[Cerebrovascular moyamoya disease associated with aneurysm at the peripheral portion of the posterior chorioidal artery (author's transl)].

Three adult cases of cerebrovascular Moyamoya disease associated with aneurysmal shadow at the peripheral portion of the posterior choriodial artery are reported. According to the follow-up study of carotid angiograms, this aneurysmal shadow is considered to be a pseudo-aneurysm, which indicates a bleeding point in the brain tissue. It has generally been thought that the mechanism of the occurrence of the symptom in adult patient with cerebrovascular Moyamoya disease is due to rupture of vessels in the subarachnoid space on the brain surface. But from our experience, it is suggested that there should be another mechanism, beginning with rupture of vessels in the brain tissue.


[Complications resulting from ventriculo-peritoneal shunt: an anticipatory comment-case report (author's transl)].

Case is 23 year-old man, Who was admitted to the University Hospital with a diagnosis of acoustic neurinoma as a manifestation of von Recklinghausen's disease. V-P shunt was performed because of the increased intracranial pressure and post-operative course was complicated by repeated bout of meningitis. Otherwise, postoperative course was uneventful till about 7 month after placement of V-P shunt when the proximal end of the shunt tube perforated into the lumen of the intestine and about 30 cm length of shunt tube emerged from anus. Subsequently the patient developed meningitis. Nowadays, the tendency was noted that ventriculo-peritoneal shunt is more frequently performed than ventriculoauricular shunt and so increased incidences of complications attributable to the position of the tip of the shunt tube in theperitoneal cavity is naturally anticipated. In this report, we discussed the mechanism of development of intestinal perforation, its prophylactic measures and the earty diagnosis. Number one factor which is attributed to the cause of intestinal perforation is a fact that any intra-peritoneal foreign body is potentially able to cause intestinal perforation. The second factor is the sharp tip of the peritoneal shunt tlbe which more easily cause intestinal perforation than otherwise. The third factor is the constant pressure at the same location of the intestinal wall over a long period of time which is applied by a peritoneal tip, which is considered to cause necrosis of the intestinal wall. The fourth factor is relatively poor general condition of the patient and secondary decrease in resistance of the intestinal wall against the foreign body. We therefore postulate for the prophylaxis and early diagnosis that we should often check the position of the tip of the shunt tube end should performed the radiological evaluation at the first sight of peritoneal irritation sign. The architecture and the location of the tip of the tube, the length and material of the tube seem to have intimate relation to the prophylaxis against intestinal perforation and these factors have to be evaluated in the future.


[A case with the combination of cerebral aneurysm and cerebral arteriovenous malformation originated from same artery in the same site (author's transl)].

Several cases associated with cerebral aneurysm and arteriovenous malformation have been reported in literature but such case of association with these two kinds of cerebral vascular lesion originated from the same artery in the same site is quite rare. The authors reported a case of coexistence of cerebral aneurysm and cerebral arteriovenous malformation in the parietal area and both of these vascular lesion were located closely and were fed by the angular artery. A 8 year-old girl was warded on March 28, 1974 with a history of attack of headache and vomitting before lapsing into semicoma on March 23, 1974. She regained consiousness 5 days later but showed speech disturbance. Subarachnoid hemorrahge was proved by her home doctor immediately after the episode. On examination, motor and sensory impairment was negative. Nominal aphasia and agonosia were noted. Four-vessel angiography proved cerebral aneurysm accompanying with arteriovenous malformation-like shadow in the left parietal area. A relative large drainage vein from the above mentioned vascular lesions drained into the superior sagittal sinus.


Sacral agenesis. Neurologic and neuropathologic features.

The neurologic deficits in sacral agenesis involve motor function much more than sensory function, in a lumbosacral distribution; autonomic involvement, with neurogenic bladder, is variable. Relative sensory sparing may be due to the derivation of sensory nerves from neural cre, t tissue, which is uninvolved. An occult sacral meningomyelocele with ectopic neural tissue was found at necropsy in one of our patients. Primary amyoplasia may account for small but histologically normal muscles derived from the same somites as the aplastic vertebrae.


Dialysis encephalopathy: a possible seizure disorder.

Dialysis encephalopathy is a progressive, fatal condition that occurs in patients receiving hemodialysis. It is characterized by abnormalities in speech, myoclonic jerks, and striking changes on the electroencephalogram. We observed dramatic reversal of the clinical symptoms and electroencephalographic abnormalities in four patients with this syndrome who were treated with diazepam. In this paper we propose that in dialysis encephalopathy, some of the symptoms and the electroencephalographic changes represent a form of seizure disorder.


Anosognosia for hemiplegia: somatosensory evoked potential studies.

Somatosensory evoked potential studies in nine patients with anosognosia for left hemiplegia and in one patient with anosognosia for right hemiplegia revealed an absence of response over either hemisphere on stimulation of the median nerve on the hemiplegic side. This apparent lack of cortical processing may underlie the impaired awareness of the hemiplegic side, manifested as anosognosia.


Neurophysiologic changes in hemiplegia. Possible explanation for the initial disparity between muscle tone and tendon reflexes.

In an attempt to clarify the neurophysiologic changes that may follow a cerebral lesion in man, we have studied patients with recent and with long-standing hemiplegia from cerebral infarction. In patients with recent cerebral lesions, inhibition of the monosynaptic reflex by vibration is enhanced. In patients with long-standing cerebral lesions, this inhibitory mechanism is less effective and a comparison of the electrically and mechanically induced monosynaptic reflexes suggests that fusimotor drive may be increased. Related clinical findings are reduced muscle "tone" immediately after the lesion and increased muscle "tone" and exaggerated tendon jerks in patients with long-standing hemiplegia.


On the movement of fluid through the brain of hydrocephalic cats.

The effects of changes in serum osmolality on the volume flow of fluid into the cerebral ventricles and on brain water content was examined in cats with kaolin-induced hydrocephalus. Slopes of the regression lines relating volume flow and serum osmolality for both normal and hydrocephalic cats are the same. The constant difference in flow rates between the two lines, 7 mul per minute, is probably due to impaired choroid plexuow rates between the two lines, 7 mul per minute, is probably due to impaired choroid plexus function of the hydrocephalic cats. The osmotic pressure gradient that causes the flow of fluid is therefore probably between blood and brain. Under these conditions changes in brain water content of hydrocephalic cats were smaller than in normals and can be related to the edema present in this disorder. Despite the inflammatory response to kaolin, the blood-brain barrier remains intact. From the calculated filtration coefficient, it can be inferred that the flow of water from serum through brain and into cerebrospinal fluid is limited by the resistance of fluid flow through the brain.


Efference copy in the control of movement.

On a two-choice tracking test of normal subjects, numerous false moves were induced when the directional relation between movement of the hand and the response marker was changed. The mean error-correction times were not consistently less than simple reaction times. When the center of the display was screened to eliminate visual feedback, numerous moves were reversed before the marker was visible. The probability of reversing an error was much greater than that of reversing a correct move. The findings are best explained in terms of a central mechanism that uses efference copy to amend errors of movement.


Brain serotonin concentration and crude synaptosomal uptake in mice with the Chediak-Higashi syndrome.

The Chediak-Higashi syndrome is characterized by a serotonin platelet defect and neuronal dysfunction. Whole blood serotonin concentration, serotonin brain concentration, and synaptosomal uptake of serotonin were determined in mice with the syndrome. While brain serotonin uptake in the affected mice was not significantly different from that in nonaffected mice, whole blood serotonin concentration was markedly reduced. These data suggest that in human neuropathies with platelet serotonin defect, a parallel neuronal serotonin disorder may not be assumed.


Femoral neuropathy during anticoagulant therapy.

Ten cases of acute femoral neuropathy complicating anticoagulant therapy were followed over periods of 1 to 5 years. Most patients had either sensory or motor residual symptoms, but the two patients who had early surgical intervention made rapid recoveries. The danger of parenteral injections or minor trauma to the abdomen, buttocks, or thighs in patients receiving anticoagulant therapy is emphasized.


Bilateral altitudinal anopia caused by infarction of the calcarine cortex.

The patient reported here had a bilateral inferior altitudinal hemianopia from lesions of the calcarine (striate) cortex of the occipital lobes. The only significant pathologic findings were bilateral calcarine artery occlusive disease, with infarcts of the striate cortex on both sides. The ages of the infarcts appeared compatible with the clinical development of the respective visual field defects. The rest of the visual system was anatomically intact.


Acute bacterial meningitis secondary to gamma hemolytic streptococcus. Case report and review of the literature.

Gamma hemolytic streptococcal meningitis in a 17-year-old boy resulted in a severe purulent reaction and death. Review of the literature shows only one other case of a gamma hemolytic streptococcus as the cause of bacterial meningitis in the absence of endocarditis.


Erythrocyte shape in Duchenne muscular dystrophy.

In a controlled and blind study we were not able to identify any abnormality of erythrocytes of eight patients with Duchenne muscular dystrophy compared with seven approximately age-matched unaffected siblings (six males, one female step-sibling). Erythrocyte morphology was found to be very sensitive to various types of cell treatment. At this time, erythrocyte morphology, evaluated by the techniques used, should not be considered an established diagnostic test for the Duchenne muscular dystrophy patient or carrier.


Comparison of radionuclide scans with computer-assisted tomography in diagnosis of intracranial disease.

Radionuclide brain scans were compared with computer-assisted tomography (CAT) for the diagnosis of intracranial disorders in 297 patients. The diagnosis was confirmed in 281 patients who formed the population for the study. The radionuclide scan was false positive for 12 patients (3.9 percent) and false negative for eight (2.6 percent). The CAT was false positive for three patients (1 percent) and false negative for one (0.3 percent). In the 133 patients in whom both tests were negative, no evidence of central nervous system pathology has been found during the 6 to 18 month follow-up. Brain tumors and intracerebral hemorrhage are more readily detectable with CAT.


[Endemic goiter in Nepal. Comparisons with endemic goiter in the Piedmont].

Comparison of certain features of endemic goitre in the Khumbu district of Nepal and Piedmont is reported. Cases in the younger generations were observed in both areas. In Khumbu, the incidence of goitre in schoolchildren was 75% and cases were even noted in children who had been receiving iodine prophylactic management (injections of iodised oil: 500-1000 mg/yr) for at least three years. The iodine content of drinking water and the most commonly eaten foods was determined. Values were very low and a daily intake of not more than 30 mug was calculated. The findings are in line with metabolic studies carried out by other workers in Upper Khumbu. While it is clear that ambiental iodine deficiency is much higher in Khumbu than in those areas of Piedmont where goitre is most markedly endemic, the inadequacy of preventive iodine administration measures, and environmental features common to both areas, suggest that iodine deficiency is a concomitant factor and not the prime cause of endemic goitre.


