Occlusion of the intradural vertebrobasilar artery. The diagnosis of occlusion of the intradural vertebrobasilar artery (OIDVBA) was made by means of cerebral angiography in 22 patients. The clinical presentation, course and followup were studied in conjunction with the angiographic findings in each case and the following conclusions made. OIDVBA is not rare. It occurs one-fourth as often as occlusion of the carotid artery. The correct diagnosis is not made clinically before angiography in the majority of patients. Complete visualization of the neck and intracranial vasculature is necessary to document the occlusion. Atherosclerotic thrombosis is the most common type of occlusive lesion. The most common predisposing factors are atherosclerosis, hypertensive cardiovascular disease, diabetes mellitus, and developmental vertebrobasilar hypoplasia. Most patients with occlusion are in the 7th and 8th decades of life and transient attacks of vertebrobasilar ischemia precede the occlusion in one-half of the cases. Emboli usually lodge in the terminal portion of the basilar artery whereas thrombotic occlusions tend not to be located in a characteristic segment. A majority of patients diagnosed angiographically survive their OIDVBA, but most distal occlusions result in death, often following several weeks of coma. In the surviving majority, disturbance of gait, impairment of vision, and symptoms of transient vertebrobasilar ischemia are the most common sequelae.


Myelography in Guillain-Barré syndrome (acute inflammatory polyradiculoneuropathy). The Guillain-Barré syndrome has been studied by lumbar myelography with watersoluble contrast media in seven cases. Abnormalities, which consisted of widening of the nerve roots and obliteration of the root sleeves, were found in three of them. It is possible that myelography accentuated the symptoms in one case while the rest tolerated the examination well.


CT scanning for the diagnosis of the cerebrellar and spinal lesions of von Hippel-Lindau's disease. The CT features of cerebellar lesions with von Hippel-Lindau's disease are analyzed. The use of CT scanning for associated spinal hemangioblastomas is discussed in the light of a case with a low cervical lesion. The role of computed tomography in the neuroradiological investigations is discussed.


The diagnostic value of CT for radiotherapy of cerebral tumors. The paper deals with CT followup studies on 73 patients with cerebral tumors who received radiotherapy. The value of CT for the indication of radiotherapy, for followup therapy and for the demonstration of therapeutic success are discussed. Since the cerebral tumors become visualized by means of CT in their entire extent and can be differentiated from perifocal edema, the question arises whether radiotherapy should consist of higher doses in the future. It is also suggested that the "clinical malignancy" may be used to compare the behavior of cerebral tumors when there is no exact histological classification. The possible histopathological effects of radiotherapy (edema, necrosis) and their demonstration by CT are discussed.


The effect of position of patient on the passage of metrizamide (Amipaque), meglumine locarmate (Dimer X) and ioserinate (Myelografin) into the blood after lumbar myelography. Lumbar myelography was carried out with the contrast media Amipaque, Dimer X and Myelografin in 10 patients each. Five of the patients treated with each contrast medium were kept in a sitting position after the examination, the others lay flat. Blood levels and excretion were measured up to 24 h. The results are interpreted as follows: 1. After lumbar injection of the contrast media there is a short phase of distribution in the subarachnoid space (lag time) and they then are transferred into the blood with a half-life of 3.9 +/- 2.4 h. The transport from the CSF is almost completed approximately after 24 h. The velocity of transport varies greatly between the individual patients. Watersoluble contrast media presumably flow passively with the CSF through the arachnoid villi into the venous blood. 2. The horizontal position of the patient reduces the lag time until the beginning of the actual transfer of the contrast medium. 3. The transfer of Dimer X begins somewhat later compared with Amipaque and Myelografin.


Role of computed tomography in the postoperative evaluation of infantile hydrocephalus. The value of CT for the diagnosis and followup of infantile hydrocephalus is discussed. The ventricular volume, subependymal periventricular hypodensity, sbudural hygroma or hematoma, position of catheter in the ventricles, ependymal inflammation and other occasional findings are considered.


Hypoglossal paralysis due to compression by a tortuous internal carotid artery in the neck. Severe hemiatrophy of the right half of the tongue in a 22 year old patient was demonstrated to be due to compression of the hypoglossal nerve by a tortuous internal carotid artery in the neck. The nerve was trapped between an abnormal loop of the internal carotid artery and the sternocleidomastoid branch of the occipital artery. Although impairment of cranial nerve function with cases of tortuous and dilated vessels has been reported frequently, twelfth nerve palsy has never been demonstrated before.


Tentorial arteries arising from the external carotid artery. Two cases illustrating an unusual connexion between the middle meningeal artery and tentorial branches, normally arising from the siphon, are reported. The significance of this anastomosis is discussed.


Bilateral aneurysms of the cervical internal carotid arteries. An unusual case of bilateral aneurysms of the internal cervical carotid arteries in a 38 year old man with right hemiplegia and aphasia is described.


[Current value of diagnostic laparatomy with splenectomy in Hodgkin's disease (critical evaluation of 188 cases)]. Diagnostic laparotomy with splenectomy was performed in 188 patients with Hodgkin's disease. Preoperative assessment by means of conventional methods of examination was confirmed in 118 cases (62.9%) and had to be modified in the remainder. Post-operative complications were observed in 12 cases (6.5%). One subject died of myocardial infarct. It is felt that the procedure is useful in establishing the stage of the disease and in planning treatment. It must not be applied indiscriminately, however, and is primarily useful insofar as it results in a modification of the therapeutic programme.


[4,000 surgical operations for calculosis of the biliary tract. II. Bilio-digestive shunts: indications and results]. Personal experience with biliodigestive derivations in calculosis of the principal bile way is reported. The operating technique is presented and indications and results discussed. It is concluded that biliodigestive anastomosis must be carried out with an appropriate technique and in the presence of particular bile duct lesions, primarily choledochic ectasia.


[Use of physical therapy in the prevention and treatment of decubitus ulcer]. The causes of bedsores and their complications are described, along with the preventive and surgical, medical and physiotherapeutic measures used in their treatment. Personal experience with an association of drugs and physiotherapy in 21 cases is reported and the modalities employed are described in detail. The advantages offered by the association in the way of simplicity and satisfacory results are explained.


[Long-term treatment of arterial hypertension with propranolol. Combination with diuretics and dihydrazinophthalazine]. The effect of long-term treatment of hypertension with propranolol, alone or in combination with hydrochlorothiazide and/or dihydralazine, was investigated in 93 patients with various types of hypertension. Normalisation of the B. P. was obtained within two-four weeks of treatment with propranolol alone in all cases with mild hypertension, and in 77% and 44% of moderate and severe forms respectively. These percentages were even higher when propranolol was employed with hydrochlorothiazide and/or dihydralazine. The rationale of this combination and the mechanism of the hypotensive effect of propranolol are discussed. The drug was well tolerated; major side effects did not occur.


[Nodule of ectopic hepatic parenchyma in the wall of the gallbladder]. A case of ectopic hepatic parenchyma in the wall of the gall bladder, independent of the remaining hepatic parenchyma, is reported. The node presented fairly advanced differentiation features in grossly lobular structures and biliary architecture.


[Scroto-perineal gas gangrene. Etiopathogenetic aspects and therapeutic prospects]. A case of scrotoperineal gas gangrene is presented. This condition is discussed as an expression of anaerobic infection and both old and new views as to its aetiopathogenesis are described. Treatment has been potentiated by the introduction of clindamycin and other particularly active drugs. It is felt that cultures should be directed to the detection of both anaerobic and aerobic germs, since the former have shown a recent tendency to reappear as causes of infection.


[Treatment of hepatic artery aneurysms]. A case of aneurysm of the hepatic artery associated with aneurysm of the abdominal artery in fissuration is discussed. The indications, possibilities and limits of exclusion or removal of the aneurysm without reconstructing the main artery axis in the treatment of cases involving the hepatic artery are examined in the hight of the reported case and modern views concerning the physiopathology of the hepatic circulation.


[Neurinosarcoma of Vater's papilla. Apropos of a case]. Neurinosarcoma of Vater's ampulla is rarely observed. A case is presented in which the tumour did not occlude the ampulla and was thus detected intraoperatively. The head of the duodenum and the pancreas were ablated. Histological examination showed a fasciculated neoformation, in which the individual fasciculi ran parallel to or crossed each other. The nuclei displayed distinct atypical pictures. The little cytoplasm there was could only be clearly made out in areas involved in oedematous dissociation.


[Morgagni-Larrey hernia (2 personal cases)]. Morgagni-Larrey hernia is a rare diaphragmatic form whose time of onset is almost impossible to determine. Its symptoms, if any, are not easy to interpret. A standing X-ray of the chest is the only way in which its presence may be suspected and diagnosis must be confirmed by the use of contrast media. Abdominal or thoracic surgery is mandatory, even in symptom-free cases. The choice of route will be determined by the facts of the case and the patient's age. The clinical picture observed in two personal cases and their treatment are described.


[Use of lactulose in the treatment of chronic renal failure]. The effectiveness and tolerance of lactulose were studied in 15 patients suffereing from terminal chronic renal insufficiency under conservative treatment with hypoproteic diet. The drug was administered in doses such that 2-4 soft faeces discharges were obtained daily and in most cases led to an increase in the feeling of wellbeing, a reduction in arterial pressure, a reduction in potassiaemia and frequently in azotaemia, with no change in residual renal function.


[The Roux-en-Y jejunal loop in extrahepatic bilio-digestive anastomoses. Technic, indications and early complications in 101 cases]. Personal experience with Roux's Y loop in 101 cases in which bilio-jejunal anastomosis was performed for mechanical icterus of malignant (66 cases) and benign (35 cases) origin is described. It is felt that this operation does not present particular technical difficulties. End-to-end anastomosis is preferable. While bilio-duodenal and bilio-jejunal anastomoses are both sound practice, Roux's Y loop offers greater possibilities of application.


[Echographic possibilities in surgical lesions of infancy]. The possibilities of applying ultrasound diagnosis techniques to the morphological and structural study of the soft tissues in infant surgical pathology have been examined. The technique's objective features mean that it is reliable in between 98 and 100% of cases of solid and cystic lesion identification and differentiation. In the further differentiation of solid lesions, such diagnostic accuracy may be limited by the operator's subjective experience and, objectively, by the dimensions of the lesions. Possibilities for application include thyroid, thoracic and abdominal pathology in preoperative diagnosis, postoperative control and in the monitoring of antineoplastic chemo- and radiotherapy. The peculiar features of the technique, i.e. its harmlessness and thus easy repeatibility, atraumaticity, and time and cost economy, are considered and it is concluded that it can be usefully employed on an extensive basis in the various field of infant surgical pathology, in view of the fact that other investigations always present some degree of risk and danger.


