Biochemistry of drugs. XXIV. Substances with antineoplastic effect. LXII. Pharmacokinetics of gamma,gamma-bis-4-ethylphenyl-alpha,beta-dibromoisocrotonic acid-3H (Edikron-3H) in experimental animals. After oral administration of Edikron-3H to mice with mammary gland adenocarcinoma HK, within 24 h after ingestion almost 50% of administered radioactivity was excreted (16% in urine, 33% in faeces), and within 4 day it was almost 80% (27% in urine, 50% in faeces). Like in mice, also in dogs the faecal excretion preponderated. In mice, the levels in most tissues and blood culminated at hour 6 after administration of the substance. Relatively high levels were found in the liver, the levels in other tissues and blood being substantially lower in comparison. The levels in the tumor were initially low, later on they rose, and culminated at hour 24. Besides, it was found that the transfer of radioactivity by milk into the sucklings' bodies was relatively low, and radioactivity penetration into fetuses was negligible. In urine, unchanged parent substance was present in very slight amounts only.


Biochemistry of drugs. XXV. Substances with antineoplastic effect. LXIII. Pharmacokinetics of delta-/2-amino-6-hydroxy-3,4-dihydro-4-oxo-5--pyrimidinyl/valeric acid-14C (Damvar-14C) in experimental animals. In experiments on H mice and Wistar rats it was found that radioactivity was excreted after subcutaneous injection of Damvar-14C preponderantly in urine, and after oral administration, in faeces. After subcutaneous injection the urinary excretion set on very fast. After subcutaneous injection of Damvar-14C to H mice with Crocker's ascitic sarcoma S 180, peak radioactivity values were found in the majority of organs, blood, and ascitic fluid at hour 1 after injection; in the kidneys the peak value appeared as late as at hour 6. The renal levels were conspicuously higher than the other ones. Relatively high radioactivity levels were found in the ascitic fluid, skin, and blood. After oral administration the radioactivity levels in all organs, blood, and ascitic fluid culminated at hour 3 after ingestion. The highest levels after oral administration were likewise found in the kidneys and ascitic fluid. With the exception of the kidneys, blood, and skin, the peak values of specific radioactivity in organs were equally high or even higher after oral than after subcutaneous administration of the labeled substance. Furthermore, it was found that after administration of Damvar-14C to rat mothers the transfer of radioactivity into the milk and then into the sucklings was very slight, and so was the penetration of radioactivity into fetuses.


Some cytostatic and pharmacological properties of 2,3-dihydro-1,3-6H-oxazine-2,6-dione ("3-oxauracil"). Cytostatic effects and some pharmacological properties of a new metabolic inhibitor "3-oxauracil" were studied. The cancerostatic effect was examined on 7 experimental tumors in mice and on two types of tumors in rats. After the i. p. application of 20 mg/kg, there was both a statistically significant decrease of tumor weight and increase of animals' survival time in NK lymphoma of mice. Significant changes in one of both parameters followed occured in all experimental tumors after the i. p. application but only in the Krebs ascitic carcinoma after the oral application of "3-oxauracil". The acute toxicity of the substance in water was 322 mg/kg i. p. and 850 mg/kg p. o. The ethanol solutions were more toxic. The distribution of the 3H- and 14C-labeled substance was followed up in blood, urine, liver, brain and kidney. After the p. o. application, the radioactivity peak was reached after 2 hr in blood and high radioactivity levels were found in kidney followed by brain and liver. 96 hr after the drug was applicated perorally, only 60% of radioactivity was found in urine.


The significance of some modifying factors during transplacental blastomogenesis by ethylnitrosourea in rabbits. The development of the transplacental blastomogenesis induced by ethylnitrosourea (ENU) was studied in rabbits under the influence of modifying factors (organospecific immunity, chronic irradiation of the peripheral nerve, injection of methylnitrosourea -- MNU). Statistical analysis of the results showed that the postnatal immunization by the antigen prepared from homologous tissue of the peripheral nerve or its chronic irritation always stimulates the frequency of the tumors development. The injection of MNU inhibits the tumorigenesis in the tested animals. According to the data different modifying factors distinctly act upon the transplacental blastomogenesis in rabbits.


Further studies on liver glyoxalase I and glyoxalase II. Activity in mice bearing sarcoma 180 and L1210 leukemia. Determinations were made of glyoxalase I and glyoxalase II acitivity in the liver of mice (BDF1 and DBA2 strains) bearing sarcoma 180 and L1210 leukemia in ascites form. A progressive decrease in the both glyoxalase I and glyoxalase II activities to about 40--60% of that of the control groups was observed within the developing period 8--9 days. Test results are interpreted in the light of the postulated role of this enzyme system in cell division and in the tumor development process.


Activity of N-acetyltransferase in patients with malignant lymphomas. Activity levels of N-acetyltransferase and acetylation types in patients with malignant lymphomas, following sulfadimidine loading, were established. The ratio of "fast" and "slow" acetylators among patients with malignant lymphomas is shown to be similar to that in control group. The rate of acetylation in "slow"-acetylating patients, however, was higher than in healthy controls. A relationship of N-acetyltransferase activity, tumor progression and, to a considerable extent, effectiveness of therapy was shown.


Anti-LH and FSH activity of melatonin-free pineal extract. The influence of melatonin (MEL)-free pineal extract on luteinizing hormone (LH) and follicle stimulating hormone (FSH) was studied comparatively with that of MEL. Administration of pineal extract to rats, 3 days running, was found to induce a statistically significant decrease of serum LH and FSH. This effect was also demonstrated by the biological tests used, namely, a decrease in weight of both rat ventral prostate (anti-LH activity) and mouse uterus (anti-FSH activity). MEL administered for 3 days, in doses of 1 microgram/day in the ventral prostate weight test or of 10 microgram in the uterine weight test, failed to induce comparable effects. The identity of the pineal substances responsible for the anti-gonadotropic activity of the pineal gland is discussed.


Impairments in lactation in the rat following destruction of the median raphe nucleus. Lesions of the median raphe (MR) nucleus were placed in cycling female rats and their ability to lactate was evaluated following subsequent pregnancies. Pups from MR-lesioned (MRL) animals grew more slowly and had greatly impaired survival rates compared to pups from sham-lesioned animals. Chronic treatment of MRL mothers with oxytocin (Oxy; 1 IU, s.c., once or twice/day) did not increase the growth rates of their litters. Acute responses to exogenous Oxy (1 IU, i.p.) in MRL mothers, measured by the weight gain of litters during 1/2-h suckling intervals before and after injection, were marginally significant. Milk yield during the total hour suckling period (stomach contents of pups) was clearly less in the MRL animals (p less than 0.01). Treatment with either prolactin (Prl; 250 microgram, twice/day), Prl + GTC (4 mg/kg gorwth hormore, 30 microgram/kg thyroxine, 0.5 mg/rat cortisol, once/day), or 5-HTP (75 mg 5-hydroxytryptophan/kg, twice/day) did not improve the growth rates of litters from MRL animals. However, when milk yield (stomach contents after 1 h) following a 14-h non-suckling interval was measured, lactogenic hormones (Prl or Prl + GTC) restored milk yield in MRL animals to control levels. This response was clearly not dependent upon exogenous Oxy. These results suggest that deficits in the release of lactogenic hormones are involved in the impairments in lactation following lesions of the MR nucleus.


Neurophysiological study of 47, XYY and 47, XXY psychopaths: contingent negative variation, evoked potentials and motor nerve conduction. Neurophysiological investigations-including sensory-evoked responses, contingent negative variation (CNV), and nerve conduction velocities-were done in 11 male polygonosomic patients and in comparison with a control group. Some significant data are reported pointing out differences which may be related to a hypovigil type (47, XYY) and a hypervigil type (47, XXY). The importance of the CNV and conduction velocity as an index of a constitutional minimal brain dysfunction is discussed.


The role of plasma volume, plasma renin and the sympathetic nervous system in the posture-induced decline in renal lithium clearance in man. Excretion of lithium in urine was studied in 2 healthy males while recumbent and while upright, either walking or standing quietly. An oral dose of 24.3 mmol of Lit was taken as three lithium carbonate tablets 13 h before clearance tests. Renal lithium clearance decreased and lithium fractional reabsorption increased while upright. Standing immersed to the neck in water, which prevents the fall in plasma volume upon changing posture from recumbent to upright, prevented the fall in renal lithium clearance as well as the rise in lithium fractional reabsorption while upright. Oral doses of guanethidine (total dose of 200 mg) or oxprenolol (total dose of 140 mg) taken to prevent high levels of sympathetic nervous system activity and plasma renin, respectively, failed to prevent the fall in renal lithium clearance or the rise in lithium fractional reabsorption upon changing posture from recumbent to upright. The findings indicate that the fall in renal lithium clearance and the rise in lithium fractional reabsorption upon changing posture from recumbent to upright is related to the fall in plasma volume but not to high levels of sympathetic nervous system activity or plasma renin activity.


Baseline characteristics of pure depressive disease. A chart review study of 86 females with pure depressive disorder (i.e., a diagnosis of depression plus a parental history of depression) is reported. Findings regarding family history of depressive illness are described. Clinically, the group is noted to be most homogeneous, various attempts at subdivision failing.


HLA typing and affective disorders: a study in the Italian population. HLA phenotype distribution was investigated in 91 affective patients. Significant increases over those of the control population were found in HLA-A 29 and in Bw 22 frequencies, while A 10 and A 30 were decreased. No significant difference was shown between the two clinical subgroups (41 unipolar patients and 50 bipolar ones). On comparing our data with those from other authors, Bw 16 was significantly increased. However, a high degree of heterogeneity was also shown for this antigen. Of some interest is the finding that relapsed and non-relapsed patients during long-term lithium therapy display diverging HLA phenotype distributions, with B 5 increased among the non-relapsed subjects.


The Capgras phenomenon: cerebral dysfunction with psychosis. A psychotic woman with Capgras symptoms is presented in whom evidence of cerebral dysfunction is documented both by neurophysiological and neurophysiological findings. The possible etiological aspects of these symptoms are discussed. The main conclusion arrived at is that Capgras symptoms cannot be explained either on the basis of cerebral dysfunction alone or on the basis of a psychosis alone. The simultaneous presence of cerebral dysfunction and psychosis is necessary for the development of symptoms.


