A critical analysis of some thyroid function tests. The results of a comparative study of thyroid function tests are reported, the assay for PBI having been used for reference. The merits and sources of error of the Bio-Rad column test, Thyopac-4 test and T3-RIA test are discussed with reference to PBI. The correlation coefficients and the sources of error being taken into consideration, PBI represents a fairly reliable indicator of T4 values and recommends itself on these grounds as a basic routine procedure, the more so as it is simple, cheap and suited for automated analysis. In case of iodine contamination or of the necessity for a selective identification of the T4 factor, the T4 column test is equally reliable. The T3-RIA test will be valuable in special diagnostic problems.


Biological significance of human prolactin in adult, healthy and infertile males. The human prolactin (hP) levels have been studied in adult healthy and infertile males. The hormone level was 8.5--38.0 ng/ml in sperm-plasma and 3.4--32 ng/ml in blood plasma. Values for normo and pathospermic patients showed no significant difference. In normo and hypospermia the hP level was higher in the ejaculate than in blood plasma. There was a close correlation between the hP and fructose levels of the ejaculate, while the correlation between hP and testosterone levels in the ejaculate was not highly significant. There is a certain relationship between the plasma hP and testosterone levels and the sperm count.


Early retinal vascular signs in hyperlipoproteinaemia. A total of 23 hyperlipoproteinaemic patients between 24 and 46 years of age were subjected to fluorescein retinography. Early microangiopathy was demonstrated in 12 cases. In 3 of these, the oral glucose tolerance test was normal and the family history of diabetes was negative. It is suggested that hyperlipoproteinaemia, mainly hypertriglyceridaemia, constitutes one of the factors accounting for the microangiopathy. The frequency of angiopathy was particularly high in the group marked by a family history of diabetes with a normal glucose tolerance test.


Effect of vasopressin on myocardial reactive hyperaemia in the isolated fibrillating dog heart. The effect of 0.15 IU/min vasopressin (VA) administered intracoronarily on postocclusion reactions following 15 sec, 30 sec, 60 sec, and 120 sec occlusions of the left coronaries of the isolated fibrillating dog heart were studied at constant pressure or constant volume perfusion with arterial blood of another dog. Basal perfusion pressure was kept at the level of 150 mmHg. Preocclusion state and postocclusion reactions were characterized by changes in coronary conductance. Peak conductance, maximum conductance, reactivity, time to peak conductance, mean transit time and repayment were computed for characterizing reactive hyperaemia. In the control state the post-occlusive conductance--time curve was higher, but shorter in duration with constant pressure perfusion than with constant volume perfusion. Upon the administration of VA, basal conductance decreased considerably while with constant pressure perfusion the hyperaemic reactions underwent hardly any change. In contrast, using constant volume perfusion, the duration of reactive hyperaemia was shortened by VA. Consequently, the differences in mean transit time observed in the controls resulted from the unequal perfusion techniques disappeared on the application of VA. On both constant pressure and constant volume perfusion, maximum conductance decreased as a result of the decrease in basal conductance, therefore the reactivity of the coronary vessels increased markedly. It is concluded that myogenic vasorelaxation may contribute to reactive hyperaemic responses not only on brief, but also on prolonged occlusion. The basal vascular tone is of importance in the coronary adaptation to ischaemia.


Modifications of the biological activity of anti-D immunoglobulin caused by heat aggregation. Some of the biological activities known to be confined to certain anti-D sera such as Ripley could be simulated using heat-treated human anti-D Ig preparations. Thus, human red cells sensitized with heat-treated anti-D Ig were found to be capable of causing Fc-receptor on lymphocyte surfaces and of fixing complement. In its other effects such as reactivity to rheumatoid factor and to anti-allotype agglutinators, heat-treated anti-D Ig seemed inferior to such anti-D sera as Ripley.


Erythrocyte acetylcholinesterase activity is not affected by adenovirus-induced haemagglutination. No correlation was found between adenovirus-induced haemagglutination and AChE activity of human RBCs as ascertained with three different types of virus. The haemagglutination titre of the adenoviruses did not decrease when RBCs with AChE inhibited by dichlorvos or eserine were used. The receptors involved in active haemagglutination by adenoviruses thus seem to differ from those acting in passive haemagglutination. The AChE inactivating effect of substances such as tannic acid and glutaraldehyde, among others, might be due to a non-specific damage of the RBC membrane.


Occurrence of malignant neoplasms in patients with chronic lymphatic leukaemia. In a group of 280 patients with chronic lymphatic leukaemia, a coexistence of malignant tumours diagnosed simultaneously with the leukaemia was found in 14 cases or 5.0%. No significant difference was observed between the development of the second malignant neoplasm in the patients studied and the expected incidence in the general population, taking into account also the sex and age of patients and their place of residence. No statistically significant relation was found between the duration of CLL and the occurrence of second malignancies. No significant correlation was found between the total dose of cytostatic drugs, corticosteroids or radiotherapy and the incidence of cancer.


Some aspects of haemorrheology of metastasis in malignant melanoma. A study of 125 patients with malignant melanoma, of which 30 succumbed to metastases, indicated that plasma viscosity and aggregation of red cells are significantly elevated in patients with metastases. Plots of the intervals between the time of the viscosity test and the time of death against plasma viscosity showed a significant negative correlation; while plots of the same intervals against blood viscosity showed a significant positive correlation. Viscosity functions (plasma viscosity vs globulin) showed a significant (P less than 0.005) difference between patients with metastases and patients free from metases. A significant difference was noted in some functions between patients of A and O blood groups.


I. Increase in bone marrow CFU-S and CFU-C after in vivo phytohaemagglutinin (PHA) administration in mice. An absolute increase in bone marrow CFU-S was observed within 4 hours after intraperitoneal administration of 3 mg PHA-M or 250 microgram PHA-P. At that time, there was no increase in spleen CFU-S, while a pronounced decrease in the number of circulating CFU-S was noted. A two to fourfold increase in bone marrow CFU-C was found within 12 hours after intraperitoneal administration of a similar dose of PHA-M or PHA-P. Addition of PHA-M or PHA-P at small concentrations resulted in a marked inhibition of granulocytic colony formation whereas macrophage colony growth became depressed only at very high concentrations.


[Hemolysis after extracorporeal blood irradiation of man?]. Haemolysis was studied before and after extracorporeal irradiation of the blood of 20 chronic lymphadenosis patients. Free haemoglobin, haptoglobin and haemopexin were not affected by irradiation, indicating that no haemolysis was caused by the transit dose accumulated during the applied procedure.


Systemic mastocytosis. Report of a case. The case of a 20-year-old woman with systemic mastocytosis is reported. The disorder was not preceded by a clinically diagnosed local form of the disease; fibrous changes in organs, bone changes, eosinophilia and increased serotonin, heparin or histamine levels had not been observed. Clinical symptomatology was typical and the patient died one year after the first signs of the disease.


Disseminated intravascular coagulation (DIC) during superacute haemolysis in a patient with ovarian dermatoid cyst treated with rifampicin. A 53-year-old female patient with ovarian dermatoid cyst and lung tuberculosis had been treated with rifampicin. During repeated rifampicin treatment she developed an acute haemolytic syndrome with haemorrhagic diathesis. Laboratory findings showed that it was caused by disseminated intravascular coagulation. Death ensued despite intensive administration of heparin and Trasylol. It is assumed that the repeated rifampicin application had provoked massive haemolysis by an allergic mechanism leading to thrombofibrinolytic haemorrhagic diathesis.


Cytochalasin B-dependent release of azurophil granule enzymes from human polymorphonuclear leukocytes. The dose-response effects of phorbol myristate acetate and cytochalasin B on secretion of azurophil and specific granule enzymes from viable human polymorphonuclear leukocytes have been examined. Secretion of the azurophil granule enzymes elastase and beta-glucuronidase from cells exposed to 50 ng/ml of phorbol myristate acetate is dependent on prior exposure of the cells to greater than 0.5 mg/ml of cytochalasin B. In contrast, the secretion of the specific granule enzyme lysozyme is not dependent on pretreatment with cytochalasin B. The concentration of phorbol myristate acetate needed to elicit maximal secretion of specific versus azurophil granule enzymes differs, being 5.0 ng/ml and 50 ng/ml, respectively. The results suggest that cytochalasin B-sensitive cellular components, possibly microfilaments, may selectively modulate some step in the exocytosis of azurophil granule enzymes from human polymorphonuclear leukocytes exposed to phorbol myristate acetate.


Condition-dependent immunoregulatory control of contact sensitivity by levamisole. The immunostimulatory activity of levamisole [1-(-),2,3,5,6-tetrahydro-6-phenylimidazo(2,1-beta)-thiazole] was investigated using oxazolone-induced contact sensitivity in C57Bl mice. Oxazolone sensitivity was induced by applying 0.1 ml of 3 or 5% oxazolone in ethanol to the shaved abdomen (day 0). Challenge with oxazolone followed on day 2 (45 h) or day 3, and was accomplished by painting a 1--5% solution of oxazolone in ethanol to the left hind paw. The response at 24 h was determined plethysmographically. Levamisole (50 mg/kg, p.o., days 0--3 or day 0 only) failed to stimulate consistently the oxazolone response in a 3-day (minimal) sensitization period regimen. Use of a subliminal (45 h) sensitization, by contrast, revealed a consistent immunostimulatory effect of levamisole (12.5--100 mg/kg, p.o., day 0 only). It is speculated that the observed difference in levamisole effectiveness is attributable to (1) the ability of levamisole to stimulate both effector and suppressor mechanisms, and (2) the apparent absence of significant suppressor influence at 2-day postsensitization, leaving only the effector mechanism to be stimulated by levamisole.


[Hepatitis B antigen (HBSAG) in hospitalized children]. Blood samples of 1940 hospitalized children aged 0--18 years were investigated for presence of HBs-Ag by counter-electrophoresis, haemagglutination and radioimmunoassay, HBs-Ag was found in 1.34% of all patients, being distributed evenly amongst boys and girls. The incidence was 1.7% in patients from a large University children's hospital and 0.6% in patients from a group of regional hospitals. Of 26 samples positive by radioimmunoassay, 1 only was found positive by insensitive counter-electrophoresis. In addition to diseases known to be correlated with HBs-antigenaemia in adults, there was an accumulation of inborn deformities as well as perinatal and neurologic disorders in HBs-Ag positive children. Vertical transmission of hepatitis-B virus from pregnant or nursing mothers to their children could not be found. The incidence of HBs-antigenaemia increases little with age, thus infection in early childhood appears probable at least in a part of the cases.


