Biosynthesis of glycosphingolipids in cultured mouse neuroblastoma cells. Precursor-product relationships among sialoglycosphingolipids.

The reaction sequence for the biosynthesis of gangliosides by mouse neuroblastoma cells has been investigated by studying the pattern of incorporation of labeled precursors into sialoglycosphingolipids. Cultured NB41A cells incorporated N-[3H]acetylmannosamine into the sialic acid moiety of GM3 in less than 10 min. Labeled GM2 was not detected in cells incubated for less than 30 min, while measurable radioactivity did not appear in GM1 until after 60 to 90 min. Analogous experiments were carried out using [14C]galactose. No significant amount of labeled hexose was incorporated into asialo-GM2 during 60 min of culture. These studies are in accord with results of previous studies on glycosyltransferases of NB41A cells (Kemp, S. F., and Stoolmiller, A. C. (1976), J. Neurochem. 26, 723-732), and further support the concept that the pathway of synthesis of gangliosides proceeds via GM3 leads to GM2 leads to GM1.


Conformational constraints in nuclear DNA.

We have investigated DNA superstructure in a wide range of nuclei of higher cells by gently lysing cells to release structures that resemble nuclei but are depleted of nuclear proteins. The sedimentation properties of these structures, which we call nucleoids, have been examined in sucrose gradients containing the intercalating agent, ethidium. The sedimentation rate of nucleoids derived from the growing cells of mammals, birds, amphibians and insects varies in the manner characteristic of circular and superhelical molecules of DNA. These characteristic changes in sedimentation rate are abolished by irradiating the nucleoids with low doses of gamma-rays, a procedure known to introduce single-strand scissions into DNA. We have also investigated by similar means DNA superstructure in nucleoids derived from a variety of different chick cells. Nucleoids derived from adult hen erythrocytes differ from the other nucleoids studied in that their sedimentation rate does not vary in the manner characteristic of supercoiled DNA.


Ultrastructural studies on the surface membrane of the mouse egg.

Fertilized and unfertilized mouse eggs were examined by scanning and transmission electron microscopy for evidence of mosaicism in the organization and concanavalin A-binding properties of their surface membranes. No obvious quantitative mosaicism in concanavalin A binding was noted. The egg membrane was microvillous over most of its surface, but was smooth in the region overlying the 2nd metaphase spindle of the unfertilized egg and on the polar body of the fertilized egg.


Contacts between pigmented retina epithelial cells in culture.

The behaviour of primary cultures of dissociated embryonic chick pigmented retina epithelial (PRE) cells has been investigated. Isolated PRE cells have a mean speed of locomotion of 7-16 mum/h. Collisions between the cells normally result in the development of stable contacts between the cells involved. This leads to a gradual reduction in the number of isolated cells and an increase in the number of cells incorporated into islands. Ultrastructural observations of islands of cells after 24 h in culture show that junctional complexes are present between the cells. These complexes consist of 2 components: (a) an apically situated region of focal tight junctions and/or gap junctions, and (b) a more ventrally located zonula adhaerens with associated cytoplasmic filaments forming a band running completely around the periphery of each cell. The intermembrane gap in the region of the zonula is 6-0-12-0 nm. The junctional complexes become more differentiated with time and after 48 h in culture consist of an extensive region of tight junctions and/or gap junctions and a more specialized zonula adhaerens. It is suggested that the development of junctional complexes may be responsible for the stable contacts that the cells display in culture.


Preferential binding of testosterone over epitestosterone by human plasma.

The main purpose of this study was to investigate if the specificity of the binding of testosterone to plasma proteins could be defined as a preferential binding of this steroid over epitestosterone. The amount of testosterone that is specifically bound was calculated using the formula: (see article) concentration, where "Ri" is the ratio (14C) testosterone: (3H) epitestosterone in plasma prior to centrifugation, "Ru" is the isotope ratio in the protein-free supernatant obtained after ultracentrifugation (149,000 x g, at 0 C, for 18 h) and "T concentration" is the testosterone concentration in plasma resulting from addition of (14C) testosterone, the endogenous steroids having been removed by preliminary charcoal extraction. The theoretical separation of the binding sites for testosterone into two populations, one non-specific with no preference for testosterone over epitestosterone, and another with absolute specificity for testosterone over its physiologically inactive stereoisomer, proved to be useful. Ovalbumin was found to be an example for non-specific, non-preferential binding. Determination of the ratio (14C) testosterone: (3H) epitestosterone in the successive fractions of various ultracentrifuged preparations showed a small but significant preference for (14C) testosterone by human and bovine serum albumin, while alpha1-acid glycoprotein had a preference for (3H) epitestosterone. Saturation curves showed at least two components: the first one, presumably corresponding to TeBG, had a higher affinity and lower capacity. This binding capacity can be accurately determined by extrapolation to the ordinate or the second component, a straight line corresponding to a binding of somewhat lower affinity and much larger capacity.


Somatomedin in cord blood: relationship to gestational age and birth size.

Somatomedin (SM) was determined by bioassay in cord blood from 100 neonates born at 24-42 weeks of gestation and from three infants with major congenital malformations. SM levels rose with gestational age and had a positive correlation with birth weight, length and head circumference independantly of gestational age. These findings suggest a relationship between somatomedin and fetal growth.


Schistoma mansoni soluble egg antigens: determination of the stage and species specificity of their serologic reactivity by radioimmunoassay.

Three highly purified Schistosoma mansoni egg antigens reactivity with sera from mice with chronic schistosomiasis mansoni (major serologic antigens-MSA1, MSA2, and MSA3) were utilized in radioimmunoassays for determining their stage and species specificity. Inhibition studies revealed that MSA1 was completely stage specific, since its binding to S. mansoni chronic infection serum (CIS) could not be inhibited either with cercarial or adult worm antigen. MAS2 and MSA3 were specific with regard to adult worm antigen but their binding to CIS was slightly inhibited by cercarial antigen. Immature eggs in comparison with mature eggs contained only negligible amounts of MSA1 whereas MSA2 and MSA3 were present in large quantities. Fluid from eggs hatched in spring water (hatch fluid-HF) contained considerable amounts of MSA1 as well as MSA2 and MSA3. With regard to species specificity, MSA1 essentially did not cross-react with crude soluble egg antigen (SEA) from Schistosoma japonicum and Schistosoma haematobium whereas MSA2 and MSA3 showed partial cross-reactivity. Antibody dilution studies with sera from animals and humans infected with heterologous schistosome species (i.e., S. japonicum and S. haematobium) indirectly confirmed the high degree of species specificity of MSA1. The degree of serologic specificity of MSA1 as demonstrated in this study parallels that of the sensitizing activity of S. mansoni eggs and SEA for granuloma formation, as demonstrated in previous investigations. This study, therefore, indicates that MSA1 may be a major immunopathologically active egg antigen. In addition, the high degree of species specificity of MSA1 suggests its use in the serodiagnosis of schistosomiasis mansoni.


The in vitro permeability of skin and buccal mucosa to selected drugs and tritiated water.

The permeability of whole human skin, human dermis, whole pig skin, and canine buccal mucosa have been determined for four chemically different solutes: tritiated water, amphetamine, estradiol, and ouabain. Several new in vitro techniques for isolation, preservation, and permeability determination of these membranous tissues are described. Water permeabilities of human epidermis and dermis using these techniques agree well with published results. Human and porcine skins are very similar with respect to water permeability, while buccal mucosa is similar to dermis in its permeability characteristics to the four representative test agents. The permeability of hydrated whole skin is determined by the permeability of the epidermis, and the dermis and buccal mucosa behave as if they are water barriers exhibiting a permeability of about 30% of the diffusion through pure water, a difference that can be ascribed to the porosity and/or tortuosity of the tissue matrix.


Plasma concentration of androstenedione during the bovine oestrous cycle.

A radioimmunoassay with Sephadex chromatography for androstenedione is described. Concentrations of androstenedione in bovine peripheral blood during the oestrous cycle ranged from 80 to 100 pg/ml. There was considerable variation and no pattern suggestive of physiological significance emerged, unlike those of oestradiol and testosterone.


Changes in uterine and ovarian blood flow during the oestrous cycle in rats.

The rates of uterine and ovarian blood flow during the oestrous cycle in rats were measured using radioactive microspheres. Blood flow was highest in the ovaries and uteri during pro-oestrus and lowest during metoestrus. During pro-oestrus, mean ovarian blood flow was 676-2 +/- 183-6 (S.D.) ml/min/100 g wet tissue and mean uterine blood flow was 249-7 +/- 120-1 ml/min/100 g. During metoestrus mean ovarian blood flow was 117-4 +/- 19-8 ml/min/100 g and mean uterine blood flow was 38-5 +/- 7-4 ml/min/100 g. In ovariectomized rats, uterine blood flow was 28-7 +/- 10-5 ml/min 100 g.


Variables affecting establishment of schedule-induced attack on pictorial targets in White King pigeons.

White King pigeons exposed to food schedules before introduction of a colored photograph of a pigeon showed sustained schedule-induced attack on that image; additional birds given an early introduction to both the photograph and the schedule subsequently attacked the image at lower rates. Other pigeons attacked a second photograph of a pigeon regardless of whether it was introduced early or late. The late-introduction procedure was also effective in establishing attack on a projected image of a conspecific. The combined results showed that 14 of 17 White King pigeons given a late introduction to a pictorial target exhibited sustained attack against it and that a pigeon's initial reaction to a photograph of a conspecific when introduced early was a good predictor of subsequent schedule-induced attack on it.


Developmental aspects of secondary palate formation.

