Metrifonate in onchocerciasis and lymphatic filariasis. Metrifonate, in doses of 10 mg/kg for 3 consecutive days, demonstrated partial microfilaricidal activity against Onchocerca volvulus in humans. Higher doses were not investigated because of the toxic reactions obtained and the absence of monitoring of the blood cholinesterase levels. Spaced doses of 10 mg/kg every 2 weeks or once monthly up to 3 doses showed neither micro- nor macrofilaricidal activity against Wuchereria bancrofti.


Chemotherapeutic studies on Litomosoides carinii infection of Mastomys natalensis. 7. Filaricidal activity of furazolidone. Investigations were carried out on the filaricidal activity of furazolidone against Litomosoides carinii infection in Mastomys natalensis. Oral administration of the drug in daily doses of 25, 50, 75, and 150 mg/kg body weight on 5 consecutive days revealed respectively 96,4, 99,3 and, with the two later doses, 100% reduction of macrofilariae in the pleural cavities, and produced a continuing dose-dependant decrease of microfilaraemia in the circulating blood. After oral doses of 5 x 50 mg/kg, all the adult parasites were killed within two weeks of the start of treatment and were found encapsulated in fibrinous masses in the pleural cavities. Deformed and degenerated embryonic stages could be seen in female worms as early as 3 days after the end of treatment. Furazolidone possesses a considerable chemotherapeutic index.


[Biometrical identification of larval instars of S. damnosum s.I. and S. adersi (Diptera: Simuliidae) (author's transl)]. The biometrical analysis of two characters measured on the postgenae of Simulium larvae allow to differentiate the seven larval instars of S. damnosum s.I. and S. adersi, and to draw the growth curves of one parameter for the different instars.


Cutaneous leishmaniasis in Eastern Saudi Arabia. Epidemiological and clinical features in a nonimmune population living in an endemic area. Cutaneous leishmaniasis is endemic in Saudi-Arabia. Nonimmune Europeans and their families living temporarily in this area were affected by the disease in great number, resembling an epidemic outbreak. Clinical features and treatment of the disease, problems of re-infection and immunity, as well as epidemiological factors are discussed. Using biochemical methods the parasite was identified as Leishmania tropical major.


Immunization against anaplasmosis and babesiosis. Part II. Evaluation of cryo-preserved vaccines using different doses and routes of inoculation. Anaplasma marginale, Babesia argentina and Babesia bigemina infected blood used as vaccines for immunization trials in Valle del Cauca, were preserved with 4 Molar Dimethyl-Sulfoxide (4M DMSO) and stored in liquid nitrogen (-196 degrees C). The effectivity of the vaccines was determined in 87 healthy calves utilizing serial 10-fold dilutions. The effects of dose, inoculation routes, time and temperature were determined. The minimum infective dose for A. marginale was 10(-3) (2 x 10(6)) when 2 ml of vaccine were given intravenously (i.v.). The same dose when given subcutaneously (s.c.) was not infective. The 10(-2) dilution (2 x 10(7)) was infective when given through both routes, however, the incubation periods were statistically different. The average incubation period using 2 ml s.c. was 30 days, but when the dose was increased to 5 ml and given s.c. the average incubation period decreased to 22 days. The minimum infective doses for b. bigemina and B. argentina were 10(-1) dilutions (4 x 10(-7)) and 10(-2) (4 x 16(6)) respectively, when 2 ml of vaccines were injected i.v.. Infectivity was also recorded when Babesia spp. vaccines were injected s.c. at dosages of 5 ml of dilution 10(-1) (1 x 10(-8)).


Investigations on the prevalence of trypanosome carriers and the antibody response in wildlife in Northern Botswana. 605 buffalo, 60 lechwe, 23 kudu, 23 impala, 15 tsessebe, 22 sable and two reedbuck from Northern Botswana were examined for trypanosome infections by serological and/or parasitological means. The indirect fluorescent antibody test (IFAT), the haematocrit centrifugation technique (HCT) and rodent subinoculation were used. The overall prevalence of patent infection with trypanosomes in buffalo, lechwe and reedbuck was 15,7%. In the case of buffalo and lechwe it was possible to classify their origin into high and low tsetse fly density areas. Serological and parasitological results showed a significantly higher prevalence of infections in areas with a high fly density. Buffalo showed a predominance of infections with Trypanosoma (Duttonella) vivax and T. (Nannomonas) congolense, while in lechwe infections with T. (Trypanozoon) brucei were as frequent. Strains of T. (T.) brucei isolated from buffalo, unlike those from lechwe, failed to infect rodents, 6 strains from lechwe proved sensitive to human serum (Blood Incubation Infectivity Test). Parasitological positive cases, antibody response and the age of buffalo were correlated. The number of patent infections in animals over one year rose to a peak at the age of 2 1/2 years and dropped steadily in the older buffalo. The frequency of positive antibody titres and their levels also increased after the first years of age, reached its peak at the age of four years an then persisted for the rest of the animals' life. Serological tests carried out on serum samples of the remaining species showed that kudu were more frequently infected than impala, tsessebe or sable.


Determination of volumes of Trypanosoma vivax and T. congolense separated from cattle blood. Trypanosomes were separated on DEAE cellulose columns from blood samples taken during the first parasitemic wave in T. vivax or T. congolense infected cattle. The mean volume of T. vivax organisms in five steers increased from 16.3 fl SE 0.7 on day five to 20.7 fl SE 0.7 on day eight. Assuming an even distribution of T. vivax throughout the vasculature, the total trypanosome volume at peak parasitemia (36.400 trypanosomes per microliter on day six) was calculated to be about 0.067% of the blood volume, i.e. 8.0 ml. The mean volume of the separated T. congolense organisms was 14.0 fl SE 0.3 on day nine post infection (mean parasitemia of 3.100 trypanosomes per microliter blood). The T. congolense organisms in the jugular venous blood accounted for about 0.0043% of the jugular venous blood volume.


In vitro feeding in the rearing of tsetse flies (Glossina m. morsitans and G.p. palpalis, Diptera: Glossinidae). The increasing demand for laboratory reared tsetse flies for research and biological control makes it necessary to develop effective and standardized tsetse fly feeding methods without using live animals for the daily blood uptake. The in vitro feeding technique, described in this paper, has been used for rearing G. m. morsitans by feeding them defibrinated equine blood through a silicone membrane. The results obtained for female longevity and productivity and mean weight of puparia are satisfactory. However, feeding defibrinated bovine blood results in significantly lighter puparia. A colony of G. p. palpalis feeding on defibrinated bovine blood is the only colony of this species that has been successfully maintained by in vitro feeding over several years. The survival rate of the females being fed defibrinated bovine, equine or porcine blood is equal. The number of larvae produced by females being fed defibrinated equine blood is significantly lower. Females younger than 50 days produce larvae which form a heavier puparia than females aged between 51 to 80 or 100 days, irrespective of blood source. Bovine blood used within the first 3 days after its collection leads to significantly higher mean weights of puparia than bovine blood used therafter. The increasing degree of haemolysis is most probably not the reason for this observation. A colony production model based on the performance of both species, G. m. morsitans and G. p. palpalis, fed in vitro, shows the importance of the first five age group periods (i.e. 45 to 50 days after emergence) for the overall performance of the flies. According to the results obtained, about 2,3 puparia per female are needed to maintain the same number of females in the colony. This level of production is reached in the fifth age group period. All larvae produced thereafter are available for colony expansion or experimental purposes. Rearing of both species with in vitro feeding is now a matter of routine.


Enhancement of the antitumor activity of adriamycin by Tween 80. This paper describes the effect of Tween 80 on the antitumor activity and on the distribution of adriamycin in mice. The dilution of adriamycin in a 10% water solution of Tween 80 produced a significant increase of the antitumor activity in mice against ascites tumors (L 1210 leukemia), disseminated leukemias (transplanted leukemias originally induced by Gross leukemai virus and Moloney leukemia virus), and solid tumors (Sarcoma 180, MS-2 sarcoma). In all these experiments the drug was administered i.v., according to different schedules. Higher antitumor activity at the optimal dose and an increase of activity at lower doses were observed in different experimental systems. Toxicity was also slightly enhanced. Tissue distribution was studied in normal mice and in tumor-bearing mice (Gross leukemia and MS-2 sarcoma). In animals give i.v. adriamycin diluted in 10% Tween 80 there was a higher drug concentration in spleen, lung and kidney than there was in mice given the drug in a water solution. In all the other organs examined (heart, liver, small intestine) and in the MS-2 tumor tissue, no significant increase was observed. In L1210 leukemia-bearing mice, i.p. treatment with adriamycin diluted in 10% Tween 80 resulted in a significantly higher toxicity than that which resulted from treatment with adriamycin in a wa ter solution; no increase of antitumor activity was observed.


Carcinoembryonic antigen and cancer: a comparative study. The sera of 212 patients with malignant and non-malignant diseases have been radioimmunoassayed for the presence of the carcinoembryonic antigen (CEA) using 3 different kits produced of Hoffman La Roche, Switzerland (RCK), BY Sorin-IRE, Italy and Belgium (SCK), and by the Istituto Sieroterapico Milanese, Italy (ICK). In the presence of endodermically-derived system carcinomas, the RCK gave more positive results (72.6%) than did the SCK (63.1%) or ICK (56.2%). With regard to other carcinomas, ICK (50.0%) and SCK (47.1%) gave better results than did RCK (30.6%). The results are discussed in terms of clinical usefulness of the CEA assay and as regards reproducibility, procedural advantages, and economical cost of each kit. It is concluded that the CEA assay cannot be used for the diagnosis of gastrointestinal cancers, although it is useful as a measure of "cancerosity" for prognostic purposes. In this sense the double antibody method employed by SCK and ICK is clinically more advantageous than is the perchloric acid extraction-zirconyl phosphate gel precipitation method of RCK.


