Interpretative problems in endoscopic retrograde cholangiopancreatography.

1. Of forty-one patients with biliary tract problems studied by endoscopic retrograde choledochopancreatography, interpretation of ductograms or endoscopic observations in ten could not be accomplished with ease for one or several reasons. 2. Although incomplete filling of the bile ducts usually signifies organic obstruction, this occasionally is not true. The specific origin and histologic character of the lesion causing bile duct obstruction are not delineated by retrograde endoscopic cholangiography. 3. Other occasional limitations of endoscopic cholangiography include difficulties in demonstrating minute stones, in recognizing confusing anatomic variations, and in defining the status of recurrent strictures. 4. Inflammatory changes in the duodenal papilla can simulate carcinoma, or vice versa, on the basis of observation by the endoscopist. The capability of achieving a pancreatogram does not rule out the presence of carcinoma at the ampulla producing jaundice. Current technics for biopsy of the papilla or ampulla are in some instances inadequate, making results of such procedures unreliable. 5. Although endoscopic retrograde cholangiopancreatography frequently permits acquisition of vital information for the surgeon and occasionally provides unexpected information of significance, interpretative difficulties in some instances always necessitate the correlation of findings with other available clinical information.


Progress in biliary stricture repair.

Between 1967 and 1970 inclusive, 119 patients underwent 158 operations for the relief of benign bile duct stricture. During this time hepaticojejunostomy was favored for biliary reconstruction, since eighty procedures were of this type. Thirty-eight were end to end repairs and the remainder were a variety of other types. Of the cases evaluated, 58 per cent of the hepaticojejunostomies and 61 per cent of the end to end repairs produced satisfactory results. This experience is an improvement over a previously reported earlier series from this institution. Only three patientd died postoperatively, a significant reduction over an earlier mortality. Further experience with the use of the modified Y tube has been gained in forty-two cases, and it suggests that the benefits might be statistically significant in hepaticojejunostomy if the number of cases were increased. We have begun to evaluate the transhepatic circle tube which can be replaced, when obstructed, on an outpatient basis, thus allowing longer use of stents. Analysis of obstructive biliary sludge in five stents suggests that the sludge is a polymer of bile pigment that is insoluble in both aqueous and organic solutions and therfore not preventable or dissolvable by the administration of chenodeoxycholic acid.


Endoscopic pancreatography: its value in preoperative and postoperative assessment of pancreatic disease.

Examples of the use of endoscopic pancreatography in the preoperative evaluation and postoperative follow-up study of patients with pancreatic disease are presented and discussed. Six cases selected from a total experience of forty-eight patients have been summarized. The direct role of pancreatography in the management of these cases is cited. There is a small but definite risk to the procedure. With increased use of endoscopic pancreatography, it is hoped that earlier diagnoses of a variety of pancreatic diseases will be obtained which will permit more accurate medical and surgical therapy.


Pancreatic abscess.

Successful management of pancreatic abscess necessitates early diagnosis and prompt external surgical drainage. The infection is predominantly gram-negative and polymicrobic. Roentgenographic contrast studies are of particular diagnostic value. Prompt recognition and external drainage are associated most frequently with recovery. Multiple system organ failure is the typical pattern of death and should alert one to the possibility of occult sepsis, secondary to pancreatic abscess.


Aberrations in Hollander test response after incomplete vagotomy. Compensating effect of antral resection in the dog.

Acid secretory and serum gastrin responses to 2-deoxy-D-glucose and insulin were compared in gastric fistula dogs before and after partial vagotomy and pyloroplasty or partial vagotomy and antrectomy. The acid response and serum gastrin curve were basically unaltered by partial vagotomy and pyloroplasty. Based on the data presented, the acid response to insulin hypoglycemia appears to be more dependent on the vagal release of antral gastrin than on direct vagal stimulation of the parietal cell. However, acid response to insulin was profoundly suppressed to only 4 per cent of control levels after partial vagotomy and antrectomy. Although acid response to 2-deoxy-D-glucose was also profoundly depressed to 33 per cent of control levels after partial vagotomy and antrectomy, it was seven times greater than that seen with insulin. Serum gastrin response was abolished after antrectomy to either insulin or 2-deoxy-D-glucose. Finally, the question to which we originally addressed ourselves appears to have been answered and, in terms of response to vagal stimulation, antrectomy appears to compensate for incomplete vagal denervation and may lead to aberrations and misinterpretations, raising serious questions as to the validity of the Hollander test in patients who have undergone distal gastric resection.


Calcium infusion test before and after total gastrectomy in the Zollinger-Ellison syndrome.

1. In a preopertive group of patients suspected of having the Zollinger-Ellison syndrome the serum gastrin and gastric acid response to calcium infusion may be highly diagnostic. 2. In a group of Zollinger-Ellison syndrome patients following total gastrectomy, the gastrin response to calcium infusion correlates well with presence or absence of tumor.


Depletion of antral gastrin after food in rats.

The results of these studies indicate that in fasting rats, there is an abrupt and prolonged rise in circulating gastrin after feeding. This increase in serum gastrin is accompanied by an early (five minutes) diminution in antral gastrin which is followed by slightly higher and more variable antral gastrin values. These findings suggest that feeding triggers the release of gastrin with early depletion of antral gastrin and that, subsequently, gastrin syhthesis and release interact cyclically to maintain antral and serum concentrations of gastrin. Antral, fundic, and duodenal gastrin values in rats are similar to those reported in dogs and cats. The jejunum of the rat contains little, if any, gastrin.


Surgical treatment of late postgastrectomy syndromes.

An analysis of the experience at the University of California Hospital, San Francisco, with the diagnosis and treatment of fifty-nine postgastrectomy syndromes shows that stomal obstruction (sixteen patients), the most common syndrome, was best treated by total reconstruction rather than stomal revision. Disappointment with the results of other procedures for the dumping syndrome (50 per cent improvement) has convinced us of the need to adopt the use of reversed jejunal interposition for surgical treatment of this condition. Because a precise etiologic diagnosis of bilious vomiting is often elusive, the preferred procedure is isoperistaltic jejunal interposition, since it eliminates the afferent loop and prevents bile from entering the stomach. All five patients with malabsorption were improved by conversion from BII to BI. Four of five patients with diarrhea were improved by various procedures (not including a reversed segment of intestine in the midjejunum). Three patients with reflux alkaline gastritis were improved by Roux-en-Y gastrojejunostomy or isoperistaltic jejunal interposition. Either is effective. Thus, in our experience if an unquestionable diagnosis of stomal obstruction, malabsorption, or reflux alkaline gastritis can be established, there is ample justification for an optimistic outlook regarding surgical therapy.


Long-term randomized prospective comparison of Finney and Heineke-Mikulicz pylorplasty in patients having vagotomy for peptic ulceration.

Two hundred patients undergoing vagotomy for duodenal ulceration over a period of forty-three months were randomly given Heineke-Mikulicz or Finney pyloroplasty. One died of a myocardial infarction twenty-four fhours after operation, six-teen died within seven years from conditions unrelated to surgery, nine were lost to follow-up study, and 174 were followed up an average of 5.2 years. These patients were evaluated for signs and symptoms of recurrent ulceration or complications of their operation. A majority underwent postoperative secretoay and gastric emptying studies. The proved rate of ulcer recurrence was higher in patients with Heineke-Mikulicz pyloroplasty (4 per cent versus 2 per cent); however, over-all recurrence (proved, probable, and possible) was 13 per cent in each category. The dumping syndrome, seen in 14.4 per cent with Heineke-Mikulicz and 10.7 per cent with Finney pyloroplasty, was the most common complication...


Lumbar epidural analgesia--the pursuit of perfection. With special reference to midwife participation.

Lumbar epidural block for the relief of pain in labour has been reported as having a variable frequency of success. Analysis of a personal series of 1544 epidurals carried out with the close co-operation of midwives shows that, with attention to details of management, satisfactory analgesia can be assured in well over 90% of all labours. Total failure should be a rare event and the causes of more than half the partial failures can be traced to errors of management.


Posture and epidural block in pregnant women at term. Effects on arterial blood pressure and limb blood flow.

Upper and lower limb blood flow was measured in 4 fullterm pregnant women in the left lateral and supine positions before and after epidural block. Radial artery mean blood pressure was recorded in 6 full term pregnant women under the same conditions. Before epidural block there was a much greater reduction in lower limb blood flow (39-1%) than in upper limb blood flow (13-5%) when women moved from the lateral to the supine position; this was probably the result of aortic compression. Mean radial artery pressure increased slightly by 4-6% due to maternal overcompensation in the upper part of the body. After epidural block, patients in the lateral position had a mean rise in lower limb blood flow of 25% and a reduction in upper limb blood flow of 37-2%. The mean arterial pressure remained unchanged. In the supine position there was no further reduction of upper limb blood flow; this was accompanied on average by a 9% fall in mean radial arterial pressure indicating decompensation in the mother. The leg blood flow fell less, 26-9% than before epidural block. In the supine position, a greater flow to the legs, associated with a decreased mean arterial pressure, would be expected to lead to a diminution in placental perfusion, which is the probable mechanism for foetal decompensation. Therefore the supine position should be avoided with an epidural block. In other patients it would be wise not to rely upon maternal compensatory mechanisms.


Intravenous anaesthesia by infusion. A technique using alphaxolone/alphadolone (althesin).

Two hundred and seventy-three patients were anaesthetised using aphaxolone/alphadolone as a sole anaesthetic agent, administered in either a 10% solution or in increments of neat drug. Analgesics were given where necessary. This technique was instituted to provide a method of anaesthesia that avoided pollution of the atmosphere, with its possible harmful effects. As experience was gained, better results were obtained. Overall, 86% of the anaesthetics administered were without problems, 12% presented some difficulty, usually minor movement of the patient, and in 2% this technique was abandoned.


Topical analgesia before tracheal intubation.

The major toxic effects of local analgesic drugs are regarded as due to over-dosage. A technique of topical analgesia for tracheal intubation using lignocaine is described based on spraying the pyriform fossae to effect a superior laryngeal nerve block combined with topical analgesia of larynx and trachea which avoids excessive exposure of the lowere airway to the local analgesic. The results show lower levels of venous blood lignocaine with slower absorption of the agent than when similar doses are applied to the trachea. This method is accordingly recommended.