Research on development of the secondary palate has, in the past, dealt primarily with morphological aspects of shelf elevation and fusion. The many factors thought to be involved in palatal elevation, such as fetal neuromuscular activity and growth of the cranial base and mandible, as well as production of extracellular matrix and contractile elements in the palate, are mostly based on gross, light microscopic, morphometric or histochemical observations. Recently, more biochemical procedures have been utilized to described palatal shelf elevation. Although these studies strongly suggest that palatal extracellular matrix plays a major role in shelf movement, interpretation of these data remains difficult owing to the complexity of tissue interactions involved in craniofacial development. Shelf elevation does not appear to involve a single motive factor, but rather a coordinated interaction of all of the abovementioned developmental events. Further analysis of mechanisms of shelf elevation requires development of new, and refinement of existing, in vitro procedures. A system that enables one to examine shelf elevation in vitro would allow more meaningful analysis of the relative importance of the various components in shelf movement. Much more is known about fusion of the palatal shelves, owing in large part to in vitro studies. Fusion of the apposing shelves, both in vivo and in vitro, is dependent upon adhesion and cell dealth of the midline epithelial cells. Adhesion betweeen apposing epithelial surfaces appears to involve epithelial cell surface macromolecules. Further analysis of palatal epithelial adhesion should be directed towards characterization of those cell surface components responsible for this adhesive interaction. Midline epithelial cells cease DNA synthesis 24-36 h before shelf elevation and contact, become active in the synthesis of cell surface glycoproteins, and subsequently manifest morphological signs of necrosis. Death of the midline epithelial cells is thought to involve a programmed, lysosomal-mediated autolysis...


Biosynthesis of DNA, RNA and proteins by mouse embryos cultured in the presence of a teratogenic dose of chlorambucil.

The effect of chlorambucil on the rates of DNA, RNA, and protein synthesis in mouse embryos was investigated using a system of whole embryo culture. Embryos were isolated on the 11th day of gestation (33 +/- 3 somites) and grown in culture media for periods of 4-8 h. Reichert's membrane and most of the placental tissue was removed leaving only the amnion and visceral yolk-sac surrounding the embryo. In the presence of teratogenic doses of chlorabucil (15 mug/ml) the rate of DNA synthesis was significantly decreased at 4 and 8 h. RNA and protein synthesis were not inhibited at either of these times. A trend toward decreasing rates of protein synthesis at some time beyond 8 h was noted, but not tested.


Postimplantation development of blastomeres isolated from 4- and 8-cell mouse eggs.

Blastomeres isolated from 4- and 8-cell mouse eggs were inserted into empty zonae and transferred to the oviduct. The products of both types of blastomere were capable of inducing decidual formation. One implant produced by an isolated blastomere from a 4-cell egg contained a small, retarded embryo at 5 1/2 days but most decidua from blastomeres of either 4- or 8-cell eggs contained only a few trophoblast giant cells. It is suggested that this lack of totipotency is due to insufficient cells being present at cavitation rather than restriction in developmental potential.


The permeability to cytochalasin B of the new unpigmented surface in the first cleavage furrow of the newt's egg.

Two of 10 mug/ml cytochalasin B (CB) caused retraction of the first cleavage furrow in Triturus eggs, a spreading of the unpigmented surface from the furrow region and a flattening of the whole egg. CB appears to act against the contractility of the microfilamentous band at mid-cleavage so as to relax the furrow and also to weaken unpigmented surface to allow the egg to flatten. Uncleaved eggs and the initial formation of the cleavage groove were unaffected by CB. A fully-retracted first cleavage furrow reformed itself on transfer of the egg to normal medium but only at the time of second cleavage. Initiation of second cleavage depended upon there being sufficient of the original pigmented surface on the animal hemisphere. Tritium-labelled CB of high specific activty was prepared and used to study its ability to penetrate the surface of newt eggs during cleavage. Scintillation couting of whole eggs showed that CB was not taken into the newt egg until mid-cleavage (about 17 min after the double stripe stage) when new surface began to spread in the cleavage furrow. Fixation in glutaraldehyde and osmium tetroxide retained radioactivity in the egg, but more CB was retained after fixation in osmium tetroxide alone than after double fixation. Most of the retained radioactivity was in yolk platelets. Autoradiographs were prepared to sectioned eggs which had been fixed at late cleavage after [3H]CB had flattend the furrow. These showed that CB entered the egg through the unpigmented surface which formed in the furrow but it could not enter through the pigmented surface. The impermeability of the pigmented surface explains the observations that CB does not prevent initial furrowing at cleavage. Once inside the egg CB is transported slowly. CB penetrates to a limited extent beneath the pigmented surface from its border with the unpigmented surface in the first cleavage furrow and this seems insufficient in some circumstances to suppress the contractile phase of second cleavage.


The developmental analysis of an embryonic lethal (C6H) in the mouse.

A development study of the effects of the C6H allele at the albino locus has identified the C6H homozygote as an early postimplantation lethal. Homozygous C6H embryos can first be recognized at 6 1/2-7 days of gestation by abnormalities of the ectoplacental and parietal endodern. At 7 1/2 days, mutant embryos appear severely retarded with obvious abnormalities in all germ layers. All C6H homozygotes are dead and resorbed by 8 days of development. It is proposed that the mutation interferes with the normal differentiation of the parietal endoderm, ectoplacental cone and extra-embryonic ectoderm of the egg cyclinder.


Experiments on blocking and unblocking of first meiotic metaphase in eggs of the parthenogenetic stick insect Carausius morosus Br. (Phasmida, Insecta).

The eggs of the parthenogenetic stick insect Carausius morosus, which remain arrested in first meiotic metaphase until oviposition, must be activated in order to develop. The activating agent is oxygen from the air, which enters the egg cell through the micropyle. An exposure shorter than one minute is sufficient to release the blockage. In non-activated (micropyle-less) eggs the first metaphase chromsomes either degenerate or change into an interphase nucleus. This nucleus polyploidizes by endoreduplication, and then either degenerates or multiplies by amitosis. Similarly more generations of nuclei may arise resulting in a chaotic development. These nuclei survive better in the anterior region of the egg. The question of whether the cytoplasmic factors which control nuclear behaviour, also operate in eggs of C. morosus is discussed.


Protein synthesis and germ plasm in cleavage embryos of Xenopus laevis.

(3H) leucine was injected into unfertilized eggs, fertilized eggs, and Stage 2-12 embryos of X. laevis. Incorporation of the leucine into protein by blastomeres containing germ plasm was studied autoradiographically. Eggs, both fertilized and unfertilized, actively synthesized protein, ad did embryos from Stage 2 onwards. Probably all blastomerers containing germ plasm were labelled. In embryos from Stages 4-12, the germ plasm itself was also labelled, and this result suggests that the germ plasm is metabolically active during cleavage.


Structure and function of the glandular vas deferens in Ascaris suum (Nematoda).

The glandular vas deferens in the linearly arranged male reproductive tract in Ascaris suum produces substances which cause marked morphological and physiological changes in the spermatozoa. The glandular secretions, presumably formed by the rough endoplasmic reticulum and Golgi saccules, are extruded from the cells and coalesce to form homogeneous masses in the gland lumen. In sexually inactive worms the secretory material is separated from the spermatozoa by a sphincter comprised of neuro-muscular-like cells. During copulation the sphincter lumen enlarges and the spermatozoa and sperm-activating glandular material are mixed and simultaneously transferred to the female worm.


Thelazia lacrymalis in horses in Kentucky and observations on the face fly (Musca autumnalis) as a probable intermediate host.

Eyes from 114 (30.3%) of 376 dead horses, examined from 3 April 1975 to 3 April 1976, were naturally infected with adult Thelazia lacrymalis; 1 horse was also infected with 1 male Thelazia skrijabini. Adult T. lacrymalis from dead horses were successfully transferred mechanically to the eyes of 3 of 4 Shetland ponies raised helminth-free. Larvae from gravid female T. lacrymalis underwent development in experimentally infected, laboratory-raised face flies (Musca autumnalis) and third-stage larvae ranging from 1.82 to 2.94 mm in total length were recovered at 12 to 15 days postexposure. A total of 866 naturally occurring face flies were collected from the head region of horses. Twelve of the face flies harbored larval stages of Thelazia spp. One of the larvae resembled third-stage T. lacrymalis that were recovered from the experimentally infected, laboratory-raised face flies. Introduction of 3 third-stage larvae from 1 face fly onto the cornea of a pony raised helminth-free resulted in the recovery of 1 male T. skrjabini 242 days later. In addition to the eyeworm larvae, other parasites recovered from the face flies included Heterotylenchus autumnalis, hypopi of astigmatid mites and a first instar beetle (Coleoptera: Rhipiphoridae). Data from these investigations indicate the likelihood that face flies are an intermediate host for T. lacrymalis and probably other species of Thelazia in this part of the country.


Changes in leadership appraisal as a function of the stress of a simulated panic situation.

Research by Mintz and Kelley, Condry, Dahke, and Hill left unresolved the question of what level of personal threat leads to group incoordination of "panic behavior." The present study set out to resolve this issue and to explore the additional relationship between leadership and behavior in the panic situation. The dependent variables were Likert-type questionnaire items designed to investigate the level of responsibility attributed to a leader by members of a group as a function of four variables: (a) two levels of stress (threat of shock or of small monetary loss); (b) two levels of leadership authority (elected or appointed); (c) two conditions of leadership ("me-last" or "me-first"); and (d) group success or failure. The specific questions were adapted from earlier pilot work by Sulzer and Sisti. One hundred and forty-four males were run in this 2 X 2 X 2 X 2 factorial design with a nonfactorial control group. The task setting, which required subjects to retrieve their wooden cones through the same hole, was designed to be analogous to the kind of situation that would occur in a theater fire where only one narrow exit existed. The results support the contention of Kelley that group incoordination (panic) increases under personal threat. Additional results were: (a) Leaders facilitated achieving the goal of safe exit; (b) elected leaders were given more responsibility and were seen as more competent than appointed leaders, but only when the stress is comparatively low, as otherwise the difference in evaluation narrows and reverses; and (c) success or failure seems to have had little effect on the leader's evaluation by the group.


[Anatomical and histological approach to the radioraphic appearance of the breast (author's transl)].

The authors present first correlations between histology, anatomy and serial radiography of the breast, in order to establish a new understanding of the mammographic picture, with respect to the tridimensional histological structures. Several essential points are considered: - Mammographic pictures only show fibrous, connecting and fatty tissues. The epithelium of the galactophores is not shown, because of its low radio-opacity. Mammographic densities are due above all to fibrous connecting tissue, which has a high percentage of water. Benign or malignant breast tumors present with a proliferation of epithelium and connecting tissue, but only connecting tissue, more or less hydrated is shown on the mammographic picture. Many mammographic patterns are related to various superimposed fibrous strands, appearing as pseudotumoral opacities. The benign or malignant tumoral opacities are hidden or modified by multiple superimposed adjacent structures. - The mammographic patterns is related to the degree of hydratation and components of the connecting tissue.


