Effect of pregnenolone-16 alpha-carbonitrile on bilirubin-and sulfobromophthalein-binding to hepatic Y and Z proteins in the rat. Pregnenolone-16 alpha-carbonitrile (PCN), administered twice daily p.o. for 3 days at a dose level of 20 mumol/100 g body weight, significantly enhances in vivo binding of 14C-bilirubin and sulfobromophthalein (BSP) to hepatic Y and Z proteins in female Charles River CD rats. 14C-bilirubin-binding to Y protein showed a 61% increase, while binding of the same moiety to the Z protein fraction was augmented by 59%. BSP-binding in vivo demonstrated rises of 114 and 71% in relation to Y and Z proteins, respectively. These data correlate well with previous investigations in which PCN was found to have a beneficial influence on experimentally induced hyperbilirubinemias and, furthermore, there is an indication that phenobarbital, another potent microsomal enzyme inducer, acts via a similar mechanism.


Lead-induced behavioral disorders in the rat: effects of amphetamine. The effects of d-amphetamine on several measures of activity and spontaneous alternation were evaluated in rats chronically exposed to a low level of lead acetate via maternal milk during the neonatal period. Alterations in the amphetamine responses of lead-treated rats were observed with some measures of activity and exploration but not with others. 'Paradoxical' responses were observed with postural rearing and spontaneous alternation. No drug response was seen in lead-treated animals with respect to center field activity in contrast to a large increase seen in controls. Normally, amphetamine reduces grooming behavior, but since this reduction was greater in lead-reared than in control rats, the data suggest that for this measure the lead-reared rat may posses an increased sensitivity to amphetamines. These results were discussed in terms of the behavioral parallels found between lead poisoning and childhood hyperactivity, and the potential of this model as an animal analog of minimal brain dysfunction hyperactivity.


Fourier analysis of the echocardiogram.

Fourier analysis of the echocardiogram. Fourier analysis has been applied to the analysis of echocardiograms, with the result that anterior mitral leaflet waveforms have been classified in a manner which is unambiguous and which lends itself easily to present-day automated technology.


Temperature gradients in low-flow vessels. A graphical representation of heat transfer measurements and a graphical solution of the heat transfer equation, describing the temperature changes in a fluid flowing in a pipe localised in a heated or cooled region, are given. The solution is applicable to the axial temperature distribution of the blood in a vessel passing a region of high or lower temperature. An experimental study of the temperature distribution in small pipes with various flow rates and pipe diameters is presented. The results add information on conductive heat distribution in vessels to available knowledge of conductive heat distribution in tissues. The results can be used for the analysis of temperature changes in the vicinity of pathological processes accompanied by vascular changes, e.g. primary venous or arterial disease, inflammatory conditions or neoplasia.


An improved uptake probe designed for a large crystal rectilinear scanner. Stationary probes are frequently used to estimate the uptake of radionuclides in particular organs such as the liver, spleen, heart or thyroid. Conventional probes have both a non-uniform response volume along the detector axis and a large diverging field of view. Therefore the sensitivity of these probes is strongly dependent on organ depth and the extent of the activity in the surrounding tissues. This paper describes a focused probe which can be used to give an improved response relative to organ depth and reduces the effect of the surrounding activity. Phantom measurements suggest that under suitable circumstances the probe could be used to measure absolute organ activity.


Platelet estimation in whole blood.

Platelet estimation in whole blood. An application of particle size analysis is described for the estimation of platelet counts in whole blood based on a variable size threshold and baseline. The simplicity of the sample preparation for this technique may enable its automation as a semiquantitative screening method. Platelets, defined as particles to the platelet side and above the minimum point between the platelet and red cell distributions were counted on specially designed electronics. The system divides the normal size distribution from the smallest platelet to the smallest red cell into four equal windows and performs three integrations to calculate the best result. Correlation of results obtained using this technique with results form the sedimentation method produced a coefficient of 0.93. In the trial period of a week in which all the samples (132) normally undergoing platelet count were also counted on the system descirbed, only six false negative results were found, four at the lower end of normal (150000) and two at the upper end (400000). The advantages of an MCA computer-based system are also discussed.


An instrument for routine measurements with x-ray therapy equipment operating between 10 and 250 kv. X-ray equipment, used for radiation therapy at low voltages, is frequently operated in small hospitals which do not have full-time physics staff. Most of the X-ray units involved are not fitted with dose-rate monitors which would allow continuous control dose so that the output must be checked at frequent intervals by the radiographer using a suitable instrument. The design criteria for such an instrument are discussed and its construction described in detail together with the tests and field trials carried out. The instrument is designed to measure dose rates from 2500 rad min-1 at 10 kV to 50 rad min-1 at 250 kV. It has been possible by use of the instrument to determine the 'normal' behaviour of each X-ray unit and to establish criteria by which 'abnormal' behaviour can be determined.


The measurement of low concentrations of radon-222 daughters in air, with emphasis on RaA assessment. A number of methods exist for the measurement of the activity concentrations of radon-222 daughters in air but in most cases interest is centred on determining the Working Levels. In those instances where individual daughter activity concentrations are assessed the precision of the assessment of RaA (218Po) is poor unless spectrometry is used. In environmental monitoring the measurement of RaA activity concentrations is a reliable indicator of radon activity concentrations. Following a brief review of established methods of radon daughter activity concentration measurement, a method is given which enables activity concentrations as low as 0.05 pCi l-1 (50 pCim-3) of RaA to be measured with simple readily transportable equipment. The method presented here also measures RaB (214Pb) and RaC (214 Bi) activity concentrations and Working Levels with improved precision compared with established methods.


Determination of certain selected bulk and trace elements in the bovine liver matrix using neutron activation analysis. Effective utilisation of neutron activation analysis (NAA) for the elemental analysis of biomedical samples with or without a radiochemical separation, especially when optimal Ge(Li) well type detectors are employed for the acquisition of complex spectra, is demonstrated by determining normal values for 25 elements in bovine liver. Optimal conditions for the determination of Ag, Br, Cl, Co, Cs, Fe, I, K, Mn, Na, P, Rb, Sb, Sc, Se and Zn with the aid of instrumental thermal neutron activation analysis (INAA) by varying the irradiation and decay time are presented. Where INAA was inadequate, simple post irradiation separation based on ion-exchange has been used to determine such elements as Au, Ca, Cd, Ce, Cr, Cu, La, Mo and W. Results from the IAEA intercomparison run for animal muscle (H-4) are also given. The influence of sample size with respect to within-tissue variation of the bulk and trace elements in liver and the contamination of liver samples from the interfering components such as residual blood are also discussed.


Trapping and re-use system for radioactive xenon in nuclear medicine. Different methods of trapping radioactive xenon are reviewed. Trapping by adsorption on activated charcoal has the advantage of being simple and cheap and also makes it possible to recycle the xenon. An activated charcoal trapping system is described which can extract 133Xe from 1001 of expired air in 10 min from patients undergoing diagnostic pulmonary or circulation studies. Details of the construction are discussed. The trapped gas can be rapidly released and returned to the spirometer. Substantial reduction of costs can be achieved with 133Xe; this becomes even more important as accelerator-produced 127Xe comes into more general use.


Transverse tomography with incoherent optical reconstruction. A thin layer of an object can be imaged by reconstruction from a so-called sinogram. It is produced by an x-ray fan beam rotating around the object while a recording film is moved in a direction perpendicular to the plane of the fan beam. Before reconstruction the sinogram image is convoluted according to a special function to remove artifacts consisting of spurious shadows between different object elements. The reconstruction is done from the convoluted sinogram by means of a back projector, which operates according to a prinicple that is the reverse of the recording of the original sinogram. Tomograms of phantoms, pork chops and the head of a dog show that the process is capable of high spatial resolution but is limited by low contrast.


Measurement for curriculum building for multiply handicapped children. Quantitative longitudinal tracking of objectively defined motor behaviors can be used with severely multiply handicapped infants and children to develop treatment curricula and assess the changes occurring as a result of stimulation programs. The frequency or duration of clearly defined motor behaviors can be observed and recorded by parents or teachers with therapists periodically observing for reliability. We have found that this recording technique can effectively be used to 1) establish a baseline of motor behaviors, 2) detect small changes in a slowly developing behavior, and 3) assist in development of finely sequential treatment curricula.


Effects of respiratory exercises on the vital capacity and forced expiratory volume in children with cerebral palsy. The purpose of this study was to determine if breathing exercises can increase the vital capacity in children with cerebral palsy. Ten children with spastic cerebral palsy, five in the experimental group and five in the control group, were the subjects for the study. A spirometer was used to measure vital capacity and the forced expiratory volume before and after the children performed a breathing exercise program. The pretest values for all 10 youngsters indicated a vital capacity lower than the normal predicted values. The breathing exercises selected emphasized strengthening of the muscles of inspiration and the muscles of expiration. In the breathing exercise program, the physical therapists also attempted to follow the Bobath treatment approach by inhibiting the abnormal breathing patterns and by teaching the child proper ways of breathing control. The results seem to indicate that a breathing exercise program can increase the vital capacity in youngsters with cerebral palsy. The vital capacity of the experimental group was increased by 0.46 liters after exercising for five to seven minutes each day for a period of eight weeks. The mean increase of the vital capacity was 31 percent over the pretest values. The control group showed no change in vital capacity. The pretest and posttest forced expiratory volumes of both groups were within normal limits.


A light-emitting diode system for the analysis of gait. A method and selected clinical examples. The purpose of this study was to design, develop, and test a comprehensive and potentially clinically useful system for the objective evaluation of sagittal-plane motion and temporal and distance factors during gait. A light-emitting diode and a 35 mm single-frame color slide photographic technique were utilized. The method of data collection and reduction produced values that are similar to reports in previous literature. High reliability was shown both within and across investigators testing normal subjects. Across-investigator comparisons when taking angular measurements demonstrated lower reliability. Specific clinical examples are presented to demonstrate the applicability of the light-emitting diode system.