Quantitative assessment of perilymph sources.

The problem of the perilymph origin--influx of cerebrospinal fluid (CSF) versus ultrafiltration within the cochlea--cannot be solved by mere qualitative proofs of tracer passage through the cochlear aqueduct. In order to gain quantitative data on the possible perilymph sources, an experimental study was designed to follow the time course of dye concentrations in the cisternal CSF and in the perilymph after tracer injection into the CSF at the vertex. By comparing the resulting concentration peaks in both fluids, the mean peak of the perilymph tracer concentrations was found to reach 36% of the maximum CSF concentration only. It is concluded that the local perilymph production within the cochlea exceeds the influx of CSF by a ratio of about 2:1. A working hypothesis of the double perilymph origin is discussed.


Simplified acoustical measurement of tubal opening.

A device is discussed in which tubal opening as one of the functions of the Eustachian tube can be measured by expressing the opening phenomena acoustically. The features of the present device are the following: introduction of the test sound of 2,000 Hz, 85 dB, SPL, directly to the tubal opening through the tubal catheter and recording of fluctuations of the sound pressure obtained at the external auditory meatus during swallowing. The results of model experiment made of resin were 85 dB, SPL, at the speaker, 76 dB, SPL, at the end of tubal catheter and 78 dB, SPL, at the external auditory meatus. In the model experiment it was also demonstrated that the height of spike waves depends on the extent of tubal opening and that the continuity of spike waves depends on the duration of tubal opening. Furthermore, in the present method, there was no so-called basic amplitude, seemingly due to the resonant effects or the direct passing sound, and the opening phenomena were correctly expressed. In the measurement on normal adults it was found that variability of the spike wave pattern between subjects was largely depending on individual subjects, and also some intra-subject variability of successively recorded spike waves on the same subject was noted. It was shown that gradual recovery of spike wave patterns occurred from initial water swallowing to successive dry swalllowing.


Vertigo and rocking sensation. A clinical analysis.

A vertigo perceived as a spinning sensation outside the head indicates a somatic vestibular disturbance including a Ménièr's disease. A turning sensation inside the head indicates a functional or vascular disorder while a sensation of unsteadiness often as if being slowly rocked indicates a functional disorder.


Primary cancer of the larynx associated with primary lung cancer. Report of 21 cases, 14 with autopsy findings and 7 biopsies.

The present paper reports 21 cases (14 autopsies and 7 biopsies) of associated primary cancers of the larynx and the lung. This association is by no means uncommon, the laryngeal lesion being usually the first to appear. Mulitple primary cancers--of the same or of a different histologic type--tend to occur in the same organ or organ system, either simultaneously or after a time interval. In case of synchronous primary malignant tumour of the larynx and lung the most lethal cancer (the lung cancer) must be managed first. Cancer patients are more likely than other individuals to develop a second primary malignant tumour. Laryngectomized patients should be followed-up possibly by means of cytologic examinations of bronchial secretions and chest X-rays at short intervals for early detection of a possible second primary malignant pulmonary lesion.


Concentration of immunoglobulins in the tonsils.

The concentration of various immunoglobulins in the faucial tonsil was determined and expressed as a portion of the total protein centration of IgA rises with age while that of IgM falls. IgE was found to be relatively high and the highest levels of all immunoglobulins examined were noted in hypertrophied tonsils. They were lowest in the atrophic tonsils of children and in adult tonsils. The results are discussed in their relevance to the overall immunological function of the faucial tonsil.


Tension pneumothorax: a teaching model.

A TPT induced in a small rabbit is an excellent teaching model for the treatment of a TPT in the small human neonate. Pediatric housestaff, neonatal nurses, and others have utilized this model to gain confidence and expertise in the diagnosis and treatment of TPT. The rabbit model is inexpensive, readily available, and recreates the clinical condition of a TPT in an educational environment.


Leg muscle blood flow during reactive hyperemia. Effects of different body positions, and of subatmospheric pressure.

In normal man at rest transition from the supine to the upright body position is accompanied by autoregualtion of the blood flow to tissues in the dependent extremities. In 11 young healthy males the influence of postural changes and external pressure changes on the blood flow in the anterior tibial muscle during reactive hyperemia was studied. The muscle blood flow was evaluated by means of the Xenon-133 wash-out technique. Transmural pressure changes in the resistance vessels were estimated by measuring the systolic blood pressure at ankle level, using the strain-gauge plethysmograph technique. The mean leg muscle blood flow increased from 48 ml - 100 g-1 - min-1 in a body position with the legs elevated 65 cm above heart level, to 101 ml - 100 g-1 - min-1 in the supine position, and to 151 ml - 100 g-1 - min-1 in a sitting position with dependent legs 70 cm below heart level. The muscle blood flows increased from 92 ml - 100 g-1 - min-1 at ambient pressure to 139 ml - 100 g-1 - min-1 at a subatmospheric pressure of -50 mm Hg. The differences were highly significant (P less than 0.001). Systemic blood pressure measured at heart level did not change during postural changes and external pressure changes. The post-ischemic muscle blood flow was found to increase with the increasing vascular transmural pressure. It is concluded that during reactive hyperemia the normal compensatory vaso-reactions can be inactivated, so that the vessels react passively to changes in the transmural pressure.


Renal intracortical blood flow distribution, function and sodium excretion in response to saline loading of anesthetized and unanesthetized dogs.

In order to study the effect of anesthesia on the canine response to saline loading, experiments were performed on 10 dogs, first while awake and then during pentobarbital anesthesia. Individual kidney function and intrarenal blood flow response to saline loading (7.5% body weight) were measured in each condition and all data are reported as the average of a single kidney. CIN is considerably reduced under anesthesia (24.7 +/- 3.2 vs. 43.2 +/- 3.9 ml/min, P less than 0.01). A directionally similar reduction of PAH clearance was noted (89 +/- 17 vs. 122 +/- 13 ml/min). The natriuretic response to saline loading of the dogs reached 290 +/- 61 muEq/min while awake, but only 70 +/- 27 muEq/min while anesthetized. No measurable increase of CIN or CPAH occurred in response to saline loading either in the anesthetized or unanesthetized state. The natriuresis was entirely due to a rise of CNA/GFR in both circumstances. The change of CNA/GFR in response to saline load was also appreciably larger while awake (1.2 leads to 4.7% vs. 0.7 leads to 1.8%). Although the fraction of blood flow to the outermost quarter of the kidney was initially the same (31 +/- 3 vs. 29 +/- 3%) awake or anesthetized, the changes with saline loading were in the opposite direction and the values reached were significantly different (37 +/- 3, awake, vs. 27 +/- 3%, P less than 0.05). We conclude that while increased outer cortical blood flow is not necessary for natriuresis, it may occur during sodium loading and may facilitate sodium excretion.


Role of conditioned reinforcers in the initiation, maintenance and extinction of drug-seeking behavior.

The development of a secondary reinforcer as a result of associating a neutral stimulus (buzzer) with intravenous (IV) doses of morpine was studied in rats. Secondary reinforcement developed in the absence of physical dependence and followed the association of the stimulus with either response-contingent or non-contingent injections of morphine. Strength of the conditioned reinforcer, measured in terms of responding on a lever for the stimulus plus infusion of saline solution, was proportional to the unit dosage of morphine employed in pairings of buzzer and drug. When extinction of the lever-press response for IV morphine was conducted (by substituting saline for morphine solution) in the absence of the conditioned reinforcing stimulus, it was seen later that the stimulus could still elicit lever responses, until it too had been present for a sufficient interval of non-reinforced responding. Similarly, extinction of the response for morphine by blocking its action with naloxone in the absence of the stimulus did not eliminate the conditioned reinforcement. Another study showed that a passive, subcutaneous (SC) dose of morphine served to maintain lever-pressing on a contingency of buzzer plus saline infusion. Furthermore, the stimuli resulting from the presence of morphine (after a SC injection) were able to reinstate the lever-responding with only the buzzer-saline contingency when such responses had previously been extinguished. Moreover, it was shown that d-amphetamine could restore responding under the same conditions, and that morphine could also do so for rats in which the primary reinforcer had been d-amphetamine. It is suggested that animal data such as these show that procedures designed for the elimination of human drug-taking behavior must take into account secondary reinforcers as well as the primary reinforcer(s).


Passive stress relaxation followed by active contracture in vertebrate smooth muscles (taenia coli of the guinea pig).

1. The time course of stress relaxation following stretch was investigated in the taenia coli of the guinea pig in the relaxed (Ca2+ free bath solution with D 600) and in the contracted state (depolarization by KCl or K2SO4 in excess). The mechanical tension was standardized with respect to the volume of the samples. 2. The tension obtained by a constant stretch of 2.5 mm of the 5-15 mm samples was highest after K2SO4-depolarization (K+ = 180 mval/l) and lowest in the relaxed muscles. Muscles contracted by KCl in escess (K+ = 60 mval/l) showed intermediate values. 3. The decrease of tension by stress relaxation to a nearly constant residual value is rapidly observed in contracted muscles during about 10 s. For the relaxed muscles the same changes are slower and take place in nearly 1/2 h. 4. The relations between the extent of stress relaxation (R) and its derivative in time (dR/dt) can be expressed by a hyperbolic function. Analogous behaviour was already noted in previous studies primarily on creep. 5. The different behaviour of the muscle in the different bath solutions used is discussed with respect to the mathematical relations just mentioned. 6. Long term active reactions of depolarized muscles following stretch and stress relaxation are noted.


Effects of acute cold exposure on the distribution of cardiac output in the sheep.