[Pulmonary bone-marrow embolism. Analysis of 53 cases]. The medical record and the lung sections were reviewed in 53 autoptic cases with pulmonary bone marrow embolism. In 31 cases the emboli could be ascribed to external cardiac massage, in one case to accident; in the other cases a definite aetiologic factor was lacking. The number of the emboli was largely variable from one section to another and sometimes very high (up to 16). The pulmonary bone marrow embolism has probably a clinical significance particularly when the underlying condition is severe.


[Epidemiological study on the dissemination of healthy carriers of Staphylococcus aureus in the hospital environment]. A study was made of the kitchen staff of the M. Malpighi Hospital of Bologna to identify healthy carriers of staphylococcus aureus. It was isolated in 19 out of 104 people, a frequency of 18.2%. Sensitivity tests to the commonest antibiotics and chemotherapeutic drugs carried out on the isolated strains of staphylococcus aureus showed average percentages fluctuating between 31.5% for penicillin to 88.5% for cephalosporin.


[Echography in the diagnosis of aneurysms of the abdominal aorta]. The principles of echography and its technique are briefly explanded, and 8 personal cases examined for suspected aneurysm of the abdominal aorta are presented. Correct and accurate diagnosis was obtained in cases. In 1 case, aortography was also performed, though its findings were less clear. It is felt that the applications of echography can usefully be extended to the screening, diagnosis and control of this form.


[Direct radioimmunological determination of plasma CEA in 1704 patients]. An original technique for the direct radioimmunological measurement of plasma CEA has been prepared. Compared to the other in use, this has the advantage of a very low incidence of false positivity. 1704 patients make up the series: the percentage of positivity in 247 suffering from gastroenteric adenocarcinoma was 66.8%, in 60 with lung cancer 30%, in 243 with malignant tumours in various sites 7.4%, in 199 with chronic liver diseases 29.6% while in 598 cases of other non-neoplastic diseases it was only 2.5%. 212 patients who underwent radical surgery for gastroenteric adenocarcinoma were also followed up and the test provided early diagnosis of the clinical re-onset of the neoplastic lesion. It is considered that plasma CEA measurement represents a useful aid to the clinician althouth it cannot be employed at present to screen gastroenteric adenocarcinomas.


[Pheochromocytoma with hypotension. Study of an unusual clinical case]. A case of pheochromocytoma marked by clinostatic hypotensive crises and otherwise normal or low blood pressure is described. The aetiopathogenetic explanations put forward by other workers are cited and a deductive reconstruction is made of the clinical course.


[Prepyloric annular diaphragm in the adult]. A case of prepyloric myo-mucosal annular diaphragm in a 47-yr-old woman with a 4-month history of subocclusion is presented. A "distal hourglass" gastric deformity was present, along with gastritis and marked spasm. The case is included in a survey of the recent literature and classed as a transitional form lying between ring diaphragm and annular hypoplasic stenosis of the antrum.


The workinghman's diet. II. Effect of weight reduction in obese patients with hypertension, diabetes, hyperuricemia and hyperlipidemia. Weight reduction is almost always successful in cases of essential hypertension if and when the weight loss is accompanied by a drastic sodium reduction. (2) Weight normalization is of remarkable help in complete reversal of abnormal glucose tolerance, decrease in insulin requirement in manifest diabetes mellitus, and - in many patients with mild diabetes - discontinuation of oral hypoglycemic agents. (3) Weight loss will occasionally relieve gout patients of their symptoms. The majority of hyperuricemic patients will benefit with a lowering of serum uric acid levels. (4) An unresolved issue is the influence of weight reduction on the cholesterol metabolism - short- and long-term results are by no means predictable. Whereas the triglycerides in obese patients almost always return to lower serum concentrations, and with them the hyperlipoproteinemias of type IIB, III and IV, the type IIA is only rarely seen in association with obesity. Therefore, information on this lipid abnormality is very limited regarding the effect of weight loss.


Plasma placental lactogen in pregnancy.

Plasma placental lactogen in pregnancy. Plasma placental lactogen (HPL) and urinary oestrogen levels were investigated in pregnant women belonging to low and high socio-economic groups. Plasma HPL levels increased progressively with increasing gestation in women of both the socio-economic groups. The mean values in the two groups were not statistically different at any period of gestation. No correlation was observed between the birth weight of the infant and the maternal plasma placental lactogen levels at term. A positive correlation was observed between urinary oestrogen excretion and plasma HPL concentration.


Effect of dietary wheat gluten in lipid metabolism in growing rats. The effect of dietary wheat gluten on liver and spleen lipogenesis in rats was studied in vitro and in vivo.  Weanling rats were fed for 2 or 3 weeks an experimental diet containing wheat gluten as the only protein source and compared to other rats fed a casein control diet. Rats fed gluten showed enhanced in vitro lipogenesis as measured by conversion of (1(-14) C)-acetate into liver and spleen lipids. These results indicated that the gluten-fed rats had a significantly higher hepatic capacity than the control rats to synthesize all lipid classes. On the other hand, the in vivo study of hepatic lipogenesis showed smaller differences between the group fed gluten and that fed casein. This suggests that the accumulation of lipids in fatty livers of gluten-fed rats is mostly due to increased rate of biosynthesis and not a result of impairment in the lipids' transport system. In the spleens of the gluten-fed groups, the enhanced in vitro lipogenesis was also found in vivo, indicating that accumulation of lipids in fatty spleens may be a result of biosynthesis only, with no other effects that can take place in vivo.


Substrate specificity of enzymes catalyzing the biosynthesis of ionic alkoxylipids from alcohols. An equimolar mixture of homologous saturated alcohols (13:0, 15:0, 17:0, 19:0) and an equimolar mixture of vinylogous alcohols (19:0, 19:1, 19:2) were fed to two groups of rats. All of the odd-numbered alcohols were incorporated into the ionic alkoxylipids of the rats' small intestine. Pronounced quantitative differences in the distribution of the various odd-numbered alkyl and alk-1-enyl moieties of choline phosphoglycerides and ethanolamine phosphoglycerides gave evidence to differences in the specificity of the enzyme system catalyzing the biosynthesis of alkoxylipids from long-chain alcohols.


Effect of a dietary rapeseed protein concentrate on the contents of alpha-tocopherol and zinc in serum, liver and tibia of rats. In order to study the effects of a dietary rapeseed protein concentrate (RPC) on tocopherol and zinc levels in serum, liver and tibia, female rats were fed a tocopherol-reduced diet for a 3-week period and were then transferred to either of a RPC diet or a control diet containing casein at 20% levels of protein. No unfavourable effects on food intakes or weight gains were recorded. The serum zinc content of the RPC group was slightly reduced and the serum tocopherol values significantly lowered in comparison to the control group. Zinc and tocopherol contents of the livers were not changed. Precipitation of sera by dextran sulphate in the presence of calcium ions indicated a reduced level of low density lipoproteins in rats fed RPC diet. In a second experiment, male and female rats were fed diets containing 10% of protein derived either from RPC or casein. Low zinc contents of tibiae indicated a low biological availability of the zinc present in the RPC diet. Rats on RPC diet also showed reduced levels of tocopherol in serum. Despite a lowered zinc status in rats fed RPC diet there was no reduction in food intake, weight gain or growth of tibia in these groups.


Development of digestive enzymes in the piglet from birth to 8 weeks. I. Pancreas and pancreatic enzymes. The development of pancreatic tissue (fresh weight, total proteins, RNA and DNA) and of the level of pancreatic enzymes (trypsin, chymotrypsin, lipase and amylase) of the piglet has been followed from birth to the age of 8 weeks in 10 animals at each of 7 stages. There was an increase with age and body weight of the total fresh weight of the exocrine pancreas. From birth until 4 weeks the development of the pancreatic gland was due to hyperplasia; from the 4th week till the 8th week of age, it was due both to hyperplasia and hypertrophy. There was a specific period, at the age of 3--4 weeks, from which total enzymatic activities markedly increased. Furthermore, from the 4th week of age there was a rise in the intake of total dietary proteins, fat and carbohydrates, due to the intake of solid food.


Polyglycolic acid sutures in cataract and extraocular muscle surgery. Dexon was used as suture material in 26 cases of cataract surgery and in 46 cases of extraocular muscle surgery. It is better than chromic catgut in muscle surgery, since it produces less conjunctival irritation and no granulomas. In cataract surgery, on the contrary, it causes a pronounced irritation of the anterior segment and rather ofter a severe uveitis, probably because the sutures are external.


Cytology of the superficial keratinised cells in experimental keratitis sicca. Keratoconjunctivitis sicca was produced in 2 rabbits by the surgical extirpation of the tear-secreting glands and the nictitating membrane in one eye. Flat mounts of the superficial corneal epithelium were prepared by the in vivo replica technique. Histomorphological and cytological studies of the keratinised cells showed the irregularly arranged, crumpled and piled-up cells. The cells contained coarse granular and fibrillar material in the cytoplasm and large granules in the nuclei. The reaction for -S-S- bridges was positive in these cells. They showed birefringence under polarisation microscopy but possessed some ribonucleoproteins.


[Acute ischemia of the optic nerve (with a color plate)]. Casuistic report of a severe bilateral ischaemia of the optic nerve (vascular optic atrophy, right eye; ischaemic oedema of the disc, left eye) of a 63-year-old woman, suffering from ulcera cruris. Tumor cerebri (for example, a classical Foster Kennedy syndrome) had to be excluded because the result of a computer tomography of the brain was 'Questionable pathologic process in the frontal lobe'. The following neurologic and neuroradiologic investigations were negative. Patient's age, extreme rise of erythrocyte sedimentation rate, dysproteinaemia, raised serum alkaline phosphatase level and aspect of the disease justified the diagnosis 'giant-cell arteritis', notwithstanding the negative histopathologic result of a biopsy of the temporal artery and regular ophthalmodynamography. Therapy was internal application of prednisolone, Cosaldon retard (later Card-Cosaldon). There was a rise of vision of the left eye to 0.4.


Diabetic retinopathy in acromegaly.

