracted patella 5 months after an injury to the left knee. The clinical and radiographic features and the findings at operation led to the conclusion that the original lesion had been a distal disinsertion of the patellar ligament combined with avulsion fractures at the medial and lateral margins of the patella, produced by the medial and lateral longitudinal patellar retinacula. Loading experiments on amputation and cadaver specimens showed that these retinacula, apart from being tendons for the vastus medialis and the vastus lateralis, respectively, constitute a direct fibrous connection of considerable strength between the patella and the tibia and thus are capable of producing avulsion fractures.


[Comparative study of acoustic trauma caused by blasts, treated by vasodilators or by a combination of vasodilators and hyperbaric oxygenation].

The authors had comparated two series of patients with noise induced hearing loss treated by vasodilatators or vasodilatators and hyperbaric oxygen. This therapy seems to give better results than the vasodilatators only, but the patients had to be treated before ten days after the noise exposition. In the two series of acoustic trauma we see rarely a complete recovery from the hearing loss.


[Clinical aspects of choanal atresia].

Clinical examination was performed on 10 patients with recently treated choanal atresia, 8 unilateral and 2 bilateral cases. All patients showed an asymmetrical facial skeleton, which could be classified as hemifacial microsomia, although sometimes in a rather subclinical form. In all unilateral cases of choanal atresia hypoplasia of the facial skeleton was manifest on the affected side. These cases did not reveal that choanal atresia can occur without any abnormality in the facial skeleton. Hemifacial microsomia is not only a clinical entity, but also has a distinct pathogenesis. In early embryonic development a trauma occurs in the first or second branchial arch, which causes focal mesenchymal destruction, and this is thought to present the pathogenesis of hemifacial microsomia. Choanal atresia did not always occur with associated orthodontic abnormalities. Clinical examination, however, revealed transversal maxillar compression at the affected side in three out of eight unilateral cases.


[Ceruminoma. Apropos of a case of ceruminal adenoma of the middle ear].

Ceruminoma is a rare form of tumor in man. Most of them are found in the external ear, rarely in the middle ear. The authors review the relevant literature and report a case of ceruminal adenoma arising in the middle ear. The prognosis of these tumors is relatively bad because of their potential malignancy and the tendency for recidivation. Recommendations for treatment are deep excision, postoperative irradiation in malignant types and regular follow-up visits.


[Latero-cervical branchial cysts and fistulas].

Twenty-four cases of cysts and fistulae of the lateral part of the neck are presented. They come from the very important modification in the branchial apparatus arising during the embryogenesis of the neck. We found these vestigal anomalies moreover under the mandibula before the sterno-cleido-mastoidean muscle, but every where in the lateral part of the neck too. The differential diagnosis must be done between lymph nodes infections, dermoid cysts, benign and malignant tumors. Therefore the puncture seems very contributive. The best therapy is for everybody the radical removal.


[Significance of the fusospirillum complex (Plaut-Vincent angina)].

The results are discussed of a retrospective study of 126 patients by whom an excess of the fusospirochaetal complex was found by direct microscopic examination of tonsillar material. These bacteria are not only found in unilateral ulcero-necrotic tonsillitis, but also in different other tonsillar and general diseases. Vincent's angina appears almost exclusively in young persons, aged from 16 to 25 years; in the adolescence (16-20 years) it forms about 40% of all cases of acute tonsillitis. The fusospirochaetal complex is also often found in chronic tonsillitis and even in morfologically normal tonsils, especially in patients with general diseases like rheumatic arthritis. In one third of the patients with infectious mononucleosis, the complex is present in the tonsillar lesions. The occurrence of Vincent's angina is double as high in women than in men. From our assessments we can conclude that the fusospirochaetal complex has a very low pathogenity, and that it only can grow in patients with a reduced local or general resistance, even without causing local lesions.


3H-Thymidine labeled mast cells in mice treated with 20-methylcholanthrene: proliferation of precursor cells, their transformation into mast cells and migration of the latter.

