[Psychotherapy with elderly patients. Experiences from a psychiatric psychotherapeutic consultation service].

Experiences with psychoanalytically oriented psychotherapy with the elderly have been made in a psychiatric consultation service at a general hospital. The life-long importance of psychodynamically relevant conflicts is illustrated by two case examples of psychosomatic patients with asthma and functional symptoms of the gastrointestinal tract. The experiences with short-time psychotherapies described here are encouraging and confirm results of other groups demonstrating the efficiency of psychotherapeutic interventions with the elderly. Special problems of psychotherapy with older patients in a psychiatric consultation service and implications for the routine medical treatment of general-hospital patients are discussed.


Thermal deactivation kinetics of CM-cellulase from a local isolate of Aspergillus niger (RD-2231).

The kinetic of thermal deactivation of CMC-ase activity of A. niger, locally isolated, was studied. The enzyme was found to be more stable in temperatures below 40 degrees C. The rates of activity decay were significant at high temperatures and can be described as a first-order kinetic model. Deactivation rate constants (Kd) were determined at different temperatures (30, 40, 55 and 65 degrees C). Kd value for CMC-ase activity decay at 65 degrees C was 28 times higher than its value at 30 degrees C. An Arrhenius type temperature dependence of Kd was found, and the activation energy (Ea) of the thermal deactivation was calculated to be 8400 cal/mole. Thermodynamic quantities (delta H) and (delta S) for deactivation process were 7700 and 11.9 cal/mole, respectively. The change of two kinetic parameters, i.e. Vmax and Km under deactivation conditions, was discussed.


Physiological and biochemical characteristics of staphylococci isolated from the rumen of young calves and lambs.

Six strains of rumen ureolytic staphylococci were isolated from young calves and lambs. Three isolates were allotted to the species Staphylococcus xylosus. Staphylococcus saprophyticus and Staphylococcus gallinarum. The taxonomy of remaining three isolates was uncertain. Total numbers of staphylococci varied between 10(4) and 10(6) per 1 ml of the rumen fluid. Rumen Staphylococci utilized a wide range of substrates and produced a bacteriocin-like substance. No strain hydrolysed gelatin. All strains produced catalase and reduced nitrate. The main product of anaerobic carbohydrate metabolism was lactate accompanied by formate, acetate and ethanol. Most of strains were sensitive to ionophores, avoparcin, bacitracin and tylosin. All strains were sensitive to rifampicin, tetracycline and chloramphenicol.


[Sources and developments in heart surgery].

This contribution deals with the development of the individual ramifications of cardiac surgery from their inception to the presence and especially highlights the personalities responsible for these breakthroughs. The trials and errors of these developments are described along with the multitude of presently unanswered questions including those related to thoracic organ transplantation, cardiac assistance, and replacement as well as the socio-economical aspects of modern cardiac surgery.


[Use of hypertonic NaCl solutions in primary volume therapy].

The i.v. bolus infusion of 4 ml/kg b.w. of hypertonic (7.2-7.5%) saline solution represents a new concept for primary resuscitation from traumatic-hemorrhagic shock; it is called "small-volume resuscitation". Experimental studies have demonstrated that for the case of a 50% blood loss the infusion of 7.2-7.5% NaCl in a dose equivalent to 1/10 of the blood loss effectively restores cardiac filling pressures and cardiac output and significantly increases systemic pressure. Simultaneous application of a colloid (6-10% Dextran 60/70; 6-10% HAES 200,000/0.5) prolongs the circulatory effect of the hypertonic solution. Moreover, "small-volume resuscitation" by means of 7.2 NaCl/10% Dextran 60 was shown to completely restore nutritional organ blood flow already within only 5 minutes. The superiority of "small-volume resuscitation" using hypertonic-hyperoncotic solution as compared to conventional volume therapy consists of its effects on the microcirculation. Recent clinical trials have revealed the efficacy, practicability and safety of this new therapeutic concept for primary resuscitation from trauma and shock.


[Duplex sonographic monitoring of infra-inguinal arterial reconstructions: can a threatened bypass occlusion be detected by this method?].

In our institution, 95 infrainguinal arterial reconstructions were prospectively entered into a graft surveillance programme which consisted of a postoperative i.a. DSA and routine assessment of graft flow velocity (GFV) and ankle pressure indices (ABI) during the first postoperative year. An average of 4.1 GFV measurements was obtained during a mean follow-up period of 8.2 months. Abnormal GFV led to arteriography in 29 bypasses identifying--aside from three false positive findings--two graft occlusions and 24 severe (> 70%) graft stenoses. Of the latter, in only 7 cases a significant decrease in ABI was found. Unheralded graft occlusion occurred in 6 patients. Including the corrections of the above mentioned lesions, secondary patency rates were 97% at 30 days and 89% at one year.


[The elderly as heart surgery patients. Pre- and postoperative analysis of the quality of life].

The aim of the study was to measure pre- and postoperative quality of life of the old patient to find out his profit of open heart surgery. 71 patients ranging from 75 to 86 years (mean 77.6 years) were examined by using a standard interview about their quality of life on the day of hospital admittance and one year after returning home (range 11-14 months). There was an improvement of postoperative quality of life. These results were similar to data reported in the literature after investigating younger patients. No one should be excluded from open heart surgery because of old age.


[Shouldice hernia report with a PTFE suture].

Between 4/90 and 2/91 we repaired 105 inguinal hernias according to Shouldice's technique. Instead of an absorbable suture (PDS no.0) we used a PTFE suture no.0. By this study we tried to assure that it is allowed to use as well the non resorbable PTFE suture no.0. in hernia repair as the slowly resorbable PDS suture no.0. We compared the rate of postoperative hematomas, seromas and pus collections and the rate of early recurrences in both groups. The results of the PTFE group were compared with those of a prospective study (n = 100) between 6.88 and 4.89 when we used PDS suture no 0. In the PTFE group we saw 9.5% hematomas, 1.9% seromas and 0.9% pus collections. In the PDS group 4% of the patients developed a hematoma, 4% a seroma and 2% a pus collection. We saw 1.9% early recurrences after 8 months (PTFE: 7-11; median: 9 months) and 3.2% after 9 months (PDS: 8-13; median: 10 months) medium follow-up time. The results did not significantly differ between both groups. (Chi-square test: p = 1.0). By these results we can draw the following conclusions: 1. The use of a non absorbable PTFE suture no 0 in hernia repair is of no disadvantage. 2. The principle of hernia repair is the induction of scar tissue in the site of hernioplasty; the use of slowly resorbable suture material is allowed as well.


[Perforated aneurysm of the left hepatic artery].

Aneurysms of the hepatic artery are second (20%) to the splenic artery the most common site of splanchnic artery aneurysms. The frequency of location in the branches of the hepatic artery is as follows: common hepatic 63%, right hepatic 28, left hepatic 5%, both left and right hepatic artery 4%. Today atherosclerosis (30 - 32%) is the most prevalent etiology, followed by trauma (22 - 28%) and inflammatory lesions (11%). The average age is 41,6 years, the male to female ratio 2:1. In 64-80% of patients rupture of the aneurysm is the first and dramatic clinical manifestation. The mortality is then about 35%. The case of a 64 years old female with perforated aneurysm of the left hepatic artery is presented and the literature is reviewed with emphasis on etiology, clinical manifestation, diagnostic and therapeutic (surgical and non-surgical) procedures.


[Post-traumatic hemobilia and successful direct treatment of the arteriobiliary fistula].

Traumatic hemobilia is a rare complication of deep and central liver injuries. Repeated and massive bleeding requires an active therapy. For diagnosis of the arterial-biliary fistula, most advantageous is a transcutaneous selective arteriography which can be used also for therapeutic embolization. Of surgical techniques, ligature of the art.hepatica comm. or propria and direct closure of the fistula in the liver parenchyma are recommended. The authors report on such a successful direct intervention in a 9-year-old girl.


[Malignant tumor of the autonomic nervous system of the stomach (GAN-tumor)--case report of a new entity].

Gastrointestinal autonomic nerve (GAN)-tumors are extremely rare. So far seven cases of intestinal and four of gastric GAN-tumors were reported. GAN-tumors, also termed plexosarcomas, arise from autonomic nervous system plexuses of the gastrointestinal tract such as those of Meissner or Auerbach. We report a case of a metastatic gastric GAN-tumor in a 40-year-old woman. A small, 1 cm in diameter, submucosal plexosarcoma located in the posterior gastric wall and a 1.5 kg, 23 x 15 x 11-cm metastasis located retroperitoneally behind the stomach between liver, spleen and pancreas without discernable invasion of any of these organs were found. En-bloc resection of the retroperitoneal mass, the spleen, the pancreatic tail, and a part of the posterior gastric wall adhering to the mass were performed. In addition, lymph node metastases in splenic hilum were noted, and resected. In CT scan liver metastases were detectable fourteen months after surgery. The diagnosis is based on light microscopical, ultrastructural, and immunhistochemical analyses. The prognosis of GAN-tumors is fatal. In spite of radical excision 8 of 11 reported patients died few month after surgery while local recurrences and/or metastases in regional lymph nodes and in the liver were found. The response to chemotherapy was poor.


[Sequential cancer of concomitant cancer?].

The generally-favoured polyp-cancer sequence hypothesis its probably wrong. The distribution of polyps in large intestine differs from that of cancer. There is evidence that different aetiological factors are involved in the genesis of polyps, their growth rate and the development to invasive cancer. Most polyps are very small (90%). They never develop a cancer. It is a diffusely abnormal state of the large bowel mucosa which renders it more liable to produce often polyps and very rare carcinoma (5%). Polyp-carcinoma concomitance is much nearer to the truth.


[The dysplasia-carcinoma sequence in the colorectum].

The concept of dysplasia-carcinoma sequence has been established for the gastrointestinal tract. Dysplasia is defined as unequivocal neoplastic proliferation of epithelium without invasion and represents the precancerous lesions of the colon and rectum. The most common appearance of dysplasia is polypoid adenoma, however, flat adenomas are increasingly diagnosed. During the last 20 years, new pathological and biological methods including molecular genetics showed the stepwise evolution of colorectal carcinoma from normal mucosa to dysplasia of increasing grade and to invasive carcinoma. Of course, dysplasia-carcinoma sequence does not imply the development of carcinoma in every focus of dysplasia. In fact, the incidence of carcinomas from adenomas is 5-10%. A new molecular or genetic epidemiology promises an improved selection of high risk individuals.


[Symptomatic stenoses following stapler anastomosis of the large intestine].

