[Arteriography of intraspinal ependymomas]. Eleven cases of spinal ependymomas were studied by angiography. In four cases there was a tumoral blush, and in five cases, indirect signs of a spinal tumor. Although direct opacification of some caudal ependymomas is of great value, the main interest of spinal angiography is in the differential diagnosis with arterio-venous malformations, when there is a spinal S.A.H. or when there are abnormal vascular markings on the myelogram.


[Social policy and a plan for mental health]. Social policy is defined; starting with the concept of health, actions are described and specified beyond the traditional medical model. Using drug dependency as an example, the concepts of damage and vulnerability are applied to illustrate how mental health actions operate in the development of social medicine and place it in the framework of social policy. The need for such a policy is outlined, with a strategy stemming from it. Priority actions in the mental health field are specified and it is shown that actions go beyond professional activities as understood in the traditional models.


[Depressive reactions in children following the loss of a paternal figure, by death or divorce]. A review of different viewpoints on the theme "Death and the child" is made. When the child loses a loved object, he has to accept it in the outside world and manage the changes in his inner world. If the lost object is very needed, his ability to comprehend death is obstructed. When and how it is possible to help the child to understand death, is also examined. Depending of the age, development stage, previous relationships with the dead person, each child reacts differently. Effects of divorce on children are studied. A method that provides better avenues for ellaboration to children is presented.


[A model of group psychotherapy for drug-dependent adolescents]. Some of the personality traits characteristic of adolescents and addicts that influence the drawing up of an "ad hoc" program treatment are briefly established. The fact that organic physical-chemical therapies are almost useless in these cases is discussed, emphasizing good results obtained by psychotherapeutic methods, mainly group therapy; also mentioned are some changes to be considered in view of the drug addiction; these changes would include the use of paraprofessional personnel. Some of the outstanding characteristics of the addict-psychotherapy are established, mainly: the therapist's activity, emphasis on reparative action, the setting of limits and the patients' regressiveness. Also discussed are the basic points of resistance to change, grouped under the headings of "internal", "family" and "gang" saboteur, detailing each case.


Experimental trabeculotomy with a monomode argon laser. The laser trabeculotomy is one of the new techniques using light as a surgical ability in the treatment of some ocular diseases. The trabecula, in fact, plays an important part in the absorption of the aqueous humor and its bad functioning is the reason for chronic glaucoma. Here are some results obtained on in vitro trabecula with YAG-neodymium laser and an argon laser, thus showing that it is necessary to have very good focussing if we want to obtain a drill on the trabecula without having an excessive laser power.


Actinomycotic dacryocystitis.

Actinomycotic dacryocystitis. The case history and the diagnostic considerations of dacryocystitis caused by Actinomyces israelii in a 40-year-old female patient are presented. It is very rare that Actinomyces is the cause of a darcryocystitis and only few descriptions of this entity are known from the literature. The course of this dacryocystitis is characterized by periods in which the patient is free of complaints, interspersed with acute fistulizing exacerbations.


[Patency of the lacrimal ducts after cryotherapy of eyelid tumors]. It is the advantage of cryotherapy of eyelid tumors that it does not destroy the lacrimal points or the lacrimal canaliculi. The patency of these is kept in spite of freezing tempertures near to fluid nitrogen boiling point. To explain this phenomenon, thermoelectrical measurements during, and histological examinations after experimental cryotherapy were performed. Epithelial lesions lasting a few days were noted and the lumen of canaliculi always remained open.


Immunopathology of the lens. I 86Rb efflux and protein leakage from normal lenses exposed to unrelated antigen-antibody interactions. Normal rabbit lenses exposed in vitro to heterologous antibody (Ab)--antigen (Ag) interactions lose control of the intracellular 86Rb; this membrane damage, which seems to be related to the quantitative ratio Ab/Ag, is relatively complement independent and is followed by a subsequent leakage of lenticular proteins. A possible implication of these findings in the development of complicated cataracts in uveitis (as 'permeability cataracts') and in the self-maintenance of recurrent uveal inflammation is shortly discussed.


Aniridia, cataract and gonadoblastoma in a mentally retarded girl with deletion of chromosome II. A clinicopathological case report. A case of bilateral aniridia, cataract and mental deficiency is described in a girl with an interstitial deletion of the short arm of chromosome 11. The child died of pneumonia and on autopsy bilateral gonadoblastoma was detected, but no Wilms' tumour. Partial deletion of the short arm of chromosome 11 seems to be a clinically recognizable syndrome with aniridia, cataract and renal, gonadal or genital dysmorphogenesis.


The pathology of Rift Valley fever. I. Lesions occurring in natural cases in new-born lambs. A widespread epizootic of Rift Valley fever occurred in the Republic of South Africa and South West Africa during 1974--75. This is a report on the gross pathology of 34 new-born lambs and the histopathology of 93 new-born lambs that died during this outbreak. The liver was affected in every case and showed the most pronounced lesions. The organ was grossly enlarged in most cases, with scattered greyish-white necrotic foci 1--2 mm in diameter and haemorrhages of varying size throughout. Haemorrhages were also frequently seen in the mucosa of the abomasum. The massive diffuse necrosis of hepatocytes (pannecrosis) associated with well-demarcated foci of primary coagulative necrosis, present in 100% of the cases examined, was characteristic of the histopathology of the new-born lamb. Bile thrombi were noticed in the livers of 31% of the lambs and intranuclear inclusions in 49% of the cases. The diagnostic significance of the microscopic liver lesions is discussed. Focal necrosis and haemorrhages were frequently seen in the adrenal cortex while generalized destruction of lymphocytes in the lymph nodes and spleen occurred in many of the animals. In addition, the following hitherto undescribed or previously not well-documented lesions are recorded: (i) mineralization of single or groups of necrotic hepatocytes in 62% of the livers: (ii) pyknosis and karyorrhexis of the cellular elements in the glomeruli and a hyalinized appearance of many of these affected glomeruli; and (iii) necrosis of the tips of the villi in the small intestine in some of the animals.


Light and electron microscopic observations on the development of Babesia bigemina in larvae, nymphae and non-replete females of Boophilus decoloratus. In Boophilus decoloratus infected by transovarian passage with B. bigemina, primary schizogony occurred as a continuous repetitive process in all 3 stages of the tick's life cycle spent on the host. The primary schizonts and the large merozoites (= vermicules) produced by them were observed in the gut epithelium, haemocytes, muscles, ad peritracheal cells. Secondary schizogony which led to the formation of small merozoites (= infective forms) occurred mainly in the salivary glands, but was also observed in the cortex of the synganglion. Mature small merozoites were observed in nymphal and adult ticks only. An infective stabilate was prepared from nymphae collected on Day 14 and Day 15 post larval infestation. The infections resulting from intravenous injection of the stabilate had a prepatent period of 8 days.


Black grain mycetoma (maduromycosis) in horses. Black grain mycetoma occurred in two horses, one a cross-bred pony and the other a Thoroughbred racehorse. Lesions were limited to wart-like growths in one case and a deep-seated girth gall in the other. In both cases the granules in the affected tissues were similar in pigmentation and structure to those produced by Curvularia geniculata in dogs. Since all the specimens were received in formalin, the causative fungus could not be isolated. These are the first cases of maduromycosis in animals to be recorded in South Africa.


Amaurosis in sheep resulting from treatment with rafoxanide. Amarurosis occurred in sheep on various farms in the Republic of South Africa after treatment with rafoxamide. Histopathological examination revealed a status spongiosus of varying severity in the central nervous system in all the cases, having a predilection for certain areas such as the periventricular area of the lateral ventricles, optic tracts, lateral geniculates and optic fasiculi. The retina was the only ocular tissue affected and lesions observed in the retina included necrosis of nerve cells in the ganglionic layer. In chronic cases of amaurosis this layer showed a complete absence of nerve cells. The possible pathogenesis of the lesions and their differentiation from those found in certain plant toxicoses are discussed.


Transplantation of cultured jaagsiekte (sheep pulmonary adenomatosis) cells into athymic nude mice. Epithelial cells of the 15.4 line, which were originally established from the adenomatous lung of a jaagsieke case and which had been cultured in vitro for 22 generations, were injected subcutaneously into athymic nude mice. A slow-growing tumour which soon became cystic was established in each case. The cysts rapidly increased in size as a result of the accumulation of a slightly turbid secretion containing aggregates of tumour cells which rapidly refilled the cysts after the fluid had been withdrawn. Cultures were readily re-established from these cells and a chromosomal analysis proved that the tumor consisted of sheep cells. An epithelial cell lining, very similar to that found in the adenomatous lung alveoli of typical jaagsiekte, could be demonstrated histologically.


[Toxoplasmosis. A common infection, not very often recognized clinically]. Epidemiological survey and microscopical diagnosis point out that toxoplasmosis is a cosmopolitan infection usually with percentages of positivity higher than 20 per cent. Even in places with prosperous economical conditions the human infections can be relatively high due to the habit of eating raw meat or not properly exposed to temperatures lethal to Toxoplasma gondii. But sometimes they can be explained by cultural patterns or to individual psicological factors in relation to cats, the definitive hosts and important sources of parasites. It is explained how to infections occur and terms are defined. Even now in some circumstances the source of infection is not known. A discussion is presented on the diagnosis. The taxonomy of the parasite is presented in brief.


[Radiological findings in total abnormal drainage of pulmonary veins, not associated to other major cardiopulmonary abnormalities (isolated form)]. Thirty patients with anomalous drainage total in the veins of the lungs (A.D.T.V.L.) not associated to greater cardiovascular deformations (in an isolated form) perfectly confirmated by a surgery or by a necropsic study, were examinated. In all of them there was a research to find out any radiologic sign which could make suspect about the anomaliation. The diagnosis could be established in eleven cases (36.6 per cent) with the thorax habitual radiologic study, owed to the recognition of some signs that have been cataloged as the characteristic; as it occurs in the A.D.T.V.L. in the level in the system in the upper left chamber that bring into existence a silhouette in "snowman" and in the drainage in the subphrenic level which makes appear a sign of the "scimitar". In the varieties of the A.D.T.V.L. it wasn't possible to discover any suggestive radiologic sign of the entity.


