[Degeneration of the afferent fibers simulating the effects of motor denervation on skeletal muscle]. Degeneration of afferent nerve fibres was induced in rats in order to observe its effects on the properties of the extra-junctional membrane of soleus muscle fibres. In one approach, removal of dorsal root ganglia L4 and L5 was accomplished in preparations with intact or impulse-blocked (with tetrodotoxin containing cuffs around the sciatic nerve) efferent innervation. Spike resistance to tetrodotoxin developed in the inactive deafferented preparations earlier and to a greater extent than in control, that is only impulse-blocked, preparations. In another series of experiments, efferent denervation alone proved to be less effective than the association of efferent and afferent denervation. On the other hand, section of the afferent fibres central to the dorsal root ganglia was without effect. These results are consistent with the interpretation that products of nerve degeneration contribute together with inactivity to the development of the extrajunctional membrane changes observed in skeletal muscle after denervation.


Different changes of glycogen content in rat muscle denervated by different procedures. Glycogen levels in the extensor digitorum longus of the rat undergo different changes after cutting the sciatic nerve compared with the destruction of the lumbosacral spinal cord. The differences most probably are due to early changes of the endocrine (adrenal and pancreatic) function after the latter type of denervation.


Behavior of the oculomotor neurons discharge during sinusoidal lateral tilt in the rabbit. The characteristics of the control exerted by macular and ampullar vestibular receptors on oculomotor neurons (OMN) have been investigated by submitting unanesthetized, encéphale isolé rabbits to sinusoidal lateral tilts of varying frequencies (0.013-0.2 Hz). The phase of the response exhibited a progressive shift towards head velocity with increasing frequencies of tilt. The sensitivity of the OMN significantly increased at frequencies above 0.025 Hz, corresponding to peak accelerations suprathreshold for canals related vestibular neurons. The convergent action of macular and ampullar vestibular receptors in the control of vertical eye movements is discussed in relation with stimulus frequency.


[Somatotopic organization of the vestibulospinal tract in the toad]. The origin of the vestibulospinal projection in the toad has been investigated by using the method of the retrograde axonal transport of HRP injected at various levels of the spinal cord. The vestibulospinal projection, in this species, was found to be somatotopically organized, since neurons projecting to the cervical segments of the spinal cord were located within the rostromedial part of the ventral vestibular nucleus and those neurons projecting to the lumbosacral segments of the spinal cord were located within the caudolateral part of that nucleus. This pattern of organization of the vestibulospinal projection in amphibia is similar to that described in mammals and birds.


[Changes of postural tonus produced by unilateral deafferentation of the musculature of the neck in pigeons]. In intact or decerebrate pigeons, unilateral functional deafferentation of the dorsal neck muscles of one side produced a postural asymmetry, characterized by an increase in flexor tonus of the ipsilateral wing and leg and an increase in extensor tonus of the contralateral limbs. This postural asymmetry was just opposite in sign to that described recently in cats, where unilateral section of the cervical dorsal roots C1-C3 produced ipsilateral hypertonia and contralateral hypotonia of the limb extensors. The striking increase in flexor tonus of the wing following deafferentation of the ipsilateral neck extensors contrasts with the decrease in flexor tonus of the wing which occurs after deafferentation of the ipsilateral leg extensors. It appears, therefore, that the proprioceptive input from the neck and that from the leg extensors exert an antagonistic influence on the flexor tonus of the ipsilateral wing.


[Experimental models of immunochemotherapeutic synergism: study of the influence of the treatment schedule]. Graded doses of LSTPA or L1210 leukemia cells were injected ip or iv into fully compatible hosts or mice incompatible for Multiple Minor Histocompatibility Loci (MMHL). Three days later the animals were treated with single doses of BCNU, NM, DTIC and VCR. The results showed that NM and VCR could synergize with the weak anti-tumor immune responses of MMHL-histocompatible mice only upon ip injection of the tumor. If the same tumor has been injected iv, only BCNU could synergize with the host's antitumor response. On DTIC treatment, no synergistic effects were detectable for either route of tumor's challenge.


[Body temperature during fasting in chickens of various ages and body weight]. Chickens of different ages will be submitted to periods of non-eating of 2 to 10 days. The non-eating causes a constant lowering of the body temperature which, in the 10 days old chickens, is 4-5 times higher than in the 3 months old ages. To an higher diminishing of the temperature it corresponds an higher loss percentage of weight. In normal conditions the temperature tends to increase from morning to evening, while during the non-eating period it diminishes. With repeated non-eating periods the colling increases. The difference between young and old animals would depend on differences in quantity of their basal metabolism (lower in the old aged) and on the different availability of energetic material in reserve (higher percentage in the old aged).


Preparation and analysis of new sulfonium derivatives from S-adenosyl(5')-3-methylthiopropylamine. The paper reports the preparation and the chromatographic separation of new deaminated analogs of S-adenosyl(5')-3-methylthiopropylamine, i.e. S-adenosyl(5')-3-methylthiopropanol and S-inosyl(5')(-3-methylthiopropanol. These compounds can be used as specific inhibitors of polyamine biosynthesis. It is also reported the characterization of new sulfonium compounds by U.V. spectrophotometry, thin layer chromatography, high voltage electrophoresis, hydrolysis to known fragments.


[Anionic detergents in Mytilus Galloprovincialis of the gulf of Naples]. The authors have investigated on the anionics detergents rate inside the Mytilus Galloprovincialis, used as animal-monitor of the environment state of a certain part of the Gulf of Naples. The data concerning 14 zones in which were drown mussels cultivated in the Gulf of Naples resumed in a specific list, shown an high concentration of above detergents.


[Effect of ethylmaleimide on the transport of Ca+ and K+ ions across mitochondrial membranes]. As already reported, it has been found that the gradient of protons, set up across the inner membrane during the Ca2+ uptake by rat liver mitochondria, can be completely reversed by the addition of NEM. Identical results have been obtained by following the energy dependent K+ uptake. In these last conditions, the rate of H+ efflux supported by succinate oxidation is greatly enhanced only when NEM is added after rotenone. It is proposed that the increased rate other than to the inhibition of Pi uptake, as suggested by Reynafarje and Lehninger, could also be ascribed to a further decrease in the energetic level of the membrane as well as to an increased rate of succinate-Pi exchange diffusion reaction induced by NEM. A possible direct effect of NEM on succinate oxidation has been also considered to account for the inhibition observed when it is added before rotenone.


[Histochemical investigation on the mechanism of action of a synthetic mucolytic compound (Na 872 Cl): preliminary results]. A histochemical study about mucolytic capacity of Na872Cl compound revealed its action upon epitelial mucins of mouse colonic and tracheal mucosa but the results depend on the chemical type of fixative employed (formalin or acetone fixed sections); the mode of action especially regarding the influence of fixatives and the nature of sensitive substrates are discussed.


[The double effect of myocardial stimulation]. The stimulus generated at the sinus node induces on the heart working cells a stronger contraction at higher frequences. The purpose of the present report is to investigate whether the two effects a) exicitation-contraction coupling and b) contraction strength are independent. Instead of the pace-maker it has been used a rectangular waves generator; the pulses are applied to isolated guinea-pig auricle or rat right ventricle. The AA. show a stronger twitch of cell when the membrane is depolarized without contraction. This phenomenon can be obtained as follows: by applying peculiar conditions of high frequency train pulses (so that they are not capable of eliciting contraction) or depolarizing the membrane with high KO concentration. The AA. believe that the stronger contraction of the muscle cell is due to the depolarization generated by the stimulus and it is not connected to the contraction. The potentiating factor is independent by cAMP and cytoplasmic Ca++. This factor is antagonized by propranolol.


[Antithrombin III assay using a chromogenic substrate in newborns]. The assay of antithrombin III activity (AT-III) was performed by chromogenic synthetic substrate in 42 full-term newborns, 1 to 7 days aged. AT-III levels were lower than normal adults in the first day of life and lessened again in the 3rd day. After this period the levels of AT-III rose slowly and in the 7th day were about half the concentration of adults.


[Structural modifications of medullary bone osteoclasts during a hypocalcemic diet]. The medullary bone of laying hens after seven days of hypocalcaemic diet has been investigated with the aim of analyzing the fate of osteoclasts, very numerous in the first days of the diet and after substituted on the trabecular surfaces by active osteoblasts. The first observations show that there is a marked change in the osteoclasts ultrastructure. Large amount of endoplasmic granular reticulum in regular rows are accumulated at the cell periphery. Cytoplasmatic blebs, microvilli and laminae ondulantes are visible on the cell surfaces. Mononuclear cells with variable amount of cytoplasm rich in organuli are detached from osteoclasts. The ultrastructure and the fate of this elements are discussed.


[Derivation of a velocity equation for a reaction model witwh two binding sites for acetylcholinesterase]. The authors suggest a kinetic model with two binding sites for acetylcholinesterase; it is suitable to study particular enzyme forms that show a kinetic pattern which cannot be explained by the model with a single binding site of Krupka and Laidler. The velocity equation was obtained using the algorithm of King and Altman and carrying out elementary calculations.


[Kinetic analysis of a reaction model with two binding sites for acetylcholinesterase]. After having suggested a kinetic model with two binding sites for acetylcholinesterase, the authors obtained the various function of [I] (1/vi; (vo/vi-1)/[I]; 1/Vi; Ki/Vi) starting from the velocity equation. An analytical study was then carried out showing the theoretical shape of such functions at different values of the kinetic parameters.


[Effects of graded doses of copper complexes with L-aminoacids on gastric acid secretion in the rat]. Gastric acid responses to intragastric administration of graded doses (14-30-45 mg/Kg) of copper (II) complexes with aminoacids (two simple complexes, Cu-Trp2 and Cu-Phe2, and on mixed complex, Cu-Trp-Phe) were investigated in Shay rats. The results (% inhibition of H+ mEq/4h) shown that graded doses of copper complexes caused a progressive inhibition on gastric acid secretion, and that percentage inhibition values were, for all complexes, in linear correlation with employed doses. A possible mechanism by which copper complexes affect gastric acid secretion is discussed.


[Conditioning system for training cats to execute a typical prehension movement]. This report describes a conditioning system for training cats to carry-out typical prehension's movements which exhibit the highest degree of reproducibility. It is composed of the following: a) a cage which is furnished with a particular foot-board to check the starting position of the front legs; b) an electropneumatic machine for transporting a bit of food; c) an electronic device for controlling and randomizing the time of nourishment.