Since 1978 the stapled colonic anastomosis belongs to the technical standard in surgery of the rectosigmoid. It is followed by an extension of indications for sphincter-preserving excisional treatment. The main advantages of the mechanical suturing are the shortening of operation time as well as the practical and easy management, especially when the anastomosis is located low in the pelvis. Early respectively late postoperative strictures represent the most frequent complications of stapled anastomosis. From 1989 to 1991, the stapling technique was used for colorectal anastomosis in 196 cases in our hospital. Clinical stenosis occurred in 5 cases, an incidence of 2.5%. Causative the size of the cartridge, the healing by second intention because of the metallic staples, a disturbed microcirculation depending on the tension around the anastomosis, missing normal fecal dilation because of protective colostomy and an incongruity of the combined lumina are discussed. Independent of localisation and grade of the stricture, repeated dilation was a successful therapy in all 5 cases.


[Minimally invasive surgery of the rectum].

Low precision of transanal techniques, their limited area of application and high rate of complications of extensive surgical techniques led to the development of an endoscopic surgical system. Its main indication is the removal of broad based adenomas and early rectal cancers. Further indications are palliative excisions of advanced cancers. From July 1983 till December 1990 the endoscopic system has been employed on 233 patients. The total sum of operations raised to 251 cases due to recurrences and new tumour formations. The overall crude 5 year survival with merely local removal of rectal cancer was 67% for early rectal carcinoma patients and 75% for patients with pT2 carcinomas. Early postoperative complications consisted of 5 intraperitoneal perforations, 4 recto-vaginal fistulas and 4 haemorrhages (complication rate 5.2%). There were 2 postoperative deaths due to cardiopulmonary failure (clinical lethality 0.8%). The overall recurrence rate of adenomas was 4.9%. In accordance with the selection criterias of other authors, our selection criteria for curative local excisions of rectal cancers enclose tumour diameter less than 4 cm, pT1 carcinomas, low grade malignancy and tumour free margins of locally excised specimen.


[Delay phenomenon of the jejunum. Studies of nutritional blood supply and oxygen supply of the jejunum of the rabbit].

Delay procedure has been shown to effectively improve microvascular perfusion in skin flaps. In analogy to skin, we have analyzed the effect of delay on regional blood flow and surface tissue PO2 of a proximal segment of the jejunum. Under nembutal anesthesia (30 mg/kg BW) and mechanical ventilation a total of 15 rabbits were laparotomized. Regional blood flow of the jejunum was estimated using radioactive-labeled microspheres, and tissue PO2 was assessed by means of a platinum-multiwire surface electrode. In order to induce acute ischemia three consecutive jejunal arteries were ligated, and the proximal marginal vascular arch was temporarily occluded by a microvascular clip. Delay procedure was induced by 1) ligation of the jejunal arteries, 2) in situ-maintenance of the jejunal segment for two weeks followed by 3) relaparotomy and occlusion of the proximal marginal arch (n = 8). Regional blood flow of the jejunum and tissue PO2 were also assessed in sham-operated animals (n = 7). After acute ischemia regional blood flow (0.27 (0.05) ml x min-1 x g-1, mean (SEM)) and surface tissue PO2 (39 (3) mmHg) of the jejunal segment were found significantly (p < 0.05) reduced as compared to baseline (0.82 (0.12) ml x min-1 x g-1 and 66 (1) mmHg) and sham-operated animals (0.69 (0.12) ml x min-1 x g-1 and 62 (5) mmHg), respectively. In contrast, delay of the jejunal segment resulted in almost complete preservation of regional blood flow (0.56 (0.04) ml x min-1 x g-1) and surface tissue PO2 (65 (1) mmHg). We therefore like to propose that the jejunal delay phenomenon may be clinically used to reduce ischemic complications in jejunal transposition for esophagoplasty.


[Status of treatment with free radical scavengers following kidney and pancreas transplantation].

The frequency of acute renal failure (ARF) after preservation and kidney transplantation is rather high. The etiology of an ARF is an interaction of multiple mechanisms as donor conditions, explantation procedure, duration of ischemia and reperfusion injury. Different experiments demonstrated, that the damage produced by reperfusion can be prevented by the scavenger of free radicals, the enzyme superoxide dismutase (SOD). After a double blind study, using consecutive intraarterial bovine SOD (n = 100) in kidney transplantation, showing a trend in favour to the SOD treated group, especially when long-time stored kidneys (> 30 h) had been grafted, a second study was designed to evaluate the efficiency of intravenous recombinant human SOD in the protection from ARF. This study (n = 180) was split into two different trials, double blind and randomized in itself: (A) grafts with cold ischemia time lower or equal 30 hrs., (B) cold ischemia more than 30 hrs. All grafts were preserved with Euro-collins. The study substances were either placebo or 200 mg rh-SOD (Grünenthal GmbH, FRG), given 10-2 minutes prior reperfusion intravenously. Parameters causing an ARF were equal and well comparable in both groups. Concerning early graft function there was no difference in study A between placebo and rh-SOD group. In study B the average and median of the day creatinine dropped the first time without interference of hemodialysis, showed a trend in favour to the rh-SOD group. If placebo was given only 19% of the grafts gained function within the first week, when rh-SOD was applied 47% functioned in the first week. The lack of significant benefit from SOD treatment could be explained by the dependency of the proportion of the total injury caused by reperfusion compared with the proportion resulting from ischemic injury per se. The rh-SOD group showed a better 3 years graft survival rate (+16%). It seems rh-SOD is able to augment the early graft function and is helpful to reduce the ARF frequency when long-time stored cadaveric kidneys have to be transplanted. These promising results encourage us to continue the study in protocol B to get greater numbers and definitive results.


[Is penicillin G the drug of choice in gas gangrene? Results of a prospective documentation of clinical, microbiological and animal experiment data].

Between 1978 and 1990 98 patients with gas gangrene were treated in the departments of general surgery and traumatology of the University of Kiel. The microbiological results of tissue samples and results of animal infectious experiments were correlated to the clinical outcome. It could be shown, that gas gangrene due to C.perfringens alone had a higher mortality than gas gangrene due to polymicrobial infection. In trauma patients, however, the rate of amputations was lower in cases of clostridial monoinfections (25%), than in patients with mixed infections (48%). The results of animal experiments with guinea pigs which were infected by patients' infectious material showed a correlation to the clinical outcome. This correlation could not bee shown using isolated and cultured clostridia. Therefore and because of the quantity of mixed infections it is necessary to use broad spectrum antibiotics for treatment in cases of gas gangrene and for perioperative antibiotic prophylaxis. Penicillin-G alone can not more be recommended for this purpose.


[Heterotopic ossifications in a patient with severe craniocerebral trauma].

Patients with severe head injury and fractures of joints or of long bones often show a hypertrophic callus formation which leads to a rapid consolidation of a fracture but can also lead to an ankylosis of the joints. This is the retrospective report of a patient who showed this phenomenon.


[The dual regulation by glucagon of the adenylate cyclase system in the embryonic chick heart].

Taken in physiological concentrations, glucagon increases the activity of adenylate cyclase from the heart of 11-day chick embryos, i.e. at the earliest investigated stage. High glucagon concentrations inhibit the enzyme from cardiac membranes at all ontogenetic stages except mature chicks in which glucagon produces stimulating effect. Guanine nucleotides potentiate this effect up to the 16th day of incubation, this effect being absent at later periods. Reconstruction of adenylate cyclase system from the heart of 16-day embryos with N-proteins from mature liver tissue of chicks results in the recovery of potentiating effect. However, at later developmental stages, potentiation was absent even in the presence of N-proteins.


[Testosterone production by the fetal testes of silver foxes selected for their domesticated behavior].

Testosterone content was determined by radioimmune assay in the testes of silver foxes between the 31st and 50th days of gestation. Small quantities of testosterone were found in the testes already at the 31st day of prenatal life, gradually increasing up to a maximum value at the 50th day. No significant difference in testosterone content was found between domesticated and undomesticated silver foxes during prenatal life. It is suggested that selection for domesticated behaviour affects rather central control of endocrine functions than steroid biosynthesis in the testes.


[The evolutionary changes in the amino acid sequences and properties of the ATP-synthase in chloroplasts, mitochondria and bacteria].

Studies have been made on ATPase from chloroplasts, cyanobacteria and mitochondria of higher plants and animals. No intraspecies and interspecies variability of chloroplast and mitochondrial ATPase was found with respect to pH optimum of the activity, to specificity to cations as substrate components, to sensitivity to stimulating and inhibiting anions and ethanol, to optimal stimulating ethanol concentration. Intergenus variation of these properties of ATPase from chloroplasts, plant mitochondria, and cyanobacteria was revealed. Analysis of homology of the amino acid sequence in ATP-synthase subunits showed that ATP-synthase genes in chloroplast DNA originate from cyanobacterial genome, whereas ATP-synthase genes in plant and animal mitochondria-from genome of Rhodospirillum rubrum or closely related species. It was established that no recombination between the genetic material of chloroplasts and mitochondria took place during evolution.


[The temperature hysteresis of water-salt metabolism in the frog Rana temporaria].

Frogs acclimated to 4 degrees C were transported to a medium with temperature 20 degrees C, which caused polyuria; recovery of normal diuresis took about 24 h. During this period, hypernatremia was observed together with the increase in natriuresis, the rate of renal excretion of potassium ions with urea remaining constant. Water content of skeletal muscles decreased. Transportation of frogs acclimated to 20 degrees C into a medium with a temperature 4 degrees C decreased their diuresis. Renal excretion of sodium, calcium and magnesium ions remained unchanged, whereas that of potassium ions significantly decreased. The content of potassium and magnesium in the blood serum increased, that of sodium--decreased. Hydratation of muscled and kidneys was accompanied by the decrease of calcium, potassium and magnesium ions calculated per wet weight of the tissues, the level of sodium remaining unaffected. The data obtained indicate significant changes in the pattern of water and salt metabolism in frogs during temperature hysteresis.


[The biological properties of Serratia marcescens bacteriophages].

Sixteen phages active against bacteria of the genus Serratia have been divided into 4 groups on the basis of the study of their biological properties. As a result, 5 typing phages have been selected, which permitted the typing of 77.3% of S. marcescens cultures under study, divided into 13 phage types.


[The resistance plasmid of Klebsiella pneumoniae that controls its cytotoxic activity].

R-plasmid (40 MD) isolated from K. pneumoniae hospital strain makes Escherichia coli strain J62 capable of inducing a cytotoxic effect which can be detected in Hep-2 cell culture. In contrast to the initial E. coli strain J62 producing no changes in the monolayer, E. coli J62 cells containing P-plasmid induced pronounced cytotoxic changes and a sharp increase in the number of nonviable Hep-2 cells by hour 24 of interaction.


[The temperature dependence of receptor structures and temperature-related reception].