Fluphenazine decanoate and fluphenazine enanthate in the out-patient management of chronic schizophrenia. 39 chronic schizophrenic out-patients were given either fluphenazine decanoate or enanthate for a 1-year double-blind trial. Doses of 25 mg were given for the first 6 months and 37.5 mg for the last 6 months. For both agents the intervals between treatments lengthened significantly over the course of the trial. Fluphenazine decanoate showed a non-significant trend for a longer duration of action coupled with a significantly lower incidence of extrapyramidal side effects.


Biogenic amines in 47, XYY syndrome.

Biogenic amines in 47, XYY syndrome. 47, XYYs represent a high percentage of patients admitted in security settings for aggressiveness. By using a polygraphic technique and amine metabolite estimation in the cerebrospinal fluid (CSF), an attempt was made to evaluate the functional activity of the central aminergic system of these patients. No drastic change was observed in sleep patterns of XYYs. The estimation of CSF amine metabolites revealed a normal value for homovanillic acid, but a significant decrease of 5-hydroxyindoleacetic acid turnover.


Angiography of the spinal cord after vertebral trauma. Angiography of the spinal cord after trauma to the spine is reported in 14 new cases with neurological signs. Three types of angiographic signs are demonstrated: (1) arterial interruption of the anterior spinal artery, the ascending branch of the radiculomedullary arteries or the extravertebral arteries; (2) displacement of the anterior spinal artery without interruption; (3) hyperemia. The mechanism and significance of these signs are discussed.


Normal and non-pathological variations in the angiographic aspects of the arteries of the middle ear. After the demonstration of the basic arterial supply of the middle ear, the different types of aberrant arterial flux using tympanic anastomotic channels are presented.


Plexiform neurofibroma (Rankenneurofibrom) of the cauda equina. The clinical and neuroradiological findings in a rare case of plexiform neurofibroma with bone scintigraphy, myelography and selective spinal angiography are described. The difficulties with the preoperative differential diagnosis from other intraspinal space occupying lesions are discussed and the importance of intraoperative biopsy and electrical stimulation is stressed.


Angiographic changes in a case of herpes simplex encephalitis. A case of herpes encephalitis predominating in the right temporal lobe with unusual angiographic changes is reported. Carotid angiography revealed a right temporal mass with vascular blush and early venous filling through irregular veins. Early venous filling and vascular blush have been known for a long time with cerebral inflammatory disease, but venous drainage through irregular veins is unusual.


[Major complications of median sternotomy]. After examining the modalities of sternal perfusion and the techniques of median sternotomy, with special regard to closure techniques, personal experience of 1000 sternotomies is reviewed. Complications may be major or minor, incidence was 1,8% and total mortality two cases. After reviewing the various causes of sternal dehiscence, reported and personal experience of the various techniques for preventing and treating the complication is discussed.


[Role of surgical deobstruction in massive pulmonary emboli. Review of 12 operated cases]. A brief survey is made of a personal series of 12 embolectomies performed under varying clinical conditions for the management of massive pulmonary embolism. Four satisfactory results were achieved. This operation is carried out under CEC and is a sound procedure. Stress is laid on its fundamental importance in the treatment of cases of this kind. Its early choice should be made in the light of the clinical picture.


[The lower esophageal sphincter in gastrectomized patients. Manometric study]. New manometric techniques in for examining the lower oesophageal sphincter (LOS) were applied an investigation of the oesophago-gastric junction after partial gastric resection. Pressure and blood gastrin data are reported for eight cases examined before and after surgery, under basal conditions and after stimulation with a protein meal. It was found that gastric resection leads to a decrease in LOS performance (43.6% fall in maximum pressure) and length (-33.3%). There is also a 93.5% decrease in the pressure response to a protein meal, and hence a predisposition to gastroesophageal reflux.


[Association of gastric cancer and hepatitis. A theory to be verified]. The protective implications of transfusion hepatitis with respect to cancer are examined. It was observed that three patients suffering from advanced stomach cancer (IIIrd and IVth stage TNM), submitted to palliative surgery, contracted a probably transfusional hepatitis in the postoperative period and thereafter showed remission of the basic disease. Mechanisms of aspecific immunitary activation and/or a direct cytotoxic action on the part of the virus are postulated.


[Celioclysis in the treatment of purulent peritonitis]. The advantages and contraindications associated with peritoneal drainage are discussed. Reference is made to the advantages of drainage combined with continuous coelioclysis in accordance with a personal method, using doxicycline diluted in saline passed into the peritoneal cavity via a small catheter. A personal series of 79 cases treated in this way to back up surgical management is presented. There was only one death due to septic shock.


[Peripheral arterial embolism. Considerations on 101 cases (121 emboli)]. The treatment of 101 patients with peripheral arterial embolism between 1970 and 1976 is discussed. Embolectomy was performed 98 times in 78 cases, antigoagulant and fibrinolytic management was employed in 19 cases, and primary amputation was necessary in the remaining four subjects. The limb was saved in 70% of those operated, while secondary amputation proved necessary in 14%. Overall mortality (after embolectomy and amputation) was 22%. Lastly, the therapeutic protocol used is discussed, together with the various factors that still prejudice the results of embolectomy.


[Achalasia caused by infiltrating carcinoma of the esophagus. Clinical case and physiopathological considerations]. A case of symptomatic esophageal achalasia due to a slowly growing neoplastic infiltration of the esophageal wall by a mammary indifferentiated carcinoma operated ten years before is presented. At admission, the clinical history and the endoscopic appearance of the esophageal lumen and mucosa led to the diagnosis of idiopathic achalasia, while the esophageal manometry showed a rather long high pressure zone (6--8 cm), which did not relax with deglutition. Barium study confirmed the length of the achalasic tract. Only thoracotomy permitted a correct diagnosis. On the basis of this case achalasia is thus considered as a syndrome which can be either idiopathic or secondary to Trypanosoma cruzi, high troncular vagotomy, benign or malignant tumor infiltrating the esophageal wall. The difficult diagnosis of some cases from the clinical point of view is underlined. Stress is laid on the necessity that all findings (history, radiology, endoscopy, manometry) be carefully evaluated to reach a preoperative diagnosis.


[Struma ovarii].

[Struma ovarii]. A case of struma ovarii in which the correct diagnosis was only suspected at the time of surgery is reported. A 131I scintiscan offers the only preoperative means of ensuring diagnosis. Indeed the condition itself is rare and its clinical signs resemble those of a small ovarian cyst, so that preoperative diagnosis may well be mistaken. Hyperthyroidism accompanied by a normally functioning cervical thyroid offers the sole reason for suspecting an adnexal mass or a struma ovarii.


[Surgical treatment of carcinoma of the pancreas]. Personal experience acquired in the use of radical and palliative techniques in the treatment of 18 cases of carcinoma of the pancreas and 1 of carcinoma of the ampulla hepatopancreatica is reported. The results show that duodenocephalo-pancreasectomy is a sound procedure, particularly in the absence of lymph node invasion. Operative mortality is low if the surgeon is experienced. In the even of serious and prolonged cholostasis, the operation can be preceded by a biliary shunt. According to the Authors there are not yet valid reasons as to the survival to prefer total pancreasectomy instead the partial pancreasectomy because of the high mortality of the former. Early diagnosis and the recognition of precancerous conditions still represent determining factors as far as operability and hence survival are concerned. The efficacy of chemotherapy is uncertain at present.


[Cancer of the gastric stump after duodeno-gastric resection]. Carcinoma of the gastric stump in patients who have undergone resection for duodenal and gastric ulcer represents a rare event which poses considerable diagnostic and therapeutic problems. 7 personal cases are examined, particular attention being paid to the utility of endoscopy, together with sampling for cytological and histological examinations, by comparison with radiology. Endoscopy in the present cases have confirmed the high positivity obtainable with transendoscopic cytological sampling using the brushing technique. The technique should therefore become routine in the study of patients undergoing gastric resection.


[Cytological studies in diagnosis of cancer of the esophagus]. The importance of exfoliative cytology in the diagnosis of cancer of the oesophagus is stressed. The examination uses a straightforward, economical technique and, in association with traditional investigations, offers diagnostic positivity of close to 100%. The interest in exfoliative oesophageal cytology does not derive solely from its confirmation of clinically certain oesophageal cancer, but from the fact that it offers early diagnosis outside of dysphagic symptomatology. Its field of use is thus extended and it proves to be a complementary but indubitably useful technique for diseases of the oesophago-gastric tract, particularly in those presenting high cancerization risk. Its use is therefore recommended for the screening of oesophageal cancer.


[Non-secreting malignant tumors of the adrenal cortex. Description of a case]. Non-secreting carcinoma of the suprarenal cortex is a rare from of neoplasia. A personal case, characterized by its large dimension (24 cm longitudinal diameter) is reported. Stress is laid on the need for early diagnosis although this is possible only in a limited number of patients owing to the disease's course. Only patients owing to the disease's course. Only early diagnosis, however, can enable the tumour to be removed before metastasis sets in. The malignity of these types is also pointed out, few patients surviving for longer than 5 years.


[Experimental model of vascular microanastomosis applicable in neurosurgery]. A model for vascular microanastomosis is presented. Attention is drawn to problems involved in the technique for such operations and it is shown that results can be greatly improved by using a microscope. Six-month angiographic follow-up results in a personal series are illustrated and some clinical indications for this form of surgery are explained.


[Oxygenating intra-alveolar lavage (OAL) with the use of some new fluorinated compounds]. Certain fluorinated carbonate compounds can carry O2 and CO2 in a physiological manner. This faculty was exploited in the elaboration of an experimental intra-alveolar oxygenating washing protocol employing such compounds as intrapulmonary oxygenating liquids conveyed by transtracheal flooding of the alveoli in 20 rabbits. AP, PaP, CVP and EP were monitored in accordance with a 35' protocol, during which the positive oxygenation and negative emptying phases of the washing process were repeated at an average 2 cycles/min. A respiratory exchange capable of keeping all the animals alive until the recommencement of spontaneous ventilation was noted, along with only slight changes in lung structure. Once an in-depth study is made of certain fundamental phenomena related to structure and lung function, it is felt that this washing method can be used clinically for the treatment of hypoxaemic situations in which normal alveocapillary exchange is impeded by extraneous material, as in desquamative interstitial pneumonia, pulmonary alveolar proteinosis, etc.


