Reye's syndrome in infancy.

Reye's syndrome in infancy. Reye's syndrome in infancy is not a well-defined entity and is infrequently diagnosed. Eight infants 6 months of age or younger had a prodromal viral illness followed by the rapid onset of lethargy, seizures, and coma, resulting in the diagnosis of Reye's syndrome. All had abnormal results of liver function tests including elevations of blood ammonia level. Three patients had pathological studies that confirmed fatty visceral infiltration. The data on these patients, as well as a review of the literature, indicate that the most prominent clinical findings in Reye's syndrome in infancy include marked respiratory abnormalities with tachypnea and apneic episodes; frequent occurrence of seizures in the early stages of the illness; and hypoglycemia in most cases. A strong socioeconomic bias was noted in these patients, with the infants coming primarily from lower socioeconomic, urban environments, while older children with Reye's syndrome have been observed to be predominantly middle-class and from suburban or rural areas.


Heart rate and respiratory rate differences between preterm and full-term infants during quiet sleep: possible implications for sudden infant death syndrome. The heart rate and respiratory rate of eight preterm (average gestational age, 33.3 +/- 2.2 weeks) and 13 full-term infants were determined during quiet sleep at home during the first year of life. Both heart rate and respiratory rate were greater in preterm infants throughout the first six months. The difference was maximum at age 10 weeks (21.2 beats per minute and 13.7 breaths per minute), with the difference being statistically significant, at least at the P less than .01 level at ages 10, 12 and 14 weeks, while P greater than or equal to .01 at all other ages. The 10- to 14-week period is precisely the same period during which the incidence of sudden infant death syndrome (SIDS) has been reported to be maximum. These results support the concept that SIDS is linked to a vulnerable phase of cardiorespiratory maturation.


Cacography in the mothers of hyperactive children with learning disorders. Mothers of 20 children with learning disorders completed questionnaires concerning the histories and current problems of their children. All the children had average or above average IQs, but below average academic achievement. Compared with a control group of 20 mothers matched for years of education, the mothers of children with learning disorders made significantly more spelling errors per 100 words. The differences in number of spelling errors between learing disorders and control groups were greater for mothers with 12 or fewer years of education than for mothers with more than 12 yr. of education.


Development of information processing in normal and disabled readers. 8- and 11-yr-old reading-disabled children were compared in two experiments with controls matched on intelligence and age. Exp. 1 measured duration of visual information store by means of a separation threshold technique. Exp. II determined the rate of transfer from visual information store to short-term memory using a backward masking technique. Results from Exp. I showed that at each age specific reading-disabled children had significantly longer durations of visual information store than controls. The difference between the reading ability groups decreased with increasing age. Exp. II demonstrated that rate of transfer of information was significantly slower for specific reading-disabled children than for controls at both age levels. In contrast to Exp. I, this difference increased with increasing age. The results are considered in terms of their possible relevance to developmental lag theories. The evidence indicates that the development of visual information processing in reading-disabled children is similar to that in controls but occurs at a slower rate.


A musical profile for sample of learning-disabled children and adolescents: a pilot study. 31 learning-disabled children and adolescents completed the Pitch, Loudness, Rhythm, Time, and Tonal Memory subtests of the Seashore Measures of Musical Talents. Results indicated that the Seashore test did not discriminate between subgroups of these learning-disabled children. However, differences were found in percentile equivalents between these learning-disabled and normal individuals. These data should be interpreted with caution due to the small size of this sample and the spread of percentiles presented by Seashore.


Influence of reflection-impulsivity and cognitive style on time estimation under different ambient conditions. 120 college students estimated seven different durations of a light by the method of reproduction. Each duration reproduction was performed while either counting fast auditory clicks, slow clicks, or with no clicks. The subjects had previously been assessed for cognitive style with the Group Embedded Figures test and for reflection-impulsively with the impulsivity scale from the Personality Research Form. Multivariate analyses of variance indicated that the rapid-tempo ambient conditions had a greater effect on estimation of duration than did either the slow tempo or control condition. There were significant differences in time estimation between reflectives and impulsives for estimations of 10, 30, and 50 sec. No interactions were observed for reflection-impulsivity by ambient conditions. Although cognitive style did not interact with ambient conditions as was predicted, it did interact with sex for three durations, 10, 20, and 30 sec. It was concluded that impulsive students tend to underestimate the brief times more than do reflective students but are not affected differently by the ambient circumstances in which the estimation is made. Cognitive style, apparently, does not have a profound influence on estimation of brief durations. However, sex and cognitive style in interaction do affect these estimations, this requires further research.


Effects of arousal level on olfactory sensitivity. 36 college students participated in a study designed to determine the effect of induced changes in arousal on olfactory sensitivity. Each subject's sensitivity was measured under conditions of low, moderate, and high arousal. The results showed that sensitivity was significantly decreased under both low and high arousal but not under moderate arousal. No difference between the conditions of low and high arousal was found. The results are discussed in terms of the inverted-U shaped function between arousal and performance.


Intercorrelations among tests of general mental ability and achievement for black and white deaf children. The purpose of this study was to compare the relative effectiveness of two measures commonly used to predict school achievement of black and white deaf children. The Wechsler Intelligence Scale for Children-Revised and the Hiskey-Nebraska Test of Learning Aptitude correlated significantly with Stanford Achievement Test scores for 23 black children but not for 36 white. Even though the groups differed significantly in WISC-R Performance IQ, Hiskey learning quotient, and in CA, they did not differ in achievement level. While the WISC-R and Hiskey appear to have some predictive validity for the black sample, the findings of no differences in achievement suggest little practical validity of these measures for grouping or placement or for making administrative or instructional decisions.


Relationship between cardiorespiratory fitness and physiological responses to films. Subject's physiological responses and rated reactions to a medical film and an erotic film were assessed. Later cardiovascular fitness levels were determined by subject's physiological responses to an exercise task. The greater the increase in  the subject's systolic blood pressure after exercise and the slower the recovery, the lower the fitness level. A median split on the fitness scores of males and females separately was used to determine levels of relatively low and high fitness. Subjects in low fitness had significantly greater sympathetic-arousal responses to the two films as measured in systolic blood-pressure increases and skin-temperature decreases. Subjects in the two fitness levels did not differ in ratings of their own physiological or emotional responses to the films. Reported interoception of the magnitude of physiological responses was inaccurate, especially for subjects in low fitness.


Simultaneous versus successive discrimination of weights: a neuroanatomical interpretation. Using the Method of Constant Stimuli, difference limens were obtained for lifted weights of 50 to 200 gm. 184 college students were assigned to one of four experimental conditions resulting from the combination of two modes of stimulus presentation with whether the preferred or non-preferred hand was used to judge the standard weight. Simultaneous interhand judgments produced significantly larger Weber Ratios and more variable Constant Errors than were produced by Successive intrahand presentation. This was contrary to earlier work in the visual modality indicating that simultaneous stimulus presentation produced more sensitive discrimination than did successive. The results are interpreted in terms of the neural organization of tactile input.


Psychotherapists' perceptions of clients' satisfaction following termination. The present investigation sought to examine psychotherapists' perception of client's satisfaction following termination. During a 6-mo. period, 86 clients who terminated treatment at a large mental health center were asked to evaluate the service that they had received from their therapists. Therapists were also asked to predict how their clients would evaluate them. Results indicated that clients were favorably impressed with the services provided by their therapists and therapists tended to underestimate the worth of their services. Further conclusions, which at this point can only be speculative due to the limited sample, were that there were no differences in reported satisfaction of clients among psychiatrists, psychologists, psychiatric social workers and para-professional groups, but psychiatrists predicted significantly greater satisfication by satisfaction by clients than the other groups. They were the only group which predicted more satisfaction by clients then was actually reported.


An automated apparatus for the study of central variables in tactile form perception. An apparatus which employs standard behavioral programming equipment is described. It enables the experimenter to program in advance with variables as auditory and visual instructional cues, delay intervals, and response mode, and to monitor response latency automatically. The apparatus is easily constructed, easily operated, and markedly increases the control of variables in tactile form perception experiments.


Right-left orientation and writing hand in children referred for neurodevelopmental assessment. 22 boys and 10 girls with school problems were referred to a pediatrician for medical and neurodevelopmental evaluation--children ranged in ages from 5-4 to 14-7. As part of the pediatric developmental assessment a simple test was used to evaluate each child's ability to identify his own right or left eye, ear, hand and foot. Hand preference for writing was also noted. 32 control children from the same population matched for age and sex with patients were also tested. Patients over 5 yr. old were more likely to have difficulty identifying right and left body parts than control children. All controls over age 7 correctly identified their body parts. 5 patients and 5 controls showed left-hand preference for writing. It is concluded that a more sensitive test for hand preference should be utilized as part of the pediatric neuro-developmental assessment.


Locus of control and cardiac response to reaction time, mental arithmetic, and time-estimation tasks. In Exp. 1 subjects, classified on the basis of locus of control scores, performed both reaction time and mental arithmetic tasks. In Exp. 2, similarly classified subjects were required to estimate the duration of a signal with feedback following each trial. Between-groups comparisons in Exp. 1 showed no differences on heart rate or performance measures. This does not support an explanation of differential heart rates during cardiac conditioning based upon cognitive styles of "rejecting" or "accepting" stimuli. Similar comparisons in Exp. 2 indicated significant differences for heart rate and proficiency in time estimation. These differences suggest greater task involvement for internally controlled subjects on feedback tasks, with cardiac acceleration a function of that involvement.


Checklist of perceptual-motor and language skills for developmentally handicapped preschoolers. This report describes the development of a checklist of perceptual-motor and language skills which has been designed to identify specific skills and to estimate acquisition of skill in 21 developmentally delayed preschoolers. The preschoolers were administered the checklist at the beginning and end of the school year. Significant mean differences between early and late total checklist scores were obtained. The correlation between early and late total checklist scores was .97. The chief advantages of this checklist are the specificity of assessment and the ease with which it may be used by professionals and paraprofessionals.


