Positive mental health, Western society and the family.

Positive mental health is used as a bio-adaptive concept, operationally defined in terms of four components: emotional capital (EC), autonomy (A), self-regulation (SR) and competence (C). It is argued that the current adaptive crisis of Western man is due, amongst other factors, to the failure of key social institutions in Western Society, including the family, to provide conditions conducive to the development and/or exercise of these components of mental health. Western man's solutions to this adaptive crisis are shown to fall into two categories-one, representing destructive (anarchist) and the other, a constructive approach. The position is taken that the latter approach needs to be applied more extensively in the functional rehabilitation of the family.


Goal-striving discrepancy stress in urban Filipino men: II. Housing.

As part of a larger investigation of social/psychological stress and psychiatric adaptation in urban Manila, efforts were made to study the effects of goal-striving discrepancy stress in housing among Filipino men from different age groups and social classes. Goal-striving discrepancy stress is an organismic state characterized by tension and discomfort due to discrepancies between aspirations and achievements. Several studies have demononstrated that goal-striving discrepancy stress are asociated with psychiatric disorder. The present study focused upon the discrepancies between aspiration and achievements in housing among Filipino men. Housing constitutes one of man's basic problems in urban societies; however, in spite of the fact that housing is related to psychiatric adaptation, relatively few studies have been made of this problem. It is important to recognize that housing has numerous psychological implications for an individual. It is a symbol of social status and social acceptance and greatly influences an individual's view of himself and others. Some investigators have even suggested that housing may be construed as a symbolic representation of the mother-child relationship. For the present investigation, twelve housing characteristics considered to be important to Filipinos e. g., size, cost, location, ownership of land, etc., were derived and ninety-six Filipino males from different age groups and social classes were asked to indicate both their aspiration and their actual achievement for each of the twelve housing characteristics. Goal-striving discrepancies were obtained by subtracting the aspirational endorsements from the achievement endorsements. The discrepancy scores were then correlated with various psychiatric symptom patterns through factor analysis. Results of the investigation revealed profound social class differences in the amount of goal-striving discrepancy stress. ......


Degree of pathology as related to readiness to accept labels in process and reactive schizophrenics.

Two experiments were performed in order to determine whether readiness to accept deviant labels, as measured by acquiescence set, interacts with type of schizophrenia (process vs. reactive) to influence level of pathology. It was found on both a behavioral measure and a psychometric measure of psychopathology that high acquiescent process schizophrenics manifested more pathology than did either low acquiescent process or reactive schizophrenics, both of whom showed more pathology than high acquiescent reactive schizophrenics. The results suggest that one's acceptance of deviant labels as well as one's past history of being assigned social and evaluative labels may influence the patient's level of pathology. Scheff (1966), in viewing the mental patient from a sociological perspective, suggests that an important determinant of mental disorder is the acceptance by the deviant individual of the various labels which stigmatize him as mentally ill. If this is the case, then individual differences in readiness to accept or agree with labels about oneself may be related to the degree of pathology manifested in a psychiatric population. The present authors sought to determine if acquiescence set, as measured by the Agreement Response Scale (Couch & Keniston, 1960), is related to degree of pathology in schizophrenic patients. The Agreement Response Scale was used as a measure of the general tendency to acquiesce to or agree with personality statements or labels. The investigators performed two experiments, in Experiment 1 a behavioral measure of pathology was used and in Experiment 2 a psychometric measure of pathology was used. In addition, the schizophrenic Ss were grouped according to the process-reactive distinction as the reactive schizophrenic may be expected to have a more favorable history of labeling than would the process schizophrenic.


In vitro enzymatic conversion of pantothenylcysteine-4'-phosphate into cysteamine.

In vivo production of taurine can not proceed from cysteine via the action of cysteinsulphinic acid-decarboxylase in those mammalian organs where this enzymatic activity is absent, such as heart. The possibility of existence of another metabolic way is strengthened by the experimental finding that, in vitro, cysteamine is obtained from pantothenylcysteine-4'-phosphate through the combined action of two mammalian enzymes, i.e. pantothenylcysteine-4'-phosphate decarboxylase and pantetheinase, used in partially purified forms. This new route should be related to the known biosynthetic pathway of CoA.


Activation of lipase by a factor present in the gall-bladder epithelium.

The action of a bovine gall-bladder extract is studied on two lipolytic systems: the pancreas lipase and the plasma lipoproteinlipase. For pancreas lipase the lipolytic activity of pancreas homogenates of different species is evaluated in the presence of different quantities of gall-bladder extract. For plasma lipoproteinlipase, the enzyme is induced by injection of optimal doses of heparin associated with different quantities of gall-bladder extract and the activity is evaluated by measuring the clarifying power of the plasmas of the treated animals. The results confirm that the gall-bladder contains a factor activating the pancreas lipase and put in evidence some differences between lipase activities in different species. For plasma lipolytic activation, the action of the gall-bladder extract is particularly evident in the inductive phase of lipoproteinlipase, according to a typical process of saturation.


In vivo effects of octanoate and oleate on glucose-6-phosphate dehydrogenase during germination of Pinus pinea seeds.

During our investigation on the effect of some fatty acids on the germination of Pinus pinea seeds (Vincenzini et al., 1973), we noted a marked decrease of G6PDH activity when octanoate or oleate were added to the culture medium. In an attempt to provide biochemical information on the effect of free fatty acids on G6PDH activity, in vivo, during Pinus pinea seeds germination, we tested different concentrations of octanoate and oleate added to the culture medium. Moreover other enzymes of fundamental metabolic pathways were also considered, particularly 6PGDH, the second enzyme of HMS.


The Ca2+-dependent incorporation of nitrogenous bases into brain microsomal phospholipid subspecies in vitro.

The specificity  of the Ca2+-stimulated choline and ethanolamine incorporation into the molecular subspecies of the correspondent choline and ethanolamine phosphoglycerides has been investigated in vitro in rat brain microsomes. In the presence of 5.0 mM Ca2+-ions and at pH 8.1, choline was incorporated 6 times faster into the tetraenoic diacyl-glycero-3-phosphorylcholines (diacyl-GPCs or lecithins) than into the saturated subspecies. The specific activities of the other species were intermediary, and decreased with increasing saturation. Hexaenoic species of lecithins were however weakly labelled. The rate of labelling of diacyl-GPC molecular subspecies was affected noticeably by changing the pH and the Ca2+-ion concentration of the incubation medium. Ethanolamine was incorporated in the presence of 2.5 mM Ca2+-ions and at pH 8.1 preferentially into the monoenoic species of total ethanolamine phosphoglycerides of rat brain microsomes. The rate of incorporation into the monoenoic species was twice that into the trienoic, tetraenoic and hexaenoic and 4 times faster that into the dienoic species. When the pattern of labelling was determined specifically for the molecular subspecies of diacyl-glycero-3-phosphorylethanolamines (diacyl-GPEs or phosphatidylethanolamines), the rate of incorporation of ethanolamine into the hexaenoic species resulted three times faster that into the saturated and monoenoic species and about twice that into the trienoic and tetraenoic species, in accordance with data for liver microsomes. The pattern of labelling of the molecular subspecies of ethanolamine phosphoglycerides and of diacyl-GPEs was not influenced by changing the pH and the Ca2+-ion concentration of the incubation medium.


Internal properties of the CASH nursing care evaluation instrument.

This article reports an analysis of the internal properties of an instrument that has been widely used to measure the quality of nursing care. Three-fourths of the 106 questions in the instrument failed to meet minimum standard psychometric test criteria. The better questions dealt with housekeeping rather than nursing duties; the instrument would appear to be reliable as a measure of cleanliness and orderliness, but not of actual nursing care.


Patient referral differences among specialties.

Data from the Seventh Periodic Survey of Physicians are examined for differences in referral rates among five major medical specialties. Referral rates for each specialty are regressed against physician-related and patient-related predictor variables. On the basis of Freidson's distinction between "colleague-dependent" and "client-dependent" specialties, the hypothesis tested is that physician-related variables explain more of the variance in referral rates of colleague-dependent than of client-dependent specialists. Although this use of Freidson's classification is not strongly supported by the results, the variables found to correlate with referral differences suggest that public policies aimed to increase access to care may produce a reduction in continuity of care as an unintended second-order effect.


Accuracy of a health interview survey in measuring chronic illness prevalence.

The accuracy of a household health interview survey in measuring the prevalence of chronic illness was tested by comparing survey responses with the same respondents' medical records. Results indicate that the survey is far from a perfect discriminator of recorded medical status. The false-positive rate was 25 percent, and the rate of false negatives was nearly 40 percent. False positives were greater for Mexican-Americans and other nonwhites than for white respondents. The household health interview survey is nonetheless an important planning tool since it reflects respondents' perceived health levels, which may be used to predict utilization of primary medical services.


Successive intervals analysis of preference measures in a health status index.

The method of successive intervals, a procedure for obtaining equal intervals from category data, is applied to social preference data for a health status index. Several innovations are employed, including an approximate analysis of variance test for determining whether the intervals are of equal width, a regression model for estimating the width of the end intervals in finite scales, and a transformation to equalize interval widths and estimate item locations on the new scale. A computer program has been developed to process large data sets with a larger number of categories than previous programs.


Quality of medical care: a factor analysis approach using medical records.

A relatively inexpensive, reliable, and unobtrusive method is described for measuring the content of medical care. Factor analysis of the content of the records of more than 11,000 physician-patient encounters from six different health insurance plans extracted four main factors or dimensions that together explained 42 percent of the variance in record content. Appropriate names for these dimensions appear to be: "prevention," "rationality," "verification," and "continuity." The method is tested by scoring the six insurance plans on the four factors.


[Hearing disturbances in multiple sclerosis (author's transl)].