Diabetic retinopathy in acromegaly. A study was made of diabetic retinopathy in acromegaly. 10 of 15 patients with acromegaly had diabetes mellitus, and 3 of the 10 showed diabetic retinopathy. 2 of them had a diabetic family history. 1 patient with a diabetic family history had retinopathy of state IIIa in Scott's classification, and the other 2 showed a few microaneurysms and/or punctate hemorrhages in the macula. Diabetes mellitus and diabetic retinopathy in acromegaly showed no correlation with the duration of acromegaly and diabetes mellitus, age, or growth hormone level. No diabetic cataract was found in the present series. It was concluded that diabetic retinopathy due to secondary diabetes mellitus is usually slight or moderate. Diabetes mellitus with severe retinopathy is probably primary diabetes due to a genetic defect, and secondary diabetes may be different in nature from the primary disease.


Monolateral vitelline dystrophy with unusual EOG findings. An unusual case of monolateral vitelline dystrophy is reported. The EOG, which at first was normal in both eyes, successively became abnormal in the affected eye and subnormal in the apparently healthy eye. The value and the actual limits of the EOG are discussed to allow a better understanding of the origin and pathogenesis of the disease.


Congenital malformations of the retinal vessels with primary optic nerve involvement. 3 cases with various degrees of racemose hemangiomata of the retinal vessels are described, in whom the optic nerve showed primary involvement. The vascular malformation ranged from multiple arteriovenous shunts (2 cases) to marked vascular tortuosity, and the optic nerve showed involvement that varied from severe hypoplasia with blindness, to normal appearance with campimetric enlargement of the blind spot. The combined malformation must be placed at the 110-mm embryonic stage, and the tissue primarily involved is the vascular tree branching from the developing central retinal artery at the end of the 4th month. The vascular anomaly, in turn, causes underdevelopment of optic nerve tissue and involvement of the bony orbit.


[Irisangiography of rubeosis iridis].

[Irisangiography of rubeosis iridis]. In 66 patients with a rubeosis iridis due to diabetes mellitus (25), old central retinal vein occlusion (22), long-standing secondary angle-closure glaucoma (6), total old retinal detachment (3) and chronic uveitis (10), iris angiography was performed. Typical angiographical findings were found in some of the cases. One can differentiate the different modes of formation of the new vessels; angiographically, rubeosis iridis is never a congestion of preexisting vessels but rather an active vascular proliferation which is always permeable to fluorescein.


The extracapsular cataract extraction without phacoemulsification. The advantage of a planned extracapsular cataract extraction is that the intact posterior capsule holds the vitreous face in a more physiologic position. The extracapsular method has been improved by newer techniques and a good result has been made more certain by the following: a large microscopically controlled capsulectomy with the irrigating cystotome, aspiration of the cortex while the wound is secured with sutures, and the use of the irrigating sand-blasted cannula when indicated. The indications for the extracapsular extraction have increased because there is a greater certainty of obtaining a clear pupil with less change of secondary inflamation. These indications and the newer technique are discussed in the body of the paper.


Intraocular lenses--current status.

Intraocular lenses--current status. An attempt is made to depolarize current positions regarding intraocular implant lens surgery by presenting a reasonable list of advantages and disadvantages of the procedure. A current position on this controversial subject is presented and is based on currently available knowledge. Although this is a personal view, it is hoped that a middle ground can be created which would be acceptable to advocates and opponents of lens implant surgery.


Prolonged-wear contact lenses in aphakia. While prolonged wear of contact lenses is possible for the aphakic patient, careful consideration must be given to patient selection and to the potential complications of such use. Currently available lenses are far from ideal and, if used at all, must be carefully monitored. The newer lenses, specifically designed for extended wear, more closely fit our needs. Several manufacturers are testing their devices under strict FDA supervision. FDA guidelines dictate a minimum of two years follow-up before a determination will be made as to which lenses are safe and effective enough for prolonged wear in aphakic eyes.


Effects of pain-attenuating brain stimulation and morphine on electrical activity in the raphe nuclei of the awake rat. Evoked potential and multiple unit responses to noxious shock and pinch as well as to innocuous air puffs were recorded in the dorsal raphe, median raphe and raphe magnus nuclei of awake rats. Concurrent measurements of various behavioral responses to noxious stimuli were also made. Electrical stimulation of midbrain central gray and of medial thalamus, as well as systemic administration of morphine, greatly diminished all behavioral and electrophysiological responses to noxious stimuli without reliably affecting responses to air puffs. At the same time that brain stimulation and morphine attenuated nociceptive responses, a significant elevation was seen in the spontaneous multiple unit activity of these brain areas, particularly nucleus raphe magnus. In another group of animals, a comparison was made of the analgesic effectiveness of stimulation sites in the bulbar raphe (including raphe magnus) and sites dorsal or lateral to this region. More consistently potent effects were obtained from  the raphe placements. These findings point to the importance of the bulbar raphe in mechanisms of analgesia. It is suggested that brain stem stimulation and morphine administration activate descending controls of raphe origin which selectively inhibit nociceptive elements in the spinal cord.


Noxious thermal input from the rat tail: modulation by descending inhibitory influences. In anaesthetized rats, single fibres have been dissected from the tail nerves. Fibres were found which became excited when the temperature of water surrounding the tail was raised above 40 degrees C. Firing rate increased with stepwise increases in temperature, showing first a transient outburst followed by adaptation to a static level. Corresponding neurones were also found in the dorsal horn at the entry zone of the roots coming from the tail. The cord neurones had a higher threshold temperature of 42.5--45 degrees C. When the spinal cord was reversibly blocked by cooling in the thoracic region, then the threshold of the dorsal horn neurones was reduced to that of the afferent fibres. In addition, at suprathreshold temperatures dorsal horn activity was greater during cord blockade. We conclude that dorsal horn neurones responding to noxious heating are subject to a tonic descending inhibitory control.


Antinociception following lesion-induced hyperemotionality and conditioned fear. Hyperemotionality and antinociception (during hyperemotional states) followed lesioning of the septal area in rats. Both of these behaviors showed parallel decreases with daily handling as well as significant positive correlations between them. Tail-flick latencies were also elevated when fear was conditioned to the environmental cues associated with the tail-flick procedure. Fear-induced antinociception trials. These results are interpreted as demonstrations of the behavioral activation of endogenous antinociceptive mechanisms and are in agreement with the postulates of centrifugal control of nociception of the gate control theory of pain.


Has acupuncture an analgesic effect in the rabbit? We studied the effect of acupuncture stimulation on pain tolerance in rabbits. Painful stimulation was provided by a tungsten lamp focused on the snout. Four acupuncture points were selected: preocular, retroauricular, in the forepaw between the median and ulnar nerves and in the ears. A control series without acupuncture stimulation was also studied. Electrical stimulation was applied bilaterally through the acupuncture needles. A statistical analysis of the reaction time to the noxious stimulus demonstrated that the responses of the acupunctured animals were not significantly different from those of the controls. On the basis of operational behavioral measurements we conclude that the acupuncture procedure--as we did it--did not produce significant changes of pain tolerance in rabbits.


Amniotic fluid infections with intact membranes leading to perinatal death: a prospective study. The pathogenesis of fatal amniotic fluid infections was analyzed in a large prospective study that included more than 1,000 medical, demographic, hereditary, and postmortem variables. The disorder was the most frequent cause of death in the study, with an overall perinatal mortality of 6.17 per 1,000 births. The mortality progressively declined after mid-gestation when antimicrobial activity normally appears in the amniotic fluid. A second peak of the fatal infections, after 37 weeks' gestation, was found mainly in the poor and undernourished. Maternal gestational weight gains were suboptimal and the involved neonates had a pattern of growth retardation characteristic of undernutrition. Maternal pregnancy weight gains were positively correlated with the number of prenatal clinic visits. Mother's race, socioeconomic status, age, short stature, and number of prior unsuccessful pregnancies lost their positive association with the fatal infections when mothers made more than nine clinic visits.


Steady state serum digoxin concentration in relation to digitalis toxicity in neonates and infants. Steady state serum digoxin concentrations were determined in 34 neonates and infants receiving standard maintenance doses of the drug. Digitalis intoxication, diagnosed by ECG criteria, occurred in four of 13 patients with a serum concentration above 2 ng/ml and not in any of 21 subjects with a serum digoxin concentration below this level. This association was found to be significant. It seems that the concept of increased tolerance to digoxin hitherto ascribed to infants is not tenable and that the monitoring of serum digoxin concentration is essential to treatment in this age group.


Electroretinography in neonates treated with phototherapy. Electroretinographic (ERG) studies were performed in 22 normal control newborns and 28 neonates who had had phototherapy during the first few days of life. Mean age at ERG testing was 16.8 +/- 2.9 days in the phototherapy group and 16.4 +/- 3.7 days in the control group. Results of routine funduscopy were normal in both groups. Amplitudes of a and b waves under dark- and light-adapted states were similar in both groups. Phototherapy did not appear to have deleterious effects on photopic and scotopic retinal function in infants whose eyes were adequately shielded.


Effect of phototherapy on nitrogen and electrolyte levels and water balance in jaundiced preterm infants. Twenty-four-hour metabolic balance studies were performed in ten jaundiced preterm infants, five light-treated (phototherapy) and five controls. Each of the light-treated infants was studied twice, once during phototherapy (period I) and once 48 hours after phototherapy (period II). Control infants were similarly studied during the corresponding days. Compared to period II and control infants, during period I the light-treated infants had less weight gain. Intestinal transit time was decreased by 50%. Fecal excretion of nitrogen, sodium, and potassium was increased. Stool water loss was increased twofold to threefold with a decrease in water balance. Unmeasured water loss was increased. These studies underscore the need for careful attention to fluid and caloric supplementation during phototherapy.


Obstetric, neonatal, and psychosocial outcome of pregnant adolescents. Obstetric, neonatal, and psychosocial outcomes were compared for 82 matched adolescents who had been pregnant, been delivered of an infant, and received health care in three sites in Rochester, New York. There were no major differences in obstetric and neonatal outcome of adolescents and their babies according to health site. Differences in outcome were expected in the psychosocial area where a specialized maternity project (Rochester Adolescent Maternity Project [RAMP]) offered more services. On follow-up two years later, school attendance and reliance on full or partial assistance were similar. Repeated pregnancy and postpartum use of contraception favored RAMP.


Sudden death in adolescence.

