Double-walled coated vesicle formation: evidence for massive and transient conjugate internalization of plasma membranes during cerebellar development. A massive and transient increase in the formation of double-walled coated vesicles (DWCVs) from surface membranes during late cerebellar development is reported here. These structures are characterized by an outer vesicle (65 nm in diameter), bearing a 15 nm thick spiny coat, containing an inner vesicle (30 nm in diameter). DWCVs occur free in the cytoplasm or attached to the plasma membranes. In the latter case, the membrane of the outer vesicle can be seen to be an invagination of the plasmalemma of the parent cell process while the membrane of the inner vesicle is an evagination of the plasmalemma of the adjacent cell process. DWCVs were observed in a variety of cellular elements in the granular and molecular layers of immature mouse cerebellum, including axons, dendrites, glia and cell bodies. Morphometric analysis revealed that the number of DWCVs in cerebellar mossy terminals became elevated between 16 and 37 days of age and reached a peak 45--50 times higher at 20 days than at either 10 or 70 days of age. The data suggest that a massive conjugate internalization of apposed plasma membranes occurs during late postnatal development which may serve to remodel neural membranes.


Some genetic considerations for the design of better mammalian assay systems for the detection of chemical mutagens and carcinogens. Fuller utilization of the potential for genetic manipulation of the laboratory animal populations producing test animals should aid in the development of more sensitive, relevant, and economic toxicologic assay systems for the generation of dose response data at environmental exposure levels. One example of such genetic manipulation is the incorporation, in laboratory mouse populations of any desired genetic structure, of dominant visible mutations which enhance tumor formation. Thus, two different levels of inherent susceptibility to tumor formation can be incorporated and visually identified in the same test population. Another example is the manipulation of the genetic structure of a laboratory animal population in order to generate F-1 hybrids, hybrid crosses, or minimally inbred stocks from the same gene pool. Which of these genetic structures is most suitable in any particular case depends on the purpose for which the assay data are to be used. In making a choice, the desired degree of genetic heterogeneity of the population and the phenotypic variability of the toxicologic responses to be assayed must be considered.


The incidence and variety of Golgi tendon organs in extraocular muscles of the rhesus monkey. Golgi tendon organs of distal tendons of rectus muscles were traced in serial transverse sections using a light microscope and their identity confirmed with an electron microscope. One or two tendon organs were present in eight of ten muscles taken from four adult rhesus monkeys and none were present in the other two. Tendon organs were unusually small averaging 270 micrometers in length and 36 micrometers in maximum width; three of them were bifid at one or both ends and the remainder were fusiform. Some lay wholly within tendon without direct attachment of muscle fibres and in the others the tip of a single felderstruktur (slow, non-twitch) muscle fibre entered the tendon organ capsule proximally and occupied the full width. Nerve terminals of most tendon organs compared with those found in other muscles with similar organelles and variety of shape. In three tendon organs with inserted muscle fibres, however, terminals with regular profiles, larger aggregations of clear vesicles and fewer mitochondria were present. The latter type of terminal and the encapsulated filderstruktur muscle fibres are features shared by the large numbers of myotendinous cylinders present in extraocular muscles and it is argued that tendon organs and myotendinous cylinders might be of common origin. If this is the case, then the overwhelming majority of myotendinous cylinders suggests that tendon organs may be an aberrant development in extraocular muscles and of little significance in the total sensory output.


Mutation assay in diploid human lymphoblasts: methodological aspects. The protocol for a recently developed quantitative assay for mutation at the hgprt locus of human lymphoblasts is presented. Practical problems affecting ease of performance and reliability are discussed with the aim of making the assay available for assessment and possible use in other laboratories.


Aberrant axon-Schwann cell junctions in dystrophic mouse nerves. 'Amyelinated' axons in the spinal roots of dystrophic mouse nerves lack typical nodal and paranodal membrane specializations. However, at the periphery of the amyelinated bundles some of the naked axons form aberrant junctions with Schwann cells belonging to neighbouring myelinated axons. These junctions are characterized by a narrow intercellular cleft containing regularly-spaced densities that closely resemble the 'transverse bands' found at paranodal axoglial junctions with respect to both configuration and spacing. In addition, the Schwann cells sometimes extend fingerlike projections towards amyelinated axons in regions where the axolemma has a dense cytoplasmic undercoating. Such regions resemble nodes of Ranvier, where Schwann cell processes interlace over the axolemma. Freeze-fracture replicas show no typical nodal or paranodal membrane specializations in the amyelinated fibres where they are apposed to each other. However, isolated paracrystalline patches of membrane occur corresponding to the aberrant junctions between amyelinated axons and Schwann cells at the periphery of the bundles. The observations show that structural differentiation of the axolemma occurs only where axons are in intimate contact with myelinating cells and does not develop independently in the amyelinated regions. Sodium channels, which are normally concentrated in the specialized nodal membrane, are, therefore, probably distributed uniformly along the amyelinated axon segments that show no sign of such regional differentiation. In addition, it is shown that Schwann cells are capable of forming specialized junctions with more than one axon at the same time.


Is there a voltage-dependent Cl conductance or do Cl ions modify other conductances in crab muscle fibre? 1. The electrical activity of crab muscle fibre disappeared in Cl-deficient solutions when Cl was substituted by an impermeant anion. 2. Under voltage-clamp conditions, the above solutions abolished Ca-inward current and altered K-outward currents. 3. In 84 mEq-Cl solutions, (Cl substituted by methane sulfonate or proprionate) it is chiefly in gCa-availability that was modified. Half-availability was shifted by 50 to 70 mV in a hyperpolarizing direction while the slope factor was noticeably increased. Similar effects, but of less amplitude, were observed when decreasing the external Cl concentration to 255 mEq. 4. Ca- and slow K-activation variables were shifted by 17 mV and 20 mV respectively in a hyperpolarizing direction by the Cl-poor (84 mEq) solution. Cl-deficiency was even more efficient on the fast outward current than on the Ca current; the former current could be significantly reprimed only if the Cl-concentration was reduced by about 10 per cent. 5. In Cl-deficient solution, electrical activity could be restored by injecting hyperpolarizing currents in order to reprime the Ca-conductance. 6. It is suggested that Cl-ions bind to positive charges on both sides of the membrane. When substituted by impermeant anions, the local anion concentration decreases at the internal surface of the membrane, thus reducing the strength of the effective field of the membrane.


Postnatal development of vagal control of breathing in the kitten. At birth, the number of vagal myelinated fibers represents about 10% of the corresponding adult value. Their diameters range between 1 micron and 5 micron. The conduction velocities, calculated from the bimodal vagus nerve action potential, are 20 m.sec--1 (range 16--30 m.sec--1) and 6 m.sec--1 (range 1--10 m.sec--1) respectively. The discharge patterns of the vagal afferent units are similar to those described in adult cat for the various pulmonary mecano receptors. The proportion (9%) of low threshold broncho-pulmonary stretch receptors is smaller than that given by Paintal (1973) for the adult cat (50%). Nevertheless, the inhibitory action of the pulmonary stretch receptors is very potent at birth. Various experimental procedures (bivagotomy, vagal stimulation and lung deflation) which reinforce the central inspiratory activity in the adult cat provoke essentially a lengthening of expiration in the newborn. The predominance of expiratory activity can be seen as part of the general motor behaviour which in the newborn is essentially characterized by activation of flexor muscles.


[High phosphatidylcholine weights compared to lysophosphatidylcholine weights, in micellar intestinal contents, in the rat (author's transl)]. Casein hydrolysat, lactose and lipids (100 mg of fatty acids) were introduced in the stomach of rats by a gastric tube: either pure tri-oleoylglycerol, or phospholipids, or phosphatidylcholines, or the mixture 9/1 to fatty acid weight of tri-oleoylglycerol-phospholipids or phosphatidylcholines. The rats were killed 2 h later. The intraluminal intestinal lipids of the oil and micellar phases were separated after microfiltration (Millipore filters) in preference to the filtration by gel chromatography on polyacrylamide agarose, as an hydrolysis of intraluminal phospholipid occurred after the column elution. 1. After a quantitative recovery of the intestinal lipids (no separation of the oil and micellar phases), a strong hydrolysis of the tri-oleoyglycerol was observed; in opposition, large amounts of intact phospholipids appeared. 2. After isolation of the micellar phases, no triglycerides were recovered, but fatty acids and partial glycerides from the hydrolysed tri-oleoylglycerol and dietary phosphatidylcholines and small quantities of lyso-phosphatidylcholines (hydrolysed forms) were present. 3. After ingestion of the tri-oleoylglycerol as lipid dietary source, the intestinal micellar phases contained endogenous phosphatidylcholines and a few amounts of lysophosphatidylcholines, which had mainly bile origin, since the fatty acid composition of these micellar phosphatidylcholines approached the bile phosphatidylcholine fatty acid composition. The micellar lysophosphatidylcholine masses represented one-fourth of the micellar phosphatidylcholine masses. 4. In these experiments the phosphatidylcholine lysophosphatidylcholine ratio was always high: this means that small quantities of exogenous and endogenous lysophosphatidylcholines appeared in the micellar phases.


Olfactory receptor cell activity under electrical polarization of the nasal mucosa in the frog. I. Spontaneous activity. The electrical activity of single olfactory receptor cells was studied under electrical polarization of the olfactory epithelium in the frog. 1. The spontaneous discharge frequency varied as a linear function of the polarizing current in the range 1--20 X 10(--6)A. 2. Surface positive polarizations caused the spike activity to increase; surface-negative polarizations suppressed the activity. 3. Partial accommodation to the current was observed. 4. After-effects of short duration occurred: Rebound suppression after positive polarization, rebound excitation after negative polarization. 5. A high percentage of receptor units found in the frog's mucosa displayed no spontaneous activity.


Olfactory receptor cell activity under electrical polarization of the nasal mucosa in the frog. II. Responses to odour stimulation. The interactions between electrical polarizations of the olfactory epithelium and odour stimulations were investigated at the level of the extracellular spike activity of the receptor cells in the frog. 1. In most cases, surface positive polarizations enhanced the excitatory olfactory responses, negative polarizations suppressed these responses; both interactive effects were graded. 2. The response of receptor cells to electrical polarization was markedly reduced or suppressed for several seconds following olfactory stimulation. This effect and the time course of the recovery period depended on the nature and the concentration of the olfactory stimulus. 3. The decrease in electrical excitability seemed to be independent of whether the recorded neuron had responded or not to the prior olfactory stimulation. 4. It is suggested that the olfactory stimulation caused the total constant current to change its distribution in the different cell pathways. Changes in conductance induced by olfactory stimuli could implicate the supporting cells. 5. The experimental findings are discussed with reference to a model of receptor cell function that assumes a deep, axo-somatic localization of the action potential trigger-zone.