Severely handicapped children in the public schools. A new frontier for the physical therapist. Recent court decisions are currently generating the need for the development of a more humane, school-based system of educational options for severely and profoundly handicapped children. This natural commitment, which includes provisions for various ancillary services, has major implications for the profession of physical therapy. This paper includes the problems, issues, and trends related to the development of public school physical therapy programs and presents some guidelines and suggestions which might be helpful in the implementation of such programs.


Laryngeal control for voicing distinction in Japanese consonant production. The aim of the present study was to investigate the laryngeal adjustments for voiced versus voiceless distinction in Japanese consonant production by means of laryngeal electromyography (EMG) and fiberoptic observation. Multichannel EMG recordings were taken of a Japanese subject and the data were computer-processed to obtain the averaged activity patterns of the five intrinsic laryngeal muscles with special reference to the voicing distinction in consonant production in various phonetic environments. It was found that there were apparent reciprocal patterns in the posterior cricoarytenoid (PCA) and the interarytenoid (INT) in terms of significant negative correlation, and active control of PCA for voicelessness was demonstrated. The patterns of the thyroarytenoid and the lateral cricoarytenoid were different from that of INT even though these two muscles are usually classified as the members of the adductor group, and their activity levels were apparently influenced by the phonetic environment. A possible contribution of the cricothyroid (CT) to the voicing distinction was also pointed out but further investigations on acoustic parameters seem to be mandatory in more critical interpretation of CT activity in speech.


Contrastive intonation of German and English. Problems and some results. For the purpose of a contrastive analysis only distinctive formal elements and functions are to be considered. The latter are "lexical or syntactic disambiguation", "syntactic characterization" and "communicative differentiation". In German, modal particles and intonation render expressive functions which are conveyed in English by intonation only. The differing punctuation systems of English and German have to be considered as a source of interference besides limited differences between the English and the German intonation systems.


Advancement of the orbits and the midface in one piece, combined with frontal repositioning, for the correction of Crouzon's deformities. We describe the use of radical craniofacial osteotomies, to improve the correction of exorbitism and to obtain better esthetic results in children with Crouzon's syndrome. We suggest some minor modifications to improve the fixation and the mechanical stability of the mobilized segments of the skull. Our procedure consists, essentially, of advancement of both orbits and the midface in one piece, plus advancement and reshaping of the frontal area. The results obtained by this technique, in children with a Crouzon's deformity without open bite, have been most satisfactory. We believe the satisfactory resultant appearance will be maintained during and after growth of the face, although these children have not been followed long enough yet to ascertain this with certainty.


Festoons of orbicularis muscle as a cause of baggy eyelids. Occasionally, baggy eyelids are caused by a laxity of the orbicularis oculi muscle. The extent of these orbicularis festoons is evaluated by a careful examination--including the "squinch" and the "pinch" tests. We excise such festoons of excess muscle and then support the orbicularis oculi of the lower lid by using periosteal and muscular sutures. (Orbicularis plication is an alternate procedure for the lower lid). Any muscle festoons of the upper lid are simply excised.


The role of psychiatry in a craniofacial team. The psychosocial assessment of the child in the context of his family and community is, we believe, an essential factor in the decision for and the timing of major reconstructive surgery. A severe congenital facial deformity does not usually affect a child's body-image, but it can have a great impact on the total self-image (which is related to social reactions). Surgery should be performed ideally before the early school years, when the child is subjected to the most teasing, provided both parents and the patient have realistic expectations and really want the major reconstruction.


Nicotine and its effect on wound healing. Our data demonstrate that nicotine impairs wound contraction in the rabbit ear model from the 4th to the 10th day of wound healing. However, the wounds contracted at essentially the same rate from the 12th to the 20th day in the experimental and control groups of animals. This study would suggest that cigarette smoking, with its associated nicotine ingestion, is adverse for a time to wound healing. It is clearly possible that in cases of extremity injury, or surgery, cigarette smoking may adversely affect wound healing.


Histological changes in skeletal muscle after temporary independent occlusion of arterial and venous supply. In both replantation and transplantation, circulation is restored to ischemic muscle by vascular anastomoses. As a result, the length of time that skeletal muscle will endure ischemia is important to know clinically. Using microsurgical techniques, we shut off the blood supply to the quadriceps femoris muscle in adult Wistar rats--by occluding the artery, the vein, or both for varying time intervals. The muscle was maintained in the animal for 48 hours, and then examined histologically. Our results indicate that the period of warm ischemia should be limited to about one hour, because a longer period of arterial ischemia produces severe histological changes in muscle. The limiting factor seems to be the arterial, rather than the venous supply. The possibility of muscle regeneration after such ischemic insults was not investigated.


Carcinoma of the skin of the foot exhibiting some verrucous features. Case report. A patient with a skin carcinoma of the foot showing verrucous features is described. The clinical course and histopathological appearance are discussed.


Tie-over dressing to prevent recurrence of a hematoma of the ear. Case report. We describe the use of a tie-over dressing to compress and eliminate the dead space in an ear after evacuation of a hematoma. This method seems to produce effective local pressure in the precise area where it is needed.


A pneumatic tourniquet as an aid to release of capsular contracture around a breast implant. The use of a pneumatic tourniquet to release fibrous capsular contracture around a breast implant is described. This method protects the operator's hands and, we believe, is potentially safer for the patient and for the breast prosthesis.


Dual curved incisions for trans-metacarpophalangeal surgery. Two transverse curved incisions have been used for surgical procedures on all 4-finger MP joints. The edema and hematoma beneath the incision are reduced, and the skin healing is excellent. The exposure is more than sufficient for all the commonly employed surgical procedures on these 4 joints. The final appearance is as good as with a single transverse curved incision.


Psychological test performance and sedation thresholds of elderly dements, depressives and depressives with incipient brain change. As expected, dements, depressives and patients with a mixed psychopathology were differentiated from one another on the sedation threshold measure and on a number of psychological tests. In depressives responding to treatment significant changes in physiological and psychological measures, which had been reported in an earlier study could not be replicated except for an increase of psychomotor speed. In the present sample of patients there were significant correlations between various psychological measures and between them and the levels of the sedation threshold, suggesting that sedation thresholds and psychological tests measured related cerebral functions. Evidence obtained from the earlier investigations to the effect that cerebral age changes short of those occurring in dementia may facilitate the occurrence of depression in late life was only weakly confirmed by the replication study.


Dichotic listening and allusive thinking. Previous work suggests that allusive thinkers have a broader attentional process associated with weak central inhibition. The method of dichotic stimulation was used to investigate this concept. Sixty-three university students completed a battery of tests including 2 dichotic listening tasks. The Object Sorting Test was used as a measure of allusive thinking. Allusive thinkers showed a trend towards impaired shadowing performance. Mislabelling of shadow as distractor words and vice versa, on recall and recognition tasks, showed the strongest correlation with allusive thinking. Such mislabelling was considered to reflect impaired discrimination learning, and provides further support for a hypothesis relating allusive thinking to weak Pavlovaian central inhibition.


Psychiatric aspects of pregnancy in schoolgirls: a review. This review has searched the literature to examine the hypothesis that illegitimate pregnancy in girls of school going age is an indicator of underlying psychopathology and, in particular, that pregnancy or sexual activity provide a form of gratification for otherwise deprived young girls. Surveys suggest that precocious sexual activity is more common in disadvantaged young teenagers and that pregnant schoolgirls are especially likely to come from large families, and to have unskilled parents. There is a suggestion that the younger groups of pregnant teenagers come from unsatisfactory home backgrounds. However, these conclusions are derived from inadequate studies and should be treated with caution. Relatively few sexually active teenagers use contraceptives but there is no evidence that this represents a subconscious intent to conceive and there is greater support for more straightforward explanations. There is a further suggestion that girls who continue with their pregnancy when the choice for termination is available are more disadvantaged than girls who obtain a termination, although the reasons for this association are not clear. Children born to very young mothers appear to do less well than children born to older mothers. However, it may be that this difference can be attributed to greater overall disadvantages in the younger group rather than to specific age related deficiencies in 'mothering ability'. The problems of schoolgirl pregnancy are compounded by interruption of her schooling and early re-conception. There is evidence that these complications can be lessened by the provision of specially designed intervention programmes.


Responses of Australian patients with gynaecological disorders to the General Health Questionnaire: a factor analytic study. One hundred and twenty-seven out-patients attending a gynaecology clinic completed the General Health Questionnaire (GHQ, 60-item version) and a role problems checklist (RPCL). Principal factors analysis of the GHQ yielded 8 factors which were named: poor performance (which accounted for 63.3% of total variance), depression-anxiety, sleep-disturbance, anhedonia anergia, loss of confidence, general illness, social dysfunction and headache. These results were compared with previous principal components analyses of the GHQ (Goldberg, 1972; Goldberg et al. 1976). A multiple regression analysis indicated that age and 7 of the 8 factors were significantly related to the number of role problems reported by the patients. However, it appears that psychiatric distress (as measured by the GHQ) and role problems were only related to a small degree (multiple R2 = 12.69% only).


Serum folic acid and B12 in 272 psychiatric in-patients. Serum folate and B12 estimations were carried out on 272 admissions to a psychiatric unit during 1972 and 1973. 21.3% had serum folate below 2 ng/ml and 26.1% serum B12 below 150 pg/ml. The organic psychosis patients had a significantly lower mean B12 than the others, and were over-represented among the low B12 group. Low B12 status was also associated with low RBC and WBC. Low folate status was linked with depression, malnutrition, physical illness and low Hb, RBC and WBC. There were more chronic alcoholics than others with serum folate greater than 4-9 ng/ml, low RBC and macrocytosis. The presence of one or more haematological abnormalities (macrocytosis, low Hb, low RBC or low WBC) predicted low folate in 76%, and low B12 in 79%, but these were also found in 40% of the normal folate and 41% of the normal B12 patients. Macrocytosis may prove to be a reliable sign of alcoholic abuse.


The movement of hostility during recovery from depression. Sixteen depressed in-patients from a hospital in Athens were assessed using the Hamilton Rating Scale and the Hostility and Direction of Hostility Questionnaire. Comparison of admission, discharge and mid-treatment scores showed that: (1) There was a larger drop in depression score in the first half of treatment. (2) Hostility scores, except for extrapunitiveness, decreased significantly over time, larger changes occurring in the first half of treatment. (3) Comparisons with British scores showed that during illness there were no significant differences between British and Greeks, though the latter tended to be more extrapunitive. At recovery, the Greeks were significantly more extrapunitive. The movement of hostility in depressive illness, the validity of the HDHQ and need for national norms are discussed.


