[Preventive programmes for school children. Organization, duties and activities of the School Health Service of the city of Basel]. From a historical point of view it was the federal tuberculosis law of 1928 which gave an impulse to the Swiss School health services. Almost simultaneously a psychological service for school children was established in Basle. Besides physicians and psychologists, the present staff comprises speech pathologists and scientific coworkers. The mandate issued by the canton's government is mostly geared toward prevention of somatic, psychological and social disorders in the individual child and in risk groups, in the sense of social pediatrics. Carrying out this mandate requires a unity of investigation methods and the decisions resulting from findings. The statistical evaluation of epidemiological data depends on efficient computer use. High priority is given to data protection. With reference to the basic possibilities and limitations of activities in preventive medicine, questions of goals, acceptability and acceptance, curability and cost-benefit are discussed. The competitive situation between therapy and prevention is critically considered. An interdisciplinary approach including all the helping professions is strongly suggested.


[Analysis of early detection among 7513 preschool children]. The development of cognitive and social abilities of preschool children in Basle is discussed. The importance of education and of detecting developments which do not confirm to standard is stressed in this context. A survey of preventive examinations, carried out during the last five years, in which 7513 kingergarten-children were examined, is given. Only findings confirmed by specialists are stated. Furthermore the measures taken to help preschool children with neurological illness and hearing loss of sensory neural type are discussed. The preventive and the individually curative medical activities have proved sensible and complementary to each other.


[Preventive activities of the Geneva Youth Health Service]. Based on a centralized structure and a mission oriented toward prevention, the Geneva Youth Health Service carries out extended surveillance activities in the areas of somatic health and environmental hygiene. Its services are directed at the two- to twenty-year-olds, and in particular the children and adolescents in preschool institutions, in public schools and in the technical instructional institutions. Its activities complement those of other services of the Geneva Youth Office, in particular in the medical-educational and social-educational areas.


[Preventive tasks of the dietary assistant and nutritional advisor]. Where is the place of work of the dietary assistant? It is no longer restricted to the hospital, and it no longer concerns patient food only. This article demonstrates the wealth of tasks waiting to be tackled by the modern dietary assistant. Increasingly her principal aim becomes stimulation of a health nutrition in the general population which means a change of deeply seated eating habits.


[Preventive medicine and nursing tasks of a public health nurse]. Points of departure are the goal of preventive medicine and a definition of ambulatory health care. The fields of practice and tasks of a public health nurse are described. An instrument for the systematic assessment of patient problems is used to illustrate the attitudes and behavior needed on the part of the public health nurse. Neither the patient (or potential patient) nor the care giver can be considered as an isolated individual or can act alone. A total approach to patient problems requires that cooperation between patient and care givers be enhanced through conscious effort. The earlier the intra/inter/extra factors are known and the more sources of information are available, the more easily and efficiently can the tasks of primary health care be perceived (with regard to individuals or groups). Good health care is a mandate for all health professionals but care of one's health is a task of every person.


[Swiss Institute for the Prevention of Alcohol Problems]. The interest in preventive measures of self-destructing behaviours is increasing considerably. However, it seems hardly possible to apply the traditional public-health model to the prevention of alcohol problems because this is influenced too much by clinical thinking. When trying to prevent alcohol-related disabilities, one has in fact to establish behaviourial standards. Preventive measures will yield success only if compulsive and persuasive strategies are combined. The Swiss institute for the prevention of alcohol problems tries to adapt its activities (research, media department, education department, alcohol policy) to the necessaries of a comprehensive concept of prevention.


[Anemia in chronic polyarthritis].

[Anemia in chronic polyarthritis]. In 216 patients, the correlation of anemia and activity of rheumatoid arthritis was studied. In 27% a concomitant anemia was found. These findings are congruent with those of other authors. There is a significant correlation between activity of rheumatoid disease and evolution of anemia as well as changes of serum iron level. With reference to the literature possible pathogenetic mechanisms of this type of anemia are reviewed. Therapeutic possibilities are briefly discussed.


[Effect of levamisole on in vitro collagen synthesis]. The effect of levamisole on collagen synthesis was studied. Tissue sections of skin of newborn rats were incubated with levamisole 10(-3) M up to 10(-5) M and 15C proline during 2 hours at 37 degrees C. Formation of soluble and insoluble collagen was inhibited only by the 10(-3) M levamisole. No effect was found with lower levamisole concentrations. Likewise an incorporation of 14C proline into collagen and collagen free proteins is inhibited. These results suggest that levamisole has not only its well-known immunostimulating action but also anti-proliferative effects.


The influence of dietary iodine and enviromental temperature on the activity of mitochondria in liver and kidney. It was found that both effect of temperatures and diets influence metabolic changes in rabbits. In animals fed basal and PTU diets (propyl-thiouracil diets) at 34 degrees C for 4 weeks the metabolic response showed a marked reduction in feed intake and body weight, compared with animals fed at normal temperatures. In the animals fed the iodine diet, there was an increase in daily food consumption and weekly body weight gain at 34 degrees C. This indicates a rise in metabolic activity in this case. Studying the activity of kidney mitochondria of the three groups of animals using succinate as a substrate revealed that the P/O ratio tends to decrease in animals kept at 6 degrees C while the RCR value was not altered by changing conditions or produced by the different diets. At the temperature of 6 degrees C both the P/O ratios and the RCR values of liver mitochondria using succinate as a substrate decreased in the group of rabbits fed the basal and iodine diets, but were not significantly different in the group fed the PTU diet. In the experiment on kidney mitochondrial activity using alpha-ketoglutarate as a substrate it was found that both the P/O ratios and the RCR values from animals fed basal and PTU diets at 6 degrees C decreased slightly as compared with animals fed at 20 degrees C and 34 degrees C. In liver mitochondria, using alpha-ketoglutarate as a substrate a significant decrease in the P/O ratio and the RCR value was found for both rabbits fed the basal and the iodine diets at 6 degrees C. In the group of rabbits fed the PTU diet, the P/O ratio also decreased but the fall was not significant. These results suggested that the activity of succinate dehydrogenase in liver mitochondria increases in animals fed basal and iodine diets at 6 degrees C. The enzyme dehydrogenase involved in oxidation of alpha-ketoglutarate which is localized in the outer membrane of mitochondria seems to be affected by different temperatures and diets as compared with succinate dehydrogenase localized in the matrix. The kidney mitochondria activity is less sensitive than that of liver mitochondria. Mitochondrial respiration and phosphorylation due to the tightness of their coupling may respond differently depending on the degree of thyroid activity.


[The distribution of destructive polyarthritic changes in the hand skeleton]. The distribution of common and erosive changes in advanced polyarthrosis is radiologically demonstrated in the hands of 32 patients. 23 of them showed erosive destructions in at least one joint. In general the alterations were symmetrical. Most of the destructions were seen in the distal and proximal interphalangeal joints, especially in DIP II, III, V and PIP III. Usually the thumb was spared. Most emphasis has been put on the differential diagnosis to rheumatoid arthritis and arthritis in psoriasis and gout. A recent concept concerning mechanical factors in the pathogenesis of so called primary osteoarthritis in the small finger joints is discussed.


[Quantitative thermography of the knee joint]. Computer-assisted evaluation of thermography of the knee joints allows diagnosis and quantitation of inflammatory processes. This needs an adequate thermography camera, registration standards and a thermographic index. With the aid of this index normal knee joints and those with inflammatory changes can clearly be differentiated: an index of less than 3.5 is normal, values above 5.0 indicate an inflammation. The author proposes to correct the thermographic index with reference to actual rectal temperature in order to improve inter- and intra-individual comparability of thermograms. Apart from the thermographic index, the formal analysis of the line-scan over the joint space and the maximal temperature of the joint can be used as further diagnostic criteria.