[Degranulation of the mast cells of syngeneic rats induced with sera of rats treated with grafts of methylcholanthrene-induced sarcoma]. The serum of rats immunized by MCA sarcoma graft may cause marked degranulation of the mast cells of syngeneic rats sensitized by a homogenate of cancer cells. The serum of immune rats has also caused more limited degranulation in syngeneic rats that have not been previously sensitized. This phenomenon would appear to be explained by a possible cross reaction of antibodies present in the immune sera with the normal histocompatibility antigens expressed on mast cell membranes.


[A new technic of gastric resection in the treatment of gastroduodenal ulcer. I]. After reviewing the modifications that have been made to the gastroduodenal resection technique according to Billroth II, a comparatively original solution is put forward. This involves subtotal resection of the stomach with simultaneous removal of the large omentum, followed by gastro-jejunal anstomosis "oralis inferior minima" and suspension of the afferent ansa at the oesophago-cardial angle. Original diagrams illustrate the practical impossibility of reflow into the afferent ansa, demonstrated in practice by short- and long-term postoperative radiography. The other advantages of the technique lie in the absolute lack of postcibal and nutritional syndromes, in the increase in body weight and in a number of sero-haematic parameters and, finally, in the complete recovery of the patients.


[Late complications of latero-lateral choledocho-duodenostomy. Physiopathology, diagnosis and therapy. Apropos of 6 cases]. Laterolateral choledochoduodenostomy is commonly used in the treatment of lithiasis and both benign and malignant stenosis of the main bile duct, and is regarded on all sides as safe and free from late complications. The latter, however, were noted in 6 personal cases and consisted of pain (5/6 cases), fever (4/6 cases), and dyspepsia (3/6 cases, icterus (1/6 cases). Surgery revealed recurrent or residual lithiasis (4 cases) and stenosis (4 cases). It is felt that the reflux of duodenal material into the main bile duct after creation of the anastomosis led to ascending cholangitis, stagnation and hence stenosis of the opening. Closure of the opening and extensive papilloplasty is not followed by immediate postoperative sequelae.


[Diagnosis of traumatic hernia of the right hemidiaphragm. Considerations on a case]. Rupture of the right hemidiaphragm is an unusual event and often misunderstood. Failure to diagnose this lesion in the acute stage, in addition to contributing to its high mortality, means that it frequently becomes apparent only months or even years after the event. Even at this late stage, diagnosis is not always easy, especially when the history is not correctly weighed and proper investigation is thus lacking. Pneumoperitoneum and liver scintiscanning are recommended in this respect. A recently observed case is presented as a more or less typical example of this rare disease.


[Diagnostic and therapeutic role of so-called laparosplenectomy in Hodgkin's disease]. Results obtained with laparosplenectomy in the diagnosis and treatment of Hodgkin's disease are reported. The soundness of this method is asserted with regard to establishment of the anatomopathological stage, the improved tolerance of subsequent antiblastic management and the virtual absence of post-operative complications. The long-term progression of the disease, however, cannot be examined, since reliable data are not available. It will the tasks of the haematologists to follow these patients and record the clinical events observed.


[Temporary defunctionalizing colostomy, a non-indispensable corollary in the Dixon anterior resection of the rectum for treatment of recto-sigmoid carcinoma]. The frequency and sites of carcinoma of the sigmoid colon and rectum are discussed. The complications associated with Dixon's anterior resection of the rectum are described, with particular reference to factors affecting cicatrisation of the colic anastomoses, followed by dehiscences and their degree of seriousness. A personal serier for the years 1969 to 1975 is presented and the advantages and disadvantages of derivative colostomy are explained. Comparison with similar series in which colostomy was or was not employed is used to elicit the reasons why it may be regarded as superfluous.


[Intraoperative peritoneal lavage in generalized acute peritonitis. Experience with 61 cases]. After wide preface about peritoneal anatomy, pathological, physiology and physiopatology and about the physiopatology of general acute peritonitis, a case records of 61 patients is produced. All the patients were shocked and urgently operated for general acute septic peritonitis and were abundantly washed with a polisaline solution during the operation. That washing technique is described and the authors remark its abundancy (at least 10-12 litres) and its systematicity. They also remark that the washing is the true and main moment of the reanimation and it is the most important salvage action in the general acute peritonitis. The antibiotical therapy, especially the topical one, and the drainage are only complementary elements in the treatment. Among 61 patients, with an average of 54 years, there were eight deaths (13%) in old patients, with an average of 71 years and they were all caused by cardiac and circulatory disease. No patient died for peritonitis or for toxic-infections causes. The postoperative morbility (eight patients-13%) was mainly caused by the infection of the laparotomy and it only prolonged some days the stay in hospital.


[Pseudocyst of the pancreas fistulized into the right pleural cavity]. The development of a pancreatic pseudocyst which fistulized into the right pleural cavity through a lesion in the diaphragm is described. The case is the 2nd in Italian literature and the 5th in the world. The relationships between pancreatic and thoracic pathology are examined, particularly the various ways in which pancreatic enzymes are spread and transferred to the abdomen and thorax. Such a fistulization phenomenon is the ultimate expression of an erosive process of the pancreatic juice and is considered quite exceptional with respect to the more frequent cases of pleural exudation with high amylase content which are often encountered in concomitance with verified pancreatic pathology.


[Cryosurgery. Current status. Problems and future prospects]. As matters new stand, cryosurgery has certain definite indications in various fields, either alone or in association with other forms of treatment. It is probably the therapy of choice for 1st-stage haemorrhoids and a series of skin lesions. It is of palliative value in the treatment of tumours and/or an addition to conventional management. The same is true of neoplasm in various sites and stages. As far as the immunological response is concerned, the data available are inconclusive. Further investigation is therefore justified, both experimentally and in man, bearing in mind all the parameters that can be used to assess a possible immune response.


[Familial Mediterranean fever. Evidence of its autoimmune pathogenesis]. Immunological disturbances in FMF have not been previously reported. In present case, positivity for RA and Waaler-Rose test as well as increase of plasma IgG and IgM immunoglobulins during an episode of acute peritonitis is described. These findings, in association with very high levels of urinary FDP, suggest an autoimmune pathogenesis of the disease.


[Regulation of the renin-angiotensin-aldosterone system. Role of the prostaglandins]. PRA (in the supine and erect subject) and urinary sodium before and after acute treatment (100 mg i.m.) and chronic treatment (100 mg per os for 8 days) were examined in two groups of subjects with no signs of cardiovascular or renal disease. It was found that indomethacin, which is a well-known inhibitor of prostaglandin synthesis, reduced PRA levels in basal conditions and as a result of postural stimulation, without causing any appreciable change in urinary sodium. Regulation of the PRA on the part of the renal prostaglandins is postulated and its probable mechanisms discussed.


[Isolation and ways of acting of morphogenetic factors during early embryogenesis]. The attempts at isolation and characterization of the factors mediating the embryonic induction are summarized. A method is described in detail which allowed to isolate the purified form from the mixtures of chick embryonic tissues a vegetalizing protein factor which induces the mesoderm and endoderm in the ectoderm of amphibian gastrulae. Besides, its inhibitor was isolated which is also a protein; the inhibitors supposedly block the action of the most inducing factors but one or some of them. The isolation of the inducing factor in the pure form allowed to reinvestigate with the greatest precision the problem whether the induction is mediated by the contact of cell surfaces or the penetration of substances in the reacting cells and to show that the inducing factor penetrates in the cells upon the induction in the gastrula ectoderm. The effect of cyclic monophosphates and changes in potassium and sodium intracellular concentration as factors participating in the induction was also tested and it was shown that neither of these factors, contrary to the expectations, led to he induction phenomena. The importance of the vegetalizing factor concentration for the segregation of the primary ectodermal zone into ectodermal and mesodermal and, secondarily, nerve cellis discussed.


[Inductive role of the edges of the bony defect in the process of regeneration of the bones of the cranial vault in adult rabbits]. In the process of regeneration of the skull vault bones in adult rabbits which proceeds spontaneously after trepanation, the destroyed and changing bone of the defect margins is an inductor of osteogenesis. Coming into the contact with the reacting material in the region of defect and in dura mater, it directs its differention along the path of osteogenesis. In the experiments where the inductor and reacting material were separated by the millipore (0.45 mcm) filter the pores of which did not prevent the penetration of macromolecules and cell processes, the bone regeneration in the region of defect slowed down, as compared with the control. The bone formation de novo was observed in these experiments at first in the places of contact of the millipore filter covering the destroyed bone margins with the reacting material, i. e. in the regions of dura mater adjacent to the filter and in the newly formed connective tissue covering the external surface of the filter. The separation of the defect margins from the reacting material by wax inhibited the bone regeneration. The region of defect was filled by connective tissue scar.


[Radioautographic study of the developmental period of the cells of the supraoptic nucleus during mouse embryogenesis]. To study the time of cell origin in the supraoptic nucleus, double labelling with 3H- and 14C-thymidine was applied to the matrix cells of embryonic ependyma with intervals of 12, 24 and 48 hrs from the 9th day of gestation. The localization of the labelled cells was studied in the brain of the offspring using autoradiography. The labelling allowed to determine the time of the last division of the matrix cells, prior to their differentiation into neurosecretory cells. The neurosecretory cells forming the supraoptic nucleus were shown to arise mainly on the 11--13th day of embryogenesis. The cells originated on the 11th day were located only in the dorso-caudal parts of the nucleus. The most neurosecretory cells arise in the second half of the 12th day and are distributed all over the nucleus with the dorso-ventral (caudo-rostral) gradient. From the 13th day on the migration of the neurosecretory cells in the supraoptic nucleus sharply reduces but still persits until the 17th day. The glioblasts begin to migrate in the supraoptic nucleus from the 14th day on.


