The investigation and treatment of renal osteodystrophy.

Skeletal demineralisation was measured for two years in 16 patients on maintenance haemodialysis; the technique employed was neutron activation analysis of a hand. The magnesium concentration of the dialysate was increased in six of the patients; oral calcium carbonate was administered to seven patients and 1-alpha-hydroxycholecalciferol, a potent vitamin-D analogue was supplied to a further three patients. An increase in skeletal calcium content of a hand was noted in the groups of patients receiving supplementary calcium and 1-alpha-hydroxycholecalciferol. It is concluded that 1-alpha-hydroxycholecalciferol appears to be effective therapy for renal osteodystropy, that oral calcium supplements may promote skeletal remineralisation and that supplementary magnesium therapy may reduce the progressive losses of skeletal calcium from some patients on maintenance haemodialysis.


Reversible acute anuric lupus nephritis.

Six cases of acute anuric lupus nephritis are described; renal biopsy showed intracapillary proliferation, epithelial crescents in some glomeruli, wire loops, and intracapillary thrombi. In two patients there were thrombotic occlusions and fibrinoid necrosis of arterioles. The patients were treated by heparin at anticoagulant doses, corticosteroids and dialysis (four). All patients showed improvement of renal function. One died following a gastric haemorrhage - the others were alive and well 64, 61, 40, 40 and 22 months from the onset of renal failure. One patient had a second episode of acute renal failure after 39 months and improved after resumption of heparin and high doses of steroids. It is suggested that heparin and high doses of corticosteroids may be a successful treatment in acute anuric lupus nephritis.


The significance of extracapillary proliferation.

Renal biopsy and clinical data from 60 patients with crescent formation were correlated. Nephropathy was related to infection (15 cases), malignancy (four) and trichlorethylene exposure (two). Four cases had extrarenal signs. Isolated proteinuria was found 0.5-20 yr before biopsy in 16. Only 17 patients had rapidly progressive glomerulonephritis on clinical criteria. Nineteen patients (35%) are alive with functioning kidneys. Outcome was significantly related to percentage crescentic involvement (p less than 0.02) and oliguria (p less than 0.05) and renal function (p less than 0.01) at presentation. Preceding infection was a favourable sign. Extracapilly glomerulonephritis is not a single entity.


Phonophoresis with 1 percent versus 10 percent hydrocortisone.

Phonophoresis, using a topical hydrocortisone preparation, is a little-used method of delivering concentrated antiinflammatory medication to inflamed subcutaneous areas. A retrospective study of 285 patients treated for a variety of common inflammatory conditions compared the results of treatment using a 1 percent hydrocortisone solution preparation and a 10 percent hydrocortisone preparation. The results of the study demonstrated the efficacy of the treatment and the superiority of the 10 percent preparation. The method offers a painless alternative to percutaneous steroid injections in the treatment of selected inflammatory conditions.


Sampling in physical therapy research.

Although the importance of appropriate statistical analyses of the results of physical therapy research is well documented, the theory and methodology of sampling, the procedure by which the data of research are usually obtained, has received much less attention in the physical therapy literature. To help fill this gap, some of the basic concepts and techniques of sampling are discussed.


[Statistical study of laryngeal frequency. Application to the analysis and synthesis of prosodic features of French].

Some precisions concerning the specification and the instruments developed for the measurement of laryngeal frequency F1 being stated, the authors give statistical results for French. In first approximation, the F1 distribution is gaussian for a given corpus; the standard deviation measured and given in percentage referring to the mean laryngeal frequency F1 is about 16% for male and female speakers. Ceteris partibus, the variations of F1 are relatively low for a given speaker from one record to an other (about +/- 1/2 tone). The means of F1 are given for samples (gaussian) concerning adults (30 males and 30 female): respectively 118 and 207 Hz with standard deviation sigma (F1) of 18 and 20 Hz. The ratio tau 1 of the voiced duration to the total duration of the corpus, dependant on the sex: 0.50 for men and 0.63 for women (the difference is significant at the 0.001 level) allows the specification of the speaking rate. When the speaking rate increases, the length of pauses decreases. These results can be used for an estimation of the precision of the statistical measurement of F1 and sigma (F1), in relation to the number of periods N. To N appears a total duration of the corpus determined by tau 1. A comparison is made between the results of the calculation and the measurement. The F1 specification can be used for determination of the vocal source of synthesizer to improve naturalness of synthetic sounds and for analysis and synthesis of prosodic features using the results of two previous papers which have allowed to specify the position of level 1, 2 and 4 and to show the differences in the perceptual importance of the variations introduced in connection with the three levels.


[Specific duration and specific tongue height of vowels].

The hypothesis that intrinsic duration of vowels correlated with tongue height is dependent on the extent of the articulatory movements is refuted. If one chooses vowels in a consonantal environment which allow far-reaching co-articulation (vowels between bilabial consonants), the phenomenon of intrinsic duration still remains. The same is valid for whispered vowels. The phenomenon of intrinsic pitch is confirmed. The author establishes the hypothesis that intrinsic duration and intrinsic pitch of vowels are a matter of compensation conditioned by different resonance factors of the vocal tract when high and low vowels are produced.


Tongue musculature and the feature of tension in English vowels.

Electromyographic techniques were employed to discover which, if any, intrinsic and extrinsic tongue muscles displayed a difference in overall amount of activity corresponding to the traditional tense-lax distinction between members of the English vowel pairs /i-I/, /e-epsilon/, and /u-u/. Although some muscles revealed a consistent difference, most did not. Even for those muscles where a tense-lax difference was found, the data do not support the notion that tension was a necessary of sufficient differentia of production.


Velopharyngeal opening in the formation of voiced stops in Sindhi.

It was proprioceptively felt that voiced and aspirated voiced stops in Sindhi are characterized by a slight nasalization. Nasal airflow during the production of voiced stops was therefore measured with a Froikaer-Jensen Electro-Aerometer. Results suggest that there is an imcomplete velopharyngeal closure which helps to absorb the transglottal airflow and thus prevents the rise in the supraglottal pressure. For the affricated palatal stops of Sindhi, the vocal fold vibrations were, however, maintained by expanding the walls of the supraglottal cavities.


Experimental approach to the study of vowel perception in German.

An experimental phonetic investigation is described whose goal it was to develop a test which could be used to establish norms in the perception of vowels by native speakers of German. Particular emphasis is placed upon the design of the experiment. The test procedure and the results are discussed.


Tongue-lip pressures during speech of Australian aborigines.

Electronic instruments to measure tongue and lip pressures and pressure patterns in Australian aborigines made it possible to differentiate physiologically between certain sounds. Lingual pressure patterns indicate that the /t/, /nt/ and /tj/ sounds in the Walbiri language require different articulatory gestures and are properly considered separate phonemes. Labial pressures distinguish classes of phonemes but not individual sounds. Tongue positioning within the oral cavity of aborigines reveals compensations for their different anatomy, but articulatory gestures are remarkably similar in aborigines and Americans.


The features of the larynx: N-ary or binary?

Multivalued features have generally not been permitted on the classificatory level of representation by generative phonologists. It is found necessary, however, to posit a multivalued scalar feature "glottal width" on the classificatory level of representation in order to provide a satisfactory explanation of the diachronic tone splits conditioned by the phonation type of the syllable-initial consonants among the languages and dialects of the Tai language family in Southeast Asia. The feature "glottal width" consists of a lineraly ordered set of terms along a single physical continuum that extends from the widest open position of the glottis to the fully closed position (i.e. glottal stop). Other proposed sets of laryngeal features are tested against this evidence and found to be inadequate. A binary feature "vibrating" is also proposed within this theoretical framework.


Variation in lingual coarticulation at certain juncture boundaries.

The acoustic spectra of [m] produced by speakers of American English in various [mV] contexts was studied for coarticulatory variations caused by the [vowel] under conditions of varying juncture boundaries occurring between [m] and [vowel]. Dispersion analysis was used to estimate the coarticulatory variation in [m] spectra. Low level junctures marked by short pauses do not disrupt nasal-vowel coarticulation. However, higher leveljunctures such as between extraposed clauses or phrases and the body of an utterance are more often than not marked with long pauses, and concomitant reduction of nasal-vowel coarticulation.


[Neutralization of English stress differences in the intonation contour].

PILCH'S analysis of the English intonation contour implies that the difference between the primary and secondary stresses exists only in the contour nucleus, but is inaudible elsewhere. This hypothesis has been checked and confirmed both by auditory and acoustic analysis and by the test responses of native speakers. The parameters by which primary and secondary stresses are heard as different are length and pitch change. The pitch difference disappears outside the contour nucleus, and the length relations may be reversed causing wrong identifications by the listeners.


Effects of several unusual sulfur-containing amino acids on rat liver cystathionine-gamma-lyase.

1. The mode of inhibition of rat liver cystathionine-gamma-lyase [L-cystathionine cysteine-lyase (deaminating), EC 4.4.1.1] was studied by using several unusual sulfur-containing amino acids newly found in this laboratory. Some cysteine conjugates (CMC, Beta-CEC, HCETC and HCPC) inhibited noncompetitively both homoserine dehydratase and diaminopropionate ammonia-lyase activities, and competitively gamma-cystathionase activity. CMTC exhibited a mixed type inhibition on both homoserine dehydratase and gamma-cystathionase activities, and a noncompetitive inhibition on the diaminopropionate ammonia-lyase activity. Some homocysteine conjugates (CMHC, beta-CEHC and HCEHC) inhibited competitively both the activity of homoserine dehydratase and of gamma-cystathionase, and exhibited a mixed type inhibition on the diaminopropionate ammonia-lyase activity. beta-CEC, CMHC and beta-CEHC were also effective inhibitors to cysteine desulfhydrase activity. 2. Among the other amino acids tested, DL-homocysteine and D-cysteine, irrespective of their concentration, exhibited a mixed type inhibition on the homoserine dehydratase activity. However, they promoted gamma-cystathionase activity at their lower concentrations and inhibited at their higher concentrations, more so than cystathionine. DL-alpha-Aminobutyric acid was a weak competitive inhibitor of the homoserine dehydratase, gamma-cystathionase and diaminopropionate ammonia-lyase activities. DL-alpha-Aminopimeric acid has the same chain length as beta-CEC, CMHC and CMTC, but it showed a very weak inhibitory effect compared with the latter sulfur-containing compounds. L-Methionine, DL-methionine sulfoxide, L-ethionine, L-cysteic acid, L-aspartic acid, L-asparagine, L-glutamic acid, L-glutamine, D-alanine, beta-alanine, L-ornithine and L-lysine had little or no effect on any activities of the enzyme preparation. These results were discussed in relation to the catalytic center of cystathionine-gamma-lyase.