Pupillary constriction and ptosis following caudal epidural analgesia.

This study reports pupillary changes occurring in seventeen of twenty pregnant women at term who received caudal analgesia for the relief of pain in the first and second stages of labour. It is suggested that 10 ml or more of analgesic solution, injected into the sacral epidural space, reaches high enough (probably to T1) to cause meiosis and/or ptosis.


Horner's syndrome as a complication of lumbar epidural block.

Two cases of Horner's syndrome complicating lumbar epidural block in pregnant women in labour are described. The aetiology of the complication is discussed and it is suggested that epidural injections should not be made while the patient is in the lithotomy position.


Paraplegia following epidural analgesia.

A case of neurological damage associated with lumbar epidural block is presented. Muscle paralysis and sensory loss were found in the immediate postoperative period and there was partial recovery of muscle power. The possible mechanisms of nerve damage are discussed.


Blood patch for spinal headache. A recurrence and a complication.

The management of a patient is described who has a blood patch for spinal headache, but who had a recurrence of symptoms 1 day later which was successfully treated by a second patch. A second case is described in which there was a second dural puncture immediately prior to the blood patch and, immediately following the blood patch, the patient complained of severe debilitating 'paralysing' pain in both legs. This pain was of short duration and the blood patch was successful. Some further observations on the use of a blood patch are recorded.


Labelled adhesive tape for the identification of syringe contents.

Labelled adhesive tape for the identification of syringe contents with suitable dispensers which can be obtained in the United Kingdom is described. The equipment can be obtained from the 3M Company at the following address: 3M United Kingdom Ltd., Converted Products, Wigmore Street, London W1A 1ET.


A syringe for extradural analgesia.

A specially designed 20 ml syringe for eliciting the loss of resistance test is described together with a suitably adapted Tuohy needle. This syringe and needle are primarily intended for use by those gaining experience in extradural analgesia (and such experience is readily transferred to any syringe) but it is considered that the consummate ease of operation will be appreciated by others.


Immediate care of burns.

The assessment, first aid treatment and immediate care of severely burned patients in the Accident and Emergency Department have been reviewed and the factors which influence the decision to transfer a case to a specialist Burns Unit have been discussed.


Intravenous regional analgesia using bupivacaine.

Intravenous regional analgesia using bupivacaine (Marcain) was employed as the anaesthetic technique in a series of 50 cases undergoing a variety of surgical procedures on the upper limb. A short pilot study was undertaken to determine the optimal dosage and concentration of bupivacaine. This was found to be 1-5 mg/kg in 0-2% concentration and proved suitable for all patients regardless of age or physical condition. The use of bupivacaine produced highly successful results in 98% of cases. Onset of analgesia was very rapid (3-5 minutes) and profound muscular relaxation occurred in approximately half of the cases. The degree of muscle relaxation was, however, always adequate for the successful reduction of fractures. Only one patient exhibited an adverse reaction to the dose of bupivacaine used and this was limited to a brief period of slight drowsiness. The results of this series suggest that bupivacaine may provide advantages over previously used local analgesic agents for intravenous regional analgesia and that it may be the agent of choice for this useful technique.


[The course of the catecholamine excretion during combination anaesthesia with halothane and thalamonal (author's transl)].

On 10 patients who had to undergo a ca. 4 hour operation of the lower abdominal region, the pattern of catecholamine excretion before, during and after operation was traced. 1. A decrease of systolic blood pressure on average of 80 mm Hg, in correlation to the concentration of Halothane and Thalamonal, was recorded. 2. The excretion of adrenaline and noradrenalin was significantly lower during anaesthesia as compared with the initial value, suggesting a depression of sympathoadrenal system. 3. The postoperative amount of adrenaline and especially noradrenaline increased markedly, when anaesthesia worn off, postoperative shivering started, and surgical wounds caused pain. 4. The excretion of urine during operation was slightly reduced, the renal output showed normal amounts, when calculated up to 24 hours. The results show, that the combined use of halothane an thalamonal because of its depressant effects on the sympathoadrenal system is capable of reducing the liberation of catecholamines during anaesthesia.


[Sodium and water balance and renal function in volume expanded dogs under neuroleptanalgesia (author's transl)].

In 8 volume expanded dogs with an equilibrium between input and renal output of sodium and water neuroleptanalgesia of 6 hours duration with a total of 9 mg/kg of droperidol and 0.35 mg/kg of fentanyl was performed. Under anaesthesia GFR was increased by about 10% (p less than 0,02) compared with the conscious state, whilst renal sodium and water excretion was reduced by about 50%. From this we conclude that active tubular transport of sodium is augmented under neuroleptanalgesia. Due to decreased excretion, retention of sodium and water increased during anaesthesia changes of functional ECFV tending into the same direction. Plasma volume and intravascular protein did not change under neuroleptanalgesia compared with the conscious state. Urine osmolality and negative free water clearance (TcH2O) increased by about 60% under droperidol and fentanyl. In volume expanded dogs under neuroleptanalgesia intravenous application of 0.5-1.0 mg of atropine resulted in a temporary water diuresis.


[The effects of combining halothane and neuroleptanalgesia on the preganglionic sympathetic activity, the respiratory centre and the circulation (author's transl)].

The effects of Halothane, Fentanyl and droperidol in combination on the circulatory system, the preganglionic sympathetic nerve activity and the respiratory centre were examined in 21 experiments carried out on cats which were relaxed and artificially ventilated with nitrous oxide in oxygen. The results showed that even the minimal dosage of 0.5 vol-% Halothane combined with 0.0042 mg/kg Fentanyl and 0.15 mg/kg droperiodol led to a significant decrease of blood pressure and a depression of the sympathetic and phrenic nerve activity both in rest and in stress during asphyxia. A dosage of 1 vol-% Halothane produced a significant increase in the above mentioned effects when at rest, while the doubled dosage of Fentanyl and droperidol combined with the original Halothane dosage of 0.5 vol-% produced no marked increase in its effects. A comparison of these results with those of previous experiments using only the inhalation of Halothane shows that an anaesthesia consisting of 0.5 vol-% Halothane combined with Fentanyl and droperidol has virtually equal effects on the decrease of blood pressure and on the depression of central sympathetic nerve activity as the inhalation of 1 vol-% Halothane alone. Using a combination of 1 vol-% Halothane, Fentanyl and droperidol the effects induced by 2 vol-% Halothane are reached.


[Characterization of clinical dextrans by gel chromatography (author's transl)].

A gel chromatographic method for the determination of the molecular weight distribution of dextrans on Spheron is described. The linear calibration function is valid for the molecular weight range from 10(3) to 10(6). For 8 commercially available dextran solutions distribution curves are given.


[The effects of neuroleptanalgesia on the sympathetic activity and the circulation in animals (author's transl)].

The effects of i.v. injected Fentanyl and droperidol used either singly or in combination were observed in 50 experiments carried out on cats which had been relaxed and artificially respirated. The preganglionic discharges of the cervical sympathetic nerve and action potentials of the phrenic nerve, the mean arterial pressure and the heart rate were recorded. The experiments showed that with the dosage of 0.0042-0.0083 mg/kg Fentanyl no significant change in the recorded functions took place. The dosage of 0.0166 mg/kg Fentanyl led to an activation of the central sympathetic activity and to a inhibition of the respiratory centre which persisted for as long as 60 min after the injections. Other than as above, a dosage of 0.15-0.6 mg/kg droperidol led to a decrease of the blood pressure and a depression of the sympathetic nerve activity, while the activity of the phrenic nerve remained unchanged. The effect on the blood pressure was mainly influenced by the central nervous system as the inhibition of the pressor effect of noradrenaline was only minimally. The dosage of 0.0083 mg/kg Fentanyl combined with 0.3 mg/kg dropendol as administered for neuroleptanalgesia led to a decrease in blood pressure and a depression of the central sympathetic and phrenic nerve activity both in rest and in stress during asphyxia. The effects were minimal and accorded virtually to the effects produced by 0.5 vol-% Halothane during the first 25 min of inhalation, which had been registered in previous experiments. Contrary to the effects of Halothane, neuroleptanalgesia produced no decrease in the heart rate, no depression on the pressor effects of noradrenaline and no accumulation of irregularities in cardiac rhythm after administration of noradrenaline.


Accurate volume ventilation of neonates with maintenance of humidification.

A method is presented for producing adequate humidification and accurate volume ventilation of neonates. This was effected by pressurizing the humidifier and fresh gas flow up to the T-piece. By using a ventilator which acted as a timed occluder of the T-piece, the system functioned as an accurate flow generator. Its precision of ventilation was confirmed with a neonatal test lung.


Difficulties with positioning Robertshaw double lumen tubes.

Difficulties in positioning Robertshaw tubes have been reviewed in a retrospective and a prospective series. Pre-operative cheat X-rays did not help in predicting difficulties. The performance of the Robertshaw tube was carefully recorded for each malposition in the prospective series, and the relationship of the malplaced tube to the tracheobronchial tree was reconstructed. This exercise allowed a more precise definition of the dangers of malpositions and formulation of procedure to minimize their incidence.


Objectives for undergraduate education in resuscitation and anaesthesia for children.

A statement of objectives for teaching undergraduates in the fields of resuscitation and anaesthesia for children is presented. The value of such objectives and the requirements for undergraduate teaching by anaesthetists in Australia and New Zealand are briefly discussed.


Cardiac pacemaker induced ventricular fibrillation during surgical diathermy.

Two demand pacemakers were observed to repeatedly fibrillate the heart during clinical surgery employing diathermy. Marked hypotension associated with a rapid, irregular venticular action was observed in another patient who had a fixed rate pacemaker implanted. Pacemakers were tested with function generators over a range of frequencies and some increased their rate to between 200-600 impulse/min. Animal experiments confirmed that, contrary to manufacturers advice, surgical diathermy produces myocardial fibrillation in the presence of some pacemakers. Mechanisms of these effects and their clinical significance are discussed.


Anaesthesia and clinical pharmacology: related disciplines.