Spontaneous activity of olfactory bulb neurons in awake rabbits, with some observations on the effects of pentobarbital anaesthesia. A specially adapted microelectrode driver device has been used to record the spontaneous activity of neurons in the olfactory bulb of awake rabbits. Several parameters of this activity were studied in 78 neurons of conscious animals. A second experiment was performed to investigate anaesthetic-induced modifications of the spike discharge initially recorded in awake animals. 1. In unanaesthetized animals, the interspike interval distribution of all cells was found to be stable over short as well as long periods of time. 2. A periodical change in firing probability, correlated with respiratory activity, was observed in a high percentage of neurons. During inspiration, the discharge was markedly increased ("well synchronized" neurons, n = 2), slightly increased ("poorly synchronized" neurons, n = 15); or unchanged ("not synchronized" neurons, n = 8). 3. The passage from the awake to the anaesthetized state resulted in more regular cell activity with sudden changes from one steady firing level to another, without affecting the cell classification. As anaesthesia wore off, the cell units recovered the characteristic discharge pattern initially observed.


Home or hospital? Terminal care as seen by surviving spouses. Among 276 married patients with cancer under the age of 65 who died in two South London boroughs during the period 1967 to 1971, 41 were still under active treatment at the time of death. I studied the remaining 85 per cent who experienced some form of terminal care, and in particular compared reports by the surviving spouses of 65 patients whose care was home-centred and 100 hospital-centred patients.Although home-centred care was most often chosen for patients who were said to have had little severe pain before the period of terminal care, during that period there was a sharp increase in reports of pain, much of it severe and unrelieved. Hospital-centred patients were said to have had much less pain and more confusion during the final phase of care and were more likely to have been confined to bed than those at home. The amount of anxiety reported by the patient's spouse was not markedly different under the two patterns of care, nor did the pattern of care influence subsequent adjustment to bereavement.Qualitative differences between the two groups are considered and it is concluded that although home-centred care can be successful it is often associated with unnecessary suffering. Implications for the home care of the terminally ill are discussed.


Use and wastage of prescribed medicines in the home. A survey of prescribed medicines was carried out in 192 homes, broadly representative of households in England and Wales. The average home had 3.2 containers of such medicines; 56 per cent were in current use, 16 per cent in occasional use, and 28 per cent were never used. One fifth of all oral antibiotics found in the study were wasted. A rough estimate suggests that pound23 million of prescription products (5.6 per cent of the total) are wasted annually in England and Wales.


Domestic accidents: their cause and prevention. The study of domestic accidents, which includes accidents in and around the home and in institutions, is of increasing importance. The mortality statistics are shown in Table 1. In 1974, 18,335 people died from accidents in the UK (RoSPA, 1974) equivalent to the population of a reasonably sized town. Accidents form one of the four main causes of death in this country and have become relatively more common in recent years. Analysis of the causes of home accidents make it possible to plan ways of preventing them. General practitioners and their colleagues in the primary health care team have the principal responsibility.


The recognition of family and social problems by general practitioners: towards developing a taxonomy. A short feasibility study to investigate the recognition rate and precision of family problems by general practitioners is described. The need for such work in preparing a taxonomy of family and social problems, and the difficulties involved are discussed. Further support by general practitioners is invited.


The management of vaginal discharge in general practice. A group of general practitioners in active practice were asked to report how they preferred to manage the symptoms of vaginal discharge presented by a woman in her twenties. Subsequently the same practitioners reported their management of such patients in their practice.A shortfall was found for all practitioners between their declared intention and their actual practice.This method of analysis offers a way of working towards a consensus in clinical care and also of auditing medical performance in general practice.


The prevalence and clinical diagnosis of vaginal candidosis in non-pregnant patients with vaginal discharge and pruritus vulvae. Two hundred and thirteen nonpregnant female patients complaining of vaginal discharge or pruritus vulvae were recruited to the study by 45 general practitioners in the Yorkshire region. Of these patients, 102 (48 per cent) were found to have demonstrable vaginal mycosis on an initial swab and a further 10 to be swab positive after one week of placebo treatment. The total prevalence in this population of women consulting their practitioner was thus 52.6 per cent.Analysis of symptomatology and of physical findings showed that a clinical diagnosis of vaginal mycosis cannot be made with acceptable reliability.The occurrence of spontaneous swab conversion is noted, and its possible origins are discussed.


Diagnostic delay in neoplastic disease.

Diagnostic delay in neoplastic disease. It may be possible to measure quality of care in general practice by selecting a single criterion of care such as the delay in the recognition of neoplastic disease. Seven general practitioners reported on 55 new cases and the results are analysed according to age, sex, and diagnostic category. An attempt is made to quantify ;quality' by comparing the theoretical ;ideal' delay (retrospectively assessed) with the ;actual' delay. The wider implications of the study are discussed.


Recurrent abdominal pain in childhood.

Recurrent abdominal pain in childhood. One hundred and sixty-two children (57 boys and 105 girls), aged between three and 15 years and suffering from recurrent abdominal pain, were seen in general practice in Thamesmead during a seven-year period. Only five were found to have possible organic causes for the pain. Comparison with a control group showed that the close relatives of children with pain consulted doctors more often, had had more abdominal complaints and operations, a higher rate of psychiatric illness and referral, and more known marital problems. Relations between mothers and children with recurrent pain were often unstable and inconsistent. The clinical picture was unhelpful and investigation unproductive.Recurrent abdominal pain in childhood is often a reflection of family disorder, and assessment of the state of the family should precede decisions on management.


A coronary screening programme in general practice. All male patients between the ages of 37 and 43 were selected from an age-sex register and invited to attend the surgery for coronary screening, which included medical history, family history, occupation, smoking habits, blood pressure, examination of the urine, measurement of weight and height, the taking of an electrocardiogram and chest x-ray, plus fasting blood levels of cholesterol, sugar, triglycerides, lipid electrophoresis, urea, and full blood picture. Sixty-four per cent responded to the invitation and of those, avoidable risk factors were found in 52 per cent.Forty per cent of those reporting had not previously had their blood pressure recorded. Fifty-eight per cent had not had their urine examined, and 71 per cent had never had a chest x-ray.Twenty per cent were found to have atypical electrocardiograms (mainly T-wave changes and ectopics) and 20 per cent had sufficiently elevated plasma lipids to justify further electrophoresis. Forty-four per cent of patients admitted to smoking more than 10 cigarettes daily.Follow-up of the smokers one year later showed that 27 per cent had stopped smoking completely, 12 per cent had reduced their smoking by more than half, 54 per cent had not changed their smoking habits at all, five per cent had given up smoking but started again, and two per cent had either moved away or could not be traced.I believe such a programme can readily be undertaken in the average general practice and can yield much useful information, such that it is possible to influence patients' smoking habits by advice.


Survival medicine in North Devon.

Survival medicine in North Devon. Last winter, heavy snow and gale force winds isolated a small North Devon village from the outside world for seven days. This paper describes one general practitioner's experience in helping to maintain community morale and health.


A follow-up survey of patients with dyspepsia in one general practice. Eighty-three patients who had been investigated by cholecystogram, barium meal and fibreoptic endoscopy more than two years previously were interviewed to enquire into their reactions to the investigations carried out, their present symptoms, and their present smoking and alcohol consumption. Comparisons were made with previously recorded observations. Those who still complained of severe dyspepsia were asked to attend for a repeat endoscopy. Sixty-three per cent of patients were asymptomatic; 13 per cent had recurrent dyspepsia, and 24 per cent had persistent dyspepsia. Thirty-nine per cent of smokers were found to have stopped altogether following medical advice.Both radiological and endoscopic methods of investigation proved acceptable. A majority of patients preferred endoscopy to barium meal.


Familial Bell's palsy.

Familial Bell's palsy. Six attacks of Bell's palsy occurring in five members of one family are described.


Assessing release courses in vocational training. A series of visits to selected vocational training schemes revealed a wide variation in attendance by trainees, content of release courses, use of teaching methods, and participation in planning by trainees. The principal criticism made by ex-trainees was the absence of enough teaching on practice management.I suggest that it is important to clarify as soon as possible the division of teaching responsibilities between training practices and release courses.


Clinical experience of a trainee in general practice. A survey of one year's trainee clinical experience in a semi-rural teaching practice is reported.The trainee saw significantly more acute minor illness and significantly less chronic illness than a principal in general practice. He also saw less life-threatening illness, psychiatry, obstetrics, and gynaecology.The balance of clinical experience gained in the trainee year is questioned. Careful monitoring, and perhaps control of the trainee workload by trainer and trainee, could provide a more balanced clinical experience of general practice.


A comparison of trainee and trainer clinical experience. The results are presented of a survey comparing patients seen in the surgery by trainer and trainee during a six-month attachment.STATISTICALLY SIGNIFICANT DIFFERENCES WERE SHOWN AS FOLLOWS: the trainee saw a younger group of patients, a higher proportion of whom were male; the trainee saw fewer musculoskeletal disorders, fewer gynaecological disorders, and gave less contraceptive care. He saw more acute respiratory tract infections. Despite there being no direction of trainee workload, some of the difference in clinical workload significantly altered over a six-month period. However, trainee and trainer experience of many clinical conditions was not significantly different.We suggest that trainees and trainers should agree at the start of a traineeship on the aspects of clinical care in which experience should be obtained. Regular monitoring of the trainee's clinical workload would then enable deficiencies to be identified and corrected by direction of appropriate patients to the trainee.


Learning general practice--the experience of one trainee. I report my experiences in learning general practice as a vocational trainee with 12 months divided between two general practices at the end of a three-year course. A parallel between developmental milestones and a trainee's educational development is drawn and the reasons which brought patients to me as a trainee are analysed.I suggest the trainee year should be a dynamic time of learning and that trainees should be in an educational environment including progressively less authority. The trainer/trainee relationship, like the doctor/patient relationship, is all important.