Co-frequency ratings of anxiety reactions. The method of direct co-frequency rating was explored for the study of relationships among individuals' self-reported anxiety reactions. The subjects were 40 adolescents who gave co-frequency ratings (how often the reactions co-occurred) for all pairs of 10 preselected reactions to anxiety. The mean co-frequency matrix was subjected to multidimensional scaling and cluster analysis. The same subjects also rated the intensity of the  same reactions in an anxiety inventory of the "S-R" type. The correlations among reactions were computed and compared with corresponding co-frequency estimates. The relationship between these two types of data was relatively high. Factor analysis of the correlations gave a "Psychic" and a "Somatic" reaction factor, whereas the main dimension obtained from co-frequency ratings reflected a general reaction factor. This outcome was supported by the cluster analyses, which yielded two and one clusters, respectively, interpretable in accordance with the dimension analyses.


Stimulus self-selection and the assessment of visual preferences in four-month-old infants. A self-stimulation choice technique was used to assess visual preferences in 4-mo--ld infants for slides of stimuli-depicting smiling vs neutral facial expressions. Preferential self-selection of stimuli did not occur even in the presence of preferential looking responses by infants.


Effect of external standards on children's evaluations of their reproduction of visual forms. 96 second grade children and 144 4-yr-old nursery school children were asked to copy geometric designs. One group was given high standards for evaluating their work, one group was given low standards, and a control group was given no external standards. Differences between treatment groups were significant (p = .01); there were no sex or socioeconomic differences. Children in the low standards group rated their drawings higher, and children in the high standards group rated their drawings lower, thah children in the control group. Results suggest perceptual judgments might be used to shape visual-motor reproduction, rather than vice vera.


Secobarbital and information processing. The Sternberg fixed-set memory-search paradigm was used to assess the relative vulnerability of hypothetical stages of information processing to an oral dose of secobarbital (2.9 mg/kg). D-amphetamine (15 mg, oral dose) was intended to serve as an active placebo. However, since the amphetamine produced a slight, non-significant reduction in choice reaction time (RT), the principal analysis of secobarbital effects was conducted between drug and baseline conditions. Secobarbital showed choice RT by 60 msec. and did not increase errors significantly. The results, as interpreted within Sternberg's model, suggest that input processes, e.g., stimulus preprocessing-encoding, are particularly sensitive to the effects of the barbiturate. There was no evidence of a drug effect on cognitive processes associated with serial comparison, binary decision, or translation-response organization (response selection). In contrast, earlier studies have indicated that another CNS depressant, alcohol, interferes with both speed and accuracy of output processes, viz, the response selection stage.


Analysis of the Development Test of Visual Perception and the Motor-Free Visual Perception Test. To identify children with learning problems and to compare test results, 28 kindergarten children were tested with the Developmental Test of Visual Perception and the Motor-free Visual Perception Test. The tests identified some children already noted by the teacher to exhibit characteristics of learning difficulty, failed to confirm the teacher's judment in others, and identified some children with previously undetected difficulties. Basic differences in the two tests are reported.


Lateral response to suggestion in relation to handedness. Lateralization of response to the suggestion of a sensation was recorded in 100 psychiatric patients and related to their handedness. Responses showed no over-all preponderance to right or left side. There was, however, a significant association between side of response and handedness.


[Battery-cages as the cause of environmental and behavioural dependent diseases (author's transl)]. Bone fragility and increased fat content in the liver of egg-laying hens are more often encountered in birds from traditional battery-cage systems than in those confined in other systems. By reviewing the relevant literature possible explanations of these phenomena are proposed. Clinical and pathological manifestations of the syndromes are described and a number of possible aetiological factors are evaluated. Bone fragility can be seen either as a general weakness of bone tissue or as a clinically manifest disease, Cage layer fatigue. It is concluded, that general restriction of the animal's possibilities to locomote and perform comfort movements are the most important aetiological factors. Fatty liver disease may be seen either as a pathological elevation of the liverfat content or it may be seen as a disease called Fatty liver haemorrhagic syndrome. Several factors may cause elevation of the liver fat content. The influence of restricted movement on the animals energy balance, however, like other behavioural disturbances seems to be the most important aetiological factors. It is concluded, that bone fragility and fatty liver in egg-laying hens are diseases caused by an inadequate environment and the restriction of essential behavioural patterns.


Copper load in Mute Swans (Cygnus olor) found in Denmark. Organs from 91 Mule Swans were analyzed for copper and lead. Swans from an area known to be polluted with copper had an average copper content in their livers of nearly 1100 mg/kg or more than twice as much as swams from other parts of Denmark.


Characterization of Micrococcaceae isolated from post mortem examined pigs. The investigation comprised 170 cases of infections due to Micrococcaceae among post mortem examined pigs that died during the preweaning period. The incidence was 3.1 promille of the live-born pigs. The infection was most frequent among pigs less than 4 weeks of age (Table I). ACute and subacute generalized infections occurred in 43.5% of the cases (Table II), and exudative epidermitis was the cause of death in 23.5%. In the remaining 32.9% of the cases, the post mortem findings included a variety of debilitating conditions, such as undersize, malformation, starvation or traumata. In all 248 strains of Micrococcaceae were isolated. A preliminary differentiation revealed 41.5% of the strains as Staphylococcus aureus and 34.5% as S. epidermidis and 22.6% as Micrococcus (Table III). A further characterization on 43 of the strains was performed (Table IV and V). Totally 19 different fermentation pattern were observed. In Table IV the strains are grouped into six groups. Fourteen strains were identified as S. aureus and 15 strains as S. epidermidis biotype 2, s. S. hyicus (Table VI). The distribution of the non-haemolytic strains according to biotypes is shown (Table VII). By this grouping, the 15 S. hyicus strains were designated type III B. It is concluded that various staphylococci may be isolated in pure culture from different pathological lesions in preweaned pigs. Biochemical characterization of the strains showed that part of the strains could not be classified by the previously described grouping systems.


[Classical special investigations in hospital neurology. Evaluation of their diagnostic contribution (author's transl)]. A quantitative analysis of the diagnostic contribution of the classical special investigation normally used in hospital neurology. Six examinations were studied: laboratory blood investigations, electroencephalogramm, lumbar puncture, optic fundus, standard skull X-ray, standard spine X-ray. The analysis involved 548 patients in whom 2219 examinations were performed with a yield of 26 "corrected" diagnosis (a diagnosis in which there was a clinical error corrected in the light of the results of these examinations).


[Echotomographic aspects of cervical incompetence during pregnancy]. During pregnancy, the opening of the cervix can be measured by perineal echotomography. Among 200 per-gravidic clinical echotomographies, 23 cervical incompetences were recognized. A "funnel-shaped" cervix is a cervix with an internal os larger than the external os; thus no clinical sign may be apparent and only a supra-vaginal Shirodkar's operation should be done.


[The regional exploration of pulmonary function using xenon 133. Value of the gamma camera connected to a computer (author's transl)]. Regional isotopic exploration of ventilation and pulmonary perfusion is not yet widely applied in clinical practice, by virtue of the complexity of the equipment required, but also because of the complicated and lengthy analysis of the results. In this respect, connection of the scintillation camera to a computer represents a major advance which other authors have already emphasized. Our own experience in this area and our method of exploration are described. The results of regional exploration in a group of 43 cases of chronic obstructive lung disease (33 patients of the chronic bronchitis type, 10 patients with emphysema) are analysed and discussed. The results indicate the following : in chronic bronchitis, a very marked fall in ventilation of the bases with inversion of the normal vertical ventilation gradient, and a fall in the ventilation/perfusion ratio of the bases; in emphysema, a fall in ventilation, but also and above all in regional perfusion of all territories with preservation of normal or even increased regional ventilation/perfusion ratios. Regional exploration may also be of value in the detection of early stages of obstructive lung disease, and in pre-operative assessment in thoracic surgery.


[Renal dlabetes and chemical diabetes. Course in young subjects with normal weight (author's transl)]. Ninety-two young patients of normal weight with glycosuria were classified according to the results of glucose tolerance tests into renal diabetes (32 cases) and chemical diabetes (53 cases). After 5 years or more 17 of the patients with renal diabetes were located. In only one case had the development of chemical diabetes led to correction of the initial diagnosis to that of potential diabetes with a reduced renal glucose threshold. Family histories of diabetes were identical in both groups (renal and chemical diabetes) (35 %) and did not provide any means for distinguishing renal diabetes from diabetes mellitus with a reduced renal glucose threshold. Amongst the 34 subjects with chemical diabetes who were located, 3 had become frank diabetics (9 %). Chemical diabetes persisted in 14 patients (42 %) and 17 (50 %) could be considered to be normal. In addition to the three subjects with frank diabetes, only 9 patients (5 with chemical diabetes and 4 normal) continued to take oral therapy at the time of the final examination. However, 13 of these patients who were not taking any treatment had abandoned it relatively recently. Even if the effectiveness of oral therapy is not fully clear, it should be remembered that continued treatment renders the patient less neglectful as far as diet is concerned. Tests for microangiopathy in the three diabetic patients were negative.


[Isolated and involvement in Crohn's disease (author's transl)]. Anorectal lesions in Crohn's disease are usually associated with colonic involvement. Under other circumstances, they reflect an additional localisation of the disease, being indicative of its progression. However, they may remain strictly isolated and pose a diagnostic problem. The authors report here a case of anoperineal lesions which remained isolated after a  5 year course of the disease and which led to the need for anoperineal excision.


[Malignant non-secreting cortico-adrenalomas. Four cases (author's transl)]. In three of these four cases of malignant tumour of the adrenal cortex, a prolonged fever and a major inflammatory syndrome were the presenting features. The precise diagnosis was made before surgery only once. In two cases, it was a surgical discovery (one patient operated upon with a false diagnosis and another with no precise diagnosis). In the last case, the malignant tumour of the cortex was discovered at autopsy. The chief characteristics of these tumours are reviewed: rare ; presenting with chest pain, a mass in the hypochondrium, metastases, or general symptoms, possibly high and prolonged fever. The prognosis is gloomy, the majority  of patients dying the six months which follow the operation.


