[Permeability of physiological barriers for chromium and its balance in the body when administered with water or food]. In experiments set up on albino male-rats by using Cr51 the permeability of physiological barriers to hexad stable chromium (sodium chromate), introduced with water per os in doses of 2.5 and 2250 gamma/kg was studied and the chromium balance in the rats' organism with an addition of the same doses of trivalent (chromium sulfide) chromium to the ration investigated. With all the tested additions of stable hexad chromium in water Cr51 is prevalently retained in the stomach and intestines. With an addition of 2.5 gamma/kg of stable chromium to the ration and without chromium addition to the ration it is only 7.8--9.5 per cent of the introduced Cr51 that is excreted in 4 days, the respective figures with additions of 24 gamma/kg and 2250 gamma/kg being 59.7 and 54.5 per cent. An addition of 2.5 gamma/kg of chromium to the ration is physiologically justified, for with this dose the retention in the barriers and excretion of chromium with this dose do not increase, whereas higher doses of tri- and hexavalent chromium are non-physiological, since with these doses the retention of chromium by physiological barriers sharply increases and so doses its elimination from the organism.


[Effect of different amounts of manganese in the daily food ration on the growth and development of the progeny of white rats]. In doses of 7.5 to 17.5 mg/kg of body weight manganese exerts a stimulating effect on the growth and development of the albino rats progeny as well as on the general condition of pregnant and lactating rat-females. The requirement for manganese rat-females in lactating rattlings is 2--3 times as high by comparison with its content in an ordinary ration, permanent for a given organism. Introduction of manganese in doses of 30.0 and 42.5 mg/kg exerts an inhibiting action on the growth, weight and viability of newborn rattlings.


Red cells and gelatin as the core of a unified program for the national procurement of blood components and derivatives. Prediction, performance, and impact on supply of albumin and factor VIII. The use of a gelatin plasma substitute as an integral part of a unified national program for the procurement of blood components and derivatives paves the way for the extensive use of red cell concentrates in the treatment of hemorrhage, the plasma from the original donations being partly diverted to the fractionation program of a national transfusion service. We estimated the potential of such a system paced by the demand for red cells and predicted that the use of 20% of fresh whole blood and 80% concentrates would not increase the demand for albumin, the yield of which would suffice to cover three-quarters of current needs in our country. The actual performance of a program using 85% of red cell concentrates in a university hospital with an exceptionally high incidence of major hemorrhage was analyzed in detail. The use of albumin per unit of transfused red cells rose by 9%. With a nationwide increase of this magnitude, 67% of the demand in our country could still be met and the estimated true need for albumin of 200 kg per million inhabitants and year would be fully covered. The yield of factor VIII is 200--300% of the demand. The determinants of the effects of such a system vary from country to country, but its fundamental potential is obviously considerable.


Effect of centrifugation and subsequent storage on red blood cells. Blood drawn into CPD solution from 33 normal donors was divided into four groups: (I) centrifuged (at 5,000 g for 7 min) after 7 days of storage, (II) centrifuged after 14 days storage, (III) centrifuged after 21 days storage and (IV) uncentrifuged. After 21 days of storage, aliquots of all units were labeled with chromium-51, reinjected into the donor from which they were drawn and erythrocyte survival was measured. Red blood cell recovery and survival for all four groups was essentially the same; 24-hour recovery was 85%; T 1/2 was 28.2--31.6 days. Our results suggest that blood can be centrifuged and stored at any time during its 21-day shelf life without detrimental effect on erythrocyte survival.


Genetic polymorphism of the fourth component of human complement. A modified electrophoretic system for the determination of C4 polymorphism has been found with which the new allotype F1 could be detected. The system has been applied to the population distribution of C4 in 266 unrelated Germans, further to association and linkage studies. Gene frequency was 0.3985 for C4F, 0.5526 for C4S and 0.0489 for the rare C4 genes. In the population sample, significant association between Bf and C4 but no indication for close association between C4 and GLO I has been found. In the families HLA, Bf and C4 segregated together.


[New food dye from sorghum grain hull and its toxicological characteristics]. The chemical composition and biological action of a new food dyestuff separated from the grain sorhum film were studied. From 1 kg of the grain sorhum 169--248 g of the film are retrieved; and from this it is possible to obtain from 17 to 40 g of a flavonoid dyestuff that consists of cyanadine, quercitrol and pelargonidine. The dyestuff can be utilized in the food industry in preparing bisquit cream products, caramels and fruit starch jellies. Biological investigations with applied testing methods proved the dyestuff to be non-toxic: its introduction to animals for six months did not produce any morphological changes in the tissues of the liver, kidneys, thyroid and pancreatic glands, nor did it affect the content of glycogen in the hepatic tissues.


Treatment of malignant pheochromocytoma. Pheochromocytoma is a tumor derived from chromaffin tissue, which secretes catecholamines. Today, about 90 percent of patients with this tumor are cured by surgical procedures. In 8 to 15 percent of patients with this tumor there is unresectable, recurrent or metastatic disease, which causes significant morbidity and mortality. The natural history of metastatic disease includes long-term survivors; many, however, die early of disseminated disease. The most common site of metastatic lesions is the skeleton. Palliation for these lesions can often be achieved with the use of radiation therapy. Other sites are, in general, less responsive to radiation therapy. Chemotherapy has been used in combination with radiation therapy, but the results generally have been disappointing. Chemotherapy with doxorubicin hydrochloride and cyclophosphamide in combination with radiation therapy has provided good palliation for skeletal disease for about five months, when disease progression was again noted. Further information is needed concerning the optimal chemotherapeutic treatment of this unusual tumor.


Head injury and early signs of tentorial herniation: a management dilemma. In 100 patients intracranial exploration was done soon after severe head injury when signs of transtentorial herniation were present. A third of patients had extracerebral hematomas shown on initial burr hole examination. An additional 18 percent had parenchymal clots of clinical significance disclosed only by angiography after burr hole exploration or at autopsy. Half the patients in whom exploration was done did not have intracranial hematomas of sufficient size to warrant an operative approach. Detailed neurological examinations soon after injury and the availability of more rapid diagnostic tools may improve the accuracy of early diagnosis and allow more specific prognostication in patients with severe head injury.


Viral hepatitis.

Viral hepatitis. Viral hepatitis may be classified into three or more forms including type A hepatitis, type B hepatitis, and a group denoted as non-A non-B hepatitis which may represent viral hepatitis of one or more causes. The differentiation of these forms of hepatitis is primarily serologic. The development of antibody to hepatitis A virus can be detected by radioimmunoassay as well as by other test systems. The serologic diagnosis of type B hepatitis rests on the detection of hepatitis B surface antigen or on the development of antibody to hepatitis B core antigen or hepatitis B surface antigen. The serologic diagnosis of non-A non-B hepatitis is a diagnosis of exclusion for assay systems for this form of disease are not yet available.A prototype hepatitis B vaccine has been prepared and is currently undergoing clinical trials. Gamma globulin is now available that contains high titered antibody against hepatitis B virus. Normal immune globulin contains high titers directed against hepatitis A virus. Therefore, for documented exposure, effective prophylaxis is available for both of these forms of acute liver disease. The past decade has resulted in rapid advances in our understanding of the pathogenesis of acute hepatitis and its extrahepatic manifestations. However, it is clear that specific treatment for acute hepatitis and the accurate description of the etiologic agents of non-A non-B hepatitis require exploration.


[Myocardial scintigraphy].

[Myocardial scintigraphy]. A distinction can be made between invasive and non-invasive methods in myocardial scintigraphy. Myocardial perfusion scintigraphy as an invasive procedure always requires catherization of the coronary arteries and can be performed only in conjunction with coronary arteririography. The technique of this type of myocardial scintigraphy is described in detail and an explanation given of the normal scintigram and the results obtainable by this method in cases of coronary heart disease. In particular, the possibilities of "doulbe-radionuclide" scintigraphy are discussed. The non-invasive methods serve either to image the still-viable myocardium (cold-spot technique) or for direct visualization of recently-infarcted myocardial tissue (hot-spot technique). The diagnostic importance of these procedures is stressed, especially dual radionuclide investigation of recent myocardial infarct with technetium and thallium.


[Diagnostic and clinical features of atrial myxoma (author's transl)]. The most common benign cardiac tumours are artial myxomas. Characteristically they may interfere with the normal functioning of atrioventricular valves or manifest themselves by embolism to cerebral or peripheral arteries or they may mimic systemic diseases. Hence, early diagnosis and immediate surgical treatment are important. A case of left atrial myxoma is reported and the various non-invasive and invasive diagnositc methods and their significance are outlined. If the angiocardiographic findings are questionable, the echocardiographic features are believed to be of greater reliability. Finally, the histopathology of atrial myxoma, the rate of tumour growth, as well as the possibility of postoperative reappearance of the myxoma are discussed.


[Occlusion of both femoral arteries in one case of ergotism (author's transl)]. In a 29 year-old female occlusions of both femoral arteries were caused by the administration of ergotamine in the form of Cafergot-suppositories. Angiographically long smooth-walled stenoses and occlusions over a segment of approximately 5 cm length in each superficial femoral artery as well as occlusions of both tibial arteries were demonstrated. Follow-up was carried out with oscillography, rheography, plethysmography and Doppler ultra-sound technique. A repeat angiogram 1 week after discontinuation of the drug and medical management with intravenous infusions of Ronicol and Valium revealed patent vessels of the lower extremities.