[Electronic circuit for the control of current intensity of stimulating impulses at high isolation]. A small electronic apparatus is described, in which the pulses of current can be regulated from 0 at 10 mA. This apparatus permits the utilization of conventional tension stimulators.


[Semiautomatic regulator for the preparation of microelectrodes for electrophysiology]. This paper describes an electronic device for making metallic microelectrodes to be used for electrophysiological experiments. These microelectrodes are endowed with a small tissue-electrode capacity and a high mechanical strength. The same microelectrodes are applicable for derivation of spikes as in the case of microstimulation of nervous structures during repeated penetrations.


[Removable electromagnetic transducer for the study of cardiac minute volume in the conscious dog]. The study aimed at evaluating the reliability of a new type of aortic flow probes to be used in conscious dogs and easy to be removed without a second surgical intervention, 48-72 hours after they have been implanted. The probes, which have been made in the Department of Human Physiology of the University of Turin, are light and thin enough to be cronically implanted around the aorta without removing the fat which surrounds the artery, and to be taken away without injuring the tissues. The records obtained 24 and 48 hours after they have been positioned, demonstrate the reliability of the probes. Histological examination of the aorta has not evidenced any tissue reaction.


The synergism acetylcholine-eserine in the epinephrine induced ventricular automaticity. Heart ventricular strips of the rat in Krebs solution were used to test the synergism acetylcholine-eserine. Ventricular automaticity induced by epinephrine 1 10(-6) is inhibited by acetylcholine (a 50% reduction of the automatism is observed with acetylcholine 1,23 10(-8) while four different concentrations of eserine cause an evident potentiation of the effect of acetylcholine (with eserine a 10(-5) the ED50 of acetylcholine is 2,57 10(-14)). It is concluded that the synergism eserine-acetylcholine is a synergism with potentiation and the acetylcholine introduced in the Krebs solution interacts with receptors different from those activated by the acetylcholine which accumulates when cholinesterase is inhibited by eserine.


Acetylcholine distribution in the spinal cord of the rat. Spinal cord of male albino rats is cut in four parts: the cervical enlargement (C2-C8) the thoracic cord (T1-T10) the lumbar enlargement (T11-L3) and the sacral extremity (L4-S4). A considerable increase in the acetylcholine levels from the cervical (0,80 g/g +/- 0,15 st.err.) to the sacral section (2,67 g/g +/- 0,48 st.err.) has been observed. It is concluded that the increase of acetylcholine levels in the lower part of spinal cord is the consequence of the relative increase of gray matter at this level.


The "grasping reflex" in rats with altered thyroid activity. The "grasping reflex" test was performed in adult rats with altered thyroid function. Any modification of the thyroid activity (hyper or hypothyroidism) caused a prolongation of the grasping time. Our data indicate that the condition of hypo or hyperthyroidism induces behavioural modifications in the adult rats.


[Aspects of the decrease of some enzyme activities in erythrocytes of subjects with beta-thalassemia]. G6PD, GSH-Px and 6PGD activity was found to be elevated in beta-thalassemia heterozygous erythrocytes. Estimates of the activities of the three enzymes in red cell fractions of differing mean age separated by centrifugation through a density gradient of Ficoll-Triosil layers, showed that the rate of in vivo decline was normal for G6PD and GSH-Px, and decreased for 6PGD. The increased enzyme activity results from increased rate of synthesis for G6PD and GSH-Px, and from higher in vivo stability for 6PGD.


The treatment of sarcoidosis by levamisole. Five patients with persistent or progressive pulmonary shadowing due to sarcoidosis were treated with 150 mg levamisole daily and one patient with 150 mg twice weekly. Only the latter patient completed a 12-week course without unwanted side-effects. One of the remaining five patients on full dose completed the course but all experienced symptoms (nausea, malaise, influenza-like syndrome or arthralgia and skin rash) severe enough to cause five to stop the drug. Haematology and biochemistry, however, remained normal, with the exception of transient rise in transaminases in one patient. Radiology, pulmonary function and numbers of circulating T-lymphocytes (E-rosettes) were unchanged, but three patients developed increased intensity of delayed hypersensitivity (DH) skin tests using PPD, Candida and Trichophyton antigens; two of these patients also developed increased in vitro lymphocyte stimulation by mitogen and PPD antigen and the other developed a 'serum sickness' syndrome with evidence of circulating immune complexes.


Papilloedema and optic atrophy in chronic hypercapnia. Two patients are described with hypercapnia of 10 and 13 years duration. Both patients had papilloedema at different stages of their illness and one patient developed optic atrophy. Whether such changes are due to local retinal vascular changes, general change in cerebral vasculature or the result of raised intracranial pressure is unknown. A combination of all seems likely. Computerized axial tomography brain scan on Case 2 was compatible with cerebral oedema and the development of optic atrophy (Case 1) suggests cerebral oedema and consequent raised intracranial pressure as the major factor in the development of papilloedema in hypercapnic patients. Skull radiographic changes have not previously been reported in hypercapnia. The duration of the papilloedema is critical in the development of atrophy.


Hydatid disease presenting as tension pneumothorax. The case of stockfarmer with hydatid disease which presented as a left tension pneumothorax is described. The diagnosis was not made until the patient underwent a thoracotomy for a complicating empyema.


[Labelling index in breast cancer and in upper respiratory and digestive tract cancer (author's transl)]. The labelling index (LI) of 96 breast adenocarcinomas and of 43 upper respiratory and digestive tract cancers has been measured. For the two histological groups, the distribution of individual values is found to be log-normal, with a mean value depending on the tumour type. Our data have been compared with other authors results. The dispersion of individual values within a same histological type suggests that the LI is interesting as an individual value depending on the patient and his own cancer. For breast adenocarcinomas the LI values obtained have been separated in two groups depending upon the patient age, the age of 53 has been chosen to separate premenopausal from post-menopausal patients. A test of significance showed that the two corresponding log-normal distributions were different, even at the 0.01 level of significance, a mean LI value thus characterizing each distribution.


[Effectiveness of VM 26, mitomycine C and methotrexate in advanced breast cancer refractory to a four drug combination (author's transl)]. 56 patients with advanced breast carcinoma, primarily or secondarily resistant to a four drug combination including Adriamycine, Vincristine, Cyclophosphamide and 5 Fluoro-Uracile, entered a phase II trial using association of VM 26, Mitomycine C and Methotrexate. The tolerance was generally good, but 17 clinical manifestations of toxicity were observed out of 216 cycles of treatment (7,8%). THese mucosal and haematologic disorders have incitated to secondarily reduce of 20 per cent the current doses of Methotrexate. 28 patients out of 53 (53%) have objectively responded to treatment and in 16 of them, major responses (C.R + P.R. > 50%) were observed (30%). The median of survival responders was 11 months. The critical analysis of responses by site showed 53 per cent of objective regression of lung metastasis which appears higher than the incidence of response observed after treatment with drug combination including Adriamycine.


[Preoperative irradiation in the treatment of rectal carcinoma: study of results of 116 cases at five years (author's transl)]. Pilot study of combined radiosurgical treatment of carcinoma of the rectum. 116 patients underwent surgical excision of a carcinoma of the rectum after concentrated preoperative irradiation giving 40 grays in 18 sessions over the pelvic tumour volume. The operation in 79 cases consisted of abdomino-perineal excision and in 37 cases of anterior resection. The node involvement noticed on the resected volume is of 16,4 per cent. The operative mortality is of 7,7 per cent and the complications due to radiotherapy itself mainly a delay in cicatrisation. Survival rate at five years is of 60 per cent. Preoperative irradiation seems to be realy a benefit in the treatment of rectal carcinoma.


Antitumor activity of alkylesters of 1-beta-D-ribofuranosyl-5-fluorouracil-5'-phosphate against murine lymphoma L5178Y resistant to 1-beta-D-ribofuranosyl-5-fluorouracil. A 1-beta-D-ribofuranosyl-5-fluorouracil-resistant clone, designated L5178Y/FUR, was established in this experiment. This is one of the colonies derived from a subculture which acquired resistance to 1-beta-D-ribofuranosyl-5-fluorouracil by passaging the L5178Y cells through four sucessive episodes of culture in Fischers' medium containing 1-beta-D-ribofuranosyl-5-fluorouracil; each analog treatment was followed by recovery intervals. In this subline, IC99 values for 1-beta-D-ribofuranosyl-5-fluorouracil was 0.57 muM, which was 24 times as great as in the parent line (0.0024 muM), and this subline showed a cross resistance to 5-fluorouracil. New alkylesters of 1-beta-D-ribofuranosyl-5-fluorouracil 5'-phosphate (FUMP-alkylesters) were synthesized and their antitumor activity was examined against 1-beta-D-5-fluorouracil-sensitive and -resistant L5178Y sublines. Only hexadecylester of 1-beta-D-ribofuranosyl-5-fluorouracil 5'-phosphate was effective, not only to 1-beta-D-ribofuranosyl-5-fluorouracil line but also to 1-beta-D-ribofuranolsyl-5-fluorouracil-resistant subline. Other compounds showed cross resistant in the 1-beta-D-ribofuranosyl-5-fluorouracil-resistant cells.


[Anatomical extension of invasive carcinoma of the uterine cervix (author's transl)]. Invasive epithelioma of the uterine cervix spreads in two different ways. Locally, tumour involves progressively upon neighbouring structures (vagina parametrium, uterine corpus, bladder, rectum). Regionally, lymphatic dissemination occur preociously moving towards the nodes of the pelvic wall. Local extension can be appreciated by clinical examination which determines the clinical staging of cervical cancer. It does not take sufficiently into account the volume of the tumour which is a principal factor in lymphatic dissemination. Nodal metastases essentially localise in the external iliac chain (obturateur group), from there spreading to the common iliac or latero aortic nodes which may, under exceptionnal circumstances be involved primarily. The incidence of latero-aortic metastases has recently been high-lighted by pre-treatment staging laparotomy. Besides lymphatic metastases, systematic metastases via a venous spread are rare. They indicate a late diagnosis or therapy failure with pelvic relapse. The therapeutic effort in cancer of the uterine cervix, at the present time, ought to be found on loco-regional treatment using either radiotherapy or surgery.