In acute experiments on rats, studies have been made on impulse activity of single fibres of n. ischiadicus evoked by stimulation of the receptive fields of the sole by focused ultrasound. Mechanical effects were produced by rectangular ultrasonic stimuli, thermal ones--by trapezoid ones. With respect to the magnitude of a threshold response to a rectangular stimuli, the receptor structures were divided into three groups, i.e. low, mean and high threshold ones. Low and mean threshold receptor units responded to local thermal stimulation. Mean threshold units exhibited an increase of the threshold to mechanical stimulation after local thermal one. In human subjects, the structures which are functionally similar to mean threshold units, evoke thermal sensations, and may be classified not only as temperature dependent, but also as temperature sensitive.


[Lipopolysaccharide changes in smooth-type avirulent Shigella in comparison with initial virulent strains].

The comparative study of the lipopolysaccharides (LPS) of virulent and avirulent strains of S. sonnei, phase I (smooth colonies), has been made. Electrophoresis of LPS and subsequent densitometry of electrophoregrams have revealed the increase of the fraction of long 0-chains with a considerable number of recurring elements in 2 out of 3 LPS preparations obtained from avirulent shigellae. In mice immunized with these LPS preparations a considerably greater number of antibody-producing cells can be detected in Jerne's test on sheep red blood cells (SRBC) sensitized with the LPS of a virulent strain than on those sensitized with the above LPS preparations. Long 0-specific chains supposedly inhibit the fixation of individual complement components on the corresponding sensitized SRBC. The LPS of the third avirulent strain of S. sonnei, phase I, with transposon integrated into its genome, which has led to the formation of the avirulent variant of a previously virulent strain, seems to contain fine structural differences from the initial virulent strain. The immunogenicity of the LPS of this avirulent strain is greatly (3-4 times) decreased, which is manifested by the number of antibody-producing cells detected in Jerne's test on SRBC sensitized with LPS preparations obtained from these two strains.


[The dynamics of the activity parameters of the neuronal populations in the dorsal hyperstriatum of hens depending on the afferent input in ontogeny].

Studies have been made on the properties of neuronal populations of the dorsal hyperstriatum of the forebrain in hens beginning from the 18th day incubation up to the 7th day after hatching, which were incubated and kept either in darkness or under periodic illumination. Among the investigated parameters of multicellular activity, mean frequency of the discharge activity was found to be most susceptible to the level of external light afferentation in ontogenesis. The discharge activity was more intense in the left hemisphere of chick embryos and chicks from illuminated group, which may be associated with asymmetrical visual afferentation resulting from embryonic position within the egg, and its modulating effect on synchronization processes in the adjacent neurones of the given structure.


[The migratory activity of HIV-infected people in the northwestern region and the routes of the possible spread of the infection].

The epidemic situation in HIV infection in the northwestern region of this country has been analyzed. The ways of the spread of HIV infection among the infected persons, residents of the St. Petersburg region, Kaliningrad, Novgorod and Murmansk, have been studied. The infection is transmitted mainly through sexual contacts, both homosexual and heterosexual. High migration activity of HIV-infected persons, homo- and heterosexuals, has been established, and a great number of unknown (casual) sexual contacts among them was noted. The results of these observations may be useful in the prognostication of the epidemic situation in HIV infection not only in the northwestern region, but also beyond its boundaries, and later in the optimization of screening.


[Microbial ecology and a retrospective assessment of the possibility of predicting an outbreak of suppurative meningitis caused by a Serratia marcescens strain in a hospital for the nursing care of premature infants].

An outbreak of purulent meningitides in a hospital ward for preterm babies, caused by Serratia marcescens strain of serovar 05/13 with multiple resistance, is described. Data on the results of the long-term observation of the ward showed that during three months preceding the outbreak the consecutive spread of the infective strain and its colonization of the intestine of children occurred. At the moment of the outbreak S. marcescens 05/13 was the dominating intestinal microflora in 37% of children in the ward and constituted 30% of the total aerobic flora in the intestine of the examined children. No S. marcescens strains were isolated from the feces and urine of the medical personnel and mothers. The importance of the observation of microflora colonizing newborn infants in the ward for the evaluation and prognostication of the epidemiological situation is discussed.


[The formation of interhemispheric asymmetry in human ontogeny during the perception of emotions in normal speech and in stuttering].

Age peculiarities of functional brain asymmetry in perception of emotional information of speech have been revealed. It was shown that the age of 4-7 years is most important for formation of this asymmetry in emotional perception. It is in this age that functional reorganization of perception in stuttering children is observed. These data indicate that correction of emotional activity in stutterers should be made at early periods of their life.


[The definition of the forms of the epidemic process in intestinal infections].

A method for the identification of the forms of the epidemic process in dysentery (annual, seasonal and outbreak forms) has been worked out. The method is based on the calculation of the upper limits of annual and seasonal morbidity from the data on the period of several years with the use of the formulae of binomial distribution, serving as the mathematical model of alternative random values, such as morbidity. The comparison of actual morbidity for each year of the analyzed period with the upper limits of annual and seasonal morbidity helps identify the form of the epidemic process.


[An evaluation of the quality of tetanus anatoxins by gel electrophoresis].

The study of tetanus toxoids obtained from different manufacturers in the USSR has shown that these preparations exhibit molecular heterogeneity. The method of gel filtration has made it possible to find out that tetanus toxoids from different manufacturers differ in the degree of their purification. The preparations produced by the manufacturing enterprises in Perm and Ufa have been found to contain considerably less ballast substances than the preparations produced in Moscow.


[Pseudomonads as parasites of protozoa].

The experimental study of the interaction of Tetrahymena pyriformis with different microorganisms of the genus Pseudomonas, isolated from the soil, was made. The study revealed that T. pyriformis phagocytosed some Pseudomonas pigment-forming species (P. cepacia, P. putida, P. fluorescens, P. pirkettii). The most pronounced cytopathogenic effect was produced by P. cepacia. The dynamic observations of the ultrastructural features of interaction between P. cepacia and protozoa were made. Even at early stages of this interaction some types of parasitiferous phagosomes containing both intact bacteria capable of multiplication by binary division and Pseudomonas cells exhibiting different degrees of destruction were registered. In several phagosomes morphologically intact bacteria differing in their cell-wall profiles and the density of their cytoplasm and nucleotide were present simultaneously. More dense cells with sinuous cell-wall membranes were more virulent. By hour 18 one giant parasitiferous vacuole was formed by fusion of smaller phagosomes, which subsequently broke up, liberating a new generation of bacteria. In infected cells disturbances in the structure of their mitochondria and macronucleus appeared. During the first 2 days of the joint cultivation of P. cepacia and T. pyriformis the accumulation of bacteria occurred due to the selection and multiplication of digestion-resistant bacterial cells, which ensured the resistance of this Pseudomonas population in association with protozoa.


[The seasonal dynamics of the adenine nucleotide level in the liver mitochondria of the frog Rana temporaria].

ATP, ADP and AMP content of liver mitochondria has been determined in frogs immediately after isolation during autumn, winter and spring periods. Seasonal changes in adenine nucleotides in frogs are similar to those observed in rat liver mitochondria during early postnatal ontogenesis. It is suggested that in frogs seasonal changes in liver intramitochondrial adenine nucleotides depend on the hormonal condition of animals.


[The antigenic activity of vaccines made from opportunistic microorganisms in an experiment to immunize animals by oral and combined methods].

The results of the study of the antigenic activity of multicomponent vaccine consisting of staphylococcal, Klebsiella, Proteus, Escherichia coli antigens and staphylococcal monovaccine, introduced into rabbits and guinea pigs by different routes, are presented. As shown in this study, the multicomponent vaccine introduced orally in 5 administrations stimulated the production of antibodies to all components, but the intensity of antibody formation to each of them was different. Antibodies to E. coli antigen were found to be at the lowest level. Staphylococcal antigen, introduced orally both as the component of the multicomponent vaccine and as the monovaccine, ensured pronounced stimulation of the production of antistaphylococcal antibodies, not lower than that observed after subcutaneous injection. The comparative study of the activity of the multicomponent vaccine introduced by combined routes, oral-subcutaneous and subcutaneous-oral, showed the advantage of the former one.


[An assessment of the immunoepidemiological efficacy of a liquid cultured killed vaccine against tick-borne encephalitis virus strain 205 in the Maritime Territory].

Inactivated vaccine against tick-borne encephalitis (TBE), prepared on the basis of strain 205, is characterized by epidemiological (53%) and immunobiological activity. The appearance of a few TBE cases among the vaccinees is probably due to different maturation rate of immune response to various strains (different specificity of immune response). A suggestion has been made that no inactivated vaccine prepared from a single strain can produce a reliable protective effect because of pronounced heterogeneity of the population of TBE virus.


[An evaluation of the scope of the circulation of Salmonella among the workers of commercial poultry- and meat-packing enterprises based on serological study data in the PHA test].

Serum samples from 641 workers of large poultry and meat-packing plants were studied in the passive hemagglutination test with the use of Salmonella complex and serogroup diagnostica. A specific increase in the level of anti-Salmonella antibodies in 60.7% of poultry plant workers and in 9.8% of meat-packing plant workers was established. Among the workers of the poultry plants the most pronounced immune shifts were detected in persons having contacts with sick poultry and pathological material and among the employees of the meat-packing plant, in those who ate raw sausage meat. A high level of antibodies in the professional groups under study was observed as early as in the first year of work at the plant and persisted over the whole period of this work. Under the conditions of constant contamination of the workers of poultry and meat-packing plants with small doses of salmonellae specific immunity to this infection was seemingly induced, which inhibited the development of the manifest forms of infection, but did not prevent the formation of chronic carrier state.


[The characteristics of the polyclonal action and immunomodulating activity of bacterial peptidoglycans in oppositely reacting mouse strains].

The data on the specific features of the polyclonal action of gram-negative bacteria on primary immune response to sheep red blood cells in oppositely reacting mouse strains are presented. Staphylococcus aureus and Bacterium flavum peptidoglycans have been found to increase the amount of antibody producing cells to thymus-dependent antigen only in the spleen of low-responsive mice. At the same time differences in the amino acid composition of these heteropolymers do not affect their stimulating activity. Differences between the capacity of B. flavum peptidoglycans to induce the activation of B cells in mice of different strains have been established.


[The chemoluminescence of the primary focus of a suppurative infection and of isolated neutrophils exposed to dimephosphon].