Acute infectious hepatitis. Clinical and epidemiological study. A retrospective study of 120 children from birth to seven years of age suffering from acute infectious hepatitis was carried out from 1971 to 1974 at the Children's Hospital "La Fe". Only the most serious cases from the region were admitted to the Hospital and were classified and analyzed according to HBAg+ and HBAg- groups. Clinical and biochemical evaluations were done at admission, and again after 15 and 30 days. The main findings were as follows: hospital incidence was 5%; seasonal distribution did not follow the expected epidemiological pattern; the disease was more common among malnourished children; HBAg+ and HBAg- cases were not randomly distributed among the various blood groups: A+ children were four times more susceptible to HBAg- than to HBAg+, and 0+ children were more than twice more susceptible to HBAg+ than to HBAg-; clinical and biochemical recovery occurred within 30 days after hospital admission; mortality was 2.5%. Steroid therapy was reserved for the most serious cases; however, it was not possible to evaluate in this study its contribution to the course of the disease.


Bile acids in serum and bile of infants with cholestatic syndromes. The concentration of individual bile acids in serum was measured in 18 neonates and infants with various cholestatic conditions (extrahepatic biliary atresia, neonatal hepatitis syndrome, chronic intrahepatic cholestasis and posthemolytic cholestasis). The cholate/chenodeoxycholate ratio in serum was smaller than one in all patients with neonatal hepatitis syndrome or extrahepatic biliary atresia, cholestatic conditions which were accompanied by signs of liver cell injury. It was greater than one in the patients with chronic intrahepatic cholestasis. Administration of cholestyramine to patients with patent extrahepatic bile ducts decreased the total concentration bile acids in serum and elevated the cholate/chenodeoxycholate ratio. Thus, cholestyramine administration may be of diagnostic value for evaluation of bile duct patency in cholestasis of infancy. Differences between the bile acid pattern in serum and bile were observed. Thus, the cholate/chenodeoxycholate ratio was always higher in bile than in serum. 3beta-hydroxy-5-cholenoic acid found in serum was not detectable in bile. This finding suggests that impairment of biliary excretion rather than increased hepatic synthesis is responsible for elevation of this monohydroxy bile acid in serum.


Studies on circulating immunoreactive calcitonin in low birth weight infants during the first 48 hours of life. Serum immunoreactive calcitonin (iCT), serum immunoreactive parathyroid hormone (iPTH) and serum Ca, Mg, P and total protein levels were determined sequentially at 5 given periods of time from 1 to 48 h of age in 16 low birth weight infants. Mean +/- SD serum Ca levels decreased from 8.99 +/- 0.79 mg/100 ml at time 1--2 h to 7.00 +/- 0.51 mg/100 ml at time 12--14 h; there was a small further decrease at time 22--26 h: 6.79 +/- 1.07 mg/100 ml. There was no significant change in serum Mg, P or total protein during the same periods of time. Serum iPTH levels increased steadily from time 1--2 h to time 44--48 h reaching above normal range values. Serum iCT levels were non detectable (less than 150 pg/ml) in 11 among 15 infants at time 1--2 h. A marked increase in mean +/- SD serum iCT levels was observed at time 12--14 h (1850 +/- 872 pg/ml) and time 22--26 h (1462 +/- 806 pg/ml) followed by a decrease at time 44--48 h. A negative correlation was found between serum iCT levels and respectively gestational age (p less than 0.01) and serum Ca levels (p less than 0.01) at time 22--26 h while serum iCT levels correlated positively with serum iPTH levels (p less than 0.05). Evidence obtained from this study indicates that a secretion of calcitonin takes place during the early neonatal period in low birth weight infants and that this secretion is a contributing factor of the socalled "early-type" neonatal hypocalcemia.


Predictive value of renal-vein renin measurements in children with various forms of renal hypertension. An international study. Renal-vein renin was determined in 55 children with renovascular or renal hypertension, 33 of whom being treated surgically. The overall cure rate after surgery was 87.9%. Of 23 patients having a renal-vein renin ratio greater than 1.5, 20 were operated successfully, but 9 of 10 operated patients with a ratio of less than 1.5 also benefited from surgery. Taking into account the frequency of "false-negative ratios" (27.3%) and the potential risks of catheterization, it is suggested that renal-vein renin measurements are not useful as a routine procedure for investigation of a child with renovascular hypertension.


Hypertriglyceridemia in homozygous beta-thalassemia. A case of hypertriglyceridemia in association with homozygous beta-thalassemia in an 11-month-old female infant is reported. The hypertriglyceridemia proved to be secondary, as it was indicated by clinical features as well as laboratory findings. Attention is called to a possible alteration of lipid metabolism in association with thalassemia major.


Classification at time of diagnosis and subsequent survival in children with cystic fibrosis. The survival rates in 204 patients suffering from cystic fibrosis observed between January 1956 and June 1976 were recorded. The patients were divided into five groups according to the symptoms present at the time of diagnosis and survival rates were recorded separately for each group. Survival was less good in the group of patients presenting initially with pulmonary symptoms compared to the group presenting with gastrointestinal symptoms. In the group presenting with meconium ileus survival was poor initially, but later in the course of the disease it became similar to that observed in the other groups. The differences in survival between the different categories occurred during the first two years after diagnosis. The study shows that, on clinical grounds, a severe form of the disease which is characterized by early manifestation of pulmonary symptoms and poor survival can be distinguished from a more protracted form with a better survival. Because of the great inter-individual variability large numbers of patients will have to be evaluated in order to achieve statistically significant results in studies which attempt to compare different therapeutic approaches. If such numbers cannot be reached, it may be necessary to compare only patients who belong to the same symptomatic category.


Influence of lyophilized total pancreas on plasma lipids and on fat absorption in cystic fibrosis. 31 children with cystic fibrosis (CF) subdivided into three groups of age were studied before and after treatment with lyophilized pancreas and compared to 27 controls. CF was characterized by lower phospholipid, cholesterol and polyunsaturated fatty acid plasma concentrations and reduced coefficient of fat absorption. Treatment tended towards normalization of these values. With age polyunsaturated fatty acids increased in normals but not in CF. The significant correlations existing between fat absorption coefficient and polyunsaturated fatty acid percentage in neutral lipids of CF children suggests the use of the latter percentage as index of the stage of malabsorption.


Pericarditis purulenta in children.

Pericarditis purulenta in children. The case history of seven children aged 1 5/12 to 5 9/12 years with non tuberculous bacterial pericarditis, observed in the last 8 years at the University children's hospitals of Basle, Berne and Zurich is reported. The history showed febrile illness of 3--14 days duration, which led to an admission diagnosis of pneumonia, angina or pseudocroup. From the signs of heart failure and cardiomegaly on chest X-ray the differential diagnosis of myocardial disease or pericardial effusion was made. The ECG-changes were uncharacteristic, and a friction rub and pulsus paradoxus was encountered once only. The effusion diagnosis should preferably be substantiated by a non-invasive method (scintigram, echocardiogram) as diagnostic pericardiocentesis does often not allow to aspirate the thick pus through the needle. Diagnostic and therapeutic surgical pericardiotomy with consecutive drainage is therefore mandatory. Halothane should be avoided as an anesthetic for this procedure of hemodynamic reasons. With surgery and antibiotics the recovery rate in our series was 100%, and no pericardial constriction was observed on follow-up 1 to 8 years later.


Aortic arch interruption type A with aortopulmonary fenestration in an offspring of a chronic alcoholic mother ("fetal alcohol syndrome"). A case is described of a newborn infant, small for gestational age, with the features of the "fetal alcohol syndrome", who presented a murmur within the first few days of life, and died at age 7 days in heart failure. Autopsy revealed interruption of the aortic arch, type A, an aortopulmonary window and intact interventricular septum. The association of "fetal alcohol syndrome" and cardiac malformation is discussed, with reference to other cases described in the literature.


Microcephalic dwarfism with associated low amniotic fluid 5-hydroxyindole-3-acetic acid (5HIAA). Report of a case of Cornelia de Lange syndrome. A very low level of 5HIAA in the amniotic fluid was found in a microcephalic dwarf presenting subsequently with Cornelia de Lange syndrome. Since both the amount of amniotic fluid and the renal function after birth were normal this observation suggests that low amniotic fluid 5HIAA may be secondary to abnormalities in foetal neurological development.


Recurrent hemolytic-uremic syndrome. A report of two cases. Two boys suffering from the hemolytic-uremic syndrome (HUS) are presented. One of them developed four episodes of the disease beginning at infancy, the other one had at least two episodes which were associated with mild portal fibrosis of the liver. Between the attacks of the disease, the children were completely healthy, and no renal or hematological abnormalities were detected. Both patients are now physically and mentally well developed healthy young men. The relatioship between HUS and thrombotic thrombocytopenic purpura is briefly discussed.


Early detection of neonatal hypothyroidism by serial TSH determination in dried blood. Six months experience with a reliable, efficient and inexpensive method. Mass newborn screening for primary hypothyroidism was introduced in Switzerland on January 1st, 1977, using a radioimmunoassay of TSH in dried blood spotted on filter paper. After incubation for 38 h at 20 degrees C, bound and free TSH is separated by double antibody precipitation. The filter paper discs of 6.5 mm diameter remain in the test tubes. At present, one TSH determination costs approx. SFr. 4.40. All reagents used are commercially available and their costs amount to not more than 15% of the total expenses. During the first 8 months of 1977, of 21862 newborns tested routinely on day 5 (together with the Guthrie-test), 7 infants with primary hypothyroidism were discovered owing to blood TSH values of greater than 100 muU/ml. Diagnosis was not recognized clinically although all of the infants showed some symptoms. Thyroxin therapy was started within the second week of life. The incidence of about 1 in 3000 newborns is higher than reported so far. It has to be shown whether this is due to genetic or geographic factors, to the occurrence of transitory forms, or to a higher efficiency of screening by the TSH (versus T4) assay.