The disciplines of anaesthesia and clinical pharmacology are related in as much as both have a mutual interest in the safe and conservative use of drugs in man. Anaesthetists have effectively been practising rational therapeutics for many years and they have much to offer academic departments of clinical pharmacology in terms of teaching and research programmes. Similarly, the clinical pharmacologist can usefully contribute to anaesthetic training and research programmes in relation to aspects such as education, precise analytical methods, data-handling and clinical trial techniques. The inter-relationship of the two disciplines can be of mutual advantage and has the potential to provide a stronger basis for sound therapeutic practice.


Diazepam prophylaxis for lignocaine induced convulsions.

The effectiveness of intraperitoneal phenobarbitone (4 mg/kg), pentobarbitone (6 mg/kg) and diazepam (2.5, 5 and 7.5 mg/kg) in preventing lignocaine-induced seizures was studied in rats. Although the barbiturates exerted a marked depressant action on wakefulness and gait of the rats, they were still associated with a very high incidence of convulsions and deaths following 100 mg/kg intraperitoneal lignocaine hydrochloride. Diazepam, however, even in doses (2.5 and 5 mg/kg) which did not produce marked sedation was able to completely prevent convulsions. Mortality was not completely prevented as one animal in each of the groups receiving these doses died without convulsing. Diazepam in the dose of 7.5 mg/kg completely prevented the seizures as well as the mortality but exerted a more profound effect on wakefulness and gait of the animals. The effectiveness of diazepam pretreatment in preventing lignocaine-induced seizures in rats is confirmed.


Enflurane (ethrane)-a preliminary study in children.

A clinical trial of enflurane with paediatric patients is reported and confirms that it is a satisfactory inhalational anaesthetic agent without serious adverse effects.


A practical apparatus for measuring average exposure of operating theatre personnel to halothane.

A procedure for the measurement of halothane in the breathing zone of operating theatre personnel is described. This is achieved by sampling air through a U-tube containing silica gel. Concentrations found in operating theatres ranged from less than 0.1 to 8 ppm. The method can be used to evaluate exposure over a full working day.


Appositional growth rate in the spongiosa of unloaded long bones of the dog.

In agreement with the results of previous investigations on the dynamics of diaphyseal osteonic bone in inert skeletal segments, it has been observed that the linear appositional growth rate on the trabecular bone of metaphyses and epiphyses does not significantly change in unloaded bones, in comparison with normally loaded ones. Only during the initial period of unloading, a moderate decrement of the aforesaid parameter seems to take place. These findings are briefly discussed in connection with the role presumably played by mechanical stresses on the processes of bone reconstruction.


Histological studies on certain autonomic ganglia in the buffalo (Bubalus bubalis).

In the buffalo the sympathetic ganglionic neurons were multipolar and contained finely granular or vesicular Nissl material and eccentric nuclei with more than one nucleolus. They measured (mean values) 23.62 X 14.30 mum in the cranial cervical ganglion, 22.51 X 13.58 mum in the vertebral ganglion, 25.25 X 15.75 mum in the cervicothoracic ganglion and 22.84 X 14.27 mum in the fourth thoracic ganglion. Their density values were 256 neurons/mm2 in the cranial cervical ganglion, 250 neurons/mm2 in the vertebral ganglion, 248 neurons/mm2 in the cervicothoracic ganglion and 252 neurons/mm2 in the fourth thoracic ganglion.


[The fine structure of the lymphatics in the rumen wall of the goat].

Ruminal lymphvessels from the goat were investigated with light- and electronmicroscope after blockade of the lymphdrainage and vascular perfusion by means of yellow fix solution. The lymphvessels of the ruminal wall do not originate directly from below the epithelium but from the deeper layers of the Propria mucosae. As far as ruminal papillae are concerned, lymphatic vessels are only to be found at their base. All lymphvessels consist of a basement membrane and an endothelium. Only the ones which are situated in the Subserosa or in the musculature of the wall are provided with lymphatic valves.


Ectopical kidney tissue in the left auricle of a rat.

A case of a 3 months old rat with ectopic renal tissue within the heart was described. The renal tissue consisted of well developed parts of the kidney cortex like glomerula and tubuli contorti. All parts of the kidney medulla such as excretory tubules and kidney pelvis were missing. It is believed that the ectopic kidney tissue developed from scattering of metanephric tissue. A physiological function of the intracardial renal tissue can be excluded.


Lumbrical muscles and contracted toes.

Dissection of fifty feet revealed a lack of correlation between absence of lumbrical muscles and the presence of contracted toe. This is at variance with assertions commonly encountered in textbooks of anatomy. Contracted toes were found in association with well developed lumbricals. Absence of lumbricals was not found to be associated with toe anomalies. These findings leave in doubt the function of lumbrical muscles of the foot.


Evolution of mesenchymal cells in fetal rat lung.

The evolution of connective tissue cells in the developing fetal rat lung is studied under the electron microscope from the 15th until the 21st day of gestation and is compared to the evolution of epithelial cells. Three successive types of stem cells ("mesocytoblasts") are present during the first stages of lung development studied (15 to 18 days of gestation). These stem cells appear to be able to differentiate into fibroblasts or into smooth muscle cells, according to their localization along the broncho-alveolar tubule. Myoblasts are situated near the bronchial epithelium, whereas fibroblasts occur under the alveolar epithelium. Epithelo-mesenchymal interactions are assumed to play a role in this differentiation process. Synthesis of both, collagen and elastic fibers and of cytoplasmic filaments by fibroblasts as well as by myoblasts reveal the multiple potentialities of the mesenchymal stem cell and suggest a common origin. The early fibroblast in characterized by long cytoplasmic processes which contain numerous cytofilaments, and by the presence of collagen fibers in the vicinity of the cell. Later on, (20 days of gestation) the mature fibroblast of the lung mesenchyme shows areas of RER, glycogen and lipidic vacuoles in its cytoplasm. Cytofilaments are numerous within very long cytoplasmic processes and elastic and collagen fibers are very frequent beside the cytoplasmic membrane. The earliest fibroblast differentiation occurs under the epithelium of primitive respiratory bronchioles, which indicate the limit between the bronchial and the alveolar territories. Later on, differentiating fibroblasts are found throughout the whole alveolar walls. Connective tissue cells other than mesenchymal stem cells, fibroblasts or myoblasts are observed during lung development. Vacuolar cells, similar to Hofbauer cells, transiently appear on the 16th day of gestation. On the 20th and the 21st day macrophage-like cells are present in the septal space of the alveolar wall. The absence of intermediate stages of differentiation and parallel evolution of blood cells suggest that those connective tissue cells are differentiated elsewhere and have then migrated from blood into lung mesenchyme. No cell death has been observed in the developing lung.


Neural crest and early fore limb development in amphibia.

Anterior trunk neural folds were exchanged between neurula stages 15 to 16 (Harrison) of several Triturus species and Ambystoma mexicanum. Donor neural crest cells migrated ventrad before and during initial bud formation. They lined the early lumb epidermis and became incorporated into the young blastema. Donor melanophores and non-melanophores contributed substantially to host limb buds.


The distribution of intercellular junctions in the developing myotomes of the clawed toad.

The distribution of intercellular junctions between premyotomal and myotomal cells of Xenopus embryos has been described. Intermediate junctions, gap junctions, and small desmosomes are found between unsegmented mesoderm cells. In the region of myotome formation gap junctions appear to be absent, although close appositions of cell membranes are found. Both gap and intermediate junctions are numerous between cells of the segmented myotomes; they occur within the myotomes close to the myosepts and at interdigitations between the myotomes across the myosepts. Gap junctions between the myotomes are found in embryos that have hatched and can swim. The observed distribution of gap junctions is correlated with physiological data on electrical coupling. Electrical connections via gap junctions may produce contraction of the axial musculature remote from motor innervation.


Use of polarized light for quantitative determination of the adjustment of the tangential fibres in articular cartilage.

According to recent research the course of the tangential fibres is gaining increasing importance for the analysis of the first signs of pathological alterations in the articular cartilage. In a model-test, parallel-running synthetic double-refracting filaments, rotated between polarisator and analysator at right angles to each other effect an extinction curve which has two maxima at 45 degrees and the minimum at 0 degrees. Crossing filaments at different angles effects curves which are specific for the different angles in such a manner that with increasing angles to 45 degrees the curves approximate to a horizontal line. On the other hand the course of the different curves make it possible to determine corresponding angles. Then the same method is used to estimate the mean crossing-angles of tangential fibres in histological sections of articular cartilage with masked collagen fibres. The method is suitable for a quantitative calculation of the crossing-angles between 0 degrees and 45 degrees, which cannot be defined by the split-line method of Hultkrantz. In contrast to the conditions of the scanning electron microscope, the integrating nature of the polarized light is advantageous because it permits analysis of a more extensive visual field. From comparisons with the test model, a considerable variety of crossing angles of tangential fibres in the cartilage can be shown to exist.


The structural organization of the kidney of the desert rodent Psammomys obesus.

The architecture of the desert rodent Psammomys obesus has been studied by means of standard histologic procedures and by single nephron injections. As other rodent kidneys (rat, mouse), the Psammomys kidney consists of two types of nephrons, 66% short looped and 34% long looped nephrons. The cortex is composed of 4 to 5 layers of glomeruli, which lie closely put together, the glomeruli often touch each other. The superficial and the midcortical glomeruli give rise to short looped neophrons, the juxtamedullary to long looped nephrons. In the strongly developed medulla the inner stripe shows the most striking pattern. It consists of two distinct compartments, that of the giant vascular bundles and that of the interbundle regions. The giant vascular bundles consist of about 8 to 14% arterial vasa recta and 39 to 47% venous vasa recta; furthermore they include the thin descending limbs of the short loops of Henle which amount to 44 to 51% of the bundle structures. The tubules of the interbundle regions surround the bundles in a regular pattern. The inner zone is almost completely surrounded by the renal pelvis; the long broad papilla protrudes into the ureter. The thin descending limbs of short looped nephrons traverse the inner stripe inside the giant vascular bundles. Leaving the bundles they turn back within the inner stripe; their ascending limbs lie in the interbundle region. Both limbs of the long loops of Henle run in the interbundle region, together with the ascending limbs of the short loops and the collecting ducts. The long loops penetrate deeply the inner zone. Many bends are found near the tip of the papilla. The renal pelvis has a very specialized form. It penetrates the inner stripe with many complexely shaped extensions, which surround the giant vascular bundles. Large parts of the bundles with their thin walled structures are thus separated from the pelvic urine only by a single layer of cuboidal epithelium. The possible functional importance of the described specializations of the Psammomys kidney (giant vascular bundles, large inner zone, special shape of the renal pelvis) for the urine concentrating and urea recyclng mechanisms is discussed.