The mechanism for the exclusion of sugars from the water in a model of the liveing cell: the ion-exchange resin: pore size or water structure?

The equilibrium distribution coefficients (p-value) of D-arabinose between the water in sulfonate ion-exchange resin and the external aqueous solution vary with the nature of the five alkali metal counterions studied. The strongest exclusion (lowest p-value) is found in the Li+ resin and the least exclusion (highest p-value) in the Cs+ resin. The p-value decreases with the increasing atomic weights for the alkali-metal ions: pCs+ greater than or equal to pRb+ greater than or equal to pRb+ greater than or equal to pK+ greater than pNa+ greater than pLi+. The water contents of these resins, on the other hand, vary in the opposite direction, being highest for the Li+ resin and lowest for the Cs+ resin. These data disprove the pore size theory but fully substantiate the predictions of the association-induction hypothesis.


Kinetics and thermodynamics of the slow hydrophobic deactivation of alpha-chymotrypsin.

A quantitative model for the slow reversible hydrophobic deactivation of alpha-chymotrypsin (alpha-CT) is proposed. Kinetic results are obtained for (1) the situation in which the inhibitor concentration, although remaining constant during the course of a run, can be varied independently of the concentration of nonself-inhibiting substrate, and for (2) the situation in which the self-inhibiting substrate concentration decreases during the course of a run, and independent variation of inhibitor and substrate concentrations is not possible. Excellent quantitative agreement between theory and experiment is obtained for a wide range of conditions using 3-(n-hexanoyl-O-benzoate (with dodecylsulfate as the inhibitor), and 3-(n-decanoyl)-O-benzoate as the self-inhibiting substrate. Activation enthalpies and entropies for the hydrophobic deactivation of alpha-CT by dodecylsulfate and tetradecyltrimethylammonium are determined. For comparison, activation enthalpies and entropies for the alpha-CT hydrolysis of 3-(n-heptanoyl)-O-benzoate are determined; evidence for a thermally induced conformational transition in alpha-CT at 30 degrees C is obtained.


The effect of the presence of the metal prosthetic groups on the subunit structure of bovine superoxide dismutase in sodium dodecyl sulfate.

Dissociation into protomers of bovine superoxide dismutase by sodium dodecyl sulfate (SDS) depends on the metal prosthetic group and incubation time in the presence of detergent. The holoenzyme containing either copper and zinc or copper and cobalt is not dissociated. The fully metal-free apoenzyme is dissociated into protomers after short preincubation in SDS. The copper-free enzyme, still containing zinc or cobalt, is dissociated to a significant extent only after 24 hours preincubation in SDS. This effect is associated with a gradual alteration of the native zinc site, as followed by optical spectra of the homologous cobalt enzyme. Removal of SDS results in significant reassociation of protomers which is apparently independent of the presence of metals.


X-ray induced behavioral reactions and detection mechanisms in the shrimp.

Red Ghost Shrimp, Callianassa californiensis, were shown from behavioral and electrophysiological studies to respond to ionizing radiation. When exposed to X-rays at 52 R/sec, the majority of intact animals could detect and avoid further irradiation by escaping into a shielded section of the test chamber. Animals continued to display escape responses after removal of eyestalks and antennae. Significant avoidance activity also occurred with partial-body exposure and indicated the existence of a radiation-sensitive receptor on the abdomen. Electroretinograms elecited by beta- and X-radiation sources corresponded closely with the waveforms produced by visible light stimulation. Electroantennograms were recorded from isolated antennules following stimulation with glutamic acid, beta-, and X-radiation. Biphasic on-off phases were recorded with an intermediate phase present during the longer duration exposures. Similarly, bioelectrical potentials were recorded from swimmeret preparations with exposure to beta- and X-radiation. The electrophysiological evidence indicates that the eye, antennules, and possibly chemoreceptors on the abdominal segments serve as routes for detection of ionizing radiations.


Graded levels of hemorrhage, thirst and angiotensin II in the rat.

Hemorrhage was evaluated as a stimulus to drink in rats prepared with chronically implanted jugular cannulae and bled either 20, 30, 40 or 50 percent of their total blood volume. Hourly observations of water intake for 5 hr after hemorrhage revealed that the volume drunk was proportional to the degree of hemorrhage. Drinking induced by 20 percent hemorrhage did not differ significantly from control values, and intake was greatest and most persistent after 50 percent blood loss. The onset of maximal drinking at 1 hr after 40 percent hemorrhage was preceded by a twofold increase in plasma concentrations of angiotensin II. This is compatible with previous suggestions that angiotensin plays a role in hypovolemic thirst.


Ability of the pig to distinguish between conspecific urine samples using olfaction.

In two female pigs it has been shown using operant conditioning techniques in which the animals pushed panels with their snouts in order to obtain food, that they could distinguish between the oder from urine samples taken from other pigs. In the discrimination task, the pigs faced two panels and a tube adjacent to one of the panels emitted urine odor used as the positive discriminative stimulus while another tube adjacent to the other panel emitted the negative discriminative stimulus consisting of odor from another urine sample. Only presses on the panel associated with the positive stimulus were reinforced on a fixed ratio schedule of 6. Both positive and negative discrimination stimuli were presented simultaneously. After each reinforcement the position of the positive and negative odor stimuli was varied according to the Gellerman series. When fully trained, the pigs made very few responses on the incorrect panel.


An economical operant space interface for the PDP-8 computer.

An inexpensive input/output transfer system between a PDP-8/1 Digital Equipment Corporation computer and two operant stations is described. An interrupt facility is included. Slight modification of this interface will also permit it to work with the newer PDP-8 series computers.


Meal pattern correlations: facts and artifacts.

The feeding behavior of 37 albino rats was used to demonstrate that significant postprandial correlations could be obtained from unordered raw data when actual intake was used as the measure of meal size. When meal duration was used instead, substantially lower correlations were obtained. It was further demonstrated that caution must be used when correlating ratio measures of feeding behavior. If the ratios are not independent then significant correlations can be obtained due to statistical bias alone. Implications and suggestions for the analysis of meal patterns were discussed.


An automated apparatus for the determination of visual thresholds in turtles.

An automated apparatus is described that permits precise and reliable measurements of visual thresholds in turtles using a conditioned avoidance technique. The entire sequence of stimulus management and the collection of response data are under programmed control.


A critical evaluation of body weight loss following lateral hypothalamic lesions.

The possibility that factors in addition to motivational or psychomotor deficits contribute to body weight losses following lateral hypothalamic (LH) lesions was assessed in 2 experiments. Rats with LH lesions failed to gain weight when compared to sham-operated controls, when equal quantities of nutrients were given by intragastric feeding. They also lost weight more rapidly than controls under total starvation conditions regardless of whether food was present or absent in the G1 tract prior to surgery. These results could not be explained on the basis of differences in urine or fecal output or activity levels. An increase in core temperature was found in LH lesioned rats immediately following surgery and throughout the experimental period. These results suggest that lateral hypothalamic lesions induce a metabolic impairment.


Ability of rats with ventromedial hypothalamic lesions to work: effects of ambient temperature.

Rats with bilateral ventromedial hypothalamic lesions decreased bar pressing at FR 64 at high ambient temperatures. No significant decrease was noted at low temperatures for VMH rats. Controls evidence no response suppression at any temperature. Pause time for the VMH rats at high temperatures suggest a VMH lesion-ambient temperature interaction.


Feeding studies in weanling rats with dorsomedial hypothalamic lesions: maintenance of competence to compensate for additional calories.

Weanling rats received bilateral electrolytic lesions in the dorsomedial hypothalamus primarily destroying the dorsomedial hypothalamic nuclei (DMN). Sham-operated rats served as controls. After a 14 day postoperative period during which food intake (lab chow) and body weight were recorded, each of the above groups were subdivided into 2 groups. One DMN group and one sham-operated control group were continued on lab chow alone throughout the remainder of the study. The other DMN group and the second control group were given additional calories in the form of a liquid diet by stomach tube during 2 separate periods of 10 and 14 days, respectivly, to increase their caloric intake beyond that taken in spontaneously. Both tube-fed groups reduced their ad lib caloric intake from chow considerably and to the same extent. Body weight gains were similar in tube-fed versus non-tube-fed rats, whether with or without DMN lesions. After the second, 14-day-long tube feeding period, however, DMN rats regulated their body weight somewhat less precisely than the controls. This may be related to their reduced food intake during that time period. The data indicate that weanling rats with DMN lesions, despite their basic hypophagia, do not show a deficit in caloric metering and gross body weight regulation.


[Effects of glucose, aminoacid or lipid infusion on dietary self-selection in the rat].

Rats with an intracardiac chronic catheter were offered dietary self-selection between glucids, proteins and lipids intakes. They are infused continuously with 0.9% NaCl except on the test day with glucose, amino acids or lipids. Parenteral load is about 25% of the daily total food intake. With glucose infusion a selective decrease in glucids intake is observed of about 80% of the caloric glucose  load. Aminoacidemic and lipidic infusions lead not only to decrease respectively in proteins and lipids intakes, but also in glucids intakes. So, in this case, total caloric intake decreased more than caloric load. Results are discussed in the hypothesis of existence of a hepatic chemosensibility.