Development of visual discrimination (pattern preference) in normal infants. Visual discrimination for vertical stripes versus an unpatterned visual stimulus (plain grey) was studied longitudinally in 75 "normal" infants born at term, at monthly intervals from 1 to 6 months of age. Total fixation time was found to progressively decrease with increasing age, with a very sharp jump between the values of 2 and 3 months. Correspondingly, the mean duration of a single fixation decreased. The number of single fixations increased by age, doubling at 6 months in comparison to 1 month. A preferential fixation for stripes was already evident at the age of 1 month. A probabilistic method for assessing discrimination in individuals is proposed. The values will be correlated with follow-up results of cognitive development until school-age.


Malignant non-Hodgkin's lymphoma (NHL) in childhood. Retrospective analysis of 34 cases. Of 47 children with an initial diagnosis of lymphosarcoma, reticulosarcoma or Non-Hodgkin's lymphoma (NHL), 13 had to be excluded at the histologic reevaluation: in 10 an undifferentiated sarcoma, in 2 Hodgkin lymphoma was found; in one patient no definite classification of the tumor was possible. Of the remaining 34 patients there were 26 boys and 8 girls. One patient had a nodular, 33 a diffuse NHL. Of the latter 16 had a Burkitt-type (LB-), 3 a lymphoblastic, convoluted (LC-), 8 a lymphoblastic, "other" (LO-) and 6 a histiocytoid (H-) NHL. Primary localization: abdomen: 13/34; "peripheral" lymph nodes: 9/34; mediastinum: 5/34; nasopharynx: 4/34; subcutis: 2/34; skeleton: 1/34. Twelve of 17 NHL with primary localization in the abdomen or nasopharynx were LB-NHL, 8/14 NHL with primary localization in "peripheral" nodes or mediastinum were LC- or LO-NHL. Only 2/17 NHL with abdominal or nasopharyngeal primary, but 9/14 NHL with "peripheral" nodal or mediastinal primary developed leukemic extension and/or CNS involvement. 6 of 34 patients are living without evidence of disease for 1 1/2+ to 13+ years; 5/34 died but lived for 85, 57, 37, 22 and 22 months; 9/34 lived 6--12 months; 14/34 died within less than 6 months. Patients with abdominal primary either died within 5 months or survived (for 165+, 63+ and 25+ months). Aggressive local therapy (surgery and radiotherapy with approximately 4000 R) may be adequate for strictly localized (stage I) disease, particularly if the primary localization is abdominal. In all other diffuse NHL of childhood an early, aggressive chemotherapy, later combined with radiotherapy to bulk disease and prophylactic CNS-treatment is essential for inducing long-term remissions and, possibly, cures. For prognosis the primary localization appeared to be more important than histology and stage. The most decisive factor, however, is therapy.


Treatment of urinary tract infections in children with a single daily dose of gentamicin. 21 children with recurrent urinary tract infections (UTI) due to bacteria resistant to the usual antiinfectious drugs were examined to evaluate whether their UTI could be effectively treated with a single daily administration of gentamicin (2.5 mg/kg i.m.) for ten days. From the data obtained it may be concluded that such a scheme of therapy is effective in all cases as far as urine sterilization is concerned during therapy, regardless of the site of infection. However, urine culture controls, 10 and 30 days after therapy was discontinued, showed a further infection in 3 out of 7 children with upper UTI, Since in urine of all our patients the antibiotic level was well above the minimal inhibitory concentration for the infective bacteria, the different therapeutic response could be related to an inadequate antibiotic concentration at the renal interstitial site.


Hypoglycorrhachia in neonatal intracranial hemorrhage. Relationship to posthemorrhagic hydrocephalus. The level of cerebrospinal fluid (CSF) glucose may be lowered after subarachnoid hemorrhage. This was observed in each of 18 cases of proven posthemorrhagic hydrocephalus in infants (study group). In one of these children with a hemorrhagic spinal fluid and hypoglycorrhachia unaccompanied by clinical signs of intracranial hemorrhage or hydrocephalus, the axial tomography showed a significant although asymptomatic hydrocephalus. To further evaluate the significance of this finding (hypoglycorrhachia), we compared the incidence of hypoglycorrhachia (CSF glucose less than 40 mg) and lowered CSF glucose/blood glucose ratio (ratio less than 0.4) at three similar time intervals from the presumed time of the intracranial hemorrhage in the study group with that of a control group of 40 neonates with similar neonatal associated pathology (mainly premature infants with hyaline membrane disease) but who did not later develop posthemorrhagic hydrocephalus or cerebral palsy. There was a statistically greater frequency of these anomalies in the hydrocephalic group. Only 3 of the 40 control patients had hypoglycorrhachia and low ratio. Hypoglycorrhachia in the absence of other known causes for decreased CSF glucose is a good index of a probably significant meningeal hemorrhage with a high risk of secondary hydrocephalus which may or may not be symptomatic. Hypoglycorrhachia may be used as an indication of the frequency of clinically inapparent subarachnoid hemorrhage in these high risk newborns.


[Familial nephropathy with retinitis pigmentosa and peripheral dysostosis]. The paper reports two siblings, 6 and 3 3/4 years old, with a congenital nephropathy (nephronophthisis), retinitis pigmentosa, heart failure and peripheral dysostosis. The severe histological changes of the kidneys with tubular atrophy and interstitial fibrosis caused the death of the older sister at the age of 7 years. The symptoms of our patients are discussed in comparison to the syndrome described by MAINZER et al.


Renal amyloidosis with nephrotic syndrome in a child suspected of having idiopathic pulmonary hemosiderosis. A case of renal amyloidosis with nephrotic syndrome in a 12-year-old girl suffering from a chronic pulmonary disease is reported. Data from this patient's history, laboratory examination and radiographic evaluation of the pulmonary lesions favour the diagnosis of a long-standing idiopathic pulmonary hemosiderosis. A possible etiologic relationship between the pulmonary lesions and amyloid deposition in the kidney may be assumed.


Sibship with histidinemia and an unrelated encephalopathy. Clinical and biochemical studies. Histidinemia was found in 3 of 4 siblings in one family, while a fatal encephalopathy with mental retardation was present in two of them and in the fourth child who did not have histidinemia. Biochemical studies of the histidinemic subjects showed elevated histidine levels in urine, CSF, and brain, while in a few urine samples histidine related imidazole compounds were found. Plasma levels of other amino acids were positively correlated with plasma histidine levels. Obesity and heart abnormalities appeared to be associated with the encephalopathy, which is probably of a new type. The histidinemia appears to be unrelated to the mental retardation or the encephalopathy in this family.


Sialidosis (mucolipidosis I).

Sialidosis (mucolipidosis I). The term "sialidosis" is suggested for the deficiency of alpha-neuraminidase activity in peripheral leukocytes and cultured fibroblasts which results in a considerable urinary excretion of sialyl-oligosaccharides. This defect was found in two siblings with a mild form of mucolipidosis I. 12 sialyl-acid rich oligosacharides have been isolated from the urine of the patients. The structure of ten of them has been determined. The studies of the patients show a remarkable variability of the clinical expression of this disease. The two siblings exhibited a progressive reduction of visual acuity, red-green blindness, a bilateral cherry red macular spot, punctate opacities of the lens, and minimal neurological symptoms. Morphologically, vacuolized lymphocytes, refringent inclusions in cultured fibroblasts, numerous cytoplasmatic inclusions containing a fine protein-like reticulum and some osmiophilic granules mainly in Kupffer's cells were found.


Fanconi's anemia in infancy. Report of a case diagnosed in the pre-anemic stage. A 6 1/2-month-old girl is described, in whom the diagnosis of Fanconi's anemia in the pre-anemic stage was made on the basis of the following findings: growth failure, microcephaly, modest epicanthal folds, pigment spots, and chromosomal breaks. 4 months later progressive bone marrow failure developed and dramatically evolved into pancytopenia refractory to therapy.


Marihuana: current assessment.

Marihuana: current assessment. Some of the controversies surrounding marihuana have been reported. The problems of multiple species and qualifications of the analyst could be resolved by basing the law on the identification and quantitation of tetrahydrocannabinol. Decriminalization of the use and the possession of the drug could help law enforcement officers, the courts, and the user. Recently reported methods for the determination of the drug and its metabolites in biological specimens should provide a basis for establishing the relationship between blood concentrations and drug effects. The short- and long-term effects of the drug are too subtle to cause much concern over any known or potential hazards.


Gases released from tissue and analyzed by infrared and gas chromatography/mass spectroscopy techniques. Two techniques for analyzing contaminants released as gases from postmortem tissues were described and compared. One technique used gas chromatography/mass spectrometry (GC/MS); the other, infrared spectroscopy (IR). Brain, lung, liver, blood and urine specimens were obtained from suspected drug-overdose victims whose deaths were contributed to or caused by inhalation of unknown gases or vapors during the period immediately preceding death. Gases from the postmortem tissues and liquid samples were separately admitted into an evacuated IR gas cell, the IR spectra recorded, and gas samples then removed for GC/MS analysis. Nitrous oxide, glue, and paint solvent constituents were identified and measured. Only the brain and lung tissues contained measurable amounts of inhalants. Both IR and GC/MS methods were adequate for normal confirmatory analyses; the GC/MS system was judged superior for fast routine efforts normally hampered by incomplete sample history.


Analytical problems with putrefaction in a fatal case involving ergotamine and pentazocine. A 29-year-old male drug addict was found dead at the bottom of a staircase. Analysis of the acid-hydrolized blood showed the presence of pentazocine and two characteristic compounds that contained L-phenylalanine and D-proline, linked together by peptide bounds. It was shown that the latter two components could emanate from the peptide part of ergotamine under the conditions used. It seemed likely that, at the time of analysis, pentazocine and ergotamine were present at concentrations far above therapeutic values. A third component in the blood could not be identified.


Human body buoyancy: a study of 98 men.

Human body buoyancy: a study of 98 men. The specific gravity and buoyancy of 98 men were calculated at various lung volumes. The data indicated that all subjects would be capable of floating in either freshwater or seawater at total lung capacity. At functional residual capacity, the value approximating the lung volume of a recently dead body, 69% of the subjects would float in seawater, whereas only 7% would float in freshwater. Results of this study indicate that while drowned bodies are more likely to sink than bodies dead of other causes, no conclusion regarding the cause of death can be made on the basis of whether bodies float or sink.


Rapid phenotyping of the group specific component by immunofixation on cellulose acetate. Determination of the genetically controlled variants of the polymorphic Gc system was achieved by electrophoresis on cellulose acetate membranes followed by immunofixation with a specific anti-Gc antiserum. The method is applicable to plasma, whole hemolyzed blood, and dried blood. Multiple specimens can be analyzed simultaneously within 60 to 80 min. The cellulose acetate electrophoretogram of the Gc variants remains as a permanent record.


