[Systemic allergic vasculitis: case report of a female patient with the Churg-Strauss syndrome].

A female patient with asthmatic attacks developed signs of peripheral and central nervous system involvement, cutaneous and joint manifestations, pulmonary and gastrointestinal involvement, with significant body weight loss. A blood eosinophilia was found and muscle biopsy revealed tissue infiltration by eosinophils and vasculitis. Very short interval from onset of first symptoms to appearance of vasculitis is a bad prognostic sign and probably cause of unsuccessful therapy.


[Side effects of gold salt therapy in patients with rheumatoid arthritis].

Observing the efficacy of the gold sodium thiomalate (under the trade name of Tauredon Byk Gulden) during the treatment of 43 patients with rheumatoid arthritis, a certain number of side effects have been noted and registered. The group being tested comprised 43 patients, 8 men and 35 women, average age being 50. The side effects were observed in 14 patients (32.5%), namely in one man and 13 woman, the most frequent being thrombocytopenia (20.8%), serious exacerbation of the disease (16.6%), thrombocytosis and dermatitis (12.5%). The recurrence rate of the side effects during the treatment with the gold sodium thiomalate was greater during the first (14%) and the second month (11.8%) than during the third (4.6%) and the fourth month (2.5%).


[Educational-motivational guidelines for working with parents of children with juvenile chronic arthritis].

This paper points at the role of parents in performance and supervision of out institutional treatment and rehabilitation of children suffering from juvenile chronic arthritis (JCA) dealing with educational--motivating elements in work of parents with ill child. Medical psycho-sociological and pedagogic aspects of work of parents with ill child has been presented. For each indicated educational--motivating unity parents have to be completely prepared for better and more complete than usual piling of facts and presenting in front of them unsolvable tasks and obligations. Should child's rheumatologist succeed in this a plan of individual continuous treatment and rehabilitation of each patient suffering from JCA shall meet with success.


[Results of a comparative study of the success of treatment of pain in the lumbar spine at the Moravske Toplice health spa, at the department of physical therapy and rehabilitation and at the department of rheumatology of the Maribor Teaching Hospital].

A parallel investigation of the success of treating patients with chronic low back pain has been carried out at the Moravci Spa, at the Department for Physical Therapy and Rehabilitation and at the Rheumatology Department of Maribor Teaching Hospital. One hundred patients suffering from low-back pain were given a 14-day treatment in the termomineral water (T--36 degrees C) of the Moravci Spa. A comparative group of another 100 patients also suffering from pain in the lumbar region of the spine underwent equal balneo-physical treatment in plain water (T--32 degrees C) at the Dept. for Physical Therapy and Rehabilitation and at the Dept. of Rheumatology at Maribor Teaching Hospital, Slovenia. The educational background of the two groups features a statistically significant difference (p < 0.001): the percentage of patients with lower education was higher at the Moravci Spa (67%) compared with only 46% among those treated at Maribor Teaching Hospital. Correspondingly, the difference in occupation of the two groups were similar (p < 0.005): prevalent among the patients at Moravci Spa were bluecollar workers (40%) compared with white-collar workers (27%). The percentage of white-collar workers at Maribor Teaching Hospital was 45%. The average age of the patients treated at the Moravci Spa was 46.9 +/- 9.5 years (28-77 years), at Maribor Teaching Hospital it was 45.2 +/- 8.2 years (26-71 years). There was no statistically significant difference in age (p < 0.10) between the two groups. Generalized spondylochondrosis was present in both groups, i.e. 87%; approximately 10% of the patients from both groups underwent surgical treatment of hernia disci.(ABSTRACT TRUNCATED AT 250 WORDS)


[The effect of verticalization of the resulting force (R) of weight bearing in the hip joint on morphologic characteristics of the medullary canal in the femoral shaft in patients with coxarthrosis].

An influence of verticalization of the resulting force of weight-bearing on the hip joint "R" on the morphological characteristics of the medullar canal on the proximal edge of the shaft of femur was researched. Progressive degenerative changes of the hip joint with a consequent sideways limping or changes of the collodiaphysial angle (ccd angle) were the cause of the verticalization of the resulting force "R". The analysis of patients treated and operated on The Orthopaedic Department of the General Hospital Osijek and The Orthopaedic Clinic of The Medical Faculty of The University of Zagreb. The research, undoubtedly, proved that the patients with coxarthrosis and side-ways in the hip or with changed collodiaphysial angle experienced verticalization of the resulting force of weigh-bearing of the hip joint and the proximal edge of femur which caused morphological changes of the medular canal of the shaft of femur.


[A community program to stimulate smoking cessation].

A community program to stimulate smoking cessation developed on the 1988 World No-smoking Day in the city of Barcelona (Spain) is presented. Participants in this program could make a written commitment to quit, and received support materials by mail. The results are evaluated in a sample of participants: 69% declare having quit on the specified date, and 29% do not smoke after one year.


[The revision of the organization of consultation for long-term treatment].

The growing drug dependency of developed societies has meant the uncontrolled use of drugs with the consequent medical risks and important economic repercussions. Primary health care in our country is characterized by high demand bureaucratization of clinics. Because of this, we consider it useful to rely on a prescription system for long term treatment, this being understood as a mechanism which allows the obtaining of prescriptions easily both for the patient and the doctor, control and monitoring of established chronic treatments, periodical therapy evaluations, which rely on the participation of other members of the primary health care team. In this report the model of the repeat prescription system in our health area is shown, from which the prescription can be obtained in a maximum time limit of 8 hours, the medication taken for chronic illness can be easily recognized and to make note of the date of the prescription.


[Socioeconomic level and mortality].

A revision of the bibliography has been carried out, referring to the influence of people's social economic condition to the cause and age at death. Special interest was taken in collecting works carried out after the Black Report was published, taking its particular relevance into account.


[The diagnosis of basic sanitation in the Erniobea region].

The aim of this report was to identify the basic sanitary situation and that of a series of health markers, in the area of influence of our health centre. The population studied have all come from places under the census and the measuring system used was a prepared survey and also, direct observation. The information collected was verified by revising all the clinical notes of the affected people. The results found are presented, referring to the characteristics of the houses and the stables, the sanitary situation of the livestock, water supply and excrement removal, rubbish removal methods and health markers. The high number of houses without adequate installation maintenance (water, excrement...) and the high incidence of infectious diseases should be highlighted.


[The ionic composition of the atmospheric aerosols in industrial areas of the north of Spain].

Over the years 1986, 1987 and 1988 determinations of the mass concentration of total particles in suspension and of the anionic components (chlorides, nitrates and sulphates) and cationic (sodium, potassium, calcium, magnesium and ammonia) contained in these was carried out in Bilbao, Sestao and Erandio. The determination of the mass of particles was carried out by gravimetry and chemical composition by ionic chromatography. The particle concentrations in Bilbao and Sestao, over the measuring period, were higher than those in Erandio. The studies of concentrations, percentages and correlations show the existence of centres of calcium emission during one season and high levels of chlorides during all of them. Surprisingly enough, the nitrate and ammonia content for all the seasons is low in comparison with other urban and industrial centres of the peninsular inland.


[An epidemiological study of the body mass index in a school-aged population of Madrid].

A descriptive study has been carried out, to perform body mass index, between 2606 schoolchildren at Madrid, during 1986 to 1990. Observational and transversal study. The data obtained were compared by age and sex for each year, and we calculated the body mass index percentiles for each group in the study. Mean body mass index rises with age and also 90 and 95 percentiles. The 1.5% and 0.8% of children at 6 years had BMI more than 26, for male and female respectively. At age 10, this percentages were 9.5% and 11.6% for male and female, and the results for age 13 were 16.1% and 17.8% respectively.


[The epidemiology of dermatologic diseases in primary care].

With the aim of finding out the prevalence and the origin of the skin disease in primary health care, a prospective study was carried out over the period of May to October of 1989 in an urban health centre, with the support of the dermatologist and using iconographic means. The 395 cases considered made up 4.85% of all the medical examinations. A limited number of diagnoses (11) made up the majority of the medical examinations (70%). 19% were referred to the dermatologist. 23% of those diagnosed were not consulted for the patient, including two malign tumours. skin disease has a relevant place in primary health care clinics; the dermatological training of the primary health care doctor should be aimed at the most frequent diagnoses in his setting; active detection of skin lesions is very important.


[The seroprevalence of human toxoplasmosis in Córdoba].

A seroprevalency study of human toxoplasmosis was carried out in Córdoba, using indirect immunofluorescence and indirect hemagglutination. The sample of people interviewed was made up of 443 serums, 356 supposedly healthy people (mainly students) and 87, considered "high risk" (patients from the "Reina Sofia" Hospital). The positiveness obtained for the total of the sample was 43.79% with IFI and 53.59% for HAI. As regards sex of the person tested, prevalence is higher in women, with 54.36% and 70.47% with IFI and HAI respectively, in men the scores were 38.43% and 44.90% for the same tests. As far as the origin of the sample was concerned, there were 31.18% with IFI and 43.25% for HAI of the normal population, in the "high risk" sample, for both tests it was 95.40%. With both tests there are significative differences in low amounts, but not in high dilutions. We conclude that human toxoplasmosis is present and widespread in the studied population.


[Current changes in the predominant mechanisms of the transmission of brucellosis in the province of Valencia].

A descriptive epidemiological study of brucellosis in the province of Valencia was carried out over the period 1985-1988. In this report predominant transmission mechanisms and their relation with sex, age and profession variables are described. Moreover, the results obtained were compared with those from other brucellosis epidemiologies which were previously carried out in the province of Valencia. It can be seen that there is a relative increase in the direct contagion mechanism and a decrease in the indirect contagion mechanism with respect to the previous periods, which has effects on the variations of sex and profession distribution of the disease. The changes observed could be attributed to a better sanitary control of milk and diary products, mainly fresh cheese, which are very important in the transmission of the disease in the province of Valencia.


[The applications to chronicity in mental health of the International Classification of Impairments, Disabilities and Handicaps].

