Effect of dietary vitamin C on adrenal cholesteryl ester content in the guinea pig. Male guinea pigs fed a vitamin C-deficient diet for 3 weeks had lower concentrations of cholesteryl esters in their adrenals than did control animals fed the recommended intake of the vitamin. Not all esters were affected to the same degree, and the fatty acid profiles of the esters from control and deficient guinea pigs differed; there was proportionately more palmitic and linoleic acids and less docosatetraenoic acid [22:4 (n-6)] in the deficient guinea pig adrenal esters. [Fatty acids are designated as X:Y (n-Z), where X and Y are the numbers of carbon atoms and olefinic bonds in the acid and Z is the number of carbon atoms after the terminal olefinic bond.] A 100-fold excess of vitamin C in the diet also resulted in lower concentrations of adrenal cholesteryl esters than did the control diet, but they were not as low as in the deficient animals. Fatty acid profiles were similar for esters from control and excessively supplemented guinea pigs. Vitamin C deficiency apparently imposes a long term stress which results in a depletion of adrenal cholesteryl esters, possibly specific esters, to meet the requirements for glucocorticoid synthesis.


Eicosenoic and docosenoic acid incorporation in serum lipoproteins in rats fed rapeseed oil. Rats were fed rapeseed oil rich in eicosenoic (20:1) and docosenoic (22:1) acids for 7 days, and the fatty acid composition of the lipid classes of serum and serum lipoproteins was determined. Concentrations of 20:1 and 22:1 acids in the lipid classes were variable, especially among lipoproteins, and were a direct function of the alimentary state of the animal. The results suggest differences in the incorporation of the above acids among the major lipoprotein types and various lipid classes within a given lipoprotein type. The quick partial disappearance of very low density lipoproteins (VLDL) and of low density lipoproteins (LDL) containing 20:1 and 22:1 acids upon starvation and the preferential incorporation of these acids in the triacylglycerols of high density lipoproteins (HDL) are discussed.


Autoxidation and effects of pro- and antioxidants in lyophilized red blood cell membranes. Oxygen uptake and effects of pro- and antioxidants have been compared at 80 C in lyophilized red blood cell (RBC) bilayer membranes (ghosts). In this dry and relatively immobile system, catalytic metals have pronounced effects. When ghosts are prepared in the usual manner, in phosphate buffer, hypotonic saline, or deionized water (DI), oxygen uptake is extremely slow and limited unless: (a) catalytic metal, e.g. cobaltous ion, is supplied in the absence of metal-complexing buffers and (b) residual phosphate buffer is removed by repeated deionized water or hypotonic saline washes. Ghosts adsorb d-alpha-tocopherol strongly from 1% alcohol emulsion in buffer in amounts far above normal RBC concentrations, whereas synthetic antioxidant uptake seldom exceeds the normal tocopherol level. Uptake and effectiveness of antioxidants introduced by either perfusion or in the vapor phase, and resistance of ghosts to autoxidation introduced by either perfusion or in the vapor phase, and resistance of ghosts to autoxidation are discussed as they relate to protection of lyophilized membranes and freeze-dried foods.


The metabolism of lithocholic acid-3alpha-sulfate by human intestinal microflora. Lithocholic acid-3alpha-sulfate is metabolized by human intestinal microflora to nonpolar metabolites which have been partially purified by Sephadex LH-20 chromatography. These metabolites were characterized by thin layer and gas liquid chromatography as well as combined gas liquid chromatography-mass spectrometry. The chromatographic properties of one of the metabolites are consistent with those described for a delta2- or delta3-cholenate. The formation of cholenates by the microflora may represent a retoxification of the sulfate ester of lithocholic acid.


Hydrolysis of biliary phospholipids in the upper small intestine of the chick. Chick endogenous phospholipids were doubly labeled by an intravenous injection of [32P] phosphate and [1-14C] oleic acid, and the free fatty acid and phospholipid fraction of gall bladder bile and in contents of upper small intestine were analyzed 4 days later. There was evidence of hydrolysis of biliary phosphatidylcholine to lysophosphatidylcholine in the duodenum and jejunum, but this did not account for the pronounced increase in the 14C radioactivity of the free fatty acids relative to the 32P phospholipid radioactivity between bile and upper intestinal segments. It is suggested that phosphatidylcholine is largely absorbed in the duodenum of the chick while the remainder is progressively hydrolyzed and absorbed.


Progressive gross changes in renal medullary composition in pregnant rats. The biochemical composition of the renal medulla and the blood pressures of pregnant rats and nonpregnant controls were compared on days 15, 18, 20, and 22 of pregnancy. Deoxyribonucleic acid and protein content of the renal medulla changed together with the tissue weight (wet weight) during gestation except on day 20 when a slight increase in protein was observed. However, the glycerophospholipids (phosphatidyl ethanolamine, phosphatidyl choline, and phosphatidyl serine) and sphingomyelin showed significant increases throughout the latter stages of pregnancy with the maxima in most cases occurring on day 20 of the gestation period. Medullary hypertrophy and increased lipid content per cell coexist with the decrease in blood pressure and may indicate peak activity in production of antihypertensive renal lipids.


Atherogenesis in swine fed several types of lipid-cholesterol diets. Eighteen-month-old Nebraska strain minipigs were fed diets containing 2% cholesterol and 20% corn oil, lard, or coconut oil for 12 to 18 months. Concentrations of serum total lipid, total cholesterol, and total phospholipid increased 200 to 300% with each diet. Changes in serum concentrations of Sf 20+ and Sf 0-20 lipoproteins varied with diets fed. Serum concentration of high density lipoprotein was increased in all cases. Intima concentration of Sf 0-20 lipoprotein fraction was elevated by feeding the corn oil diet. There was no development of atherosclerosis as a result of feeding the corn oil-cholesterol diet, but there was an increase in atherosclerosis as a result of feeding the lard or coconut oil diet. There were no correlations between fatty acid patterns of several lipid fractions from serum and corresponding lipid fractions from aortic intima of corn oil fed animals.


Mass spectrometric identification of C20 fatty acids in bovine lens using the pyrrolidide derivative. Unsaturated C20 fatty acids from bovine lens have been examined via gas chromatography-mass spectrometry of their pyrrolidide derivatives. The presence of arachidonic acid and 5,8,11-20:3 in bovine lens has been confirmed by this study. In addition, the 10-, 11-, 12-, and 13-isomers of 20:1 and the 7,13-, 18,14-, and 12,15-isomers of 20:2 were identified.


Effect of catecholamines on gastrin release. In vivo and in vitro techniques have been used to study the effect of catecholamines on gastrin release. The i.v. infusion of epinephrine in dogs produced a significant rise in plasma gastrin concentration. This response was prevented by the administration of propranolol to block beta-adrenergic receptors. The infusion of isoproterenol, a beta-adrenergic agonist, produced a significant rise in gastrin levels, while phenylephrine, an alpha-adrenergic agonist, had no effect. In in vitro studies using isolated pieces of rat antrum, isoproterenol stimulated acute phase release of gastrin, whereas phenylephrine was again without effect. The studies indicate that catecholamines directly influence G cell function.


Serum thyroid hormone concentrations during prolonged reduction of dietary intake. In nine obese but otherwise healthy subjects the effect of caloric restriction on the serum concentrations of thyroxine (T4), 3,3',5-triiodothyronine (T3), 3,3',5'-triiodothyronine (rT3), urea, uric acid, creatinine, and bilirubin was studied. Blood was obtained before and 2, 4, and 6 wk after the subjects had changed to a chemically defined diet (31 g amino acids, 44 g carbohydrate, and 1.5 g fat; 300 kcal/day). A decline of body weight to 88% and of serum T3 to 70% of the pretreatment values was observed. Creatinine and bilirubin increased to 115% and 163%, respectively. Uric acid and rT3 showed a transient rise to 148% and 180%, respectively. Serum urea was lowest (72%) from the second until the fourth week. There was a highly significant correlation between serum rT3 and uric acid (r = 0.77, p less than 0.001). The time course of the changes seems to indicate that conversion of T4 into T3 and rT3 is mediated by separate processes.


Physiologic regulation of body energy storage. Both new and published data (rats, mice, and human beings) on three parameters--fat mass, fat-free body mass (FFBM), and total body mass in some cases--are evaluated. Steady state values of the parameters are analyzed for changes in response to specific perturbing agents and for their frequency distributions. Temporal sequences of values on individuals are examined for evidence of regulatory responses. The results lead to the hypothesis that the FFBM is regulated, but probably not as a unit, and that mass of fat is regulated with a high priority near the range extremes but with a much lower priority in the mid-range. Properties and advantages of such a mechanism are discussed.


The application of the interference microscopy for the refractive index determination of the cell wall and cytoplasm in plant cells. Interference microscopy method has been used for measuring the refractive indices of cell wall and cytoplasm of two plant species: Funaria hygrometrica and Lemna trisulca. The refractive index of the cytoplasm was determined by measuring the centrifuged cells. The mean values obtained for different wavelengths lie in the range 1.41-1.42.


Initiation and direction of polymorphonuclear leucocyte locomotion. The particle collision hypothesis. A simple model of the initiation of locomotion, the random movement and the directional locomotion during chemotaxis is derived from observations on moving human polymorphonuclear leucocytes (PMNs). This model provides a unifying concept of initiation of PMN locomotion, PMN random movement and PMN chemotaxis. The lamellipodium is thought to be the direction-determining cell organelle.


Mechanisms of decubitus ulcer formation--an hypothesis. Understanding of the etiology of decubitus ulcer formation is fragmentary and the existing literature contains much experimental data that are inconsistent with the idea that pressure sore formation is due extensively to depriving a tissue region of blood. In fact, there is substantial data that illustrate that tissue can remain viable for very extended lengths of time, up to 13 hours, when subjected to externally applied pressures that collapse the blood microvasculature in a region. Based on these observations and on studies done in this laboratory on lymph propulsion and pressure sore prevention, an hypothesis has been formulated that is consistent with the published data and with clinical observations. The hypothesis states that a major contributing factor to pressure sores is the tissue necrosis that is caused by the accumulation of anaerobic metabolic waste products due to occlusion of the lymph vessels.