Thryo-endocrine pathology, obstetric morbidity and schizophrenia: survey of a hundred families with a schizophrenic proband. This preliminary communication reports that the mothers of 104 schizophrenic patients had: (1) a significantly higher incidence of thyroid disease than a carefully matched control group; (2) significantly more abortions, still-births and greater infant mortality. The findings and possible relevance of thyroid disease to schizophrenia are discussed. Three prospective studies currently in progress are outlined.


The late effects of necrotizing encephalitis of the temporal lobes and limbic areas: a clinico-pathological study of 10 cases. The clinical and neuropathological features are reported of 10 patients who had suffered, usually for several years, from the after effects of an acute or sub-acute necrotizing encephalitis of the limbic grey matter and of the adjacent temporal lobes. Emphasis is laid on the memory disturbance and on the behavioural and emotional aberrations that tended to occur and that are in some ways reminiscent of the Klüver-Bucy syndrome.


Prostaglandins and schizophrenia: further discussion of the evidence. It has been proposed that schizophrenia is a prostaglandin-deficiency disease and also that it is a disease of prostaglandin excess. New evidence is reviewed which suggests that 'classic' schizophrenia is due to a specific deficiency of prostaglandin E1 while certain toxic and vitamin-deficiency psychoses may be due to a broader spectrum of prostaglandin deficiency. There is also good evidence that a particular schizophrenic subgroup, which includes catatonic schizophrenia but may not be confirmed to it, is associated with an excess of prostaglandins. Part of the explanation may be that prostaglandin E1 has a 'bell-shaped' dose-response curve with high concentrations having effects similar to those of prostaglandin deficiency.


Effects of certainty, modality shift and guess outcome on evoked potentials and reaction times in chronic schizophrenics. Evoked potentials and reaction times were obtained from chronic schizophrenics and normal controls to light and sound stimuli presented in random order. In the 'certain' condition subjects were told what the next stimulus would be, in the 'uncertain' condition they were asked to guess. Amplitudes were usually larger for normals than for schizophrenics, for 'uncertain' than for 'certain' conditions, and in cross- than in ipsimodal stimulus-sequences. The effect of certainty was stronger in normals across 4 leads; so was the effect of modality shift at vertex. While these findings replicate earlier results from acute schizophrenics, no condition X group interactions could be found in the reaction time measures. Two additional results were interpreted as showing basically different attitudes with respect to the predictability of events: (1) there was a slow positivity between the verbal information and the following stimuli which was largest for schizophrenics in the conditions of certainty; (2) while normals showed long-term habituation only in N1- but not in P3-amplitudes, the reverse was true for schizophrenics.


The relationship between psychological and physiological measures of anxiety. The responses of 6 representative physiological parameters frequently assumed to be measures of anxiety along with a set of 4 psychological tests for measuring anxiety were obtained under naturalistic conditions from 25 patients hospitalized with a first myocardial infarction. A canonical correlational analysis failed to show any relationship between anxiety as assessed by the Taylor Manifest Anxiety Scale, Mood Adjective Check List, State-Trait Anxiety Inventory and Multiple Affect Adjective Check List psychological tests, and anxiety as assessed by the physiological indices of heart rate, systolic and diastolic blood pressures, epinephrine, norepinephrine and VMA. The intercorrelation matrix revealed a significant positive pattern of relationships among all 4 psychological tests, a non-significant, positive pattern of relationships among the physiological indices, and a non-significant, negative pattern of relationships between the psychological and physiological measures. The absence of mood-specific physiological measures for anxiety, as measured by the psychological tests, supports previous theory and investigation and points to the inadvisability of assuming that studies on anxiety that use diverse physiological and psychological measures yield results that may be compared as though they were assessing a common mood.


Sylvatic trichinosis in British Columbia: potential threat to human health from an independent cycle. The results of a 3-year study of trichinosis in British Columbia wild-life, based on the testing of more than 9,000 tissue specimens from a large variety of animal species, indicated that trichinosis is widespread among wild mammals in the southern and central parts of British Columbia. This continuing survey has established that the disease is carried by at least 15 species of terrestrial mammals including 3 species of rodents. The finding of Trichinella spiralis in ground squirrels and nonsynanthropic mice may be the first reported in North America. Although trichinosis appears to be eradicated in domestic pigs in British Columbia, a sylvatic cycle of the disease continues to exist independently and poses a potential threat to human health. It is possible for human beings to contract trichinosis by consuming inadequately cooked meat from certain wildlife species, especially bears, as well as meat products (such as pork or beef sausage) to which game meat has been added; several local outbreaks were caused by this source. Another hazard of unknown potential is the spread of trichinosis from the wild animal reservoir--from rodents in particular--to domestic pigs and thus to man.


The public health need for abortion statistics. As with the delivery of any medical service, abortion has definite public health effects that should be evaluated. The Center for Disease Control (CDC) has monitored the impact of abortion in three ways: (a) conducting epidemiologic surveillance of legally induced abortion beginning in 1969. (b) funding a multicenter study of abortion morbidity beginning in 1971, and (c) undertaking surveillance of abortion-related mortality beginning in 1972. These activities are intended to identify health problems related to abortion, to assess the magnitude of these problems, and to make recommendations directed at eliminating the problems. In addition to the Programmatic uses of abortion data, the CDC statistics have also provided a basis for both legislative and judicial decisions that have had national and local impact. The CDC and the National Center for Health Statistics are currently working collectively to strengthen the reporting of national abortion statistics so that the public health need for abortion statistics can be met.


[Roentgenographic findings in hemangioma of the skull (author's transl)]. Neuroradiological aspects of diagnosis of skull hemangiomas are analysed in 25 surgically treated cases. Selective internal and external carotid angiographies are important if recurrence after incomplete excision is to avoided.


[Roentgen diagnosis of hypoglossal nerve canal (author's transl)]. Roentgenographic demonstration of the hypoglossal canal had been neglected for a long time, mainly because of superposition of other bone structures. For full evaluation of the hypoglossal canal, tomographic studies with multidirectional tube positions are essential. In order to visualize the canal in three dimensions and to examine its osseous contours in detail axial, frontal and oblique views should be obtained. The jugular tubercle -- forming the roof of the hypoglossal canal -- is of special significance. The roentgenologic features of infiltrating and expansive tumor growth in the region of hypoglossal canal are discussed.


[Cranio-vertebral junction anomalies and osseous dysplasias (author's transl)]. The cartilaginously preformed occipital region of the cranium is ontogenetically a part of the backbone. The cranio-vertebral junction is unique among the other junctional areas of the backbone: 1. It has not yet been proved that different combinations of cranial and caudal junction anomalies are not combined with cervical junction anomalies. 2. The assimilations of the atlas which are considered to be progressive and regressive variants and the so-called manifestations of the occipital vertebra, i.e. diametrically opposed members of a developmental line occur together with a frequency that is inconsistent with the above assumption. 3. Both variants occur combined with the most serious developmental abnormalities of the cranio-vertebral junction. All described occipital-cervical abnormalities may have clinical significance with extends far beyond an assessment as simple variants (deviations) and includes extremely serious, life-threatening osseous deformations.


[Bony malformations of the cranio-vertebral junction and its clinical relevance (author's transl)]. A statistical analysis is performed in 86 cases suffering from osseous malformation of the cranio-vertebral junction. The material consists of 71 cases with basilar impression, 8 cases with hypoplasia or absence of the odontoid process, and 7 cases with a congenital atlanto-epistropheal dislocation. The patients are clinically asymptomatic in 23 cases, and are marked by a para-respectively tetraparesis in 28 cases, by bulbar-pontine-cerebellar disorders in 24 cases, and by syringomyelia in 11 cases. A control group is included consisting of 30 cases without neurological symptoms and with a normal radiological finding of the cranio-vertebral region. The following measured values are taken in consideration to perform a statistical calculation using the simple variance analysis: The height of the odontoid process above of McGregor's line, the distance between the back of the odontoid process and the inner limit of the arch of C1, and, concerning the groups with hypoplasia of the odontoid process process and with atlanto-axial dislocation, the narrowing of the spinal canal at the level of C1 dependent on movements of the head. The measured values are referred to the different clinical syndromes and are described and divided according to its statistical significance related to the clinical groups.


[Traumatic and posttraumatic lesions of the cranio-vertebral junction (author's transl)]. Trauma of the cranio-vertebral junction does not only cause osseous and ligamentous injuries but also nervous and vascular damage. The peculiar structure of these joints and trauma by hyperextension as well as forced bending of the spinal cord provoke distorsion, dislocations and fractures of atlas and axis as well as occipital condyles. A radiographic examination of these lesions must be minute and tomography and functional tests employed. Post-traumatic, neurologic and vascular complications are often the cause for acute and chronic bulbo-medullary alterations.


[Radiologic differential diagnosis of osteolytic lesions of the base of skull (author's transl)]. The radiologic differential diagnosis of radiolucencies of the base of skull is discussed by clinically and microscopically verified cases. For clarification of lesions in the base of skull tomography is frequently necessary. The specific diagnosis of these lesions is often only possible by angiography and consideration of the patient's history and physical findings.


[The aid of bone scans in diagnosis of fibrous dysplasia (author's transl)]. Fibrous dysplasia of the bone does not only occur in childhood as commonly believed, but may also be diagnosed during adult life as a stepwise progressing disease. Bone scans are useful to differentiate active from non-active disease. Suspicious accumulations of the radio-pharmaceutical which may be detected by total body scanning, should be confirmed by roentgen examination as a more specific method. Bone scan is helpful in early detection of focal disease and may visualize lesions in wide-spread disease for further radiological workup.


[Roentgen-anatomy of the distal fibula (author's transl)]. Based upon 1000 x-rays of the ankle the radiologic appearance of the sulcus peronaealis is evaluated. Three types may be differentiated. The muscle tone seems to be responsible for the development of the sulcus.