Conscious adult Merino sheep were studied in a thermoneutral environment and then during cold exposure. Microspheres labelled with 141Ce, 51Cr, 85Sr, and 46Sc were used to measure blood flow (Q) in most tissues of the body. (Microspheres labelled with 125I were found to be unsatisfactory.) Cold exposure which caused a marked decrease in skin surface temperature and mild, continuous shivering but no change in deep body temperature, was associated with mean increases in oxygen consumption, heart rate, and cardiac output (C.O.) of 100%, 62%, and 48%, respectively; blood pressure and total peripheral resistance were unchanged. There was approximately a 6-fold increase in Q in perirenal white adipose tissue, and a 3- to 4-fold increase in muscles of the upper foreleg and hindleg, and the intercostals; myocardial Q also increased significantly. There was a marked decrease in Q in skin of the legs and ears, in the maxillo turbinals and in the nasal mucosa, and a decrease in the total proportion of C.O. passing through arteriovenous anastomoses. Thus, not only did C.O. increase, but there was a redistribution appropriate to meet the challenge with which the animal was confronted.


Alleviation of narcotic withdrawal syndrome by conditional stimuli.

We systematically paired auditory, olfactory, and social stimuli with each injection of morphine in rats. We found that, when morphine was kept constant at a low dose, the external stimuli acquired the property of a conditional stimulus (CS) to cause hyperthermia which was antagonized by naloxone. In rats in which morphine doses were regularly increased to cause morphine dependence, the CS presented during withdrawal, caused reduction in withdrawal signs (wet shakes, hypothermia, aggression) and produced hyperglycemia as well as elevation of striatal homovanillic acid. CS-induced alleviation of withdrawal hypothermia was blocked by mecamylamine, phenoxybenzamine, haloperidol, benztropine or naloxone but not by cyproheptadine or propranolol.


Mechanism of inhibition of gastric acid secretion by hypertonic solutions and vasopressin.

An experiment was performed in female rats in order to assess the influence and mechanism underlying the effects of hyperglycemia, hypertonic saline and vasopressin upon the gastric acid secretion and mucosal blood flow (MBF). Infusion of isotonic saline did not alter acid output and gastric clearance of plasma aminopyrine whereas hypertonic solutions (20% glucose or 3% NaCl) significantly increased plasma osmolality and decreased the acid secretion within 30 min and recovered to normal levels after 2 h. Vasopressin also effectively inhibited acid secretion. Both hypertonic solutions and vasopressin decreased the mucosal blood flow. However, the ratio (R) of MBF to gastric secretory rate which is a helpful guide to the mechanism of secretory inhibition did not significantly change in either case. We concluded that all three agents probably had a direct action on secretion rather than decreasing MBF. The mechanism of inhabition of acid secretion and its relationship to MBF was suggested and discussed.


Acclimatization of rats to moderate heat: body water distribution and adaptability of the submaxillary salivary gland.

Changes in plasma and extracellular fluid volumes were studied in rats during exposure to 35 degree C for 28 days. In addition the adaptability of the submaxillary salivary gland to these conditions was studied by measuring its weight, plasma and extracellular volumes during the acclimatization period. Major changes in parameters studied occurred during the first 10 days of acclimatization. Total plasma volume on day 10 was less than in controls (P = 0.02), but from then on returned to normal values. Extracellular fluid volume was expanded for most of the period. An enlargement of the submaxillary salivary gland was present during the whole period, but maximal enlargement was observed on day 10 (42%). On day 28 the gland was 14% larger. No changes in plasma and extracellular volumes of the gland were observed. It appears that due to redistribution of the blood pool at the beginning of heat exposure, plasma and extracellular volumes remain constant.


The influence of cardioactive steroids, metabolic inhibitors, temperature and sodium on membrane conductance and potential of crayfish giant axons.

1. The resting membrane potential and the current-voltage relation were measured in crayfish giant axons before and after treatment with cardioactive steroids, metabolic inhibitors, extracellular sodium depletion and low temperature. 2. The membrane resistance of axons treated with cardioactive steroids, metabolic inhibitors, and low extracellular sodium was reduced by 30-53% depending on the treatment. Low temperature also caused a decrease in the membrane resistance of the axon but the decrease was limited to potentials around the resting membrane potential. The temperature response of sodium depleted or ouabain treated axons was an increase in resistance at all points along the current-voltage relation. 3. All inhibitors and low temperature caused a depolarization of the membrane potential. Ouabain and strophanthidin were the most effective, reducing the membrane potential by an average of 9.6 mV in 10-20 min. Low sodium did not cause a depolarization but consistently reduced the membrane resistance by an average of 30%. 4. The data suggest that there is an interaction between the activity of the ouabain-sensitive transport system and resting membrane resistance in the crayfish axon.


The influence of chloride on the ouabain-sensitive membrane potential and conductance of crayfish giant axons.

1. Resting potential and current-voltage relation were measured in crayfish giant axons bathed in chloride-free and sodium-free solutions with and without ouabain. 2. Chloride-free solution caused a transient depolarization but did not alter the steady-state membrane potential. Utilizing isethionate as an anion substitute, the membrane resistance increased 12.5%. 3. In the absence of extracellular chloride, ouabain (0.5-1 mM) depolarized the axon 6-7 mV. The shape of the current-voltage relation did not change but the curve was shifted along the current axis. 4. These results indicate that ouabain inhibits a steady-state hyperpolarizing electrogenic pump current of approximately 3 muA/cm2. 5. Extracellular sodium removal from axons equilibrated in chloride-free solutions transiently hyperpolarized the membrane 6-7 mV without a change in membrane resistance. The transient hyperpolarization was ouabain and temperature sensitive. The steady-state potential reached in sodium-free and chloride-free solution was not ouabain sensitive. Temperature sensitivity of the steady-state membrane potential was greatly reduced. 6. The transient hyperpolarization produced by extracellular sodium removal was metabolically driven and may present the expression of a sodium efflux transport current of 7.0-7.5 muA/cm2. 7. Using electrophysiologically measured parameters, sodium and potassium conductance, influx and efflux currents and the coupling ratio for sodium/potassium transport are calculated from a modification of the conductance equation. 8. The sodium/potassium transport coupling ratio for steady-state conditions was estimated at 5:3 (1.67:1).


Use of endogenous triglycerides to support gluconeogenesis in the perfused isolated rat liver.

The carbon balances in isolated perfused rat liver during gluconeogenesis from L-alanine and sodium L-lactate indicate that assuming the substrate unaccounted for were fully oxidized the energy yielded was not sufficient to support the observed rates of glucose synthesis. This observation indicates that endogenous substrates must also be oxidized. The possibility that endogenous fatty acid oxidation was the source of the energy needed to support glucose synthesis was investigated by measuring the rate of 14CO2 formation from tracer quantities of added [U-14C] palmitate. Short pulses of L-alanine or sodium L-lactate infusion produced an increased rate of 14CO2 production paralleled by increases in oxygen uptake indicating that more endogenous fuel is being mobilized. That the rate of 14CO2 output is an expression of fatty acid mobilization was supported by experiments demonstrating that the addition of octanoate to dilute the fatty acid pool produced an immediate fall in the rate of 14CO2 output. On the other hand, the administration of glucose produced no changes in oxygen uptake or 14CO2 output. However, lactate even in the presence of glucose induced a rise in 14CO2 production which occurred in parallel with the enhancement in oxygen uptake. It is concluded that mobilization of hepatic endogenous fatty acid is a metabolic event intimately associated with enhancement of gluconeogenesis. Consequently the control of the different steps of this process may indirectly control gluconeogenesis.


The effect of capsaïcin on temperature regulation of the rat.

1. Subcutaneous injection of capsaïcin (6-11 mg, or 21-66 mg cumulative), permanently reduced the capacity of rats to withstand a hot environment, as described by Jancsó-Gábor et al. (1970). 2. The treated rats thermoregulatory behaviour was not different from that of control rats, both in hot and cold environments. 3. Saliva secretion was decreased in a hot environment, and the weight of the submaxillary glands was reduced in capsaïcinized rats. 4. It is concluded that hyperthermia present in treated rats when subjected to a warm environment is not due to a disruption of sensu stricto temperature regulation, but rather to a decreased salivary secretion. Whether this decrease has a central or a peripheral origin is not known.


The effect of heart rate on the membrane responsiveness of rabbit atrial muscle.

The maximum rate of rise of action potentials in myocardial fibers of the rabbit atrium decreases with an increase in heart rate. This decrease of the dV/dt max is accompanied by a decrease of the diastolic transmembrane potential prior to the moment of activation (take-off potential). Comparison of the membrane responsiveness curve (relation between dV/dt max and take-off potential) as measured by varying the extracellular potassium concentration at a fixed rate of stimulation, with the effect of changes in the frequency of stimulation on dV/dt max and take-off potential made clear that the fall in dV/dt max after a sudden increase in heart rate was stronger than could be explained by the concomitant decrease of the take-off potential alone. This implicates that the membrane responsiveness itself is heart rate dependent. A possible explanation for this observation is that when heart rate is increased the active Na/K pump is not able to maintain the intracellular concentration of Na and K at the original level. Acceleration of the heart will lead to an intracellular loss of potassium and a gain of sodium. The first causes a diminishment of the diastolic membrane potential which according to the membrane responsiveness curve is attended with a decrease of the dV/dt max. The second results in a decrease of the sodium concentration gradient and therefore in a further reduction of the dV/dt max. This hypothesis was confirmed by experiments with ouabain added to the perfusion fluid. Ouabain, which is known to inhibit the Na/K pump, caused a decrease of both the take-off potential and dV/dt max that was completely comparable with the effects of an increase of the frequency of stimulation. In addition, observation of the time course of the changes in dV/dt max and membrane "resting" potential after a sudden change in the rate of stimulation, gave support to the electrogenic concept of the active Na/K pump in cardiac muscle.


Oxygen transport capacity of the capillary blood within the carotid body.

Local deltaPo2 deltat in the carotid body after perfusion stop depends on the oxygen consumption of the tissue and the apparent O2 solubility coefficient alpha of the blood. Oxygen consumption of the carotid body tissue can be determined by measuring the local deltaPo2 deltat with Po2 needle electrodes after Krebs-Henseleit perfusion. Assuming the same deltaPo2 deltat for the blood-perfused carotid body the actual Po2 decrease can be used to estimate the hemoglobin content of the tissue. The influence of hemoglobin is described by the factor alpha/alpha. Control values measured in the Krebs-Henseleit-perfused carotid body yielded values of alpha/alpha = 0.8-3. In a series of 11 blood-perfused carotid body preparations with 105 perfusion stops the quotient alpha/alpha changed with arterial Po2. At Po2 values higher than 100 Torr alpha/alpha was between 0.8 and 2. This value thus was in the same range as the control values. Below 100 Torr higher values up to 11 were observed. Since a blood-perfused tissue (15 g% Hb) would have an alpha/alpha of about 128, we conclude that the carotid body is mainly perfused by plasma, and that with decreasing arterial Po2 more red cells flowed through the carotid body.