Sialoresponsin and an antiviral action of ascorbic acid. Several pathogens, both viral and bacterial, employ the enzyme neuraminidase (N-acetylneuraminate glycohydrolase, EC 3.2.1.1.8). The neuraminidase renders ineffective the hemagglutinin inhibitory mucins that confine the pathogens in a coating of host mucins. Sialoresponsin is a receptor "decoy" that inhibits neuraminidase. Several known antiviral agents, including ascorbic acid, inhibit neuraminidase. It is proposed that ascorbic acid may mediate an antiviral effect through the incorporation of ascorbic acid or some derivative of ascorbic acid as a part of the sialoresponsin molecule. Whether ascorbic acid works alone as a pharmacological inhibitor, or is incorporated in sialoresponsin as a physiological inhibitor; it may be useful against pathogens that employ neuraminidase.


The recession of gastric cancer and its possible causes. The paper re-examines the hypothesis that excessively hot drinks constitute an important risk factor in the causation of gastric cancer. The recession of gastric cancer mortality rates in the United States in recent decades is attributed to dietary changes tending to supplant the traditional hot beverages. One such change was the appearance of domestic refrigerators, promoting iced drinks, another the popularisation of soft drinks. The example of Okinawa is quoted where in 1972, after 27 years of American administration, gastric cancer mortality rate was 11.3 per 100,000, in contrast to Japan's 46.7, presumably due to the introduction of American dietary habits. While in most Western European countries gastric cancer risk decreased in the last decades, there was little change in Eastern Europe, and rates were rising in some countries, like Portugal, Mexico and Hong-Kong. This is attributed to the increasing pollution of water, promoting its boiling and flovouring. In some countries water is disinfected by chlorination in which case boiling and flavouring may be used to mask the unpleasant smell and taste of disinfectant.


Comparison of transthoracic square-wave defibrillation experience in the dog and calf. Data from 5,280 fibrillation-defibrillation episodes in medium-size dogs, size scaled to a hypothetical 100-kg dog, and from 3,240 episodes in 100-kg calves, are used to derive families of curves showing percentage of success of unidirectional square-wave pulses in achieving defibrillation versus current amplitudes for energy levels in the range of 200 through 2,000 J. From the 3,240 episodes in the calves and 3,240 additional episodes in dogs, the incidence of post-defibrillation complete A-V block was found. In calves, the optimal 800-J curve peaks sharply at about the 93 percent success level for a current amplitude of 70 A. For the hypothetical dog, the 800-J curve has a broad peak at substantially the 100 percent success level for currents of 40 through 120 A. In general, the incidence of complete A-V block is very low in the dog and very high in the calf.


Transthoracic ventricular defibrillation in the adult. Since the lower the energy used, the less the possible myocardial damage, two studies of 214 patients in ventricular fibrillation (VF) were conducted, using two types of defibrillators each charged to 200 Wsec and 100Wsec. In the first study, each defibrillator was charged to 200 Wsec (150-165 Wsec delivered). Up to three 200-Wsec shocks successfully converted 222 of 233 VF episodes. In 199 episodes, a single shock successfully removed the fibrillation. In 48 episodes in patients weighing more than 80 kg, VF was removed in 43 (90 percent). In the second study, from a stored energy of 100 Wsec, 74 to 82 Wsec of energy were delivered in the initial shock to treat 161 VF episodes in 94 patients. The first shock was successful in 101 (63 percent) of the 161 episodes. Up to three 100-Wsec shocks achieved 81 percent conversion in 52 episodes. A third 100-Wsec shock seldom succeeded. Using a sequence of 100 - 200 - 400 Wsec shocks, 93 (91 percent) of 102 episodes were successfully converted. There was not a single instance of failure to remove VF among the 214 patients with a maximal delivered energy of 330 Wsec. Thus, the direction towards the production of larger instruments storing more than 400 Wsec energy seems unwarranted.


Evaluation of the operating internal resistance, inductance, and capacitance of intact damped sine wave defibrillators. A method is developed for determing actual values of circuit elements in a damped sine wave (Lown waveform) defibrillator solely from measurements of the output, using two or more power resistors and a storage oscilloscope. If a defibrillator containing capacitance C, inductance L, and internal resistance RI, is discharged into increasing 5- to 100-ohm resistive loads R, it is shown for underdamped output waveforms that â = RI/2L + R/2L and ĉ = CRI + CR, where â = pi[t2tan(pit1/t2)], ĉ = 2â/[â2 + (pi/t2)2], t1 = time from onset to peak, and t2 = time from onset to first zero crossing of the output waveform on the oscilloscope trace. Linear plots of â vs R are constructed for seven defibrillators, and values of RI and L computed as intercept/slope and 1/(2 slope) respectively. C is given by the slope of a linear plot of ĉ vs R. Delivered energy is accurately predicted as stored energy X R/(RI + R).


Cardiac damage produced by transchest damped sine wave shocks. High-energy transchest damped wave sine defibrillation shocks have been shown to produce cardiac damage when applied in rapid sequence. However, there are no reports as to whether single, threshold-intensity shocks produce damage. In this study, nonfibrillating dogs were subjected either to a single, threshold-intensity (1 A/kg) shock, or to a series of 6 shocks with high intensity (3 to 4.8 A/kg). Electrodes of 8 cm diameter were used to apply the shock through the chest wall. Dogs receiving shocks of adequate (but not excessive) strength to defibrillate showed no cardiac damage, although they exhibited transient ventricular arrhythmias after the shock was applied. All dogs receiving the higher intensity, multiple shocks showed gross and microscopic evidence of cardiac damage. Ventricular lesions were observed in both right and left ventricular free walls and were sometimes transmural in extent. ECG analysis of the records from the dogs receiving multiple, high-intensity shocks showed second and third degree A-V block, ventricular ectopic beats, ventricular tachycardia, S-T segment changes, and T-wave inversion. Although multiple, high-energy, high-current defibrillation shocks produce permanent cardiac damage in dogs, threshold shocks do not produce morphologic changes.


[Asbestos fibre dust, an actual hazard (author's transl)]. Late results concerning the effects of fibre dust in the human lungs have enormously raised the actuality of fibronous and cancerous reactions of airborne asbestos fibres. The hithero experiences with diseases, resultant from airborne asbestos fibres (asbestoses, cancer, and mesothelioma) are looked on and discussed with respect to 2 asbestos diseases out of the office of the author. Special attention is given to the asbestos-caused mesothelioma which has also been affiliated in the 7th decree of diseases resulting from the work (Berufskrankheitenverordnung) on the 1.1. 1977. Own experiences resulting as well from preventive control examinations as from special collectives of patients (workers in asbestos contaminated surroudnings and smokers) are discussed with respect to restrictive or obstructive ventilation problems. Finally some examples of asbestos free materials wich could be used substiutionarily are quoted.


The effect of shock separation time on multiple-shock defibrillation. Reports in the literature of studies of the efficacy of multiple, staggered shocks used for cardiac defibrillation have shown widely varying results. Twin half sinusoids, separated by an integral number of 60-Hz half-cycles, were used for transthoracic defibrillation of dogs. The separation of the pulses was varied from 0 to 13 half-cycles (0 to 108 msec). An online computer was used to determine the energy content of each shock and to obtain curves of the percentage of success vs energy, current, and voltage. The results show that 2 pulses, separated by 9 half-cycles (75 msec), require 57 percent of the peak current and 87 percent of the peak voltage required by a single pulse. The energy requirement, however, was 9.9 percent higher with the staggered shock. Other pulse separations required higher voltages and currents. Possible mechanisms for the effect are discussed.


Impedance to transthoracic direct current discharge: a model for testing interface material. An in vitro method for screening the relative impedance of gels has been developed. A nonconductive chamber was built with 1-cm-diameter electrodes placed 1 cm apart. This chamber is filled with electrode gel to be tested. The defibrillator used delivers a half-sinusoidal waveform. When the same stored energy is discharged by this defibrillator into increasing impedance, the resultant delivered current wave decreases while the voltage wave increases. Thus, with increasing impedance, the delivered volt-time interval increases. Twelve electrode gels were studied; 10 measurements were made on each gel. There is a marked variation in the impedance to direct current discharge of commercially available electrode gels. A large number of commercially available electrode gels are not suitable for use as the interface between the paddle electrodes and the chest wall during elective cardioversion and emergency defibrillation.


[Death from or in asthma ? (author's transl)]. 23 deaths of patients with severe asthmatic dyspnea were analyzed. There was no correlation between clinical presentation and cause of death certified by post-mortem examination. The cause of death was found outside the airways in 14 patients. Of diagnostic-therapeutic implications are the relative frequency of spontaneous pneumothorax (5) and pulmonary embolism (3). Six times another cause of death was discovered (like tumor invasion, arterial thrombosis, hemorrhagic pancreatitis, myocardial infarction). Acute asthmatic death was prone to happen in the middle-aged asthmatic with less than two years of bronchial asthma. Here like in 5 patients with chronic obstructive airways disease lack of awareness of the seriousness of the patients' state, sometimes cessation of cortisone long-term therapy, seldom abuse of bronchodilator-aerosols seems to be important for the lethal outcome.


A simple approach to standardized spinal radiographs. Present methods of obtaining spine radiographs for the clinical assessment of scoliosis are inadequate. Routine quantitative measurements made on anterior-posterior (A-P) and lateral radiographs describing the spinal deformities are grossly inaccurate since they are two-dimensional measurements of three-dimensional deformities. The approach described in this paper uses a simple device, the "Throne," which ensures reproducible positioning of patients for sitting spine radiographs as well as exact orthogonality of A-P and lateral film exposures. These two views of the spine form the data in digitized form for input into a computer program which generates the 3-D geometry of the line passing through the centers of each vertebral body from L5 to T1. Parameters describing the 3-D deformities of the spine are calculated automatically and converted to printed form for detailed examination and to plotted form for clinical use. Approximately 80 postambulatory Duchenne muscular dystrophy patients are being followed using this method. Of these, 20 have been followed for periods of 2 to 3 years. Costs of the method are minimal. The "Throne" can be built for approximately $50 of materials and 30 hours of labor. Each set of A-P and lateral radiographs can be processed in less than 5 minutes, including digitizing time at a computer cost of about 50 cents. The computer program may be handled by a minicomputer.