Sudden death in adolescence. The majority of adolescent deaths are sudden and unexpected; of these, the great majority result from violence. These violent deaths largely accounted for the 25% increase in total adolescent mortality during the 1960s. Yet, sudden death in adolescence is not a distinct entity and receives little study from either pediatricians or pathologists. Some cases of sudden death in adolescence are puzzling and difficult to classify. The pathologist must in each case obtain a detailed history, usually perform a complete autopsy, and obtain consultation when necessary. Only then will each case be adequately studied, and related medical questions and other problems be properly resolved.


Staphylococcus aureus sepsis in children with cancer. Seventy episodes of Staphylococcus aureus sepsis occurring over a nine-year period in pediatric cancer patients are reviewed. Prominent findings at the time of diagnosis included fever, granulocytopenia, and active malignancy. Probable or suspected sites of primary infection were present in 40 episodes (57%). Serious direct complications of staphylococcal sepsis included only three cases of pneumonia and one of myositis. However, second infections by other organisms developed in 16 episodes (24%), resulting in nine nonstaphylococcal infectious deaths during therapy. Endocarditis and osteomyelitis never occurred in this group of patients. The median duration of antistaphylococcal therapy was 15 days.


Group C streptococcal surgical wound infections transmitted by an anorectal and nasal carrier. Streptococcus equisimilis (Lancefield group C), an unusual cause of nosocomial surgical infection, was isolated from two orthopedic postoperative wound infections. Both operations had been performed by the same surgeon within a three-day period. Examination of the surgeon revealed perianal dermatitis from which S. equisimilis was isolated. The organism was also recovered from the surgeon's nose and rectum. The wound infections responded to treatment with penicillin derivatives. The surgeon was successfully treated with topical bacitracin and oral penicillin and vancomycin. This report documents the pathogenicity of the C Streptococcus in postoperative infection and suggests a possible nosocomial source of the organism.


Ataxia and hearing loss secondary to perilymphatic fistula. Ataxia is rarely attributed to lesions of the peripheral vestibular system. In 1973, the first case of ataxia and hearing loss secondary to a labyrinthine fistula was reported. Until now, this syndrome has not been reported in patients under the age of 10 years. A case is presented of a 5-year-old boy with symptoms of ataxia and hearing loss as well as vertigo and tinnitus after head trauma. Three physical findings appear to be most characteristic of patients with perilymphatic fistulas: a positive fistula response, positive positional testing with the involved ear down, and evidence of vestibular ataxia when testing station and gait. The absolute diagnosis of perilymphatic fistula can only be established by exploration of the middle ear space. If a fistula is found, it may be sealed with soft tissue and, if this fails, actual stapedectomy may be required.


Reevaluation of levodopa-propranolol as a test of growth hormone reserve in children. The growth hormone (GH) reserve of 15 short children was evaluated with the levodopa-propranolol test (DPT) and the sequential arginine-insulin test (AIT). Four patients failed to respond to both tests and were classified as hyposomatotropic. In the other 11 children, the mean GH peak response to the DPT was significantly higher than that to the AIT, mainly because five subjects who had a normal response to the DPT failed to respond to the AIT. These children had a generally poor yearly growth increment prior to testing associated in three with an obvious emotional problem, and were found at follow-up to have resumed a normal growth pattern. These data confirm the effectiveness of the DPT as a test of GH reserve. Although hypoglycemia can occur occasionally during test, this procedure is safer and easier to perform than the widely used AIT. Finally, the DPT seems to detect a category of children who have a temporary growth failure and nonresponse to the usual GH tests but who are not hyposomatotropic and consequently do not require human GH.


Normal blood pressure and the evaluation of sustained blood pressure elevation in childhood: the Muscatine study. This study describes the seated blood pressure distributions of 6,622 predominantly white schoolchildren in Muscatine, Iowa. Subjects with seated pressures equal to or greater than the 95th percentile for age and sex or 140 mm Hg systolic or 90 mm Hg diastolic were examined on repeated occasions. Approximately 13% of subjects were found to have blood pressures at these levels when first examined, but less than 1% were found to have persistent blood pressure elevations. Of 41 subjects found to have persistent blood pressure elevations, 23 were obese with relative weights in excess of 120%. Of the 18 lean subjects, 5 had secondary hypertension and 13 were considered to have essential hypertension. Mass screening of school-age children identifies many children with transient elevation of blood pressure and few with fixed high blood pressures. Children's blood pressures should be assessed during their continuing care where pressures can be measured over a period of time to identify those with fixed blood pressure elevations.


HLA antigens in Kawasaki disease.

HLA antigens in Kawasaki disease. Two hundred five patients with Kawasaki disease and 500 normal controls were HLA-typed, using a standard microcytotoxicity test of tissue typing. HLA-BW22 was more common in patients with Kawasaki disease than in normal controls (25.4% instead of 11.8%, corrected P less than .0005). Among subtypes of HLA-BW22 antigen, Kawasaki disease was associated with HLA-BW22J2, which was found specifically in Japanese and not in Caucasians. These facts may suggest that there is a gene controlling the susceptibility to Kawasaki disease and linked with a Japanese-specific HLA antigen.


The effect of open- vs. closed-book testing on performance on a multiple-choice examination in pediatrics. A study was undertaken to test the effect of open- vs. closed-book testing conditions on performance on a graduate-level, multiple-choice examination in pediatrics. A group of practicing pediatricians and a group of medical students took the examination. For the practice group, no significant difference between mean scores was observed, and the correlation between scores under the two testing conditions was high. In the student group, however, the mean score was significantly higher under open-book conditions and the correlation between scores under the two testing conditions was positive but low. The mean score obtained by practitioners was significantly higher than the mean score obtained by students under both testing conditions. The effects of time limit and level of motivation were not explored in the present study.


Conservative surgery for splenic injuries. Splenectomy for traumatic injury of the spleen has recently been questioned, due to the occurrence of postsplenectomy sepsis. During the past year we have operated on six children with splenic injuries and, by utilizing different surgical manuevers, have successfully reserved all or part of the spleen. The following report describes the management of these children and the operative techniques that allow the injured spleen to be salvaged.


Periorbital and orbital cellulitis in children. The clinical and laboratory data  on 87 cases of orbital and periorbital cellulitis were reviewed. Two distinct clinical presentations were encountered. One group of 45 patients had no history of trauma or apparent focus of infection. Blood cultures on these patients were positive in 34%. Haemophilus influenzae accounted for 82% of the positive blood cultures. This group of patients shares common features with children who have facial cellulitis due to H. influenzae type b. The second group consisted of 42 patients with adjacent soft tissue focus of infection. There was only one positive blood culture in this group. Staphylococcus aureus and/or group A beta-hemolytic Streptococcus were isolated from conjunctival or wound exudate in the majority of these patients. Thirteen patients with orbital cellulitis were encountered among the 87 cases. These patients were older and had a higher incidence of demonstrable sinus disease when compared with the overall group. The pathophysiology of orbital and periorbital cellulitis is reviewed and an approach to the management of these disorders is formulated.


Complex acid-base disorders in subacute necrotizing encephalomyelopathy (Leigh's syndrome). This report describes a case of subacute necrotizing encephalomyelopathy (Leigh's syndrome) in a 7-month-old boy. The clinical data suggest an association with a disorder of renal tubular acidification, characterized by both (proximal) type II and (distal) type I renal tubular acidosis (hybrid type). Concomitantly, the initial uncompensated metabolic acidosis evolved into a mixed metabolic acidosis and respiratory alkalosis-features of this syndrome not previously reported.


Chest physiotherapy in the neonate: a controlled study. The effect of postural drainage alone was compared to postural drainage with chest percussions on the arterial blood gases of 20 neonates with respiratory distress. There was no significant alteration in the arterial PO2 following postural drainage alone, with a significant increase (14.5 mm Hg) following postural drainage with chest percussions. The PO2 midway through postural drainage with percussions showed a small (5 mm Hg) but nonsignificant rise in the PO2, suggesting a gradual improvement throughout the use of this form of therapy. There was no significant change in the pH or PCO2 with either procedure. Appropriately performed chest percussions will result in an improvement in oxygenation in neonates with respiratory distress.


A case of generalized Wegener's granulomatosis in childhood: successful therapy with cyclophosphamide. An 11-year-old white boy had Wegener's granulomatosis, a rare condition in the pediatric age group. The clinical course, pathological findings, and mode of treatment are outlined. The disease is in remission on a regimen of cyclophosphamide therapy as judged by both clinical and pathological criteria. This syndrome with protein manifestations should be considered in children with symptoms of repeated upper respiratory tract infections along with pulmonary and renal involvement. Early renal biopsy helps to establish the diagnosis of generalized involvement and to guide the course of treatment. Follow-up renal biopsies may serve as an indication for the continuation of treatment. Cytotoxic agents, especially cyclophosphamide, dramatically alter the course of the disease.


Gonadotropin excretion and body composition. Urinary follicle stimulating hormone (FSH) and luteinizing hormone (LH) excretion was correlated with calculated total body water (TBW) and body fat (BF) in 140 normal girls and 142 normal boys, ages 3 to 16 years. In girls, there was a significant increase in gonadotropin excretion at the time of a significant increase in BF as a percent of body weight and decrease in TBW as a percent of body weight. Pubertal changes in body composition were seen in girls at the same chronological age and stage of puberty as increased gonadotropin excretion. Similar findings were observed in boys. Pubertal changes in body composition (an increase in TBW as a percent of body weight and decrease of BF as a percent of body weight) accompanied significantly increased gonadotropin excretion. Both developmental changes were seen at the same chronological age and stage of puberty. Our findings are consistent with the hypothesis that characteristic changes in body composition as well as the other hallmarks of puberty, including menarche in girls, result from increased gonadotropin and gonadal steroid secretion. They do not support the hypothesis that changes of body composition trigger increased hypothalamic function and hormone secretion leading to the subsequent events of puberty.


On the reliability of the magnesium serum value as an indicator of body magnesium status. The interrelationships between serum Mg and HCR, and between serum Mg and K were investigated in pigs fed on a low Mg diet. A positive dependence was found between serum Mg and HCR, and between serum Mg and K. It was concluded, that in Mg-deficient pigs, Mg ions originating from soft tissues or erythrocytes can cause an increase of serum Mg level. The serum Mg value, consequently, can not be considered as a reliable parameter indicating the body Mg status. Some difficulties in diagnosing the body Mg status and the effects of the spontaneous increase of serum Mg level on Mg deficiency symptoms were discussed.