Lactate oxidation by skeletal muscle during sustained contraction in vivo.

Estimation of lactate oxidation in vivo was carried out by a tracer technique in the muscles of the lower hindleg of the dog during tetani of different duration. The fractional (%) rate of lactate oxidation increased markedly, compared with that of the resting muscle, after the first 2 min of stimulation. Lactate oxidation afforded a large contribution to the total oxygen consumption. Fatigue appeared to play a role in limiting lactate oxidation in the later phase of sustained contraction.


A time- and voltage-dependent potassium current in the rabbit sinoatrial node cell.

Voltage clamp experiments were conducted in the rabbit sinoatrial node (S-A node) using the double microelectrode technique. When the membrane was repolarized to the resting potential after depolarizing test pulses, the outward current slowly decayed to the steady level (outward current tail). The magnitude of the outward current tail was a sigmoid function of the amplitude of the preceding depolarization. The degree of activation of this current varied from 0 at about -50 mV to 1 at about +20 mV. The time course of the current change was a simple exponential and was independent of the preceding depolarization. The reciprocal time constant appeared to be a U-shaped function of the membrane potential with a minimum value of about 3s-1 at -40 mV. The instantaneous current voltage relation was an inward-going rectifier, but showed no detectable negative slope. The reversal potential, obtained between 10 and 50 mM [K]o, decreased with a slope of 58 mV for a 10-fold increase in [K]o. These findings indicate that the outward current tail in the S-A node cell is attributable to a single component of K current (pacemaker current component). The pacemaker current component is mainly responsible for the slow diastolic depolarization.


Evolution in vivo of the synthesis rate of catecholamines in various peripheral organs of the rat during cold exposure.

The synthesis of catecholamines (CA) has been studied in the heart, spleen, submaxillary glands and adrenals of rats exposed to 4 degrees C for 2.5, 24 or 48 h. The synthesis rate has been estimated 30 min after an i.v. injection of 3H tyrosine (TY) by the evaluation of the ratio: 3H-CA specific activity/3H-TY specific activity. In the sub-maxillary glands, cold exposure reduced the noradrenaline (NA) synthesis by 40% at times 24 and 48 h. In the spleen, NA synthesis was multiplied by a factor 1.6 at times 2.5 and 24 h and 2.8 at time 48 h. In the heart, it was increased by a factor 1.3 after 2.5 h, 2.8 after 24 h and 5.5 after 48 h: an important fall in cardiac NA level was observed during the first 24 h of cold exposure indicating that the synthesis capability was unsufficient to compensate the cold-induced NA release. In the adrenals, adrenaline + NA synthesis was not significantly enhanced during the first 24 h of cold exposure and increased by a factor 2.4 at time 48 h. The important increases in CA synthesis which are observed during the 24-48 h interval are likely consecutive to the induction of tyrosine hydroxylase which has been reported in the rat exposed to cold.


Simple and stable techniques for recording slow-wave sleep.

1. A combination technique of a telemetric system and a Walter-type analyzer have been used in the rat to allow on-line display of the sleep-waking cycle of a freely-moving animal on three consecutive days. 2. The characteristics of slow-wave sleep can be analyzed completely by this technique. 3. Telemetric recording of the integrated slow wave is a good method that allows faster and accurate scoring of slow waves to measure the length of sleep in freely-moving animals.


Referencing procedure for location of lumbosacral alpha-motoneurons.

This report presents a simple referencing procedure to facilitate microelectrode positioning within a desired motor nucleus in the cat spinal cord. The procedure is used in conjunction with the conventional technique of interpreting microelectrode position in the ventral gray column on the basis of the relative amplitude of antidromically or orthodromically evoked field potentials from select motor nuclei. The procedure optimizes the use of a single surface anatomical landmark such that the nuclei can be quantitatively referenced both horizontally and sagitally.


Single nephron glomerular filtration rate ratios of superficial, intercortical and juxtamedullary nephrons in rats during development.

In 20, 40 and 60-day-old rats the filtration rate was studied using Baines modification of Hanssen's Na4Fe (14CN)6 method enabeling the determination of single nephron glomerular filtration rate (SNGFR) ratio between superficial (S), intercortical (I) and juxtamedullary (J) nephrons. The proximal tubule lengths were determined as well. A close correlation was obtained between age and S/I, I/J and S/J of proximal tubule lengths and between age and I/J, S/J 14C-activities of ferro-cyanide. Presented findings confirm the data on the increasing role of superficial nephrons in the course of postnatal development of rat.


Observations on blood flow related electrical impedance changes in rigid tubes.

Mammalian blood in pulsatile flow through a rigid tube has been shown to be anisotropic with regard to its electrical conductivity. When flow increases there is a rise in conductivity in the longitudinal and a fall in the radial direction. These changes are caused by flow-dependent variations in the orientation of the disk-shaped erythrocytes.


[The cell count in milk of goats].

Weekly milk samples were taken from mammary halves from 30 goats from 8 different herds each with from 2 to 5 experimental animals throughout their lactation periods. The physiological variations in the cell counts of goats milk during lactation were investigated by a projection microscope. Only small variations were found in the average cell counts in milk samples from goats in the same herd, but big variations from one herd to another (Table I and Fig. 3.). The curves of the average cell counts in milk samples of 5 herds showed a rise at the beginning of the season at pasture (Fig. 1 and Fig. 2). Also in the housed periods the cell count showed transitory rises. The herd with the lowest average cell count (220,000/ml) was milked by an ordinary bucket milking system, while the herd with the highest average cell count (1,490,000/ml) was milked by a pipeline milking system. Five herds milked by machine had an average cell count of 720,000/ml and three herds milked by hand 540,000/ml. All the herds in the material had an average cell count of 680,000/ml.


Diagnosis and differential diagnosis of colonic diverticulitis.

A patient over 40 years of age who complains of lower abdominal pain, constipation or diarrhea or both, and increased flatulence should be suspected of having diverticulosis. When pain becomes more severe and persistent, diverticulitis must be considered. Diagnosis depends on roentgen demonstration of the presence of diverticula. Sigmoidoscopy and barium enema study are essential to exclude coexisting disease but in diverticulitis may need to be postponed until severe local and systemic signs of inflammation have subsided. A number of diseases can simulate diverticulitis, and differential diagnosis may present considerable difficulty. Irritable colon syndrome and acute appendicitis may be indistinguishable clinically from diverticulitis. Differentiation from carcinoma is usually not difficult, but exclusion of coexistent carcinoma may be impossible except by resection. Ulcerative colitis is also easily distinguished except when, rarely, it coexists. Crohn's disease of the colon is less easily differentiated, especially in patients over 40, in whom the two diseases often coexist. Other colonic diseases, such as ischemic colitis, and pelvic inflammatory diseases usually show characteristic features which make them readily distinguishable from diverticulitis.


Toleracne to equine IgG after immunosuppression in patients with multiple sclerosis.

Fourteen patients with multiple sclerosis were given two tolerizing doses of equinine gammaglobulin followed by equine antilymphocyte globulin. Twelve were sufficiently tolerant to have no clinical symptoms of hypersensitivity, no skin reactivity and normal plasma clearance rates. Some tolerance was lost in the following months revealed by immediate wheal and flare skin reactions. No correlation between success in tolerance induction and beneficial effects on the disease process could be established in the short term follow-up period of this pilot study.


The in vitro assessment of anti-human lymphocyte globulin.

A simple reproducible in vitro test of anti-human lymphocyte globulin activity is discribed. The method is a "microtitre" complement-fixation test using human platelets as a source of antigen, guinea-pig complement and an amboceptor of sheep red blood cells sensitized by rabbit anti-sheep haemolysin.


Conditions affecting plasma amino acid patterns in chickens fed practical and purified diets.

Experiments were conducted to investigate plasma free amino acid concentrations in the chick. After one hour of fasting, total plasma amino acid concentration decreased to approximately half of the full-fed value. Within three to six hours, most amino acids had returned toward the full-fed level but did not exceed it throughout a 48 hour period of starvation. However, after 48 hours fasting lysine, threonine, and isoleucine accumulated three-fold, two-fold and two-fold of the full-fed level, respectively. Serine and glutamic acid exceeded the full-fed level at three hours and then declined. Alanine reached its highest level after six hours of fasting and then declined. In full-fed chicks diurnal variations of plasma free amino acid concentrations were observed. The lowest and highest concentrations were observed at 11 a.m. and 8 to 11 p.m., respectively under a 24 hr-lighting. Reference plasma amino acid patterns are reported for chicks fed a practical diet ad libitum. In day-old chicks, concentrations of total amino acids, methionine plus one half cystine, lysine, and arginine were high. Alanine and glutamic acid concentrations were low. Most amino acid concentrations declined gradually during the first four weeks of life, but methionine plus one half cystine, phenylalaine, threonine and serine concentrations decreased sharply between two and four weeks. Lysine concentration continued to decrease in chicks fed the starter diet. At 20 weeks, plasma amino acid concentrations had decreased considerably except for methionine plus one half cystine and basic amino acids. The plasma amino acid pattern for chicks fed an isolated soybean protein diet was similar to that of chicks fed the practical diet.


Ovarian 125I transference in the laying Japanese quail: apparent stimulation by FSH and lack of stimulation by TSH.

Six-hour accumulations of 125I were measured in the growing oocytes and thyroids of laying Japanese quail injected with 0.002 to 2 mg. of FSH or 0.004 to 4 I.U. of TSH per day for six days. FSH at 0.2 and 2 mg./day increased the 125I content of the growing oocytes to 1.4 times the control values. The numbers and the total weights of these growing oocytes doubled. The egg-laying rate remained unchanged. The FSH-induced apparent stimulation of 125 I transference was seen as a consequence of the increase in oocyte material rather than to a direct effect of FSH on the membranes of the avarian follicular cells. TSH did not increase the transference of 125I.


Effect of biotin and niacin on lipid content of livers in the laying hen.