[Value of lymphography in teratoid testicular tumors (author's transl)]. In 72 patients with malignant testicular tumors lymphograms were reviewed and correlated with the microscopic findings of the resected lymphnodes. In 55 patients (76%) the roentgenographic diagnosis was confirmed by histology. In 6 patients lymphography was false positive as microscopic examination of the resected lymphnodes showed. In 4 patients lymphography was considered negative but metastatic disease proven microscopically from retroperitoneal lymphnodes. Out of 7 patients with questionable positive lymphograms 2 had retroperitoneal metastases confirmed by microscopic examination. The limits, errors and value of lymphography in patients with testicular tumors are discussed.


Augmented arterial flow and pressure resulting from selective injections through catheters: clinical implications. Injection of fluid through catheters positioned selectively in arteries results in substantial increases in flow and pressure in those arteries for the duration of the injection. This produces certain artifacts which may lead to misinterpretation of the arteriograms. Apparent direction of flow in major vessels, extent of collateral circulation, distribution of contrast medium throughout various branches of the arterial tree, and density of accumulation of contrast material in organs or tumors can be altered significantly by the injection technique.


The fabella sign: fabella displacement in synovial effusion and popliteal fossa masses. Normal and abnormal fabello-femoral and fabello-tibial distances. Posterior displacement of the fabella is a reliable sign of synovial effusion or mass which may be applied even when inflammation or post-traumatic edema obscures the extrasynovial fat lines of the knee joint. The fabella normally moves posteriorly as the knee is flexed, but correlation of fabella position with degree of flexion defined ranges of normal and abnormal fabella position which are useful in diagnosis. If all lateral views are obtained with the knee flexed over a standard angle bolster, fabella position is standardized and fabella displacement readily detected without need for measurement. With experience, fabella displacement is readily apparent in non-standard positions as well. Normal fabella position does not rule out small effusion or effusion which is confined to the suprapatellar pouch because the knee is extended.


The influence of thin-section tomography on the treatment of cervical spine injuries. A study was performed to determine the influence of routine thin-section tomography on subsequent treatment of the patient with acute trauma to the cervical spine. Of 79 such patients who underwent tomography over a 14-month period, 55 had suspicious indirect findings on the radiograph and 25% of these were shown to have fractures, while 67% of the patients without radiographic abnormalities who presented with a neurological deficit also demonstrated fractures on tomography. Of the patients who were shown to have fractures prior to tomography, 54% had more extensive injury than originally suspected. In nearly 18% of patients, the mode of therapy was changed significantly after tomographic evaluation. Indications for tomography are discussed and specific recommendations for systematic radiographic evaluation of cervical spine injuries are presented.


On-line computer storage, retrieval, and reporting of coded angiographic data. Interpretations of angiographic images have been coded and stored using an on-line computer terminal for seven years. Decoded angiographic information is incorporated in computer-generated reports which are printed on demand after completion of cardiac catheterization procedures. Currently, almost 5,500 cases are stored in an off-line data base which has been designed to help identify patterns with prognostic potential. Also, the program has helped standardize angiographic nomenclature, saved much clerical time, and virtually eliminated clerical errors. The program interacts with other software in the hospital, avoiding repetitious entries. The advantages and shortcomings of the program and commonly used approaches to computer storage/retrieval of radiographic information are described.


Telephone transmission of radiographic images. A new system for telecommunication of radiographic images using readily available telephone transmission circuitry is described. The resulting video images were satisfactory for accurate interpretation in 80% of the cases tested. The system is moderately priced and has facilitated maintenance of radiodiagnostic interpretive services at a satellite office form the central hospital location.


Economic analysis of body computed tomography units including data on utilization. All operating body computed tomography installations in the United States were surveyed in May 1977; data were obtained from 74 of 118 installations. Utilization and economic data from this survey are compared to similar data from January 1976. Scheduling delay data indicate that computed tomography availability is closer to meeting the clinical demand for CT studies than in January 1976; however, CT demand (as indicated by scheduling delay) is rising at installations with greater than 5 months BCT experience. The estimated annual technical cost of BCT is $359,000--$392,000 with a patient volume of 25--50 patients per week and is higher than the current net technical revenue.


Computed tomography and radionuclide imaging of the liver: a comparative evaluation. The authors retrospectively analyzed the results of radionuclide imaging (RI) and computed tomography (CT) of the liver in 174 patients. RI correctly identified 90% of patients with focal hepatic lesions while CT identified 85%. CT was capable of differentiating tumor, abscess/hematoma, and cyst while RI was more sensitive in the detection of hepatocellular disease. CT distinguished regenerating nodules from other focal lesions. Radionuclide imaging remains the preferred initial screening examination in patients with suspected focal liver disease, while CT is the examination of choice to distinguish obstructive from nonobstructive jaundice.


Computed tomography of tumors of the musculoskeletal system in children. Clinical applications. Studies indicate that computed tomography (CT) has several important clinical applications in the evaluation of tumors of the musculoskeletal system. These include (a) diagnosis of lesions involving difficult areas such as the sacrum and ilium, (b) demonstration of soft-tissue components of bone tumors or primary soft-tissue masses, (c) assessment of bone-marrow involvement, and (d) follow-up after irradiation or chemotherapy. Several selected pediatric cases are described in detail.


Malignant melanoma metastatic to the central nervous system. The CT appearance of metastatic malignant melanoma is varied, but it can show features suggesting the correct diagnosis. Intracerebral hemorrhage alone, associated with an adjacent tumor nodule or mixed diffusely with a tumor, occurred in 10 of 33 patients. Identification of a tumor nodule is important, since it may be the site of recurrent hemorrhage if not removed completely at surgery. Unusual presentations such as meningeal carcinomatosis and lesions simulating primary gliomas also occurred.


Spinal cord angiography using 4x magnification. Angiography at 4X magnification using a microfocal x-ray tube (0.05 mm) gives better resolution and detail of the spinal cord than conventional angiography. This technique permits demonstration of feeding arteries and draining veins, the course of the radiculomedullary arteries (including the artery of Adamkiewicz), ramification of communicating branches, and location of stenotic portions.


Renal uptake of 99mTc-sulfur colloid in congestive heart failure. Renal uptake of 99mTc-sulfur colloid during liver and spleen imaging was observed in 4 patients; all had moderate to severe congestive heart failure. Four similar patients with this association have been reported. Although the exact mechanism of colloid uptake by the kidneys is not known, an association with congestive heart failure seems likely.


The diagnostic significance of gallium lung uptake in patients with normal chest radiographs. Nine patients were encountered with normal chest radiographs, but diffuse bilateral lung uptake of 67Ga-citrate. They were divided into three groups. The first consisted of 6 patients who had lymphoma or leukemia and had had multiple cycles of chemotherapy. Here, abnormal uptake may have resulted from a toxic effect of the drugs or from a low-grade, subclinical infectious process. The 2 patients in the second group were drug addicts and a subradiographic interstitial inflammatory reaction was probably responsible for abnormal uptake. The last patient had diffuse uptake of 67Ga-citrate throughout the lungs two weeks before lymphomatous infiltrates became radiographically visible.


Epidural hematoma of the posterior fossa: radionuclide features. Since epidural hematomas usually present as acute neurosurgical emergencies, they are rarely studied by radionuclide imaging. An epidural hematoma in the posterior fossa showed characteristic anterior displacement of the torcular Herophili and separation of the superior sagittal sinus from the inner table of the skull on cerebral radionuclide imaging and angiography.


Cystic retroperitoneal lymphangioma in infants and children. Retroperitoneal lymphangiomas are uncommon benign tumors usually presenting in early life. They may cause significant pressure on adjacent structures, most often with superior and medial displacement of the kidney and medial deviation of the ureter. Relative radiolucency on total body opacification during excretory urography, and features of a cystic structure on ultrasonography and computed tomography should further suggest the possibility of a retroperitoneal lymphangioma. Vascular stretching and displacement without neovascularity on angiography and contrast entry into the cysts on lower extremity lymphography are additional features, but such procedures are usually unnecessary.


Peritoneographic demonstration of femoral hernia. Four cases of congenital hernia demonstrated by positive-contrast peritoneography are reported. Its differentiation from indirect inguinal hernia is described.


False aneurysms of the left ventricle. Identification of distinctive clinical, radiographic, and angiographic features. False aneurysms of the left ventricle were observed in 14 patients. They were caused by obstructive coronary arterial disease with resultant myocardial infarction in 11, bacterial endocarditis in 1, a knife wound in 1, and disruption of a ventriculotomy in 1. Most of them extended posteriorly on the lateral radiograph, as opposed to the usual anterior position of true aneurysms. Enlargement was frequently observed on sequential studies. Angiography usually demonstrated involvement of the diaphragmatic or posterolateral segment due to occlusion of the right coronary artery; in contrast, true aneurysms are apical or anterolateral and are due to occlusion of the left anterior descending artery. The frequency of rupture of false aneurysms points up the importance of dinstinguishing them from true aneurysms.


Ultrasonic study of the normal and dilated biliary tree. The "shotgun" sign. With the advent of real time scanners, segments of the normal biliary tree can now be seen  regularly. Normally, the biliary junction is narrower than the portal vein or the portal division. With early dilatation of the bile ducts the diameters of the two systems tend to equalize. Thus, the presence of two parallel ducts with similar diameters is pathologic. As the dilatation of the biliary tree progresses, the portal system may become flattened, thus reversing the initial proportion between the diameter of the biliary junction and that of the biliary tree.


Gray scale ultrasound of the scrotum.

Gray scale ultrasound of the scrotum. Clinical differentiation of the various pathological conditions which affect the scrotal contents can be difficult. The value of gray scale ultrasonography was assessed prospectively in 55 patients (110 testes) with specific clinical presentations and was compared to the reported results of other noninvasive imaging procedures. The homogeneous texture of the testes and the coarser pattern of the epididymal region were normally more clearly separable with gray scale signal processing. In this series, a clear differentiation of the origin of an abnormality was possible in 80% of the cases. A negative sonogram was highly reliable. However, the benefits of scrotal ultrasonography can only be evaluated after consideration of the clinical setting and alternative noninvasive diagnostic modalities.