The development of latent fingerprints on human skin: the iodine-silver plate transfer method. With the iodine-silver plate transfer method latent fingerprints on human skin can be developed. The continuation of experiments leading to the eventual application to a bona fide case processed through a judicial system will indicate the "arrival" of a new and useful tool for the law enforcement officer in identifying the perpetrators of our more serious crimes.


An unusual tear-gas gun fatality.

An unusual tear-gas gun fatality. A case of death involving a tear-gas pen gun, firing .45 ACP metallic ammunition, is presented, in which the recoil generated by the cartridge converted the weapon into a missile, penetrating the brain of the shooter. The injury potential to shooter and shooting victim is briefly discussed, and the added hazard to the shooter illustrated by this case is noted.


Acute ethanol poisoning: a two-year study of deaths in North Carolina. A 24-month study of fatalities in North Carolina with high blood ethanol levels (300 mg/100 ml or over) revealed 502 cases with either acute alcoholism or the effects of this range of blood ethanol concentration having caused or contributed to death. This investigation reassessed the criteria for ethanol poisoning, including its cause and manner of death, and revealed recurrent patterns common to this syndrome. This inquiry also contrasted the frequency of ethanol poisoning in different areas of the country.


Some observations concerning blood morphine concentrations in narcotic addicts. Blood samples from deceased narcotic addicts were analyzed for morphine, and the results form persons who died from narcotic addiction were compared with those from homicide victims. In most instances morphine was detectable in both types of death, and usually the values obtained were less than 30 microgram/dl. Narcotic addiction deaths involving only morphine, or morphine plus a combination of ethanol, quinine, or diazepam (Valium), were also evaluated. In some cases high quantities of ethanol were present, and death could be attributed to the combined CNS depressant effects of morphine and ethanol. The quinine levels would not normally be considered toxic, however, and it could not be ascertained that the quantity of this drug present contributed to death. Diazepam was present in elevated concentrations, and its depressant effect may have been a factor in some narcotic addiction deaths.


Toxicology and sudden infant death.

Toxicology and sudden infant death. One hundred thirty cases of sudden infant death occurring in Wayne County, Michigan, (population 2.7 million) were analyzed for possible drugs. The toxicological protocol has been outlined. Six cases were found to be positive, and in five of these the drugs found had been prescribed for a variety of illnesses. In one case methadone was found in the blood of an infant whose mother was undergoing methadone treatment for drug addiction, the drug being transmitted through breast milk. In none of the 102 cases of sudden infant death syndrome (SIDS) included in the study did the toxicological results affect the diagnosis. In our study, toxicological analyses never contradicted an initial diagnosis of SIDS, and, therefore, we feel that this diagnosis should be made promptly based on investigative and autopsy findings.


The phase II evaluation of Bacillus Calmette-Guerin plus megestrol acetate in patients with metastatic renal adenocarcinoma. The case is reported of a patient with pulmonary metastases from a renal adenocarcinoma who experienced subjective improvement and objective tumor regression on Bacillus Calmette-Guerin (BCG) and megestrol acetate therapy. In a subsequent Phase II trial, no objective responses were noted among 15 patients treated with megestrol acetate (160 mg/day X 56 days) and BCG (five immunizing doses intradermally, every 2 weeks X 5). It is concluded that this treatment regimen is not clinically useful in patients with metastatic renal adenocarcinoma.


Prognosis in children with metastatic rhabdomyosarcoma. Distant metastases were documented in 83 of 161 children with rhabdomyosarcoma seen between 1953 and 1974. Of these, 31 had metastases at diagnosis (Group IV) and 7 were noted to have metastases only at autopsy. Only 6 are living with no evidence of disease activity at 6, 20, 77, 85, 105, and 112 months from time of metastasis. One child is living with disease at 98 months. Late deaths occurred in 2 at 31 and 41 months after metastasis. Sixty-four of the 66 deaths occurred within 24 months. The median durations of life after metastasis were less than 9 months in Groups I and II patients, less than 6 months in Group III patients, and about 12 months in 31 Group IV patients. The median time to metastasis in Groups I, II, and III patients was 9 months.


False positive lymphography in Hodgkin's disease: a histologic-lymphadenographic correlation. A series of 99 consecutive patients having a staging laparotomy for Hodgkin's disease was reviewed. Negative lymph nodes removed during the laparotomy were correlated with lymphograms reported as positive or suspicious. Four patients had large nodes with a prominent hilar area or irregular cortical fat deposits. In two other patients a cluster of small lymph nodes accounted for the radiologic misinterpretation.


[Epidemiologic evaluation of health program in perinatology. I. Region rhône-Alpes 1972-1975 (author's transl)]. In 1971, a Health Project was established in order to organize some actions destined for the prevention of perinatal mortality and morbidity. A first examination of these actions was studied in the Rhône-Alpes Region by comparing the results of two surveys, one carried out in 1972 and the other in 1975, both on a representative sample of births. This article successively examines the evolution of morbidity and prevention. The authors note an important improvement in the quality of prevention and a slight progress in the results: perinatal morbidity declined as well as certain signs of fetal distress, while on the other hand, the term and birth weight showed no significant change. In the second part of this article the authors studied the relationships between the socio-cultural characteristics of the parents and the use of prevention measures. They found that certain social inequalities observed in 1972 had decreased while some others increased, new measures seem to be adopted sooner by the higher social classes when they were first envisioned for the interest of better protecting the lower social classes. However, the inequalities diminished for certain fundamental elements of prenatal surveillance, such as the respect for the minimum number of prenatal consultations.


[Cardiac mortality among working middle aged Frenchmen according to their socio-economic class and geographic region (author's transl)]. The cardiac mortality of working Frenchmen aged 44-65 is studied from the national mortality statistics in 1968. Cardiac mortality causes are joined into four categories according to their a priori precision. The distribution of mortality rates for cardiac causes is analysed according to the socio-economic classes (9 classes) and the geographic regions (19 regions). Important differences of the cardiac mortality are put into evidence according these two sampling schemes and particularly high rates are observed in the class of employees and the North East part of France. The cardiac fraction of the global mortality and the ischaemic fraction of the cardiac mortality augment according to the usual hierarchy of the socio-economic classes but are less variable among the geographic regions. Disparities in the notification of mortality causes may partly explain these results.


[The decline of fertility in Western Europe. III. Some considerations on future evolution and on policy measures aiming at supporting fertility (author's transl)]. The analysis of recent fertility trends in France lead to hold as plausible that women born after 1950 will not reach replacement level. On the other hand, the period total fertility rate, which has not fallen as low as those observed in some neighbouring countries, might well continue to decline and thus disturb the alimentation of age-pyramid, despite its slower decrease in the course of 1976. Considering present fertility situation in France, an action of the State appears to be desirable. The factors which condition fertility fall largely out of the range of well-established knowledge. Though, it seems that they are deeply rooted in collective consciousness and that the possibilities they leave to voluntary action on fertility trends is relatively modest. Moreover, to be efficient, the means used must be important. The lines of possible action seem, in our view, to relate to two main fields: research of a better conciliation of professional activity and motherhood, increase of family benefits for second but specially for third and following children.


[Priorities in health activities in refugee camps (author's transl)]. In times of natural or man-made disasters, settlements of refugees in temporary camps face the health authorities with new public health problems. The allocation of priorities and resources among Medical Care, Prevention and Sanitation, and Nutrition are usually not based on objective assessment of the situation. The potential role of epidemiological techniques and particularly of the surveillance is illustrated by the case studies of the Bengladesh civil war and the Niger drought. A rational priority order will usually rank nutrition at the top and individual medical care at the bottom.


[Attitude toward the risk of epidemics during sudden disasters (author's transl)]. Following sudden disasters, major outbreaks are rare unless malnutrition and starvation are common. No dramatic increase of water borne diseases has been reported and adequately documented in the aftermath of the earthquakes, cyclones or floods of this decade. However, the attitude of the public, the mass media and of the health services is sometimes irrational leading to impressive but ineffective mass immunizations. An epidemiologic system and accurate information on the actual situation are essential in case of major disasters.


[Atmospheric pollution and acute respiratory diseases. Denain and Quievrechain epidemiological study (author's transl)]. The subject of this study is to evaluate a possible relation between air pollution levels and acute diseases with a special interest in acute respiratory diseases. The study was performed in two towns located in the "département du Nord, France", (Denain and Quievrechain) with mid levels of air pollution. A slight but statistically significant relation was found though the study was performed during an unusually mild winter season. Meteorological conditions have been taken in account in the evaluation of the relation.


[Genitourinary infection, smoking and alcohol in the male (author's transl)]. Among 3 000 patients attending a subfertility clinic, the proportion of cases with a history of urethritis was found to be very high among heavy smokers. A similar increase was observed among those whose daily alcohol consumption was equivalent to more than a litre of wine. When standardised for age, both these differences remained highly significant. The alcohol effect remained clear when smoking was taken into account, but that due to tobacco was less apparent when alcohol was taken into consideration: in particular an increase was found to be strong among the heavier drinkers. Although the more frequent occurrence of urethritis could be explained by a difference in sexual behaviour, it is plausible that there may be a biological explanation in terms of an impairement to the subjects' immune responses.


[Long term effects of low concentrations of noxious gases on the respiratory system: results of an epidemiological study among iron mines workers in Lorraine (France). (author's transl)]. An epidemiological study of 1,178 iron-mine workers in the Lorraine basin was conducted in order to assess the long-term effects on the respiratory system of low concentrations of noxious gases produced by the machinery and explosives in use. The subjects were selected at random from 5,300 workers who were aged between 35 and 55, had been in the mines for at least five years and who were free from radiological abnormalities such as siderosis, tuberculosis, fractured ribs, etc. For each subject a standard questionnaire (E.C.S.C. bronchitis/emphysema questionnaire) was completed and a clinical examination was performed along with the following tests-vital capacity; forced expiratory volume in 1 second; residual volume; acetylcholine test; steady state CO test for calculation of total and partial transfer functions. A venous blood sample for the determination of blood CO was taken as the subject left his place of work.