Dizziness and provoked or even spontaneous nystagmus are common findings in multiple sclerosis. Disturbances of hearing are thought to be rare, and there are few case reports in the literature. The importance of characterizing the audiometric abnormalities of disseminated encephalomyelitic disease of uncertain neurological aetiology is stressed. They may be defined as follows: 1. The pure tone threshold level may be normal or may be seen as a flat loss. 2. Pulse tones are better heard that continuous tones (Bekesy, tone decay tests). 3. Recruitment or its equivalents demonstrate hearing impairment at neural or neuronal levels. 4. The acoustico-facial reflex (impedance audiometry) cannot be elicited or is obviously reduced on the affected side. 5. Intelligibility of numbers in speech audiometry is not altered or may be better than that expected on the pure tone threshold findings. The intelligibility of monosyllabic words is obviously bad. 6 Dichotic discrimination of speech may be completely absent on one side even though the pure tone threshold is near normal. Multiple sclerosis primarly involves the central nerve fibres. The presence of remissions distinguishes the disease from vascular lesions and from acoustic neuromas. An audiological approach offers a new application of otology in neurological practice.


[Radical mastoidectomy in the treatment of masked mastoiditis (author's transl)].

Endocranial complications, which are undiagnosed or diagnosed late, present the greatest danger in masked mastoiditis. Inadequate treatment will inevitably result in irreversible and progredient loss of conductive hearing. In children, deterioration of the general condition and disturbances in physical development are frequently the first symptoms indicating mastoid infection. Because its pathohistological specifity, a reliable interruption and elimination of the mastoid infection can only be achieved by radiacal mastoidectomy. Negative criticism of mastoidectomy is not supported by recent clinical results. This paper suggests an early indication of radical mastoidectomy in masked mastoiditis.


[Decompression of the orbit in malignant exophthalmos (author's transl)].

Transantral decompression of the orbit for malignant exophthalmos can be recommended on the experiences of Walsh and Ogura, and Gorman et al. The case of a 70 year old man with exophthalmos and marked deterioration of bilateral visual acuity that recovered postoperatively is reported. The exophthalmos disappeared completely.


[The legal situation of the physician in the treatment of under-age patients (author's transl)].

Legal questions relative to the common and special understanding of care, to the valid consent to diagnostic or operative procedures, and to the professional discretion involved in the treatment of under-aged patients are discussed. Consideration is given to the different applications of law which utilize either the patient's age group or his intellectual faculty as an underlying basis for a legal decision.


[Reconstruction of tracheal stenosis at thoracic inlet level (author's transl)].

Complex operative cases of tracheal stenosis in the region of the thoracic inlet are described. The stenosed tracheas were additionally constricted by: a dislocated osteomyelitic clavicle, which was tethered by scar-tissue; an osteoma of the manubrium sterni; a goitre, which was fixed into the thoracic inlet by scar tissue of an early childhood tracheostomy; and a retrosternal goitre. In two further cases the reconstruction of a long tracheal stenosis at the thoracic inlet was complicated by an existing paraplegia.


Relationship of psychopathology to death in asthmatic adolescents.

With the help of three illustrative cases, all of whom died during an acute asthmatic attack, it is proposed that patients with severe psychopathology who also have asthma are particularly susceptible to the more serious complications of asthma. This is related to the circular reactions to anxiety and the patient's incapacity to cope with it. Often these patients are either unusually sensitive to the pharmacological agents used in the medical regime, or they overmedicate themselves. At the same time the reactions of the family and medical staff tend to increase anxiety in these patients. This finally leads to psychological decompensation, making medical treatment extremely difficult. Some therapeutic interventions in dealing with this problem have been suggested. These include the development of an asthma team which can provide supportive psychotherapy to high risk patients.


The first dream as the chief complaint of the unconscious, and its utilization by the primary physician.

Based on the theory that the dream represents an important conflict of wishes essentially occurring between the id and superego, with some participation by the adaptive ego, the first dream reported by the patient is considered to be the chief complaint of the unconscious. Eighteen first dreams, chosen at random, were tentatively interpreted in re the unconscious conflicts. These tentative interpretations were amplified by a battery of projective tests. It is proposed that the primary physician with a talent for understanding the nature of inner conflicts, revealed by the frist or early dreams, may slowly venture into the area of psychotherapy by including in the history of the patient a study of inner conflicts indicated by the dream material. In this way, the conscious chief complaint may be utilized by the physician with ability to impart to the patient his understanding of the inner fears of the patient. In general, it may be assumed that improved somatic therapy results when the patient realized that the physician is trying to treat not just the pathological organ, but the patient as a whole, including subtle processes within the psyche itself.


[Recurring ulcers following vagotomy. Apropos of 107 cases].

The authors analyze 107 cases of recurrent ulcer after vagotomy. This study suggests that the most common cause is incomplete vagotomy and, more rarely, defective gastric drainage. The therapeutic deductions depend on the etiology. The most logical attitude is verification of the initial vagotomy associated with antrectomy without forgetting the successes obtained by simple thoracic vagotomy when wide gastric resection has already been carried out.


[Fistulae in esophageal surgery. (Solidity of the esophageal wall and the role of infection)].

The strength of the eosophageal wall has been tested in 20 autopsy specimens: it proved to be as resistant as the stomach and the jejunum. It dépends as elsewhere in the digestive tract on the deep layer of the mucosa (Halstedt's submucosa): the success of an anastomosis depends on the passage of sutures through this submucosa. Vascularization does not seem to be a problem, provided certain precautions are taken. The necrotizing properties of saliva and infection especially in cancerous surgery might be the main causes of fistulas.


[Hyperparathyroidism. Reoperations].

Sixteen patients were re-operated on for treatment of their hyper-parathyroidism. After analysis of the cause of failure or relapse, the authors discuss the examinations which led to a definite diagnosis and, in some cases, pre-operative localisation of the lesion. All the patients were treated by the cervical route only. Operation may be very difficult Technical advice is given here. Tetany and recurrent laryngeal nerve paralysis are common complications. They are often due to an inefficacious or incomplete first operation.


[Cancers of the thoracic esophagus in gastrectomized patients. Technical problems].

The authors report three cases of carcinoma of the thoracic part of the esophagus who had previously undergone gastrectomy. They study, in the absence of a stomach, the possibilities of restoration of digestive continuity after esophagectomy and describe three possibilities: -- mobilisation and use of the remaining gastric stump; --esophageal resection and anastomosis restoring continuity; -- colonic interposition. Of the three procedures used, only the first and last are advised by the authors.


[Abdominal emergencies in the daily practice of a traumatology center].

This study analyses 57 cases of abdominal trauma occurring in patients with multiple injuries admitted to the accident unit in Garches, over a period of four years. After a few remarks concerning the use of a safety belt, the authors discuss in particular: -- 25 hepatic lesions; -- 20 splenic lesions. These lesions were operated on by the surgeons on the unit with the exception of 9 cases where a specialised surgeon was called in. In the vast majority of cases, we consider the patient should not be transferred to the other units but, if possible, all lesions should be treated simultaneously in one centre.


The surgeon and the immunotherapy of cancer.

The cancerolytic effect of active systemic immunotherapy, which has been shown experimentally able to eradicate a complete population of tumour cells provided they are not very numerous, has been confirmed in various forms of human leukemia and in a few solid tumours against which it was applied as treatment of the imperceptible residual disease which remains after chemotherapy or surgery. Its main indication is thus this residual disease composed of cells which are left behind after chemotherapy of systemic tumours, for this treatment obeys the laws of first degree kinetics, and surgery and/or radiotherapy which, even if they remove or completely sterilise a local tumour, often leave behind a few cells which have already migrated to the future sites of metastases. Active systemic immunotherapy of large volume tumours, especially when combined with chemotherapy, is of doubtful efficacy. Local immunotherapy has given interesting results but its clinical indications are not yet clear.


[Experimental study of portal and caval clamping in dogs. Its significance in the direction of vascular exclusion technics of the liver in men].

An experimental study of portal and inferior vena-caval clamping in the dog showed the respective roles of splanchnic blood sequestration and inferior vena-caval blood sequestration in the onset of the hemo-dynamic disturbances caused by vascular exclusion of the liver, with severe arterial hypotension. Stasis in the inferior vena cava is corrected by a caval shunt which, on the other hand, has no effect on splanchnic stasis. Clamping of the aorta may, however, act on both components of the hypotension, and this has proved promising.


[Approaches to the semilunar bone and their indications].

The authors review incisions for exposure of the lunate bone and describe them in detail. They study the advantages and disadvantages of each approach, then consider their indications in peri-lunar luxation, scapholunar luxation and Kienboeck's disease. They emphasize the interest of the palmar routes in all cases, except for scapho-lunar luxation.


[Pulmonary embolism, an unrecognized risk of post-traumatic arterio-venous fistulae of the hepatic veins (1 case)].

A stab wound of the right lobe of the liver, initially treated by suture, led to the development of a large arterio-venous fistula with hemobilia. Re-operation on the 23rd day in order to carry out right hepatectomy, was rapidly followed by a massive and recurrent pulmonary embolism. A Trendelenburg operation associated with right hepatectomy did not prevent the patient's death. This risk of pulmonary embolism during post-traumatic hematoma of the liver is not fully recognised and the authors suggest, in cases of arterio-venous fistula of the hepatic veins, primary vascular exclusion of the supra-hepatic vena cava.


[Spontaneous perforation of the hepatic duct during biliary lithiasis complicated by acute pancreatitis].

The association of perforation of the common bile duct, cholecystitis and acute pancreatitis, should be emphasized. Physiopathology of perforation of the bile duct may be compared with that of pancreatitis. Repair of the bile duct may be delicate requiring hepatico-jejunostomy on an isolated loop.


[Upper implantation of an axillo-femoral bypass. Technical point].

Very medial implantation of an axillo-femoral by-pass at the level of the external thoracic artery, permits one to avoid mobilisation of the anastomosis during movements of the arm and thus avoid breakdown of the sutures.


[Technic of heterotopic transplantation of the small intestine in swine: reno-mesenteric transplantation].

The authors report a new technique of heterotopic transplantation of the small intestine : reno-mesenteric transplantation. The advantages of this technique are recalled, especially when intestinal transplantation is carried out some time after removal of the intestine. In fact, in this case, orthotopic transplantation is difficult owing to the relationship between the mesenteric stump and the fibrous scar.


Human orf.