Single Comb White Leghorn layers maintained in cages were fed a corn-soy diet with a simplified vitamin premix for a 12-week experimental period to determine the effect on liver lipid accumulation. Lipid content was only 29.6% of the liver dry matter and, therefore, was in the normal range and less than that seen in hens with fatty liver syndrome. Adding niacin (44 mg./kg.) or biotin (110 mug./kg.) either alone or in combination failed to significantly alter liver weight or liver lipid content. Liver lipid content of hens fed another diet with a more complex vitamin premix also was not significantly different from that of hens fed the diet with the simplified vitamin premix. None of the diets significantly affected egg production, egg weight, feed consumption or body weight changes observed over the 12-week period.


Diurnal cycles of gastric motlity in normal and fasted turkeys.

Strain gage transducers were chronically implanted on the muscular stomachs of 12 young turkeys to study diurnal patterns of gastric motility. Continuous recordings were made for several days before and after a period of two or three days of fasting. Pronounced diurnal cycles in gastric motility were observed in which the frequency and amplitude of gastric contractions were increased during the daylight and depressed during darkness. Fasting caused a reduction in both frequency and amplitude and, during fasting, the diurnal cycles were somewhat obscured. Motility improved upon refeeding and cycles were agina apparent. The diurnal cycles appeared to be at least partially regulated by an intrinsic biological rhythm.


Twin pigeon embryos.

Twin pigeon embryos were found on incubation day 18 in a pipped egg. The egg was pipped at the small end. The embryos were dead. Removal of a portion of the shell allowed removal of one embryo and revealed the second one. Both appeared normal in development and size.


[Differential changes in serum levels of N-acetylneuramic acid and L-fucose as manifestations of physiological and physiopathological adaptation in man. Pregnancy as an experimental model. The tumoral, vascular and hepatic diseases as possible pathological models].

In this paper we report on the modifications that normal pregnancy introduces on the blood maternal serum concentrations of both N-acetyl maternal serum concentrations of both N-acetyl-neuraminic acid which is elevated above normal level and L-fucose which on the contrary is diminished. The experiences were performed with women in the last trimester of normal gestations. The probable physiochemical meaning and biological significance of those such changes are discussed in connection both to the maternal physiological adaptation during pregnancy and to the possible metabolical changes in intracellular regulation that might take place in such a situation. Similarly it is emphasized the probability that numerous pathological conditions including malignancy vascular diseases and hepatic disorders which course with overt changes in plasma glucoproteins might be amenable to present notorious modifications in N-acetylneuraminic acid and L-fucose plasmatic levels.


[Immobolization of beta-galactosidase on silochrome].

Beta-Galactosidase (beta-D-galactoside galactohydrolase 3.2.1.23) from Curvularia inaequalis was immobilized by glutaric dialdehyde on gamma-aminopropyl triethoxysilane treated porous siliceous carrier silochrome. From the crude preparation with a specific activity of 3.1 U/mg immobilized beta-galactosidase with an activity of 113 U/g was obtained. The immobilized enzyme did not show significant changes in its enzymic properties. The column filled with the resultant preparation and used to hydrolyze lactose in milk whey maintained 50% of its initial activity after a 30-day work at 50 degrees C.


Papaverine, drug-induced stereotypy and catalepsy and biogenic amines in the brain of the rat.

The effects of papaverine on haloperidol-induced catalepsy and apomorphine-induced stereotypy as well as brain monoamines concentrations in rats were studied. Papaverine increased cataleptogenic effect of haloperidol whilst reduced stereotypy induced by apomorphine. Slight but significant decrease in brain dopamine concentration was observed in rats treated with papaverine. The present study indicates that papaverine has influences upon dopaminergic mechanisms in the brain.


Spontaneous and amphetamine induced head-shaking in infant rats.

A variable proportion of albino rats 6-11 days old exhibit spontaneous and infrequent rotatory head-shaking episodes. This motor pattern is slightly anticipated and significantly increased in occurrence and duration by the administration of D-amphetamine (5 mg/Kg), with a maximal effect of the drug on the 9th day. The rate of amphetamine induced rhythmic head oscillations increases with age from below 5 cps on the 5th day to about 9 cps on the 10th day. The results are discussed in relation to maturation of both the underlying catecholaminergic pathways, activated by D-amphetamine, and the stretch reflex systems of the head and neck muscles participating in the rhythmic activity. Emphasis is placed on the difference between head-shaking and stereotyped activity.


Relative role of catecholamines in head-shaking of infant rats.

The relative contribution of catecholaminergic mechanisms in head-shaking (H-S) of infant rats was explored by comparing the H-S inducing effects of apomorphine and amphetamine in rats from 4-14 days old, and the blocking effect of neuroleptic drugs (chlorpromazine and haloperidol) and more specific alpha- and beta-adrenergic receptor antagonists (phenoxybenzamine and propranolol), on amphetamine induced head-shaking. As apomorphine, but not amphetamine, may induce H-S in four-day-old rats, and the latter drug potentiates apomorphine induced H-S, even in days in which, if injected alone it has no effect, it is suggested that both dopaminergic and noradrenergic mechanisms are involved in H-S, thus differentiating this motor item from other motor patterns included in stereotyped behaviour. This suggestion is further supported by the demonstration that while D-amphetamine induced H-S is blocked by phenoxybenzamine, other stereotyped motor patterns continue unimpaired.


Cortical administration of somatostatin (SRIF): effect on sleep and motor behavior.

Cortical administration of SRIF in unrestrained, freely moving rats produced an early activation, stereotyped behavior patterns and later, coordination difficulties often associated with drowsiness. A few animals showed a tendency toward paraplegia-in-extension. A considerable, prolonged alteration in the sleep-waking cycle was also observed. Similar results were obtained in both intact and hypophysectomized animals. Intraperitoneal administration of SRIF induced several other effects in addition to those seen after cortical application. The latter were however, restricted in variety, intensity and duration.


Abolition of nomifensine-induced stereotypy after 6-hydroxydopamine lesions of ascending dopaminergic projections.

The effects of bilateral focal injections of 6-hydroxydopamine into the zona compacta of the substantia nigra (SNC) on nomifensine-induced stereotypy were examined in the rat. These lesions reduced neostriatal dopamine levels to less than 1 percent of control levels. They also abolished nomifensine-induced stereotyped behavior. It is suggested that nomifensine-induced stereotypy is mediated via a presynaptic action on dopamine uptake and release.


On the anticataleptic action of cyproheptadine.

The anticataleptic action of cyproheptadine, a tricyclic compound known as antiserotonin, anticholinergic and antihistaminic drug in comparison to that of atropine, promethazine, imipramine, desipramine, chlorimipramine and nomifensine was studied in rats. The catalepsy induced by spiperon, pimozide or fluphenazine was antagonized by cyproheptadine, atropine and promethazine. Imipramine and nomifensine were less active, desipramine and chlorimipramine without effect. The reserpine- and alpha-methyltyrosine-catalepsy was counteracted by cyproheptadine, promethazine and nomifensine, but not by atropine or tricyclic antidepressants. Only cyproheptadine and promethazine antagonized the catalepsy caused by a combined treatment with reserpine and alpha-methyltyrosine. The pilocarpine-catalepsy was abolished by atropine, promethazine and nomifensine and unaffected by tricyclic antidepressants. Atropine and promethazine antagonized also the physostigmine-catalepsy. The catalepsy induced by both cholinomimetic drugs was not changed or increased by cyproheptadine. The results presented indicate that cyproheptadine differs in its anticataleptic activity from all the drugs used for comparison. Possible mechansims of this activity are discussed.


Response suppression on a mixed schedule of reinforcement during alcohol withdrawal.

Two groups of rats were maintained on a mixed fixed-ratio, fixed-interval schedule of food reinforcement until performance was stable. The animals were intubated daily with ascending doses of alcohol or water 30 min before each session, starting with 4.0 g/kg and increasing to the final dose of 8.0 g/kg. The results show that withdrawal from alcohol suppresses responding in all components of a mixed schedule and this suppression lasts approximately 14 hours. These results support previous reports which suggest that the duration of the behavioral aberrations produced by alcohol withdrawal are most severe 6 to 14 hours post-withdrawal.


Effects of nicotinic and muscarinic compounds on biting attack in the cat.

Predatory-like biting attack on a rat, as well as hissing, growling, and other threat behaviors, could be induced in normally non-aggressive cats by systemic administration of the muscarinic agonist, arecoline (7-12 mg/kg). In contrast to arecoline, nicotine was found to suppress aggressive behaviors. Systemic administration of nicotine (0.5 mg/kg) prior to arecoline injection resulted in a significant reduction in elicited attack and threat behaviors. Furthermore, nicotine (0.075-0.500 mg/kg) was found to produce a dose-dependent suppression of natural predatory behavior as well. This nicotine-produced suppression of attack did not appear to be due to the induction of general malaise, since attack suppression could be seen in the absence of general behavioral inhibition, and doses of nicotine resulting in complete suppression of attack had little effect on food intake. Results indicate that muscarinic and nicotinic compounds can exert antagonistic control over some types of aggressive behaviors.


Ethanol elimination rates in normal and ethanol dependent animals.

Ethanol elimination rates were determined in rats using an intravenous route of ethanol administration after several experimental manipulations. Twenty-four hr food deprivation resulted in a 30% reduction to 35 mg/100ml blood/hr in elimination rate from a non-deprived rate of 50 mg/100 ml blood/hr. After 2 months of ethanol drinking (5% v/v), 24 hr starvation resulted in only a 10% reduction in elimination rate (45 mg/100 ml blood/hr), and did not increase the non-food-deprived rate (49.2 mg/100 ml blood/hr) over that obtained in the above animals' drinking water rather than 5% ethanol. Animals which chronically overdrank ethanol or water for 3 months on a schedule-induced polydipsia procedure, known to result in ethanol physical dependence, showed a decreased rate of ethanol elimination (37.9 mg/100 ml blood/hr for water drinkers) in the non-food-deprived condition. By providing 750 mg of liver powder daily as a food supplement in the ethanol overdrinking regimen, the ethanol elimination rate remained at a rate comparable to the normal animal (48.4 mg/100 ml blood/hr).


The role of hippocampal cholinergic mechanisms in the aquisition of a barpress response.

The role of hippocampal cholinergic mechanisms in learning a bar-press response reinforced with food was investigated. Firstly, an interstrain comparison showed that mice having a low choline acetyltransferase activity in the dorsal hippocampus were quicker to associate the barpress with reinforcement. Secondly, when the activity of this enzyme was reduced by a subseizure electrical stimulation of the hippocampus learning was accelerated. It is suggested that acetylcholine availability at the hippocampal synapses slowed the apparition of these learned responses.