Clinical details, cytogenic studies,and cellular physiology of a 69, XXX fetus, with comments on the biological effect of triploidy in man.

A triploid fetus, 69, XXX, aborted spontaneously at 26 weeks' gestation. It had multiple abnormalities including syndactyly of the hands and feet single palmar creases, hypoplasia of the adrenals and ovaries, hypertrophy of thigh muscles, and abnormalities of the brain. The placenta was large and showed hydatidiform degeneration. The pregnancy had been complicated by acute dyspnoea, pre-eclampsia, and postpartum haemorrhage. Detailed cytogenetic studies, using banding and fluorescence techniques, were performed on fetus and parents. Meiotic studies were made on the fetal ovaries. Muscle cell differentiation and electrophysiological relationships of cultured skin fibriblasts were examined in an attempt to study the way in which the extra haploid set of chromosomes exerts its effect on the phenotype. The antenatal diagnosis of late triploidy is discussed. The finding that 25 per cent of late triploids have spina bifida is further evidence that meningomyelocele has a genetic component and strongly suggests that this results from chromosomal imbalance or a regulatory gene disturbance.


The de Lange syndrome in one of twins.

A pair of female monozygotic twins, one of them affected by the de Lange syndrome is described for the first time. Monozygosity was established by most of the accepted standards in use at the present time. Speculation is offered as to whether the discordance in the manifestation of the syndrome provides any clues for understanding its controversial pathogenesis. In this regard two genetic mechanisms are discussed. One is the hypothesis of a chromosomal or mitotic instability. The other possibility would be a postzygotic new mutation of a gene or large effect.


Trimethylhydrazine hydrochloride as a tumor inducer in Swiss mice.

A 0.05% solution of trimethylhydrazine hydrochloride (TMH) administered for a lifetime in drinking water to outbred Swiss albino mice, beginning at 6 weeks of age, induced tumors of blood vessels, lungs, and kidneys. The tumor incidences in these tissues in untreated controls were 5,22 and 0%, whereas in the treated groups the corresponding tumor incidences increased to 85, 44, and 6%, respectively. Histopathologically, tumors were classified as angiosarcomas of blood vessels and adenomas of the lungs and kidneys. The study thus demonstrated the tumorigenicity of TMH. Contrary to expectation, the chemical structure modification apparently failed to alter qualitatively the tumorigenic response.


Age incidence and site distribution of mammary dysplasias in young beagle bitches.

The age incidence and site distribution of 2,142 mammary dysplasias were documented for 39 beagle bitches 6 months to 4 years of age. Lesion onset was at 2-3 years of age, at which time more than 50% of the females had dysplasias. Dysplasias appeared before palpable tumors. Posterior mammae developed more lesions than did anterior mammae. Thus the gradient for early onset of lesions coincided with the gradient for tumor frequency reported previously; a preneoplastic potential is suggested for (some) dysplasias. Problems of defining normal tissue are discussed.


Hepatic angiosarcomas in dogs: an excessive frequency as compared with man.

A series of 18 angiosarcomas of the liver in dogs reported by veterinary schools in the United States and Canada suggested that certain breeds may have an excess of the tumor and that there is no marked predilection by sex. Histologic characteristics of hepatic angiosarcomas were similar in man and dog, but the relative frequency in dogs was about 25-100 times that of man.


Mutant lines of guinea pig L2C leukemia. II. Comparative cytogenetic studies and banding analyses of normal and leukemic karyotypes.

Chromosomes of normal guinea pig (strain 2) cells and of cell lines dervied from a spontaneously arising leukemia were analyzed in detail. All cell lines studied, LG-L2C, GH-L2-C, BZ-LC, and EN-L2C, contained one M1 marker and two X chromosomes, in addition to other chromosome abnormalities specific for each cell line. The presence of the M1 marker and the two X chromosomes confirmed that all of these leukemic cell lines are derived from one ancestral line. Comparison of the chromosome markers and immunologic characteristics of these lines revealed that possibly the gene involved in the determination of C3 receptor sites is located on the terminal portion of the long arm of chromosome No. 2, but no other correlations could be made.


Tumorigenicity of tetramethylhydrazine hydrochloride in Swiss mice.

Tetramethylhydrazine hydrochloride (TEMH) was administered in drinking water as a 0.125% solution to randomly bred Swiss mice for life beginning at 6 weeks of age. As a result of treatment, the incidence of blood vessel tumors rose from 5 to 96% in females and from 6 to 88% in males, while that of lung tumors increased from 21 to 36% in females and from 23 to 28% in males, as compared with untreated controls. The increased incidence of blood vessel tumors, but not of lung neoplasms, was statistically significant. Histopathologically, the tumors exhibited the characteristics of angiomas and angiosarcomas of blood vessels and adenomas of the lung. The investigation proved for the first time the tumorigenicity of TEMH. The possible role of increased methyl substitution on hydrazine in tumorigenesis was also discussed, as well as hydrazine derivatives as a tumor-producing class.


The influence of vesical distension on the urethral resistance to flow: a possible role for prostaglandins?

The possible role of prostaglandins in the mediation and/or modulation of the urethral response to vesical distension was investigated in female dogs. Three criteria for the possible involvement of these mediators have been investigated. Indomethacin could block the reduction of urethral resistance observed during vesical distension. Intra-arterial infusion of exogenous prostaglandin E2 resulted in a dose-dependent reduction in the urethral resistance to flow. Moreover, a significant release of prostaglandin E2 in the venous blood during the course of vesical distension could be demonstrated. The functional significance, mechanisms of release and mode of action of these highly active lipids are discussed.


Colpocystourethropexy: the way we do it.

In pure stress urinary incontinence the sphincteric mechanism is intact. Restoration of normal position and support to the vesicourethral segment usually re-establish normal sphincteric function. A suprapublic approach is used to gain adequate mobilization of the anteriorr vaginal wall and vesicourethral segment. Full thickness sutures applied in the anterior vaginal wall as far lateral from the urethra as possible are then tied to Cooper's ligament. Forward and upward lifting of the vesicourethral segment is achieved but the urethra is free in a wide retropubic space. Normal position with limited mobility of the sphincteric segment is attained, yet compression or obstruction of the urethra and surgical trauma to the delicate sphincteric musculature are avoided. Adsorbable sutures are used. Permanent fixation is to be achieved by the postoperative fibrosis made possible after all retropubic fat has been cleared away. This technique has been uniformly successful in virginal cases and in the great majority of the least favorable cases, after repeated failures. Adequate mobilization proper placement of sutures and prevention of compression and surgical damage are the keys to longlasting successful repair.


[Current therapeutic orientations for malignant teratomas of the testis with a choriocarcinomatous element. 14 cases (author's transl)].

In teratomas with a choriocarcinomatous element, the association with surgery of sequential chemotherapy lasting at least two years would appear to represent an improvement. Definitive conclusions may only be drawn from the study of large series.


[Reconstruction of the female urethra using the roots of the clitoris. Eleven cases (author's transl)].

In 10 cases of obstetric and surgical necrosis of the urethra and in one of congenital aplasia, the canal was reconstructed using as an intermediate layer the roots of the clitoris, freed and applied. In the ten cases in which treatment has been completed, continence was restored in 8, either with one operation only (3 cases), or with the addition of various procedures for suspension of the bladder neck using autografts (5 cases).


Mediastinal choriocarcinoma in a chromatin-positive boy.

A case of primary mediastinal choriocarcinoma in a chromatin-positive boy is reported. The incidence of neoplasms in patients with so-called Klinefelter's syndrome is discussed as well as embryogenesis and diagnostic evaluation in patients presenting with this tumor.


[Considerations relating to multiple primary carcinomas of the urinary tract (author's transl)].

The patient with more than one primary malignant neoplasm has ceased to be a pathologic curiosity and has instead become a practical problem. It is possible for a patient to have two simultaneous developping independant cancers, but is also possible for a second primary cancer to develop in a cancer prone individual after the initial malignant lesion has been removed by radical surgical procedures. The generally improved survival rate after treatment of cancer has permitted more patients to live long enough for a second or even a third primary lesion to develop and it probably also reflects the more thorough pathological studies in both surgical and autopsy cases. It may be hoped that factors of genetic predisposition, ethiology and pathogenesis that are obscure in the patient with single lesions may be brought out in patients with multiple cancers. We present the case of a 83 years old patient with three different primary malignancies. His first tumour was a clear cell carcinoma of the left kidney at the age of 71, followed by a transitional cell carcinoma gr. II/IV of the bladder seven years later, and followed by a third one two and a half years latter which was a distinct adeno carcinoma of the prostate.


[The signification of renal sequential scintigraphy with determination of regions of interest for the therapeutical purpose in urology (author's transl)].

Sequential scintigraphy with regions-of-interest technique has a firm position in the diagnosis of localized lesions of renal parenchyma. The method is of little annoyance to the patient and is often decisive for the further diagnostic and therapeutical proceedings. The mathematical evaluation process takes little time, an advantage in emergency cases. Main indications are pathological duplex kidneys, staghorn calculi and anomalies of renal form and position. Radiation doses are low, a valuable factor in long-term controls, above all renal trauma and urotuberculosis.


Effects of rubidium on behavioral responses to methamphetamine and tetrabenazine.

Different groups of mice were injected subcutaneously every other day with rubidium chloride at three doses (0.41(50), 1.23(150) and 3.69(450) meq/kg (mg/kg)) or with saline as a control for a period of 2-3 weeks. Rubidium administered acutely did not affect spontaneous locomotor activities, while it tended to increase the activities when administered repeatedly though the increase was not statistically significant. The methamphetamine-induced hyperlocomotor activities were potentiated in the rubidium groups as compared with those in the saline group, this effect of ribidium being increased with prolongation of repeated administrations. Monotonic decreases in ambulation after tetrabenazine were not significantly affected in the rubidium-treated animals though the decreases were sometimes preceded by slight increases and recovery from the decrement tended to be more rapid. After tetrabenazine in the rubidium-treated groups, incidences of catalepsy were increased and jumping behavior and Straub tail responses occurred in a few cases. The results suggest that rubidium potentiates the excitatory action of methamphetamine on spontaneous locomotor activities, as contrasted with inhibitory influence of lithium.