[Long-term examinations of fundic mucosa in gastroduodenal ulcer after SpV and pyloroplasty (author's transl)]. Morphological examinations of the fundic mucosa with quantitative analysis of the parietal, chief and mucous neck cells were carried out with duodenal ulcer cases before selective proximal vagotomy and pyloroplasty, and over a period of more than four years after the operation. In the material removed by forceps biopsy from 15 duodenal ulcer cases, an early post-operative parietal cell density reduction of 74.15% was found, and from 5 gastric ulcer cases a reduction of 73.77%. This result occurred over an examination period of four years. The post-operative displacement in the distribution of the parietal cell within the fundic gland was pointed out, as well as the increased post-operative inflammatory indurating changes in the fundic mucosa, which occur only in gastric ulcer cases. The thickness of the mucosa was measured with an ocular micrometer pre- and post-operatively in 8 cases, and a post-operative reduction of about 20% was found. The relationshiop between the degree of post-operative parietal cell reduction and the insulin-stimulated acid-secretion was checked and no significant difference between the absolutely insulin-negative and insulin-positive groups was found post-operatively. To supplement these findings, the reaction of the succinatdehydrogenase activity in the mitochondria of the parietal cell was analysed semiquantitatively and by absorption-photometer. Thus a post-operative reduction of enzyme-activity of 20.45% on average was found in duodenal ulcer cases. In gastric ulcer cases there was no evidence of any reduction.


[Chemically induced carcinogenesis of stomach of the rat after vagotomy and resection (author's transl)]. 180 male Wistar-rats were daily exposed to 30 and 100 mg MNNG/1000 ccm tapwater. After 7 weeks exposure 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.


[Pancreatic dose-response curves to cholecystokinin in dogs (author's transl)]. Dose-response (DR) curves for pancreatic flow rate, bicarbonate and protein output to cholecystokinin (CCK) were determined by two techniques in 3 conscious dogs with gastric and duodenal Thomas fistulas. With the continuous DR technique the dose of CCK was doubled each 45 minutes and with the single DR technique, only one dose of CCK was infused on each test day. The dose-response curves for pancreatic flow rate and bicarbonate output did not differ with the two techniques. The maximal protein output was higher with the single DR than with the continuous DR technique.


[Technetium 99m-diphosphate as an imaging agent in acute myocardial infarction (author's transl)]. To test the sensitivity and specificity of 99m-Technetium-Diphosphat myocardial scintigraphy in the diagnosis of acute myocardial infarction we examined the scintigrams of 53 patients admitted to our CCU. In all 38 patients with transmural myocardial infarction positive scintigrams with localized uptake of the tracer found. Myocardial imaging was performed 70--90 minutes after the intravenous injection of 15 mCi 99m-Technetium-Diphosphat in anterior and LAO position. The clinical value of the method for proving the presence or absence of a myocardial infarction is demonstrated on infarctions combined with bundle-branch block, pacemaker Ecg and on reinfarction. All normal cases in this group showed no tracer activity outside the bones. In unstable angina pectoris a faint but not localized tracer activity was found.


[Contractile and relaxation reserve of the left ventricle. III. Patients with cardiomyopathy (author's transl)]. Seven of 22 patients with cardiomyopathy increased maximal rate of left ventricular pressure rise (max dP/dt) above 3200 mm Hg/s and dP/dt/P above 60/s. Relaxation reserve was normal with an increase of min dP/dt above 2400 mm Hg/s.--In 15 patients contractile and relaxation reserve was reduced. In congestive cardiomyopathy, contractility and relaxation reserve were equally reduced. Left ventricular enddiastolic pressure increased during exercise slightly or not (grade 1). Enddiastolic volume was elevated to 173 +/- 50 ml/1.73 m2 and endsystolic volume to 63 +/- 22 ml/1.73 m2; ejection fraction and mean circumferential fiber shortening were reduced (61 +/- 17%; 1.3 +/- 0.9 circ/s). In hypertrophic cardiomyopathy without obstruction, contractile and relaxation reserve and ejection phase parameters could be found to be normal. Enddiastolic pressure at rest was elevated. In severe cases, contractile and relaxation reserve were markedly reduced and enddiastolic pressure increased to a greater extent than in congestive cardiomyopathy. In addition, relaxation reserve was reduced, especially in patients with excessive hypertrophy of the myocardium. These had abnormal (grade 2) and pathological reaction to exercise: contractile and relaxation reserve were decreased and enddiastolic pressure (grade 3) increased. Left ventricular contractility was found to be almost normal in patients with hypertrophic obstructive cardiomyopathy. This was the case despite increases in enddiastolic pressure. Contractile reserve was reduced, however, in patients with excessive hypertrophy. Diastolic filling was impeded during exercise.--Measuring left ventricular function during exercise, different types of cardiomyopathy correlate with typical hemodynamic alterations.


[Contractile and relaxation reserve of the left ventricle. IV. Patients with coronary heart disease (author's transl)]. 51 patients with coronary heart disease had exercise tests on a bicycle ergometer (86 +/- 32 watts). Compared to a normal control group, only 13 patients had normal contractile reserve (group 4.1). In 32 patients the increase in contractility during exercise was reduced (max dP/dt below 3200 mm Hg/s, group 4.2). Patients with reduced contractile reserve were graded according to the height of left ventricular enddiastolic pressure during exercise: In patients with grade 1, enddiastolic pressure was normal. In patients with grade 2, enddiastolic pressure increased between + 4 and + 15 mm Hg and in the patients with grade 3a a above + 15 mm Hg. Contractile and relaxation reserve decreased along with a rise in enddiastolic pressure and an increase in the complaints of the patients. Severe chest pain led to termination of exercise in patients of grade 3b. Enddiastolic pressure increased above + 15 mm Hg. During ischemia, peak-measured velocity of contractile elements (dP/dt/P) and the maximal rate of left ventricular pressure fall (min dP/dt) decreased. In conclusion, with increasing chest pain a decrease of contractile reserve was observed. Left ventricular enddiastolic pressure rose excessively. This has to be taken as a sign of myocardial failure due to ischemic dyskinesia and impeded relaxation.


[The comparative hemodynamic effects of antiarrhythmic drugs in acute myocardial infarction (comparison of propafenone and lidocaine) (author's transl)]. Hemodynamic changes after single intravenous injection of antiarrhythmic doses of propafenone (70 mg) and lidocaine (100 mg) were measured comparatively in 11 patients with acute myocardial infarction, stable cardiac rhythm and without evidence of manifest left heart failure. The effects of propafenone were characterized by a significant decrease of cardiac index by 6% and an increase in left and right ventricular filling pressures by 15% and 23%. Mean arterial pressure was significantly lowered (8%) and left ventricular stroke work index decreased by an average of 11%. Mean pulmonary artery pressure significantly increased by 7%. A fall in systemic vascular resistance by 7% was not statistically significant. Intravenous administration of propafenone at a dose of 70 mg thus caused a transitory decrease in ventricular function and acute vasodilation with a fall in systemic blood pressure. The intravenous administration of lidocaine did not result in significant changes of cardiac index or left and right ventricular filling pressures. Mean pulmonary artery pressure, systemic blood pressure and vascular resistance increased significantly.


[Hemodynamic differences in the effects of mepindolol-sulfate and propranolol after 4 weeks treatment under conditions of rest and physical exercise in patients with coronary heart disease (author's transl)]. The hemodynamic effect of mepindolol-sulfate, a new non-cardioselective beta-receptor blocking agent, was compared with the hemodynamic effect of propranolol at rest and during exercise in five patients with coronary artery disease during an eight week double blind cross-over study. 1. The beta-receptor blocking effect of mepindolol-sulfate is 25 times higher than that of propranolol. 2. No hemodynamic difference between mepindolol-sulfate and propranolol was seen at rest. 3. The increase of blood pressure during exercise was less pronounced during mepindolol-sulfate-medication compared to propranolol. 4. Propranolol seems to achieve a more pronounced negative inotropic effect than mepindolol-sulfate.


The interrelationship of cataract and glaucoma. The visual loss in a patient with cataract might actually be due to a coexistent glaucoma. This significant interrelationship of cataract and glaucoma is discussed. A thorough ophthalmic evaluation is mandatory in every case of cateract.


Febrile morbidity following vaginal hysterectomy. The author suggests that each gynecological service determine the incidencd of febrile morbidity before adopting routine use of prophylactic antibiotics or vaginal cuff suction drainage.


[Distribution patterns and functional relationships of the encephalopathy (author's transl)]. "Wernicke's encephalopathy", as one of the sequelae of chronic alcoholism, is discussed with regard to its effects on driving ability. The neurological symptoms are presented with reference to 33 cases and the possible personality defects with thalamic lesions and abortive types of disease are emphasized.


Post-mortem vitreous ammonium concentrations in estimating the time of death. On a total of 150 specimens of vitreous humor the post-mortem ammonia value was determined by diffusion method. The results established that there existed a regular ammonia increase after a sudden death and that deviating high or low vitreous ammonia values are strongly correlated with the cause of death and with environmental temperature. The ammonia content of the vitreous humor extracted from both eyes at the same and at different post-mortem intervals showed no differences in the concentrations between both specimens sampled at the same moment while an obvious variation in the individual rate of the vitreous ammonia increase is found, especially when hospital cases with antemortem existing disease are concerned.


[Mathematic-statistical discrimination between suicide and accident in falls from height (author's transl)]. On the basis of 185 deaths caused by falls from height we examined the probability to differentiate between suicide and accident. Variables about the person, about the course and the background of the action as well as about the injury-pattern were taken into consideration. Contingency table analysis, chilsqare tests and probportional reduction in error measure were used first to determine the significant differences in criminal classification: sex, job, domicile, hour of the day, locality and height of the fall and the injuries established by postmortem examination. To test the discriminative power of the identified characteristics discriminant function analysis was used. Utilizing only 11 characteristics 88,6 percent of the deaths could be classified correctly.


Determination of glucose in human vitreous humor. Various analytical methods give different results. In twenty cases, human vitreous humor glucose concentrations were measured with five different methods in common use. Striking differences in glucose values were obtained by the various analytical procedures. The reasons for these discrepancies remain obscure. Before interpretation of a given vitreous value, therefore, the analytical method employed must be known.


[On the proof of MN-differentiation from blood samples (author's transl)]. 1. The results of MN testing are--so far as the factor N is concerned--especially in the case of older samples to be used only with caution. 2. The provision for a reliable result demands several good sera that have been previously used in testing and found to be satisfactory. 3. It is especially necessary to work with two different methods. The mixed agglutination method is no longer reliable in cases of months-old or very dryly stored samples.