Imaginary companions, fantasy twins, mirror dreams and depersonalization.

Illustrative case material is presented to demonstrate genetic linkages between the presence of imaginary companions or fantasy twins and extensive mirror play in childhood and early adolescence, and the appearance of mirror dreams and depersonalization in later adolescence and adulthood. The defensive splitting of the self-representations observable in these phenomena is viewed as a means of warding off castration anxiety and anxiety about object loss, anxieties which arise because of conflicts primarily centering on intense aggressive drive derivative wishes. Formulations about depersonalization are discussed.


Dopaminergic influence on withdrawal jumping behavior in morphine-dependent mice.

Abrupt withdrawal jumping behavior in morphine-dependent mice is accompanied by a decrease in brain dopamine turnover and an increase in brain dopamine level which parallel strain differences in jumping incidence. Both naloxone-precipitated and abrupt withdrawal jumping behavior are inhibited in a dose-dependent manner by the dopaminergic agonist apomorphine. A cataleptic dose of the dopaminergic antagonist, haloperidol, does not block naloxone-precipitated jumping, but does significantly block the inhibition by apomorphine. These findings indicate that there may be a decrease release of dopamine in the brain during the expression of withdrawal jumping behavior and that dopaminergic activation may be inhibitory to this behavior.


[Risks to consumers and PVC workers from vinyl chloride].

Over the past two years the level of exposure of workers in PVC polymerization factories to vinylchloride has been greatly lowered. Thus there should be no further cases of so-called vinylchloride disease, which mainly affects the connective tissues. Also, the risk of liver hemangiosarcomas should not be higher under present working conditions than in the general population. Worldwide, 42 cases of VC sarcomas have been described among the 20,000 to 40,000 workers exposed since 1930. The consumer uptake of VC from PVC-packaged food is almost a million times lower than the carcinogenic threshold dose, and this rules out any danger arising from that source.


Suppression by 1,3-butanediol of the ethanol withdrawal syndrome in rats.

1,3-Butanediol was tested for its ability to suppress an ethanol with drawal syndrome. Male Sprague-Dawley rats were rendered physically dependent on ethanol by intragastric administration of ethanol at a dosage of 9 to 15 grams per kilogram per day over a 4-day period. A nonintoxicating oral dose of 1,3-butanediol at 4 grams per kilogram administered after elimination of ethanol from the blood was effective against the tremulous and conbulsive components of the ethanol withdrawal syndrome in all animals for 1 to 5 hours. This period coincided with the time of maximum severity of the withdrawal syndrome, as seen in the control animals.


Total lipids, cholesterol, phospholipids and inorganic phosphorus in the amniotic fluid of premature infants.

Total lipids, total cholesterol, phospholipids and inorganic phosphorus were determined in the amniotic fluid of 36 normal and 12 premature neonates. Total lipids, phospholipids and cholesterol were significantly decreased in the premature patients and the extent of decrease was more pronounced in patients who developed respiratory distress syndrome. On the other hand, inorganic phosphorus content of the amniotic fluid was within the normal range.


Postpartum haemolytic-uraemic syndrome.

In a young woman a twin pregnancy and uneventful labour were complicated by the development of the postpartum haemolytic-uraemic syndrome. A number of unusual features of this syndrome were present, including early onset, accompanying hepatocellular necrosis, hepatic encephalopathy and bleeding diathesis. Early institution of heparin therapy combined with coagulation factor replacement was followed by cessation of haemorrhage and complete recovery from acute renal failure.


Ultrastructural aspects of ascosporulation in Arthroderma quadrifidum (=Trichophyton terrestre).

The ultrastructural features of developing and mature ascospores were delineated after mating Arthroderma quadrifidum on pablum cereal agar. Incipient ascospores each contained a granulated nucleus bounded by a nuclear envelope while presumptive ascospore cytoplasm was bounded by a double membrane and resided in glycogen-rich epiplasm of the ascus. Mature ascospores contained nuclei and mitochondria while the ascus epiplasm still retained abundant inclusions. The ascospore wall demonstrated the presence of heterogeneous material between the plasmalemma and the outer spore membrane which appeared smooth.


The multifactorial/threshold concept -- uses and misuses.

The common congenital malformations have familial distributions that cannot be accounted for by simple Mendelian models, but can be explained in terms of a continuous variable, "liability," with a threshold value beyond which individuals will be affected. Both genetic and environmental factors determine liability, making the system multifactorial. Cleft palate is a useful experimental model, illustrating a number of factors that contribute to palate closure, the nature of a developmental threshold, and how genes and teratogens can alter the components of liability to increase the probability of cleft palate. The nature of the genetic component to liability in human malformations in not clear, and various possibilities, ranging from polygenic in the strict sense to a major gene with reduced penetrance are compatible with the data -- but the important feature is the threshold. Much of the confusion over the concept results from inconsistent use of terminology. The term "multifactorial" should be used for "determined by a combination of genetic and environmental factors," without reference to the nature of the genetic factor(s). "Polygenic" should be reserved for "a large number of genes, each with a small effect, acting additively." When several genes, with more major effects are involved, "multilocal" can be used. When it is not clear which of these is applicable the term "plurilocal" is suggested, in the sense of "genetic variation more complex than a simple Mendelian difference." Since teratological data often represent threshold characters the concept also has important implications for the interpretation of data on dose-response curves, synergisms, and strain differences in response to teratogens.


Inhibition of pinocytosis in rat yolk sac by trypan blue.

Day 17.5 yolk sacs from rats injected with partially denatured 125I-labeled bovine serum albumin (I-BSA) were cultured in vitro by a raft technique. The rates of release of [125I]iodotyrosine were similar in control yolk sacs and in yolk sacs from rats preinjected with trypan blue. Day 17.5 rat yolk sacs were also cultured in medium containing I-BSA. Following pinocytic uptake the substrate was degraded intracellularly and [135I]iodotyrosine released into the medium. Trypan blue, when present in the medium in concentrations above 100 mug/ml, inhibited pinocytosis of I-BSA and so decreased the rate of [125I]iodotyrosine production. Trypan blue similarly decreased the rate of pinocytic uptake of 125I-labeled polyvinylpyrrolidone. Pinocytic uptake of macromolecules was not decreased in yolk sacs from rats pretreated with trypan blue. The relevance of these results to the mechanism of teratogenic action of trypan blue is discussed. It is proposed that if trypan blue in teratogenic doses similarly inhibits pinocytosis by the yolk sac during the organogenetic period teratogenesis might result from a transient interruption in the flow of metabolites through the yolk sac to the embryo.


Primary cardiac Kaposi's sarcoma.

We report the clinical, laboratory, and necropsy findings in a 14-year-old boy with a primary Kaposi's sarcoma of the heart. Primary cardiac Kaposi's sarcoma and angiosarcoma are compared, and the pathogenesis of Kaposi's sarcoma is discussed. Relevant literature is briefly reviewed.


Use of a tissue sectioner to expose internal structures of biological samples for scanning electron microscopy.

A procedure yielding sections of unembedded biological samples for observation by scanning electron microscopy is described. Sections of samples, fixed and hardened in OsO4, were obtained in quantity with a tissue sectioner. Subsequent treatments to osmium-coat cut surfaces were employed prior to critical point drying. The procedure yields cleanly cut surfaces through cells and cytoplasmic organelles which are retained in their normal position. Sections of apple leaf and mouse kidney are illustrated. Sections can be readily cut in a desired plane with less structural damage than is typically encountered by other sectioning or dissection techniques.


Incidence of fascioliasis in cattle slaughtered in Buachi (Nigeria).

A survey was carried out in Bauchi abattoir during the period March 1973 to February 1974 in order to estimate the incidence of bovine fascioliasis. A total of 14,270 cattle originating from various markets in North-eastern Nigeria were examined. The incidence rate varied considerably, the highest being recorded in cattle from markets adjacent to large floodplains. The overall incidence rate was 31-7 per cent. The monthly incidence was highest during the periods immediately before and after the onset of the rains and was more a reflection of the marketing policy of the cattle owners than of the epizootiology of the disease. The annual loss in revenue caused by liver condemnations alone was estimated as 19,375 Naira.


Specific binding protein for 17 beta-estradiol in prostate with adenocarcinoma.

A specific binding protein for 17beta-estradiol has been detected in prostates of patients with prostatic adenocarcinoma, who had no endocrine manipulation prior to the removal of their prostates. Both the sucrose density gradient centrifugation and dextran-coated charcoal techniques were employed. The 17beta-estradiol binding protein has an approximate sedimentation coefficient of 3.6S and is distinct from cystolic dihydrotestosterone binding protein.


The effect of LSD on the histology and ultrastructure of the neuroepithelium of young chick embryos: a stereological study.

Five control chick embryos and fifteen exposed to LSD at concentrations of 2.5, 12.5 and 50 mug/ml were examined. The morphometric analysis performed at the light microscope level shows that (1) the section area of the neural tube increases with the two highest doses of lysergic acid diethylamide (LDS) employed, (2) the volume fraction of the intercellular spaces decreases with the two highest doses of LSD, (3) the volume fraction of the nuclei in the neural tube is not modified with any concentrations of LSD employed, (4) the volume fraction of the cytoplasm in the neural tube increases with all three concentrations, and (5) the nucleo-cytoplasmic ratio decreases with all three doses employed. Moreover, at the ultrastructural level, it was found that (1) the volume fraction of mitochondria in the cytoplasm decreases at doses of 12.5 and 50 mug/ml (2) the surface to volume ratio of the mitochondria is unchanged with any of the concentrations of LSD employed and (3) the surface density of the endoplasmic reticulum in the cytoplasm increases only with a dose of 2.5 mug/ml of LSD.


Delayed transection of urethra by mersilene tape.

This report is of a patient with complete urethral transection after undergoing a mersilene sling urethral suspension. This unusual complication eventually presented as anterior urethral pseudodiverticulum containing the mersilene tape with a secondary calculus.


The use of frozen blood in neonatal exchange transfusion.

Because of inability to quickly locate donors to provide fresh heparinized blood, seven exchange transfusions were performed on four newborns with hemolytic disease due to Rhesus incompatibility using previously frozen erythrocytes suspended in albumin or heparinized, decitrated fresh frozen plasma. Platellets were added to one unit of previously frozen erythrocytes because of severe thrombocytopenia in one patient following an earlier exchange transfusion. The hematologic and bilirubin removing responses were comparable to those seen with fresh heparinized whole blood. Using this method, the safest red blood cells available, namely the mother's, can be drawn and frozen early in gestation for subsequent exchange transfusion.