The present work focuses on the difficulties to accomplish an adequate valuation of needs in "chronic" psychical patients. First, a reference is made to the characteristics of the so-called "new chronics", mostly cared outside the hospital, after the process of deinstitutionalization carried out during the last years. Then, an analysis of the International Classification of Deficiencies, Discapacities and Invalidities published by the World Health Organization in 1980, (as annex of the International Classification of Diseases) is carried out. This work studies basically the description of its classification contents and a valuation of its effectiveness as and instrument to be used in the planning and evaluation works and in the care of patients with mental "chronic" diseases.


[The validation of the process and the results of an information system in primary care].

The needs of information for the primary health care centers planning and management, and the poor situation we started from, have generated a large amount of information systems, which, as a general rule, have not been sufficiently evaluated. Since 1986, in the Area de Gestión, 7, Centro, of the ICS here exists an information system of the general medicine services with a sampling method (ANAC-2). The validation of some aspects of the process and content is shown in order to evaluate the quality of information. The problems arisen during the process of collecting data from nine centers are analyzed during six months and its information content is compared with the one of each system with a standard respect their value. To evaluate the concordance, we have used a graphic representation of the differences of each system with a standard respect their mean value, and the "limits of agreement". On relation with the problems of collecting data, two centers show a nonfulfillment of the observation calendar higher than 20% and the logical divergences are not important. The kind of visits distribution is quite correct, even if the estimate of the whole number of visits is higher than 20% in two centers. In the activity indicators, the system of reference has a tendency to give average values lower than the ANAC-2, with the exception of prescription/visit. In referrals and prescriptions, the use of different sources of information between systems produces an average difference of 3.3 interconsults/100 visits and 0.8 prescriptions/visit respectively. Generally, the limits of agreement are wide and become unacceptable in laboratory. The study carried out is evaluated positively, for it detects the problematical areas which can be modified or require further studies. The importance of validating the information systems is emphasized, in spite of difficulties.


[Searching for the utility of an information system in primary care in Castilla and León].

In Castille-Leon, there is an information system in primary health care. The target is to describe several operativity indicators in a primary health care center with the date collected with this system and indirectly, to initiate its evaluation. The study was carried out in an urban primary health care center in Valladolid. A descriptive analysis of the data, related to the health problems demanded in 1990, collected in first sampling during a week of every month, is carried out. The global work load was 30-2 problems demanded to the doctor per day. The 5.7% of consult were home visits, and the prevailing problems were circulatory and respiratory. Per 100 problems, 10 laboratory test, 4.4 radiographies, 1.4 electrocardiograms and 5.25 other different tests were required. No adequate nor periodical informations was received from the administration to which data were sent. Insufficiency in the system to characterize in an adequate way, the health care activities complexity and lack of use of the provided data and of analysis.


[The potability of the water in a region with a high level of natural radiation].

The recent Spanish legislation on drinkable waters for public use includes a paragraph establishing the requirements to be fulfilled by waters in relation with their radioactivity and the methods to be used to measure it. As water radioactivity depends on the radioactive content of the grounds and rocks where it flows, it is possible to expect high levels in those zones whose characteristic is their high level of natural radiation. For this reason, we have organized two measurement campaigns with the objective of characterizing the drinkable waters in an Spanish area, where the radioactive elements concentration in the ground is high. The methodology used is as described in legislation, using a low-bottomed proportional counter. The results we have obtained indicate that the zone, where measurements have been made, shows lower radioactivity levels than the legally established limits, nevertheless, at same time, there appear several points, where the radioactivity levels are high, showing values exceeding in great measure the legal limit for drinkable waters. With the results, we have obtained, its seems necessary that a greater attention is paid to drinkable waters in those points, where the radioactivity levels are high including corrective measures.


[Hepatitis C viral infection and the consumption of intravenous drugs].

To know the antibodies seroprevalence against hepatitis C virus (HCV), as well as other factors associated to these antibodies presence in a group of intravenous drug users (IVDU) in Baleares. To know what screening test would be the most adequate to detect antibodies against HCV in this group. The presence of HCV antibodies in serum was determined in 110 IVDU patients, admitted to hospital during 1990 in a unit of opium detoxifying, by techniques enzyme immunotesting (ELISA) and immunoblotting (RIBA); the drug abuse history as well as serologies against human immunodeficiency virus (HIV), hepatitis B (HBV) and syphilis. The seroprevalence found by techniques ELISA is 71% and 95% respectively for the tests of first and second generation; using the method RIBA the seroprevalence is 86%. The HIV seroprevalence was 36% and a 53% were anti-HBs positive. No significative differences were found between the positive and negative anti HCV in relation with drug use variables: as first year of consumption and time of addiction, nor with the presence of HIV and HBV markers. The HCV seroprevalence among IVDU of the sample studied is similar to those described for this risk group by other authors in other zones. Such infection is not statistically associated with other variables of the drug abuse history nor with the infection by HBV and HIV. Despite the discordances of the HCV seroprevalence with the three test used in the study, the technique ELISA of second generation could be the ideal method of screening of antibodies against the HCV in this risk group.


[A survey on the satisfaction of the users of the Zaidin-Sur de Granada Health Center (1989)].

In order to know the users's degree of satisfaction in the Primary Health Care Center of Zaidin-Sur in Granada, a survey has been carried out by means of a personal interview at home in an aleatory sample of 615 individuals. The questionnaire has 28 closed questions with multiple answer and collects sociodemographic variables, self-perception of health condition, acceptability of medical and nursery care. The interview was anonymous and carried out by nursery students of third year. The 52% of the sample expressed that his health level was "excellent" or "good" and it was worse when the educational level was lower and the age was higher. The group of workers showed the highest valuation of health condition. The levels of trust on the doctor, the time of dedication and the information given to the patient reach slightly lower values than the ones found in literature; personal treatment and interest towards the patient have been valued the best. Center space structure and timetable have been the most penalized variables. We conclude that there is a need of improving the nursery service care a need of the information, from all the professionals working in the center, given to the patients on their problems, which are the cause of their going to the health consult, and the need of enlarging the space of the center.


[The evaluation of the effects of ambient noise on the residents of the historic center of Valencia].

The acoustic contamination in residential areas is a generalized problem to solve it, it is necessary to have an available precise information about its magnitude and effects upon the population. We show the first results of a study on the acoustic contamination in the historical center of Valencia and about its effects upon that district residents. A noise map has been made measuring the daily sound level in 135 points regularly distributed. At the same time, 418 telephone polls among the residents in that district has been carried out. The noise levels, existing in the studied zone, are very high, it has been obtained an average equivalent sound level (Leq) of 71.6 decibels A (dBA). About a 60% of the surveyed persons declare to be "troubled", because of the noise and one out of four surveyed persons find it difficult to get to sleep for the same reason. Road traffic is the main source of trouble. There has been observed a relation between certain personal characteristics in the surveyed persons and the answers obtained, although it does not reach an statistical significance. In the historical center of Valencia, there exists an important problem of environmental noise and the daily levels exceed clearly the recommended limits. It seems that traffic is the main source of noise probably combined with a deficient urban structure which does not allow a fluid vehicular traffic. The residents in this zone are aware of the problem and a great proportion of them declare to be damaged in a greater or smaller magnitude. Although the sensitivity to noise could be in relation with certain personal factors in the surveyed persons.


[The spread of human immunodeficiency virus infection (HIV-1/HIV-2) and of hepatitis B and C in non-drug-addicted prostitutes. Extremadura].

The proportion of cases of AIDS in Extremadura, in which sexual transmission has existed, is comparatively lower than the national one. The possibilities of the infection introduction in the general population may increase the relative importance of this way of transmission in the future. Penetration of HIV is unknown in prostitutes living and working in the Autonomous Community of Extremadura, as a collective associated to virus sexual transmission and to other socio-cultural risk factors involved. Women exercising prostitution are established as "target" population; the existence of intravenous drug addiction in the last 5 years is the criterion for exclusion, the sample comes from 11 nodal populations of Extremadura, and is constituted by 95 persons, selected in their own working places and having previously obtained their informed consent. The city American bar, 37.9%, the prostitution house 32.6%, and the road American bar are the most frequent kinds of prostitution. Besides the socio-sanitary poll, infections by HIV-1, HIV-2, Hepatitis B,C, virus, associated to certain risk practices are investigated. The prevalence of infection by HIV-1 is 1.05% with confidence intervals of 0 and 3%; no seropositivity to HIV-2 was detected. In forty-two out of the women surveyed, 44, 21% show some positive marker of the hepatitis-B (HBV) (C.I. 95% 34.1-54.2). Antibodies to the Hepatitis C virus (Anti-HCV) are present in three women, 3.16% (C.I. 95% 0-6%). Among the risk practices studied, it stands out that 44% use condoms in their relations with clients and only in 2.54% because of clients demand. In unremunerated couples, between 50 and 70% never use preservatives in sexual relations. These results suggest that infections by HIV-1/HIV-2 are not prevalent in non drug-users prostitutes in Extremadura. Likewise, the low use of preservative, in professional relations as well as in couples, is significative; and it stands out the high frequency of refusal to use preservatives by clients or partners. It is considered necessary to increase health education of these collectives and general heterosexual population, in order to change attitudes in private or professional sexual relations.


[An epidemiological study of congenital dyschromatopsias in schoolchildren].

Taking into consideration that present-day communication is based on colours and shapes, the prevalence of anomalies in the chromatic sight in the red-green axis has been studied in the school boys of the city of Albacete. The test of Ishihara has been used in an aleatory representative sample; and dyschromatopsic pupils, so classified in this test, have been further explored with the anomaloscopy Pickford-Nicolson, in order to know their anomaly kind and degree. The prevalence obtained is similar to those reported by other studies carried out in the European white race. Taking into account the transcendence of this phenomenon, we consider that this exploration must be included in the systematic examinations at school labour and general level.


[The prevalence of enteropathogens in urban day nurseries].