[Partial thromboplastin time (PTT) in the pediatric age group. Normal values and changes under different storage conditions (author's transl)].

Normal values for PTT were obtained from 60 infants and children- age 3 days to 14 years- who had unremarkable preoperative coagulation tests and had tolerated surgical procedures without bleeding complications. The 27 infants, who were less than 0.5 years old, had significantly longer PTT-times (mean value 37.65 sec., extreme values 29.6-47.4 sec) than the older children (mean value: 32.72 sec., extreme values: 24.9-40.5 sec). These results, which were obtained with PTT-reagent ROCHE, are considerably shorter than comparable values in the literature. There were no differences in the values from boys or girls. No positive correlation between PTT and bleeding time were found. There were no significant changes of PTT when the whole blood had been stored at room temperature (22-25 degrees C) for 6 to 10 hours before it was tested.


[Retention of platelets in newborns (author's transl)].

In healthy, 24-72 hour-old newborns, platelet retention is significantly elevated compared to adults. A relationship could not be established between the retention and the erythrocyte count, bilirubin in the serum or the content of energy-rich phosphates in the erythrocytes. The above results indicate that the platelet function in newborns is elevated and/or comparable with the adult norm. The basic cause of the frequent symptoms of hemorrhage during the newborn period cannot be traced back to disturbed thrombocyte function.


Neonatal respirator allowing simultaneous ventilation and suction.

A new type of respirator for newborns allowing tracheal suction and ventilation simultaneously is presented. Additional characteristics are: a partly disposable air supply system, no apparatus deadspace and with one exception no moving parts. The performance of the respirator under varied conditions of lung mechanics was tested using a pneumatic lung thorax analogue. The procedure of tracheal suction was simulated and the effect on tidal volume and alveolar pressure investigated. Triggervolume and response time were also determined. Analysis shows that the respirator has qualities of flow- and pressure preset ventilators. Tracheal suction during ventilation does not impair the delivery of tidal volume. In mechanical ventilation with PEEP the alveolar pressure remains positive throughout the respiratory cycle despite suction.


[Corticosteroid therapy in atopic diseases of children? (author's transl)].

Of 416 children suffering from different atopic diseases who were admitted as in-patients in a German aero-biological childrens clinic, 69.2% had previously received corticosteroid therapy. According to dermatological findings, 81.9% of these patients developed undesirable side effects. Of the children whose atopic dermatitis was treated prolonged with topical corticosteroids, also irreversible body changes developed through the transcutaneous absorptive processes, which were more evident and appeared more often in girls than in boys.


[Cytostatic therapy in a patient with histologically verified, but not irradiatied, brain stem glioma (author's transl)].

A boy, aged 8 1/2 years, was operated becuase of a brainstem tumor (polymorph mixed glioma) more than 4 years ago. Because of its dimension and location in the medulla oblongata the tumor was resected only partially. Radiotherapy was refused at that time. A combined cytostatic therapy proved to be successful. The marked neurological symptoms diminished considerably during treatment. The patient (with minor neurological symptoms) has been living a normal and active life for the last 4 years.


[Intracranial hemorrhage in idiopathic thrombocytopenic purpura (ITP) (author's transl)].

Intracranial hemorrhage is a rare, lifethreatening complication of immun-allergic thrombocytopenia (ITP). A 4 8 1/2 year old boy, who developed intracranial hemorrhage while receiving long term steroid treatment for ITP, was successfully managed by emergency splenectomy. Possible treatment for this condition is discussed.


[Heroin withdrawal syndrome in newborns (author's transl].

A case of a severe heroin withdrawal syndrom in a newborn infant is reported. Diagnostic and therapeutic aspects of the disease are reviewed.


[Risks and results of banding surgery (author's transl)].

A Muller-Dammann banding operation was performed in 64 infants and small children within 5 years. The diagnosis and the surgical risk (between 5.9% and 65% depending on the degree of intracardial malformation) were presented. Complications and cause of death were described and compared with data presented in the literature. Twenty-three patients were given a follow-up examination with special cardiac diagnostic methods. The hemodynamic results were compared with those from 9 children who were operated on late. As other authors, were also found a pronounced reduction in pulmonary flow in those children operated on early and not in those operated on late.


[Casuistic contribltion to acquired knee extension contracture in childhood (author's transl)].

On the basis of two observations, the clinical symptoms for acquired knee extension contracture in childhood was presented. A progressive fibrosis of the vastus intermedius of the musculus quadriceps femoris develops as a result of multiple injections into the ventral thigh musculature. This method of application should, therefore, be avoided and an intragluteal or intravenous method used.


Cytoskeletal elements of chick embryo fibroblasts revealed by detergent extraction.

Treatment of chick embryo fibroblasts with 0.5% Triton X-100 extracts most of the cell protein, leaving an organized part of the cell structure attached to the tissue culture dish. This "Triton cytoskeleton" consists largely of intermediate-sized filaments and bundles of microfilaments. SDS polyacrylamide gel electrophoresis reveals that this cytoskeleton is made up of three main proteins. One protein component is 42,000 daltons and co-migrates with muscle actin. The other two components are 52,000 and 230,000 daltons and remain quantitatively associated with the cytoskeleton during the detergent extraction. The possible identity of these three protein components and their organization into a supramolecular structure is discussed.


Morphological and biochemical abnormalities in hearts of cardiac mutant salamanders (Ambystoma mexicanum).

The effect of homozygosity for recessive gene c in Ambystoma mexicanum is the absence of a heartbeat even though initially heart development appears normal. Mutant embryos (c/c) are first distinguishable from their normal siblings (+/+;+/c) at stage 34 (7 days after fertilization) when the normals develop contracting hearts. The mutant hearts at this stage, upon gross examination, appear structurally normal but fail to beat. Nevertheless, the mutants survive through stage 41, which is about 20 days beyond the heartbeat stage, and they exhibit normal swimming movements, indicating that gene c does not affect skeletal muscle. Electron microscopic studies of normal hearts show some myofibrils to be present at stage 34; by stage 41, the normal myocardial cells have become highly differentiated muscle cells. Although some mutant heart cells contain a few thin 60 A and thick 150 A filaments, organized myofibrils are absent. Instead, amorphous proteinaceous collections are prominent. Heavy meromyosin (HMM) binding experiments were performed on mutant hearts to determine whether the myocardial cells contain actin. Mutant myocardial cells that are glycerinated but not treated with HMM contain intact amorphous bodies. After incubation in HMM, the amorphous collections are no longer present and large numbers of decorated actin filaments appear. The.results suggest that the amorphous proteinaceous collections contain actin in a nonfilamentous form, and the addition of HMM induces this actin to polymerize into filaments. SDS-polyacrylamide gel electrophoresis of mutant heart tissue supports this conclusion by showing a prominent 43,000 dalton band suggestive of actin. The electrophoresis experiments also demonstrate a significant reduction of myosin heavy chain (200,000 daltons) in mutant hearts when compared to normal, and this latter observation is confirmed by radioimmunoassay experiments. Muscle tropomyosin (34,000 daltons), prominent in normal hearts, is virtually nonexistent in mutants. Thus, it appears that this single gene mutation affects the accumulation and organization of several different muscle proteins, including actin, myosin, and tropomyosin.


Selective breeding of rats for differences in reactivity to alcohol. An approach to an animal model of alcoholism. I. General procedures.

Strains of rats are being developed which have distinct responses in spontaneous locomotor activity to a subhypnotic dose of alcohol. The purpose is to produce one strain in which the injection of a standard dose of alcohol will result in objectively measurable intoxication and a second in which an identical dose will result in virtually no effect.


Effect of housing density on alcohol consumption by rats.

Rats housed six to a cage drank significantly more of a 10% alcohol solution than those housed three per cage or individually. Open-field behavior was negatively correlated with alcohol intake.


Alcohol withdrawal effects on brain serotonin in mice behaviorally attracted to alcohol.

Serotonin concentration in whole brain tissue of CF1 mice behaviorally attracted to a 3% alcohol solution was significantly depressed 48 hours after access to the solution was denied. Norepinephrine concentration was not affected.


Studies on the mechanisms of 6-hydroxydopamine cytotoxicity.

The uptake-accumulation and binding of radioactivity in mouse heart after administration of the catecholamine neurotoxin [3H]6-hydroxydopamine (6-OH-DA, 1 or 3 mg/kg, i.v.) has been investigated. It was confirmed that a substantial portion (8--20%) of the radioactivity taken up and retained by the heart could not be extracted with perchloric acid, in all probability representing covalently bound oxidation products of 6-OH-DA to tissue proteins. Pharmacological analysis showed that a large part of this fraction was associated with the adrenergic nerves. The time-course of the perchloric acid resistant binding to the adrenergic nerves was found to parallel that of the neurotoxic action of 6-hydroxydopamine as evaluated by monitoring the change in [3H]noradrenaline uptake. Calculation of the intranelronal 6-hydroxydopamine concentration (average) needed to induce degeneration showed it to be in the order of 50 mM. The binding ratio for tritium deriving from [3H]6-OH-DA between the intraneuronal and extraneuronal compartments was found to be 10,000 to 30,000, pointing to a very high neuronal specificity for 6-hydroxydopamine. The 'covalent' binding of oxidation products of [3H]6-OH-DA was considerably reduced after desipramine or 1-phenyl-3(2-thiazolyl)-2-thiourea administration, treatments both known to protect the adrenergic nerves from undergoing degeneration. Conversely it was found that the binding increased during conditions known to potentiate the neurotoxic action of 6-hydroxydopamine, e.g., after monoamine oxidase inhibition with nialamide. Subcellular fractionation studies indicated that the predominant site of interaction between 6-hydroxydopamine oxidation products and neuronal proteins is the cytoplasm and the axonal membrane. Analysis of the effect in vivo administration of 6-hydroxydopamine on the field-stimulated induced release of [3H]noradrenaline previously taken up in the adrenergic nerves showed a 6-hydroxydopamine indiced reduction in [3H]noradrenaline release which was approximately proportional to the reduction in the number of nerve terminals. These findings further support the view that 6-hydroxydopamine acts largely in an "all-or-none' fashion with respect to the neurodegenerative action. Administration of [3H]dopamine also resulted in a fraction which was not extractable with perchloric acid, although this fraction was very small compared to that found after an equal dose of [3H]6-hydroxydopamine. These data may indicate that oxidation products of dopamine can interact with tissue proteins. From the present results it can be concluded that there is a close relationship between 'covalent' binding of 6-hydroxydopamine oxidation products to neuronal elements and the cytotoxic action of 6-hydroxydopamine, indicating that this binding may play an important role in the neurodegenerative action of 6-hydroxydopamine on catecholamine neurons.