In an attempt to clarify the kinetics of increase of mast cells, autoradiographic studies were performed on the mice which received a painting of 20-methylcholanthrene on the skin. In the first experiment, mice received 20-methylcholanthrene painting on their back for two, four and eight weeks. A fourty-eight hours' cumulative labeling with 3H-thymidine was performed directly before sacrifice. No labeled mast cells were found in the painted skin, despite a marked increase of mast cells in number. In the second experiment, mice received 20-methylcholanthrene painting for thirty-one days. A twenty-four hours' cumulative labeling was performed three, five, seven, fourteen, twenty-one and thirty-one days before sacrifice. A high labeling index of mast cells, up to 61.29%, was obtained in each group. When the time lapse between the time of cumulative labeling and the sacrifice is long, the labeling index is higher in the subcutaneous tissue, and when the time lapse is short, the labeling index is higher in the subepidermal tissue. From these results it was concluded that; 1) An increase of mast cells is due predominantly to the proliferation of precursor cells and their transformation into mast cells. 2) The proliferation of precursor cells occurs mainly in the subepidermal layer of the skin. 3) After the transformation, mast cells may migrate into the deeper layer of the skin.


Sarcoma botryoides arising from the biliary tract of children. A case report with review of the literature.

Sarcoma botryoides (embryonal rhabdomyosarcoma) originating from the common bile duct is reported in a 4-year-old girl. Grossly, the tumor is characterized by multiple polypoid and grape-like projections into the lumen of the common bile duct and shows plate-like thickening of the common bile duct wall. On multiple cut-sections these polypoid masses are soft and light yellow white except for multifocal hemorrhage. Histologically the tumor consists of undifferentiated mesenchymal cells with a myxomatous appearance; rhabdomyoblasts with varing degree of maturation are scattered here and there within the matrix. These cells are characterized by a strap and racket shape with abundant eosinophilic cytoplasm and elongated cytoplasm with cross striations. The histogenesis of the tumor may be related possibly to an abnormal differentiation of the primitive mesenchymal cells toward striated muscle cells.


Histopathology of Behçet disease. Review of the literature with a case report.

An autopsy case of Behçet disease which was considered to be typical both clinically and histopathologically was reported. Cerebral abscess was also noted. Consequently it was presumed that some of the findings which had been called softening, demyelination, cavitation among others as the lesions of Neuro-Behçet might be closely related to abscess. Besides suppurative endoaortitis which was thought to be of interest as the lesions of Vascular-Behçet was observed. In order to substantiate the above, a general review of the literature of Behçet disease was made.


Disturbances in the electrical and contractile gastric activities after bilateral transthoracic vagotomy.

Experiments were made on four dogs with chronically implanted electrodes. Fistula according to Bassov was made in one of the animals, and in each of the remaining three - two semiconductor silicon tensotransducers were sewn to the gastric wall. Bilateral transthoracic vagotomy results in inco-ordination between the rhythm of slow potentials generation from the body and from the antrum of the stomach. Slow potentials and contractions with frequencies usual for the stomach are recorded from the body of the stomach, while in the antrum there appear from time to time bursts of slow potential groups with relatively high frequency. These groups are not followed by contractions of the stomach wall or by changes in the intragastric pressure. Bilateral transthoracic vagotomy leads to disturbances in the conduction of the slow potential generated in the proximal segments of the stomach, as well as to distrubances in the propagation of the peristaltic wave.


Character of the mechanical activity of the various sections of the complex stomach upon vagal stimulation.

The experiments are carried out on chloralose-anaesthesized sheep (50-70 mg/kg). The increase in the force, frequency and duration of the stimulating impulses in a geometric progression leads to an increase in the amplitude of the contractions in all sections of the complex stomach. The amplitude and nature of the evoked contractions for one and the same parameters of stimulation are different in the different sections. The latency of the response in the reticulum is always shorter and its contractions increase faster than in the other sections. The relaxation of the muscles after elimination of the stimulation to the initial level is slowest in the rumen and in the case of high parameters of stimulation it takes more than 10 min.


Participation of adrenergic mechanisms in the genesis of the cortical brain electrical activity.

The changes both in the spontaneous and in the evoked electrical activity of the somatosensory cortex, occurring after local or systematic administration of chlorpromazine, have been studied on 36 cats. The neuroleptic used weakens both the spontaneous cortical electrical activity and that induced by stimulation of n. radialis and of MRF. The potentials evoked by stimulation of VPL do not change. Systematic administration of chlorpromazine causes analogous changes in the electrical activity of the somatosensory cortex. Stimulation of n. radialis and MRF, though not of VPL, results in a sharp increase in the activity of the adenylate cyclase in the somatosensory cortex. Local administration of chlorpromazine leads to statistically significant less marked increase in response to applied stimulations of the adenylate cyclase activity. The results obtained substantiate the assumption that adrenergic neurones participate in the formation both of the spontaneous and of the induced electrical activity in the somatosensory cortex of cats.