[Lymphographic evaluation of cervico-uterine carcinoma (author's transl)]. Bilateral pedial lymphography is a technique which has already been long employed and which had aroused great hopes in the detection of metastatic node involvement. The method has nevertheless failed to form an invariable part of the pretherapeutic assessment of cervico-uterine carcinomas. This attitude may be easily explained by the difficulties encountered in the interpretation of lymphographies as indicated in the first publications. New data nevertheless have made it possible to refine the method. Whilst false negatives remain inevitable in almost half the cases with histological evidence of involvement, false positives may be reduced to a minimum by very strict criteria of interpretation. Lymphography, a harmless technique, can then provide valuable information which enables the surgeon to confirm the success of his lymph node dissection and the radiotherapist to define areas requiring treatment. It is of major prognostic value. It may be used to guide transparietal lymph node biopsies and secondary detect lumbo-aortic nodes.


[The value of tomodensitometry in the treatment of carcinoma of the uterus (author's transl)]. The authors performed pelvic and lumbo-aortic tomodensitometry (TDM) in 67 patients with invasive carcinoma of the cervix. Localisation of the cervix is aided by the insertion of a vaginal marker and by opacification of the bladder and rectum. The density and appearance of tumour tissue are identical to those of normal uterine muscle. Under such conditions, TDM is of no use in seeing partial or total involvement of the cervix without any increase in cervical size. TDM gives a clear picture of hypertrophic neoplastic cervices and may be used to obtain exact measurements. TDM offers valuable information in cases of spread to the parametrium, lymphadenopathy or visceral metastases. During radium therapy, TDM shows the relationships between the radioactive sources and the centri-pelvic tumour. It facilitates the drawing of isodose curves. TDM is not a method suitable for the early diagnosis of carcinoma of the cervix. It adds very useful complementary information to clinical examination and classical investigation.


[Carcinoembryonic antigen in carcinoma of the uterine cervix (author's transl)]. The authors analyse 123 cases of carcinoma of the uterine cervix treated by radiotherapy, with CEA radio-immuno-assay performed before treatment then each time patients are seen in follow-up. The CEA level is positive in 35 per cent of the cases with a mean value of 21 per cent for stage I, 36 per cent for stage II and 48 per cent for stage III. CEA level become negative at the end of the treatment (80%) or after (100%) when there is a complete disappearance of the tumour. The persistence of a positive level is well correlated with the abscence of sterilization, and reappearance of CEA evokes a recurrence. Preliminary results do not seem to show a prognosis value of pre-therapeutic level of CEA according to survival rate at 2 years.


[Carcinoma of the cervix. Stages I and 2 proximal. Treatment by radiotherapy alone (author's transl)]. Carcinoma of the cervix stages 1 and 2 (1b and 2a) can be treated either with physical agents exclusively, or by surgery or by combining the two methods. No randomized trial has been performed until now, and to assess the different techniques, the different results found in literature must be used. We analyse here the results of the C.R.L.C. of Montpellier. The improvement of the results over last years' survey, can be judged after the use of external radiotherapy, which started in 1967. The doses must be given according to the size as well as the stage of the lesion. A thourough study of relevant literature confirms the fact that results are as good when only physical agents are used than with other techniques. Local recurrence are exceptional at stage T1, and no more than 4 to 5 per cent at stage T2 (proximal parametrium included. Whem comparing the side-effects and complications to those in other methods (but which are very rare after radio-therapy, at an early stage), the quality of the results may be seen. Actually, side-effects which occur at more advanced stages should not have an influence on the choice of the therapy in the early stages. We can conclude that there is a link between the course of the carcinoma and the chosen therapy starting from early forms to more advanced stages, and that physical agents can in every circumstance be used with benefit.


[Exclusive radiotherapy of late stage II and stage III carcinoma of the uterine cervix. Results and therapeutic complications for 393 cases treated at the Institut Curie (author's transl)]. Late stage II and stage III uterine cervix cancers are actual pelvic tumours and their treatment requires high doses. Therefore there is a risk of complications for the neighbouring structures. External and intracavitary irradiation are associated, the latter in a second time. For 141 late stage II and 252 stage III cases treated at the Institut Curie from 1963 to 1971 included, the respective actuarial survival are: 61 and 43 per cent at 5 years; 55 and 35 per cent at 10 years; and 55 and 30 per cent at 15 years. There is a significantly statistical difference between unilateral and bilateral stage III cancers actuarial survival: at 5 years, 52 and 34 per cent; at 10 years, 45 and 29 per cent; at 15 years, 37 and 25 per cent. Likewise, the survival for stage III cases with an abnormal urogram is distinctly poorer than for cases with a normal urogram: 48 and 18 per cent at 5 years; 41 and 13 per cent at 10 years; 38 and 8 per cent at 15 years. The crude cure rate for all the cases remains almost unchanged from the seventh year on. Failures due to cancer are mostly pelvic evolutions or recurrences, excepted a few isolated metastases (about 15 per cent of the overall failures). The majority of the failures occur during the first three years. The treatment complications are mostly moderate (4/5 are mere sequelae); rectum and bladder are the most exposed to the risk; only 5 per cent of the cured patients had severe complications.


[Results of radiotherapy of 406 carcinomas of the cervix (T2 distal and T3). Comparison between classical irradiation in one phase and split-course irradiation (author's transl)]. Between 1963 and 1971, a total of 406 inoperable cases of cervical cancer were treated by high-dose radiotherapy at the Centre René-Huguenin. Most of the patients (243) were irradiated by continuous therapy. In the other group (163) there was a 3-week interval in the middle of the treatment. The five-year survival rates (direct method) were respectively 60 and 39 per cent for the patients staged as T2 and T3. Local cure rates were 85 per cent for T2 and 65 per cent for T3. Unfortunately a high rate of complications was noted (12%), 4 per cent of which were fatal. Classical radiotherapy proved to be more beneficial than "split-course" technique considering survival rates. Yet, the rate of local cure is identical in both procedures, and the large rate of death in "split-course" seems to be irrespective of the method. Nevertheless, we have abandoned the "split-course" because the incidence of sequelae had not improved and in as much as the total dose had been reduced, the continuation of such therapy was less justified.


[Radiation therapy for stage IV carcinoma of the cervix (author's transl)]. Fifty four cases of stage IVa carcinoma of the cervix and treated with radiotherapy were collected between 1971 and 1977. Overall actuarial survival was 16 per cent at 3 years and almost all the deaths occurred before that time. Amongst the factors studied, the initial size of the pelvis tumour and lumbo-aortic lymphography findings were the determing factors in the prognosis. To a lesser extent, the age of the patient, tumour differentiation and the amount of irradiation modified the prognosis. It was thus possible to define, within the stage IVa category, several prognostic groups, the determination of which has therapeutic consequences.


Predominant parameters in the planning of radiation therapy of carcinoma of the cervix. The radiobiological parameters at the basis of radiation are: randomness of cell killing by irradiation, hypoxia and reoxygenation, does response curves, relationship of histology and radiosensitivity, doses necessary to control sub-clinical disease and gross tumor, and the rationale for combining irradiation and surgery. The volume of cancer is the determining factor in treatment planning. Since there is no correlation between the volume of the tumor and 1971 FIGO staging, staging should not be used in treatment planning but instead the volume and extent of the tumor. For the "barrel-shaped" lesions originating in the endocervix, a simple extrafascial hysterectomy is very effective after somewhat diminished irradiation. Great interest has been given to irradiating not only the pelvic wall but also the common iliac and/or paraaortic lymphatics. Since the volume of tissues irradiated to high doses of external irradiation is a limiting factor, with fields extended to L4 or T12, the total external irradiation dose cannot exceed 4,500 rad.


[Estimation of survival rates: technics used (author's transl)]. The direct method and life-table methods (actuarial and Kaplan-Meier) for estimating survival rates are described here. The difference between direct method and lifetable method is the use of information about the patients who are still alive. Practical examples of calculation are given with recommandations for graphical displays.


The response of the lower extremity to impact forces. II. Computerized mechanical impedance measurements. The preferred method for the noninvasive assessment of the mechanical properties of the musculoskeletal system is the measurement of mechanical impedance by means of an instrumented impact hammer and accelerometer. When coupled to an interactive computer system, this is shown to be a powerful tool in the quantitation of mechanical parameters associated with various orthopaedic conditions. The technique of measurement and the interpretation of results is discussed with reference to a model based on elastic rebound.


Loosening and infection in the post-implantation hip--diagnostic screening with radionuclides. Loosening and infection are the most common complications of the Charnley Low Friction Arthroplasty (CLFA). A non-invasive diagnostic approach to the symptomatic patient consists of plain radiographs of the hips and nuclear imaging with a bone seeking isotope compound. Nuclear imaging is a more sensitive indicator of post-implantation complications than plain radiography, though both complement each other. Bone scintigraphy may be positive when radiographs are normal. In no patient with loosening or infection was the nuclear study normal. In the presence of a normal nuclear image and normal radiographs, there is a small probability that either complication is present.


Properties and applications of acrylic bone cement. Mechanical properties of acrylic cement and its interface characteristics with cancellous bone have been described. Applications and techniques for optimal use of the cement in joint replacement, treatment of pathologic fractures, and implant revision procedures are presented.


Chondromalacia as a separate entity: new perspectives on osteoarthrosis. Cartilage fibrillation does not necessarily progress. There appears to be different mechanical factors involved in the initiation and the progression of cartilage changes in osteoarthrosis. This means there is some rationale behind what we see clinically happening after successful osteotomy or other operations that lower the stress on degenerating joints, and it means that if we can do something about the level of stress and, therefore, the level of bone remodeling in patients with fibrillation, we may be able to keep that cartilage from further degenerating.


Effect of refractive error in visual tests with sinusoidal gratings. While sinusoidal grating stimuli are finding increasing application in clinical tests for visual disturbance, the possible effects on the test results of simple defocus of the retinal image, due to refractive or accommodative error, are not always acknowledged. Theoretical considerations and experimental measurements emphasize that the degradation in visual performance due to such defocus effects is minimal when the eye pupil is small and the spatial frequency of the grating test objects is low.


A possible physiological basis for ocular dominance. An experiment is undertaken to investigate the relationship between "sighting" and motor dominance. A review of recent work on the neurophysiology of vision is carried out and an attempt to explain ocular dominance using this is made.