The cyclodesulphurization of thio-compounds. Part 15: Synthesis of 6-substituted aminophenanthridines from some thiourea derivatives. Several N-alkyl, aryl, and aralkyl-N'-2-biphenylthiourea derivatives have been synthesized and cyclodesulphurized into the corresponding 6-substituted aminophenanthridines. The ring closure was brought about with mercuric chloride, phosphoryl chloride or polyphosphoric acid. Phosphoryl chloride was found to be the most efficient in inducing ring closure and producing the highest yield of cyclized products. The results of study on the cyclodesulphurization reaction mechanism suggested the formation of a carbodiimide intermediate and identified some of the organic mercurials involved in the various stages of the reaction.


Fluorometric determination of some butyrophenones after permanganate treatment. A fluorometric method is described for direct and sensitive determinations of azaperone, haloperidol and bromoperidol in pharmaceutical preparations. These compounds can be converted into strongly fluorescing derivatives by the action of potassium permanganate on their alcoholic solutions in acid medium, the limits of detection being respectively 8.10(-3), 5.10(-2) microgram/ml. The fluorescence phenomenon is very stable. Preliminary results are reported on the isolation and structure determination of one of the main fluorophors, produced in the case of azaperone.


[Lupus profundus].

[Lupus profundus]. Seven cases of lupus erythematosus profundus are described (chronic discoid lupus erythematosus with athrophic panniculitis) with dissemination of one of them. All patients were females. The authors stress their opinion that it should not be called as lupus profundus, the cases of lupus erythematosus disseminated with erythema nodosum neither the cases of L.E.S. preceded or associated with the so called Weber-Christian's type of panniculitis. Six of the cases had athrophic alopecia of scalp by lupus discoid.


In vitro adsorption of some corticosteroids on antacids. The adsorption of prednisone, prednisolone, fluprednisolone, betamethasone, triamcinolone, beta-methylprednisone acetate and hydrocortisone acetate on various antacids or adsorbents was studied at 37 degrees C. The antacids or adsorbents used were magnesium trisilicate, aluminum hydroxide, bismuth oxycarbonate, magnesium oxide, magnesium carbonate, calcium carbonate, talc, kaolin and charcoal. Magnesium trisilicate and charcoal had the highest adsorption capacity for the corticosteroids tested. Bismuth oxycarbonate and talc had intermediate adsorption properties while kaolin and aluminium hydroxide had lower effects. Other antacids were without any adsorption character. Results of the elution study confirmed the higher affinity of magnesium trisilicate over that of bismuth oxycarbonate and talc for the steroids tested. Further in vivo testings are still needed to assess the effect of antacids on the bioavailability of coadministered corticosteroids.


Biopharmaceutical studies on sulphadimidine modifications. The authors studied sulphadimidine crystal forms with particular reference to the occurrence of polymorphism. They were able to differentiate five crystalline forms by microscopic examination. Differential thermal analysis and IR absorption spectral methods were not reliable. The data from X-ray diffraction patterns of two crystal forms (methanol form I, ethanol form II) were reproducible by estimating their relative intensities. The crystal forms investigated were compared by in vitro and in vivo experiments. Experiments showed that sulphadimidine crystals recrystallized from ethanol had better dissolution and absorption characteristics than sulphadimidine crystals recrystallized from methanol.


[Ophidic accident. Report of 38 cases].

[Ophidic accident. Report of 38 cases]. Thirty-eight patients admitted into the Hospital Escuela O'Horán for snake bites were studied. Most of them, 68.4 per cent, were from the state of Yucatan; 18.4 per cent from the state of Cameche and 13.1 per cent from the state of Quintana Roo. There was a predominance for the males (86.8 per cent); the most frequent age was the third decade (20-30 years) and most of these patients were peasants and students. The species identified in most of the accidents (63 per cent) were C. terrificus and B. atrox in equal proportions, and the body sections more often affected were the distal portions of the members. No difference, with statistic signification, was found for the different season. The time, between the bite and beginning of the treatment was directly proportional to the unfavorable development of the process: five amputations were necessary and two patients died.


The functions of polarized water and membrane lipids: a rebuttal. In 1973, experimental evidence was reported in support of the view that water polarized in multilayers rather than simple lipid is responsible for the semipermeable properties of living cell membranes. The present article presents a full rebuttal to a subsequent attack on that view.


Potassium adsorption sites in frog muscle visualized by cesium and thallium under the transmission electron microscope. Frog muscles in which a major portion of the intracellular K+ was reversibly replaced by Cs+ or Tl+ were frozen, freeze-dried, and embedded in Spurr medium. Electron microscopic observation revealed a well-stained striation pattern of myofibrils, indicating that in the living state heavy tracers of K+ are mainly located in the A bands and Z lines. The findings contradict the membrane theory but are in accordance with the association-induction hypothesis.


K+ localization in muscle cells by autoradiography, and identification of K+ adsorbing sites in living muscle cells with uranium binding sites in electron micrographs of fixed cell preparations. Localization of K+-adsorption sites on two peripheral regions of the A band and the Z line in frog voluntary muscle cells has been demonstrated with the aid of autoradiography and radioactive 134Cs and 204 Tl. The findings confirm the association-induction hypothesis, according to which intracellular K+ is adsorbed on the beta- and gamma-carboxyl groups of intracellular proteins.


Solid state physical theory of nerve impulse conduction: Elovich kinetics of axon repolarization currents. The sodium repolarization currents of Myxicola single axons clamped at -100 mV with and without tetrodotoxin conform to the Elovich equation, which implies that in the axon, Na+ is associated with charged sites on macromolecules and water is structured, and that an activation energy barrier to conduction of Na+ exists at the axon surface.


Solid state theory of competitive diffusion of associated Na+ and K+ in cells by free cation and vacancy (hole) mechanisms, with application to nerve. If, as recent evidence indicates, most cell potassium is associated with macromolecular fixed charge, then diffusion of potassium ions in cells might occur by (1) diffusion of the small fraction of free potassium in cell water (analogous to electrons in the conduction band of a semiconductor) or by (2) diffusion of vacancies on association sites (analogous to holes in a semiconductor). Derivations of the Fick first law of diffusion predict that partial substitution of sodium for potassium in the cell produces opposite effects on the effective diffusion constant of potassium for those mechanisms. Application of that substitution to nerve data suggests that rubidium ions diffuse by a free cation result when the nerve is clamped at its resting potential, but by a vacancy mechanism when the nerve is clamped at zero voltage.


In vivo bioelectrochemical changes associated with exposure to extremely low frequency electric fields. One hundred seventy-four 21- to 24-day-old Sprague-Dawley rats were continuously exposed to a 60 Hz electric field of 150 V/cm for one month in ten separate experiments. Biological effects observed included depressed body weights, serum corticoids, and water consumption. The findings are tentatively in terpreted as indicating that a power frequency electric field is a biological stressor. The observed effects cannot be a consequence of Joule heating and therefore indicate that electric fields can influence biological systems either at the systemic level, or at the cellular level via electrochemical alteration of the microenvironment.


Nuclear magnetic resonance chemical shifts of potassium ions (39K) on ion exchange resins and in muscle. Chemical shifts of potassium (39K) were calculated from frequencies of beat patterns measured by a pulsed NMR method. This method indicates large chemical shifts for 3 molar KNO3 and 6 molal KI in good quantitative agreement with the steady state NMR measurements of previous investigators. 39K on two wet ion exchange resins and 39K in fresh muscle show insignificant chemical shifts relative to 0.1 M KCl solution. Previous studies showed marked shortening of NMR relaxation times (T1 and T2) for 39K in ion exchange resins and in muscle compared to free solution. These results seem to indicate that even though potassium on resins and in muscle experiences high electric field gradients, these have relatively little effect on the chemical shift of potassium, which may be correlated with the low pK values of the anionic groups in the resins and muscle.


NMR in cancer: VIII. Phosphorus-31 as a nuclear probe for malignant tumors. Spin-lattice relaxation times (T1)  for 31P were determined in normal and malignant tissues by a saturation technique employing a 90 degree -tau-90 degrees pulse sequence. Results for five normal tissues from rat were (in seconds): 2.33 +/- .14 for liver; 2.19 +/- .05 for muscle; 1.13 +/- .05 for brain; 1.43 +/- .15 fro kidney; and 1.97 +/- .12 for intestine. Results for two rat malignancies, Novikoff hepatoma and Walker sarcoma, were 5.98 +/- .57 and 5.38 +/- .68, respectively, and for Crocker sarcoma of mouse, 5.19 +/- 1.42. No individual measurement of malignant tissue overlapped any of the normal measurements; probabilities of insignificance ranged from .029 for Crocker sarcoma to .000184 for Novikoff hepatoma. The data call attention to another nucleus of potential value for NMR detection of internal malignancies in humans. Also suggested, because of the strategic placement of the 31P nucleus in the nucleic acid molecule, is a possible new probe for exploring the mechanism of carcinogenesis.


[Indirect micro-haemagglutination method with duck erythrocytes for the diagnosis of hydatid disease (author's transl)]. The AA. have compared the results obtained with a indirect micro-haemagglutination method with sheep erythrocytes with those obtained with the indirect micro-haemagglutination method with duck erythrocytes for the diagnosis of hydatid disease. The results obtained with the two methods were not different and there was a good correlation between both methods. The direct micro-haemagglutination method with duck erythrocytes appears to be a valid alternative of the method with sheep erythrocytes.


[Eaton-Lambert myasthenic syndrome: clinical, electrophysiologic, histological and ultrastructural study]. In this case, showing the classical features of the Eaton-Lambert myasthenic syndrome, the neuromuscular symptoms appeared 21 months before the bronchial carcinoma was diagnosed. The electrophysiological study demonstrated, beside the marked potentiation under repetitive nerve stimulation at 30 c/sec., some modifications of distal latency, specially after administration of Edrophonium chloride. The muscle biopsy showed changes secondary to a peripheral motor nerve involvement; electronmicroscopic study of the motor end-plates revealed a highly developped subneural apparatus. Long-run treatment by guanidine hydrochloride determined haematologic and renal toxic manifestations. Prednisolone was for a time active on the myasthenic syndrome.