On the neurogenic vasoconstriction of the resistive vessels in cutaneous vascular bed--rabbit ear.

A study was made of the effect of increased sympathetic activity during bilateral carotid occlusion (BCO), during haemorrhage and during i.v. injection of Tetramethylammonium jodatum (TMAI) on the resistive vessels in rabbit ears. The animal was under slight urethane anaesthesia, with spontaneous respiration after tracheotomy and vagotomy. The ear was perfused by roller pump with constant flow with tempered oxygenized Tyrode solution or with blood from a donor-animal. The increase in sympathetic activity during BCO, haemorrhage and injection of 100 mg/kg TMAI did not change the perfusion pressure in the perfused rabbit ear. The initial perfusion of the ear with blood increased the resistance of the ear, while perfusion with blood from donor-animal which had suffered considerable haemorrhage caused additional increase in the resistance by about 150 per cent. The effect of sympathetic constrictory influence of the resistive vessels is studied in view of the anatomic-functional specificities of the nerve supply of the ear and of the cutaneous vessels, in view of the passive dilatation of the resistive vessels, and of the thermoregulatory function of the ear. It is indicated that considerable hormonal vasoconstriction probably occurs in the rabbit ear during haemorrhage.


Vascular effects upon experimental increase in the interstitial osmolarity.

Experimental increase in the interstitial osmolarity in the limb of a cat is caused by intraarterial infusion of hypertonic solutions. The limb was autoperfused with blood at a constant flow using a roller pump. Hypertonic Tyrode solutions with increased content of NaCl, glucose, l-ascorbic acid, with normal or increased KCl content, were infused together with the blood. The perfusion and arterial pressures were measured and the constrictory response upon local intraarterial injection of 0.2 mug 1-noradrenaline was determined. The intraarterial hypertonic infusion evoked a vasodilatatory response which was maintained irrespective of the reduced or preserved vascular contractility. The magnitude of the vasodilatation was determined by the hypertonicity of the solution and by the KCl content. Hyperosmolaric reduction of the vascular contractility was lacking in the case of solutions with increased KCl content or addition of l-ascorbic acid. The vasodilatation observed also when the contractility was not reduced is discussed in view of the participation of a passive vasodilatation caused by the dehydration of the vascular wall. The effect of the changes in the transmembrane Na+ and Ka+ concentrations on the reduction of the vascular contractility is also discussed.


In vitro effect of prostaglandine F2alpha on the motility of the myometrium. Interactions with adrenergic and cholinergic receptors.

The in vitro effects of prostaglandine F2alpha(PGF2alpha) on the spontaneous contractile activity of the myometrium of rat, guinea-pig and rabbit and its interactions with adrenergic and cholinergic receptors were studied. All animals were with oestrogen domination. One myometral strip of each animal species was placed under identical conditions in a common bath with Krebbs solution. Each strip was connected to a strain gauge for the recording of the contractile activity. L-Noradrenaline (N) and Adrenaline (A) in doses of 10(-6) g/ml inhibit the contractile activity of rat myometrium (stimulation of the beta-receptors) and this effect is antagonized by beta-blocking agents. Conversely, N and A stimulate the myometrium of guinea-pigs and rabbits (stimulation of the alpha-receptors) and this effect is antagonized by the alpha-blocking agents. Unlike N and A, PGF2alpha stimulates the contractile myometral activity in all three species and its effect is not antagonized either by adrenergic or by cholinergic blocking agents. The stimulating effect of PGF2alpha antagonizes the inhibitory effect of N and A on rat myometrium and potentiates their stimulating effect on the myometrium of guinea-pigs and rabbits with a noncompetitive mechanism.


Effect of exhaustive swimming on the oxidative phosphorylation and the activity of some enzymes in rat liver mitochondria.