Failures (cause and time) of radiotherapy in oral cancer. The results of retrospective clinical evaluation concerning 434 cases of oral carcinomas treated with radiotherapy from January 1959 to December 1967 are presented. The analysis of the results obtained shows that radiotherapy alone may offer a reasonable possiblity of success in limited lesions (68.3% 5-year survival of Stage I patients). In more advanced local cases, and especially those with regional adenopathies, radiotherapy alone cannot consistently control the disease for a long period of time; 5-year survival from the onset of treatment was respectively 36.5% and 24.5% for Stage II and III cases. Moreover, if controlateral of bilateral metastatic adenopathies or fixed lymph nodes are present, the prognosis becomes dramatic (2.6% 5-year survival of Stage IV patients). Among the irradiation techniques currently available, curietherapy (intersitial applications or surface molds) presumably offers the best possibility of success, since the observed failures, both overall and stage by stage, are inferior. Radiotherapy alone may generally be of proven efficacy if the local or locoregional extension is limited. In more advanced cases a combined surgery-chemotherapy treatment method is recommended. The criteria for a combined therapeutic approach for these tumors are also discussed.


Cytopathologic manifestation of uterine leiomyosarcoma. Case report. The presence of malignant tumor cells in a vaginal and cervical smear of a 53-year-old female with vaginal bleeding and with subsequent negative hsitology of the scraping material could be later correlated with a leiomyosarcoma of the myometrium that produced deep local invasion and pulmonary metastases. The findings that favor the cytologic diagnosis of this neoplasm are the presence of isolated cells or the side-by-side arrangement of the tumor cells, the elongated shape of the cytoplasm, and the ovoidal cigar-shaped nuclei with sparse, coarse chromocenters. Cytologic differential diagnosis of other malignant neoplasms capable of cellular exfoliation into the vagina is discussed.


Malignant histiocytosis: a clinicopathologic study of 18 consecutive cases. The clinical records and histologic material of 18 consecutive patients with malignant histiocytosis were reviewed. The age of the patients ranged from 20 months to 72 years (median 35 years). There were 14 males and 4 females (3.5:1). Lymph node and liver enlargement, fever, and skin nodules were the most common physical findings; and leukocytosis was frequently the most abnormal laboratory test. Seven of 18 patients died, and their survival ranged from 1 to 15 months (median 8 months) after histopathologic diagnosis. The histologic findings on lymph nodes, spleen, liver, bone marrow, and skin were investigated with special reference to both the cellular composition and the pattern of lymph node involvement. Vascular invasion of small perinodal vessels was observed in 4 fatal cases. The absence of capsular invasion and the lack of cohesiveness among atypical proliferating histiocytes of malignant histiocytosis appeared to be inconstant. Sequential lymph node biopsies revealed in later stages the extension of the histiocytic proliferation from the sinuses into the cords and the complete obliteration of the nodal structures. The radiologic investigations yielded numerous pathologic findings that were consistent with the dissemination of the disease. Complete response to initial treatment was achieved in patients that were treated with radiotherapy and/or chemotherapy. Complete response with chemotherapy was achieved only when the treatment included adriamycin. The histologic and clinical features of the present  series provide future evidence for the recognition of malignant histiocytosis as a distinct clinical and pathologic entity.


Cytology in the diagnosis of malignant melanoma. Some cytologic criteria useful for routine examinations in the diagnosis of malignant melanoma are reported and the diagnostic value of the pre-operatory cytologic smears is also emphasized.


An improved criterion for the evaluation of estrogen receptor binding data in human breast cancer. The evaluation of the data is an important step in performing the estrogen receptor test. For this reason an effort has been made to derive a more reliable threshold criteria. Among the parameters considered, Xo, Ka, and BI%, only the former 2 appear to be suitable to allow a proper evaluation of the results. From the analysis of different types of carcinomatous or normal breast specimens, limit values of these parameters have been recovered for positivity and negativity of the estrogen receptor test. We found all the samples showing Ka less than 1.5 x 10(9) M-1 or Xo less than 5 fmol/mg proteins to be negative, those characterized by low values of both the parameters were borderline, and all the remaining ones were positive.


Breast cancer in a patient under levodopa treatment. A case history of a patient who developed mammary cancer (T1N1bMo) after 5 1/2 years of continuous treatment with Levodopa for Parkinson's disease is presented. The prolactin inhibition by the Levodopa was verified, and the clinical and mammographic growth, the doubling time, and the labeling index of the tumor were determined. The results were not significantly different than those obtained from patients with breast cancer not under treatment with Levodopa. The rapid growth and evolution of this tumor suggests that prolactin does not have an inducer or promoter effect in mammary cancer.


Stage I melanoma of the limbs: assessment of prognosis by levels of invasion and maximum thickness. The prognostic significance of 2 histological parameters, level of invasion and maximum thickness is evaluated in 248 cases of malignant melanoma of the limbs staged T1-3NoMo which were collected for Trial No. 1 of the W.H.O. Collaborating Centres for the Evaluation of Methods of Diagnosis and Treatment of Melanoma between September 1967 and December 1974. There is a linear relation of tumor thickness to mortality with a high statistical significance (P = 0.0002). Mortality also increases with progression of the level of invasion. The incidence of occult metastases to the regional lymph nodes increases with increasing thickness or level of invasion. Moreover the age and sex corrected survival curves are also dependent on both parameters. The comparison of the 2 methods revealed that maximal tumor thickness is a more powerful measure of prognosis than is the determination of the level of invasion.


Comparative aspects of pigmented nevi in children, youths and adults. Clinicomorphological correlations in children of different ages, youths, and adults with various pigmented nevi are analyzed to determine the diagnostic significance of certain structures. The study included 129 pigmented nevi surgically removed from 122 children, 27 from youths, and 133 from adult subjects. A comparative analysis of the reasons that caused the removal of the pigmented nevi made it possible to clarify a number of peculiarities of pigmented nevi in children that play an important role in the clinical and diagnostic aspects, as well as the decision of management policy. For diagnostic purposes, in the evaluation of pigmented nevi in children, particular attention should not be paid to the marked cellular proliferation of junctional melanoblasts, invasion of the epidermis by nevus cells, and pigmentation of the epidermis by melanin.


Relationship between curative radiation therapy of paravertebral tumors and the incidence of radiation myelitis. The literature about radiation damage to the spinal cord is reviewed and 4 of own cases are presented. It is pointed out that in curative radiation therapy the risk of myelitis that accompanies higher spinal cord doses must be weighed against the therapeutic gains. However, in view of the lack of information about radiation damage to the spinal cord, this may be quite difficult.


The role of irradiation in the management of head and neck cancer: analysis of results and causes of failure. The records of patients with squamous cell carcinoma of the oral cavity, oropharynx, supraglottic and glottic larynx, whose primary lesion was treated with radiation therapy from 1964 through 1973, were reviewed. End points of the study are local control rate at the primary site, ultimate control with surgical salvage, and causes of failure. The local control rate at the primary site was 90% for T1 lesions, 80% for T2 lesions, and approximately 70% for selected T3 lesions. The control rates for the advanced T3 and T4 lesions are unsatisfactory; therefore, preoperative or postoperative irradiation is combined with appropriate surgical procedures to improve the local control rates and in some instances survival rates. Analysis of cervical node metastases treatment shows that the incidence of local recurrence in the radically dissected neck can be significantly reduced with either pre- or postoperative irradiation. Elective irradiation of initially clinically uninvolved areas of the neck (both ipsilateral and contralateral) has almost eliminated subsequent nodal metastases.


Malignant lymphoplasmacytoid lymphomas. Clinical and evolutive data. A series of 31 cases of malignant lymphoplasmacytoid lymphomas (excluding Waldenström disease) is analyzed. Two-thirds of the patients initially had localizations elsewhere than in the lymph nodes and presented clinical stage I or II. The median survival is around 4 years and is particularly favorable for stage I and II patients who have received an association of radiotherapy and systematic chemotherapy; the estimated "cure rate" for these patients is around 80%.


Cytogenetic study of pleural effusions.

Cytogenetic study of pleural effusions. Chromosome analysis of effusions has been recently regarded as useful means in the diagnosis of cancer. Cytological and cytogenetic findings of 19 pleural effusions from patients with benign and malignant diseases are compared. Conventional cytology does not always give correct positive results because of the high percentage of false negatives, whereas cytogenetic analysis reveals a considerable spread of the chromosome number in neoplastic fluid, with structural chromosome changes, marker chromosomes and minute fragments. Absence of mitosis does not exclude the malignant etiology of the effusion when the patient had been previously treated with antineoplastic drugs. Benign diseases were never falsely classified as malignant by cytogenetic analysis.


Novel ultrasonic real-time scanner featuring servo controlled transducers displaying a sector image. This paper describes a new real-time servo controlled sector scanner that produces high resolution images and has functionally programmable features similar to phased array systems, but possesses the simplicity of design and low cost best achievable in a mechanical sector scanner. The unique feature is the transducer head which contains a single moving part--the transducer--enclosed within a light-weight, hand held, and vibration free case. The frame rate, sector width, stop action angle, are all operator programmable. The frame rate can be varied from 12 to 30 frames s-1 and the sector width from 0 degrees to 60 degrees. Conversion from sector to time motion (T/M) modes are instant and two options are available, a freeze position high density T/M and a low density T/M obtainable simultaneously during sector visualization. Unusual electronic features are: automatic gain control, electronic recording of images on video tape in rf format, and ability to post-process images during video playback to extract T/M display and to change time gain control (tgc) and image size.


The effects of ultrasound on the mechanical properties of rat cardiac muscle. The mechanical properties of cardiac muscle during ultrasonic irradiation have been studied in vitro. Left anterior papillary muscle from normal rats was suspended in buffered lactated Ringers solution equilibrated with 95% O2, and 5% CO2 and maintained at 20 degrees C. The muscles were stimulated to contract isometrically three times per minute at the length which produced maximum tension. Each muscle was irradiated with a MHz ultrasound at an average power of 2.4 Wcm-2 for a period of 10 min with a 10 min recovery period. Irradiation caused an average increase in temperature of the muscle of 1.7 +/- 0.2 degrees C (mean +/- SEM). Irradiation caused the resting tension (1.46 +/- 0.13g) to decrease by 17.8 +/- 4.7% and the developed tension (3.33 +/- 0.61g) to decrease by 4.1 +/- 0.9%. Since changes in contractile properties have been reported with temperature the bath temperature was raised and changes in contraction observed. When compensated for effects of temperature, the changes in resting tension became - 13.3 +/- 4.1% while the change in developed tension became + 1.6 +/- 2.3%. The change in resting tension is highly significant (p less than 0.05 paired t-test) while the change in developed tension is not. Thus 1 MHz ultrasound at an intensity of 2.4 Wcm-2 appears to affect resting tension of cardiac muscle without affecting the active tension. Since changes in cardiac mechanics of this type have not been described previously the effects of ultrasound appears to be unique.