Human orf is usually considered a rare disease caused by a virus belonging to the paravaccinia subgroup of pox viruses and transmitted to man from sheep and goats. This paper presents 119 new human cases with epidemiological, clinical, histopathological and ultrastructural findings. Erythema multiforme was found to be a common complication of human orf. Other complications tended to be caused by overtreatment. Electron microscopy of negatively stained suspensions from lesions was found to be the best and most rapid diagnostic method available.


Topical 5-fluorouracil treatment of superficial basal cell epithelioma. A light and electron microscopic study.

A 27-year-old patient developed superficial basal cell epitheliomas approximately 20 years after taking Fowler's solution. One of the lesions was successfully treated with topical 2% 5-fluorouracil soultion under occlusion. Sequential biopsies of the lesion before, during and after therapy were examined by light and electron microscopy, and the changes at various stages are described. Changes occurred only in tumor cells and adjacent epidermis, and only after occlusion of 5-FU. After one week of occlusive therapy, focal discontinuities in the basal lamina and intercellular spaces were wider with reduction and condensation of tonofilaments. Mitochondrial degeneration was seen along with irregularities in nucleoli. These changes were most prominent after two weeks of occlusive therapy, and many degenerating keratinocytes were seen detached from other cells. One month after cessation of therapy, the entire area was excised, and no evidence of tumor was seen.


Nevus lipomatosus cutaneus superficialis (Hoffmann-Zurhelle).

We are reporting seven cases with nevus lipomatosus cutaneus superficialis. A review of the literature indicates that this is a relatively rare type of connective tissue nevus with little more than 50 cases recorded. Localization of the cutaneous nodular lesions over the upper thigh and buttock and histologic findings of fat lobules within the substance of the nevoid malformation differentiate these lesions from other varieties of the connective tissue nevi.


[Examination of the uterine cervix using the scanning electron microscope].

Scanning by electron microscopy of the cervix of the uterus allows us to study the various aspects, both normal and pathological, as well as the architecture of sections of the organ. All the same, as in all practical examinations carried out using scanning we have to beware of pictures that are but artefacts due to the method of preparation. The views obtained from a normal cervix of from pathological cervices show very different aspects. In the normal cervix the surfaces are more or less smooth and the architecture of the deeper levels shows a thick and regular texture. Infectious lesions of the outer aspect of the cervix show punched-out patterns, like craters, which penetrate more or less deeply into the sub-epithelial plane. While cervical dysplasia shows little except perhaps a more or less bossed-up epithelial surface, cancer of the cervix on the other hand shows a pavement pattern which is irregular. The pavements are formed by buds which are separated by faults which are more or less deep. In section the structures show a degree of disorientation in the texture. After treatment with radium the appearance is rather like ground glass of spiders webs and the architecture of the structures seems to be pock-marked and chaotic.


[Free amino acids in the amniotic fluid and in maternal blood in advanced pregnancy].

We have studied a series of sixteen free amino-acids as well as total blood amino-acid and liquor amino-acids in 56 women between the 25th and 44th weeks of pregnancy. The results have been analysed statistically and demonstrated graphically. The amino-acid levels rise from the 25th week of the pregnancy until term (p less than 0.05) in peripheral blood. On the other hand the total level of amino-acids in the amniotic fluid drops from the 25th week of pregnancy remarkably (p less than 0,01). Different amino-acids show different curves. The increase in the level of total blood amino-acids is principally due to a rise in glycine and leucine, while the other amino-acids as a whole stay constant. The spectrum of amino-acids in the amniotic fluid is however a little different and the drop in total amino-acids if principally due to the threonine-serine fraction and partly to the glutamine, proline, alanine, lysine and valine elements, whereas the rest stay the same or even raised.


[Hormonal function of the ovarian corpus luteum during benign mammary diseases].

Plasma progesterone and oestradiol levels were estimated in 54 women who were suffering from breast pathology. (There were 18 cases of benign breast dysplasia, 28 cases of cystic disease of the breast and 8 cases of adenofibromata.) All these women had menstrual cycles that were apparently ovulatory, and the blood sampling was carried out on the 4th day after the rise in the temperature plateau. By way of controls, the same estimations were carried out on 20 normal women of the equivalent age at the same stage of the raised plateau. The levels of plasma oestradiol in patients who had breast pathology (136 +/- 75 pg/ml) were not significantly different from those of normal women (120 +/- 50 pg/ml). On the other hand patients with mastopathies had a far lower level of progesterone in the phase of the cycle that was considered to be luteal (5-7 +/- 3-1 ng/ml) in comparison with normal women (13-2 +/- 3-5 ng/ml). From these results the conclusion can be drawn that women who have benign breast disease while they are active from the ovulation point of view show a defect in secretion of progesterone by the corpus luteum. This defect is an isolated one. The physiopathological implications derived from this observation are discussed.


[Idiopathic hemoperitoneum in young women].

We present three cases of idiopathic hemoperitoneum or abdominal apoplexy in young women. At laparotomy a large quantity of blood was found in the abdomen in each patient, but active bleeding had stopped and the site of its origin was not established. A well-developed corpus luteum which was intact was found, of pregnancy in one case and of the progestationl phase in the two others. In all three cases the abdomen was closed without hemostasis being carried out. Recovery was rapid but the young woman who was pregnant aborted later. Etiology and the relationship of this syndrome with the state of pregnancy or the progestational phase are discussed as well as prognosis and the management.


[Diagram for the prognosis of cephalo-pelvic disproportions. Application in 300 cases of pelvic contraction].

The authors using the information obtained by X-ray pelvimetry and ultrasound cephalometry in 300 cases of contracted pelves, suggest a diagram of cephalo-pelvic disproportion that can be used in the great majority of cases of contracted pelves. It is not applicable to those where there is significant deformation of the middle strait or an abnormality of presentation. It is divided into three zones: 1. A superior zone, favourable, into which the majority (60%) of cases of contracted pelvis fit. The risk of a serious dystocia during delivery is so small (less than 2%) that it can be considered scarcely different from those found in women with a normal pelvis. 2. An intermediate zone into which 24% of cases of contracted pelvis fit where the prognosis is uncertain. The labour should be considered as an "at risk" labour and a trial of labour conducted. 3. A lower zone into which 16% of the cases fit and which consists of two categories: --those in which the biparietal diameter is equal to or less than 90 mm. Prophylactic caesarean section should be avoided in these cases where disproportion is rare and where there is a risk of delivering a premature infant: and --those more numerous (9 out of 10) where the biparietal diameter is more than 90 mm and where, unless there is a clinically definitely favourable prognosis, it is justifiable to carry out prophylactic caesarean section. If this line is followed: one can avoid a large number of trials of labour, all of which are inconvenient and some of which are dangerous for the child; few unnecessary caesarean sections are carried out.


Hereditary multiple exostosis. A comparative genetic evaluation in man and horses.

Comparative studies are being conducted on hereditary multiple exostosis in man and the horse. In both, there is an unquestionable inheritance pattern of a typical single, dominant, autosomal gene. Those who carry the gene have a one-half chance of transmitting it to each offspring, whereas, those who do not carry the gene do not transmit this abnormality to their progeny. The lesions are clinically and histologically similar; no persistent chromosomal irregularities have been associated with the abnormality in either man or the horse and no single evidence of malignancy in either man or animal has been detected in this study to date.


Genetics of the W locus in foxes and expression of its lethal effects.

The Georgian white mutation for coat color in foxes is inherited as a partially dominant character. It is allelic to the previously observed white-faced and platinum mutations. It was established that large litter size in Georgian white females and long daylight during pregnancy promote embryonic viability in homozygotes for this mutation. As a result, in offspring segregation patterns for coat color the proportion of homozygotes increases and that of heterozygotes decreases. It is suggested that a competitive relationship between embryos with different genotypes is established as early as at the preimplantation stage.


Chondrodystrophy: an inherited lethal condition in turkey embryos.

Chondrodystrophy was found to occur as an embryonic lethal in a special line of turkeys. Inheritance of the condition was studied in embryos produced parthenogenetically from virgin dams and also in embryos from the same dams in bisexual matings. Expression was similar to other forms of the disorder encountered in various avian species. Micromelia and brachycephaly were recognized in affected embryos after 9 days while lethality occurred mainly after 16 days of incubation. A few affected embryos expressed modified phenotypes and these were also nonviable. Modified phenotypes were not observed in parthenogenetic production, and it was thus inferred that such embryos may have been heterozygotes. No changes were evident when the genetic background was altered. The condition was inherited as a single, autosomal, recessive lethal, in both parthenogenetic progeny and in progeny from bisexual matings. The symbol ch is designated for the mutant allele.


Genetics of eye-gap and maroon-eye mutants in the mosquito.

Linkage analysis of two new eye mutants, eye-gap (e) and maroon-eye (mar), in the mosquito Culex pipiens, is presented. Both mutants are sex-linked, recessive, and demonstrate complete penetrance and high expressivity. The gene order is e-m-mar. The most representative map distances in e-m and m-mar segments are 17.7 and 26.1, respectively. Our maroon-eye was isolated from Belem, Brazil and is allelic to another maroon-eye mutant isolated from Lake Charles, Louisiana. However, while mar (Lake Charles) straddles along the sex locus, m (map distance approximately 1 unit), the mar (Belem) gene is far removed from m (map distance 26.1 units).


The mitotic, polytene, and meiotic chromosomes of Drosophila ananassae.

The mitotic chromosome complement of D. ananassae consists of four structurally distinguishable submetacentric pairs and all four have been identified with their linkage groups. For the polytene chromosome complement of six arms representing the X, second and third chromosomes, an improved reference map has been constructed and used to describe selected cytogenetically useful rearrangements. In meiotic prophase of spermatocytes, chromosomes 2 and 3 form pachytene-diplotene bivalents whose arms may be associated by chiasmata in postdiplotene stages, but the X, Y and fourth chromosomes participate in a complex multivalent. No correlation was detected between meiotic chromosome behavior and specific genes that regulate crossing over in males. In male inversion heterozygotes having high levels of genetically monitored crossing over, no unequivocal evidence was found for formation of either pachytene inversion loops or anaphase bridges and fragments.


Degenerative myopathy of the deep pectoral muscle in the turkey.