[Histopathological findings in drug addicts (author's transl)]. Human organic lesions, which were induced by narcotic poisons, are caused by application and directly or indirectly by toxic substances. Cause of death is very often edema of the lung and the brain or toxic circulatory failure as well as an insufficiency of organic functions by cellular degeneration. Users of narcotic poisons mainly show liver damage. Cell degeneration and infiltration of round cells in the portal-biliary areas are mostly interpreted as drug hepatopathy and not as viral hepatitis. Enzyme levels in histochemical reactions are decreased in the damaged liver tissue. The kidneys show toxic degeneration and inflammatory reactions. Brain lesions are confined to cellular damage, without necrotic degeneration of larger areas. Sporadically perivascular hemorrhages are seen. Heart and vascular system mainly show an inflammatory reaction caused by the application of the poison and seldom embolism in the capillaries by injection of dissolved tablets. Centrally stimulating substances cause hypertrophy of the tunica media in the lung vessels, combined with pulmonary hypertension.


[Myocardial lesions in acute increase of the intracranial pressure (author's transl)]. Myocardial lesions occuring in diseases with acute increase of intracranial pressure were investigated. Morphologic alterations in heart muscle in spite of different lengh of surviving and various causes of the death were of similar type. In every case subendocardial haemorrhage could be observed on the septal surface and on the papillary muscle of the left ventricle. Focal intracellular edema, myocytolysis were revealed in 76%, focal necrosis of hypercontractic type developed in 52% of the cases. Cellular infiltration occurred around the alternations observed in 3 cases. It is concluded, that damage to the heart muscle is not caused directly by the increased intracranial pressure or catecholamine mobilisation, but seems to be the consequence of the acute myocardial hypoxia.


[Occurrence of diazepam in blood samples of drivers under the influence of alcohol (author's transl)]. Diazepam was determined by radioimmunoassay and gas chromatography in 2050 unselected blood or serum specimens of subjects, who were sus,ected of driving under the influence of alcohol in the years 1974 and 1976. A "cut-off" limit of 20 ng/ml was selected. Diazepam was found in 46 samples corresponding to 2.24%, 27 samples (1.3%) exhibited concentrations of 20--100 ng/ml, 14 samples (0.7%) of 100--500 ng/ml, 1 sample (0.05%) of 500--1000 ng/ml and 4 samples (0.2%, as related to the total of 2050 samples) of more than 1000 ng/ml. Furthermore, 44 blood specimens of subjects were analyzed, who had claimed diazepam intake before the blood sample was withdrawn. Diazepam was found in 27 cases corresponding to 61%. Finally, blood specimens of 219 unselected inpatients of a surgical ward were investigated; 59 of these (27%) were found to be diazepam-positive.


Fractures of the axis caused by hanging. Prerequisities for fractures of the neural arch of the axis in the region of the isthmus (hangman's fracture) during hanging are considered to be a long drop and a submental knot. A case is presented showing that hangman's fracture arising in hanging can result from stretching of the neck combined with anteroflexion of the head.


[DNA-synthesis and DNA-repair in chronic rheumatism influenced by small doses of natural radioactivity (radon)]. Elevated natural radioactivity during a treatment at Badgastein (Austria) caused an increase in DNA-repair of lymphocytes of patients with ankylosing spondylitis and osteoarthritis. Semiconservative DNA-synthesis was remarkably lower after the treatment in patients with ankylosing spondylitis and a small decrease was obtained also in lymphocytes of osteoarthritis patients. These effects are discussed in relation to late effects.


[Behavior of the complement components C3 and C4, C-reactive protein and blood sedimentation rate for activity control in arthritis patients during thermo-hydrotherapy]. 21 male patients suffering since years from classical rheumatoid arthritis were treated with daily thermal baths of 37 degrees Celsius temperature during a 3 week period. To control the activity of the rheumatoid inflammation we used the complement components C3 and C4, the C-reactive protein and the blood sedimentation rate. No changes in the different activity parameters could be found during the course of the treatment. Joint function improved significantly. Therefore the combined treatment of rheumatoid arthritis with physio- and pharmacotherapy is recommended.


[Age-dependent changes of stress-related immunosuppression]. The present investigations on the influence of physical stress and physical training and on the influence of aging on 19-S-antibody producing spleen cells showed: 1. Physical stress causes a failing of immunity in mice, which had no training. The immune response can be diminished by physical stress before and after sensitization. The immunosuppressive effect of stress is greater, if it was placed after sensitization. There is a strict correlation between the immunosuppressive effect of physical stress and the time of maximum production of 19-S-antibodies. 2. The immunosuppressive effect of physical stress increases with increasing age. The protecting effect of physical training is lower in adult and old animals than in young mice. 3. There is an increase of antibody loaded spleen cells until an age of eight months. In elder mice the number of immunocytes decreases significantly. 4. The mortality rate is greater in stressed and trained young mice than in the adult and old animals. Supposing a better adaptation in young mice it is to be considered that the biologically better developed animals survived by selections.


[Progressive chronic polyarthritis from the viewpoint of individual psychology]. In 106 patients with rheumatoid arthritis it could be shown by Adlerian Psychology that in more than half of the patients both physical over activity before the disease and painful inhibition of movement during the disease were an imaginary solution of the problem. Both are functions of a threatened mental and physical mobility and autonomy. In pointing out this relationship we aim to show lifestyle as a risk factor for the disease and indicate causative therapeutic aspects.


[Lymphocyte nucleoli in the peripheral blood and knee joint effusions in patients with rheumatoid arthritis]. Since the activation of nucleoli in lymphocytes reflected by the presence of nucleoli with more or less distinct nucleolonemata (compact nucleoli in the light microscope) in these cells is considered as a marker of the autoimmune disease development, nucleoli of lymphocytes were investigated in the peripheral blood (22 investigations) and knee joint fluid (52 investigations) of juvenile and adult persons with rheumatoid arthritis. The results clearly indicate that the investigated joint exudates possessed a higher number of "active" lymphocytes (lymphocytes with compact nucleoli) in comparison with the peripheral blood. This observation can be interpreted as an accumulation of stimulated immunocompetent cells in the target organ.


[Mode of action of D-penicillamine in chronic polyarthritis. 1. Protein synthesis inhibition in synovial fluid cells]. The influence of D-Penicillamine on protein synthesis in synovial fluid cells was investigated in 5 patients suffering from rheumatoid arthritis. Intra-articular injection of this substance at a dosage of 5 to 250 mg is followed by an inhibition of protein synthesis in the synovial fluid cells.


[Mode of action of D-penicillamine in chronic polyarthritis. 2. Studies on DNA repair in synovial fluid cells following intra-articular administration of D-penicillamine]. 6 patients with rheumatoid arthritis were treated intraarticularly with 50 or 100 mg D-Penicillamine. The influence of this substance on DNA repair in cells of synovial fluid was investigated. DNA repair was investigated by gradient centrifugation. 50 mg D-PA showed no effect, 100 mg D-PA a slight slowing of the DNA-rejoining till the native supercoiled DNA form.


[Seasonal shifts in the chemical makeup of the fatty tissue of the Arctic suslik, Citellus parryi]. Fat stores in three forms of adipose tissue (brown, subcutaneous and visceral) differ in their composition in five populations of the ground squirrel C. parryi. Oleic aicd content is always several times higher in subcutaneous and visceral fat during spring period as compared to the content of linoleic acid. Linoleic and linoleic acids content increased in autumn animals, although in the most northern population it remained unchanged.


[Neural control of somatic muscle function in the earthworm, Allobophora longa, and in the leech, Hirudo medicinalis]. Studies have been made on the electrical activity of the segmentary nerves and connectives of the abdominal nervous chain in the earthworm and leech. It was shown that the electrical activity of the isolated piece of the abdominal chain of the leech is manifested of periodic outbursts of impulsation. Presumably this central periodicity accounts for the discharge-like pattern of muscle rhythmic activity which was revealed in our earlier investigations. The electrical activity in the central nervous system of the earthworm depends on afferent influences which pass to the ganglia from the peripheral sensory nervous cells. Stimulation of the abdominal nervous chain did not result in extra discharges of muscle activity, but only affected some of the parameters of the latter.


[Age-related characteristics of the electrical activity of the cardiac fibers in the human embryo]. Transmembrane action potential and intercellular electric coupling have been studied in isolated heart during various stages of intrauterine growth of human embryos as well as in heart preparations of human adults. Formation of electrical properties of ventricular myocardium was slower than that of atrial fibres and was found to be fully completed in the first 14 weeks of intrauterine growth. Intercellular electrical coupling enhanced in the course of the embryonic development as indicated by a drop in the input resistance and an increase in electronic length.


[State of the hypothalamo-hypophyseal neurocirculatory system of the gerbil, Rhombomys opimus, during dehydration]. Big gerbils, inhabitants of desert, were found to have indices of an increased functional activity of HHNS: low content of neurosecretory material all over the system, relatively large volumes of neurosecretory cell nuclei and nucleoli, hyperemia. Under the condition of a seven-day dehydration, the neurosecretory material reduction in all links of HHNS, enlargement of neurosecretory cell nuclei and nucleoli, intensification of hyperemia were found. With the increase in dehydration time to 23 days a progressive reduction of neurosecretory material in cell processes and hypophysis are seen. However, the decrease in nuclear size takes place under the condition of continuing increase in nucleolar size both in supraoptic and paraventricular nuclei. Extremely intensive hyperemia of all regions of HHNS is seen. The activation of HHNS under the water-salt regime change, seen in big gerbils, is not as pronounced as in albino rats. This is, evidently, due to a specificity of the function and their osmoregulating system.


[Thalamic neuronal reactions of the tortoise, Emys orbicularis, to visual stimuli]. Reactions of 300 neurons and characteristics of their receptive fields (RF) in response to moving stimuli and diffuse illumination have been investigated in three hypothalamic regions of the tortoise Emys orbicularis. With respect to their reactions to different stimuli, the neurons investigated were divided into two groups. Neurons of the 1st type (85%) were activated by the stimuli of any size exhibiting large, small and mean RF. Adaptive changes were usually weak and mean (63%); strong changes were less frequent (37%). Some of the neurons (33) did not react to diffuse illumination, whereas other ones produced reactions of different types: 57% of the neurons exhibited a spontaneous activity, 9%--directional sensitivity. Neurons of the 2nd type (15%) reacted only to large stimuli and were characterized by large RF, strong adaptation (89%), low reactivity to diffuse illumination (46%); 35% of the neurons revealed the spontaneous activity, 20%-directional sensitivity.