[Arteries of the thalamus in man. Choroidal arteries. I. Macroscopic study of individual variations. II. Systematization]. One may describe 4 types of individual dispositions for the postero-median choroideal and thalamic system: Type A with a single artery of anterior origin, type P with two consecutive arteries (a mesencephalothalamic artery and a posteromedian artery of posterior origin), type D with two parallel arteries and type O. One may also describe 4 types of individual dispositions for the postero-lateral choroideal and thalamic system. Type C is constituted by a single postero-lateral chorideal artery giving off thalamic branches. Type D comprises two arteries, a postero-lateral choroideal and a postero-lateral thalamic artery. According to the relative importance of the two arteries one may describe subtypes Dc, De and Dt. Type T is constituted by a single postero-lateral thalamic artery giving off choroideal branches. In type H hippocampothalamic arteries intervene. We also studied the variations of the ending point of the anterior choiroideal artery.


[Arteries of the thalamus in man. Choroidal arteries. III. Absence of the constituted thalamic territory of the anterior choroidal artery. IV. Arteries and thalamic territories of the choroidal and postero-median thalamic arterial system. V. Arteries and thalamic territories of the choroidal and postero-lateral thalamic arterial system]. The anterior chor oideal artery cannot be considered as an arterial source for thalamic vascularization. Its territory is primarily pallidocapsular and reaches the thalamus only irregularly and superfically. 2. The posteromedian choroideal and thalamic system, in its infrathalamic portion, gives off lateral mesencephalosubthalamic, inferocentral (for the tips of the arcuate nucleus and the inferolateral part of the centre median nucleus), brachiopulvinarian and posterocentral arteries. In its suprathalamic portion it gives off medial pulvinarian and superomedian thalamic arteries. These arteries irriguate the major part of nucleus medialis and the nucleus anterior. 3. The posterolateral choroideal and thalamic system gives off lateral genicular arteries (for the lateral geniculate body), inferolateral pulvinarian and superolateral thalamic arteries. These arteries irriguate the dorsal part of the interal region of the thalamus.


[Opsoclonia: oculographic study].

[Opsoclonia: oculographic study]. Oculographic study of a case of opsoclonus associated with infectious meningoencephalitis was used to determine the criteria of definition of this abnormal ocular movement, distinguishing it from the other abnormal movements of flutter and dysmetria. The authors first discuss, on the basis of these recordings, the possible relationship between opsoclonus and myoclonia, and then the role of the cerebellum. The disturbances noted in the course of study of saccadian movement lead them to suggest the hypothesis of overall involvement of the saccadian oculomotor system. They stress the value of oculographic recording in better understanding the general mechanisms of saccadian movement and the pathogenesis of the various changes which may be encountered.


[Deficitis in the "verbal fluency" test in left-handed subject with unilateral hemispheric lesions]. In contrast to findings in right-handed subjects with a unilateral hemispheric lesion, in the left-handed there is no significant difference in "verbal fluency) test scores between right and left lesions, nor between anterior and posterior lesions. These findings are in favour of a certain degree of cerebral ambilaterality and of a lesser focalisation of the mechanisms responsible for language in the left-handed than in the right right-handed.


"Normal" pressure hydrocephalus in chronic inflammatory diseases: a clinical and laboratory study. A review of the 21 cases of "normal" pressure hydrocephalus (N.P.H.) identified by means of radioisotope cisternography, seems to support the basic views of Adams et al. (1965) that a chronic inflammatory disease is an important cause of N.P.H. The clinical and laboratory date made it possible to identify a substantial number of cases affected by N.P.H. in the course of a chronic inflammatory disease; of particular interest were those affected by syphilis. In this connection it seems possible that the symptoms of classical neurosyphilis may be very similar to those often seen in patients with N.P.H.


[A synthetic review on the cerebral extracellular space evaluated by biochemical procedures (author's transl)]. The Authors present a synthetic review on the problem of the cerebral extracellular space evaluated by biochemical procedures. The studies in vitro are numerous, focused on various aspects, such as the choice of the marker, the influence of temperature, and that of the chemical composition of incubation media, the regional heterogeneity of the brain, and so on; it has been observed that inulin, which is the most commonly employed marker, gives an extracellular space of about 40-66%, whereas other markers give values higher than 45%; the variability of values depends on various experimental factors. The studies in vivo present some methodological difficulties due to the existence of the brain barrier; the most reliable procedure appears that of the continuous perfusion of the marker into the cerebrospinal fluid associated with a simultaneous intravenous perfusion; this procedure gives quantitative estimates of extracellular space of about 14-30%. Taking into account that other experimental methods (such as the morphological and the electrophysiological) give lower values, respectively of 5-20% and 18-25%, the Authors found that it should be possible to agree about an average value of cerebral extracellular space of 15-20%. This appears to be of some relevance especially in studying the pathological problems of the brain, and particularly cerebral edema.


[Preliminary observations on computerized axial tomography (CAT) in 32 patients with various epileptic syndromes (author's transl)]. Thirty-two subjects affected by various types of epilepsy have been studied as follows: 1) from the clinical point of view with careful case history or by direct observation of the seizures; 2) from the EEG point of view by means of prolonged recordings during wakefulness and nocturnal sleep or with pharmacological activations; 3) from a radiological point of view with standard skull radiography, air-encephalography (PNX), brain scanning and, when necessary, with cerebral angiography, mono or bilateral. Furthermore, all the patients underwent a CAT at least once; in the majority of cases this examination was repeated after administration of contrast medium. The following results were obtained by comparing the various examinations: 1) anatomo-elector-clinical correlation was present only in some cases; 2) only in patients with cerebral neoplasms was there proof of an agreement in site between EEG, CAT and PNX; 3) it was not possible to detect in a definite manner epileptic glial lesions with CAT; 4) the EEG analysis, when repeated several times with different methods of investigations, whoed epileptic foci in a higher number compared to the anatomical focal lesions proved by CAT; 5) compared with air-encephalography and morphological brain scanning, CAT usually pointed out a higher number of focal and/or diffused cerebral lesions with a higher degree of precision; viceversa cerebral angiography proved to be irreplaceable in cases where it was necessary to study possible circulatory alterations.


Search in short-term memory during inhalation of a general anesthetic in man. Effects of controlled subanesthetic concentrations of enflurane on short-term memory functions were studied in male volunteers. Short-term memory processes were assessed through a search task: A series of digits, words, or familiar pictures, was visually presented, followed by a test digit which in half the trials was part of the series, and in half of the trials it was not. The subject responded by a press on one of two switches signalling 'yes' or 'no' accordingly. Memory set size varied between 1 to 11 for digits and 1 to 8 for words and pictures. Enflurane in air was delivered through a non-rebreathing system. Low concentrations of enflurane did not change the slope of the search function, but increased the intercept by few hundred milliseconds. This was interpreted to indicate anesthetic effect on the cognitive processes reflected in the intercept, that is, stimulus reception and evaluation and response variables. No effect was observed on retrieval time from the short-term store.


Effect of skin surface temperature on localization error and two-point threshold. The average localization error and two-point threshold were determined from 9 subjects at 5 skin temperatures on the volar forearm. The temperatures were physiological zero (31 degrees--32 degrees C), 19 degrees C, 25 degrees C, 38 degrees C, and 44 degrees C. Localization error was not significantly affected by skin surface temperature. This was verified on palm and forehead locations. The two-point threshold was increased by skin surface temperatures above physiological zero and decreased by skin surface temperatures below physiological zero. These results are consistent with a previous report of similar changes in punctate pressure sensitivity with varied skin surface temperatures. Such cross-model effects are considered in terms of cutaneous sensory mechanisms combining broad receptor specificity and subsequent coding of information by patterns of neural impulses.


The dipole layer as a model for scalp potentials. Estimates are made of the potential field at the scalp and cortical surfaces due to large numbers of synchronously active cortical current sources. The basic model is a dipole layer in an infinite, homogeneous conducting medium. Estimates are made of the effects of various inhomogeneities on the attenuation of potentials. It is shown that these approximate methods seem to illuminate the following questions which are of interest in EEG research: (1) The interpretation of reference recordings in terms of local source currents; (2) The differences in amplitude between scalp and cortical recordings; (3) The differences in frequency spectra between scalp and cortical recordings; (4) The observation that alpha rhythm can be recorded deep in the brain; and (5) The effects of simple inhomogeneities on the attenuation of potentials.


Computerized brain impedograph.

Computerized brain impedograph. Design of an on-line system utilizing a minicomputer and a specific dedicated hardware for 2T brain tissue impedance is provided. The prototype system, which can operate from 2 Hz to 10 kHz, covers most of the frequency range of interest in the encephalographic research. Driving the brain tissue with constant current and sampling the response current and voltage, the coefficients for a Fourier series expansion can easily be obtained. Real (resistance) and imaginary (capacitance) impedance components at each chosen frequency are printed on a Teletype printer.


Experimentation in family planning delivery systems: an overview. Experiments in the delivery of family planning services are an important means of testing new approaches on a relatively small scale. Over the past 20 years, extensive experimental efforts have explored such key aspects of service delivery as personnel, the use of mass media, integration of family planning with other services, intensive efforts and camps, incentive payments to acceptors, and inudation or community-based distribution. Approaches that proved successful have often been incorporated into regular programs. An examination of the methodology and findings of family planning experiments, based on a survey of 96 projects testing various approaches, highlights successes, failures, and continuing problems. The discussion of past experience halps point to criteria that might be followed in formulating future experimental projects.


Legal abortions in an Indian state.

Legal abortions in an Indian state. Induced abortion in India was liberalized by the Medical Termination of Pregnancy Act, which became effective in April 1972. Analysis of 8,073 abortions performed in the state of Karnataka between April 1972 and March 1975 indicates that abortions have increased rapidly since legalization. Age of women obtaining abortions, their family size, duration of pregnancy, and age of new contraceptors after abortion have declined, while proportions of women with less than primary education obtaining abortions and number of new contraceptors after abortion have increased. Data suggest that if there were more approved rural hospitals and a greater diffusion of information, the number of legal abortions would increase further.