[Development and differentiation of mycelium of Trichothecium roseum in submerged culture].

Ontogenesis of Trichothecium roseum during biosynthesis of trichothecin was studied during submerged cultivation on maize and synthetic media. Growth of the fungus is polycyclic; several generations of the submerged mycelium develop from the submerged conidia on the maize medium, and from the submerged conidia, chlamydospores and budding mycelium on the synthetic medium. Differentiation of the mycelium favours biosynthesis of the antibiotic. The nuclei in the cells of the submerged mycelium differ by their number, dimensions, and shape (round and elongated, polyploid). Several nuclei are found in the cells of the submerged mycelium more often during growth on the synthetic medium; this phenomenon is related to the reproductive cells -- submerged conidia and chlamydospores.


[Cytological mechanisms involved in assimilation of n-alkanes by yeasts].

The paper describes cytological mechanism of adaptation of yeasts to assimilation of aliphatic hydrocarbons added to a growth medium as a sole source of carbon. The process was studied by light optical and electron microscopy, employing fluorescent labelling and electron microscopy contrasting. Two types of yeasts were found, which differed by the response of the cell walls to hydrocarbons: those that formed "channels" and those that did not form them. Cytological response to hydrocarbon assimilation was detected also in the mitochondria and canals of the endoplasmic reticulum. Components of the Golgi apparatus may also participate in this process, in particular, in formation of peroxisomes (microbodies). Close contacts of the yeast cells with the hydrocarbon being assimilated is important; assimilation may start in a close vicinity of the cell walls. The rate of flavin production by Candida tropicalis 303 IBFM increases during growth on solid paraffins, beginning with C20-paraffin.


'3H-testosterone distribution and binding in rat thymus cells in vivo'.

Autoradiography and biochemical investigations showed that [3H]-testosterone where injected intraperitoneally into male white rats was incorporated rapidly into thymus lymphocytes. Thymic cortex contained more silver grains than medulla, and larger lymphocytes were more labelled than medium or small lymphocytes. Cytosol fraction of thymus cells labelled in vivo with [3H]-testosterone, contained the largest quantity of labelled hormone. A 4S cytosol fraction binds [3H]-testosterone. This could be separated by Sephadex chromatography or by linear sucrose gradient centrifugation. Nuclear extract contained also a small quantity of the labelled hormone.


Stabilization of double-stranded DNA molecule by non-histone peptidic effector from calf thymus.

A peptidic effector from calf thymus causes a strong stabilization of DNA double-stranded molecule in vitro. The active factor was isolated from aqueous ultrafiltered thymus extracts and purified by means of chromatography on DEAE-cellulose and then on Dowex 50 WX2. The purified thymic factor was characterized as a peptide of low molecular weight (less than 5000). The biological activity of the thymic factor cannot be attributed to a histone fragment. Melting data of the control DNA and of the DNA-active factor complex in various conditions of ionic strength and dielectric constant of the solution medium are recorded.


Synthesis of delta crystallin from embryonic chick lens messenger ribonucleoprotein complex.

A single, major 21 S messenger ribonucleoprotein (mRNP complex) was isolated and purified by sucrose gradient centrifugation after EDTA treatment of high salt washed polysomes from 15 day embryonic chick lenses. A 17 S mRNA was released from the 21 S subunit of delta crystallin. Similar results were obtained with the 17 S mRNA released from the 21 S mRNP complex.


Characterization of poly(A)-protein complexes isolated from free and membrane-bound polyribosomes of Ehrlich ascites tumor cells.

Proteins present in messenger ribonucleoprotein particles were labeled with [35S]-methionine in Ehrlich ascites tumor cells in which synthesis of new ribosomes was inhibited. Poly(A)-protein complexes were isolated from free and membrane-bound polyribosomes by sucrose gradient centrifugation and affinity chromatography on oligo(dT)-cellulose. Both classes of Poly(A)-protein particles contain a poly(A) chain of about 70 adenyl residues and a protein with a molecular weight of 76000 attached to it.


Cytoskeletal control of surface membrane mobility.

Cytochalasin B induced redistribution of actin microfilaments into a bulge of the cytoplasm, bringing cell-surface elements to the corresponding surface area. This process was reversible, inhibited by colchicine and enhanced by antibodies to cell-surface antigens.


Porcine pituitary peptides with opiate-like activity: partial purification and effects in the rat after intraventricular injection.

A peptide material with opiate-like activity in the guinea-pig ileum was extracted from porcine pituitaries using a hot glacial acetic acid extraction method and was partially purified by gel filtration. When injected intraventricularly in rats, these purified peptides induced strong analgesia, catelepsy, respiratory depression and other opiate-like effects, which lasted for several hours.


Tolerance and dependence induced by morphine-like pituitary peptides in rats.

An extract from porcine pituitaries containing peptides with opiate-like activity (endorphins) was investigated for possible tolerance/dependence liability in rats. Repeated intraventricular administration of endorphins induced a degree of tolerance similar to that induced by normorphine. Rats made tolerant to morphine by repeated pellet implantation proved cross-tolerant to the pituitary extract as well as to synthetic methionine-enkephalin. Naloxone given to rats, repeatedly pretreated with endorphins, precipitated a withdrawal syndrome strongly resembling that induced in rats treated with normorphine. Withdrawal precipitated in morphine-dependent rats was suppressed by intraventricularly applied endorphins. The results suggest that identical sites and mechanisms are involved in the development of tolerance/dependence induced by opiates and pituitary endorphins.


Inverse diurnal variation of blood plasma 11-hydroxycorticosteroids level in cancer patients.

The plasma level of 11-hydroxycorticosteroids was examined twice a day by means of MATTINGLY'S fluorometric method in patients with malignant and other chronic diseases and in control subjects. Higher values in the afternoon or the same as those in the morning were found in each case of malignant disease. This change of physiological diurnal rhythm was not observed in the vast majority of healthy subjects or in patients with non-cancerous diseases.


[Determination of blood polyamines in patients with brain tumor -with special reference to relationship between varieties of tumors and concentrations of blood spermidine and spermine (author's transl)].

Examination of blood polyamines in 38 patients with brain tumor and 17 normal volunteers was carried out by columnar chromatography--cellulose acetate membrane electrophoresis. The upper limits of the normal values; M.+2S.D. of the blood polyamine concentrations in 17 normal volunteers, were less than 2.1 mg/ml for spermidine, less than 1.6 mg/ml for spermine, and less than 2.2 mg/ml for spermidine plus spermine. The values of blood polyamines in 21 cases with glioma were significantly higher than those in normal subjects (p less than 0.01). And in 14 out of them, the concentrations of the blood polyamines were higher than the maximum normal value. In one case with reticulum cell sarcoma, the concentrations of the blood polyamines were remarkably increased. In 2 out of 4 cases with metastatic brain tumor the concentration of the blood polyamines were higher than the upper limit of normal amount, and values of the blood polyamines in 4 cases with metastatic brain tumor were significantly higher than those in normal volunteers (p less than 0.05). In none of 2 cases with pituitary adenoma, 3 cases with meningioma, 4 cases with neurinoma, one case with hemangioblastoma, and one case with pinealoma, the values of the blood polyamines were significantly higher than those in normal volunteers. The CSF samples obtained from 9 patients with brain tumor, consisted of 6 gliomas (glioblastoma multiforme 2, anaplastic glioma 4), 1 teratoblastoma, 1 von Recklinghausen's disease (neurinoma and meningioma), and 1 craniopharyngioma, were analyzed for detection of polyamines, but no detectable amount was present in those cases.


[Normal meatogram (author's transl)].

Meatograms obtained in 33 patients (41 examinations) in whom cerebello-pontine angle tumor was excluded clinically and operatively, were studied. Meatographies were performed with a small quantity of contrast medium, and restricted to the visualization of the structures in the auditory canal. Tomographies of antero-posterior view were utilized in all the cases. Normal tomomeatograms were classified into 4 types. In the first type the internal auditory canal not opacified, in the second the contrast medium recognized as a single stream along the superior wall of the internal auditory canal, in the third another parallel line of contrast medium is recognized close to the middle of the internal auditory canal, and in the fourth the contrast medium fills the internal auditory canal with two transparent lines corresponding to the arrangement of the nerves. The nerve roots were recognized as peripheral recess in lateral tomograms of the internal auditory canal. These types of normal meatograms are related to the width of the internal auditory canal. The height of the internal auditory canal of type I is about 3 mm., that of type II is 3 to 5 mm., that of type III is 5 to 7 mm., and that of type IV is over 7 mm.


[A case of the anterior choroidal artery aneurysm combined with the abnormal intracranial vascular network (author's transl)].

A case of the anterior choroidal artery aneurysm combined with the abnormal intracranial vascular net-work was reported. The patient was 43-year-old male who was attacked by subarachnoid hemorrhage in February 25th 1975. When he was admitted to our clinic 30 days after the ictus, his general status was good and the neurological examination showed no particular findings except only slightly accelerated deep tendon reflexes on the left side. Cerebrospinal fluid still remained xanthochromic although no nuchal rigidity was denoted. Based on the angiographic four vessel studies, the circulatory condition of the patient's brain was summarized as follows; the internal carotid arteries were stenosed or occluded between the C1 and C2 segment on both sides, and abundant collateral circulation was developed mainly around the circle of Willis making an angiographically peculiar vascular net-work in tha base of the brain. Another angiographic finding to be noticed was a berry aneurysm which originated from the distal part of the left anterior choirdal artery. No special treatment was performed on him. He was discharged without any neurological residuals. It would be difficult to find out any hemodynamic relationship between the occlusion of the internal carotid arteries and occurence of the aneurysm. But the abnormally dilated anterior choroidal artery might suggest that the vessel wall of this artery would be burdened in the abnormal distension stress due to the increased transaxial pressure in this artery. Unqder such a hemodynamically stressed state, it would be possible the aneurysm like outpouching of the vessel wall being developed in some fragile portion of the artery functioning as a prominent collateral circulation.