Aversive effects and retention impairment induced by acetoxycycloheximide in an instrumental task.

AXM, when subcutaneously injected during the first 3 min following the acquisition of a nondiscriminative instrumental learning task, induced an aversion for the food reinforcement which had been associated with the training situation and with the pharmacological treatment. The high number of nonreinforced responses preceding the first reinforced response(RR) that animals performed when tested 6 days after AXM treatment, was not due to forgetting of the lever significance, but to this aversion. Animals treated with AXM showed low levels of lever pressing response and long latencies for their first RR; this deficit did not seem only to be due to food reinforcement aversion; it disappeared, as well as food aversion, when food reinforcement which had been associated with the learning situation and to treatment, was added to the daily feeding regimen during treatment-test interval. It has been shown, moreover, that more than 90 percent of cerebral protein synthesis was inhibited during the 5 hr following subcutaneous AXM injection. These findings are interpreted as an indication that AXM does not affect memory consolidation of a non discriminative instrumental learning.


Effects of hypothalamic knife cuts on the ingestive responses to glucose and insulin.

Parasagittal knife cuts through the perifornical hypothalamus either medial or lateral to the fornix produced hyperphagia and obesity and altered the rat's ingestive responses to dilute glucose solutions. The lateral knife cut rats drank less dilute glucose solution under both nondeprived and food deprived conditions and displayed less of a feeding suppressive response to glucose ingestion compared to controls. The lateral cut rats were also deficient in their feeding response to insulin-induced hypoglycemia, although their altered sensitivity to glucose and insulin did not appear to be causally related. The medial knife cuts decreased the responsivity to glucose, but less so than the lateral cuts, and did not alter the ingestive response to insulin. Both the medial and lateral knife cuts did not appear to change the rat's responsivity to concentrated blucose solutions. The neuroanatomical and functional nature of the disorder responsible for these effects and its relationship to the hyper-phagia-obesity syndrome are discussed.


VMH lesions facilitate baitshyness in the rat.

Normal rats and rats with lesions of the ventromedial hypothalamus were compared on the acquisition of a single trial, long CS-US interval, conditioning task (baitshyness). The rats with hypothalamic damage exhibited facilitated baitshyness when tested both shortly after surgery and several months after surgery. The magnitude of the suppression observed in these animals could not be related to either specific anatomical structures within the hypothalamus or to the amount of obesity exhibited following the lesions. Similarities and differences between the results of the present study and previous studies are discussed.


Pavlovian conditioning of eating induced by spreading depression in cortex, striatum and hippocampus of rats.

A single wave of unilateral spreading depression in the cortex, hippocampus or caudate nucleus of rats elicits eating after 2-6 min. The present experiments provide evidence that such spreading depression-induced eating can be classically conditioned to a complex conditioned stimulus. A wave of spreading depression was triggered by injection of 0.5-2.0 mul of 25 percent KCl solution. In a first experiment successful conditioning was demonstrated in 20 rats, involving 7 cortical, 5 caudate and 8 hippocampal spreading depression sites. Four animals failed to show any conditioned eating. A control group of 8 animals, in which cortical spreading depression did not induce eating, showed no increase in eating in the presence of the CS after conditioning trials. A second experiment, which included pseudoconditioning and NaCl control groups, confirmed the results obtained in Experiment 1. Classical conditioning was successful in 11 animals, involving 6 cortical and 5 caudate spreading depression sites. Neither the pseudoconditioning (14 animals, involving 8 cortical and 6 caudate spreading depression sites) not the NaCl control group (8 animals, all with cortical sites), showed eating in the presence of the CS. In both experiments the conditioned eating underwent gradual extinction.


Patterned response of lamina V cells: cutaneous and dorsal funicular stimulation.

Single unit activity was recorded in spinal lamina V (LV) in unansthetized cats. Poststimulus-time histogram (PSTH) analysis of responses to intracutaneous stimulation demonstrated similar firing patterns for all cells. In addition to a direct relationship between stimulus intensity and the duration of cellular response, modulation of firing frequency and distinct delayed PSTH peaks in 77 percent of the units were observed. The pattern of delayed peaks was associated with the same high intensity intracutaneous stimulation reported as painful when applied to human observers. A background of dorsal funicular stimulation selectively inhibited the delayed response of LV cells to high intensity stimulation. Thus, LV cells, by their duration of firing, trasmit information related to stimulus intensity, and by their patterned responses, have the potential to relay other information, possibly related to their nociceptive role. As delayed LV activity is associated with a high proportion of small fibers in the afferent input, presynaptic inhibition of A-delta and C fibers might account for the selective inhibition associated with dorsal funicular stimulation.


Low dose-response for 2-deoxy-D-glucose-induced feeding, and the involvement of peripheral factors.

Latencies to feed and meal sizes were observed in recently satiated rats injected intraperitoneally with an isotonic solution of 2-deoxyglucose, using 3-0-methyl glucose for the control injection. The feeding response latency shortened monotonically with dose from about 0.3 mmole/kg (50 mg/kg) to 0.5-0.6 mmole/kg, with an extended plateau up to dehilitating doses. At modest doses, the latency to feed was shorter in adrenal demedullated rats than in intact rats, suggesting that the hyperglycemic response to 2DG partially inhibits the feeding response. Food-deprived rats took larger meals following 2DG injection, if there had been recent rapid intestinal absorption of glucose. It is suggested that a major action of 2DG is to block the satiating consequences of the process of absorption, possibly at hepatic receptors.


The increasing complexities in the world of plastic surgery.

The increasing complexities in medicine, in medical education, and in plastic surgery seem to almost defy resolution. The best way to cope with these complexities, and to provide opportunity on an individual or a group basis, is by adherence to quality training program of the type which has served us well and in which the objective is constant. This implies the selection of high-quality candidates for training, and the control of resident flow, so that we may continue as a learned profession. History witnesses change--and time will bring new philsophies, new surgeons with changing values, and a public oriented to a different system of medical care. Shakespeare said, "when the day ends, the end will be known." I am confident that plastic surgery, with its traditional emphasis on quality and excellence, will long endure as a most learned profession.


Lymphangioma. A long-term follow-up study.

At the Hospital for Sick Children 177 patients with lymphangioma, exclusive of those who had intra-abdominal lesions, were seen between 1927 and 1964. Forty-nine of these (aged 8 to 41 years) were available for follow-up examination. The results of treatment by surgical excision, aspiration, incision and drainage, and radiation are reported. No cases confirmed histologically as lymphangioma underwent spontaneous regression. Two histologically unconfirmed cases underwent partial regression. Four of the 11 who were left with lymphangioma tissue at operation never had significant recurrences. Therefore, this clinical study does not clarify the possible role of spontaneous regression in lymphangioma. Extensive surgery is the treatment of choice whenever feasible, but in unilocular or bilocular cystic lymphagnioma subsequent regression can be expected after palliative treatment (aspiration, or incision and drainage). Clinical and pathological criteria should be established for differentiation between lymphangioma and primary lymphedema. Lesions involving subepithelial, subdermal, and subcutaneous or internodal networks of lymphatics will produce lymphagioma; lesions of the collecting lymphatic trunks will result in lymphedema.


Surgical management of lymphedema of the extremity.

Lymphedema of the extremity has been managed in 14 patients by staged excisions of the edematous subcutaneous tissue beneath skin flaps. Six patients have been followed for 4 to 6 years. This method has been successful in dealing with the symptoms of this condition. No episodes of postoperative celluitis have occurred in these patients. Normal function of the extremity has been achieved, and the contour has been preserved. It appears at this time that excision of the subcutaneous tissue is the most important aspect of the surgical management of lymphedema.


[The problem of apparent schizophrenic symptoms in juveniles].

In the clinic we frequently come across cases of indistinct accentuated schizophrenic behaviour in youth. We mention here a casuistry which can be considered as a juvenile asthenic denial syndrome with coenaesthetic symptoms. This picture can be differentiated from coenaesthetic schizophrenia, hebephrenia, neurotic symptoms and physical psychoses which can be proven. The problem of differential diagnosis is considered with particular regard to progressive diagnosis.


[The use of nitrous oxide as a contrast medium during fractionated gas encephalography in halane-nitrous-oxide anesthesia].

40 children were employed as test cases in fractionated gas encephalography using Halan-nitrous oxide anesthesia, and the level of cerebrospinal pressure, the röntgenoparent quality of the extracerebral spaces and the duration of postencephalographical symptoms were examined using air and nitrous oxide as contrast media. In the course of the examination the cerebrospinal pressure showed a tendency to rise when air was introduced, to fall when nitrous oxide was introduced. After instillation of N2O however the filling of the subarachnoid space was over so quickly that it could not be included in the assessment. Sufficient röntgenograms were obtained for all diagnostic demands through 'hybrid filling', (introduction of nitrous oxide into the ventricles, introduction of air into the subarachnoid spaces). With the aid of the results obtained from this examination attempts will be made to derive differentiated indications for filling with nitrous oxide.


[Against the concept of a uniform schizophrenia].

500 chronic schizophrenics (250 men and 250 women) were examined and divided up into two groups according to whether occurrences of psychosis had been proved in the family ('family' cases) or not ('spordic' cases). Considerable discrepancies were found when the two groups were compared. The examination showed the 'sporadic' schizophrenics to be older; their first admission to hospital lay further in the past, they had been in the meantime less frequently discharged, they stayed longer in hospital, more frequently never left hospital after their first admission and showed more rarely fluctuations of the syndrome between two poles. With a more insidious development of the disorder there thus followed a worse prognosis for the sporadic patients than for the familiy patients. The basic discrepancies were significant, for the most part very significant. Sporadic schizophrenics are found more frequently amongst men, family schizophrenics more frequently amongst women. The vast majority of schizophrenics in the families of our test cases were women.