[Paronychia, the general practitioner, the surgeon and antibiotics (author's transl)]. Antibiotic therapy for paronychia has seen its day. It is indicated only rarely and justified only when on the day following infection or during the next few days there are signs of regional or systemic spread. The surgical treatment of infections of the hand is not difficult but should be known, if not learned. A paronychia which has been opened but not cured should be reoperated upon rapidly. An "old" paronychia is a major catastrophe: small fistula, great damage. No surgical quarter for evil organisms!


[The repair of large abdominal dehiscences by anchored mersilene plates (author's transl)]. We propose a new technique for repair of abdominal ventral eventration, using a large mersilene mesh prothesis which is sutured to the anterior pelvic ridge below (Cooper's ligament and the dorsal aspect of the conjoint tendon) and to the intra-abdominal aspect of the ventral abdominal wall above, by means of three sub-costal attachments which have been compared to boat shrouds. This prostetic sheet therefore runs through two distinct anatomical spaces and is fixed to the abdominal wall all along its periphery.


The weight of human lungs as a diagnostic criterium (distinction of normal lungs from shock lungs by histologic, morphometric and biochemical investigations). Lung weight, extravascular water content, hemoglobin content as an index of blood congestion, and DNA content as an index of cellular content, were determined for 57 patients dying from multiple, extrathoracic trauma. This report, which confirms previous publications, concerns itself in particular with the problems of determination of the "normal" lung weight. Studies of the influence of survival time on the lung showed that lung weight may significantly increase to twice its value after very short times up to one hour after trauma as a result of blood congestion, and following longer survival may be elevated several times as a result of developing interstitial edema. Early appearing interstitial edema is morphometrically detectable already 10 minutes after the beginning of shock. Normal weights were obtained from 10 cases after immediate death following severe cranial trauma or decapitation by being run over. Our results show that normal lungs have an average weight of 234 g (s +/- 39). Literature values for "normal" lung weight are approximately twice as high.


The pulmonary air-blood barrier of human shock lungs (a clinical, ultrastructural and morphometric study). Interstitial edema in the alveolar septa is the first morphologically recognisable change to be observed in cases of shock. It is brought about by the altered function of the membranes of the damaged epithelium and endothelium in the alveolar wall. At the same time there is an impairment of gaseous exchange, which is rendered more difficult by the exudative process in the interstitium. Pari passu with these events there is injury to the cells of both the alveolar epithelium and the alveolar capillary endothelium. Both these processes are still reversible. The point of irreversibility appears to be reached--so far as time is concerned--at the end of the first week, after which the injurious effects on the cell are established, since the thin alveolar wall necessary for the exchange of gases becomes overgrown with bulky alveocytes (Tpye II), and the fibroblasts in thealveolar interstitium push the capillaries away from the surface of the alveolus. In most of the advanced cases of shock this process of thickening of the alveolar wall exceeds the critical value, and respiratory exchange is so impaired that satisfactory functioning of the lungs is no longer possible.


Is shock-induced lung fibrosis reversible? A report on recovery from "shock-lung". As the consequence of a road accident a 19-year-old man developed respiratory insufficiency. Radiology and gas analysis revealed signs of "shock-lung". Morphometric analysis of a punch biopsy from the lung confirmed the diagnosis. Gas exchange grew worse in spite of conventional treatment. At the end of the third week after the trauma the maintenance of a highly negative fluid balance and the administration of high doses of corticoids were given a trial. The patient recovered. Although no functional pulmonary deficiencies remained, years later the patient still shows radiological evidence of extensive scarring. The lung parenchyma is intact, as judged by morphometric examination. This case shows that patients with "shock lung" can recover, but scars in the extrapulmonary space can remain, even though the lung parenchyma returns to normal.


Cytophotometric DNA-measurements in abortion. Triploid abortuses ascertained by cytogenetic analysis histologically show molar degeneration of the placental villi. Changes of this type which are occasionally encountered in routine material may suggest chromosome abnormality although chromosome analysis is precluded due to fixation. However, suspected triploidy can be proven in Feulgen-stained sections by DNA-measurements. In nine cases of molar degeneration selected according to histological criteria, evaluation of nuclear DNA-content revealed only two triploid placentae. It seems acceptable to assume that such molar changes in diploid abortuses may be due to prolonged retention of the placenta. Thus, histological criteria may suggest but cannot establish the diagnosis of triploidy. In case of susepcted triploidy of the feto-placental tissue, DNA-measurements can confirm or exclude the diagnosis even if a cytogenetical analysis is not applicable.


The diagnosis of endometrial carcinoma by means of jet wash and DNA flow-through cytophotometry. Flow-through cytophotometric determination of nuclear DNA content on jet wash material from the endometrium was employed in the diagnosis of endometrial carcinoma. One hundred and thirty cases were studied. In comparison to results from cytodiagnosis, flow-through photometry yielded a false negative rate of 31.6% and a false positive rate of 42.2%. The false negative findings resulted in part from the small relative frequency of atypical cells in a mixed population of normal and atypical cells in certain cases. Besides this, we often found carcinomas with a diploid DNA stem line, which could not be distinguished cytophotometrically from normal corpus endometrium (Sandritter, 1952; Atkin et al., 1959; Hustin, 1976). The flow-through photometrically false positive findings may have resulted either from cell aggregates or from a nuclear DNA content elevated over the diploid value in proliferating cells (D. Wagner et al., 1968; D. Wagner and Richard, 1968). The observed false negative and false positive rates demonstrate that flow-through photometric determination of nuclear DNA content is unsuitable for the diagnosis of endometrial carcinoma.


A stereological study of adrenocortical cells in spontaneously hypertensive rats (shr). The ultrastructure of SHR (Spontaneously Hypertensive Rats) fasciculata cells was compared descriptively and quantitatively with that of nonstimulated fasciculata cells of Wistar rats using sterological methods. The volume and surface densities are expressed per cm3 of cytoplasm. The smooth endoplasmic reticulum in the SHR was significantly increased compared to the control animals (surface density : 28%, volume density: 35%). Mitochondria volume remained unchanged although the inner mitochondrial membranes were significantly reduced (37%). An attempt was made to draw up a relation between sterological and biochemical data of steroid synthesis within the fasciculata cell. A genetically determined enzymatic defect in the early steps of the transformation of cholesterol to pregnenolone may exist at the level of the inner mitochondrial membrane. Whether this altered steroid metabolism is important to the etiology of hypertension in the SHR requires further investigation.


[Dressings made of multilayer unwoven fabric]. The multilayer unwoven fabric dressings have been examined both in laboratory and clinic. The properties of metalized and ordinary dressings have been compared. In clinical examinations the usefulness of metalized materials was proved to burns and granulating wounds. Also the advantages of unwoven fabric materials over the classic dressings have been ascertained.


[Testing of plastics for orthopedic equipment]. The testing of plastics in medicine is regulated by law only for the purpose of implantation. These rules are not including the plastics for skin contact use. In consequence of the increasing offer of the chemical industry, it is necessary to develop specific procedures of testing for these materials, e.g. for the orthopedic engineering.


[Use and examination of unwoven fabrics in the production of dressings, surgical and bed linens]. The results of physicochemical examination of 32 kinds of unwoven fabrics as well as the examination of 7 kinds of the three-level dressings, operation, and bed clothes are reported. The fabrics consisted of polypropylene and viscose fibres, dilana, argona, polyamides and bonding agents (fixatives). In their water extracts the content of the chloride, sulphate and alkaline ions, reductors, the presence of heavy metals, the surface active substances and the pH were determined. The practical applicability of the dressings was tested in 300 cases. The dressings were well tolerated by the patients. The operation and bed clothes as well as the surgical clothes made from unwoven fabric and sterilized by radiosterilization may facilitate, the great deal of work in the operation units and in surgical wards.


Study by vaginal cytology of ovarian function in pre-menopausal women. In the pre-menopausal years, the ovarian secretion waxes and wanes until its cessation. In this study of women in the pre-menopausal period neither did the menstrual pattern prove to be a reliable criterion by which to judge the extent of oestrogen effect or deficiency nor was there correlation between serial colpocytology and endometrial histology, Hyperplasia of the endometrium was seen with different degrees of oestrogen status and in the menopause. Maximum cases of hyperplasia were seen in the irregularly menstruating group of women. It is therefore emphasized that before beginning oestrogen therapy, both colpocytology and endometrial histology should concur to establish oestrogen deficiency. A close watch should be kept on cases showing an endometrial hyperplasia.


An investigation of the immune response of patients suffering from anorexia nervosa. Patients suffering from anorexia nervosa rarely appear to develop the common cold or influenza. This study examines the immunological response of fifteen female anorexia nervosa patients of both the vomiting and carbohydrate-abstaining type and compares them with a control population matched for age and occupation. Both anorectics and control populations received the admune influenza vaccine. Initially both groups had similar haemagglutination inhibition titres against the three different viral antigens: A/HK; A/PC; A/Eng. However, the anorectics showed over a 2-month period a higher titre of antibody especially to the Hong Kong virus: this was sigignificant. Cellular immune responses were measured using a tuberculin and a macrophage inhibition test, no significant difference between the two groups was obderved. These results which support the clinical findings are discussed.


The spectrum of paracetamol (acetaminophen) overdose: clinical and epidemiological studies. In a regional survey of paracetamol overdose, 201 patients were admitted to hospital over 12 months. Chronic alcoholism was present in 10% of cases. Over 25% of patients were females aged 20 years or less. Initial blood paracetamol levels were in the toxic range in 16% and histologically severe liver damage eventually found in 20% of those biopsied. This finding corresponded to a serum aspartate aminotransferase of 600 i.u./l or more. Renal failure severe enough to require peritoneal dialysis developed in 1%. Elevated serum amylase was recorded in 22% of a 108-patient subset. Evidence of myocardial damage was found  in 11.6% of an eighty-six patient subset. An unfavourable prognosis was indicated by a prothrombin ratio of 20% or less and hepatic coma, the overall mortality being 3.5%. The apparent safety of this useful analgesic is compromized by its widespread employment in parasuicide. This, the insidious and delayed onset of toxicity in overdose and ineffectiveness of late treatment argues for controlling availability to the general public.