[Duration of the cell cycles and mitotic phases during the cleavage period of the salmon Salmo salar L]. The temporal, parameters of the cell cycle in the Atlantic salmon embryos were studied at the temperature 4.8 +/- 0.1 degrees from 10.5 hrs after fertilization (end of interphase of the 1st cleavage division) till 93 hrs (beginning of blastulation). The period of cleavage comprises 11 cell cycles. The II--V cell cycles equal each other by their duration, then the divisions accelerate and the VII--X cell cycles are shorter than the former by 10%, on the average. The duration of some phases (pro-, ana- and telophase) in different cycles proved to be variable and all mitotic phases varied by their relative duration from cycle to cycle; however, in all cell cycles of the cleavage period the mitosis occupied 2/3 of each cycle. The synchroneous character of the passage of cell cycle phases by all the cells is preserved only up to 8-blastomere stage. Beginning from the 16-blastomere stage when two cell layers appear along the animal--vegetative axis, the gradient is initiated: the animal layer cells in the cycle phases leave behind the vegetative layer cells which border the yolk.


[Effect of 0.2--0.3M sodium chloride solutions on the properties of the chromatin of lymphocytes in different stages os maturation]. The response of lymph node lymphocytes stimulated to proliferation at different stages of maturation by cell seeding at the high cell density was studied. The binding of acridine orange (A3) and 3H-actinomycin D (3H-AMD) to the cell nuclei was used as a criterion of the functional state of lymphocyte chromatin. The "crowding" stimulation of the lymph node lumphocytes resulted in the increase of AO and 3H-AMD binding by the cells of different sizes, i.e. at different stages of maturation. The degree of binding differs in cells of different size and the increase is expressed to a greater extent in small lymphocytes. The cell treatment with 0.2--0.3M sodium chloride solutions eliminates the differences in AO and 3H-AMD binding between the activated an non-activated lymphocytes of all sizes what appears to be due to the removal of some weakly bound non-histone proteins from the activated cells. The differences in AO and 3H-AMD binding between the cells of different sizes are retained after this treatment. Hence, the proteins removed from the chromatin under the effect of such a treatment are not responsible for the chromatin changes accompanying the cell maturation.


[Organ specific spectra of the glutamate dehydrogenase of corn, Zea mays L]. The characteristic spectra of glutamate dehydrogenase in the endosperm, embryo and pericarp of the developing seed, in the organs of the seedling (scutellum, root, mesocotyle, coleoptyle, leaf and root parenchyma of stem and ear) appear to be due to the differential activity of the genes controlling the enzyme synthesis. The type of spectrum of the initial tissue is preserved in the in vitro culture. The nature of organ specificity is discussed with respect to supposed mechanism of the formation of GDH isozyme spectrum.


[Age and features of the suppressor activity of antigen primed spleen cells of CBA strain mice and regulation of the immune response in old age]. A study of primary immunological response to the ram erythrocytes and response of primed CBA mice of different age has shown a sharp fall of the primary immunological response in senility. The young animals responded to the priming by the decrease of formation of direct antibody-forming cells in the spleen what is connected with the activation of suppressor cells. The response of primed animals increased with the age and attained in old mice the values markedly exceeding that of primary immunological response. In the system of syngeneic adoptive transfer of the spleen cells from the primed mice of different age, the response of recipients of young animal's cells was lower that of recipients of old animal's cells. The data obtained suggest the devrease of the suppressor activity of the primed spleen cells with the age.


Fluorographical findings in familial primary amyloidosis. A 50-year-old man, diagnosed as having familial primary amyloidosis due to his systemic symptoms, family history, and to histological examination of biopsy specimens, was examined by fluorescein angiography. The following results were obtained: (1) The sheathing retinal artery showed a defect of dye filling in one region, but not in the other region. Dye leakage from the sheathing artery was observed. (2) The configuration of macular vessels was rough, a microaneurysma-like change and the leakage of dye were also recognized in the capillaries of this region. (3) It was speculated that vitreous opacity originated from vascular lesions.


Scanning electron microscopic study of the human retina. The photoreceptors and their synapses, the amacrine cells and a vein the nerve fibre layer of the human retina are shown on the basis of scanning electron microscopic investigations.


Pathological-optic approach of cataract and lens. By weighing cataractous lenses and by scanning lenses of patients with acute diabetes with an ultrasonic A scan, it is made probable that hypermetropization in those cases is to be atributed to alterations of the refractive index of the lens.


[Photocoagulation in diabetic retinopathy]. At the present time, photocoagulation is the treatment of choice of diabetic retinopathy. It is founded on well-defined principles. The results are better than in the non-treated cases, on the condition that the indications are well established and the techniques appropriate. Fluorescein angiography remains indispensable. The objective of the photocoagulation is the destruction of ischaemic and avascular zones by large coagulations (avascular retinal photocoagulation). Depending on the severity and the rapidity of the evolution of the retinopathy, more extensive coagulations have to be performed in non-ischaemic zones (vascular retinal photocoagulation). The association of these two techniques is the so-called panretinal photocoagulation. This step need not be taken at once, but is indicated in some well-defined cases. The newly formed vessels are not coagulated, except when they are intraretinal.


Current views and some suggestions about mutual influences of eye dipoles as revealed by EOG. Electro-oculographic response is recorded from a number of normal subjects: one eye becomes adapted to light, while the contralateral one persists in its dark-adapted state. The viewing eye shows the expected light-induced amplification effect. The contralateral eye shows the expected "paradoxical' curve in 12 cases; in addition, a flat curve is found in 4 cases, and a curve running parallel to that recorded from the light-exposed eye is found in 8 cases. In agreement with a previous report, found in the literature, cortical bio-electrical activity (on-going EEG) also shows a light-induced amplification after the onset of an adapting field. This latter finding is once more confirmed by us. This fact,  in conjunction with some recent psychophysical findings (Lansford and Baker effect) leads to infer that interocular EOG influences are mediated by other mechanisms, in addition to spread across facial tissues.


Inadequacy of nitrous oxide/oxygen mixtures for maintaining anaesthesia in cats: satisfactory alternatives. Under carefully controlled conditions, nitrous oxide/oxygen mixtures alone, in concentrations up to 80% nitrous oxide, are shown to be unsuitable for maintaining anaesthesia during physiological recording in cats. An alternative technique is described, in which N2O/O2 (72.5% : 27.5%) is supplemented with minimal amounts of intravenous pentobarbitone (averaging 1 mg/kg/hr), following induction and surgical preparation under halothane. The technique is suitable for single unit recording from the CNS of cats in long-term acute experiments, especially those involving immobilisation with muscle relaxants. With appropriate antibiotic prophylaxis the technique is also suitable for shorter-term recording sessions in chronically implanted cats permitted to recover between sessions.


Endorphins in chronic pain. I. Differences in CSF endorphin levels between organic and psychogenic pain syndromes. A series of 37 patients with chronic pain was investigated with regard to neurologic and psychiatric variables. Twenty of the patients were classified as having mainly organic (= somatogenic) pain syndromes while 17 patients were rather suffering from psychogenic pain syndromes. Samples of lumbar cerebrospinal fluid (CSF) were obtained from the patients and analyzed for the presence of opiate receptor-active material, here called endorphins. Patients classified as having mainly organic pain syndromes were found to have significantly lower endorphin levels than patients with predominantly psychogenic pain syndromes. In the total group of patients as well as in the two subgroups, there was a significant correlation between CSF endorphin levels and the depth of depressive symptomatology as reported by the patients. On the other hand, there was no correlation between CSF endorphin levels and extent of anxiety or motor retardation. It is concluded that CSF endorphins reflect central processes involved in chronic pain syndromes.


Emotional adjustment and chronic pain.

Emotional adjustment and chronic pain. Previous work has suggested that patients with organic lesions causing pain may show as much emotional disturbance as patients with pain but without lesions. This study examined 141 chronic pain patients for their life experience, both currently and premorbidly, in terms of upbringing, neurotic traits and personality disturbance. Patients with an organic cause for pain reported significantly less family disturbance in childhood, less premorbid personality problems and less neurotic traits than patients who did not have any organic cause for their pain. The data provide support for the view that a significant proportion of the emotional disturbance associated with chronic pain is a secondary effect. Adjectives used to describe pain and factors causing exacerbation and relief of pain, although overlapping, also differed in the two groups.


Abdominal pain and the emotions.

Abdominal pain and the emotions. Sites in the gut that are related to pain are reviewed with respect to the special psychophysiological factors that operate locally. Topics considered are the irritable bowel, appendicitis and appendicectomy, duodenal ulceration and biliary disorders. Psychological states that promote the complaint or experience of abdominal pain are discussed. Possible psychological mechanisms are considered for abdominal pain with the reservation that we still do not know even the main physical mechanisms of pain related to gut disturbance.


Neonatal thyroid screening.

Neonatal thyroid screening. Recent advances in science and technology have led to the capability of early screening of newborn infants for congenital hypothyroidism. Preliminary screening programs in North America have been established in Quebec and in the Northwestern and Northeastern United States. To date these programs have screened approximately 750,000 newborn infants and detected 163 with congenital hypothyroidism. Preliminary information suggests that the early diagnosis and screening does in fact prevent mental retardation. Such programs appear to be economically sound in that they minimize the impact of congenital hypothyroidism on public budgets for care and rehabilitation of the mentally handicapped.


Neonatal dwarfism.

Neonatal dwarfism. We have not attempted to discuss the many forms of dwarfism with onset in childhood or adolescence, nor has it been possible to examine the many other causes of the small for gestational age infant, recently the subject of a review in this series. The evaluation of a child with a skeletal dysplasia requires a multidisciplinary approach utilizing clinical, genetic, radiographic, and morphologic findings. Because of the marked heterogeneity of this group of disorders, genetic and prognostic counseling should not be given until the physician is confident that he has made a definitive diagnosis.