Electrocardiogram of the reindeer, Rangifer tarandus tarandus. Electrocardiograms were recorded for 50 Finnish reindeer of age 1 day to 9 years, using standard and unipolar extremity leads in the frontal plane. The range of heart rate was 40-250 beats per minute. Atrial and ventricular depolarization times were 5-10 ms shorter in newborn calves than in other reindeer, and showed only minor variance with respect to heart rate. The duration of depolarization was dependant on heart rate, and was more rapid in young calves. A-V conduction time decreased with increasing heart rate. The mode of the QRS vector was 280-290 degrees, and the mode of the T vector 200-230 degrees in the older animals, but 100-120 degrees in young calves. The main deflection in the QRS complex was S in the leads II, III and aVF.R was dominant in aVL and I.


Transmission of Spironucleus and Giardia spp. and some nonpathogenic intestinal protozoa from infested hamsters to mice. Intestinal protoza belonging to the genera Spironucleus (Hexamita), Giardia, Trichomonas and Entamoeba, carried by conventional hamsters, were successfully transmitted to and established in protozoa-free sucking or newly-weaned specified-pathogen-free inbred mice by exposure of the mice to hamster intestinal contents.


Simple focus assay for Encephalitozoon cuniculi. In this is vitro infectivity assay for Encephalitozoon cuniculi, lesions due to the organism appeared as macroscopically distinct foci. The number of such foci was used as a direct measure of the number of infectious units in the original sample. The expected correlation between focus-forming units and 50% infectious doses was observed in limit dilution experiments.


India-ink immunoreaction for encephalitozoonosis: phototechnique. We present photographs of an immunoreaction which has to be viewed as a vet preparation under highpower oil-immersion microscopy. The difficulties of varying focal plane and constant movement of the specimen were overcome by the use of electronic flash.


Ultrastructural features of spironucleosis (hexamitiasis) in x-irradiated rat small intestine. An alteration in the host response to the intestinal protozoan Spironucleus (Hexamita) muris was noted in x-irradiated rat small intestine. When few were present in the crypt lumina, the intestinal microvillar border was normal. However, when larger numbers were present, the microvilli were greatly reduced in numbers or entirely absent in some regions. The organism was identified in the base of the crypt lumen, in apical portions of mucous cells, and near the basement membrane. Spironucleus enclosed by digestive vacuoles occasionally appeared to be in the process of being extruded through the basement membrane. Not all intracellular protozoa were surrounded by such digestive vacuoles. Spironucleus was never seen in association with the digestive vacuoles of Paneth cells. Since it has been suggested that Paneth cells have a role as a fixed phagocyte, ingesting protozoa and other microorganisms, the results presented here suggest that this function may have been impaired in irradiated animals.


Diagnosis of encephalitozoonosis: a simple method for collection of rabbit blood. The blood was collected on filter paper, dried, put into an envelope and posted to the laboratory. One drop of blood extracted with 1 ml PBS was satisfactory for detecting natural cases of encephalitozoonosis by the india-ink immunoreaction.


Warfarin-resistance genotype determination in the Norway rat, Rattus norvegicus. The 2-stage determination is based on changes in blood coaggulation activity brought about both by the administration of warfarin in conjunction with vitamin K1 epoxide and by feeding a vitamin K-free diet for 4 days. When it was applied to laboratory-bred rats of known warfarin-resistance genotype, 35/35 homozygous susceptible, 44/44 homozygous resistant and 131/133 heterozygous rats were correctly classified. This method was equally effective in identifying the genotype of wild rats carrying the warfarin-resistance gene, Rw2. The procedure is rapid and accurate.


Some aspects of the physiology and anatomy of the cardiovascular system of the ferret, Mustela putorius furo. The resting heart rate was monitored in 50 urethane-anaesthetized (387 +/- 54 beats/min) and 4 conscious (341 +/- 39 beats/min) ferrets. The arterial blood pressure in the anaesthetized animals was 140/110 +/- 35/31 mmHg. The circulatory responses to vagal stimulation, carotid artery occlusion and a variety of humoral agents were examined. The vagal innervation of the heart and of the distribution of the great vessels are described.


Myopathy and steatitis in the common guppy, Poecilia (Lebistes) reticulata (Peters). There was 1% mortality among female guppies just imported from Southeast Asia. Moribund fish showed discoloration, lethargy and kyphosis. Microscopically, myopathy and steatitis were observed, together with an extensive ceroid storage. These findings are indicative of vitamin E deficiency, and illustrate the risk of using fish of unknown origin in toxicological studies.


Evaluation of room cleaning procedures in a laboratory animal facility. Animal room cleaning procedures were developed that could be used routinely and economically in this animal facility. Bacterial samples from the floors of rooms housing rabbits, rats and mice provided a useful way to evaluate the effectiveness of the cleaning procedures, and to determine the in-use effectiveness of disinfectant solutions.


The influence of Bacillus piliformis (Tyzzer) infections on the reliability of pharmacokinetic experiments in mice. The half-lives of warfarin and trimethoprim were significantly longer in mice acutely infected with Bacillus piloformis and in mice which ad clinically recovered from previous experimental infection with the organism. The volume of distribution of trimethoprim but not of warfarin was significantly greater in infected mice than in controls. Body clearances of warfarin was significantly reduced in both disease states. For trimethoprim this parameter was only reduced in the acute state of the disease. The importance of careful control of Tyzzer's disease in laboratory animals for use in pharmacological research is stressed.


A barrier cabinet for mice based on the Houghton chicken isolator. Nuclei of a disease-free foundation stock of mice housed in a barrier unit and a barrier cabinet constructed from resin-bonded glass-fibre were compared over a period of 7 years. The cabinet was found to be a satisfactory alternative to a flexible-film isolator and was thought to be preferable. A description is given of the cabinet, the method of sterilization and the breeding schedules for 2 generations adopted to make the maximum use of the 10-month life of the high-efficiency filter employed. Throughout many cycles of this duration the degree of cleanliness was of a high order. A major contribution towards this was the collection of excreta on a tray lined with both absorbent and grease-proof paper, and the removal from the cabinet of dirt boxes when weaners were issued in them at the age of 5 weeks. These boxes were replaced in the cabinet by clean, sterile ones.


Breeding performance of a captive colony of rhesus macaques (Macaca mulatta). For most of the 18 years recorded, fewer than 50% of the adult females gave birth in any one year. The colony, of 6 social groups, showed a clear-cut breeding season. Female parity and dominance had no effect on breeding rate, though 1st infants were born earlier in the year than 2nd-born ones. Only when females gave birth in successive years were the months of giving birth correlated. Mothers and daughters may tend to give birth closer in time within a breeding season than do other females.


Exteroceptive factors, sexual maturation and reproduction in the female rat. Keeping a sexually mature male with a weanling female rat advanced neither the time of vaginal opening nor that of 1st oestrus. In 2 of 3 experiments females kept singly after weanling reached sexual maturity significantly earlier than did grouped females. The reproductive performance of females mated at 1st oestrus was not significantly different from that of older primiparae. 26 rats gave birth to an average of 9.3 young at 59.5 days of age, and 22 of them reared 96% of the young to weaning.


[Benign mesenchymal tumors of the uterus]. Benign mesenchymal tumours of the uterus are discussed. The results are compared with those of other authors and respective epidemiological findings are put forward. Clinical and histological characteristics of uterine myomas and adenomyomas are described in more detail. Irregular bleeding is most frequent among clinical symptoms; it is caused by the persistence of the proliferative endometrium. The secretory conversion of the ectopic endometrium in adenomyoma appears in the glandular epithelium only, while the stromal response to progesteron activity seems inadequate. Maturation of the ectopic and the uterine endometrium is discordant. The cause is the retardation of both the proliferative and secretory phases in the ectopic endometrium. After secretory conversion of the ectopic endometrium the exhaustion and destruction of glands appears. The regeneration of the ectopic endometrium fails to occur because of the absence of the basal layer in the ectopic endometrium. Therefore the authors suppose that the regression of the ectopic endometrium in adenomyomas might be the result of ovulatory cycles.


[Dynamics in the 3d stage of labor observed by ultrasound]. In two groups, with 50 pregnant women each, changes in the third stage of labour were followed up by a real-time scanner. In the experimental group the umbilical cord on the mother's side as not tied up, while in the control external uterine wall to the chorionic line in the separated placenta immediately before a cord traction intervention amounted to 5.45 cm, while in the control group, under the same conditions, it amounted to 8.61 cm and was caused by the intensified development of the retroplacental hematoma. The difference was statistically significant (P < 0.001). In the way presented, along with the shortening of the third stage of labour, the authors prevent the development of anemia in parturients.


[A case of bilateral gonadoblastoma].

[A case of bilateral gonadoblastoma]. A case of a patient with bilateral ovarian tumours is described. She was operated on and hysterectomy with bilateral adnexectomy was applied. Histological diagnosis of both tumours was gonadoblastoma. The patient has had an orderly menstrual cycle during her life and fertility was proved by two deliveries. No karyogram was performed. There have been no pathological disorders observed in the patient so far.


[A neurogenic cyst of the ovary].

[A neurogenic cyst of the ovary]. A case of a bilateral adult cystic teratoma of the ovary in a 45-year-old woman is reported. The cyst of the right ovary was a typical "ovarian dermoid". The cyst of the left ovary consisted of adult neurogenic tissue, with islands of the ependyma on the surface. The tissues of the endodermal and mesodermal origin were also present in small quantities. It is evident from the literature that "neurogenic cysts" are much larger than "dermoid cysts", and they are reported only in preburtal girls. In the case presented the "neurogenic cyst" was not substantially larger than the "dermoid cyst" in the contralateral ovary. The the authors' knowledge, this is the first case of a "neurogenic cyst" of the ovary in the reproductive life reported so far.


[Gestational characteristics in women with breast cancer]. In a survey of 250 women with breast cancer and 250 healthy women from a matched control group (matching in age, nationality, and residence) no significant difference was found between the diseased and the healthy women in the average number of pregnant women and the average duration of pregnancy. In the group of the diseased there were significantly more women with 1--2 pregnancies, i.e. below modal values in the healthy women (P < 0.10), and also a higher number of women with more frequent pregnancies. No significant difference was found in the number of nulliparas, but in the diseased both a larger and a smaller number of births in relation to the modal values of both groups (2 births) were characteristic, There was no significant difference in the distribution of the first delivery according to the women's age. The diseased had significantly fewer artificial abortuses (P < 0.001). There were more healthy women with 1--5 abortuses (P < 0.001) while the number of women with 5 and over 5 abortuses was the same in both groups. The number of women with spontaneous abortus proved significantly higher in the diseased than in the group of healthy women (P < 0.10). No evidence was obtained concerning the protective role of breast feeding which lasted longer in the diseased, both in the period of intensive breast breeding and following this period.