In liver mitochondria of control animals and of animals subjected to swimming for three hours experiments are made to determine the activities of rotenone-insensitive NAD.H-cytochrome c-oxireductase, succinate-cytochrome c-oxireductase, MDH, SDH, ATP-ase and cytochrome oxidase, as well as oxygen uptake, respiratory control index and ADP/O ratio upon oxidation of succinate and glutamate + malate. Decrease of the ADP/O ratio and of the respiratory control index, as well as increased ATP-ase activity, are established after swimming. The e--transport rate decreases. The activity of the remaining enzymes is unchanged. The activities of MDH, SDH, NAD.H-cytochrome c- and succinate-cytochrome c-oxireductases decrease 22 hours after exhaustive swimming. The activities of the cytochrome oxidase and the ATP-ase are unchanged compared with the controls. A single exhaustive loading results in changes in the capacity of phosphorylation in the liver mitochondria and the changes in the activities of the enzymes studied are established 22 hours later.


Experimental study of the effects of imidazol, papaverine and histamine on convulsive-seizure reactivity.

In experiments on male albino rats and mice a study is made of the effects of imidazol which is a phosphodiesterase stimulator, papaverine which inhibits phosphodiesterase and histamine which stimulates adenylate cyclase, on the convulsive-seizure reactivity. The substances are introduced intraventricularly and intracerebroventricularly, imidazol also intraperitoneally in different doses and at different intervals before the convulsive agent. Electrical, pentylenetetrazol (Cor) and strychnine convulsion models are used. The effect of imidazol on the spontaneous cortical bioelectrical activity is studied throuth its i. v. administration in rabbits. Imidazol markedly increases the convulsive reactivity, and in large doses it alone results in electrographic and motor convulsions. Paperine slightly lowers the convulsive-seizure reactivity only in pentylenetetrazol convulsions. The results obtained and their comparison with the results of previous experiments of ours with other drugs affecting the cyclic adenosinemonophosphate (cAMP) system, such as lithium, haloperidol, caffeine and theophyline, do not permit to assume a considerable significance of the influence of these substances (in the doses tested) on the cAMP system in the mechanisms of their effects on the convulsive-seizure reactivity.


Effect of the verbal instruction on the late positive wave P3 of auditory evoked potentials in human subjects.

The changes in the late positive wave P3 of the averaged evoked potentials (AEP) are studied under conditions when: (a) only high tones were presented requiring no motor response; (b) only low tones were presented requiring motor response; (c) the subject was instructed that the two types of tones will be presented in random order with a definite probability (50%:50% or 25%:75%, or conversely 75%:25%) requiring motor response only to the low tones. In fact, however, only high tones were presented to which no motor response was required (pseudo-mixed series). It has been established that under the effect of the verbal instruction used, the P3 wave of the AEP of the pseudo-mixed series increased at the beginning of the series, and thereafter the P3 "behaviour" was different with the different subjects: (1) In some of them P3 persisted until the presentation of a definite number of signals (different for the individual subjects) and afterwards it disappeared; (2) In some others P3 now increased now disappeared in a manner different for the different subjects; (3) Subjects in which P3 remained pronounced throughout the entire series; they also "heard" low tones. All these changes in P3 did not depend on the probability characteristics of the pseudo-mixed series ascribed by the instruction. The dependence of the late positive wave P3 on the processes of probability prediction in the human brain functioning, and on the changes in the arousal, is discussed.


Dynamics of the partial restoration of slow-wave frequency of the duodenum below transection.

Transection of the proximal duodenum of dogs was followed by end-to-end anastomosis. The electrical activity of the duodenal wall of both segments was recorded. On the background of decreased slow-wave frequency below the section single slow waves were observed with duration similar to that of the slow waves above the section. In the days after surgery their number increased, small groups of such waves appearing during and after spike activity. In some of the experiments from the end of the first month of the sixth month after surgery the slow wave frequency below the section approached the slow wave rhythm above the section as evidenced by the histograms. This was a temporary phenomen, which was partly eliminated by cholinergic and alpha- and beta-adrenergic antagonists. Such a phenomenon was also observed in definitively spearated distal segments of the duodenum. Histological examination of intestinal wall taken from the area of anastomosis showed on the 3rd day the presence of single smooth-muscle cells among the granulation tissue, filling the gap between the wound edges; on the 6th day the number of these cells increased and on the 9th and 12th day they formed small groups. From the end of the first month to the sixth month small sheaves of smooth-muscle cells were observed in the cicatricial tissue. It is concluded that the intrinsic nervous system keeps the slow wave frequency below the duodenal transection at a higher level than the smooth muscle cell regeneration might ensure.


On the adrenergic mechanism of cerebrovascular resistance regulation.