Umbrella catheter for nonoperative closure of atrial septal defects. Since a 1974 report of nonoperative closure of atrial septal defects (ASDs) using an umbrella catheter device, an additional 25 dogs have undergone creation of atrial septal defects, 12 of which have subsequently had successful transvenous closure. An improved model of the closure device has been developed, still using a pair of interlocking umbrella-like components made of stainless steel and Dacron. The umbrellas are smaller, lighter, and have an automatic opening ring. They are loaded simultaneously into a single capsule on the distal end of the outer catheter and are passed into the heart on a single passage, thus eliminating several steps of the original technique. Closure time has diminished from an average of 30 minutes to 5-10 minutes. The completeness of closure was documented in 12 animals by repeat cardiac catheterization which included hydrogen electrode studies. Autopsies on 10 sacrificed dogs revealed no adverse effects or migration of the device; two dogs are living and healthy. In the one clinical application, the patient has done well, remaining afebrile with an increased activity tolerance and resumption of normal activities. The umbrella has remained in position and appears to be functioning well.


[Anticoagulation and immunosuppression in rapidly progressive glomerulonephritis of poststreptococcal type (author's transl)]. In the majority of cases acute poststreptococcal glomerulonephritis is characterized by a good prognosis. Only relatively rare courses of this disease with clinical symptoms of rapid progressive glomerulonephritis and morphological signs of extracapillary glomerulonephritis together with crescent formation are sometimes prone to an infavorable outcome. A widely accepted medication does not exist up to now. Our own observations including clinical and morphological follow up studies are suggesting a combination of anticoagulants and immunosuppressive drugs. Indication and usefullness of that regimen are discussed.


[Diagnosis, therapy and longterm results of atrial myxoma (author's transl)]. Refering to a case report of five patients with atrial myxoma the symptoms, diagnosis, and therapy of this disease were described. In one case a biatrial tumor was found. In four cases atrial myxoma imitated a mitral-valve disease. An elevated BSR was found in all patients. The non invasive diagnostic procedure of ultrasound-echocardiography led in the last two cases to the correct diagnosis before heart-catheterization. The diagnosis was ascertained in all cases by angiocardiography. If left atrial tumor is suspected transpulmonary laevocardiography can be considered as a save diagnostic procedure better than the direct injection into the left atrium after transseptal puncture. Even the left ventricular angiogram in right anterior oblique position led in four of the five cases to the diagnosis of left atrial tumor. Coronary-angiography was performed in three patients and revealed pathologic atrial vessels in all three cases. Immediate operation is the indicated therapy. Two of the five patients were reviewed over a eight year period after operation without any signs of recurrence of the tumor.


[The effect of nifedipine on the pulmonary artery pressure in patients with coronary heart disease (author's transl)]. Nifedipine was administered in a dose of 30 mg orally to 14 patients with coronary heart disease and clinical evidence of left heart failure. Measurements of pulmonary artery and pulmonary wedge pressure were performed before and 1, 2 and 4 hours after administration of Nifedipine at rest and under loading conditions. The effects were characterized by a significant decrease in systolic, mean and enddiastolic pulmonary artery pressures by 18--21%. The pulmonary wedge pressure decreased significantly from 2,3 to 1,6kPa (17 to 12 mm Hg). These changes were accompanied by a significant decrease in systolic and diastolic arterial pressure by an average of 10.5%. No signifcant change of heart rate was seen. The increase in pulmonary artery pressure during exercise is suppressed effectively by Nifedipine. The duration of activity lasted for four hours and was maximal in the second hour after administration of the drug. The suppression of exercise induced rise of pulmonary wedge pressure was paralleled by a substantial decrease in dyspnoea and anginal pain.


[Pharmacokinetics of digoxin and methyldigoxin in patients with acute hepatitis (author's transl)]. After i.v. application of 3h-digoxin or 3H-methyldigoxin to 5 healthy volunteers and 5 patients with acute hepatitis, respectively (0.75 mg daily for 3 days and 0.375 for the following 2 days) total radioactivity in urine and plasma were determined. Chloroform-soluble and -insoluble glycosides were separated and the chloroform-soluble fraction was determined by TLC. 3 days after methyldigoxin application plasma levels reached toxic values in the patient group (2.73 +/- 0.48 ng/ml), whereas in patients receiving digoxin a mean plasma level of 0.91 +/- 0.21 ng/ml was obtained. During the first 24 hours following administration of digoxin 44 +/- 12% of the dose were recovered in urine of control subjects and 48 +/- 13% in patients with acute hepatitis, after methyldigoxin 34 +/- 5% and 34 +/- 8%, respectively. Metabolism of digoxin in patients with acute hepatitis was unaltered, whereas a diminished demethylation rate of methyldigoxin could be observed. 16 patients with acute hepatitis and 7 healthy volunteers received unlabelled digoxin p.o. as maintenance dose. Plasma glycoside concentrations were studied by radioimmunoassay. The average glycoside plasma concentrations were 0.59 +/- 0.21 ng/ml and 0.63 +/- 0.24 ng/ml, respectively.


[EEG changes following spirolactone treatment (author's transl)]. EEG studies were done on patients with CNS disease who were treated with d-aldosterone and spirolactone. The baseline EEGs of these patients were found to be slightly abnormal. During infusion of the spirolactone derivative potassium canrenoate a transient deterioration of preexisting EEG disturbances was observed; in addition, bursts of increased muscle activity and transient relative bradycardia were seen. These findings indicate that potassium canrenoate or its lipophilic metabolite canrenone may affect the nervous system directly, possibly via a disturbance in the electrolyte balance. These results are compatible with recent findings in animal studies.


[Studies on a new hepatotropic contrast medium]. The contrast-material Biliscopin was clinically studied in 101 patients. No side-effects were observed when the injection time was stretched over a 5 min period. The visible heterotopic excretion which correlates with the iodine concentration was low in the case of Biliscopin. Optimal visualisation of the biliary tract was obtained 60--90 min after injection. The remarkably long visualisation of the biliary tract allows tomography beyond 90 min after injection; this is seen as an advantage for X-ray departments with limited tomographic facilities.


[Colonic melanosis].

[Colonic melanosis]. Among 1072 rectoscopies we found 100 patients (9,3%) with melanosis coli. All patients suffered from a long-standing constipation together with laxative abuse. Anthrachinonic laxatives which are jointly responsible for the cause of melanosis coli are contained in 70% of all laxatives but also in many cholagogues and weight-reducing preparations. Severe inflammation of the colonic mucosa was seldom found. Colitis simplex, often found histologically and cytologically, could be due to increased turn-over of the mucosa cells. The endoscopic finding of melanosis coli is not regarded as an independent clinical picture but as an expression of chronic constipation unsuccessfully treated with laxatives.


[Diagnosis of sick sinus syndrome: sinus node recovery time as a bedside-investigation (author's transl)]. Prolonged sinus node recovery time is the most important diagnostic parameter of the sick sinus syndrome. In consideration of the therapeutic proceeding (antiarrhythmic drugs, pacemaker implantation or combination of these two therapeutic measures) an exact diagnostic proceeding is desirable. In 103 atrial stimulations we found in 42 cases a prolonged sinus node recovery time. There are shown details, which make the atrial stimulation practicable as a bedside-investigation.


[Heart tumour in the right atrium: clinical recognition and therapeutical management (author's transl)]. A 62 year old lady came to the hospital in cause of right heart failure. Right and left heart catheterization and cineangiocardiography revealed a tumour in the right atrium. Further angiographic investigations demonstrated a hypernephroma in the left kidney. The operation of both tumours was successful. Pathohistological examination confirmed the diagnosis of hypernephroma in the left kidney with metastasis into the right atrium.


[Ventricular fibrillation under quinidine medication--quinidine syncope (author's transl)]. Ventricular fibrillation which may occur unexpected under quinidine medication--called quinidine syncope--is one of the most dangerous complications of quinidine application. These life threatening accidents occur in 0,5-4,4% treated cases. The quinidine syncope occurs mostly at the attempt to eliminate atrial fibrillation or flutter. This dangerous side effect is dose independent. The ECG shows an increased QT duration and large U-waves. It seems to be a reentry-tachycardia caused by unequal recovery times in different parts of the ventricular myocardium.


Linearizing mechanisms in conventional tomographic imaging. Implicit in the concept of conventional tomography and in any attempt to characterize the tomographic process by a modulation transfer function is the assumption that the tomographic process is linear. A Fourier decomposition approach and an analysis of nonlinear contributions to the integrated tomographic image intensity are used in this paper to establish the validity of this assumption and to determine the mechanisms by which the tomographic process is effectively linearized.


Solid-state electrophotography with Al2O3. Solid-state thermocurrent and radioconductivity (electrical conductivity during irradiation) experiments are described with attention to the feasibility of using ionic solids for radiographic imaging. The radioconductivity varies with temperature giving rise to temperature windows of potential usefulness. The electrophotographic image is formed at atmospheric pressure using Al2O3, collecting the charge on mylar film. Development is by the power cloud technique. A transparency, which can be viewed as a conventional radiographic image, is easily produced. A successful transfer image, free of electric discharge artifact, was produced.


Image resolution of a microchannel plate x-ray image intensifier. The resolution has been evaluated for an experimental x-ray image intensifier employing three microchannel plates (MCPs) as the photon absorber and electron multipliers. The line spread function (LSF) was measured and used for determination of the modulation transfer function (MTF). The MTF was found to be independent of the incident photon energy from 20 to 150 keV. An additional measurement using a lead-bar test pattern showed that the resolution exceeded 7 line pairs (lp)/mm. The factors influencing the resolution capabilities of the intensifier are discussed. The resolution is limited primarily by the 53-micron center-to-center separation of the channels of the MCPs.


Single-step calculation of the MTF from the ERF. A method is presented whereby the modulation transfer function can be calculated directly from the edge response function without having to find the line spread function as an intermediate step.


A least-squares technique for extracting neutron spectra from Bonner sphere data. The accurate assessment of neutron flux and dose-rate levels in a medical environment is a topic of much current interest. In this paper, a least-squares data-analysis technique has been used for extracting neutron spectra and related information from Bonner sphere data. This technique, incorporated in the FORTRAN IV code NFLS is worthy of consideration as an alternative to the count-rate ratios and iterative-unfolding techniques used in the past. The analysis provides calculated total neutron flux density, dose-equivalent rate, and average and median-neutron-energy information as well as a plot of integral neutron-flux-density spectra. The method allows the calculation of the statistical uncertainty of each of the above quantities, which has not always been possible with other analytical methods. Results of calibration and experimental data analysis are presented and compared to results of the iterative-unfolding technique.


Temporal response of microdensitometers. Microdensitometers have both spatial and temporal finite responses which may lead to degradation in images being analyzed. These responses may be quantitated in terms of spatial and temporal modulation transfer functions (MTFs). The temporal response of microdensitometers is studied here. Specifically, the technique of differentiating temporal step-function responses to determine the temporal MTF is presented. Experimental results illustrating the theory are described using a Baird Atomic microdensitometer.