[Congenital anomalies of the uterus. (Pregnancy, delivery, and the newborn]. A total of 123 women with congenital anomalies of the uterus were analysed. It has been found that earlier pregnancies terminated with abortus in a high percentage (68.09%). In the course of the last pregnancy and the first in primiparas, 39.02% of women developed one or more complications. The delivery itself was completed by cesarean section in 75.6% of parturients. In the course of labour, complications appeared in 44.71% of women; most frequently there was a premature rupture of the bag of waters and the adhered placenta. The abnormal position of the fetus was found in 54.47%, it was mostly the pelvic presentation. A comparison between the perinatal mortality in earlier deliveries and the last one has shown that there is a significant association between the use of cesarean section and perinatal mortality. In earlier deliveries the perinatal mortality rate was 48.78% and in the last pregnancy 8%. There were 19.2% before-term babies. By Apgar score 1--8, 55.73% of newborns were assessed. The babies were often hypotrophic in relation to their gestation age. A high percentage of congenital anomalies in newborns (16.8%), mostly joint deformations, was established. It is concluded that uterine congenital anomalies exert an unfavourable effect on pregnancy. They put both mother and child at risk. The risk could be diminished by a timely detection of uterine anomalies, by the appropriate therapy, and by the use of cesarean section.


[Premature deliveries at the Gynecology-Obstetrical Department in Titovo Uzice from 1974 to 1979]. In the course of four years there were 7099 deliveries, 399 of them (5.63%) premature, at the Gynecology-Obstetric Department in Titovo Uzice. The mortality rate in premature children was high (19.72%), representing a persistent medical, social, and economic problem, and one of the most urgent tasks facing the health service is therefore the reduction of premature deliveries. This could be done by an early detection and treatment of conditions likely to cause premature deliveries. The use of tocolytics and corticosteroids, both for preventive and therapeutic purposes, is recommended. It is pointed out that a special obstetric problem is to avoid birth injuries in prematures.


[Diagnostic evaluation of stress incontinence]. Diagnostic evaluation of stress incontinence is the summary score of the disease presented in percents. On this basis the classification of the disease has been made. The classification, unlike other classifications, includes all parameters, not only the degree of incontinence. The author investigates the role of every diagnostic parameter and makes comparison between them. The percentage range of every parameter in the diagnostic index of the disease is as follows: anamnesis 0--10%, age 0--5%, constitution 0--5% metabolic diseases 0--3%, clinical valuation of the hormonal hypotrophy of the tissue 0--5%, gynecological examination 0--7%, urethrocystoscopy 0--15%, urethrocystography 0--12%, cystometry and sphyncterometry 0--7%, difference between measures of the pressure in the urinary bladder and the urethra 0--16%, uroinfection 0--15%. According to this evaluation, the complexity of the first stage of disease could reach the score of 15--30%, the second stage 31--55%, and the third stage 56--100%. It was deducible mathematically but more upon the authentication in practice. The examination covered 667 female patients.


[A full-term abdominal pregnancy. (A case report)]. A case of mature ectopic abdominal pregnancy diagnosed preoperatively by ultrasound is described. Up to the establishment of the diagnosis the case was treated as a normal pregnancy. The foetus died 3 weeks before the term of delivery. The patient was discharged in a good condition 25 days after operation.


[Characteristics of pregnant women, labor, and the newborn at the Skopje Clinic from 1978 to 1979]. An analysis was made of the first computer data received from the IFRP (International Fertility Research Program) within the framework of the International Study "Maternity Record" -- "Maternity Monitoring Care'. The main findings are the following: The women who were confined at the Skopje University Hospital during 1978--1979 were young, in their twenties. Women over thirty were confined very rarely. Most of the women surveyed had about 12 years of education. Pregnant women had artificial abortions very rarely (1:5.7 in favor of terminating pregnancy). Preventive work on contraception should include women at the time of delivery. Pregnant women in Skopje come to the Consulting Centers for a check-up mostly five times. The higher the parity, the less frequent the visits. More than half of pregnant women during the antenatal period had no complaints. Younger pregnant women had fewer difficulties and complications. The values of haemoglobin under 10 g% were very often in primiparas and over 12 g% in multiparas. The birthweight of women smoker's babies proved lower than that of women non-smokers' babies. In two thirds of women the delivery was induced by drugs and amniotomy. The delivery mostly lasted between 7--12 h, regardless of parity. Prolonged deliveries were the more frequent the younger the women. Primiparas gave birth to babies with a lower birthweight than multiparas. Almost all women (92.4%) were previously using no contraceptive devices. The main method of protection was coitus interruptus.


Alcohol-induced alterations in hippocampal afterdischarges and afterdischarge thresholds: dose-reponse studies. The hippocampal afterdischarge (AD) has been suggested as an index of toxicant-induced CNS change [1]. The present experiments report raised AD thresholds, decreased AD durations, shorter post-stimulation latencies to AD onset, decreased numbers of AD spike complexes and increased numbers of spikes/complex following alcohol administration. Results are discussed in light of single-unit data concerning alcohol effects upon hippocampal cells, and the biphasic effects of alcohol upon behavior.


Altered saccharin preference during chronic dietary administration of lead in adult rats. Procedural variables are crucial in using taste aversion as a measure of lead toxicity. Rats were given saccharin and water to drink while ingesting a diet containing lead acetate (PbAc). Rats showed high preference for saccharin (over water) before lead was introduced. Saccharian preference fell during PbAc ingestion and rose when PbAc was removed from the diet suggesting that saccharin preference may correlate with the physiologic action of the toxicant. When saccharin was introduced simultaneously with PbAc aversion was almost total, but recovered with continuous PbAc exposure. When saccharin was introduced after the start of PbAc exposure saccharin aversion diminished with the duration of presaccharin PbAc exposure.


Effects of selenium, alone and in combination with silver or arsenic, in rats. In two experiments, Sprague-Dawley rats were administered elemental selenium (Se; 10 ppm), silver (Ag; 1000 ppm) and arsenic (As; 50 ppm), either alone or in combination (Ag+Se or As+Se). Administration was via drinking water. Body weight, fluid intake, and food consumption were monitored weekly and measures of forelimb and handlimb strength were taken. Se depressed body weights in both experiments, as did As+Se. Food consumption relative to body weight tended to be increased by Se alone; none of the other treatments affected body weight, except for As+Se. Water consumption was depressed in all cases, which was attributed to a palatability effect. Limb strength was not affected by any treatment. The addition of Ag to the drinking water containing Se appeared to reduce the toxic effect of Se. However, As appeared to interact in a potentiating fashion with Se. There was 1 death in the Se alone group, none in the As group, but 7 out of 10 animals receiving As+Se had died by the end of the 18 week dosing period.


Behavioral teratology of marihuana extract in rats. Prenatal exposure of rats to marihuana extract impaired Rotarod performance in female offspring but did not affect inclined plane, spontaneous alternation, learning/memory, or open-field performance.


[Contamination of the operating room with anesthetic gases and vapors. Analytical methods]. An approach for the measurement of the contamination of the operating room air is presented. The measurements were performed in three operating rooms used for general surgery, partly in model experiments and partly while anesthesia was in progress. During anesthesia, the measurements were taken when oxygen 3 l/min containing ethrane 1.0--1.5% was passed into a semi-closed circle and the exhaled gas vented directly to the environmental air with no scavenging system in use. The daily exposure of operating room personnel was determined by adsorption of ethrane on glass tubes containing activated charcoal. The ethrane was subsequently desorbed in toluol and quantified by gas chromatography. The concentration of contaminant was found to be significantly greater in the anesthesiologist's position than in the areas of surgeon and circulating nurse. Some pitfalls in sampling, standardization, and analysis are indicated. Attention is drawn to the numerous factors influencing the extent of contamination.


[Elimination of anesthetic gases and vapors from operating rooms. System for passive conveyance of gases to the outside]. Mathematical calculations were employed in an assessment of the resistances associated with a passive outward conveyance system for the removal of anesthetic gases and fumes from operating theatres. It was found that the magnitude of such resistances was not enough to interfere with the patient's respiratory dynamics.


[Risk and choice of anesthetics for patients with previous malignant hyperthermia syndrome]. Two cases of m.h. are reported. Various parameters--age of patients, predisposing situation and diseases, family history and enzyme changes, use of certain anaesthetics and myorelaxant--are examined and evaluated. Alternative anaesthesia techniques are suggested for patients presenting a family history of m.h. or who have manifested the syndrome on other occasions and who have to undergo further surgery.


[Anesthesiological problems in cardiopathic patients. Clinical updating]. The activity of a drug is completely defined by experimentation and the results of clinical experiments. Specifically, the use of anaesthetic drugs in cardiopaths must meet certain requirements: no toxicity, no rises in cardiac rhythm. A slight hypotensive action can be tolerated because this is not related to cardiac hypoxia and thus places the myocardium in a more favourable situation.


[Thrombosis of the right internal jugular vein caused by a catheter in the subclavian vein. A complication precluding the insertion of a ventriculo-atrial cerebrospinal fluid shunt]. The Authors describe a case of right internal jugular vein thrombosis caused by a catheter in the subclavian vein which occurred in a four-month-old baby with chronic subdural hematomas. They emphasize that this thrombotic complication precludes the insertion of a ventriculo-cardiac shunt and point out the opportunity to prefer left subclavian cannulation in those patients who probably will need a ventriculo-cardiac shunt.


[Risks caused by chronic contact with volatile anesthetics. Working hypothesis for anesthetists]. Numerous researches concern the risk that operating-theatre personnel and especially anaesthetists expose themselves in contact with anaesthetics gases. Epidemiological and experimental studies have been made in the last years. Some proposals are explained to reduce the risk. This work takes into consideration also operating-theatre injury considered highly stressing place.