Use of light intensifiers in improving acuity in retinitis pigmentosa. An English Electric Valve Co. P8073 light intensifier was set up with a viewing system to assess the performance of retinitis pigmentosa sufferers at low luminance levels. Six subjects had their acuity measured at different luminance levels using a light intensifier initially and subsequently using direct vision. All subjects showed an improvement in acuity using the intensifier compared with direct vision at levels of illumination ranging from 0.25 cd m-2 to 20 cd m-2.


After-image transfer--evaluation of short-term treatment. The records of treatment by the after-image transfer method of 21 children, mainly with strabismus amblyopia, were examined to evaluate the acuity improvement in the short term. There was no significant improvement in 15 cases. In several other patients, an immediate response to the after-image method occurred, but these patients' binocular vision and acuity had deteriorated following previous improvement achieved by other orthoptic methods.


Evaluation of a CCTV device for partial sight. Closed circuit TV has proved to be a valuable aid for many patients with partial sight and a new device for magnification of printed material has been developed. This is in the form of a small camera, guided over the page by the subject's hand and incorporating a roller drive for a scanning mechanism. The scanning head fits into the hand easily; it is linked to an electronic TV receiver in the form of a mosaic. Tracking the scanner manually operates a flow of the display to the left, with new material emerging from the right of the screen. The present paper outlines an evaluation of the device under different conditions with patients.


Modern trends in perimetry.

Modern trends in perimetry. In this review of perimetry the subject is treated in two main sections. Part I discusses developments, particularly during the last thirty years, in classical clinical perimetry including the topics of kinetic and static perimetry, the use of multiple stimuli and the role of automation and objective techniques. Part II describes the development of various special techniques designed for more specific information about visual function. These include reference to the importance of controlling target illuminance, the value of spatial and temporal summation in perimetry and the use of coloured targets. The paper concludes by emphasizing the clinical value of routine field screening and the urgent need for standardization in perimetry.


Changes in the position of the binoculus with unequal retinal illuminance. An investigation was carried out into the effect of a monocular neutral density filter on the position of the binoculus. Two experiments were used, and it is postulated that the difference in the results obtained is due to the presence of a motor component in one of the experiments.


The foveal reflex in amblyopia.

The foveal reflex in amblyopia. The relative brightness of the foveal reflex between amblyopic eyes and their fellows was examined. Differences in reflex appearances were found in some patients but not in others. Equal appearance of the foveal reflexes does not eliminate the possibility of amblyopia, nor is there a difference in appearance related to the degree of amblyopia.


[Tc99m pertechnetate in the study of gastric function]. The authors explored the gastric function of 20 volunteers by classical methods and by the assessment of gastric 99Tc pertechnetate clearance. From a comparison of results obtained with the various methods they come to the conclusion that the pertechnetate clearance method is dependable, easy to perform, and noninvasive; accordingly, they recommend its use as the method of choice for monitoring the treatment of duodenal ulcers and evaluating its results.


[The role of supraduodenal choledocho-duodenostomy in non-neoplastic obstructive pathology of the principal bile duct]. The authors review the indications of their 146 cases of supraduodenal choledochoduodenostomy (SDC) from 1970 to 1977. The conditions for which the procedure was carried out were dilatation of the choledochus (100%), multiple calculosis (83%), and primitive or secondary stenosing odditis (17%). After a detailed discussion of these indications, the authors report their immediate and long-term results, which were good in 96% of the patients. In the matter of surgical technic the authors give preference to laterolateral SDC, stressing that effective anastomosis requires a choledochal diameter of at least 10 or 12 mm. In good accord with data published from other sources, the authors' data suggest further restriction of direct procedures (in view of the associated risk of acute pancreatitis) in favor of SDC. The authors also review the objections to, and complications of, this surgical procedure, and conclude that these are never so important as to discourage the procedure when definitely indicated.


[Internal biliary drainage in benign diseases of the extrahepatic bile ducts]. Through analysis of a fairly large series of cases treated by internal biliary drainage for non-neoplastic disorders of the terminal choledochus and papilla (72 cases of choledochal anastomosis, mostly to the duodenum; 238 cases of surgery of the Oddi sphincter), the authors present a remarkable accurate picture of the indications for this kind of surgery and of the immediate and long-term results obtained with it. Their collected observations also provide an opportunity for comparison with published reports from other quarters; in particular, the authors offer a detailed discussion of the relative advantages and limitations of the two main procedures in this category, namely papillosphincterotomy and choledocoduodenal derivation. From their own experience and in good agreement with current dominant opinion, they conclude by recommending the last-named procedure as the most rewarding, provided that the indications be correct and the operation be done with the necessary technical accuracy.


[Intraoperative evaluation of the high pressure zone in anti-reflux plastic operations]. It has been done a manometric intraoperating study on 18 patients (7 acalasical megaoesophagi, 6 herniae of hiatus, 5 duodenal ulcers) who had undergone an operation of modified Dor's anti-reflux plastics. After Haller H.P.Z. pressure has gone down of 13 mmHg, and has gone up again of 5,5 mmHg after modified Dor; after plastics H.P.Z. average intraoperating pressure has been of 18 mmHg. The posterior plastics of hiatus and the reconstruction of His' angle for hernia of hiatus modify scarcely H.P.Z. pressure. During a superselective vagotomy we have recorded a modest reduction of H.P.Z. pressure, of which average intraoperating values after vagotomy and anti-reflux plastics have been of 16,5 mmHg. At a distance of 30 months from the operation it has been done a follow up on 70% of patients that had undergone an operation of anti-reflux  plastics and also 18 patients that had had en intraoperating inspection. However it has been, a degradation of manometric values, the results have been satisfactory over 90% of cases. The authors insist on the utility of intraoperating manometry for a valuation of the completenes and the efficacy of the operation.


[So-called cystic stump syndrome].

[So-called cystic stump syndrome]. After outlining and discussing the etiology and pathophysiology of the postcholecystectomy syndrome, the authors describe their own series of 35 cases, therapeutic policies, and results obtained. In the discussion they suggest that the so-called cystic stump syndrome has probably been overplayed, since in the authors' own series of cases there was a high incidence of associated pathology.


[Circular myotomy in the reconstructive therapy of esophageal atresia. Experimental study in the rabbit]. The authors report their experimental results in 22 rabbits subjected to circular myotomy of the esophagus, with radiological followup and final autopsy verification. This relatively simple surgical procedure may prove valuable for the correction of neonatal atresia of the esophagus; in particular, when done upon the cranial stump, it affords primary anastomosis of the viscus without undue tension even in cases of faulty esophageal continuity involving a length of several centimeters.


[Intestinal infarction caused by mesenteric venous thrombosis during contraceptive treatment]. The authors treat a case of mesenterial venous thrombosis that they have observed in a young woman during oral contraceptive treatment with estrogens. In the anamnesis the patient hadn't any unhealthy precedent that could be ascribed to vascular alteration and of hemocoagulation. Analysing the observations of some anglo-saxon authors and recent studies about the rol of plaques, the authors establish a casual relation between the use of oral contraceptives and endothelial lesions of vascular bottom, and they outline the utility, like a new screening, of antithrombin III dosage.


[A case of duodenal schwannoma (clinical study)]. Taking a case of duodenal schwannoma, that they had observed, as a starting point, on the base of their experience and the data of literature, the authors discuss the epidemiological, of classification and anatomo-pathological aspects of this rare neoplastic form. They particularly outline the clinical aspect, the diagnostic pre-operating iter and the correct and radical surgical behaviour that must be practiced during laparatomy.


[Anesthesia in particular cases of acute abdomen (volvulus of the intestine)]. Description of a total of 236 cases of intestinal volvulus of which, 141 cases concerning the small intestine, 2 of the transverse, 13 of the caecum and 80 of the sigmoid. Detailed discussions are made on each type of volvulus, the etiology, pathogenesis, pathological anatomy, while particular extensions is given to the description of the results obtained that are compared with the data found from the examination of the literature. A separate treatment is reserved to the anaesthesia in the cases of intestinal acute volvulus and particularly to some technical measures to which is to be submitted the patient who suffers from mechanical occlusion with serious intestinal ache.


[Acute abdominal symptoms caused by segmental enteritis]. The clinical and anatomo-pathological patterns of Crohn's ileitis are reported and the various etiopathogenetic hypotheses are briefly considered. The acute forms of Crohn's ileitis are then described: appendicular, peritonitic, occlusive and toxic forms. The study is based on 68 personal cases.


[One of the aspects of precancerous gastropathy; chronic atrophic gastritis with intestinal metaplasia]. Functionally, cronic, athrophic gastritis is associated with a disturbance of gastric mucosal resistance. Alteration of the gastric mucosal barrier is thought to play a major role in the pathogenesis of the cancer of the stomach, particularly in presence of a special histological picture of mucosal intestinalisation.


[Lipoid pulmonary granuloma in Parkinson's disease. Presentation of clinical case]. The authors describe one case of lipoid granuloma of the lung in a patient with PARKINSON'S disease. The cause of this pulmonary sequel is probably to be found in the alteration of the mechanism of deglutition, typical of PARKINSON'S disease, with aspiration bronchopneumonia and subsequent evolution to granuloma formation. In the case presented (a man of 64) the X-ray picture resembled the irregular mass opacities and bronchial amputations characteristically associated with cancer of the lung. As the actual anatomical extent of the process exceeded the limits indicated by radiological examination, the whole left lung was removed at surgery; histological studies, however, revealed the essentially benign nature of the lesion. The patient was discharged in due course of time as surgically cured. There was no major deterioration of his neurological status either at discharge time or at later rechecks.


[Irrigation of colostomized patients].

[Irrigation of colostomized patients]. After a brief recall of the main problems of post-colostomy patients, the authors describe the method of colonic irrigation, which affords the complete discharge of fecal matter and continence over the ensuing 24 hours. The authors give an account of the results obtained with this methodology at the Stoma Center of Catania; and they conclude that the method in question, applied correctly and appropriate cases, seems to represent the treatment of first choice for the postoperative management of colostomy cases.


[Anatomo-clinical considerations on surgery of the deep lobe of the parotid gland]. In the light of their first-hand experience in actual clinical cases, the authors review the problems of surgical anatomy of the deep lobe of the parotid gland in malignancy. After discussing certain differences between normal and surgical anatomy of the region, they explore therapeutic possibilities and conclude that also in malignancies involving only the deep lobe of the gland the treatment of first choice is still total parotidectomy with preservation of the facial nerve.