[Pattern of familial psychoses--systematic and unsystematic schizophrenia and cycloid psychoses].

604 cases were examined, 309 of which were systematic schizophrenics, 191 were unsystematic schizophrenics and 104 cycloid psychotics. With the systematic schizophrenics the average period spent in hospital amounted to 16.9 years, with the unsystematic schizophrenics 13.8 years, with the cycloid psychotics 8.2 years. The systematic schizophrenics were discharged from hospital on average 1.5 times, the unsystematic 2.3 times, the cycloid psychotics 4.1 times. Of the systematic schizophrenics, 37.5% were never discharged after their first admittance to hospital, of the unsystematic 25.7%, of the cycloid psychotics 9.6%. Bipolar fluctuations were detected in 1.6% of the systematic schizophrenics, 49.7% of the unsystematic and 78.8% of the cycloid psychotics. 15.9% of the systematic schizophrenics had occurrences of psychoses in their family compared to 50.8% of the unsystematic and 22.1% of the cycloid psychotics. The systematic schizophrenics had 17.5% of their family ill, the unsystematic 69.6%, the cycloid psychotics 25.0%. Of the parents of the systematic schizophrenics 2.3% were ill, of the parents of the unsystematic schizophrenics 11.6%, of the parents of the cycloid psychotics 5.0%. Of the brothers and sisters of the systematic schizophrenics 2.4% were ill, of the unsystematic schizophrenics 10.9%, of the cycloid psychotics 3.0%. These variations in the pattern and occurrence of psychoses in the family seem to prove that the three groups of endogenous psychoses are genetically separable. There are also differentiating features inside the groups. Periodic catatonia in particular is characterized by the great number of psychotics in the family.


[Radiological pictures of the skull following brain-tumor surgery].

In 90 patients, the majority of whom was operated upon for a brain tumour, we have systematically controlled the post-operative x-ray pictures of the skull. Clips set in during surgery, calcified epiphysis and changes of the sella due to pressure were the most important signs. To complete the follow-up of tumours we should like to propose to use clips not only as a hemostyptic measure, but also to have marks in cases of possible relapses.


[Group round].

The traditional clinical round as a means of communication, information and teaching has considerable disadvantages; therefore a procedure is proposed after 5-years testing called "group round" as a supplementary procedure. It spares the time of the physician, enables the orientation in the individual patient and moreover the observation of interaction between the patients themselves and between patients and personal staff and facilitates teaching. The less experienced physician gets an easier approach to group psychotherapy, essential effects of which become effective in the procedure. The breaking of professional secrecy can be avoided.


[Serum creatinphosphokinase (CPK) in endogenic psychoses].

Creatinphosphokinase (CPK) was determined in 141 patients with manic-depressive and schizophrenic psychoses. In general endogenic psychoses of the manic and depressive type as well as chronic schizophrenias show normal CPK values. In acute cases of paranoid-halluzinatory schizophrenias normal values are predominant. In catatonic schizophrenias, as a rule, clearly increased enzyme activities are found. Thise increased values suggest a postulated somatic disease as a cause of the psychosis. Thus, the determination of CPK provides a useful aid in the diagnosis and control of the course of catatonic schizophrenic.


[Electroencephalographic examinations following strangulation].

An electroencephalogram (E.E.G.) was recorded from 12 patients within 4 hours after strangulation. The tracings were mainly flat and showed severe general alterations. Repeated recordings were performed in 16 patients during the further course at regular intervals until the findings had normalized. Despite the marked initial findings, in 13 patients the basic activity had normalized within 48 hours after strangulation, but often it was asymmetric. Marked asymmetry and focal findings subsided within a year. Only in juvenile patients with initially marked neurological symptoms and subsequent demential course focal findings were found over several years. Contrary to the results of other investigations, spike potentials occurred in 2 patients with tonic-clonic seizures as focal and generalized, resp. steep. waves.


[Examinations with the modified VNPI].

The revised design of a psychometric procedure (VNPI) is described. Additional factors were extracted by intercorrelations and factor analysis: increased perseveration, inhibited contact, defective flexibility, instability of moods. They provide information, additionally to the evaluation of the factors of vegetative lability, neuroticism, and introversion. A random test in 360 persons from a screening series is used for the presentation of the relations between VNPI values and findings of social and internal medicine. The possibilities of individual diagnosis of the procedure are demonstrated by VNPI profiles of patients.


[Side-effects of lithium therapy].

Side-effects and complications of lithium therapy were examined by evaluation of data registered from 73 patients. Transitory subjective complaints would often occur during the initial phase of therapy, but they do not require any additional therapy. Occasional development of struma and sometimes high increase of body weight require regular controls of these values. Disposing factors concerning the possible occurrence of epileptic seizures and extra-pyramidal disorders under lithium therapy are Melipramin as well as organic cerebral lesions.


[On the problem of psychodiagnosis in psychiatry and psychotherapy].

Owing to the changed concept of psychiatry and psychotherapy, greater demands are also being made on psychodiagnostics. The article deals with the prerequisites, possible significance and application of the clinical methods and psychological tests, describes the problems of standardization and quality testing and discusses indications and problems of the different groups of methods. The demands of the clinician addressed to test designers are dealt with, as well as the question of which group of methods should be used and by whom.


[On the problems of psychophysiological data determination].

Together with the description of difficulties of registration specific individual, stimulus, and motivation reactions are dealt with. Possibilities are shown of changes of the signalto-noise ratio in the example of a superimposition related to an event. Particularly the problems of the design of psychological complementary diagnostics for the recognition of habitual factors and factor related to specific reactions to trauma are discussed.


[Incidence of infantile cerebral lesions in children with behavioral disorders].

The delimitation of behavioural disturbances predominantly due to organic brain lesions from those caused by reactions due to environmental factors has practical importance for drug therapy and pedagogic guidance. Figures on the incidence of infantile brain lesions among children with behavioural disorders range from between 20 to 90%. However, comparison of the results is difficult, because different authors followed different aspects for the evaluation of their material. The authors have collected data from 497 children from the 3 to 15 year-old age group who suffer from behavioural disturbances: history, neurological and psychological findings, electroencephalogram, native x-ray picture of the skull, pneumo-encephalogram and echoencephalogram were reviewed for signs and findings suggesting infantile brain damage. Certain signs of intantile brain lesion were found in 28.6% of the children. Among the apparative diagnostic procedures without impairment to the patients, the electroencephalogram proved particularly suited for the support of the diagnosis. The most accurate data on the localization and extent of the lesion are provided by the pneumo-encephalogram. However, its performance is not possible or justified in each child.


[Studies on protein genetic factors in multiple sclerosis and psychoses].

In more than 200 cases of multiple sclerosis, psychosis and cyclothymia, the Hp types are studied with the help of polyacrylamide gel electrophoresis (Schreyer and Schaible, 1967) and the Gc types wtih agar gel electrophoresis (Schlesinger, Vogt and Prokop, 1963). All Hp and Gc types were found in these diseases, but there was no frequent occurence of any particular type in multiple acleroses of psychoses. According to our results, there is no interdependence between these diseases and the Hp and Gc types.


[Regressive myopathy with myasthenic syndrome in idiopathic gluten enteropathy].

The authors report on a case of sprue myopathy with myasthenic syndrome. Pathophysiological ideas are discussed and the necessity of complex examinations in myopathy-syndromes is emphasized.


[Out-patient treatment of psychoses using depot-fluphenazin].

43 courses of treatment in various psychoses are reported. Peculiarities of dosage and application, and the position of Depot-Fluphenazin as compared to other Depot-neuroliptics are considered in detail.


[Suicidal trends in urban and rural districts of Brandenburg].

Statistic methods are used to investigate the discrepancy in the occurrence of suicides and attempted suicides in the urban and rural districts of Brandenburg. Although the socilolgical structures of the rural districts are much like those of the town, there exist obvious discrepancies in the incidence rate. The suicide rate is paradoxically in contrast with what may be expected when one has read the literature. The rate is higher in the rural districts than in the town. The possible causes of this phenomenon are discussed indetail. It is considered recommendable for the planning of preventive measures that not only the figures for actual suicides  be taken as a representative rate and starting point, but also the figures for suicidal acts (suicides and attempted suicides).


[Pathological visual field and brain tumor].

The general relationships between an operatively or autoptically localized tumor and the visual field determined by means of ikineticer perimetry are investigated, the patient stock being a total of 1756 neurosurgical brain-tumor inpatients. Examination of the visual field was possible with four fifths of the brain-tumor patients. Hemianopic, quadrantanopsic, or scotomatous defects of a topically localizable nature could be found in almost one third of the total patient stock available for examination. The clinically particularly interesting criteria of localization of homonymous-hemianopsia defects such as macular sparing and incongruence/congruence of visual field changes should be of no importance to the localization within the visual pathway of brain-tumor patients.


[Changes of the visual field with cerebral tumors].

Neurosurgical material of 1,746 tumours is reviewed for the relations between operative and post mortem localization of cerebral tumours and pathological findings of isopteric perimetry; and the incidence of defects of the visual field with the different localizations of tumours is discussed. The aim was to localize the tumours as accurately as possible. At least in brain tumour patients the defect of the visual field does not allow conclusions on the level of lesions to the visual pathway. Only the superior quadranopsia is important for the temporal localization.


[Liepmann's test and its specific significance in the alcoholic delirium].

The perceptional characteristics of hallucinatory events and the phenomenal forms of artificially produced hallucinations were studied on a total of 210 patients (144 patients with delirium tremens, alcoholic hallucinosis, abstention from alcoholic beverages freedom from abstinence symptoms and 66 subjects with schizophrenia, symptomatic epilepsy, general paralysis, neuroses, and conditions of intoxication). The results of our studies show that Liepmann's test may be used to reliably diagnose genuine hallucinoses. They are usually preceded by a number of different stages, these being the stages of stability of development and full development of prehallucinatory phenomena, simultaneous and suggestive periods of geniune hallucinations. Liepmann's test is specifically distinctive of psychopathological disorders associated with delirium tremens.