On the effect of food magnesium level on the activity of BASP, ALAT, ASAT and LD in pig serum. Studies were made to investigate the effect of food Mg level on ALAT, ASAT, LD and BASP values in pigs. The following conclusions were drawn:--a high food Mg level (0.31% in ordinary pig food) can cause an increase in serum BASP values.--leg weakness, at the primary stage, is hardly caused by disturbances in bone.--an ordinary diet low in Mg may cause an abnormal rise in ALAT values in pigs.--when feeding pigs on an ordinary diet, pigs may suffer from Mg deficiency despite the fact that the food Mg content is distinctly higher than that recommended by international norms for feeding.--a prompt lowering of food Mg level can cause a manifest increase in ASAT, LD and BASP values within 2 to 3 days in pigs. Heart and liver injuries caused by low Mg diets and the individual ability of pits to utilize magnesium were discussed.


[Glucose tolerance test in children of diabetic mothers. Evaluation from birth to twelve years of age (author's transl)]. Twenty-five children born of 23 diabetic mothers, 17 of whom were treated with insulin, underwent glucose tolerance tests with estimation of blood insulin levels. These tests were performed on a regular basis before the age of five years, then every two years. Blood glucose and insulin disturbances were slight but appeared frequently since they were present in 56% of our cases. Our data show that blood glucose disturbances in children of diabetic mothers are more common if the diabetes of the mother suggests a maturity onset type on the basis of accompanying symptoms and treatment, and hence not insulin dependent. In this case, the chances that the child will become diabetic are much greater and this may be detected very early by a minor disturbance in the oral glucose tolerance test.


[Intra-abdominal haemorrhage: control by perfusion-dialysis (author's transl)]. Puncture-dialysis has taken its place amongst emergency surgical procedures in the diagnosis of intra-abdominal haemorrhage. On the basis of experimental, theoretical and clinical considerations, it is suggested that the lavage fluid not only be left in the abdomen after diagnostic puncture-lavage, but that lavage should be continued in the form of a perfusion system, in addition to intravenous fluids in order to re-establish or maintain normal pressure levels.


[The contribution of whole body scanning in the exploration of haematological diseases. Preliminary study of 100 patients (author's transl)]. One hundred patients suffering from haematological diseases were explored by whole body scanning. The diagnosis was a lymphoma in the majority of cases (77). Analytical study of the images obtained was made on the basis of the various sections made systematically in the protocol of the study. Scanning proved to be of particular value in the thorax in the study of pleural and juxta-pleural lesions. In the abdomen, study of the liver, spleen and retro-peritoneal space benefited from the use of this means of investigation. Supra-mesocolic sections were felt to be of the greatest value, making it possible to demonstrate lymphadenopathies not revealed by lymphography. Scanning, perfectly harmless, provides a valuable contribution in determining the extent of lymphoma spread and facilitates the therapeutic surveillance of haematological disorders.


[Familial idiopathic haemochromatosis with diabetes. Study of glucagon and growth hormone secretions (author's transl)]. In the course of familial idiopathic haemochromatosis with diabetes, after stimulation with arginine, the alpha cell responds perfectly to stimulation, in contrast to the case of chronic pancreatic diseases. After an oral glucose load, there is no reduction in plasma glucagon concentrations, and a paradoxal increase is sometimes seen. These results are quite similar to those reported in common diabetes. Secretion of growth hormone after an infusion of arginine and insulin hypoglycaemia seem to be significantly reduced in comparison with normal subjects and those suffering from common diabetes, paired and explored using the same protocol. This may perhaps explain the low degree of severity and slow course of associated vascular disease.


[Renal toxicity of the association: gentamicin/furosemide. One case (author's transl)]. The association in therapeutic doses of gentamicin and furosemide resulted, in a young patient suffering from post-B virus hepatitis cirrhosis, in renal insufficiency which was spontaneously regressive when the drugs were stopped. Gentamicin, used without furosemide, was not associated with any impairment of renal function. A review of the literature indicates a number of pathogenic hypotheses to explain the increased nephrotoxicity of this drug combination.


[Surgery for carcinoma of the cervix: frozen section examination of the external iliac nodes (author's transl)]. Since 1970, the authros have carried out colpohysterectomy with external iliac node dissection for carcinoma of the cervix at stages 1 and 2. The nodes were subjected to frozen section histological examination. In the presence of signs of invasion, primary iliac block dissection is carried out. Two hundrend and seventy cases have been treated in this way, with only 7 cases of error in the frozen section diagnosis (2,5%). There was 1 false positive, 4 false negatives and 2 doubtful cases with a suspicion of invasion. It is therefore suggested that frozen section histological examination of the external iliac nodes is possible and reliable.


[The action of antilymphocyte serum in severe aplastic anemia (author's transl)]. The etiology of aplastic anemia is unknown. A stem cell lesion caused by a toxic or a virus or a microenvironment defect are the main hypothesis. An auto-immune origin has been recently suspected but never proved. To demonstrate the auto-immune origin of the disease. We have treated 17 patients with severe aplastic anemia with antilymphocyte serum (ALS). Nine patients showed no improvement and seven patients died within two months of infectious or hemorrhagic complications. In contrast, eight patients had a prompt rise of granulocytes and reticulocytes counts. Although the hematological reconstitution is not complete. This eight patients are still alive between 4 months and 15 months after treatment. This study shows that A.L.G. may have a beneficial effect in the treatment of patients with severe aplastic anemia.


[Cerebro-costo-mandibular syndrome. Three new cases (author's transl)]. The cerebro-costo-mandibular syndrome combines bucco-mandibular abnormalities similar to those of the Pierre Robin syndrome, delayed psychomotor development and characteristic costal malformations. On each side, several ribs are interrupted in their dorsal portion. In the three children studied here, there were only eleven pairs of ribs. This brings the number of cases in the literature to twelve. The prognosis of the cerebro-costo-mandibular syndrome is severe, since eight of the children described died during the first months of life.


[Immobilisation hypercalcaemia. 1 case (author's transl)]. A 21-year-old man suffered severe (up to 15.5 mg%) and prolonged (7 months) hypercalcaemia as a result of immobilisation following severe trauma. During the period of hypercalcaemia, plasma parathormone and calcitonin levels were undetectable. A study using radioactive calcium revealed a very marked increase in bone resorption, a moderate increase in accretion and virtually no intestinal absorption. Iliac biopsy revealed dense calcification front and there was no osteoid substance. This hypercalcaemia appeared to be due to increased bone resorption, while the synthesis of osteoid substance seemed to be insufficient to permit an equivalent increase in calcium accretion.


[An external fixation frame in auto-polymerising acrylic resin (author's transl)]. An external fixation frame for the leg is made up of Bonnel pins, strengthened by bands of autopolymerising resin. The experiment shows this apparatus to be solid, reliable and easy to use. The technique of application is extremely simple and the cost low. The indications are the same as those of proven classical fixation devices, which must be preferred for the moment, when possible. Its use is therefore limited, but justified under special circumstances (poorly equipped units far from major centres, war surgery).


360 MHz PMR studies on the involvement of the Y-nucleoside in the conformation of 2'-OMeGpApApYpAppsi from torula yeast tRNAphe. 360 MHz measurements of chemical shifts, 3J1'-2', and T1 as a function of temperature for various protons of the hexanucleotide 2'-OMeGpApApYpAppsi from torula yeast tRNAphe have revealed a unique involvement of the Yt base in the structure and conformation of this oligonucleotide. Whereas the adenosine residues in the anticodon triplet are relatively stable to temperature increase, the Yt readily undergoes destacking and a change in ribose conformation. The destacking most likely involves a torsional displacement of the Yt base occasioned by a rotation of the phosphate-ribose backbone. The possible relevance of this unusual behavior to the influence of the Yt residue in tRNA function in protein biosynthesis is discussed.


Chromatin assembly in isolated mammalian nuclei. Cellular DNA replication was stimulated in confluent monolayers of CV-1 monkey kidney cells following infection with SV40. Nuclei were isolated from CV-1 cells labeled with [3H]thymidine and then incubated in the presence of [alpha-32P]deoxyribonucleoside triphosphates under conditions that support DNA replication. To determine whether or not the cellular DNA synthesized in vitro was assembled into nucleosomes the DNA was digested in situ with either micrococcal nuclease or pancreatic DNase I, and the products were examined by electrophoretic and sedimentation analysis. The distribution of DNA fragment lengths on agarose gels following micrococcal nuclease digestion was more heterogeneous for newly replicated than for the bulk of the DNA. Nonetheless, the state of cellular DNA synthesized in vitro (32P-labeled) was found to be identical with that of the DNA in the bulk of the chromatin (3H-labeled) by the following criteria: (i) The extent of protection against digestion by micrococcal nuclease of DNase I. (ii) The size of the nucleosomes (180 base pairs) and core particles (145 base pairs). (iii) The number and sizes of DNA fragments produced by micrococcal nuclease in a limit digest. (iv) The sedimentation behavior on neutral sucrose gradients of nucleoprotein particles released by micrococcal nuclease. (v) The number and sizes of DNA fragments produced by DNase I digestion. These results demonstrate that cellular DNA replicated in isolated nuclei is organized into typical nucleosomes. Consequently, subcellular systems can be used to study the relationship between DNA replication and the assembly of chromatin under physiological conditions.


Isolation from rat liver and sequence of a RNA fragment containing 32 nucleotides from position 5 to 36 from the 3' end of ribosomal 18S RNA. Crude tRNA isolated from rat liver by the method of Rogg et al. (Biochem. Biophys. Acta 195, 13-15 1969) contains N6-dimethyladenosine (m6-2A) and was therefore fractionated in order to identify the m6-2A-containing RNAs. A unique species of RNA was purified which contained all the m62A present in the crude tRNA. Sequence analysis by postlabeling with gamma-32p-ATP and polynucleotide kinase revealed that this RNA represents the 32 nucleotides AAGGUUUC(C)U GUAGGUGm62Am62ACCUGCGGAAGGAUC from position 5 to 36 of the 3' terminus of ribosomal 18S RNA. The 36 nucleotide long sequence from the 3' end of rat liver 18S rRNA exhibits extensive homology with the corresponding sequence of E. coli 16S rRNA and with the 21 nucleotide long 3' terminal sequence so far known from Saccharomyces carlsbergensis 17S rRNA. A heterogeneity in this sequence provides the first evidence on the molecular level for the existence of (at least) two sets of redundant ribosomal 18S RNA genes in the rat.