The spectrum of ultrasonic findings in endometriosis. Ten cases of endometriosis presenting as pelvic masses are reviewed. Ultrasonically, these lesions were classified into three categories: cystic, mixed, and solid. In the cystic pattern, none had the smooth, well-defined wall and totally echo-free appearance characteristic of a simple cyst. Instead, the wall was shaggy and somewhat irregular with some evidence of septation. In the mixed type, the echographic appearance was compatible with pelvic inflammatory disease of an infectious etiology. In 3 cases with the solid pattern, the ultrasound appearance suggested ovarian malignancy. When the clinical setting and the age of the patient are suggestive of endometriosis, the sonographer should consider this possibility in his differential diagnosis of pelvic masses, regardless of the consistency of the lesion.


Ultrasonic detection of nonopaque renal calculi. Four patients with 5 nonopaque renal calculi composed of uric acid were examined by ultrasound. The calculi varied in size from a 1.5 X 1.5-cm intrapelvic stone to a staghorn calculus measuring 4 cm. All stones were satisfactorily imaged by ultrasound, allowing a diagnosis of nephrolithiasis to be made with confidence in each case. In 2 patients with poor excretion on urography, the diagnosis was not suspected prior to the ultrasound examination. The authors feel that ultrasound has great potential value in the investigation of nonopaque filling defects of the renal pelvis and in patients with urographic nonvisualization who have a high risk of uric acid lithiasis.


Histopathologic studies of the liver following intravenous colloidal 198Au therapy. Histologic studies of liver tissue from 27 patients given up to 395 mCi (cumulative) of intravenous colloidal 198Au showed no definite radiation injury and no correlation between hepatic abnormalities and dose. Demonstration of aggregates of colloidal gold in the Kupffer cells was inconsistent, suggesting slow removal or dispersion. Although the liver ordinarily receives the highest radiation dose, the critical organ is the marrow. Results support the recent introduction of 198Au to supplement teletherapy for certain neoplasms diffusely infiltrating the liver. Apparently the beta distribution minimizes endothelial injury in large vessels, which has been shown to be the cause of radiation hepatitis.


Reduction of patient exposure by use of heavy elements as radiation filters in diagnostic radiology. The effect on patient exposure of x-ray filters made of heavy elements has been studied in excretory urography and lumbar spine examinations. Several elements with atomic numbers between 62 and 74 were tested in experiments using radiographic phantoms and in patient studies. A holmium filter reduced skin exposure by more than 50% in excretory urography. Similar results were obtained with ytterbium and tungsten in lumbar spine studies.


A film dosimetry system for use in computed tomography. The authors describe a film dosimetry system for use in calculating the surface dose delivered by a CT scanner. Kodak XV-2 film is wrapped around a cylindrical water-filled phantom and the dose distribution is recorded. This system is easier to use than thermoluminescent dosimetry (TLD) and provides a detailed map of the dose distribution. Comparison with TLD measurements for a variety of CT scanners indicates that an accuracy of +/-15% can be achieved using this system. Dose distributions obtained with several scanners are shown.


A computer-assisted three-dimensional treatment planning system. The three-dimensional treatment planning system developed at the Rhode Island Hospital visualizes the spatial interrelationships of the radiation beam, the tumor, and the adjacent organs within the patient. It is possible to rotate and vary the scale of the display to better comprehend the extent of these structures. By viewing the display as if from along the radiation beam, one can design shaped treatment fields which best suit the three-dimensional nature of the disease. With this system, it is possible to reduce the volume of normal tissue which would typically be irradiated if two-dimensional treatment planning techniques and assumptions were employed.


Percutaneous biopsy using a safe, effective needle. A specially designed three-pronged aspiration needle is described. It was used in 166 percutaneous lung biopsies in 151 patients. A correct diagnosis was obtained in 141 patients (93.3%). Only minor complications were seen, including pneumothorax (7.8%) and pulmonary hemorrhage with hemoptysis (2.4 percent).


Fluoroscopic guidance in femoral artery puncture. Analysis of 100 femoral arteriograms demonstrated a consistent relationship between the course of the femoral artery and the femoral head. Fluoroscopic guidance can be of value in femoral puncture when the arterial pulse is diminished or obscured, for training purposes, and for analysis and correction of missed punctures.


Pseudoaneurysm of the left ventricle. Radiographic and angiocardiographic diagnosis. Left ventricular pseudoaneurysms represent intrapericardial ruptures contained by adherent pericardium and fibrous tissue, forming an avascular wall; in contrast, the wall of a true aneurysm is formed of fibrous elements of the infarcted myocardium and contains coronary vessels. Prior myocardial infarction and/or aneurysmectomy may predispose to pseudoaneurysm formation. Plain radiographs, echocardiography, gated cardiac blood pool imaging, and left ventriculography are helpful, and the combination of left ventriculography and selective coronary arteriography is diagnostic. A uni- or multiloculated chamber communicating with the left ventricle by a relatively small orifice without draping of coronary vessels is diagnostic of pseudoaneurysm.


Aspiration biopsies of chest lesions.

Aspiration biopsies of chest lesions. 1223 patients underwent aspiration biopsy with a diagnostic yield of 86.4%; 24.2% of the patients had a small pneumothorax, but only 4.4% required treatment; one patient developed a moderate hemothorax. The method, problems, and complications including morbidity and mortality are discussed. The relative success of aspiration biopsy with different lesions of the lung and mediastinum is identified.


Giant hyperplastic parathyroid gland in the mediastinum--partially cystic and calcified. A large, calcified paratracheal mass was identified in a patient with secondary hyperparathyroidism. The mass proved to be a giant, calcified, cystic, hyperplastic parathyroid gland. Radiographic and ultrasonic imaging techniques were quite useful in diagnostic evaluation. Whenever a calcified mediastinal or neck mass is discovered, especially in a patient with hyperparathyroidism, parathyroid enlargement should be a diagnostic consideration.


Right posterior oblique: the projection of choice in aortography of hypertensive patients. The right posterior oblique (RPO) is the most helpful aortographic projection for demonstrating the origins of the renal arteries. In 59% of the 692 hypertensive patients studied, the origins of both renal arteries were seen in this projection. The second most helpful aortographic projection was the anteroposterior (AP) view, which showed the origins of the renal arteries in 22.6% of these patients. The remaining 18.4% of the patients required both the AP and RPO projections in order to show the origins of both renal arteries.


The use of Pro-Banthine to induce gastrointestinal hypotonia. Immediate and satisfactory gastrointestinal hypotonia was induced in 48 patients with 5--10 mg of intravenous Pro-Banthine during radiographic examination; side-effects were minimal. If given intravenously in small doses, Pro-Banthine is a satisfactory alternative when glucagon is contraindicated or not available.


Profile roentgenographic features of benign greater curvature ulcers. Certain roentgenographic features have been considered typical of benign gastric ulcers, based almost entirely on studies of the lesser curvature. However, these features frequently are not present on the profile view in benign greater curvature ulcers. Moreover, features stated to suggest malignancy in gastric ulcers are commonly simulated by benign greater curvature ulcers. The authors reviewed the profile roentgenographic features of 19 benign greater curvature ulcers and found that they often appeared to be intraluminal and had shouldered edges due to spasm of the surrounding circular muscles. In 6 patients the adjacent gastric contour was scalloped. These features frequently cause radiologists to misinterpret benign greater curvature ulcers as malignant.


Radiologic-pathologic correlation from the Armed Forces Institute of Pathology. Inflammatory fibroid polyp. The inflammatory fibroid polyp of the stomach, sometimes called eosinophilic granuloma, is a relatively uncommon lesion usually presenting a solitary, benign-appearing filling defect. The differential diagnoses include polypoid adenocarcinoma, hyperplastic mucosal polyp, adenoma, leiomyoma, epitheliod leiomyoma and leiomyosarcoma, and aberrant pancreas. Although difficult to distinguish by gross morphologic features, the inflammatory fibroid polyp shows a distinctive inflammatory response of the mucosal stroma in which eosinophils may be prominent. It is unrelated to the eosinophilic granuloma of lung or bone.


Portosystemic communications studied by transhepatic portography;. The experience of collecting 120 transhepatic portograms, performed in patients with different degrees of portal hypertension, affords the opportunity for discussing the anatomical and hemodynamic features of portosystemic communications. Multiple pathways of decompression were found. The coronary-gastroesophageal collateral formed pathways in 108 cases, other major collaterals in 41, and minor collaterals in 2. This multiplicity of communications suggests that no one vessel is indispensable as a collateral pathway.


Suture granuloma of the stomach following total colectomy. Stitch granuloma is rarely a consideration in the differential diagnosis of stomach lesions. This report documents the occurrence of a granulomatous mass of gastric origin simulating an intramural tumor.


Radiology of colon loop diversion: anatomical and urodynamic studies of the conduit and ureters in children and adults. Colon loop diversion of the urinary stream is a relatively recent procedure designed to decrease the frequent incidence of reflux, infection and calculus formation in ileal loop conduits. Fifty-seven colon conduits and 107 ureters were studied. No reflux occurred in 67 ureters with intracolonic loop pressures exceeding 40 cm H2O. To evaluate and manage possible ureteral obstruction, percutaneous (antegrade) pyelography was utilized in 11 kidneys, ureteral perfusion (pressure-flow) studies in 8, and percutaneous catheter nephrostomy in one.


Epinephrine renal venography in severe inflammatory disease of the kidney. In a comparative study of the diagnostic value of epinephrine renal venography (ERV) and angiography in eight patients with severe inflammatory disease of the kidneys, the spectrum of abnormalities exhibited by ERV was more striking than the angiographic findings. Complete disorganization of the renal venous architecture with linear streaking of contrast agent is a sign of renal inflammatory disease. ERV is a useful adjunctive diagnostic procedure in cases of a nonfunctioning kidney.