A degenerative myopathy affecting only the supracoracoideus in the domestic turkey, with a greater incidence in white turkeys than in Broad Breasted Bronze, was first observed in 1967. The defect is variable in expressivity and penetrance and is apparently part of a polygenic system involving modifiers. The defect is found principally in turkeys of breeding age, and only to a very limited extent in birds under 24 weeks of age. The abnormality has a higher incidence in females. Muscle damage takes the form of a localized hemorrhage, edema, degeneration and necrosis of muscle leading to encapsulation. Ultimately there is liquefaction and absorption of necrotic tissue.


EMG analysis of stereotyped voluntary movements in man.

EMG activity was recorded in biceps and triceps while subjects voluntarily flexed their elbows during a visual matching task. With fast flexion, the initial EMG was characterized by a triphasic pattern with a burst of activity first in biceps, then in triceps with a silent period in biceps, and finally in biceps again; these components were analysed quantitatively. Smooth flexion was characterized by continuous activity in biceps. Inhibition of tonic activity of triceps in relation to a fast flexion occurred in the 50 ms before the initiation of biceps activity. A patients with a severe pansensory neuropathy performed normally on these tasks. Physiological mechanisms underlying these patterns are analysed; an important conclusion is that the triphasic activity with fast flexion is 'centrally programmed'.


EMG analysis of patients with cerebellar deficits.

EMGs from biceps and triceps were recorded during stereotyped elbow flexion tasks performed by 20 patients fulfilling clinical criteria for 'cerebellar deficits' and the data were compared with previously established normal standards. In a fast flexion task, 15 of 18 patients showed prolongation of the initial biceps and/or triceps components, and it is suggested that this abnormality might be an elemental feature of dysmetria. Ten of 14 patients showed the normal pattern of smooth flexion indicating that, with cerebellar deficits, smooth movements are better preserved than fast movements. The timing of the cessation of triceps activity before the initiation of biceps activity in an alternating movement was abnormal in 12 of 16 patients; this abnormality might be an elemental feature of dysdiadochokinesia.


Hypertrophic granulomatous cranial pachymeningitis causing progressive blindness in a chronic dialysis patient.

A patient on chronic haemodialysis because of renal failure developed progressive visual field loss and eventual blindness. A postmortem examination indicated that the blindness was caused by granulomatous thickening of the pachymeninges which constricted the optic nerves as they passed through the optic foramina. Exhaustive bacteriological and histopathological studies failed to identify a specific cause for this hypertrophic cranial pachymeningitis.


Studies of sensory conductions. Comparison of latencies of orthodromic and antidromic sensory potentials.

Latencies of orthodromic and antidromic sensory potentials were compared in 16 normal median nerves. Peak latency was longer in the antidromic sensory response in every case. The peak latency of the antidromic sensory response depended on the distance between the recording electrodes; with shorter interelectrode distances it was similar to that of orthodromic sensory response.


No-reflow phenomenon in the cerebral circulation of the gerbil.

The no-reflow phenomenon has been produced in the cerebral hemispheres of the gerbil by 30 minutes of bilateral carotid artery occlusion. The no-reflow phenomenon was found to develop in relation to the fall in blood pressure which occurred on release of bilateral carotid clips. Metaraminol tartrate intravenously prevented the fall of blood pressure and significantly reduced the occurrence of the no-reflow phenomenon. Metaraminol tartrate, however, did not alter the morbidity or mortality of carotid artery occlusion for 30 minutes. There is thus no support from these experiments for the view that the no-relow phenomenon plays an important functional role in the reversibility of the effects of severe cerebral ischaemia.


Ischaemic swelling of cerebral hemisphere in the gerbil.

Ligation of the common carotid artery in the gerbil was found to be associated with an increase in wet weight, volume, and area of the ipsilateral cerebral hemisphere. True swelling and oedema of the hemisphere occurs. This evidence suggests that it is reasonable to continue to use the gerbil as an animal model of the oedema that many accompany cerebral infarction.


Ischaemic brain damage in the gerbil in the absence of 'no-reflow'.

Approximately 40% of gerbils subjected to one hour of unilateral carotid artery occlusion displayed neurological abnormalities during that time. Most such animals were subsequently found to have ischaemic neuronal alterations within the territory of the ipsilateral middle cerebral artery. In contrast, impaired reperfusion ('no-reflow') rarely occurred and cannot therefore be implicated in the pathogenesis of ischaemic brain damage.


Dexamethasone in the management of symptoms due to herniated lumbar disc.

One hundred consecutive patients with radicular pain due to myelographically proven herniated lumbar intervertebral discs were treated with initially high but tapering doses of intramuscular dexamethasone for seven days. All patients had reflief of pain within 24-48 hours. Bed rest was eliminated as a significant factor in the improvement. Nine patients required surgery at the end of the hospital treatment period. Another 11 required surgery during the follow-up of 15 months. Review of work status and recurrent pain during the follow-up indicates that the non-surgically treated patients in this series fared better. It is concluded that nerve root inflammation is the immediate cause of radicular symptoms in case of ruptured lumbar disc and that treatment with dexamethasone gives prompt relief of pain and may avoid the need for surgery in most cases.


Congenital narrowing of the cervical spinal canal.

The clinical and laboratory findings in six patients with congenital narrowing of the cervical spinal canal and neurological symptoms are described. A variable age of onset and an entirely male occurrence were found. Signs and symptoms of spinal cord dysfunction predominated in all but one patient. Symptoms were produced in five patients by increased physical activity alone. Congenital narrowing of the cervical spinal canal may result in cord compression without a history of injury and occasionally without evidence of significant bony degenerative changes. The clinical features may be distinguishable from those found in cervical spondylosis without congenital narrowing. Intermittent claudication of the cervical spinal cord appears to be an important feature of this syndrome. Surgery improved four out of five people.


Multiple crossed false localizing signs in a posterior fossa tumour.

Involvement of the lower cranial nerves as false localizing signs of intracranial tumour is very rare. A laterally placed posterior fossa meningioma gave rise to contralateral cerebellar ataxia and palsies of the fifth, ninth, and tenth cranial nerves.


The management of soft tissue sarcomas in adults: surgery and postoperative radiotherapy.

Traditionally soft tissue sarcomas have been managed by surgery, because they were considered radioresistant. Experience has shown that the local recurrence rate after a simple excision is 90 per cent and 30 per cent after radical surgical procedures. The treatment of soft tissue sarcomas by radical ratiation therapy alone is also unrewarding-the local recurrence rate being 66 per cent. In order to preserve a functional limb, a selected group of patients was treated using a conservative surgical excision of the gross tumor (usually a simple "shelling out"), and immediate postoperative radiation therapy. The rationale for removing all gross tumor by conservative surgical excision is that the remaining subclinical disease can be destroyed with moderate doses of postoperative irradiation. In 70 patients with soft tissue sarcomas of the extremities, all local failures occurred in tumors of the fleshy parts with a recurrence rate of 17.2 per cent, independent of the histological type. In spite of generous radiation fields, 4 of the 12 local recurrences were outside of the irradiated volume, some more than 5 cm from the margin of the field. This documents the tendency of soft tissue sarcomas to spread along the fascial planes for a great distance. To avoid complications only part of the entire circumference of an extremity must be irradiated since a severe constricting fibrosis may result with varying degrees of edema distal to the irradiated volume when all of most of the circumference is irradiated. This retrospective review of patients treated for extremity lesions by conservative excision and postoperative radiotherapy shows that a functionnal limb can be preserved in 80 per cent of the patients.


[Systematic preservation of teeth and prophylaxis of dental decay on irradiated patients].

200 patients were irradiated on the oral cavity and on salivary glands with doses of 3,000 Rads and up. Teeth were preserved. A prophylactic treatment of dental decay was made using 5 minutes daily a fluoride gel into a carrier. The results showed an incidence of 5% for dental decay and 1% for osteo-radionecroses. Details are given about the selection of patients, the dental work-up and dental care before, during and after radiation therapy.


[Fifty cases of penile tumors treated at the Claudius-Regaud center from 1958 to 1973].

From the study of this series of 50 patients suffering from cancer of the penis, and in particular from the comparison of two successive groups, several facts stand out which determine our present attitude: -subjects suffering from cancer of the penis, at least in our area, are aged, fragile people, whose cause of death, in more than half of the cases, was not the penile cancer. Proposable therapeutic methods must take this specific background into account; -tumoral and glandular indications must be looked at separately, as there does not seem to be any strict correlation between the size of the tumor and glandular invasion; -inguinal glandular invasion must as far as possible, be proved histologically, whatever the appearance of adenopathy on palpation; -No and N-patients should not be treated in the inguinal folds, but carefully followed-up; in this connection, very strict follow-up, at least for the first three years, seems to be indispensable; -N+ patients must evidently undergo bilateral removal and subsequent irradiation. This therapeutic attitude, leads to bilateral edema of the lower limbs in a high percentage of cases, against which no therapy is at present active; -tumors of the penis, classified T1, T2, or T3 are best benefitted by the technique of interstitial curietherapy using irridium 192, the only conservative technique offering a high level of local sterilization, without major after-effects; it permits possible reparatory surgery; -on the other hand, T4 tumors cannot be marked, the target-volume being too large, and they justify radical surgery.


Dosimetric reliability of thermoluminescent phosphors (TLD-too).

The dosimetric reliability of TLD-100 has been studied in view of the fact that these TLDs are extensively used for patient dosimetry in the case of irregular fields and where patient's contour creates special problems. TLDs have also been used in intercavitary dosimetry (e.g. esophagus and rectum) and in some cases of dosimetric comparison of radiation output. However, it appears that these TLDs are unsuitable for most practical dosimetry due to poor reproducibility and system error. It is found that the same TLD-chip gives widely divergent readings for the same exposure even when correction for the system error is made. The composite uncertainty under the best experimental conditions is about +/-3.5%.


[Measurement of linear exposure nominal pose used in curietherapy].