Apurinic DNA endonuclease activities in repair-deficient human cell lines. Several autosomal recessive diseases are associated with apparent DNA repair defects in cell culture. It seemed likely that a defect in excision repair reported for ataxia telangiectasia cells might reflect a lack of apurinic endonuclease activity. We report here normal levels of apurinic endonuclease activity in extracts of cell lines derived from patients with ataxia telangiectasia, xeroderma pigmentosum (complementation group D), Cockayne dwarfism, Fanconi anemia and Bloom syndrome.


Sequence arrangement of the 16S and 26S rRNA genes in the pathogenic haemoflagellate Leishmania donovani. Kinetic and chemical analysis show that the haploid genome of Leishmania donovani has between 4.6 and 6.5 X 10(7) Kb pairs of DNA. Cot analysis shows that the genome contains 12% rapidly reassociating DNA, U3% middle repetitive DNA with an average reiteration frequency of 77 and 62% single copy DNA. Saturation hybridization experiments show that 0.82% of the nuclear DNA is occupied by rRNA coding sequences. The average repetition frequency of these sequences is determined to be 166. Sedimentation velocity studies indicate the two major rRNA species have sedimentation values of 26S and 16S, respectively. The arrangement of the rRNA genes and their spacer sequences on long strands of purified rDNA has been determined by the examination of the structure of rRNA:DNA hybrids prepared for electron microscopy by the gene 32-ethidium bromide technique. Long DNA strands are observed to contain several gene sets (16S + 26S). One repeat unit contains the following sequences in the order given: (a) A 16S gene of length 2.12 Kb, (b) An internal transcribed spacer (Spl) of length 1.23 Kb, which contains a short sequence that may code for a 5.8S rRNA, (C) 26S gene with a length of 4.31 Kb which contains an internal gap region of length 0.581 Ib, (d) An external spacer of average length 5.85 Kb.


Reconstitution of chromatin: assembly of the nucleosome. The order of reassociation of the four histones H2a, H2b, H3 and H4 to the DNA during the reconstitution of chromatin was determined. At each step of the reconstitution the DNA and associated histones were separated from the free histones by centrifugation in a glycerol gradient. The unbound and reassociated histones were analysed by gel electrophoresis and the histone-DNA complexes characterized by circular dichroism and electron microscopy. We show that H3 and H4 bind first to the DNA between 1.2 M NaCl and 0.85 M NaCl and impose a nucleosome like structure; in a second step histones H2a and H2b are placed around this kernel to complete the nucleosome.


Superstructure and CD spectrum as probes of chromatin integrity. Two types of chromatin were extracted from the same stock of rat liver nuclei by a short exposure to micrococcal nuclease and by shearing respectively. These two materials which are identical in their protein/DNA content and by the presence of the five histones, were compared by means of circular dichroism and electron microscopy. Under the electron microscope and in absence of any divalent cation a superstructure of the unfixed chromatin fiber can be viewed only with native material but is no more present in sheared one. The increase of CD signal at 280 nm (from 2000 to about 4000 cm2 deg.dmole-1) in the case of sheared chromatin is not related to the loss of superstructure but to the structural changes of DNA inside the nucleosomal core which are always produced by shearing. These two correlated observations offer new sensitive probes of the integrity of any native or reconstituted chromatin.


Chemical and conformational changes in chromosome regions being actively transcribed. U.V. microspectrophotometry has been used to calculate quantities of nucleic acids and proteins of complete polytene chromosomal sets and specific regions of these chromosomes. It has been found that in chromosomes the ratio of DNA to proteins is approximately 1:4. This ratio however changes when specific regions are compared. The average ratio of DNA to proteins in a puffed region (2-48B4C5) increases to 1:16 in contrast to 1:6 from the same region but in non puffed state. At the same time the RNA quantity increases by a factor of 2. thermal denaturation profiles of formaldehyde fixed chromosomes show that the Tm of this region in puffed and non puffed state differ by 10 degrees C. Moreover these profiles suggest that a large fraction of histone-bound DNA is destabilized during puffing.


Proximal gastric vagotomy without drainage. Proximal gastric vagotomy without drainage is widely accepted in Great Britain and Europe but in the United States has been done mainly in university centers. The operation denervates the acid-secreting parietal cell mass of the stomach, preserving vagal innervation to the gastric antrum and extragastric abdominal viscera. The procedure is safe and is associated with few underisrable side effects. Long-term studies are needed to determine the rate of recurrence of duodenal ulcer in patients treated surgically in this way.


Headaches in children: meeting the challenge of management. Headaches that interfere with optimal functioning appear as often in children as in adults. Most common are tension (usually psychogenic) headaches. Brain tumors occasionally present as headaches; diagnosis rests on associated signs and symptoms. Migraine may cause frightening headaches, but prognosis is good for relief and long-term remission.


Laboratory tests: basic concepts and realistic expectations. Ordering and interpreting laboratory tests take familiarity with the concepts of normal limits, specificity, sensitivity, and prevalence. The relative importance of these test properties for clinical decisions is presented.


Phenobarbital dyskinesia.

Phenobarbital dyskinesia. A patient was admitted to hospital following an overdose of phenobarbital. During her recovery she developed both chorea and torsion dystonia which could only be related to her high plasma phenobarbital levels.


Cerebral haemorrhage in haemophilia.

Cerebral haemorrhage in haemophilia. A young male haemophiliac child is here described in whom intracerebral haemorrhage required craniotomy and the subsequent insertion of a ventriculo-peritoneal shunt. These procedures can now be attempted in severe haemophilia A because of the ease in clotting factor replacement therapy.


The use of dilute hydrochloric acid and cimetidine to reverse severe metabolic alkalosis. Two cases of severe metabolic alkalosis associated with gastric hypersecretion were successfully treated with dilute hydrochloric acid and a histamine H2-receptor antagonist given by intravenous infusion. This combined therapy with electrolyte replacement and suppression of gastric secretion is valuable in the control of this serious metabolic abnormality when conventional treatment is unsuccessful or contraindicated.


Acute renal failure from the use of acetazolamide (Diamox). The clinical histories of two patients are presented, who both developed haemorrhagic anuria after a short course of therapy with the carbonic anhydrase inhibitor, acetazolamide (Diamox). The clinical findings, in particular the radiological changes, are illustrated in this potentially fatal condition. The therapeutic success of immediate relief of the ureteric obstruction is emphasized and it is hoped that this report will act as a reminder of the importance of this agent as a cause of anuria.


Cardiac rupture in post-myocardial infarction syndrome. A fatal case of post-myocardial infarction syndrome (PMIS) followed by a rupture of an inferior left ventricular aneurysm is described. Attention is drawn to the growing number of reports of aneurysm in PMIS, and the clinico-pathological significance of this association is discussed.


Penetration into bone and tissues of clindamycin phosphate. Clindamycin phosphate is an antibiotic which is effective against both Staphylococcus aureus and the anaerobic organisms. In thirteen patients, its concentration following joint replacement was measured by the agar diffusion method. In bone, the concentration was (mean +/- s.e. mean) 5.01 microgram/ml +/- 1.16, N=10; in capsule, 3.29 microgram/ml +/- 0.71, N=12; measured between 1.75 and 3.75 hr after intramuscular and intravenous injections, and in drainage fluid it amounted to 4.61 microgram/ml +/- 0.38, N=11 in 48 hr. Two patients developed diarrhoea which settled within a short period.


Gout without crystals on initial synovial fluid analysis. In five patients with acute arthritis in whom gout was eventually documented, an initial synovial fluid analysis failed to reveal urate crystals. Four of the patients were seen in one hospital during a period of 30 months in which 103 cases of gout were documented on initial aspiration. While this is an uncommon event, the importance of being able to make a definitive diagnosis of gout is such that re-aspiration of the same or other joints may be justified under certain circumstances.


The outcome of pregnancy in women suffering from migraine. The reproductive histories of 777 women suffering from migraine were compared with 182 non-migrainous women. The incidence of miscarriage, stillbirth and toxaemia of pregnancy was very similar in both groups and there was no increase in the number of congenital malformations in the children born to women who suffered from migraine compared with the control group or with the national average. It was concluded that women suffering from migraine did not have an increased risk of giving birth to children with deformity and it was unlikely that drugs most commonly used in the treatment of migraine were teratogenic.


[Diaplacentar transfer of local anaesthetics (author's transl)]. A very rapid resorption of the amide-type local anaesthetic agents most commonly used in obstetrics results in detectable plasma levels in mother and fetus within 5 to 10 minutes, respectively, after peridural anaesthesia. The various local anaesthetics differ from each other as far as their protein-binding capacity and the resulting ratios of umbilical vein to maternal blood levels are concerned. The feto-maternal ratio is inversely correlated to the degree of protein-binding. Both, the protein-binding capacity and the feto-maternal ratio do not indicate the total amount of the anaesthetic transferred across the placenta. In contrast to measurements of the plasma concentrations only the measurement of the anaesthetic in the fetal tissue would give an exact information about the fetal uptake of local anaesthetics. Several observations hint at the possibility that there are interactions between local anaesthetics and other drugs: A competitive displacement of local anaesthetics from their protein binding sites resulting in an increase in the unbound fraction is suggested. Since the feto-maternal equilibration exists only for the unbound fraction interactions of local anaesthetics with simultaneously administered drugs should be taken into consideration.


[Pain relief in childbirth; an analysis of the analgesic effects of transcutaneous nerve stimulation (TNS), pethidine and placebos (author's transl)]. The analgesic affects of TNS, pethidine and placebos on labour pain were studied in 30 parturient women during the first stage of labour. 10 had TNS paravertebrally in the region of the afferent nerves at Th 10-Th 12; one group of 5 had unspecific (wrong) TNS; in another group of five no current was applied (placebo); five women were given 50 mg of pethidine intravenously; five patients acted as a control group. To assess the analgesic effects the women were asked to estimate the intensity of pain (grades 1-6) over a period of 70 minutes. There was no significant difference between the placebo, unspecific TNS and control groups as regarded the increase in pain during the test period. Patients who had received pethidine and those who had been given TNS at the site of the afferent nerves transmitting impulses from the uterus experienced considerable relief of pain. The differences were highly significant. The observations prove the genuine analgesic action of TNS. The use of this technique in obstetrics is discussed.