The influence of dimephosphone at concentrations of 0.001 M-0.75 M on the chemiluminescence of tissues at the focus of purulent infection in the ear of a guinea pig, on the survival rate of the experimental animals injected with the lethal dose of Staphylococcus aureus, as well as on the spontaneous and stimulated chemiluminescence of blood neutrophils in patients with wound infection, was studied. The study showed that different concentrations of dimephosphone oppositely influenced the intensity of the chemiluminescence of neutrophil suspensions and tissues at the focus of infection: low concentrations were found to produce stimulating action and high concentrations, suppressive action. At the highest concentration used in this study (0.75 M) dimephosphone prevented the death of the animals receiving lethal doses of S. aureus.


[The methods for correcting with specific and nonspecific immunomodulators the immunopathological processes arising from the administration of a staphylococcal vaccine].

In mice immunized with staphylococcal vaccine the arresting of graft-versus-host reaction under the influence of small doses of staphylococcal vaccine, hyperimmune antistaphylococcal serum, cyclophosphamide, antilymphocytic serum has been demonstrated. Small doses of staphylococcal vaccine stimulated the production of antibodies to staphylococci and dermal extract in the animals, previously immunized with this vaccine, with the simultaneous suppression of cell-mediated immune reactions to both antigens. Immunosuppressing agents have been found to inhibit humoral and cell-mediated immune response to microbial antigen and dermal extract. No influence of vermox and levamisole on the outcome of the graft-versus-host reaction has been registered; the latter preparation has been found to intensify cell-mediated immune reactions to microbial and tissue antigens.


[Interferon type I in protective body reactions in an experimental Klebsiella infection].

The study on mice with experimental generalized Klebsiella infection, carried out with the use of microbiologic, immunologic and pathomorphologic methods, revealed that the intraperitoneal injection of type I interferon into the animals prevented their death and led to the rapid elimination of the infective agent from their body, enhanced the phagocytic and metabolic activity of polymorphonuclear lymphocytes of their peritoneal exudate, decreased the manifestation of microcirculatory and dystrophic changes in the parenchyma of their internal organs.


[The use of immunoenzyme analysis and immunoblotting for the serological characterization of mycobacterial antigens].

The enzyme immunoassay and immunoblotting were used for the study of the serological activity of different mycobacterial antigens and the spectrum of antibodies to them in patients with different forms of tuberculosis and healthy persons. Antibodies in patients' sera were shown to bind antigens with different molecular weight. The level and spectrum of antibodies to purified protein fraction I made it possible to differentiate between patients with various forms of tuberculosis and healthy persons.


Molecular basis for the functional diversity of enzyme forms of the LMW (Mr 38,000) acid phosphatase of the frog liver.

Recent studies on the structure and function of the tartrate-resistant acid phosphatase (Mr 38,000) of the frog liver are reviewed. The nature of the enzyme heterogeneity is elucidated on a molecular and physiological basis. The following structure-activity relationship is proposed: the enzyme protein is modified by glycosylation processes leading to formation of the different enzyme forms. The oligosaccharide chain stabilizes the final structure of the enzyme forms with altered conformation causing different exposure of the essential functional groups (e.g. sulfhydryl residues, antigen determinants). This leads to different physiological events necessary for fulfillment of metabolic requirements of the cell.


Exopolysaccharides of Rhizobium leguminosarum biovar trifolii harbouring cloned exo region.

Rhizobium leguminosarum bv. trifolii produces an acidic exopolysaccharide (EPS) which plays an important role in the development of nitrogen-fixing nodules. Tn5 mutant of R. trifolii 93 defective in EPS production (Exo-) forms ineffective (Fix-) nodules on red clover. This Exo- mutation is complemented by the pARF1368 and pARF25 cosmids isolated from gene bank of Rhizobium trifolii TA1, but the complementation is not correlated with restoration of Fix+ phenotype. Furthermore, these cosmids introduced to wild-type of R. trifolii 24 repress its ability to form nitrogen-fixing nodules. These results might suggest that bacteria with cosmids carrying the exo region form EPS of altered structure. It has been shown by 1H-n.m.r. that exopolysaccharides produced by R. trifolii 93pARF-1368 and 93pARF25 contain less non-carbohydrate residues (acetyl, pyruvyl and 3-hydroxybutanoyl) than the wild type EPS. These data suggest that the biological activity of the exopolysaccharide of R. trifolii depends on the contents of the non-carbohydrate substitutions.


Adenosine deaminase: physical and chemical properties of partially purified mitochondrial and cytosol enzyme from rat liver.

Adenosine deaminase (ADA) was partially purified 486- and 994-fold from rat liver mitochondria and cytosol, respectively. Relative molecular mass of the enzymes from both fractions was 34,000. Km for adenosine and 2'-deoxy-adenosine were 3.08 x 10(-5) M and 3.03 x 10(-5) M for mitochondrial ADA and 3.12 x 10(-5) M and 2.87 x 10(-5) M for cytosolic ADA. The enzyme from both subcellular fractions had the maximum activity at pH 7.5-8.0, and pI 5.2 and 4.2 for mitochondrial and cytosolic enzyme, respectively. The enzyme was inhibited by erythro-9-(2-hydroxy-3-nonyl)adenine and 2'-deoxycoformycin with Ki 4.4 x 10(-7) M and 3.2 x 10(-7) M for mitochondrial ADA and 4.9 x 10(-7) M 2.8 x 10(-7) M for cytosolic ADA. Among the natural nucleoside and deoxynucleotide derivatives tested, deoxy-GTP and UTP inhibited only cytosolic adenosine deaminase by 60% and 40%, respectively.


The 45 kDa and 27 kDa yeast's protein kinases are not immunologically related.

Two yeast casein kinase type-1 species of 45 kDa and 27 kDa (CK1) were purified to apparent homogeneity and used for investigation of their immunological affinity. Antisera against the two kinases were isolated; the antibody against the 45 kDa kinase did not react with the 27 kDa enzyme. The 27 kDa casein kinase was recognized only by its own antibody. The obtained data strongly suggest that the low molecular mass CK-1 is not a proteolytic product of the 45 kDa kinase species.


Uptake and subcellular distribution of intraventricularly injected [1-3H]dolichol in rat brain.

The uptake of C95[1-3H]dolichol in the form of liposomes into rat brain after the intracerebral and intraperitoneal injection was investigated. Efficient, time-dependent uptake of dolichol into the brain was observed exclusively after the intraventricular injection. Within 24 h after the injection about 10% of the applied dolichol was found in the brain and 1.5% in liver. The distribution of dolichol in various parts of rat brain decreased in the order: cerebellum greater than midbrain greater than grey matter and brain stem greater than white matter. Seven days after the injection total radioactivity in the brain decreased and concomitantly a significant increase was observed in blood circulating and liver of the rat. The highest activity was found in grey matter and it remained a few times higher in comparison with that in white matter. About 80% of the dolichol taken up by the brain membrane was recovered in the following subcellular fractions: crude nuclear fraction greater than microsomes greater than mitochondria greater than synaptosomes greater than myelin. These results demonstrate for the first time that dolichol is actively taken up by the brain membrane exclusively after intraventricular injection of dolichol-phosphatidylcholine in the form of liposomes; this method may be useful in studies on the role of dolichol in brain function.


Rapid separation of tyrosine-specific tRNA from white lupin.

During isolation of total ribonucleic acids from white lupin (Lupinus albus) and their subsequent separation by 10% polyacrylamide gel electrophoresis, a fast migrating RNA band is very well separated. The nucleotide sequence analysis of 76 nucleotide long sequence with many modified nucleosides was found to be identical with that of tyrosine specific tRNA of yellow lupin seeds (Lupinus luteus) and wheat germ (Triticum aestivum). Also this tRNA(Tyr) is identical with plant amber suppressor tRNA. The presented approach offers a very rapid method of purification of plant tRNA with UAG suppressor activity.


Quantitative analysis of ventricular late potentials (LP) in healthy subjects. Comparative study with Holter monitoring.

Signal averaging is a technique that improves the signal-to-noise ratio. It allows the detection of low-amplitude wave formes in the terminal portion of the QRS complex, also known as ventricular late potentials. A high incidence of arrhythmic events is found in patients with abnormal ventricular late potentials after an acute myocardial infarction. Few wide studies have been conducted in healthy subjects to assess normal values. One hundred sixty-five healthy subjects are enrolled in our study (59 men and 106 women). The results (mean +/- standard deviation) are as follows: duration of filtered QRS: 89.5 +/- 9.1 ms; duration of the low-amplitude signals in the terminal portion of QRS < 40 microV: 27.1 +/- 7.8 ms; root-mean-square voltage in the last 40 ms: 47.2 +/- 29.5 microV. A signal difference is noted between men and women for the QRS duration. No difference is found in HFD40 and RMS40. QRS duration confidence limits of 95% are < 108 ms for the total group. HFD40 and RMS40 confidence limits of 95% are respectively of 43 ms and 13 microV. There is no significant difference of the values for age. There is no relation between the severity of a ventricular arrhythmia and the values of the three parameters of the late potentials in a healthy subjects population.


Defibrase, a purified fibrinolytic protease from snake venom in acute myocardial infarction.

To investigate the thrombolytic effects of defibrase in AMI, 157 pts with AMI were studied. Of the 157 pts, 87 were assigned to defibrase thrombolysis and 70 to the conventional therapy plus heparin (control). Coronary arteriography was performed in 36 pts of the defibrase group and 26 of the control group. Pretreatment coronary arteriography was performed in 10 pts and total occlusion of infarct-related artery (IRA) was demonstrated in 7. Thirty to 45 min after either intracoronary or intravenous defibrase thrombolysis, recanalization occurred in 4 of the 7 pts. The perfusion and stenosis was improved in 2 of the 3 pts with patent IRA. Of the 10 pts who underwent emergency coronary arteriography after the onset of i.v. defibrase thrombolysis, 6 were shown to have patent IRAs. Of the 16 pts who underwent coronary arteriography two weeks after the i.v. defibrase thrombolysis, 13 were shown to have patent IRAs. In contrast, only 11 of the 26 pts in the control group had patent IRAs two weeks after admission to the hospital. Of the 36 angiographic cases of the defibrase group, 15 underwent follow-up coronary arteriography, only 1 pt showed reocclusion. In comparison to the control group, the pts in the defibrase group had earlier CPK peaking, higher percentage of pts with LVEF > 0.5, a lower mortality and complication rate. Major spontaneous bleeding complications were rarely seen with defibrase. The results indicate that defibrase is an effective thrombolytic agent with a reasonable recanalization rate, low reocclusion rate and a low rate of bleeding complications.


Does the measurement of left ventricular isovolumic relaxation time allow early prediction of cardiac allograft rejection?