[Principles of optimization and scaling of certain processes in the vaccine production technology. 3. Method of determination of the optimal method of thermal sterilization of sugar solutions]. One of the most widespread methods of thermal sugar sterilization is the use of saturated water vapour under pressure in the capacity of heat source. Guaranteed sterility of solutions should be reached under conditions providing the least sugar splitting. However, in practice the integral effect of the thermal field on the solution is as a rule not taken into consideration. A new calculation method permitting to determine the amount of sugar split in the varying thermal field.


[Comparative characteristics of the spatial hearing in the dolphin, Tursiops truncatus, and in man]. The paper presents data on the directional selectivity of hearing in the bottlenose dolphin as a function of masking noise angle. It has been shown that the hearing system of dolphins is characterised by sharp lowering of masked thresholds depending on the noise going in the high frequency region. The same effect is shown in man, but not so evidently.


[Comparative bioacoustical study of diurnal and nocturanl rodents from closed ranges]. Studies have been made on the evoked potentials at the level of the colliculus inferior in the nocturnal rodent Glis glis and diuranl one--Eutamias sibiricus. In G. glis, the evoked potentials were recorded in a wide range of sonic and ultrasonic frequencies up to 90 kc, while in E. sibiricus these potentials were recorded in a range of frequencies up to 60 kc. The auditory threshold curves for G. glis exhibited two areas of minimum thresholds-- a low frequency area and an area at a boundary between sonic and ultrasonic frequencies. Threshold curves for E. sibiricus have no clear sensitivity maximum. In G. glis, correlation between the spectrum of their communication signals and acoustic noise in the habitat was observed. The species investigated differ in the rate of the recovery of the evoked potentials to paired stimuli and in the values of critical summation time.


[Neurochemical analysis of the brain structures in the formation of adaptive behavior in chicken embryogenesis]. Studies have been made on the rate of biosynthesis of high molecular and neurospecific proteins in the hippocamp and archistriatum of chick embryos during the formation of adaptive changes in motor activity under controlled experimental conditions and unmonitored occasional stimulation. It was shown that during uncontrolled sensory stress the rate of synthesis of high molecular and neurospecific proteins in the structures investigated is increased whereas during learning these changes are absent.


[Reaction of single cercal mechanoreceptors of the cricket, Gryllus bimaculatus, to mechanical stimulation]. Naked tungsten microelectrodes were introduced through the chitinous wall close to the cell body of the receptor cells of trichoid hair sensillae, and responses to airpuffs, and rectangular, and trapezoidal displacements of the hair were recorded. Receptors of dorsal zone are activated during lateral deflection, those of ventral zone--during medial deflection and receptors of medial and lateral zones--during deflection to the cercal base. Sensitivity of receptors to the air-puffs is a function of hair length, the largest hairs being most sensitive. During trapezoidal displacement of the hair with different velocities of the slope, discharge frequency of the dynamic response is a function of velocity and angle in the range of angles up to 3-5 degrees (fig. 1). Discharge frequency of the stationary phase (corresponding to the plateau of the stimulus) is mainly a function of velocity in the range up to 6 degrees (fig. 2). The presence of sensillae with different hair length, and hence sensitivity, and definite directionality of receptors in different hair length, and hence sensitivity, and definite directionality of receptors in different zones may provide a basis for amplitude, velocity and direction discrimination of air-puffs or low-frequency mechanical stimulation by the cercal system of crickets.


[Electrophysiological study of the functional connections of the hypothalamus with the forebrain in the tortoise Emys orbicularis]. During stimulation of the posterior hypothalamus, the evoked potentials with short latent periods, high amplitude and poor exhaustion by rhythmic stimulation were recorded in the hippocampal cortex. In the piriform cortex, the evoked potentials exhibited longer latent periods and complex configuration. Less readily the evoked potentials appeared in the neocortex, their latency being very large. During stimulation of the anterior hypothalamus, maximum activity was also localized in the hippocampal cortex. The data obtained indicate close connection between hypothalamic structures and the hippocampal cortex. The latter is presumably the main projectional area for the ascending afferentation from the hypothalamus.


[Erysipeloid on the islands of the Ohhotsk Sea. 2. Landscape types of the natural foci of erysipeloid]. Cases of skin (skin-artericular) form of erysipeloid were recorded in the islands of the Sea of Okhotsk. The natural foci of the causative agent of this infection were polyhostal and polyvectoral in character. The causative agent of erysipeloid exists among the animals habitating on land and sea. Mass species of animals characteristic of the island landscape served as the sources of infection. Their four landscape types (mountaineous-taiga, of sea coast and rocks, anthropurgic settlement, and of water bodies--salt and freshwater) were preliminarily distinguished by the combination of biocenological, epidemiological, and epizootological peculiarities of natural erysipeloid foci.


[Para-aminohippuric acid secretion by the vertebrate kidney]. Tubular secretory capacity has been investigated in the kidney of marine fishes Scorpaena porcus, Spicara smaris, frog Rana ridibunda and albino rat by determination of maximal transport of p-aminohippurate--TmPAH, Following values of Tmax expressed in mg/hour per 100 g of body weight were obtained: 0.73 +/- 0.17 for S. porcus, 0.92 +/- 0.09 for S. smaris, 0.93 +/- 0.10 for R. ridibunda and 15.6 +/- 1.6 for rats.


[Cortical representation of nonclassical parts of the visual system]. Cortical evoked potentials and extracellular evoked neuronal activity have been investigated in unanesthetized d-curarine immobilized rats during stimulation of the superior colliculi. The focus of responses was found in the lateral part of the visual neocortex (area 18a according to Krieg [5]). The evoked potential includes a negative and subsequent positive waves, its latency being equal to 7.9 +/- 2.8 msec. With deepening the electrode the amplitude of the response decreases, although its polarity remains unchanged. The neuronal activity is of phasic character. During simultaneous record of the evoked potentials and neuronal activity, temporal correlation between impulse activity and the ascending part of the main negative wave of the EP is observed. The data obtained indicate imcomplete overlapping of the retino-geniculo-cortical and retino-tecto-thalamo-cortical channels in the visual system of rats.


[Study of the multiple puncture method in smallpox vaccination of children]. In this work the multiple puncture method (in 76 cases) was compared with the scarification method--2 clinear cuts (in 70 cases). "Vaccine take" of the vaccines demonstrated a statistically significant difference: by the first method the percentage of personal "vaccine take" was 98.7, and by the second--86.4. The multiple puncture method produced a less pronounced local and general reaction. Immunological efficacy of the multiple puncture method (evaluated by hemagglutination inhibition test and neutralization test in the tissue culture) was quite satisfactory and failed to differ from such in vaccination by scarification.


[Effect of hydrocortisone and methods of infection on the isolation of Brucella from the body of albino mice]. It was experimentally revealed that subcutaneous method of albino mice infection in combination with hydrocortisone administration offered a possibility of decreasing the period of discharge of brucella to 7 days with a 100% culturing from the inguinal, paraaortal lymph nodes and the spleen. In intracerebral method of infection with a preliminary treatment with hydrocortisone the period of the culture isolation decreased to 14 days.


[Certain data concerning the analysis of the foci of infectious hepatitis in cases of subsequent occurrence of the disease in families]. Materials of epidemiological analysis of familial infectious hepatitis nidality in 104 families are presented. The data obtained pointed to the preponderant affection of children constituting 97.1% of primary and 87.7% of subsequent cases in familial foci. Infection was brought to the families by schoolchildren in 57.7% of the cases, and by organized preschoolchildren--in 31.7% of the cases. The greatest affection of schoolchildren aged from 7 to 14 years in the foci with subsequent occurrence of the disease (77.7%) was explained by their marked age activity. This led to the conclusion that mass prophylaxis with alpha-globulin of these particular groups of children was of primary importance. The differences of the specific ratio of adults who contracted the disease in familial foci and in the region as a whole pointed to the possibility of infection of adults outside the family and on the prevalence in them of serum hepatitis.


Prognosis of the duration of the remissions in attack-like schizophrenia. On the basis of a clinico-epidemiological study of patients with attack-like developing schizophrenia and duration of the disease of 15 years and more the authors report of some results of the prevalence of remissions of different duration. The paper contains data concerning correlations between different duration intra-attack intervals, the type of the sustained attacks, number of sustained attacks and the patient's age at the onset of the disease. The study demonstrated direct correlations between the duration and the type of the attack on the one hand and the character of negative changes--on the other. The formation of protracted remissions is more characteristic of shift-like attacks, i. e. attacks possessing more destructive qualities than in attacks characteristic of recurrent schizophrenia.


Clinical psychological problems in the rehabilitation of mental patients. The paper deals with the problems of the clinico-physiological and socio-psychological bases of rehabilitation of mental patients. The basis of the analysis of these problems is a patient's personality in its relationship with social environment (medical personnel, family, working surrounding. The author puts forward the tasks to be solved by physians and specialists in the field of clinical psychology.


[Experience with the early use of combined intensive drug and occupational (at an industrial enterprise) therapy of schizophrenic patients]. The report contains some results of a 3 year study of combined intensive psychopharmacological and occupational therapy of 120 patients (on the basis of the Gannushkin City Mental Hospital N4 and 2 industrial plants) during the stage of a subacute development of the schizophrenic process. On the basis of clinical and methodological criteria the authors distinguish 3 groups of patients and 3 types of rehabilitative programmes respectively. The medical and socio-occupational effectiveness of the new modification of combined intensive psychopharmacological industrial therapy of schizophrenic patients has been confirmed.