[Public and private hospital care--an economic approach (author's transl)]. In an investigation involving over 1,000 patients, the LEGOS group (Univ. de Dauphine) has studied the two sectors which co-exist in the French hospital service--the public sector and the private profit--making sector. This paper gives the economic results of the investigation. The private clinics function in a commercial framework and define a privileged area of treatment related to the "cost" of the medical activities which occur in this sector. The public hospital aims at satisfying certain needs, in particular those associated with emergencies, and economic considerations are only considered in the last resort. These conclusions are drawn from observations on medically defined situations treated in the two sectors and on medical activities occurring in them.


[Some demographic datas from Ixodes ricinus Linné: vector of a virus strain of central european encephalitis in Alsace (author's transl)]. This work shows the montly variation in the density and stage composition of the population of the tick Ixodes Ricinus in the Rhine forest. Some factors influencing this variation are analysed. These include the locality of egg-laying and of down localisation and the main climatic variables. We also try to link these ecological data with the strains of Central European Encephalitis virus isolated from this arthropod.


[Interest of the prevention of uterine cervix cancer at prenuptial examination (author's transl)]. The French obligatory prenuptial certificate is issued by a doctor in the light of certain examination results. The medical consultation which it implies offers a special opportunity to obtain from women a cervical smear that would allow the finding of possible pre-cancerous lesions of the uterine cervix. Such smears, along with supervision or treatment of the lesions discovered would amount to genuine prevention of cervical cancer. The evaluation made in this article shows that, among 370,000 women, it would be possible to find 5,800 dysplasias and 2,400 in situ cancers each year. This form of prevention would give 165,000 extra years of life and would economise treatment costs amounts to 250 millions francs, whereas the smears taken at prenuptial examination would cost 30 millions francs.


[Etiological study of low fertility in eastern Gaboon. I. Scheme and first findings (author's transl)]. The etiological study conducted in 1975 in Haut-Ogooué and Ogooué-Lolo included 1,548 patients male and female. In the 21 investigated areas the patients were asked questions and examined by a medical team which took swabs so that bacterial, parastic, immunological and genetical assays could be carried out. The object of this article is to review the feasibility of such a local inquiry and state the first findings. Abnormalities of the epididymis are more commonly verified in non-fertile men. Microfilaremia is related to the presence of hydroceles and epididymis lesions. It shows more often in men with less than 3 children. The authors do not refer to any of physiopathology to explain these findings which need to be ascertained in further inquiries.


[Etiological study of low fertility in eastern Gaboon. II. Results according to the geographical distribution and the ethnic group (author's transl)]. An epidemiological study was conducted in Haut-Ogooué and Ogooué-Lolo, and included 875 men and 673 women. The purpose of this article is to precise the geographical distribution of the factors related to low fertility, and to verify the stability of the etiological relations according to the region, the place of residence and the ethny. Among men, hydroceles and epididym lesions are more frequent in Ogooué-Lolo, in small villages, and in forest areas. Microfilariae Loa-loa and D. perstans has the same distribution. In both regions and what ever the type of residence (town or village), the epididym lesions are more frequent in non fertile men, microfilariae is linked with genital lesions and is more seldom found in men who are the fathers of more than two children. Among women, leukorrheas, pelvic pains, and adnexal masses are related to low fertility, what ever the place of residence is.


Fiberscopic diagnosis of gastric carcinoma: results of a two-stage screening. After preliminary screening, 162 cases of gastric carcinoma were diagnosed by fiberscopy. Microscopic study revealed that 13 of these cases, i. e. 8% were in the early stage. The clinical features of these early cases are analysed. It is concluded that 1. persistent gastric symptoms call for fiberscopic investigation even if the previous finding was negative. 2. The relative youth dose not exclude early gastric cancers. 3. Improvement of the detection rate of early gastric carcinoma rests with the use of fiberscopy in combination with gastric biopsy.


HLA antigens in patients with adrenocortical hyperfunction. The HLA antigen frequencies in 100 Caucasian patients with adrenocortical hyperfunction were compared with those found in 352 healthy unrelated subjects. Fourteen antigens on the HLA--A locus, seventeen antigens on the HLA--B locus and three antigens on the HLA--C locus were determined using the standard NIH microlymphocytotoxicity test. The frequency of HLA--A1 antigen in the patient group was 49% as compared with 28% in the controls (pcorr less than 0.01). An increased frequency of HLA--B8 and HLA-BW35 antigens was also found, but the difference was not significant. Increased A1--B8 and A1--BW35 haplotype frequencies were observed. The relationship between the HLA system and various endogenous and exogenous factors eliciting hypercorticism, together with complementary family studies indicate that the HLA system may be a useful genetic marker of the disease susceptibility gene.


Antibody-dependent cellular cytotoxic activity in patients with Hodgkin disease. Antibody-dependent cellular cytotoxic activity (ADCC) of twenty-one previously treated patients (stage I--IV) with Hodgkin disease (HD) and eleven healthy controls was studied using specific antibody coated chicken erythrocyte target cells. Cytotoxicity was found to be normal in seven, slightly increased in ten, and considerably increased in four patients. No correlation with the absolute number of lymphocytes, the percentage of spontaneous rosette-forming cells and immunoglobulin bearing lymphocytes was noted. Nor did ADCC correlate with age and clinical or histological classification.


Effect of combined immunosuppressive-cytostatic treatment on antibody-dependent cellular cytotoxicity of patients with chronic glomerulonephritis. Antibody-dependent cellular cytotoxicity by peripheral blood mononuclear cells was evaluated in 25 patients with chronic glomerulonephritis before and after combined vinblastine-cyclophosphamide-6-mercaptopurine-prednisolone therapy. Purified peripheral blood mononuclear cells of the patients mediated normal killed activity before the treatment and a strong suppression of their cytotoxic capacity was observed after the therapy. The possible significance of the inhibitory effect of immunosuppressive cytostatic treatment on human antibody-dependent cellular cytotoxicity is discussed.


Antibody-dependent cellular cytotoxicity in systemic lupus erythematosus. Antibody-dependent cellular cytotoxicity of peripheral blood mononuclear cells from fourty-six patients with systemic lupus erythematosus was found to be reduced in two independent test systems. The percentage decrease in cytotoxicity was similar in the tests with allogeneic and xenogeneic targets and it was related to the activity of systemic lupus erythematosus.


Delta wave changes following attacks of paroxysmal tachycardia in WPW syndrome. A case of WPW syndrome associated with recurrent attacks of paroxysmal tachycardia for 25 years, is reported. Vectorcardiograms recorded after an attack offered evidence of multiple anomalous pathways between the left atrium and the left ventricle. The high sensibility of the angle recording channels of the triaxicardiometer, i. e. the polar vectors, is considered to represent a factor essential in delta wave analysis.


Blood coagulation defect in Masugi nephritis. The platelet count and the coagulation pattern have been studied on the basic of nine laboratory tests in Masugi nephritis of the delayed type. Platelet consumption was found to constitute the initial manifestation of Masugi nephritis. The prenephritic stage and the manifestation of nephritis were invariably associated with hypercoagulability, as reflected by a loss of the spontaneous fibrinolytic activity of plasma, together with an elevation of the fibrinogen level and an increase in maximal thrombus elasticity. At the onset of nephritis the platelet count declines again. The hypercoagulability is attributed to intravascular coagulation in the kidney.


[A 1-year study of a private pediatrician practicing in a Swiss urban center]. This paper represents a retrospective statistical study of the private activity of a pediatrician practicing in a Swiss urban center. The study ecompases one year (1974). 1325 infants and children were the object of 4665 contacts with the physician, an average of 3.5 contacts per child per year. These contacts were analyzed with regard to the reason why the contact was sought, to the kind of problem observed, to the precise diagnosis, including accessory diagnoses. These contacts wre also analyzed from the point of view of patient's age, nationality, and socio-economic group of the parents. The incidence of affective and behavioral problems, of referals to a consultant or to the hospital, and of requests for laboratory workup etc. was also studied. The suggestion is made that other similar, if possible prospective studies should be undertaken by pediatricians practicing in somewhat different conditions and in other areas of Switzerland. Such studies could be used to influence the teaching of pediatrics in Switzerland.


Cerebrospinal fluid and serum lysozyme activity in bacterial and viral meningitis. Cerebrospinal fluid (CSF) and serum lysozyme concentrations were determined in infants and children with and without acute infectious disease of the central nervous system. Serum lysozyme values from patients with bacterial and viral meningitis were found within the normal range. Lysozyme activity was absent or very low (below 0.5 microgram/ml) in normal CSF. High levels (4-12 microgram/ml) in patients with viral meningitis. A decrease of the lysozyme activity coincided with the clinical improvement of the bacterial meningitis. The lysozyme activity in CSF should be of significant value in detecting an inflammatory disease of the central nervous system.


Principles of a full 'relay toxicity' experiment and results conducted with carbadox, a feed additive used as growth promoter for growing swine. Relay toxicity is a new approach which permits an evaluation of the harmlessness of residues found in tissue, for the human consumer. Farm animals, swine for example, received high quantities of the additive over a long period. The swine were sacrificed without any withdrawal. Their meat and liver were added to the feed ration of laboratory animals to study the eventual problems of residue and metabolites. The following experiments were performed using carbadox:--Levels of carbadox up to 200 ppm were added to the swine ration (a maximum of 20 ppm is authorized). The meat and dehydrated liver were given in doses of 20% and 10% respectively, in the rat feed for 2 years or 3 generations.--The fresh meat, frozen then thawed at the time of use, was distributed to dogs daily for 7 1/2 years. No abnormalities were found, either in the growth of the animals or in their descendants. No abnormalities were observed macroscopically or microscopically after sacrifice. Relay toxicity gives high coefficients of security when the additive is used without withdrawal up to the time of sacrifice. This study demonstrated that the use of carbadox in swine doesn't present any disadvantage to the human consumer.


[The Schwartz-Jampel syndrome (myotonia chondrodystrophica)]. Report on three siblings with typical features of Schwartz-Jampel's syndrome which is transmitted by a rare autosomal recessive gene: odd facies, stiff posture, high pitched voice, myotonic reaction, Perthes-like dysplasia of the femoral head. Biochemical and histological findings are minimal and nonspecific.


Clinical, diagnostic and therapeutic aspects of caecal displacement in calves fed reconstituted milk. On the basis of a large number of cases the occurrence of displacement of the caecum is reported in calves fed reconstituted milk. This displacement, a classification of which is given, occurs with the movement of the caecum into the left half of the abdomen in contrast to what occurs in animals fed a different diet. After a description of the various clinical and diagnostic aspects, details are given of the surgical technique used for treatment, and an aetiopathogenic hypothesis is formulated to explain the disease process.