Survey on the intestinal pathogens prevalence in a population of preschool children attending to the urban day-nurseries. Samples of faeces of 408 children and 31 adults, in their charge, were collected. The children were classified per sex, age and kind of day-nursery they were to; data on their physical condition and the faeces characteristics were obtained. Parasites were the enteropathogens, found with the greatest frequency (21% of children and 19% of adults), next were rotavirus (3% of the children's samples and only one case in adults). The cases of a double parasitization only were 0.74% of the total number of the children surveyed (3 children per each case). The highest prevalence of enteropathogens in children attending to the urban day-nurseries in our community belongs to the group of parasites; rotavirus are a much smaller group and bacterium are only isolated cases.


Stability and reconstitution of D-glyceraldehyde-3-phosphate dehydrogenase from the hyperthermophilic eubacterium Thermotoga maritima.

The molecular basis of thermal stability of globular proteins is a highly significant yet unsolved problem. The most promising approach to its solution is the investigation of the structure-function relationship of homologous enzymes from mesophilic and thermophilic sources. In this context, D-glyceraldehyde-3-phosphate dehydrogenase has been the most extensively studied model system. In the present study, the most thermostable homolog isolated so far is described with special emphasis on the stability of the enzyme under varying solvent conditions. D-Glyceraldehyde-3-phosphate dehydrogenase from the hyperthermophilic eubacterium Thermotoga maritima is an intrinsically thermostable enzyme with a thermal transition temperature around 110 degrees C. The amino acid sequence, electrophoresis, and sedimentation analysis prove the enzyme to be a homotetramer with a gross structure similar to its mesophilic counterparts. The enzyme in the absence and in the presence of its coenzyme, NAD+, exhibits no drastic structural differences except for a 3% change in sedimentation velocity reflecting slight alterations in the quaternary structure of the enzyme. At low temperature, in the absence of denaturants, neither "cold denaturation" nor subunit dissociation are detectable. Guanidinium chloride and pH-dependent deactivation precede the decrease in fluorescence emission and ellipticity, suggesting a complex denaturation mechanism. An up to 3-fold activation of the enzyme at low guanidinium concentration may be interpreted in terms of a compensation of the tight packing of the thermophilic enzyme at low temperature. Under destabilizing conditions, e.g. moderate concentrations of chaotropic agents, low temperature favors denaturation. The effect becomes important in reconstitution experiments after preceding guanidinium denaturation; the reactivation yield at low temperature drops to zero, whereas between 35 and 80 degrees C reactivation exceeds 80%. Shifting the temperature from approximately 0 degrees C to greater than or equal to 30 degrees C releases a trapped tetrameric intermediate in a fast reaction. Concentration-dependent reactivation experiments prove renaturation of the enzyme to involve consecutive folding and association steps. Reconstitution at room temperature yields the native protein, in spite of the fact that the temperature of the processes in vitro and in vivo differ by more than 60 degrees C.


[Waste water management in a health area: environmental hygiene in primary care].

Within the scope of the programmes to be developed by the primary health care parties, we consider it interesting to investigate the sewage management in our health area because of its impact on the population health and welfare and the main socioeconomic local activities: agriculture and tourism. We carry out an epidemiological descriptive study: we review the most important structural and functional characteristics of the sewage depuration and collection in the municipality of S. Javier (Murcia). The evaluation of the collected data made it obvious that deficiencies exist in the collection system as well as in the sewage processing; both deficiencies were shown in some places of the locality and in particular periods of the year, with a consequent risk of environmental contamination and enteric diseases transmission among population and summer holidaymakers. A positive corrective action on the installations by the organisms responsible for the local sanitation as a response to these conclusions, which we informed due time, constitutes a good stimulant to go on investigating this question of such a great sanitary and general interest, which is almost unknown in medical literature.


[Environmental sanitation and typhoid-paratyphoid infection morbidity in Valencia].

We intend to study the evolution of morbidity by typhoid-paratyphoid infections (TPI) in Spain and Valencia (1940-1990) as well as TPI morbidity and degree of sanitation in Valencia. Data related to morbidity, as well as the sanitation basic data in Valencia, have been obtained from official sources. Morbidity rates belonging to Spain and Valencia have been calculated. It is found a decreasing trend of morbidity in Spain and Valencia. By Health Areas, a great decrease stands out in Valencia-City and, as a general rule, the highest rates belonged to the lowest automatic chlorination percentages. In general, there is an improvement in chlorination, sewers and sewage-depuration equipment. TPI morbidity in Spain shows a decreasing trend in both cases; it is more evident in Valencia when establishing a relation of TPI morbidity with the degree of hygiene by Health Areas of Valencia, an inverse relation appears and the highest rates belong to the interior Areas. The conclusion is that there is a remarkable improvement in the hygiene general situation in Valencia; in the city as well as in all the Health Areas.


[A microbiological and physicochemical analysis of the water in swimming pools on the island of Tenerife].

A microbiological and physiochemical analysis has been made from 60 samples of water from two swimming pools in Santa Cruz de Tenerife in order to know the hygienic condition and to establish the most adequate microbiological indicators. The water of the two swimming pools has a different origin: sea water (Swimming pool B) and public supply (Swimming pool A), and so, different processings are used. The analytical methodology was based on the Spanish current day regulations for the control of drinkable waters for public use, as well as on the methods the American Public Health Association recommends. There have been found differences between one swimming pool and the other, depending basically on the water characteristics and the processings used to treat it; there exists a greater microbiological contamination in the samples from the swimming pool B. It has been proved that medium R2A is better than medium P.C.A. to recount total mesophilic aerobes in both swimming pools. The isolation of St. aureus species in samples from the swimming pool B makes of it a possible microbiological indicator for the hygienic control of swimming pool waters of marine origin. Likewise, the presence of mycobacterium species in samples of the swimming pool A confirms its resistance to concentrations of growth inhibitors of free chlorine.


[The tobacco habit among fishermen of the Barbate coast (Cádiz)].

Nowadays, in scientific spheres, it is unquestionable that tobacco damages health. We study the introduction of tobacco habit among inshore fishermen of Barbate (Cádiz), for we consider that this is a highly receptive population to tobacco use because of hard work and its low socio-cultural level. A transversal descriptive study is carried out in order to determine the prevalence of tobacco use in this population. With this purpose, a questionnaire of 26 variables (epidemiological, sociodemographic and related to tobacco use) has been elaborated; 207 fishermen, equal to 10.35% of the whole inshore fishing fleet of Barbate, have been surveyed. The mean age of the sample is 39.9 years, with distribution per age groups from 16 to 65 years. The result of the survey carried out is an smoker percentage of 81.15% among the fishermen of the inshore fishing fleet of Barbate. It is obvious that this population has an important deeply rooted tobacco habit. Anyway, our results are similar to those obtained by other Spanish authors when they study tobacco habit in fishermen.


Short-term strenuous exercise training: effects on blood pressure and hormonal levels in mild hypertension.

The effect of a six-week strenuous exercise training programme (modified Bruce protocol, treadmill, three times per week) on resting and exercising blood pressure, heart rate, plasma catecholamines, chromogranin A, renin activity and aldosterone levels was investigated in 15 patients with mild hypertension. An identical exercise test was conducted at baseline and study close (six weeks). At follow-up, seven to ten days after study close, patients completed an exercise test of equivalent intensity to that at baseline, achieving comparable heart rate levels at maximal exercise. On each occasion, blood pressure, heart rate and hormonal variables were measured at rest (supine), maximal exercise and ten minutes after stopping exercise. Resting and exercising blood pressure and heart rate were reduced by the six-week exercise regimen. There was a trend, although not statistically significant, for resting plasma noradrenaline levels to be lower at study close. The reduction in blood pressure and heart rate at maximal exercise was associated with a significant attenuation of the plasma renin response to exercise. Plasma catecholamines also appeared to be lower after exercise training, although this effect was not statistically significant. Plasma levels of chromogranin A and aldosterone measured at rest and maximal exercise were not influenced by the exercise regimen. Further controlled studies are required to corroborate the results of this preliminary study.


Boerhaave's syndrome as a complication of pre-existent gastrointestinal disease.

Two cases of Boerhaave's Syndrome complicating vomiting of gastrointestinal obstruction are described. The successful management of each case is recounted and certain pitfalls noted. This association has received scant attention in the extensive literature on Boerhaave's Syndrome. We were not able to find a previous report of successful management of this dual pathology. Nevertheless, the location of two such cases at a District General Hospital within a decade suggests that it may not be exceptionally rare. We review the literature pertaining to the association of Boerhaave's Syndrome with pre-existent gastrointestinal disease. The suggestion is made that the possibility of a second surgical condition should be borne in mind when treating patients with this syndrome. We stress that the presence of symptoms due to pre-existent upper gastrointestinal disease may contribute to diagnostic delay in the recognition of Boerhaave's Syndrome.


Spinal epidermoid cyst and cauda equina syndrome in a teenage girl.

A sixteen year old girl presented with a four year history of hip pain followed subsequently by back pain radiating down her left leg, progressive urgency of micturition, urinary incontinence, a feeling of bladder fullness and incomplete bladder emptying, faecal impaction and finally, numbness in both of her buttocks. A diagnosis of Cauda Equina Syndrome was suspected on the history and the clinical examination. A plain X-ray of her lumbar spine revealed evidence of a slow growing mass within the vertebral canal at the level of L3. A Magnetic Resonance Imaging (MRI) scan confirmed an intradural space occupying lesion at the same level. This lesion was surgically removed and histological examination revealed a benign epidermoid cyst.


[The prevalence of headaches in a university population].

We have been interested in the prevalence of cephalalgias in a population of university students, as well as its intensity, frequency and duration parameters. A group of 490 adult persons, students in the university of Murcia, was put to a questionnaire prepared for this purpose in which they were asked about the presence or absence of cephalalgia episodes during the last 12 months, as well as about their intensity, frequency and duration. They were also asked whether they knew about their headache cause or diagnosis. Results show a characteristic profile 91.9% of persons declare to have suffered from migraines during the last year. Out of them, 40.5% with a minimum frequency of one episode per week with a perceived intermediate intensity of (43.2%) and a duration of 1 to 4 hours (59.7%). Furthermore, statistically significant differences were found in relation with sex: women suffered from more frequent lasting migraines than men; on the contrary, no differences were found between sexes in relation with headache intensity. It is also noticed that 89.65% of persons do not know about the diagnosis or etiology of his trouble. Data make evident the high prevalence of headache in University students; This justifies, in our opinion, the implementation of programmes of evaluation dealing with this problem in University students populations.