[Intracranial invasion of ethmoid cancer --a report of two cases (author's transl)].

Two cases of intracranial invasion of the ethmoid cancer were reported. With additional six cases reported in Japan, the precise clinical course and pathophysiological findings of the disease were reviewed, and the following several points became clear; 1) The incidence of the ethmoid cancer was rare. 2) These were divided into main groups according to the onset of intracranial signs, such as the frontal lobe symptoms and I-VII cranial nerve involvement. The first group showed the intracranial symptoms early, and the second group late. 3) The tumor invaded the cranial cavity along the perineural sheeth of each cranial nerve mainly. 4) It was very difficult to identify the paranasal sinus of origin after invading the cranial cavity. 5) The prognosis was extremely poor. All cases were died within one and half year.


[An infantile skull fracture followed by the enlarging of the fracture line ("enlarging skull fracture") (author's transl)].

We experience sometimes an infantile skull fracture which is followed by the skull fracture line and bulging of the fractured area day by day after the head injury. Since John Howship reported the case of the partial absorption of the right parietal bone, arising from a blow on the head in a child aged 9 month in 1816, this phenomenon was variously described meningocele spuria, traumatic cephalohydrocele, leptomeningeal cyst, fibrosing osteitis, cerebrocranial erosion, traumatic meningocele, die wachsende Schädelfrakture, growing skull fracture, etc. So called "growing skull fracture" has generally the triad of the symptoms which are the parietal skull fracture in infancy or childhood, traumatic dural tears, and subsequent enlargement of the fractures. And it is said that the dural tear is an indispensable condition for the developing of the "growing skull fracture". But we recently had the case of a 14 day old male infant who had neither traumatic dural tear nor subdural hematoma, but the progressive enlarging of the fracture line in the left parietal bone. The authors suggest that there should be the difference between the growing skull fracture (with the dural teat) and the enlarging skull fracture (without the dural tear).


[Surgery of vertebral aneurysms at the origin of PICA (author's transl)].

Thirteen cases of vertebral aneurysm at the origin of PICA (VA-PICA aneurysm) were operated on at the Department of Neurological Surgery of Kitano Hospital from March, 1970 through July, 1975. Those included 9 cases of saccular aneurysm and 5 cases of fusiform aneurysm (Table 1). The incidence of VA-PICA aneurysms among our whole series of intracranial aneurysms was 4.2%. Patients with subarachnoid hemorrhage were subjected to our routine 4 vessel angiography. For those with suspected vertebral aneurysm vertebral angiography was performed in a transoral projection. In this method, when the angle between the film and the horizontal plain of Frankfurt is fixed at 50 degrees, the origin of PICA is projected on the film between the upper and lower teeth line. Since X-ray beam falls vertically on the origin of PICA, the resultant vascular shadow is free from shortening, elongation and distortion, leading to precise demonstration of anatomical arrangement of the vessels. At surgery a lateral suboccipital incision was made. With the position of VA-PICA junction the surgical approach was slightly different. When the junction was located higher than the line between the lowest point of the occipital bone and the basion by 1 cm or more, the approach was made through the middle of the sigmoid sinus which was exposed by suboccipital osteoclastic craniectomy (mid-lateral cerebellar approach). When the VA-PICA junction was situated lower than the line by 1 cm or more, the operation was initiated at the upper limit of the lower one-third of the sigmoid sinus (lower-lateral cerebellar approach). Since VA-PICA junction is ventrally situated to the lower cranial nerves, surgical attack to the junction can be attained only through the space among the nerves. Two spaces are available for this direct attack. One is the space between the facial nerve, acoustic nerve and the group of vagal nerves. The other is between accessory nerve bundles or between the group of accessory nerves and the hypoglossal nerves. The former procedure is employed for reaching the aneurysm by mid-lateral cerebellar approach and the latter by lower-lateral cerebellar approach. In the patients in acute stage of ruptured VA-PICA aneurysm, hemisuboccipital craniectomy and laminectomy of the atlas were carried out for the purpose of decompression. Surgical procedures used included coating in 2 cases, trapping in 2, proximal ligation of the vertebral artery in 2 and neck clipping in 6. Two patients died due to grastrointestinal bleeding. Surgical complications noted were hypoglossal nerve palsy in 1 case mild sensory disturbance contralateral to the aneurysm in 3 cases. Those symptoms were thought to be caused either by direct injury to the lower cranial nerves or circulatory disturbance in the medullary branches of the vertebral artery. To eliminate those postoperative complications it is desirable to devise smaller aneurysm clips and smaller clip foreceps.


[Experimental study of acute brain swelling under acute intracranial hypertension (author's transl)].

There are many problems about the cause, pathophysiology and treatment of acute brain swelling under intracranial hypertension frequently encountered in the neurosurgical clinics. Generally, rapid increase of the cerebral vasoparesis caused by unknown etiology is thought to be the main cause of acute brain swelling under intracranial hypertension. Moreover, disturbance of the cerebral venous circulatory system is discussed recently by many authors. But, research from the point of systemic respiration and hemodynamics is necessary for resolving these problems. This experiment was designed to study the effects of respiration and hemodynamics on the cerebral vasoparesis. Using 22 adult dogs, acute intracranial hypertension was produced by epidural balloon inflation sustained at the level of 300 - 400 mmH2O. Simultaneously with measurement of intracranial pressure at the epidural space, superior sagittal sinus pressure, respirogram, systemic blood pressure (femoral artery), central venous pressure, common carotid blood flow, EKG and bipolar lead EEG were monitored continuously. The experimental group was divided by the respiratory loading into 5 groups as follows: control (6 cases), 10% CO2 hypercapnia (4 cases), 10% O2 hypoxia (4 cases), stenosis of airway (5 cases), 100% O2-controled respiration (3 cases). 1) Cerebral vasoparesis under acute intracranial hypertension took place earlier and showed more rapid progression in groups of stenosis of airway, hypercapnia and hypoxia than control group of spontaneous respiration in room air. No occurrence of cerebral vasoparesis was found out in a group of 100% O2 controlled respiration. It is proved that increased airway resistance or asphyxia, hypercapnia and hypoxia have strictly reference to the occurrence and progression of cerebral vasoparesis and for the prevention of cerebral vasoparesis, correct 100% O2 cont rolled respiration is effective. 2) From the hemodynamic change, the progression of rapid increase of cerebral blood volume with increase of blood volume in the superior sagitta sinus during cerebral vasoparesis under intracranial hypertension is presumed. It is suggested from the superior sagittal sinus pressure in various experimental groups that the site, reactivity and disturbed degree of the cerebral venous system are changed by the difference of respiratory or ventrilatory state and the cerebral venous circulatory disturbance has also reference to the occurrence of acute brain swelling. 3) During cerebral vasopareris under acute intracranial hypertension, remarkable supression of respiration, increased central venous pressure and increased common carotid blood flow were observed. It is concluded that the reaction of systemic hemodynamics following respiratory change effects on cerebral circulation markedly and they are being important factors to occurrence of acute brain swelling.


[Tentorial dural arteriovenous malformation--a case report (author's transl)].

A case of tentorial dural AVM was reported. A 52 years old man came to the Jichi Medical School hospital on July 29, 1974, with the chief complaints of intermittent left exophthalmos, diplopia and left blepharoptosis, which had been noted since March of 1974. He had episodes of severe headache attack since 3 years prior to the hospital visit. Angiography done at the out-patient department demonstrated the dural AVM with the nidus in the left tentorium. The nidus was fed by the left posterior middle meningeal artery, the dural branch of the left occipital artery, the left posterior cerebral artery, the left superior cerebellar artery and the dural branches of vertebral artery. It was drained to the vein of Labbé and the two cortical veins of the occipital lobe. He was appointing admission under the diagnosis of dural AVM, but he had an apopleptic attack three days before the appointed date, so was admitted in emergency. Neurological examination on admission: The patient was in drowsy state, papilledema on the both sides and right hemiparesis including the face were noted. The bruit was not audible. Left CAG revealed intracerebral hematoma in the left tempotal lobe, so that the removal of the intracerebral hematoma and the middle meningeal artery ligation were carried out after his general condition improved, on October 18, 1974. On October 30, 1974, the second operation was performed in an attempt of the radical excision of the AVM nidud. But, unfortunately, the patient fell into the shock state so that the operation had to be stopped at the stage of the ligation of the feeders running in the dura of the posterior fossa. The third operation was done on February 19, 1975. The AVM nidus was removed with the left transverse sinus and a part of tentorium. He was discharged on March 3, 1975, with only the right homonymous hemianopsia. Nine months after his discharge, there was no sign of recurrence of AVM. The left transverse sinus was almost occupied with AVM tissue. The endothelium of arteries were hypertrophied and the internal elastic bnadles were partly defected. Veins showed also hspertrophy of the endothelium and the thrombus formation. The dural AVM of the posterior fossa is not a rare malady, especially in the recent years, probably due to the technical advances in the roentgenology, such as magnification techniques as well as selective arterial catheterization. The most common signs and symptoms of this disease picked up from the reports of 112 cases in the literature are: bruit 47%, headache 44%, papilledema 26% and SAH 24%. The extra cranial ligation of feeders were reportedly carried out on 39 cases, but only 9 cases (23%) were effective. Therefore, the radical excision of the nidus would be the most desirable method for the complete treatment of the dural AVM.


[A case of the lateral ventricular tumor (subependymal glomerate astrocytoma) with preceding Parkinsonian symptoms due to normal pressure hydrocephalus (author's transl)].

Authors report a patient with a subependymal glomerate astrocytoma in the right lateral ventricle. He maifested parkinsonian symptoms and dementia related to the preceding normal pressure hydrocephalus which was proved by an infusion test, and then advanced an akinetic mutism. Soon after a shunting operation was carried out he showed a full recovery from the symptoms, which may suggest that an incomplete block of the ventricular system is one cause of the normal pressure hydrocephalus. From pathology it was revealed that the tumor is an intraventricular astrocytoma with a fibrous stalk and was totally removed with an ease. The findings seem to accord with "Subependymal glomerate astrocytoma" (Boykin.) Further corroboration would be necessary to establish this entity.