[Liver findings in Felty's syndrome. A review]. A reaction of the RES with its organs (lymph nodes, spleen, bone marrow and Kupffer's cells) is not uncommon in rheumatoid arthritis. Although these manifestations are pronounced in Felty's syndrome, reviewing articles about Felty's do not mention liver manifestations. This paper summarises the publications about liver findings in Felty's syndrome. Hepatomegaly, abnormal bromsulfalein tests, raised alkaline phosphatase and transaminases have been stated in many case reports. Among 34 patients, the frequency of hepatomegaly was 68%, of abnormal bromsulfalein tests 27%, of alkaline phosphatase 23% and of transaminases 18%, respectively (52). Alkaline phosphatase and transaminases were raised in almost all of 12 patients (3). The histological correspondence is an infiltration with lymphocytes of sinusoids and portal fields, a portal fibrosis and occasionally a cirrhosis. These histological abnormalities, as well as enlarged lymph nodes and splenomegaly, have to be considered as organic manifestations of rheumatoid arthritis. If the nodular regenerative hyperplasia of the liver, which has been reported also after use of contraceptives, is a manifestation of Felty's syndrome, remains unresolved.


[Psychic disturbances in students].

[Psychic disturbances in students]. 43 of 80 students, who came to the student psychiatry service in Basle, had mainly specific problems concerning their studies. Those are divided into three typical syndromes: 1st: a syndrome of examination-anxiety (in 52% of the patients), 2nd: a syndrome of ambivalency with current changes of faculties, with many cessations of study and with long-term study (in 30%), and 3rd: a syndrome of chronic learning disability (in 18%). A conflict of authority is found psychodynamically with examination-anxiety, because these students often had an authoritarian father, who never acknowledged them. An unsolved dependence on their parents (especially on their mother) is the main reason for a syndrome of ambivalency and of learning disability. Therefore, the step from the university to professional independency is impossible or the gradual, "modest" learning is prevented by the continuing infantile illusions of omnipotency. A provisional one-year catamnesis shows a good prognosis for examination-anxieties. Long-term students and students with chronic learning disabilities need a longer therapy because of their deeper anal and narcissistic problems.


[Transsexualism and transvestism].

[Transsexualism and transvestism]. The author examines the genetic and the psychodynamic points of view of transexualism and transvestitism, on the basis of literature and of his clinical experience. While the genesis of the syndromes still remain obscure, in spite of new psychodynamic hypothesis, it is now possible to understand the inner world of the parents better than ever before. The author is able to show by means of his own cases that on the basis of the syndrome is a personality development which is centered in the struggle of self-identity and which does not correspond to our definitions of neurosis or of psychopathy but, rather can assume, at least in some patients, very realistic traits of solving an objective problem of sexual identity.


[The teaching of understanding as science]. The author mentions and cites two documents: the first being part of a scientific treatise on deafness, the second part of a medical report. These are the starting points from which the difference between explaining and understanding (Dilthey) is interpreted and illustrated, including points that go beyond the general use of these two terms.--Following the interpretation of the two processes, explaining and understanding, the danger is demonstrated which comes along by mixing up the two ways of coming along with problems, that is to say, using explanations for the domain of understanding and vice-versa. Understanding is not less a realm of science than explaining. On the other hand, the use of explanations in a situation where understanding is required, is as unscientific as is an understanding that oversteps its methodology.


[Short-term dialyses using the Rhodial system]. In order to achieve an optimal rehabilitation of patients undergoing dialysis an abbreviation of the periods of dialysis with unchanged frequency of dialysis is necessary, when the patients are widely free of symptoms. Using conventional dialysators we only conditionedly succeed in shortening the time and this is not without any problems. The development of the acrylonitril-membrane (RP 6) and the use in the closed system (Rhodial-system) allows an extreme shortening of the time. It is reported on the use of the Rhodial-system since June 1975. The efficiency of the dialysator (RP 6) in the region of the middle molecules makes possible periods of dialysis of 3 times 3 hours a week in oligo-anuric patients. It is reported on the results of more than 3,000 dialyses in the behaviour of the micromolecular substances, of haemoglobin and haematocrit, blood pressure, polyneuropathy as well as of the subjective behaviour of the patient. These results led to abandoning dialyses with conventional membranes, as far as they transgress the time of dialysis of 9 hours a week.


[Subvesical urinary track obstruction in children as the cause of chronic renal failure]. The infantile stenosis of the vesical cervix is a rare disease, etiology and pathogenesis of which are controversial. If it is not treated it leads to uraemia. On the basis of a clinical material consisting of 8 patients clinic and course of the disease are discussed. In the children with stenosis of the vesical cervix observed by us disturbances of the miction (bilateral mictions, thin urinary stream), relapsing abdominal pain, enuresis, minor growth and haematuria were in the first place. We got clearness on the diagnosis by judging the mode of miction, by means of miction cystourethrography and by urethrocystoscopy. Even in stenosis of the vesical cervix with advanced renal insufficiency also in childhood an operation should be performed.


[Effect of a calcium-deficient, phosphate- or ammonia-rich diet on the development and mineral metabolism of growing miniature pigs]. The metaphylaxis of renal calculi in form of partial withdrawal of Ca and the nutrition rich in phosphate or NH4C1 in children was disputed and not ascertained by animal experiments. For this purpose growing female dwarf pigs got a semisynthetic ration with 1 g Ca and 23 g P, respectively, or 15 g NH4C1 per kg dry feeding mass during 168 days. The dwarf pigs fed poor in Ca had a reduced increase of body-weight of 30%, the pigs fed rich in P and NH4C1 a reduced increase of body-weight of 11 and 16%, respectively, compared with the control dwarf pigs. The feeding regime chosen has no significant influence on the Ca-, P-, Cu-, and Mn-state of the dwarf pigs (alpha greater than 0.05). Only the animals with deficiency of a Ca statistically ascertained stored more Zn in the liver than the control animals. The applied NH4C1 as well as the medicament Ammonchlor SSW contained traces of Cd. Concerning the lacking significant changes of metabolism on account of the retardation of growth conditioned by therapy it cannot be concluded that there is possible a metaphylaxis of the lithiasis in children by partial withdrawal of Ca or additions of P and NH4C1, respectively.


[Catheter embolization of malignant kidney tumors]. It is reported on the occlusion of the renal artery with Spongostan in 25 cases of malignant renal tumours. The embolisation takes place immediately after the angiographic diagnosis of the renal tumour, in which case on account of the simplicity of the method every radiologist working in the field of angiography is able to perform the occlusion of the renal artery. It is not difficult to get embolisation material and it is available in nearly every surgical department. In 15 cases the later on performed extracapsular nephrectomy was, compared with the non-embolised kidneys, was facilitated by an edematous marginal zone and diminution and lacking filling of the tumour veins and on account of the smaller loss of blood led to a reduced operation stress of the patient. Apart from this on account of the missing blood supply of the kidney the ligature of the renal vein could be performed at an earlier moment of the operation and thus an intraoperatively haematogenic metastasation could be prevented. In 10 inoperable cases the embolisation was performed for the exclusion of haematuria and in order to stop and to decrease the further growth of the tumour. On account of the simplicity if the method, connected with the advantages resulting from this, the authors would like no more to miss this approach in future.