Sleep, mood, and fatigue during a 14-day He-O2 open-sea saturation dive to 850 fsw with excursions to 950 fsw. To obtain information on sleep, mood, and performance of divers and surface support personnel during deep dives in the open sea, 12 divers and 12 surface support personnel were monitored during a 14-day open-sea saturation dive using the U.S. Navy Deep Diving System, Mark 2, Mod O. Divers lived in the deck decompression chambers at 850 fsw equivalent and made 5 days of excursion wet dives to approximately 950 fsw via the Personnel Transfer Capsule. Electroencephalographic and self-report measures of sleep, and measures of mood, anxiety, and 4-choice reaction time performance were obtained during a predive base-line period and throughout the dive and decompression. Results suggested that, unless personnel are rotated, there are limitations to the practical duration of very deep open-sea saturation dives caused by the accumulation of sleep debt, fatigue, and loss of psychological vigor.


Reduction of the incidence of decompression sickness in rats by smooth-muscle activating factor (SMAF). Normal rats were injected with a smooth-muscle activating factor (SMAF) to examine the dose-response relationshio of SMAF to the incidence of decompression sickness. After injections of saline or 1.0, 5.0, or 10.0 mg/kg SMAF, the animals were compressed to 6 ATA breathing air for 1 h and were then rapidly decompressed to 1 ATA. Results indicate that predive injections of SMAF or exposure to the SMAF substance protected rats against decompression sickness and that higher doses appear to offer more protection.


Development of unlimited duration excursion tables and procedures for helium-oxygen saturation diving. Excursion ascents were performed during a series of experimental helium-oxygen saturation dives ranging between 150 and 1000 fsw to study the limits of multiple and extended duration excursions both deeper and shallower than the saturation depth. The distance a diver can safely ascend without decompression following saturation was found to be a function of depth, increasing from 75 ft at a saturation depth of 225 fsw to 180 ft at 1000 fsw. Initiation of saturation decompression immediately after an excursion was found to be safe. This information is incorporated into new U.S. Navy Unlimited Duration Excursion Tables and Procedures for Saturation Diving.


Observations after loss of consciousness under water. Two diving incidents were investigated in which 1) an experienced professional diver (A) lost consciousness during an air dive to 69 meters, and 2) an amateur sports diver (D) lost consciousness during a 40-meter air dive. In subsequent tests both divers' ventilatory responses to inspired carbon dioxide were found to be extremely low. Under simulated diving conditions, Divers A and D exhibited marked carbon dioxide retention during exercise at 30 meters (end-tidal PCO2 = 65 and 57 mmHg, respectively) and at 70 meters, Diver A stopped work in less than 3 min because of severe dizziness. Reduced sensitivity to carbon dioxide, perhaps caused by the interaction of hypercapnia and nitrogen narcosis, is thought to have been partly responsible for these incidents.


Spectrum of multicystic renal dysplasia: diagnosis and management. Multicystic renal dysplasia represents a spectrum of pathologic states, from unilateral multicystic kidney through segmental and focal multicystic dysplasia to bilateral multicystic kidney. Diagnosis can be established with low-risk procedures with reasonable accuracy. Treatment may be nonoperative in selected cases, but the physician must be responsible for long-term follow-up of the child until more is known about the natural history of this process.


Does cyclophosphamide induce bladder cancer? An increasing incidence of bladder neoplasms temporally associated with chemotherapy, usually cyclophosphamide, is being reported. These secondary primary bladder malignancies are characteristically found in two groups of patients: those with lymphoproliferative or myeloproliferative tumors, and those with immunosuppression after organ transplantation. A case of adenocarcinoma of the bladder associated with malignant lymphoma is reported, and the known cases of second primary bladder malignancies after cyclophosphamide therapy as reported in the literature are reviewed. Studies relating to the enhanced occurrence of second primary cancers in lymphoproliferative disorders are presented. The recognized urologic toxicities of cyclophosphamide, including cytopathologic changes in animals and humans, are discussed. The observed association between immunosuppression and second primary malignancies is explored, as supported by studies on congenital immunodeficiency in humans, viral oncogenesis in experimental animals, and neoplasia after organ transplantation. Possible mechanisms of carcinogenesis associated with cyclophosphamide are reviewed, including suppression of humoral and cell-mediated immune defense mechanisms, direct carcinogenesis, or cocarcinogenesis. A plea is made for the orderly reporting and careful documentation of bladder tumors in patients receiving cyclophosphamide. It is suggested that prospective studies in these patients and in patients receiving cyclophosphamide for nonmalignant disorders would be of value in assessing the culpability of cyclophosphamide as a carcinogen.


Excessive proliferation of peripelvic fat of the kidney. Excessive proliferation of the peripelvic fat of the kidney (EPPF) is a benign process with an innocuous effect on the patient. However, this condition may assume major clinical significance by producing pyelocalyceal deformities that may be mistaken for true renal masses. Rarely, EPPF may masquerade as a renal pelvic tumor. We present the second reported case of EPPF simulating a renal pelvic tumor and review the history as well as the characteristic radiographic and sonographic features of this condition.


Renal function damage in 131 cases of urogenital tuberculosis. The functional sequelae of 131 patients with urogenital tuberculosis were examined. At the time of diagnosis, more than half of the patients already suffered from global renal failure which was moderate in 42.7 per cent and severe in 15.5 per cent. We believe that the primary functional damage occurs at the medullary level with tubular and interstitial involvement. Indeed, the red phenol test for postglomerular blood flow was altered in a higher proportion than was the creatinine clearance (67.9 per cent). The maximum concentrating ability was altered even more frequently (84 per cent). When we compared various glomerular filtration levels with the grade of alteration of the maximum ability concentration test, we also saw clearly that the alteration of the tubular interstitial medullar function dominated the alteration of the glomerular global function. This proves at a functional level the predominantly medullary localization of the lesion in renal tuberculosis.


Epodyl in management of noninvasive vesical neoplasms. A prospective study to assess the effects of triethylene glycol diglyceridyl ether (Epodyl) in the management of superficial noninvasive vesical neoplasm (T1) is presented. Apart from a few local side effects, the response of the tumor to Epodyl was very good as assessed up to three years. Further long-term studies are being done.


Suprapubic cystostomy: a simplified technique. A simple technique for performing a suprapubic cystostomy is presented. The only necessity is a modified male urethral sound.


Glans condom drainage system.

Glans condom drainage system. A form-fitting glans condom has been developed for use in small uncircumcised males with neurogenic bladders to avoid the problems inherent with diapers. The method to make the glans condom and early successful use in 19 of 33 patients are noted.


Transient fertility after vasovasostomy. Sperm generally appear in  the ejaculate within three weeks after vasovasostomy, but may soon disappear because of scarring of the anastomotic site. For this reason attempt at conception early after the operation should be encouraged.


Pelvic lipomatosis with associated cystitis glandularis. Pelvic lipomatosis and florid cystitis glandularis are rare. We report a case in which these two conditions were associated.


Primary penile reanastomosis.

Primary penile reanastomosis. Two cases of penile amputation with the techniques of reanastomosis are presented. Other techniques are briefly reviewed. A microvascular anastomosis of the dorsal vessels or nerves does not appear to be necessary, although gentle thorough reconstruction of the urethra and corpora obviously is.


Bilateral herniation of renal pelves: a complication of cutaneous pyelostomy. The first reported case of bilateral herniations of the renal pelves as a complication of cutaneous pyelostomy is presented. We describe a modification of the original surgical technique that may prevent herniation, based on fixation of the pelvis to the lumbodorsal fascia as well as the cut edge of the pelvis to the skin. In our patient the bilateral herniations were corrected by repairing the fascial defects and suturing of the pelvis to the fascia.


Perirenal malignant Schwannoma presenting as renal cell carcinoma. Clinical and radiographic evaluation of a fifty-six-year-old male with microscopic hematuria led to radical nephrectomy for renal cell carcinoma. Histologic examination by light and electronmicroscopy was most compatible with malignant schwannoma. The tumor was close to the kidney without actual renal involvement. This case is of interest for both its rarity and its unusual presentation.


New concepts on formation of Brunn's nests and cysts in urinary tract mucosa. To the present time, Brunn's nests have been conceived as being the result of pinching off of epithelial nests from urothelial buds. Mucosal cysts were considered to originate from Brunn's nests. In the present study, it was observed that under the influence of a strong stimulus of repair, the urothelial cells in the proximity of the focus of repair undergo numerous mitoses. The underlying connective tissue becomes loose, isolated cells of the lining urothelium "drop off" into the lamina propria in which they migrate as in a culture medium. There they multiply and form nests of cells at a distance from the lining urothelium. These migrating cells frequently have an early tendency to become arranged into cysts. Thus, during this process of repair urothelial cells behave temporarily as malignant cells.


Preoperative diagnosis of unilateral multicystic kidney with hydropelvis. We present 2 patients with congenital unialteral multicystic kidney disease with hydropelvis. In the first patient the diagnosis was made by precutaneous puncture of a renal cyst followed by injection of contrast medium; in the second the diagnosis was confirmed by percutaneous puncture of the renal pelvis and injection of contrast medium, although an earlier ultrasonic examination had been strongly suggestive. Since in this condition the cysts and the renal pelvis communicate, either can be punctured to make the diagnosis. The procedures herein described are definitive for the diagnosis and should be followed whenever the urologist desires such a diagnosis.


Enhanced detection of asymptomatic renal masses with routine tomography during excretory urography. In a prospective study of a diagnositc scheme for evaluating renal masses, it was observed that a significant number of masses (29 per cent) would have been undetected without the aid of routine tomography. The renal masses detected with the aid of tomography are either small or peripheral lesions which cause no impingement upon the renal collecting system. Without specific symptoms referable to a renal mass and without hematuria, many renal masses will be overlooked on standard excretory urography. The general improvement in diagnostic quality, the ease with which this procedure may be added to excretory urography, and the minimal expense involved would be additional factors which should justify the use of routine tomography with excretory urography in any radiology department.


Large varicocele presenting as pulsatile scrotal mass. A case is reported in which a patient with tricuspid insufficiency presented with a painful, moderate-sized, pulsatile, scrotal mass on the left side. Selective transfemoral gonadal venography revealed this to be a large varicocele.