Family planning in Mauritius: a national survey. In the context of the Mauritian government's policy of encouraging fertility reduction, in 1975 the Ministry of Health requested the University of Mauritius to conduct the first national survey of contraceptive knowledge and use. The results for the 1,821 ever-married women under age 50 who were interviewed indicated high levels of knowledge and use of contraception. Nevertheless, there is still a need for increased efforts to retrieve dropouts and to improve the efficiency of contraceptive use.


Factors determining the incidence of suicide within families. This paper addresses itself to the reasons why suicide tends to repeat in some families. Factors include entire family exposure to stresses, grief, and guilt induced by the suicide, the provision of a model by the original suicide, suicidogenic interpersonal styles in families, suicidogenic child-rearing practice, and innate predispositions to depression.


Lunar association with suicide.

Lunar association with suicide. Suicides in Cuyahoga County, Ohio, for 1972--1975 are tabulated by year, month of year, day of week, lunar phase, and holiday occurrence. Only lunar phase demonstrates a significant (p less than .01) variation in suicide rate; an increase is observed in this sample with respect to new moon phase but not for full moon phase. Explanations for this finding are considered, but the precise reasons remain unknown.


The role of death romanticization in the dynamics of suicide. Suicide is an emotional, complex event, the causes of which are not well understood. Hence, the subject of suicide cannot be adequately treated in an objective, simplified, scientific discussion without ignoring its essentially personal nature. In an attempt to add some insights into the personal dimension of suicide to analytical theory considered in the following pages, subjective, spontaneous thoughts, both philosophical and indulgingly emotional, have been included. The subjective thoughts have been separated from the theoretical discussions and will be found in the sections labeled with a letter a (e.g., iii a and v a) following the theory sections to which they most closely relate. A reading of these extra sections is extraneous to the understanding of the suicidal theory presented here, and they have been included only for the reader's interest.


Suicidal behavior as a form of communication in married couples. Suicidal behavior, specifically threats of suicide and acts of self-injury and self-poisoning, are interpreted by suicidologists as acts of communication directed to some person important in the social life of the potential victim. Four groups of married couples were studied using a measure of their marital communication habits and an intensive personal interview. These groups included wives who (a) were volunteer workers in a suicide prevention center, (b) were experiencing marital problems but were not actively suicidal, (c) had called the suicide prevention center and made a verbal threat of suicide, and (d) had actually committed acts of self-injury or self-poisoning for which they received emergency room or hospital treatment. Analysis of the data revealed that the quality of interpersonal communication between spouses significantly deteriorated across the groups as the degree of suicidal behavior increased. Descriptive data are discussed for their relevance to clinicians who, if they correctly interpret the meaning of the "suicide attempt," may be in a position to facilitate its being a successful one.


An assessment of community suicide risk. The contributions of several core variables to the white suicide rates in 24 Florida counties were examined, and a prediction equation, using multiple linear regression, was developed. Age was found to be about 50% more important than divorce. With both age and divorce controlled, loneliness and insanity were found to be significant core variables (p less than .05). A prediction equation including age, crime rate, insanity, and alcoholism was found that accounted for 79% of the variation in the suicide rates across counties. The observed rates were divided by predicted rates to yield standardized mortality ratios. It is proposed that these ratios may serve to assess both the need for and the impact of community suicide prevention services by placing suicide rates in the context of relevant social conditions.


Death on every weekend.

Death on every weekend. This essay is a personal account of situations experienced by a medical technician in a large emergency room. It includes examples of stressful situations that daily confront medical personnel and the inability of medical institutions to aid them in understanding and coping with death and.dying. Stemming from these stressful situations, the paper illustrates the importance of the need for medical institutions to pay direct attention to the stressful topic of death itself if the medical personnel are to work efficiently in an environment where death and dying are everyday occurrences. Although some institutions do offer in-service sessions to nurses, these services are far and few between. But the stress for all medical personnel remains high, and there remains an unfulfilled need to teach effective thanatological techniques to all medical personnel.


Religiosity and self-destructive crises in the institutionalized elderly. The relationship of religiosity to self-destructive behavior has largely been considered in terms of the impact of religious affiliation, or church membership, on rates of suicide for various geographical populations. This study departs from that approach and focuses instead on the relationship of intensity of religious commitment to the use of indirect life-threatening behavior (ILTB) among elderly, chronically ill hospital patients. A rating scale to measure the occurrence of ILTB was developed and administered to a sample of 58 patients in a Veterans Administration hospital. Findings for this sample indicate that intensity of religious commitment is a potentially more meaningful measure of religiosity than is formal church membership, that intensity of religious commitment tends to vary inversely with the extent of ILTB observed for the patient, and that "stigma avoidance" may play a role in the tendency for certain religious affiliates to make more extensive use of ILTB.


Attempted suicides-35 years afterward.

Attempted suicides-35 years afterward. Most follow-up studies of suicides are made after a relatively short period of time. The present study involved 229 attempted suicides (93 men and 136 women) hospitalized during the years 1933-1942. It was possible to trace 96.8% of the men and 95.6% of the women. An earlier investigation 0 to 12 years after hospitalization showed that in the first 4 years 9 men (9.7%) and 5 women (3.7%) had committed suicide. The observation time for the present study ranges from 21 to 42 years, with a mode of 35 years. It was found that an additional 4 men and 7 women had committed suicide in the interim-in the cases of 2 men and 6 women, 15 years or more after the initial attempt. This incidence of suicide so long after the original attempt, at least in the case of the women, statistically exceeds the expected incidence. In the time now elapsed, 10.9% of the study sample (14% of the men and 8.8% of the women) have taken their own lives.


Suicide in Maine: a social psychological approach. This paper reports the results of a field study on five proximal social psychological variables derived from Farber's theory of suicide: Hope in the Future Time Perspective; Demands for Interpersonal Giving; the Availability of Succorance; Demands for the Exercising of Competence; and the degree of Toleration of Suicide. The subjects were mature, long-term residents of counties of Maine that proved stable in their relative rate of suicide. The value for each variable was assessed by a questionnair devised for this purpose by the author. The differences between the mean scale scores for the high and low suicide areas were analyzed by t-tests. The between group differences for all variables were significant at or beyond the .01 level of significance. A correlational study indicated that the relationship among the five variables was compatible with Farber's theory of suicide. The research generally offers strong support for Farber's theory of suicide at the social psychological level of analysis.


Ecological variation in self-injury behavior. Only recently have efforts been made to discover the extent of self-injury behavior in the general population. The study reported here was designed to ascertain and examine the degree of relationship between the ecological distribution of self-injury behavior and the indices of economic and ethnic status. The general hypothesis predicts that high rates of self-injury behavior are associated with low economic status and high ethnic status census tract populations in a northern metropolitan area. A total of 2,755 cases of self-injury were collected for the year 1972 from the records of the city and county police departments hospital emergency facilities, and a sample of private physicians. Self-injury behavior was defined as any case of self-inflicted overdosage, asphyxiation, or injury, whether or not there was evidence of suicidal intent. The indices of economic and ethnic status for the various census tracts were computed in the manner suggested by Shevky and Bell (1955). All the measures of economic status were found significantly related to self-injury in the predicted direction. The relationship between ethnic status and self-injury rates was not significant. When ethnic status was disaggregated, a significant relationship was found between self-injury rates for nonwhites and foreign-born whites. The explanation was offered that ethnic differences in self-injury are mediated by economic status variables and subcultural factors.


A psychotherapist's reaction to his patient's death. A case history of a patient who died during the course of psychotherapy is initially presented in the form of an essay. Three therapeutic points (one related to the therapist's awareness of his anger toward the patient) are focused on in regard to working with the dependent, suicidal patient: the importance of being in touch with one's own anger toward the suicidal patient; the need to vary one's attitude and approach toward the dependent patient as he travels through different emotional phases; the importance of promptly involving significant friends and relatives in close observation of and relating to the acutely suicidal person. The emotions and psychodynamic factors in the author and other psychotherapists in response to the death of a patient are then examined with particular emphasis on the therapist's allowing himself to mourn the personal loss.


Law enforcement and crisis intervention services: a critical relationship. Law-enforcement officers tend to look at traditional mental health services as being of little help to them in dealing with persons they encounter experiencing emotional emergencies. They are frequently skeptical that emergency mental health programs offer more than they deliver. Because of their traditional base as the primary, and frequently only, available emergency "field" service in a community, a mental health emergency program must have a cooperative working relationship with law enforcement to serve a community successfully. This paper describes the development and maintenance of such a relationship, designed to increase the police case-finding potential.


Estimation of suicide risk by the use of clinical models. This report details some preliminary experience in the use of clinical models to develop scales for the estimation of suicide risk. A cohort was drawn for each of two models: Stable with Forced Change (N = 333) and Alienated (N = 566). A set of postulated discriminators regarding suicide was examined with negative results. Available data revealed 12 items for the Stable with Forced Change model and  20 items for the Alienated model that discriminated between the suicides and the nonsuicides at a .05 level of confidence. That only 4 items were common to both supports the idea that the models represent different populations in regard to vulnerability to suicide and thus require independent lethality scales.


Optic nerve infarction.

Optic nerve infarction. A specific type of optic disc damage and visual field loss has been emphasized. The changes occur acutely at the inferotemporal disc margin and do not seem to progress. Such patients have normal intraocular pressures. We have termed this entity "acute inferotemporal prelaminar optic disc infarction syndrome" in an effort to avoid using the word glaucoma. Although similar events can occur in glaucomatous eyes, we feel that such changes are not progressive and that sophisticated diagnostic studies should be avoided. Three cases are presented as examples.


Visual prognosis of optic nerve sheath meningiomas producing shunt vessels on the optic disk: the Hoyt-Spencer syndrome. Nine patients, including seven women and two men, had meningiomas of the optic nerve sheath. The defect was bilateral in two, in the right eye in six, and in the left eye in one. Most had edema of the disk, and all had progressive loss of vision to blindness in the affected eye owing to optic nerve atrophy. In 10 of the 11 affected eyes, opticociliary shunt veins developed on the optic disk. Exophthalmos was mild and not more than 3 mm in any patient. Ocular movement was mildly impaired in three patients. Indentation and flattening of the posterior pole of the eye was documented in five eyes. Nine of the eleven eyes went on to blindness; one was worse after operation, and the eleventh was lost to follow-up. Surgical treatment has not been effective in these cases or in those reported in the literature.