Hepatic haemangiosarcoma in a patient with psoriasis and Crohn's disease.

Hepatic haemangiosarcoma is a rare condition although there are known carcinogens in 25%. This case reports hepatic haemangiosarcoma in a 59 year old man with psoriasis and Crohn's disease who had previously received combined treatment with psoralen and UVA light.


Cheilectomy for hallux rigidus.

Cheilectomy is the excision of an irregular osseous rim that interferes with joint motion. Twenty cases of hallux rigidus/limitus treated by cheilectomy have been reviewed 18 months after surgery. A satisfactory outcome was achieved in all but 2 cases, which were failures. Range of joint motion, in particular dorsi flexion, improved in all but 6 cases. Cheilectomy is a simple and effective alternative to arthrodesis in the treatment of hallux rigidus.


TSH as an index of L-thyroxine replacement and suppression therapy.

When hypothalamic-pituitary function is normal, serum TSH levels measured by ultrasensitive assay yield bioassays of endogenous thyroid action and thus provide an ideal index of thyroid secretion and its relationship to fluctuating endogenous thyroid levels. It is theoretically possible that patients receiving exogenous L-thyroxine for primary hypothyroidism should have suppressed TSH levels if physiological needs are constantly met. To examine this possibility free thyroxine, FT4 and TSH were measured in 90 clinically euthyroid patients receiving treatment with L-thyroxine for primary hypothyroidism. TSH levels were normal in 44, suppressed in 16 and elevated in 30 patients. FT4 levels were normal in 68, elevated in 13 and suppressed in 9 patients. Normal TSH levels were associated with normal FT4 levels in 79.5% of patients, elevated FT4 levels in 13.6% and low FT4 in 6.8%. Suppressed TSH levels were associated with elevated FT4 levels in 37.5% of patients and normal FT4 levels in 62.5%. When FT4 levels were normal, however, TSH levels were normal in only 51.5% and abnormal in 48.5%. We also examined the possibility that FT4 levels may remain within normal range when TSH is suppressed during L-thyroxine treatment for goitre or cancer. FT4 and TSH were measured in 45 patients on L-thyroxine as TSH suppression treatment. TSH was suppressed in 23 patients (51.1%), normal in 20 (44.4%) and elevated in 2 (4.5%). When TSH was suppressed, FT4 was elevated in 30.4% but normal in 69.6% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)


[Promotion of infant health. Experiences in a rural health center].

The evaluation of the feeding changes in the first months of life is used to estimate the achievement of more healthy practices, after a year of developing the infant health surveillance programme. A retrospective study was carried out in a unit of Pediatrics of a Primary Health Center.... The clinical histories of children, born between 1-4-90 and 30-9-90 (group I, n = 55) and those of the children born between 1-4-89 and 30-9-89 (group II, n = 41) were reviewed. The evaluation ended the 30-3-91. Neonatal hospital morbidity, socio-familiar data, and the feeding practices during the first six months of life were studied. The mothers, who were 20 years or less at delivery, were 12 in the group I, and 2 in the group II. The proportion of housekeepers was near the 70% in both groups. Breast-feeding during the first month of life is 85,45% in group I and 53,66% in group II (p < 0.001). Increase of adolescent mothers and SO, higher number of children with possible psycho-social and health risks. Suitable social conditions for maternal participation in the activities of the Infant Health surveillance Programme. Health education is the most adequate method to establish a more healthy relation between mother and child.


[Screening methods in mental disorders of children and adolescents in primary health care].

A revision of the principal studies of prevalence of mental disorders in childhood is made. We present a bibliographic research about screening instruments for mental disorders in children and adolescents comparing the child behaviour scales checklists most usually employed in epidemiological surveys.


[Evaluation of a project of primary prevention of smoking: the Barcelona PASE project].

The results of the short-term evaluation of a program to prevent the use of tobacco and other substances among schoolchildren of sixth and seventh grade are presented. Schoolchildren who participated in the project show significant differences when compared to a reference group through a matched analysis in the regular use of tobacco and having bought tobacco, but not in the experimentation nor in the intention to smoke. The results suggest the program is useful to prevent the onset of smoking, although longer term evaluation data are needed. The results and their implications for a comprehensive smoking prevention approach in schools are discussed.


[Immunogenicity of the vaccine against hepatitis B virus in schoolchildren of Madrid].

We carried out a vaccine program against Hepatitis B in scholar population aged 5 to 17 educated in 3 institutions of Madrid city/ region. Those children who followed the vaccination criteria (negative HBsAg and Anti HBc markers) were vaccinated. The vaccination regimen (Engerix B recombinant DNA vaccine) was 0-1-6 months and dose was 10 and 20 ug i.m. for those aged 6 to 13 and 13 to 17 respectively. The postvaccine serologic results (anti-HBs titer) was evaluated one month after tha last dose, at 7th month from the beginning. The variables of study were age and sex for each individual. Corresponding to these variables both seroconversion rate (percentage of patients with 10 Ul/l of-anti-HBs) and the geometric mean titer of antibodies (GMT anti-HBs titer) were determined. The overall seroconversion rate at 7th month was 99%. There is not significant association neither regarding the sex nor mean age between "responders" and "no responders". The titer of anti-HBs antibodies, expressed using the G.M.T., which was reached at 7th month was 9.283.2 UI/I. Finally, there is not correlation between age and anti-HBs antibody titer.


[Evolution of adolescent fertility and its association with evolution of income in the Spanish provinces during the period 1975-1985].

Fertility rates in women under 21, during the period 1975-1985 in Spain, have analyzed, as well as their association with the evolution of the socioeconomic indicators in order to study the distribution and associated factors to adolescent maternity in our environment. The fertility rates have been elaborated from the Official Demographic Statistics. The socioeconomic indicators have been obtained from the Statistics Year Book of the National Institute of Statistics and from other complementary sources. The method of weighted linear regression has been used to analyze the association between the indicators and the rates at the provincial level. The fertility rates have decreased a 16% in mothers from 15 to 19 years old in Spain, between 1975 and 1985. The highest accumulated rates belong to the Communities of Canarias (42.8 births by 1000 women of 15 to 19, Galicia (38.1) Murcia (33.7) and Andalucía (30.3). In the regression analysis, the income evolution shows an association with the fertility evolution in the group from 15 to 19 years old, and this association remains when we take into account unemployment, index of provincial development and birth rate, which allows to explain a 49% of the variance. Fertility of adolescent under 15 is only associated with the income evolution, with a determination coefficient of 0.29. Results indicate that early maternity has decreased in Spain, although there are geographical differences, which cam, in some measure, be related with social-economic factors.


[Implementing secondary poliomyelitis vaccination].

Revaccination is necessary also in poliomyelitis immunisation. Recommendations concerning type and frequency of vaccination vary. According to the results of an investigation in vaccinating patients 10-20 years after the last oral vaccination life vaccine can be administered for revaccination. After more than 20 years patients are seronegative. Therefore, a new basal immunisation is necessary after prevaccination with inactivated vaccine.


[Smoking in a mining enterprise in Asturias: habits and knowledge].

Tobacco is the first avoidable cause of mortality and morbidity in the developed countries. A survey on the tobacco habit was carried out in a mining firm of 1420 workmen. The target was to quantify the severity of this problem, to carry out an information campaign and to provide help with nicotine chewing gam and psychological support. A 63% were usual smokers; a 20.1% were nonsmokers; and a 16.8% were former smokers. The group of smokers had a smaller knowledge on the risks of tobacco than the other two groups. Only a 1% of smokers went to the audio-visual information meetings in their respective localities and to the antismoking consulting of our hospital. An informative programme on "Tobacco and Health" was sent to all them.


Comparison between enalapril and lisinopril in mild-moderate hypertension: a comprehensive model for evaluation of drug efficacy.

The objective of this study was to compare enalapril with lisinopril in terms of blood pressure control at rest, during dynamic exercise test, during isometric exercise test, and during 24 h--with special focus on blood pressure control during the morning hours, 18-24 h post-dose. Furthermore, we compared ACE activity in serum before and after 4 weeks of drug treatment. A four-week double-blind, randomized parallel group study compared enalapril 20 mg o.d. with lisinopril 20 mg o.d. preceded by a 4-week single blind run-in period on placebo. Fifty-eight patients (49 males and 9 females, mean age 50.9) were recruited and 56 completed the study. Blood pressures at randomization were 161/108 and 164/106 for the enalapril and the lisinopril subjects, respectively. Echo: LVPWd 9.5 (normal range 6-12 mm) and IVSd 10.3 mm (normal range 6-12 mm). ANCOVA. Enalapril and lisinopril were equally effective in lowering blood pressure at rest, during dynamic and isometric exercise as well as during 24 h. The attained blood pressure levels during the early morning hours were for enalapril treatment 119/76 and 121/76 mmHg for lisinopril treatment. The ACE activity in serum 24 h post-dose was lower (p < 0.001) after treatment with lisinopril 8.0 (SD 3.3) mumol/min/1 than with enalapril 16.1 (SD 6.0). The corresponding values for placebo were 18.8 (SD 4.6) and 17.8 (SD 5.7). No difference was found in blood pressure lowering efficacy between enalapril and lisinopril even though the blood pressure changes were evaluated in a more comprehensive way than in earlier studies of these drugs.(ABSTRACT TRUNCATED AT 250 WORDS)


[Measles outbreak in Tormaleo (Asturias)].

We have studied a measles outbreak in the town of Tormaleo. The number of cases went beyond all the expectations and tendencies of the disease in the area. As a great proportion of the cases were older children, we thought it appropriate to inquire into it, as well as to evaluate the vaccine effectiveness. The research was carried out retrospectively, at the end of the epidemic, in a cohort retrospective study. The children who had not suffered the disease or had not been vaccinated were considered as the group at risk, with no immunological protection, and the vaccinated ones as the protected immunized group. It is assumed that practically the whole collectivity gets into contact with the virus in a measles epidemic. The affected population consisted of 92 children: 41 males and 51 females. A total sum of 36 cases of measles was clinically diagnosed: 13 boys and 23 girls. The highest incidence came from the age group of 12, 13 and 14 years old. The different measures of frequency, epidemiological risk parameters and global effectiveness of the vaccine were calculated. The incidence, among the nonvaccinated ones, was 84%, and 15% among the vaccinated ones with a global effectiveness of the vaccine of 82%. The effectiveness of the vaccine is similar to the one found in other studies. The risk of suffering. The disease for non-vaccinated people is extremely high.