[Internal abdominal hernia caused by anomaly of the falciform ligament (a case report)]. The authors describe a truly uncommon case of internal abdominal hernia attributable to malformation of the falciform ligament. The patient, a man aged 26, had complained in the past of cramping pain in the epigastric region, usually occurring after meals and sometimes ending with vomiting of ingested food; but all diagnostic methods and procedures had consistently ruled out any extant pathology of the stomach, duodenum, biliary tract, or pancreas. Present hospitalization was justified by a clinical picture suggesting peritonitis from perforated gastric or duodenal ulcer. At operation the authors found a strangulated loop of small intestine following left-to-right migration through a hole in the falciform ligament of the liver. In the authors' interpretation the background cause of the trouble was incomplete development of the falciform ligament, and the immediate cause of the acute episode was abnormal motility and exaggerated peristalsis of the ileum, possibly due to the presence of a diverticulum; the latter two conditions are invoked as a possible explanation for the repeated episodes of abdominal pain in the patient's history.


[Unusual case of pericecal internal hernia of the retrocecal fossa]. Prompted by actual observation of one case, the authors call attention to this rare form of pericecal hernia. After a brief recall of pertinent anatomical features, they emphasize the rarity of this of hernia and the difficulty of diagnosing it preoperatively on the basis of clinical semiotics and radiological findings. In the last part of their paper the authors review the possible complications of this disorders and discuss therapeutic methods for its correction.


[Necrotizing amoebic colitis (a propos of 12 cases observed in Dakar)]. Twelve cases of necrotizing amoebic colitis recorded in Dakar Hospital Principal are studied. The authors draw basis rules for an early surgical indication giving opportunity to detect not too extensive lesions and implement intensive care which may prove effective. Prognosis is still unfavourable with a death rate of two thirds.


[Dengue at Reunion: isolation of a strain at the Pasteur Institute of Madagascar]. During the dengue outbreak which occurred in Reunion Island, one dengue type 2 strain was isolated at Institute Pasteur in Madagascar.


[A left pseudo-pleurisy syndrome manifesting as a liver abscess complicating malignant localized amebic colitis]. The authors report on a case of localised bipolar malignant colic amebiasis in a 34 year old man, as a complication of undiagnosed benin colic amebiasis; the initial signs consisted of left basi-thoracic symptoms for which a sub phrenic abcess secondary to rupture of two abcesses of the left lobe of the liver was responsible. The surgical intervention consisted of a right hemicolectomy without anastomosis with a double derivation by ileostomy colostomy and drainage of the abcesses. The evolution was rapidly fatal by an irreversible state of shock.


Cutaneous leishmaniasis in Saudi-Arabia: an overview. Taking advantage of an investigation on cutaneous leishmaniosis in Saudi Arabia, the authors present an overview of the situation in three main foci: those of Riyadh and El-Khardj, El Hassa and Bisha. They present a list of the twelve species of phlebotomine sandflies found in the country and out of which predominates Phlebotomos papatasi, the possible vector of the disease in these foci.


[Glucose-6-phosphate dehydrogenase deficiency in Mali. Epidemiology and pathological aspects]. I,858 semi quantitative G6PD determinations were done in Mali (mostly in the Point G Hospital, in Bamako). 15.7% of the men and 4.5% of the women had a G6PD deficiency. The age did not affect the incidence of the disease. G6PD deficiency was more frequent among the Sonrais than among the other ethnic groups tested. It did not occur more frequently among subjects having the sickling trait of AC hemoglobinopathy but no G6PD was found among subjects having a major hemoglobinopathy (SS or SC). Severe hemolytic anemia was rather infrequent among adults subjects. Hemolysis was induced by drugs--such as dapsone or niridazole--but it was usually mild and time-limited.


[Eosinophilia in Europeans returning from tropical countries (apropos of 36 cases)]. The etiological investigation of hypereosinophilia in 36 Europeans having returned from tropical zones permitted, by direct and indirect paraclinical tests, the diagnosis of helminthiasis in 26 cases (72.2%). The parasites in cause were bilharziosis, filariosis, strongyloidiasis, ankylostomiasis and liver flukes. Certain subjects were polyparasited. The investigation remained negative for 6 patients (16.6%), even though a parasitism was strongly suspected in at least 5 cases. In the other cases (11.1%) the etiological investigation remained doubtful with the exception of a case of non parasitic eosinophilia (polymyositis). There still remains much progress to make in rendering the actual serological tests more specific, more constant and presenting less cross reactions.


[Ecology of a focus of cutaneous leishmaniasis in the Thies region (Senegal, West Africa). 2. Epidemiological and clinical peculiarities of the human disease]. During their epidemiological survey of a cutaneous leishmaniasis focus, the authors study the epidemiological and clinical aspects of 60 proven human cases observed in the studied area (Thies region). The disease can occur at any age but is more frequently seen in the pre-adolescent (10-15 years), adolescent (15-20 years) and adult (20-40 years) age classes. During the year, 76.5% of the lesions appear between july and the end of november. The spontaneous evolution of the disease seems to have a one year duration. Less than 10 lesions are observed in the majority of the cases (91.5%). The lesions are mainly located on upper and/or lower limbs and are generally of humid ulcerated type, often covered by a deep scar; a lymphatic nodular dissemination from a lesion occurs in 25% of the cases.


Diabetic truncal mononeuropathy--a new clinical syndrome. Although diabetic mononeuropathy affecting the cranial and peripheral nerves is well recognized, there is little known or documented about diabetic mononeuropathy affecting the thoracic nerves, i.e., the truncal nerves. This series of 40 cases attests to its frequency; equal sex distribution; significance in differential diagnosis including coronary artery disease, intra-abdominal surgical diseases such as gallbladder pathology and appendicitis, pleurisy, and neoplasms. Truncal mononeuropathy has characteristics that differ from those of other diabetic mononeuropathies in that it is primarily sensory and typically not a first manifestation of clinical diabetes, whereas the other forms of diabetic mononeuropathy are primarily motor in effect and not infrequently may be the initial clinical presenting manifestation of diabetes. Finally, diabetic truncal mononeuropathy has a good prognosis.


[Pathology  in Malagasy lemurs and their relation to human pathology]. From researches conducted in Institute Pasteur in Madagascar and from bibliographical work, the authors try to draw up a general picture of the pathology of lemurs. Several aspects are developed (bacteriology, hematology, mycology, parasitology, virology), especially those which could be interesting for human pathology, for instance the relationships between lemurs and viruses because of the arbovirus programme in progress in Institute Pasteur. The authors emphasize on the possible use of lemurs, the only non human primate in Madagascar, as laboratory animals in order to develop colonies and, then, to promote their conservation.


Noneffect of oral urinary copper ascorbic acid on reduction glucose test. References and texts in the fields of diabetes and clinical chemistry commonly report that ascorbic acid when given orally or parenterally gives a false-positive reaction to the copper reduction glucose test (Clinitest). This impression is based on a study in which ascorbic acid (250 mg./dl.) was added to urine in vitro, with a resultant positive-test reading in the absence of glucose. Ascorbic acid is a reducing agent, and theoretically it could interfere with the copper reduction method of glucose detection. In the current study 10 nondiabetic men were ingesting 4 and 6 gm. ascorbic acid per day. A total of 360 glucose detection tests with the copper reduction method were undertaken. In no instance was there a positive reaction to the glucose test.


Noneffect of methyldopa on urine glucose tests. Methyldopa has been reported to cause a false-positive urine glucose test by the copper reduction method (Clinitest). We investigated the effect of methyldopa on urine glucose tests in 30 patients by comparing commonly used glucose oxidase methods to Clinitest. The results of our study indicate that methyldopa does not interfere with the copper reduction method for urine glucose determination.


[1,2,3-triazole derivatives of arylalkanoic acids]. A series of several 1,2,3-triazole derivatives, by reaction of p-azidophenylacetic and 2-(p-azidophenyl)propionic acids with active methylene compounds, was synthesized. Some of the derivatives obtained were subjected to pharmacological study and among these compounds (II m) showed an analgesic activity 2.5 times greater than phenylbutazone.


Schmidt's syndrome in a child with diabetes mellitus. Schmidt's syndrome (thyroid and adrenal insufficiency) and concurrent diabetes mellitus represent an intriguing multiple endocrinopathy in children. This report describes an eleven-year-old girl with diabetes of eight years' duration presenting in adrenal crisis. Serum thyroxine was undetectable, and antibodies to both thyroglobulin and adrenal tissue were found in high titer. The child's condition stabilized with hormonal replacement therapy, except for persistent growth failure. Approximately two years later she succumbed during a rapidly fulminant episode of ketoacidosis. The natural history of her illness supports recent speculation based on serologic data that juvenile diabetes mellitus may be an immunologic disorder in some children.


Derivatives of 1,2,3,3-tetramethyl-2-azabicyclo[2.2.2]octan-5-endo-ol with antiarrhythmic and other activities. II. Cyanoethylation of 1,2,3,3-tetramethyl-2-azabicyclo[2.2.2]octan-5-endo-ol, followed by LiAlH4 reduction and reaction with acyl chlorides, gave a series of amides derived from 5-endo-(3-aminopropoxy)-1,2,3,3-tetramethyl-2-azabicyclo[2.2.2]octane. The syntheses of N-methyl, N,N-dimethyl and N,N-dipropargyl derivatives of the afore mentioned amine, as well as of 5-endo-methylcarbamoyloxy- and 5-endo-phenylcarbamoyloxy-1,2,3,3-tetramethyl-2-azabicyclo[2.2.2]octane, are also described. Strong antiarrhythmic and local anesthetic activity was observed in two amides; an urethane showed antiarrhythmic activity only.


Policy statement on materials for testing glucose in the urine. The Committee on Materials and Therapeutic Agents, American Diabetes Association. Semiquantitative methods for measurement of glucose in the urine are useful for monitoring glucose homeostasis in subjects with diabetes mellitus where quantitative blood and urine glucose measurements are not available. The use of a "plus" scale for glucose measurement is confusing because the same plus values are assigned to different quantities of glucose with different methods. The two-drop Clinitest method is the most quantifiable and readable test for urine sugar, particularly if there is high sugar spill. Therefore, it is the most useful method for monitoring insulin-dependent juvenile diabetes. Its major disadvantages are its potential toxicity, the cumbersome methodology, the cost, and the possibility of interference from other reducing substances. The enzyme "dipstick" methods are most sensitive for detecting the presence of glucose. Among the available "dipstick" methods, Diastix is the most quantifiable and readable. These methods are inhibited by the presence of ketones and a number of other substances. Tes-Tape is the least expensive and, where there are inhibiting substances, the most useful, because it can be read at the liquid front where the glucose reaction is chromatographically separated. Clinistix and Chemstrip are essentially screening methods for the presence of glucose and not useful for quantification. Basing therapy on these and other plus values is irrational and should be discontinued.