Treatment planning in Cobalt-60 radiotherapy using computerized tomography techniques. Cobalt-60 transmission measurements were made through an Alderson phantom utilizing a transverse axial tomographic device and a NaI (Tl) detector. Measurements were made on different sections of the phantom for as many as 162 angles and 120 linear increments. The attenuation coefficients were reconstructed using both convolution and algebraic reconstruction techniques. Three-dimensional isodose distributions were obtained using the reconstructed attenuation coefficients. Comparison with standard treatment plans and measured isodose distribution using TLD techniques suggest that a more accurate isodose distribution may be obtained using the reconstructed attenuation coefficients, particularly in regions involving tissue heterogeneities.


Behavior of p-n junction silicon radiation detectors in a temperature-compensated direct-current circuit. The behavior of silicon p-n junction radiation detectors used in the direct-current short-circuit mode without bias was examined under such load resistance which ensures operation in a temperature-compensated state. The objective was twofold; to check whether the compensation is achieved and to investigate the extent of compensation shown at temperatures other than that initially selected as the operation point. It was found that the detector performance in various thermal conditions can be predicted from a knowledge of the behavior of the individual detector and circuit parameters and that it is possible to stabilize the detector response within +/- 2% over a relatively wide temperature range: 18 degrees-40 degrees C. However, in the case of devices which show thermal currents of large temperature sensitivity, compensation at small and at large dose rates needs to be considered separately.


Laser "cross-hair" sidelight.

Laser "cross-hair" sidelight. A technique is described for forming an optical laser cross-hair image for use as a radiotherapy sidelight. The technique is developed from a concept introduced earlier by which a line image is formed from a laser beam using a cylindrical lens. By using two cylindrical lenses and appropriate reflectors, two line images can be made to form a cross.


Empirical formula for 30Co axial depth doses. An empirical formula has been developed to approximate the published axial depth doses of 60Co radiation with greater accuracy than available hitherto. With sets of nine constants, varying slightly with SSD, a total of 2100 percentage depth doses are reproduced with root-mean-square deviations ranging from 0.13 to 0.16 for four values of SSD from 50 to 100 cm.


Image information content and patient exposure. Presently, patient exposure and x-ray tube kilovoltage are determined by image visibility requirements on x-ray film. With the employment of image-processing techniques, image visibility may be manipulated and the exposure may be determined only by the desired information content, i.e., by the required degree of tissue-density descrimination and spatial resolution. This work gives quantitative relationships between the image information content and the patient exposure, give estimates of the minimum exposures required for the detection of image signals associated with particular radiological exams. Also, for subject thickness larger than approximately 5 cm, the results show that the maximum information content may be obtained at a single kilovoltage and filtration with the simultaneous employment of image-enhancement and antiscatter techniques. This optimization may be used either to reduce the patient exposure or to increase the retrieved information.


PL-promoted transcription of the promoter-proximal N-trp region is insensitive to chloramphenicol in the absence of N function. When the trp operon is translocated into the early region of lambda phage, transcription originated at the PL promotor is known to be modified by function of the N gene product so that transcription of the operon continues when translation is blocked by nonsense mutations or by ribosomal antibiotics. When N function is deficient in a phage that joins the trp operon to a point distal to the N gene, deleting the tL site, nonsense mutations (Franklin, 1974) or chloramphenicol (Nakamura et al., accompanying paper) again block transcription of the bacterial operon. However, here we report that transcription over about the first 800 nucleotide pairs starting from the PL promotor of the N-trp operon is still insensitive to chloramphenicol even in the absence of N function. The region covers the full N gene and the initial bit of the trp operon.


Morphogenesis in Mucor mucedo: mutations affecting gamone response and organ differentiation. Mutants of Mucor mucedo minus strain that are affected in their trisporic acid (TA) mediated zygophore formation have been isolated. We have found mutants with cold sensitive (cs), with temperature sensitive (ts) and without zygophore formation as well as mutants with unstable zygophores (Zst-). From the appearence of certain pleiotropic phenotypes we deduce a one-dimensional sequence of states of competence of the mycelium to form different organs. TA appears to be a growth substance for zygophores acting on one transient state of competence. The fact that all isolates with lowered response to TA also have a lowered response to the mating type specific TA-precursor P strongly suggests that P has to be converted into TA before inducing zygophore growth. Furthermore, one mutant with lowered sensitivity to TA exhibits an excess zygophore formation in the presence of high TA-concentrations, while high concentrations of P cause a depressed zygophore formation (Fig. 6). Our interpretation of this behaviour is that P acts as an antagonist to TA in the regulation of zygophore growth.


Sequence homology in DNA molecules of temperate phages phi81, phi80 and lambda. Homology maps between bacteriophages phi81, phi80 and lambda were constructed on the basis of electron microscopy observation of DNA heteroduplexes. In phi81/phi80 heteroduplex, the left half and the right terminal region of 13% the total molecular length were highly homologous, while the remaining region covering the early gene cluster was entirely nonhomologous. In phi81/lambda heteroduplex, high-degree homologies were detected at the left 14% terminal region covering the head gene cluster, the central 3.8% region covering the att-int-xis region and the 1.3% Q homology region. Low-degree homologies of shorter length were scattered at the tail gene cluster, b2 region, cIII region, PQ region and SR region. Comparing our results with the homology maps of other lambdoid phages reported by Simon et al. (1971) and Fiandt et al. (1971), a phylogenic relation of phi81 to other lambdoid phages and the role of recombination in the course of divergence of lambdoid phages are discussed.


[Role of serine-rich histone (H5) in bird erythrocyte genome inactivation]. The ability of H5 and H1 histones, purified from immature or mature pigeon erythroid cells, to suppress RNA synthesis in vitro was compared. It was found that H1 histones from both sources as well as histone H5 from bone marrow suppress RNA synthesis to a comparable degree while H5 from the mature erythrocytes exhibits significantly higher suppression efficiency. H5 histone subfractions, differing in phosphate content, also had different ability to restrict the template activity of chromatin: the higher is the phosphorylation level of H5 histone, the weaker is its effect on the transcription.


[Optical rotatory dispersion by 5 viruses of the tobacco mosaic virus group and their components]. Optical rotatory dispersion (ORD) spectra in 250 to 350 nm region were measured for preparations of five TMV-like viruses (TMV vulgare, HR and U2 strains of TMV dolihosenation mosaic virus and cucumber virus 4) and also for RNA and protein preparations of these viruses. The data obtained testify against the possibility that the double peak with maxima at 286 and 293 nm observed in ORD of all the five viruses is due to interaction of tryptophan residues in virus coat protein with the RNA of the virul particle. The spectra of intravirus RNA of the five viruses, calculated as the difference between ORD of the intact virus and of its coat protein, were found to differ significantly from each other and from ORD of free RNA. ORD spectra of hybrid viruses, reconstituted from RNA of one virus and coat protein of another, proved to be identical to the ORD of the virus, whose protein was used in reconstitution. We suppose that the difference in ORD of the intravirus RNA of the five viruses reflect differences of RNA-protein interactions in them.


[Stereochemical theory of the 3-dimensional structure of globular proteins. I. Highly helical intermediate structures]. The authors analyze the physical prerequisites on which the proposed stereochemical theory of the three-dimensional structure of globular proteins is based. The theory represents a stereochemical modelling of the mechanism of protein self-organization suggested earlier by one of the authors. According to this mechanism, a highly helical intermediate structure(s) is formed at first and then it passes into the native one. In the highly-helical intermediate structure the arrangement of the polypeptide chain in space is the same as in the native structure. These two structures differ mainly by the secondary structure of the chain. The transition into the native structure proceeds under the effect of long-range interactions which transform the excess alpha-helices into beta-structural and irregular conformations. The so-called s-helices are considered (the alpha-helix, whose hydrophobic groups form a separate cluster on its surface). s-Helices can be obtained on the greater part of the polypeptide chain of any globular protein. In the unfolded protein chain they are the most stable and rapidly formed structures. It has been shown that namely s-helices are the initial blocks for the formation of the highly-helical intermediate structure. Stereochemical principles of the s-helix packing that permit to predict the three-dimensional structure of highly helical proteins have been found. According to these principles the highly helical structure represents the packing of hydrophobic surfaces and s-helices. In their turn, hydrophobic surfaces are formed as a result of complementary interaction of borders of hydrophobic clusters of two s-helices according to the "knob-hole" principle.


[Efficiency of photophosphorylation in chloroplasts with steady and pulsed illumination]. The quantum yield of noncyclic photophosphorylation in chloroplasts excited by a series of 8 mus flashes of the saturating intensity displays a two-fold decrease when the flash-frequency is reduced from about 1.1 to about 0.8 s-1, whereas further decrease of flash frequency does not affect the average ATP yield per flash. Under excitation by two-flashes series the ATP yield is also about half-maximal. These observations are inconsistent with the concept postulating accumulation of energy contributions from several parallel or consecutive one-electron transfers as a prerequisite for ATP formation. The two-state model of a thylakoid membrane and of a coupling site is put forward according to which only one of these states ensures ATP formation in response to one electron transfer through one coupling site, whereas the other state is nonphosphorylating.


[Nitrate content of carrots in baby formulas (author's transl)]. The nitrate content of carrots and of commercial processed carrot formulas for infants was examined. Fresh and canned carrots were found to contain between 40 and 850 mg NO3/kg carrot. Processed infant foods made of carrots contained between 55 and 215 mg NO3/kg of the ready-to-serve food. It is suggested not to recommend household preparation of carrots for healthy and diseases infants during their first months of life. It is questioned whether the legal limit of 250 mg NO3/kg is really safe for carrot preparations used in feeding infants during their first months of life.


[Haematuria in children. I. Differential diagnosis of haematuria in childhood (author's transl)]. Haematuria in children is either of glomerular or nonglomerular origin. In the latter case intravenous urography should always be performed. A renal biopsy is indicated if unexplained haematuria persists for at least one year or if an unfavorable prognosis is indicated by the appearance of hypertension, significant proteinuria or persistently low levels of serum complement (C3). The importance of screening the families of haematuric patients is emphasized. More than half of our cases with persistent or intermittent haematuria undergoing renal biopsy showed no or only minimal glomerular changes. In other children with a similar clinical picture more severe histological lesions were detected. In any case the kidney tissue obtained by biopsy should be examined by immunofluorescence and by electron microscopy. One of the most frequent causes for persistent or intermittent haematuria during childhood is Berger's disease (IgA/IgG nephropathy).