[Comments on the exchangeability of herring-gull chicks (Larus argentatus) after the 1st week of life]. In the Biville chalk cliff area the Herring gulls nest both in slope and ground colonies and on cliff ledges. Like the Kittiwake (CULLEN 1957), the cliff-nesting pairs still accept other chicks after the 1st week of life. Gulls in slope and ground colonies, however, attack those chicks older than 4 days in close proximity to their nests (TINBERGEN 1936).


On social organization and behaviour of the gerenuk Litocranius walleri (Brooke 1878). The social organization of the gerenuk in Tsavo East National Park, Kenya, is characterized by single adult male on territories encompassing their entire home ranges, small female-groups of variable composition, often associated with territorial male, and small groups of subadult male. There appear to be no non-territorial adult male ("bachelors"). Subadult male wander about considerably, often alone, before they succeed in taking over a territory. Territorial male perform linked urination/defecation and mark dry twigs with the antorbital gland secretion. Agonistic and courtship behaviour resemble those of other gazelles. Mother-young relations conform to the "hider type" among bovids.


[Measurement of CO2-production in incubationvessels using an infrared-CO2-analyser in a gas circuit system (author's transl)]. A method of recording C-mineralization using an infrared-CO2-analyser is explained. The procedure is based on a closed circuit system containing the incubationvessels. In that circuit gas is streeming until CO2-concentration is constant. Using the observed concentration-value produced CO2 quantity can be determined.


Survival and efficiency of cowpea rhizobia on pelleted and non-pelleted peanut seeds, treated with fungicides. Peanut seeds were either normally inoculated with the legume inoculant Okadin, containing cowpea rhizobia, or pelleted and treated with each of the fungicides Brassical, Thiram, Orthocide 75, Falisan, Vitavax 75, and Agrosan. The seeds were then incubated at room (+/- 25 degrees C) or refrigeration temperatures (+/- 5 degrees C). Survival tests were made after 2 and 10 days. Treated seeds were also planted in pots containing Nile silt for testing the efficiency of rhizobia as affected by the fungicide and the pelleting treatments. Pelleting of peanut seeds enhanced the survival of rhizobia whether seeds were incubated at room or refrigeration temperature. Protection was more pronounced when seeds were kept at low temperature. This was true of the fungicides Brassical, Orthocide 75, Vitavax 75, Thiram, and Agrosan. Falisan, however, did not help the rhizobia to survive. All the fungicides tested reduced the number of rhizobia to nil within 10 days when the seeds were normally inoculated and then treated and incubated at room temperature. The numbers of rhizobia were appreciably reduced when incubated at refrigeration temperature. Pelleting tended to prevent the harmful effect of the fungicides. This was clearly demonstrated with a tendency of an increase in the total nitrogen of the plants. On the contrary, normally inoculated and treated seeds grew into plants with reduced amounts of total nitrogen fixed.


Race identification of Pseudomonas solanacearum E. F. Smith in Egypt. Twenty one isolates of Pseudomonas solanacearum E. F. Smith, which does not occur on hosts other than potato in Egypt, obtained from diseased potato tubers, were collected from different localities in Egypt and used in this study. These 21 isolates were found pathogenic to potato plants, but they were not pathogenic to tobacco and banana plants. All the 21 isolates caused only a yellowish discoloration of the infiltrated area of tobacco leaves by 48 hrs after inoculation and produced low melanin pigments on a tyrosine agar medium. These results indicate that the obtained isolates belong to Race 3. Biochemical studies, performed on five representative isolates, indicated that they all belong to the biochemical biotype II. The results obtained in the present investigation appear to be the first record of P. solanacearum races in Egypt.


[A solid culture medium, inducing intensive production of conidia in moulds of the species Aspergillus niger (author's transl)]. Two citric acid-producing strains of the mould Aspergillus niger, cultivated on different sporulation media recommended and well-tried for Aspergilli, showed only poor formation of conidia the harvesting of which was difficult. Starting with a sporulation medium of MOYER et al. and substituting some of the constituents and determining their optimum concentrations, two semi-synthetic media were developed, containing glycerol and/or citric acid. On these sporulation media the two strains exhibited excellent growth and formation of a dense and regular carpet of conidia which could be easily harvested. Attention was payed to the significance of the cultivation temperature. The original biochemical properties of the two strains were not altered.


Isolation of Bacillus thuringiensis for microbiological control of insects. Eleven of 180 local isolates, belonging to Bacillus thuringiensis, were tested for their pathogenicity to pinkbollworm larvae (Pectinophora gossypiella). Three strains, namely RS-25, RS-35, and RS-45, showed a positive insecticidal activity. Their activities based on the crystalline inclusion bodies. The LD50 (hours) for larvae was 8, 12, and 6 hours, respectively.


Tests in vitro and in pots with certain chemicals for inhibition of Pseudomonas solanacearum. Twenty one isolates of Pseudomonas solanacearum E. F. Smith (Race 3) from various parts of Egypt were inhibited in vitro by Ampicillin, Chloramphenicol, Kanamycin, Oxytetracycline. Tetracycline, Penicillin G, Streptomycin, Nabam (Dithane A-40), Maneb (Dithane M-22), Zinc-ion maneb complex (Dithane M-45), and the insecticide Chlorthion. On the basis of in vitro-sensitivity to the selected 11 chemicals the 21 isolates could not be separated into different groups. Carbendazin (Bavistin), Benomyl, Drazoxolon (Mil-Col), and Temik proved ineffective in inhibiting the in vitro growth of all isolates at all tested concentrations. Preliminary investigations indicate that drenching the soil with solutions of Dithane M-22 (0.25% w/v, Dithane M-45 (0.25%) w/v, or insecticide Chlorthion (50 microgram/ml active ingredient) decreased the incidence of potato wilt disease that developed in soil, artificially infested with P. solanacearum.


Sensitivity to lytic agents and DNA base composition of several aerobic spore-bearing bacilli. The authors studied the possible relationship between a genetic characteristic, like DNA base composition, and certain phenotypic characteristics, i.e., sensitivity to lytic agents, morphology of colonies, and biochemical reactions in 34 strains of spore-bearing bacilli. From the results obtained two groups of bacilli have been identified. The first group includes the species B. subtilis, B. pumilus, B. licheniformis, and B. firmus and one strain of B. megaterium. The mean value of the GC% of the DNA is 44.22 +/- 1.76. All the strains examined are highly sensitive to lysozyme and resistant to sodium lauryl sulphate (S.L.S.); the surface colonies have a "rhizoid" appearance and the microcolonies on slide microculture are star-shaped. The second group includes the species B. cereus, B. cereus var. mycoides, B. anthracis, and B. thuringiensis. The mean value of the GC% of the DNA is 33.65 +/- 0.59. All the strains belonging to this group are resistant to both lysozyme and S.L.S., and the surface macro-colonies and the microcolonies have a "medusae head" appearance. The two groups also have certain different biochemical reactions; e.g., anaerobic growth and the egg yolk reaction, with few exception, are negative for the first group and positive for the second; furthermore, the strains in the first group (with rare exceptions) cause fermentation in the three carbohydrates, glucose, arabinose, and xylose, while glucose only is fermented by all strains with one exception in the second group. The position of B. megaterium is not yet clear, although one strain may certainly be included in the first group. Lysis by lipase is extremely variable and does not correlate with any of the other characteristics studied. The other species studied in relation to the characteristics, considered in our research (B. coagulans, B. macerans, B. polymyxa, B. laterosporus, B. alvei, B. circulans, B. stearothermophilus, and B. brevis), are not susceptible to grouping, either in the first, or in the second or even in a separate group.