[Disorders of higher mentae functions as first symptoms in patients with brain tumors].

It has been established that in 29 (or 36,25%) of examined patients with neoplasms of the brain in the left dominant hemisphere, disturbances in the psychic functions seem to be the first and most early symptoms of the disease. They develop slowly, progressively, or in the form of epileptic language equivalents (in 5% of examined patients). As early symptoms, disturbances in language indicate existance of a brain disease and give cause to suspect a neoplasm, in this way stating the necessity of further examination, and from the other side - in some cases show the localization of the process.


[The integration of methods in residential psychotherapy].

The trend toward integration of psychotherapy into general medical practice has, especially in inpatient treatment of neurotic diseases, led to the development of psychotherapeutic systems, the differences of which are largely dependent upon both clinical conditions and therapeutical objectives. The author, in the light of ten years of practical experience with group psychotherapy of patients living in a hospital, gives a schematic outline of the Berlin system of integration of methods, discussing the system with reference to Kabanov's four basic principles, namely, the principle of the partnership of doctor and patient, the principle of the differences in efforts and effects, the principle of the unity of efficacy of methods, and the principle of the gradual transitions between methods and procedures. A detailed discussion is given of the gradual transition principle by reference to the phase-specific procedure of group psychotherapy and the methods of treatment coordinated therewith.


[Individual therapy as a special form of complex psychotherapy].

A combination of several psychotherapeutic methods will be meaningfull only if they are tuned to, and supplement, each other. Indiscriminate combinations may produce harmful effects. The choice of psychotherapeutic methods depends upon the objective that the psychotherapist desires to accomplish. In psychotherapy it is essential that all actions taken be governed by plans worked out in accordance with the particular objectives to be accomplished.


[Objectifying the effect of autogenic training on disordered ventilation in bronchial asthma].

Forty-one persons suffering from asthma (aged 20 to 55; duration of disease: greater than or equal 2 years) were divided into 2 groups and participated in courses of instruction in autogenic training. The control group was comprised of 14 patients. The effects of autogenic training on the maximum rate of expiration as well as the limiting respiratory value were recorded. The control group showed a seasonal decrease in the maximum rate of expiration and the limiting respiratory value by 10 to 20% in the period extending from April through November. The autogenic-training patients showed a temporally similar increase in the maximum rate of expiration of 27 and 22%, respectively (the difference to the control group being 47 and 42%, respectively). In 35 patients the increase in the limiting respiratory value was equal to or greater than the effect produced by novodrine. Catamnesis after one year (n = 40): Absence from work in a twelve-month period was 663 days prior to autogenic training and 77 days (11.6%) subsequent to autogenic training. Accordingly, autogenic training may be considered to be an objectively effective component of a combination of therapeutical methods used in the treatment of bronchial asthma.


[Reactive music therapy in psychotherapeutic group talks].

The authors, after presenting a survey of the literature on techniques of receptive musical therapy used for both individuals and groups, describe the use of Schwabe's reactive musical therapy within psychotherapeutical group talks. Experience gained using this particular technique of muscial therapy is reported, the institutional and theoretical reference system, by which reactive musical group therapy may be used, being described in greater detail. Also, special mention is made in this paper of contraindications and their respective conditions.


[The multiple selection vocabulary test (MSVT-B)--an accelerated intelligence test].

A new accelerated intelligence test is presented which is known as the multiple selection vocabulary test B. This is a very objective and reliable test measuring the general level of intelligence. The time of testing will be about three to five minutes in the case of persons that are free of any psychiatric disorders. Test results will be only negligibly influenced by psychic and mental disorders.


[Relations between pneumoencephalographic and electroencephalographic findings in childhood].

During simultaneous testing of electro-encephalograms and pneumoencephalograms in 200 children of various ages a proven correlation of statistics between both test procedures emerged as a well-defined parameter for evaluation. When making a statement about the correlation in findings between E.E.G. and P.E.G. the age of development in a child must be taken into consideration. Thus it emerged that in infants pronounced enlargement of the ventricular system correlates with active tension E.E.G. at increased inter-cranial pressure, while the coincidence of focal changes in E.E.G. and P.E.G. with advancing years becomes at first more pronounced after the tenth year of life (or puberty) but afterwards lessens.


[Interpersonal exposure to danger and risk-taking in the group therapy process].

The writer singles out from the complexities of the group psychotherapeutic process the dynamic pair: inter-personal exposure to danger and the taking of risk. According to his empirical experience and tests the degree of risk-taking is a good parameter for assessing the psychotherapeutic process. For this purpose the inter-action matrix devised by Hill proves itself most useful.


[The personality of the teacher as a patient type in psychological diagnosis].

The report concerns the questioning of 200 pedagogues using the questionnaire concerning introversion, neuroticism, rigidity and autonomic instability. All the patients are teachers and pupils in working relationships who were chosen from medical dispensary care with present symptoms of exhaustion and conflicting reactions, and who were transferred to psychological supervision. From the resulting data in the scales investigated, a configuration frequency analysis of the symptoms of introversion, neuroticism, rigidity and autonomic instability is given. Three oft-occurring typical configurations of scale can be found. From this a configuration type (with stikingly rigid behaviour and an otherwise unobtrusive scale constellation) can be interpreted as the "typical tacher" product of lengthy pedagogic activity.


[Dispensary care of suicidal cases in later life].

Experience drawn from daily work with suicidal cases and from special tests related to and connected with this work is generalized. Differences in suicidal behaviour between people in later life and the younger age grouping are elaborated, corresponding characteristics of suicidal behaviour are specified and information or suggestions on the guidelines for the necessary therapeutic and preventative work are given.


[Care of the mentally defective in Finland].

In Finland the organisation for the rehabilitation of those of retarded development is independent and total, It includes all special welfare needs. Its main objects are the normalisation and integration of those of retarded development into society; this means creating personal and social opportunities for them and helping them in many ways to facilitate thier integration into society.


[Idiopathic orthostatic hypotension].

The disease picture of idiopathic orthostatic hypotonia is described from a clinical and histological point of view with reference to a case treated by the present authors. The independent character of this particular ailment may be considered as resulting from the virtually uncontrollable orthostatic decreases in blood pressure in connection with the progressive disorders especially of the motor system. Also, the etiology is not yet fully understood.


Dynamic and holistic ideas of neurosis and psychotherapy.

In this paper I want to discuss certain weaknesses of the traditional dynamic psychoanalytic conception of neurosis and their psychotherapeutic consequences. At the same time, I would like to advocate an alternative conception of neurosis, a holistic or characterological conception, and I will try to indicate some of the therapeutic ideas and practices which follow from it.


Masochism: a clinical and theoretical overview.

This paper will review some of the theoretical and clinical features of masochism from an eclectic point of view. The topic of masochism has been taken up by authors of many perspectives because it addresses one of the anomalous, absurd, difficult-to-explain aspects of behavior for which no psychological system has an easy answer. Therefore, a wide-ranging literature on the topic of masochism is available. However, few previous reviewers have attempted to draw from a variety of disciplines and theoretical frameworks. In this review the historical development of the term and some of the psychoanalytic conceptualizations will be presented first. Since previous reviews of masochism from a strictly psychoanalytic perspective are adequate (Brenner, 1959; Eisenbud, 1967; Fenichel, 1945; Loewenstein, 1957; Panken, 1967), our discussions of masochism will be developed employing more extensively the interpersonal, social, learning theory, and biological perspectives.


Epidemic hysteria in Malaysian schools: an illustrative episode.

This paper discusses the prevalence and characteristics of epidemic hysteria among predominantly rural Malay schools in Malaysia. An illustrative episode in a Malay residential girls' school is described, and contributory factors to this outbreak are elaborated. An attempt is made to analyze the complex interweaving of psychological, religious, cultural, and sociological factors in the precipitation of the outbreak.


The Chinese student--acculturation and mental illness.

This paper reviews the history of the Chinese student in America and examines the conflicts which the special role of the Chinese on campus created. Specifically the nature of the problems manifested by Chinese students who sought help through the student health program at a large West Coast university are examined as a reflection of the stresses caused by currently changing attitudes toward assimilation in the Chinese-American population. Interestingly, except for a brief overview by Fong, this is a group that, despite its size and significance, has been ignored in the literature.


Symposium on The Ego and the Id after fifty years. The structural hypothesis--theoretical considerations.

Freud reformulated his model of the psychic apparatus because certain clinical observations did not fit into the earlier framework of his theory. In the new theory, he emphasized the role each element plays in psychic conflict. Because Freud philosophically was committed to a materialistic, nonteleological, biologically based theory, he carried over into the new formulations some of the metapsychological assumptions of the earlier theory. It is suggested that this transposition is responsible for some of the confusion concerning the application of the structural theory. It is proposed that if a more strict usage of the concept of metapsychology with more precise conceptualization is employed, some of the problems connected with the application of the structural theory may be overcome.


Symposium on The Ego and the Id after fifty years. Clinical formulations and research.

The Ego and the Id has served as an organizing model which has advanced psychoanalysis as a science and as a therapy. The paradigm offered by the structural formulations provided a framework for many developmental and clinical studies as well as an approach to a general psychology of human behavior. Therapeutic advances have been made, but the art of therapy has not kept pace with the scientific advances. Dissatisfaction with psychoanalysis and psychoanalytic theory is discussed. Theories have become too far removed from their clinical base; a changing sociologic climate that has reduced the impact of the rational attitude offered by psychoanalysis and the failure of psychoanalytic therapy to cure all ills have contributed to the dissatisfaction.


Symposium on The Ego and the Id after fifty years. The need for a new general theoretical frame of reference for psychoanalysis.

This paper briefly discusses some of the serious problems in current psychoanalytic metapsychology and the need for a new general theoretical frame of reference. It highlights the lack of explanatory power and the primitive nature of current metapsychology. The paper suggests the usefulness of an information processing and systems model which is consistent with neurophysiology.