[Fractional composition of the RNA of mouse Krebs-II ascitic cell tumor and rat ovarian carcinoma].

Main fractions (28 S, 18 S and 4S RNA) of cytoplasmic and nuclear RNA were isolated preparatively from two variants of ascites tumor cells i. e. Krebs-11 carcinoma in mice and ovarian tumor in rats. The method of analytical and preparative electrophoresis in 2.5% polyacryl amide gel has revealed a similarity in the spectrum of main fractions -- for c-RNA and n-RNA -- in both ascites tumors.


[ Somatostatin in insulin-dependent diabetics and in pancreatectomized patients (author's transl)].

The inhibitory effect of somatostatin on the secretion of glucagon permits the examination of the effect of glucagon on some metabolic parameters in the insulin-dependent diabetic patient. The results obtained in 5 insulin-dependent diabetics and in 4 pancreatectomized patients revealed an inhibitory effect of somatostatin on blood glucose in the juvenile-type diabetics, but failed to show this influence of somatostatin in the pancreatectomized patients. These observations indicate a participation of glucagon in the generation of hyperglycaemia in diabetes mellitus. However, the failure of somatostatin to influence the blood glucose level in pancreatectomized patients contrasts with the results obtained in dogs and emphasizes the difficulty and pit falls in the application of animal experiments with somatostatin to humans.


[Evaluation of some epidemiological factors in human toxoplasmosis].

The authors compared a group of 197 women with different ascertained forms of toxoplasmosis and a group of 72 women with negative serological reactions on toxoplasmosis and hereby they revealed that the consumption of insufficiently heated meats as well as the contact with animals (rearing and digestion embowelling or drawing of coat) play an eminent part. As test animals above all cats were used. The results of the two groups were compared and a significant difference between them was ascertained for the consumption of the insufficiently heated meat as well as for the contact with the animals. The women with toxoplasmosis more frequently consumed insufficiently heated meat and had more contact with cats and other animals.


[Possibilities of erroneous interpretation of echocardiograms].

Diagnostic ultrasound is capable of providing important information on cardiac structures and motion. Diagnostic misinterpretations and errors, however, are not uncommon, due to the manner in which data are acquired and displayed during an echocardiographic examination. This paper discusses the typical echocardiographic patterns of a variety of important conditions concerning the mitral valve, the left ventricle, the interatrial and interventricular septum as well as the influence of respiration on the performance of echocardiograms. Essential pitfalls in establishing a correct diagnosis in each of these conditions are discussed and demonstrated by illustrations.


Microfilaments in Naegleria fowleri amoebae.

Examination by electron microscopy has revealed 2 types of microfilament in the cytoplasm of 3 strains of axenically grown Naegleria fowleri amoebae. Thin, actin-like microfilaments 5-7 nm in diameter are randomly oriented in the nonmotile amoebae, and are concentrated near the plasma membrane. In the actively motile amoebae these microfilaments aggregate to form colateral bundles in close proximity to the plasma membrane. Thick, myosin-like microfilaments 17-19 nm in diameter also occur in the amoebae cytoplasm. The significance of these 2 kinds of microfilament in amoeboid motion is discussed.


[Vitellogenesis in Echeneibothrium beauchampi Euzet, 1959 (Cestoda: Tetraphyllidea, Phyllobothriidae) (author's transl)].

The vitellogenesis in Echeneibothrium beauchampi is studied by means of electron microscopy. In the follicles, the vitelline cells undergo three progressive changes characterized by cellular size, membrane system development and nature of stored inclusions. 1. Immature cells have a gonial morphology. 2. Maturing cells display a very well developed membrane system. Their cytoplasm is gradually filled with abundant lipid droplets. At the same time, a small number of homogeneous vesicles occur which contain protein material moderately electron dense. Glycogen (alpha and beta) appears at the end of the vitellogenesis. 3. Mature cells show a conspicuous regression of the membrane system. Cellular organelles, nucleus and protein vesicles are found in the peripheral cytoplasmic layer which still contains numerous free ribosomes. The amorphous remaining cytoplasm is filled with large amounts of aggregated lipid droplets which often surround glycogen areas. 4. The presence of numerous lipid droplets and glycogen in the vitelline cells of E. beauchampi shows evidence that this Tetraphyllidea is close to Pseudophyllidea, but the aspect of protein vesicles (shell-protein material) brings it near the Cyclophyllidea.


[Heavy metal toxicity in mammalian cell cultures (author's transl)].

Static suspension cultures of L-A cells, a subline of L 929 mouse fibroblasts, were exposed to inorganic metal salts (chlorides). There was an increasing cytotoxicity from lead over mercury to cadmium as determined by reduction of viability and inhibition of proliferation. After 7 days' exposure the LD50 of lead was approximately 3 X 10(-4) M, of mercury 5 X 10(-5) M, and of cadmium 1.3 X 10 (-5) M. The doses causing a 50% inhibition of increase in cell number (ID50) after 7 days' application were determined as follows: 4 X 10(-5) M for lead, 1.3 X 10(-5) M for mercury, and 7.5 X 10(-6) M for cadmium. The biological effects of lead during chronic exposure were studied in more detail. Under continuous presence of the heavy metal the cells developed lead resistance, even to concentrations approaching the LD50. However, the proliferation rates of cells tolerating 1.4 X 10(-4) M were slightly, and of those tolerating 2 X 10(-4) M were clearly reduced as compared to the non-resistant (parent) cells. Cultivation of the resistant cells over 46 days (maximally 60 generations) in lead-free medium lead to a considerable loss of tolerance; this finding indicates that the induced lead resistance is caused by adaptation rather than by mutation and selection.


[The interaction between cells and fibrous dusts (author's transl)].

The shape of fibrous dust particles is an important factor for the biological effects in cell cultures. The fibres elicit a special mechanism of incorporation which is dependent on their length and diameter but independent of their chemical composition. Fibres with a length less than 5 mum are phagocytized rapidly and completely by the cells, comparable to granular dust particles or milled fibres. Phagocytosis of long inorganic fibers is delayed and/or remains incomplete. Incomplete incorporation of the fiber causes a localized discontinuity in the cell membrane. There results continuous liberation of intra-cellular enzymes, which is compensated by an increasing glycolytic metabolism. The interaction between cell and fibre means a chronic irritation which is discussed as a factor in tumour induction. Fibrous dusts, e.g. asbestos and glass fibers, induce the formation of polykaryotic giant cells by way of fusion; asbestos possibly also causes the interspecific fusion of cells. There are indications that in the process of asbestos-induced cell fusion integrated virus genomes are activated and infectious viruses are released. There seems to be a causal relationship between the fibrogenic and carcinogenic effects of inorganic dusts and their shape, i.e. their length and diameter, regardless of their chemical composition. Thus the fibrogenic and carcinogenic effect is limited by a minimal length and a maximal diameter. The findings are discussed with regard to the air burden of fibrous dusts and their implications for human health.


Influence of x-rays on diurnal viration in 131I uptake by guinea pig thyroid.

The 131I uptake by guinea pig thyroid is subject to distinct diurnal variation. In control males, peak values occurred at 12 h, and minima at 24 h. In control females, peak values were also at 12 h, but minima at 6 h. In guinea pigs irradiated with 500 R of X-rays, a rise in 131I uptake began 1 h after termination of irradiation in both sexes and at all intervals, but maximum and minimum values were at the same time as in controls.


[The effect of potentiating factors on the bradykinine effect in vitro].

Bradykinin potentiating factors from the venom of Bothrops jajaraca and Agkistrodon halys blomhoffii potentiate the action of bradykinin at several smooth muscles. This potentiation is specific for bradykinin and has to be distinguished from an unspecific potentiation. The potentiation induced by BPF is not due to an indirect cholinergic mechanism or to a kininase inhibition in vitro. The results suggest that there would be an allosteric transition of the bradykinin receptor.


[The effect of nicotine and amphetamine on the exploratory behavior of rats].

The effects of nicotine and amphetamine were found to be dependent on genetic variables. Nicotine produced a stimulant effect on exploratory behavior, while amphetamine produced stereotyped behavior patterns.


[Injuries of the pelvic bone and lower urinary pathways].

We are all witness of the rapid tempo of our life styles made possible by recent advances in modern technology. The powerful, fast automobiles used in our society are an important contributing factor in trauma and polytrauma. Etiology of injuries therefore are changing before our eyes. Based on statistics of the hospital taken on a series of 753 polytraumatized cases during 1961--1967, the most common etiological factor was automobile accidents. According to predictions for 1977, in Serbia there will be 70,000--105,000 injuries resulting from automobile accidents. 7,000 of these injuries will result in death, 36,000 will be severe injuries, and 62,000 will be minor injuries. These are frightening statistics, and further comment is not needed. Until recently, the principle cause of pelvic trauma was falling from high heights. However, today, statistics show that 60%--80% of all pelvic fractures occur in automobile accidents, only 19% are caused by falls, and 6.4% by industrial accidents. This illustrates the trastic change in etiology of fractures of the pelvis and trauma of the lower urinary pathways.


[First clinical experiences with scintiphotosplenoportography].

This paper reports on the clinical applicability and efficiency of Scintiphotosplenoportography (SPSP) by means of 99mTc Pertechnetate. This diagnostic process permits obtaining the following data: actual route and patency of the portal vein, localizing of collaterals, as well as information on the actual speed of portal flow. By determining the time of transit of the radionuclid via the collateral pathways into systemic circulation, additional assessments as to the hemodynamic functional importance of these collaterals can be made. This process is of particular value for the speedy assessment of the patency of a surgically effected portocaval shunt in cases of shunt-bleeders. In patients without cirrhosis, a stop in the filling along the course of the portal vein indicates portal thrombosis. In cases of manifest cirrhosis, however, the lack of an SPSP image for the proximal portal vein and the liver itself, merely points to the existence of extensive caudal collaterals. Traumatization as the result of intrasplenal application of a volume of less than 1 ml (of tracer) remains minimal. In contrast with radiological splenoportography this methods entails practically no risks. However, as a result of the restricted field of view and the relatively coarse power of resolution, the quality obtainable by szintiphotosplenoportography is somewhat inferior to that of X-ray splenoportography.