Production of gentamicins by Micromonospora purpurea. The natural medium contained the following ingredients (g/l): glucose 8.0, or black strap molasses (treated with 0.2--0.3 g/l EDTA) 12.0, fodder yeast (50.0% total nitrogen) 2.0, or folder yeast (40.0% total nitrogen) 6.0, or yeast extract 8.0, or tryptone 8.0, and CaCO3 1.0. Treated black strap molasses with EDTA and fodder yeast proved to be effective in the fermentative production of gentamicins. The most suitable chelating agent was EDTA in the form of disodium for the treatment of Komombo molasses in a concentration of 0.2--0.3 g/l, while potassium ferrocyanide and methylene blue had depressing effects on the production of gentamicins. The most effective carbon source, present in Egyptian black strap molasses, was glucose. Addition of glucose to the medium was preferable at the beginning of the fermentation process. Trace elements present in molasses were very essential for the microbial growth and biosynthesis of gentamicins as proved when molasses ash was added to the natural medium. Organic nitrogen sources were more suitable than inorganic nitrogen sources for the production of gentamicins by Micromonospora purpurea. The microorganism utilized the synthetic medium, but the antibiotic yields were less than those produced in the natural medium. The synthetic medium exhibited stimulatory effects of certain amino acids, organic acids, vitamins, and purine and pyrimidine bases on the fermentative production of gentamicins. Therefore, the ingredients increasing yields of gentamicins were mainly phenylalanine, iso-leucine, lysine, methionine, leucine, arginine, glycine, beta-alanine, cystine, tryptophan, malic acid, maleic acid, cobalamin, folic acid, riboflavin, vitamin B1, vitamin B6, biotin, nicotinamide, uracil, adenine, guanine, and adenosine. Trace elements (Co, Mo, Fe, Cu, Zn, and Mn) exhibited their important role on the biosynthesis and production of gentamicins by Micromonospora purpurea.


[Diagnostic prerequisites of hyperselective vagotomy (author's transl)]. On admission to hospital the radiologic diagnosis of ulcer in 640 patients (407 duodenal ulcer, 233 gastric ulcer) was supplemented by means of gastroduodenoscopy in 207 cases; ERP was performed in few cases. In 51 patients with the initial radiologic diagnosis of duodenal and 28 gastric ulcer (12,3%) decisive alterations of the operative tactics based on the initial diagnosis were made. The differences in the findings neither discredit nor favor one or the other diagnostic procedure. The necessary collaboration between radiologists, endoscopists and surgeons is based, as usual, on technical perfection. When no such prerequisite is available the radiologic diagnosis should be optimized or supplemented through an endoscopic examination.


[Protheses of the penis; 130 cases (author's transl)]. The authors report their experience (13 years) with circa 130 operations and over 300 exercises on corpse-penes. From 1966 till 1972 the authors used an unilateral device, with inconstant good results. 1972 to 1975: a bifurcated penile implant made from Teflon with better results, but without firm proximal footings; (76 patients). 1975 to 1977: 73 cases = 26 with the new developped penile implant with one-way articulation and 11 with modified Small-Carrion penile implants. These modern protheses can create a true "phallus" = 130 to 150 mm long. The implants with one-way articulation guarantee solid posterior footings (very important for immissus in vaginam). The technique with the 3 approaches (perineal, praesymphyseal and distal) is described. The presence of a rigidified big penis was no problem for the patients, as long as it can be bent at its base, painless and efficient = potentia satisfaciendi. In doubtful situations the indication for operation should be settled by a team of specialists.


[Malignant tumours of the small intestine (author's transl)]. 31 cases of malignant small intestine tumours were treated surgically in a 14 years period. There were no characteristic early signs of disease. The correct preoperative diagnosis was based on radiological examination only. Although radical surgical treatment could be performed in 14 patients only, 29% of the cases reached a survival time of 5 years.


[Unrecognized perforations of gastric und duodenal ulcers after surgery (author's transl)]. After operative procedures of greater extent stress ulceration in the stomach or duodenum can arise, sometimes perforating the wall. Unfortunately, such perforations are not diagnosed in time. In a postoperative breakdown of the circulation, which otherwise cannot be explained, stress ulceration and perforation should be taken into consideration.


[Vagotomy and exocrine pancreatic secretion (author's transl)]. In dogs supplied with chronic pancreatic fistulas, there is no change of the basal exocrine secretion of volume three weeks after a bilateral truncular vagotomy. The normal initial reflex secretion during meal ingestion or glucose loading are abolished. On the whole, the secretory activity is reduced by about 50% after feeding. Secretions of volume and of enzyme protein are inhibited to the same extent, but that of bicarbonate is more strongly influenced. After vagotomy the inhibitory influence on all secretions of a rabidly produced hyperglycemia is reinforced. In pancreatic juice there is immunocreactive insulin activity (less than 1% fo the daily secreted amount). Insulin secreted in pancreatic juice after feeding is strongly reduced after vagotomy. This is the best reproducible proof of an influence on the exocrine pancreatic function of vagotomy.


[Secondary acute cholecystitis (author's transl)]. A case of acute postoperative cholecystitis following subtotal gastrectomy for carcinoma has been observed. The combination of temporary intraoperative shock and probably vagal denervation of the gallbladder initiated secondary acute cholecystitis. After an emergency type cholecystectomy the patient recovered.


Immunogenicity of UV-inactivated measles virus. By means of the antigen extinction limit test it was shown that a triple dose vaccination of guinea pigs with UV-inactivated measles virus gave better results, than a single dose vaccination which was proved by the very low immunogenicity index. For both vaccination schemes (single and triple) the immune response was only slightly influenced by a change of dose from 10(5) to 10(6) HadU50/ml or by the addition of aluminum adjuvant. In the antigen extinction limit test the antibody levels were determined by two methods (HIT and NT) the results of which were statistically equivalent. The UV-inactivated measles virus was also found to induce hemolysis-inhibiting antibodies.


[Epidemiological investigation of staphylococcal infections in stocks of SPF-animall (author's transl)]. The occurrence and spread of staphylococcal infections in stocks of SPF-animals were studied over a period of more than three years. The results were compared with observations made by other authors. Staphylococcus aureus strains isolated from both sick and healthy animals (mice, rats, rabbits, guinea pigs) as well as from veterinary staff were lysotyped with the international phage set for epidemiological investigations. The majority of the lysotypes demonstrated in sick mice and rats belonged to lysogroup III (77% and 96% respectively). S. aureus strains with the phage patterns III 6/42E/47/53/54/75/83A/ +, III 54/83A and III 54/83A/85 were most common amongst these animals. The lysotype 80/3c/47/53/54/75/84/85 + occurred in rabbits and guinea pigs only. S. aureus strains of lysogroup I and II, which are frequently involved in skin infections of man, were either found only very scarcely or not at all discovered in the animals tested. Among the veterinary personnel staphylococcal strains of the lysogroups I and III as well as non-classificable strains occurred at a similar rate of approximately 25% each. Several lysotypes (I 29, III 42E/47/53/54/75/77/84/ + M 187) persisted in members of the staff over a stretch of two to three years without causing infection to the animals under their charge. On the other hand, lysotypes isolated from infection sites (abscesses) in the animals were mostly found also in swabs from the nasopharynx of healthy animals and the personnel. The implications of the importation and the spreading of Staphylococci in animal stocks by veterinary staff are pointed out. Factors promoting staphylococcal diseases in animals and measures to prevent S. aureus infection from SPF-animal stocks are discussed.