[Outpatient arrest of recidives and exacerbations in schizophrenia]. The report contains successful results of ambulatory treatment of 54 patients with relapses of attack-like developing forms and exacerbations of continuous forms of schizophrenia. The basic principles in the treatment were intensity and dynamic influence of psychopharmacotherapeutical agents. As a rule under such conditions there were a rapid reduction in the acuity. The authors distinguish clinical, family-environmental and organizational-therapeutic indications, which may lie at the basis of the place of choice for treatment--hospital or dispensary (out patient clinic).


[Ophthalmocalibrometric assessment of the state of the microcirculation in the retinal vessels in transient disorders of cerebral circulation]. The report analyses some results of a neuro-ophthalmological study of 82 patients from 34--76 years (37 males and 45 females) with transient disorders of cerebral circulation. Besides clinical studies the authors applied EEG and REG registrations, studies of the lipid metabolism, coagulative and anticoagulative blood systems. Ophthalmological studies included the assessment of visual acuity with and without correction, quantitative perimetry, the determination of a genuine intra-ocular pressure, ophthalmodynamometry, biomicroscopy of the conjunctiva and episclera, biomicro-ophthalmoscopy, ophthalmoscopy with the use of electro-ophthalmoscopy, a large nonreflex ophthalmoscope, ophthalmocalibrometry. By means of ophthalmocalibtometrical studies the authors established an existence of expressed pathology of microcirculation in the form of a marked narrowing of arterioles and a dilatation of the venoules with a significant decrease of the arterio-venous correlations. The achieved data are analyzed with consideration of the etiology, development and topography of transient disorders of cerebral circulation.


[Experimental and psychopathological characteristics of psychophysical infantilism in the structure of the hysterical form of psychopathy]. The authors report of some results of an experimentalpathopsychological study of 100 patients with hysterical forms of psychopathy and the syndrome of psychophysical infantilism. It was demonstrated that there is an irregular intellectual development (according to Wecksler's method) which is described by the authors in the form of a characteristic "intellectual profile" and a high level of claims with inadequate reactions of selection, a high assessment of physical and psychic "I", with a low evaluation of the "situational I". The achieved personality characteristics are closely connected with abnormal behaviour and asocial actions of the patients.


[Suicidal behavioural characteristics in depressive states in children and adolescents]. The author discusses 40 cases of suicidal attempts in children and adolescents with depressive states of a different nosological affinity. Special attention was drawn to the different traits of a depressive syndrome connected with the formation of suicidal tendencies. The data obtained demonstrate that the degree of a suidal risk depends not only on the depth and quality of depressions, but on the nosological and syndromal traits. A special role in the genesis of a suicidal attempt belongs to supplementary psychotraumatizing factors.


[Computer tomography of the brain in neurology]. The results of the studies, obtained in a computer head tomography confirms its effectiveness in the diagnosis of ischemic and hemorrhagic strokes, tumor and degenerative brain diseases, as well as in investigations of the brain ventricular systems and subarachnoidal spaces. A computer head tomography--is a perspective method in the study of brain lesions with the aid of X-ray equipment and computers.


[Cerebral infarct risk factors].

[Cerebral infarct risk factors]. The possible risk factors were evaluated in 249 patients with cerebral infarction and in the control group consisting of 190 subjects of the same age and sex distribution. The following factors were significantly associated with brain infarction: elevated blood pressure, cardiac abnormalities, elevated blood glucose content, abnormal glucose tolerance, elevated blood cholesterol and beta-lipoproteid content and hemoglobin level. It was concluded that at present the key to stroke prevention is the early detection and control of hypertension and cardiac activity impairment.


[Loss of consciousness in migraine].

[Loss of consciousness in migraine]. The author conducted a clinico-electrophysiological study of 350 patients with migraine. In 12.5% of the patients there were cases with a loss of consciousness. The conclusion is made that in combination of one attack of symptoms of migraine and epilepsy they have one pathogenesis: vasomotor disorders evoking both migrainose crises and syncopes with a convulsive syndrome. Quite typical of such conditions are precursors, massive vegetative disturbances, a tonic character of the convulsions. A loss of consciousness in the intra-attack period may be assessed as a syncope, mainly of orthostatic and vaso-vagal type; a loss of consciousness during the attack--as a syncope connected with migrainose disorders of cerebral hemodynamics. In alternation of migrainose and epileptical attacks it is claimed that there is a combination of 2 diseases. The conclusion is made that a loss of consciousness in migraine and epilepsy are different not only by clinical signs, but by its pathogenesis. This fact determines the preventive therapy of both diseases.


[Correlation of electroencephalographic, autonomic and rheoencephalographic indices in I- and II-stage hypertensives under emotional strains]. The paper is concerned with a study of 55 pateints with hypertensive disease and of 14 normals under the conditions of emotional stress. These studies were conducted in order to detect interrelationship between vegetative, EEG and REG indices. In 3 groups of patients distinguished according to symptoms of vegetative changes the indices of the tone in the sympathetical and parasympathetical parts of the nervous system in the working period (i. e. during the period of emotional stress) significantly differed from the indices of the control group. They also correlated with the character of activity and the EEG indices. Unlike normals, patients with hypertension in the working period demonstrate not a dilatation of the frequency spectrum in the EEG, but are somewhat narrower. Correlations between shifts on the EEG and REG were not detected. However, in the group of patients with weakened vegetative reactions in a visual assessment of the REG there was a weakening of the autoregulation of cerebral reactions, which coincided with somewhat less frequent alpha-rhythm in a lower work productivity.


[Structural characteristics of the EEG in the secondary stem syndrome in patients with acute circulatory disorders in the cerebral hemispheres]. The authors analyse changes seen in the EEG and secondary dysfunction of the brain stem structures in patients with acute disorders of circulation in the brain hemispheres. On the basis of implicative analysis of the clinico-morphological and EEG data the authors come to the conclusion on the existence of significant EEG criteria in secondary dysfunctions of brain stem structures on the different stages of its development. The significance of EEG in differential diagnosis of primary and secondary brain stem lesions is stressed.


[Role of congophilis angiopathy in the genesis of subarachnoid--parenchymatous hemorrhages in middle-aged and elderly persons]. The author conducted a morphological analysis of 8 cases (from 61--83 years old) with extensive subarachnoidoparenchymatous hemorrhages, accompanied by expressed congofil angiopathy in different clinical processes. In 5 cases congofil angiopathy was the only lesion of cerebral vessels, in 3 cases it was combined with hypertensive angiography and atherosclerosis. In the latter cases the morphological picture was characterized by a great diversity due to greater expressiveness of accompanying hyalinosis and proliferative changes in the walls of the vessels. In both subgroups all the changes were prevalently in the meningocortical vessels. The author points to frequent relapses of the process.


[Blood serum enzymatic spectrum in vascular diseases of the brain]. The presentation deals with the enzymatic spectrum of the blood serum (aminotransferase-glutamino-pyruvic and glutamino-oxaloacetic acid, sera cholinesterase, histidase, acid alkaline phosphatase) in 100 patients with transient disorders of cerebral circulation in the form of ischemic and hemorrhagic strokes. These disorders of circulation appeared on the background [corrected] of atherosclerosis and hypertensive disease or in other combination along with vasculitis of a different etiology. The most significant were changes of histidase and acid phosphatase activity and an inhibition of cholinesterase activity in ischemic and hemorrhagic strokes with expressed focal disorders of cerebral circulation. In an improvement of the clinical state following medicative therapy there was a normalization of these indices. The only exclusion was histidase the content of which in some cases remained cunhanged.


[11-hydroxycorticosteriod content in the peripheral blood plasma and in the cerebrospinal fluid in acute disorders of the cerebral circulation]. The author studied the glucocorticoid function of the adrenal cortex in 93 patients (40 males and 53 females) with acute disturbances of brain circulation, in 59 patients with ischemic strokes and 21 patients with cerebral hemorrhages. The functional activity of the adrenal cortex was judged by the content of 11-oxycorticosteroids in the plasma of the peripheral blood and in the liquor in the dynamics during 4 weeks from the beginning of the stroke. The patients with a severe course of the stroke (in spite of its character) demonstrated a statistically significant increase of 11-OCS concentration in the above-mentioned biological fluids during the acute period of the disease (first 14 days).


[Active attention and the conditioned slow negative potential in schizophrenia]. The detected changes of conditioned slow negative potential (changes in the configuration of potentials, its increase in duration, a drop in the amplitude) as well as results of corrective tests in schizophrenic patients testify to changes in the function of active attention in this form of pathology. The authors discuss the possible moderation of changes of attention in schizophrenic patients--by disordres of the thalamo-cortical system, the activity of which is expressed in the electrographical phenomena of the conditioned slow negative potential.


[Hemolytic properties of the lymphocytes of schizophrenia patients]. The authors studied the cytotoxic activity of the lymphocytes in the peripheral blood of 16 schizophrenic patients and 14 normal donors in respect to autological erythrocytes. It was demonstrated that the hemolytic activity of the lymphocytes of patients was significantly higher, than in the control group. Activated cells possess cytotoxic properties.


[General and cerebral hemodynamics in atherosclerosis of the cerebral vessels with transient disorders of cerebral circulation]. The authors studied general and cerebral hemodynamics in 51 patients with cerebral atherosclerosis transient disorders of cerebral circulation. The studies demonstrated correlation between the indices of general peripheral resistance of the blood flow, cardiac and pulse indices. The rate of the blood flow in the segment hand-ear was slower. REG studies detected deficit of blood repletion, intrahemispheric asymmetry, a drop in the elasticity of the vascular wall. These data may be used in prescribing pathogenetical treatment to patients with transient disorders of cerebral circulation.


[Clinical and catamnesic study of slowly progressing, juvenile schizophrenia]. A clinico-catamnestical study of 154 patients demonstrated, that following 10--15 years after their initial state it was first evaluated as sluggish schizophrenia with pseudoneurotic, psychasthenia-like, depersonalizational and obliterated affective disorders, the prognosis in such cases was relatively favorable. In the majority of the cases even during remote periods the disease had a slowly progressive character of the process. In half of the cases there was a tendency to a reduction of the positive disturbances, a compensation of the personality defect and distinct signs of social and working readaptation, after the adolescent period was behind.