Urologic management in cloacal dysgenesis. Eleven cases of cloacal dysgenesis from the experience in the Baylor affiliated hospitals from 1969 to 1977 are reviewed. Clinical features including radiographic studies are presented in representative case reports. Despite the initial urgent need for intestinal surgical intervention in these patients, the long-term morbidity and complications are typically related to the genitourinary system. A review of the literature with emphasis on embryogenesis is given. Recommendations for diagnostic approach, and acute and long-term urologic management are made.


Renal growth in maternal-fetal axis: clinical and laboratory studies. A hormone (renotropin) is said to play an important role in compensatory renal growth. The role of renotropin in obligatory growth (normal developmental growth) is unknown. It was observed that contralateral renal size in children with unilateral multicystic kidney was found to be normal at birth but became hypertrophied later. The kidneys of twenty-one-day-old fetal rats were significantly smaller than sham controls in animals whose mothers had uninephrectomies at day 8 (26.5 +/- 1.1 mg. versus 18.5 +/- 1.1 mg.). The mothers' kidneys hypertrophied compared with sham controls (1,065 +/- 23 mg. versus 1,347 +/- 78 mg.). It was concluded that renotropin passes the placenta and modifies so-called obligatory renal growth.


Treatment of skeletal metastases from urologic malignancies. Metastases from genitourinary tumors frequently involve the skeletal system and often produce the most disabling symptoms. Judicious early orthopedic management may prevent paralysis and maintain ambulation, thus significantly improving the quality of life. The role of prophylactic surgery for impending fractures and the symptomatic therapy of painful metastatic foci are discussed.


Multilocular cysts of kidney: a diagnostic dilemma. Multilocular cyst of the kidney is a rare pathologic entity occurring in both children and adults. Although diagnosis cannot be firmly established preoperatively, the use of intravenous pyelography, angiography, ultrasonography, and delta scan may aid in its diagnosis. Because of the difficulty in accurate diagnosis and the documented association with renal neoplasia, we recommend exploration and possible nephrectomy as the treatments of choice.


Extravesical ureteral ectopia.

Extravesical ureteral ectopia. A case of an extravesically ectopic single ureter draining into the seminal vesicle is presented. Age of diagnosis, embryology of ureteral ectopia, and locations of the ureteral orifice are discussed. Suggestions are made for the diagnosis and treatment of ureteral ectopia.


Urinary cytology and bladder biopsy in patients with bladder cancer. Two hundred fifty patients with bladder tumor were evaluated over a three-year period. Cystoscopy, cytology, and random bladder and tumor biopsy were part of the workup. The follow-up of these patients resulted in a total of 509 cystoscopies, 772 specimens of bladder washings and urinary cytologies, and 503 tumor or selected mucosal biopsies. The value of cytologic study of bladder washings and cystoscopic urine samples as well as the importance of selected site mucosal biopsies in detecting "field changes" in the bladder epithelium associated with bladder tumors are discussed.


Survival of patients with unsuspected prostatic carcinoma after open prostatectomy. This study is concerned with the clinicopathologic findings in 40 patients with unsuspected carcinoma of the prostate found at the time of open prostatectomy and the correlation of these findings with survival. There is a significant correlation between pathologic findings and clinical outcome.


Childhood urethral trauma.

Childhood urethral trauma. Urethral trauma in childhood due to external violence other than vehicular accident is discussed. The need for careful, planned management is highlighted by a satisfactory outcome in each of 4 cases, with no incontinence and no persistent urethral stricture. Temporary suprapubic cystostomy in 2 of these children caused no difficulty in the ultimate repair and permitted a more deliberate approach to these diminutive strictures in the pediatric age group.


Urethral injury due to external trauma.

Urethral injury due to external trauma. Fifty-six patients with urethral injuries comprised 35 involving the posterior urethra and 21 involving the anterior urethra. Immediate retrograde urethrography confirmed the clinical diagnosis made when blood was found at the external urinary meatus after external trauma. Traffic accidents caused most of the posterior urethral injuries and were associated with severe injuries to multiple systems and a significant mortality rate (34 per cent). Primary realignment of the urethral injury by a urethral catheter in all cases of urethral rupture (plus a suprapubic cystostomy in most of these cases) resulted in a stricture rate of 62 per cent on follow-up. However, only half of these strictures required surgical correction. The incidence of incontinence was 10 per cent and of impotence 38 per cent.


Urologic implications of von Hippel-Lindau syndrome. A patient with von Hippel-Lindau syndrome is presented. Bilateral simultaneous radical nephrectomy was performed for bilateral renal cell carcinoma without evidence of metastasis. The literature is reviewed and the urologic implications of this syndrome are emphasized.


Microsurgical two-layer vasovasostomy: word of caution. Microsurgical technique, with separate mucosal and muscular layer anastomosis, recently has been advocated as the most successful method of vasovasostomy. Unexpected difficulties may be encountered using this method; moreover, considerable practice in the microsurgical laboratory is mandatory before actual performance of the procedure. As with any innovation in surgical technique, a judgment of the clinical superiority of the two-layer anastomotic method must await substantiating results from other investigators.


Retroperitoneal neurilemmoma.

Retroperitoneal neurilemmoma. The clinical and pathologic features of benign and malignant retroperitoneal neurilemmoma are reviewed, and the pertinence of this tumor to the urologist is stressed. Two additional case reports are added to the literature.


Posterior urethral stenosis in newborn with renal nonfunction syndrome. A newborn male infant presented with the "renal nonfunction syndrome" and subsequently was found at autopsy to have congenital stenosis of the posterior urethra. Additional urinary tract malformations included a prostatic diverticulum, bladder hypertrophy, bilateral hydroureter, and bilateral renal hypoplasia with dysplasia. Autopsy evidence suggested that the urethral stenosis had manifested itself very early during embryologic development and accounted for the associated urinary anomalies. The infant had the physical stigmata, clinical course, and pulmonary hypoplasia commonly observed in "Potter's" or the "renal nonfunction syndrome."


Transcatheter angiographic control of bleeding. The therapeutic uses of transcatheter angiographic techniques are reviewed, and the applications in various organ systems are described. Recent experiences in the urinary tract are discussed as well as our experience in a case of radiation cystitis and recurrent bladder tumor.


Ureteroneocystostomy for bilateral ureteral obstruction in carcinoma of prostate. "Fish-mouth" ureteroneocystostomy was successful in a patient with bilateral ureteral obstruction secondary to locally invasive adenocarcinoma of the prostate. The complications of permanent intubation are avoided and renal function is restored.


Microdissection findings of medullary sponge kidney. Findings on microdissection of specimens of medullary sponge kidney showed uniform enlargement of collecting tubules in part of the papillae. Nephrons were normal in fragments without calculi and infection.


Metastatic prostatic adenocarcinoma of male breast. Three cases of metastatic adenocarcinoma of the male breast from prostatic carcinoma are added to the 15 well-documented cases reported in the literature. These 15 cases had received estrogen therapy for prostatic cancer and gynecomastia developed; 14 had clinically palpable breast nodules containing adenocarcinoma. Our 3 cases also received estrogen therapy but differed in that gynecomastia developed in only 1 patient clinically, and diagnoses were made at autopsy with no clinical symptoms related to breast metastases. Moreover, 1 cases also showed remarkable florid lactation-like changes of the breast almost indistinguishable morphologically from that seen in the female breast during pregnancy. The histopathologic differential diagnosis of metastatic prostatic carcinoma of the breast from primary cancer of the male breast is stressed. Its importance is obvious because of the differences in clinical treatment and prognosis. Microscopically, the differential points consist of duct hypertrophy and periductal fibrosis (gynecomastia), absence of any ductal involvement by carcinoma cells, frequent presence of cancer cells in lymphatics and vascular channels, morphologic similarity between the cancers in the breast and prostate, and finally, the usual presence of acid phosphatase in the tumors of the prostate and breast.


Malignant papillary mesothelioma of tunica vaginalis testis. A malignant papillary mesothelioma of the tunica vaginalis testis with retroperitoneal lymph node and pulmonary metastases is reported in a seventy-seven-year-old man. Electron microscopy of a local recurrence documented its mesothelial origin. The clinical and pathologic features of these rare neoplasms are discussed.


Gray scale echography in evaluation of hepatorenal relationships. Excellent methods are available to produce quality images of the liver and kidneys. Gray scale echography is the only suitable method of simultaneously showing hepatic and renal anatomic detail in addition to the instantaneous relationship of these organs to each other. Gray scale echography may be used to determine (1) if normal liver and a normal right kidney have interacted to give the false clinical impression of disease, (2) when renal lesions simulate hepatic disease, (3) when hepatic lesions mimic renal disease, and (4) if structural hepatic and structural renal disease are related or unrelated.


Roentgenographic evaluation of nephroptosis. Vertical and medial nephroptosis was assessed on 60 consecutive excretory urographic examinations. Ptosis, both vertical and medial, was seen more commonly in females, and vertical ptosis was more frequent than medial ptosis. In our series there was no significant evidence of predominance on the right side. Dietl crisis, nausea, vomiting, hypotension, oliguria, or orthostatic hypertension were not encountered. Nephroptosis was mostly asymptomatic. In those patients with symptoms, lumbar pain was common and could be either aggravated or relieved by change in position. A new sign, paradoxic displacement, is described. This could be of value to the surgeon and radiotherapist in evaluating enlargement of a huge abdominal mass - a difficulat task to assess clinically.


[Diagnosis and treatment of acute testicular diseases in children]. The analysis of clinical symptoms and treatment of 103 children with acute diseases of the testicles is presented. The authors consider that an outcome of acute diseases of the testicles in children depends on the character of the disease, degree of circulatory disorders of the testicle, time of the surgery and on the condition of the hematotesticular barrier and autoimmune processes. They also believe that an active surgical technic in children with acute diseases of the testicles should be combined with immunodepressive and desensitizing therapy.


[Indications for hypothermia in the surgery of congenital heart defects and the results of its use]. The authors operated 1056 patients on "dry" heart under the conditions of hypothermia. The total lethality constituted 4.5%. Since 1970 they have been applying craniocerebral hypothermia method using the apparatus "Kholod-2F". Secondary failures of the interatrial septum and valve stenosis of the pulmonary artery in patients aged from 18 to 20 are the most common indications for operation. 450 and 248 patients, respectively, were operated upon; lethality was 3.7% and 4%. The 16 years' experience with the superficial hypothermia in the correction of congenital heart diseases has proved this method to be highly effective and economical one, allowing to obtain quite favourable results after a thorough preoperative diagnosis and strict selection of patients.