[The influence of non-metabolizable alpha- and beta-glycosides on the regulation of sorbose fermentation of salmonellae (author's transl)]. Fermentation of sorbose by late positive Salmonella wildtype cultures and by mutant strains splitting this sugar promptly is restrained by the beta-glucoside salicine and likewise by 1-o-methyl-alpha-D-glucopyranoside (MGP), but is not influenced by lactose or sucrose. In growing cultures salicine works more powerful on sorbose utilization than MGP while in dense suspensions of non-multiplying bacteria the relations are reversed. Among the majority of wildtype strains this suppressive effect is diminished or abolished by dimethylsulfoxide (DMSO), but there are strains in which the glucoside effect is enhanced by DMSO. The sorbose fermentation lag in the presence of salicine or MGP is detectable, too, in dense suspensions of promptly splitting Salmonella mutant strains in media poorly supplied with nitrogen and must therefore be attributed to a non-mutative event. From prior work (Stenzel, 1977c) we got some evidence that this event might depend on an inhibition of enzyme induction. Targets and mode of action of the alpha- and beta-glucoside largely seem to be identical, though possibly there might exist minor differences.


Antibiotic resistance factors and other plasmids in bacterial isolates from hospitalized patients. Among 186 arbitrarily selected gram-negative as well as gram-positive bacterial strains isolated from hospitalized patients, 63% were found to harbour plasmids, 42% of the strains with extrachromosomal DNA showed more than one plasmid DNA band in the agarose gel electrophoresis. The highest plasmid frequency was found in the enteric gram-negative microorganisms: 95% to 76% of the analyzed Enterobacter species, Klebsiella pneumoniae and E. coli isolates harboured plasmids. The plasmid frequency in the Staphylococci and group D Streptococci ranged between 36% and 75%. The examined Pneumococci strains were sensitive to all antibiotics and were found to be free of plasmids. In 45% of the enteric strains studied, the resistance markers were found to be transferable to a sensitive E. coli recipient by conjugation. Some of the resistance genes had not formed a stable complex with a plasmid and were lost during in vitro passage of their bacterial host. The loss of R-factors in vitro causes false diagnostic findings in regard to the in vivo antibiotic sensitivity of such strains. With purified plasmid DNA, individually isolated from E. coli strains, transformants were obtained carrying ampicillin resistance specifying plasmids of different molecular size. This result indicates that plasmids of different molecular size in a single bacterial cell can simultaneously carry ampicillin resistance genes. All findings indicated that the plasmids play an important role for the transfer and the maintenance of antibiotic resistance specifying genes in the bacterial isolates from clinical patients. However, most of the functions coded for by the numerous plasmids in the bacterial isolates remained unknown.


[The evaluation of the inhibition of the macrophage migration inhibition test with the polysaccharid antigen "C" of Taenia saginata in human taeniasis (author's transl)]. The statistical analysis of results of the leukocyte migration inhibition test with polysaccharide antigen C of T. saginata in 49 patients with taeniasis and 20 healthy persons was performed. Examinations took place in two series: before medication (series I) and 7 days after treatment (series II). In the first series, a significant decrease in the migration index (0.42) was found in the patients' group as compared with that of the control group (0.92). In the second series, the migration index was subject to an increase (0.62) which, however, did not reach the value obtained in the control group. In both series, statistically significant differences in the indices of the test performed were observed between patients and the control group of healthy individuals. The results obtained in the present studies demonstrate that T. saginata invasion in human brings about the development of a cellular hypersensitivity reaction of delayed type which is revealed in the leukocyte migration inhibition test; the elimination of the parasite leads to an impairment of the effect of this reaction within a relatively short period.


[Fenbendazole therapy of experimental larval echinococcosis. I. The effect of fenbendazole on worm burden and protoscolex development of Echinococcus multilocularis (author's transl)]. Application of fenbendazole (methyl-5-(phenyl-thio)-benzimidazole-2-carbamate) in Echinococcus multilocularis infected mice showed a significant efficiency on the development of the cysts; the worm burden and the number of protoscolices were significantly reduced in the treated animals in comparison with the non-treated control mice. The degree of efficiency was subject to the way of application, the duration of medication, and the parasite strain: 1. On application of f. as medicated feed (500 ppm) worm burden and protoscolex number were reduced the most an average parasite weight of 105 mg and 2 protoscolices against 1942 mg and 99 protoscolices. Treatment by oral application with emulsion of 2.5% (1 ml/mouse/day, 5 x per week over a period of 2--5.5 months) the efficiency was less expressed (845 mg, 53 protoscolices). 2. By extending the treatment from 60 to 102 and 165 days resp. the reduction of worm burden can be increased from 81 to 95%. 3. From 2 parasite strains one which was recently isolated from a fox, reacted more on the treatment than the other one: 85 mg parasite weight against 1218 mg in the nontreated controls. On the other strain continued since about 25 years by intraperitoneal inoculation, the efficiency was more reduced: The worm burden was 866 against 2666 mg in the control mice.


A comparative study of Staphylococcus epidermidis isolates from clinical material and healthy carriers. A total of 190 Staphylococcus epidermidis isolates from healthy carriers and clinical material were biotyped according to the Baird-Parker scheme, phage typed by a provisional set of 18 typing phages and tested for antimicrobial susceptibility. The majority of the strains from both groups were found to belong to biotype 1. A considerable number of strains were lysed at 100 x RTD by at least  one phage. The strains from healthy carriers were distributed in 24 phage types and about half of them were clustered among three major phage types. Nine of the 30 clinical isolates were of the phage type 130/456 and another nine strains were of eight different phage types. The strain 130/456 represented only three per cent of the phage types from healthy carriers. The clinical strains exhibitbd a multiple resistance pattern to 13 antibiotics. Statistically significant was the difference in the resistance to Penicillin, Streptomycin, Carbenicillin, Erythromycin, Lincomycin, Ampicillin and Kanamycin between the groups of strains from clinical material and healthy carriers. No correlation was observed between biotypes, phage types and antimicrobial susceptibility in both groups of the isolates.


Epidemiologic Surveillance for Staphylococcus epidermidis infections related to cardiopulmonary bypass. Epidemiologic investigation of 20 Staphylococcus infections among valvular and aortocoronary bypass graft patients indicated a broad spectrum of clinical illness in these two groups. The highest infection rate (9.3%) and case specific mortality rate (54.5%) were noted among those patients undergoing cardiovalvular replacement surgery with protheses. The median onset of infection was 6 days suggesting infection during the intraoperative period. Using the epidemiologic data from this investigation, a transmission pattern was formulated and a series of control measures designed to interdict the routes of transmission were instituted wigh marked success. These measures significantly reduced the incidence of S. epidermidis infections among these high risk patients.


Ivestigation of coagulase-negative staphylococci from infections in surgical patients. All available isolates of coagulase-negative staphylococci from patients admitted to a unit for cardiac surgery during a 14-month period were examined. During this time 382 operations, in 220 of which a prosthetic valve was implanted, were performed. 65 patients suffered 76 episodes of postoperative infection. All coagulase-negative staphylococci isolated were classified by biochemical typing, bacteriophage typing and testing of anitbiotic susceptibility. The results of this investigation were reported and discussed especially from an epidemiological point of view.


Serological investigations on the polylysogeny of micrococci. Specific antisera against 11 micrococcal phages could be produced by immunization of rabbits. Using the neutralisation test all antisera were tested against their homologous and heterologous phages. The corresponding K-values were calculated. It could be demonstrated that phages coming from the same micrococcal donor strain can be of different genetical relationship. Therefore it was concluded that micrococci can be not only lysogenic but also polylysogenic.