It has been found out experimentally that there is a decrease in the pressor action of noradrenaline on cerebral vessels during repeated injections, which is probably due to the increased concentration of endogenic prostaglandins in response to noradrenaline administration. During inhibition of prostaglandin biosynthesis we have observed reverse action -- increase in noradrenaline pressor action and sympathetic effect on cerebral vessels. The hypothetic scheme of prostaglandin participation in adrenergic regulation of cerebrovascular tone is presented.


Effect of the drug AS2 on the central and peripheral mechanisms of vascular tone regulation.

The effect of the compound AS2 (N'-benzhydryl, N''-allylpiperazine dihydrochloride) on the central and peripheral mechanisms of vascular tone regulation is studied. Six series of experiments on cats are carried out. The effect of the compound is tested on a model of central-hypertensive reaction, on the spontaneous bioelectrical activity of the renal nerve, on the transmission of excitation to the upper cervical ganglion and the ganglia of the solar plexus. Experiments are made to study its adrenolytic a-d myotropic properties. Cinnarizine is tested as control. The results show that the compound AS2, similar to Cinnarizine, affects the central and peripheral mechanisms of vascular tone regulation. In small doses (1-5 mg/kg) AS2 manifests poor myotropic properties. Administration of the drug in doses of 10-20 mg/kg results in considerable inhibition of the vasomotor centres, brief disturbances in the excitation transmission in the sympathetic ganglia and slight inhibition of adrenergic transmission.


Effect of imidazole, papaverine and histamine on learning and memory in albino rats.

In experiments for learning of albino rats in a maze and testing of the memory 24 hours and 30 days after learning, it was established that: Imidazole introduced i.p. in doses of 10, 30 and 60 mg/kg had no effect on learning, though it improved the memory both after administration 1 to 15 min before learning and when injected immediately after learning. Papaverine in doses of 2, 0.5 and 0.1 mg/rat and histamine in doses of 0.1, 0.01 and 0.001 mg/rat, introduced ventricularly before learning, make learning impossible (the large doses), deteriorate it (the medium doses), or have no effect on it (the small doses). Memory also deteriorates, with the exception of the smallest histamine dose. Introduced immediately after learning, the large dose of papaverine deteriorates memory, while the small dose results in a tendency to improve the memory indices upon testing 24 hours after the administration. The large dose of histamine administered after learning has no effect, the small dose results in a certain tendency to improve memory when tests are made 30 days after learning. The results obtained and their comparison with the results of previous works of ours involving other drugs with a known effect on the system of the cyclic adenosinemonophosphate (cAMP), e.g. haloperidol, lithium, caffeine and theophylline (in the doses tested), do not suggest any essential role of the effect of these drugs on the cAMP system in the mechanism of their effects on learning and memory.


Method for assessment and comparison of the average rate of development of the phases of the contractile process in isolated smooth muscles.

In certain methodological setups the pharmacological agent is applied in a flowing fluid and washes the smooth-muscle preparation for a certain period of time. In such cases it is possible to observe differences in the slope of the curves of the contractile and relaxation phases of the contraction and appearance of the amplitude maximum at different moments in the total duration of the contractile process. The recording of the average development rates of the contraction phases, in addition to the commonly accepted indicator of th effect of the amplitude maximum, could give an additional characteristic to the action of the pharmacological substances. A method is proposed for determination of the average rates of the contractile and relaxation phases, as well as the relative dependence between them.


Pharmacological effect on the average rates of development of the contractile and relaxation phases of the acetylcholine contractile effect in the smooth muscles of guinea-pig caecum.

The average rates of development of the contractile and relaxation phases and their relative dependence in the acetylcholine contractile effect, after treatment with papaverine, prostaglandines E1 and F2 alpha and BaCl2, are tested on longitudinal and circular smooth muscles of guinea-pig caecum. Changes are observed in the effect on the phase rates of the contractile process caused by acetylcholine in the two muscles under the effect of the different drugs. In both muscles the relative dependence between the phase velocities is lowered by papaverine and raised by BaCl2. It is assumed that the interaction of the pharmacological substances with the calcium ions plays a role in the rate of manifestation of the pharmacological effect.


Coordination between the longitudinal and circular layers of the stomach during the excitator-contractile process.