[Role of lipids in the organization of the vicinity of photosystem 1 centers]. The effect of galactolipase and phospholipase A on the spectral properties of light chloroplast fragments enriched by photosystem I has been studied. Treatment by various lipases or by two enzymes in differing sequences affected absorption and fluorescence spectra of light fragments. The concentration of phospholipids and their composition were determined before and after treatment with various enzymes. Data obtained allowed to make suggestions concerning the location and functions of various lipids.


[Evaluation of evidential data of diabetic children (author's transl)]. On the basis of the evidential data of 365 children with diabetes mellitus the interrelation between certain data and the manifestation of the diabetes mellitus has been examined. There is a positive correlation between the birth weight and the body length observed at the manifestation. The number of extremely tall children is higher than expected with regard to the population. Equally, the age of parents at the time of birth of their diabetic children is relatively higher when compared to the average of the population. In addition, there are seasonal changes; the most frequent manifestation of diabetes is seen in the months January and October, and--surprisingly--is lowest in May.


[Significance of serum-gentamycin measurements in childhood (author's transl)]. Gentamicin serum levels were determined in 113 children of different ages (premature infants, full-term neonates, infants, older children) using a rapid microbiological method. It turned out to be favourable to take blood samples at two different times (30 and 120 min after administration of drug). In this way we found out the maximum concentration in serum and moreover by determining the serum half-life the velocity of elimination of the drug. In the group of premature infants mean serum half-life was 3.88 h and significantly longer than serum halflife in the group of older children (1.76 h) or full-term neonates (2.64 h). Children suffering from urological diseases showed a slower excretion of gentamicin, even when creatinine and urea concentrations in serum were not elevated. The rapid microbiological method used turned out to be reliable, simple and time-saving.


[Oligonucleotides and their analogs. II. Spectra of the circular dichroism of dinucleoside phosphate analogs containing 4-thiouracil]. The dinucleoside phosphates analogues APpSU, SUPpA and UPpSU have been synthesised by direct thionation of DNP analogues, containing cytosine. The structure of compounds prepared was proved by UV- and PMR-spectra. The CD spectra of the DNP analogues were examined. It has been demonstrated that the "induced" dichroism contribution in the Cotton-effect of DNP was substantial in the case of stacking conformations and negligible for unstacking conformations.


[Study of the state of intracellular iron in photosynthesizing purple sulfur bacteria using the Mossbauer effect]. The work presents the results of the first stage of the study on the valent and structural state and function of the iron atoms in the donor-acceptor environment of the photosynthetic reaction centres of purple bacteria. 57Fe was introduced by cultivating the microorganisms in a medium enriched in this isotope. At 77 K the maxima observed in the Mössbauer spectra in intact freeze-dried cells at a speed of +2 mm/s and --1 mm/s are attributed to doublets 1.11 with the isomer ahifts of 1.3 and 0.5 mm/s respectively and the constants of the quadrupole splitting (Q.S.) of 2 mm/s and 2.2 mm/s. These are presumed to arise from cytochromes type c. The Mössbauer parameters of the intense assymetric quadrupole-split doublet of a more complex nature in the mid of the spectrum with line widths of 0.5 to 7.0 mm/s and 0.5 to 1.5 mm/s fit to these of bacterial ferredoxin. From the analysis of the control and dithionite-treated samples of the temperature dependency of the observable parameters over a temperature range of 77 to 300 K it can be concluded that in cells the iron atoms are present in various valency and spin states and the relation between the redox states of the iron atoms is dependent, in particular, on the age of the culture. The Mössbauer spectra of the cell fragments indicate that most of the intracellular iron, first of all the heme iron, is bound to the fraction of photosynthetic membranes.


[Study of temperature-dependent conformational changes in serum albumin using an adsorbed dye]. 4-N (p-sulfoaniline),5-methoxy,1,2-benzoquinon (1) is bound by hydrophobic regions of the native molecule of bovine serum albumin (BSA). In the temperature interval 0--65 degrees C the interaction characteristics such as energy, entropy and the average number of the binding sites on a BSA molecule were determined. Under experimental conditions BSA is found in at least in two equilibrium conformational states distinguished by quantity of hydrophobic regions capable of binding with 1. Below 17 degrees C no conformational changes of BSA was observed. With the increase of temperature from 17 to 47 degrees C the equilibrium is driven in the direction of protein form with the hydrophobic binding sites which are more available for the solvent. Heating above 47 degrees C produces "predenaturation" structural changes in the BSA molecule. Hydrophobic regions of the BSA have different thermal stability.


[Adrenal function after long term treatment with beclomethasone dipropionate in childhood asthma (author's transl)]. Evaluating plasma levels of cortisol and corticosterone after ACTH-stimulation, and the urinary metabolites tetrahydrocortisone and tetrahydrocortisol in asthmatic children it could be demonstrated, that in most cases there was no suppression of adrenal function following treatment over 6 to 18 months with a daily dose of 200 to 300 microgram beclomethasone dipropionate. Since in a few patients suppression was found, an ACTH stimulation after a six months treatment is recommended.


[Psychological development of children with hypothyroidism. I. Psychometric results in relation to clinical features (author's transl)]. Thirty-two children suffering from congenital or late acquired hypothyroidism were studied with respect to intelligence, motor development, visuo-motor coordination, and social maturity. Psychological test results are represented for the group as a whole as well as in their relation to age at onset of symptoms and therapy, ataxia, and speech disorders.


[Psychological development of children with hypothyroidism. II. Motor development and psychopathology (author's transl)]. In addition to a preceeding report the relation of motor development to ataxia and age at onset of symptoms and therapy as well as psychopathological symptoms in relation to intelligence and sex in 32 children with hypothyroidism are reported.


[Electron microscopic study of the myocardium in cyanide poisoning]. Effect of the KCN poisoning on the cardiac muscle was studied by the aid of electron microscopic cytochemical methods. The early lesions revealed were: alterations in the region of the Z-lines, "septum formation" in the mitochondria, crystolysis, enlargment of the sarcotubules. Later destruction of the thick and thin filaments alteration of the intercalar discs were observed. Activity of the succinate-dehydrogenase and cytochromoxydase decreased. Authors emphasize the non-specific character of the alterations described.


[Pathogenesis of lung changes caused by inhalation of organic solvents]. Pulmonary lesions were studied in autopsy material and in model experiments by light- and electron microscopy. Histologically in lung severe haemorrhage was found. Electronmicroscopically damage to the permeability could be revealed. Authors assume, that these investigations evidence the hypothesis, according to which inhalation of organic solvents causes morphologically detectable alterations in the lung tissue.


[Pulmonary arteriovenous fistula].

[Pulmonary arteriovenous fistula]. A case of arteriovenous fistula of the lung is reported. The patient's--a 44 years old male--dyspnoe and cyanosis during several years were thought to be of cardial origin. After the onset of the symptoms of severe portal hypertension progression of the disease and death followed. At the autopsy in the lower lobe of the right lung a circumscribed arteriovenous fistula was found. Origin, types, pathomechanismus--especially pathomorphological aspects--of the arteriovenous fistula are discussed.


[Ependyma cyst of the 3d ventricle, causing sudden death]. A case of ependymal cyst of the third ventricle in a 18 years old female causing sudden death is reported. The patient had no typical clinical symptoms. Literary data dealing with the origin and clinical symptoms of the ependymal cysts are reviewed. It is assumed, that ependymal cyst is a congenital fissular tumour.


[Eosinophilic granuloma of the stomach]. Two cases of the eosinophil granuloma of the stomach are reported. The male patients (52 and 48 years old) had had gastric disorders. By the X-ray examination the suspition of a tumour had been raised. At both patients resection of the stomach by Billroth II was performed. The tumours histologically were eosinophil granulomas.


[Renocerebral oxalosis following glycerin infusion]. At the autopsy of a 55 years old male patient renocerebral oxalosis was found, the most frequent cause of which--the ethylenglycol poisoning could be excluded by toxicological examination of the organs. Authors suppose that intravenous administration of 500 ml of 10 per cent solution of glycerol several hours before the death for the treatment of cerebral oedema might have caused the renocerebral oxalosis. The fact that in the catabolism of glycerol, ethylenglycol and xylit causing most frequently renocerebral oxalosis glycoxylic acid, precursor of the oxalic acid in the organism is formed, seems to evidence this supposition.


[The use of the adenosine desaminase (ADA) system in paternity cases]. Authors described genetically determined hereditary polymorphisms and pattern of inheritance of the adnosindesaminase (ADA) system. After a methodical review, results of their own investigations are reported, which were the first in the Hungarian population. The incidence of the ADA phenotypes among 1234 adult persons investigated was found: ADA-1=88%, ADA 2-1=11,58%, ADA 2=0,42%. Rare phenotypes were not detected. Values of gene frequency found: ADA1=0,93,79; ADA2= 0,0621; Results of the investigation of 561 mother-child pairs are also reported. The pattern of inheritance in every case examined was found to be regular. According to the author's data the maximal (theoretical) chance of the exclusion of paternity was 5,48%. In 561 cases of discussed paternity beside the examination of the systems of A1A2BO, MN, Ss, Hp, Rh, Gm(a,x,b), INV (1), Gc, Kk, Fy(a,b), SEP, PGM, GPT, and AK the ADA system was also examined. On the base of the last examinations the paternity could be excluded in 11 (1,97%) cases. In two cases (0,36%) exclusion of the paternity was based on the results of the examination of the ADA-system only. In the biostatistical evaluation of the results of examinations of blood-groups the role of the ADA system seems to be important. Examination of ADA system in cases of disputed paternity is recommended.


[Infantile coronary fibroelastosis].

[Infantile coronary fibroelastosis]. Two cases of fibroelastosis of the coronary arteries in infants are reported. The fibroelastosis was complicated with coronary thrombosis. Histologically isolated proliferation of the intima, fibrosis of the media and disintegration of the lamina elastica interna was found.