The effects of potassium supplements, spironolactone of amiloride on the potassium status of patients with heart failure. Extra potassium supplements, spironolactone or amiloride were given for 5 months to forty-nine patients with heart failure who were taking furosemide and were in a steady state. Plasma potassium increased with all three treatments but there was no significant increase in total body potassium or red cell potassium. These findings together with other studies suggest that patients with heart failure taking diuretics do not have a significant depletion of body potassium.


Ileo-caecal tuberculosis in immigrants.

Ileo-caecal tuberculosis in immigrants. Four cases of ileo-caecal tuberculosis in Asian immigrants were seen in a 6-month period at The London Hospital. Although rare in Caucasians, this condition is an important cause of gastrointestinal symptoms in this ethnic group. Definitive diagnosis can frequently be made only by histological examination and culture of biopsy material obtained at laparotomy. However, in suitable cases, where there is a high index of clinical suspicion, a trial of chemotherapy may be preferable to operation. If laparotomy is performed, resection with subsequent chemotherapy is the treatment of choice.


Staphylococcal aortic valve endocarditis with aortic root to right atrial fistula. Infective endocarditis can be complicated by the development of intra-cardiac shunts. A case of endocarditis secondary to staphylococcal septicaemia is reported where various conduction defects preceded the development of a fistula from the aortic root to the right atrium. Before emergency surgery there was marked worsening of heart failure with the appearance of a new loud murmur throughout diastole.


Intravascular haemolysis and acute renal failure following potassium dichromate poisoning. An 18-year-old girl developed acute renal failure 24 hr after ingestion of potassium dichromate. Laboratory data revealed associated intravascular haemolysis. Renal histology showed features suggestive of acute tubular necrosis. She went into diuretic phase after 11 days of oliguria and subsequently regained normal renal function. Both direct toxic damage by dichromate and intravascular haemolysis may have contributed to the development of acute tubular necrosis and acute renal failure.


Granulomatous sarcoid nephropathy.

Granulomatous sarcoid nephropathy. When sarcoidosis of the renal parenchyma occurs it is rarely of major clinical significance. The clinical features and post-mortem findings of a case of subacute uraemic syndrome due to severe granulomatous involvement of the kidney by sarcoidosis are described. The case is unusual in that granulomatous sarcoid nephropathy resulted in death from renal failure within 4 months of onset of symptoms in the absence of clinically apparent sarcoidosis.


Pancreatitis and duodenal obstruction due to periampullary carcinoma associated with familial polyposis coli. Duodenal lesions are being reported in cases with familial polyposis of the colon. A case is described presenting with duodenal obstruction and pancreatitis complicating a peri-ampullary carcinoma in a patient with familial polyposis (adenomatosis of the colon and rectum). Upper gastrointestinal lesions notably in the duodenum include duodenal polyps and carcinoma and peri-ampullary malignancy. It is suggested that endoscopy and hypotonic duodenography be considered in patients with adenomatosis of the colon and rectum presenting with non-colonic alimentary symptoms.


Unexplained absence of an ovary and uterine tube. A case is reported of an incidental laparotomy finding of absence of left ovary and ipsilateral distal Fallopian tube. This is the fourth case to be reported in the English language literature. The three previous cases are reviewed and the probable aetiology discussed.


An unusual presentation and complication of acute appendicitis. A case history is presented to illustrate an uncommon complication of acute appendicitis which itself was overshadowed by an acute arterial embolus.


Inappropriate secretion of antidiuretic hormone associated with cerebellar and cerebral atrophy. The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is described in a 67-year-old man with cerebellar and cerebral atrophy. This is the first reported case of this association.


[Pulmonary silicosis (not including asbestosis and berylliosis]. The pleuro-pulmonary pathology of asbestos, top most of silicates, is today well known. Other silicates, talcum powder, clays, micas essentially, are exploited and commercialized. Their pathology is less well known and often contradictory because of the heterogeneity of the inhaled minerals. All can contain large quantities of quartz and some varieties of talcum and a considerable proportion of asbestos fibres. These minerals can provoke severe pneumoconioses, silicoses and asbestoses respectively. Some relatively pure products do not contain these contaminants. In case of intense and prolonged dust inhaling, they can produced an impressive pneumoconiosis with relatively mild clinical signs as shown by the series of 27 cases of pneumoconiosis from the french talcum powder as reported by the authors. The chemical nature and electronic structure of different silicates are very similar. It raises the question of the noxious effect of asbestos and the relative innocuousness of other minerals of the same family, and wether the fibrous structure alone is implicated.


[Two surveys on farmer's lung disease and bird breeder's disease in the Pyrenees region]. Two different surveys, one strictly epidemiological in rural areas, the other retrospective and within hospitals, led to a better knowledge of the setting of the FLD and BBD in South Pyrenees region. In the country, more than 12% of patients had specific precipitins, 6% had either one or both diseases; women had anti-aviary precipitins more frequently than men. The retrospective hospital survey yielded 456 cases of patients admitted or consulting revealing numerous correlations between the different clinical, radiological and functional syndromes on the one hand and the serological positivity on the other. Serological diagnosis was most useful, as a wide variety of antigenic extracts was used (actinomycetes thermophiles, mouldy hay, bird droppings), mixed sensitizing was extremely frequent. The widely found positivity towards avian antigens seems specific to the South Pyrenees region.


[Farmer's lung disease in the Aveyron department (a retrospective study of 82 cases)]. The authors present a retrospective study of 82 cases of farmer's lung disease in the Aveyron department. Observations were selected on precise diagnostic criteria classified on acute (8 cases), progressive (69 cases) and chronic alveolitis (5 cases). They observe an almost exclusive repartition in the bovine breeding areas, which are regions of large hay culture and of high humidity. They show the annual repartition of cases is strongly linked to the pluviometry of the previous hay-making. They underline the fact that the modernising of agricultural work reduces some factors favourable to the disease but can promote new ones.


[Respiratory and hemodynamic functional tests in funnel chest]. Fifty three patients with Pectus excavatum, 12.5 years of age on average, were studied. They frequently had respiratory history (in 36% of cases): asthma, repetitive bronchites or rhinopharyngites, and associated squeletal deformities (17%) : kyphoscoliosis, lordo-kyphosis and scoliosis. As far as ventilation is concerned, the restrictive syndrome was found in 49% of cases, severely in 23% (20% decrease in C. V.) An obstructive syndrome was found only in cases of associated asthma. Bodypletysmography done parallely in 5 cases puts in evidence or increases the ventilatory abnormalities. In the cardio-vascular check up, the chest X ray, E.C.G., the pulmonary scintigraphy or straight microcatheterization, usually reveal some abnormality (15% of cases). The synthesis of results points out two facts : 1) when the heart is in its position and the cardiomediastinal shadow enlarges, the E.C.G. abnormalities are unimportant; when the heart is displaced towards the left, the electrical disorders are bigger ; 2) microcatheterization done on 22 subjects revealed a gradient of systolic pressure, right ventricle-pulmonary artery, definite or severe in 4 cases, lesser in 9. Surgery rarely improves the spirometry and E.C.G. abnormalities, but does seem to cure the hemodynamic disorders.


[Funnel chest. Generalities, Surgical treament]. The Pectus excavatum (P.E.) or funnel shaped thorax is a relatively frequent malformation of the chest wall. After a survey of references, the authors recall the main elements of an affection with functional results sometimes important. The results of surgical treatment are analized in relation with the kind of intervention and the age of the patients. Modelling sternochondroplasty with temporary retrosternal support for the deep funnels, the subcutaneous filling of the deformity in slight P.E. should at present be recommended. Definitive results can only be appreciated after 3 to 5 years.


[Surgical treatment of funnel chest].

[Surgical treatment of funnel chest]. The main problems of indication, operating techniques and results are recalled after 39 cases of pectus excavatum (P.E.) operated on 74 followed up children. Analysis revealed frequent family trend, respiratory past records of Marfan's morphological type and intrathoracic spur. Sternochondroplasty had varied stabilizing ways : first Garnier's technique, then Judet's costal clips, today the mediastinal rod of Morel. The relative deterioration of morphological results depended on the reliability of the manner of fixing. For good results, neither age, sex, nor the importance of the retraction interfered. The unfavourable elements are the gently sloping thorax and associated vertebral manifestation.


Acute renal failure.

Acute renal failure. Acute renal failure even today carries a high mortality, which is related directly to the aetiology of the condition and the age of the patient. Modern radiological techniques have added considerably to the early diagnosis of obstructive factors and acute tubular necrosis. Early treatment and correction of prerenal factors can frequently forestall the development of established acute renal failure but if this is inevitable total patient care and full supportive measures including dialysis should be available.


Methyclothiazide in hypertension. A report from the General Practitioner Research Group. In view of the statistically significant falls in blood pressure achieved at the end of two weeks only, it would seem that methyclothiazide is an effective antihypertensive agent, at least in the new cases of mild hypertension treated in this trial. The results are, perhaps, particularly impressive in view of the fact that the majority of patients were treated with the smaller dose of 5mg daily. In this trial, postural hypotension was of no importance whatsoever, and the incidence of side effects was minimal. Methyclothiazide would seem to be a suitable choice for the treatment of mild hypertension in general practice.


[Diabetes mellitus and the state of ocular accommodation in schoolchildren]. The author presents characteristics of refraction in 67 children and adolescents suffering from diabetes mellitus. The state of accomodative function of the eyes was studied in 39 schoolchildren with spherical refraction. Accomodation was found to be reduced in diabetic schoolchildren, this being connected with a prolonged course of the main disease.