Senile macular degeneration: a histopathologic study. The histopathologic features of 176 eyes from 115 patients with senile macular degeneration have been studied. The results support the view that older persons with drusen are predisposed to the development of serous detachments, areolar retinal pigment epithelial atrophy, and subretinal pigment epithelial neovascularization. Direct clinicopathologic correlation was accomplished in 11 cases. Serial sections through the macular lesions were prepared and studied in 45 eyes. Five eyes were studied with stepped-serial sections through the macula at 0.1 mm intervals. Two-dimensional map reconstruction of the macular lesion of eight eyes was performed. Electron microscopic study of Bruch's membrane was performed in five eyes. A flow chart illustrating the interrelationships of the various morphologic forms of senile macular degeneration is proposed.


Primary open-angle glaucoma and sensitivity to corticosteroids in vitro. Corticosteroid inhibition of mitogen induced lymphocyte transformation was studied in patients with definite or suspected primary open-angle plaucoma (POAG). Patients without glaucoma served as normal controls. From a dose response curve with prednisolone-21-PO4 or prednisolone the value of 50% inhibition (I50) was determined for each patient. In Series I it was necessary to disqualify 70% of the data whereas in Series II less than 5% were excluded. In Series I the median I50 (M X 10(-8) prednisolone-21-PO4) was 12 for 11 controls and 8 for 18 total POAG'S (p less than .01). In Series II the opposite result was obtained. The median I50 was 8 for 49 controls and 12 for 79 total POAG'S (p less than .01). In series II similar results were obtained with prednisolone. There was no difference between definite and suspected glaucoma patients. The cause of the discrepancy between the present two series and among the other published studies is not clear. The source of normal controls, from either an eye clinic or volunteer groups, may be a factor.


A cytologic aid in the diagnosis of congenital glaucoma. The superficial corneal epithelium of 17 patients with glaucoma varying in age from nine days to 16 years and 25 normal individuals varying from nine months to 16 years were studied comparing findings using the Giemsa and Papanicolaou staining methods. The normal individuals exhibited a high frequency of precornified cells and a paucity of cornified cells with pyknotic nuclei. Smears of 16 of the 17 patients with glaucoma stained by the Papanicolaou method illustrated striking tinctorial changes. In a 9-day-old patient with glaucoma there were occasional normal cells, but many others varied greatly both in shape and size. In addition, highly cornified, deep orange, Papanicolaou stained cells with pyknotic nuclei were noted. These changes were so pronounced that examination of a single section strongly suggested a diagnosis of glaucoma. Cells in the older patients (6 to 16 years) frequntly exhibited a high degree of cornification, extensive cell fragmentation, darkly stained pyknotic nuclei, and areas of ghost cells. The cytologic characteristics of stained corneal epithelium cells were a demonstrable aid in the early diagnosis of glaucoma.


Pityrosporum species associated with dacryoliths: in obstructive dacryocystitis. Two dacryoliths removed from the obstructed and enlarged lacrimal sac of a 54 year-old female patient during dacryocystorhinostomy were found to contain the filamentous forms consistent with Pityrosporum oribulare. It does not seem that this fungus has been observed before in a dacryolith or in dacryocystitis.


Silicone intraocular lenses in rabbits.

Silicone intraocular lenses in rabbits. 1. A series of rabbits have been operated upon utilizing two extracapsular techniques. An intraocular lens cast from several silicone materials was placed in each eye with the exception of one (number 9). 2. The eyes from these animals have been evaluated by clinical and microscopic techniques (including scanning electron microscopy). 3. From this limited study, it would appear that an intraocular lens made from cast silicone does not remarkably affect the physiological function of the rabbit eye. 4. Electron microscopic studies on some of the lenses in this series indicates no particular cellular reaction to or upon these lenses evaluated by this technique.


Visual prognosis in advanced glaucoma: a comparison of medical and surgical therapy for retention of vision in 101 eyes with advanced glaucoma. A detailed analysis of 101 eyes of 76 patients with advanced glaucomatous visual field loss but with retention of good visual acuity is presented. Patients were followed for a minimum of 4 years with an average duration of follow-up of 7.1 years. Loss of central vision, defined by permanent reduction of visual acuity to less than or equal to 20/200, occurred with equal frequency in eyes treated medically (15.8%) or surgically (13.6%) for glaucoma. Sudden loss of central vision also occurred following cataract extraction (8.7%). No patient lost central vision suddenly following surgery when central vision was spared at the time of operation. In addition, all cases that eventually lost central vision, either medically or surgically, demonstrated field defects which split fixation prior to its loss. Loss of central vision is seen rarely when medical therapy maintains the average intraocular pressure below 18 mm Hg, but increases markedly with higher pressures, reaching approximately 30% when average intraocular pressure is above 22 mm Hg. Progression in field loss is rare after successful glaucoma surgery, although cataracts develop in about 32% of such eyes. Cataracts also develop in 21% of medically treated eyes. In addition, about 50% of unoperated eyes demonstrate further field loss even when central vision is maintained. In spite of very definite risks, serious consideration should be given to glaucoma filtering surgery when the intraocular pressure is consistently over 22 mm Hg in patients on medical therapy with advanced glaucoma.


Adie's syndrome: some new observations.

Adie's syndrome: some new observations. Adie's syndrome is a disease of unknown etiology. We known where the damage is, and which nerves are involved. We even know something of how the nerves react after the damage is done, but we don't known what causes the primary injury. The first step in working a jigsaw puzzle is to getall of the pieces right side up and take a good look at them. Some of the jigsaw pieces handled in this paper are listed below. Some of them are new observations; many of them are old concepts, partly modified and partly made secure by new facts. 1. Not all "tonic pupils" are due to "Adie's syndrome"; some are due to local injury and some to a generalized peripheral neuropathy (Table II). 2. All patients should have serologic tests for shyphilis. In this series one in six had positive serology. 3. The incidence of Adie's syndrome in Iowa in the early 1970's was approximately 4.7 per 100,000 population per year. 4. The prevalence of Adie's syndrome, therefore, was approximately 2 per 1000. 5. The mean age of onset of Adie's syndrome was about 32.2 years (Figure 1A). 6. The sex ratio was 2.6 females to each male. 7. Right eyes and left eyes were involved at approximately the same rate (Figure 2). 8. The incidence of second eye involvement in unilateral cases was about 4% per year during the first decade of the disease (Figure 18). 9. If this rate of second eye involvement (4% per year) persists during subsequent decades, then most Adie's pupils will eventually become bilateral. 10. The incidence of Adie's syndrome in a largely caucasian patient group is independent of iris color (Figure 4). 11. Only 10% of patients with Adie's syndrome had completely normal muscle stretch reflexes. 12. The muscle stretch reflexes in the arms were just as frequently imparied as those in th elegs, but the degree of impariment tended to be more severe in the ankles and triceps. 13. When there was any light reaction remaining in an Adie's pupil, a segmental paralysis of the sphincter muscle could be seen. 14. The near reaction of the pupil was often segmental and frequently involved segments which did not respond to light. 15. The segmental paralysis to light was randomly distributed around the sphincter (Figure 6B). 16. There was some tendency for the sphincter palsy to gradually become worse. This progression was also random (Figure 8). 17. Almost all patients with Adie's syndrome had an accommodative paresis at the time of onset. 18. Reading glasses given to a patient with a fresh Adie's pupil were soon discarded as accommodation recovered (Figure 9). 19. Accomodative effort induced an astigmatism in about half of the eyes with Adie's--presumably the result of a segmental palsy of the ciliary muscle. 20. Tonicity of accommodation was present in about 1/2 of the eyes with Adie's, making it difficut for the patient to maintain a steady level of ciliary muscle tone. 21. An occasional patient complained of brow ache from ciliary spasm with near work. 22. In most patients with Adie's syndrome the ciliary muscle was supersensitive to pilocarpine 0...


The posterior staphyloma of pathologic myopia. A total of 250 myopic patients with posterior staphyloma affecting one or both eyes received a complete ocular examination including binocular indirect ophthalmoscopy, refraction, and axial length measurement. Ten types of staphyloma were noted; five primary and five compound. The primary staphyloma involved the posterior pole (Type I), macular area (Type II), peripapillary area (Type III), the fundus nasal to the disc (Type IV) and the area below the disc (Type V). Compound staphylomas consisted of combined primary staphylomas or distinctive and complex variations of a primary staphyloma, usually Type I. This type also was found to have the greatest prevalence of all ten types. Patients in this group had a 19% incidence of legal blindness with 34.5% of staphylomatous eyes having a vision of 20/200 or less. A remarkably wide range of refractions and axial lengths were found for each staphyloma type. These results indicate the importance of the staphyloma in the diagnosis and prognosis of pathologic myopia. It also offers an improved basis for genetic studies of this disease.


Clinical aspects of the visually evoked potential. The visually evoked potential (VEP) was studied in normal and abnormal human subjects, and in Rhesus monkeys with central, paracentral, and peripheral photocoagulation lesions. A relatively simple protocol for clinical VEP testing is described. The monkeys showed similar VEP responses but these were smaller in amplitude than those obtained from human subjects. Central, but not paracentral or peripheral retinal lesions were associated with VEP abnormalities. For both monkey and human subjects, some variability of responses between normal and subjects was noted. Generally, there are differences in VEP responses obtained from the affected eye of abnormal subjects who had one eye which could serve as a control, as compared to responses from the normal eye. In these subjects as well as in subjects with two abnormal eyes, computer analysis of digitized VEP data from 10 Hz stimulus responses was performed. Fourier transformation analyses showed abnormalities which could be detected easily by evaluating the pattern of the amplitudes of the fundamental and first three harmonics. With this technique, it was possible to group correctly normal VEP's with eyes with normal visual acuity (greater than or equal to 20/30 or 0.67), and abnormal VEP's with eyes with poor visual acuity (less than 20/30 or 0.67) in 72% of cases. Analysis of the data obtained with 1 Hz and 10 Hz stimulation suggests that the components of the VEP related to visual acuity occur within the first 60-100 msec of the response, corresponding to the primary evoked response of Chiganek. The second, smaller wave of the response complex to 10 Hz flash stimuli corresponds to the primary evoked response, and is closely related to visual acuity. This was further supported in another series in which the digitized data was filtered around the stimulating frequency. It was possible to recognize visually this VEP waveform and subjectively interpret the record correctly in 85% of eyes with regard to visual acuity. Therefore, the clinician can "read" the VEP record in response to nonpatterned flash stimuli. This test was further validated in a series of patients with opacities of the ocular media, such as cataract, corneal scarring, and vitreous hemorrhage. VEP promises to become a procedure of diagnostic and prognostic value in ophthalmology.