[Pain relief during delivery by transcutaneous electrical nerve stimulation (author's transl)]. The analgesic effect of transcutaneous electrical nerve stimulation (TNS) during delivery has been evaluated. The usual technique of TNS was modified to suit the specific needs of pain control during the whole course of delivery. Two pairs of electrodes were taped to the patient's back, one pair level with the spinal processes Th 10-L1 and the other with S2-S4, corresponding to the influx of pain during the first and second stages respectively. Stimulation was delivered as biphasic pulses at 60-80 Hz. A low-intensity stimulation was given continuously, and a high-intensity stimulation was initiated by the patient herself whenever pain increased. As a rule, stimulation via the thoracic electrodes was given throughout delivery and sacral stimulation added from the later part of the first stage. No complications with respect to mother or child have occured. Three hundred and forty-seven women have been treated, 47% of them considered the analgesia with TNS to be good or very good, 42% experienced a certain effect whil 11% considered that TNS made no difference. In view of the relatively good results and the absence of complications, the authors recommend the method as a primary pain relieving measure to which conventional methods can be added if necessary.


[Epidural analgesia as a routine method is obstetrics (author's transl)]. Epidural analgesia does not only produce relief of pain in childbirth; in many cases it also has therapeutic effects and prevents foetal injury. The adoption of epidural analgesia as a safe routine method for the relief of labour pain is subject to certain conditions: the indications and contra-indications must be carefully assessed; equipment and obstetric anaesthetic service must be adequate; potential complications following epidural analgesia must be considered; the patient should he told that epidural analgesia is going to be used and her consent should be obtained. Shared responsibility and close co-operation between obstetrician and anaesthetist provide the best conditions for the success of epidural analgesia.


[Deep spinal anaesthesia and saddle-block technique in surgery during pregnancy (author's transl)]. The efficacy of peridural, spinal, and saddle-block technique in the operative treatment of the gravid patient is briefly described. Factors influencing height and spread of analgesia are indicated. In our series of 288 patients, where intrathecal techniques have been used, we compare the spread of analgesia in those positioned in the horizontal (following injection), and those propped to an angle of 45 degrees. We discuss the operative possibilities with such techniques. In conclusion we describe the side effects encountered and their treatment.


[A case of malignant hyperthermia unrelated to anaesthesia (author's transl)]. Narcots and muscle relaxants are proven causes of malignant hyperthermia. Alcohol and a large number of drugs are capable of inducing myopathic changes which resemble malignant hyperthermia. The case of a 47-year-old man is reported who presented with the clinical symptoms of maligant hyperthermia. The similarity in the course of the disturbance, the clinical and chemical findings and the changes in the morphological features of the muscle suggested that the abnormally high body temperature had been induced by psychotropic durgs in a pre-disposed patient with an history of chronic alcoholism.


[A new tongue guard for comatose patients with masticatory spasms (author's transl)]. A device for the prevention of intraoral soft tissue injuries in comatose patients with uncoordinated chewing movements is presented. Shape and material of the device, which is easily fashioned and handled, are designed to protect oral and buaccal soft tissue structures against self inflicted injuries.


[The effects of halothane and enflurane on uterine activity during childbirth (author's transl)]. The effects of equipotent low concentrations of halothane and enflurane on uterine contractions during labour were studied by means of transcervical toko-ergometry. Administration of halothane was followed by a highly significant reduction of uterine activity to 48% +/- 14 of its original value. Ethrane in equipotent concentration of 1.0% reduced uterine activity in 5 women to only 83.7% +/- 29 (not significant). Five other women were also tested with ethrane in 1.5% concentrations: uterine activity was reduced to 79% +/- 24 of its original value (not significant). The findings indicate that low concentrations of ethrane relax uterine contractions less than do equipotent concentrations of halothane. The clinical applications of the observations are discussed.


[Volatile phenolic compounds in white wines]. By gas-liquid chromatography the following volatile phenols were identified in extracts and distillates of white table wines prepared with the aid of husks and pulp used in fermentation: phenol, m-cresol, guaicol, ethyl-4-phenol, vinyl-4-phenol, eugenol, tyrosol; phenol, m-cresol, guaicol, ethyl-4-phenol, vinyl-4-phenol. The amount of volatile oils grew significantly with an increase in the number of husks in the fermenting liquid and fermentation temperature.


[Purification of the extracellular trypsin inhibitor from Actinomyces janthinus 118]. From the culture liquid filtrate of Actinomyces janthinus 118 a trypsin inhibitor (TI-AjI) was isolated by sulphate ammonium precipitation, DEAE-cellulose chromatography, QAE-Sephadex chromatography and two-fold crystallization. The resultant preparation was homogeneous during polyacrylamide gel electrophoresis and ultracentrifugation. As measured by gel filtration, the TI-AjI molecular weight was estimated to be 13,000+/-1,000. The culture liquid of Act. janthinus 118 was found to contain another substance with anti-trypsin activity that differed from TI-AjI in its molecular weight.


[Realization of the maximum specific growth rate of yeasts on optically heterogeneous media]. The method of controlling the rate of the nutrient medium flow was developed with respect to the level of heat release during yeast cultivation on the optically heterogeneous nutrient medium. This method of cultivation allowed attainment of the maximum specific rate of growth of Candida tropicalis which was estimated to be 0.45 hr-1 in the experiments.


[Amino acid makeup of feed yeasts grown on a wood hydrolysate with a varying nitrogen, phosphorus and potassium content]. The content of "raw protein" (N2X6.25), amino acids and fat in the biomass of yeast Candida scottii Tul-6 grown on wood hydrolysate with varying content of nitrogen, phosphorus and potassium was measured. Changes in the content of protein, total amino acids and fat in the biomass of yeast grown on the hydrolysate with a deficiency or an excess of the above macroelements were revealed.


[Amino acid makeup of preparations from baker's yeast autolysates]. Yeast autolysis and hydrolysate composition were studied with respect to the autolysis of baker's pressed yeast. A method of isolating a mixture of amino acids and lower peptides from autolysates was developed, using ion-exchange resins. The above compounds reached maximum accumulation by the 15-20th hour of autolysis. A mixture of amino acids applicable to nutrition, including dietotherapy, was prepared.


[Role of sterol photoconversion products in the regulation of cholesterol biosynthesis in rat skin]. In order to clarify the effect of products of photochemical conversion of sterols on cholesterol biosynthesis, rat skin samples were incubated with 2-(14)C-acetate in the presence of the antirachitic agent Dk and 7beta-hydroxycholesterol. The synthesis of sterols from acetate was activated in the presence of Dk. A correlation between the activation of sterol synthesis and the concentration of the antirachitic agent was found. An addition of 7beta-hydroxycholesterol to the incubation medium inhibited acetate incorporation into the sterols. The level of synthesis inhibition increased with an elevation of the 7beta-hydroxysterol concentration in the incubation medium. This indicates that both products of sterol photoconversion can be involved in the control of cholesterol biosynthesis.


[Comparative characteristics of acetylcholinesterase preparations from human erythrocytes with varying degrees of purity]. Preparations of human erythrocyte acetyl cholinesterase (HEACE) that differed in their specific activities (0.7 to 4.1 U/mg) and the final purification method were examined for protein and isoenzymic spectrum (by polyacrylamide gel disc electrophoresis), catalytic properties in the reaction of acetytriocholine hydrolysis, sensitivity to the specific organophosphorus inhibitor Gd-42, concentrations of active centres of HEACE, and activity of one catalytic centre. The preparations showed a stable spectrum of 11-12 proteins: HEACE had molecular heterogeneity and was electrophoretically separated into 3 fractions that differed in their aggregation level. Preparations with varying specific activity contained different HEACE quantities. Regardless of the purification degree, HEACE displayed similar activity of the catalytic centre and enzymic properties in reactions with the substrate and inhibitor.


[Improvement of the method of collection of blood flowing from the adrenal glands in the experiment on dogs]. Blood from the adrenal gland can flow in two directions--into the caudal vena cava and by anastomoses into the portal vein. A method of multiple blood procuring from these vessels in dogs for the purpose of studying the adrenal gland function is suggested. Polyethylene catheters, 0.9 mm in diameter and 35--40 mm in length glued to capron plates, mandrins, Gordeev's needles and blood-drawing needles are necessary. Transperitoneal surgical approach to the caudal and mesenteric veins is to be provided. Purse-string suture is applied on the wall of the mesenteric vein. The catheter is washed with heparin, the mandrin is introduced into it and it is inserted into the Gordeev's needle. A puncture is made in the centre of the purse-string suture with this needle, which is introduced into the vein together with the catheter. Gordeev's needle is withdrawn and the catheter is pushed through to the portal vein. The purse-string suture is tightened, and the capron plate is fixed in the wall of the vein. The mandrin is recovered from the catheter, heparin is administered into its canal, polyethylene plug is inserted and withdrawn through the abdominal wall outside with the aid of the blood-drawing needle. The catheter is introduced into the caudal vena cava in the same way. Blood samples can be obtained on the 14th postoperative day.


[Nucleic acid and protein biosynthesis in the accessory sex organs of rats during blockade of testosterone effect by androgen antagonist 4-nitro-3-trifluoromethylisobutyranilide]. The influence of testosterone and antiandrogen 4-nitro-3-trifluoromethylisobutyranilide (4N3TFMIBA) on the content and biosynthesis of nucleic acids and the protein in the ventral prostate and the seminal vesicles of Wistar rats was studied under experimental conditions. As revealed, with the simultaneous administration of the androgen and its antagonist there was a fall in the organs under study of the RNA and protein content and a reduction of incorporation of labeled precursors into the DNA, RNA, and protein. Similar changes were seen after castration. A conclusion was drawn that the capacity to block the stimulating influence of testosterone on the nucleic acid and protein biosynthesis underlay "castration" effects of antiandrogen 4N3TFMIBA, this causing atrophy of the accessory genital apparatus.


[Effect of corticosteroids, androgens and their metabolites on the activation of lymphoid cells]. The character of hydrocortisone and testosterone, and also of their metabolites (cortisone and 5alpha-dihydrotestosterone) influence on the lymphocyte blasttransformation induced with PHA and various antigens was studied. Testosterone proved to produce a preponderant depressive action on the blasttransformation induced by PHA. On the contrary, hydrocortisone considerably suppressed the blasttransformation to the antigen. The suppressive influence on the blasttransformation to PHA is intensive in case of a simultaneous administration into the culture of the hormonal preparations and mitogen. Transformation of the hormones into metabolites is accompanied by some reduction of their suppressive influence on the blasttransformation. On the whole, blasttransformation to PHA is more resistant to the action of the hormones than that induced with the antigen.