[Comparative evaluation of membrane, bubble and foam-film oxygenators in artificial circulation during heart surgery]. Single-use membraneous oxygenators "Teflo" (TMO) and bubble oxygenator "Variflow" (VF-1) issued by "Travenol" firm were used on 30 patients in open-heart operations with extracorporal circulation. A comparative assessment of working, technical and functional performances of these devices against the foam-membraneous oxygenator (FMO) of "AIK-5m" apparatus proved the reliability, safety, feasibility and high effectiveness of the single-use oxygenating systems, membraneous oxygenator in particular, which is the most promising one for the use in extracorporal circulation.


[Primary cancer of the duodenum].

[Primary cancer of the duodenum]. 8 patients with primary carcinoma of the duodenum were operated upon: 3 pancreatoduodenal resections were carried out upon 3 patients. 1 patient underwent duodenectomy, the rest were mitigating and exploratory interventions. There were no fatal outcomes after radical interventions. The authors believe that radical operations for carcinoma of the duodenum allow to look forward to a longlasting cure.


[Operability and late results of treating recurrences and metachronous malignant tumors of the large intestine]. The analysis of the authors' observations has proved that the surgery in case of the recurrence of cancer of the rectum and colon is a quite justified method of treatment (the average survival period is about 2.5 years). But according to the authors' data, the operability and late results in the treatment of primary multiple metachronal cancer of the colon are higher than in case of the recurrence of cancer and practically do not differ from the operability and late results in solitary cancer (59.1% of cases survived more than 5 years). The authors have come to the conclusion that in such cases the differential diagnosis is a very important prognostic criterium.


[Radical surgical treatment of sigmoid volvulus]. The results of surgical treatment of 106 patients with sigmoid colon volvulus against the background of megacolon are set forth. The total lethality constituted 19%. The resection of the sigmoid colon was carried out upon 62 patients: one-step operation was performed upon 45 patients (of them 11 died--24.4%), 17 patients underwent the obstructive resection, of them 4 patients died (23.5%). In case of sigmoid colon gangrene lethality, following one-step resection of the sigmoid colon, constituted 26.5%, with the viable gut lethality was 18%. The detorsion of the sigmoid colon was carried out upon 44 cases of mesosigmoidopexy; the lethality was 11.4%.


[Surgical procedure in pancreatic cysts and fistulae]. The authors have generalized the experience with the treatment of 11 cases of pancreatic cysts and 4 cases of external pancreatic fistulas. The anastomosis with hollow organs (7 cases) has proved to be a method of choice in the surgery of pseudocysts. In authors' opinion, the internal drainage creates favourable conditions for persistent decompression of the duct system, promotes the obliteration of the cyst and the attenuation of inflammatory process in the pancreas, while the external drainage of the cyst is indicated in fresh cysts with a loose easily tearing capsule, when anastomosis is impossible for technical reasons.


[Data on pancreatic sclerosis and the possibilities of its prevention in the process of treating an attack of acute pancreatitis]. Some data concerning the possibility of the pancreatic sclerosis development following an attack of edematous hemorrhagic pancreatitis are proved in this paper. Recommendations on the decrease of the possibility of the development of indirect sclerosis and on the necessity of the prevention of pancreatic edema in the acute stage of the disease are set forth, which favours a more rapid resorption of edematous fluid before its formation in the subacute period.


[Surgery of acute pancreatitis].

[Surgery of acute pancreatitis]. On the grounds of the experience with the treatment of 786 consecutive cases of acute pancreatitis and its complications and on the grounds of the experimental findings obtained in 1077 animals the author makes her comments on the therapeutic tactics in acute pancreatitis and its complications and on the grounds of the experimental findings obtained in 1077 animals the author makes her comments on the therapeutic tactics in acute pancreatitis. It has been found that the treatment of all the cases should start from an early and widely planned conservative therapy, while emergent surgical interventions in acute pancreatitis are undesirable. The volume of early and delayed surgical interventions is discussed. The author's attitude towards bursa omentalis tamponade, omentopancreatopexy, dissection of the abdominal posterior layer over the pancreas and towards the resection of the pancreas, in the absence of suppuration, is negative.


[Treatment procedure with surgical patients with acute renal insufficiency]. The results of the treatment of 49 cases of surgical diseases complicated with acute renal insufficiency are presented. The lethality was 36.8%. The effectiveness of the treatment depends upon proper time and a radical character of a surgical intervention. Preoperative treatment includes an active hemodialysis aimed at the arrest of uremic intoxication. Cardiovascular insufficiency does not make a contraindication for hemodialysis.


[Complications and lethality after operations on the lungs]. The analysis of the lethality (4.8%) and postoperative complications (2.3%) following 740 lung operations was carried out. The authors developed methods of early preclinical diagnosis of intrapleural complications through the studies of neutrophilic leucocytes histochemical indices and biochemical and cytological changes of postoperative pleural extravasate.


[Plastic repair of the abdominal aorta with enzymatically treated lyophilized vascular xenografts]. 44 observations on the replacement of the abdominal aorta with vascular xenografts are presented. The enzymatic processing of the grafts clears away the antigenic properties of plasty material and decreases significantly the immunological response of the recipient. Poor results of xenoplasty are due to an inadequate mechanical strength of the graft wall.


[Does restoration of the patency of the hypogastric arteries affect the state of sexual function in patients with obliterating arteriosclerosis of the pelvic arteries?]. The sexual function state was studied in 180 cases of obliterating atherosclerosis of the aorta and iliac arteries. The importance was found in 74% out of them. The author believes that the introduction of the internal iliac artery into the blood flow in obliterating atherosclerosis of the aorta and iliac arteries is expedient from the point of view of rehabilitation of such cases, as 77% of patients remain or become impotent following operations in the aorto-iliac zone.


[Bone biopsy in the diagnosis of primary hyperparathyroidism]. In case when the diagnosis of primary hyperparathyroidism is unclear or difficult to establish the authors recommend to use the method of bone biopsy. The histological picture of the bone in hyperparathyroidism is described. It has been found that the bone biopsy ensures the differenciation of hyperparathyroidism from other forms of osteodistrophies, esteodisplasies and myeloma.


[Lesser circulation hemodynamics after radical operations on the lungs in children]. Using the methods of perfusion scintipneumography, transtracheal polysegmental electropneumoplethysmography, right heart catheterization, associated with tensiography and angiopneumography, a study of the lung blood flow in 109 children following radical lung operations for chronic non-specific broncho-pulmonary pathologies was performed. The studies were carried out before operation and during the period from the first day to 5 years postoperatively in catamnesis. Certain specific patterns of the lung blood flow reconstruction, terms of its recovery in an operated lung etc. were found.


Polyarteritis in a colony of beagles.

Polyarteritis in a colony of beagles. The clinical and pathological features of polyarteritis occurring in a colony of beagles are described. Meningeal and cardiac arteries were most commonly involved. Amyloidosis and lymphocytic thyroiditis were also present in some of the affected dogs. The polyarteritis is probably of autoimmune origin.


Distribution of trimethoprim/sulphadiazine in plasma, tissue and synovial fluids. The subcutaneous implantation of tissue cages was used to study the distribution of trimethorprim and sulphadiazine into tissue (interstitial) fluid in calves, sheep and dogs over a 24-hour period. After oral dosing there was good gastrointestinal absorption of both antibacterial agents in dogs but only of the sulphonamide in sheep. The concentration of trimethoprim in tissue fluid peaked at five to seven hours after administration when it exceeded the plasma concentration. Sulphadiazine persisted in the plasma for longer than trimethoprim, but distribution into tissue fluid was slower. The findings show that reliance on plasma concentration curves alone in determinations of bioavailability of chemotherapeutic agents may lead to false interpretations.


Discovery and application: lessons from animal research. The cumbersome administrative machinery for agricultural research set up following the Rothschild Report is criticised and the view challenged that mission-oriented research is quicker, cheaper and more useful than problem-oriented research. Examples are give from two areas of biological study, corpus luteum physiology and cell membranes, to illustrate the rapid application of basic discoveries to livestock health and production.


Isolation of a virulent strain of Ehrlichia phagocytophila from the blood of cattle in the Isle of Man. A blood sample from a cow in the Isle of Man caused a severe Ehrlichia phagocytophila infection when inoculated into a splenectomised calf. The parasite was passaged successively into a further splenectomised calf and then into two intact animals. One of the splenectomised calves and one of the intact animals died of the infection which was characterised by causing a sustained febrile response apparently correlated with a marked invasion of monocytes by the rickettsiae.


Haemorrhage from the bovine penis during erection and ejaculation: a possible explanation of some cases. Leakage of polyester resin from the cavernous spaces of the corpus spongiosum penis (csp) into the terminal part of the urethral lumen was demonstrated in one post mortem specimen. No information was available on service performance or semen characteristics immediately before slaughter. It is suggested that haemorrhage from the csp into the urethral lumen may cause spurting of blood from the apex of the penis at service.


Rickets in growing pigs and response to treatment. The clinical, radiological and pathological findings in a natural outbreak of rickets affecting 82 pigs are described. An interesting feature was the presence of gross articular abnormalities including resorption of subchondral bone with folding and ulceration of the articular cartilage. The diet was deficient in calcium and vitamin D. A diagnosis of rickets complicated by nutritional secondary hyperparathyroidism was made. The results of treatment and the economics of the outbreak are discussed.


A simple estimation of the immunoglobulin content of ewe colostrum. Use of the optical refractometer in performing a rapid assessment of the immunoglobulin content of ovine colostrum under farm conditions was investigated. Refractometer readings were compared with total protein levels and with gamma-globulin levels, determined by the ZSTT, to assess the validity of the technique. In both cases correlation coefficients were high (0.98 and 0.79 respectively). Refractometry was shown to be a valid substitute for the ZSTT in studies on colostrum gamma-globulin levels.


Detection of antibodies to alphaviruses and flaviviruses in some migratory birds of the Danube Delta. Data are reported on the presence of antibodies to some group A(alphavirus) B(flavivirus) arboviruses in 8 species of migratory birds (Ardea cinerea, Plegadis falcinellus, Anas querquedula, Anser albifrons, Gavia arctica, Fulica atra, Larus minutes and and Phalacrocorax corbo) of the Danube Delta.