[Age-related dynamics of outpatient forms of schizophrenia (on the age-related dynamics of so-called latent schizophrenia in light of late catamneses in senescence)]. The report contains a study of 45 patients aged 60--84 in whom during the entire life there were gradually increasing subclinical symptoms of schizophrenia: emotional shallowness, oddness, episodic rudimentary affective or paranoial disturbances. However, the level of adaptation and mental activity did not suffer significantly. The age-specific dynamics of such forms corresponded to general regularities in the development of schizophrenia: in the involutional period there was revivification of the above-mentioned symptoms of schizophrenia while in senescence only paranoial disorders and an increase of deficitary changes remained. The author discusses the question of justified diagnosis of latent schizophrenia in such cases.


Distribution of CAP and methylated nucleotides between the RNase sensitive and resistant fractions of mRNA in messenger ribonucleoprotein particles. When polyribosomal mRNP is exposed to ribonucleases most but not all of the mRNA is converted to acid soluble products. If mRNP is prepared under isotonic conditions there are two types of ribonuclease resistant core fractions, one which contains the poly(A) part of the mRNA and a second which contains mRNA fragments, 30-40 nucleotides in length. Like poly(A) these fragments appear to be protein associated in the mRNP complex. Non-poly(A) fragments in mRNP prepared from adenovirus-infected cells harvested in the late phase of infection contained only 3% of CAP structures and 12% of internally located methylated nucleotides. This indicates that no CAP structures but one out of the seven internally located methylated nucleotides found in the mRNA are situated in protein associated regions.


Cytology of human cerebro-spinal fluid after cardiac arrest. The cytology of the cerebrospinal fluid (CSF) (obtained by suboccipital puncture) from patients after cardiac arrest was investigated by means of the cytocentrifugation method. In patients with unsuccessful resuscitation an increased number of monocytes and macrophages was found immediately after abandoned resuscitation. A pronounced increase in the number of granulocytes, monocytes, and macrophages was found in patients with poor neurologic restitution. The increase in the number of macrophages was seen immediately after cardiac arrest. The granulocyte increase was most pronounced after 24 h. The CSF from patients with full neurologic restitution after cardiac arrest showed small numbers of lymphocytes and granulocytes and an equal amount of monocytes and macrophages. The findings indicate that monocytes/macrophages appear in the cisternal fluid shortly after anoxic/ischemic damage to the brain and that the increase of macrophages and later granulocytes probably is a result of damage to brain tissue.


Long-term prognosis of patients with central cerebral ventricular enlargement. A fifth follow-up study of 100 patients with a 3rd ventricle measuring 12 mm or more in width. One hundred patients with a 3rd ventricle width of 12 mm or more were examined for the fifth time in 1976 after an average observation period of 20.8 years. On first admission, a predominant aetiological factor was found in 27 cases. Two patients had air-encephalogrophical findings indicating normal pressure hydrocephalus. One of these had a shunt operation, however, without improvement. Seventy-one patients had died, 7 patients were in need of care and supervision, 11 patients were unable to work, the remaining 11 were able to work to some extent. The group studied had a significantly increased mortality rate. The causes of death were divided into three groups: 1. Probably related to the underlying brain disorder; 2. Related to those in an average Norwegian population; and 3. Minor disorder usually not leading to death. The following factors indicated a poor long-term prognosis: 1. Serious associated disease; 2. A relatively high age; 3. Associated cardiovascular disease; 4. Marked degree of ventricular enlargement; 5. Marked enlargement of the temporal horns; 6. Many and/or marked neurological signs; and 7. Prognosis intellectual deterioration.


Mitogen stimulation of cerebrospinal fluid lymphocytes in aseptic meningitis. The cell responses to different polyclonal lymphocyte activating substances were studied in 15 patients with aseptic meningitis by analysis of lymphocyte proliferation. The in vitro response to phytohaemagglutinin (PHA), concanavalin A (Con A) and poke weed mitogen (PWM) was investigated in blood and CSF lymphocytes simultaneously. The blood lymphocytes responded stronger than the corresponding number of CSF lymphocytes. These cells were, however, always capable of a response, suggesting that they were immunologically competent. No predominance of either PHA or Con A populations of T lymphocytes could be demonstrated in CSF compared to blood by this technique. When culture conditions were changed from the optimal cell or mitogen concentrations, the decrease in proliferation of the CSF lymphocytes was more pronounced than that of blood lymphocytes.


The resistance to cerebrospinal fluid absorption in humans. A method of evaluation by lumbo-ventricular perfusion, with particular reference to normal pressure hydrocephalus. In order to measure the resistance to cerebrospinal fluid absorption in humans a lumbo-ventricular perfusion test, using several intraventricular pressure levels, has been developed. The test has been performed in 15 patients fulfilling criterias of normal pressure hydrocephalus. A considerable variation in the resistance to cerebrospinal fluid absorption revealed by the test indicates that clinical and pneumoencephalographic signs of normal pressure hydrocephalus are of little use in the selection of patients who may benefit from shunting procedures.


Computed axial tomography in otorhinolaryngology. The value of computed tomography in ORL and its applications have been briefly discussed. Better soft tissue detail and its relationship to bony structures is obtained. At the present time this modality may be utilized as a screening test in some suspected cases or as an adjunct of conventional methods. With the technical refinements that are constantly being made, better diagnostic information will be obtained in CT scanning.


Nasal and paranasal sinus polyposis. Current concepts in radiologic diagnosis and surgical therapy. We believe that hypocycloidal tomography is the method of choice in the pre and postoperative evaluation of chronic nasal and paranasal sinus polyposis, based on the radiographic examinations of 80 patients who have undergone intranasal ethmoidectomy. Although our overall study is incomplete at this time due the extended period necessary for follow-up, we hope that the basic information which is now available will be beneficial to others.


Computed tomography of the paranasal sinuses. The diagnostic value of computer tomography in lesions of the paranasal sinuses has been investigated in three cases with maxillary carcinoma and in five cases with fractures of the facial bones. In most of the cases, particularly in carcinoma, computer tomography was found to provide additional information to that obtained with conventional X-ray techniques. In fractures, however, a supplementary plain film examination was found to be indispensable.


Congenital deformity of the internal auditory meatus and labyrinth associated with cerebrospinal fluid fistula. A type of inner ear deformity characterised by a tapering internal auditory meatus and dilated, dysplastic labyrinth was demonstrated by tomography in seven patients. Two of these developed cerebrospinal fluid fistulae through the oval window. The path of the fistula in this and other congenital deformities of the inner ear is discussed.


Value and limits of computerized axial tomography in ORL. The CT findings in some selected cases presenting lesions of the paranasal sinuses and the orbits are compared with the conventional tomograms. Referring to these examples, our experience of value and limits of CT in ORL is reported. Furthermore, a few remarks to CT in cerebellopontine angle tumors are given. Finally, there are pointed out some general considerations concerning radiodiagnostic questions in tumors of the ORL region.


Acoustic neuromas presenting with symptoms of morbus Menière. If a patient with Menière's disease or a sudden deafness does not respond to adequate therapy, an acoustic neuroma should be excluded. This is achieved by a positive contrast cisternography using multidirectional tomography. The examples might have shown that sometimes acoustic neuromas present with atypical symptoms, with sudden deafness or even with the typical symptoms of morbus menière.


Effects of a low-stimulus environment on behavior. Psychological studies related to sensory and perceptual deprivation, immobilization, and isolation provide a body of literature that describes behavioral deficits occurring in experimental low-stimulus and meaningless environments. Specific hospital environments analogous to those used in the sensory deprivation experiments can also be used to identify patients who may be at high risk for maladaptive behavioral change. The studies offer extensive experimental evidence to support occupational therapy theory that a variety of meaningful tasks and stimuli are necessary to support the hospitalized person's adaptive behavior.


The effectiveness of laboratory vs written examinations in an anatomy course. This paper reports a two-year study on the methods used to evaluate 63 junior occupational therapy students in a musculo-skeletal anatomy course offered at the University of Florida. Laboratory learning processes were not significantly different compared to class learning processes as shown by test results. There was also no significant difference between laboratory and written examination scores in anatomy when compared with final grades in subsequent courses with both laboratory and lecture components. This study was undertaken because of the varying attitudes of students and faculty and their knowledge about the most efficient and productive manner in which to conduct the course. Very little research on educational methods has been completed in our profession and the validation of current methods is needed.


Claw finger.

Claw finger. Besides the known intrinsic paralytic claw hand, the claw hand without intrinsic paralysis is also observed. The mechanisms of clawing of the finger in individuals with intrinsic paralysis are reviewed and are explained by the tensing effect of the flexor tendons and the relaxation of the extensor digitorum communis tendon distal to the transverse lamina as the metacarpophalangeal joint is extended. Early recognition, prevention, and treatment are essential. The clawing of the finger in those without intrinsic paralysis is a result of maintaining a position of flexed wrist, extended metacarpophalangeal joint, and flexed interphalangeal joints; thus an extension contracture of the metacarpophalangeal joint may develop. Experiments show that this contracture blocks not only the action of the extensor digitorum communis tendon, but also the interossei in finger extension. Early proper positioning and exercises may prevent the deformity.


A variation of a four-post cervical collar. The four-post cervical collar constructed from polyform is an effective means of supporting the neck for a patient with complex special requirements negating the use of a commercial cervical collar. This collar can easily be adjusted and put on independently and removed by the patient by leaving one side of the collar attached. The cervical collar can be molded and adjusted to the individual. It is light weight, comfortable, and easily cleaned.


Improving free play skills of severely retarded children. Severely and profoundly retarded children are usually deficient in play skills. Since play facilitates socialization, language, and motor development, it is a vitally improtant skill to acquire. This pilot study examined the effects of a behavioral training program on the autistic, independent, and social types of play of four severely and profoundly retarded children. The training program involved the use of instructions, modeling, physical guidance, and verbal reinforcement. Results indicated that a marked increase in independent and social play occurred with the introduction of the training program with all four children. Occupational therapists can play an increasingly important role in helping educators formulate relevant educational programs for severely retarded children, particularly in the areas of play and motor skill development.