The idea, and subsequent construction, of a dose rate meter for measuring linear exposure dose originated in those pilot centres of Curietherapie which wished to replace radium by the artificial radionucleides, Irdium-192, Caesium-137 etc. The aparatus makes it possible to measure, directly and quickly, the activity of a specified length of a linear source, a measurement which has only been possible until now by dividing the exposure dose by the length whose activity it is desired to know. If the dose-rate obtained by these two methods agrees, this apparatus shortens the time for which the sources need to be handled, thereby reducing the danger of irradiation to staff and technicians. The apparatus is thus able to reveal heterogeneity of activity along the length of a line-source. In the specific case of Iridium, our experience shows that wires which have been used in several applications may develop mechanical bends and constrictions, which can lead to fluctuation in dose rate along their length. The apparatus was first constructed in 1967, after preliminary experiments in 1965. As Curietherapy has become more widely used, the apparatus has undergone many modifications which is more precise and specific than it was initially. At the present time it can only be used with Iridium as wire, and with Caesium in the form of trains of seeds (corresponding to the AGS sources) or needles. Nevertheless, a third scale is under consideration, for use with newer radioelements, which may be used in future.


[Use of lithium fluoride in clinical dosimetry. Application to the measurement of the dose delivered to axilla by iridium 192 with endocurietherapy for carcinoma of the breast].

The aim of the work was the evaluation of the dose delivered to the axilla during endocurietherapy for carcinoma of the breast using Iridium 192. The position of the radioactive material with respect to the axillary zone differing with the patient seated or lying, the authors carried out an vivo dosimetric study using Lithium fluoride. They refer to the chief properties of Lithium fluoride which render it the dosimetric agent of choice for clinical work and give details of their experimental conditions, stressing the problems encountered in practice (response in relation to dose, mass of thermoluminescent powder to use, fading, regeneration etc.). They then describe the technique used for placing the thermoluminescent dosimeter in the axillary zone adjacent to the target volume irradiated. Results concerning 43 patients made possible the establishment of a significant correlation between the dose delivered to the axillary region and the site of implantation of the radioactive material in the breast, and show that, with identical tumour doses, this dose is little dependent upon the structure of the radioactive implant itself. They conclude that the dose delivered to the axillary region is of the order of 25% of the tumour dose if the radioactive implant is localised in the axillary tail, 10% if it is in the upper outer quadrant and negligeable if it is elsewhere.


[Radiolesions after radiotherapy of breast cancer].

A study is presented of the late radiolesions which occur after breast cancer irradiation. These lesions are described and the etiological factors are studied, with special emphasis given to the effect of dose and time factors. For the large volume considered in the irradiation of breast cancers, the tolerance dose for normal tissue (skin and connective subcutaneous tissue) can be set at 1,700 rets, that is, 5,600 rads in 28 sessions of 200 rads over a period of 38 days. Technical irradiation problems are given special mention as they can be the cause of dosimetric errors resulting in complications. Dosimetry should be in the whole volume, and not only in a single plane, as is still most often the case.


[Sequelli and complications of irradiation of mammary carcinomas].

a) Doses of 6 000 to 6 500 rads to the supra- and sub-clavicular regions are an extreme limit which should not be exceeded (the three cases of serious complications previously cited has received doses of 6 000 to 7 500 rads). b) With the technique before 1969, we were not giving doses of 6 000 to 6 500 rads to the supra- and sub-clavicular regions as we had thought, but in reality a lesser dose of 5 000 to 5 500 rads. In addition this dose is revealed in the analysis to be sufficient for controlling the majority of lymph nodes microscopically invaded at the same time permitting as to avoid serious complications. c) All the sequelli serious complications follow principally irradiation of the axillary and supra-clavicular regions.


[Post-radiation nephritis. Study of the renal consequences of splenic irradiation for lymphoma].

The authors studied the left kidney consequences of splenic irradiation in 40 patients with lymphomas. The renal work-up performed before irradiation and every six months afterwards includes : blood pressure, biological tests, IVP and 197 Hg Neohydrine renal scan. Computer scan data processing showed a partial disfunction of left kidney in 16 patients with 18 month-follow up. Renal disfunction appeared within 8 to 10 months following spleen irradiation. During that period no clinical or radiological abnormalities were observed.


The effect of phencyclidine anaesthesia on the blood chemistry and haematology of the chacma baboon (Papio ursinus).

Blood was collected from 14 baboons 3 - 5 min, 30 min and 60 min after the intramuscular injection of phencyclidine at a dosage rate of 1,5 mg/kg body mass. The determination of blood chemistry and haematology was then undertaken. An abrupt decrease in total plasma protein occurred after the injection of phencyclidine but thereafter it remained at approximately the same level. The sodium, potassium, chloride and cholesterol remained practically unaltered throughout. A significant decrease occurred in the blood urea level. The blood sugar value showed a highly significant decrease over the first 30 min period and less over the second 30 min period. Plasma enzyme activity and corticosteroid levels did not show marked alterations. Marked and significantly lowered values occurred in white blood cell count, erythrocyte count, haemoglobin concentration and haematocrit level but these values returned to within normal limits at 60 min.


Porcine parvovirus in pig herds in Southern Africa.

Evidence of the presence of porcine parvovirus in Southern Africa is given and the diagnostic significance of this finding is discussed. Minor abnormalities in the replication of the virus were observed.


The elimination of albumin, ployvinylpyrrollidone and dextran from the circulation in sheep.

The rates of elimination of iodinated human serum albumin (ALBUMIN-125I), polyvinylpyrrolidone (PVP-125I); and tritiated dextran (DEXTRAN - METHOXY-3H) (mol masses of 69 000 - 72 000, 30 000 - 40 000 and 60 000 - 90 000 respectively) from the circulation of sheep were studied; albumin and PVP initially disappeared from the circulation rapidly having half-life times (t 1/2) of 10,5 +/- 3,7 and 43 +/- 45 hours respectively. This phase is regarded as being due to equilibration within the initial volume of distribution, the rate being determined primarily by the relative mol. mass of the molecule. Hereafter PVP-125I was eliminated considerably faster (t 1/2 = 176 +/- 39 h) principally via the kidneys. The limited data available for dextran-3 H suggests that this particular substance is rapidly excreted via the kidneys (t 1/2 = 9 h).


On the toxicity of procaine for pigs.

Procaine caused respiratory arrest in halothane-anaesthetized normal Landrace pigs at a dose of 4,2 - 8,2 mg/kg. In some cases death due to respiratory failure occurred after giving 10 - 13 mg/kg. Because of its toxicity in pigs procaine is unsuitable for treating the porcine malignant hyperthermia syndrome.


Trials with rafoxanide. 7. Efficacy against Fasciola hepatica, Haemonchus placei and Bunostomum phlebotomum in cattle.

Anthelmintic efficacy studies involving 49 cattle either naturally or artificially infested with Fasciola hepatica are described. Some of the animals were also artificially infested with Haemonchus placei and Bunostomum phlebotomum. At dosage rates of 3,75 and 5,0 mg/kg live mass rafoxanide was 64,6 and 92,6 per cent effective respectively against adult naturally acquired infestations of F. hepatica. At 7,5 and 10,0 mg/kg it was 37,9 and 55,7 per cent effective against 42 day old liver fluke. At 7,5 mg/kg it was 100, 87,4 and 94,6 per cent effective against mature F. hepatica, fourth stage H. placei and adult B. phlebotomum respectively.


Percutaneous infestation of calves and lambs with Oesophagostomum spp.

Oesophagostomum radiatum and Oesophagostomum columbianum became established in low numbers when 2 calves and 2 sheep respectively were exposed percutaneously to pure cultures of infective larvae of these worms. A further sheep infested in the conjunctival sac became heavily infested but this may have occurred via the lachrimal duct. As far as can be ascertained this is the first time that development of O. columbianum has been demonstrated after percutaneous exposure.


The preparation, mincing and canning of bovine offal (ruminal and intestinal wall) for human consumption.

The results of a sudy of methods of cleaning and preserving bovine ruminal and intestinal wall by canning are described. Such offal could be converted into a hygienically satisfactory and safe food by laboratory washing and canning, and töe end product had a extended shelf life. Methods are described and suggested as a basis for ensuring safe utilisation of a valuable food product.


Beef carcase icterus: an evaluation of diagnostic methods in terms of visual assessment.

Two laboratory tests on beef carcase fat, two on serum and one on urine from suspect icteric carcases were compared. Used singly on serum, the indirect van den Bergh and Fouchet tests were found to be most useful, and either of these two used together with the indirect van den Bergh test on fat gave results which agreed most closely with a subjective assessment of the marketability of suspect jaundice carcases after 24 hours' chilling.


Echinococcosis (hydatodosis) in wild animals of the Kruger National Park.

Echinococcosis has been diagnosed in the following wild species in the Kruger National Park : lion, Panthera leo, spotted hyena, Crocuta crocuta, Cape hunting dog, Lycaon pictus, Burchell's zebra, Equus burchelli antiquorum, buffalo, Syncerus caffer, hippopotamus, Hippopotamus amphibius, and impala, Aepyceros melampus. Infestation rates in the herbivores vary from 60% in zebra to less than 1% in impala. Species like elephant, Loxodonta africana, and blue wildebeest, Connochaetes taurinus, do not seem to be susceptible. The successful artificial transmission of Echinococus granulosus felidis from Burchell's zebra to the lion is reported for the first time.


Dystocia in a free-living impala (Aepyceros melampus).

Dystocia in a free-living impala (Aepyceros melampus) in Kruger National Park (KNP) is described. An exaggerated unilateral foot-nape posture is held responsible for a complete obstacle to parturition.


Aortic stenosis in a dog.

A case of valvular aortic stenosis in a dog is described. The presenting sign was syncope during exercise. An unusual feature was right bundle branch block electrocardiographic pattern. During syncope electrocardiograms usually indicated atrial standstill and always had sever ST segment changes indicative of myocardial ischaemia. Pathological findings included chronic valcular changes which did not appear to be the result of a infectious inflammatory condition.


Ulcerative glossitis. A facet of feline panleukopenia.

The clinical findings and the macroscopic and microscopic lesions in a kitten which died during an outbreak of ulcerative glossitis in a cattery are described. A brief review of the literature is given to support the theory that the virus of feline panleukopenia may well be the aetiological agent in this outbreak.


Heterozygote detection in phenylketonuria. Measurement of discriminatory ability and interpretation of the phenylalanine loading test by determination of the heterozygote likelihood ratio.