Detection and preliminary characterization of extrachromosomal DNA in clinical isolates of Staphylococcus aureus and Staphylococcus epidermidis. Isolates of Staphylococcus aureus and Staphylococcus epidermidis frequently harboured extrachromosomal DNA. From the 20 Staphylococcus aureus strains examined 85% contained extrachromosomal DNA and 65% carried more than one plasmid DNA species. The results obtained with the 19 Staphylococcus epidermidis strains analyzed were similar, 84% of the strains had extrachromosomal DNA and 68% contained several DNA species. The agarose gel electrophoresis of the DNA obtained from cleared lysates of the staphylococci proved to be efficient for the detection of plasmids and the determination of their molecular weights. The gel method appeared therefore to be suitable for the establishment of the role of plasmids in the phage typability of staphylococci. Using a Staphylococcus epidermidis strain as an example it was shown by electron microscopy that the extrachromosomal DNA demonstrated by the agarose gel electrophoresis represented covalently closed circular plasmid DNA. This plasmid DNA could be sufficiently labeled with 3H-thymidine to undertake studies on the relationship and molecular characterization of staphylococcal plasmids.


Experiences with the typing of coagulase-negative staphylococci and micrococci. Strains of coagulase-negative staphylococci and micrococci from many sources were biotyped and tested with a set of 20 phages, 19 of which were described by Dean et al. Strains resistant to many antibiotics were generally untypable with these phages. Nearly 50% of untypable strains could be typed by "reverse" typing--the characterisation of strains by the pattern of lysis given by their supernates on the propagating strains for the typing phages. This method was also used to clarify the relationship between isolates from an outbreak of septicaemia in a cardiac unit.


Atrio-ventricular shuntinfections and endocarditis due to Staphylococcus epidermidis. Two groups of patients (with endocarditis and with atrioventricular shunt infections due to Staphylococcus epidermidis) are presented together with analysis of the causative agents by bio- and phage-typing. Additionally phagocytic function of polymorphonuclear leukocytes of selected patients was investigated but no decreased phagocytic function was found. A possible way of treatment is discussed.


[Serological typing of Vibrios, nonagglutinating with O-cholera serum, isolated in USSR]. The authors carried out serological typing of 2008 strains of NAG vibrios isolated in 1968--1975 in 18 territories of the Soviet Union from humans and from the objects of environment. Serological type was established in 40.5% of the srains isolated from humans and in 16% of the strains obtained from the environmental objects. Among persons with acute gastrointestinal diseases serotype 5 was the one which dominated, and among strains from the environment--serotype 8 Sakazaki. Serological type 15 was revealed for the first time in the USSR at the territory of Siberia and the Far East among the NAG-vibrio strains isolated from the environment.


[Molecular parameters of sensitization of tannin-treated erythrocytes with Salmonella d-flagellin]. A study was made of the molecular parameters of sensitization of tannin-treated sheep red blood cells with salmonella d-flagellin, depending on the protein dose, exposure, and temperature of the medium; the role played in this process by physical and chemical mechanisms was ascertained, the latter proving to determine the hemosensitization level. Senstivity of the erythrocytic diagnostic agent to the agglutinating action of the specific serum was maximal with a stable binding by a single red blood cell of about 200 000 flagellin molecules, although the limit of stable binding constituted 340 000 molecules per one red blood cell. On condition of saturation limit of the erythrocyte flagellin should block not over half of the cell surface. The temperature elevation during the diagnostic agent preparation is advantageous in technological respect, since it leads to reduction of flagellin expenditure and increases the sensitivity of the passive hemagglutination tests.


[Organ specificity and cytotoxic properties af autoantibodies in brucellosis]. The presence of freely circulating autoantibodies was studied in patients with various clinical forms of brucellosis. Autoantibodies to the tissues of the liver, lymph nodes, spleen and the heart were revealed in the patients with acute, subacute, and chronic brucellosis. Investigations directed to ascertain the biological role of autoantibodies in brucellosis pointed to the organ specificity. Results of determination of the influence of the circulating antibodies on the intensity of tissue respiration and the processes of dehydration in the hepatic tissue showed antihepatic autoantibodies to produce a cytotoxic (aggressive) action. This confirmed a definite significance of autoimmune processes in the pathogenesis of brucellosis.


[Changes in the peripheral blood lymphocytes after immunization and its effect on the course of experimental inflammatory process in the lungs]. It was shown that in the immunization of rabbits with sorbed staphylococcus toxoid and human albumin, at the height of the immune response there occurred an intensification of biosynthesis and destabilization of lysosomal membranes of blood leukocytes, with a simultaneous development of microcirculation disturbances in the lungs. Development of pneumonia against the background of immunization led to a greater destabilization of the lysosomic membranes of leukocytes and to the intensification in the lungs of infiltrative and destructive processes, in comparison with the course of inflammation in the nonimmunized animals. Peculiarities of the antigens used caused some specificity in the course of pneumonia. A relationship between the changes of blood leukocytes and disturbances in the lungs in immunization is supposed.


[Mechanism of staphylococcin formation]. The author studied the optic density and the viable cell count in 2 strains of bacteriocinogenic staphylococci and their variants in which the bacteriocinogenicity factor was eliminated. Latent phase was prolonged in strains devoid of bacteriocinogenic factor; it was practically absent in bacteriocinogenic cultures. Bacteriocin production began on the 60th minute and this was accompanied by the death of cells and their lysosomes. With further culture growth bacteriocin formed in jerks and this was accompanied by the death of cells and their lysosomes.


[Role of lysosomes in immunodepression]. Degrading of heterologous protein--bovine serum albumin--under the action of lysosomes inhibited the immunodepressive preparations with chlorophos and 2,4-dichlorphenoxyacetic acid (2,4-D). Immunodepressors (chlorophos, 2,4-D, cyclophosphane, phosphestrol, methotrexate, ftuoruracil) suppressed the activity of cathepsin, whereas dibasol--an immunostimulant--failed to alter its activity. The principal possibility of the selective immunodepression at the level of lysosome enzymes is substantiated.


[Immunogenic properties of cholerogen-toxoid and killed corpuscular vaccine in acute experiments on guinea pigs]. A comparative assessment of the immunogenicity of cholerogen toxoid and of killed corpuscular cholera vaccine was given. Guinea pigs immunized with cholerogen toxoid acquired a greater resistance to the intrapulmonary infection with virulent cholera vibrio culture (immunity index--2.1.10(4)) than those immunized with killed corpuscular vaccine (immunity index--3.5.10(2)). Immunogenicity of cholerogen toxoid could be increased in its combined administration with killed corpuscular vaccine.


[Interrelationship between delayed hypersensitivity and macrophage resistance to infection by influenza virus]. Interaction between the influenza virus and the sensitized cells, depending on the number of animal immunizations, was studied on a model of mouse peritoneal macrophages. The maximal suppression of the macrophage migration was observed in 2 weeks in 21% of mice immunized once, and in 35% of mice immunized twice. Three hours after the infection of the macrophage culture with the influenza virus in a dose of 10 EID50 there were revealed in the cells obtained from mice immunized once 70%, and from mice immunized twice 8% of the infectious virus in comparison with the intact macrophages. There was a direct relationship between the delayed hypersensitivity determined in the macrophage inhibition migration test and the macrophage resistance to the infection with the influenza virus.