Persistent measles virus infection in a calf kidney cell line. Note II. Study of some biological markers of the measles virus isolated from a selected chronically infected cell line. The biological characteristics of a measles virus strain (Co-69/pi) isolated from a selected chronically infected calf kidney cell line (K-2) are studied in comparison with those of thw wild parental CO-69 and of the attenuated Schwarz measles virus strain. Co-69/pi is a variant of the parental Co-69 virus and has characteristics of an attenuated strain. Some of the characteristics acquired by the Co-69/pi strain (cytopathogenicity, size of plaques) proved to be stable in the course of passages on a simian substrate. The mechanism having led to the appearance of this variant in the chronically infected cell line are discussed.


[Questionnaire method in conducting prophylactic oncological examinations of the population of a rural locality]. The authors describe the method of conducting mass prophylactic oncological examinations by means of questionnaires at the first stage, which was developed at the N. N. Petrov Research Institute of Oncology of the USSR Ministry of Health. Questionnaires were aimed at the recognition of somatic pretumor and tumor lesions of the main localizations and the increase of oncological vigilance of general practitioners. The method has been tested on 11386 inhabitants of rural district of Leningrad and Novgorod Provinces. As a result of mass prophylactic oncological examinations 738 different pathologies were revealed (in 6.6% of all questionnaires), pretumor lesions making 2.05% malignant neoplasms--0.06%. The use of the questionnaire method in conducting prophylactic examinations made it possible: to enhance their medical efficacy, to reduce the number of individuals subject to medical control, to employ instrumental-laboratory tests on more proper grounds, and on the basis of a questionnaire to make a registry of the primary account of persons undergoing prophylactic examinations.


[Hospital care norms for treating patients with malignant neoplasms of the head and neck]. The authors have studied the rate of malignant head and neck tumors morbidity among the population of Vinnitsa Province for 1960--1974 as well as the condition of stationary medical service, frequency of hospitalization, and average terms of patients' stay at the hospital. The index for specialized hospital beds for patients with malignant head and neck tumors was found to be 2.6 per 100 000 population. Within a 15-year period an average annual utilization of hospital beds for every 100 patients with lip cancer rated 7.2 beds, with cancer of the tongue--22.4, salivary glands--11.7, oral mucosa--19.7, pharynx--15.6, nose and sinuses--15.3, larynx--20.7, jaw--20.9, skin--5.3. These data may be rather helpful for the planned development of specialized hospitals at any site of the country.


[Economic aspects of the fight against cancer]. Social importance of malignant neoplasms lies not only in the fact of high morbidity and mortality rates but also in the economic damage. One half of males and females develop malignant tumors in their prime of life. As a result, the economic damage according to the materials of Omsk Province reports, in particular, makes 770, 6 rubles in skin cancer, 1010, 6 rubles- in cancer of the lower lip as calculated per one patient. But general economic losses due to malignant tumors in Omsk Province reached 20 818 483, 4 rubles in 1970. Taking into account these data on approximate value for the whole country will amount to no less than 3.4 billion rubles.


[Blastomogenic activity of substance complexes that leached out of rubbers into food media]. The complex of agents migrating from low-dispersed soot resins PM-15 and PGM-33, injected in the stomach or applied onto the skin of mice C57Bl, showed an insignificant blastomogenic activity. Most sensitive to their effect were the tissues of organs at the site of injection (proventricular papillomas in 8.3% of cases, skin papillomas in 12.5%), in the lung (adenomas in 12.5%) and in the pancreas (fibroadenoma in 4.2%). In the negative control groups of animals no tumors of such localization were noted. The whole complex of substances migrating from resins renders the blastomogenic effect, i. e. there is a combined action with an enhancement of blastomogenic effect.


[Risk of stomach cancer in pretumorous states]. Analysis of the late results of the surgical treatment and longterm follow-up of non-operated patients with chronic benign diseases of the stomach evidences gastric cancer high-risk in patients with anacid gastritis, polyposis and  ulcerous disease. The gastric cancer high-risk groups should also include the patients previously subjected to surgery for ulcerous affection of polyposis of the given organ. From the point of view of the organization of oncological service, patients with the mentioned pretumor diseases of the stomach do need postoperatively a life-long dispensary supervision and regular check examination.


[Gastric peptic ulcer and cancer].

[Gastric peptic ulcer and cancer]. The authors report some peculiar features in the diagnosis and surgical treatment for cancer of the gastric stump and gastroenteroanastomosis in 13 patients, previously subjected to gastric resection and gastroenterostomy for duodenal ulcerous disease (4--34 years ago). The radical operation (subtotal or extensive gastrectomy) was performed in 9 patients, 3 of them died in the immediate postoperative period. Of 6 radically operated patients with a favourable outcome, late results were studied in 3. No tumor recurrence was noted. Histologically, there were adenocarcinoma--in 8, solid cancer--in 1, hemangioma--in 1, benign polyps--in 2 cases.


[Fibergastroscopy in the diagnosis of cancer of the stomach stump]. The work is based on studying the examination and therapy data of 108 patients with gastric stump cancer. In patients subjected to proximal gastric resection (8 observations) tumor was recognized in all cases both by fibergastroscopy and radiography. Of 100 patients with cancer of the gastric stump following distal resection the true character of the pathology was revealed fibergastroscopically in 97% of cases, while radiographically--only in 86%. Directed gastrobiopsy and cytological test of the material obtained by fibergastroscopy supported the diagnosis of gastric stump cancer in 67.05% and 76.60% of cases accordingly. Squamous cell-infiltrative cancer of the gastric stump, located in the region of the postperative scar, proved to be mostly difficult to diagnose both by fibergastroscopy and radiography. No distinct correlation was noted between the efficiency of fibergastroscopy for diagnosing gastric stump cancer and the size of tumor, while tumors of no more than. 1.0--1.5 cm in diameter were found to be mostly difficult to diagnosis radiographically. Among 108 gastric stump cancer patients 25 patients were radically operated upon.


[Precancerous changes and the histogenesis of stomach cancer]. 142 cases of gastric cancer, 20 cases of chronic ulcer, 800 gastrobiopsies, performed for chronic gastritis, were studied morphologically. Adenocarcinoma and undifferentiated gastric cancer were found to have different precancerous lesions in the background. It was shown that among undifferentiated cancers the signs of  chronic ulcer preceding cancer are noted more frequently than among adenocarcinomas. Grave forms of atrophic gastritis and gastritis of the mucous membrane regeneration beyond the tumor were revealed more frequently in adenocarcinomas than in undifferentiated cancers. These precancerous affections were found to be associated with the proliferation of different cell elements of gastric mucous membrane, that conditions various listogenesis of basic histological forms of cancer of the stomach. The proliferation of the lining-gastric pit epithelium, mainly observed in gastritis, results in the appearance of adenocarcinomas. The proliferation of the glandular epithelium, particularly that of glandular ducts in ulcerous disease would condition the development of undifferentiated forms of gastric cancer.


[Use of the cytological method in benign pathological processes of the stomach (based on data from the prophylactic examination of persons with a high risk of cancer morbidity)]. The author examined the cytographs of gastritis, polyps and ulcers according to the materials of the prophylactic examination of a dispensary group, comprising 265 patients at high risk for gastric cancer. The differential features of the cytographs were examined in the cases in which the complex gastrogical investigation showed the concidence in the results of gastrofiberscopy, gastrobiopsy and cytological tests. The differential cytologic diagnosis of polyps and gastric ulcer is found to be possible in the presence of papillary structures in the first case, and in the second--a great variety of stromal infiltrate cell structure with the obligatory presence of lymphocytes, plasmatic cells, histiocytic elements, eosinophilous and neutrophilous leucoctyes. The differential cytological diagnosis between different histological forms of gastritis needs further studies.


[Clinical x-ray and fibergastroscopic comparisons in the diagnosis of different forms of stomach cancer growth]. A radiological examination associated with fibergastroscopy was performed in 145 gastric cancer patients. All these patients were radically operated upon--extremely subtotal resection of the stomach was accomplished. The preoperative diagnosis of gastric cancer with both technics used simultaneously proved to be correct in 96.55%. However, the anatomical and ulcerous-infiltrative growth, especially in their cardiac and subcardiac localization are found to present the greatest diagnostic difficulties. The data obtained made it possible to believe that the detailed diagnosis of gastric cancer should comprise two steps--a radiological examination and fibergastroscopy.


[Malignant carcinoids of the stomach].

[Malignant carcinoids of the stomach]. The work is concerned with the study of gastric tumors showing histological similarity with carcinoids, but differing from them by morphological and clinical signs of malignancy. A conclusion is made on the carcinoid nature of the neoplasms under consideration, the following evidences being presented: 1) despite some differences the tumors correspond histologically to classical carcinoids; 2) as in common carcinoids, argyrophil or argentaffine granules may be revealed in tumor cells; 3) the occurrences of tumors is related with a peculiar neoplastic transformation of glandular epithelium of the stomach resembling carcinoid rather than cancerous one. Not excluding the possibiltiy of their origin from common carcinoids, the author believes that they are likely to be primary malignant tumors.


[Clinical physiological evaluation of the splenopancreatogastrectomy operation in stomach cancer patients]. Clinico-physiological data on 52 patients after spleno-pancreatogastrectomy are analysed. The mortality was 25%, the late results were as follows: a 3-year survival--in 28%, a 5-year survival--in 14.7%, a 10-year survival--in 9%. This group of patients was examined for the functional state of the cholinergic system, carbohydrate metabolism, external respiration and basic metabolism. Carbohydrate metabolism is found to change but insignificantly and requires no corrective measures. The cholinergic system activity was reduced, that adversely affects the respiratory function and contributes to the decreased basic metabolism. The latter would necessitate including of cholinomimetics and lipocain in the scheme of the postoperative management.


[Patterns in the development of radiation tumors of the stomach and intestines]. In the experiments on dogs and rats it was shown that gastric and intestinal neoplasms arise under the influence of different kinds of radiation, these may be located in all portions of the stomach and bowel and are of a different histological origin. They are not infrequently primary multiple, mostly benign neoplasms which show multicentric growth. The frequency of tumors appearance, their localization, an average latent period, the degree of malignancy and multiplicity are conditioned by the amount of tissue dosage, the topography of their distribution in the alimentary tract and the level of total irradiation of the organism. With the increased dosage of local irradiation the latent period and multiplicity are decreased, while the incidence of malignancy raised. The optimum levels of the tissue dosage and the time of maximum tumor appearance were determined for each type of radiation.