[Delayed radiation necrosis of the brain simulating a brain tumor--report of two cases (author's transl)].

Two cases of delayed radiation necrosis of the brain were reported. Case 1 was a 50-year-old man who had right hemiparesis and disorientation 26 months after Linac irradiation (5,000 rad), preceded by the operation for right maxillar carcinoma. A left carotid angiogram demonstrated a left temporal mass lesion, extending the frontal lobe. Case 2 was a 41-year-old man who had previously the operation for right intraorbital plasmocytoma, followed by two times Co irradiation (6,400 rad, and 5,000 rad). He had the signs and symptoms of intracranial hypertension 36 months after last irradiation. A left carotid angiogram demonstrated a left temporal mass lesion. Both cases were treated by administration of steroid hormone, which alleviated the signs and symptoms, followed by the temporal lobectomy. Microscopic examinations showed necrosis of the brain tissues associated with hyaline degeneration of blood vessel walls and perivascular cell infiltration. The signs and symptoms of intracranial hypertension subsided postoperatively. The other thirteen cases as same as ours were collected from literature, which showed the signs and symptoms simulating a brain tumor (like a metastic brain tumor) after the irradiation to extracranial malignant tumors, and the diagnosis of radiation necrosis were made by the operation or autopsy. A follow-up for a long time is necessary, because the pathological changes in the brain may be progressive and extending in some cases, although the decompressive operations for mass lesion are excellent in result.


Suckling and LH-induced progesterone secretion in lactating hamsters (Mesocricetus auratus).

The effects of suckling and LH upon serum progesterone levels in lactating hamsters were investigated. Diurnal rhythms in serum levels of progesterone and LH occur throughout lactation in the hamster and these levels are normally higher between 15.00 and 17.00 than between 8.00 and 12.00 (lights on 6.00-20.00). Hamsters injected with 10 mug of LH at 8.00 on day 9 of lactation had higher levels of serum progesterone 2 h after injections than did vehicle-injected controls. Suckling was also found to induce an increase in serum progesterone concentrations. 30 min of suckling from 10.30 to 11.00 on days 10 or 11 of lactation resulted in increased serum levels of progesterone and prolactin, but had no measurable effect upon serum LH levels in animals bled at 11.00. However, suckling for 30 min from 15.00 to 15.30 had no effect upon serum progesterone levels, although it did result in increased titers of both serum LH and prolactin at 15.30. Ovariectomy on day 7 of lactation resulted in lowered levels of serum progesterone at 11.00 on day 11 of lactation and abolished the suckling-induced increase in serum progesterone concentrations. These findings suggest that in the lactating hamster (1) suckling bouts stimulate progesterone secretion from the ovaries, and (2) the diurnal rise in serum progesterone levels is stimulated in part by the increase in serum levels of LH.


Neonatal hydrocortisone: effect of the development of the stress response and the diurnal rhythm of corticosterone.

Neonatal rats were given s.c. injections of 1 mg of hydrocortisone acetate, and the effect on the subsequent development of the pituitary-adrenal response to ether stress and the development of the circadian rhythm in adrenal and serum corticosterone (B) was investigated. Following exposure to ether, adrenal steroids were elevated in 11-day-old controls. The response did not appear in treated animals until 25 days. At this age, the time-course of response to ether in the adrenal was more sluggish in hormone-treated rats. After stress, serum corticoids were high in controls at 20 days; however, this rise did not appear in treated rats until 25 days. Serum corticoids, 5-60 min after ether, tended to be lower in 25-day-old runts than in controls. The diurnal rhythm in serum B first appeared in controls at 27 days and in treated animals at 30 days. The rhythm in adrenal corticoids appeared in both groups at 30 days.


Anterior segment ischemia and sector iris atrophy: after strabismus surgery in a patient with chronic lymphocytic leukemia.

A 69-year-old woman with chronic lymphocytic leukemia developed segmental iris atrophy and iridocyclitis after routine surgery for exotropia. Both the clinical picture and fluorescein angiogram indicated anterior segment ischemia. It is postulated that this was related to hyperviscosity of the blood caused by a high white blood cell count (114,000/cu mm). The possibility of anterior segment ischemia should be kept in mind when contemplating strabismus or retinal detachment surgery in the presence of hematologic disorders likely to increase blood viscosity. In these cases a minimal amount of surgery should be done with proper supportive therapy. Strabismus surgery should be done in stages allowing for hemodynamic compensation between procedures.


Scanning electron microscopy of the endolymphatic sac epithelium.

In this study, scanning electron micrographs of the dog endolymphatic sac surface epithelium are presented. According to our morphological findings, three portions were recognized, the proximal, intermediate and distal part. The intermediate or 'rugose' portion was found the most differentiated where two types of cells were identified. These cells were seen to have many of the criteria for fluid absorption and phagocytosis. In man, alteration in the ability of these cells may lead to endolymphatic hydrops.


Histological findings in infantile otoantritis.

The histopathological findings in the granulation tissue removed at mastoidectomy from 34 infants between 1971 and 1974 are described. Granulation tissue was present in every case, characterized by the histological features of chronic inflammation and fibrosis (sclerosis), although the process was of short duration. The great number of thick fibers was a surprising finding. To prevent fibrosis (sclerosis) to develop later on, it is advisable to operate as early as indicated.


Emergency repair of traumatic drum tears.

Tympanic membrane tears have been found in about 20% of casualties in modern combat (war of October 1973). Repair of the tears that do not seem to have the optimal chances for spontaneous healing should be undertaken during the first few days of trauma. This prompts healing, prevents complications, and obviates the need for future intervention.


Symptoms and signs of acute maxillary sinusitis.

Symptoms and signs of acute maxillary sinusitis have seldom been specifically analyzed. Since there is a gradual transition from rhinitis to sinusitis it can be expected that many symptoms are common for the two diseases. However, since sinusitis requires drainage measures and/or antibiotic treatment, both of which seldom are actual for rhinitis, the differential diagnosis is important. The present investigation confirms most of the symptoms presented previously in textbooks. However, most of these sympatoms which conventionally are supposed to indicate sinus disease were found to be just as common in radiologically normal sinuses and in sinuses with pronounced changes. The subjective or objective finding of purulent nasal secretion was more helpful in the differentiation between rhinitis and sinusitis. It appears that the patient's symptoms do not constitute a reliable diagnostic basis for the confident differentiation between the two diseases. The simplest and least discomfortable means of demonstrating sinusitis is by radiology.


[Late results in the removal of vocal-cord polyps].

A follow-up of 60 patients in whom polyps of the vocal cord have been removed between 1966 and 1974 is analyzed. Two thirds of the patients were male, mostly between 30 and 55 years of age. Most of the female patients were between 25 and 60. The most frequent localization was the typical one between the anterior and middle third of the vocal cord (47 patients). In 38 patients a direct laryngoscopy in local anaesthesia was performed; in 22 the removal of the polyps was done in microlaryngoscopy under general anaesthesia. The follow-up shows no recurrence. 55 patients had a clear voice, the remaining 5 showed signs of chronic laryngitis. It is concluded that microlaryngoscopy under general anaesthesia is indicated in cases of unfavourable anatomical configuration of the neck, sessile polyps or in cases where precise endoscopical manipulations are called for. The direct laryngoscopy remains an approved method in favourable cases, for instance pendular polyps, as these represent an affection of the vocal cord which shows no tendency to recurrence after mediculous removal.


[Velo-pharyngeal closure before and after adenotomy and tonsillectomy].

Prior to and after removal of the tonsils and adenoids at the ENT clinic in Lucerne, phoniatric and X-ray examinations were performed in 42 children with normal velo-pharyngeal closure. Prior to the operation the velo-pharyngeal closure took place against the adenoid tissue. The surface of contact and the inclinatation of the velum were dependent on the amount of hyperplastic adenoid tissue. The configuration and the mobility of the velum were more important for the post-operative velo-pharyngeal closure than the distance from the pharyngeal wall. 3 months following the operation the velum was reaching the posterior pharyngeal wall. A distinct Passavant ridge was only visible in cases having slight difficulties in the post-operative adaptation of the velo-pharyngeal closure.


[Spastic dysphonia].

Between 1968 and 1974 10 patients (4 men, 5 women, and 1 10-year-old girl) with spastic dysphonia were observed at the Phoniatric Department of the ENT clinic in Lucerne. According to the clinical documentation, the probable etiologic factors, the clinic appearance as well as the therapeutic measures and their results are discussed.


[Approach and reconstruction in the operative treatment of tumors of the tongue, epiglottis, floor of the mouth and pharynx].

This paper explains a new way of a temporary splitting of the lower jaw and the reconstruction of the tongue and the floor of the mouth. The described way of the temporary splitting of the lower jaw allows to maintain the nerve and results in better suppositions for the reposition and osteosynthesis. For the reconstruction of the tongue and the floor of the mouth, an island flap is reommended. The flap consists of the musculus sternocleidomastoideus, pedicled inferiorly in its cranial part of the skin. The skin taking extends over the insertion of the muscle up to the beginning of the hairy part. With this flap it is possible to cover even large defects in the floor of the mouth and its taking does scarcely bother the patient. Thus, in many cases the flap gives the suppositions to maintain the lower jaw.


[Modification of a technic of reconstruction after total or subtotal resection of the lower lip].

It has been shown that two different kinds of modification are able to improve Meyer's operation after subtotal or total ablation of the lower lip. Either a flap taken from the top of the tongue or the Estlander-Abbé's triangular flap can be used in the intention of widening the new lip and consequently avoiding an excess of tension of it.


[Cervico-facial lesions caused by windshields of tempered glass].

The authors stress the dangers presented by windshield fragments of tempered glass to soft parts of the cervicofacial region, in cases of traffic accidents. With the aid of seven recent clinical observations, the difficulties in emergency surgical treatment, late complications due to the persistence of foreign bodies, and permanent facial mutilations are successively discussed.


[Rupture of the aorta secondary to perforation of the esophagus by a foreign body].