Prenatal diagnosis of hemoglobinopathies. Techniques are currently available at a few specialized centers for the antenatal detection of hemoglobinopathies such as beta thalassemia and sickle cell anemia. The risks are not yet clearly defined, but it seems reasonable to suggest that about 90 per cent of families may obtain useful information about the genotype of their fetus. Obtaining fetal blood as well as analyzing the sample requires considerable experience and skill. These factors continue to limit the availability of this procedure.


Effects of propranolol during pregnancy and development of rats. I. Adverse effects during pregnancy. Pregnant rats, treated with high doses of propranolol, gave birth to small for dates neonates. Litter size was affected in daily doses of 100 and 150 mg/kg/day. Propranolol markedly influenced the gain in weight normally observed in pregnant rats. The placentas of the rats which received the higher doses of propranolol weighed about 30% less than normal placentas. Pregnant rats, treated with propranolol, gave birth to small for dates neonates. This effect is possibly the result of a drug-induced reduction in transport across cellular membranes, resulting in malnutrition. Since similar effects were reported in humans, treatment with propranolol during pregnancy should be further reevaluated in laboratory animals.


Polygraphic studies of normal infants and infants at risk for the sudden infant death syndrome: heart rate and variability as a function of state. Spontaneous heart rate and variability were examined as a function of age and state from birth to 6 months of age in 10 normal infants and 10 infants at risk for sudden infant death syndrome (SIDS). The risk group showed a higher heart rate at 3 months of age, particularly in the waking state. The risk infants' heart rate also increased more markedly during the first month after birth in both quiet and active sleep. Heart rate in both groups declined after 2 months in every state; however, the risk infants lagged in the 2- to 3-month decline seen with the normal infants. In the awake state, heart rate variability in the risk group did not follow the increase seen with the normals during the 1-week to 2-month age period.


Evaluation of a patterning treatment for retarded children. Three groups, each with 15 seriously retarded institutionalized children, were employed to evaluate a modification of the sensorimotor patterning treatment developed at the Institutes for the Achievement of Human Potential (IAHP). The treatment group received a program modeled after the IAHP methods for approximately two hours per day, five days per week, for one year. For the same length of time, a matched motivational control group participated in activities with foster grandparents designed to create positive, success-oriented interactions to improve self-esteem and feelings of efficacy. A no treatment group continued to receive the standard care of the institution, which was enlightened and resident-oriented. A wide variety of behavioral measures were employed, including the IAHP Developmental Profile, IQ, motor and language development scales, and measures of affective, social, and maladaptive behaviors. On the majority of the measures there were no differences in posttest performance among any of the three groups. In no case did the pattern of change of the treatment group differ from that of its crucial comparison, the motivation group. However, all three groups showed some improvement in performance between the beginning and end of the study. It was concluded that the patterning treatment investigated in this study cannot be recommended for seriously retarded children.


Computed tomography in child abuse and cerebral contusion. Cerebral contusion is considered to be the lesion leading to neurological sequelae of mental retardation and cerebral palsy in abused children. This has been difficult to document other than at autopsy or craniotomy by previously available techniques. Acute contusion or hemorrhage presumably secondary to contusion is readily documented by computed tomography (CT). We are reporting the cases of four children with alleged or suspected abuse and CT evidence of cerebral contusion. The contusion has been found both with and without external evidence of head injury.


Cerebral white matter lesions in sudden infant death syndrome. In 21.6% of infants who died of sudden infant death syndrome, the cerebral white matter showed areas of leukomalacia. Of those infants with congenital heart disease, 24.8% had lesions, whereas 4.4% of infants who died from known acute causes had lesions. The sites of the cerebral white matter lesions, subcortical or periventricular, seem to be related to the age of the infant.


Observations on immediate reactions of families to sudden infant death. Many health professionals do not adequately support newly bereaved parents and may in fact ignore and abandon them at the time of bereavement. A possible reason for this lack of involvement may be the discomfort experienced by these individuals during such encounters and a misunderstanding of the normal grief reactions. From a two-year experience observing 351 families in whom an infant has died suddenly and unexpectedly, I have noted the most common immediate grief reactions. These reactions are discussed to increase the professional's awareness of the particular needs of these individuals. These immediate reactions include shock, disbelief, and denial; negativism, hostility, and anger; self-reproach and guilt; demonstration of former unresolved grief; verbalization of previous fears of loss; and sometimes, even, relief. Families are entitled to assistance during this distressing time from a warm, caring professional who is able to allow free expression of grief however it is manifested and answer accurately the disturbing questions about the death of their infant.


Follow-up families who experience a perinatal death. We conducted a retrospective study by telephone interview (10 to 22 months later) of 26 families who had experienced a perinatal death. Six of 26 mothers had a prolonged grief reaction (12 to 20 months). Those mothers with a surviving twin or subsequent pregnancy less than five months following the death were at higher risk for a prolonged grieving period than were those without subsequent pregnancy or one more than six months later. Half of the families obtained information about the cause of death and risk of recurrence only during hospitalization; subsequent contact, weeks to months later, provided additional information for the other half. Twenty-two of 26 mothers met predetermined criteria for having an adequate understanding of cause of death and risk of recurrence; four of 26 knew neither. Sixty percent of the mothers who had adequate understanding and who had no prolonged grief response felt totally dissatisfied or only partially satisfied with the information they received and the way they received it. Follow-up contact by phone or in person increased understanding significantly; mothers who had had in-person follow-up were more likely to be satisfied with the information they received.


Childhood cancer: Parental discord and divorce. Parents of 191 children who were treated for cancer over a seven-year period completed and returned a questionnaire concerning marital status. Contrary to the prediction of a high divorce rate among these families, the study found a person-year divorce rate of 1.19%. This is slightly lower than the 2.03% person-year divorce rate among married couples with children in the states of Kansas and Missouri. The Arnold sign indicator analysis of the Minnesota multiphasic personality inventory was used to measure marital stress in 38 intact couples whose children were treated for cancer. The study sample experienced more stress than a comparison group of 23 couples who had hemophilic children. Both of these populations had more stress than a normal standardization group but less than a standardization group of marriage counselees.


Behcet's disease presenting as chronic aphthous stomatitis in a child. Behcet's disease is a chronic, recurrent, inflammatory disease of unknown cause that involves mucous surfaces, skin, eyes, joints, and the CNS. Although not reported in the pediatric literature, some cases start in childhood. This report describes a child whose chronic oral and genital ulcers preceded recognition of her gastrointestinal tract, eye, and CNS disease for nine years. The current knowledge of Behcet's disease in children is discussed.


On the capacity of directionally selective mechanisms to encode different dimensions of moving stimuli. Direction-specific losses of contrast sensitivity for sinusoidal test gratings as a function of the contrast of a sinusoidal adapting grating were found to be similar to those measured previously with square-wave gratings. Furthermore, both relationships were similar to that between motion aftereffect duration and the contrast of sinusoidal adapting gratings, and all three sets of data can be fit by a single function. The function shows that the magnitude of direction-specific adaptation effects increases linearly with the logarithm of adapting contrast in the low contrast region, but is essentially independent of contrast once the contrast exceeds threshold by more than a factor of five-six. In addition, it was found that direction-specific losses of contrast sensitivity are restricted to limited ranges of spatial frequency.


Geometric transformations of pictured space. In general, a picture can represent a specific environment of scene only when the picture is seen from a unique viewing point. The determination of this unique point and of the distortions that occur when the picture is viewed from other points is crucial to all aspects of pictorial perception. To clarify the effects of the point of observation on pictorial space, the present paper discusses how the correct point may be calculated, provides a geometric analysis of the effects of altering the viewing point, and briefly reviews the effects of such alterations on space perception.


The Penrose triangle and a family of related figures. Starting from a study of the Penrose triangle, the theory is advanced that our perception of the relative spatial positions of parts of a figure is mediated by a set of significant directions (or axes). Illustration and exploration of the theory in this paper revolves around examples drawn mostly from a family of figures related to the Penrose triangle. This family is defined partly in terms of the common nature of its members' anomalies, and partly by the feature that they are seen as configurations of 'beams'. This feature and the conditions for it are also examined by the use of examples.


Assimilation theory, attentive fields, and the Müller-Lyer illusion. The assimilation theory of geometric illusions was employed to predict changes in the outgoing and ingoing forms of the Mûller-Lyer illusions as a function of attentive field size. It was found that the theory predicted correctly the form of the function relating amount of illusion and size of attentive field only for the outgoing Müller-Lyer. For the ingoing illusion the prediction was opposite to the empirically obtained results. The findings are seen as additional evidence for the untenability of a unitary theory, such as assimilation theory, for both versions of the Müller-Lyer illusion as they fail to account for substantial difference between them.


Aftereffects of sustained vertical divergence: induced vertical phoria and illusory target height. Maintaining vertical divergence of about 2 diopters for 6, 8, or 10 min was shown to yield an induced vertical phoria (IVP). IVP increased with the duration of the inducing period and decayed with time in the dark, though not completely. Decay of IVP decreased with duration of induction period and increased as a result of maintaining the normal fusional response for 30 s. Vertical eye movements in the dark, however, were ineffective in reducing IVP. Some evidence also was provided for eye-specific errors in the perception of elevation of a visible target that were appropriate to the direction of the induced phoria. It was proposed that IVP may be modulated by resetting the output of the system used to induce the original effect.


Binocular utilization of monocular cues that are undetectable monocularly. The latency time of tracking dynamic random-dot stereograms can be shortened by as much as 100 ms when monocular cues are added by introducing a difference in dot density between target and surround. It has been tacitly assumed that perception time will be reduced only if the added monocular cues are above the detection threshold for each eye. However, the experiments reported here clearly show that stereoscopic performance as measured by an eye tracking task can be greatly enhanced by added monocular cues that cannot be detected. Observers were instructed to track a suddenly displaced vertical bar (portrayed as a dynamic random-dot stereogram) while their eye movements were recorded by EOG. The bar had either a given binocular disparity or zero binocular disparity with respect to its surround. For the target with a disparity (in a wide range), the latency time of tracking decreased by more than 30 ms (10%) as density difference increased from 0 to 4%, whereas in the control conditions with no stereoscopic cues (zero disparity) subjects were unable to track the bar at all within that range of density difference. Thus stereopsis is greatly aided by minimal monocular cues that by themselves elude monocular detection.