[Peptic ulcer in the anamnesis of stomach cancer patients]. To recognize the causes of late diagnosis of gastric cancer in patients suffering ulcerous disease, in the oncological examination unit of Orekhovo-Zuevo, Moscow Province there was conducted a retrospective examination (for the period of 1970--1975) of the anamnesis of 35 gastric cancer patients (5.5%). As a rule, there were three periods in patients' address to medical specialist, namely: 1) seeking medical advice for chronic gastric affection; 2) a "calm" period; 3) a new character of gastric complaints with the ultimate diagnosis of gastric cancer. The late diagnosis of cancer of the stomach was due to number of errors on the part of general practitioners: undue cessation of dispensary supervision in a "calm" period of ulcerous disease, their being unable to recognize a new character of complaints after the remission, errors on the part of roentgenologists.


[Staging of primary cancer of the stomach stump]. Cancer of gastric stump arising after gastric resection, performed for ulcerous disease, did not differ biologically from cancer of non-operated stomach, therefore it may be classified by the same principles as common gastric cancer. An analysis of 67 cases of primary cancer of the remaining gastric portion, the study of the tumor localization and spread indicated the possibility to classify the cancer according to the 4--stage system and TNN system.


[Characteristics of the course of peritonitis in oncological patients]. Among 16 patients admitted into the Volynsk oncological dispensary with far-advanced tumors of the stomach and colon, the tumor perforation was recognized prior to surgery only in a half of the cases. Despite marked local proliferation and distant metastases there may be a pronounced pain syndrome. The absence of parallelism between the moment of intestinal content getting into the abdominal cavity and the protective reaction of the anterior abdominal wall musculature was characteristic of these patients. While the symptoms of peritoneal irritation in perforated gastric cancer can be recognized within the period up to 2 hours, the perforation of rectal cancer is frequently not accompanied with peritoneal signs. Among gastric cancer patients the perforation was diagnosed within 6 hours in six cases. The time of recognition of perforated cancer of the transverse colon and rectum was 15--16 hours.


Studies on splenic megakaryocytes. I. Recovery of megakaryocytes from the splenic venous outflow. Spleens from 14 healthy adult cats were isolated and perfused with cell-free Ringer's solution. Histological studies on the splenic megakaryocytes, as well as a search for splenic megakaryocytes in samples of the splenic venous outflow, were performed. The samples of the splenic venous outflow contained a lower cellular concentration when perfusion was prolonged, but the number of megakaryocytes appearing in the venous samples increased. At least five different forms of megakaryocytes were observed from smears of the venous outflow: (i) unipolar, (ii) multipolar, (iii) foamy, (iv) mobile and (v) nuclear types. These types were also found in splenic venous outflow of dogs, kittens and bled cats. It is suggested that not only platelets but also the larger megakaryocytes can pass out of the splenic circulation. This may imply that megakaryocytes can be culled, matured in the splenic red pulp, and ultimately released into peripheral blood.


Lack of linkage between hereditary angioedema and the A and B loci of the HLA system. A large 81 member, four-generation black family with hereditary angioedema is reported with regards to its clinical course and the association with the histocompatibility system. No mortality was seen related directly to the disease. Assuming that this trait is autosomal dominant it appeared to have no linkage with the histocompatibility system as noted by an estimated recombination rate in males and females of 0.5 and a maximum lod score of 0.0. Further evidence of no linkage is given by the fact that lod scores below -3.0 were observed for values of theta less than 0.5.


Radioimmunoassay for the detection of the antibody against hepatitis-B-core antigen (anti-HBc). In this paper we describe a new sensitive solid phase radioimmunoassay for the detection of anti-HBc. This test was shown to be more sensitive than the widely used immune adherence hemagglutination test (IAHA) and at least as sensitive as the radioimmunoassay using the blocking principle. The new test system appears to be very useful to screen larger groups of individuals (e.g. blood donors) for the presence of anti-HBc.


Different fates of hepatitis B virus markers during plasma fractionation: a clue to the infectivity of blood derivatives. Hepatitis B surface antigen (HBs Ag) and associated particles, e antigen (e Ag) and DNA polymerase are unevenly distributed during Cohn's cold ethanol fractionation of plasmas positive for these markers of the hepatitis B virus (HBV). Most of the e Ag, Dane particles and DNA polymerase are retained in fraction III whereas the bulk of HBs Ag is recovered in fraction IV where only 22 nm spheres and short filaments are still identified. These results suggest that differences in quantitative distribution of HB virions together with alteration of infectious particles during the fractionation process may in addition to heat inactivation account for the relative hepatitis risk of the various plasma derivatives.


Abnormal glycolipid composition of erythrocytes with a weak P antigen. The erythrocytes of a normal man were agglutinated more weakly than normal cells by several anti-P1PPK sera, and exhibited a decreased capacity to absorb these antibodies. Analysis of his erythrocyte glycosphingolipids revealed that the globoside (P antigen) content was less than 25% of normal, and trihexosyl ceramide (the PK antigen) was 30-40% of normal. The ganglioside content of his erythrocytes was approximately four times normal and sialosylparagloboside was increased about sixfold. It appears that his erythrocytes was unable to synthesize normal quantities of trihexosyl ceramide, and that these serological and chemical features constitute a new phenotype in the P blood group system.


Serological studies of the H activity of Oh red cells with various anti-H reagents. Several examples of Oh cells have been investigated with various anti-H reagents. After enzyme treatment of the cells with either papain or neuraminidase, very high titres were obtained, particularly with some preparations of Ulex europeus. Fractionation of anti-H Ulex showed that the anti-H component inhibitable by L-fucose required papain treatment of the Oh cells for optimal activity whereas the component not inhibitable by L-fucose agglutinated preferentially Oh cells treated with neuraminidase. The anti-H lectin Cytisus sessifolius which is not inhibitable by L-fucose gave no reaction with papain-treated Oh cells but reacted well when the Oh cells were treated with neuraminidase. Normal O cells were almost equally well agglutinated by the lectins when treated by either of the two enzymes. That the various lectin components activated by enzymes had H specificity was shown by the fact that their activity was inhibited by purified H substance, partially inhibited to L-fucose and 2-fucosyllactose and not at all by purified Lea substance and non-secretor salivas. In spite of the high titres obtained with Oh cells by the enzyme technique, the amount of H present on the red cells, judged by inhibition tests, in comparison with normal group O cells was very small.


Unusual inheritance in the ABO blood group system: a group O child from a group A2B mother. A serologically typical group A2B mother with no unusual anti-A or anti-B agglutinins delivered a normal group O infant with no demonstrable A or B antigens. By the age of 1 year the child had developed anti-A and anti-B agglutinins. He had H antigen and secreted H substance in his saliva. A second group O child has since been born. Although family studies were inconclusive, the most likely explanation is that the mother is a cis-AB. If this is the case, she differs from other reported cis-ABs in her apparently normal B antigen and the lack of anti-B antibodies in her serum.


[Benign intermittent intrahepatic cholestasis]. Two cases with benign intermittent intrahepatal cholestasis are described for the first time. Young males are concerned with repeated mechanical jaundice with free bile ducts at operation and roentgenologically. The prognosis of both cases was favourable. The effect of periarterial sympathectomy is discussed as well as the T-shape drainage application.


[Pathogenesis of diabetes in adulthood. II. The nature of the insulin secretory defect]. Insulin secretion was studied during three successive stimulations: with tolbutamid, with tolbutamid +0.25 g glucose/kg body weight and with tolbutamid +0.50 g glucose/kg body weight in 30 patients with diabetes mellitus at a mature age, subdivided into two groups (SUP-sensitive and SUP-resistant). The rate of insulin secretion was found, in the first 10 minutes (early insulin secretion) to depend only on tolbutamid, remaining constant with blood sugar level fluctuations from 90 to 254 mg%. Later, insulinemia was higher in the test with combined loading, being most manifested with the most massive glucose loading. Similar correlation was not observed in the group of SUP resistant patients with diabetes. The results provide grounds to conclude that in SUP-sensitive diabetes, the ability of B-cells to synthesize and secrete insulin is being preserved but the sensitivity of glucose receptor versus the signal glucose information was declined. At the same time, the signal sensitivity versus other stimulations of insulin secretion, tolbutamid in this case, was still preserved. In this way, one of the possible pathogenic mechanisms of diabetes development at a mature age is elucidated.


[Total thyroxine level in human serum].

[Total thyroxine level in human serum]. Eighteen healthy subjects and 42 patients with diseases of the thyroid gland were examined. Total thyroxin in serum was determined in all, by past StaT4 (Oxford laboratories) and according to the method of Murphy and Pattee, modified by Benotty and Peno. Thyroxin values obtained, by the two methods, were similar and correlated well with the subjects' clinical state. Certain advantages of paste StaT4 were established, making it more applicable in clinical practice as compared with the procedure of the modified method of Murphy and Pattee.


[Clinical and laboratory studies of the hemorrhagic syndrome in hypo- and aplastic anemias]. Hemorrhagic manifestations were found in 142 (66.6%) out of 213 followed up patients with hypo- and aplastic anemia. Detailed clinical-laboratory study on the hemorrhagic syndrome was conducted in 58 of them. The hemorrhagic manifestations display a considerable polymorphism, being present both at the onset of the disease and its course. Changes in the laboratory tests were also found, associated mainly with thrombocytopenia. The tests, reflecting coagulation states, were most often normal. In four of the patients, hemorrhagia was due to disseminated intravasal coagulation. No correlation was found between granulocyte number and Factor VIII level.


[Maximal forced expiration indices in young symptom-free smokers]. The indices of maximal forced expiration were investigated spirographically, with flowmeter of Wright and pneumotachorgaphically in 205 symptonless smokers and 154 healthy subjects, aged 18 to 28. In 16.7 to 26.7 per cent of the young symptomless smokers with normal forced vital capacity and forced expiratory volume per second, anomalies in some of the indices, determined pneumotachographically were found, namely MMEFR75--85, T25--75, V25, PEFR/V25.


[Climate therapy studies at Sandaski health resort of bronchial asthma patients during the cold and warm months of the year]. Two hundred patients with bronchial asthma were examined, 110 being examined during the warm and 90 during the cold months of the year. The bioclimatic constants of Sandanski resort have a favourable effect upon the clinical and functional indices. Especially manifested in the effect during the cold months of the year. The results obtained are with a high statistical significance. The very favourable effect on the bronchial asthma patients, both during the warm and cold months at Sandanski resort, makes it unique for a round-year climate treatment. The problem treats national and international interests.