[The anesthesia outpatient department. A structure in keeping with the Health Service Reform]. Attention is drawn to the pressing need to establish out-patient departments for anaesthesia and anaesthesiological treatment within anaesthesia, resuscitation and intensive therapy services. In addition to offering specialist services, such as anaesthesiological therapy, and such services as may be in keeping with the local situation, such departments should be engaged in research, and towards the provision of preoperative anaesthesiological management prior to admission, on behalf of patients undergoing surgery of choice, so as to cut down the overlong period of preoperative stay. An assessment is made of the economic and social benefits of such departments, particularly in the light of the experience gained from similar structures that have long been in use in other countries.


The ocular findings in infantile spasms. The results of this study suggest that a careful ophthalmoscopic examination of children with infantile spasms will help to establish an etiologic diagnosis in at least 20% of cases. The two clinical entities identifiable by this examination are tuberous sclerosis and Aicardi's syndrome. It is emphasized that the retinal hamartomas of tuberous sclerosis seen in infancy are flat, semitransparent, and small. The mulberry-like lesion is distinctly unusual in this age group. The essential ocular feature of Aicardi's syndrome is a chorioretinopathy of the posterior pole. This may be accompanied by microphthalmus, persistent pupillary remnant, and colobomas of the optic nerve and choroid. Diagnosis of either of these two entities is helpful in establishing the prognosis for a child with infantile spasms since both of these disorders usually lead to severe neurologic handicap and premature death. Moreover, genetic counseling is essential for the family suffering with this tragic disorder. Tuberous sclerosis is inherited as an irregular dominant trait. The genetic interpretation of sporadic cases, which are in the majority, is difficult due to the presence of unrecognized incomplete or "fruste" forms within families. On the other hand, Aicardi's syndrome has never been reported to be familial and future pregnancies can be undertaken without fear of producing another child with infantile spasms.


The histology of human glaucoma cupping and optic nerve damage: clinicopathologic correlation in 21 eyes. We have examined by light and electron microscopy the retina, optic nervehead, and optic nerves of 21 human eyes from glaucoma patients in whom clinical information was available for comparison. In several cases it was possible to correlate the degree and distribution of optic nerve damage with the clinical appearance of the optic disc and visual field studies. There was no selective loss of astrocytes of the optic nervehead in early glaucoma cupping. Acquired increases in optic disc cup size prior to detectable visual field loss probably represent loss of ganglion cell axonal fibers which is not yet significant enough to produce field defects. It is unlikely that the mechanism of axonal damage in chronic human glaucoma involves early loss of astrocytic glial cells at the optic nervehead. At the level of the retrobulbar optic nerve, the ganglion cell axonal fibers of the superior and inferior quadrants seem to be lost earlier than the fibers of the nasal and temporal nerve periphery. Since the superior and inferior poles of the optic nerve may contain the fibers of arcuate area ganglion cells, these data confirm the presumption from visual field testing that arcuate area ganglion cell fibers are selectively more susceptible to damage in chronic glaucoma.


Cherry-red spot-myoclonus syndrome.

Cherry-red spot-myoclonus syndrome. A 21-year-old woman had typical clinical and biochemical findings of the cherry-red spot-myoclonus syndrome. She had 20/50 acuity in each eye, flutter-like ocular oscillations, rebound nystagmus, and transient vertical dissociation. Cherry-red maculas and optic atrophy were present. Although electroretinographic signals were normal, visual evoked potentials were almost absent. Levels of neuraminidase were significantly reduced in cultured ebroblasts from the patient and her parents, while lysosomal inclusions probably containing oligosaccharides were found in her conjunctival fibroblasts.


Peripheral nasal field defects in glaucoma. One hundred fifty-one eyes of 101 consecutive patients with chronic open-angle and low tension glaucoma showed typical visual field changes. Sixty of the eyes had a nasal step, either alone or in combination with other defects. In 17 of these eyes, it was possible to demonstrate an isolated scotoma in the nasal periphery. It was concluded that the peripheral nasal step is a nerve fiber bundle defect that in its earliest phase produces a scotoma. In this sense, it behaves similar to the more central defects, rather than simply as a depression of isopters nasally.


Sicca complex and cholangiostatic jaundice in two members of a family probably caused by thiabendazole. An entire family (father, mother, and three daughters) were given thiabendazole because one of the children had acquired pinworm infestation. The mother and one daughter (non-infected) developed a sicca complex (keratoconjunctivitis sicca and xerostomia) accompanied by cholangiostatic jaundice. Sjögren's syndrome is an autoimmune disease and presents many immune mechanism aberrancies. An association between autoimmune liver disease and sicca complex has been reported. Labeled mitochondrial antibodies bound to the parotid duct have been noted in patients with autoimmune cholangiostatic jaundice and such antibodies may be similar to the antibody against salivary duct found in Sjögren's syndrome. It is suggested that in these two patients, thiabendazole may have acted as a hapten and by binding to the body protein induced the production of autoantibodies which may have acted against the biliary epithelium, the salivary duct epithelium, and the lacrimal gland ducts.


The clinical characteristics of presumed choroidal nevi observed in green light. Thirty-two patients with presumed choroidal nevi were examined and photographed in both white and green light. Twenty-one lesions disappeared or became markedly attenuated when viewed with green light. The remaining 11 lesions did not disappear when viewed with green light. Many of these nevi demonstrated visual field defects and fluorescein angiographic abnormalities. The clinical applications of green light ophthalmoscopy and photography are discussed.


[Echinococcus granulosus infection in urban areas]. In a previous survey, carried out in 100 dogs in Rome by Tassi and Widenhorn (1977), two animals, which always lived in the urban area, were found infected by Echinococcus granulosus. An urban infection was therefore hypothized. During a following experiment 6 three-month old Beagle dogs were fed for nine months with raw meat sold in the butcheries of Rome as "food for pets". Two dogs of the same breed and origin were fed for the same period with canned food and were kept as control animals. At the end of the experiment three of the six dogs were found infected by E. granulosus, while the renmant three and the two controls resulted negative. An additional similar trial was carried out in Bologna. Three dogs were fed for seven months with the same kind of raw meat sold in three butcheries of Bologna, and a fourth dog was kept as control. At the end of the seven months also one of the three dogs was found infected by E. granulosus. These results seem to confirm the hypothesis of an urban infection by E. granulosus in dogs. Various possibilities of contamination of raw meat sold in butcheries as food for animals are discussed.


[Introduction to the study of Sciomyzidae (Diptera Acalyptera) in Italy]. A list is given of Sciomyzidae recorded from Italy (Tab. 1). It results from literature and from our collections (species with one asterisk in tab. 1) that there 70 species in Italy. On the other hand some of these (three asterisks in tab 1) are records of old Authors. Some dubious records (in the opinion of Verbeke and Knutson, 1967) are signed with two asterisks in tab 1. Pherbellia annulipes (fig. 1) and Limnia paludicola (fig. 2) seem new records for Italian fauna. The species listed in Tab. 1 have the next types of geographical distribution: central-south-European (30%), European (17,14%), central north-European (15,7%), oloartic (14,2%), west-mediterraneous (8,5%), Eurasiatic (5,7%), borealpine (2,8%). Observations are also reported on preferential habitat of Sciomyzidae collected in some "natural damp places" (see figg. 3-4).


[Infestation of roe deer by Cephenemyia stimulator (Clark) (Diptera, Oestridae) in Trent province]. Cephenemya stimulator (Clark) (Diptera Oestridae) is first recorded in Italy parasiting roe deer (Capreolus capreolus). Diagnosis was made by examination of II-III instar larvae (fig. 1-2) from roe deers killed in Trient province. In these last years in the Trentin region, there was an increasing of roe deers number (actually about 20.000); at the same time growed roe deers infestation by C. stimulator (Tab. 1). Females of C. stimulator probably attack young roe-deers lying down on field-pastures near forest (fig. 3). From examination of killed roe-deers (Tab. 2) there is evidence of debilitation status of infested specimens. Location and dislocations of parasitising larvae in the head cavity was that shown in fig. 4 and 5.


[E antigen (HBeAG) and surface antigen (HBsAg) in bladder schistosomiasis]. The problem of the relationship between surface B antigen and schistosomiasis or other parasitic infections which are transmitted though the skin is not still resolved. Serum samples from 54 Somalian patients infected by Schistosoma haematobium were tested for the presence of the surface B antigen (HBsAg) and the e-antigen (HBeAg). The HbsAg was found in 14.8 per cent of these patients, while among controls (47 cases) the frequency was of 34.0 p]er cent; no e-antigen was found among the patients and controls, the prevalence of anti-HBs antibodies was of 57.4 per cent among the patients with urinary schistosomiasis and of 44.6 per cent among the controls; a low rate of anti-e antibodies was found in the patients (7.4%) and in the controls (10.6%). These observation seem to indicate that the problem of an increased frequency of hepatitis B virus markers among patients with urinary schistosomiasis needs for further investigation.


[Parasites of Salmo trutta L. from the Tirino River. II. Host-parasite interactions of helminth species]. The hundred and sixteen brown trout (Salmo trutta L.) which were examined for helminth parasites were captured in the River Tirino, (L'Acquila - Italy). Six parasite species (Phyllodistomum simile, Crowcrocaecum testiobliquum, Crepidostomum metoecus, Cyathocephalus truncatus, Truttaedacnitis truttae and Dentitruncus truttae) were recovered. Ecological studies on each helminth species recovered have been carried out analysing the following aspects; the preference of each parasite species for certain microhabitats in the host; the incidence and intensity of each parasitic infection according to sex, age and season.


[Parasites of Salmo trutta L. from the Titino River. Part III. Histological observations of parasites of the intestinal tract]. During researches on helminth parasites of Salmo trutta L. from the River Tirino (L'Aquila - Italy) histological studies of the intestinal tract of brown trout infected by the following species: Crowcrocaecum testiobliquum (Wisnewski, 1932) Skrjabin e Koval, 1956; Cyathocephalus truncatus (Pallas, 1781);o Truttaedacnitis truttae (Fabricius, 1794) Petter, 1974 and Dentitruncus truttae Sinzar, 1955 have been carried out. The attachment of the single species and the histological changes in the host gut due to parasite species have been described.