[Content of placental lactogen in the blood of pregnant women with diabetes mellitus]. The content of placental lactogenic hormone (PLH), one of the indices of the hormonal function of the placenta, was studied in the blood of pregnant women suffering from diabetes mellitus, depending on the compensation of the disease and the presence of complications in pregnancy. Despite the high weight of placenta, usually observed in this pathology in pregnant women, the blood PLH level did not significantly exceed that in normally coursing pregnancy. In case of decompensated diabetes mellitus there was a significantly lower blood PLH level in comparison with that in the compensated one, this pointing to the direct influence of metabolic disturbances characteristic of decompensated diabetes mellitus on the hormonal function of the placenta. The lowest PLH level was found in the patients with diabetes mellitus at the period of decompensation of the disease in the presence of complications in pregnancy. An unfavourable influence of decompensated diabetes mellitus on the hormonal function of the placenta and the known data on the fact that decompensated diabetes mellitus promoted the development of complications in pregnancy, also deranging the placental function, confirmed the necessity of compensation of the disease during pregnancy.


[Mineralocorticoid function of the adrenal cortex in adolescent girls with thyrotoxicosis]. As a result of clinical examination of patients with juvenile thyrotoxicosis there was revealed an increase of the blood plasma renin and a derangement of mineralocorticoid function of the adrenal cortex expressed in increased aldosterone excretion, retention of sodium in the organism and reduction of potassium excretion. Normalization of aldosterone excretion in thyrotoxicosis compensation and after the surgical intervention can indicate the influence of increased amount of thyroid hormones on the mineralocorticoid function of the adrenal cortex.


[Content of growth hormone in the blood in insulin-resistant and insulin-sensitive patients with diabetes mellitus during compensation]. The growth hormone and blood sugar level was determined during compensation in 38 insulin-resistant and in 48 insulin-sensitive patients with diabetes mellitus, on fasting stomach and after an intravenous injection of insulin. The insulin-resistant patients were given insulin in the amount of 100 and more Units per 24 hours at the period of achievement of compensation. In the insulin-sensitive patients with diabetes mellitus during the compensation the growth hormone level in the blood serum on fasting stomach displayed a significant reduction; no significant change occurred in the insulin-resistant patients. On the achievement of normoglycemia a high growth hormone level in the patients with insulin-resistant forms of diabetes mellitus was probably conditioned by disturbance of the adaptation processes, and possibly also by the preservation of decreased glucose metabolism at the cell level. Under these conditions the growth hormone apparently produced a diabetogenic action and prevented stable compensation creating conditions for the preservation of insulin resistance.


[Nucleic acid and protein synthesis in the lymphocyte populations of men, women and patients with karyotype 45,XO]. The synthesis of DNA, RNA and protein was measured in the lymphoid cells of the palatine tonsils in children aged from 3 to 15 years. The rate of RNA synthesis was also studied in the peripheral blood lymphocytes of men and women of different age and also in the patients with Shereskevsky-Turner's syndrome. 3H-thymidine incorporation into the tonsillar lymphocytes was independent of sex. 3H-uridine incorporation both into the palatine lymphocytes and into the peripheral blood lymphocytes in persons under 20 years of age and over 50 years old was greater in males. The rate of RNA and protein synthesis in the lymphocytes with kariotype 45,XO proved to be greater than in the lymphocytes with kariotype 46,XX and 46XY. The detected differences are discussed from the aspect of sex differences of the hormonal background and dyshormonal condition in patients with Shereshevsky-Turner's syndrome and possible differences in the temporary parameters of the mitotic cycle.


[Osmotic stability of erythrocytes in Turner's syndrome]. Osmotic stability of erythrocytes was determined in 11 patients with Shereskevsky-Turner's syndrome and in 11 practically healthy persons. There was revealed an increased sensitivity of the patients' erythrocytes to the hypotonic NaCl solutions in comparison with the population of erythrocytes in control. Analysis of the age composition of the red blood cells demonstrated an increase in the number of young and old forms with an inadequate quantity of mature cells, this serving as a characteristic feature of the red blood in ageing. The results presented serve as an additional fact pointing to early ageing of patients with the Shereshevsky-Turner's syndrome.


[Placental permeability in experimental diabetes mellitus]. The work was performed on female rats to which alloxan was administered at immature age. Placental permeability was studied in female rats, healthy ones (170 fetuses), with prediabetes (124 fetuses), with latent diabetes (102 fetuses), and with manifest diabetes (112 fetuses). Permeability of placental membrane was assessed by means of the fluorimetric method of determination in the fetal organism of uranin, a stain administered into the blood of a pregnant animal. The results of the investigations demonstrated that in rats with alloxan prediabetes, latent and manifest diabetes permeability of placental membrane showed a significant elevation (P less than 0.001). There was revealed a direct relationship between the extent of the insular insufficiency and permeability of the placental membrane.


[Comparative data on the radioimmunological and biological activity of luteinizing hormone in the pituitary gland and the blood serum of human fetuses]. Determination of immunoreactive luteinizing hormone (LH) was carried out in 291 hypophyses of 8--34-week human fetuses, and in 92 blood serum samples of 14--34 week human fetuses. Immunoreactive LH was revealed in human hypophyses as soon as the 8th week of embryogenesis. In female fetuses the concentration and content of the hormone showed a sharp rise from the 14th--16th to the 19th--20th week. The LH concentration displayed a gradual decrease and the hormone content remained at the same level from the 21st--22nd to the 32nd--34th week. The LH concentration and content showed practically no change in male fetuses from the 14th--16th to the 23rd--24th week. A sharp elevation of the hormone level was observed from the 23rd--24th to the 27th--28th week. Immunoreactive LH was revealed in the blood of human fetuses from the 14th to the 34th week. The LH concentration was significantly greater from the 21st--22nd and 23rd--24th weeks in female than in male fetuses. In comparing the data obtained as a result of application of radioimmunological and biological methods there was revealed a coincidence of the time of appearance, of the changes and of the sex differences in the immunoreactive LH level and its biological activity in the hypophysis and in the blood of human fetuses.


[Estradiol reception and induction of DNA-dependent RNA synthesis and adaptive enzymes in the mammary glands of mice]. The content of estradiol receptors in the mammary glands of virgin female mice, and the capacity of this hormone to induce RNA synthesis, hexokinase, pyruvatkinase, and glucose-6-phosphoric dehydrogenase in the glands was studied. H3-estradiol binding to the mammary glands was found to be highly specific: only estradiol, and, to a lesser degree, estron, competed with H2-estradiol for the binding sites, while progesterone and hydrocortisone failed to affect the binding of H3-estradiol. As determined by the method of exchange of the receptor-bound endogenous hormone for the labeled exogenous one, the value of H3-estradiol specific binding was 4.3+/-1.5 10(-15) M/mg protein. Under the influence of estradiol the incorporation of H3-adenine and H3-orotic acid into the RNA of the mammary glands increased by 70%, and activity of the enzymes under study was almost doubled.


[Role of dopamine in the regulation of the thyrotropic function of the pituitary gland]. Acute experiments on sexually mature mongrel male rats showed that microinjection of dopamine into the area of paraventricular nucleus of the hypothalamus and the anterior lobe of the hypophysis failed to influence the secretion from the hypophysis of the thyrotropic hormone (TTH), the content of which was determined radioimmunologically. Dophamine injections in the mediobasal hypothalamus decreased the TTH content in the blood of euthyroid rats. In animals given thyroxin preliminarily, an increase in the TTH level occurred in the blood serum in response to dophamine administration into the mediobasal hypothalamus. A conclusion was drawn that dophamine of the mediobasal hypothalamus took part in the TTH secretion from the anterior lobe of the hypophysis. The normalizing action of the given mediator is expressed under conditions of the changed functional activity of the hypophysis-thyroid gland system.


[Effect of long-term administration of thyroxine on the content of nucleic acids and certain indicators of phosphorus metabolism in the liver in experimental thyrotoxicosis]. In the liver of albino rats with experimental thyrotoxicosis a study was made of nucleic acids and some indices of phosphorus metabolism: total and inorganic phosphorus, total and acid-soluble phosphorus, phosphorus of RNA, DNA and phosphoproteins. A significant elevation of the RNA and DNA content was noted 1 1/2 months from the beginning of the experiment. An increase of the concentration of nucleic acid phosphorus and a simultaneous reduction of the content of phosphorus of phosphoproteins and inorganic phosphorus was noted in the phosphorus metabolism indices under study. The content of total and acid-soluble phosphorus displayed no significant change. The data obtained indicated that, along with increased catabolism in thyrotoxicosis there occurred rather intensive synthesis, without reaching the normal level, however.


[Insulin activity of blood plasma in fetuses and newborn infants with asphyxia. Effect of insulin on the course of hypoxia and elimination of its sequelae under experimental conditions]. In this clinico-experimental work data are presented concerning the blood plasma insulin activity in mature fetuses and neonates in asphyxia; the influence of insulin on the course of hypoxia and elimination of its sequelae under experimental conditions on the newborn and sexually mature rats was also noted. The blood plasma insulin activity proved to increase in the neonates born of mothers with normally coursing pregnancy. A statistically significant reduction of the insulin activity was noted in neonates whose mothers suffered from toxemia of the second half of pregnancy. The death of fetuses and neonates was accompanied by a marked reduction of the blood plasma insulin activity. Preliminary administration of insulin increased the tolerance of experimental animals to hypoxia. Administration of insulin at the period of normalization of physiological functions after hypoxia produced a positive influence on the animal revival. Data are presented on the mechanism of insulin action in hypoxia.


[Effect of hydrocortisone on the ribonucleic acid biosynthesis in the liver mitochondria, heart and spleen of rats with alloxan diabetes]. Mitochondrial RNA biosynthesis in diabetic rats under the influence of hydrocortisone (0.5 or 2 U per 100 g for 7 days) increased in the liver and decreased in the spleen. Heart mitochondrial RNA biosynthesis increased after hydrocortisone injection in a dose of 0.5 U per 100 g, but decreased after hormone administration in a dose of 2.5 U per 100 g. Thus, hydrocortisone played an important role in the changes of RNA biosynthesis in the liver, heart, and spleen mitochondria of diabetic animals.