Two tests of heterozygosity for phenylketonuria, the phenylalanine/tyrosine ratio in the plasma after a fast and the response to an oral load of phenylalanine, have been compared in obligate heterozygotes for phenylketonuria and apparent normal homozygotes. The discriminatory ability of the tests is measured using both parametric and non-parametric methods, the correlation between them is determined, and the reproducibility of the loading test is examined. Because complete separation between the genotypes cannot be achieved by these tests, a method of interpretation which avoids possibly erroneous categoric statements and which enables the family history of a subject and his test result to be combined in a quantitative and meaningful way is described.


Hirschsprung's disease associated with congenital heart malformation, broad big toes, and ulnar polydactyly in sibs: a case for fetoscopy.

Successful fetoscopy using a 9 mm laparoscope was carried out on an 18-week pregnancy of a healthy woman who had had two previous male infants with bilateral double big toes, bilateral ulnar supernumerary digits associated with short segment Hirschsprung's disease, and ventricular septal defect of the heart, a syndrome apparently not previously described. The fetus was found to be normal, but an amniotic membrane defect was detected, which accounted for amniotic fluid leakage from 24 weeks up to delivery by caesaren section of a normal male infant at 35 weeks. The possible genetic basis and recurrence risk, put at probably one in four for this syndrome, is discussed. The indications for fetoscopy are set out and a fundal approach at laparotomy after placental localization is recommended for the procedure.


Polydactyly and brachymetapody in two English families.

Two new pedigrees of polydactyly associated with brachymetapody are discribed. In one the two defects occur in different members of the family, while in the other both occur in the same individuals. Both anomalies appear to be inherited as dominants, the polydactyly showing incomplete manifestation.


Differences in human X isochromosomes.

In this paper we describe two types of i(Xq), in three patients. A classification is proposed for at least seven different types of human i(Xq)s or X long-arm duplications described by banding in the literature. Type 1 reported here and also in the literature may be the most common. It consists of a single visible centromere, metacentric, length similar to number 3, G-banding interpreted as i(X)(qter leads to cen leads to qter), one C-band like a normal X. Type 2 reported here may not have a counterpart in the literature; it exhibits a single visible centromere, submetacentric, length similiar to number 3, extra G- and C-bands on region ql. The classification summarized in this paper implies that different breakpoints are involved in the production of human X long-arm isochromosomes or duplications. Some include duplications of short arm. Morphological differences in i(Xq)s will complicate their use for studying the effect of X chromosome structure on phenotype, unless differences are defined clearly. It seems important to resolve the question of whether these reported abnormal X chromosomes involve rearrangements between the same or two X chromosomes. We also report X chromosome defects in three generations of a family; both the mother and maternal grandmother of one 45,X,i(Xq)/45,X patient are themselves mosaics for 45,X/46,XX/46,X,r(X). This family suggests that familial predisposition to X chromosome abnormality included isochromosome formation, as well as ring formation and mosaicism.


The Stickler syndrome presenting as a dominantly inherited cleft palate and blindness.

The Stickler syndrome is a newly recognized, but probably relatively frequent inherited generalized connective tissue disorder involving skeleton, eye, and oro-facial structures. A family with three affected generations is discussed. Severe myopia leading to blindness, cleft palate, or subnucous cleft, Pierre Robin anomaly, premature degenerative arthritis, or a family history of any of these indicates further evaluation.


Trisomy of the short arm of chromosome 10.

A case of a fetus with multiple malformations is described. The mother showed a 46,XX,rcp(10;22) (p11;p11) karyotype. Amniocentesis at the 16th week of gestation revealed that the male fetus had a der(22) chromosome--that is, he was trisomic for a large part of 10p (10pter leads to 10p11). Clinical findings of cases with 10p, 10q, and mosaic 10 trisomies are briefly reviewed.


Autosomal recessive oculopharyngeal muscular dystrophy.

Oculopharyngeal muscular dystrophy is known as a rare automsomal dominant disease. A family is reported suggesting that there may be genetic heterogeneity in oculopharyngeal muscular dystrophy and that in some families the mode of inheritance may be autosomal recessive.


Partial trisomy for the long arms of chromosome no. 5 due to insertion and further 'aneusomie de recombinaison'.

Five members of a family with a balanced insertion (1;5)(q32;q11q22) are presented. The daughter of one of them shows multiple malformations and a partial trisomy for the long arms of chromosome No. 5 (5q11 to 5q22 segment) resulting from a 'aneusomie de recombinaison' in her mother. The propositus' karyotype is 46,XX,rec(1;5)ins (1;5)(q32;q11q22). This case is the first reported example of an insertion between two chromosomes followed by 'aneusomie de recombinaison'. It also is the first reported case of trisomy invovling the long arms of chromosome No. 5.


Bloom's syndrome: a probable new case with cytogenetic findings.

A 19-year-old Jordanian girl, born to first-cousin parents, has most features of Bloom's syndrome but is tall and has secondary amenorrhoea. Blood and skin cultures revealed a normal diploid female complement but about one-quarter of the cells show chromosome or chromatid gaps, breaks and rearrangements. These abnormalities were localized after trypsin banding and having been found non-randomly distributed along the chromosomes.


Trisomy 4q32 leads to 4qter due to a maternal 4/21 translocation.

The case is described of a malformed girl with partial trisomy for a segment of the long arm of chromsome (4q32 leads to qter) due to an unfavourable segregation of a maternal reciprocal translocation t(4;21) (q32q22). The clinical comparison between the child and patients previously described by other authors does not suggest the existence of a syndrome associated with trisomy 4q+.


[Retroperitoneal hematoma caused by rupture of an aneurysm of the renal artery trunk. Survival].

A dramatic accident, the rupture of an aneurysm of the renal arterial trunk is exceptionally accompanied by survival. This case enables one to look at different problems, especially diagnostic and therapeutic.


[A long standing cystostomy is not a definitive infirmity in the paraplegic (author's transl)].

The author presents the case of a tetraplegic patient who had a cystostomy for 12 years. It was possible to abolish the infirmity by bladder closure and endoscopic resection of the striated sphincter of the urethra.


[Restorative surgical treatment of renal artery stenosis in the child. Concerning 5 cases (author's transl)].

The authors present 5 cases of restorative surgery of the renal artery in the child. Four gave an immediate and lasting excellent result, with return of the arterial blood pressure to normal in the absence of any post-operative medical hypotensive treatment.


[The diagnosis and partial nephrectomy of angiomyolipomas (author's transl)].

Renal angiomyolipoma is not a malignant tumor, and it is therefore to be treated only conservatively. The difficulty in distinguishing it from carcinoma nearly always leads to total nephrectomy. The study of the selective renal arteriogram enables preoperative diagnosis of angiomyolipoma even when not associated with tuberous sclerosis, and a partial nephrectomy. The arteriographic signs are: aneurysmatic images of the main vessels the neoplastic vessels with a helicoid course or arranged as bunche of grapes, their frequent anastomoses, the slowness of bloodflow in the angiomatous vessels and finally the mosaic picture during the nephrographic phase.


[Urogenital tuberculosis. Study of 34 cases].

The authors deal with their experience on 34 cases of urogenital tuberculosis they treated between 1961 and 1972. The follow-up runs over at least 3 years.


Plasma renin and hypertensive vascular complications: an observation in the stroke-prone spontaneously hypertensive rat.

The hypothesis that plasma renin is a major risk factor in the development of cardiovascular complications of hypertension was evaluated in a model animal, the spontaneously hypertensive rat (SHR). Plasma renin levels and pathological findings were studied in stroke-prone and -resistant strains of SHR at various ages. The stroke-prone strain showed significantly higher plasma renin levels at and after seven months of age, while the stroke-resistant strain showed no significant differences from the control at any age. High plasma renin levels were always associated with evident vascular complications in the kidney and the brain, indicating underlying angionecrosis and malignant transformation of hypertension. However, no evidence indicated that a higher plasma renin preceded the development of vascular lesions. Thus the high plasma renin would be a result rather than the cause of hypertensive vascular lesions.


A correlative study of the experimental cardiac dynamics and myocardial energy metabolism.

Relationship between cardiac dynamics and myocardial energy metabolism was studied using dogs treated by isoproterenol, dinitrophenol, propranolol or amobarbital. Isoproterenol changed cardiac dynamic state to positive chronotropism with positive inotropism and myocardial energy liberation to uncoupling of oxidative phosphorylation. Dinitrophenol inducing uncoupling of oxidative phosphorylation, revealed also positive chronotropic and positive inotropic state. Propranolol changed cardiac dynamic state to negative chronotropism with negative inotropism, and myocardial energy liberation to suppression of oxidation. Amobarbital inducing inhibition of intracellular terminal oxidation, revealed also negative chronotropic and negative intropic state. From the above-mentioned results, it might be clear that the positive chronotropism with positive inotropism appears to be relating to the uncoupling of oxidative phosphorylation, as well as the negative chronotropism with negative inotropism to the suppression of mitochondrial respiration.


Scanning electron microscopic studies on the formation of cardiac intercellular connection in culture.

The fine surface structural appearance of the cardiac intercellular connection was studied scanning electron microscopically in culture. When individual heart cells contract each other, they start to beat synchronically. On the base of scanning electron microscopic observation, the early pattern of the formation of it could be suggested as follows: five ramified processes extend from the edge of the cells, and the ends of these processes bridge each other to form the intercellular connection.


False atrial dissociation (the Deitz-Marques phenomenon) and its dependence on dyspnea.

Three cases of false atrial dissociation (the Deitz-Marques phenomenon) were presented to show the dependence of this phenomenon on dyspnea. 2) The pseudo-P wave of the Deitz-Marques phenomenon coincided with the beginning of inspiration. 3) In a case of silicotuberculosis, the length of the pseudo-fibrillation was nearly equal to that of laborious inspiration. 4) In a case of aspiration pneumonia, every second cardiac contraction was synchronized with the beginning of inspiration two hours before death. 5) In a case of hyperpotassemia, the pseudo-P wave persisted even after the disappearance of the sinus P wave. 6) The pseudo-P wave was not affected by retrograde activation of the atria by the A-V junctional impulse.


An autopsy case of congenital interruption of the aortic arch.