Cyclical variations in the excretion of intestinal coccidial oocysts in the rabbit. Faecal oocyst counts during subclinical intestinal coccidiosis demonstrated clear correlations between the parasite levels in the does and those in their respective litters. In the does, pregnancy did not seem to have an effect on the course of infection, whereas the effect of season was much greater. Intestinal coccidiosis was found in all the young rabbits examined from the start of the third week of life. However, after a phase of great fluctuation in the parasite levels in the faeces, a phase which extended over the initial period of weaning, the infection tended to become stabilized at extremely moderate levels that permitted an optimum state of health and high productivity.


Evaluation of a photoluminescence technique for the detection of gunshot residue. More than 170 gunshot residue samples were analyzed by the inorganic luminescence technique to assess various factors affecting the utility of this and similar methods of elemental gunshot residue detection. Indoor firings consistently produced more residue in samples than did outdoor firings. Experiments were conducted to determine the effects of activity after firing on the ability to subsequently detect residue in samples. It was shown that residue can be transferred from hand to hand and can be detected in pockets under suitable conditions. Antimony, when present in the ammunition, was found to be the most useful indicator for the presence of residue, in that nearly all firings resulted in more Sb than was found in any of 45 handblank analyses obtained in these studies. Data obtained with a .32 pistol suggest that Sb normally exceeds environmental levels when residue is collected from the hand following delays up to several hours after firing. However, it will rarely exceed the currently used threshold levels of 0.1 to 0.2 microgram. Therefore, elemental analysis is best suited to screening applications for which threshold levels can be greatly reduced.


The use of buffered celite columns in drug extraction techniques and their proposed application in forensic toxicology. The recoveries of acidic, basic, and neutral drugs through buffered celite columns are reported. The methods are rapid, simple, clean, and efficient, especially with compounds having a high volatility.


Incidence of drugs and alcohol in fatally injured motor vehicle drivers. All motor vehicle accident fatalities occuring in Dallas County during a 1 1/2-year period were studied to determine drug usage at the time of death. Blood samples obtained at autopsy or at the time of hospital admission were analyzed for the presence of drugs and alcohol. Of the drivers, 70% were positive for alcohol or drugs. Ethyl alcohol alone was detected in 52%, drugs in 9%, and both drugs and alcohol in another 9%. Seventy-six percent of the drivers determined to be at fault in their respective accidents had alcohol or drugs detected compared to 41% for not-at-fault drivers. The minor tranquilizer diazepam accounted for over half of all positive drug findings, while barbiturates, antihistamines, methaqualone, propoxyphene, and pentazocine were each detected in more than one instance.


Cocaine-related death.

Cocaine-related death. Cocaine use and abuse, an ancient custom, is once again commonplace. While severe toxicity appears to be rare, overt poisoning including death can occur. This report documents nine cases of death associated with cocaine use; in three of these cocaine appears to be causative. Toxicologic analysis of body fluids and tissues was affirmative and levels are reported. Cocaine should be considered in serious drug overdose-reactions, especially after illicit injection.


Estimation of stature in children from radiographically determined metacarpal length. Whether radiographically determined second metacarpal diaphyseal length could provide a reliable estimator of stature in children was investigated. The data consist of measurements of stature and 1597 left hand-wrist radiographs of children from 1 to 7 years of age from rural Guatemala. The errors in estimating stature in children from metacarpal length are comparable to those from equations estimating stature from long bones. It is concluded that second metacarpal length may be a reliable and practicable referent for the estimation of stature in children.


[Onset of menarche in Skopje. (Comparative studies on 22,727 women up to the 6th decade of age)]. Studies of menarche in Skopje have shown that its secular trend is significantly more pronounced in younger than in older generations. While in the young it amounts to 2.5--3 months per decade, in the elderly it is up to one month per decade. The total acceleration in the course of this century has proved to be 13.5 months. The earliest menarche was recorded in Romanies (13.46 +/- 0.92), the latest in Albanians (14.05 +/- 1.22), while Macedonian girls are somewhere in--between, along with other nationalities (14.0 +/- 1.40). Menarche proved to appear earlier in girls from very well-to-do families (13.95 +/- 1.36) than in those from families with a very low income (14.19 +/- 1.43). The latest beginning of the menstruation has been recorded in girls from peasant families (14.38 +/- 1.17). Sporadic repeated investigations of this king in different parts of the country, by using a more modern "status quo" method, appear necessary in order to determine differences in the menarcheal age in the country as a whole and to shed more ligh on their underlying causes.


[Ability to conceive after intentional interruption of intrauterine contraception]. Out of 3415 first insertions, the intrauterine contraceptive device was removed in 152 women (4.45%) owing to planned pregnancy. Nineteen cases dropped out of evidence, so that 133 remained for further analysis. Out of these 133 women, 120 (90.23%) became pregnant, the reamining 13 (9.77%) did not. In the first three months following the removal of the intrauterine contraceptive device, 77 women 57.89% conceived, 3--6 months after the removal 22 (16.54%), 6--12 months 18 (13.53%), and after one year 3 women (2.26%) were recorded pregnant. The ability to conceive is analysed according to the age of the women surveyed, the length of the use of intrauterine contraceptive devices, and the number of previous births and abortions. It is concluded that the use of intrauterine contraception has no influence on the later ability and speed of conception and that, for this reason, this contraception method could be considered fully reversible.


[Relationship between the activity of alanine aminopeptidase and alkaline phosphatase in the blood of pregnant women]. The determination of the activity of alkaline phosphatase (AP)--orthophosphate-monoesterphosphohydrolase, EC.3.1.3.1.--and alanine-aminopeptidase (ANA)--alpha-aminoacyl-peptide hydrolase (microsomal), EC.3.4.11.2--in the serum of non-gravid and gravid women has shown that in non-gravid women normal ANA values range from 17.0 to 32.0 I. U. and normal AP values from 14.4 to 26.0 I. U., the ANA/AP quotient amounting to 1.28 (S = +/- 0.301 I. U., KV = 23.5%, n = 29). The determination of the activity of the above quoted enzymes has shown that in the course of pregnancy the values of both enzymes increased by the exponential curve which allowed the calculation of the ANA/AP quotient for each month of pregnancy. The ANA/AP quotient determined in this way is proposed to serve as a diagnostic parameter in the routine control of pregnant women.


[Premature rupture of fetal membranes and intra-amnionic infection]. Although the group under study was small (90 cases) but compared with the control group of the same size it did reveal some facts: 1. The duration of labour was much shorter (by 8 hours on the average) in the control than in the study group. 2. The result of the assessment of the condition of children by the Apgar score was somewhat better in the control group, which is understandable with regard to the subsequent delivery course in the group of children with a premature bursting of the bag of waters. 3. The percentage of directed labour in the group under study was significantly higher (60%). 4. Surgical completion of labour in the study group (10%) was more frequent than in the control group (4.4%). Breech presentation was observed only in the study group (5.5%) which corroborates the old rule that in any premature bursting of the bag of waters, along with all kinds of delivery complications, also the cephalopelvic disproportion and some irregular presentation of the fetus in labour should be expected. 5. Although in the premature bursting of the bag of waters the duration of labour is longer (14 hours and 19 minutes) than in the control group (5 hours and 40 minutes), no more frequent infection, either in newborns or mothers, has been observed.


[First spontaneous micturation in early puerperium]. The time of the first spontaneous miction after delivery was analysed in 500 primiparae and 500 multiparae, all of them having had a normal pregnancy and a normal delivery. In none of them the first miction was recorded before the fourth hour following labour. In the first six hours, spontaneous miction was recorded in 16.6% of multiparae and 8.4% primiparae, up to 12 hours following labour in 99.6% multiparae and 51.4% primiparae. The latest appearance of miction in multiparae was recorded 22 hours after labour and in primiparae 32 hours after labour. The catheter was not employed in any single case. In the author's opinion, the primiparae is the protracted labour which reversibly or functionally impairs the urinary bladder.


[Leiomyosarcoma uteri].

[Leiomyosarcoma uteri]. The authors present a 55-year-old patient with leiomyosarcoma uteri who died six months after surgical and subsequent radiation therapy. They point out difficulties in diagnosing the disease owing to a very scarce symptomatology. The fast growth of the myoma is considered very symptomatic of a malign alteration. In the patient presented, in only eight months, a slightly myomatously increased uterus gew to the size of two male fists.


[Intra-abdominal bleeding due to the rupture of the corpus luteum]. A total of 28 patients with extensive intraabdominal bleeding caused by the rupture of the corpus luteum in the period from 1961 to 1970 were analysed. In all of them the ovarian lesion was pathohistologically verified. Most of the patients (15) had never been pregnant. In all the patients the rupture occurred in the second half of the cycle. None of them developed any serious hyin 3 patients. A wrong preoperative diagnosis was established in all the patients Its intensity depended directly on the amount of the blood observed in the abdominal cavity. Still active bleeding was found in 8 patients. In 20 patients surgery was applied within 24 hours, in 5 within 48 hours, and in 3 it was delayed 4 days. Oophorectomy was performed in 10, resection of the ovary in 15, and adnexectomy in 3 patients. A wrong preoperative diagnosis was established in all the patients presented.


[Acute edema of the uterine cervix in pregnancy]. A case of the acute edema of the uterine cervix in a woman in the ninth lunar month of pregnancy is described. The cervix was the size of a fist, livid, succulent, with a slightly bloody discharge. No other objective or subjective disorders were obserevd. The swelling disappeared after seven days of rest and antibiotic therapy.


[Chemotherapy of malignant tumors in gynecology]. Chemotherapy is routinely applied in a number of malign tumours of female genital organs, primarily in the tumours of the trophoblast and ovarian carcinoma. Its use is often in discord with the present-day konwledge, either in the choice of cytostatics and the optimal time of application or in the combination of different drugs and their dosage. A brief review is given of the basic aspects of cellular biology, of the characteristics of normal and tumour cells, and the principles underlying present-day chemotherapy. Cytostatics having proved particularly effective in the treatment of gynecological tumours are listed separately, along with their daily and total doses and the toxic effects they produce. Also the most frequent schemes for polychemotherapy are presented. Except for the treatment of choriocarcinoma, chemotherapy in gynecology is still the auxiliary method, and for this reason it should be rendered accordant with the classical treatment by radiation and surgery. Chemotherapy is developing very rapidly and what at present is considered peripheral may become of prime importance tomorrow. An all-round plan in the therapy of genital carcinoma can be established only in institutions in which teams of related experts monitor all advances in this field.