A case of traumatic rupture of the aorta due to a foreign body in the esophagus is presented. After extraction of the foreign body and chemotherapy there was a rapid recovery. Thereafter, the patient died from a recurrent hematemesis. Two factors have produced the aortic lesion: the sharp edge of the foreign body (which probably provoked a superficial lesion of the aortic wall), and the diffuse mediastinitis (which provoked a necrosis of the aortic lesion).


[Clinical aspects of leishmaniasis].

Report of an extremely rare localization of leishmaniosis with primary affection of the hard palate. The diagnostic methods, differential diagnosis and therapy are discussed.


[Differential diagnosis of salivary disturbances by quantitative scintigraphy].

The scintigraphy of salivary glands with technetium-99m pertechnetate is predisposed to be an excellent test for evaluating salivary gland function. But the absence of a sufficiently precise and simple quantitative analysis procedure of the technetium uptake has reduced its clinical use. For this reason, the authors propose a new and quick method:  the quantitative salivary gland scintigraphy. With an uptake index (ratio of technetium uptake between the glandular tissue and a cervical reference) they get precise quantitative information on functional activity. Among other applications, the test allows to make within a few minutes, in a case of xerostomia, the differential diagnosis between Sjäogren syndrome and sialosis.


[Xerography in otorhinolaryngology].

This study compares, in the field of oto-rhino-laryngology, the xerography (a radiographic method recently introduced in the Cantonal Hospital of Geneva) with conventional radiography. In spite of the quantity of irradiation which is by far superior, the xerography, with its larger field of information and with its sharpness of outlines, permits a more precise topographic diagnosis, particularly as far as the pharyngolarynx is concerned.


[Futher experimental studies on the relationship between the stapedius reflex threshold and speech discrimination].

This paper discusses the functional relatiohship between the position of the stapedius reflex threshold and the results of the Feldmann test. 25 hearing-impaired patients have been examined in this respect. A positive correlation on a 5% level of significance has been confirmed between these two parameters.


[Clinical significance of preoperative impedance measurements].

On the basis of six particular cases in which the various impairments of the middle ear were verified during the surgical intervention, the authors show how it is possible to obtain by means of the Madsen ZO 70 electroacoustic impedance meter and of the Grason-Stadler Model 1720 otoadmittance meter useful additional information about the preoperative dynamic behavior of the tympano-ossicular system. With regard to the measurement of 'susceptance' and the 'conductance' at 220 and 660 Hz, it permits to establish a better differential diagnostic.


[Change of working place in occupational noise].

Nowadays noise in industry cannot be eliminated by technical means alone. Therefore, exposed workers have to wear an ear protector to prevent the occurrence of deafness caused by professional noise. Patients with chronic otitis media and permanent or intermittent otorrhea should avoid the prolonged use of ear protectors. On principle, such patients are not allowed to work in a noisy environment (inaptitude for noisy employment/change of occupation) unless the contraindication for use of ear protectors can be eliminated by therapeutic means (such as operation).


[Meningitis and labyrinthitis in childhood].

The Haemophilus influenzae meningitis is the most common cause of deafness following meningitis. Five of 22 children (23%) had this complication in spite of antibiotic treatment (ampicillin). The question must be raised whether a different antibiotic treatment could avoid the inner-ear problems occurring in Haemophilus influenzae meningitis. Early decompression of the internal auditory canal has reversed deafness in one of four children.


[Tympanoplasty and congenital cardiopathies].

During the course of 1974, 16 tympanoplasties were performed on patients who suffered from serious congenital heart defects. 50% of the cases had recurrence of the perforation. It was not possible to deny the evidence of other failing factors such as the poor hemodynamic condition. Indications for performing a tympanoplasty were motivated by the necessity to eliminate a focus of dangerous infection to the patient before under-going a major cardiac intervention. These indications have been modified to the following: (a) chronic cholesteatomatous otitis remains a valid surgical indication and (b) simple chronic otitis could be controlled by local medical treatment. The tympanoplasty could be postponed after the cardiac intervention when the hemodynamic condition had been corrected.


[Radiologic aspects of temporal-bone fractures with facial paresis].

The value of the radiobiological diagnosis in establishing the localization of a facial palsy resulting from temporal bone fractures has been investigated in 49 cases. Radiological confirmation was found in 21 out of 37 cases of longitudinal fracture and in 11 out of 12 patients (90%) with a transverse fracture. The fracture line was seen by polytomography alone in 1 out of 21 (5%) longitudinal fractures and in 5 out of 11 (45%) transverse fractures. A precise readiological localization of the facial nerve lesion was only possible if the fracutre line was running across the long axis of the pyramid. The surgical revision of 37 patients has shown that the labyrinthine segment of the facial nerve was injured in 93% of longitudinal fractures and in 70% of the transverse fractures. Therefore, one should always be prepared to expose the labyringhine segment of the facial nerve when revising a facial nerve palsy due to a fracture of the temporal bone.


[Experimental studies on the suppression of the stapedius reflex in comparison with EMG-results in idiopathic facial paresis].

The recording of intra-aural muscle reflexes elicited by acoustic stimulation is a routine method in clinical audiology. The most important quantitative examinations of the reflex dynamic, i.e. Metz recruitment and reflex decay in low frequencies, allow the judgement of function of the afferent pathway in the stimulated inner ear and acoustic nerve. Quantitative determinations of the efferent branch were carried out by several authors in a few normal subjects and in several patients with multiple sclerosis or facial palsy. Absolute acoustic impedance - a method yielding wide scattering - was used in order to determine changes in reflex activity in pathological conditions. In the first part of our investigations we tried to find a parameter or reflex dynamic allowing to characterize the functional capacity in the efferent part of the reflex arch in the facial nerve. We examined particularly the steepness of the onset of recorded reflex. Statistical analysis showed an extraordinary stability of this parameter in normal and pathological conditions. Measurements in normal subjects yielded very small intra- and inter-individual variability. In the second part of our experiments we studied normal-hearing patients with unilateral Bells palsy. In the early phase of the lesion we found a significant decrease of the onset steepness in the reflex diagram recorded on the paralyzed side. The greatest reduction of this parameter was seen with a 1,000-Hz stimulus. The time course of the alteration of the onset steepness also seems to have a characteristis pattern. In a further investigation we compared the variations of this reflex parameter with findings in stimultaneously recorded electroneuronograms.


[Tissue adhesives in facial-nerve surgery].

Large amounts of the tissue glue Histoacryl applied over the circumference of the epi- and perineurium of the facial nerve produced a rapid decrease of the summation potentials of the face in acute and chronic experiments performed in cats and guinea pigs. No toxic action on the motor neurons of the facial nerve was seen after application of 1 or 2 drops of the tissue glue over the epi- or perineurium of the facial nerve in association with or without a collagen tube splint.


[Treatment of posterior epistaxis by ligation of the internal maxillary artery in the pterygo-maxillany fossa].

The microsurgical, transantral ligature of the internal maxillary artery is the treatment of choice for recurring posterior epistaxis. An immediate success was obtained by this method in 5 out of 7 patients. In one case the concomitant coagulation of the ethmoidal arteries was necessary and in another instance a revascularization of the spheno-palatine artery could be visualized by arteriography.


[Extirpation of nasopharyngeal fibromas after selective preoperative angiographic embolization].

The gross amount of bleeding during surgical removal of nasopharyngeal angiofibromas is feared. An excellent method to reduce this amount is the preoperative selective embolization of the feeding vessels of these tumors under angiographic control. The advances in selective angiography of the branches of the external carotid artery by femoral catheterization make it possible to applicate Gelfoam emboli in the very arteries which are to be embolized. There is a case report about two young men who have been pretreated in this manner. The intraoperative bleeding was minimal.


[Tympanometry in chronic otitis media].

We present an analysis of the otological and audiological findings in 63 patients (113 ears) in which a myringotomy for suspected serous otitis media has been performed. In 98 ears (87%) the impedance data correlated with otoscopy. Tympanograms did not give further information than otoscopy alone in 49 patients with reliable pure-tone audiometrical results, whereas tympanograms would have missed 6 out of 78 ears containing fluid and 6 out of 49 ears who improved in hearing following myringotomy and transtympanic tube therapy. We feel, however, that, in patients who are too young or too retarded to be tested audiometrically, tympanometry in combination with otoscopy could eventually be helpful in settling the indication for a myringotomy, since 3 out of 83 ears with middle ear fluid and hearing improvement following transtympanic tube therapy had pathological tympanograms in spite of normal-seeming ear drums.


[Vocal and laryngo-tracheal sequelae of prolonged intubation at the university medical clinic of the cantonal hospital at Lausanne].

70 patients (39 men and 31 women) submitted to a prolonged intubation at the Centre respiratoire de la Clinique médicale universitaire de Lausanne have been investigated. They represent the half of the patients having survived of 488 cases treated between January 1966 and June 1974. 33% of the investigated patients (i.e. 18% of all men and 48% of all females) complain about a permanent dysphonia related to the intubation. 17% of the patients (i.e. 13% of all men and 23% of all females) presented with a laryngotracheal lesion induced by the prolonged intubation. This study shows that laryngo-tracheal complications following prolonged intubation are more frequent in females than males. The time of intubation is a determinant factor for the development of complications. Following the first 48 h or intubation of the risk of laryngo-tracheal complication is proportional to the duration of the permanence of the nasal tube. The presence of pathogenous microbes (Klebsiella, Staphylococcus aureus, Bacterium coli, Proteus, Pseudomonas aeruginosa) in the tracheo-bronchial secretion is also important for the development of sequelae. In conclusion, laryngo-tracheal complications following prolonged intubation occur in the male when predisposing factors are present, whereas in the female post-intubation sequelae occur without such predisposing factors.


Variability of blood pressure in normal and abnormal pregnancy.

Using an automatic indirect method of measurement, diurnal blood  pressure patterns have been studied in normal and hypertensive pregnancies. In the last trimester, normotensive and hypertensive pregnant subjects show small but significant increases of blood pressure that develop especially during the evening and night. This change is more clear-cut for the systolic than the diastolic pressure. The tendency to a relatively greater increased pressure at night is exaggerated in preeclampsia. This fact explains earlier observations of a dimunution of the nocturnal fall of blood pressure in preeclampsia. In very severe preeclampsia, the nocturnal increase of blood pressure may be so exaggerated as to reverse the normal diurnal blood pressure pattern. These changes have been documented sequentially, and their implications are discussed briefly.