Alkaline phosphatase in the bovine endometrium and trophoblast during the early phase of implantation.

Alkaline phosphatase in the endometrial and chorionic epithelium from the 22nd to 24th day post insemination was investigated according to the method of Hugon and Borgers (1966a, b). In the precontact phase the reaction products of this enzyme were found light microscopically in the caruncular and intercaruncular area in the apical part of the uterine surface epithelium. Although a definite, continuing reaction line between the maternal and fetal epithelium was present in the apposition phase, there was no activity of this phospho-monoesterase ascertainable following consolidated adhesion. Independent of implantation, lead salt precipitate was observed in the apical cytoplasma in the upper third of the uterine epithelial glands. Electron microscopic investigations in the precontact phase demonstrated the localisation of the reaction products of this hydrolase as electron dense grains on the outer plasma lamella of the uterine microvilli. During apposition this reaction appeared on the microvilli of the dark uterine epithelium and the cell membrane of the trophoblast cells. In addition to the existence of alkaline phosphatase on the microvilli of the uterine glandular cells, reaction products were discernable in the kinocilia between the inner lamellar of their plasma membranes and the tubules ring, as well as between the latter and the central tubule pair. There is a possibility that this hydrolase plays a role in the transport of metabolites for the purpose of histiogenic uterine milk production.


Cytochemical establishment of acid phosphatase in the bovine endometrium and trophoblast during implantation.

Acid phosphatase in the endometrial surface epithelium is seen in connection with autophagy and autolysis. In the precontact and initial apposition stage, enzyme-positive Golgi vesicles, lysosomes and secretion granules all indicate autophage performance of the dark uterine epithelial cells in the sense of a histiogene embryotrophe development. At the time of progressing apposition this is joined by cell degradation with the aim of histiolytical uterine milk production. Following the completed implantation in the adhesion phase no activity with autophagy and autolysis-correlated acid phosphatase can be established. In trophoblast giant cells the localisation of acid phosphatase speaks for secretional processes. The incidence of this enzyme in the adhesion stage in "ordinary" trophoblast cells leads to the supposition of autophage processes which must be investigated in more detail. The endometrial gland epithelium shows the same acid phosphatase-dependent autophage indications in the upper third of the glands as shown in the surface epithelium prior to apposition. However, the acid phosphatase activity and the secretion deduced therefrom, thus the histiogene embryotrophe development, is conserved during the whole early gravidity of the cow, independent of the implantation process.


Morphology of the epididymis of the cock (Gallus domesticus) and its effect upon the steroid sex hormone synthesis. I. Ontogenesis, morphology and distribution of the epididymis.

The epididymis of the cock is divided into a main part and an appendix epididymidis. The main part of the epididymis is firmly connected to the testis. The sperm transporting tubes open into the ductus epididymidis along its entire length. The rete testis, as the most proximal part of the epididymis, develops from mesenchym cells. The rete testis connects the tubuli seminiferi with the ductuli efferentes proximales which develop from the Bowman's capsules of the mesonephros. The ductuli efferentes distales develop from the proximal tubules, conducting segments (loops of Henle), and the distal tubules of the mesonephros. The short ductuli conjugentes which open into the ductus epididymidis, originate from the connecting segments of the mesonephros. In the sexually mature cock the rete testis, the ductuli efferentes proximales, and the ductus epididymidis all show an enlargement in the lumen. In the ductuli efferentes proximales and in the ductus epididymidis one can observe a formation of globuli and cell protrusion which lead to a loss of the surface structure of the epithelial cells. The appendix epididymidis and the capsula fibrosa of the adrenal gland are joined by connective tissue. The appendix epididymidis consists of the blindly ending ductus aberrans (the crainal continuation of the ductus epididymidis) and the ductuli aberrantes which open into the ductus aberrans. The blind ends of the ductuli aberrantes end in the capsula fibrosa of the adrenal gland.


Morphology of the epididymis of the cock (Gallus domesticus) and its effect upon the steroid sex hormone synthesis. II. Steroid sex hormone synthesis in the tubuli epididymidis and the transformation of the ductuli aberrantes into hormone producing noduli epididymidis in the capsule of the adrenal gland of the capon.

Distinct histochemical and ultrastructural signs of a steroid hormone synthesis are found in the sexually mature cock, particularly in the ductuli efferentes proximales of the main part of the epididymis and in the blind ends of the ductuli aberrantes of the appendix epididymidis. These signs are more distinct in the appendix epididymidis of the capon since the blind ends of the ductuli aberrantes transform into steroid sex hormone producing noduli epididymidis after they sprout out intensively and branch inside or beneath the adrenal capsule. The signs of virility were lost immediately after castration. They become more distinct again due to the hormonal activity of the noduli. Due to the morphologic agreement the noduli epididymidis of the capon are homologous to the noduli epoophori of the hen.


Absorption of the impact energy in the palmar soft tissues.

In 30 anatomical specimens of the forearm the dynamic fracture of radius has been performed with a special hammer. In these specimens the pure kinetic energy of the fracture of the radius and the absorption of the impact energy in the palmar soft tissues has been determined.


Association between alphas1-, beta- and kappa-casein loci in two Italian cattle breeds.

The genetic polymorphism alphas1-, beta- and kappa-caseins was examined by gel electrophoresis in two Italian breeds, Valdostana and Piedmont. The results obtained from acid and basic migration show that the gene frequencies of the two breeds are very similar. Non independent assortment of genotypes among these milk protein loci was also studied. Results of analyses carried out on loci pairs showed that the genetic complex alphas1-CnB - beta-CnA2 was the most common in both breeds. In addition, the measure of linkage disequilibrium or gametic association (denoted delta) showed a close association between alphas1-Cn and beta-Cn, and between beta-Cn and kappa-Cn. No significant association was found between alphas1-Cn and kappa-Cn. This is in line with the model proposed by Grosclaude et al. (1973).


A genetic role of isozyme types in plasma alkaline phosphatase activity in the young chicken.

A genetic role of isozyme types in plasma alkaline phosphatase (AP) activity within dam families in the young chicken was investigated in a White Plymouth Rock strain kept in our laboratory since 1961. Plasma samples were obtained at 32 and 56 days of age and subjected to horizontal polyacrylamide gel electrophoresis and two methods of analysis. A higher level of plasma AP activity of the fast (F) type relative to that of slow (S) type was re-confirmed. The F types of full-sib chicks had distinctly higher AP activity than the S types. Also within isozyme types, family differences were significant in the F type but not in the S type. The correlation of AP activities between 32 and 56 days of age was significant in the F type but not in the S type, which could be attributed to the effect of aging. The genetic control of plasma AP activity in young chickens were discussed under a hypothesis of two independent genetic systems, i.e. major genic and polygenic.


Further studies on the genetic control of chicken plasma alkaline phosphatase isozyme.

The effects of neuraminidase treatment on the electrophoretic pattern of alkaline phosphatase (AP) isozymes and AP activity were investigated in chicken plasma. AP comprised three isozymes. The zymogram of an individual chicken plasma had two bands, either the faster (F) or the slower (S) moving band by isozyme types and the B band irrespective of isozyme types. Mobility of the S band and AP activity in chicken plasma were not affected by neuraminidase treatment. The treatment has a reduced migration rate of the F band equal to that of the S band and the B band of both types closer to the origin. The genetic control of these bands is discussed.


Esterase polymorphism in the Adriatic sardine (Sardina pilchardus Walb.). 1. Electrophoretic and biochemical properties of the serum and tissue esterases.

At least four zones of esterase activity designated I, II, III and IV were found after electrophoretic separation of sera and soluble extracts of sardine tissues on starch gel. Each zone consisted of one or more bands that were distinguishable from other zones by electrophoretic mobility, substrate specificity and sensitivity to various inhibitors. Polymorphism was noted in zones I, II and III, while zone IV consisted of a single band. A genetic interpretation of the polymorphism was given for zone I esterases in the tissue, which appears to be controlled by four codominant alleles. The zones designated I, II and IV in the sera and II, III and IV in the liver were characterized as carboxylesterases, zone II in the sera was the only one with cholinesterase activity, while zone I in the liver tissue was unclassifiable.


The use of carp, Cyprinus carpio (Linnaeus, 1758), instead of rabbit as antibody donor in immunological research on fishes.

Antisera produced by carp were tested in the differentiation between two cyprinid fishes, bream and roach, and between the lipovitellins of two grey mullets, Mugil cephalus and Liza ramada. These antisera were more specific in the recognition of different fish species than those produced by rabbits. An antiserum against carp lipovitellin was produced with male carp as antibody donor.


Retina-specific LDH isozyme in blueback herring, Alosa aestivalis (Mitchell), and alewife, Alosa pseudoharengus (Wilson).

The retina of 390 Alosa aestivalis and 410 Alosa pseudoharengus have been examined by means of starch-gel electrophoresis. The retina-specific E4 isozyme has been found to occur in all the fish examined. This study demonstrates for the first time that the E4 isozyme occurs in A. aestivalis. Because the E4 isozyme is not polymorphic and has an identical mobility in A. pseudoharengus and in A. aestivalis it is neither suitable for use as a species identification characteristic nor a population marker.


[The concept of renal dysplasia. Apropos of 67 cases].

The aim of this study, based upon 130 nephrectomies in children, was to emphasise the importance of congenital lesions in comparison with inflammatory lesions. In the context of congenital abnormalities, the abundance of our material made it possible for us to review our anatomical findings in the context of clinical and radiological data. This had led us to propose an anatomical classification of renal dysplasias. Although overlap cases exist, this classification into four separate entities according to the nature and extent of the histological and topographical lesions is satisfactory by virtue of its clarity. It is an agreement with the most recent publications of authors interested in the vast problem of renal malformations.


[Histology and prognosis of cutaneous malignant melanomas. Study of 50 cases].

50 cases of malignant melanoma of the skin followed up for more than 5 years are analysed according to histological criteria established at the Sydney conference. Two groups of 25 patients, one in which the course was favourable and the other in which it was not, are compared. Positive conclusions in terms of the prognosis may be drawn.