[Suprapubic drainage of the urinary bladder]. The author describes the method of the suprapubic drainage of the urinary bladder by using the Snaider Urevac of the firm "Zimmer". In 20 patients all urinocultures sampled one and five days after the surgery were negative. The method involves no danger, it is simple and comfortable for the patient in comparison with the transurethral drainage. According to the initial experience of the author, the method of suprapubic drainage could be recommended for a more frequent use in the continuous drainage of the urine in the postoperative period of gynecological patients.


[Epidural analgesia--effect on the fetus and uterine activity]. The effect of continuous epidural analgesia on the fetus, newborn, and uterine activity was studied in a group of 50 parturients. No untoward effects, either in the fetus or uterine activity, that could be ascribed to this procedure, were observed. The authors use their own modicifation of the epidural block by titrating the amount of the local anesthetic according to the intensity of pain in labour.


[Role of the partogram in the modern conduction of labor]. The authors present an original partogram showing the course of labour. The partogram consists of three parts. Its back first contains columns for general data, the position of the fetus, the results of amnioscopy and prepartal cardiotocography with the oxytocin test. The second part contains data on the progressed dilatation of the uterine cervix, the condition of the bag of waters, the quality of the amnionic fluid, uterine contractions, and he results of the pH-metry and the interpretation of cardiotocography in the course of labour. The third part contains the diagnosis of delivery and the newborn's vital symptoms. Six partograms of women with different characteristics and different pathologic conditions are presented. The authors underline the simple way of composing and using the partogram, as well as the benefit deriving from it, especially when several labours are conducted at the same time.


[Conization of the portio by Kullander's method]. The author presents his experience goined in performing 100 conizations after the modified Scott-Burghardt bloodless method reported by Kullander. In this whole series only one case of more serious postoperative bleeding (solved by electrocagulation) was recorded. Time advantages of the method over the previously used Sturmdorf method of conization with the plastic surgery of the portion are emphasized.


[Whole-body retention studies of 169Yb-citrate.--Estimation of radiation dose to humans from 169Yb-citrate (author's transl)]. For purpose of the estimation of the radiation dose to humans from 169Yb-citrate, the whole-body retention studies using five rats were carried out. Following intravenous administration of 169Yb-citrate, the whole-body activity was monitored for 40 days by the animal counter. The whole-body retention curve consisted of three components: the first with a 3.6 hours effective half-time, the second with an 154 hours effective half-time and the third with a 29.9 days effective half-time. Therefore it was assumed that 32% of the administered 169Yb-citrate clears from the kidney with a short biologic half-time (3.6hours), 18% remains in the liver and other soft tissues with a relatively long biologic half-time (194 hours) and 50% remains in the bone with a long biologic half-time (850 days). Based on these biological data and the MIRD Committe method, the average dose to the bone and whole-body were 20.8 rads/mCi and 4.5 rads/mCi respectively.


[Clinical application of extracellular fluid measurement using 35S-sodium sulfate (author's transl)]. ECF (extracellular fluid volume) was measured by 35S-sodium sulfate and the same time value of PV (plasma volume) was determined by 131I-RISA in each subject. In normal ECF was an average of 181 ml/kg, 6.21 l/m2 and PV was 49.1 ml/kg, 1.69 l/m2. Both values of ECF and PV in essential hypertension were almost the same as those in normal. In congestive heart failure ECF was 232 ml/kg, 7.51 l/m2 and PV was 55.8 ml/kg, 1.80 l/m2. In the patients with ascites or edema, ECF was 256 ml/kg, 8.69 l/m2 and PV was 53.0 ml/kg, 1.79 l/m2. The results of the measurement by the two compounds also corresponded to the conditions of the patients who showed electrolytes disorders (ACTH deficiency, SIADH) and was improved by treatment.


[General problems in long-surviving experimental animals following complete heart replacement]. Total heart replacement was performed in 7 calves. All animals were alive at 3 weeks, and four survived more than 2 months up to 121 days. Failure of the pumping equipment was responsible for death in each case. At autopsy increase both in size of the right atrium and of liver weight and evidence of thromboembolism were regular findings.


[Distribution and causes of injuries in seat belt-wearing automobile passengers]. We analized 71 car head-on collisions with 100 persons involved wearing seat belts. All 31 passengers with faulty belt function (group II) suffered injuries, 7 of them fatal. 69 passengers with correct belt function were only slightly injured if at all (group I). The majority of the injuries in group I are those of the chest and lower extremities, in group II, however, of the head and lower extremities. The "absolute degree of trauma" revealed the maximal extent of trauma for group II in the region of head, chest and pelvis/abdomen. Increased deformation of the vehicle results in an increase of severe injuries especially in passengers of group II.


[Clinical and biometric studies of the adaptive response of shock parameters in patients with multiple injuries and its prognostic significance]. In 35 patients with multiple injuries hemodynamic and renal function parameters measured early after trauma were analysed by biometric methods. Statistically significant prognostic results and differences in the cybernetic behaviour could be demonstrated.


[Cardiovascular parameters following severe multiple injuries]. Cardiovascular parameters of 35 patients with multiple injuries are monitored over a period of 7 days. Pulmonary artery pressure, pulmonary vascular resistance, intrapulmonary shunts and cardiac output appear to have a significant prognostic value.


[Comparative study of energy metabolism of the skeletal muscles in man, dogs and rats during long-term ischemia]. A comparative investigation was made on muscle tissue of man, dog and rat during ischemia of five hours duration. The content of energy rich phosphates was measured. The ATP level decreased after two hours ischemia to 68% in man, to 45% in the dog, and to 23% in the rat. By five hours it had fallen further to 25% in man, 9% in the dog and only 1% in the rat. It is concluded that human muscle has a higher tolerance to ischemia.


[Changes in liver metabolism following a standardized skin burn and intraperitoneal injection of a burn toxin isolated from burned mice skin. Studies on rat liver using isolation perfusion]. Parameters of liver metabolism were studied in the isolated perfused rat liver 5 days after a standard skin burn or an i.p. injection of a specific cutaneous burn toxin. Decreased values of the energy quotient ATP/ADP compared with normal controls were found. The absolute content of adenonucleotides was unchanged. The excretion of glucose and urea was also decreased in both groups and glucose synthesis after a lactate load was only slightly stimulated. The results show a direct influence of a burn toxin on hepatic metabolism suggesting a possible disturbance of oxydative phosphorylation.


[Comparative transmission and scanning electron microscopy studies of liver changes in mice followed sublethal skin burns and intraperitoneal injection of a specific skin burn toxin]. Ultrastructural alterations of the liver were examined on the 1st, 2nd, 3rd, 5th, 7th and 14th day after a standard burn in mice. Our results can be divided pathogenetically into two groups: 1. Alterations explained by the primary thermal injury including electron-optically empty vacuoles and sinusendothelium destruction. 2. Alteration due to the influence of a specific burn toxin including mitochondrial changes and the formation of autophagic vacuoles. Evidence of this distinction was produced by a second investigation. Burn toxin isolated from the serum of severely burned patients was injected intraperitoneally (15 mg) into 4 mice. The livers were examined by electron microscopy on the 2nd, 4th, 7th and 14th day. Alterations described in 2 above were not observed in any case of this investigation series. The nature and timing of liver alterations were similar to those described in 2 above. In none of the cases were changes similar to those in 1 above observed.


[Angiographic studies of kidney failure in endotoxinemia]. Exogeneous endotoxaemia caused vasoconstriction of the juxtaglomerular arteries in otherwise healthy minipigs. This supports the view that reduced renal cortical blood flow in patients with liver disease can be caused by endotoxin. After portocaval anastomosis the efficacy of the liver RES to clear endotoxin was decreased due to the haemodynamic disorder. Thus, a dose of endotoxin, which was sublethal to healthy animals, became lethal owing to decreased RES-function. The increased endotoxin toxicity leads to a Shwartzman-Sanarelli-reaction. A dose of toxin which caused death in all animals with a portocaval shunt alone was not lethel in any animal in which an arterialization procedure was simultaneously performed, suggesting a possible improvement of RES function. These findings are of clinical importance for patients with renal failure in liver cirrhosis and hepatic failure. They suggest that endotoxaemia is of pathogenetic relevance in the development of functional renal failure.


[The effect of portacaval anastomosis and liver arterialization on the oxygen supply of the normal and the cirrhotic liver]. The application of the Platinum-Multiwire Surface electrode for local oxygen determination permits the determination of microcirculatory changes in the normal and cirrhotic liver. The normal liver is capable of compensating for portal blood deprivation whereas in the cirrhotic liver shunting of portal blood leads to a striking hypoxia of the liver tissue. Lack of oxygen can be prevented by means of arterialization, but despite oxygen adaptation at the time of operation uncontrollable hyperoxygenation can occur as well.


[Liver blood flow studies using cineangiodensitometry]. In 12 anesthetized beagle dogs breathing spontaneously flow in the hepatic artery (168 ml/min + 10 SEM) and portal vein (576 ml/min +/- 20 SEM) was measured by means of angiodensitometry. Total hepatic blood flow (THBF) was 185 ml/100 g/min +/- 11 SEM. In our opinion this relatively high THBF depends upon the method used.


[Increased myocardial adenine nucleotides induced by adenosine]. The tissue of adenine nucleotides in the myocardium of rabbits, rats and dogs can be raised up to 40% by the infusion of adenosin. This increase is a function of the applied dose, the duration and the mode of application of adenosin; it does not result from the adenosin-induced reduction in cardiac work.


[Functional studies of the cardia muscles in achalasia]. 1. The mechanical properties - extension behaviour and ability to contract per muscle cross-section - were the same for healthy and aganglionic cardiac sphincter. 2. The acetyl choline threshold is higher in aganglionic muscle strips. The maximum effective acetyl choline dose (2 microgram/ml) remained the same. 3. Achalasia is characterized by a considerable reduction of adrenergic beta-receptor activity and alpha-receptor predominance.