Radioimmunoassay of 13, 14-dihydro-15-keto-prostaglandin F2alpha. A simple method is described for the determination of 13, 14-dihydro-15-keto-prostaglandin F2alpha (PGFM), using a highly specific antiserum raised in New Zealand rabbits. It involves extraction of human peripheral venous plasma with diethyl ether after addition of tritiated PGFM and HCl. Radioimmunoassay is performed on appropriate aliquots; after 2 hours or overnight equilibration the bound and free metabolite are separated using dextran-coated charcoal. The mean values +/- S.D. obtained are as follows: healthy males 32 +/- 16 pg/ml, females during follicular phase 48 +/- 18 pg/ml, luteal phase 37 +/- 8 pg/ml, first trimester of pregnancy 66 +/- 33 pg/ml, second trimester 67 +/- 42 pg/ml and third trimester 72 +/- 26 pg/ml.


Urinary excretion of prostaglandin E2 and prostaglandin F2alpha in potassium-deficient rats. Potassium-deficiency was induced in rats by dietary deprivation of potassium. The animals became polyuric and urine osmolality decreased more then three-fold compared to controls. Urinary excretion of prostaglandin E2 (PGE2) and prostaglandin F2alpha (PGF2alpha) did not increase during 2 weeks of potassium depletion. Partial inhibition of renal prostaglandin synthesis by meclofenamate did not increase the urine osmolality after water deprivation. These results make unlikely the hypothesis that the polyuria of potassium-deficiency, is the result of enhanced renal synthesis of prostaglandins with subsequent antagonism of the hydro-osmotic effect of vasopressin. Male animals consistently excreted less PGE2 than female animals.


Prostaglandin E inhibition of mitogen stimulation in patients with multiple sclerosis. Kirbey et al have reported that leukocyte function from patients with multiple sclerosis is not suppressed by PGE2, as are normal leukocytes. We examined the ability of PGE2 (0.01-0.5 microgram/ml) to suppress Phytohemagglutinin induced 3H-thymidine incorporation in peripheral blood lymphocytes from multiple sclerosis patients and normals. There was no difference in sensitivity between the two groups. There was also no difference in activity of the prostaglandin producing suppressor cell between the multiple sclerosis patients and controls.


A comparison of prostaglandin F2alpha and three 16-aryloxy analogues on the isolated rabbit jejunum. Three 16-aryloxy analogues of PGF2alpha are potent, full agonists on the isolated rabbit jejunum. Their actions are more prolonged than that of PGF2alpha, and radioactive tracer studies with one of the analogues reveal a slower wash-out of the analogue compared to PGF2alpha, under superfusion conditions. During the prolonged contractile response diminished responses to PGF2alpha were obtained: this effect was investigated in terms of receptor desensitization. The actions of these analogues were also investigated on the isolated guinea-pig ileum and the rabbit oviduct in vivo.


Effect of prostaglandin I2 and related compounds on vascular permeability response in granuloma tissues. The effects of prostaglandin I2, 6-ketoprostaglandin F1alpha, prostaglandin E1 and thromboxane B2 on the vascular permeability response in rat carrageenin granuloma were studied with the aid of 131I- and 125I-human serum albumin as indicators for the measurement of local vascular permeability. A single injection of 5 microgram of prostaglandin I2 methyl ester or I2 sodium salt into the locus of the granulomatous inflammation elevated local vascular permeability 2.0-2.5 times over the control within 30 min. The potency was equal to that of the positive control prostaglandin E1 which has been known to be the most potent mediator in this index among several candidate prostaglandins for chemical mediator of inflammation. The other prostaglandin and thromboxane B2 tested were essentially inactive.


Tracheobronchial irritancy of inhaled prostaglandins in the conscious cat. A novel test was developed to measure the tracheobronchial irritant activity of inhaled prostaglandins. Conscious restrained cats were challenged with separate aerosols of PGE1, PGF2alpha, acetylcholine or isoprenaline. All of the aerosols except isoprenaline caused coughing in a concentration related manner. Tolerance developed very quickly to the tracheobronchial irritation and lasted 1-2 days for PGE1 and less than 1 day for PGF2alpha and acetylcholine. When a 3 day interval between each aerosol challenge was used, PGF2alpha was approximately 700 times more potent than acetylcholine as a tracheobronchial irritant. The highest PGE1 aerosol concentration (500microgram/ml) also caused sedation, diarrhoea and salivation. This test probably provides a useful method for evaluating the tracheobronchial irritant activity of potential prostaglandin bronchodilator analogues and for investigating the mechanism of action of prostaglandin induced tracheobronchial irritancy.


Responsiveness of the lamb ductus arteriosus to prostaglandins and their metabolites. The relative potencies of the prostaglandins A1, A2, E1, E2, F2alpha and their 15-keto-, 15-keto-13,14-dihydro-, and 13,14-dihydro-metabolites were investigated on isolated lamb ductus arteriosus preparations contracted by exposure to elevated PO2. All the prostaglandins (except PGF2alpha and its 15-keto-metabolites) relaxed the tissue. However, only PGE1, E2, and their 13,14-dihydro-metabolites, were effective at concentrations below 10(-8) M. Therefore, events that alter metabolism of circulating PGs in the perinatal period may have significant effects on the relative patency or closure of the ductus arteriosus.


Biosynthesis of prostaglandins and thromboxane B2 by fetal lung homogenates. The conversion of arachidonic acid to prostaglandins (PG's) and thromboxane B2 (TXB2) was investigated in homogenates from fetal and adult bovine and rabbit lungs. Adult bovine lungs were very active in converting arachidonic acid (100 microgram/g tissue) to both PGE2 (10.7 microgram/g tissue) and TXB2 (6.2 microgram/g tissue. Smaller amounts of PGF2alpha (0.9 microgram/g) and 6-oxoPGF1alpha were formed. Homogenates from fetal calf lungs during the third trimester of pregnancy were quite active in converting arachidonic acid to PGE2, but formed very little TXB2, PGF2alpha or 6-oxoPGF1alpha. Homogenates from rabbit lungs converted arachidonic acid (100 microgram/g) mainly to PGE2, both before and after birth. The amount of PGE2 formed increased during gestation to a maximum of about 6 microgram/g tissue at 28 days of gestation. It then decreased to a minimum (1.5 microgram/g) which was observed 8 days after birth, followed by an increase to about 4 microgram/g in older rabbits.


Determination of menstrual prostaglandin levels in non-dysmenorrheic and dysmenorrheic subjects. We have developed a method which can measure the menstrual prostaglandin (PG) activity in a single tampon specimen by bioassays. This method makes it possible to monitor the menstrual PG activity continuously during menstruation. Using this technique, we determined the menstrual PG patterns of two normal non-dysmenorrheic subjects, one subject on oral contraceptives (OC) and one subject with moderate to severe dysmenorrhea. Two to four cycles were studied per subject. We observed three mentrual patterns among the four subjects studied. Compared to the two normal controls, the subject on OC had a significantly lower menstrual fluid total and menstrual PG activity. The mean values +/- S.E. per menstrual period were 33.4 g +/- 1.5 vs 21.5 g +/- 2.0 and 28.6 microgram (PGF2alpha equivalent) +/- 1.5 vs 11.3 microgram +/- 4.2 respectively (control vs OC). The dysmenorrheic subject had a menstrual fluid total of 37.0 g +/- 1.9 similar to the two normal controls. Her menstrual PG activity (49.8 microgram +/- 7.7), however, was nearly two times higher than the normal controls. In one cycle studied, the dysmenorrheic subject was treated with a PG synthetase inhibitor, ibuprofen (Motrin). Remarkable relief was achieved. The alleviation of symptoms was accompanied by a concomitant marked reduction in the menstrual PG activity.


Specific production of prostaglandin E by human amnion in vitro. Prostaglandin production by intra-uterine human tissues has been investigated using a method of tissue superfusion. Tissues were obtained at elective Caesarean section and after spontaneous vaginal delivery. It was found that all the tissues studied (amnion, chorion, decidua and placenta) produced more prostaglandin E (PGE) and 13,14-dihydro-15-keto-prostaglandin F (PGFM - the major circulating metabolite of prostaglandin F) than prostaglandin F (PGF). Amnion produced significantly more PGE (but not PGF or PGFM) than any other tissue. Prostaglandin production by each tissue was similar whether it was taken at elective Caesarean section or after spontaneous vaginal delivery.


Resolutions in imaging with Fresnel zone plate. A coarse Fresnel zone plate (FZP) may be used as a large-area coded aperture for imaging incoherent sources. The longitudinal and lateral spatial resolutions are discussed on the basis of experiment using an FZP having 18 or 19 zones as an aperture. In this paper, it is then shown that the lateral spatial resolution is about 5 mm and the longitudinal is about 1 cm, respectively and it is appropriate to use the longitudinal resolution factor 3.7 as a guide to know the tomographic effect. These results may be extended for imaging incoherent gamma-ray sources. According to our experiments, radioactivity of several tens of a millicurie is necessary for imaging with 99mTc, when using X-ray film as a detector. Therefore, it is important to improve the detector in order to apply to the human organ imaging generally.


[Effect of 60Co gamma-irradiation on dilute aqueous solutions of surfactants]. Present work deals with the effects of gamma irradiation from 60Co gamma-ray source upon aqueous solutions of three kinds of surfactants. When dilute aqueous solutions of sodium dodecyl sulfate (SDS, anionic), cethyl trimethyl ammonium chloride (CTAC, cationic), and polyoxyethylene lauryl ether (POE, non-ionic) were irradiated with gamma-rays at a room remperature, the residual concentration, products, surface tension, and forming power were examined by colorimetric method, IR spectrophotometric method, gaschromatography, Ross-Miles method, and Traube's stalagnometer etc.. These surfactants were decomposed by the irradiation and thus the surface tension increased and the forming power, on the contrary, decreased with dose. Radiation chemical yields (G-value) of the degradation were about 1 for the solutions of SDS and CTAC, and about 0.3 for the POE solution. From the experimental results, it was found that following chemical reactions seem to occur followed by the radiolysis of water; a) bond cleavage of ester for SDS, of CN for CTAC, and of oxyethylene for POE, b) hydrogen abstraction from the surfactants, c) production of CO bond in the presence of dissolved oxygen.


Incidence of pulmonary embolism.