Inhibition of endothelin (ET-1) induced pressor responses by the endothelin (ETA) receptor antagonist FR139317 in the pithed rat.

The effects of the novel ETA receptor antagonist, FR 139317, on ET-1 induced blood pressure changes were studied in the pithed Sprague-Dawley rat. FR139317 in a dose of 0.025 mg/kg b.w. had no effect while 0.05-1 mg/kg b.w. dose dependently inhibited the pressor response to an i.v. bolus injection of ET6-1 (800 pmoles/kg). While FR139317 potently inhibited the magnitide and duration of the ET-1 induced pressor response, the ETA antagonist did not significantly influence the shortlasting initial depressor response. We conclude that FR139317 in the pithed rat potently inhibits ET-1 mediated pressor responses and that this agent may become a significant tool to elucidate the putative physiological and pathophysiological role of ETA receptor mediated responses.


Prospective randomized open blinded end-point (PROBE) study. A novel design for intervention trials. Prospective Randomized Open Blinded End-Point.

A novel design for intervention studies is presented, the so called PROBE study (Prospective Randomized Open, Blinded End-point). This design is compared to the classical double-blind design. Among the advantages of the PROBE design are lower cost and greater similarity to standard clinical practice, which should make the results more easily applicable in routine medical care. Since end-points are evaluated by a blinded end-point committee it is obvious that there should be no difference between the two types of trials in this regard.


Pathologic hypertrophy with fibrosis: the structural basis for myocardial failure.

The major risk factor associated with the appearance of adverse cardiovascular events and outcome attributable to cardiovascular disease is left ventricular hypertrophy (LVH). Why this should be so resides not in the increase in myocardial mass per se, but in the disruption of myocardial structure. An abnormal accumulation of fibrillar collagen within the adventitia of intramyocardial coronary arteries and neighboring interstitial spaces represents such a distortion in structure. Furthermore, this fibrosis disrupts the electrical and mechanical behavior of the hypertrophied myocardium. Mechanisms responsible for fibrillar collagen accumulation have been examined in intact animals and cultured cardiac fibroblasts. In vivo studies indicate that myocardial fibrosis is associated with the presence of chronic mineralocorticoid excess, relative to sodium intake and excretion, not hemodynamic workload. Accordingly, fibrosis can appear in both the hypertensive, hypertrophied and nonhypertensive, nonhypertrophied ventricles. In both primary and secondary hyperaldosteronism it was possible to prevent myocardial fibrosis with an aldosterone receptor antagonist, while in unilateral renal ischemia angiotensin converting enzyme (ACE) inhibition was similarly cardioprotective. A regression in fibrous tissue and normalization of diastolic stiffness has also been possible using ACE inhibition, bringing forward the concept of cardioreparation and the notion that heart failure due to fibrosis may be reversible. In vitro studies indicate that effector hormones of the renin-angiotensin-aldosterone system stimulate fibroblast collagen synthesis. Aldosterone, in pathophysiologic concentrations, and angiotensin II, in much larger concentrations, each enhance collagen synthesis without altering the mitogenic potential of these cells. Thus, elevations in circulating aldosterone and angiotensin II, relative to sodium intake, have the potential to not only alter sodium homeostasis and vascular tonicity, but also the structure of cardiovascular tissue. Thus, myocardial fibrosis represents a structural basis for pathologic hypertrophy and ultimately accounts for the appearance of adverse cardiovascular events and outcomes.


Enhanced blood pressure response to mineralocorticoid stimulation in normotensive members of hypertensive families.

Currently normotensive offspring of essential hypertensive parents often have disturbances in blood pressure (BP) regulation such as abnormalities in electrolyte homoeostasis, increased salt-sensitivity and/or impaired renal Na(+)-excretion. Whether an altered reactivity to mineralocorticoids may also play a role is presently unknown. Therefore, we investigated BP (recorded during 24 h), plasma atrial natriuretic factor (ANF), cyclic guanosine monophosphate (cGMP), aldosterone (PA) and renin activity (PRA), 24-h urine electrolyte and cGMP excretions measured on 4 consecutive days, as well as other variables, after 1 week on placebo and after 3 weeks of 9 alpha-fludrocortisone-acetate (9 alpha F) administration, 0.6 mg/d in 12 normotensive sons of essential hypertensive parents (SEH) and 12 body-mass-index- and age-matched (25 +/- 1[+/-SEM]yr) sons of normotensive parents (SN). On placebo, the 2 groups did not differ significantly in average 24 h BP (mean BP 95 +/- 2 vs 95 +/- 2 mmHg), plasma-ANF (40 +/- 7 vs 30 +5 pg/ml), cGMP (6 +/- 0.4 vs 6 +/- 0.5 nmol/l), PRA (1.3 +/- 0.1 vs 1.6 +/- 0.2 ng/ml/h), PA (9 +/- 0.5 vs 10 +/- 0.9 ng/dl), hematocrit (44 +/- 0.7 vs 44 +/- 0.4%) and 96-h urinary-Na+ (mean 205 +/- 13 vs 195 +/- 16 mmol/d), -K+ (69 +/- 6 vs 78 +/- 7 mmol/d) or -cGMP (461 +/- 35 vs 483 +/- 32 nmol/d). 9 alpha F significantly increased BP in SEH (p < 0.005) but not SN (107 +/- 2 vs 100 +/- 2 mmHg, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)


Metabolic effects of pindolol and propranolol in a double-blind cross-over study in hypertensive patients.

Metabolic effects of pindolol and propranolol were investigated in a randomised study of double-blind, double-dummy design in 39 Caucasians with newly detected hypertension. Each active treatment period was 6 months long. A euglycaemic hyperinsulinaemic clamp test was done to measure insulin sensitivity, and i.v. glucose tolerance was investigated with insulin determinations. Lipoprotein concentrations were quantified and lipoprotein lipase activities were determined in muscle and adipose tissue and in plasma after heparin injection. The blood pressure was significantly reduced by both regimes. The insulin sensitivity index was decreased by 34% during propranolol treatment and by 17% during pindolol treatment. The insulin concentrations in plasma were elevated at the end of the i.v. glucose tolerance test but were not high enough to compensate for the insulin resistance, so HbA1c and glucose concentrations were increased. A significant reduction of lipoprotein lipase activity in skeletal muscle during propranolol treatment probably explains the pronounced increase in serum triglyceride concentration during propranolol treatment despite lower free fatty acids and higher lipoprotein lipase activity in adipose tissue. These changes of lipoprotein lipase activity were not correlated to the changes in insulin sensitivity. In summary, the metabolic effects were significantly less pronounced with pindolol than with propranolol, which probably can be ascribed to the agonistic effect of pindolol on beta 2 adrenoceptors.


[Anticardiolipin antibodies--detection and diagnostic value].

Anticardiolipin antibodies belong to a family of antibodies to phospholid and are important in pathogenesis of some diseases. Statistically significant high titer of circulating anticardiolipin antibodies were found in SLE patients, thromboembolic events, thrombocytopenia and recurrent fetal loss. We tested 53 sera of SLE patients to anticardiolipin antibodies by own modification of ELISA. Only two sera were positive, one of them was associated with recurrent fetal loss and disease. The incidence of anticardiolipin antibodies in we have found no correlation with the activity of to those reported in other studies. Our tested sera (4%) was much lower in comparison.


[Agglutinins in the diagnosis of pertussis].

The performed investigation showed that the results of agglutination test in diagnostics must be explained with reserve as a supplement to the clinical picture and the other laboratory findings. Titre must be followed at least for 20 days on many blood samples. The more reliable diagnosis according to agglutination test can be given only if we know in question is a nonimmunized child and titre is > or = 1:80. The negative and lower titres cannot exclude or confirm the disease.


[The complement activation system in acute poststreptococcal glomerulonephritis].

The activation of the complement system is very important part of the immunologic process. Measuring levels of products of complement activation is a useful diagnostic and prognostic procedure. This report presents the results of a follow-up of 54 children with acute poststreptococcal glomerulonephritis. At the beginning of the disease, all patients (i. e. 100%) had decreased levels of C3 component of the complement system, and 72.2% patients had decreased levels of the haemolytic complement. The mean value of the control measurements increased significantly from one measurement to another (with p < 0.01, and within 6 weeks after the beginning of the disease, it reached the normal range. According to our results, the activation of the complement system was induced by the classical pathway. We cannot explain why the component C4 did not take part in it. According to the results of the haemolytic assay, the alternative pathway of activation was used too. We found that there was a correlation between improvement of clinical features and decrease of metabolisation of complement components.


[Morphologic changes in the lung and liver parenchyma in pregnant female rats treated with petroleum and trichloroethylene].

Light and heavy petrols influence as well, as that of trichloroethylene on morphological changes in the hepar and lungs of gravid Wistar females was investigated. It was found that inhalation of petrols and trichloroethylene in small concentrations caused degenerative changes in the hepar parenchyma, while there were no changes in the lungs.


[The significance of synergism between cervical infections and prostaglandins in inducing preinduction priming in the 3rd trimester of pregnancy].

The length of labour and foetal trauma could be significantly reduced by reduction of cervical resistance in the cause of labour. It is well known that the most effective way of priming is by prostaglandins. Microorganisms of cervico-vaginal flora, with or without inflammatory component, can produce factors which can create predisposition for preterm delivery. Namely, increased levels of prostaglandins E2 and F2 alpha could be noticed in amniotic fluids, compared with these levels in pregnant women without signs of infection. The study included 60 parturients with low Bishop score (less then 5), with average gestational age of 40.5 weeks. Group A: Prepidil gel with 0.5 mg of prostaglandin E2 was applied to cause priming. Group B: Half of doses of Prepidil gel (0.25 mg) was applied to the 30 patients with clinical signs and with positive laboratory findings of cervical infection. After 12 hours all patients were induced with oxytocin. All obstetrically important parameters were closely followed in the course of priming and induction. Presence of cervical infection could be beneficial, because priming can be produced with half of doses of prostaglandin, which means medical (reduction of side-effects and dangers of hyperstimulation) and significant economical benefits regarding the high price of prostaglandins.