[Studies of arterial blood flow of the stomach in the application of long-section esophagoplasty]. The individual supply areas of the stomach arteries are clearly shown by the technovit corrosion methods, angiography and measurement of the circulation by radioactive microspheres. All three methods prove that the right gastro-epiploic artery is capable of maintaining an adequate blood supply of the stomach including the critical fundus region.


[An additional use of the small intestinal invagination valve]. Extensive small intestine resection (70--90%) as should be done after mesenteric infarction produces a chronic malabsorption syndrome with its consequences. Applying an invagination valve of the small intestine (Kock) and using the isoperistaltic modification, passage of the chyme is delayed and its resorption improved. A small intestine resection of 90% was done in 8 mongrel dogs. After an average of 2--3 months an obvious cachexia as well as a steatorrhea could be observed. By adapting an isoperistaltic small intestine invagination valve near the colon weight reduction could be stopped during another 6 months and the steatorrhea disappeared No ileus occured.


[Radioactive microsphere studies of stomach wall blood flow in dogs following truncular vagotomy]. Blood flow in the mucosa of fundus and antrum behave quite contrary after TV: Whereas mucosal flow of the fundus is reduced, mucosal flow of the antrum increases significantly. But 3 weeks after TV flow values of the fundus are in the range of the initial blood flow and are decreased significantly in the antrum. The early diminution of the blood flow in the mucosa of the fundus can be partly responsible for the favourable effect of TV, which is observed on erosive bleedings in this region.


[Electromyographic studies of the stomach following selective proximal vagotomy in the awake dog]. Electrical and mechanical activity of the stomach following selective proximal vagotomy (SPV) were studied with 79 single experiments in 10 awake dogs. The influence of several pharmacological agents and feeding was tested: 1. The AP-Index of the gastric electrical activity rises to 1. 2. High frequency, atypical electrical activity resulting in mechanical inactivity increases with the postop. time interval. It reaches 60% of measured time on the 7th postop. day. 3. Normal electrical coupling of corpus and antrum is lost. 4. Pentagastrin increases the frequency of AP-rhythm only in the denervated corpus. 5. Carbachol and insulin have no such effect. 6. Feeding decreases electrical frequency in the innervated antrum. The altered electrical activity explains the known impairment of gastric emptying following SPV. The electrical desynchronization of corpus and antrum and the increased incidence of high frequency potentials in the antrum seems to overcome the high AP-Index.


[Acute stomach lesions and changes in histamine level of various organs in immobilization stress]. In the glandular part of the stomach, the histamine content was significantly increased during stress by immobilization. Following 8 hours of restraint these alterations were observed only in lung tissue, but not in other organs investigated. Although the maximum of stress ulcer formation did not correspond with the maximum increase in gastric histamine content as far as the time course is concerned, a role of histamine in stress ulcer disease cannot be excluded.


[Sympathectomy of the stomach: an effective preventive measure in stress-induced gastric mucosa lesions in swine]. 15 mini-pigs were bled to a mean aortic blood-pressure of 40 mm Hg, which was sustained for 3 hours. 2 groups were studied: Control-Group: Shock alone without splanchnicectomy (n = 8); Test-Group: Shock after splanchnicectomy 14 days previously (n = 7). In all animals a stimulated gastric secretion test was performed 3 days before and 8 days after this operation. All animals of the control-group showed severe gastric mucosal lesions after shock. Piglets with splanchnicectomy (test-group), conversely, developed no (5 animals) or only minor changes (2 animals). The efficiency of splanchnicectomy was proved by a stimulated gastric secretion test: Basal acid output did not change after operation, peak acid output however increased significantly. This study in piglets shows, that splanchnicectomy of the stomach prevents gastric stress-lesions almost completely.


[Gastrointestinal hormone release in dumping symdrome before and after reconstruction of duodenal passage]. Serum gastrin, serum-GIP and serum insulin levels were measured before and after interposition operation (Henley-Soupault) in 10 patients with severe dumping-syndrome (PGS). The results were compared to those obtained in 10 normal subjects without any gastrointestinal disease. In the PGS pre-operative group there was a significantly lower serum gastrin concentration compared to normals, while the serum-GIP-concentration was significantly higher. After interposition operation all serum-hormone-levels tended towards normal values. There was no difference between the basal serum insulin levels of the three groups. The change in postprandial insulin release was parallel to the serum-GIP-levels. It is concluded that there is a close connection between disturbed release of gastrointestinal hormones and the dumping syndrome.


[The effect of vagotomy on the gastrin level of serum, of antrum mucosa and of gastrin cells]. Truncal vagotomy (TV) causes an increase in basal and postprandial serum gastrin levels. Furthermore, TV results in an increase of antral mucosal gastrin content by doubling the antral G-cell-number. The activity of the G-cell and the molecular forms of gastrin are not changed by TV.


[The role of the duodenum in the regulation of the lower esophagus sphincter]. Instillation of a 20% peptone solution into the isolated duodenum causes a significant increase of LES-pressure in the dog. No comparable increase of LES-pressure after instillation of a 0.9% saline solution into the duodenum or of 20% peptone solution into the stomach is observed. As shown in this investigation, it is possible that the duodenum regulates the LES-pressure in the dog.


[Kidney preservation by mechanical perfusion and by hypothermic storage: a comparative study]. 72 dog kidneys were stored under hypothermia as described by COLLINS and SACKS between 24 and 72 hrs and then transplanted. The immediate function of the kidneys was measured by PAH and inulin clearances. 24 hrs proved to be the maximum safe preservation time with both methods. The immediate function of the kidneys stored under hypothermia could not be improved by the addition of furosemide to the flushing solution. These results were compared with those gained by mechanical perfusion of the organ: kidney function after 72 hrs of hypothermic mechanical perfusion was significantly better than after 24 hrs of hypothermic storage.


[Gluconeogenesis in perfused rat liver following preservation in various temperature ranges]. Experiments with perfused rat livers have shown that rates of various metabolic processes are influenced by changes in temperature in different ways. Cytosolic processes exhibit a linear temperature dependence when plotted in an Arrhenius-diagram in the range between 37 degrees and 1 degree C. In contrast, processes which are bound to mitochondrial membranes show phase changes at 22 degrees C. Furthermore, with gluconeogenesis another phase was observed at 11 degrees C. After 24 hour of perfusion at 11 degrees C the livers produced more glucose from gluconeogenic precursors when perfused at 37 degrees C than after perfusion at 4 degrees C. The importance of the balance of metabolism during hypothermia is discussed by comparison with metabolism of poikilothermic animals.


[The significance of sodium intake in postoperative aldosteronism]. The postop. aldosteronism of a control-group with a sodium intake of 1.5 mval/kg bw/d can be suppressed by increasing the sodium intake up to 5 mval/kg bw/d. A postop. increased need for sodium is supposed to be the most possible cause for this aldosteronism.


[Hormonal and pharmacological modification of the ileocecal sphincter]. Ileocecal shincter (ICS) pressure was evaluated in response to hormonal and pharmacological stimuli in rabbits. The effect of exogeneous gastrin (pentagastrin) and glucagon, metoclopramide and neostigmin on the ICS pressure was studied. Gastrin, glucagon and metoclopramide increased the pressure whereas neostigmin lowered it. These results suggest that this junctional zone is not only a valve but a real shincter, which is affected by gastrointestinal hormones and pharmacological substances. Further examinations are necessary to study the role of the ICS after gastrointestinal surgery.


[Histo-topography of gastric mucosa changes in benign and malignant stomach diseases]. The incidence and distribution of chronic gastritis, chronicatrophic gastritis and epithelial dysplasia I-III have been investigated in 50 resected stomachs of patients suffering from duodenal ulcer, gastric ulcer, early or advanced gastric cancer. Only in gastric cancer epithelial dysplasia III has been frequently observed, particularly in the neighbourhood of gastric cancer. Distribution of chronic-atrophic gastritis was similar to the distribution of dysplasia I and II. These mucosal lesions were detectable with the same frequency in patients with or without gastric cancer.


[Chemically induced stomach carcinomas in rats following vagotomy and Bilroth II gastrectomy]. 180 Wistar-rats were daily exposed to 30 and 100 mg MNNG/1000 ccm tapwater. After an exposure of 7 weeks a truncal vagotomy with pyloroplasty or a Billroth II-resection was performed in 25 animals of each dosage-group. 80 rats were not operated. The incidence of carcinomas in the Billroth II-rats of both dosage-groups was evidently higher than in the exposed controls. In the vagotomized rats an increased occurrence of carcinomas could not be observed.


[Improvement of specificity and reactivity of the leukocyte migration test for the diagnosis and follow-up care in stomach cancer]. The leukocyte migration assay proved to be a very sensitive tool in gastric cancer diagnosis. When patients' leukocytes were exposed to a panel of 3m KCl extracts, positive reactivity was found at a rate of 92%. All patients with non-malignant gastric diseases exhibiting "positive" reactivity with gastric tumor extracts also showed a pathological migration index with a 3m KCl extract of normal gastric mucosa, while only in 16% of patients with gastric cancer leukocyte migration was influenced by this extract. Using gastric tumor extracts patients with colorectal cancer showed a cross-reactivity in 67% and patients with carcinoma of the pancreas and oesophagus in 42% of the tests. Three months after curative surgery most patients' leukocyte migration was found to be in the normal range. Positive reactivity reappeared in patients with local recurrence or metastases.


[Modifications in bone structure caused by plate osteosynthesis of the long bones in growing experimental animals]. Periosteal function of growing bones was studied in young sheep. Periosteal devascularisation and tibial plate implantation caused partial cortical necrosis and porosity of endostally vascularized cortex. Plate implantation induced epiphyseal activities. After 8 months differences in bone length of 2.5 mm were observed.


[Animal studies on the modification of neuroma formation]. In conclusion, the formation of the whole neuroma cannot be prevented completely by the local application of triamcinolon. The outgrowth of the neuronal fibres though, which seem to be responsible for the painful discomfort of the patients, can be suppressed or even prevented completely.


[Molecular mechanisms of receptor-potential generation by the photoreceptor. I. Photic induction of a change in the permeability of artificial lipid membranes modified by photoreceptor membrane fragments]. Artificial lipid membranes modified by ultrasonic fragments of rod outer segments increase their conduction in response to illumination. Conduction increase is followed by the spontaneous foll in the dark to the unitial or somewhat higher level. The time constant of conduction increase was about 30 msec at room temperature, the constant of its following drop was about 300 msec; the activation energy of the last process was 19 +/- 3 kcal/mole.