Perception of contour in music reading.

Perception of contour in music reading. Musicians and nonmusicians were required to make written reports of briefly presented displays of pitch symbols. Whilst musicians were not superior to nonmusicians at identifying individual notes they were superior at retaining information about the contour of note sequences. In addition, manipulation of task difficulty by requiring whole or partial report of the displays had a significant effect on performance only when global, rather than specific, response measures were taken. The results are in accordance with the theory that global analysis precedes detailed analysis in perceptual processing.


Development of sensitivity to information provided by cast shadows in pictures. The shadow cast by an object in a two-dimensional picture can specify for the observer the spatial relations between that object and its surroundings, and also the shape and size of the object itself. Some sensitivity to this information is present even in three-year-old children. Experiment 1 provided evidence that three- and four-year-old children can rely on the shape of the shadow cast by an object to judge the shape of the object. In experiment 2, with adults and three- and four-year-old children, the location of the shadow cast by an object influenced the perceived depth and height off the ground plane of the object. Although even the three-year-old children were sensitive to the location of the cast shadows, there was evidence of improvement with age in judging the distance and size of the object. The three-year-olds were not able to judge the object's size when the location of the cast shadow provided the only differential information for size. In contrast, they were significantly better in judging size when the location of the object, rather than the location of the shadow, was varied.


Comparison of eye movements over faces in photographic positives and negatives. Eye movements were recorded while subjects viewed ordinary portraits and photographic negatives of those portraits. Under both conditions they first studied sixteen portraits and then tried to decide which of forty-eight portraits they had just seen. They made more errors of recognition while viewing negatives, and their fixation patterns were significantly altered: there was a decrease in the percentage of fixations directed to the eyes, nose, and mouth, and an increase for such details as the ears, cheeks, chin, cap, and necktie. There was also a decrease in the ratio of fixations to the most fixated detail compared to the least fixated detail.


Acid-base status of canine blood during storage. The changes in pH, pCO2, pO2, based excess, standard bicarbonate and lactic acid during storage of canine blood 24 hours at different temperatures were measured (table I a, b) and illustrated (figs. 1 and 2). A correction table (table V) for determination of the initial acid-base data is constructed based upon regression equations (table IV) of the in vitro changes during storage of the blood. The changes in the acid-base values of canine blood differ from that of bovine and human blood (tables II and III).


Acid-base status of equine blood during storage. The changes in pH, pCO2, pO2, BE, SBC, and lactic during storage of equine venous and arterial blood in 24 hours at different temperatures were measured (tables I, II), and illustrated (fig, 1, 2, 3). Correction tables (tables VI, VII) for determination of the initial acid-base data are constructed based on regression equations (tables IV, V) of the in vitro changes of the blood. The changes in the acid-base values of equine blood differ from that of bovine and canine blood (table III).


[The background of the serological cross-reaction between Yersinia and Brucella and the possibility of differential diagnostics by the ELISA technique and the electroimmuno assay (rocket electrophoresis) (author's transl)]. A strong serological cross-reaction appears between different species of genus Brucella and Yersinia enterocolitica (Y.e.) serotype 0--9, which seriously complicates the diagnostic works of brucellosis and yersiniosis both in humans and animals. This cross-reaction makes it impossible to perform a differential serological diagnosis using common routine procedures such as the agglutination test and the complement fixation test. By the use of immunological, immunochemical and structural chemical methods it has been shown that the common antigenic structures of Brucella and Yersinia are situated in the lipopolysaccharides (LPS) of the cellwalls. In order to do structure analysis gaschromatography in combination with mass spectrometry of LPS from Brucella and Yersinia bacteria has been achieved. The results show that two monosaccharides (glucose and galactose) constitute common components of the LPS-molecules. A discovered cross-reaction between Y.e. 0--9 and Salmonella urbana (0--30) confirms the hypothesis that glucose and galactose are responsible for the serological cross-reaction between Brucella and Y.e. 0--9. An enzyme-linked immunosorbent assay (ELISA) has been developed in order to be used as a differential routine test. The results show that by using ELISA, a differentiation between antibodies against Y.e. 0--9 and B. abortus can be done with high sensitivity and accuracy. Another differential diagnostic system has been developed by the use of electroimmuno assay (rocket electrophoresis). This method raises the possibility of a rapid and a simple qualitative differentiation of antibodies against Brucella and Yersinia.


[Zoonotic aspects of Yersinia enterocolitica infections (author's transl)]. Yersinia enterocolitica (Y.e.) is presented from taxonomic point of view. The increased accounts of isolates performed during the last years from both humans and animals are described. Y.e., which is of great interest both in human and veterinary medicine, has been isolated in an increased frequency, from domestic as well as wild animals, from different foods, and also from drinking waters. The modes of transmissions are in many parts unknown, but clinical and epidemiological data suggest that the majority of infections both in humans and animals occur through the digestive tract. From different countries reports have been presented on the assumption that swine are playing an important role as reservoirs for infections in man. Foods contaminated with Y.e. bacteria either, primarily or secondarily, seem to be an important source of infections in the occurrence of Y.e. outbreaks.


Evaluation of the tuberculin test in Malawi. In a trial involving 371 head of cattle, the results of using avian plus bovine tuberculin and avian plus mammaliam tuberculin were compared. One group of 185 cattle from areas of low tuberculosis incidence and another group of 186 cattle from areas of high incidence were tuberculin tested and examined for pathological lesions. Using the interpretation "non-specific infection not established" with avian plus mammaliam tuberculin on the readings from cattle from high incidence areas, the test detected 83% of the cattle with visible lesions, whereas the avian plus bovine tuberculin test only detected 63%. The avian plus mammaliam tuberculin test is therefore more accurate; however, it appears to be too sensitive as it produces a higher rate of inconclusive results from non-infected cattle, and is thus more difficult to interpret. Many cattle giving positive reactions were found to be free of tubercular lesions when examined post mortem; the possibility is discussed of their allergy to the test being caused by mycobacteria other than tuberculosis, as mycobacteria belonging to Runyons Group IV have been isolated from some of these cases.


Coxal dysplasia in a pig. A case report. A deformed hip joint which was accidentally found in a test pig is described. On the grounds of radiological, macroscopic and microscopic examinations, this is considered to be caused by a congenital dysplasia of the hip joint.


Bacteriological examination of urine specimens from non-catheterized and catheterized dogs with symptoms of urinary tract infection. A bacteriological investigation of 199 urinary specimens from dogs with symptoms of urinary tract infections is presented. No bacterial growth was detected in 55.7% of all specimens examined. Isolation rates from urine specimens from noncatheterized and catheterized dogs were 35.2 and 66.7%, respectively, thus emphazising the importance of the sampling method and also that urinary tract infections in dogs can not be diagnozed solely on the basis of clinical symptoms. Bacteria belonging to the Enterobacteriaceae were most common isolated. Ampicillin was the drug to which resistance was least common (16.2%) while 79.1% of the strains examined were resistant to sulphonamide.


[Lead poisoning in Norwegian waterfowl (author's transl)]. In connection with routine autopsy of wild birds, liver samples from 56 waterfowl, representing 12 species, were analyzed for the content of lead. The median value for the birds examined was 0.2 microgram Pb/g wet weight. Concentrations probably causing lead poisoning were found in 1 mallard (Anas platyrhychos) with 11 microgram Pb/g liver and in 8 whooper swans (Cygnus cygnus) with 5.8--55 microgram Pb/g liver. Clinical observations and pathological findings of "typical" lead poisoning were found in 2 of the whooper swans with 25 and 55 microgram Pb/g liver, respectively. Lead was not detected (less than 0.1 microgram Pb/g liver) in 29% of the 34 whooper swans examined, while another 29% contained more than 1.0 microgram Pb/g liver. In some swans with a low liver lead concentration the autopsy findings strongly indicated an intoxication. The necessity of chemical analyses for the verification of lead poisoning is emphasized. The limited number of birds examined and the uneven selection among species prevent the drawing of general conclusions. This investigation indicates, however, that lead poisoning, especially in the whooper swan, may be a problem also in Norway, but hardly a so important one as in some other European countries and in the USA.


[Continuing and graduate veterinary education in the Scandinavian countries]. In all the Nordic countries the veterinary continuing education is organized in somewhat the same way. Short courses (1 to 5 days) are arranged in the different subjects of the professions at the teaching institutions or out in the regions. The veterinary medical associations are heavily involved in this education. In all the Nordic countries except Sweden, the doctor's degree is exclusively based on a research project. In Sweden a charge has taken place with formal course work in addition to the research project, more like for the Ph.D. degree. In Finland no formal graduate education is organized. Denmark and Norway have a licentiate degree in addition to the doctor's degree. The licentiate studies in both countries are a three years graduate course with a major subject and 2--3 minors and a research project.


Pasteurella multocida from canine and feline teeth, with a case report of glossitis calcinosa in a dog caused by P. multocida. A case of glossitis calcinosa in a dog caused by Pasteurella multocida is reported. Swelling of the tongue and reduced appetite were the predominant clinical symptoms. Due to latent infections with P. multocida in many species there is a risk of bitewounds being infected with this microorganism. In order to find the carrier-rate of P. multocida samples in canines, teeth and gingiva of 121 dogs and 30 cats were examined bacteriologically, revealing a carrier rates of 55% and 80% respectively. The rate is significantly higher in dogs with poor oral hygiene (calcula), and there is a tendency towards small dogs being more at risk than large dogs and male cats more than females. The isolated strains of P. multocida were most sensitive to chloramphenicol and tetracycline whereas, many were resistent to penicillin and sulfa. The theory, that this pattern should be explained by the common use of the latter drugs in veterinary practice, is not valid under Danish conditions, where chloramphenicol and tetracycline are commonly used in the small animal clinic. Accordingly suspected P. multocida infections should be treated with chloramphenicol or tetracycline, until the result of a sensitivity test is available, and not with penicillin which today is the general routine.