[Hemodynamics of the eyes in diabetes mellitus]. The authors present evidence on the state of hemodynamics of the eye in patients suffering from diabetes mellitus on the basis of rheoophthalmographic and ophthalmoscopic studies with the use of the method of fluorescent angiography of the retina. The volume circulation of the eye proved to be connected with the intraophthalmic pressure and depended on the degree of affection of the eye vessels. Its changes were two-stage in character and depended on the state of the venous outflow. Diabetic retinopathy of the II stage served as the stage during which there was a sharp reduction of compensatory possibilities of hemodynamics, and further progress of vascular disturbances were observed. Rheoophthalmography permits to assess indirectly the degree of compensation of hemodynamic disturbances and can be used to asses clinical evolution of diabetic retinopathy.


[Indicators of lipid metabolism in early stages of diabetes mellitus]. The authors studied the lipid metabolism indices (total lipids, cholesterol, triglycerides, phospholipids, serum gonadotropin) in 60 patients with a latent form of diabetes mellitus, 40 persons with doubtful results of TTH, and 120 persons with a normal TTH type. In 50 patients with latent diabetes the lipid metabolism indices were determined depending on the character of treatment--diet treatment, treatment with diet and adebit, and unlimited diet. Disturbance of lipid metabolism indices was noted already at the early stages of diabetes mellitus: there was an elevation of total lipids, triglycerides, serum gonadotropin, and cholesterol. An improvement of lipid metabolism indices occurred under the action of adebit; it produced a particularly significant effect on triglycerides.


[Early diagnosis of circulatory insufficiency in thyrotoxicosis]. On the basis of the results of examination of 256 patients with various forms of thyrotoxicosis the author distinguished criteria for early diagnosis of circulatory insufficiency of thyrotoxic origin. The following were referred to their number: a) prolongation of the ejection time with normal or decreased expulsion values; b) increase of the minute heart volume chiefly or exclusively on account of increased frequency of cardiac contractions; c) disproportion between the indices of heart work and the rate of cardiac contraction; d) the presence of hypodynamic reaction to the altering volume load in cardiac fibrillation. Comparison of the mentioned indices with those of clinical symptoms permitted to begin cardiac glycoside therapy in time and to differentiate the therapeutic tactics.


[Use of the clomiphene test for evaluation of the functional state of the hypothalamus-pituitary gland-ovarian system in ovarian hyperandrogenia]. The authors studied the content of gonadotropins and testosterone in the blood; functional condition of the hypothalamus-hypophysis-ovarian system was characterized in patients with ovarian hyperandrogenia by using the klomiphen test. Testosterone level in all the patients and prolactin level in 70% of the patients proved to exceed the normal values, wheras the LH level could be low, normal or high. With klomiphen test it was shown that both the gonadotropin and estrogen levels rose against the background of action of the preparation; as to testosterone level--it remained unchanged. In induced menstrual cycles estradiol peak preceded the gonadotropin peak. In patients with ovulation testosterone level diminished by the end of the observation period.


[Functional state of the pituitary gland-ovarian system in gonadal agenesis and dysgenesis]. Functional condition of the hypophysis-gonad system with the determination of the LH and FSH level in the course of one month, of estrogens and testosterones in the blood, of estrogens in the urine, sex chromatine, kariotype, roentgenomorphology and histology of the gonads, as well as the changes in gonadotropines against the background of estrogen treatment were studied in 30 patients (in 18 with Shereshevsky-Turner's syndrome, and in 12 with pure gonad agenesis). There were differences in the state of gonadotropic activity in patients of these groups, rather similar by condition and time of the gonad affection. In Shereshevsky-Turner's syndrome gonadotropic activity was characterized by a sharp elevation of the LH and FSH level with frequent chaotic desynchronized fluctuations; in pure gonad agenesis the FSH level was elevated and subject to chaotic fluctuations; as to LH level--it was stable and within the normal limits. Shereshevsky-Turner's syndrome with pure agenesis displayed a retention of the feedback in the hypophysis-gonad system, this being indicated by reduction of the LH level against the background of estrogen therapy. The FSH content was a more informative index for the diagnosis of the gonad agenesis than the LH content. There was revealed no correlation between the kariotypes and the gonadotropin level in the patients. Estrogen therapy in the gonad agenesis and dysgenesis is required not only for feminization of the patients, but also for suppression of increased hypothalamic activity characteristic of these cases.


[Problem of autonomy of adrenal cortex adenomas of different histological structures in Cushing's syndrome]. The authors analyzed the results of examination of 69 patients operated on for Itsenko-Cushing's syndrome (ICS); in 32 cases tumours of the adrenal cortex were revealed during the operation. Two histological forms of adenoma of the adrenal cortex were distinguished, i.e. adenomas of mono- and polymorphous structure. Increased background urinary excretion of 17-oxycorticosteroids (17-OCS) in patients with ICS suffering from tumours of polymorphous structure persisted at the former level or increased in the tests with 8 mg of dexamethazone (DMZ). The character of tests with 8 mg of DMZ in patients with ICS having adenomas of monomorphous structure was analogous to such in patients with ICS, but without any adrenal gland tumours--urinary 17-OCS excretion was either decreased or suppressed by 50 or more per cent of the initial level. A suggestion is put forward on functional dependence of the adrenal cortex of monomorphous structure on the hypothalamo-hypophysial control.


[Analysis of the function of the spinal cord monosynaptic apparatus in rats with manifest alloxan diabetes]. The intensity of the monosynaptic spinal cord reflex was studied in rats with prolonged severe diabetes mellitus and with that of moderate severity, of short duration. Methods of H-reflex and M-response of the motor nerves and muscles were used. The number of motor neurons taking part in the reflex proved to be less in diabetic animals; rhythmic H-reflex was depressed. These disturbances were primarily connected with the functional changes of the primary afferent terminals of the segmental spinal cord level. In animals with moderately severe diabetes the operative mediator fraction was readily exhausted and the mediator emission decreased. Besides, animals with a severe form of alloxan diabetes displayed postsynaptic disturbances. A positive correlation between the extent of the H-reflex depression and the severity (duration) of alloxan diabetes was demonstrated.


[Study of the insulin-receptor interaction on the plasma membranes of rat liver]. The radioreceptor method was applied to the study of specific insulin binding on the plasma membranes of the rat liver. Highly purified plasma membranes were obtained and conditions of their incubation with insulin were worked out for this purpose. Two types of insulin receptors were revealed: the first one with Cass=3.8( +/- 0.4)x10(11)M-1 and binding capacity=0.7( +/- 0.1) pM/mg; the second one--with less relationship of Cass=8( +/- 1)x10(10)M-1 and binding capacity=5( +/- 0.7) pM/mg.


[Effect of thyroid hormones and iodine ions on the amino acid incorporation into proteins of liver mitochondria]. The thyroxin-like effect of I2 and ICl on the 3H-glycine and and 14C-leucine incorporation into proteins of mitochondria isolated from the liver of thyroidectomized animals was demonstrated. Triiodthyronine and iodine-containing substances increased in vitro incorporation of labeled amino acids into proteins of isolated mitochondria. The stimulating effect of T3 and ICl was eliminated by olivomycine and chloramphenicol. The action of ICl in these reactions had a much shorter latent period in comparison with the T3 action. The effect of IC1 was expressed as soon as the 30th minute after the injection. The results obtained confirmed the supposition that under definite conditions iodine ions could imitate the effect of the thyroid hormones on the protein synthesis in the cell of animals; the problem of a possibility of thyroid hormones to realize its biological effect at the moelcular level with the aid of iodine ions is thus put forward.


[Effect of thyroxine and thyroidectomy on the activity of adenylate deaminase in the tissues of guinea pigs]. The authors studied the influence of thyroxin and thyroidectomy on adenylate deaminase activity in the liver, the myocardium, the brain and the skeletal muscles of guinea pigs. Thyroxin used in normal animals (200 microgram/100 g of body weight for 7 days) failed to alter the enzymatic activity in the tissues under study, whereas in thyroidectomized guinea pigs (50 microgram/100 g of body weight at the same interval)--it enhanced this activity. Thyroidectomy diminished the adenylate deaminase activity in the skeletal muscles and considerably increased it in the myocardium and in the brain.


[Mechanism of oliguria in experimental hypoparathyroidism]. Diuresis was found to diminish considerably in dogs with removed (by enucleation or burning out) parathyroid glands chiefly on account of intensified tubular reabsorption. In the mechanism of oliguria in hypoparathyroidism a definite role is played by hypocalciemia. An acute reduction of blood calcium in intact dogs also suppressed diuresis. Dogs with hypoparathyroidism displayed a marked elevation of blood plasma antidiuretic activity and a high level of reabsorption of osmotically free water. Intravenous injection of adrenoblocker dihydroergotamine eliminated the suppression of diuresis in the parathyroprived dogs. Apparently, a definite role in the origin of oliguria belonged to substances of adrenergic nature.


[Morphofunctional characteristics of the thyroid gland after correction of iodine and bromine deficiency]. Experiments were conducted on rats; morphofunctional changes of the thyroid gland in correction of iodine and bromine deficiency, depending on the regimen of the microelements administration in the course of a one-week cycle were studied. Daily administration of a one-week dose of iodine and bromine proved to be most effective in respect to the normalization of the morphofunctional condition of the thyroid gland in animals given iodine-deficient diet. The lowest thyroid gland weight, intensification of the synthetic processes in the thyrocytes, complete utilization of the thyroid gland iodine, and enrichment of the organism with trace elements were noted. Recommendations are given concerning the expediency of the change of regimen of iodine and bromine administration in group antigoiter prophylaxis.


[Function of the neuromotor apparatus in diabetes mellitus]. Peculiarities of the reflex and motor responses (H-and M-responses) of the soleus muscle in stimulation of the tibial nerve were studied in 69 patients with diabetes mellitus and in 44 healthy persons. The ratio of the maximal amplitudes of the H/M potentials studied usually decreased in patients with diabetic polyneuropathy in comparison with analogous indices in healthy persons. However, in the presence of labile or ketoacidotic forms of diabetes H/M increased considerably. Accelerated restoration of the H-reflex amplitude in coupled stimulations of the nerve in such patients indicated intensification of the facilitating cerebrospinal influences. A marked increase of the tendon and H-reflexes amplitude in patients with diabetes against the background of Jendrassik's method pointed to a possible deafferentation of the spinal centres. The results obtained indicated that, irrespective of the manifestations of the neuropathy symptoms, there were functional disturbances of both the segmental and suprasegmental formations controlling the motor function.