An autopsy case of congenital interruption of the aortic arch in a four months old male with PDA and VSD is reported and a review of the pertinent literature is presented.


[Therapeutic significance of controlling heart rate in aortic regurgitation (author's transl)].

The hemodynamic effects of aortic regurgitation are characterized by an increase of left ventricular volume load due to the diastolic regurgitation and a decrease of aortic diastolic pressure or coronary perfusion pressure. It is presumed that an increase of heart rate in such a situation diminishes the regurgitant flow and elevates the coronary perfusion pressure so far as it is not accompanied by an improper increase of myocardial oxygen consumption. The present study, although it was the one performed on dog heart with an aortoventricular shunt rather than aortic valvular destruction, demonstrated that the increase of heart rate, if not beyond 160 beats per min, minimizes regurgitant flow as well as regurgitant ratio and maintains effective cardiac output without impairing coronary circulation. Thus it is suggested that it would be of beneficial therapeutic means in aortic regurgitation to keep the heart rate high or, at least, to avoid its excessive deceleration.


[Circulatory reflexes in primary aldosteronism (author's transl)].

1. In 7 patients with hypertension, aldosteronism, and low plasma renin (6 patients with a solitary adrenal adenoma, 1 patient with bilateral adrenal hyperplasia) circulatory reflexes (Valsalva's maneuver, head-up tilt and cold pressure test) were examined. Furthermore, the reactivity to the pressor action of tyramine and norepinephrine was determined. For comparison 10 patients with essential hypertension were studied. 2. In 4 of the 7 patients with primary aldosteronism no overshoot following Valsalva's maneuver could be observed. Compared to the patients with essential hypertension the mean overshoot in the patients with primary aldosteronism was significantly reduced. The decrease in blood pressure during head-up tilt was significantly more pronounced in the patients with primary aldosteronism. However, both groups did not differ in their reaction to the cold pressure test. In the patients with primary aldosteronism responsiveness to tyramine was significantly reduced compared to the patients with essential hypertension. No significant difference was observed in the reactivity to norepinephrine between both groups studied. 3. The results point towards a disturbance of the sympathetic nervous system in patients with primary aldosteronism.


[Radio-iodine treatment of hyperthyroidism. Experience in more than 2000 patients (author's transl)].

Results of radioiodine therapy (131/125) of hyperthyroidism are reported. The individually calculated doses of 131-iodine were: 6000 rad in cases of small (not more than 60 g) diffuse goiters, 8000-10000 rad in large diffuse goiters, 10000-12000 rad in nodular goiter and 30000-40000 rad in autonomous adenoma. In about 75% of the patients a single application of 131-iodine was sufficient to control the hyperfunction. The cumulative risk of myxedema ten years after therapy was: 31% in small diffe goiters, 12% in large diffuse goiters and 6% in nodular goiter. All cases considered together, the cumulative myxedema risk was about 12%. This figure compares favourably with the results of surgical treatment and they document the necessity of individual calculation of the dose in order to get optimal results. 125-iodine was applied since October 1972 in cases of small diffuse goiters. The dose was standardized according to the gland weight, uptake and effective half value time (dose at the colloid-cell interface 12000-15000 rad). 5-12 months thereafter, there were about 60% of the patients euthyroid. The genetic and somatic risk of radiation is considered quantitatively and we conclude that there is no real argument aginst radioiodine therapy of hyperthyroidism except in children and in youth. Risks and efficiency of other treatments (surgical, antithyroid drugs) are compared with the radioiodine treatment and it is concluded that radioiodine is to be preferred in the major part of the hyperthyroid patients.


Hereditary angioneurotic oedema.

Three families with hereditary angioneurotic oedema (HANE) are described. Serum CI-INH and C4 immunochemical determinations were performed on 23 members of the families: in 6 persons low CI-INH and C4 levels were found with typical symptoms of HANE, and in one asymptomatic subject. Normal ranges of both proteins for adults, children and newborns are given for comparative purposes. The importance of the early diagnosis and treatment is emphasized.


Therapeutic and toxic lanatoside C serum concentrations in hospital patients.

Serum lanatoside C concentrations were measured by radioimmunoassay in 56 patients on oral maintenance therapy. Seven patients were judged to have digitalis toxicity and the lanatoside C concentration in this group was 6.99+/-2.00 ng/ml (mean +/-1 SD). 49 patients were non-toxic and the mean serum lanatoside C concentration in this group corresponded to 2.32+/-1.08 ng/ml.


[Oxygen pressure values in the ischemic muscle tissue of patients with occlusive arterial diseases (author's transl)].

The local oxygen pressure of muscle tissue was measured in 10 patients with occlusive atherosclerosis and in 9 healthy volunteers using a micro-Pt-electrode. In 3 cases, the muscular pO2 values of an ischemic leg were compared to the non-ischemic leg of the same patient. In both groups, there was a statistically significant difference in the oxygen pressure of the muscle tissue in normal legs of volunteers as compared to the ischemic legs. Measurements of the local oxygen pressure in the muscle enables us to have a quantitative measure for the ischemic situtation. It is a useful diagnostic method in patients suffering from ischemic claudication and seems to be an objective criterium of therapeutical methods.


[Pancreatic response to graded doses of synthetic secretion: comparison between intravenous and pernasal administration in man].

The response of the human pancreas to varying doses of pure synthetic secretin administered intravenously and, for comparison, 8 days later in the form of snuff was examined, intraindividually, in 10 healthy test subjects. After intubation of the stomach and duodenum and continuous instillation of radioactive vitamin B12, the recovery rate of the marker substance was measured in duodenal aspirates and employed to compute the pancreatic bicarbonate and enzyme outputs. The dose-response relationship between pancreatic bicarbonate production and varying doses of synthetic secretin administered intravenously and in the form of snuff, was good. The pancreatic response to a dose of secretin snuff was only about 1/25 of the response obtained with the same dose of secretin injected intravenously. The level of the pancreatic enzyme output remained relatively uninfluenced by varying doses of synthetic secretin.


[The determination of catalase activity in liver tissue (author's transl)].

In 31 patients with carcinoma and 45 controls catalase activity of liver tissue was measured spectrophotometrically. In patients with carcinoma the activity was significantly lower. Within the control group patients with pathological liver findings or inflammatory disease of the pancreas or bile ducts showed a relatively low catalase activity which are obviously higher than in patients with carcinoma.


[Serum level of thyroxin-binding globulin under oral contraception (author's transl)].

The use of oral contraceptives results in an increase in thyroid-binding-capacity in conformity with a change of results by T3/T4-tests. Using Laurell-electrophoresis and an anti-serum produced by Behringwerke the determination of the thyroid-binding-globulin (TBG) in serum is easy to handle. TBG was determined in serum from 137 women using oral contraceptives for more than 3 months. The apllication of oral contraceptives is followed by a statistically significant increase in the TBG level in serum. Thereby oral contraceptives change the TBG-level in a different degree. Preparations with a marked estrogen potency on the average effect a higher TBG-concentration than those with progesterone activity derived by menses-delay test. The difference of TBG-level is statistically significant. According by the increase of TBG-concentration in serum is caused by estrogen, the extent of the increase is modified by the progesterone component.


[Quantitative determination and phenotyping of ceruloplasmin in morbus Wilson (author's transl)].

Sera of 17 patients with Wilson's disease and of 48 relatives were investigated as to a possible correlation between ceruloplasmin phenotypes and Wilson's disease. The control group included 727 healthy subjects. The results of the quantitative determination of ceruloplasmin confirmed the overlapping in the groups of so-called heterozygotes and controls known from the literature. The ceruloplasmin phenotypes in starch gel electrophoresis we observed were of the most common phenotype Cp BB in the patients as well as in the controls. Therefore, patients with Wilson's disease also show the normal Cp-phenotypes.


Current concepts in management of cervical spine fractures and dislocations.

In order to manage the patient with a cervical spine injury, one must be familiar with a diagnostic classification of these injuries and be able to apply this classification to the individual patient. When a cooperative effort is made between orthopedists and neurosurgeons, we have found that most cervical spine injuries can be managed successfully without operative means using Cheshire's classification for predicting late instability. We have been able to identify (1) those patients who would not substantially benefit from surgical intervention; (2) certain types of injuries where relative indications for surgery may be considered; and (3) we have confirmed the danger and risk of early operative intervention following cervical spine trauma in the neurologically damaged spinal cord.


The anterior drawer sign: what is it?

1. The anterior drawer is a test of anterior cruciate ligament integrity. 2. The anterior cruciate ligament is composed of two parts: the anteromedial band and the posterolater bulk. 3. The anteromedial band is the primary check against anterior drawer. 4. Other structures may contribute to the resistance of anterior drawer only if the anteromedial band has been injuried. 5. The posterior cruciate ligament is a check against posterior drawer. 6. In long term follow-up, the presence of anterior drawer is associated with poor overall results.


[Asbestos pollution: criticism on methods and experiences in the city of Bari (author's transl)].

The author deals with an air sampling and identification technique for asbestos fibers. By means of such technique measurements were made in the city of Bari, where there is also an asbestos-cement manufacturing plant. The obtained results are reported and some critical remarks done.


[Liver disease in polyvinyl chloride production workers - Clinical and peritoneoscopic aspects (author's transl)].

Peculiar clinical symptoms observed in polyvinyl chloride production workers of a nearby chemical plant arose the suspicion of liver and spleen disease in these workers before first reports on vinyl chloride-induced angiosarcoma of the liver became known. Starting at the end of 1972, 44 workers were followed up by biochemical investigations, peritoneoscopy and liver biopsy. As early as 1973 it could be ascertained, that advanced vinyl chloride-induced liver damage presents as hepatic fibrosis with splenomegaly, portal hypertension, and thrombocytopenia without conspicuous deterioration of hepatic parenchyma function. Similar symptoms have been observed after chronic intoxication by arsenic and thorium dioxide (thorotrast). The clinical and peritoneoscopic aspects of the disease are described.


[Extrahepatic portal hypertension and pregnancy (author's transl)].