In order to evaluate the value of isovolumic relaxation time measurement for the diagnosis of moderate acute rejection episodes in cardiac allograft recipients a comparison was made with the histological results from the endomyocardial biopsy. A total of 202 isovolumic relaxation time measurements from 26 patients were compared to the biopsy results. The technique used to record isovolumic relaxation time was dual M-mode echocardiography. In addition a combined phonoechocardiography was used for 54 isovolumic relaxation time measurements from 17 patients. A good correlation was found between these two methods. When the biopsy results were normal the isovolumic relaxation time was 71.4 +/- 15.1 ms. When moderate acute rejection episodes were present isovolumic relaxation time decreased to 50.2 +/- 21.2 ms (p < 0.001). In spite of the close correlation detected at group level, there was a large variability of the measurements without accompanying changes in the biopsy specimen. At the same time a significant overlap was found between the measurements taken during rejection and non-rejection periods making it impossible to use these methods for clinical decision making. We conclude that isovolumic relaxation time measured with these methods is not a sufficiently sensitive parameter for the diagnosis of moderate acute rejection episodes in the individual patient, and in our experience, it is not a substitute for endomyocardial biopsy and can not be applied for clinical decision making.


A comparison of cardioversion of atrial fibrillation using oral amiodarone, intravenous amiodarone and DC cardioversion.

Fifty-two consecutive patients with atrial fibrillation underwent 86 episodes of attempted cardioversion with oral amiodarone, intravenous amiodarone or DC cardioversion. The presence of chronic obstructive pulmonary disease or a presenting heart rate of less than 110 beats per minute were associated with a favourable outcome. Conversion to sinus rhythm was achieved in 29% of the group treated with oral amiodarone, 42% of the group treated with DC cardioversion and 64% of the group given intravenous amiodarone. The overall statistical significance of this distribution on chi square testing was p < 0.032. However when only first attempts at cardioversion were analyzed there was no difference between intravenous amiodarone and DC cardioversion.


Target organ status and cardiovascular risk in borderline hypertension.

In order to assess the prevalence of target organ damage 78 men with borderline hypertension, according to the World Health Organization criteria, and 67 normotensive controls underwent echocardiographic, electrocardiographic and fundoscopic examination, followed by ambulatory blood pressure monitoring for 24 hours. Echocardiographic left ventricular hypertrophy was found in 13 borderline hypertensive subjects (16.6%), while no electrocardiographic or fundoscopic abnormalities could be detected. Our data suggest that noninvasive assessment of cardiovascular status, including echocardiography, allows recognition of a subset of borderline subjects with an increased risk for subsequent cardiac morbid events, thereby improving prognostic stratification.


Surgery for massive pulmonary embolism.

Pulmonary embolectomies were performed in 30 patients from January 1973 until December 1991 in the University Hospital of Leuven. There was an 80% hospital survival. The late follow-up showed no recurrent pulmonary emboli. The preoperative haemodynamic status was the most important predictor for survival. Patients, under cardiopulmonary resuscitation or in profound cardiogenic shock before surgery, had a survival of only 50% while all other patients survived. Angiography, performed in only 23% of the cases, remained the most important diagnostic tool until the advent of transthoracic and transoesophageal echocardiography. Thrombolysis is an acceptable alternative in the stable patient, but pulmonary embolectomy is life-saving in the haemodynamically unstable patient and when thrombolysis is contraindicated.


Early venous coronary bypass graft occlusion in a patient with non-specific aortitis: a case report.

A 58-year-old woman with aortic valve regurgitation and bilateral ostial coronary artery stenosis due to non-specific aortitis is presented. Four months after aortic valve surgery and venous bypass surgery, orificial occlusion or high grade stenosis of the bypass grafts occurred. Repeat coronary arteriography was followed by cardiac arrest and emergency surgery but patient did not survive. The etiology, pathological findings and surgical approach are discussed.


Thrombolytic therapy and acute aortic dissection.

Thrombolytic (tissue plasminogen activator) and antithrombotic treatment (heparin and aspirin) were given to a 47-year-old man with an acute type II aortic dissection presenting as an acute anterior myocardial infarction. During treatment he developed cardiac tamponade and an ischaemic stroke. Transoesophageal echocardiography (but not computed tomographies of the chest) revealed the correct diagnosis. After surgical repair (Bentall procedure) there was a complete recovery.


The nursing care recording system. A preliminary study of a system for assessment of nursing care demands in the ICU.

A new system, Nursing Care Recording (NCR), for the recording of nursing care in a general ICU is presented. NCR classifies ICU patients according to their need for intensive nursing care. Comparing the NCR with the Therapeutic Intervention Scoring System (TISS), a correlation coefficient of 0.60 was found. The main difference between the two systems was related to recording procedures allowing changes in nursing intensity within a 24-h period, reflecting patient improvement due to therapy, which was detected by NCR but not by TISS. NCR can be used to estimate nursing capacity during different shifts and may be useful in the assessment of the total nursing staff necessary for a given ICU. It is suggested that NCR will allow detection of changes in the nursing care work load, whether this change is due to new activities in the unit or to alterations in the individual patient care.


Influence of the type of anaesthesia on post-operative subjective physical well-being and mental function in elderly patients.

Standardized behavioural observations were used to establish the influence of the type of anaesthesia on the mental function and the subjective physical well-being in 60 patients, all men, following urological surgery. The patients were randomized to two groups, receiving spinal or general anaesthesia. For evaluation of the influence of pre-operative physical condition on post-operative mental function, a supplementary group of 34 patients with pre-existing cardiovascular and/or pulmonary disorders was included in the study. These patients all received spinal anaesthesia. The patients were observed from the day before surgery until 4 weeks after. In all patients a short-lasting temporary decline in mental function was observed. The outcome was not influenced by the type of anaesthesia. In the two groups receiving spinal anaesthesia the decline in post-operative mental function and subjective sense of well-being was most pronounced in patients with a compromised physical condition pre-operatively. Four weeks after surgery, no signs of mental deterioration were present; however, the subjective sense of physical well-being had not fully returned.


Anaesthetic uptake and washout characteristics of patient circuit tubing with special regard to current decontamination techniques.

The amounts of halothane and isoflurane trapped after exposure for up to 3 h at 2 MAC in commonly used anaesthesia circuit tubing were quantitated by gas chromatography. The decontaminating effects of procedures such as flushing with oxygen, thermal disinfection and/or routine storage were assessed in a similar way. After halothane exposure, anaesthetic content was highest in silicone (398 +/- 55 mg 100 g-1). Lower quantities were found in all other tubings investigated (electrically conductive latex: 64 +/- 4, conductive rubber: 62 +/- 4, polyethylene-vinyl-acetate (PEVA): 293 +/- 10 and 149 +/- 17 for non-conductive corrugated and spiral tubes, respectively, polysulfone (Hytrel): 155 +/- 10 mg 100 g-1). The isoflurane contents were substantially lower (silicone: 278 +/- 23; others: 55 +/- 7, 61 +/- 6, 163 +/- 9 and 86 +/- 8, 74 +/- 4 mg 100 g-1). The tubings' content did not correlate with the material's partition coefficient as full saturation was not achieved during exposure. Decontamination procedures reduced the content of volatile anaesthetics to a variable extent. Conductive latex and rubber showed the highest residual content, even after thermal disinfection and subsequent storage. Twenty-minute flushing with oxygen (8 l min-1) decreased effluent gas concentrations below 5 p.p.m. in all tubings. With silicone, after 1 h flushing, halothane concentrations still exceeded 10 p.p.m. (isoflurane: 8 p.p.m.). It is concluded that urgent decontamination by a 20-min flush warrants the safe re-use of previously 'contaminated' conductive rubber and latex as well as polysulfone tubings in critical situations, e.g. in malignant hyperthermia patients if disposable tubing is not immediately available.(ABSTRACT TRUNCATED AT 250 WORDS)


Is acupuncture an alternative in idiopathic pain disorder?

This study investigated the pain-relieving effect of an intensive type of periosteal acupuncture stimulation in patients with idiopathic pain disorder. Twelve patients, 2 males and 10 females, with a mean age of 54, were included in the study. The average duration of their pain was 12.6 years. Each treatment consisted of brief but painful manual stimulation of 3 to 4 periosteal sites. Over a 3-8-month period each patient had between 4-11 treatments, an average of 7. Analgesic drugs that patients were on prior to the study were continued but no other physical or psychological treatment for their pain was applied. Ten patients had either no responses to treatment or only transient responses which were not maintained until the following treatment. Two patients benefitted from treatment, having long periods of substantial pain reduction. All responses were assessed on pain scales maintained daily before and during the entire period of treatments. For the majority (83%) of patients in this study, with an idiopathic pain disorder, periosteal acupuncture stimulation was not a treatment alternative.


Intra-articular bupivacaine plus adrenaline for arthroscopic surgery of the knee.

The purpose of the study was to evaluate three different doses of intra-articular bupivacaine plus adrenaline in relation to per- and postoperative pain relief following arthroscopy. Sixty patients were allocated to three groups of 20 patients each scheduled for arthroscopy. They were randomized prospectively to receive bupivacaine plus adrenaline 25 mg + 50 micrograms, 50 mg + 100 micrograms, 75 mg + 150 micrograms, respectively, diluted to a volume of 30 ml. Four patients were excluded because the operation could not be carried out under intra-articular analgesia, 18 patients had a diagnostic arthroscopy and 38 patients had different arthroscopic operations performed. The number of patients scoring pain in the knee as moderate or severe was less in Group 3 than in the other two groups, i.e. the highest dose had a better pain relief. No adverse effects were registered. With respect to per- or postoperative administration of analgesics, postoperative pain occurrence, and the surgeon's acceptance of the method, there were no statistically significant differences. Ninety-two percent of the patients would prefer intraarticular analgesia if they should need to have another arthroscopy performed.


Effect of piroxicam in addition to continuous thoracic epidural bupivacaine and morphine on postoperative pain and lung function after thoracotomy.

Twenty-eight patients scheduled for lung resection with lateral thoracotomy and postoperative chest drains during combined thoracic epidural bupivacaine plus morphine and general anaesthesia were studied. Postoperative pain treatment was continuous epidural infusion of bupivacaine 0.25% 5 ml h-1 plus morphine 0.2 mg h-1 for 48 h and, in addition, the patients received rectal piroxicam 40 mg randomly and double-blind 12 h and 1 h before surgery and 20 mg 24 h-1 postoperatively or placebo. Pain was evaluated at rest, during cough and mobilisation, together with pulmonary function (FEV1, FVC, PEFR) and sensory level of analgesia repeatedly for 48 h. The results showed efficient pain relief, but without differences in pain scores or need for supplementary analgesics between the two groups. Pulmonary function decreased similarly in the two groups. Thus we were unable to show enhanced analgesia by supplementing an otherwise effective low-dose epidural bupivacaine and morphine treatment with piroxicam after thoracic surgery with chest drains.