[Effect of steroids with anti-androgenic properties on the androgenic and myotrophic activity of testosterone and its various derivatives]. Experiments were conducted on castrated male rats. The effect of antiandrogen 17,17-dimethyl-18-norandrostadien-4,13-one-3 on the androgenic and myotrophic activity of testosterone and of some of its modified analogues, preparations with anabolic action, was studied. The intensity of the antihormonal effects depended not only on the antiandrogen dose used, but also on the dose of the agonist preparation. The author suggests a modification of the method used to assess the biological action of antiandrogens, consisting in a single administration of the "anabolic" preparation with a prolonged action and a 7-day administration of antiandrogen to castrated animals.


[Effectiveness of nerobol and enteral oxygen therapy in experimental liver dystrophy]. Experiments were conducted on 115 female albino rats; a study was made of the efficacy of nerobol and enteral oxygen therapy in acute dystrophy of the liver on the 7th and 14th days after the beginning of carbon tetrachloride administration. The use of nerobol, particularly in its combination with oxygen therapy, favoured gain in weight of the animals, improved their general condition, accelerated normalization of hepatic functions. Treatment promoted more rapid and complete restoration of the intensity of bile secretion, enhanced the synthesis of free bile acids, and also their conjugation with glycine and taurine. When combined with enteral oxygen therapy the efficacy of nerobol increased considerably.


Studies on the crystalline form of phenytoin. Two crystalline forms of phenytoin were isolated and characterized by X-ray diffraction, IR spectroscopy and differential thermal analysis. The dissolution behavior of the two forms was determined in water. The crystals of needle shape (form II) were found to exhibit slower dissolution rate than the other crystal form (form I).


A voltammetric study of trimethoprim.

A voltammetric study of trimethoprim. With a dropping-mercury electrode well-developed dc. polarographic reduction waves of trimethoprim (1) were obtained with 0.1 M H2SO4, citrate buffers (pH = 3--4) and acetate buffers. The solutions contain 25% ethanol as co-solvent. The reduction process is irreversible and the limiting currents are directly proportional to the concentration of I within the range from 5.10(-5) to 10(-3)M. Coulometric measurements indicate that 4 electrons are consumed per molecule. The reduction process is initiated by the reduction of the 3, 4 double bond in the pyrimidine moiety but results in the final splithing-off of two amino groups. In acetonitrile with 0.1 M LiClO4 as supporting electrolyte, two concentration-proportional anodic oxidation waves are obtained with a rotated gold disk electrode.


Application of orthogonal functions to the determination of prednisolone and hydrocortisone in some pharmaceutical preparations. Glenn's method of orthogonal functions has been successfully applied to the direct spectrophotometric determination of the title compounds in presence of phenylephrine and/or neomycin sulphate without preliminary separation. The proposed methods when applied to the analysis of market preparations are in good agreement with those of the triphenyltetrazolium colour reaction recommended as the official method.


MAO activity in rat brain stem and cerebral cortex: effect of acute and chronic treatment with ethanol and tetrahydropapaveroline. Brain mitochondria were prepared from rat brain stem and cerebral cortex. Four substrates were used for enzyme characterization: dopamine, serotonin, noradrenaline and tryptamine. Monoamine oxidase (MAO) activities were tested on two different groups of rats treated with ethanol and tetrahydropapaveroline (THP); another group was used as control group. Data obtained show that there is almost always activation of MAO activities after acute treatment with either ethanol or THP, while after chronic treatment, the two drugs show opposite effects. In particular, the same type of MAO activity continues to be activated by ethanol, whereas it is inhibited by THP.


Action of cytidine diphosphocholine on functional and hemodynamic effects of cerebral ischemia in cats. The depression of evoked cortical potentials caused by brief periods of cerebral ischemia is attenuated by prior intracarotid injection of cytidoline (2, 4 or 8 mg/kg). Studies performed in hypercapnic cats suggest that the protection afforded by cytidoline is of metabolic rather than hemodynamic origin. The participation of the central dopaminergic structures by the drug is suggested according to the previous data.


Reversal by theophylline of some changes characteristically accompanying hypothyroidism in rats. Chronic dietary administration of theophylline (0.625, 1.25 or 2.50 g/kg food) for 7--9 weeks prevented the decrease in resting oxygen consumption, heart rate and systolic blood pressure characteristically observed in rats treated simultaneously with either of the antithyroid drugs, aminotriazole (ATZ; 0.25 g/kg food) or propylthiouracil (1.0 g/kg food). However, theophylline failed to restore both the food intake and growth rate of hypothyroid rats to that of euthyroid controls. Measurements of 131I uptake by the thyroid gland, thyroid acinar cell height and protein-bound iodine failed to reveal an effect of theophylline in either control or hypothyroid animals although theophylline increased thyroid to body weight ratio in both groups. Thus, the restoration of rate of oxygen consumption, heart rate and systolic blood pressure of hypothyroid rats to that of euthyroid controls was apparently not exerted through an increase in thyroid activity. The reduction in rate of oxygen consumption, heart rate and systolic blood pressure, generally associated with lack of thyroid hormone, appear more likely to be associated with reduced responsiveness to catecholamines in the hypothyroid rats. The results suggest that an increase in the half-life of cAMP by administration of theophylline to hypothyroid rats returned these functions to the level of euthyroid controls.


Biochemical effects of gum arabic, gum tragacanth, methylcellulose and carboxymethylcellulose-Na in rat heart and liver. Repeated oral administration of commonly used suspending media, gum arabic, gum tragacanth, methylcellulose, and carboxymethylcellulose-Na to rats caused uncoupling of oxidative phosphorylation in liver and heart mitochondria and partial inhibition of mixed function oxidases of liver endoplasmic reticulum, as measured by 2-biphenylhydroxylation and 4-biphenylhydroxylation. There were considerable differences between the compounds with regard to potency and reversibility of these effects. Only methylcellulose at a concentration of 0.5% did not alter mitochondrial function and mixed function oxidases. It is recommended as suspending medium for the use in pharmacological and toxicological experiments.


Effect of salicylic acid on articular cartilage in organ culture. An organ culture system was used to study the metabolic effects of exposure of articular cartilage to increasing concentrations of salicylic acid. It was shown that concentration of salicylate above 1 mM inhibited the incorporation of 35S-sulphate into proteoglycans and at concentrations above 2.5 mM inhibited the incorporation of 3H-proline into collagen. Long-term exposure of the cartilage to salicylic acid at concentrations above 1 mM had a toxic effect on both proteoglycan and collagen synthesis.


Anti-inflammatory and antiproteolytic properties of 2-[acyl-N-(substituted benzylidene)hydrazino]5-phenyltetrazoles. Ten 2-[acyl-N-(substituted benzylidene)hydrazino]5-phenyltetrazoles were synthesized, characterized and evaluated for anti-inflammatory and antiproteolytic activity. The protection afforded by these tetrazoles at a dose of 100 mg/kg i.p., against carrageenin-induced edema in rats, ranged from 11 to 46%. Oxyphenbutazone (40 mg/kg i.p.), and hydrocortisone (10 mg/kg i.p.), used as reference drugs, exhibited protection of 54 and 47%, respectively. The antiproteolytic activity of these tetrazoles, as reflected by their ability to inhibit trypsin-induced hydrolysis of bovine serum albumin, ranged from 17 to 57%. The antiproteolytic activity was found to be unrelated to the anti-inflammatory activity possessed by these tetrazoles.


Model of central chemical 'serotoninectomy' in mice. The influence of 5,7-dihydroxytryptamine (5,7-DHT) and 5,6-dihydroxytryptamine (5,6-DHT) on the level of noradrenaline (NA), dopamine (DA), 5-hydroxytryptamine (5-HT), and 5-hydroxyindoleacetic acid (5-HIAA) in discrete brain areas of mice was studied. Moreover, the level of free and total acetylcholine (Ach) in the whole brain was measured. The behaviour of animals was also observed. 5,7-DHT caused a relatively specific short-term decrease of 5-HT and 5-HIAA level in discrete areas of mice brain with the decrease of DA level in the striatum. This substance seems to produce a relatively specific disruption of central 5-HT neurons in mice. 5,7-DHT is an unspecific neurotoxic drug for mouse brain. Both substances did not affect the gross behaviour of mice.


Interaction of pargyline with rat hepatic microsomes. When administered by intraperitoneal injection daily for 3, 7 or 14 days, pargyline (75 mg/kg) significantly reduced rat hepatic microsomal ethylmorphine N-demethylase activity and cytochrome P-450 content. Injection of a lower dose of pargyline (15 mg/kg) failed to alter significantly either ethylmorphine N-demethylase activity or cytochrome P-450 content. Studies performed in vitro reveal that pargyline is metabolized to at least three compounds by rat hepatic microsomes. Thin-layer chromatography and other analyses suggest that one metabolite is an N-demethylated form, norpargyline.


Initial studies on the disposition of quinolinium dibromide (NSC-176319) in mice and rats. The disposition of quinolinium dibromide (QdB), a highly active agent against murine L1210 leukemia was studied using 14C-labeled drug. Excretion of radioactivity was slow, with only 10 and 16% of the dose eliminated in the urine and 19 and 24% in the feces, 96h after intraperitoneal administration of QdB to mice and rats, respectively. Plasma levels of 14C were low and decreased with time, whereas tissue concentrations were high and remained elevated. Differences in tissue concentrations observed in the rat 96 h following intravenous and intraperitoneal dosing could be explained by QdB binding. A strong association between QdB and DNA was indicated by the effect of DNA on the absorption spectrum and Sephadex G-200 elution profile of QdB.