[Antithrombin III in chronic renal insufficiency].

In a group of fourty eight patients with chronic renal failure and a group of twenty patients on chronic hemodialysis, we studied the biologic activity of Antithrombin III by using immunoelectrophoresis and coagulation methods. We found that increased values of biologic activity of Antithrombin III, were significant. This can be an additional factor in explaining the origin of bleeding in patients with chronic renal failure and uremia without nephrotic syndrome. The index of biologic activity of Antithrombin III was significantly decreased after giving heparin to the patients with chronic renal failure on hemodialysis. The obtained values were low and within the ranges found in patients suffering from thrombosis. This decrease in biologic activity of Antithrombin III, together with the well known increase in factors of hemostasis during hemodialysis, is an important cause of frequent thrombosis, which can be fatal for patients. In the same group, antigenic values of Antithrombin III measured before and after giving heparin, were not changed. These facts show the necessity of measuring the biologic activity of Antithrombin III because the quantity of Antithrombin III is not a reliable indicator of its functional validity.


[Rotaviruses--causes of minor epidemics of diarrheal diseases in the neonatal department of the Pediatric Clinic in Sarajevo].

A rotavirus epidemic took place at the above mentioned department (8. V 1987 until 19. VI 1987). During that period, 36 newborn infants were treated for rotaviral symptoms and they all had their stools checked for rotaviruses or their antigen. Rotaviruses were found by 17 patients (47.2%). As a lab method we used immunoelectrophoresis. 20 patient of the overall number of 36 were boys and 16 were girls. Stool samples showed rotaviruses in 9 boys (45%) and 8 girls (50%). The age of patients was 3 to 34 days. After 1-14 days all children were well.


[Microsurgical treatment of tubal factors in sterility].

In the period from 1982-1988, 164 patients were operated due to the tubal factor sterility. Indications for operations were based on HSG and laparoscopy. Microsurgical process was applied. 57 (34.75%) of 164 operated patients conceived. There were 41 (25.90%) intrauterine and 16 (9.14%) ectopic pregnancies. The most frequently pregnancies happened in the patients who had been treated by fimbroplasty and isolated adhesiolysis. The patients, who had been treated by salpingostomy terminalis and tubal implantation had lower pregnancy percentages.


[Rehabilitation approaches in patients after percutaneous lumbar discectomy].

The lumbar ache syndrome is more and more getting sign of a social disease because of its rate. Beside the conservative treatment very often the operative treatment is used too. Except the classical discectomy, a percutaneous lumbar discectomy had been used since the last year. In the work we gave the basic anatomical characteristics of the spiral column, stages of intervertebral disk dislocations and general characteristics of the acute ache syndrome. According to Aesculaps prospect we described the operating technique of percutaneous lumbar discectomy as well as the rehabilitation treatment of classical and percutaneous lumbar discectomy.


[Ergometry testing in the past and today].

Exercise testing on bicycle-ergometer or treadmill represents a simple and relatively cheap medical procedure. It may be managed in any level of medical evaluation and especially for discovering persons with low or high cardiac risk, beside the asymptomatic or symptomatic status during the testing. The cumulated experience gave the proof than the exercise testing is superior to coronarography and ventriculography. Test protocol and conclusions must be together with the recommendations of the cardiology association and the author gives some of his own remarks and practical recommends. In personal everyday practice someone can find improvements too.


[Hemorrhagic fever with renal syndrome--etiology].

HFRS was confirmed serologically in two patients, who were infected in the natural focus near Zupanja. Using the bigger number of virus antigens in indirect immunofluorescent antibody test, afterwards was proved the agent could be classified into the serotype 3 of Hantaviruses, and antigenically is identical with virus NE (strain Hällnäs), respectively Yugoslav isolate "Vranica". Serotype differentiation of the agent in patient who were infected in the area of Igman, near Sarajevo, has not been performed by the same test. There was assumed a possibility for circulation of "new", up to now non-identified, serovariant of Hantaviruses in this natural focus.


[Relation of epithelial metaplasia and calcification with epithelial proliferation in fibrocytic breast disease].

By semiserial microscopic investigation of the complete tissue of 65 surgical excised fibrocystic lesion of female breast we have found that there exist (a) the high frequency (58.5%) of the apocrine metaplastic epithelium, predominantly located in lobules and topographically widely distributed (mean 9 focuses on a sample), (b) the rare occurrence (3%) of lobular and ductal squamous metaplasia and (c) the high frequency (40%) of sparse (mean 3 focuses on a sample) lobular calcifications. Statistically, apocrine metaplasia and calcifications were significantly (p < 0.001 and p < 0.01) more frequent in the samples of proliferative fibrocystic lesions. The level of the positive spacial correlation (O = 0.512) of proliferative and apocrine metaplastic epithelial changes, as well as a common stratification and papillation of the apocrine epithelium indicate indirectly a possible influence of a steroid hormonal unbalance in the promotion of the apocrine epithelial metaplasia.


[A complicated foreign body in the esophagus--case report].

Our female patient B. V. 47 years old, by eating the fried pork tongue, got strangled. Immediately it was accompanied by a very intense, strong pain in the lower portion of the neck. Otorhynolaryngologists performed esophagoscopy the same day, but corpus alienum was not found. Three days later, the patient came in the hospital again, complaining to an intense pain in the lower portion of the neck, so that she could not eat anything for three days. Immediately after being accepted to the hospital was done Rtg of cervical spine and lungs, as well as Rtg of passing through esophagus which demonstrated a piece of metal wire 4 cm in length at the level of the second thoracic vertebra. The wire perforated the esophagus at both lateral sides. Alter removal of the wire, mediastinitis was treated medically.


[Chronic changes in the liver in our patients].

VHB infection together with alcohol ist the most important ethiologic factor in the genesis of chronic liver parenchyma damage in our sample. Selection of patients with chronic diseases of the liver should be done on the basis of hepatitis markers determination, that is on the presence of HBsAg and HBeAg and the activity of aminotransferases in blood. Doing this it can be seen that more that half of the patients with chronic liver damage do not need therapy, and they have work capacity preserved. In these cases occasional controls of hepatitis markers and the level of AT in blood are needed. Presence of the virus replication can be determined on the basis of presence of the HBeAg in blood and HBcAg in the hepatocyte nucleus (histologic assay), since HBV-DNA and HBV-DNA polymerases in blood are not determined in the day's routine. Biopsy and rebiopsy of the liver tissue (pathohistologic assay) is the only confident my to determine the degree of liver damage. Introducing of the unique criteria in the management of the patients who have the signs of chronic liver damage would lower the diagnosis and treatment costs, as well as the unnecessary patient's absence from work. Proceeding of the preventive measures, vaccination of the persons who are exposed to VHB infection, as well as the struggle against alcoholism, stay on as the main source in prevention of chronic liver damage genesis.


[Morphometric aspects of seminiferous tubules in rats treated with melatonin and whole body irradiation (stereologic analysis)].

The volume density of the seminiferous epithelium, lumen of tubules and the testis interstitium in the shampinealectomized adult Wistar rats was determined after melatonin treatment and whole-body irradiation with 8 Gy of gamma rays produced by 60 Co. The solvent was injected to the control group of animals. By the comparison of stereological results, it was shown that melatonin modifies the quantitative characteristics of seminiferous tubules reducing the effects of irradiation originally produced.


[Specifics in the treatment of epilepsy in children with mental retardation].

Authors discuss some specifics in treating epilepsies in children with mental retardation that have to be considered. First is the problem of precise diagnosis, because of certain phenomena in mentally retarded children, and a possibility of the so called pseudoretardation that can be caused by epileptic seizures or inadequate medication. A specific problem is vulnerability of these patients regarding antiepileptic drugs, especially phenytoin and phenobarbiton. Usage of psychopharmacs should be minimized and drugs interaction has to be considered permanently. A general trend in treatment should go towards increase in usage of carbamazepine and valproic acid, preferring monotherapy.


[Asymptomatic and manifest forms of listeriosis in neonates].

Pointed out has been a danger of listeria monocytogenes infections, which is most frequently transplacentally transmitted from the mother to the baby. In such cases, it results in early, septic forms with disseminated abscesses and granulomas in many organs. A case with a positive outcome has been described. Infection incited during delivery or soon after it results in late, meningitic form of listeriosis, which is characterized with a high mortality outcome. Such a case that resulted in death has also been described. Three children infected by listeria remained asymptomatic. Pointed out has been the inevitability of antibiotic treatment of such children, too, to prevent listeria from developing septic meningitic form. Imperative to prevent nosocomial listeria infections in obstetric wards, which is a reality, are strict measures of hygiene.


[Effects of nifuroxazide (Ercefuryl), trimethoprim-sulfamethoxazole and bactisubtil in acute diarrhea].

The clinical effects of Nifuroxasid (N), Trimetoprim sulphametoxasol (TS) and Bactisubtil (B) on bacillar dysentery and alimentary toxicoinfections in the patients treated at the Clinic from January 1984 to the end of December 1989 have been analysed. According to the clinical signs, patients have been divided in ten categories of light, mild and heavy forms. In total, 329 cases of bacillar dysentery and 89 cases of alimentary toxicoinfections have been analysed. The following was established: A. Bacilar dysentery: the fastest normalization of the stool was achieved with N in every clinical form (averages 2.2, 3.5 and 4.05 days). With TS the effects were slower (3.0, 3.9 and 4.4 days), but the slowest normalization was recorded with B (3.4, 4.6 and 5.4 days). However, with TS, some Shigella strains showed resistance (in 23 out of 94 antibiograms), which diminished the effects. B. Alimentary toxicoinfections were treated only with N and B, since these forms of diarrhea caused by toxigenic factors were milder. Better results were achieved with N in this case as well.