Incidence of pulmonary embolism. During the last 5 years in a community hospital of 219 beds, the most common cause of death (primary and secondary or contributory) was pulmonary embolus. In the US fatal pulmonary emboli occur in 5 patients for 1,000 inpatients, nonfatal pulmonary embolism in 20 patients per 1,000 inpatients, about 142,000 patients suffer fatal pulmonary emboli and 568,000 suffer nonfatal pulmonary emboli each year. In 422 autopsies 93 patients (21%) have pulmonary emboli undiagnosed during the patient's life time. In comparing with other statistical studies, about 21% represent the death rate of patients treated for pulmonary emboli if the diagnosis is previously made. On the basis of this observation the incidence of pulmonary emboli and thrombosis of the lower limbs appears to be about the same in community and the university hospitals, disregarding if the patients are having the highly skill care or are treated by the general practitioner without the sophistication of expensive technology.


Oxygen cost of breathing in dogs.

Oxygen cost of breathing in dogs. The O2 cost of breathing has been calculated in awake and anesthetized dogs breathing spontaneously. Respiratory variables were measured in tracheostomized dogs in the standing position, while supported in a canvas sling, at room temperatures between 20 and 23 degrees C. Minute ventilation ranged between 3 and 53 liters/min while VO2 ranged from 61 to 686 ml/min. VE, VO2 and f varied considerably from measurement to measurement even though body temperatures and experimental conditions changed very little. VO2 increased with VE: VO2 = 10.2 VE + 58.4 r = 0.94. A cubic polynomial equation was also calculated for these data: VO2 = 11.6 + 19.0 VE-0.42 (VE)2 + 0.0057 (VE)3. Awake dogs showed panting and considerable hyperventilation (PACO2 = 22.5 +/- SD of 4.5 mm Hg). Anesthetized dogs had lower average values of f, VE and VO2; while average PACO2 was 29.1 +/- 4.5 mm Hg. VO2 and VE measured when the dogs were anesthetized, paralyzed and artifically ventilated were related by this equation: VO2 = 5.9 VE + 87.5, r = 0.88. The O2 cost of breathing, calculated by subtracting the regression equation obtained while the dogs were under artificial respiration, from the cubic polynomial equation, increased with increasing VE in a curvilinear fashion. The values for O2 cost of breathing at high levels of ventilation were high because dogs' lungs are small. After correcting for lung size, values for O2 cost of breathing were similar to those in humans.


Structural alterations of the lung in anthracosilicosis--automatic quantitation with an image-analysing computer. A morphometric method of assessing anthracosilicotic alterations in lung structure was studied in 4 patients. The introduced model and a special technique for preparation permit the evaluation of anthracosilicotic dust deposits, secondary emphysema, and intact residual parenchyma by means of an image-analysing computer. This method appears particularly suitable for investigating and correlating morphology to clinical data, because the parameter 'intact residual parenchyma' can be reproduced in a short time with sufficient accuracy by random samples.


[Prevalence of bronchitis in socio-professional groups. III. Unexposed workers (author's transl)]. Besides the two groups of exposed workers (building workers and workers of a steel mill), a reference group of age-matched (40--60 years) unexposed workers was studied. They were examined by the same procedures (interrogation by ESC questionnaire, vital capacity, forced expiratory volume in 1 sec residual volume, apnea CO test and steady-state Co test at rest and exercise of 40 W. Results are presented according to age and smoking habits. They are compared with results observed in the two exposed groups, and discussed.


Giant intralobar sequestration.

Giant intralobar sequestration. A case of intralobar sequestration is reported in a 20-year-old male who had recurrent localized infections since age 5. The prolonged course without diagnosis, the very large size of the lesion, and the demonstration of an anomalous artery from the abdomen on the plain chest film represented unusual features. Classification, clinical presentation, and diagnostic and therapeutic approaches are emphasized.


Variations in nasal resistance in man: a rhinomanometric study of the nasal cycle in 50 human subjects. The alternating congestion and decongestion of the nasal mucosa, termed the "nasal cycle", was investigated with current mask (posterior) active rhinomanometric techniques. This communication reports variations in nasal resistance in 50 human subjects, each studied for about 7 hours. Approximately 600 resistance values (cm H2O/liter per second) were obtained from each subject. The nasal cycle defined in rhinomanometric terms was that alternating congestion and decongestion of the nasal turbinates which produced a change in pressure and airflow values calculated as resistance (comparing one side with the other) of 20% or greater for two consecutive observations (at least 15 minutes). The data demonstrated that 36 of 50 subjects (12 of 18 males and 24 of 32 females) had at least one nasal cycle during the period of observation.


The clinical significance, diagnosis and treatment of bulla formation in the nose. Nasal stenosis as a result of a bulla formation in the middle concha and uncinate process, together with hypertrophy of the bulla ethmoidalis, is described on the basis of 4 case histories. The condition obstructs drainage from the paranasal sinuses and produces an unphysiological airstream through the nose. This results in a disease complex which is dominated, in particular, by nasal stenosis, a feeling of pressure with radiating pains to the neighbouring regions, together with chronic infection of the upper and lower airways. It appears to be difficult to make the diagnosis clinically and from routine x-rays. The importance of the differential diagnosis from nasal polyps and mucosal hypertropy is emphasized. It is suggested that the term "bulla cavi nasi" by employed as a common name for bulla formation in the nose.


Porcine atrophic rhinitis: a model for studying nasal physiology and pathophysiology. Porcine infectious atrophic rhinitis is a disease of swine which ought to be of considerable interest to rhinologists. We have reviewed some aspects of human atrophic rhinitis, and some aspects of etiology incidence, pathology and physiology of porcine infectious atrophic rhinitis. Swine with this nasal problem fail rather dramatically, to gain as much weight as unaffected animals. We have speculated on several reasons for this including altered nasal physiology and trigeminal reflexes and reduced olfaction. Photographs of infected pigs are included.


Microscopic and ultramicroscopic alterations of the respiratory mucous membrane in experimentally provoked bronchitis. The noses of four experimental dogs were surgically obstructed, and thus their entire respiration was disturbed, and this affected the mucous membranes of the lower respiratory passages. Normal histological examinations and electronic microscopy found chronic irritation of the bronchial mucous membranes. It was possible histologically to follow the most subtile alterations on the membranes from the very beginning of the chronic bronchitis. The importance of nasal obstruction as a contributing factor of chronic bronchitis is stressed.


[The reliability of arthrography of the knee joint via medium format technique (author's transl)]. Reports on 217 arthrographies of the knee joint with operative control. Partly or entirely erroneous roentgen diagnoses were made in 4.8-16.3% of the cases, depending upon the technique by which the patients had been examined. Lateral meniscus lesion was wrongly diagnosed three times as often as the medial lesion. The lowest incidence of wrong diagnoses occurred when examining via the medium format technique.


[On the meaningful filing period for x-ray films (author's transl)]. A total of 19,577 x-ray films made from 5,092 patients was examined, subdivided into 94 different kinds of examination. The following observations were made: The time since the last x-ray examination of the patient up to Jan. 6 1973 was less than 2 years in 30.1% and less than 5 years in 63.8% of the patients. These figures are due to the fact that the hospital is still very young. The period between two successive x-ray examinations was less than 2 years in 88.2% and less than 5 years in 95.8% of the patients. It is obviously not necessary to file roentgenographs for more than 5 years, since after that time only 4.2% of the patients return for a follow-up examination, and only a fraction of these can probably be regarded as really remarkable (Brolin).


[Studies on the biliary excretion of the hepatotropic contrast media ioglycamate and iotroxinate in pigs and men (author's transl)]. The distribution and biliary excretion of two hepatotropic contrast media, Ioglycamate and Iotroxinate, has been studied in the anaesthetized pig in infusion experiments. The new substance Iotroxinate exceeds the Ioglycamate in two of the investigated parameters: it was excreted faster and reached a higher biliary concentration. The biliary transport maximum, however, was unchanged. On the basis of these experiments the new contrast medium Iotroxinate was tested in men.


[X-ray installations for gastrointestinal diagnosis. The technical state of the art and problems (author's transl)]. Today, the X-ray industry offers a side range of products with varying facilities and prices for the X-ray examinations of the gastrointestinal tract. All the further stages of development from the simple unit to the highly sophisticated installation have a common aim: The earliest, reliable diagnosis, as the prerequisite for early and effective therapy. Certain expenditures are necessary to achieve this objective. The main point is to find the optimum, wherein the requirements of the user, the technical possibilities and the costs are matched to one an other. Besides the enhancement of image quality in both, fluoroscopy and radiography, improvements in working conditions and the automation of technical processes also contribute to improving the diagnostic possibilities. The technically sophisticated installations guarantee a uniform standard of the pictures "documented", so that the examiner can concentrate more intensively on the medical problems. The introduction of fluoroscopy via image intensifier and TV has led not only to improvements in the conventional examination unit, but also to the realization of a new unit conception which, because of more universal application, can be more economically used, and because of new projections, provides additional information. Each X-ray installation must be configurated according to its specific medical application.


[Inventory relating to roentgen diagnostics of the gastro-intestinal tract (especially of the small intestine, colon, and biliary tract) (author's transl)]. The article describes the authors' experience in their Department in Nijmegen (Holland) with the various types of x-ray equipment: in gastroenterology--especially in the examination of the small intestine, colon, and the bile ducts--and also within the framework of a general roentgenology diagnostics section. Problems of cost are also considered, relating on the one hand to the equipment required in an examination room, and on the other hand to gastroenterological examination. In conclusion, the authors suggest the most suitable type of apparatus to be acquired for a particular purpose.


[Tomography (author's transl)].

[Tomography (author's transl)]. Conventional and Computerized Tomography are radiological techniques with the objective to reproduce tomographique images, both with different features with regard to detail recognition. Both techniques can be considered as methods complementing one another and not as competitive ones following the present stage of development and experiences gained in this field. Conventional Tomography with its proper range of application is regarded as a fully developed technique, whereas Computerized Tomography will possibly allow further development and improvements with regard to technology and performance. The limits, however, in the relation price/performance regarding tomopgraphic equipments and the relation dosage/image quality regarding the method can already be recognized. If we compare both techniques, we may say, however, with certain reservations, that Conventional Tomography stands out for a superior spatial resolution whereas a better distinction between small density differences in tissues one of the most distinguished features is Computerized Tomography is known for.