Cholestatic effects of cis-chlorprothixene on the perfused rat liver. The cis-isomer of chlorprothixene (CPX) inhibited the excretory function of the isolated perfused rat liver. It decreased the biliary clearance and transport maximum of sulfobromophthalein (BSP). Calculation of the BSP 'clearance constants' suggested that the primary effect of the drug was on excretion and not uptake. The ability of the drug to inhibit the excretion of indocyanine green suggested that the effects of CPX were not the result of inhibition of hepatic conjugative enzymes. Measurement of 14C-erythritol clearance indicated that the deleterious effects of CPX on bile formation were at the canalicular level and that they were mainly on the bile acid-independent fraction of bile. The data indicated that the adverse effects of CPX were at the excretory level of the hepatocyte.


Effect of delta9-tetrahydrocannabinol on the gastrointestinal tract of the rat. THC was neither ulcerogenic in 'semi-fasted' of 18-hour fasted rats following an oral dose of 100.0 mg/kg nor did it promote fecal blood loss (51Cr-labelled erythrocyte test) in the fasted rat after a dose of 200.0 mg/kg. On the contrary, 200.0 mg/kg of acetylsalicylic acid was ulcerogenic and caused fecal blood loss in the fasted rat. Neither substance caused mortalities at the doses tested.


Effects of delta9-THC on the synaptosomal uptake of 3H-tryptophan and 3H-choline. The in vitro addition of (-)-delta9-tetrahydrocannabinol (delta9-THC) resulted in a dose-responsive inhibition of the high-affinity specific synaptosomal uptake of both 3H-tryptophan and 3H-choline in mouse forebrain crude synaptosomal preparations. The approximate concentrations of delta9-THC required to cause a 50% inhibition of the uptake of 3H-tryptophan and 3H-choline were 33 and 16 muM, respectively. Kinetic analysis showed that inhibition of both compounds were consistent with a noncompetitive mechanism. The pretreatment of mice with doses of 10, 30 or 100 mg/kg delta9-THC had no effect on the subsequent in vitro synaptosomal uptake of either 3H-tryptophan or 3H-choline into forebrain synaptosomes.


Survey of physical therapy provided to infants uder three months of age. A survey of the extent and type of physical therapy provided to infants less than three months of age was carried out by means of a questionnaire sent to 208 administrators of physical therapy departments in medical school-affiliated hospitals across the United States. Of the 142 administrators who responded, 58.5 percent did not treat or evaluate infants under three months of age. Those treating infants under three months of age used a wide variety of treatments and evaluative forms. The types of treatments and evaluations used are presented.


Primitive reflex profile. A pilot study. Seven primitive reflexes used by physical and occupational therapists in evaluating children with cerebral palsy were each graded on a 0 to 4+ scale to constitute a Primitive Reflex Profile. The reflexes studied were the asymmetrical tonic neck reflex, the symmetrical tonic neck reflex, the tonic labyrinthine reflex, the positive support reflex, the derotational righting reflex, the Moro reflex, and the Galant reflex. The Primitive Reflex Profile was studied in 53 cerebral palsied patients to assess both the feasibility of its administration and its usefulness in discriminating functional levels of ambulation. The Primitive Reflex Profile was administered by at least two members of a team consisting of four pediatric developmentalists and two physical therapists. In using this instrument, the extreme functional groups were clearly defined and showed the expected overlap with the intermediate classification.


Semicircular canal stimulation in cerebral palsied children. Twelve cerebral palsied children were exposed to 16 sessions of horizontal and vertical semicircular canal stimulation over a four-week period in order to determine the effectiveness of this form of stimulation as a therapeutic procedure. A control group of 11 cerebral palsied children was included. A quantitative evaluation of a series of reflexes and of gross motor skills showed a highly significant degree of improvement following the four weeks of treatment. A qualitative evaluation of each subject corroborated these findings and suggested improvements in fine motor control and in social/emotional behavior. A possible central nervous system mechanism underlying the improvement in motor skills is discussed.


Who should make moral policy decisions in health care? Physical therapists are not always involved in the formulation of moral policy that significantly affects their professional practice as clinicians, researchers, and educators. This paper analyzes five major positions being taken regarding what the physical therapist's role ought to be, and suggests possibilities for increased involvement in the policy-making process.


Countertransference examples of the syntactic expression of warded-off contents. This is a preliminary statement of the hypothesis that syntax in speech may act as an "incidental stimulus" in the communication of mental contents which the speaker is motivated both to conceal and to express. Ten clinical examples, taken from verbatim transcripts of one psychoanalyst's interventions in a recorded case, illustrate the expression of countertransference attitudes by syntactic and other linguistic properties such as: the agentless passive, pronominal ambiguity, yes/no questions, extraposition, the pseudocleft construction, delaying tactics, the passive construction and conceptual focus, lists and logical complexity, foregrounding, syntactic and lexical ambiguity, subordinate clauses and syntactic opacity.


A critical consideration of Bowlby's ethological theory of anxiety. Freud acknowledged how difficult it is to understand why some people are able to utilize anxiety effectively for the purposes of their lives, whereas others suffer psychopathology on account of it. Bowlby has recently advanced the hypothesis that the cause of the difference is to be found in the relation of children to their mothers and their substitutes. It is upon this relationship that individuals depend for the homeostatic regulation of their reactions of anxiety. This paper is a critical evaluation of Bowlby's theory of anxiety.


Sex differences in psychoneuroendocrine reactions to examination stress. Sex differences in adaptation and coping were studied by comparing neuroendocrine and psychological functions in male and female high-school students during 2--3 hr of routine school work (control condition) and a 6-hr matriculation examination (stress condition). In the control condition sex differences were slight and nonsignificant. During examination stress, the urinary excretion of cortisol, adrenaline, noradrenaline, and 3-methoxy-4-hydroxy-phenylethylene glycol (MOPEG or MHPG) increased in both sexes, but to a consistently greater extent in the male group, significantly so for adrenaline and MOPEG. Both sexes performed equally well in the examination, but self-reports showed that feelings of success and confidence were common among males, whereas feelings of discomfort and failure dominated in the female group. High discomfort correlated with poor performance in the males but with good performance in the females.


Evidence for physiological response stereotypy in migraine headache. Several biological theories of psychosomatic disorders predict that susceptible individuals will have stereotypic physiological responses to stress. This hypothesis was tested in a sample of 13 migraine headache subjects by observing their head and hand temperature, frontal electromyography (EMG), heart rate, skin conductance level, and finger pulse amplitude under the conditions of rest, orienting to a tone, time estimation, reaction time, and mental arithmetic. Thirteen nonheadache cohorts served as a control group. For the migraine group, analyses of variance revealed significantly warmer head and hand temperatures and lower frontal EMG. Range-corrected data, which allow comparisons among the physiological measures, showed the migraine group to have a more stereotypic response pattern across tasks. Discriminant analyses, using both untransformed and range-corrected data made excellent post-dictions of group membership.


Facial electromyography in the assessment of improvement in depression. Depressed patients who showed decreases in resting corrugator muscle tension levels, as measured electromyographically, also showed improvement in clinical symptoms, as assessed by the Hamilton Psychiatric Rating Scale over a 2-week period. Patients showing good clinical improvement after 2 weeks had resting pretreatment corrugator levels higher than those showing little clinical improvement, suggesting that corrugator activity might also serve as a forecaster of subsequent change. These findings support Darwin's 1872 hypothesis concerning the role of the "grief" muscle in depression. Furthermore, psychophysiological recording of patterns of facial muscle activity may have value in the clinical assessment of depression and treatment effects.


Effects of news events on response to a breast cancer screening program. An opportunity to examine the effects of significant, widely reported events on participation in a breast cancer screening program was presented when countrywide public attention was called to breast cancer by reports of the breast surgery of the wives of President and Vice President of United States. These events occurred in September and October 1974 while a breast cancer screening program was underway in the health Insurance Plan of Greater New York. The research design of this program permitted measurements to be made of the participation of the plan's members in the screening before, during, and after these famous mastectomies and of the participants' characteristics during different periods of the research program. In late 1974, when there was great mass media emphasis on breast cancer, participation rates in the breast cancer screening program increased significantly. In the study periods immediately following, however, participation rates declined to previous levels. The increase in Participation rates in late 1974 was fairly uniform among all demographic groups, whether classified by age, education, income, race, or religion. In addition to increases in the participation rate associated with the events of late 1974, there was also an increased tendency among women who were screened to respond readily to mailed invitations to appear for screenings. This increase insensitivity to efforts to win their participation was more pronounced among those groups that this study and other studies have shown are more likely to participate in preventive health programs and to respond more readily to request to participate.


Monitoring digoxin therapy. The use of plasma digoxin concentration measurements in the diagnosis of digoxin toxicity. The usefulness of measuring plasma digoxin concentrations in the diagnosis of digoxin toxicity has been assessed in 83 in-patients. The mean plasma digoxin concentration in clinically toxic patients was significantly higher than the mean concentration in non-toxic patients. The overlap between the groups, however, was extensive and could partly be accounted for by hypokalaemia in those toxic patients whose plasma digoxin concentration was less than 3 ng/ml. There was, in addition, a higher incidence of hyperkalaemia, without obvious cause, in toxic patients than in non-toxic patients. Consideration of the incidence of various non-cardiac factors, specifically plasma potassium concentration greater than 5.0 mmol/l, plasma creatinine concentration greater than 150 mumol/l, daily maintenance dose greater than 6 microgram/kg, and age greater than 60 years, led to the development of guidelines to aid in the diagnosis of digoxin toxicity. Patients with plasma digoxin concentration greater than 3 ng/ml or with hypokalaemia should be considered probably toxic and those with plasma digoxin concentration greater than or equal to 3 ng/ml in the absence of hypokalaemia should only be considered toxic if they have at least two of the non-cardiac factors outlined above. Plasma digoxin concentrations could not be predicted with more than 31 per cent certainty by considering the magnitude of those non-cardiac factors.