[Immunogenic and antigenic properties of continuously cultured typhoid bacteria]. It was shown that in continuous cultivation of typhoid bacilli, by changing the rate of dilution and the regimens of carbohydrate and oxygen supply it was possible to determine conditions under which the most highly immunogenic vaccines were obtained and the maximal synthesis of antigens was observed. The regimen optimal for obtaining the highly immunogenic typhoid vaccines (D = 0.4 h-1; So = 5 g/l; pO2 = 50%) coincided with the regimen at which the maximal O-antigen synthesis was seen, and failed to coincide with the regimens necessary for the greatest synthesis of Vi- and H-antigens.


[Pathogenesis and treatment of torsion dystonia]. A study of the catecholamine excretion, their precursor DOPA and final metabolites--Homovaniline and vanilylphenylglycolic acid in torsion dystonia, detected certain changes which were different in patients with various clinical forms of the disease. On the basis of clinical and biochemical data 3 forms of torsion dystonia were distinguished: 1) with a prevalence in the clinical picture of muscle rigidity, leading to the development of pathological postures;  2) hyperkinetic forms and 3) mixed forms. In patients of the first group there was a decreased excretion of all catecholamines. On the basis of obtained data the conclusion is made that there is a drop in the intensity of the process of dophamine synthesis and an increase of its catabolism. In the hyperkinetic form, on the contrary, there is a tendency to an increase of dophamine synthesis. It is assumed that there is a drop in the intensity of the process of adrenaline synthesis and an increase of its catabolism. On the basis of biochemical heterogeneity of torsion dystonia the authors recommended different approaches in treating different forms of this disease. In a prevalent muscular rigidity the functions of the dophaminergic systems should be intensified: on the one hand, by administering precursors of dophamine L-DOPA, on the other--by inhibiting antagonistic activity with the aid of different cholinolytic preparations. In a hyperkinetic form a favorable effect is attained by preparations, inhibiting the dophaminergic activity (mainly preparations of the phenothiazine and butyrophenon series).


[Use of seduxen to arrest acute cochleovestibular syndromes in transient cerebral disorders]. The authors give a concise characteristics of different types of the cochleovestibular syndromes. On the basis of a study concerning the effect of injectable Seduxen in 54 patients with vascular brain disorders (transient disorders of cerebral circulation, ischemic strokes, chronic vertebro-basillar insufficiency) and 3 patients with cochleo-vestibular syndromes of a non-vascular genesis the conclusion is made of the effectiveness of this preparation for arresting acute vestibular disorders of vascular etiology. The preparation exerts a normalizing multidirected action on the different links of the CNS and the vegetative nervous system.


[Clinico-rheoencephalographic characteristics of the cerebral form of neurocirculatory dystonia]. The study is related to a clinical and REG study of 387 patients with cerebral forms of neurocirculatory dystonia, proceeding against the background of normal, increased and decreased arterial pressure. These studies were performed in order to clarify the question of the state of cerebral hemodynamics in this form of vascular pathology. The study detected some general regularities of the changes of cerebral hemodynamics (an increase of the cerebral vascular tone, difficulties of the venous outflow, signs of vascular dystonia in the form of unstable curves and intrahemispheric asymmetry) and some traits in different types of neurocirculatory dystonia as well as some traits of semiotics.


[Effect of droperidol on cerebral circulatory indices in cerebral hemodyscirculations]. The study deals with the influence of Droperidol introduced intravenously in doses 2.5 mg on the REG indices of cerebral hemodynamics in patients with disorders of cerebral circulation. The achieved data indicate its mild hypotensive effect, an increase of the module of elasticity of the walls in large brain vessels along with a distinct decrease in the cerebral vascular resistance, as well as an improvement of the venous outflow of blood due to the influence of droperidol. The effect of this preparation appeared to be more expressed in patients with hemmorrhages into the brain and its membranes. A drop in the amplitude of brain fluctuations along with a drop of the arterial pressure made it possible to adequately correct the prescription of droperidol to patients with disturbed brain circulation.


[Prognostic possibilities for polyrheography in patients with different variants of the clinical course of myocardial infarct during the acute period]. The paper pertains to a comparative study of the nervous system, cerebral and peripheral circulation in 83 patients with different clinical variants of myocardial infarctions during the first decade of the disease. There were no direct correlations between a decrease in the absolute figures of cerebral pulse repletion and the development of a cerebral stroke. However, the study demonstrated a distinct correlation between the development of cerebral stroke in patients with myocardial infarctions during the first decade and insufficiency of the compensatory intensity of blood repletion both in the cerebral and peripheral vascular basins.


[Carbon dioxide gas provoking and stopping an epileptic seizure]. The author discusses some mechanisms, conditioning the double role of carbon dioxide in the genesis of epileptical activity, first as a provocative factor, when carbon dioxide is a background against which the epileptical seizure appears and then as arresting the sequalae during the administration of CO2 during a seizure. It was demonstrated that the different action of CO2 was due to different phases in the changed functional state of the brain. The study was accomplished on 80 rabbits of the chenchille breed. The evalution of phases in changes of the functional state of the brain was performed with the aid of the encephalographic method.


[Discrepancies between clinical and anatomic diagnoses in the diagnosis of brain tumors]. The presented paper contains some results pertaining to 32 cases of divergent diagnosis in brain tumors according to the data of the prosectorium of the Leningrad N1 psychoneurological nursing home of a hospital type from 1955--1977. The most frequent clinical diagnosis were "atherosclerosis" and "hypertensive disease". Most of the nondetected brain tumors were arachnoendotheliomas. The authors analyze the causes of such discrepant diagnosis and retrospectively consider some problems of treatment.


[Two symptoms of elective paresis of individual hand muscles]. The author describes 2 symptoms of elective lesions of the hand muscles: one of the central genesis, the other--peripheral, vegetative. The first symptom is characterized by a weakening of volar and dorsal interossal muscles of the hand in an increased electrical activity, which is beyond the weakened muscles. It is due to a lesion of filogenetically new cortico-spinal path, adjacent to the pyramidal and participating in the innervation of the muscles of the distal parts of extremities. The second symptom is "the symptom of the fifth finger", which is characterized by a selective weakening and decreased electrogenesis of the muscles in the fifth finger--abductor, adductor and the flexor brevis. Due to this it is likely caused by the activation of beta2-adrenoreceptors in the neuromuscular synapse, evoked by the irritation of cervical sympathical nodes and seen in degenerative changes of the cervical intravertebral discs, isolated cervical sympathalgia and toxico-infectious vegetative-vascular processes, especially hypothalamic.


[Use of focused ultrasound in studying the tactile sensitivity of neurologic patients]. Tactile thresholds were measured with the focused ultrasound in 21 healthy subjects and 30 patients with various neurological diseases. All patients in spite of the level and origin of the disorder in the tactile--conducting pathways exhibited increased thresholds which were the most evident with 0.1--1 msec stimulus duration. This method allows not only to confirm the disorder of the tactile sensation, but to characterize it quantitatively including "subclinical" degree as well.


[Comparison between clinical and pathologoanatomic diagnoses according to the records of the Irkutsk Nervous Diseases Clinic for the past 20 years (1956--1975)]. The authors have studied post-mortem data of the Irkutsk Clinic of nervous diseases for the past 20 years (1956--1975). During this period a total of 19277 primary patients were treated, 371 of whom died (the per cent of lethality--1,9%), a coincidence of diagnosis was in 83%, a discrepancy--in 12,6%. A discrepancy of diagnosis was being analyzed according to the 3 largest groups: tumours, disorders of circulation, malignant brain tumors and undiscerned complications of the main disease and accompanying disorders. The large sectional material of the clinic over the past 30 years (1946--1975) including 666 postmortems (the material from 1946--1955 consisting of 342 sections was studied and published previously) gives ground to attempt to find out the causes of errors and to suggest some recommendations, related to the Instructions for Comparison of Clinical Pathoanatomical Diagnoses. The authors stress the exceptional importance of collaborative work both of clinicians and prosectors in order to improve the health organization and treatment of patients.