Pulmonary granulocyte accumulation is reduced by nebulized corticosteroid in septic pigs.

Nebulized beclomethasone dipropionate was administered to 14 anesthetized and artificially ventilated pigs at 6-hourly intervals after infusion of live S. aureus (BDP group). Changes in pulmonary activity from autologous granulocytes labeled with In-111 was detected externally for 12 (n = 8) to 44 h (n = 6). The changes were compared with those in ten pigs (12 h n = 7, 44 h n = 3) subjected to the same insults but given no corticosteroid (placebo group). Serial measurements of blood radioactivity, and cardiac output were performed in animals observed for 12 h. Corticosteroid-treated pigs showed a gradual decline in decay-corrected pulmonary In-111 activity. The placebo group displayed a more varied reaction, but most animals had an increased activity compared to the corticosteroid group. The difference between the groups was significant at 8 h (BDP-group 92% (88-98), placebo-group 107% (97-121), median (lower-upper quartiles), baseline = 100%. P < 0.01, U-test). Blood radioactivity and cardiac output did not differ significantly between the two groups. Nebulized corticosteroid thus diminished pulmonary granulocyte accumulation, which may be of value in the treatment of septic respiratory distress.


Ten ml bupivacaine 0.125% with 12.5 micrograms epinephrine is a reliable epidural test dose to detect inadvertent intravascular injection in obstetric patients. A double-blind study.

A double-blind study was designed in order to determine the specificity and sensitivity of an epidural test dose to detect inadvertent intravenous injection in obstetric patients undergoing epidural analgesia. Forty unselected obstetric patients were given an intravenous injection of 10 ml bupivacaine 0.125% with 12.5 micrograms epinephrine (test dose) or 10 ml normal physiologic saline. The maternal heart rate was monitored by the direct ECG mode of a fetal monitor and registered simultaneously with the tocogram. The primary investigator was blinded to the solution he injected into an antecubital vein. After the injection was given, he recorded his judgment of which solution he had administered. Eight other anesthesiologists made similar judgments on the basis of the recordings plus various levels of additional information (presence or absence of epidural analgesia, time of injection, subjective signs and symptoms). In contrast to the primary investigator, the blood pressure values were not given to them. For the primary investigator, the specificity of the test dose was 100% and the sensitivity 97.5%. The judgments of the 8 other anesthesiologists resulted in an excellent specificity (99.1%) and a good sensitivity (91.9% with information on time of injection and subjective signs and symptoms). The better performance of the primary investigator is probably due to the availability of blood pressure data.


Thiopentone or propofol for induction of isoflurane-based anaesthesia for ambulatory surgery?

This study compares psychomotor recovery following induction of anaesthesia with either thiopentone or propofol in 30 healthy, unpremedicated patients undergoing outpatient arthroscopic procedures of the knee. A battery of tests including simple reaction time (SRT), choice reaction time (CRT), perceptive accuracy test (PAT) and digit symbol substitution test (DSST) were done before anaesthesia. The patients were randomly divided into two groups: Group 1 was induced with thiopentone 5-6 mg/kg while Group 2 was induced with propofol 2-3 mg/kg. Anaesthesia was then maintained with isoflurane (0.5-2%) in oxygen and air, and supplements of alfentanil were given for analgesia during spontaneous respiration with a face mask. Psychomotor recovery assessed every 30 min postoperatively for 120 min showed that patients in Group 1 had not returned to baseline values until 120 min after the operation on the PAT, while those in Group 2 had returned to baseline values at 60 min. No patient had any significant side effects. The SRT, CRT and DSST proved to be relatively insensitive in the detection of residual effects of anaesthesia and had a significant learning effect. This study suggests that induction of anaesthesia with propofol followed by maintenance with isoflurane in oxygen and air during spontaneous ventilation is associated with rapid psychomotor recovery and is a suitable method for ambulatory surgery. The PAT is sensitive and not associated with some of the problems found with other commonly used tests.


Effects of verapamil on histamine-induced changes in lung mechanics.

The effects of verapamil on airway resistance and total thoracic compliance were studied in 15 rabbits with histamine-induced changes in lung mechanics. The animals, after being tracheotomized under anaesthesia, were subjected to mechanical ventilation in a time-cycled, volume-limited mode. Airway pressure and gas flow signals measured by a pneumotachograph and integrated for volume, were registered on a recorder. Each animal was given histamine hydrochloride in an isotonic solution of sodium chloride at a rate of 0.05 micrograms.kg-1.min-1 through a peripheral venous line. Verapamil was infused intravenously in an isotonic solution of sodium chloride at a rate of 20 micrograms.kg-1.min-1 after the initiation of histamine. Verapamil reduced the histamine-induced increase in airway resistance by 20% at 20 min after the start of administration.


Haemodynamic changes associated with thermodilution cardiac output determination during myocardial ischaemia or pulmonary oedema in dogs.

Since the technique of thermodilution (TD) cardiac output measurements per se causes haemodynamic alterations, the authors examined whether the alterations elicited by iced injectate are augmented in the presence of myocardial ischaemia (MI) or pulmonary oedema (PE), compromised conditions frequently associated with critically ill patients. MI (N = 7) or PE (N = 7) was induced by clamping the anterior descending coronary artery or by a slow infusion of oleic acid into the right atrium, respectively, in anaesthetized dogs. Injection of iced injectate, 3 ml, caused similar changes in heart rate, mean systemic and pulmonary arterial pressures, pulmonary blood flow, right ventricular dP/dt, and right atrial pressure in dogs with and without MI or PE. Cardiac output estimated by TD correlated closely with pulmonary blood flow measured by electromagnetic flowmeter in both MI and PE (r > 0.9). No profound alterations in haemodynamics were observed at any injection during TD cardiac output measurements under MI or PE. These results indicate that TD cardiac output determination does not cause serious haemodynamic alterations, and can estimate right ventricular output accurately under MI and PE.


Effects of epinephrine and clonidine on plasma concentrations of spinal bupivacaine.

ASA II-III patients, scheduled for peripheral vascular surgery, were included in a study designed to assess the effect of spinal epinephrine and clonidine on plasma concentrations of spinally administered 0.5% glucose-free bupivacaine. Patients were allocated randomly to three groups to receive via a spinal catheter 22.5 mg (4.5 ml) of bupivacaine alone (Group B, 9 patients) or combined with 0.3 mg epinephrine (Group BE, 10 patients) or 0.15 mg clonidine (Group BC, 10 patients). Sensory blockade was assessed by pin-prick and motor blockade on the Bromage scale. Bupivacaine plasma concentrations were measured by gas chromatography. A trend to prolongation of local anaesthetic blockade was documented in patients receiving bupivacaine plus epinephrine or clonidine. (Time to regression of sensory blockade to L2: 170 +/- 75 min in Group B, 230 +/- 50 min in Group BE, 232 +/- 64 min in Group BC.) The maximum peak concentration (Cmax), the time to reach Cmax (Tmax) and the time-concentration curve from 0-180 min (AUC) were not different for the three groups (Cmax 228 +/- 112 ng.ml-1 in Group B, 215 +/- 103 ng.ml-1 in Group BE, 234 +/- 159 ng.ml-1 in Group BC; Tmax 41 +/- 34 min in Group B, 59 +/- 31 min in Group BE, 68 +/- 32 min in Group BC; AUC 31.0 +/- 1.7 mg.ml-1.min-1 in Group B, 27.3 +/- 1.1 mg.ml-1.min-1 in Group BE, 27.0 +/- 1.1 mg.ml-1.min-1 in Group BC). The results of this study suggest that epinephrine and clonidine do not decrease blood resorption of spinal bupivacaine.


Plasma prilocaine and mepivacaine concentrations after combined lumbosacral plexus block.

In a pharmacokinetic study of combined sciatic/3-in-1 block for lower limb surgery, the two moderate-acting local anaesthetics prilocaine and mepivacaine were compared. The mean maximum venous plasma concentrations of mepivacaine were more than twice as high as when prilocaine was used as anaesthetic (5.1 micrograms/ml vs. 2.37 micrograms/ml). When used in combination with the former, ornipressin did not reduce plasma concentrations of mepivacaine to values which were below the threshold for toxic symptoms (5-6 mg/ml). The peak plasma concentrations exceeded the threshold of 5 micrograms/ml in four of the nine patients of the mepivacaine group (maximum value 7.21 mg/ml) and in two of the nine patients of the mepivacaine+ornipressin group (maximum value 8.61 micrograms/ml).


Prilocaine in lumbosacral plexus block--general efficacy and comparison of nerve stimulation amplitude.

The significance of the threshold amperage of peripheral nerve stimulation (PNS) for the efficacy and latency of sciatic block is shown in a controlled randomized study of stimulation amplitude. In all cases the block was complete within a short time when the threshold amperage was 0.3 mA or less. Incomplete motor and sensory blocks occurred with higher stimulation amplitudes of 0.5 and 1.0 mA. In view of these results a prospective study of the clinical efficacy of 852 combined sciatic/3-in-1 blocks using prilocaine, and performed by means of peripheral nerve stimulation was carried out. No CNS or cardiovascular complications, no problems resulting from methaemoglobinaemia and, above all, no nervous lesions were observed. The limiting factor for surgery of the lower limb with this method of anaesthesia is the tolerance of the femoral tourniquet which depends mainly on the efficacy of the 3-in-1 block. Ninety-one per cent of the combined blockades were primarily successful when there was no tourniquet at all, and 87% when the tourniquet was placed on the lower leg. In the course of surgery with a femoral pneumatic tourniquet, only 55% of the blocks did not require supplement when 20 ml of 1% prilocaine was used for the 3-in-1 block, while 72% and 74% were efficacious with 30 ml and 35 ml, respectively. The efficacy of the sciatic block proved to be extremely high (> 95%), its success depending on the dosage of the local anaesthetic and correct execution of the peripheral nerve stimulation.


A two-dose epidural morphine regimen for cesarean section patients: therapeutic efficacy.

A single dose of epidural morphine (EM) usually produces 24 h of post-cesarean section (CS) analgesia and patients require supplemental analgesics beyond this period. This study assesses if a second dose of EM administered 24 h after the first one offers superior therapeutic efficacy compared to conventional analgesics. Patients (n = 100) were randomized to receive one or two doses of epidural morphine. In all patients, EM 5 mg was administered after delivery. After 24 h patients received epidurally either normal saline (n = 50, Group 1) or morphine 5 mg (n = 50, Group 2). An independent observer used a visual analogue scale to assess nausea, itching, and analgesia 24 h after each injection. Results were expressed as mean +/- 1 s.e. mean and analyzed using nonparametric methods. The second dose of EM produced a significantly lower incidence and severity of nausea and itching than did the first dose (P < 0.01) in Group 2 with no difference in analgesia. The second day postoperative pain score in Group 1 was significantly greater than the first day score in the same group, and significantly greater than the severity score in Group 2. Only 36% of patients receiving two doses of EM required supplemental analgesics beyond 48 h compared to 76% of those receiving one dose (P < 0.01). No serious complications were noted. In summary, the use of a second dose of EM for post-CS analgesia produces better analgesia and reduces the need for oral analgesics. The second dose produced fewer side-effects, probably due to acute tolerance to morphine.