Symposium on The Ego and the Id after fifty years. The past and future of ego psychology.

Having six roots in ordinary observation and introspection, ego psychology has a long pre-Freudian history, which influenced Freud's first usages of Ich. His works before 1923 contain much that is substantively ego psychology; The Ego and the Id was not a paradigm change but a consolidation of pre-existing ideas. The structural theory replaced a model (topographic) which Freud actually used very little, especially clinically, and he failed to remedy its gravest methodological faults. The ego-id model is an integral part of metapsychology, and will pass out of use as the latter dies, with no detriment to clinical psychoanalysis.


Three strands of narcissism.

The development of narcissism is usually studied from the standpoint of the drives, or more specifically of the libido. This paper considers narcissism from the standpoint of the ego and seeks to delineate separate developmental lines. From this point of view, a variety of forms may be distinguished which are ordinarily structured during the oedipal period. It is postulated that narcissism cannot be considered as truly separable from the vicissitudes of the love and hate of objects. This formulation makes possible consideration of recent observations concerning the 'narcissistic personality' without requiring major new economic, structural, or dynamic metapsychological constructs.


Early object loss and denial. Developmental considerations.

The psychoanalytic treatment of a young woman whose father had been killed in a concentration camp when she was four years old serves to illuminate certain aspects of libidinal and ego development, particularly as it touched on the effects of losing one's father just before entering the oedipal phase and on the defensive use of denial in lieu of mourning. Further consequences of the patient's loss are seen in the extent to which it influenced the self-image, sexual identity formation, and superego functioning, especially with regard to the role of guilt.


Psychobiology of partnership behaviour.

Animal experiments demonstrate that it is not only the quality of transmitted and received social signals that is important, but also their frequency and the timing of the information transmitted. In order for progress to be made in the investigation of human social behaviour and its disorders, methods must be developed which allow the transmission of verbal and non-verbal information to be measured. Experiments carried out with healthy adults and healthy and disturbed children to investigate human eye contact and distance behaviour are reported, along with experiments on the influence of gaze and body posture on spoken communication. Finally, a report on the use of behaviour therapy for an autistic child is outlined in order to explore the psychobiological correlations between social behaviour and language, which concur with extensive experiments on brain stimulation. It is suggested that there is a cerebral representation for species-specific social behaviour and a vocalization system embedded in these brain structures which is a phylogenetically-patterned prerequisite for the development of human language.


Value of family background and clinical features as predictors of long-term outcome in anorexia nervosa: four-year follow-up study of 41 patients.

This is a prognostic study on 41 patients with anorexia nervosa (including three males) who satisfied defined diagnostic criteria. The patients had all been admitted to a metabolic unit where the mainstay of treatment was nursing care aimed at rapid restoration of body weight. A follow-up was conducted after a minimum lapse of four years after each patient's discharge from hospital. The outcome of the patient's illness was expressed in terms of an 'average outcome score' and a 'general outcome'. The series included a relatively high proportion of patients with a long illness who had received previous psychiatric treatment. Their families tended to come from higher social classes; a disturbed relationship with the patient was frequent. Premorbid disturbances in personality development were also common. The immediate response to treatment was excellent, with the majority of the patients returning to a normal weight, but relapses after discharge were common and readmissions were necessary in half the patients. At follow-up, the patients fell into the following defined categories: 'good' (39%), 'intermediate' (27%), 'poor' (29%), died (5%). Most of the patients who failed to recover continued to display the clinical features characteristic of anorexia nervosa. Among predictors of an unfavourable outcome were found a relatively late age of onset, a longer duration of illness, previous admissions to psychiatric hospitals, a disturbed relationship between the patient and other members of the family, and premorbid personality difficulties. It is suggested according to the severity of their illness, rather than on the method of treatment itself. The illness may last several years before eventual improvement or recovery, and a follow-up study must be extended over at least four years to be meaningful. An accurate prediction of eventual outcome is almost impossible, but late recoveries justify an optimistic outlook and continued therapeutic endeavour.


Mental health care in the community: an evaluative study.

A study was designed to assess the therapeutic value of attaching a social worker to a metropolitan group practice in the management of chronic neurotic illness. The psychiatric and social status of a group of patients before treatment and after one year was compared with the status of a control group treated more conventionally over the same period. The results indicate that the experimental service conferred some benefit on the patient population.


Factors associated with attempted suicide among hospitalized depressed patients.

An attempt was made to identify background, sociodemographic and clinical variables which are associated with attempted suicide in depression. Within a sample of 308 depressed psychiatric inpatients, suicide attempters were younger than non-attempters and were identified by a pattern of chronic interpersonal maladjustment reflected clinically in withdrawal from social contact and the display of hostility or irritability toward others.


Correlates of placebo reaction in an outpatient population.

Variables describing 113 outpatients of a mental health clinic were derived from a Placebo Test, the MMPI, a Symptom Check List, measures a response style, and a questionnaire containing historical and demographic information. Two highly reliable scales, the Placebo Effect Scale (PES) and the Side Effect Scale (SES) were derived from the Placebo Test and served as dependent variables. PES scores were inversely related to reporting symptoms and unrelated to measures of response style. SES scores were directly related to reporting symptoms and with several measures of response style. There was a curvilinear relationship between placebo response and reporting side effects. Implications of results for further research are presented.


Changes in serum tryptophan and albumin binding of tryptophan in chlorpromazine-treated chronic schizophrenics on withdrawal and restoration of drug therapy.

Withdrawal of drug from a group of chlorpromazine-treated chronic male schizophrenics led to a significant rise in the initially low serum tryptophan concentration, and a rise in the fraction freely diffusible. These changes, which would be expected to lead to an increase in tryptophan influx into the brain, and hence to an increase in cerebral serotonin synthesis, could be related to the clinical effects of drug withdrawal.


Time course for the effects of cocaine on fixed-ratio water-reinforced responding in rats.

Four male rats performed during 35-min sessions under a schedule that arranged water delivery (0.04 ml) after every fortieth response. Cocaine (1.0-16.0 mg per rat, i.p.) was administered 15 min, 30 min, 60 min or 120 min prior to a session. When given 15 min prior to a session, cocaine (1.0-8.0 mg) in all rats produced dose-related decreases in responding. The largest dose, when given 15 min pre-session to two rats, almost completely suppressed responding. Lengthening the time between drug injection and test session attenuated the rate-decreasing effects of cocaine (1.0-8.0 mg), but did not affect the almost complete suppression of performance seen with the largest dose. Small doses (1.0-4.0 mg) had no effect on the pause in responding that occurred after water delivery. The 8.0-mg dose lengthened the pause by approximately 9000% and 650% when given 15 and 30 min prior to a session, respectively, but by less than 50% when given 60 or 120 min pre-session. Cocaine effects depend on the dose as well as the time of its administration prior to testing.


Differential effects of methylphenidate on reticular formation and thalamic neuronal activity.

Intravenous administration of methylphenidate (1 or 2 mg/kg) markedly attenuated the unit discharge rate in the mesencephalic reticular formation of rats and cats. Concurrently this drug enhanced the neural activity in the primary sensory nuclei of the thalamus. The differential effect of methylphenidate on these two neural systems suggest a possible mechanism by which it may improve attentive processes in hyperkinesis.


The effects of 2,5-dimethoxy-4-methylamphetamine (DOM), 2,5-dimethoxy-4-ethylamphetamine (DOET), d-amphetamine, and cocaine in rats trained with mescaline as a discriminative stimulus.

The effects of mescaline (3,4,5-trimethoxyphenylethylamine), a hallucinogen, can function as a discriminative stimulus in appropriately trained rats. As a test of the hypothesis that those pharmacologic properties which distinguish hallucinogens and non-hallucinogens in man are reflected in distinctive stimuli in rats, the present experiments examined the effects of 2,5-dimethoxy-4-methylamphetamine (DOM), 2,5-dimethoxy-4-ethylamphetamine (DOET), d-amphetamine, and cocaine in rats trained with mescaline as a discriminative stimulus. Administration of a range of doses of DOM and DOET to subjects in which saline functioned as SD and mescaline as Sdelta revealed that a dose of 0.3 mg of either DOM or DOET was equivalent to the training dose of mescaline. When tested in rats in which mescaline served as SD, DOM and DOET were likewise found to mimic mescaline. In contrast, doses of d-amphetamine and cocaine (1 and 30 mg/kg, respectively) which were equivalent to the training dose of mescaline as Sdelta, did not result in responding appropriate for the mescaline condition when mescaline was trained as SD. When DOET (0.3 mg/kg) was substituted for saline as Sdelta, no evidence of discriminated responding was obtained in the course of 50 sessions. The present data, in conjunction with previous observations, suggest that those effects of mescaline in the rat which function as a discriminative stimulus are better correlated with pre-hallucinogenic LSD-like activity in man then with hallucinogenic activity per se. Thus, these effects in rats represent a necessary but not a sufficient condition for prediction of hallucinogenic activity in man.


The effects of metiamide on the "activity-stress" ulcer in rats.

Forty rats were housed in standard activity wheel cages and fed for only 1 hr per day. The animals were equally divided into 4 groups that received either saline, 12.5 mg/kg, 25.0 mg/kg or 50.0 mg/kg of metiamide, an H2 receptor antagonist, 3 times a day. All animals died within 11 days and all demonstrated significant gastric lesions in the glandular fundus of the stomach. The 50.0 mg/kg dosage group, however, demonstrated significantly fewer ulcers than the saline animals and the lesions that did occur were significantly smaller than those noted in the control animals. Several hypotheses were offered to explain these results which took into account metiamide's effects on gastric secretion and motor activity. It was suggested that secretion of acid may be an important contributing factor in the formation of gastric ulcers in animals subjected to the "activity-stress" procedure.