The coordination between the longitudinal and circular layers of the stomach muscle is studied using strips of cat stomach cut along the longitudinal and circular axis of the stomach, preserving the connection between them. The longitudinal muscle layer plays a leading role both with respect to the bioelectrical and to the contractile activity of the stomach. Under the effect of acetylcholine (10-7) the delay time of the circular muscle layer is shortened compared with the longitudinal layer (from 2.44+/-0.17 to 0.8+/-0.7 s). Under the effect of Ba ions not only shortening of this time is observed, but also inversion of the process-the circular layer becomes leading with respect to the contractile process in some moments.


Duration estimation of visual light and dark stimuli.

Estimation of visual light and dark stimuli duration is studied in eight subjects. The intervals are within the range of 100 to 1,100 ms. Three of the subjects were trained with intervals presented with light stimuli, the others - with dark stimuli. Time intervals presented in both ways were given for estimation to both groups of subjects. The extimates depend on the position of the time intervals in the range, on the type of the stimuli with which they are presented and on the way of training.


Estimation of time intervals in an array of intervals. I.

It has been shown that when man estimates the duration of separate brief time intervals(300-1,000ms), elements of a certain array of time intervals within the same range, the estimation is not affected by changes in the other elements of the array. The complex light and dark intervals are considerably underestimated. The separate estimation of two elements (light and dark interval) from the array has shown that the sum of the separate responses exceeds the estimation when the same two elements have to be estimated together as a total interval. The results could be explained by the existence of at least two "internal clocks".


Mechanisms of correction in a "hit the target" task experiment.

The ability of men to change their behaviors depending on previous errors is studied. It is found that in a task involving pressing of a key simultaneously with the second of two consecutive light signals with a constant intersimulus interval (800 ms), the subjects altered their responses alteration depending on the preceding error. Using the same task but with variable intersignal interval (750, 800 and 850 ms) and provided the subjects did not understand that in fact three different intervals were presented to them, it was found that the same corrections were made as in the task with constant interval. The different subjects accepted the task differently and therefore their mean response times and the slope of the regression line are different.


Changes in the late positive wave of auditory evoked potentials in simple reaction--time tasks.

A comparison is made of the averaged evoked potentials (AEP) to auditory signals obtained in three different series: (a) a series consisting of high tones only to which no motor response was required; (b) a series consisting of low tones only in which quick motor response was required; (c) a series consisting of the same low tones and elimination of the requirement for quick motor response. It was found that the late positive wave P3 of AEP changed in the different series. In the series requiring no motor response P3 was poorly expressed, in the series requiring quick motor response P3 markedly increased and in the series in which the requirement for quick motor response was eliminated, it decreased again. The AEP configuration from the last series repeated that obtained from the indifferent signals. Moreover, on evoked potentials to signal trials and analysis was made of the dispersions in the P3 latencies under conditions requiring motor response. Their difference was found to be insignificant. The results obtained are explained by the assumption that the wave P3 reflects the activity of the central nervous system related to evaluation of the outcome and with the result of the prediction and the planned speed of the motor response.


About the human visually evoked cortical potentials in response to train stimulation.

Cortical potentials were elicited by means of light pulse trains delivered at varying number and frequencies of flashes. The stimulation trains evoked distinct series of individual responses up to flash interval of 35 ms, the shape of which was influenced by the number of the flasches in the trains. A gradual decrease of the second (and some later) wave in the response was observed beginning at flash interval of 80 ms and depending on the number of the flashes in the stimulation train. The fading away of the second wave at high-rate intermittent light stimulation is discussed in respect to some previous findings at retinal and cortical levels.


Participation of bivalent ions in the acetylcholine-provoked gastric smooth-muscle phasis contractions.

Experiments were carried out on muscle strips from cat antrum. Acetylcholine added to Ca++ -free medium containing EDTA (10-5M) exerted no effect on the phasic contractions of the gastric smooth muscle. Ba++at low concentrations (0,1 to 0,5mM) replaced Ca++with respect to the acetylcholine effect. On the background of blocked cholinergic (atropine 10-5M) and adrenergic (phentolamine 10-5 M and propranolol 10-5M) structures Ba++ provoked slow potentials and cotractions with a frequency of 9 to 10 cpm. delta600 (10-5M) blocked the Ba++-induced myogenic electrical and contractile activities of the smooth muscle. The role of the cholinergic structures for synchronizing the electrical and contractile activities of the smooth muscle is considered.


[Vital contact with reality].