[Parasites of Salmo trutta L. from the Tirino River. Part IV. Intermediate hosts of Cyathocephalus truncatus (Pallas, 1781) and Dentitruncus truttae Sinzar, 1955]. During studies on helminth parasites of brown trout (Salmo trutta L.) from the river Tirino (L'Aquila - Italy), the intermediate hosts of Cyathocephalus truncatus (Pallas, 1781) and Dentitruncus truttae Sinzar, 1955 have been searched for. A total of 15,444 amphipoda belonging to the following 3 species: Echinogammarus roco Karman, 1973, Echinogammarus tibaldii Pinkster and Stock, 1970, and Gammarus italicus Goedmakers and Pinkster, 1977, have been dissected. E. roco, E. tibaldii and G. italicus were found infected with procercoid of Cyathocephalus truncatus (new hosts record and first procercoid record in Italy). E. roco, E. tibaldii and G. italicus were found infected with acanthella and cystacanth of Dentitruncus truttae (first record of intermediate hosts). Accordingly the ecology of the cestod C. truncatus and of the acanthocephalan D. truttae in their intermediate hosts has been studied considering principally the incidence and the seasonal occurence of the parasites.


[Experimental infection of horses with Trichina larvae]. The occurrence of a trichinellosis epidemic in the province of Reggio Emilia in 1975, the source of which was attributed to horse meat, led the authors to use this animal for experimental infections. By using the trichina strain isolated from the above outbreak, 4 horses were infected orally. All 4 animals became infected. The most affected muscles were the lingual, masticatory and neck ones. Meat from the 4 horses was subsequently fed to laboratory animals (rats, mice, guineapigs) and other domestic species (cats, dogs, pigs) and further infections were obtained. An attempt to infect also a sheep was successful.


[Some coccidia from the Nubian ibex (Capra ibex Nubiana Cuvier, 1825)]. The authors describe three coccidian species (eimeria arloingi, E. ninakohylakimovae, E. parva) found in the faeces of some Nubian ibexes (Capra ibex nubiana) in the "Hai-Bar Wildlife Reserve", Israel. The results of the study represent the first finding of coccidia in C. ibex nubiana.


[Haemaphysalis concinna Koch, 1844 in Italy]. The authors provide here the data concerning the first italian finding of tick Hemaphysalis concinna (Ixodidae). Two males of this species--which has a large geographic diffusion--were actually caught for the first time in Italy, in July 1977. They were found on the ground of the Castel Porziano estate (Rome) at sealevel, in two different grassy places. The authors describe their morphological characters and provide some essential data on the environment of Castel Porziano.


[Isolation of Cheyletiella yasguri Smiley, 1965 in a dog in Italy]. Adult females of Cheyletiella yasguri Smiley, 1965 were found in a dog parasitized by Otodectes cynotis, whose owners exhibited skin eruptions. C. yasguri is reported for the first time in the dog in Italy; the pathogenicity of this mite for both the dog and man has already been established by other authors.


[Parasite contamination from feces of dogs and cats in soil and sand-boxes in public parks and schools in Bologna]. In Bologna (Italy), about 1/10 (public parks) and 1/5 (schools of soil samples from sand-boxes and 1/5 (public parks) and 1/10 (schools) op soil samples from the surroundings were found positive for dog and/or cat parasites. The finding of Toxocara sp. eggs in about 1/20 of soil samples from public parks and schools is especially important due to the possibility of human infection. Conspicuous was also the parasitic contamination of the faeces collected from green arcas: 48% of the samples resulted positive.


[The occurrence of hepatic trematodes in sheep from Emilia-Romagna]. In the present investigations, 563 samples of ovine faeces from 32 flocks of Emilia-Romagna have been examined for the presence of hepatic trematodes eggs. All flocks proved positive for Dicrocoelium dendriticum and 16 for Fasciola hepatica; 511 (90,76%) out of 563 animals proved positive, with 507 (90,05%) for D. dendriticum and 50 (8,88%) for F. hepatica, 46 of these last ones were positive for both parasites.


[The occurrence of broncho-pulmonary nematodes in sheep from Emilia-Romagna]. In the present investigations 510 sheep have been examined for the presence of lungworm larvae: 342 (67,05%) of them proved positive. The identification of the parasites demonstrated the presence of Dyctiocaulus filaria in 18,62% of the examined animals, Muellerius capillaris in 50%, Cystocaulus ocreatus in 26,86% and Protostrongylus spp. in 12,35%. All positive flocks were positive for two or more genera of lungworms.


[Dissemination of Fasciola Hepatica in cattle of Novara Province]. The diffusion of F. hepatica in the cattle of the Novara Province was studied by means of a necroscopic survey on 2184 regularly slaughtered animals and a copro-microscopic survey on 5063 feaces samples picked up from 162 breedings farms. The 28.40% of the slaughtered animals resulted infected with F. hepatica. The parasite also resulted present in 52.74% of the examined breeding farms. A large diffusion of Paramphistomum sp. was shown, too. The diffusion areas of these Trematodes may be seen in the figures 1, 3, 6 and 7.


[Effect of mating on the maturation of ovarian follicles in Anopheles atroparvus Van Thiel]. Blood fed virgin females of Anopheles atroparvus did not develop ovarian follicles to maturation. In these females, the ovaries were characterized by small follicular size and little yolk deposition. Only the ovaries of blood fed mated females completed development. Thus, the mating permits the complete maturation of the eggs in these mosquitoes.


Genetic distance between two sibling species of the Aedes mariae complex (Diptera, Culicidae). Two sibling species of the mariae complex of the Aedes genus have been studied: Ae. mariae and Ae. zammitii. Thee mosquitoes are allopatric and show similar adaptations to rocky mediterranean coasts. The isolating mechanisms between the two species are well studied. A partial sterility of hybrid F1, limited to males, has been found with laboratory cross experiments. Strong pre-mating isolating mechanisms were shown in nature by means of release experiments, the frequency of hybrids never exceeding 2% without evidence of introgression. We analyzed genetic variation at 26 enzyme loci in a population of each species: 35% of loci were polymorphic, with an observed mean heterozygosity of 0.07 in Ae. mariae and 0.06 in Ae. zammitii; 6 loci allow discrimination between the two species at a probability of at least .99. Nei's measures of genetic identity and genetic distance are respectively I = 0.6096 and D = 0.2828. The distribution of genetic identities relative to loci is strongly bimodal, reflecting a different contribution of highly variable and fast evolving loci on one side and conservative and slowly evolving loci on the other. We consider, on the base of various experimental data (see Powell, 1975), in the first class ("fast evolving" loci) both variable substrate and regulatory enzymes, in the second ("slow evolving" loci) non regulatory enzymes. Values of genetic distance calculated separately for the "fast" (54% of the loci studied) and "slow" (46%) evolving loci are respectively Df = 0.41 and Ds = 0.03, showing that the main contribution to genetic distance in the first period of divergence is due to fast evolving loci, whose rate of evolution is about ten times more rapid with respect to slow evolving loci.


Isocitrate dehydrogenase in Aedes aegypti: formal genetics, preliminary linkage data and study of natural populations. Two loci for isocitrate dehydrogenase (Idh-1 ad Idh-2) are described in Ae. aegypti, both polymorphic with two codominant alleles. Crosses made to test linkage relationships of Idh-1 indicate that this locus is independent from sex (chromosome 1) and from Sod-1 and Hk-1 loci (chromosome 3), while it is linked to Pgm on the second chromosome. Average percent of recombination is 11.37, but significant differences have been found among strains. Data on genetic variability of Idh-1 and Idh-2 in three domestic african field populations are presented.


[Effect of an anticoagulant rodenticide on the female albino rat with offspring]. Lactating female albino rats have been treated with coumatetralyl rodenticide, having anticoagulant activity. The letal effect on mothers was of 40% (using a maximum concentration of toxic substance) while it was of 54% in offsprings. Among the probable causes of death in offsprings, the authors suggest the hypothesis that an interference in the relationship mother-offsprings is due to the influence of coumatetralyl on parental behavior.


[Double heterozygote Hb C/Hb O Arab in a family of the Maghreb (author's transl)]. Studies on five generations of the Maghrebian family representing two double heterozygous subjects Hb C/Hb O Arab. Review of literature concerning Hb O Arab; identification and screening techniques; historic and genetic implications.


Cardiac performance in hemorrhagic shock. Blood loss of sufficient magnitude to over-ride compensatory mechanisms and result in a lowering of arterial pressure will ultimately lead to irreversible circulatory collapse. Identification of the organ or tissues which may trigger a terminal cascade remains controversial. The weight of evidence supports the view that cardiac performance deteriorates with prolonged oligemic hypotension, although this may not be the initiating or sole reason for irreversible failure of the circulation. Controversy regarding the heart as an important target organ is no doubt in part due to the multiplicity of preparations and protocols, and variety of methods used to characterize cardiac function. We have used ventricular function curves to calibrate LV performance in terms of pump function, while arterial pressure remains at a pre-determined level. With this approach, a progressive decline in stroke volume for a given LV end diastolic pressure is consistently observed in hemorrhagic shock (AP, 30 mmHg). If arterial pressure is briefly re-elevated at 30 minute intervals, permanent deterioration is prevented. However, if the hypotension is sustained for 2 hours, LV performance remains depressed following pressure re-elevation. Among the mechanisms responsible for deterioration of performance, coronary perfusion pressure (CPP) exerts a pivotal role. Thus, no LV depression occurs after 2 hours of shock provided CPP is maintained at normotensive levels. But if myocardial O2 availability falls below 10 ml/min/100 gm of heart, both O2 uptake and extraction decline and this is uniformly accompanied by cardiac failure. This likely reflects mitochondrial damage and impaired aerobic metabolism. These changes are potentiated by the appearance of metabolic acidosis and failure of sympathetic neurohumoral activity. Both factors directly reduce myocardial contractility, but assume much greater importance during shock. While E. coli endotoxin has been shown to reduce cardiac performance, the relative importance of bacterial products which may enter the circulation during hemorrhagic shock in uncertain. Reduced O2 availability, metabolic acidosis and adrenergic failure appear the major determinants of diminished cardiac performance and thereby may contribute to irreversible collapse of circulatory function.