Taking into account 6 own cases and 51 cases reported in the literature the question is asked, whether pregnancy influences portal hypertension due to extrahepatic block and vice-versa. Complications arise in about 50% of the patients, hemorrhage from esophageal varices making up to 40%, as the most common complication. Most esophageal bleedings occur in the second of third trimenon. The physiological changes of the circulatory system during pregnancy are held to be responsible for these complications; especially temporary increase of portal pressure tend to aggravate the preexisting extrahepatic portal hypertension. The prognosis for mother and child in these cases is less severe than in patients with portal hypertension due to liver cirrhosis. Therapeutic procedures which have to be adapted to the individual case are discussed.


[The present status of portal vein surgery in liver cirrhosis (author's transl)].

Surgical procedures concerning the portal vein in liver cirrhosis must be carefully planned preoperatively. If there is still a residual blood supply of the liver through the portal vein it should be preserved. This can be done best by establishing a pressure-adapted arterialisation of the liver plus portacaval end-to-side anastomosis. The portacaval shunt is the method of choice if there is no residual blood flow through the portal vein. A spleno-renal venous anastomosis is to be performed, if there is a total or partial thrombosis of the stem of the portal vein. Treatment of acute bleeding from esophageal varices is still a problem unresolved. The pathophysiology of this situation is considered; a method is proposed which combines a quick stop of bleeding and relief of the detoxfying function of the liver.


[Ultrasonic diagnosis of liver metastases (author's transl)].

166 patients suspected to harbor metastases in the liver were examined by ultrasonics. The results of this examination could be evaluated in 113 cases, yielding a correct diagnosis in 92%; in 53 cases with uncharacteristic changes of the liver the presence of metastases could be neither proven nor excluded, thus the overall yield of correct results was 72%. In 124 patients ultrasonic findings could be compared with scintigraphic findings (99m-Tc-sulfur colloid): A false diagnosis was made on the basis of ultrasonic findings in 5 cases, on the basis of scintigraphic findings in 18 cases; no conclusive diagnosis could be made by ultrasonic procedures in 34 cases, by isotope scanning in 48 cases. The ultrasonic diagnostics has the advantage of low cost and no risk and allows to differentiate between solid and cystic lesions.


Clinical application of exercise testing.

Direct measurement of oxygen consumption during monitored exercise can safely be used for assessment of functional reserve in established cardiorespiratory disease. Indirect prediction of aerobic capacity enables the clinical application of exercise testing to be extended outside the laboratory setting. Information so obtained can provide useful guidelines when one is prescribing exercise for the prevention and rehabilitation of ischaemic heart disease.


Chlorpropamide-induced hyponatraemia.

A case of hyponatraemia occurring in a 69-year-old diabetic woman taking chlorpropamide is reported. Increasing the dose of chlorpropamide aggravated the hyponatraemia, and the condition corrected itself when the chlorpropamide was withdrawn. It is believed, therefore, that, in the absence of any other cause for the hyponatraemia, chlorpropamide was the cause.


Management of patients who overdose.

People who overdose appear to arouse a mixture of emotions in their attending doctors, some of which are associated with feelings of inadequacy on the doctors' part. If this group of people is approached in a logical and emotionally neutral faxhion, the problem becomes essentially a manageable one. Perhaps most importantly, by this method a reasonably accurate prediction can be made of whether the person will repeat this pattern of abnormal behaviour.


Absorbable subcuticular sutures. How to avoid the childhood ordeal of suture removal.

Suture removal is psychologically traumatic to a child, and in the majority of relatively minor elective operations is a totally unnecessary procedure. Skin repair with subcuticular sutures of absorbable polyglycolic acid (Dexon) is advocated. Techniques of suturing are described. Advantages, potential disadvantages and contraindications are discussed.


Some pharmacological aspects of drug dependence.

The self-administration of drugs to achieve altered states of consciousness is recognized as normal human behaviour. Community attitudes towards drug use vary according to the drug and often bear little relationship to the known pharmacological and toxicological effects of the drug. For an objective assessment of the potential dangers associated with drug use, a distinction is made between drug use and drug abuse. It is stressed that the progression from drug use to drug abuse involves social and psychological factors in addition to the pharmacological factors which are outlined in this paper. The sequential development of drug dependency is described under the headings: Induction; continued consumption; compulsive consumption; withdrawal; abstinence; reinduction. Man uses psychotropic drugs because he finds the effects rewarding. Some experimental models to explore the neurophysiological basis of the reward are described. Experiments employing inhibitors of protein synthesis suggest that the phenomena of tolerance and physical dependence involve the synthesis of new protein. It has been suggested that the new protein might be new receptor molecules for the drug or neurotransmitter substances. These new receptors might constitute a "drug memory" and provide a possible explanation for high relapse rate of drug dependent subjects. A pharmacological basis for the methadone maintenance programme of management of narcotic dependent subjects is briefly outlined.


[Modification of tRNA 1 Val from yeast with monoperphthalic acid].

A method is proposed for analysis of natural and chemically modified polynucleotides which consists in enzymatic conversion of the polymer or oligomer into nucleosides followed by cation-exchange chromotography on the microcolumns. By using the method developed it was shown that after treatment of the yeast tRNAVal and tRNAPhe with monoperphthalic acid N-oxides of adenosine and cytidine were formed. Poly (U, G) was not modified at a measurable extent whereas GMP was decomposed. In tRNAVal (yeast)the adenosines and cytosines of the anticodon loop and 3'-end are most reactive; it is the case for the C17 of the diHU-loop as well. These data are in agreement with the results obtained for tRNA modification with other reagents and for limited enzymatic hydrolysis of the tRNAVal. The limitations of the reaction of the monoperphthalate with nucleic acids are briefly discussed.


[A new approach to the synthesis of enzyme inhibitors].

On the basis of the application of transition-state theory to enzymatic catalysis a novel approach to the synthesis of inhibitors of enzymes involving conformational rigid substrate has been proposed. It is predicted that the substrates which resemble the natural species in the structure of functional groups, but posses conformational flexibility, will be bound to the enzyme more tightly and converted more slowly than the natural substrate.


[Self-assembly of extracellular tubular structures of non-protein nature produced by an actinomycete].

When grown on the solid synthetic medium with glucose as the only carbon source the dedifferentiated "fructose" mutant of Actinomyces roseoflavus var. roseofungini accumulated aggregates of tubular-like structures. The individual tubules had the internal diametre of 80 A and external diametre of approximately 200-220 A. These structures were isolated as a distinct fraction and their non-protein nature was demonstrated. They were easily soluble in acetone and reconstitutable in vitro. The possible significance of production of self-assembling structures by a mutant with impaired differentiation is discussed. The possibility of involvement of self-assembly processes in the formation of surface sheath of aerial mycelium in normally differentiating actinomycetes is mentioned.


[Early changes in liver chromatin in response to partial hepatectomy].

Guinea-pig and mouse liver chromatin responds to the partial hepatectomy by an increase in binding of a basic dye acridine orange (AO) and by a decrease of its stability to heat in thermal denaturation test in situ. Degree of the changes in AO chromatin binding is identical in the cells of different ploidy and proportional to their DNA content. Treatment of the preparations by 0.6 M NaCl solutions under conditions bringing about the selective removal of histone H1 from the cells produces in vitro changes in DNA properties taking place in cells in vivo in the course of their activation. The treatment of cells with 0.35 M NaCl solution results in the disappearance of changes occurring in the chromatin of activated cells whereas the properties of control cells remain unchanged. The data obtained are interpreted as a result of the removal of some non-histone regulatory proteins from the chromatin of activated cells that is accompanied by changes in the character of DNA-histone interaction. At the time of maximum increase of AO binding a significant intensification of endogenous RNA polymerase activity was found, the incorporation of [3H] UTP in the nucleolus being higher than that in the extranucleolar part of the nucleus. High ionic strength in the incubation medium (0.4 M (NH4)2SO4) results in drastic increase of radioactive label in the nucleus and in the disappearance of differences between activated and non-activated chromatin. It is concluded that the intensification of RNA synthesis under the influence of proliferative stimulus is more likely dependent on the additional opening of DNA-matrix than on the direct activation of the enzyme.


[Structure and functions of hemoglobin].

The present status of our knowledge of different levels of hemoglobin molecule structural organization and of the conformation changes accompanying a hemoglobin action is reviewed. The main functional properties of hemoglobin such as cooperative effects in oxygen binding. CO2 transport, protons and organic phosphates effects on oxygen affinity are described on molecular ground. The description is based on the data obtained by different physical and chemical methods especially by X-ray analysis. The application of some mathematical models of cooperative effects in enzymes to hemoglobin is discussed.


[Kinetic studies of leucyl-tRNA synthetase: measurement of the ratio rates of overall and exchange reaction].

Equations for the ratio of the rates of aminoacylation of tRNA and the rates of ATP-PP exchange show characteristic dependences on the concentrations of substrates, products and inhibitors according to the reaction mechanism. Analyses of leucyl-tRNA synthesis show that these differences may be explained by the ratios of rates for the individual partial reactions. The ratio of rates as a function of tRNA concentration suggests that alternative mechanisms might exist but present methods do not allow the distinction of these possibilities.


[Physico-chemical properties of ribonuclease A modified with pyridoxal-5'-phosphate].

The physico-chemical properties have been studied of RNase A selectively modified at the E-NH2-group of Lys-7 and Lys-41 with pyridoxal-P. Modification did not affect conformational stability of the protein globule, thus all changes in the molecule of the modified RNase A were localised around the alkylated Lys residue. In the both cases pyridoxyl-P. The residue was shown to be localized in the active site region of the (P-Pxy)-Lys-7-RNase A and its chromophore parts was highly exposed to the solvent. (P-Pxy) E-Lys-7-RNase A and its chromophore parts was highly exposed to the solvent. In the Lys-41 derivative, pyridoxamine-P was situated exactly in the active site and is partially hidden in the protein grobule. The pH-dependence of absorption spectra indicates that the chromophore of pyridoxyl-P in modified proteins is quite sensible to the ionic state of its surrounding. The usefulness of pyridoxyl-P as a reporter group was proved in the study with (P-Pxy)-Lys-7-RNase A. Some conformational changes involving His-119 were shown to take place in the course of the enzyme-nucleotide complex formation.