[Arteriographic study of the hand in 52 cases of Raynaud's phenomenon of varying aetiology (author's transl)]. Digital occlusive arterial disease was demonstrated in all cases in which there was a precise aetiology and in many cases in which an aetiology could be suspected. However, the arteriogram was most often normal in cases of Raynaud's disease. Whilst the arterial lesions seen were not specific to a precise aetiology, their presence in a patient with Raynaud's phenomenon should lead to a search for a systemic disease, first and foremost scleroderma in view of the fact that it is the most common condition.


[Quantitative cytochemical study of local immunostimulation of the respiratory mucosae by mineral spa water (author's transl)]. After non-specific stimulation (by mineral spa water) of the secretion of IgA by the respiratory tract of rabbits, the animals were killed and a study made of the number of plasmocytes per 500 diameter field by phase contrast microscopy. The number of plasmocytes was markedly increased on the 15th day and remained 5 times higher than in control animals on the 100th day. Immunocytochemical labelling by the secretory anti-IgA Fab fraction confirmed these data electron microscopically.


[The economical use of methods employed in the diagnosis of jaundice: decisional attitude as opposed to diagnostic attitude (author's transl)]. For the diagnosis of jaundice, a comparison is established between a classical diagnostic attitude and a decisional attitude which consists in guiding and restricting the investigations according to the therapeutic possibilities. It appears from the comparative study of the two groups of patients that the decisional attitude is better, resulting in a treatment which occurs earlier, is less expensive and probably of a better quality.


[Relationship between gastric acid secretion and plasma calcium, parathormone and calcitonin levels in patients with chronic renal failure on haemodialysis (author's transl)]. In twelve patients on chronic haemodialysis, a relationship was established between gastric acid secretion on the one hand, and certain parameters of calcium metabolism on the other hand: in a multifactorial statistical analysis, plasma calcium before dialysis (p less than 0,05), plasma parathormone levels before dialysis (p less than 0,05) and plasma calcitonin before dialysis (p less than 0,05) were variable explicatives of basal gastric acid secretion according to a direct relationship, whilst plasma calcium (p less than 0,05) was the only explicative variable of maximal gastric acid secretion after pentagastrin, with an inverse relationship. These preliminary results suggest that gastric acid secretion in the haemodialysis patient must be interpreted in the light of the state of calcium metabolism. Thus hypocalcaemia may be accompanied by decreased basal acid secretion and by contrast by an increased maximal acid secretion. These results require confirmation in a larger number of patients.


[Angioimmunoblastic lymphadenopathy and Prurigo strophulus (author's transl)]. Angio-immunoblastic lymphadenopathy (A.I.L.) was classified as a special type of malignant lymphoma. However, the same morphologic features can be observed in non-malignant diseases. We report a case of A.I.L. associated with Prurigo Strophulus: pseudo-tumoral adenopathy and cutaneous involvement disappeared with parasiticide treatment.


A contribution to the functional morphology of articular surfaces. The variations of the joint shape are first analyzed in the acetabulum and the ulnar trochlear notch of man. Then an attempt is made to explain the basic shape of the lunate surface and the types of articular surface diverging from it with regard to causal histogenesis and the general theory of joint stress (Pauwels), as well as the theoretical distribution of stress in the perfect ball and socket joint (Kummer). Certain statements are made about the position, size, changes in direction and course of the resultant forces at the joint, statements which seem very likely to be accurate when compared to facts already known about the hip joint in man. Under these preconditions, the various forms of the observed articulating surfaces may be theoretically reconstructed in every case. In this connection, it is first shown that the preservation of the joint cartilage is also dependent on the period of time during which the resultant force is effective in the various areas of the articular surface. The term "relative constancy" is used to express this time factor. Two functional explanations are given for the presence of incisions and divisions in the lunate surface and in the trochlear notch: 1. It is assumed that the "relative constancy" of the resultant forces is of varying magnitude in the different areas of the articular surface. The incisions and divisions in the joint cartilage are thus seen as areas in which the resultant joint stress does not rise above the minimum value for preservation of the articular cartilage. 2. The radius of the convex articular surface can be slightly larger than the radius of the concave articular surface. Because of this incongruity no pressure will be transmitted in an area of the lunate surface or of the trochlear notch because of the defective contact. It follows that the cartilage-preserving stimulating pressure is also absent from this area. According to Pauwels, the magnitude and distribution of the stresses arising in the articulating surfaces may be determined from the varying density distribution of the subchondral bony tissue, as seen in x-rays. The density distribution of the subchondral bone at the ulnar socket shows clear basic parallels to the extent of the surface covered by joint cartilage. The relatively low density in the area of the notch is seen as being the result of lower stress, in accordance with the functional explanation of division of the cartilage surfaces. In photoelastic model experiments, the dependence of the degree of relative stress on the form of the articular surface is illustrated by means of the number of isochromes. Here, the distribution of density of the subchondral bony tissue corresponds to the local magnitude of stress in the corresponding model joint. Functional analysis of the tangential fiber layer of the joint cartilage at the femoral head and the elbow joint, shows basic agreement between the split line patterns and the trajectoral pattern, as described in articulating surfaces examined by Pauwels, Konermann and Molzberger...


Mass spectral studies of probe pyrolysis products of intact oligoribonucleotides. Pyrolysis of underivatized homogeneous oligoribonucleotides in the source of a mass spectrometer leads to production of simple mass spectra which resemble the spectra of the bases themselves. It is proposed that pyrolysis occurs by hydrogen transfer to the base moiety followed by elimination of the neutral base. Ionization by electron impact gives rise to the observed spectra. Mixed oligoribonucleotides pyrolyze readily to give spectra of adenine and uracil, but evidence for the presence of guanine and cytosine in mixed polymers and native RNA's is difficult to obtain presumably because of their low vapor pressure. The method may be useful for detection of modified bases in tRNA and for studies of temperature effects on RNA pyrolysis.


'A' forms of RNAs in single strands, duplexes and RNA-DNA hybrids. Helical parameters have been calculated for the 'A' form minimum energy conformations of ApA, CpC, GpG, UpU, GpC and UpA. The helix geometries are base sequence dependent. The single strands are narrower and more tightly wound than that duplex RNA-11 form. 9-12 kcal./mole are needed to convert these single strands to the RNA-11 conformation. However, in some sequences other 'A' type conformers capable of complementary base pairing may be formed at lower energetic cost. There is substantially more base stacking in the calculated single strands than in the RNA-11 conformation. Calculated intrastrand base stacking energies reflect these differences, and also are sequence dependent. The 'A' form RNA subunits differ from the analogous DNAs in possessing a larger rise per residue, needed to accomodate the 2'-OH. RNA-DNA hybrids are consequently more likely to be in the 'A-RNA than in the 'A'-DNA conformation, although the base sequence determines the extent of the preference.


Photochemical cross-linking of histones to DNA nucleosomes. Ultraviolet (UV)-induced cross-linking was utilized in order to identify histone-DNA interacting regions in the chromatin repeating unit. Fractionated mononucleosomes which contained 185 base pairs of DNA and a full complement of the histones, including histone H1, were irradiated with light of lambda greater than 290nm in the presence of a photosensitizer. Equimolar amounts of histones H2A and H2B were found, by two independent labeling experiments, to be cross-linked to the DNA. Based on previous finding that the UV irradiation specifically cross-links residues which are in close proximity, irrespective of the nature of the amino acid side chain or the nucleotide involved, our results indicate that the four core histones are not positioned equivalently with respect to the DNA. This arrangement allows histones H2A and H2B to preferentially cross-link to the DNA. A water soluble covalent complex of DNA and histones was isolated. This complex was partially resistant to mild nuclease digestion, it exhibited a CD spectrum similar to that of chromatin, and was found to contain histone H1. These results are compatible with a model which suggests that histone H1, though anchored to the linker, is bound to the DNA at additional sites. By doing so it spans the whole length of the nucleosome and clamps together the DNA fold around the histone core.


Genetic organization of the ribosomal transcription units of the yeast Saccharomyces carlsbergensis. The genetic organization of the multiple ribosomal transcription units (RTUs) on the genome of the yeast Saccharomyces carlsbergensis was studied by electron microscopy of purified ribosomal DNA hybridized to 26S rRNA using the R-loop technique (Thomas, M., White, R.L. and Davis, R.W. (1973) Proc. Natl. Acad. Sci. U.S. 73, 2294-2298). Plasmid pBR 322, the molecular weight of which is known, was used as a standard for converting contour length of double-stranded DNA into molecular weight. The 140 yeast RTUs were found to be arrayed in tandem repeats, each repeat containing at most 0.4 X 10(6) D (about 6% of the length of the RTU) of non-transcribed spacer DNA. The repeats, in turn, are arranged in a number of clusters separated by much longer stretches of non-ribosomal DNA.


Chemical synthesis of a self-complementary octanucleotide, dG-G-T-T-A-A-C-C by a modified triester method. The synthesis of a self-complementary octanucleotide, d(G-G-T-T-A-A-C-C-), using a modified triester approach is described. The protected dinucleotides, d(Me2O)TribG(C1C6H4) ibG, d(Me2O)TrT(ClC6H4)T, d(Me2O)TrbzA(ClC6H4)bzA, and d(Me2O)TranC(ClC6H4)anC were synthesized by a one step triester procedure. After removal of the trityl group, the dinucleotides, dT(ClC6H4)T and danC (ClC6H4)anC were coupled to d(Me2O)TribG(ClC6H4)ibG and d(Me2O)TrbzA(ClC6H4)bzA, respectively to yield the respective tetranucleotides. The tetranucleotide, d(Me2O)TrbzA(ClC6H4)bzA(ClC6H4) and (ClC6H4)anC was detritylated and then coupled with d(Me2O)TribG(ClC6H4)ibG(ClC6H4)T(Cl6H4)T to give octanucleotide. The fully protected octanucleotide was deblocked by treatment with aqueous NH3 followed by acid and was characterized by nucleotide sequence analysis.