Graded treadmill stress testing. Patterns of physician use and abuse. Treadmill stress testing is used in assessing the condition of patients with known or suspected heart disease. We did a prospective study to clarify physician ordering and integration of the test. Ordering criteria were always complied with, although most tests were ordered for evaluation of atypical chest pain and only a few for high risk patients with known cardiac dysfunction, indicating a misplaced emphasis on the diagnostic capabilities of the test. Tests in patients with atypical chest pain and stress-induced ischemic changes were always integrated, but in 30 percent of patients with atypical pain and no stress-induced electrocardiographic changes, the tests were not used in patient management. This was often due to the misconception that negative findings on a stress test excluded coronary disease. Physicians should be alerted to this misplaced emphasis and misconception.


Severe iron deficiency anemia.

Severe iron deficiency anemia. Severe iron deficiency anemia remains a continuing major health hazard among inner city children in Los Angeles. Over a 24-month period, 60 children in whom hemoglobin values were below 7 grams per dl were admitted to hospital; 11 (18 percent) of them were in overt congestive heart failure. Contrary to the popular conceptions, two thirds of the anemic children were undernourished, approximating the 16th percentile for weight on the Iowa growth chart, and the frequency of premature birth was not greater than in the general population. There were no deaths in this series. A management protocol which included partial exchange transfusion of children in congestive heart failure and supportive transfusion for children with hemoglobin levels below 5 grams per dl was employed.


Sexual therapy of patients with cardiovascular disease. Physical illness or disability inevitably has a damaging effect on sexual relationships. Physicians are usually unaware of the sexual consequences of illness on their patients, and lack experience in treating sexual dysfunctions. The report of treatment of a couple with serious cardiovascular disease illustrates the potential efficacy of brief sex therapy for improving the quality of a patient's life. If a primary physician lacks the skills to conduct sex therapy, he may collaborate with nonphysician therapists. The physician's knowledge of the physiological and psychological effects of a specific illness on his patient is essential to successful therapy. Often, simple education, encouragement or reassurance by the physician is enough to overcome the damaging effects of illness on a patient's sex life.


[The value of sputum cytodiagnosis as a screening method for lung cancer detection--results of a study (author's transl)]. In the course of a screening program for lung cancer detection which has been going on for several years, 2432 male risk persons, aged 42-67, were examined cytologically in 1974 and 1975. The annual rate of incidence of lung cancer in this population is unknown. We estimate it at 3-4%. From two sputa of each patient we screened one specimen. 24.7% of the sputa were unsatisfactory. In the remaining preparations there were neither tumor cells nor cells suspicious for cancer. This result is discussed in view of the experiences of other authors, that the sensitivity of cytological screening for lung cancer is 33-38%. Recommendations are given for increasing the number of detected cases.


[Evaluation of a bronchopulmonal screening program for the aims of occupational health in workers exposed to cement dust (author's transl)]. 180 workers exposed to cement dust were examined in a bronchopulmonal screening including standardized history, clinical examination, spirometry and bronchial reactivity testing. The program proved to be suitable. The time needed for each person was 45 minutes. The workers have been selected in such a manner that the informational value of the methods of lung functional diagnostic could be verified in workers exposed to dust before manifestation of lung diseases. In view of individual diagnosis and rehabilitation bronchial reactivity tests lead to valuable information in workers exposed to cement dust. In the other hand no higher frequency of bronchial hyperreactivity in workers without lung diseases and exposed to dust could be proved. The rates of decrease of FEV1 after inhalation of acetylcholine, however, revealed a positive correlation to the duration of exposure.


[Impairments of co2-gas-exchange during the provocative inhalation in children with bronchial asthma (author's transl)]. Report on the investigation of CO2-Gas-exchange during provocative inhalation tests in children suffering from bronchial asthma. An increased difference in CO2-gradients by increase of PVCO2 and decrease of PACO2 was found. The values of Pco2a are unchanged. The capnography seems to be useful in continious monitoring of obstructive ventilation disorders during provocative inhalation tests, especially in children.


[Significance of contemporary methods of lung function testing for the detection of airway obstruction in children and adolescents (author's transl)]. In the article we outlined the basic principles of some recent methods of lung function testing, suitable for the assessment of airway obstruction in children and adolescents. There is also a brief description of various methods, normal values expressed in a form of regression equations, significance of different methods for the assessment of airway obstruction in patients with respiratory diseases and in children from a region with increased levels of air pollution. Among the various functional indices we found the most sensitive for the assessment of airway obstruction maximum expiratory flow rates measured at lower lung volume levels. Airway conductance appeared as the most sensitive method for the evaluation of bronchodilation following inhalation of some drugs. The measurements of airway conductance in a body plethysmography during normal quiet breathing and of maximum expiratory flow rates from flow-volume curves represent the basic methods for the detection of airway obstruction, i.e. in the larger central airways, and in the peripheral airways respectively.


[Investigations on the stability of droplets from medical jet and ultrasound aerosol atomizers (author's transl)]. The droplet size distribution of aerosols is not only determined by the process of aerosol production. After generation of an aerosol its spectrum undergoes very rapid changes due to vaporization and condensation process, that result in a spectrum depending on type and concentration of the used medicament and the partial pressure of water vapour in the vicinity of the droplets. The resulting spectrum is measured and calculated.


[The stratified tuberculoma caused by Mycobacterium kansasii with cavitation (author's transl)]. Report on a 39 years old female textile worker with an acute cavity. M. kansasii was repeatedly isolated by cultivation from the sputum. The patient became negative by treatment with INH, SM, PAS, Ethionamide, but the cavity persisted. Therefore seven months after the onset of the disease the left upper lobe was resected. A colliquative Stratified tuberculoma and some lesions of caseated bronchitis and peribronchitis were found in the neigh bourhood. Clusters and microcolonies of M. kansasii could be observed as well in the wall of the cavity as in the centre of caseated bronchial lesions. The mycobacteria had a characteristic shabe of long segmentated rods. All about the microcolonies situated in the lumina of small bronchi and bronchioli caseated lesions were present, surrounded by specific granular tissue consisting of epithelial cells, some Langhans giant cells, lymphocytes and fibrocytes. The alterations caused by M. kansasii did not differ from those lesions caused by M. tuberculosis (human.) formerly described as stratified tuberculoma and caseated bronchial lesions with mycobacteria centrally located.


Parenteral treatment of sarcoidosis with triamcinolone. The parenteral use of triamcinolone acetonide (Kenacort A) is said to have the following advantages: to keep the effect for two weeks by one injection, to be able to reduce the total treatment dosage and to secure the dosage regardless of patients cooperation. From these reasons, a trial of the Kenacort A treatment was made for 40 cases with sarcoidosis by 7 times of intramuscular injection at two-week intervals: 80 mg each at the 1st and 2nd and 40 mg at the 3rd to 7th. The results were compared with the already reported double blind trial using the oral initial dosage of 30 mg of prednisolone followed by a a reduced dosage for a period of 6 months. This paper will give an interim report of the 4 month follow-up after the ceasation of treatment. The results showed: 1. the disappearance rate of chest findings, either BHL or parenchymal pulmonary lesions, was higher in this trial than the above-mentioned oral treatment, 2. the high rate of improvement was found in ocular lesion, and 3. side effects were less in this trial than the oral treatment.


Modification of human platelet behaviour in diabetes. Among the different factors which could be responsible for the retinal vascular disturbances in diabetic retinopathy, we have investigated platelet populations, sialic acid content of platelets and collagen-induced platelet aggregation. The following results were obtained: a) there was no modification of platelet population distribution except for population A; b) there was a modification of collagen-induced platelet aggregation; the lag time was increased in diabetics.


Congenital malformations in diabetic offspring. A retrospective study of 215 deliveries in diabetic mothers at Hospital de Clínicas (Montevideo, Uruguay) has been performed. Presence of congenital malformations (CM) was considered in relation to age of the mothers, class of maternal diabetes, maternal angiopathy, treatment and metabolic control. The prevalence of CM in the series was 9.8%. None of the factors analyzed seems to be statistically linked to the prevalence of CM.


Some genetic problems in physical growth and development. A longitudinal study on children aged 0--7 years. Aiming at determining the influence of some genetic factors on growth and development, a longitudinal study of 180 children (90 M and 90 F) from the city of Lublin was carried out, with periodical medical examinations and anthropometric measurements from birth to 7 years of age. The parents of each child were also examined. The correlation coefficients between parents and children show that, as regards height, the greatest similarity occurs between mothers and daughters, and a lesser one between fathers and sons. As regards weight, sons are more similar to fathers than daughters to mothers. The relationship between the growth and development of children and the mating type of parents, parental age, and birth order, was also investigated. In negative assortative mating, the children are taller than the children of middle-height parents from positive assortative mating couples. Children (especially daughters) of tall mothers and short fathers grow taller than children of tall fathers and short mothers. Finally, the dependence of growth on parental age and birth order was analysed and the conclusions reached were quite interesting.