[Prognostic factors in idiopathic myeloid splenomegaly].

The study of the evolution of 168 cases of idiopathic myeloid splenomegaly allowed to point out the prognostic value of the clinical, hematologic, isotopic and radiological parameters. The correlation of these data with the histological type of the osteomedullary lesions at the time of the diagnosis, allows to confirm the long survival of the hyperplastic formes (type I), and the more reserved prognosis in advanced myelofibroses (type II and type III together) without it being possible to bring out a significant difference between the average presumption of survival of type II and type III considered each separately. Indeed, average survival is of 82 months for type I, and 60 months for type II and type III together. The regrouping of these two types seems to be justified and allows to individualize two anatomoclinical forms. One is characterized by hyperplastic marrow with reticulinic fibrosis, usually associated with enlarged spleen and sometimes even with polyglobulia but without radiological bone lesions. The other form is characterized by a marrow of middle importance or frankly hypoplastic, fibrous, with or without osteosclerosis, and shows moderate or marked radiological changes (respectively 16,9 p. 100 of the cases, and, as a rule, pancytopenia.


[Influence of parenterally injected trehalose in mammals having trehalase activity at different sites].

When trehalose is injected via parenteral pathway into animals lacking kidney trehalase (rat), more than 75 per cent of this disaccharide is eliminated in urine. When the injected animals possess an active kidney trehalase (guinea-pig, rabbit), there is only a low urinary trehalose excretion. Moreover, in rabbit, a marked hyperglycaemia is observed which is due to the rapid hydrolysis of trehalose by kidney trehalase.


[Automated determination of serum BSP. Improvement of dialysis by sodium salicylate].

Because of the great difficulty of BSP dialysis in automatized determinations in serum the authors investigated the effect of sodium salicylate. They proved its good performance with aqueous and proteic solutions of BSP. About 70 mul of patient sera is used to perform the analysis with Technicon Autoanalyser. Comparison of data from about 220 serum evaluated by their proposed method and manual technique are studied.


[An unusual case of talco-asbestosis].

The authors present an unusual case of asbestosis. The latter had very diffuse macrophagic and giant cell granulomatous lesions. The morphological findings and the history enabled one to relate the appearance observed to the conjoined handling of asbestos and talc. A primary adenocarcinoma developed on these lesions.


[Quality control of analyses and automation].

Multichannel analysers are becoming more and more usual in biochemistry laboratories. Then, a very severe quality control program is requisite. In Toulouse a three years experiment was carried out on a computer connected twenty four channels Autochemist and an unconnected Technicon SMA 12/60. The traditional quality control from control lyophilized serums is still necessary and useful, mainly at the level of a region. The remaining valuable methods are automatic calibration and statistical controls on frequently tested samples from human polled serum and on results from patients, these being provided through various procedures.


[Peculiar aspects of viral type particles ("viroplasms") in hepatocytes in hepatitis with Australia antigen].

Electron microscope studies of liver biopsies in 32 cases of hepatitis with Australia antigen (aggressive chronic hepatitis, polyarteritis, hepatitis on alcoholic cirrhosis and in kidney transplants) showed original intranuclear formations. They are different from the usual viral type particles connected with Australia antigen and appear to be formed of dense, granulofilamentous accumulations, scattered at random in the nucleus, sometimes in close proximity of nucleoles and nuclear bodies. Within these accumulations outlines of complete or partial rounded particles have been observed the morphology of which resembled that of the usual intranuclear particles. Comparison with former descriptions of the chronological aspects of viral replication allowed the author to refer to these formations by the term of "viroplasms". Thus, they are considered representative of an intermediate stage in the formation of the nuclear particles. This interpretation would add an argument to the notion of nuclear replication of the particles related to Australia antigen.


[Allergy to animal hair. Cutaneous manifestations (author's transl)].

The authors report 25 cases of allergy to animal hair in childhood. 13 patients were polisensitized, and in the remaining 12 hair was the only allergen responsible for the clinical picture. The main clinical features are discussed and the high incidence of atopic cutaneous signs pointed out. In three patients these were the only clinical manifestation. Desensitization was successful, although this is, difficult to undertake without a substantial modification of the surrounding environment.


[Plasma levels of HGH, insulin and NEFA in diabetic children (author's transl)].

Plasmatic levels of HGH, insulin and NEFA are measured after oral glucose loading in 14 diabetic children and are compared with those obtained in 7 normal children. The average values of HGH are higher in the diabetics at 0', 30', 60', and 190', and on the contrary the release of HGH which is produced at 90' and 120' with a glucose load is increased in the normal controls. None of these differences are significant. The insulin and NEFA response observed in the normal cases is not observed in the diabetics where the obtained values do not show variation with the administration of glucose.


[Tumors of cardiac ventricles (author's transl)].

Clinical and pathological findings are reported in 3 cases of cardiac tumors involving the ventricular septum and free walls. In 2 cases death occurred at ages 4 hours and 3 1/2 years and the pathological study revealed the presence of rhabdomyomas in the heart and tuberous sclerosis in the brain. The cardiac involvement was much more pronounced in the newborn infant than in the 3 1/2-year-old boy. The remaining patient, is a 6-month-old infant who is still alive. An angiocardiographic study performed at age 1 1/2-months revealed the presence of multple filling defects which were localized in the ventricular septum and in the left ventricular free wall. The angiocardiography was indicated on the basis of a previous clinical situation of severe heart failure which had been difficult to bring under control. A discussion is also presented dealing with the most characteristic clinical features of cardiac tumors in infants and children.


[Typhoid fever and Salmonella gastroenteritis in children (author's transl)].

A study on 25 hospitalized children with salmonellosis in the two forms of typhoid fever and gastroenteritis is reported. It confirms the higher incidence of gastroenteritic forms under the age of 3 years, and of typhoid fever in older children. We verify the limited value of the white cell count and the enlargement of the spleen. An appraisal of the serologic tests is made. The direct relationship between group D salmonella and typhoid fever form is pointed out. Finally we analyze the action of ampicillin, chloramphenicol and trimethoprim-sulphamethoxazole, due to the current appearance of resistances to antibiotics.


[Malformed tumoral hemangioma of the mediastinum. Apropos of 10 cases].

The malformed tumoral hemangioma of the mediastinum is highly specific tumoral entity, which must be distinguished from other varieties of hemangioma -- tumors arising in young subjects above all, and frequently large tumors of the mediastinum, whose radiological discovery leads to the most disturbing suppositions. It is however a benign tumor, most frequently surgically curable. Il is not so rare as it is said to be, at least in the child: it can be evoked in certain cases and even characterized sometimes. It is always better to avoid operative surprises in this connection, in this surgery of the mediastinum.


[Use of propranolol in permanent essential hypertension].

The anti-hypertensive effect of propranolol is studied in 35 essential permanent hypertensive patients. The decrease in blood pressure in higher in the presence (p is less than 0.01) than in the absence of diuretic therapy. The anti-hypertensive effect is higher in severe than in moderate hypertension. No side effect was observed except the decrease in heart rate (p is less than 0.001). Dihydralazine was added in 4 severe hypertensive patients and induced in 2 of them anginal attacks.


[Umbilical artery catheterization. A simplified method to predict the catheter localization (author's transl)].

A simplified method is presented to predict localization of the distal tip of the umbilical arterial catheter in thoracic aorta. When the segment of the catheter introduced equals a third of the length of the baby in cms., a correct position between the vertebral bodies of T-6 and T-10 was obtained in more than 90% of the cases. With this technique need to correct the position of the catheter and to obtain repeated roentgenographic controls is avoided.


[Common variable immunodeficiency (author's transl)].

In a boy initially diagnosed as X-linked hypogammaglobulinemia, the later clinical and analytical course and the application of new immunological techniques led to the new diagnosis of common variable immunodeficiency. The patient shows panhypogammaglobulinemia, a scarce number of plasma cells with a normal number of precursors and circulating B lymphocytes with membrane bound immunoglobulins and C3 receptors. Delayed hypersensitivity is absent despite normal amount of circulating T lymphocytes which were able to transform when stimulated by PHA. The anergy seems primary and not related to the clinical malnutrition. The authors make a differential diagnosis between both illnesses as a tentative pathogenetic interpretation of B cell development arrest.


[Juvenile rheumatoid arthritis: Characterisation of its clinical variations (author's transl)].

This study of 42 patients affected with juvenile rheumatoid arthritis (JRA), in which two defined clinical forms are established: febrile and non-febrile. Patients with JRA with high temperatures for more than 3 weeks, are included in the febrile form when any other cause for the fever can be excluded. In this study, 18 patients had febrile JRA, and the main clinical features were the higher number of joints involved, the presence of rash and the higher incidence of increase in size of the liver and/or spleen. Laboratory studies in cases affected by febrile JRA are characterized by higher frequency of high white blood count (p less than 0.001) and low frequency of rheumatoid factors (0.025 less than p less than 0.05) and antinuclear antibodies (0.001 less than p less than 0.005). Another finding is the incidence of microvasculitis: 31% in a group of 38 patients with JRA. Although microvasculitis is more frequent in the form of JRA without fever. it is a statistically significant characteristic of both forms of JRA described.


[Anal extrusion: a complication of ventriculo-peritoneal shunt for hydrocephalus (author's transl)].

The authors report a case of rectal perforation eight months after the placement of a ventriculo-peritoneal shunt. There was no peritonitis, but an "E. coli" meningitis was found. The patient died two hours after surgical removal of the shunt. At autopsy, a perforation by the tip of the catheter was found in the anterior face of the rectosigmoid.


[Echography in heart valve diseases].

The authors discuss the value of echorcardiography in cardiac valvular disease. Exploration of the mitral valve gives very precise data concerning diagnosis and evaluation of the degree of mitral stenosis. It may be of value in the diagnosis of certain complications such as intra-atrial thrombosis and gives reliable information in postoperative surveillance. In mitral insufficiency, echocardiography sometimes permits the recognition of certain mechanisms such as rupture of the cordae, ballooning of the lesser cusp and abnormal kinetics in obstructive cardiomyopathy. Exploration of the aortic valve is less informative. Aortic insufficiency gives scarcely any direct signs, whilst echocardiography is of value in aortic stenosis. Ultrasonic study also is useful in surveillance of the kinetics of valvular prostheses. The total absence of risk makes repeated studies possible, rendering echocardiography an essential element in the study of valvular disease.