From the standpoint of existential phenomenology, the contact with reality lies in the very phocus of theory, being closely related to another basic conception: that of being-in-the-world. In order to ratify those conceptions, the author reviews some concepts imported from Kurt Lewin's Field Theory, among which: a) vital psychological space, embedding the subject and in close interchange with him; b) intrapsychic regions, having, to a certain extent, autonomous functions, but being related to each other and integrated into the higher unity of the subject. As both systems are interdependent, any modification of the equilibrium of one of them reverberates into the other's, and changes the general conditions of both of them. Reviewing, at the same time, Minkowski's views on schizophrenia, the author sets forth the production of an inner world that becomes autonomous and possesses a degree of reality that overwhelms the true outer world. There is not only the splitting from reality, but the creation of a whole fantastic field, in which the individual participates with all his vital availability. Both views lead to a similar contention: that in some pathological states, the primal link man-real world, is replaced by a new inner correspondence, focused on the imaginary and having effects similar to those of the real world.


[The epistemological obstacle in the constitution of social sciences].

I. General conception. The author contends that the constitution of science requires the completion of two different tasks: a) a negative-critical one, i.e. the clearing of the theoretical field through expurgating all pre-scientific ideologies jeopardizing the growth of scientific concepts; and b) a positive-constructive one, or the actual building up of a science through the production of the formal-abstract object, using ontically indeterminate raw material. Those tasks have characteristics that differ from the formal and factic-natural sciences to the social sciences. The reasons for the differences are: a) the former two have established objects, whereas the latter ones have their objects in the process of undergoing constitution, and thus possessing and oscillating ambiguity; b) the former two sciences have specific methods related to their specific objects, whereas the latter ones have a host of methods, all of them advocating scientific status; c) the former two sciences integrate their concepts into systems so as to constitute the unity of their meaning, whereas the latter ones lack a systematic integration. The consequence is that sciences already constituted (formal and factic-natural sciences) have, by the same token, established the co-implication of both moments (negative-critical and positive-constructive), to the extent that they are in the midst of universes admitting some law-system. Social sciences, on the contrary, set a double register of problems: a) "in-themselves", as they suppose the opening of a new way to approach the object; and b) "for-themselves", as long as that opening is performed at the expense of pre-scientific ideologies that bar the developments to be done "in-themselves". Furthermore, the double task is not accomplished in the same fashion in logic-formal sciences and factic-natural ones, both groups having an apodictic adequation (absolute in the first group, relative in the second one) between the context of discovery and the context of justification, be it formal or experimental, whereas in social sciences there is no such adequation, as they are still searching and trying to establish the mutually foundating relationship between both contexts. II. The epistemological obstacle in Psychology. Psychology, belonging to the general class of social sciences, is subject to two kinds of epistemological obstacles: a) those stemming from "common sense", born and nourished in the naïve, day-to-day experience, and being used as a general canon for usual as well as entirely new situations; they reach the status of a pre-critical "knowing", based solely on beliefs, and advocating to provide the grounds for our opinion on singular and general subjects; and b) those stemming from the "speculative discourse", understood as a system of notions encircling themselves and pretending to have an analogical reference to real objects, when analogy only actualizes objects that are absent...


[The concept of health and disease].

1. The author reviews some current concepts concerning the definitions and uses of the concepts of health and illness. Starting from the definitions in Psychiatry, "normality" is considered from the statistic, the normative and the clinical standpoints, and as a part of a continuum stretching from health to illness. Several approaches are analyzed, among which Wittaker's, who sets forth the following indicators of normality: a) self-knowledge; b) self-esteem; c) self-security; d) capacity for giving and receiving affection; e) satisfaction of corporal needs; f) productivity and capacity for happiness; g) lack of tensions and of hipersensitivity. 2. The concept of illness as an operative concept is also analyzed, leading to the following statements: a) it is inexistent in non-biological sciences; b) it appears in social sciences only through extrapolation; c) in medicine it means the breacking of homeosthasis; d) in psychology and dynamic psychiatry it means the abnormal stressing of normal mechanisms, common to all persons. 3. The concept of health as equilibrium is also analyzed, with the following precisions: a) equilibrium is defined within a system as affecting the whole of it, and implying transformation and self-regulation; b) homeosthasis is a case of equilibrium for steady complex systems; c) adaptation is the maintenance of equilibrium when there are exchanges with the evironment. 4. Finally, those concepts are applied to mental illness and its limits, and the following criteria are set forth: a) amount of anguish; b) depression related to its motives, intensity, persistence and frequency; c) regression to previous development stages; d) use of defense mechanisms in an inadequate or stereotyped way.