Self-esteem and depression in adolescent diabetic girls. This investigation was designed to examine self-esteem and depression in diabetic adolescent girls. One hundred nondiabetic girls age 12-16 and 105 diabetic girls age 12-16 were administered the Rosenberg Self-Esteem Scale and the Beck Depression Inventory. Results indicated no significant difference between diabetic and nondiabetic girls in self-esteem scores. Diabetic girls showed significantly more depression than nondiabetic girls. Close examination of results revealed that, in fact, diabetic and nondiabetic adolescent girls were very similar. A major finding was that depression in the diabetic group was expressed primarily through physiologic symptoms of depression as seen in the vital depression scores, rather than through the pessimism, indecision-inhibition, or self-debasement measures of depression. Results were interpreted to mean that diabetic girls did not manifest deeper depression than nondiabetic girls but, rather, a greater awareness of their physiologic status. Diabetes emerged as a focus for the expression of normal adolescent conflicts. The importance of integrating developmental issues into the treatment plans for diabetic patients is emphasized.


[Synthesis and antimycotic activity of 3-methylamino derivatives of various 2-mercapto-5-aryl-1,3,4-oxadiazoles]. In continuation of previous work designed to obtain derivatives of 2-mercapto-1,3,4-oxadiazole of possible biological interest, the Mannich bases (III - XXX) were prepared. The compounds prepared bear at position 5, with respect to the oxadiazole nucleus, 3,4,5-trimethoxy and 3,4-dihydroxymethylenephenyl radicals which have proved of interest in other series of derivatives. The antimycotic activity of the compounds is reported.


Physicochemical parameters in biological correlation analysis: meaning and limits. Correlation analysis assumes that the physicochemical factors governing the transport, metabolism and drug-receptor interaction can be factored into hydrophobic-lipophilic component, polarizability and dispersion forces, electronic and steric effects and into indeterminate factors. Using computerized regression analysis, a generalized equation can be formulated to correlate the biological response of a set of compounds with their chemical structures in terms of physicochemical parameters of substituents. In order to explore the scope of each defined physicochemical parameter, correlations between biological effects and some combination of substituent indices are discussed.


Benserazide induces migraine attacks. Irrelevance of concomitant hyperprolactinemia. Migrainous women underwent acute administration of sulpiride (25 mg i.v.) and benserazide (125 mg per os), both drugs increasing prolactin secretion. A similar increase in prolactin levels was found following the administration of the two drugs. A typical migraine attack was observed only in the 4 women given benserazide. These data, though being preliminary, stress the scarce or irrelevant role of prolactin in the pathogenesis of the migraine attack.


Interaction between DNA and some congeners of tilorone. Four compounds having a molecular structure analogous to that of tilorone and tilorone itself, taken as a reference compound, were examined for complex formation ability with DNA. While the association constants of the various complexes were almost the same, the r values in saturation conditions (that is the highest number of molecules bound per nucleotide of DNA) increased with the size of the planar moiety or with the length of the two basic side chains of the molecules. Concerning the structure of the complexes, it was evidenced by means of flow dichroism measurements that the non-covalent binding to DNA occurs via an intercalative mode. Moreover, it was observed that by decreasing the ionic strength, the affinity of the drugs for the macromolecule increases, indicating that in complex formation, electrostatic forces exerted between the DNA phosphate residues and the positively charged nitrogen of the side chains of the drugs are involved. It seems also possible that, in this condition, and in the presence of high concentrations of the drug, a secondary binding consisting only of electrostatic interactions outside of the helix takes place. In connection with the complexing ability with DNA, the examined compounds proved able to inhibit DNA and RNA synthesis in Ehrlich ascites tumor cells. A correlation was found between complexing ability and inhibitory activity on nucleic acid synthesis.


Bis-basic derivatives of planar heterocyclic compounds. Four compounds derived from the furocoumarin, benzodipyrone and benzodifuran nucleus respectively, have been synthesized. They have molecular structures analogous to that of tilorone, namely an aromatic tricyclic moiety and two basic chains linked to the nucleus through ester or amido groups. Like tilorone, the new compounds efficiently from complexes with DNA, consisting in an intercalation of the planar aromatic moiety between two base pairs and an electrostatic interaction of the positively charged nitrogen atoms of the side chains with the phosphate groups of the macromolecule. When tested for their capacity to stimulate interferon production in mice, the compounds showed different activities; in particular the diethylamino ethyl ester of bis-benzodifuranic acid (III) proved to be twice as active as tilorone, assayed in the same experimental conditions for comparison purposes.


Research on durene derivatives. Note I - hypertensive activity of 2-(2,3,5,6-tetramethylbenzyl)imidazoline and related compounds. A series of substituted 2-(2,3,5,6-tetramethylbenzyl)imidazolines and related compounds have been synthesized to study the steric and hydrophobic effects on the vasoactivity of the introduction of four methyl groups on the phenyl moiety. The 2-(2,3,5,6-tetramethylbenzyl)imidazoline (I) showed a high hypertensive activity, whereas the 2-benzylimidazoline possesses an adrenolytic activity. The 2-(2,3,5,6-tetramethylphenoxy)methylimidazoline (XVII) retained the hypertensive activity, whereas the corresponding thioether (XIX) was inactive. Some structure-activity relationships with regard to the presence of substituents in the 4-position of the phenyl moiety and on the benzylic CH2 are reported.


[Preparation and antifungal activity of carbamic and thiocarbamic esters of thiophenols]. A series of N-substituted carbamic and thiocarbamic esters of thiophenols [substances (I leads to XLII)] was prepared and tested for in vitro antifungal activity. The substances were obtained by condensation of thiophenols with suitable isocyanates and isothiocyanates. The antifungal activity of the products was tested in vitro against the following strains: Candida albicans, Candida tropicalis, Saccharomyces cerevisiae and Trichophyton mentagrophytes. The results obtained, given in the Table I, show that the carbamic and thiocarbamic esters of the thiophenols examined have marked antifungal activity. The results give some information on structure-activity relationships and also show that in general the derivatives of dithiocarbamic acid are more active than the bioisosteric derivatives of thiocarbamic acid. Of the compounds examined the most active were esters of N-benzyl and N-allyldithiocarbamic acid.


C-Alkylpiperazines. IX (1) - reversion of N1 and N4-substituents and its influence on the pharmacological activity in 2-methylpiperazine derivatives. The synthesis of N1-(2'-pyridyl)-N4-(3,4-dimethoxyphenyl-ethyl)-2-methylpiperazine is reported. This compound was found definitely less active as an adrenolytic and vasodilator than the previously tested isomer in which the position of N1 and N4 substituents is reverted.


[Comparison of two point discrimination on the thumb and the big toe]. The functional value of operations for the replacement of thumbs by autotransplantation of the great toe depends on the recovery of sensibility. The two-point-discrimination of 107 thumbs compared to 121 great toes in persons aged between 10 and 70 years was examined. The thumb had age-independent mean value of 4,5 mm while that of the great toe decreased from 9,1 to 16,0 mm.


[Microvascular thumb replacement surgery following traumatic amputation]. The possibilities of thumb restoration are improved by the availability of microsurgical techniques. As a secondary rehabilitation procedure the auto-transplantation of great toes and fingers is described. The indications for planning of the operation are demonstrated by case-examples.


[Local therapy in a case of intravenous mercury injection]. Intravenous injection of metallic mercury is very rare. It may induce pulmonary and renal complications. Locally serious abscess formation may occur. Radical dissection and excision of affected venous system may result in a satisfactory outcome.


[The distraction method in reconstructive surgery of the thumb and fingers]. The distraction method proves successful in reconstructive surgery of the hand: 1. For reconstruction of the thumb and fingers after amputation. 2. For elongation of a hypoplastic thumb or finger. 3. In cases of congenital deformities of the hand including correction of contractures, dislocation, and clinodactyly. 4. For reduction of old dislocations of finger joints.


[Functional and cosmetic results in thumb replacement surgery]. The operations to replace the thumb have been proved in thalidomide embryopathy both functionally and cosmetically. The best results are achieved in the pollicisation of dolichophalangeal triphalangeal thumbs. Simultaneously existing radial club hand impairs the operative results considerably.


[Contribution to camptodactyly].

[Contribution to camptodactyly]. Camptodactyly occurs relatively often but it rarely needs therapy. For decades the genesis of camptodactyly was not clear until it was discovered that the deformations causing the contraction of the PIP joint are to be found in the area of the dorsal aponeurosis (MILLESI) and of the intrinsic muscles of the hand (WILHELM, KLEINSCHMIDT). At the Münster University anomalies of the lumbricals were found, on occasion of exploration of the palm, but not in all cases. Probably there exist several types of camptodactyly with different defects. The necessity for exploration of the palm is confirmed.


[Contribution to camptodactyly].

[Contribution to camptodactyly]. A case of camptodactyly of three fingers in the left and four fingers in the right hand in a 20 year old patient is described. His mother showed the same appearances with great changes in the skeleton. This case emphasizes that an early operation is justified for the prevention of skeletal deformities.


[An unusual cause of carpal tunnel syndrome]. One year after rupture of the 5th flexor profundus tendon, a 45-year-old man showed signs of carpal tunnel syndrome. At surgery the proximal stump of the 5th flexor profundus tendon was found in the carpal tunnel. Due to an anomalous origin of the 4th lumbrical muscle from the profundus tendon of the 4th finger the proximal stump of the 5th flexor profundus tendon had withdrawn far proximally and in this way produced a carpal tunnel syndrome.


[Unusual causes of the carpal tunnel syndrome]. In 193 cases of carpal tunnel exploration, carried out because of compression of the medium nerve, we have encountered 15 unusual findings (7.8%). This emphasizes the necessity for thorough exploration of the carpal tunnel. Four unusual disease processes are described, which led to a median compression syndrome: Tuberculous tenosynovitis, lipomatous hyperplasia, chondroma of a superficial flexor tendon and monofascicular neurinoma of the median nerve.