Cocaine and amphetamine modification of cerebral energy metabolism in vivo.

At the time of maximal behavioral stimulation after injection of amphetamine (5 mg/kg) in mice, elevation of cerebral cortical levels of malate in the citric acid cycle and of the amino acid, alanine, was observed, suggesting that this drug has widespread effects on energy metabolism. Cocaine (20 mg/kg), in contrast, produced elevation of brain glucose but not of citric acid cycle substrates or amino acids at the time of maximal hyperactivity. These observations are discussed in terms of the mechanisms of action of these two central nervous system stimulants.


The reliability of the hole-board apparatus.

Two aspects of the reliability of the hole-board apparatus were investigated-the similarity between scores of different samples of the same population on their first exposure to the apparatus, and the test-retest reliability. Rats and mice were given a 5-min exposure to the hole-board and then retested for 5 min after 1, 2 or 8 days. Male rats and mice showed good initial exposure reliability, whereas the female mouse groups differed significantly. All animals showed a positive test-retest correlation (range 0.31-0.78), but a homogeneous group (e.g. all animals habituating) produced higher correlations (range 0.60-0.99). Comparison of scores on the two 5-min exposures showed that not all groups showed significant habituation, but the animals exposed to the hole-board for two 10-min periods showed both significant habituation and test-retest reliability.


Validity of head-dipping as a measure of exploration in a modified hole-board.

To determine whether head-dipping could be validated as a measure of exploration a modified hole-board was developed with four holes in the floor, under which novel objects could be placed. Two criteria for considering head-dipping as a measure of exploration were proposed: firstly that it should reflect novel aspects of the environment; secondly, that exposure to the hole-board should result in information storage. That head-dipping reflected novelty was indicated by the longer duration of head-dips on initial exposure if objects were present, and also on a second exposure when objects were introduced for the first time. Information storage was indicated by habituation on re-exposure to the hole-board. A significant positive correlation between head-dipping in the "four" and "sixteen" hole-boards was obtained for rats, but not for mice. This provided some indirect evidence that rat head-dipping in the "sixteen hole-board" also reflects exploration. (+)Amphetamine and alcohol were tested in the modified hole-board, and (+)amphetamine decreased and alcohol increased the frequency and duration of head-dips.


Response suppression in rats: a comparison of response-contingent and noncontingent punishment and the effect of the minor tranquilizer, chlordiazepoxide.

A comparison of the behavioural effects of response-contingent and noncontingent shock was carried out in a series of experiments examining (a) suppression of an operant response (lever-pressing); (b) release from suppression following injection of the minor tranquilizer chlordiazepoxide, and (c) suppression of behaviour in a situation not associated with shock. The major findings were that response-contingent shock produced far greater suppression of the operant response than did noncontingent shock, as well as greater suppression of behaviour in a neutral environment following the shock experience. Chlordiazepoxide was found to be far more effective in releasing behaviour from suppression when shock was response-contingent than when shock was noncontingent, a result which does not appear to reflect simply the greater suppression produced by response-contingent shock. A discussion of methodology and interpretations in this field, suggests why discrpancies have arisen in the past.


Chlordiazepoxide and isolation induced timidity in rats.

The effects of chlordiazepoxide (CDP) on emergence behavior was examined in socially reared and isolation reared rats. It was found that low doses of CDP decreased the emergence times of isolated animals but had little effect on the emergence of social animals. At higher doses the drug retarded emergence in all groups but there were no differential effects. The results do not support claims that rearing conditions influence the susceptability of rats to CNS depressants, rather they suggest that particular levels of CDP selectively influence "emotional" behavior.


Morphine enhancement of shuttle avoidance prevented by alpha-methyltyrosine.

Rats were given 6 days of training (180 trials) to make a two-way (shuttle) avoidance response. "Poor performers" making less than 50% avoidances in the 6th block of 30 tials were given drug treatments on the next 2 days. Both morphine sulfate (15 mg/kg) and d-amphetamine sulfate (1 mg/kg) increased the avoidance level by 70-100%. Prior treatment with alpha-methyltyrosine (50 mg/kg) prevented the effects of both drugs. Nalorphine hydrochloride (5 mg/kg) also blocked the effect of morphine. The action of alpha-methyltyrosine to block enhancement of avoidance is taken to indicate that this effect of morphine is attributable to a catecholamine-dependent excitatory component of its activity profile.


Assessing the aversiveness of intracranial stimulation.

A comparison was made between rats' performance to escape intracranial stimulation in a shuttle-box, two-lever box and a single-lever Sidman avoidance situation. The former two tasks also provided concurrent rate-independent measures of the rewarding properties of ICS. The rate-independent measures of aversion (latency to escape ICS) obtained in the shuttle-box and two-lever task were significantly correlated with each other but were not significantly correlated with the lever-press rates on Sidman avoidance. A number of animals that would not lever-press to initiate ICS would perform the locomotor response very vigorously to initiate the same ICS suggesting that even rate-independent lever-press measures may not accurately reflect the motivational characteristics of ICS. These data are discussed in the context of the problem as to why animals escape rewarding ICS and it is suggested that the escape behaviour is an independent phenomenon which merits further study in its own right.


The effects of tranquillizing drugs on timing behaviour in rats.

Timing behaviour was generated in rats by a schedule which required responses to be spaced at least 15 sec apart in order for them to produce food reinforcement (DRL 15 sec). The behaviour maintained by this schedule was then studied after administration of chlordiazepoxide, phenobarbitone and chlorpromazine. Several doses of both chlordiazepoxide and phenobarbitone were found to disrupt timing behaviour by increasing overall response rates although the highest dose of each of these two drugs produced sedative effects. Chlorpromazine produced mainly a decrease in overall response rates. Analysis of performance in terms of interresponse times (IRTs) showed that both chlordiazepoxide and phenobarbitone markedly increased the percentage of IRTs less than 1.5 sec in duration (response bursts). Chlorpromazine had no consistent effect on response bursts. Reduction of the animals' body weights from 85% to 75% of their preexperimental levels had no effect on operant performance, suggesting that the effects of the drugs were probably not due to actions on motivational processes.


Effect of chlorpromazine on the interaction between phasic and tonic electrocortical arousal mechanisms.

The effect of chlorpromazine on the rate of habituation of phasic arousal responses has been studied in cats carrying permanently implanted cortical recording electrodes. In the sleeping animal repeated presentation of an auditory stimulus (1 sec duration, 3000 Hz) at intensities which only produced a localised, phasic electrocortical change in the auditory cortex, resulted in the rapid habituation of this latter response. Once habituation had occurred the intensity of the stimulus was increased until a similar change in electrocortical activity once again appeared in the auditory cortex. The habituation procedure was then repeated. In this way it was possible to habituate the animal gradually to successively higher intensities of auditory stimulation without ever inducing behavioural arousal or tonic, generalised changes in electrocortical activity. Indeed, it was possible to reach a level of stimulation which previously would have induced overt behavioural effects and tonic arousal. It may be concluded that alterations in the activity of the mechanisms responsible for phasic electrocortical responses leads to changes in the responsiveness of the animal even during sleep. Following chlorpromazine phasic electrocortical responses were still elicited but their rate of habituation was significantly increased. Thus the overall effect of chlorpromazine was a marked shortening in the time taken to "train" the animal while still asleep, not to respond behaviourally or with tonic electrocortical changes to a particular auditory stimulus.


[Whiplash injury (author's transl)].

The whiplash injury is the result of a collision from behind in the motorized street traffic. The impact in the rear of the vehicle causes a sudden thrust to of the head and cervical spine in dorsal direction. The result is a shear effect of the cervical spine. Pathologically, this is characterized by hematoma of the capsules of the joints of the vertebral arches and contents of intervertebral foramina. Tears of discs and vertebral fractures are usually absent. The prognosis is good.


[Orthopaedic treatment of whiplash injuries of the cervical spine (author's transl)].

Short review of the different types of propulsion injuries of the cervical spine in acute and chronic cases. The basic principles of the therapy as well as the different techniques of physiotherapy, orthesis and surgical treatment and described.


[Whiplash injuries of the cervical spine and Swiss insurance against accidents (author's transl)].

The indemnity for the consequences of a whiplash injury on the cervical spine by the Swiss Insurance against Accidents is discussed. The number of these cases can be only roughly extimated. We can calculate yearly with about 600 distortions of the cervical spine resulting from motoring accidents. The definition of the whiplash injury is defined on the base of recent German literature. The supposed mechanical assumptions for a lesion of the cervical spine are based mainly on the works of Erdmann (Frandfurt). The relations between the lesion of the cervical spine an the rebound injuries of the skull are discussed. The significance of the preexistent degenerative alterations of the cervical spine in the whiplash injury and the problem of the psychogenic superposition are presented by means of 46 observed cases.


[Radiological study of osteoarticular lesions secondary to cervical trauma (author's transl)].

The radiological study of the traumatic cervical spine must often be undertaken in two different ways depending on the time of examination. In patients severely involved, no manipulations can be undertaken during the acute state. Later on in these patients, as well as in those not so deeply involved, a thorough radiological investigation may be performed, e.g. in sitting position. The characteristics of both types are reviewed. Various syndromes are then considered following the different mechanisms of production.


[The post-traumatic cervical syndrome. The whiplash injury. Symptoms, diagnosis, treatment (author's transl)].

The post-traumatic cervical syndrome (PTCS) is analysed in 61 cases. the symptomatology can be local (neck pain), cervicocephalic (traumatic vertebrobasilar insufficiency), cervicobrachialgic and also in some cases cervicomedullar. The PTCS is classified into the injuries of the cervical spine with vascular lesions: these injuries may induce severe or benign osteoarticular lesions on the one hand, sevre or reversible vascular lesions on the other hand. All these combinations are studied. The diagnosis of the PTCS is established by vertebral angiography. The surgical treatment according to the authors consists in freeing the vertebral artery or cervical nerve roots by uncusectomy or uncoforaminectomy. The results of these operations are analysed; they are very successful.