[Functional changes in the respiratory system in acquired heart defects]. A total of 52 patients were examined, 8 out of them healthy and 44 patients with acquired valves defects without accompanying pulmonary and other diseases. The indices of external respiration, alveolar-arterial gradients for O2 and CO2 were followed up as well as diffusion capacity of lungs and its components, acid-alkaline balance, functional and real shunts in the pulmonary circulation, etc. The summed up results revealed that considerable disturbances in external respiration, leading mainly to a restrictive ventilatory syndrome, developed with the lesion of myocardium and valve apparatus of the heart. The values of diffusion lung capacity for CO and its components--Dm and Vc are decreased. O2 and CO2 metabolism was disturbed. The results pointed to a moderately manifested hypoxemia, marked elevation of alveolar-arterial gradients for O2 and presence of respiratory alkalosis. A considerable increase in the functional and real shunts of the lungs were established, manifestations of the disturbed pulmonary ventilation and hemodynamics in the pulmonary circulation.


[Ergometric assessment of lung-heart function in obesity in young men]. Increased quantitiy of lean body mass, obstructive ventilatory syndrome and elevated initial maximal arterial pressure were found in 47 obese as compared with 70 control males, all aged 18--24. With the progressive cycling loading on a veloergometer up to an oxygen uptake of 1.5 1/min--1, considerably higher oxygen uptake was established in the obese as comparable loading grades and in some of the cases--hypeptensive reaction was found. The physical work capacity (PWC170) is insignificantly decreased and the ventilatory parameters were unchanged as compared with the control group. With obesity among young males, the physical work capacity was concluded to be decreased and the frequency of cardiac activity, with submaximal loading, to be increased on both cases--per one unit of body weight, per one unit of lean body mass resp.


[Gastric secretion study by maximal pentagastrin stimulation in healthy persons and peptic ulcer patients]. Gastric secretion was investigated in 187 subjects under conditions of maximal stimulation with pentagastrin. Thirty subjects, out of them, were healthy, 30--with gastric ulcer, 110--with duodenal ulcer and 17--with double ulcer localization--in duodenum and stomach. The indices of gastric secretion in duodenal ulcer and ulcer disease with double localization are considerably higher than those on the healthy subjects and differ essentially. With single gastric ulcer they are significantly lower than those of the healthy controls.


[Changes in uricemia in acute myocardial infarct]. The authors studied in dynamics the concentration of uric acid in 84 patients in the acute stage of myocardial, in 28 patients with non-stable stenocardia. The average value of uricemia, in the first 1--2 days post infarction is 6.35 +/- 2.23 mg%, considerably higher than that in case of non-stable stenocardia--4.75 +/- 1.25 mg%. In all the patients with myocardial infarction, 34.04 per cent have uricemia over 6 mg% (upper limit of the norm). The hypouricemia was normalized by the 14--15 day after the onset of infarction--4.25 mg%. The highest values of uric acid (up to 13 mg%) were found in case of severely progressing infarctions. A parallelism was established between serum concentration of uric acid and the creatinine-phosphokinase level. The possible pathogenic mechanisms of hyperuricemia in the acute stage of myocardial infarction are discussed.


[Changes in the carotid sphymogram and apex cardiogram in the mesosystolic click-telesystolic apical murmur syndrome]. Synchronous records of ECG, PhCG, CSG and ACG were made of 25 patients with the syndrome of mesosystolic click-telesystolic apex murmur as well as of 62 subjects with healthy hearts. Mesosystolic retraction in CSG was found in 14 patients (57%) and incisura of the ACG systolic wave in 22 patients (88%). Similar changes were not established in the subjects with healthy hearts. The possibility of explanation of the changes found are discussed and those CSG and ACG changes are concluded to be useful as additional bloodless methods in the diagnosis of the syndrome of mesosystolic click-telesystolic apex murmur.


[Serum lipid group response after intralipid loading]. A method is presented for the determination of serum lipid groups changes in conditions of venous fatty tolerance test as well as for time defining in reaching the initial levels of serum triglycerides. A variant of the quantitative thin-layer chromatography is applied, combined with carbonization and densitometry for lipid groups determination in the serum of 40 patients, subdivided into four groups: with  chronic ischemic heart disease, with arterial hypertension, with obesity and a control ggroup. Lipid analysis was carried out by the 5th, 20th and 40th minute after the beginning of the test. After loading with Intralipid, it was established to develop quantitative changes not only in triglycerides but in the rest of the lipid groups as well. At the same time, the time for reaching the initial values of triglycerides, calculated by extrapolation, shows significant differences between the control group and those with ischemic heart disease and arterial hypertension. The investigation method adopted guarantees more thorough information about lipid changes after Intralipid infection, than the method with the determination of plasma opasity in corresponding time intervals. The criterion "time for reaching the initial values" characterized more fully the dynamic changes in triglycerides and could be used in the detection of latent anomalies in lipid metabolism.


[Distribution and characteristics of chronic constipation among a part of the population of Sofia District]. The authors studied the chronic constipation morbidity among the Sofia district population. It was established that 20.6 per cent of the efficient population is affected. The effect of numerous factors upon the defecation rhythm and constipation incidence is statistically studied. The subjective patient's assessment in the disease diagnosis is underlined. The clinical characteristic of the disease and the present state of the treatment are determined on the base of the data obtained by the inquiry carried out among 3509 inhabitants from the district. The necessity of wider health education upon the problem among the population is stressed upon.


[Malignant degeneration of a primary leiomyoma of the inferior vena cava (leiomyosarcoma) with the clinical picture of the chiari-budd syndrome (author's transl)]. Malignant degeneration of primary leiomyoma of the dorsal wall of the upper segment of the inferio vena cava (leiomyosarcoma) is reported in connection with the Chiari-Budd Syndrome. The facilities for improved ultrasonic diagnosis are pointed out and, hence, the possibility of earlier initiation of therapy.


[Statistical aynalysis of tumour cases at the University Department of Maxillo-Facial Surgery, Vienna]. 39,606 pathological reports issuing from the Department of Pathology, University of Vienna, during the years 1936, 1956 and 1976 were examined retrospectively. The Department of Maxillo-facial Surgery had referred 3.2% of the specimens. On analysis of the individual diagnoses, carcinoma was represented by 36.6% of the cases. Age, sex, distribution and tumour localization data are recorded in tabular form. In addition, data concerning in-patients treated for tumours at the Department of Maxillo-facial Surgery from 1974 to 1976 were stored in the Computer Centre of the University of Vienna. These data were subsequently analysed with regard to diagnosis, sex and average age of the patients.


[Osteopathy and serum parathormone and 25-hydroxycholecalciferol levels in patients on long-term haemodialysis (author's transl)]. Skeletal radiological changes were analyzed in 22 patients treated by chronic haemodialysis. Furthermore, the serum parathormone and 25-hydroxycholecalciferol concentrations were determined. X-ray evidence of renal osteopathy was found in 13 patients (59%). Extraskeletal calcification, subperiostal erosions and cystoids were the predominant lesions. Serum iPTH concentrations were increased in 21 out of 22 haemodialyzed patients. The serum 25-hydroxycholecalciferol concentration was normal. The results of this study seem to indicate that other factors apart from secondary hyperparathyroidism have a share in the development of renal osteopathy in patients on chronic haemodialysis.


[Influence of topical ice application on accommodation ability (the mechanism of action of cryotherapy) (author's transl)]. An investigation was carried out on 100 muscles (14 patients) and it is concluded that the ability to accommodate by nerve and muscle fibres is influenced by the topical application of ice. The factor of accommodation, the Reizungsdivisor according to Kries [6], was determiend before and after cryotherapy. This ratio, which is an index of adequate muscle-fibre innervation, was significantly depressed after the application of ice.


[Application of acerbine, a mixture of organic acids containing propylene glycol as lotion or ointment in paediatric surgery (author's transl)]. Acerbine has been available for clinical trial since three years ago. Promotion of epithelialization, as well as antiphlogistic, antibacterial and fungicidal actions have been attributed to this preparation. This paper presents a critical appraisal of our own results with Acerbine; initial scepsis was soon dispelled by the evident efficacy of this preparation, both in the form of a lotion and ointment, and its wide scope of application. Moreover, our own studies revealed an excellent effect on keloids, which became smoother and visibly paler. A very good prophylactic and curative effect was observed in respect to all types of skin transplantation. So far Acerbine has been successfully applied in 117 patients who have completed their course of treatment. Acerbine is being currently employed in the case of 16 further patients who are still in hospital. No untoward side effects were recorded. Our findings confirm the opinion of other authors that hospitalization is shortened by the use of this preparation. The availability, more recently, of the new preparation in form of an ointment enables treatment to be continued on an ambulant basis or at home in many cases. Certain new fiies. The results of further explorative investigations into these aspects are under review at present.


[Plasma 25-hydroxycholecalciferol after daily vitamin D administration in comparison with massive single-dose prophylaxis (author's transl)]. The effect of daily administration of 1200 IU vitamin D3 was compared with the response to a single oral dose of 200,000 IU in 21 young infants by determination of the plasma 25-OHCC levels. After about one week the mean value recorded in group 1 was 27 +/- 13 ng/ml; the corresponding value in group 2 was 127 +/- 78.4 ng/ml. At the second control examination about one month subsequently, the mean values were 61 +/- 26.2 ng/ml and 104 +/- 69.0 ng/ml respectively. The wide range of values found in the single-dose group clearly demonstrates the advantage of daily vitamin D administration for routine prophylaxis against rickets in infancy.


[Results of radical Wertheim's operation 1964 to 1972 (author's transl)]. In the years 1964 to 1972 239 women with cervical carcinoma were treated by extended abdominal radical (Wertheim's) operation at the II. Department of Obstetrics and Gynaecology, University of Vienna. The total number of invasive cervical carcinomas is decreasing in comparison with previous years, but the figure of 40% cases treated surgically remains stable. 69.5% of the women are alive after a 5-year observation period, the figure for stage Ib being 71.4% and for stage II 55.2%. In cases with positive lymph nodes an improved 5-year survival rate is demonstrated and the total number of patients who died of carcinoma is reduced in comparison with the respective figures for previous years.