The mutagenicity and cytotoxicity of selenite, "activated" selenite and selenate for normal and DNA repair-deficient human fibroblasts. At doses varying from 8 x 10(-5) to 3 x 10(-3) M sodium selenite (Na2SeO3) induced DNA fragmentation, DNA-repair synthesis, chromosome aberrations and a mitotic inhibition in cultured human fibroblasts. The response of DNA repair-deficient xeroderma pigmentosum (XP) fibroblasts to selenite is comparable to that of control cells. Incubation with mouse liver S-9 microsomal fraction increased the capacity of selenite to induce chromosome aberrations, DNA-repair synthesis and a lethal effect. XP cells behaved as control cells when treated with activated selenite. Sodium selenate (Na2SeO4) at doses ranging from 8 x 10(-5) to 3 x 10(-3) M could not be activated by incubating with a S-9 preparation. Selenate had the capacity to induce a small but significant DNA-repair synthesis.


Natural history and treated course of usual and desquamative interstitial pneumonia. Patients with confirmed interstitial pneumonia were initially classified histologically into "desquamative" (n = 40) and "usual" (n = 53) types, and followed for one to 22 years. Both the diagnosis and the extent of fibrosis affected the course and response to therapy. Mortality in desquamative interstitial pneumonia was 27.5 per cent, and mean survival 12.2 years, as compared with 66.0 per cent and 5.6 years in usual interstitial pneumonia (P less than 0.01). Without treatment, 21.9 per cent with the desquamative but none with the usual type improved. With corticosteroid therapy, 61.5 per cent with desquamative and only 11.5 per cent with usual interstitial pneumonia improved, whereas 27.0 per cent and 69.2 per cent worsened. We conclude that the histologic classification of chronic interstitial pneumonia used here permits forecasts of prognosis and response to treatment that cannot be deduced from other data.


Prevention of nitroprusside-induced cyanide toxicity with hydroxocobalamin. To investigate hydroxocobalamin's role in preventing cyanide intoxication from sodium nitroprusside, we studied two groups of patients. One group received nitroprusside alone, and the other received nitroprusside and hydroxocobalamin. Red-cell and plasma cyanide levels were 83.44 +/- 23.12 and 3.51 +/- 1.01 microgram per 100 ml after nitroprusside alone and were 33.18 +/- 17.29 and 2.18 +/- 0.65 microgram per 100 ml after nitroprusside plus hydroxocobalamin. Acidosis developed in patients with red-cell cyanide levels higher than 75 microgram per 100 ml. When hydroxocobalamin infusion was stopped before sodium nitroprusside infusion was discontinued, blood cyanide levels and base deficit increased in a manner similar to that in the untreated group. The dose of nitroprusside used in each group did not differ statistically. These data show that hydroxocobalamin prevents cyanide transfer from red cells and plasma to tissue after nitroprusside metabolism, and thereby prevents cyanide toxicity from large intravenous doses of the drug.


Taking care of the hateful patient.

Taking care of the hateful patient. "Hateful patients" are not those with whom the physician has an occasional personality clash. As defined here they are those whom most physicians dread. The insatiable dependence of "hateful patients" leads to behaviors that group them into four stereotypes: dependent clingers, entitled demanders, manipulative help-rejecters and self-destructive deniers. The physician' negative reactions constitute important clinical data that should facilitate better understanding and more appropriate psychological management for each. Clingers evoke aversion; their care requires limits on expectations for an intense doctor-patient relationship. Demanders evoke a wish to counterattack; such patients need to have their feelings of total entitlement rechanneled into a partnership that acknowledges their entitlement--not to unrealistic demands but to good medical care. Help-rejecters evoke depression; "sharing" their pessimism diminishes their notion that losing the symptom implies losing the doctor. Self-destructive deniers evoke feeling of malice; their management requires the physician to lower Faustian expectations of delivering perfect care.


Brain histamine receptors as targets for antidepressant drugs. A large number of structurally diverse drugs with clinical antidepressant properties share the ability to act as potent inhibitors of histamine-sensitive adenylate cyclase in cell-free preparations from mammalian brain. This common biochemical action may represent part of the molecular basis for the antidepressant properties of these compounds.


Evolution of homeothermy in mammals.

Evolution of homeothermy in mammals. We propose that mammalian homeothermy was was acquired in two steps. The first step enabled mammals to invade a nocturnal niche without an increase in resting metabolic rate. The second step enabled them to invade a diurnal niche and involved the acquisition of higher body temperatures and metabolic rates.


The relationship between function and DNA sequence in an intercistronic regulatory region in phage lambda. rho factor-mediated transcription termination at the tr1 terminator site of bacteriophage lambda is examined. Mutations affecting the termination event are characterised. These mutations define features of the site which seem to be important to terminator function. In addition, other related transcriptional and translational regulatory elements are defined within the region surrounding the termination site. The potential molecular interactions and structural overlaps of these control signals apparently couple the regulation of the decision between lytic and lysogenic growth patterns by phage lambda.


Evidence for a direct action of amphetamine on dopamine metabolism in the rat substantia nigra in vivo. The intraperitoneal administration of D-amphetamine (0.2--2.5 mg/kg) decreases dihydroxyphenylacetic acid (DOPAC) content not only in the caudate nucleus but also in the substantia nigra. This effect persists both in the substantia nigra and in the caudate nucleus after loss of dopamine-sensitive adenylate cyclase and presumably of dopamine receptors, induced by intrastriatal injection of kainic acid. These results indicate that the effect of amphetamine on DOPAC levels in the nigra is not mediated through a strionigral feedback loop.


Inhibition by opiate narcotics of rat flexor alpha-motoneurones. Specific effects of opiate narcotics on rat flexor alpha-motoneurones were studied in ventral roots of laminectomized rats under halothane anaesthesia. The alpha-motoneurones were activated by tetanic stimulation of the cut ipsilateral common peroneal nerve, exciting up to group II- but not group III- and C-afferents. Morphine (0.5--3.0 mg/kg i.v.) reduced or completely suppressed the discharge rate of flexor alpha-motoneurones in a dose-dependent manner. This effect was antagonized by naloxone (0.5 mg/kg i.v.) and mimicked by levorphanol (1.0 mg/kg i.v.), but not by an equal dose of its stereoisomer dextrorphan, suggesting that the effect described is a specific one. After spinalization, the inhibitory effect of morphine was abolished. Previous studies had shown that opiates (e.g. morphine, given in a dose of 2 or 4 mg/kg i.v.) excite rat extensor alpha-motoneurones, an effect opposite to the opiate narcotic action on flexor alpha-motoneurones. The action of opiates leading to an inhibition of flexor alpha-motoneurones may contribute to akinesia and catalepsy, and opioid-induced muscular rigidity. From the results presented it appears that morphine produces a reciprocal change in the activity evoked in extensor and flexor reflex pathways.


Lack of evidence for a temperature-mediated change of adrenoceptor type in the rat heart. 1. Responses to phenylephrine of left and right atria of the rat heart have been measured at 37 degrees C and 21 degrees C. 2. Differences in basal force of contraction at the two temperatures were attributable solely to differences in frequencies of contraction. 3. Reduction in temperature produced no change in EC50 for phenylephrine nor any greater susceptibility of the responses to blockade by phentolamine rather than propranolol. 4. It is concluded that beta-adrenoceptors of the rat heart are not converted to alpha-adrenoceptors by a reduction in temperature.


Muscle relaxant properties of the identified metabolites of dantrolene. Identified metabolites of dantrolene, a skeletal muscle relaxant, were studied for inhibition of skeletal muscle contractions. Inhibition of muscle contractions were studied in vivo in the rat gastrocnemius muscle preparation, and in vitro using isolated rat diaphragm strips. Dantrolene (D) and 5-hydroxydantrolene (5-HD) inhibited muscle contraction responses in a dose dependent manner, both in vivo and in vitro. 5-HD was less potent than D.


Reversible decrease of collagen crosslinking by protein low diet and aminoacetonitrile--effect of D-penicillamine and prednisolone on the rise of crosslinks. After ending a 4-week period of low-protein diet with or without aminoacetonitrile (AAN), the tail tendons of rats showed an increase of hydroxylysinonorleucine (HLNL) together with other unidentified reducible crosslinks. The binding of dihydroxylysinonorleucine type (DHLNL) was an exception: its content remained unchanged. It may be, assumed, therefore, that the procedures mentioned above act indiscriminately against all reducible crosslinks with the exception of DHLNL. The rise in crosslinks after the 4-week pretreatment was disturbed, when d-penicillamine was given, because it specifically inhibited the formation of HLNL. The content of other crosslink components was slightly increased above that of controls so that the absolute content of total isolated crosslinks increased in the presence of d-penicillamine. No statistically significant differences could be obtained under prednisolone.


Transient desensibilization of isolated hepatocytes against phalloidin by treatment with phospholipase A. The development of typical protrusions in isolated hepatocytes after incubation with phalloidin was prevented by phospholipase A (from bee venom). When cells were preincubated with low concentrations of phospholipase A and the enzyme was removed by washing, the number of cells affected by 10 microgram phalloidin/ml was markedly reduced. If the pretreated cells were allowed to recover after removal of phospholipase, the sensitivity to phalloidin returned to nearly normal values. Transient treatment of hepatocytes with sublytic concentrations of phospholipase A did not destroy cell membranes, whereas 5-fold higher concentrations of the enzyme produced large protrusions quite different from those appearing during phalloidin poisoning. These findings suggest that phosphatides are needed for the recognition of phalloidin by liver cells. A series of marker enzymes were analysed in isolated plasma membranes from rat liver after treatment with phospholipase A. Changes in the activities of K+ Na+-ATPase and of p-nitrophenylphosphatase were observed. Other membranal enzymes were not markedly influenced. The inhibitory effect of phospholipase A on the phalloidin response is discussed in context of earlier findings suggesting an evident role of a membranal protein for the recognition of phalloidin.


Subclasses IgG1--IgG4 in 84 sera with IgG paraprotein. The distribution of subclasses IgG1-4 was determined in 84 sera with IgG paraprotein. The results were as follows: IgG1--58.3%, IgG2--25%, IgG3--11.9%, IgG4--4.8%. After division into the group of IgG myelomas (n = 47) and the group of non-myeloma IgG paraproteinemias (n = 37), the following distribution was found: IgG1--55.3%, IgG2--25.5%, IgG3--12.7%, IgG4--6.5% and IgG1--62.1%, IgG2--24.3%, IgG3--10.8%, IgG4--2.7%, respectively. The distribution of light chains in the individual subclasses of IgG paraproteins was also studied. In three double IgG and IgA myeloma paraproteinemias, subclass 1 IgG paraprotein was always demonstrated.