[Acute viral hepatitis--present status and perspectives].

Recent advances in epidemiology, virology, of clinical of hepatitis are presented in the paper. The authors pointed out that hepatitis A never becomes chronic. On the other hand, with hepatitis B or B and D, evolution to chronicity is possible. Two distinct forms of non-A non-B hepatitis are now distinguished: parenterally transmitted non-A non-B hepatitis, mainly due to hepatitis C virus; enterically transmitted non-A non-B hepatitis mainly due to hepatitis E virus. C virus hepatitis is characterized by a frequent course to chronic hepatitis, cirrhosis and hepatocellular carcinoma. Chronic forms are associated with the presence of anti-HC antibodies in the serum. These antibodies are rarely present in the acute stage of the disease. Hepatitis E is almost exclusively encountered in developing countries. Like with A virus hepatitis, chronicity never occurs. However, fulminant hepatitis is possible in pregnant women in the third trimester of pregnancy. There is no routine serological test. Development of vaccines against A, E and C viruses can be expected very soon. There is no specific treatment of acute viral hepatitis.


[Body weight loss with the aid of alginic acid].

The researchers were done in the Counselling Service for Nutrition of the Institute of Hygiene in Sarajevo. The voluntary group of researched persons was treated regarding the body weight. The corpulance was for about 25-30% (percent) higher than it was normal for the persons with their individual characteristics--sex, age, height and body constitution. The investigated persons were classified into two groups--the experimental group A, one to which besides diet the reduction the "Alginete" pills were given helping the (acceleration) process of weight reduction--losing weight. The controlling group was only an individual reduction diet. The way and the results of standing the diet were given in the work.


[Abuse of cannabis preparations].

The author reviews the basic features, nature of action and the effects of the canabis drugs (hashish and marijuana) on human organism. The review starts with the well known fact that these kinds of drugs are the oldest ones and the most widely known to the civilization. It reviews in details very wide effects of the canabis drugs on the mental functions as well as the clinical expression of that action, where the basic mechanisms dominate: euphorogenic, sedative and psychodelic. With a detailed description of all psychopathological phenomena that appear in the chronic hashish and marijuana addicts, where the amotivation syndrome and flash back are particularly pointed out.


[Evaluation of health legislation within the context of the goals and strategies for "Health for All by the Year 2000" in Bosnia and Herzegovina].

In this paper significant changes have been presented concerning to the health legislation of Bosnia and Herzegovina in the period from 1970 till today. These changes could have had an effect on the changes in the health system as well as in the health status of the population. This is all aimed at achieving strategy and targets for Health for All by the year 2000. Certain systematic solutions for achieving strategy and targets exist in the health legislation of Bosnia and Herzegovina (Law on health care the 1986), but they are set without clear content and holders of office. We could notice the absence of legislative support for resolving group of targets 13-17 and partially 32-38.


[Evaluation of citizen satisfaction with the organization of the primary health care system].

The state of organization and distribution of PHC networks in our Republic is not satisfactory. It is so mostly for the reason of absence of extramural PHC units in settlements, schools, and working collectives, i.e. unavailability of health care to the people and closeness of the health care system. A poll carried out among 1859 patients in the health centre waiting rooms in Bosnia and Herzegovina has shown that only 35.1% of the polled citizens--health care beneficiaries are satisfied with the work of doctors and nurses in PHC surgeries. The poll has also shown that about 65% of the patients of all age groups realize the health care protection only after long waiting and with some other difficulties. Then, 96% of the out-patients expressed their dissatisfaction with the organization of PHC, either owing to frequent changes of physicians, i.e. health personnel, or to inadequate working hours, waiting long etc. Only 6.5% of the polled patients said there were satisfied with the work of PHC service and did not ask for changes in the structure. The author in his paper quotes the principles on which a good PHC service should be based and proposes adequate measures for its promotion.


[Development of health care services in Bosnia-Herzegovina during the Ottoman empire].

Organized health service in Bosnia and Herzegovina practically started by the treatment of the sick in the Hadji Sinan's Tekke that was founded in 1768. Before that, the civilian population had been mainly treated in their homes, while the army were treated in barracks or hired hans (inns). As late as the nineteenth century, health care was provided by quack doctors, treating physicians or surgeons and barbers, who were trained, beside the circumcision of male children, for tooth extraction, broken bone setting, and sometimes even for performing minor surgical operations (a specially trained barber called djerah). The first trained medical personnel were the Franciscans and Jews, who studied at the Universities of Italy, Austria, Hungary etc. The first Muslim trained physicians studied at the Medical Faculty in Istanbul. The first ones were: Dr. Mehmed Serbić and Dr. Zarif Skender, while the first Bosnian graduate in pharmacy was Jakov Sumbul. In Sarajevo and Bosnia and Herzegovina worked many a doctor who came from abroad. The majority of them converted to Islam and worked in the barracks, and later on in the Turkish Military Hospital when it was founded in Sarajevo. All of them played an important role in the prevention and treatment of the most frequent mass infectious and non-infectious diseases that were raging among the population--plague, cholera, syphilis, leprosy, tuberculosis, fungoid diseases etc.


[Traditional medicine in the Cazinska region from 1790 to 1878].

The inhabitants of Mala Kladusa are mostly refugees from Cetingrad and Dreznik, and between 1790 and 1878 they had chances to cure more than 1200 wounded and a few thousand ill people in barber's shops in Gornja and Donja Baraka. Gornja and Donja Baraka are good places for hospital (barber's shop) because they are near the river Kladusnica, and in the wood. In barber's shop worked a barber who cured people and also prepared cures from local herbs. Also barber's wore bags with cures and medical instruments, and had duty to help people even if it was against law or patient was poor.


[Arterial aneurysms].

The author analysed etiology, morphology, localization, symptomatology, diagnostics and surgical methods of treatment in 63 patients with 81 arterial aneurysms. Arterial aneurysms are not rare in vascular pathology. Most of them are atherosclerotic etiology (62%). Abdominal aorta is the most frequent localization (49%). Symptomatology and clinical findings depend on the localization, size and complications. Echosonography, with clinical finding, has presented the most accurate diagnostic procedure. Surgery is the method of the treatment of such patients, but the optimal method is the aneurysmectomy or resection of aneurysm with arterial reconstruction.


[Urinary infections during pregnancy and methods of prevention].

Urinary tract infections in pregnant women develop owing to the short urethra in women, mechanical pressure of the uterus onto atonic urethra during pregnancy, atony of the urinary bladder caused by the level of progesterone, iatrogenic factors (catheterization), some metabolic disorders, anemia, obstipation etc. These are frequent reasons why pregnant women over the pregnancy period develop infections of urinary tract, where a significant number of them have bacteriuria showing no symptoms of acute infection whatsoever. The research covered unselectively 4,850 urine samples of pregnant women. The results obtained by classical methods--taking urinoculture and doing antibiogramme--have shown that in this sample there is a large number of asymptomatic bacteria (13%), which is complicated by an increased incidence of pyelonephritis gestoses in the second half of the pregnancy. In our sample, the commonest cause of urinary infections has been E. Coli, then the second trimester of risk gestation period; the risk group with regard to parity are primiparas, while the risk age is between 20 and 29.


[Significance of two-dimensional echocardiography in the diagnosis of mitral valve calcification--sensitivity and specificity].

The effect of two-dimensional echocardiography in assessment mitral valve calcifications was compared to computed tomography (CT) in 50 patients with pure rheumatic mitral stenosis (MS). Echocardiography revealed no mitral calcifications in 23 patients, respectively 46 per cent (grade 0). Twelve patients (24 per cent) had calcifications smaller than 2.5 mm (grade 1). Eleven (22 per cent) had moderate calcifications, smaller than one half of length of the anterior mitral leaflet (grade 2) and four (8 per cent) had calcifications larger than one half of the length of the anterior mitral leaflet (grade 3). The last two groups were thought to have clinically important calcifications. Specificity and sensitivity were examined in comparison to CT. By echocardiography, five (ten per cent) false positive findings were found in the group 2. There were neither false positive nor false negative findings in the last two group. The first group when compared with other three groups showed sensitivity of 100, specificity of 85, and predictive accuracy of 81 per cent. But the first two groups together compared with the last two groups showed sensitivity, specificity and predictive accuracy of 100 per cent.


Alignment, classification, and three-dimensional reconstruction of single particles embedded in ice.

Cryo-electron microscopy of single biological particles poses new challenges to digital image processing due to the low signal-to-noise ratio of the data. New tools have been devised to deal with important aspects of 3-D reconstruction following the random-conical data collection scheme: (a) a new shift-invariant function has been derived, which promises to facilitate alignment and classification of single particle projections; (b) a new method of orientation search is proposed, which makes it possible to relate random-conical data sets to one another prior to reconstruction; and (c) the foundation is laid for a 3-D variance estimation which utilizes the oversampling of 3-D angular space by projections in the random-conical reconstruction scheme.


Three-dimensional crystallographic reconstruction for atomic resolution.

Three-dimensional structures have recently been determined by electron crystallography at a resolution high enough to determine atomic arrangements in both protein and mineral specimens. The different nature of these two types of specimens produces some very significant differences in the way data is obtained and processed, although the principles are the same. The sensitivity of proteins to damage by the electron beam limits the signal-to-noise ratio in the image and the resolution to which data can be extracted from the image. A number of constraints, such as the amino acid sequence and the connectivity of atoms within amino acids, can be used in interpreting the limited image data. In materials samples, the relative insensitivity to damage allows obtaining resolution limited only by the microscope. In many samples, dynamical scattering and other non-linear effects limit the information in the image, but this limit can be circumvented by working in very thin areas of the specimen.


Confocal microscopy and three-dimensional reconstruction of thick, transparent, vital tissue.