Influence of plasma cholinesterase activity on recovery from mivacurium-induced neuromuscular blockade in phenotypically normal patients.

The significance of plasma cholinesterase (pChe) activity for the duration of action of mivacurium in phenotypically normal patients was evaluated in 35 patients during neurolept anaesthesia. The response to train-of-four nerve stimulation was recorded using a Myograph 2000. Ten patients with normal pChe (Group I) and five patients with decreased pChe activity (Group 2) were given a small test dose of mivacurium 0.03 mg kg-1. Mivacurium 0.1 mg kg-1 was administered following spontaneous recovery from the first dose. The mean suppression of the height of the first (T1) of the train-of-four responses following mivacurium 0.03 mg kg-1 patients with normal and decreased enzyme activity was 40% and 56%, respectively, and the mean T1 suppression after mivacurium 0.1 mg kg-1 was 100% in both groups. The times to different levels of twitch height recovery following the 0.1 mg kg-1 dose did not differ between the two groups of patients. Another 20 patients with normal or decreased pChe activity (Group 3) were given mivacurium 0.2 mg kg-1. In this group the time to maximum block was 1.4 min (1.0-4.0) mean (range) and the time to reappearance of the T1 response was 15.0 min (7.4-22.7) (range). An inverse relationship was found between the patients' pChe activity and the time to first response. It is concluded that mivacurium is short-acting in patients with normal pChe phenotype and normal to low-normal pChe activity. No patient with very low pChe activity was included in the study. A prolonged response to mivacurium may, however, be expected in these patients.


Failure of anaesthesia after accidental subdural catheter placement.

A case is described where an epidural anaesthetic was complicated by dural puncture, following which attempted conversion to a continuous subarachnoid infusion technique resulted in failure of anaesthesia. Accidental subdural catheter placement was confirmed radiologically, subdural spread of solution being demonstrated; however, only minimal anaesthetic effects were produced.


Comparison of ketorolac and morphine for postoperative pain after major surgery.

This study was designed to determine the relative analgesic efficacy and safety of single intramuscular injections of ketorolac (10 mg or 30 mg) and morphine (10 mg) in patients of either sex with moderate to severe pain after major surgery. In a single-dose, randomised, double-blind study of parallel design, pain was assessed immediately before injection of test medication and at regular intervals for 8 h thereafter. One hundred and seventeen patients (109 undergoing cardiac surgery; 8 lung surgery) were randomized to one of the three treatment groups. Pain intensity was assessed using a 5-point verbal scale before administration of study drugs. Postadministration, at 30 min and hourly for 8 h, pain intensity and pain relief were assessed, again using the 5-point verbal scale. Additionally, as a measure of analgesia, forced expiratory volume (FEV1) was obtained in all patients. Vital signs including blood pressure, pulse, temperature, respiratory rate and blood gases (PaCO2) were recorded prior to and after study medication. Based on hourly pain intensity differences and hourly pain relief observations, ketorolac 10 mg was generally more effective than morphine 10 mg, and ketorolac 30 mg was generally more effective than ketorolac 10 mg. The results of this study show that ketorolac is an effective and safe (with regard to arterial pressure, blood gases and lung function) analgesic for relief of postoperative pain after major surgery in stable patients. No clinically significant adverse effects occurred during the study. One cannot exclude an influence on patients with organ system dysfunction or on parameters not measured in this study.


Lidocaine hydrocarbonate and lidocaine hydrochloride for cesarean section: transplacental passage and neonatal effects.

Twenty-six patients, ASA physical status 1, scheduled for elective cesarean section, were divided at random into two groups and received via an epidural catheter 20 ml of 2.2% lidocaine hydrocarbonate (17.3 mg.ml-1 lidocaine base) with 5 micrograms.ml-1 epinephrine freshly added (Group CO2 = 13 patients) or 20 ml of 2% lidocaine hydrochloride (17.3 mg.ml-1 lidocaine base) also with 5 micrograms.ml-1 epinephrine freshly added. Following clampage of the umbilical cord (at 40.1 +/- 4.9 min after the injection of lidocaine for the CO2 group and at 41.0 +/- 5.4 min for the HCl group), serum concentrations of lidocaine were measured both in the mother and in the umbilical vein. All newborns were examined by the same blinded pediatrician with Apgar scores at 1, 5 and 10 min and with Neurobehavioral Adaptive Capacity Scores (NACS) at 15 min, 2 h and 24 h. The concentrations of lidocaine in the serum were comparable in both groups: in the mothers 8.61 +/- 1.48 mumol.l-1 for the CO2 group vs 8.04 +/- 2.36 mumol.l-1 for the HCl group and in the newborns 3.86 +/- 0.84 mumol.l-1 for the CO2 group vs 3.92 +/- 0.95 mumol.l-1 for the HCl group. The ratio of umbilical vein to maternal vein concentrations of lidocaine was also similar in both groups: 0.45 +/- 0.07 for the CO2 group vs 0.54 +/- 0.24 for the HCl group. The percentage of newborns with a normal NACS (score > or = 35/40) was equal in both groups, i.e. 91% at 15 min and 2 h of life and 100% at 24 h of life.(ABSTRACT TRUNCATED AT 250 WORDS)


Onset and duration of hypoalgesia of lidocaine spray applied to oral mucosa--a dose response study.

Lidocaine is often used as a topical analgesic prior to painful procedures performed in the oral cavity and upper airways. In this study the optimal time interval for performance of painful procedures in the oral cavity and the upper airways was determined by spraying lidocaine solution on the mucous membranes of the mouth with subsequent measurements of pain thresholds induced by argon-laser stimulation. Two different dosages (30 mg and 60 mg) of lidocaine spray were administered to the oral mucosa of the lower lip in healthy volunteers. Repeated measurements were performed until normal sensitivity returned after 15 min. Pain thresholds increased 62% after 30 mg lidocaine and 50% after 60 mg lidocaine (a non-significant difference). Thus repeated applications were found to be without any additional hypoalgesic effect. Maximal hypoalgesia was reached after 4 to 5 min. Complete analgesia was not obtained. The hypoalgesic effect lasted until 14 min, but painful procedures should be performed in the time interval 3-8 min after application.


Increased volume of gastric contents in diabetic patients undergoing renal transplantation: lack of effect with cisapride.

Gastroparesis is a frequently unrecognized complication of insulin-dependent diabetes mellitus, which subjects these patients to the risk of aspiration at induction of anaesthesia. The effect of oral cisapride on volume and pH of gastric contents was studied in 24 diabetic and 24 non-diabetic uraemic patients undergoing renal transplantation. All patients were allocated randomly in a double-blind fashion to receive either 10 mg of cisapride or placebo orally approximately 100 min before anaesthesia and three times daily for the first 2 postoperative days. After the induction of anaesthesia, gastric contents were aspirated through a nasogastric tube, and the pH and volume were measured. The emptiness of the stomach was verified by gastroscopy. Gastric volumes exceeding 0.4 ml.kg-1 were observed in 12/24 of the diabetic and 4/24 of the non-diabetic uraemic patients (P < 0.01). The pH of the gastric contents did not differ between the groups, ranging from 1-8 in diabetics and 1-7 in non-diabetics. Cisapride lacked effect on gastric contents and postoperative gastrointestinal motility. Diabetic uraemic patients had larger gastric volumes than their non-diabetic controls at induction of anaesthesia. Cisapride had no effect on gastric emptying preoperatively nor on postoperative bowel function.


Individual variability of pathological parameters in chemically induced rat colon tumors.

The development of tumorigenic conditions in the carcinogen-exposed rat colon was studied using selected morphological, histochemical, immunohistochemical and biochemical methods of analysis. Rats were treated with two carcinogens: 1,2-dimethylhydrazine and N-methyl-N'-nitro-N-nitrosoguanidine alone or with deoxycholic acid as a tumor promoter. It was found that 3 months after treatment of animals with the carcinogens the following changes were developed in colonic tissue: infiltration of lymphocytes in the mucous membrane, high increase in mitotic index among epithelial cells, negative reactions of colonic cells for neutral mucopolysaccharides and sulfomucins and positive reactions to carboxyl groups, nonsulfated acid mucosubstances and tissue polypeptide antigens. An increase in the activity of ornithine decarboxylase in colonic tissue was developed within the same time period and has been seen only in those tissues which were characterized by the development of precancerous conditions. Individual variations were observed in the manifestation of the studied parameters in rat neoplastic colonic tissues. It is suggested that these differences reflect an individual sensitivity of animals to carcinogens and the magnitude of the dysplastic processes induced in the colon.


Ultrastructure of the parathyroid gland of fetal and pregnant golden hamsters subjected to hypergravity environment.

The ultrastructure of the parathyroid glands of fetal and pregnant golden hamsters exposed to 5-gravity environment was studied. In the centrifuged fetal animals the Golgi complexes associated with some prosecretory granules were significantly increased compared with those of the control fetal animals, and several secretory granules were located in a peripheral position just beneath the plasma membrane. In the centrifuged pregnant animals the Golgi complexes associated with numerous prosecretory granules were significantly increased, cisternae of the granular endoplasmic reticulum appeared to be increased compared with those of the control pregnant animals, many secretory granules were located in the peripheral cytoplasm and several granules were situated close to the plasma membrane. These findings suggest that in the parathyroid glands of the fetal golden hamsters as well as the pregnant animals the synthesis and release of parathyroid hormone may be stimulated in response to a hypergravity environment.


Degranulation of rough endoplasmic reticulum in M phase and adenosine-triphosphate-treated interphase cells is reversible.