[Computer tomography--present role and future prospects (author's transl)]. The actual CT apparatus requirements connot be estimated at present. For cranial CT, one apparatus for every 200,000 inhabitants is considered necessary. For radiotherapy, apparatus with a slow scanning rate will be sufficient. A scanning time below 1 second is required for cardiac investigations. More attention should be paid to the kinetics of organ-specific contrast media, so that better diagnostic information may become possible by effecting the roentgenograms at the most favorable time.


[Filmsizes; physical-technical aspects of x-ray image recording (author's transl)]. Formats of full-size radiographs are determined by the dimensions of the anatomy to be recorded, the enlargement factor is always larger than unity. Given a certain film screen combination exposure and film-density cannot be chosen independently--whereas with X-ray I.I. fluorography this is possible. In the former case they depend on X-ray absorption, energy efficiency and the luminescent spectral emission of the screens in combination with the corresponding characteristics of the photographic film. The respective characteristics of standard film-screen combinations and those based on rear earth screens are discussed and compared. X-ray image intensifier fluorography is presented as a logical enlargement of I.I. fluoroscopy, in itself and indispensable tool in X-ray diagnostics. Its real or imaginary pro's and con's are elucidated.


[Format and image contents of x-ray picture (author's transl)]. This article is essentially on the lines of the paper read at the German Congress of Radiologists ("Deutscher Röntgenkongress") at Münster. It deals with the visual interpretation of the contents of roentgenographic films of widely different origin. On going deeper into the subject, it was found that by examining the pictures for structural contents as far as the image permits, it becomes possible to obtain a survey of all the usually prepared x-ray photographs--a viewpoint which has so far been greatly neglected. Knowledge of the conditions of observation and of the prerequisites is promoted at the same time. The need for radiation protection is re-emphasized from a new angle.


[X-ray format and dose (author's transl)]. The paper discusses conventional roentgenographic methods and image amplifier fluorography. 1. Reduction of the required dose in conventional roentgenographic examinations has been achieved by the use of CaWO4 special foils, or , to an even greater extent, on rare earth basis (lanthanum oxibromide). 2. A considerably greater reduction in dose is achieved with image amplifier fluorography of medium format. 3. The possibilities offered by both systems are discussed. Possible future developments are examined.


Influence of sex and age on serum immunoglobulin concentrations in healthy subjects. Cencentrations of serum-immunoglobulins IG, IgA and IgM in 440 apparently healthy subjects aged 15 to 70 years were estimated by assay against the WHO International Reference Preparation 67/97. An improved single-radial-diffusion technique was used. Sex-related differences were separately examined for each age group by means of Stusdent's t test. Except for IgA mean value of the younger males (15--24 years), which was significantly (p less than 0.05) higher than that of females, no other significant sex differences were found for IgA mean levels; in contrast, mean IgM concentrations were significantly (p less than 0.001) higher in females than in males, in all but one (55--70 years) of the age groups. Linear-regression analyses of log10 Ig concentration on age have evidenced that a significant decrease in IgM levels with age occurred only in females (r = - 0.390; p less than 0.001); on the contrary, significant increases with age occurred in IgG concentrations of males (r = 0.271; p less than 0.001), as well as in IgA levels of both males (r = 0.240; p less than , less than 0.001) and females (r = 0.263 ; p less than 0.001).


Hemodynamic stresses and atherosclerosis. An attempt is made to summarize the recent available information on the atherogenic role of hemodynamic stresses. The paper focuses attention on the interrelations between hemodynamic stresses, on the one hand, endothelial cells, smooth muscle cells, aortic and coronary walls on the other. In addition data are presented on the atherogenic role of hemodynamic changes induced by arterial hypertension and myocardial revascularization.


The enzymatic equipment of neutrophils in patients with precancerous states of the larynx. Cytochemical investigations performed in 24 men with precancerous states of the larynx, i.e. leukoplakia, papillomas and pachydermia, indicated that the peripheral blood neutrophils from these patients exhibit a significant intracellular deficiency of beta-glucuronidase activity and of total lipids, as well as an increased alkaline phosphatase activity. Acid phosphatase and N-acetyl-beta-glucosaminidase activities did not differ significantly between patients and normal controls. In the authors' opinion, the neutrophil beta-glucuronidase deficiency might be a specific disturbance of neutrophils in the precancerous states and the cancer of the larynx. The possible significance of this disturbance and the subsequent decrease of antitumor immune reactivity are discussed.


Continuous electrocardiographic monitoring during upper gastrointestinal endoscopy. ECG changes were followed up in 69 patients under continuous electrocardiographic monitoring before, during and after esophago-gastro-duodenoscopy (EGD). Of these 32 (46.5%) had ischemic heart disease (IHD). One or more varied abnormalities including supraventricular or ventricular ectopic beats, sinus tachycardia or sinus bradycardia, intermittent right or left bundle branch block, S--T segment depression (and increased preexisting S--T segment depression), T wave flattening or inversion appeared during EGD. Only one patient with IHD developed anginal chest pain during endoscopy. Despite the high incidence of recorded rhythm abnormalities, these were transient, and no treatments were needed. However, it seems advisable to have resuscitation equipment and emergency drugs available during EGD, particularly when it is performed in patients with IHD.


Ventricular monophasic action potentials during intermittent left bundle branch block. A case of intermittent left bundle branch block is presented. Simultaneous recording of right and left ventricular monophasic action potentials allowed a more accurate demonstration of delayed left ventricular activation during intermittent left bundle branch block. His bundle electrogram was also of great help in the interpretation of infrahisian conduction in the patient studied. These methods may be useful in the complex electrophysiologic investigation of certain cases.


Gastro-duodenal motility: 24 hour continuous recordings in normal subjects. Twenty four-hour continuous recordings of gastric and duodenal motor activity were obtained in 12 normal subjects. A regular, cyclical variation in gastro-duodenal motility, consisting of periods of intesnse activity for 15--30 minutes alternating with periods of almost complete quiescence during the following 30--90 minutes, was noted in all subjects. All wave types previously described in short term studies were observed. Antral and duodenal activity were often linked, but there were many occasions when either occurred independently. Motor activity while the patient slept differed little from the waking pattern. There was no consistent motility pattern which could be associated with the subjects' hunger sensation. Eating was followed by a significant increase in duodenal motor activity which has not been previously described; the authors assume it to be due to endogenous gastrin release.


Antigens with glycoprotein structure in the gastric juice. I. Immunological and chemical determinations. To demonstrate the presence of specific antigens in the normal and malignant gastric juice the immunological and chemical features of certain antigens with glycoprotein structure from malignant gastric jucice and gastric tumors were studied comparatively with those of antigens obtained from normal gastric juice and gastric tissue. The investigation was carried out in tumor tissue extracts from 7 patients with malignant gastric tumors and in gastric juice from 45 patients with other non-cancerous diseases. From the five fractions obtained, which gave immunoelectrophoretic precipitin lines in the beta and alpha-globulin regions with the antiserum against total normal gastric juice, a single specific was separated by means of successive chromatographies on sephadex G--100 and DEAE-Sephadex -a--50 (eluted in NaCl concentration gradient). This fraction represented 11.1 per cent of the total proteins. None of the five fractions could be identified with carcinoembryonic antigen (value in gastric juice and gastric malignant tumors = 2 to 10 ng per mg lyophilized products).


Serum hydroxyproline and hydroxylysine levels in viral hepatitis. High serum levels of total hydroxyproline (Hyp) and hydroxylysine (Hyl) in patients with acute viral hepatitis were found to be due to a marked increase of the peptide-bound form of these aminoacids. The concentrations of free Hyp and Hyl were only slightly changed. The levels of serum Hyp and Hyl were higher in patients with bilirubin concentration, and decreased during recovery.


Effect of indomethacin on lysosomal acid phosphatase activity in peripheral blood lymphocytes. In 25 patients with discopathies and degenerative disease of the vertebral column, treated with indomethacin (Metindol, Polfa) in a dose of 100 mg per day during 10 days, the acid phosphatase (AP) activity was determined in the peripheral blood lymphocytes by means of the cytochemical method of Barka and Anderson. Indomethacin administration induced an increase of total lymphocytosis related to the elevation of the AP-negative lymphocyte count. These changes were accompained by an increased lymphocyte count including enzyme-positive lysosomal granules within their cytoplasm and a decrease of those showing diffuse enzymatic reaction and no granules. In the author's opinion, such changes reflect the stabilizing effect of indomethacin on lysosomal membranes within lymphocytes and a diminished release of this enzyme from lysosomes to the cytoplasm.


Use of angioscintigraphy in the diagnosis of malignant tumors of the liver. Dynamic hepatic angioscintigraphy, a method of estimation and follow up of the double (arterial and portal) circulation in the liver, was performed in association with static liver scanning in 20 patients with suspicion of primary or secondary tumors of the liver, and in 5 healthy controls, after administration of 113min colloid. This procedure allowed confirmation of primary neoplastic tumors of the liver in 3 patients and of hepatic metastases in 5. The method supplies additional diagnostic information in malignant tumors of the liver and reduces the irradiation of the patients by using a single radiopreparation.


Study of mediastinal and lung involvements in Hodgkin's disease. Clinical, biological, radiological and radioisotope investigations in 224 patients with Hodgkin's disease revealed a great frequency (100 cases, i.e. 44%) of mediastinal and pleuro-pulmonary involvements, most of them in advanced stages of the disease. The predominant histologic types in these cases were mixed cellularity or nodular sclerosis. Evolution and prognosis were improved by combination chemotherapy in COOP courses; X-ray therapy was associated after drug therapy only if absolutely necessary, on limited areas.


[Evaluation of the tumor mass and its regression under treatment of multiple myeloma of the bones. Critical comments apropos of 22 patients]. In reference to 22 recent cases of multiple myeloma the authors underline the value of estimating the tumour size and its variations under treatment, according to the method of Salmon and Durie. This allows an estimation of the initial prognosis and rapide evaluation of the response to treatment given, permitting a truly strategic approach to the treatment of multiple myeloma.