Infrared thermovision in tumors of the orofacial region. The authors present briefly the physical principles of infrared thermovision and an overview of its utilization in stromatology. Among the 21 patients, suffering for the most part from a tumorous affection of the orofacial region, they describe in more detail the case of a carcinoma of the lower lip. A correlation of their clinical, histological and X-ray findings with those of infrared thermovision revealed agreement in every case insofar as the localization of the pathological process was concerned. They stress that infrared thermovision is not meant to replace histo-pathological investigation whose significance in the diagnosis of malignant tumors continues to be decisive.


Effectiveness of radiation therapy and combined radiation and surgical treatment in advanced breast cancer. The effectiveness of two modes of combined radiation-surgery treatment and the correlation between the therapeutic results and the clinical type of primary breast cancer were followed in a group of 221 patients with Ca mammae in the III clinical stage. As criteria of evaluating, use was made of analysis of the temporal sequence of relapses and metastases formation following primary treatment. The higher effectiveness of the mode--surgery combined with pre- and postoperative irradiation as against that of surgery with only post-operative radiotherapy became manifest in the frequency of relapses but not in that of distant metastase formation. Simultaneously, a relationship has been established between the course of the disease after treatment and the various categories of T, or its dependence on the relation between the primary tumor and the skin and this within the IIIrd clinical stage of breast cancer.


Study on incorporation of 3H-DNA in the L-cells by means of electron microscopic autoradiography. Uptake of isologous DNA (labeled with 3H-thymidine) by L-cells was investigated by means of electron microscopic autoradiography. It was found that exogenous 3H-DNA occurred not only in the cytoplasm, but, already from the 1st hr of incubation, permeated as far as in the host cell nuclei. During continuous cultivation, radioactivity established in the nuclei and cytoplasm increases with maximum value after 12 hr incubation. Beginning at the 3rd hr of incubation, in cytoplasma, grain clusters over loci of higher radioactivity were found. After 24 hr incubation, similar grain clusters in L-cell nuclei were observed. In the cytoplasma of the cells, the grains were often determined over or in the vicinity of lysosomes; in the nuclei they were localized predominantly over heterochromatine. The manner of 3H-DNA and 3H-TdR labeling was also compared.


Neutral lipids in nuclei and chromatin fraction of young and old Ehrlich ascites tumor cells. Determination of lipid content of Ehrlich ascites tumor cell nuclei devoid of the nuclear envelope and chromatin isolated from them revealed considerable amounts of neutral lipids present in both preparations. The neutral lipid content always exceeded that of the phospholipid. An age dependent accumulation of neutral lipids could also be observed. The chromatin fraction always contained relatively higher amounts of neutral lipids than the respective nuclei with a predominance of cholesterol esters.


Cytofluorimetric measurement of DNA content in the cells of the transplantable melanotic and amelanotic Bomirski melanoma in golden hamster (Mesocricetus auratus, Waterhouse). Cytofluorimetric measurements of the DNA content in transplantable melanotic and amelanotic tumor cells were carried out. The mean content DNA is higher in the amelanotic cells. The DNA distribution patterns are different in both tumors: there is a distinct stem line of the cells in the melanotic tumors whereas in the amelanotic cells there is a great variability in the DNA content and the stem line of the cells is absent. The correlation between these findings and some biological properties of the melanotic and amelanotic tumors are discussed.


Electrochemical properties of polycyclic compounds studied by the polarographic method in anhydrous systems. V. Oxidation potentials of carcinogenic hydrocarbons in acetonitrile. The half-wave oxidation potentials of polycyclic carcinogenic hydrocarbons have been studied at the rotating platinum electrode in anhydrous acetonitrile with sodium perchlorate as the supporting electrolyte. The good agreement was obtained by the comparison of the carcinogenic activity of studied compounds with the values of the oxidation potentials. The values of the oxidation half-wave potentials were correlated also with the reduction potentials measured in acetonitrile and with the root xn of the Hückel secular equation for the highest bonding orbital.


In vitro cell proliferation studies in Hodgkin's disease. A cytologic and proliferation analysis was performed in the lymph node samples of 30 nontreated Hodgkin patients using tritiated thymidine, the autoradiographic technique, and two different in vitro incubation schemes. A group of 9 inflammatory reactive patients was used as control. The results confirmed previous labeling data but showed that DNA synthesis can also be detected among the reticulum cells. The role attributed by some authors to the large rounded basophilic cells of lymphoid appearance found in Hodgkin's tissue is discussed in the light of the results in Hodgkin's and non Hodgkin's samples. Finally, some aspects dealing with the relationship and possible role of the Hodgkin and Sternberg-Reed cells are commented.


Effect of chemotherapy on the lymph node and bone marrow cell chromosomes in patients with Hodgkin's disease. Chromosomal aberrations in bone marrow and lymph node cells have been investigated in 47 patients with lymphogranulomatosis 24--72 hr after administration of a single therapeutic dose of cyclophosphan and natulan. It is shown that the injurious action of cyclophosphan and natulan lasts more than 72 hr. An analysis of the dynamics of various types of chromosomal aberrations testifies that cyclophosphan and natulan affect cellular constituents found in the synthetic or post-synthetic phases of the cell cycle.


Parathyroid hormone and calcium blood levels in acute renal failure. With special reference to one patient developing transient hypercalcemia. Parathyroid hormone (PTH), creatinine, calcium and phosphate blood levels were repeatedly measured in 5 patients with acute renal failure. 1 patient developed hypercalcemia during the recovery phase of the illness. PTH was elevated in all cases before starting hemodialysis treatment and returned to normal when renal function recovered. Calcium and PTH were inversely correlated in 3 patients including the patient with transient hypercalcemia. These data show that parathyroid function in acute renal failure is closely related to changes in renal function and the hypercalcemia, when occurring, is not necessarily due to parathyroid hyperactivity.


Hereditary lecithin cholesterol acyltransferase deficiency. Report of a new family with two afflicted sisters. One case of lecithin cholesterol acyltransferase (LCAT) deficiency is discovered by renal biopsy. Through the study of a French family, native to Brittany, one sister is found to be carrier of the trait. This finding suggests that the gene defect hitherto reported from Scandinavia is not restricted to this region. The patient shows typical signs of the disease, corneal opacities, anemia with a hemolytic component and lack of plasma LCAT activity. She has proteinuria, HTA, hematuria, no renal insufficiency. Signs previously unreported were noted: sensorineural hearing loss and platelet environment disorder. Histological abnormalities of two types are found: foam cells and subendothelial deposits, of which the tinctorial characteristics indicate a lipid composition. The lack of glomerular fluorescent staining observed is not in favor of an immune complex nephropathy. The study of this case suggests the determining role of lipid abnormalities in the genesis of anemia and of the vascular depositions in the induction of renal failure encountered in several cases of LCAT deficiency.


Glucose-6-phosphate dehydrogenase in kidneys of lead-poisoned rats and adrenalectomized rats. Glucose-6-phosphate dehydrogenase (G6PDH) activity, assayed biochemically, was significantly increased in kidney homogenates of lead-poisoned rats when compared with controls. Histochemically, G6PDH activity was greatly increased both in the distal tubules and the macula densa, but showed no significant changes in the proximal tubules. Biochemical assay of G6PDH in kidney homogenates of adrenalectomized rats was three times that in control animals. In this condition also, histochemical staining showed G6PDH activity to be increased in both macula densa and distal tubules. This demonstrates an increase in G6PHD in two completely different experimental conditions and suggests that the distal renal tubule in the rat might operate in functional unity with the macula densa.


Renal tubular sodium and water excretion in antibiotic-induced nephrotoxicity. Renal function in antibiotic nephrotoxicity. Clearance techniques were used to evaluate renal tubular sodium and water excretion in 4 patients with antibiotic-induced acute renal failure (ARF). Creatinine clearances and maximal urine flow rates of patients with ARF (22.6 and 5.23 ml/min, respectively) were significantly lower than control values during hypotonic volume expansion (125.5 and 13.71 ml/min, respectively, both p less than 0.01). During the period of maximal hydration, fractional sodium excretion (CNa/Ccr) and maximal urine osmolality (11.4% and 171 mosm/kg H2O, respectively) were increased compared to controls (1.04% and 53 mosm/kg H2O, respectively, both p less than 0.05). The increased CNa/Ccr observed in patients with ARF was consistent with reduced proximal sodium reabsorption as reflected by increased (CH2O + CNa)/Ccr and reduced fractional distal sodium reabsorption as indicated by decreased  CH2O/(CH2O + CNa). The reduction in proximal and distal sodium reabsorption cannot be explained on the basis of an osmotic effect of urea as fractional clearances of BUN (CBUN/Ccr) were similar in patients with ARF and controls.


[1st hospital admissions and deaths from cerebrovascular diseases in the Warsaw population]. On the basis of an analysis of documentation from hospital the annual rate of first admissions for cerebrovascular disturbances was assessed in the population of the city district of Warsaw. The total rate was 123/100 000, including 22 for subarachnoid and cerebral haemorrhage. The rate was highest in the age group over 70 years (1162/100 000). The annual average death rate caused by these disease was 94/100 000. In the first month after admission 41% of patients died (including 77% with the diagnosis of cerebral haemorrhage) and during 6 months 52% died. The diagnosis of cerebrovascular disturbances was mentioned in only about 75% of death certificates of patients dying within one month from admission. In the Wrasaw population the annual rate of first admission and average annual death rate were on the average 1.5 times higher than the mean values for the whole country. Difficulties with the use of medical documentation for epidemiological studies are discussed.


[Arachnoid cyst of the cauda equina: a contribution to the etiology of coccygodynia]. The authors report a case of arachnoid cyst of cauda equina with severe chronic coccygodynia. The value of radioculography in the diagnosis of this condition is pointed out. Resection of the cyst abolished coccygodynia completely and permanently. No case of arachnoid cyst causing coccygodynia has been found in the available literature.


[Electromyographic studies in a rare case of periodic muscular rigidity with spontaneous rest activity]. The results of EMG investigations with pharmacological and functional tests are reported in a rare case of periodic muscular rigidity with spontaneous activity at rest mainly in shouldergirdle muscle. The aetiology of the syndrome is unknown.