Automated upper extremity progressive resistive exercise system. This paper describes a semiautomated, motorized skateboard and skate system for use in progressive resistive arm exercises. This experimental system has been evaluated in an occupational therapy clinic for the past two years and found to be valuable in the treatment of impaired upper extremity function. It is superior in function and design to the previously used apparatus and provides the following features: adjustable load (force), adjustable range of motion limits, an automatic method of counting the correct repetitions of the prescribed exercise, the visual feedback to patients regarding their performance. Based on therapists' evaluations, the system's three main advantages are: a decrease in the amount of therapist/attendant time needed for the exercise program, improved performances by the patients, and a better, quantitative measure of the patients' progress.


Experience and Youth Group: for elderly and adolescent psychiatric patients. Patients in a state psychiatric hospital often have little exposure to groups of various ages. This paper describes an occupational therapy group that brought together geriatric and adolescent mentally disabled patients to provide them with an opportunity to increase socialization skills, to practice role playing, and to explore authority relationships while working together on planned activities. In addition, the group leaders could stimulate expression of feeling and increased self-esteem.


Parent education in well-baby care: a new role for the occupational therapist. Children who grow up without adequate stimulation often develop learning problems that require intensive treatment to permit them to perform at their optimum level. Many times they do not have the opportunity to make up for the experiences missed and become school drop-outs. Remedial services are time-consuming for children and wasteful of public funds, whereas preventive services enable children to achieve their intellectual potential. Occupational therapists can make an important contribution to ambulatory pediatrics because of their background in physical and mental development, as well as their expertise in planning and carrying out treatment programs. They could put these skills to good use in the pediatric clinic playroom by screening children who presentdevelopmental lags and who could then be referred for additional testing and evaluation. The playroom could extend its role to provide needed services: a base for a cognitively oriented educational program for parents of infants and toddlers; recreation activities for waiting children and their siblings; and early detection of developmental and/or emotional problems.


Drool control and tongue thrust therapy for the mentally retarded. The evaluation and neurophysiologically based treatment for drooling and infantile tongue thrust found in adolescent, mentally retarded persons living in an institution is reported. Eleven residents were treated over a two-year-period. Evaluation was made of the specific oral dysfunctions thought to contribute to drooling, rather than the composite dysfunction of drooling, so that treatment could be definitive. Tongue immobility, including infantile tongue thrust, is the dysfunction most often seen. There has been some success in inhibiting infantile tongue thrust, resulting in improved ability to eat, as well as in decreased drooling.


A comparison of operant and sensory integrative methods on developmental parameters in profoundly retarded adults. The expertise of speech pathologists and occupational therapists was combined to compare the relative effectiveness of an operant approach, a modified sensory integrative approach, and a combination of both methods in eliciting vocalization on other developmental skills on a sample of 27 profoundly retarded, minimally vocal, institutionalized adults. The combined results indicated that the therapy programs promoted significant gains in frequency of eye contact, frequency of vocalization, and quality of postural adaptation. There were no differences in the effects of the respective therapies. The fact that the more controversial sensory integrative procedures elicited comparable gains when compared with the more widely recognized operant method lends credence to the viability of sensory integrative methods.


Arthroscopy of the knee.

Arthroscopy of the knee. Fiberoptics permit a minimally invasive direct inspection of the knee joint. Arthroscopy is indicated when no definitive clinical diagnosis can be made. An organized approach includes inspection of the suprapatellar pouch, the articular surfaces of the patella, the medial and lateral compartments of the knee and the intercondylar area. Common afflictions diagnosed by arthroscopy include chondromalacia, meniscal lesions, osteoarthritis, cruciate ligament injuries, chronic synovitis and loose bodies. Complications and morbidity are minimal.


Skin signs of internal malignancy.

Skin signs of internal malignancy. Nonspecific dermatologic problems occasionally associated with malignant disease include pruritus, reactive erythemas and skin infections. Frequently associated with internal neoplasms are acanthosis nigricans, dermatomyositis, rapid development of multiple seborrheic keratoses, hypertrichosis lanuginosa and other syndromes. Skin metastases may be the first signs of internal cancer. The most common visceral primaries are the lung and colon in men and the breast, colon and ovary in women. Recognizing these lesions can lead to early diagnosis and improved prognosis.


Behavioral pediatrics.

Behavioral pediatrics. The family physician can, through instruction in standard caregiving skills and discussion of parental expectations, prevent or minimize behavioral problems in infants and toddlers. Behavioral problems can be detected early by having parents describe a typical day. When detected early enough, many problems which occur at bedtime, mealtime and when dressing can be managed by the interested physician.


Pleural effusion.

Pleural effusion. Pleural effusion unassociated with other radiologic evidence of disease is a challenging diagnostic problem. With small effusion, only silhouetting of the diaphragm may be noted. A lateral decubitus view will often be helpful. After a careful history, physical examination and selected hematologic studies, diagnostic thoracentesis is indicated. The following determinations on the fluid may be useful: color, character, protein, lactic dehydrogenase (LDH), glucose, amylase and cytology. Pleural biopsy may be helpful with tuberculosis and malignancy.


Psychologic stress in myocardial infarction. During the acute phase of myocardial infarction, patients may experience anxiety, depression, denial and decompensation. Their ability to master the painful aspects associated with the stress of this severe illness and to convert defenses to beneficial coping directions depends on their character traits and effective psychiatric intervention. Sequelae to myocardial infarction include invalidism and prolonged disruption of the patient's family life and development.


Consequences of childhood irradiation.

Consequences of childhood irradiation. Many patients as children or adolescents received treatment for nonmalignant conditions with therapeutic-range doses of ionizing radiation. Great interest exists in this group of patients because of the possible long-term adverse effects of such irradiation. A thorough physical examination should be performed, and a careful history, listing any instances of radiation exposure, should be taken. Photographic documentation of skin and/or mucosal changes is beneficial.


Blunt and penetrating abdominal trauma.

Blunt and penetrating abdominal trauma. Physical examination and selected x-rays are helpful in diagnosing blunt abdominal trauma. Peritoneal lavage may assist in diagnosis of free abdominal blood. Stab wounds may be trivial injuries to the abdominal wall or penetrations of the peritoneum and underlying viscera. The "stabogram" offers some diagnostic help in selecting patients for operation. Gunshot wounds require laparotomy. The spleen is the solid organ most often injured in blunt trauma. Splenectomy is the only satisfactory treatment for this injury.


The effect of probe bluntness on sampling particulates from calm air. The size-selective characteristics of circular inlets as a function of bluntness was examined using polydisperse spherical glass beads. Four levels of bluntness (0.5, 1, 5, and 50) and three sampling velocities (4, 20, and 40 cm/sec) were studied. Particle count and weight percent distributions were determined using a 15-channel electronic counter. At a sampling velocity of 40 cm/sec the weight percent distributions shifted toward particles of larger diameters with increasing bluntness. Little or no effect was discerned at sampling velocities of 20 and 4 cm/sec. As the velocity increased from 4 to 40 cm/sec at constant bluntness, the weight percent distributions shifted away from larger diameter particles. The results suggest that at some sampling conditions probe bluntness may be a variable which deserves consideration in particulate sampling.


Modeling the uptake, metabolism and excretion of dichloromethane by man. Data were obtained from the exposure of eleven men to dichloromethane concentrations of 50, 100, 250, and 500 ppm, 1,3 or 7.5 hours per day, for up to five successive days and from the exposure of nine women to 250 ppm on a similar schedule. Breath concentrations of the solvent following exposure were related mathematically to exposure parameters as were blood concentrations of the metabolite, carbon monoxide (as carboxyhemoglobin percentage saturation elevations). The resulting emprical equations can be used to predict the consequences of many industrial and non-industrial exposure situations.


Size characteristics of cigarette smoke. The aerodynamic size distribution of cigarette smoke was measured using an aerosol centrifuge and a cascade impactor. The observed size distribution was log normal with an initial mass median aerodynamic diameter which decreased from 0.52 to 0.38 mu m as the dilution was increased from 10:1 to 700:1. The average geometric standard deviation was 1.38. The differences between these results and those reported by other investigators are attributed to differences in measurement methods.


Evaluation of glass sampling tubes for industrial breath analysis. The storage of halogenated hydrocarbons in breath and air samples in glass cylindrical tubes was investigated to determine procedures to achieve a representative breath sampling technique. The loss of solvent vapor concentration over a fixed time period was observed and postulated to result from non-reactive absorption. If considerations are made for adverse sampling conditions of moisture, temperature, and tube surface condition, glass tubes prove to be an acceptable container for breath samples.


Hemoglobin concentration in white, black, and Oriental children: is there a need for separate criteria in screening for anemia? The concentration of hemoglobin in blacks was found to be 0.5 to 1.0 g/dl lower than that of income-matched whites in several large surveys. This difference could be a racial characteristic of blacks, or it might be due to a higher frequency of genetic traits such as thalassemia minor and hemoglobinopathies, or to environmental factors such as iron deficiency. To help in making this distinction, we analyzed the data from multiphasic examinations (1973 to 1975) on 1718 white, 741 black, and 315 Oriental healthy, nonindigent children between 5 and 14 years of age. In the entire population, the median hemoglobin concentration averaged 0.5 g/dl lower in blacks than in whites of both sexes (t test, P less than 0.001). The differences still averaged 0.5 g/dl (P less than 0.001) after exclusion of all those with abnormal hemoglobin by electrophoresis (Hgb S and C) and those whose mean corpuscular volume was more than 5% below the normal mean for age (to exclude iron deficiency or thalassemia minor). The data strengthen the impression that blacks normally have a concentration of hemoglobin averaging about 0.5 g/dl less than in whites. If this is the case, about 10% of normal blacks will be mistakenly designated anemic, if the same norms are applied.