Detection, significance and treatment of paraprotein in patients presenting with 'idiopathic' proteinuria without myeloma. This paper describes the detection of a paraprotein in blood or urine in 12 of 260 patients with 'idiopathic' proteinuria, most of whom presented with the nephrotic syndrome. None had myeloma at presentation and only two have developed it. Initial clinical and biochemical findings did not suggest paraprotein-associated disease, total serum globulins and individual immunoglobulin levels usually being in the normal range. In seven of the 12 cases the paraprotein was detected only after repeated analysis of serum and urine specimens over months or years. Renal histopathology varied from case to case and is described in detail; amyloid deposition did not occur in patients who excreted kappa chain Bence Jones protein and was extensive in only three. One of these eventually developed myeloma. Patients were aged 27--69 years at onset and were observed without specific therapy for up to 56 months. Glomerular filtration rate tended to decline and proteinuria persisted. All patients have now been treated by a chemotherapeutic regimen consisting of 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU), cyclophosphamide, melphalan, and prednisolone, in repeated short courses. In some patients, particularly those who had kappa Bence Jones protein, there was striking improvement. Overall survival is good, eight patients being alive 17--90 months after the onset of symptoms. The importance of repeated search for paraprotein in apparently idiopathic renal disease in adults is emphasized.


The definition and classification of stroke. A new approach. Accuracy of diagnosis, both anatomical and pathological, and disability scoring would add to the quality of certification data, and would help in comparing reports on strokes as well as with data regarding referral history and therapeutic trials. Considerable information could be made available by the use of new types of certification. The problems of existing definition and classification are discussed and a new classification for stroke is described.


Death after legally induced abortion. A comprehensive approach for determination of abortion-related deaths based on record linkage. The sources for determination of abortion-related deaths in Georgia are the cause of death listed on the death certificate and reports from informal reporting channels. Although Georgia residents 10-44 years of age obtained 19,877 induced abortions in 1975, no deaths related to abortion were found through these two usual sources. To determine the sensitivity of this system, all abortion certificates for 1975 were compared with all death certificates of Georgia females aged 10-44 who died in 1975 and the first 2 months of 1976. Based on the age and racial distribution of the women who received abortions, approximately 13 deaths (from all causes) would be expected to have subsequently occurred during the period of time studied. The authors found only 10. From national death-to-case rates for legal abortion, the expected number actually atrributable to abortion was 0.78 death. Of the 10 deaths, 2 were potentially related to the previous abortion, but a causal relationship to the preceding abortion was not clearly evident for any of the 10 deaths. The data, therefore, tend to support the assertion that no large numbers of deaths related to abortion are undiscovered and that current measurements of abortion mortality are accurate.


Opinions of rural physicians about their practices, community medical needs, and rural medical care. In a study in the State of Washington during 1971-73, 41 general practitioners in rural areas were asked their opinions about (a) their present practices, (b) the medical care needs of their communities, and (c) rural medical care in general. The most frequently mentioned enjoyable aspects of their practices were the variety and challange of medical problems confronted, the favorable working conditions of the practices, and the types of communities in which the practices were located. The most frequently mentioned sources of frustration to the physicians were the "excess work, responsibility, demands and expectations by patients and community." The physicians were more reluctant to criticize the care received by the residents of their communities than they were to criticize the care that patients received in other rural areas. Suggestions made by the physicians for improving medical care in rural Washington focused on ways to increase the number of resources used to produce medical care, rather than on structural changes in the way medical care is organized, delivered, and financed.


The ageing gut: a study of intestinal absorption in relation to nutrition in the elderly. This study was designed to assess the functional efficiency of the ageing small intestine and the possible role of malabsorption in old people with nutritional deficiencies. Fifty subjects aged 65 to 92 years were studied, of whom 33 presented with anaemia, chronic diarrhoea or bone pains, and 17 were apparently healthy 'controls' with no relevant symptoms. Tests of intestinal function included blood xylose and iron absorption curves, a double isotope Schilling test, faecal fat, urinary indican and small bowel radiology, with duodenal aspiration and jejunal biopsy in some cases. On the basis either of steatorrhoea or at least two other abnormal parameters of absorption, there were 15 cases of malabsorption. Thirteen of these had symptoms but two were 'controls'. Four of these had duodenal diverticulosis, two had the post-gastrectomy syndrome, and one had calcific pancreatitis. Malabsorption in the remaining eight cases was not fully explained. The age range of this last group was 72--86 years; one of them had a contaminated small bowel and two showed some evidence of pancreatic insufficiency. Malabsorption emerged as a significant cause of low levels of serum iron, haemoglobin and calcium. The blood xylose test is a useful screening procedure for intestinal malabsorption in old age, but full evaluation calls for investigation of pancreatic function.


Health problems in a city-county workhouse. This study was part of a continuing effort to define the health profile of a city-county workhouse inmate population. To supplement data previously obtained on the health status of inmates on admission, all subsequent encounters for medical problems were recorded and analyzed. Of 491 inmates examined on admission, 312 subsequently made 1,257 visit for medical care. The rate of clinic use was two to three times higher than rates reported in national surveys. Of 1,549 problem encounters, trauma, musculoskeletal complaints, skin disorders, and diseases of the eyes, ears, nose, and throat accounted for 52.3 percent. Dental  disease, trauma, and other musculoskeletal disorders comprised 66.3 percent of problems that required referral of patients to the city-county hospital. A significant relationship was seen between depression as determined by a self-rating questionnaire and numbers of visits and problem encounters, as well as several frequently encountered problems. The results of this study have implications for health services in correctional institutions with similar inmate populations. The provision of limited but onsite dental services is advisable. Athletic activities and work details should be closely supervised. Physicians and nurses should be skilled in the evaluation and management of minor trauma and other musculoskeletal disorders. Algorithms are appropriate aids in the management of common but minor medical problems. These measures and proposals are designed also to deal with the problem of overuse of clinic services. However, the measures do not diminish and, in some instances, they increase access to care for medical and dental health needs.


Analytical subcellular fractionation of neutrophils from patients with chronic granulomatous disease. Demonstration of the enzyme defect in four cases. Analytical subcellular fractionation studies were performed on neutrophils from five patients, including two females, with chronic granulomatous disease. The density distribution and marker enzyme activities of the principal subcellular organelles in unstimulated cells were similar to those in unstimulated neutrophils from control subjects. NADH dependent reduction of nitroblue tetrazolium was measured in four of the patients including one female. In homogenates of whole cells the specific activity of this enzyme expressed as milliUnits/mg protein was lower in the patients than in the controls, but the difference was not statistically significant. There was however a highly significant difference between the specific activities of this enzyme in the plasma membrane fractions isolated from neutrophils of the four patients and the three controls. These findings suggest that the primary microbicidal oxidase of neutrophils, defective function of which manifests as the syndrome of chronic granulomatous disease, is a plasma membrane NADH oxidoreductase.


Dermatitis herpetiformis--a skin manifestation of a generalized disturbance in immunity. Detailed investigations on 42 patients with dermatitis herpetiformis (DH) are presented, emphasis being placed on the presence of other disorders having a prominent immunopathogenic basis. These patients and 42 age and sex matched controls were submitted to an extensive clinical and investigative search for the presence of disorders with an immunological basis including the atopic disorders. The findings provided further evidence supporting the association of dermatitis herpetiformis with thyroid disease and pernicious anaemia. A statistically increased incidence of Raynaud's phenomenon and atopy was found in the patients with dermatitis herpetiformis compared to the control group. In addition, of the patients with dermatitis herpetiformis, two had rheumatoid arthritis, two had ulcerative colitis, one had systemic lupus erythematosus and four had splenomegaly. The possible basis for these associations is discussed and it is suggested that dermatitis herpetiformis may be part of a wider spectrum of disease. Genetic linkage and the formation of immune complexes following exposure to a dietary antigen may both be responsible for the disorders associated with DH.


Apert's syndrome.

Apert's syndrome. This paper describes two cases of acrocephalosyndactylia (Apert's syndrome). Both very clearly showed the characteristic malformations. In addition, both patients showed synostosis between the calcaneus and the cuboid bone; this synostosis is not a typical feature of Apert's syndrome, but has been described in the literature once before.


Selective arterial embolization in renal tumors. Selective arterial embolization with Gelfoam was performed in 45 cases of hypernephroma. In 33 cases this technique has been utilized as preoperative procedure and almost always (97%) nephrectomy was facilitated: 97% of the cases had slight or moderate operative bleeding; in 82% of the cases separation of the tumor-containing kidney from adjacent tissues was easy. Embolization has been employed in 12 inoperable patients and was effective mainly in management of bleeding. Angiographic controls after embolization (from 13 to 162 days) were performed 8 times and it was assessed that the efficacy of the procedure on primary tumor growth is limited in time by renal artery revascularization. The embolized patients never presented severe complications, except several episodes of transitory renal failure.


Intubation macrodacryocystography.

Intubation macrodacryocystography. Macrodacryocystography, when combined with bilateral canaliculus intubation gives simultaneous distension of the duct system and better contrast filling. As a result there is improved radiographic visualization of the exact site of pathology, particularly an obstruction. This important information makes it easier to chose the correct surgical technique to relieve epiphora. In addition, other pathology such as diverticula and fistula may be visualized. Subtraction may be a useful adjunct to the method. After a description of the normal anatomy of the lacrimal system, the technique is explained and the results of 52 examinations given.


Bronchial vascularization in patients with bronchiectasis. An analysis of the angiographic patterns of bronchial vascularization in 22 patients with bronchiectasis is presented. The studies disclosed three types of angiographic patterns: (1) bronchial hypervascularization alone; (2) bronchial hypervascularization associated with bronchopulmonary anastomoses, and (3) bronchial hypervascularization with plexiform enlargement of bronchial arteries, vascular collections or angiomatous structures. These types of angiographic pattern show a good correlation with the clinical features and supplment the global assessment of the extent and character of bronchiectasis. Selective bronchial arteriography is useful in patients with bronchiectasis where surgical treatment has been planned, especially if the disease is associated with hemoptysis.