[New aspects in the treatment of breast cancer (author's transl)].

The specific treatment of primary breast carcinoma in the future may depend on viral genes in the development of antiviral substances, or a specific chemotherapeutic method. In this manner the turnover rate of the RNS virus is successfully inhibited (as the preceding communicated observations about the probably produced inhibition effect of rifampicin derivates of streptovarizin complexes). Prophylactically, by familiar breast cancer, breast feeding must be prohibited so that a supposed virus factor would not transfer with the milk. So far we hope that a supposed virus diagnosis of the primary tumor leads to decreased surgical interventions (tumorectomy, radical mastectomy), and technical as well as high energy postradiotherapy. This would not only give a smaller psychologic shock to the patient (small operation trauma) but would also decrease the complications (arm edema, movement restriction). This opinion now appears to effect international thinking after radical and subradical surgery have not given better results. For the late stage there is modern chemotherapy, combined with proper radiotherapy treatment of painful skeletal metastases, eventually also brain metastases which can now be successfully irradiated. Whether better late results are obtained by the early chemotherapy as well as the improvement of the immunity reaction quickly after sugical intervention (modified radical mastectomy) will be seen in the near future.


[Surgical treatment of breast cancer. Present problems (author's transl)].

The protocol of surgical treatment of breast cancer at the Institut Gustave-Roussy is presented. The long-term results concerning 1,002 patients treated according to this protocol are reported. Considering these results, the place of extended mastectomy and of conservative procedures is discussed. The necessity of randomized trails to appreciate the real value of the different treatements is emphasized, and two international trials proposed by the Institut Gustave-Roussy are briefly described.


[Small breast cancer and radiotherapy (author's transl)].

Small breast cancer is not a clear entity and is often very difficult to classify (e.g. TNM). The role of radiotherapy is far from being generally accepted; it is now clear that the smaller the tumor is, the better are its chances to be cured by X-rays. The first step after diagnosis is the search for distant metastases. That postoperative radiotherapy increases the risk of distant metastases remains to be proved and clinical trials are under way. At the present time, the treatment of breast cancer requires a multidisciplinary approach.


[Radiotherapy of mammary cancer related to tumor size, tumor localization and surgical management (author's transl)].

Postoperative irradiation of the regional lymphatics is indicated when suspected positive lymph nodes remain after mastectomy. Postoperative chest wall irradiation is carried out in cases where staging of the tumor is T-3 and T-4. A local tumor control can be achieved with irradiation as the only means of therapy. Preoperative radiotherapy seems to lead to favorable results and should be encouraged in cases of advanced breast cancer.


[Systemic chemotherapy of early breast cancer (author's transl)].

The management of early cancer of the female breast still remains an unsolved problem. Current information on the spread of the disease indicates that metastases are present in one quarter of the patients even if thorough clinical investigation reveals local tumor invasion only. There is no substantial evidence that unproved surgical or radiotherapeutical procedures in the future might improve cure rates. Cytostatic chemotherapy given early in the course of the disease, i.e. following surgery of a primary breast cancer, therefore, has been advocated. Arguments pro and con postoperative chemotherapy are discussed.


[Pretherapeutic evaluation of bone matastases in patients with potentially curable breast cancer (author's transl)].

A pretherapeutic evaluation of skeletal metastases should be carried out in all patients with proven mammary cancer including early stages. The scintigraphy is more reliable for detecting bone metastases than the conventional roentgenological survey. We recommend to employ complementally skeletall scintigraphy and conventional X-ray survey in the search for bone tumors. Negative scintigraphical results do not require any supplementary research. In case of a pathological scan or skeletal pain, a target roentgneological examination should be carried out to differentiate between benign diseases and neoplatic lesions.


[Radiological diagnostic of retroperitoneal extrarenal tumors in childhood (author's transl)].

This reports about 54 children suffering from retroperitoneal tumors excluding renal tumors. Characteristic radiological findings of neuroblastomas, pheochromocytomas, suprarenal carcinomas, adenomas, and teratomas are discussed. The diagnosis is made by the following roentgenological investigations: intravenous urography via the V. cava as "Cavo-Urography" or infusion urography (including zonography), sonography and nuclear medicine studies. Arteriography, pneumoretroperitoneum and lymphography are indicated if the primary tumor is unknown, in order to reveal suspected metastases, to decide about operability and for controlling radiotherapy. Further radiological examinations are made depending on the type of the metastasis.


[Contribution to diagnostic radiology of tumors of the adrenal glands (author's transl)].

Diagnostic radiological procedures in tumors of the adrenals are demonstrated and correlated to their clinical symptoms. Radiographic findings and special symptoms are described in 21 cases. Various investigative methods are demonstrated and their diagnostic value and approach in cases of adrenal diseases are debated. Differential diagnostic problems of tumors of the adrenals are discussed also.


[Technique and results in adrenal phlebography (author's transl)].

Following a brief description of the anatomy of the adrenal gland the technique of adrenal phlebography is explained. So far this method has been used in 118 patients. This examination is indicated in cases with suspected hormon - active disease of the adrenal glands and to rule out spaceoccupying lesions as well as metastases in the adrenal gland. Characteristic radiologic findings are demonstrated. Causes for complications of this method and their possible prevention are discussed.


[Contribution to the radiological diagnosis of primary retroperitoneal sarcomas in adults (author's transl)].

Modern radiological procedures to diagnose rare tumors of the retroperitoneal space and especially of the mesenchyma are discussed. Previous publications are considered and five own new cases are described (2 spindle-cell sarcomas, 1 reticulo-sarcoma, 1 fibrochondroblastic sarcoma, 1 teratogenic sarcoma). Since retroperitoneal sarcomas are in most cases detected very late, results of surgery and radiation therapy as prognosis of these diseases are very poor. The value of different radiological investigations and their significance for early recognition of these tumors are emphasized. In patients with obscure abdominal symptoms knowledge about retroperitoneal sarcomas and their differential diagnosis is important. In consequence, special diagnostic procedures and therapy will become more successful.


[Ureteral obstruction caused by the right ovarian vein (author's transl)].

A case of a right sided ureteral obstruction is reported. This may be interpreted as ovarian vein syndrome. It demonstrates that not only aberrant renal arteries but also atypically running veins may produce ureteral obstruction.


Role of a University Medical Center in the education of radiologic technologists: advanced education in radiologic technology.

The development of new and sophisticated imaging equipment, the rapidly changing medical diagnostic techniques, and larger and busier radiology departments put increasingly heavy demands on radiologic technologists. To cope with these demands, superficial knowledge and experience is not enough. The technologist who wished to advance on the career ladder must have more solid facts at his disposal and know how and when to use them if he is to perform efficiently and satisfactorily. The program described here provides a type of education that will permit the technologist to so advance with a feeling of security in the knowledge that he has the foundation needed to meet the challenges of his profession.


The case for colorimetric two-point stopped-enzyme-activity determinations exhibiting zero-order reactions.

A careful assessment is made of the relative merits of the two common approaches to enzyme determinations: the so-called kinetic and the two-point colorimetric. A plea is made for a pluralistic approach to the selection of enzyme methods based on a full understanding of the modalities of each procedure. A rational approach to clinical enzymology demands an intellignet choice of methods, irrespective of mode, that will best suit a particular laboratory situation.


Effect of PGF2 alpha and 15(S)-15-methyl PGE2 methyl ester on feline generalized penicillin epilepsy.

The effect of PGF2alpha and 15(S)-15-methyl PGE2 methyl ester on transient generalized epilepsy in the cat induced by penicillin was examined. Epileptic activity before and after administration of the prostaglandins by several routes was determined from continuous EEG recordings and expressed in epileptic bursts per min. The PGE2 analogue given in single non-toxic doses (1.6-3 mug/kg) by intramuscular or intravenous routes at the peak of epileptic activity significantly reduced epileptic activity for up to four hours. Subcutaneous administration was less effective. PG2alpha given by the intramuscular route (0.3 mg/kg) also markedly reduced the number of epileptic bursts. Increasing the dosage 4-fold almost completely suppressed epileptic activity. Intracarotid infusion of PGF2alpha for one hour (10 mug/min) almost abolished all epileptic activity. Neither prostaglandin given in non-toxic doses induced EEG abnormalities in non-epileptic cats. Toxic doses of the E2 analogue (greater than 16 mug/kg) caused bilaterally synchronous high voltage slow wave activity. It is concluded that these prostaglandins reduce penicillin epilepsy in the cat. The findings are consistent with either a direct excitatory action on neurones of the medial reticular formation or anatagonism of the depressant action of norepinephrine on Purkinje cells.


Production of prostaglandin-like substance at the time of mating in the rat.

The amount of prostaglandin-like substance (PG--LS) in the reproductive tract of the male and female rat following mating (p.c.) has been measured and compared with non-mated (control) values. Negligable amounts of PG-LS were detected in the control female tracts but a mean of 2 mug PGE, equivalents was detected immediately p.c. The PG--LS is probably generated in the vas deferens since nearly 1 mug PGE1 equivalents per rat remained there p.c. No other tissue in the male reproductive tract contained significant amounts of PG--LS suggests that the bulk of the activity is due to PGE2 with a smaller amount being due to PGF2 alpha.


Prostaglandins in neural crest-tumors.

Prostaglandin and catecholamine concentrations were estimated in tumour tissues taken from four phaeochromcytomas and five other neural-crest tumours. Prostaglandins were found to be present in tumours both associated and non-associated with chronic diarrhoea. Prostaglandin F, as well as catecholamine, concentrations were higher in phaeochromocytomas than in other tumours. The hypothesis has been made that while prostaglandins do not reach arterial circulation to give rise to pharmacological effects, such as chronic diarrhoea, prostaglandins F present in phaeochromocytomas may contribute to a higher catecholamine synthesis and/or release, resulting in a higher incidence of hypertension associated with these tumours.