Relationship of maternal amino acid profiles at 25 weeks of gestation to fetal growth. In a study of the relationship of maternal nutrition to fetal development, the free amino acid concentration was determined in the plasma of 43 subjects sampled between the 20th to 30th (25 +/- 3.7) week of pregnancy. Significant positive correlations were found between mothers' 25-week plasma levels of aspartic acid, serine, alanine, tyrosine, ornithine, and arginine, and babies' size at birth. The concentration of total free amino acids in plasma from mothers of fetally malnourished infants, was significantly lower than that from mothers having normal babies. The branched chain amino acids isoleucine and valine were at normal levels, suggesting a sparing effect for these amino acids.


Relative zinc availability in human breast milk, infant formulas, and cow's milk. The concentration and bioavailability of zinc was analyzed in 10 varieties of milk. The concentration of zinc averaged 4.1 microgram/ml in unprocessed (raw) cow's milk; fortified infant formulas contained about 3 to 5 microgram Zn/ml; human breast milk and processed cow's milk contained approximately 2 microgram Zn/ml; sweetened condensed milk contained 1.3 microgram Zn/ml, and reconstituted nonfat dry milk contained 0.4 microgram Zn/ml. The mean values for zinc bioavailability to rats were as follows: sweetened condensed milk = 66%; human breast milk 59.2%, processed cow's milk = 43.7 to 50.9%; unprocessed (raw) cow's milk = 42%; nonfat dry milk = 41.2%, and infant formulas = 26.8 to 39.5%. Assuming similar absorption of zinc in rats and humans, our experimental results provide some guidelines for estimating the quantity of zinc that would actually be absorbed from various types of milk.


Zinc anc copper status of Polynesian residents in the Tokelau Islands. Analyses for zinc and copper were performed in samples of serum, hair, toenails, and a 24-hr urine from Polynesian men and women resident in the Tokelau Islands. Selection of subjects was according to rank of systolic blood pressure obtained in a previous survey. The only difference in zinc anc copper values between the men and the women was a higher hair zinc concentration observed for the men. Rank of blood pressure had no influence on the measurements for zinc or copper, although within blood pressure ranks the men again had a higher hair zinc concentration than the women. Analysis of Tokelauan foods showed that most contained very low concentrations of zinc anc also low concentrations of copper. Octopus was one of the few rich sources of zinc and copper. Estimated daily dietary intakes (excluding water) were 4.5 mg Zn and 1.5 mg Cu. The reliability of measurements in serum, urine, hair, and toenails for assessing zinc and copper status is questioned.


Antioxidant effects in the development of Ehrlich ascites carcinoma. The effect of Ehrlich ascites tumor growth on selenium-turnover rates and selenium-75 distribution in liver, kidney, and immunological tissues (spleen, thymus, and lymph nodes) was investigated in Swiss Webster mice that had been prelabeled with selenium-75. Ehrlich ascites tumor caused a decrease in the selenium-75 content of liver, kidney, and thymus; it also decreased the rate of the total-body selenium-turnover. In liver, depletion of selenium-75 was almost as great as that produced by a selenium and vitamin E-deficient diet. When mice had been fed an antioxidant-deficient diet, considerable quantities of selenium-75 were accumulated by the tumor; the specific activity of the tumor increased 9-fold over that in antioxidant-supplemented mice. The same diet produced a premature, and in some cases drastic, contraction in tumor volume. The possible significance of tumor-induced antioxidant deficiencies to the etiology of certain paraneoplastic syndromes is discussed.


Effect of calcium supplementation to undernourished mothers during pregnancy on the bone density of the bone density of the neonates. Eighty seven pregnant women belonging to poor socioeconomic groups of population were investigated to find out the effect of calcium supplementation during pregnancy on the bone density of the mother as well as of the neonate. Supplements of 300 and 600 mg of elemental calcium administered daily from the 20th week of gestation onward until term, brought about a significant increase in the bone density of the neonates born of such mothers compared to that of the neonates born to unsupplemented mothers. Although no significant difference was observed between the initial and final values for bone densities among the mothers, there was a tendency for an increase in the bone density of the mothers who received 600 mg of calcium supplements. Individual variation of different neonatal bones in their response to maternal calcium supplements was observed. Bone density of the neonate was not related to the birth weight, crown-heel, or crown-rump lengths.


Alteration of the zinc anc copper concentration of hair. A washing and analytical procedure for the analysis of the zinc and copper concentrations of hair samples is described. The treatment of samples with nonionic detergent + EDTA wash removed the most adsorbed zinc anc copper from hair and was the washing procedure chosen for routine analyses. Beauty treatments had a variable effect on hair zinc and copper concentrations; the most drastic procedures were cold waving and bleaching; conditioner, hair spray, tint, and a permanent dye had a less drastic or no effect. Increasing distance of the hair from the scalp was associated with a regular increase in copper concentration and also increases in zinc concentration for most subjects.


Hair as a biopsy material. V. Hair metal as an index of hepatic metal in rats: copper and zinc. Hair copper in 500 day-old adult rats was found to correlate directly with copper in whole liver (P less than 0.001) and the subcellular liver nuclear (P less than 0.022), and cytosol fractions (P less than 0.001). An inverse correlation was found between copper in liver microsomes and plasma cholesterol (P less than 0.044). Similar data analysis for zinc showed no significant correlations (P greater than 0.05). The determination of copper in hair may be useful for assessing total liver copper content in human beings. Copper in liver microsomes may participate in the control of plasma cholesterol.


Intake of nickel and vanadium by humans. A survey of selected diets. The nickel and vanadium contents of nine institutional diets were determined by atomic absorption spectrometry with background correction. The following values were obtained for nickel: mean concentration, 0.27 +/- 0.02 microgram/g (dry weight); range, 0.19 and 0.41 microgram/g; mean intake, 165 +/- 11 microgram/day or 75 +/- 10 microgram/1000 cal. The respective values for vanadium were: 0.032 +/- 0.004 microgram/g (dry weight); 0.019 to 0.050 microgram/g; 20.4 +/- 2.3 microgram/day or 8.9 +/- 1.0 microgram/1000 cal. Thus, vanadium is present at approximately one order of magnitude less than nickel.


Nutrition and infant behavior: a replication study in the Katmandu Valley, Nepal. As a cross cultural comparison with an earlier study done in West Bengal, behavioral observations were made in the Katmandu Valley of 36 well-nourished and 38 undernourished children, 7 to 18 months of age, and their mothers. Undernourished children showed lowered levels of exploratory activity and attachment behavior, especially distance interaction, and a heightened need for physical closeness to the mother. Moreover, among the undernourished children the level of intellectual performance and the overall time spent in play were decreased, while time spent sucking at the breast was increased. In contrast to the West Bengali study, maternal behavior showed no differences between the two nutritional groups, and the intercorrelations between maternal and child scores showed similar or parallel patterns of reciprocity for the well-nourished and the undernourished children. No sex or age differences were found. The findings were interpreted to support Levitsky and Barnes' hypothesis of "functional isolation" as a mechanism between undernutrition and environmental stimulation to produce long-term behavioral changes. In addition, hunger as a motivational state, expressed as increased sucking, may interfere with other motivational determinants that might lead to exploration and/or increased social contacts.


"Inflammatory pseudotumor" of liver with occlusive phlebitis: report of a case in a child and review of the literature. An unusual "tumor" involving the right lobe of the liver of a young child is reported. Morphologically, the lesion had the features of "inflammatory pseudotumor." We were able to find only one previous report of a similar case in the literature. Unusual changes, which may be designated "occlusive phlebitis," were present in the medium-sized and large veins. Histologically, the lesion, including the vascular changes, had similaritites to the entities included in the group of "multifocal fibrosclerosis." It is believed that these unusual vascular changes, which have also been observed in a case of "inflammatory pseudotumor" of the parotid gland, probably contributed to the disease process.


Interstitial pneumonitis associated with azathioprine therapy. A 24-year-old female patient with rapidly progressive renal failure secondary to membrano-proliferative glomerulonephritis is thought to have subsequently had acute interstitial pneumonitis as a consequence of azathioprine therapy. The occurrence of the pulmonary injury coincided with the rapid onset of severe renal failure and was reversible with cessation of the drug. Accumulation of toxic metabolic products of azathioprine with subsequent injury to the pulmonary interstitium is suggested as the etiology. Azathioprine should be considered in the differential diagnosis of interstitial pneumonitis in all patients taking the drug.


Prosthetic-valve endocarditis due to Listeria monocytogenes. Clinical and necropsy observations in the case of a patient with prosthetic-valve endocarditis due to Listeria monocytogenes are presented. Although rare cases of L. monocytogenes infection of natural cardiac valves have been reported, this represents the first known case of infection of a prosthetic cardiac valve by this organism.


Social stress and community psychology.

Social stress and community psychology. Two questions that embarrass community psychologists are: "What do community psychologists do?" "What's the difference between community psychology and clinical psychology?" A conceptual model is proposed to help to find answers to these questions. The model describes a process whereby psychosocial stress leads to psychopathology. The argument is developed that the apparently disparate activities of community psychologists are uniformly directed at undermining the stress process but, given the complexity of this process, vary because they tackle it at different points.


The consultation readiness scale: an attempt to improve consultation practice. The Consultation Readiness Scale is designed to facilitate mental health and other forms of human services consultation. The scale is based on the assumption that consultee-consultant relationships vary in their "readiness" for consultation. A basic task for consultants is to assess the current readiness level and help move the relationship to a higher level. The Consultation Readiness Scale facilitates this process by specifying six levels of readiness and indicating the general intervention strategies appropriate for each. Initial, descriptive data based on five consultants and 366 consulteees are presented. Most consultation relationships were not as high levels of readiness; readiness varied with the amount of time consultants had worked in the consultees' setting and did not vary by more than one level over a 6-month period.


The verbal helping skills of trained and untrained human service paraprofessionals. The verbal helping skills of human service paraprofessionals in a youth service agency were studied. Workers who had previously completed a 10-week systematic training program in basic helping skills were compared to untrained volunteer staff. Using simulated helping interviews, it was found that training made a significant impact on trainees' verbal helping responses. Skill level was maintained at a 2-month follow-up for certain responses whereas others returned to pretraining levels. Trainees were found to use significantly more "helpful" responses than volunteers. The need for training even carefully selected paraprofessionals is discussed.