[Modifications of phosphocalcic metabolism in patients treated with anticonvulsivants (author's transl)].

Differences in the seric values of Ca, P and alk. phosphatase before and after 12 to 18 months of anticonvulsant therapy in 45 patients are reported. They were significant for alk. phosphatase in patients under either barbiturates or barbiturates associated with hydantoin. For calcium they were significant in patients treated with barbiturate plus hydantoins and either one of these plus other drugs. It is assumed that supplementary vitamin D can be necessary in these group of patients.


[Smith-Lemli-Opitz syndrome. Cardiologic considerations (author's transl)].

A new case of the Smith-Lemli-Opitz Syndrome is reported, associated with a type of congenital cardiopathy not described previously in this syndrome.


[Menopause: apropos of some psychological and psychiatric aspects].

Menopause, begining of woman's involutional period, may (or must) be systematically treated by estrogens, preventing most of immediate or later menopausel complications and limitating effects of aging. This use of estrogens (which causes many controversies and resistances) has also probably a positive neuropsychic effect. The author reminds classical psychopathological explanations supporting mental troubles of this period which are usually considered as reaction to a crisis, instead properly psychiatric diseases are included in involutional pathology. A short review of psychiatric litterature indicates that psychiatrists refuse any specificity to menopausal psychic troubles. He points out also "the phobia of menopause", the increasing fear of old age in a "youth culture", in spite of progress of woman emancipation, social liberation following biological liberation (birth control, decrease of child mortality, etc). The reports of Jaszmann and Van Keep and Kellerhars are summarized. They show the main role of sociological, economical and familial factors in appearance, intensity and duration of climacteric troubles and progressive degradation with aging of: personnal integration, intellectual and cultural integration, and human relation-ships, and mental sanity. These reports seem to indicate that menopause is only a critical period of the slow process of aging and decadence. But systematic estrogen treatment and improvement of femine social condition should change drasticelly these troubles and this decadence.


[Severe psychomotor instability in child psychiatry. Hyperkinetic states or psychomotor incontinence].

The pedopsychiatric problem of severe psycho-motoric instabilities of hyperkinetic states, that we prefer to designate as psychomotoric incontinence, is at the origin of great amount of publications of inequal value. After having delimitated the concept of severe psycho-motoric instability (hyperkinetic syndrome or motoric incontinence) and a critical historic review of the problem, the author relates the various clinical aspects with twenty personal cases as example. The clinical and therapeutic experience of the author, the etiology, pathologic antecedents, neuro-psychological and electro-encephalographic data concerning this clinical condition, show that only ameliorations (in 40% of the cases), and not recoveries, are to be expeected.


[Psychiatric disorders in immigrant French Moslems].

The authors base their report on the case histories of 50 psychiatric in-patients, all Moslem French immigrants. The common characteristics are: 1. the absence of mental illness before immigration and throughout the first years in France; 2. a stay of at least one year in France. Five tables illustrate these case histories. Once again the question of immigration and in particular that concerning Algerian Moslems who chose French nationality in 1962 has been taken up. Certain problems concerning the failure of integration of immigrants have been highlighted. A bibliography comprising 24 books or articles completes this work.


[Children of alcoholics. Survey of 66 children of alcoholics in a child psychiatry service].

In a department of infantile psychiatry half of children have at least 1 alcoholic parent (66 over 136). We have compared 2 groups of children: one group of 66 children of alcoholics (65 alcoholic fathers 28 alcoholic mothers), and one group of children without alcoholic parent. In both group psychiatric illness is common: for children of alcoholics mental troubles needing psychiatric cares are found for 44 mothers and 20 fathers. Among children of non-alcoholic parents mental troubles are found for 19 mothers and 10 fathers. Alcoholic parents are more often divorced (21%) and only 40% are living together. Only 46.9% of children of alcoholics are bred by non-parental persons (28.5% for children of non-alcoholics). Some data (with statistical analysis) are given on children development and psychiatric symptoms. Half of 2 groups of children show mental deficiency. Among children of alcoholics character disorders and idiopathic epilepsy are more frequent. Among children of non-alcoholics cerebral damage and symptomatic epilepsy and possibly infantile psychosis are more frequent. This emphasizes evidence for many pathogenic factors and very bad milieu conditions. These offsprings of alcoholics are children at very high risk.


Dissociation of Mycoplasma gallisepticum membranes with lithium diiodosalicylate and isolation of glycoprotein.

M. gallisepticum membranes were treated with 0.3M lithium diiodosalicylate (LIS) and, on average, 43% of the original membrane proteins were extracted. The extract contained particles with a sedimentation coefficient of 13S and some aggregated proteins. This LIS extract was immunogenic, stimulating the production of haemagglutination-inhibiting, growth-inhibiting and precipitating antibodies in rabbits. It was devoid of haemagglutinating (HA) activity for chicken erythrocytes but did inhibit the HA activity of membranes of M. gallisepticum. This inhibitory activity was destroyed by periodate and trypsin, but not by heat. By sedimentation equilibrium in a caesium chloride gradient, the LIS extract was separated into a lipoprotein-like and a glycoprotein fraction. The lipoprotein-like fraction contained the majority of the proteins present in the original extract, had HA activity and blocked antibody which inhibits haemagglutination. These activities were apparently due to the protein moiety, since they were not removed by extraction with n-butanol. The lipoprotein-like fraction behaved similarly to the unfractionated LIS extract in immunodiffusion tests and polyacrylamide gel electrophoresis, producing one periodic acid-Schiff positive band in the latter. The glycoprotein fraction consisted of about 66% carbohydrate and 33% protein. The sugar components were identified as glucose, galactose, glucosamine, galactosamine, glucuronic acid. The glycorprotein fraction did not possess HA but blocked the HA activity of M. gallisepticum membranes. In immunodiffusion it produced one faint precipitation band. The possible significance of glycoprotein in mycoplasma membranes has been discussed.


Comparative study on two methods for serotyping of Staphylococcus aureus: the Pillet method and the Oeding method. II.-Possible identity between Pillet's antigen 9 and Oeding's antigen h1.

Using two techniques (agglutination and immunoprecipitation), the authors have observed that: -Pillet's strain CK9 and Oeding's strains 670 and 17A are very similar; -antigen 9 is also present in the three strains; the same relation is found in wild strains. Using agglutination and immunoprecipitation, there is a cross reactivity between h1 factor serum, serum 9 and strains CK9, 670 and 17A. A precipitation line involving strain CK9 and serum CK9 is described in the Pillet system. Finally, there is a strong presumption that Oeding's h1 antigen and Pillet's antigen 9 are identical.


[Evolution of fecal microflora in a "heteroxenic" infant maintained in a plastic isolator and trial on decontamination by antibiotherapy (author's transl)].

This work deals with the bacteriological study of an immunodeficient infant, delivered by aseptic cesarean section, and subsequently maintained in a plastic isolator. After a short period of germfree maintenance, several strains of bacteria were fortuitously introduced into the isolator, and became established in the infants' gastrointestinal tract. The qualitative and quantitative evolution of the fecal flora of this "heteroxenic" infant was followed for 170 days. Decontamination of the gastrointestinal tract was accomplished with a mixture of antibiotics, and the conditions of maintenance of sterility under antibiotic treatment were studied.


[Evaluation of interferon induced by rabies vaccines (author's transl)].

Two rabies vaccines originated from baby mouse brain or from human explant cells tissue culture (calf foetal kidney) with a high protection index induce in mice and hamsters a good interferon titre. It seems that the action of this kind of vaccine is double: non specific at the beginning by inducing interferon and later specific (4-5 days) by producing antibodies.


Assay of nitrogenase activity in intact plant systems.

Nitrogenase activity was assayed in intact system of Cichorium intybus, a non-leguminous commercially cultivated crop, Dahlia pinnata and Helianthus annus, and Taraxacum officinale, a common weed plant. The assay was made in fabricated cylinders which could accomodate pot with plants. In such kind of assay along with rhizosphere microflora, the nitrogen fixed by phyllosphere nitrogen fixing microflora could also be accounted, which otherwise was difficult to be accounted for.


[O and H antigens of "Levinea malonatica" (author's transl)].

A serological study of representative strains of Levinea malonatica allows to identify fourteen O factors and seven H factors. The structure of the somatic antigens is rather complicated: group factors (1, 4, 5, 11, 13, 14) and type factors (2, 3, 6, 7, 8, 9, 10, 12) can be distinguished. Flagellar antigens are monophasic; reciprocal cross-reactions between H antigens of L. malonatica are rarely found. The determinations of O and H antigens are performed by the tube agglutination method. A preliminary scheme of serotypes (serovars) is proposed: thirty-nine strains of L. malonatica are distributed among fourteen different serotypes (serovars). A more extensive serotyping scheme would be useful in the future for epidemiological purposes.


[A study of polysaccharides in fast growing "Rhizobium" (author's transl)].

This work is an attempt to use the composition of exopolysaccharides in the Rhizobium genus as a criterium of taxonomic importance. The organisms were first cultured in media and under conditions which led to the production of as many polysaccharides as possible. The medium chosen for proliferation conditions was Wright's medium; for conditions of non-proliferation conditions was Wright's medium; for conditions of non-proliferation, a minimal medium without nitrogen was used. The polysaccharides synthesised in Wright's medium consists in neutral sugars such as glucose, galactose, mannose and sometimes rhamnose and in uronic acid in various quantities. If no mannose is found in the polysaccharides when they are synthesised in non-proliferation conditions and if mannans are found in yeast broth, it may be thought, as suggested by Humphrey, that mannose would come from those mannans. The study of the composition of these polysaccharides enables us to sort out two groups of fast growing Rhizobium. The first one, relatively uniform, corresponds to the strains of R. leguminosarum, trifolii and phaseoli. In these strains, the polysaccharides are made of about 70% of neutral sugars and 20% of glucuronic acid.


Sensitivity and resistance of pathogenic yeasts to 5-fluoropyrimidines. II.--Mechanisms of resistance to 5-fluorocytosine (5-FC) and 5-fluorouracil (5-FU) (author's transl).