Pulmonary circulatory adaptation to acute atelectasis in man. Pulmonary functional veno-arterial shunt determinations were made breathing 100% oxygen in thirty consecutive patients during thoracotomy with one-lung anesthesia. Initially, with both lungs ventilated (FiO2 100%), the mean shunt value was 18.1 +/- 1.2% (S.D.). With the collapse of one lung by deflation and surgical pneumothorax, the shunt rose to 36.0 +/- 1.5%. With time the value fell: 36.0 +/- 1.5% at five minutes, 30.3 +/- 1.4% at fifteen minutes, 30.3 +/- 1.4% at thirty minutes, 28.1 +/- 1.4% at sixty minutes, and 24.6 +/- 2.8% after two hours. This trend was significant at a p value of less than 0.001. This study for the first time documents in man the phenomenon of pulmonary circulatory adaptation to acute atelectasis.


Glycosaminoglycans: potential determinants in cardiac morphogenesis. Treatment of the embryonic heart shortly after looping with 6-diazo-5-oxo-L-norleucine (DON) primarily inhibited the secretion of hyaluronate by the myocardium, an event accompanied by delayed and reduced formation of AV cushion cells (valvular and septal primordia). Sulfated glycosaminoglycan synthesis (primarily chondroitin-6-sulfate and heparan sulfate) was not significantly reduced until after cushion cell formation, an event accompanied by their altered migratory behavior. Results thus support a causal relationship between the morphogenesis of cushion tissue and extracellular glycosaminoglycans.


Effects of hyaluronic acid on cardiac cushion tissue cells in collagen matrix cultures. To initiate the experimental exploration of the role of extracellular macromolecules in influencing developmental events in the heart, a 3-dimensional substrate culture model of the developing cardiac cushion was devised. One cardiac jelly component, hyaluronic acid, was tested for its effects on morphology and migratory capacity of cushion tissue cells within the collagen matrix substrate. Hyaluronate treatment resulted in: (1) an increase in the number and extent of filopodia, reflected as an increase in cell surface area, and (2) an increase in migratory capacity, reflected as an increase in maximum depth to which cells migrate through the collagen lattice. These results suggest one major role for hyaluronate in the early cardiac cushion is the promotion of a high level of motility capability in the newly seeded cushion tissue cells, required for the key event of cell migration across the developing cushion.


Matrical ordering in the morphogenesis of tunica media. The cells which will form the smooth muscle tunica media are derived embryologically from the cardiac mesenchyme referred to as endocardial cushion tissue. These progenitor smooth muscle cells, however, are derived primarily from aortic arch mesenchyme as opposed to the endocardium in the prevalvular areas. The matrical microenvironments of these cells begin to change at approximately 5 days of development when the progenitor smooth muscle cells acquire a more fibrillar matrix. The prospective adventitia and valvular areas still maintain an environment rich in hyaluronate and proteoglycans. By Day 6, the 110Ao microfibril, characteristic of smooth muscle cells, appears in the matrix well in advance of the amorphous elastin component seen at Days 8 and 9. The orientation of the collagenous microfibrils and elastic microfibrils is non-random with respect to the layers of cells, and this precludes a simple substrate alignment model in establishing the characteristic laminarity of this tissue.


Electron microscopic studies of connective tissue repair after myocardial injury. Myocardial infarcts were artificially induced in a series of dogs by ligation of the circumflex coronary artery. Infarcted areas were studied by transmission electron microscopy at varying times between 3 1/2 days to 126 days post-ligation. A granulation phase was demonstrated up to 13 days post-ligation, but fibrin and inflammatory cells were not usually seen after that. The fibroblasts showed increased rough endoplasmic reticulum and Golgi vesicles up to 30 days. Beyond that they reverted to a more quiescent morphology. Myofibroblasts were abundant at 13 days but were not found beyond 30 days. Many microvessels were occluded by excessive numbers of endothelial cells from 22 to 30 days. Beyond this period they, again, became patent. Many similarities exist between the healing stages of myocardial infarctions of dogs and deep injury to the body surface in man. It is suggested that animals form the equivalent of hypertrophic scar or keloid, but resolution of hypertrophy, or the self-limiting process, is much more rapid and efficient in animals than in man.


Morphological factors of clinical significance in myocardial infarction - a review. The foregoing consideration of myocardial infarction has centered largely on a correlation of morphological events and their possible clinical significance. It is hoped that some contribution has been offered to the better understanding of this important entity.


Energy metabolism in the ischemic heart. A reduction in myocardial oxygen supply during ischemia, not only leads to reduced aerobic ATP production but does not stimulate glycolytic ATP synthesis. The residual aerobically synthesized ATP comes primarily from continued inefficient (i.e., compared to glucose in terms of moles of ATP produced per mole of O2 consumed) oxidation of fatty acids. This leads to elevated tissue levels of long chain fatty acyl-CoA and fatty acyl-carnitine. Both are potentially cell damaging metabolic intermediates. Restriction of glycolysis is due to inhibition of glyceraldehyde-3-phosphate dehydrogenase by accumulated metabolites, such as H+, lactate and NADH. The reduced production of ATP leads to decreased levels of high energy phosphate stores which in turn may impair myocardial mechanical function.


Control of carnitine-related metabolism during myocardial ischemia. Induction of ischemia in the open-chest dog or isolated rat heart caused a series of critical changes in carnitine-related metabolism. As a result of these metabolic changes, the LCACA/carnitine ratio rapidly increased which, in turn, may have reduced the activity of mitochondrial ANT and a number of other enzyme systems necessary for normal heart function. Carnitine administration apparently reversed these carnitine-linked metabolic changes and protected the ischemic myocardium. Possible mechanisms for the protective action of carnitine were discussed.


Myocardial triacylglycerol metabolism in ischemia. The utilization of transmural myocardial triacylglycerols, phospholipids and tissue free fatty acids was studied in dogs with and without left circumflex coronary artery occlusion for time intervals up to 4 hours. Results from 14C-labeling experiments reflected a continuous and dynamic turnover of transmural triacylglycerol fatty acids, phospholipid fatty acids and tissue free fatty acids in control dogs with patent coronary arteries. Coronary artery ligation resulted in markedly diminished glycerolipid utilization. However, 14C-labeled free fatty acid utilization continued in the ischemic state. No net changes in chemically determined total triacylglycerols were observed in any region through 2 hours of occlusion, but a substantial increase was observed transmurally after 4 hours. Certain mechanisms involved in the observed ischemia-induced alterations of myocardial lipid metabolism are discussed within the context of the current literature.


Role of mitochondria in heart cell function. Mitochondrial oxidative phosphorylation constitutes the primary energy (ATP) supply in the myocardial cell. The principle substrates utilized in AtP synthesis are free fatty acids which must be converted to acylCoA esters prior to transport into the mitochondrial inner compartment. Although heart mitochondria are capable of rapidly accumulating significant amounts of calcium, their role in myocardial calcium metabolism is probably that of a "cytosolic buffer or reservoir" system. Energy-linked calcium transport and ATP synthesis compete for essentially the same "high-energy pool" in mitochondria. The integrated control of these processes remain to be elucidated. The acylCoA transferases, adenine translocase, CPK-MB enzyme system, Pi-OH exchanger and calcium influx and efflux channels located in the mitochondrial inner membrane all represent potential control points in the regulation of functional activity. Alterations in mitochondrial functions due to cardiac disease will not be fully understood until the fundamental mechanisms governing these processes in the normal myocardial cell are understood.


Determination of 5-(p-hydroxyphenyl)-5-phenylhydantoin and studies relating to the disposition of phenytoin in man. A gas chromatographic on-column methylation technique was developed for the routine laboratory determination of 5-(p-hydroxyphenyl)-5-phenylhydantoin (p-HPPH), the principal urinary product of phenytoin )PHT) metabolism in man. 5-(p-Hydroxyphenyl)-5-(p-tolyl)hydantoin (HMPPH), a new internal standard, was synthesized and evaluated against 5-phenyl--5-(p-tolyl)hydantoin (MPPH), the compound normally used as the internal standard in p-HPPH assays. HMPPH withstood the challenges of intralaboratory quality control checks and tests of precision of p-HPPH values at times when MPPH provided erratic and unreliable values. Both an enzyme and acid treatment of urine were studied for the purpose of hydrolysis of p-HPPH-glucuronide, the form in which p-HPPH is excreted in urine. The use of both treatments in studies of three different patient urines pointed to the conclusion that acid-catalyzed decomposition of PHT dihydrodiol, a minor urinary metabolite of PHT in man, was unimportant from the analytical point of view, contributing little if anything to total urinary p-HPPH content. Some aspects of PHT disposition, as evidenced by studies of PHT plasma levels and p-HPPH urinary outputs in individual patients, are discussed.


Mephobarbital and phenobarbital plasma concentrations in epileptic patients treated with mephobarbital. Plasma mephobarbital and phenobarbital concentrations were determined in 11 epileptic patients receiving mephobarbital alone or in combination with other antiepileptic drugs. The analysis was carried out by a selective ion monitoring (SIM) mass fragmentography technique following formation of N-propyl derivatives of both drugs. The plasma concentrations of phenobarbital ranged from 4 to 32 micrograms/ml and those of mephobarbital from 0.2 to 1.7 micrograms/ml. Differences in the metabolism rates of the drugs accounted for the plasma concentration differences; mephobarbital is metabolized more rapidly than phenobarbital. Phenobarbital concentrations obtained by SIM mass fragmentography were similar to those obtained by gas-liquid chromatographic on-column methylation, which quantitates only "total phenobarbital" (mephobarbital plus phenobarbital).


Salicylate treatment of epidemic Kawasaki disease in New York City. Kawasaki disease, mucocutaneous lymph node syndrome, thought to be rare in the continental United States, occurred in epidemic form in New York City and adjacent New York and New Jersey in November-December, 1977. Aspirin and corticosteroids, reported to be ineffective treatment, were found to completely control the illness in affected children, provided adequate doses to achieve therapeutic blood levels were administered. Patients were found to malabsorb aspirin (and perhaps also to destroy it) and so required extraordinarily high doses during the acute phase; during recovery, doses had to be lowered to the usual range to avoid toxicity. The need for hospitalization and morbidity were reduced and, hopefully, mortality will also be reduced. The importance of not judging a drug ineffective in a disease without demonstrating adequate serum levels was again shown.