The three-dimensional visualization of the 400 micron thick, transparent, in situ cornea is described to demonstrate the use of confocal light microscopy for noninvasive imaging of living cells and thick tissues in their normal, vital conditions. Specimen preparation and physiological stability, as well as light attenuation corrections are critical to data acquisition. The technique to provide mechanical stability of the specimen during the duration of the image acquisition is explained. A laser scanning confocal light microscope (LSCM) was used to obtain optical serial sections from rabbit eyes that were freshly removed and placed in a physiological Ringer's solution. This study demonstrates the capability of the confocal light microscope to obtain a series of high contrast images, with a depth resolution of one micron, across the full thickness of living, transparent tissue. The problems of nonisotropic sampling and the limited eight-bit dynamic range are discussed. The three-dimensional reconstructions were obtained by computer graphics using the volume visualization projection technique. The three-dimensional visualization of the cornea in the in situ eye is presented as an example of image understanding of thick, viable biological cells and tissues. Finally, the criterion of image fidelity is explained. The techniques of confocal light microscopy with its enhanced lateral and axial resolution, improved image contrast, and volume visualization provides microscopists with new techniques for the observation of vital cells and tissues, both in vivo and in vitro.


Early diagnosis of anaphylactic reactions to neuromuscular blocking drugs.

Neuromuscular blocking drugs (NMB) are involved in most of the anaphylactic reactions occurring during anaesthesia. Patients are evaluated usually 6 weeks after the reaction, by skin testing. In order to obtain an earlier diagnosis, we have measured plasma concentrations of histamine, tryptase and NMB-specific IgE antibodies in 14 patients after an anaphylactoid reaction. We have compared the results with those of skin tests and specific IgE obtained 8 weeks later. Good agreement was observed in all subjects between the results of skin tests and the values for histamine and tryptase, provided that both markers were measured simultaneously. Furthermore, there was no significant difference between the concentrations of NMB-specific IgE antibodies observed at the time of the reaction and 8 weeks later. Thus anaphylaxis to neuromuscular blocking drugs can be demonstrated at the time of the reaction by measuring plasma concentrations of histamine, tryptase and specific IgE. In the event of the patient's death, such measurements may be useful in identifying the likely cause.


Renal stone disease in the 1990s: the powder keg and tinderbox theory.

Abnormal dietary habits that lead to hypercalciuria, hyperoxaluria, hypereruricosuria, and hypocitraturia do not always result in nephrolithiasis. A concept is emerging according to which, to account for renal stone formation in the face of the aforementioned biochemical disorders, one must search for underlying conditions in patients with the disease. Work carried out over the past few years and reviewed herein definitely supports this idea and includes the following processes: 1) interleukin-1 production by monocytes to augment the impact of dietary hypercalciuria; 2) disturbed activation of pyridoxine to pyridoxal 5'-phosphate to aggravate dietary hyperoxaluria; 3) abnormal intestinal transport of citrate to aggravate dietary hypocitraturia; 4) molecular abnormalities of glycoprotein inhibitors to aggravate the promotive effect of the diet on urinary crystallization; and 5) renal tubular lesions to favor particle retention and stone formation. This article reviews the most recent literature and discusses the author's "powder keg and tinderbox" theory of idiopathic calcium stone disease.


[Associations among non-metric features of the atlas in the human species].

Six non-metrical variants has been studied in a series of 500 human atlases. A bipartition of the superior articular facet has been observed in 20.8% of cases, a posterior ponticulus in 14.2% of cases, a retrotransverse ponticulus in 14.2% of cases, an anterior dehiscence of the foramen tranversarium in 10.2% of cases, a dehiscence of the posterior arch in 2.8% of cases, and a lateral ponticulus in 1.8% of cases. Bilateral occurrence has been noted in 42.2 to 46.2% of cases for the anterior dehiscence of the foramen transversarium, the posterior ponticulus, and the bipartition of the superior articular facet. Bilateral occurrence is less frequent for the retrotransverse ponticulus (29.6%), and particularly for the lateral ponticulus (11.1%). The incidence of a given lateral character according to the side has been found identical or similar on the left and on the right sides. In the present series, 51.6% of the atlases showed none of the six variants studied; 46.8% of the atlases showed one or two variants; and only 1.6% of the atlases showed more than two variants; any cases with more than four variants were observed. The most interesting association observed is the association of the lateral ponticulus with the posterior ponticulus.


The floor of the fourth ventricle in the perinatal period in humans: new morphological findings.

The floor of the fourth ventricle is generally believed to show basically adult morphological characteristics in man by the perinatal period. This descriptive study and statistical analysis of 163 brainstems from human fetuses and neonates demonstrates that in this period, the floor of the fourth ventricle presents a series of folds and grooves of variable size and sequence, which during the perinatal period clearly increase the surface area of the germinal layer overlying them. These features are not seen in adults.


[Methods for the anthropologic and teleradiographic study of the pterygoid process].

The relationships of the external pterygoid plate with the other components of the craniofacial building has hardly been explored because of recording difficulties. A method to accurately identify in a reproducible way the main axis of the pterygoid process with the help of two small iron balls was contrasted with other methods seen in the literature. The iron balls technique was shown to be the method of choice with regard to biostatistical consistency.


[Relative growth of the human cerebellum: a quantitative estimate].

The relative growth of the cerebellum was studied in 300 human foetuses by using of the equation Y = bxk. The cerebellum weight was correlated to the cephalic perimeter and to the fetal weight. The relative growth of the cerebellum presented positive allometry (k = 3.3; k = 1.3 respectively). Masculine foetus presented greater index than feminine foetus.


Variations of the pronator teres muscle: predispositional role to median nerve entrapment.

The variability of the human pronator teres muscle is studied in 60 upper limbs. The humeral head was present in all cases and was double in 3 cases (5.0%). The ulnar head was present in 47 cases (78.3%). The ulnar head was muscular in 11 cases, tendinous in 6 cases, and mixed in 30 cases. The collateral branches of the median nerve destined to the pronator teres muscle were found to be arranged in three main patterns: arising directly from the median nerve, arising from the superficial flexor antebrachial muscles nerve, and mixed type. Special reference is made to the influence of variations in the pronator teres muscle on the compression or the entrapment of the median nerve (pronator syndrome). The proposed determinant variations are: short and tendinous ulnar head, ulnar head joined to the arch of the flexor digitorum superficialis muscle, ulnar head with triple origin slips, and humeral head perforated by the median nerve.


[Demonstration of sensor nervous endings in the rat thyroid gland].

The nerve sensitive endings or receptors of the thyroid gland have been studied in twenty adult male rats. Their morphology, their acetyl-cholinesterase specific activity, their mono-amino-oxidase activity and VIP were investigated. Few but constant nerve sensitive endings were observed in the thyroid gland. These receptors were subdivided by their morphology in the next groups: pear-shaped receptors with capsule; capsuled spherical receptors located near vascular walls; ovoidal receptors with capsule and glomerular structure; simple or complex mace-shaped receptors without capsule. The acetyl-cholinesterase technique could just show a unique type or receptor, which corresponds with last one described. The mono-amino-oxidase technique can not show any type of receptors. VIP was not localized immunohistochemically in the sensitive endings of the thyroid gland.


[Prenatal growth of the human skull: quantitative study].

The relative growth of the skull was studied in 300 human foetuses by using of the allometric equation Y = aXb. The skull growth was correlated to the crown-rump length and to the fetal weight. The relative growth of the skull presented positive allometry. Masculine foetus presented greater index than feminine foetus.


Histophysiological studies on sex steroid induced changes in the interrenals of the male frog Rana cyanophlyctis (Schn.).

Administration (i.m.) of either estradiol-17 beta (0.5 microgram/frog) or progesterone (10 micrograms/frog) on alternate days for 15 days to adult male frogs induced the following changes in the interrenal cells: i) nuclear and cellular hypertrophy, ii) increase in the activity of delta 5-3 beta-hydroxy-steroid dehydrogenase and iii) decrease in sudanophilic lipid droplets. Treatment with testosterone propionate (100 micrograms/frog) dit not elicit marked changes in the above parameters. These results demonstrate that some sex steroids modify the interrenal gland steroidogenic activity in R. cyanophlyctis.


Acetylcholinesterase activity in the human subfornical organ.

The acetylcholinesterase activity (AChE) in the human subfornical organ (SFO) was detected by the method of Koelle and Friedenwald in 16 human brains collected between 6 and 12 hrs postmortem. The only AchE-positive structures found were neuronal cell bodies and processes, morphologically classified as stellate and fusiform neurons of large, medium and small size. Large ones prevailed in the dorsal zone. The neurons were homogeneously distributed in the rostral area of the SFO. The penetration and ramification of large blood vessels produced a decreasing neuronal density in the medium-caudal area. The architecture of the SFO in sagittal sections comprised a central zone with neurons juxtaposed to the walls of the vascular plexus, whose dendritic and axonal processes showed an intricate pattern without a special arrangement. This neuronal zone of the SFO was surrounded by a peripheral layer of neurons with axonal projections to the rostral area. This layer was thicker in the dorsal zone of the SFO, where axonal fibers "climbing-up" from the central perivascular neurons could be demonstrated. In coronal sections some neurons with prolongations of arcuate distribution connected the dorsal and ventral zones.


Engineering resistance to mixed virus infection in a commercial potato cultivar: resistance to potato virus X and potato virus Y in transgenic Russet Burbank.

Potato virus X (PVX) and potato virus Y (PVY) infection in potato may result in the loss of certification of seed potatoes and affect quality and yield of potatoes in commercial production. We transformed a major commercial cultivar of potato, Russet Burbank, with the coat protein genes of PVX and PVY. Transgenic plants that expressed both CP genes were resistant to infection by PVX and PVY by mechanical inoculation. One line was also resistant when PVY was inoculated with viruliferous green peach aphids. These experiments demonstrate that CP protection is effective against mixed infection by two different viruses and against mechanical and aphid transmission of PVY.


[Left caudal vena cava: report of a case].

The infrarenal part of the vena cava inferior running at the left side of the abdominal aorta has been observed in a 70 years old caucasian man without any other anomaly in the position of the abdominal viscera. This atypical vascular pattern was associated with the persistence of a rudimentary right inferior vena cava corresponding to the right supracardinal vein. The embryonic origin of this anatomical variation and its clinical importance are discussed.