Incorporation of labelled 14C-pyrimidines and 5-fluoropyrimidines (5-FC and 5-FU) in four different phenotypes of wild strains of Candida isolated from man showed comparable results to those obtained by the minimal inhibition concentration (MIC) test. Kinetics studies demonstrated significant rates of incorporation after 24 hours of culture in each case. It was also possible to infer the biochemical mechanisms of resistance to 5-FC, namely a defect in UMP pyrophosphorylase, cytosine deaminase and 5-FU permease in the ease of the following phenotypes: 5-FCR 5-FUR, 5-FCR 5-FUS and 5-FCS 5-FUR (R = resistant; S = sensitive). In this study, the permeation process was approached by a consumption assay which determined the rate of labelled substrates into the medium before and after 24 hours of culture. Thus, it was found that the consumption levels of the phenotype 5-FCS 5-FUS were very high, while those of the phenotype 5-FCR 5-FUR were minimal. The 5-FCS 5-FU5 phenotype had no detectable consumption of 5-FU. With regard to the 5-FC5 5-FUS phenotype, it seems that the non-incorporation of 5-FC into the RNAs after the consumption by the yeasts has a feed back effect on the permeation process.


[The role of heavy metals and their derivatives in the selection of antibiotics resistant gram-negative rods (author's transl)].

The authors have studied 116 Gram-negative strains, 27 of which were sensitive to antibiotics and 89 showed multiple resistance. The MIC of mercury chloride, mercuric nitrate and of an aqueous solution of mercuresceine were much higher in the case of the sensitive strains. The transfer of resistance to mercury, which has been achieved in 56% of cases, was always accompanied by transfer of resistance to the antibiotics. The MIC of phenylmercury borate, mercurothiolic acid and other heavy metals (such as: cobaltous nitrate, silver nitrate, cadmium nitrate, nickel nitrate, zinc nitrate, copper sulphate and sodium arsenate) are approximatively the same for all strains. The normal concentrations of mercury in nature are lower than the rate of microbial selection. But in areas of accumulation, particularly in biological chains or in hospitals, the mercury compounds could play a part in the selection of antibiotic resistant Gram-negative bacteria.


[Supplement No XVIII to Kauffmann-White scheme (author's transl)].

In that supplement are given the characters of new Salmonella serotypes recognized in 1974 by WHO International Salmonella Center. Twenty-six belong to the sub-genus I, 20 to the sub-genus II and 8 to the sub-genus III. A new O antigen (67) and a new H antigen phase 1 (Z60) have been approved. Biochemical and antigenic variants of already known serotypes are described.


[In vitro intestinal absorption of sugars in the rat. Changes in concentrations of adenine nucleotides and inorganic phosphate in mucosa].

The absorption of three sugars by the rat gut: glucose, fructose and galactose, was studied in vitro' with a jejunal everted loop technique. The concentrations of the sugars in the serosal medium and in the mucosa cells were measured at given times, as well as the concentrations of ATP, ADP, AMP and inorganic P (Pi) in the mucosa cells. The time course of these concentrations was analyzed with the aid of polynomial regression, using the least squares method.


[Metabolism of paraffinic and naphthalenic hydrocarbons in higher animals. I. Retention of paraffins (normal, cyclo and branched) in rats].

Apparent retention of aliphatic hydrocarbons in the Rat is studied. Animals weighing 150 g are put into metabolism cages and given a 15 mg dose of one of the paraffins studied in solution in the peanut oil of the ration. There is no urinary excretion, and fecal elimination is low (5-10%), as long as the carbon chain stays below 24 atoms. Real retention is measured on animals recieving a single dose of 15 mg in the same conditions. Branched paraffins give only very low residual amounts 15 days after ingestion, while n-paraffins and cyclo-paraffins remain unchanged in the carcass, as long as the number of carbon atoms is not greater than 20; the proportion of the latter paraffins is about 8% of the dose ingested (5 days as 21 days after intake). Beyond C 20, real retention decreases rapidly to zero.


[Metabolism of paraffinic and naphthalenic hydrocarbons in higher animals. II. Accumulation and mobilization in rats].

Accumulation of dodecylcyclohexane and eicosane is observed over a long period in rat fed a diet containing 0,1 p. 100 of these hydrocarbons. Carcass retention of the amounts ingested is of the order of 7 p. 100; preferential fixation occurs in adipose tissue. Almost linear accumulation is observed as long as carcass lipids continue to increase. If hydrocarbon administration is discontinued, mobilization is slow since only 2/3 of the amount stored disappears in 4 months. Finally, if the animals are fed an energy-restricted diet, mobilization of stored hydrocarbons, although more pronounced, occurs at a lower rate than stored lipid mobilization.


[Effect of cooking on content of nitrates, vitamin C, magnesium and iron in spinach].

Cooking is known to lower the mineral and vitaminic content of foodstuffs. Recently, contaminant became to be a problem in foods, and it was proposed to use blanching or boiling to diminish contaminant residues in foods, specially vegetables. An example of this attitude is given by the use of blanching to lower nitrates levels in spinach specially prepared for baby foods.


[Quantitative variations in food intake of Ranatra linearis L. (aquatic heteropter, carnivore)].

Among causes of variation of ingestion in Ranatra linearis (Heteroptera) the following aspects have been studied:--different stages of development; --annual rhythm; --the state of repletion or fast.


[Effect of nutritional quality of diet on chemical composition of organs and their interrelations in Bombyx mori L].

Changing the qualitative and quantitative level of diet may affect the physiology of the insects. However only the total growth of the larvae is generally pointed out. Biochemical changes in undernourished larvae have been rarely investigated. For this purpose Bombyx mori larvae reared upon Spring leaves are compared to larvae reared upon Autumn leaves (poor nutritional value because of their Chemical composition). In both cases the analyses were carried out from the fourth larval ecdysis to the beginning of spinning. Three measurements indicate the development of larvae growth:--the mean weight of the larvae;--the fresh and dry weight of fat body;--the hemolymph volume.


[Vascular sarcomas of the ethmoid sinus (hemangioendothelioma)].

Vascular sarcomas (haemangio-endotheliomas) are tumours which are very rarely encountered in the facial mass. Only 10 cases have been found in the literature. Two cases are described: the first patient was operated on in 1968 for a localization in the left side of the ethmoid and presented 9 year later with a recurrence on the right side symmetrical with the first which remained apparently cured; a year later, there was a recurrence on the right then diffuse pulmonary metastases. The second case was that of a patient with an ethmoid localization cured by radiotherapy and surgery 20 years before, but presenting with a recurrence in the ganglia 10 years later and a parapharyngeal recurrence developing over the past 6 years. In connection with these two cases, the diagnostic difficulties involved in distinguishing these tumours from epitheliomas and sarcomas of the facial mass, which sometimes show considerable vascularization, from other vascular tumours, benign haemangioendotheliomas, glomus tumours and, in particular, haemangio-pericytomas, are described. The possibility of a long survival should be noted for some rare facial localizations: this is in contrast with the usually very rapid development of vascular sarcomas in other localizations.


[New method of deafness classification].

Appreciating the difficulties in interpreting tonal audiograms using the classifications previously suggested, the authors, inspired by a paper by Wedenberg, have compared phonetic studies of phonemes and tonal audiograms. By this method they have obtained a simple audiometric pattern indicating both the degree of auditory loss and the rate of the curve. This is of value, from the point of view of classifying audiograms, for deciding on possible hearing-aids and for auditory education.


[Auditory threshold for white noise].

The liminal auditory threshold for white noise and for coloured noise was determined from a statistical survey of a group of 21 young people with normal hearing. The normal auditory threshold for white noise with a spectrum covering the whole of the auditory field is between -- 0.57 dB +/- 8.78. The normal auditory threshold for bands of filtered white noise (coloured noise with a central frequency corresponding to the pure frequencies usually employed in tonal audiometry) describes a typical curve which, instead of being homothetic to the usual tonal curves, sinks to low frequencies and then rises. The peak of this curve is replaced by a broad plateau ranging from 750 to 6000 Hz and contained in the concavity of the liminal tonal curves. The ear is therefore less sensitive but, at limited acoustic pressure, white noise first impinges with the same discrimination upon the whole of the conversational zone of the auditory field. Discovery of the audiometric threshold for white noise constitutes a synthetic method of measuring acuteness of hearing which considerably reduces the amount of manipulation required.


[Epithelioma of the tip of the tongue. Analysis of a series of 1200 cases].

The authors carried out a survey of information proved by 16 institutions on a series of 1200 cases of epithelioma of the tip of the tongue to present before a meeting of European practitioners of curietherapy. They examined indications for curietherapy using radium and iridium alone or in association with external treatment by telecobaltherapy and gives details of the results -- local cures, cures maintained over three and over five years, necroses -- corresponding to the degree of development of the primary tumour. They indicate the possibilites of curietherapy in lesions of varying size and discuss indications for thorough curettage. They draw attention to the fact that lesions at an advanced stage chiefly require external irradiation (Cobalt 60 and gamma photons) or combined irradiation and chemotherapy.


[Parapharyngeal nerve tumors (10 recent cases)].

The authors describe ten cases of these rare tumours. They run through rapidly the histological and anatomical classifications. The cases consist of 8 schwannomas (one retropharyngeal schwannoma, two which had developed in the anterior sub-parotid space one of them a malignant schwannoma, the other two were two schwannomas of the sympathetic and three schwannomas of the X). A ganglioneuroma of the sympathetic and a paraganglioma of the X are also described. The authors draw attention to the clinical and anatomopathological distinction between the anterior and posterior sub-parotid spaces; to the need to treat tumours which develop there by surgery; to the different surgical techniques and methods of approach.


[Congenital malformation of the inner ear and repeated meningitis. Anatomo-clinical considerations illustrated by a case].

The atuhors analyze the case of a three-year-old child suffering from an abnormal condition of the left internal ear, revealed by copious discharge of cerebro-spinal fluid at the onset of 5 attacks of meningitis. A direct approach to the plate and the bony and aponeurotic contents of the oval fossa made it possible to seal this off and this was checked surgically eighteen months later. On this occasion a general survey was carried out into the usual circumstances in which such a discovery is made, pathological concepts and treatment for these accidents. It would appear that unusual permeability may be found either in the internal auditory meatus or in the cochlear aqueduct. Therapeutic procedure depends on circumstances. Blocking the oval fossa is not always effective and should be reserved for cases in which abnormalities impair function. Choice between blocking the internal auditory meatus and eradication of the cochlear aqueduct depends to some extent on the information supplied by tomography, but more on the pathogenetic conclusions reached.