Haloperidol plasma level monitoring in pediatric patients. Plasma levels of haloperidol were monitored in children and teenagers suffering from psychotic episodes and/or abnormal movements (tics and Gilles de la Tourette's syndrome). Steady-state concentrations of haloperidol ranged from 0.7 to 19 ng/ml without any apparent relationship with the administered dose (15--285 micrograms/kg/day) and a 15-fold variability was observed for the same daily dosage. On the contrary, a significant (p < 0.02) relationship was found between the age of the patients and the plasma concentrations to dose ratios, lower values being present in younger patients. Side effects too appeared to be related to plasma levels, with a significant increase (p < 0.01) in incidence for concentrations over 6 ng/ml. In most of the cases suffering from tics and Gilles de la Tourette's syndrome, a positive response was associated with plasma levels of 1--4 ng/ml, while no relationship could be established for the psychotic group. The relevance of monitoring plasma drug levels when prescribing haloperidol in pediatrics is discussed.


Thyroid replacement therapy: a rational approach to laboratory monitoring. A brief summary of the diagnostic laboratory criteria for primary hypothyroidism and the practical aspects of the pharmacology of thyroid hormone therapy are presented. A minimal testing protocol for the adequacy of replacement therapy is advocated based on classic studies of restored thyroid function.


High performance liquid chromatographic assay of vancomycin in serum. A liquid chromatographic procedure is described for rapid and accurate quantitation of vancomycin in serum. Vancomycin is extracted from serum by using a CM-Sephadex column and is measured by reversed-phase chromatography with detection by UV absorption. Ristocetin is used as an internal standard. Concentration and instrument response are linearly related in the range of therapeutically useful concentrations. Results correlate well with those obtained by bioassay. The between-day coefficient of variation (n = 8) was less than 4%. Recovery of vancomycin from serum is nearly complete, and no substances that interfere with the procedure have been detected in clinical specimens.


Stability of pulmonary function during periodic intravenous bolus aminophylline therapy. Peak expiratory flow, forced vital capacity, forced expiratory volume at 1 sec, and midmaximal expiratory flow were measured immediately before and 1 hr after a scheduled intravenous maintenance dose of aminophylline in 12 recently hospitalized asthmatic patients. Serum theophylline concentrations were also determined. No significant improvement was noted in any of these pulmonary function tests despite a significant increase in serum theophylline concentration (10.5 +/- 5.2 to 18.2 +/- 6.3 micrograms/ml, p < 0.001). These results were consistent with previously developed pharmacologic response theory.


Phenytoin: EEG effects and plasma levels in volunteers. The electroencephalographic (EEG) and behavioral effects of oral doses of phenytoin from 100 mg to 1 g in normal male volunteers were measured. The electroencephalogram exhibited decreases in power in the slow frequencies and increases in the fast frequencies, accompanied by an increase in mean frequency. These changes are similar to those seen with psychostimulants. They occurred at average plasma levels of 8 micrograms/ml and above. The time course and the intensity of EEG effects parallel plasma levels. Drug-related EEG changes were bilaterally symmetric. EEG changes at plasma levels of 8--12 micrograms/ml were not associated with behavioral toxic signs. These findings suggest that future psychiatric studies of phenytoin as a psychostimulant should include monitoring for plasma levels, with a minimum of 8 micrograms/ml as a guide to clinical efficacy.


Blood flow to the kidney via the gonadal-renal capsular artery. The gonadal artery is an important collateral pathway of blood flow to the kidney. Collateral routes may be from the gonadal artery to the inferior capsular artery (gonadal-renal capsular artery) or to the periureteric arteries. These pathways develop in cases of renal artery stenosis, or when a vascular renal tumor increases the kidneys need for blood. We present five cases in which the gonadal artery served as a source of blood supply to the kidney.


Computed tomography and ultrasonography in the evaluation of mesonephric duct anomalies. Three cases involving developmental anomalies of mesonephric duct derivatives were examined by computed tomography and ultrasonography. Cases included an ectopic ureter inserting into a cystic seminal vesicle, an ectopic ureterocele, and agenesis of the seminal vesicle and vas deferens. Computed tomography and ultrasonography were valuable noninvasive methods, supplementing standard radiographic techniques, for evaluating these anomalies.


Computed tomography staging of renal carcinoma. The ability of fast thire-and fourth-generation scanning devices to supply images of sufficient quality to delineate the kidney, its vascular supply, and surrounding fascial envelope has provided a modality which permits preoperative staging of tumors of the kidney with an accuracy of about 90% in limited series of 20 specimen cases. The unreliability of bolus injection to evaluate tumor extension to the renal vein accounted for two errors.


Traumatic strictures of the prostatomembranous urethra in children: radiologic evaluation before and after urethral reconstruction. Impassible strictures of the posterior urethra are frequent sequelae of injuries of the prostatomembranous urethra. To select the appropriate type of urethral reconstructive procedure, the surgeon must know the length of the stricture, whether local complications are present, and whether the anterior urethra is strictured or bound down by fibrosis. The authors describe the radiographic techniques they use to plan urethral reconstruction and evaluate the operative result. The principles of the one-stage transperineal and combined transpubic-transperineal repairs and the two-stage Turner-Warwick scrotal skin inlay urethroplasty are presented to enable radiologists and urologists to interpret contrast studies of the lower urinary tract in patients who have undergone these operation.


Rectourethral fistula on the urethrogram. Radiologic demonstration of a rectourethral fistula is of importance in the evaluation of the male neonate with imperforate anus. After pull-through operation a remnant of the fistula may remain as a small unimportant sinus tract or may cause problems.


Recurrent transitional cell carcinoma in an ileal conduit. A patient with recurrent transitional cell carcinoma involving an ileal conduit is reported. This case is unusual for the following reasons: the malignancy was located in an area where there was no transitional epithelium; a "napkin ring" deformity was present; there was a 6-year interval between the initial cystectomy and the recurrence of the malignancy.


"Bell-shaped ureter," a radiographic sign of antegrade intussusception. A unique case of a hitherto unreported antegrade intussusception of the ureter secondary to a lead pedunculated polypoid transitional cell tumor is presented. Radiological documentation and surgical verification are illustrated. An attempted explanation of the peculiar radiographic appearance proximal to and within the intussusception is given. The potential aid in preoperative recognition of such an entity is proposed.


Ureteral involvement by metastatic disease. Ureteral obstruction secondary to metastases from distant primary tumors may be studied by urography, pyelography, venography and lymphagiography. An added dimension to the study of this disease process is obtained by the use of sonography and computed tomography since these techniques are better able to demonstrate the extent of the disease in the retroperitoneum.


99mTc-DTPA renal scanning as a confirmatory study in the diagnosis of neonatal adrenal hemorrhage. 99mTc-DTPA renal scanning offers a method for demonstrating adrenal hemorrhage as a cause of flank mass in the neonate and for assessing renal function. The hemorrhagic adrenal appears as a tracer-free area over the flattened and displaced kidney. The method is low in radiation and is not hampered by obscuring bowel contents.


An unusual vascular impression on the renal pelvis. In a female patient who presented with the complaint of dysuria, angiography was required to distinguish a vascular impression on the renal pelvis from a possible tumor or calculus. Neither intravenous urography nor retrograde pyelogram clarified the smooth filling defect sufficiently to rule out the possibility of a urothelial tumor.


The striated nephrogram in renal contusion. The striated nephrogram following renal trauma is reported for the first time. Previously, the striated parenchymal pattern has been oted in obstruction and in a small number of cases of hypotension. Tamm-Horsfall proteinuria, and renal vein thrombosis.


Barium enema as an adjunct to the urogram when the left kidney is not seen. The barium enema is a useful adjunct to urography when the left kidney is not seen. When the anatomic splenic flexure of the colon is in normal position, a non-visualized kidney is present in the renal fossa.


Congenital giant hydroureteronephrosis.

Congenital giant hydroureteronephrosis. Four patients with giant hydroureteronephrosis are reported to emphasize the massive proportions attained by a dilated ureter. Ureteral obstruction was congenital in each case; duplication with ectopic insertion was present in three of the four patients. In three patients the massively dilated ureter caused partial obstruction of the contralateral ureter. If ultrasound and/or computed tomography demonstrate a huge, septate, cystic structure crossing the midline, massive megaureter should be suspected. Antegrade puncture can be used to confirm the diagnosis.


The "stipple sign" - urographic harbinger of transitional cell neoplasms. The trapping of contrast material within the interstices of a papillary growth produces a stippled appearance when viewed end on. Since the majority of transitional cell neoplasms have a papillary configuration, the stipple sign is highly suggestive of the presence of this lesion.


Renal vascular changes as reflected by angiography. Gray-scale ultrasonography and whole-body CT have narrowed the indications for renal angiography. However, as illustrated here, there remain a number of vascular disorders for which angiography still provides the only means of establishing a correct diagnosis. Some of these cases may also be treated by transcatheter embolization in connection with angiography.


Multilocular renal cysts.

Multilocular renal cysts. Multilocular renal cysts are benign lesions with an unknown histogenesis. We report 3 children and summarize information currently known about these lesions. Capsular veins were seen in two patients during the early phases of intravenous urography. Intravenous urography with sonography and arteriography may suggest the diagnosis prior to surgery.


Emphysematous pyelonephritis: optimal diagnosis and treatment. A case of emphysematous pyelonephritis is presented in which computerized tomography (CT) both confirmed the diagnosis and demonstrated extension of the gas to the region of the adrenal glands and inferior cava. The etiology and pathogenesis of emphysematous pyelonephritis is discussed. Radiologic evaluation of this disease should be prompt and noninvasive. Plain films establish the diagnosis, isotope scanning assesses function of the opposite kidney, and CT demonstrates the full extent of the pathological process and confirms the diagnosis. Aggressive treatment is recommended.


Nonobstructing radiopaque ureteral calculi. Twenty-two unilateral nonobstructing radiopaque ureteral calculi were found on excretory urography in 21 patients over a 6-year period. The calculi were frequently (12/22) not associated with pain at the time of urography. Of the 21 patients, 19 had intrarenal pelvis configuration which may limit the potential dilatation of the collecting system. Twelve calculi eventually passed spontaneously and two were removed surgically. Three remained in the ureter for prolonged periods (up to 18 months), still nonobstructing. The majority (13/22) of the calculi were in the distal third of the ureter.


Changes in membrane fluidity of mast cells, induced by antigen-anaphylactic antibody reaction. Binding of IgE to rat mast cell receptors caused a distinct decrease of membrane fluidity. The antigen-IgE antibody reaction was followed by rapid changes in membrane fluidity of sensitized mast cells. In the earliest phase of the antigen-antibody reaction membrane fluidity decreased, however, this decrease was followed by a quick increase 10 min. later.