Expression of bacteriophage M13 DNA in vivo. Localization of the transcription initiation and termination signal of the mRNA coding for the major capsid protein. During the infection cycle of the filamentous bacteriophage M13 a phage specific RNA species is made which selectively directs in vitro the synthesis of the precursor of the major capsid protein encoded by gene VIII. This RNA is unstable (its mean half-life is 11 min) and is made in amounts representing at least 2% of the newly synthesized RN. Nucleotide sequence analysis have indicated that the synthesis of this RNA species is initiated and terminated at the same promoter (G0.18) and termination signal (T0.25) of the M13 genome as the 8S RNA species made in vitro under the direction of M13 replicative form DNA.


Studies on the single-stranded discontinuities of the cauliflower mosaic virus genome. The Cauliflower Mosaic Virus (CaMV) genome is a double-stranded DNA molecule of about 5 million daltons. Native DNA molecules appear heterogeneous when analysed by gel electrophoresis. We have examined the nature of this apparent heterogeneity. Besides, this genome is shown here to contain three single-stranded breaks, as revealed by different denaturation experiments: heating at 75 degrees C, treatment with NaOH or dimethyl sulfoxide (DMSO). Labelling with terminal transferase proves that the 3' ends at these interruptions all have free hydroxyl groups. Electron microscopy and alkaline gel electrophoresis indicate that these three discontinuities are shared by both strands, and that they are not randomly located. S1 nuclease is active on CaMV DNA and generates three fragments. The comparison between the sizes of these fragments and of the products of denaturation leads us to consider that S1 acts at the level of the interruptions. We have determined that two of them, distant by one third genome unit, are in the same strand; the other is in the opposite strand, distant by one sixth genome unit from the nearest other one. The combined use of restriction enzymes and S1 nuclease has enabled us to locate these three discontinuities on the restriction map of the CaMV genome that we have otherwise established.


Biosynthesis and utilization of extensively undermethylated poly(A)+ RNA in CHO cells during a cycloleucine treatment. The role of RNA methylations in the control of mRNA maturation and incorporation into polysomes has been investigated through a study of the effects in vivo of cycloleucine, a specific inhibitor of S-adenosyl-methionine mediated methylation. During the cycloleucine treatment, the rate of biosynthesis of hnRNA and its subsequent polyadenylation were only slightly reduced as compared with untreated cells. However a significant lag-time in the cytoplasmic appearance of poly(A)+ undermethylated molecules was observed, in parallel with a transient shift in the average size of hnRNA towards higher molecular weight. Nevertheless, the total amount of pulse-labelled poly(A)+ mRNA transferred to cytoplasm after a long chase time (3 h.) was approximately the same for both cycloleucine-treated and control cells. Extensively undermethylated poly(A)+ cytoplasmic RNAs, possessing a 5' terminal cap were incorporated into polysomes in proportions very similar to control messenger molecules. These results suggest that a normal level of methylation is not stringently required for the production of the functional mRNA molecules although it appears to be of importance for the kinetics of the maturational process.


Transcription of nucleosomes from human chromatin. Nucleosomes (chromatin subunits) prepared by micrococcal nuclease digestion of human nuclei are similar in histone content but substantially reduced in non-histone proteins as compared to undigested chromatin. Chromatin transcription experiments indicate that the DNA in the nucleosomes is accessible to DNA-dependent RNA polymerase in vitro. The template capacities of chromatin and nucleosomes are 1.5 and 10%, respectively, relative to high molecular weight DNA, with intermediate values for oligonucleosomes. Three distinct sizes of transcripts, 150, 120 and 95 nucleotides in length, are obtained when nucleosomes are used as templates. However, when nucleosomal DNA is used as a template, the predominant size of transcripts is 150 nucleotides. When oligonucleosomes are used as templates longer transcripts are obtained. This indicates that RNA polymerase can transcribe the DNA contained in the nucleosomes.


Excretion of newly synthesized DNA by tonsil lymphocytes. The main part of newly synthesized DNA is preferentially released in vitro both by non-stimulated or phytohemagglutinin-stimulated tonsil lymphocytes. Freshly isolated cells excrete DNA faster than phytohemagglutinin-stimulated ones. The acid-precipitable 3H-thymidine lost can be accounted for in the culture medium as labeled, double stranded DNA isolated on hydroxyapatite column.


[Corticotropic testing during long-term beclomethasone dipropionate treatment in asthmatic children]. The authors looked for undesirable side-effects in prolonged treatment with beclomethasone dipropionate aerosol (BDP) at the daily dose of 400 microgram in asthmatic children. Growth in height was not impaired, the height gain (5.35 +/- 4.06 cm) not being statistically different from the theoretical gain (5.46 +/- 2.94 cm) (t : 1.33 0.20 less than p less than 0.01). Testing the corticotropic chain at pituitary level by the L8VP test did not reveal any decrease in patients treated by BDP alone (delta of elevation of cortisolemia; 9.08 +/- 2.79 microgram/100 ml, not very different from the controls 9.79 +/- 4.32 microgram/100 ml). On the other hand, the results in patients with continuous or alternating conventional corticotherapy showed a corticotropic decrease (delta of elevation : 5.39 +/- 4.53 microgram/100 ml, a significant difference from the controls t : 7.54 p less than 0.001). In 5 of these observations, the repetition of L8VP testing revealed the progressive restauration of the corticotropic function together with the decrease and the stopping of conventional corticotherapy. The average cortisolemia of patients definitively off corticotherapy, before and after L8VP, was not significantly different from that of controls. The elevation delta of cortisolemia of deprived patients (9.30 +/- 4.92 microgram/100 ml) become comparable to that of normal controls (9.79 +/- 4.32 microgram/100 ml. The analysis of the main literature data, in agreement with the results presented here, showed that prolonged treatment with BDP had no harmful effect on height growth. There was no corticotropic decrease in a child unsubjected to previously conventional corticotherapy or after completely stopping the treatment.


[Short-term use of beclomethasone dipropionate in the treatment of spasmodic obstructive bronchopneumopathies]. Forty-two patients were treated with beclomethasone dipropionate in doses of 400 microgram daily for no longer than three months. There were three main indications : attempt to withdraw corticosteroids or sympathomimetics ; treatment prior to desensitization ; treatment of asthma with severe permanent dyspnea. In 8 patients, systemic steroids of sympathomimetic drugs could be withdrawn. Dosage could be reduced by 50% or more in 21 cases, and by less than 50% in 9 cases. There were 3 failures, and results were unassessable in one case. No major side-effects were observed.


[Isolated cystic lymphangioma in the mediastinum]. Cystic lymphangioma localized only in the mediastinum is a rare type of primitive tumour (less than 1% of the mediastinum primitive tumours). These three new observations concern lymphangiomas with an anterior position ; therir anatomical connections with the lymphatic system are difficult to show. Treated by surgery these benign tumours have a good prognosis and only a few cases of local recurrences have been reported.


[Elementary precautions necessary for the validity of ventilatory function measurements with electronic spirometers]. The increase of morbidity rate of chronic bronchitis demonstrates the interest of an early check-up, in the free symptom phase of illness, because obstruction of small bronchii may be reversible, as it has been pointed out by previous longitudinal studies. These finding involve the use of simple devices, easy to manage and rebrabld. The three apparatus have been tested : Ohio 842 spirograph, Oude Delft expirometer and Chemetron Corporation P.F.I., in 165 patients. All of them have been compared to Jaeger spirometer. No good agreement has been found between expirometer, P.F.I. and Jaeger spirometer. But Ohio 842 spirograph values were quiet close to those observed with Jaeger spirometer. Electronic spirometers present a digital display without graphic recording or calibration. It has been difficult to detect errors at a first glance. Mostly they came from non linearity of response of thermistance, irregular expiratory flow, insufficient cooperation of patients.


[Bronchofibroscopy. 6 questions, 6 fundamental answers]. The authors report the aims, methods, techniques of sampling and the tolerance of broncho-fibroscopy, correlating literature and their personal experience of  a thousand examinations. They consider it a very simple examination which without any inconvenience can be used in very serious cases as well as for out-patients. They insist on the technique of biopsy and directed aspiration and demonstrate that with experience the yield of the method can be improved. They conclude by saying that a histo-cytological diagnosis can be made in 95% of cases of bronchial cancers. In their experience, tolerance to this examination is always very good.


[Our experience with bronchofibroscopy]. Five hundred and eighty three broncho-fibroscopies were performed by the authors. Tumoural pathology represents 60% of diagnostic indications. Histological samples have a satisfying yield : 72.4% for the whole tumoural pathology, 80% for primitive bronchial tumours. The comparison with the results of sampling done by bronchoscopy is in favour of broncho-fibroscopy, especially for distal localizations (62% of positive results against 47%). In respiratory intensive care, a place of its own should be given to bronchoaspiration, where this technique of tracheo-bronchial clearing seems well adapted.


[Value of bronchopulmonary fibro-lavage in the treatment of severe suppurative pneumopathies]. The therapeutical use of bronchial fibroscopy is very promising. Already today it is much used in postsurgery atelectasies by obstruction or in suppurative atelectasies related to important infectious foci. It considerably improves the bronchial clearing previously done by blind aspiration or bronchoscopy. The coupling of this aspiration to a perfusion-lavage in severe suppurative bacterial pneumopathies yielded interesting results.


[Value of selective pulmonary lavage under fibroscopic control in alveolar proteinosis]. The authors report the case of a 43 years old male with severe alveolar proteinosis : after failure of various treatments, they attempted a pulmonary lavage, using a fiberscope. The instrument was directed towards each lobar bronchus, one after the other, with a total of 20 lavages during a period of 4 months. A saline isotonic solution was imposed through the fiberscope then collected using air vacuum. The results were satisfactory, this patient living his normal life since july 1976. The clinical, radiological, biological data remain normal on April 1978.


[Weaning a patient from the respirator (author's transl)]. Weaning a patient from the respirator should be started as early as possible. The right time when to stope artificial ventilation is determined by certain criteria. Pathological processes which might interfere with the weaning process should be corrected beforehand. Incipient septicaemia, peritonitis, circulatory instability and a marked postoperative or posttraumatic rise in intracranial pressure are extrapulmonary contraindications for weaning. Apart from conventional weaning, continuous positive airway pressure ventilation and intermittent mandatory ventilation are discussed.