[Primary tumors of the cervico-brachial plexus].

Together with a description of two cases, the authors analyze all the cases they have been able to find in the literature and review the question from the histogenic, the anatomo-pathological, the clinical and the therapeutic points of view.


[Resection of the depressor muscle of the tip in esthetic rhinoplasties].

Musculus depressor septi nasi is a muscle of facial expression, supplied by the facial nerve, it is more or less visible according to the individual. Easily exposed, using the intersepto-columellar incision, it is dissected from the skin surrounding it, then resected and in cases where the muscle is clearly defined, he can be brought up immediately. We consider resection of the musculus depressor septi nasi to be invaluable in rhinoplasty: -- firstly, to keep the tip of the nose well positioned during; -- secondly, to prevent certain "pseudo crow's-bill" deformities; -- finally, to give an impression of length to certain short upper (white ?) lips.


[Meatomyosynangiosis (Ugo Fisch operation) in progressive perceptive deafness. Principles, results and indications].

Meatomyosynangiosis is the operation suggested by Ugo Fisch. It consists of positioning a flap of superficial temporal muscle in contact with the osteoperiosteal and vasculo-neural elements of the internal auditory meatus. In about one third of the cases this operation results in tonal and vocal improvement for patients suffering from progressive perceptive deafness. According to Ugo Fisch, these results are due to retrograde revascularisation of the internal ear starting from the implanted muscular flap. Our own surgical experience confirms these clinical findings. The greatest chance of securing such an improvement is with young patients under fifty and results from this operation in other cases of perceptive deafness are definitely less conclusive and more uncertain. The main indication then for this meatomyosynangiosis is, at present, for progressive perceptive deafness in young patients with no more than 50 Db at lower frequencies. Furthermore, the arteriolar anastomosis pictures we have obtained after this operation was carried out on animals would appear to confirm the physiopathogenetic explanation suggested by Ugo Fisch.


[Fronto-ethmoidal anterior encephalocele (case report)].

The author presents a case of Encephalocele fronto-ethmoïdal in a 9 year old girl without hereditan or personal antecedent history. Surgery was performed the hernial sac was cut and the neck ligated; a piece of fascia of the temporal muscle was used as a graft. The patient was seen two years later with good result.


[Functional investigation of the sense of smell and its role in the diagnosis of sense of smell disorders].

The authors deal in turn with: -- the anatomical classification of disorders of the sense of smell, -- the various clinical and instrumental methods used to investigate the sense of smell, -- a practical method of investigation enabling the topography and the nature of the lesion to be found when a patient presents with a disorders involving the sense of smell. Finally, a classification of the various disorders which may be observed is suggested based on the topography of the lesion in the olfactory system.


[Recurrent deforming juvenile nasosinusal polyposis and latent mucoviscidosis].

Three children from a family of eight,  had a cystic fibrosis diagnosed by Sweat test. Two of these had a nasal polyposis wigh widening of the nose, ethmoid and intercanthal distance. Every cases of this rare type of nasal polyposis in children observed since 1953 (Sweat test) and related in the litterature, had cystic fibrosis. It is concluded that cystic fibrosis may be the one only, cause of nasal polyposis with widening of the nose.


[Contribution of data processing in otospongiosis. Part I. Statistics on otospongiosis].

The use of data processing in their otology clinic allowed the authors a better approach to otospongiosis and to its treatment, thus completing the knowledge of the otospongiotic disease according to their enzymatic concept. An important material has been gathered since 1959 to the present (June 1, 1974), based on more than 16 000 stapedectomies and nearly 100 000 otology out-patients. It has been studied both through a conventional method and an informatic one on the computer of their clinic. Statistical data, apparently valuable, could be drawn from this mass of information for each patient, starting from his first consultation and following him through his secondary consultations, operation, immediate postoperative follow-up and various postoperative check-ups performed. It also takes into account the general state of the patient and all the accidents which may happen during a remote postoperative period. First of all, the authors give the data for these statistics established according to the systematization of the parameters for otospongiosis they have previously published in 1973. In the first part, they gather statistical data obtained about the otospongiotic disease itself, some of which differ from the classical notions of frequency or importance. These statistical conclusions confirm some percentages stated by other authors (predominance of the woman and of the white race, severity of the disease in the young, etc.), but differ in relation to the number of deafs, the percentage of unilateral otospongiosis in comparison, to the bilateral ones, the importance of pure cochlear otospongiosis, the separate valuation of audiometric stages and that of anatomic types, the relation between age and anatomic type, finally the respective frequency of pre-and postoperative vertigos. In the second part, which will be presented later, the authors will study the postoperative functional results obtained within a period of 15 years by stapedectomy according to three techniques. But the particularity of this study will be the fact that functional results will not be considered only from the operative point of view, but from the whole of the factors acting upon the functional result, i.e.: operative mechanical factor, otospongiotic cochlear component, finally general state of the patient. We will thus have a better knowledge of this very peculiar disease of the otic capsule, hat is otospongiosis, characterized by its two phases: a first lytic phase provoked by an enzymatic factor, then a second rebuilding phase according to a pseudo haversian process. During the long progression of the disease, these two phases intermingle and juxtapose much more than they follow each other in the course of time.


[Tissue effects of intra-arterial chemotherapy in pelvilingual cancers and their lymphatic metastases (Apropos of 47 cases)].

Forty-seven patients with pelvi-lingual (mostly T4) cancers treated bAE intra-arteri chemotherapy (I.A.C.) were studied histologiccaly to discover the effects of the chemotherapy. The results observed were classified according to a six degree histological scale ranging from total absence of tumoral regression to complete involution of the cancer. The product used, dosage, time lapse, clinical regression and histological formula were compared with the histological findings. The results were also compared with those obtained with other pelvilingual cancers treated by radiation and primary surgery and with cancers of the facial masse after I.A.C. In the event, 10 tumours remained unchanged after I.A.C., 30 showed more or less marked changes and 7 completely regressed. Furthermore, the metastatic ganglia underwent the same involution as the primary tumour. A survey of survival in relation to tumoral regression, showed that, after a sufficient time lapse, of the 17 patients with considerable tumoral modification, 11 were in a satisfactory condition after 4 or 5 years (65%). Pelvi-lingual cancers are therefore a good indication for I.A.C. which gives very encouraging results.


[Homografts of the tympano-ossicular systems. Technic of removal and preservation].

The use of homografts appears to be a promising method of repairing the sequelae of chronic otitis. The authors describe their method of removing the temporal, dissecting the tympano-ossicular system and labelling and preserving the grafts. A homograft bank can be set up and this is a very necessary preliminary in the regular application of this type of surgery.


[Paradoxical case of intelligibility without hearing in the upper levels in a 17-year-old subject].

The authors describe the case of a young man of 17 with no otological history who presented with perfect comprehension of language in spite of a total absence of hearing above 1500 VD. Obstetrical trauma with anoxia is the only aetiology possible. This paradoxical case can only be explained as the result of some sort of spontaneous re-education.


[Predation of Lymnaea (Galba) truncatula Müller by Zonitoides nitidus Müller (Mollusca Gastropoda Pulmonata) (author's transl)].

Zonitoides nitidus is omnivorous with carnivorous tendancies: the presence of food coming from snails is required for growth of this predator. This snail is not selective for the choice of its preys. Zonitoides cannot be taken for an absolute predator for all growing periods of Lymnaea truncatula: eggs and large snails are not eaten. This species can be cannibal.


Parasitic Protozoa of the blood of rodents. V. Plasmodium vinckei brucechwatti subsp. nov. A malaria parasite of the thicket rat, Thamnomys rutilans, in Nigeria.

A description is given of the blood stages of a new subspecies of Plasmodium vinckei in the blood of naturally infected thicket rats (Thamnomys rutilans) from Nigeria and experimentally infected mice. Sporogony was obtained at 25 degrees C in Anopheles stephensi A. quadrimaculatus and A.l. atroparvus, but sporozoites in the salivary glands of the mosquitoes were never infective. The new parasite is differentiated from 7 other species of malaria parasites of African rodents principally on the morphology of the erythrocytic stages. It is designated as a subspecies of P. vinckei (P.v. brucechwatti subsp. nov.) because of the (i) zoogeography, (ii) morphology of sporogonic stages and (iii) forms isoenzymes of blood stages.


[Simultaneous presence of a Cestode cysticercoid (Cyclophyllidae, Hymenolepididae) and a Trematode metacercaria (Dicrocoeliidae) in Oxydesmus granulosus Palisot de Beauvoir (Myriapoda, Diplopoda, Polydesmidae) from Dahomey].

We report observations of cysticercoids of Hymenolepis gilloni (Hunkeler, 1972), a flatworm parasite of five species of Crocidura in Africa. The cysticercoids are found up against the outside of the gut of Myriapode, Oxydesmus granulosus, from Porto Novo (Dahomey). We also found the metacercaria of a Trematode which is probably a Dicrocoeliidae.


Parasites of the relict fauna of Ceylon. V. New species of nematodes from uropeltid snakes.

Two new species of nematodes have been found in endemic snakes of the family Uropeltidae which is restricted to montane regions in India and Sri Lanka. A trichostrongylid, Oswaldocruzia gansi sp. nov., is described from the small intestine of Rhinophis drummondhayi from Watawala (1 075 m) and the Namunukula area (1 200-1 300 m), R. philippinus from Pallatenne (618 m), and Uropeltis melanogaster from Kandy (800 + m). It is distinguished from other species of the genus chiefly by the trifurcate nature of the distal end of its dorsal ray and the number of terminal processes of each spicule. A cosmocercid, Aplectana uropeltidarum sp. nov., is described from the rectum of the same hosts as well as of Uropeltis phillipsi from Gammaduwa (720 m), and Rhinophis blythi from Talawakele (1 016 m). It was also found in the rectum of Teretrurus sanguineus from the Nalumukku Estate, Mandjolai (1 524 m) in S. India. It differs from all other species of the genus, especially in the number and arrangement of the caudal papillae of the male.