Prevalence of diabetes among glycosuric individuals in an urban area of Greece. Epidemiologic data on the frequency of diabetes in the urban Greek population were lacking in Greece. Postpranadial urine samples of 21,410 inhabitants of a subturb of Athens were examined for glycosuria by two different enzymatic methods. It was found that 569 persons, i.e. 3.20% of the whole population aged 10 or more, presented postprandial glycosuria (cases of previously known diabetes were excluded); 417 persons out of these were submitted to an OGTT (50 g) and 135 new cases of diabetes were discovered. Glycosuria was associated with diabetes mostly in the age-groups above 40. Obesity was frequent among the newly discovered diabetes. Two thirds had abnormal blood sugar levels already in the fasting condition. The prevalence of non-diabetic glycosuria was 2.70% in males and 1.60% in females. The frequency of a family history positive for diabetes was found to be approximately twice as high in diabetics compared to subjects without glycosuria.


Malformations of the umbilical cord.

Malformations of the umbilical cord. In 184 autopsies of death newborns, stillborn infants and aborted fetuses (mostly with congenital malformations), 57 (30.98%) umbilical cord anomalies were discovered (38 M and 19 F): 19 cases with knots (10.32%), 17 with arterial agenesis (9.2%), 8 with focal fibrosis of Wharton's jelly (4.34%), 7 with varices and thrombosis (3.8%), and 6 (3.25%) with other anomalies. Thirtyone of the fetuses were born from first pregnancy, 32 were stillborn and 26 premature.


Diabetes prevalence in patients with bradycardiac arrhythmias. The prevalence of diabetes was investigated in 473 patients who had been fitted with pacemakers because of severe bradycardiac arrhythmia. Irrespective of the type of arrhythmia, 36.1% of the male and 45.5% of the female patients exhibited overt diabetes. The metabolic disorder was known in about half (55%) of the cases; average duration of known diabetes in these patients was 7.1 years (0.5-23 years). The more frequent occurence of diabetes in women was attributed to the frequency of overweight (twice as high) in this group. Only one fifth of the male and one tenth of the female patients had myocardial infarction as a sign of manifest coronary arteriosclerosis. The 6 to 10 times higher diabetes prevalence of pacemaker patients compared to the general population of corresponding age may indicate ischemic damage to the conduction system caused by diabetes-specific vascular changes.


Glucose intolerance in uremia (A- and B-cell function during conservative and dialytic management. Glucose tolerance and insulin and glucagon secretion were investigated in two groups of uremic patients, respectively on conservative and hemodialytic treatment. For this purpose, a glucose infusion was performed in the fasting state. Glucose intolerance was observed in uremic patients; hemodialysis improved, but did not normalize the glucose disposal. In uremic patients both on conservative and dialytic treatment plasma insulin and glucagon levels were higher than in the control group; the pattern of glucagon suppression was well maintained. The data obtained suggest that glucose intolerance in uremia is related mainly to peripheral insulin resistance and is not due to hyperglucagonemia.


Duplication deficiency of an X-chromosome with and without 45,X mosaicism in three girls. Cytogenetic, clinical, and hormonal findings. In three girls, aged 14, 15 and 16 years, the chromosome analysis revealed a morphologically abnormal, enlarged X-chromosome resembling in size and centromere position the chromosome no. 2. The translocation points were different in all three cases. The Barr-bodies were enlarged. In two girls a 45,X mosaicism (25% and 10%) was found in lymphocyte cultures. The length at birth was 43, 47 and 48 cm, and none of the girls was born before term. The main clinical abnormalities in all three cases were a marked growth retardation, slight morphological dysplasias, lack of sexual development and social immaturity. GH and cortisol secretion during an insulin tolerance test were normal. LH and FSH were elevated and showed an exaggerated reaction on LH-RH. Oestrogens were low normal and androgens within the normal range. At laparatomy the gonads were found to be streak gonads. For two girls cell cultures of gonadal tissue were set up, the chromosome findings of which corresponded to those of the lymphocyte cultures. The abnormality of the gonosomes reported here seems to represent a special form of gonadal dysgenesis. Although the translocation points were different in the three patients and one had no mosaic, while the other two showed 45,X/46,XX mosaicism, the clinical and hormonal findings were nearly the same for all three girls.


Palmar creases and diseases: cancer and tuberculosis. The palmar flexion creases of fully diagnosed patients of throat cancer (n = 120) and tuberculosis (n = 80) have been compared with a control group (n = 150) of the same stock. The palmar flexion creases of cancer and tuberculosis patients are significantly different from those of the control population.


ABO blood groups and chicken pox in an Indian population. ABO blood groups have been examined in a sample of 400 chicken-pox patients and their 383 unaffected siblings from Hyderabad, Andhra Pradesh, India. Subjects of blood group A (and possibly AB) would appear to have a somewhat higher risk than persons with group B and O to develop chicken pox.


Haptoglobin polymorphism in the Ladakhi population. Haptoglobin polymorphism has been studied in 148 Ladakhis -- a Mongoloid population inhabiting the northern-most region of India. With a frequency of 0.270 for the allele Hp1 the Ladakhis compare favourably with other Mongoloid populations.


[Effect of furosemide on venous capacity in anuric or binephrectomized patients]. Several reports about an extrarenal effect of Furosemide, consisting in venodilatation and venous pooling have been published during the last years. Some authors however deny any extrarenal effect. Changes in venous capacity of the leg were measured before and after Furosemide administration in anuric and binephrectomized patients, using the technique of occlusive rheography. According to the augmented venous pooling, all patients showed a significant decrease of venous capacity after Furosemide. This effect is certainly extrarenal.


[Extracorporeal uric clearance for the demonstration of in vivo bound uric acid]. Although numerous in vitro experiments demonstrated a variable degree of urate bound to human serum albumin and other macromolecules of human plasma, only few data are available on in vivo bound urate. Extracorporal clearances of uric acid, urea nitrogen, creatinine and phosphorus were performed at the beginning, the midtime and the end of 10 hours of hemodialysis. A continuous decrease of uric acid clearance was observed in ratio with the capacity of the artificial kidney used. In contrast to uric acid the clearances of urea nitrogen, creatinine and phosphorus remained constant during the time of dialysis. From the fall of uric acid clearance, the authors conclude a partial binding of uric acid in human plasma.


[The differential diagnosis of chronic bronchitis and emphysema from mutually supplemental functional and radiographic criteria]. In a retrospective study in 91 patients an attempt was made to differentiate the primary and/or predominating disorder "emphysema" or/and "chronic bronchitis" by independent evaluation of a number of X-ray signs and lung function criteria in routine diagnosis. Good congruency of the diagnosis from these two different aspects, could be established. Patients with 3 or more X-ray signs of emphysema were found to have larger lung volume and smaller diffusing capacities than those without. Vice versa, patients with functional diagnosis of predominant emphysema more often showed the full X-ray pattern of emphysema, than those with predominant "chronic bronchitis". In either method of diagnostic procedure, the occurence of the "small heart of emphysema" was obviously much more frequent in patients believed to have predominant or primary emphysema. Assessment of X-ray signs of changes of the lesser circulation can be obtained in a stage of the disease, when structural changes have become irreversible. Considering the different pathophysiologic pattern of predominant panacinar emphysema, the destruction of alveolar walls and, consequently of the capillary bed, is more likely to reduce DCO as well as cardiac output before pulmonary hypertension can develop. The X-ray signs resulting from this effect on the lesser circulation, exist in widened right hilar branch and abrupt narrowing of peripheral vessels, with a small heart and lack of prominence of the pulmonary trunk. In chronic bronchitis, however, signs of pulmonary hypertension are expected to occur early in the disease. The relevance of the X-ray changes of the heart size and the pulmonary circulation in both types of lung disease, could be confirmed by lung function data.


[Thyroxine in an amount of 150 micrograms daily for the prevention of the recurrence of goiter]. 24 patients, who had undergone a subtotal thyroidectomy, were given 150 micrograms thyroxine daily for 6 weeks for prevention of goiter recurrency. 14 patients had been included in an earlier reported study using 75 micrograms thyroxine daily. Prior to this trial 10 patients had 100 micrograms thyroxine daily; the 14 above mentioned patients had had no therapy for 4 weeks. A significant decrease of the TSH response to TRH is observed when compared with the prestudy regimen. According to this parameter the incidence of hyperthyroidism is increased and the incidence of euthyroidism and hypothyroidism decreased. 2 patients however remained hypothyroid. The before mentioned hyperthyroid patients had only an abnormal TSH-response and were euthyroid when determined by clinical signs or ETR-values. It is concluded, that the dosage of 150 micrograms thyroxin is indicated in patients when reduction of goiter size is desired or a high demand for thyroid replacement is suspected. This (and every comparable) regimen needs a clinical and biochemical control.


Clinical experiences with naloxone in neuroradiology. In 17 patients, the reversal by naloxone of a short duration narcotic anesthesia done for neuroradiology, was studied. Neuroleptanalgesic technique comprised d-hydrobenzperidol (5-10 mg) and fentanyl (+/- 0.4 mg) after barbiturate induction, and curarization with pancuronium, reversed by neostigmine. In group A 2 microgram/kg naloxone I.V. was given and 1 microgram/kg I.M. 30 min. later and in group B 1 micrometer/kg I.V. and 30 min. later 0.5 micrometer/kg. Reversal of narcotic depression was good and well maintained for 60 min. in both groups, as evidenced by respiratory rate, respiratory minute volume, pHa, PaCO2. Marginal temporarily cardiovascular stimulation occurred with arousal. Tolerance was good. It is concluded that antagonisation of respiratory depression due to narcotic anesthesia is possible with small titrated dosis of naloxone.


Preliminary report of domperidone (R 33182), a new antiemetic compound. A pilot study. The effect of domperidone (R 33 812), a new antiemetic, was studied in 27 patients presenting with postoperative vomiting and staying for at least six hours in a recovery room. All patients received 4 mg domperidone intravenously because of the vomiting. Nineteen patients were fully protected during the subsequent 6 hours observation period, 8 patients required a second 4 mg-dose: only one of these 8 patients was not protected at all. No side-effects were observed.