[An anatomical variation as an unusual cause of the ulnaris compression syndrome]. An anatomic variant was the cause of a compression syndrome of the ulnar nerve at the wrist. It was an accessory muscle of the M. palmaris longus that initially created difficulties in diagnosis. By excision of the muscle the symptoms were relieved.


[Trophic significance of sensory innervation of the skeletal muscles--an experimental study on the m. sternomastoideus of the rat]. In this study the morphological changes of the sternomastoid muscle of the rat caused respectively by division of sensory afferents, the motor efferents and by total denervation of the muscle are investigated one, two, three and four months after surgery using sections from the middle part of the muscle stained by Sudan-Black-B, Succinodehydrogenase- and ATP-ase-reagent. Small quantitative changes, as shown in curves of distribution of the sizes of muscle fibers, and a remarkable increase in the density of mitochondria in the middle sized muscle fibers after division of the sensory fibres are reported and discussed.


[Multiple enchondromas of both hands with ulna hypoplasia and radius dysplasia on the left]. A 33 year old patient with multiple enchondromas of both hands, ulna hypoplasia and radial dysplasia is described. In addition, a deformity of ulna and radius was present on the left side. The first signs of the disease appeared in 1949. The diagnosis, made by biopsy and X-ray was the indication for surgery. The result was very satisfactory. The differences of this undescribed syndrome from Morbus Ollier disease are discussed.


[Anomalies of the upper arm--tuberculosis cutis luposa of the hand]. An anomaly of the right pectoralis major muscle is reported. Two muscle bundles are demarcated from the pars abdominalis. Some fibres of these bundles radiate into the distal part of the normal insertion on the humerus; most fibres, however, insert into an accessory tendon which attaches to the medial humeral epicondyle. The medial intermuscular septum is fixed to this tendon. The septum is traversed by filaments of the triceps muscle. Fibres of the triceps muscle also surround the ulnar nerve and the ulnar collateral blood vessels before they pass through the medial part of the septum. These findings are discussed under functional aspects. Catamnestically a tuberculosis cutis luposa exists on the right hand. A patho-causal connection between the anomaly and the tuberculosis of the skin cannot be excluded, because this may arise easier in an area of disturbed blood supply.


The role of muscle reeducation in dynamic tendon transfer surgery of the hand. Tendon transfers are used commonly to improve function following damage to major nerve trunks. For the transfer to function dynamically and in harmony with other active hand muscles, proper integration of the action of the transfer into the available hand movements is essential. This concept is discussed together with the rationale and methods of pre and postoperative training that contribute immensely to the success of such operative procedures.


[Behavior of the long extensor tendon of the thumb in experiments]. Experimental studies on the long extensor tendon of the thumb have shown that experimental rupture of the tendon occurs in the same region as in clinical cases. The application of a new plastic imprint method has demonstrated an area of smallest diameter in the tendon. This part is nearly identical with the usual site of the rupture, which can, therefore, be simulated in experiments.


[Large cyst of the ulnar head and simultaneous lunatomalacia]. The correlations between symptoms at the distal end of the ulna and lunatomalacia are discussed by demonstration of a case with large subchondral bone cyst within the head of the ulna and simultaneous lunatomalacia. The possible common factors with regard to the etiology are discussed.


[Results of the surgical treatment of bridge callus through silastic membrane interposition]. A report on 5 cases with successful treatment of a posttraumatic synostosis of radius and ulna by resection and interposition of a silastic-membrane is presented. This membrane has to ensheath one of the forearm bones for at least half of its circumference and it is fixed partially with Dexon sutures. During operation it is necessary to confirm this fixation of the membrane, which must be unchanged after rotation of the forearm. The range of movement reached 4 years after operation was about 120 degrees (100-130 degrees) on an average. A better result can only be expected by an osteotomy of the radius and correction of its position.


[Corrective osteotomy in malalignment of healed fractures of the metacarpal and phalangeal bones]. As a result of improper immobilization in extension following phalangeal and metacarpal fractures, rotation and deviation deformities can occur. The functional disturbance and aesthetic deformities can be corrected with an osteotomy through the proximal phalanx of the metacarpal. The technique and results of this correction osteotomy are described. Prevention of these malunions by proper positioning at the time of primary treatment is emphasized.


[Treatment of the swan neck deformity].

[Treatment of the swan neck deformity]. The pathogenesis and the anatomic causes for the swan neck deformity are reviewed. Many different soft tissue operations can succeed in preventing catastrophic loss of function if the deformity is treated while still in stage 1 or 2. In the later stages (3 and 4) restoration of finger is often not possible as a result of joint stiffness and irreversible joint changes. In this case, arthroplasty and arthrodesis should be considered.


[A case report: pseudarthrosis of the os lunato-triquetrum?]. The reported case is in its development, diagnostic, course, and legal aspect so extraordinary, that an explicit report is justified. The patient complained of pain in his right wrist region some days following an unusual work with a drilling machine for eight days. The X-rays six months later showed an irregular joint space between the lunate and triquetrum bone, while on his left wrist a synostosis between these bones was found. These changes seemed to be suspicious for a pseudarthrosis of a congenital synostosis, but this diagnosis led to a six years' controversy in several legal procedures. The different interpretations (judgements) by the attending doctors, specialists, and judicial experts, show again the importance of an exact early documentation with sufficient primary X-rays, eventually with comparison of the other hand. During treatment, nothing should be left undone which could support or refute especially an unusual diagnosis.


[Total ulnar nerve paralysis in epiphysiolysis of the radius]. Closed epiphysiolysis of the distal radius was followed by a complete sensomotor paralysis of the ulnar nerve revealed on removing the cast. The cause of paralysis was entrapment of the nerve and flexor carpi ulnaris in the fracture. After release of the incarceration and microsurgical extraneural and intraneural neurolysis very good rehabilitation of nervous function resulted. To exclude nerve injury the importance of exact detailed examination of recently injured persons is re-emphasized.


[Can pathological changes in the upper arm and axilla prevent a successful axillary plexus block? A case report]. Even if one can find in the literature many contra indications to nerve blocks, this case with a pseudarthrosis of the humerus and severe scars in the axilla shows that non-inflammatory pathologic-anatomical changes need not prevent a brachial plexus block. Prerequisites are the ability to palpate the axillary artery and a reliable technique.


[Case report of a giant cell tumor of the second metacarpal bone and implantation of a cement prosthesis]. Report on a 15 year old girl with a giant cell tumor of the second metacarpal bone. The resected bone was replaced by a special model made of Sulfix A in combination with a St. Georg-MP-joint endoprosthesis. The result was very satisfactory from the functional standpoint as well as from the aesthetic one.


[Management of patients after pacemaker implanation (author's transl)]. Although pacemaker therapy is characterized by a high degree of reliability, follow-up of pacemaker patients is necessary to provide early detection of pacemaker failure and optimal setting of programable pacemakers as well as to render adequate treatment of underlying disease. The most common cause of pacemaker failure is battery depletion. In spite of the available data on the mean life-expectancy of the various batteries, the individual time of depletion cannot be predicted with accuracy. Furthermore, a defect in the electronic circuitry and/or electrode may still be rarely encountered even though technical standards are high and, occasionally, threshold elevation or lead dislocation may occur in spite of conscientious implantation technique. For patients with programable pacemakers, follow-up monitoring also enables adjustment for optimal pacemaker function. Thus, through lowering of the current or narrowing of the pulse width, the life of the battery can be prolonged or, on incrementation of these 2 parameters, an increasing threshold can be compensated for within certain limits. More important, however, is the possibility of inductive pacemaker rate changes through external programing to yield the most favorable pulse interval with respect to the underlying disease. Since, in addition to impairment of the cardiac conduction system, other disease processes are frequently presented--approximately one in three patients has coronary artery disease and almost half of the patients have congestive heart failure--follow-up visits not only serve the purpose of monitoring pacemaker function but also provide an opportunity to insure an optimal clinical condition of the patient. Accurate interpretation of pacemaker function prerequisites knowledge of the type of stimulation (fixed rate, synchronized, hysteresis, magnet rate, interference frequencies), of the battery (mercury-zinc, lihium, nickel-cadmium, isotope), of the programability (rate, current, pulse width) as well as the location of impulse capture and detection and through ascertainment of secured position of the lead and generator. While the pacemaker rate enables interpretation of the state of charge of the battery, evaluation of capture and tracing threshold permit assessment of the presence of a threshold elevation, lead dislocation, an electrode fracture or a defect in the electronic circuity. Stimulation of extracardiac muscle areas may be indicative of improper positioning and inadequate isolation of the generator, lead dislocation or lead perforation.


[Incomplete lead fracture as a cause of bradyarrhythmia in patients with artificial pacemakers (author's transl)]. The fracture of a permanent cardiac pacing lead may be complete or incomplete. In the first case, the function of the pacemaker system will completely cease. An incomplete fracture, however, is defined as a capillary interruption of the wire and will lead to a loose connexion between both parts of the electrode. This, in turn, may result in sudden changes of the electrical resistance of the lead and, therefore, in alterations of the electrode voltage during the second part of the biphasic current wave delivered by the pacemaker; this voltage change--in the 10-mV-range--will inhibit a blocking demand pacemaker with an intermittent, irregular increase of the pacemaker escape interval as the corresponding ECG finding. Usually, this "oversensing" phenomenon can be eliminated by turning the pacemaker function to the fixed rate mode with a test magnet applied. -- Although this malfunction is more often seen with bipolar pacemaker systems and with epicardial wires, it may also occur in a unipolar, transvenous system. -- Among 2100 patients, we have seen this malfunction in 6 cases in whom other, even more rare causes--such as a defect of the electronic circuit of the pulse generator, muscle potentials, etc.--could be ruled out. The x-ray findings revealed no evidence of a lead fracture in any case. The diagnosis was established on the ECG, the examination of the surgically removed electrode in 2 cases, and the finding, that only the implantation of a new lead abolished the malfunction, whereas the implantation of a new pacemaker alone ws ineffective.