[Teaching of mental health in Latin America].

The author contends that in order to meet Mental Health requirements in Latin American countries, an effort must be made in modifying the training of personnel, ranging from high ranking psychiatrists and specialists, to community leaders. He examines the current possibilities and needs and assesses the consequences of new training methods. Starting from a summary review of the three main models for Mental Health Programs: Mental Institution or Hospital, Mental Health Unit and Comprehensive Program, an evaluation is made of the many advantages of the latter. The training of personnel for the Comprehensive Program reflects its structure of delegations. The lower level, D5, is the whole population having any mental health risks. In order to prevent them, leaders at the D4 level must be trained, preferably among recovered patients, at the ratio one D4 for every 500 D5. Training and supervision of D4 leaders is made by D3 leaders, recruited among intermediate professionals: teachers, nurses, priests, auxiliaries in mental health, etc. The ratio is one D3 every 20 D4. The following level is that of D2 leaders, in which specialists (psychologists, social assistants, psychiatric nurses, etc.) act on a professional basis. The ratio is one D2 every 4 D3. Finally, the upper level is D1, the directors of the program, psychiatrists having the direction, supervision and training of D2 leaders. The ratio is one D1 every 2,5 D2. An evaluation is made of the experience carried out at Santiago (Chile) where it lasted eight years, and at Córdoba (Argentina) during eight months. The final evaluation stresses the advantages of the system, which at an extremely low cost/benefit ratio provides a comprehensive covering, profiting by the natural health resources of the community, otherwise neglected in their full potential benefits.


[Diagnosis of family relations. A clinical example].

Starting from the contention that family processes are much too complex to allow any direct approach, the author proposes the simultaneous use of four models. They are: I. A communication model. Adopting the theory of paradoxes in communication, it is possible to formulate in those terms any pathological issue of the OEdipus complex. II. An identification model. The outcome of the OEdipus complex implies the adoption os a system of identifications. It is possible to formulate any pathological structure in terms of disturbed identification pattern. III. A kinship model. The anthropological model of Lévi-Strauss allows an approach to the patterns of alliances and prohibitions; it is also possible to read into those patterns the pathological issues of the family group. IV. A semiotic model. The sessions can be considered as a corpus liable to analysis from the theory of discourse, and of the values in it. Disturbances in the discourse can be related to pathological situations. All four models are applied to a casestudy, aiming at testing their validity and articulations. Some final conclusions are drawn on the usefulness of the method, both for diagnostic and therapeutic purposes.


[Study and treatment of the drug addict and his family].

The addict was approached at a Hospital of a private community with the following working plans: a. Amission. a.1. Diagnostic individual interview. a.2. Familiar interview. b. Evaluation. c. Therapeutic criteria and recommendations. c.1. Individual psychological. c.2. Group psychological. c.3. Drug therapy (Psychiatric). Some general characteristics common to all patients are reviewed, among them: age (all patients are adolescents); vulnerability of personality and ego weakness; absent father; narcissistic mother; disgregation of the family and pathological communication among their members; unaccepted griefs; magic expectations on the activity of the drug. Some case-studies are summarized, and some conclusions are drawn, among which: a) the patient usually employs maniac mechanisms, leading to the omnipotent negation of the illness and the refusal of any treatment; b) the family grows very anxious because of the patient, and shows marked reluctance to accept its role in the patient's disorders; c) the therapist is under permanent pressure from the patient and the family; d) the therapeutic team obtains more results from the coordinated action than the single therapist; e) the institution must provide an adequate container for the anxieties of all people involved in a therapeutic procedure.


[Attitudes towards alcohol in 2 groups of children 13 years of age].

Two groups of children, thirteen years of age, were given a questionnaire to study their attitudes towards alcohol consumption and alcoholism. The children belonged to two different socio-economical levels: low and high, and were selected at random, in the zone "Oriente" of the National Health Service, Chile. The analysis of answers was made along three directions: a) affective component; b) cognitive component; c) reactive component. The results show that children of low socio-economical level are more negative and rejective towards alcohol consumption than the others, and show more conflicts about it. Both groups reproduce adult patterns and opinions of their respective level. A future development of this type of research can be the criteria for prognosis in relation to early attitudes towards alcohol.