Mechanism of action of D-glyceraldehyde-3-phosphate dehydrogenase. A computer approximation with polynomial quotients was used to evaluate from experimental data the dependence of the initial velocity of D-glyceraldehyde-3-phosphate dehydrogenase reaction on the concentration of substrates. The initial velocity values were determined at optimum conditions, over a wide range of substrate concentrations and by interpolating the time curve of enzyme reaction as t leads to 0. A further computer approximation with polynomial quotients, without any implied hypothese, gave the best fit to the experimental results. The analysis of this final equation shows that two types of catalytic sites may exist. Due to the complexity of the system, the results are compatible either with the ordered binding or with rapid equilibrium random binding of substrates to each separate, but interacting type of sites. Previous experimental data showing the formation of abortive and dead-end complexes can be interpreted as kinetic effects, inherent in the mechanism. Results at variance with earlier data can be explained by the different experimental conditions.


Hydrolysis of alkyl ester and amide substrates by papain. The ratio of the rate constants of acylation of papain with some amino acid ester and amide substrates is unexpectedly low. The contribution to this low ratio by the N-acyl group and the amino acid side chain was studied by measuring the rate constants of substrates containing various acyl groups (benzoyl and benzyloxycarbonyl) and various side chains (glycine, alanine, norleucine, citrulline and arginine). The benzoyl esters were found to be less reactive than the corresponding benzyloxycarbonyl esters, whereas the benzoyl and corresponding benzyloxycarbonyl amides reacted with papain at similar rates. These findings can be explained by the dominance of hydrogen bond formation between the enzyme and amide substrates, which comprensates for the less favourable binding of the benzoyl group. It is also apparent from the similar acylation rate constants for norleucine, citrulline and arginine derivatives that the guanidyl group only slightly affects the reaction of arginine derivatives with papain.


Role of tetramer in equilibrium dimer equilibrium in the dephosphorylation and activity of phosphorylase a. Skeletal muscle phosphorylase a exists as a tetramer or a dimer depending upon the temperature and protein concentration. The rate of dephosphorylation by phosphorylase phosphatase is very low at 18 degrees C where phosphorylase a exists as a tetramer. Caffeine markedly increases the rate of dephosphorylation of tetrameric phosphorylase a at 18 degrees C but has no effect on the dephosphorylation of the dimeric form. Caffeine also enhances the enzymic activity of phosphorylase a at 18 degrees C. The results presented here indicate that caffeine can shift the tetramer in equilibrium dimer equilibrium toward the dimeric form at 18 degrees C. This conclusion in supported by sedimentation analyses.


Effect of divalent cations on the extraction of nuclear proteins. TSCM-(0.01 M Tris-HCl, 0.25 sucrose, 3.8 mM CaCl2, 12 mM MgCl2, pH 7.2) and TS-(0.01 M Tris-HCl, 0.25 M sucrose, pH 7.2)-soluble proteins of isolated rat liver nuclei were analyzed by a two-dimensional polyacrylamide gel electrophoresis method. Light microscopy showed that treatment with the TSCM solution did not alter the morphology of isolated nuclei. After treatment with the divalent cation-free TS solution, the isolated nuclei were swollen; some were disrupted and clumped together. The TSCM solution extracted 20 additional proteins including histones. These results suggest that Ca++ and Mg++ play an intracellular role in the interactions between nuclear proteins and chromatin.


Studies on human tonsillar lymphocyte membranes. II. Biological properties of membraneous glycoprotein fractions derived from human tonsillar lymphocytes. Microsomal and mitochondrial glycoprotein fractions were isolated from human tonsillar lymphocytes. The microsomal glycoprotein was purified by DEAE-Sephadex chromatography. Yielding three subfractions. The different glycoprotein fractions were studied and characterized in two different ways. The isolated glycoproteins inhibited spontaneous (E) rosette formation. This effect was similar to that exhibited by some immunosuppressive drugs and the inhibitory property was heat-labile. The microsomal and mitochondrial glycoproteins and the DEAE-Sephadex subfractions of the microsomal glycoprotein inhibited the mitogenic effect of phytohaemagglutinin and concanavalin A. This inhibition was much stronger than the effect of monosaccharide haptens (N-acetyl-D-galactose-amine and D-glucose) and may be attributed to the lectin-binding property of the glycoprotein fraction.


A full stochastic description of the Michaelis-Menten reaction for small systems. A method is presented to solve the Komogorov-equations for the stochastic model of the Michaelis-Menten reaction. The results are given for the case when only one enzyme molecule is involved in the reaction and can be extended to the case when a few enzyme molecules react. The important differences between the results of stochastic and deterministic treatment are emphasized, and their possible biological implications are discussed. Beside the exact solution of the time course of the irreversible reaction also the equilibrium is described for the reversible reaction. The method provides means for studying other biologically important reactions assuming stochastic behaviour. A comparison is made also with the steady state approximation.


A case of 22-trisomy mosaic.

A case of 22-trisomy mosaic. An extra small acrocentric chromosome was found in 50% of the cultured blood cells of a somato-mentally retarded girl with congenital heart failure and different dysmorphic symptoms. The supernumerary chromosome proved to be chromosome No. 22.


A trisomy for 10q24--qter from a familial translocation; t(4;10) (q33; q24) in both grandparents. A trisomy for 10q24--qter was found in a male infant. The clinical findings of the propositus were similar to those reported by other investigators. Both paternal grandparents are close relatives, and show the same balanced translocation, t(4; 10) (q33; q24). Their reporductive history reflected an extremely severe genetic imbalance. Four out of five children died in early infancy. The only living offspring is the father of the proband who has the balanced translocation.


Mumps meningitis: electroencephalography and leukocyte migration inhibition by basic myelin protein. In 20 patients with mumps meningitis, electroencephalography and leukocyte migration inhibition tests with basic myelin protein were carried out. Fourteen patients had mild or moderate EEG abnormalities indicative of encephalitis as well. Cellular reactivity to basic myelin protein was found in 4 cases only. The observations support the concept that mumps meningoencephalitis is a consequence of a direct viral impact onto the nervous tissue, i.e. no neuroallergic mechanisms are involved.


Circulating antibodies in coeliac disease. Antibodies produced against gliadin were demonstrated in the sera of patients suffering from coeliac disease as well as of immunized rabbits and rats. In the patient sera the specific antibodies proved to be of the IgG type. IgE may have a role in sensitization against gliadin only in the cell-fixed state.


Transverse diameter of the chest and of the heart of infants in the course of physiological cardiorespiratory adaptation. The morphology of the lungs and heart was analysed in 824 newborn infants with normal cardiorespiratory adaptation. Under normal conditions, the air content of the lungs became satisfactory in the first 6--12 hours and normal in all cases after 24 hours. The values for the transverse diameter of the chest and heart were brought into correlation with birth weight, body length and gestational age. The transverse diameter of the chest and heart did not change during the early postnatal period (between 6--12 hours and 5 days). Both diameters were correlated with birth weight. The closest correlation was found in newborns under 1500 g, a varying one in those between 1500 and 2000 g and a close correlation in the category over 2000 g. The correlation of the two diameters with both length was linear and close, without any difference between the values obtained at different times of examination. A rather loose correlation was found between the transverse diameter of the chest and heart, and gestational age.


Poland anomalad: dermatoglyphic study in seven cases. A dermatoglyphic study was made in seven patients with Poland anomalad. The ipsilateral hand showed great variability of the defect. The patterns were typical when the hand was synbrachydactylic. When there was only brachydactyly, there were peculiar configurations. Though the hand on the side of the defect may seem normal, some patterns are infrequent and on the "normal" hand on the other side, rare dermatoglyphic types were found.


Pathogenesis of angiodysplasias.

Pathogenesis of angiodysplasias. The pathogenesis of angiodysplasias was studied in 382 patients. Of the primary and secondary morphogenetic factors importance is attached to fetal diseases, intrauterine reparation, hormonal effects in neonatal age and early walking. It is concluded that angiodysplasias develop under the joint effect of genetic and environmental factors. They are evolutional anomalies undergoing changes in the course of life.


Variations on the response characteristics of oxygen electrodes. To summarize: The works presented in this and the previous paper (2) have produced an operational model for describing the oxygen reduction process in common medical grade sterile saline media at a platinum disc shaped electrode with a fairly specific surface conditioning. This paper has illustrated some of the variations possible in electrode current responses. An important feature of these data is that they are highly consistent and repeatable and can be discussed in terms of the model. However, the question still remains: What is the aging process? Is it due to a decrease of active sites for the electrochemical reduction process, brought about by the reduction process itself, or is it a process caused by other species in the media? To answer these questions, it may be necessary to employ some of the sophisticated techniques such as angle-resolved photoelectron spectroscopy (4) and extended x-ray absorption fine structure (5), available today for the study of atomic and molecular arrangements on solid surfaces.


A comparison of two nonclassical models for oxygen consumption in brain and liver tissue. Experimentally observed steady-state pO2 profiles in tissue slices can be described by a Michaelis-Menten oxygen consumption model. Calculated values for Km = 0., torr in brain tissue, and Km = 2.2 torr in liver tissue are two orders of magnitude higher than Km values determined from mitochondrial suspensions. Brain tissue has a higher metabolic rate and higher affinity for oxygen than liver tissue.


Models for pulsed polarographic electrodes. A simple model has been developed for analyzing the pulsed polarographic electrode. For short pulse durations the charge transfer kinetics must be incorporated into the boundary condition at the electrode surface. The predicted velocity dependence for long pulse durations is in good agreement with experimental data.


Myoglobin-O2-saturation profiles in muscle sections of chicken gizzard and the facilitated O2-transport by Mb+. It has been shown that the oxygen transport in intact muscle can be quantitatively determined using Mb as an oxygen indicator in the cryomicrophotometric method. 1) The influence of the parameters such as time, temperature, boundary PO2 and metabolism on the oxygen transport in sections of chicken gizzard could be quantitatively determined from measured MbsO2-profiles; 2) The MbsO2-profiles measured under various conditions can be reproduced using a mathematical model which considers not only the diffusion of dissolved O2 but also the facilitated diffusion as well as O2 consumption. From this mathematical results it can be concluded that the mobility of the Mb in the muscle cells is limited and that Mb in the PO2-region between 5 and 0 mmHg contributes to at most 40% to the total O2-transport in chicken gizzard.