Latent vaginal choriocarcinoma in a postmenopausal woman.

A 50-year-old Japanese female with choriocarcinoma showed three unusual features: the primary tumor developed in the vagina ectopically without uterine lesion; the first symptoms of atypical vaginal bleeding and coughing occurred 23 years after the last pregnancy; and the tumor appeared during postmenopause. The possible mechanisms for the ectopic location and latency are discussed.


Intracellular cysts in gastric carcinoma.

Intracellular cysts were often found in the tumour cells in gastric carcinomas of intestinal as well as diffuse type in specimens from stomachs resected for gastric cancer. In the light microscope, the cysts appeared usually as solitary cytoplasmic vacuoles. In the electron microscope, the intracellular cysts were seen as round cavities, often containing homogenous or granular mucous material which stained with the periodic acid-silver methenamine (PASM)-method. Relatively long microvilli were lining the cysts and, not infrequently, abundant cytoplasmic microfilaments would surround the cyst wall. Similar cysts have been observed in a number of other tumours and, accordingly, their diagnostic significance must be considered in connection with other methods such as differential staining of cellular mucosubstances.


Precipitins in Liberian sera reacting with goat and sheep sera.

Precipitins in nine sera from normal Liberian adults were shown to react with an alpha-globulin in goat and sheep sera. No cross-reaction was demonstrated with bovine sera. Hence these precipitins are different to others previously described. At present their significance, if any, is unknown. They are important as a possible cause of unexplained reactions in serological tests using sheep or goat serum as a source of antigen or antibody.


Reducing patient exposure to ionizing radiation--is it really necessary?

The thesis that medical radiation exposures to the general population in the United States are excessive and that urgent steps need to be taken to reduce them is examined. At the present time, no evidence is found that deleterious effects result from radiation exposures at the level of a few rads or less. Nevertheless it is prudent that we assume the possibility of harmful effects of radiation exposure. However, because medical radiology is clearly so beneficial, and the harmful effects are problematical, it is doubtful whether the public should be alarmed by the suggestion of any crisis. A balancing of risks and benefits in the medical uses of radiology supports this latter contention.


The fate of folate polyglutamates in meat during storage and processing.

The rate of hydrolysis of chicken liver folate polyglutamates, by endogenous liver conjugases, under various conditions of storage, heat, and tissue disruption, were investigated. The procedure used was to allow a radioactive tracer dose of the vitamin to equilibrate into the folate polyglutamyl pool. After various storage periods and treatments the polyglutamyl state of the folate present was examined by analytical techniques based on oxidative degradation of native folate polyglutamates to the corresponding p-aminobenzoylpolyglutamate followed by chromatographic separation on DEAE cellulose anion exchange resin. Identification of folate polyglutamates present was made by simultaneous elution of known p-aminobenzoylpolyglutamate markers. In an intact tissue sample only slight degradation was found after 48 hr at 4 C; complete degradation of folate polyglutamates taking 120 hr. Samples of homogenized tissue show complete degradation to folate monoglutamates and a small amount of diglutamate after 48 hr storage. Superimposed on the above is the consideration that if at any time prior to or during storage the liver is heated to greater than 100 C irreversible inactivation of the endogenous conjugases takes place and the folate polyglutamate pattern is stabilized. It was also demonstrated that during two different heating procedures no extra deconjugation occurred.


ABO hemolytic disease of the newborn, without hyperbilirubinemia.

ABO hemolytic disease of the newborn without hyperbilirubinemia is described in 17 full-term infants. The erythrocyte characteristics, such as reticulocytosis, microspherocytosis, and positive indirect antiglobulin (Coomb's) test, resembled those in ABO disease with hyperbilirubinemia. Erythrocyte acetylcholinesterase activity was reduced in this group to the same degree as in the more severely affected infants. Negro infants predominated over white, in a 2.5:1 ratio in this mild ABO group.


Obstetrician-gynecologists are primary physicians to women.

Our studies of the practice patterns of Michigan obstetrician-gynecologists indicate that they serve in a dual capacity: that of primary physicians to women and that of specialist obstetrician-gynecologists. They provide a considerable amount of general medical care for their own patients in the former role, and traditional specialist services for their own patients and for those referred by other physicians in the latter. The objectives and educational content of most house officer training programs do not reflect these changes. Training is directed almost exclusively toward preparing residents for specialty practice and often does not offer them basic experience and permit them to develop basic skills in other disciplines, notably internal medicine nad psychiatry, which they will need to practice as parimary physicians to women. An educational program designed to prepare residents more broadly for what they will actually be doing in practice without compromising their training as specialists is described.


The embryologic development of the human vagina.

Our present understanding of the sequence and mechanisms of human genital organogenesis is reviewed. Current theories about the derivation of the vaginal epithelium are examined and tested against two anomalous circumstances, congenital androgen insensitivity and agenesis of the lower vagina, which are presented as examples demonstrating the respective participation of the urogenital sinus or of the Müllerian ducts alone in the developmental process. The abnormalities recently described in the vagina and cervix of girls exposed in utero to diethylstilbestrol (DES) correspond remarkably with those encountered in lower vaginal agenesis, particularly with regard to the presence of vaginal adenosis, the deficiency of glycogen in the squamous cells (squamous metaplasia), and the abnormal response of the squamous epithelium to Schiller's iodine test. It is concluded that the development of the human vagina is best explained by the theory which holds that the Müllerian ducts in fetal life extend caudally to the level of the future hymen. After fusion of these ducts, squamous cells arising in the epithelium of the urogenital sinus invade from below, advance, and replace completely the Müllerian mucosa up to the level of the external os of the cervical canal.


Management and outcome of pregnancies associated with the Copper T intrauterine contraceptive device.

The clinical outcome of 918 pregnancies in women who conceived while using one or another of four models of the Copper T intrauterine contraceptive device (IUD) is presented. Elective abortion was chosen by 58 per cent of the women. The clinical management and course of 275 women who elected to allow their unplanned pregnancy to continue are described. The Copper T was either expelled or extracted during the pregnancy in 118 of the women, while the IUD remained in situ for the duration of the pregnancy in the remaining 157 patients. The incidence of spontaneous abortion more than doubled when the IUD remained in utero. The chance of a live birth being premature was four times greater when the IUD remained in situ than when it was removed. There were 27 ectopic pregnancies in this entire series, giving an incidence of 3.4 per cent. In addition, the data suggest, but do not prove, that there is an increased risk of having an ectopic pregnancy if the woman has worn the Copper T for more than two years. A benign fibroma of the vocal cord was the only congenital anomaly detected. These observations suggest that the incidence of developmental defects is not adversely affected by the presence of intrauterine copper.


True hermaphroditism: an analytic review with a report of 3 new cases.

Three new cases of true hermaphroditism are described: a 14-year-old patient with a testis on one side and an ovotestis on the other side and a 11-year-old patient as well as a 6-year-old patient both with an ovary on the one side and an ovotestis on the other side. Twenty-four cases, which were personally investigated, were previously reported. Therefore, this analytic review is based upon the author's experience of 27 cases as well as 340 cases reported in the world literature since 1899. The presenting symptoms and age of diagnosis are discussed. Apart from ambiguous genitals, the development of breasts in a patient reared as male is an important presenting symptom. The variations found regarding the external and internal genitals are described. An ovotestis is the most common gonad found in true hermaphroditism. Among 116 ovotestes available for analysis, 46 per cent are located in an ovarian position, 26 per cent in the labioscrotal fold, 24 per cent in the inguinal canal, and 4 per cent in the internal inguinal ring. Evidence of ovulation is found in 50 per cent of ovotestes. Spermatogenesis has not been observed in the testicular portion of an ovotestis. Spermatogenesis was present in only 12 per cent of testes found in true hermaphroditism. Dysgerminomas occur with a frequency of 1.3 per cent. A fallopian tube and a vas deferens were never found together next to an ovotestis. Cytogenetic findings are reported in 115 cases of true hermaphroditism, including the cases described in this paper. A 46,XX chromosomal complement is the most common finding, occurring in 57.4 per cent of cases. It is interesting that 42.6 per cent showed no evidence of a Y chromosome. With the use of the fluorescent technique in metaphase chromosomes as well as the Y chromatin body in interphase cells, no Y chromosome was detected in the three new cases reported here. The various possibilities for the development of testicular tissues in the absence of a Y chromosome are discussed. In the diagnosis of true hermaphroditism the palpation of an ovotestis with a soft testicular portion and a firm ovarian portion is stressed. As far as the treatment of true hermaphroditism is concerned, the external genitals should be changed according to the gender identity which usually correlates with the sex of rearing.


The effects of dexamethasone on plasma free androgens during the normal menstrual cycle.

In order to evaluate the ovarian and adrenal contribution to peripheral plasma concentrations of total testosterone (TTe), indixes of the plasma concentrations of free testosterone (FTeI), free 17 beta-hydroxysteroid androgens (FHSI), and testosterone-binding globulin (TeBG) during the menstrual cycle, women were examined during three normal cycles and three other cycles under dexamethasone (0.5 mg., four times a day) suppression. All study cycles were apparently ovulatory. The mean TTe and FTeI during the midcycle period were significantly higher than during the early follicular (P less than 0.005) and the midluteal periods (P less than 0.01 and P less than 0.001, respectively). During the menstrual cycles under dexamethasone suppression only the difference in TTe and FTeI between the midcycle (37 +/- 12.4 (S.D.) ng. per 100 ml. and 10.5 +/- 4.0 (S.D.), respectively) and the midluteal (26.0 +/- 10.1 (S.D.) ng. per 100 ml and 7.2 +/- 3.2 (S.D.), respectively) periods was significant statistically (P less than 0.05). No significant differences in the mean levels of FHSI and TeBG between three periods within the cycle were noted in either the control or the dexamethasone-treated cycle. When each phase was compared, the mean levels of TTe, FTel, and FSHI were significantly lower in the dexamethasone-treated cycles than in the normal cycles. The data suggest that the level of TeBG is not perceptibly affected by physiologic fluctuation of estrogen levels during the menstrual cycle, and the FHSI levels are stable throughout the ovulatory cycle. Decrease in levels of TTe, FTeI, and FHSI during dexamethasone suppression seems to be due to reduction of androgen production as TeBG, a major determinant of the metabolic clearance rate of androgens, was not affected by dexamethasone.