[Somatic types of patients with multiple sclerosis]. In 129 patients with multiple sclerosis (61 men and 68 women) anthropometric measurements were taken and 5 somatic indices calculated. The types of somatic constitution and the so-called somatic composition were determined using the method of reference points of Wanke. The results were compared with those in a control group representing the Polish population and with a group of patients with psoriasis. The usual male patient with multiple sclerosis was of athletic-pyknic constitution with very strongly expressed (in relation to the control group) features of dysplastic type (A). The typical male individual from the control group had pyknic-athletic constitution. The typical female patient with multiple sclerosis had leptosomic-dysplastic constitution, while the typical control female was leptosomic-pyknic. Male and female patients with multiple sclerosis had the hyperbrachycephalic skull configuration while the control group was branchycephalic. There was no difference between controls and patients with multiple sclerosis with regard to blood groups A1, A2, B, O and Rh.


[Activity of various lysosomal hydrolases in peripheral blood granulocytes in patients with multiple sclerosis]. The activity of acid phosphatase, acid and neutral proteases in the serum, white blood cells and lysosomal granules and in the supernatant of the lysosomal fraction of peripheral blood granulocytes was determined in 33 patients with multiple sclerosis. The control group included 20 clinically unaffected subjects. A rise in the activity of neutral proteases in white blood cells was demonstrated at the time of multiple sclerosis exacerbations and a fall in the activity of these enzymes in lysosomal granules with its simultaneous rise in the supernatant of the lysosomal fraction of granulocytes was observed.


[Preliminary assessment of the effectiveness of L-dopa with prolonged action (Medidopa retard) as compared to conventional L-dopa preparation]. The therapeutic effectiveness of a L-DOPA preparation of sustained action was established in 9 patients with parkinsonism on the basis of a neurological parkinsonism scale and Northwestern University Disability Scale. The investigations were carried out by the method of cross test with conventional L-DOPA preparation (Larodopa). In these investigations no higher effectiveness of the retard form was shown. Side effects during administration of the retard form were more frequent and more intense than during administration of the conventional drug.


[Levels of ammonia in patients with stroke]. The authors determined peripheral-blood ammonia level in patients with cerebral strokes. The determinations were done by the method of Konitzer et al. on the 1st, 3rd and 7th days of the disease. The results of determinations were subjected to statistical analysis with the t test of Student. It was found that the mean serum ammonia level in patients with cerebral stroke on the 1st day of the disease was higher than in the control group. The difference was statistically significant. The level of ammonia in the blood of patients with cerebral haemorrhage was significantly higher on the 1st day of the disease than in patients with encephalomalacia. The difference was statistically significant with error probability of 0.05.


[Varicosity of the lower part of the vertebral canal]. In a group of 300 patients with the diagnosis of lumbar nucleus pulposus prolapse treated surgically the authors found in 4 cases not the expected prolapse but varicose blood vessels surrounding the nerve roots and immobilizing them in adhesions. In another 5 patients vertebral canal varicosities were associated with nucleus pulposus prolapse. None of these cases of vertebral canal varicosities had been diagnosed before operation since the clinical state of these patients was not significantly different from the state of patients with nucleus prolapse and radiculography failed to supply sufficient diagnostic data or suggested presence of small prolapse. An auxiliary diagnostic finding in cases of vertebral canal varices may be frequent association of spinal anomalies (in 3/4 of the observed cases) and obesity (in 2/3 of cases). Surgical decompression of vertebral canal and liberation of roots from adhesions without excision or ligation of varicose veins gave good therapeutic results.


[Lumbosacral tumors of the vertebral canal simulating prolapse of the nucleus pulposus]. The authors analyzed the signs and clinical data from the preoperative period in 39 patients with tumours of the conus terminalis and cauda equina. Most patients had been treated for a long time for lumbar discopathy with sciatic pains. Most symptoms and neurological signs were in many cases suggestive rather of lumbar disc prolapse than spinal tumour. Radiological examinations of the spine failed in a overwhelming majority of cases to provide clues for correct diagnosis, only the type of tendon jerks loss, results of Queckenstedt's test and protein level in the cerebrospinal fluid suggested spinal tumor as a cause of the disease. Contract radiological examination of the vertebral canal gave definite answer in all cases.


[Combined treatment of intravenous immunoglobulin and antibiotics for severe postoperative meningitis (author's transl)]. Incidence of postoperative meningitis by gram-negative bacilli infection, so called "opportunistic infections", has recently increased in the neurosurgical field. The opportunistic infection is caused by suppression of the host's immunity and consequently limitation of the host defense mechanisms. Based on the results obtained from 4 cases of postoperative severe meningitis presented here, the authors concluded as follows: 1) Special care must be taken for intrathecal injection of antibiotics because of causing paralytic ileus, convulsion and paraparesis of the lower limbs. 2) The combined use of intravenous immunoglobulin (Gamma-Venin) and antibiotics produced potentiated effects. Accordingly, the amplification of the host's immunity is of major importance for the treatment of severe meningitis. 3) Using immunoadherence hemagglutination test of patient's CSF and the serum, it is considerably easier to determine whether or not to withdraw antibiotics.


[Familial gliomas].

[Familial gliomas]. As a contribution to the present discussion on genetic determination of gliomas two cases of gliomas in father and son are reported. Familial occurrence of gliomas suggests a possible role of genetic factors in the development of intracranial gliomas.


[Blood-brain barrier disorders and changes in intracranial pressure in cats with surgical brain wound following sudded brain decompression]. The condition of the blood-brain barrier and changes in intracranial pressure were studied in cats with surgical brain wounds and after sudded decompression. It was found that evident disturbances of the barrier function appeared only 48 hours after removal of brain tissue and were affecting mainly the white matter. Sudden decompression led to disturbances of blood-brain function when it was proceded by at least 2 hours of epidural compression. Changes developed in the cortex and basal ganglia. After 48 hours from tissue removal a significant rise of pressure was observed in the cisterna magna to a mean value of 11.5 mm Hg. Decompression caused a fall of cerebrospinal pressure, often below zero, and this was followed by a rise to values significantly exceeding the level before decompression.


[Supraventricular subarachnoid cysts].

[Supraventricular subarachnoid cysts]. Five patients with supraventricular subarachnoid cysts are described. In most patients epilepsy was the presenting sign. Cerebral angiography showed in all cases only an avascular lesion and and the correct diagnosis was established only during the operation. In only one case recurrent filling of the cyst was observed.


[Case of chronic cerebrospinal memningitis with lymphocytic-monocytic reaction]. A case of cerebrospinal meningitis was observed with persistence of cerebrospinal fluid changes during 24 months of follow up. The changes had a lymphocytic-monocytic character with pleocytosis ranging from 49 to 1500/mm3. The course of the disease was mild with meningeal signs occurring only periodically. Despite very long duration of the inflammatory process no signs of nervous system damage were observed and the general condition of the patient was good. The investigations performed failed to explain the aetiology of the disease.


[Intracranial surgery under hemodialysis (author's transl)]. A case of pituitary adenoma operated on under hemodialysis was reported. The patient was a 43-year-old male who had been obliged to hemodialysis since April 1975 because of chronic renal failure. He was admitted in February 21, 1976 because of progressive visual symptoms. Neurological examination revealed decreased visual acuity and bitemporal hemianopsia. Radiology showed enlarged sella turcica and calcified mass in the suprasellar region. Laboratory examination disclosed severe anemia and the operation was postponed until the hematocrit improved up to 39% by blood transfusion. The operation was performed in March 17, 1976 under conventional GOF anesthesia. The tumor was covered by a calcified capsule and after nibbling off the calcified covering, the tumor was removed. Postoperative course was uneventful. Peritoneal dialysis was continued for three days immediately after operation. Urinary volume of the patient increased up to 600 ml per day after operation, probably due to the postoperative diabetes insipidus. The diabetes insipidus was rather favorable sequela in this case because the patient was released from the severe restriction of water intake.


[Case of epidural tuberculosis of the vertebral canal]. A patient aged 16 years was admitted to a neurological departement for flaccid paresis of lower extremities. Contrast radiological examination demonstrated obliteration of the vertebral canal between Th12 and L3, without coexistent changes in the bone parts of the vertebral column on plain films. During the operation a tumour situated epidurally and compressing the dural sac posteriorly and laterally from both sides at the level Th12--L3 was removed. Histological examination of the excised tumour showed presence of a chronic inflammatory process with presence of granulation tissue of probably tuberculous character. The tuberculous aetiology of the disease was confirmed by development of cold abscess in the postoperative scar 2 months after the operation. Neurological, neurosurgical and antituberculous treatment led to complete cure with return of normal neurosurgical status. The patient has been followed up for 5 years.


[Unilateral exophthalmos caused by organized hematoma of the orbit--report of a case (author's transl)]. The authors reported a case with unilateral proptosis of over ten years' duration due to organized hematoma of the orbit. It has generally been accepted that any given hemorrhage within the orbit can be resolved in a relatively short period of time. Persistent intraorbital hematoma, therefore, in the form of organized hematoma is very unusual in incidence and has been reported very few in the literature. Our patient presented himself with a ten-and-several-year history of unilateral exophthalmos, limited ocular movement and decreased visual acuity on the involved side. There was no specific symptom when compared with the other intraorbital tumors. Total resection of the tumor was performed through transcranial frontozygomatic approach. Histopathologic examination revealed evidence of organized hematoma without definite sources of bleeding such as microangioma, microaneurysm or arteriovenous malformation. Retrospective review of history failed to uncover episodes of hemorrhagic tendency or direct trauma to the head or the orbit. Subsequently a diagnosis of spontaneous organized hematoma was made. Great emphasis was laid on the fact that CT-scan was one of the most useful diagnostic tools. Our surgical approach was introduced and discussed.


[Atypical case of the Ramsay-Hunt syndrome]. The authors report a case of Ramsay-Hunt syndrome during cervical zoster in the C2--C4 area. The case reserves attention in view of the fact that facial nerve paralysis and paralysis of both parts of the right acoustic nerve occurred as a second exacerbation of the disease 16 days after the onset. Permanent hearing impairment in the right ear after regression of facial nerve paralysis and paralysis of the vestibular part of the acoustic nerve were also exceptionally rare signs.


Amipaque myelography without late adhesive arachnoid changes. Sixty-three myelographies were performed with Amipaque. Remyelography after an interval of longer than 2 months showed that in one case there was progression of an arachnoiditis which had already been present during the first Amipaque study. In one other case there were minimal, unilateral nerve root changes caused by an intervening operation. Altogether 269 remyelographies without secondary late reactions are registered. Two cases of increased arachnoid changes from a previous myelography with another contrast medium hardly can be due to Amipaque.