[External interference of cardiac pacemakers (author's transl)]. The pacemaker patient is faced with potential origins of interference to the pacemaker function in his daily life, at his working place and during medical-therapeutic interventions. Technical faults in the electronic circuit induced by external sources can be neglected. Malfunctions of synchronized cardiac pacemakers may occur in the presence of electrical signals similar to the intracardiac ECG (e.g. nerve stimulators) or by the influence of high energy electrical field (e.g. pulsed electromagnetic fields). Technical improvements like metalshielding of the unit, electronic filtering components and automatic conversion to fixed rate stimulation increase the reliability to a high degree.


[Pacemaker therapy in infants (author's transl)]. Since April 1974 until January 1978 permanent pacemakers were implanted in 21 children. The patient age at the time of operation averaged 4.5 years; the youngest patient was 3 months old. Indications for pacemaker implantation were: congenital total a-v block (TAVB) (n = 4), sick syndrom (S-S-S) (n = 4), postoperative TAVB (n = 13). Cardiac failure was present in all patients despite optimal medical treatment. Pacemakers were implanted under general anesthesia and intubation. The stimulation electrodes were positioned by the transvenous route in 16 subjects and by direct fixation upon the ventricle and the atrium in 5 patients. 5 children obtained an atrial triggered, 14 patients R-inhibited demand pacemaker and 2 subjects an asynchronous pacemaker. After a mean observation time of 16.4 months mean pacemaker function is normal in 14 patients. 6 children died 1 to 33 months after implantation despite functioning pacemakers because of congestive heart failure. Pacemaker malfunction was observed in 4 patients. The type of malfunction induced: failure of the impulse generator (n = 2), dislodgement of the electrode (n = 2), threshold increase (n = 1). In 5 children generators were changed 9 to 36 months (m = 23 plus or minus 10) after implantation because of battery depletion. The use of the pacemakers in small children is connected with several specific problems: 1. Application of large generators is hazardous because of impending perforation and secondary infection. 2. Until now miniaturization of pacemakers decreases function time and therefore implies frequent surgical intervention. 3. Stretching and dislodgement of transvenous electrodes may occur due to growth of the child. 4. Threshold increase may limit the life-span of myocardial electrodes. 5. Physiological changes in natural frequency requires changes in stimulation rate. 6. To guarantee normal physical activity demand related adaptation of heart rate is necessary. Because of these reasons a pacemaker system for children should have the following criteria: low weight, small wolume, high energy capacity, atrial or programmable stimulation, a thin elastic perhaps coiled electrode.


[V.A.T.E.R. association and its limits]. Comparative investigation of 92 cases of V.A.T.E.R. syndrome (4 personal cases) and 62 cases of caudal regression (Duhamel syndrome) (2 personal cases) are performed. There is much analogy between these two entities. Initial impairment would be an early dysfunction of mesoderm setting up located on esophagus in V.A.T.E.R. syndrome and on kidneys in Duhamel syndrome. Etiopathogenic factors remain unknown. Genetic counseling is good. Detection of only one mesodermal malformation leads to inquire other unnoticed anomalies (kidneys, heart, spine, alimentary duct).


Hereditary factors in stammering.

Hereditary factors in stammering. A pedigree from Hazaribagh District of Bihar (india) with 12 stammerers spread over five generations was analysed for the mode of inheritance of stuttering. A predisposition seems to be a prerequisite for its occurrence. The relative roles of heredity an environment in the expression of stammering were evaluated. Transmission appears to be by a dominant autosomal. Variable expressivity, incomplete penetrance as well as partial sex-limitation as other causes have also been considered.


[Septo-optic dysplasia: clinical study and elements of genetic counseling]. The authors report two cases of optic hypoplasia associated with neurological abnormalities and discuss the anatomical, pathophysiological and genetic aspects of the "Septo-Optic Dysplasia". This syndrome is not a homogeneous condition. Available data suggest that the septo-optic dysplasia occurs as a consequence of an embryofoetopathy and not of a genetically determined failure of development. The genetic counselling is described.


[Society of Nephrology, Computer Technology Commission. Dialysis computer program. VI. - Survival and risk factors]. The sixth report of the "Diaphane Dialyse Informatique" Program concerns 2,518 adult patients (age 15 and over) treated by chronic hemodialysis or hemofiltration in 33 French dialysis centres between June 1972 and December 1978. 1) The number of centers participating to the program is progressively increasing. Overall duration of follow-up represents 4,192 patient-years, allowing precise evolutive studies of terminal renal failure treated by hemodialysis. 2) Mean age at start of treatment continues to increase. Among 709 patients who started treatment in 1977-1978, 8,8 p. 100 of men and 11 p. 100 of women were over 69 years old. 3) Patients with diabetic nephropathy represent 4,4 p. 100 of all patients dialyzed between 1972 and 1978 and 5,9 p. 100 of the patients starting treatment in 1977-1978. 4) The percentage of patients temporarily treated by peritoneal dialysis before hemodialysis decreases from 32,9 p. 100 in 1973-1974 to 15,9 p. 100 in 1977-1978. 5) In 1978, 65,3 p. 100 of patients are dialyzed 3 times a week with a mean weekly duration of 14,0 h for male and 12,9 for female. 73 p. 100 of the patients are dialyzed during the night. 6) Disposable parallel plate hemodialyzers (71,8 per cent of dialysis sessions in 1978) and hollow fiber hemodialyzers (11,6 per cent) progressively replace disposable coil dialyzers and non disposable Kiil dialyzers. 7) Transient hypotensive episodes during dialysis sessions remain the most frequent complications (21,7 per cent of sessions in 1978). Transient hypotensive episodes are more frequently observed with coils than with parallel plate hemodialyzers or with hollow fiber dialyzers. 8) Mean diastolic blood pressure (DBP) +/- SD is 101,9 +/- 21,7 mmHg at start of dialysis and 81,4 +/- 11,8 mmHg when dialysed. During the course of treatment 28,7 per cent of the patients receive long term antihypertensive treatment. In spite of dialysis and antihypertensive treatments 11 per cent of all patients followed up maintain DBP greater than or equal to 95 mmHg. 9) Viral hepatitis remain the most prominent infectious problem with 30 per cent of patients being chronic Hbs antigen carriers. 10) Annual death rate calculated in the 2,518 patients dialyzed between 1972 and 1978 (78/1000) is 12 times superior to the death rate of the French population, adjusted for sex and age to the dialysis population. 43,1 per cent of deaths are of cardiovascular origin. Risk factors for overall mortality are age, sex (male), existence of a vascular or diabetic nephropathy, twice weekly dialysis strategy, elevation of systolic or diastolic blood pressure during the course of dialysis treatment, hypocholesterolemia and to a lesser extent hypotriglyceridemia. On the contrary, hypercholesterolemia, hypertriglyceridemia and hyperuricemia do not appear as risk factors for overall mortality or cardiovascular mortality. These results plead for a perfect control of hypertension and to the extension of thrice weekly dialysis for the whole population of patients treated by maintenance hemodialysis.


[Use of the DIAPHANE information system for the monitoring of patients treated by home hemodialysis]. Data of the DIAPHANE Dialyse-Informatique system of the Society of Nephrology have been collected by patients just on a home dialysis program after training in the hemodialysis Unit of the Hospital of Montreuil. 35 patients have been using the computerized records since January 1978. A critical analysis of the first year has been made and results obtained have been compared with those obtained during the same period in patients dialysed in the Hospital. Results show that home dialysis patients are well able to fill in the computerized medical record concerning the dialysis session follow-up, and that the quality of the recorded information is similar to that recorded in hospital by nurses. Nevertheless few simplifications of home dialysis data sheet are considered. Computerized treatment of data collected on home dialysis program should allow useful comparisons required to improve the quality of care and expansion of this dialysis method.


Influence of anthocyanoside treatment on the cholesterol-induced atherosclerosis in the rabbit. We have studied the effect of treatment with anthocyanosides from Vaccinium myrtillis on cholesterol-induced atheroma of rabbits. We have found that the drug did not modify the serum cholesterol levels, but decreased the proliferation of the intima the extracellular matrix production the calcium and lipid deposition in the aorta, and the DNA and lipid contents. The alterations in the biochemical composition of the isolated brain microvessels were also diminished. The following mechanism may explain the protective action of the treatment: the collagen of the vessel walls participates in the control of vascular permeability. This permeability is increased by a cholesterol-rich diet. The protective drug interacts with collagen, increasing its cross-links, thus diminishing the permeability in small, as well as in large blood vessels.


Comparative effects of metformin and phenformin on the progression and regression of cholesterol induced athreosclerosis in rabbits. This work was undertaken to determine the comparative effects of metformin and phenformin on the development and the regression of atherosclerosis in cholesterol fed rabbits: 1. Both compounds reduced very significantly the elevated lipid content of plasma induced by a high cholesterol diet, they limited and sometimes suppressed the appearance of lipid deposits in the liver. Only metformin prevented the development of aortic and coronary lesions. 2. In rabbits fed a cholesterol enriched diet for a period of 2 months, followed by a normal diet during 12 months, both compounds accelerated the sponanteous regression of hyperlipidemia and of the excess lipids in the liver, observed in the corresponding controls. Only metformin promoted a marked elimination of arterial lipids and displayed a protective action against coronary atherosclerosis.


Cholesterol ester degradation by transacylation with lysolecithin and hydrolysis in the arterial wall. Transacylation with lysolecithin of cholesterol oleate > linolenate > linoleate > palmitate > stearate, along with different hydrolysis of these esters, and acyl transfer from lecithin on cholesterol in appropriate two-substrate reactions mixtures with enzyme extract from pig aorta and cofactors, have been demonstrated. The results are discussed according to the acylenzyme theory of substrate decomposition and in relation to the metabolism of lipids in the arterial wall.


Morphological and biochemical changes in propylthiouracil-diet induced coronary atherosclerosis under a regression regimen. Many of the morphologic and biochemical features of porcine coronary atherosclerosis produced by high cholesterol, high fat diet and propoylthiouracil returned to control values after cessation of the atherogenic regimen. These include disappearance of foam cells and a decrease in lipid content, DNA concentration, and DNA and protein synthesis. The morpholigic and biochemical features of te atherosclerotic lesions described herein were similar to those produced in swine and other species by a variety of inciting agents during both the progression and regression phase of the disease. These results indicate that the porcine propylthiouracil-diet model may be useful for the study of coronary lesions. Second, the similarities of response of arterial tissue in several experimental animals suggest the possibility that human coronary lesions by analogy may regress under therapeutic regimens.