In the preferential harvesting of rounded mitotic (M phase) cells of human Chang liver monolayer cultures by mechanical agitation in Ca(2+)-free phosphate-buffered saline, degranulation of endoplasmic reticulum (ER) was observed. Mitotic cells are known to have a series of Ca2+ transients and, without being subjected to Ca(2+)-free washings, did not have degranulated ER. Quiescent cells incubated with 0.7 mM adenosine 5'-triphosphate (ATP) in Ca(2+)-free HEPES-buffered saline produced very similar ER degranulations. Confocal argon laser imaging of fluo-3-loaded cells showed a Ca2+ transient peaking at 2 min after ATP treatment. In the absence of extracellular Ca2+, transients of Ca2+ elevation in the cytosol would exit the cell in a down-gradient, draining the ER Ca2+ stores. Substituting ATP with 1 microM brominated A23187 calcium ionophore in the incubation that contained 1-100 mM CaCl2, respectively, did not produce ER degranulation, thereby excluding raised cytosolic Ca2+ per se as the cause of ER degranulation. In fact, incubation with 0.7 mM ATP in the presence of 1-5 mM CaCl2 failed to produce ER degranulation. ER degranulated cells, from treatment with ATP without extracellular Ca2+ as well as from Ca(2+)-free washings at M phase, could be rescued by subsequent incubation in growth medium that contains Ca2+ whereupon the rounded cells re-flatten (a round-to-flat change) and have well-defined rough ER. It therefore seems possible for Ca2+ depletion, or at least a reduction, to be causally related to ER degranulation. If that were the case, ER granularity would appear to be a facultative rather than a constitutive state.


Gamma-aminobutyric acid immunoreactivity in the enterochromaffin cells of the rat stomach.

The present immunocytochemical study revealed gamma-aminobutyric acid (GABA) immunoreactivity in the oxyntic and pyloric mucosa of the rat stomach at light- and electron-microscopic levels. GABA-immunoreactive endocrine cells were numerously seen in the lower half portion of the pyloric mucosa but rarely in the oxyntic mucosa. These cells were round or oval in shape and sometimes had a short cytoplasmic process. Serotonin-immunoreactive enterochromaffin (EC) cells were also observed in the oxyntic and pyloric mucosa of the stomach. The distribution and shapes of the immunoreactive cells were similar to those of the GABA-immunoreactive cells. With a double immunolabeling technique using anti-GABA and antiserotonin serum, GABA-immunoreactive endocrine cells showed serotonin immunoreactivity and were identified as EC cells. At the electron-microscopic level the GABA-immunoreactive cells contained round or oval, spindle-like, pear-shaped granules in EC cells. The immunoreaction product in the EC cells was generally confined to the granular cores. These findings suggest that GABA may be synthesized in the EC cells and be released from the granules of the cells after adequate stimuli.


The mandible--an analysis.

In this study, an attempt has been made to examine and analyse the ancient mandibles of people who have died several hundreds of years ago during the second and first millenium B.C. These mandibles have been recovered from the burial mounds in Bahrain (Arabian Gulf) and preserved in the National Museum and the Department of Antiquities in Bahrain. The dental conditions recorded are e.g. attrition, caries, fluorosis, periodontitis or antemortem tooth loss. The results indicate the age, sex, diet, occupation and environmental conditions that existed and even the culture of the people. A comparative study of the ancient mandibles and those of the present generation has been carried out.


Distributions of antibovine-pepsinogen-positive cells in glandular regions of forestomach in the bactrian camel, Camelus bactrianus.

The present paper describes mucous cells in the forestomach glandular region which immunoreacted to antibovine pepsinogen serum in adult and young bactrian camels, Camelus bactrianus (female, 25 years old; female, 6 months old; from Hilar Inner Mongolia, People's Republic of China, in August 1988). These immunoreactive cells in forestomach glandular regions also reacted to Alcian blue (pH 1.0) and/or periodic acid-Schiff. Cross-reactivity of antibovine pepsinogen serum against extracts from the forestomach glandular region was analyzed by Western blotting, supporting that this serum could detect pepsin and/or pepsinogen in the bactrian camel. It was suggested that mucous cells in forestomach glandular regions produce pepsinogen molecules.


Cartilage canal growth: experimental approach in the rat tibia.

This paper studies the influence of an antimitotic factor (puromycin) and a hormonal factor (thyroid hormone, TH) on canal growth. The tibiae of 15 six-day-old rats were cultured in a serum-free chemically defined medium. The cultures were carried out for as long as 6 days. Our results show: (1) canal growth is not dependent on perichondrium or chondro-epiphysis growth; (2) the canal is greater and has a complex pattern in a triiodothyronine (T3)-treated assay group; (3) round and multinucleated cells are more numerous in the T3-treated assay group than in the other groups. We hypothesize that the canal grows by a physiological phenomenon of programmed cell death and that it is stimulated by TH.


Distribution of glycoconjugates localized by peanut and Maclura pomifera agglutinins during mouse molar root development.

Glycolipids, glycoproteins, glycosaminoglycans and sialoglycoproteins have all been implicated in a number of developmentally significant processes related to complex interactions between cell surfaces and the extracellular matrix. The present study was designed to localize glycoconjugates recognized by peanut agglutinin (PNA) and Maclura pomifera (MPA) lectins during mouse molar root development. Postnatal ICR mice at 10, 15, 21, 28 and 42 days were used. Lower jaws were dissected, fixed in 4% paraformaldehyde, decalcified in 5% EDTA and embedded in paraffin. Serial sections were made and stained with FITC-conjugated PNA or MPA. beta-Lactose was used as an inhibitory sugar for PNA, and alpha-D-melibiose for MPA. PNA specifically stained Hertwig's epithelial root sheath (HERS), whereas MPA stained a number of tissues. The outermost layer of root dentin, forming cellular cementum, alveolar bone and HERS showed positive reactions with MPA. Glycoconjugates localized by the lectins may be functionally related to molecules which contribute to root formation and cemento-genesis.


Modulation of phenotype and cytoskeleton architecture by interleukin-1 alpha in human osteoblast-like cells in vitro.

Interleukin-1 alpha, a growth factor produced by macrophages as well as many other types of cells, is able to modulate biosynthetic activities in bone cells. In this work, the authors show that the administration of interleukin-1 alpha to osteoblast-like cells in vitro induces a marked change in cell morphology, which becomes dendritic, with a smaller cellular body and numerous prolongations. The morphological changes are also accompanied by an altered expression in the pattern of cytoskeleton proteins.


Increase of DNA synthesis in uterine adenomyosis in mice with ectopic pituitary isograft.

Ectopic pituitary isografts (EPI) have been found to induce a high incidence of uterine adenomyosis in SHN mice. All the SHN mice given EPI in the right uterus at 40 days of age developed uterine adenomyosis, and more than 80% of mice showed the genesis of subserosal nodules, an advanced state of adenomyosis, 65 days after EPI. Activities of both thymidylate synthetase and thymidine kinase, i.e. DNA-synthesizing enzymes in de novo and salvage pathways of pyrimidine metabolism, respectively, were significantly increased in EPI-induced uterine adenomyosis to approximately 2-fold those in normal control uteri. Bromodeoxyuridine-immunoreactive cells were regarded as the cells in S phase, and the number in the endometrial epithelium and stroma in EPI-induced uterine adenomyosis was more than 1.5-fold that in normal control uteri. EPI may affect the genesis of uterine adenomyosis generally, but not locally, because there were no differences between the right uterus with EPI and the left without EPI in the incidence of adenomyosis, histology or DNA-synthesizing enzyme activities.


Identification of sugar residues in human fetal olfactory epithelium using lectin histochemistry.

Lectin-binding histochemistry was used to investigate the distribution and the changes of the glycoconjugate saccharidic moieties in the olfactory epithelium of human fetuses ranging from 8 to 12 weeks of gestation. It was found that the basal cells, the sustentacular cells and the olfactory neurons exhibit differences in oligosaccharide cellular content and distribution. Differences in lectin binding was also demonstrated at the dendrite, cell body and axon of the receptor cells. From the 11th week onwards, Ulex europaeus agglutinin I was found to be a marker of the olfactory neurons.


Clomiphene citrate alters surface ultrastructure of uterine luminal epithelial cells.

Scanning electron microscopy was used to evaluate the uterine luminal epithelium from ovariectomized rats treated with a single minimal physiological dose of clomiphene citrate, oestradiol-17 beta or progesterone. It was found that clomiphene treatment produced some ultrastructural surface features which were similar to those seen with both oestrogen and progesterone treatment, but in addition it produced features unique to clomiphene treatment.


Are Ranvier's nodes of the central nervous system also artifacts by preparation?

Recent research on peripheral nerves of six species of vertebrates concluded that Ranvier's nodes may be artifacts by preparation. As a consequence, the question as to whether or not Ranvier's nodes of the central nervous system may also be artifacts was logically raised. The ultrastructural data concerning our field of research (the cerebellar cortex) support the notion that Ranvier's nodes are real features in the central nervous system; otherwise, the occurrence of vesicular outpockets establishing, along myelinated axons, well conspicuous en passant nodal synapses cannot be explained.


Isolated pancreatic islets of the rat: an ultrastructural study.

Pancreatic islets from adult Wistar rats were isolated by an improved collagenase digestion technique. Examination of the preparations showed that they contained B cells possessing secretory granules, each having an eccentric electron-dense core surrounded by an electron-lucent halo; the Golgi bodies with their characteristic features were located in a juxtanuclear position. Roughly surfaced endoplasmic reticulum and mitochondria were present and were mostly normal in appearance. The cell possessed all the ultrastructural attributes indicating that they were fully functional and structurally intact.


[Quantitative analysis of the isthmo-optic nucleus and projection neurons to the retina in adult fowl (Gallus gallus domesticus)].

Quantitative analysis of the isthmo-optic nucleus (IO) and centrifugal projection to the retina in the fowl was made using Nissl preparation and retrograde horseradish peroxidase (HRP) methods. Seven adult fowls (Gallus gallus domesticus) were used for Nissl stain. Serial sections were cut on a freezing microtome at 60 microns and stained with cresyl violet. IO was situated just medial to the caudal part of the tectum and laterodorsal surface of the brain stem. Rostrocaudal extension of IO was about 800-1,000 microns. The average total volume and neuronal population of the IO was 280 x 10(-3) mm3 and 5,600 neurons, respectively. Eight animals were used for HRP study. One hundred microliters of 30% HRP solution in physiological saline was injected into the vitreous body of one eye of each hen. Serial transverse sections of 60 microns were treated with tetramethyl benzidine (TMB). Many labeled neurons were found in contralateral brain stem. Average total number of contralateral HRP-labeled cells in IO and peri-IO were 5,268 and 1,492, respectively. Labeled neurons peri-IO were mainly distributed ventrally and rostrally to IO. No labeled neurons in IO, and only a few labeled neurons peri-IO were found ipsilaterally. The number of HRP-labeled neurons in IO corresponded to the neuronal population of IO in Nissl preparation, which suggested that most of isthmo-optic neurons might be projecting to the contralateral retina. In contrast to the round and small IO neurons (long axis 15-20 microns, short axis 10-20 microns), peri-IO neurons were multipolar and longer (long axis 15-30 microns, short axis 10-25 microns).