[Latent endogenous depressions. II. Clinical systematics]. On the basis of clinico-catamnestical study of 384 patients with cyclothymia (96 cases), schizoaffective psychoses (104 cases) and shift-like schizophrenia (184 cases) with the syndrome of larvate depression the author describes the autodevelopment of syndromes beginning from astheno-vegetative, cenestopathic up to delusional-hypochondriacal. Due to the obtained data and literature data the author bases the clinico-scientific continuity of the problem of larvate depressions with the most ancient problem of hypochondria. The independency of larvate depressions as a separate disease is being denied.


[Pathophysiologic mechanisms of depressive states of endogenous or exogenous origin]. A total of 117 patients with depression of a various genesis were studied. The patients with endogenous (circular) depression displayed a correlation between the EEG, vascular and vegetative tonus, catecholamine excretion (especially noradrenaline) and peculiarities of the clinical picture. In patients with somatogenic depression a correlation between the studied indices of a functional state of an organism is not present. Psychogenic depression is characterized by a domination of desynchronized activity of low volts in the EEG and the existence of expressed sympathicotony of the peripheral vegetative system, while statistically significant shifts of the vascular tonus and catecholamine excreation are absent.


[Serum enzyme activity in epileptic patients]. The authors studied the activity of blood transaminase in 50 epileptic patients during different clinical periods--interattack period, prior  to attacks and following different by severity paroxysms. It was found that there was increase in the transaminase activity due to the occurence of seizures. It is considered that at the basis of such changes are hemodynamical changes due to seizures and changes caused by long-term treatment with anti convulsive drugs.


[Role of the degree and character of identical parental loading as a factor in the clinical polymorphism of epilepsy]. A comparative clinico-constitutional analysis of 73 cases of epilepsy with an identical parental loading and 179 without it, demonstrated that the degree and character of a parental loading is one of the genotypical factors determining the fenotypical polymorphism of epilepsy. This circumstances causes the frequency of associations with dysgenesia, epileptoid traits, modifying the age of manifestation and progression of the disease. This should also be taken into consideration in prognosticating the severity of epilepsy during treatment and socio-labor adaptation in patients depending upon the degree and character of identical parental loading.


[Initial mental disorders in rheumatism]. The paper deals with 11 cases of mental disorders appearing during the initial phases of rheumatism. Their duration and psychopathological traits were related to the development acuity and expressiveness of the clinical picture of rheumatism. The author indicates special traits of mental disorders in latent rheumatism, the beginning of which are at times difficult to estimate. Factors promoting the appearance of relapses of mental disorders are being evaluated.


[Speech disorders in senile dementia].

[Speech disorders in senile dementia]. A neurolinguistical analysis of speech by the articulation method of E. N. Vinarskaya in patients with senile dementia (4 cases) and its combination with cerebral atherosclerosis (4 cases) permitted to detect a primary "level" defect in the speech functional system. The study demonstrated a prevalent lesion of the lower, gnostico-praxis level in combination of 2 processes and prevalence of disorders of a higher, phenological (lingual)--in cases of "pure" senile dementia. A comparison of the clinical stage of the disease and the level of lesion in the speech functional system showed a possibility of an unusual (from lower to higher) destruction in patients with senile dementia with preservation of the "ordinary" regularity from the higher to lower) in memory and intellectual impairment. The detected characters of a primary speech defect in senile atrophy permitted to allocate speech disorders in such cases to genuine aphatical (focal)--the syndrome of superior-temporal area of the left hemisphere of the temporal-acoustical aphasia according to A.R. Luria. It is demonstrated that in this defect there is an involvement and disturbance of the subcortical structures as an expression of a diffusion of the destructive process.


[Several functions of the visual analyzer in chronic alcoholic patients]. The authors examined 615 patients with chronic alcoholism. The study demonstrated an increased number of individuals with myopia, presbyopia, amblyopia, angiomas and angiosclerosis among them as compared to that of the general population. The frequency of optical nerve atrophies in the patients was not high (0.32%). In 205 cases the function of colour sensory and darkness adaptation was determined. The highest frequency of colour sensory was in the group of patients with the withdrawal syndrome. Eventually this function had a tendency towards restitution. The velocity of darkness adaptation was drastically changed in patients with chronic alcoholism but it was also reversible.


[Long-term treatment of schizophrenic patients with leponex (clozapine)]. The authors studied a prolonged (3--5 years) use of leponex in 23 patients with the most progressive forms of schizophrenia (hebephrenic, paranoid and close to them attack-like). The study included the influence on the frequency and duration of relapses, on the dynamics of the so-called productive and negative disorders and social adaptation. The achieved data indicate that leponex possesses certain advantages compared to other neuroleptical drugs in prolonged maintenance therapy. Leponex has a rather "universal" psychopharmacological effect which includes a capability of arresting acute psychoses, exerts a psychoregulating influence on the general behaviour, contacts and socio-working adaptation, distinctly alleviates the clinical signs and frequency of relapses. Due to the absence of motor disturbances and minimum of other side-effects leponex is quite convenient for prolonged use and promotes a higher quality of remissions.


[Reaction of the pre-edematous brain to an increase in venous pressure]. Changes in the volume of the open brain were recorded in rabbit experiments ("chest-head" preparation) in a series of tests with controlled increase in general venous pressure by approximately 13 mm Hg. At the beginning of the experiments the changei in the volume of the open brain and general venous pressure occurred parallely to each other, but later, when the brain became preedematous, hysteresis was detected on the curves of their dependence. Hysteresis increased gradually during the experiment, indicating that impedement of blood drainage from the venous system of the brain and/or resorption of fluid from its tissue had begun to the development of stable edema. It is assumed that the predematous condition of the brain is caused by changes either in the mechanical properties of its tissue or in its osmolarity.


[Role of intracerebral pressure and local cerebral blood flow in predicting the outcome in brain lesions]. Long-term, continuous quantitative study of intracerebral pressure and local cerebral blood flow in patients with lesions of the brain was undertaken for the purpose of using the data obtained for prognosticating the outcome in the postoperative period. Statistical analysis of the data showed that the most probable outcome of the disease (P less than 0.05) may be prognosticated from the relations between the intracerebral pressure and the local cerebral blood flow for each postoperative day (10 days). The authors obtained the values of intracranial pressure and local cerebral blood flow which are characteristic of an unfavourable outcome in lesions of the brain.


[Effect of body position on cerebral circulation in neurosurgical patients]. The mechanisms of the regulation of blood drainage from the brain were defined more precisely in 87 neurosurgical patients on the basis of comprehensive examination of cerebral circulation. The vertebral venous plexus was found to play the most important role in this process. Under normal conditions, when the patient is lying blood drains along the internal jugular veins, when he is sitting it drains mainly along the vertebral venous plexus. In patients remaining in a horizontal position for a long period of time the regulation of venous drainage is impaired. In such cases blood drains along the internal jugular veins and the vertebral venous plexus both when the person is lying and when he is sitting. This may cause a deterioration in the condition of bed-ridden patients during and after an operation performed with the patient in a sitting position.


[Transcapillary water filtration in the presence of an increase in intravascular pressure as a factor in the development of brain edema]. The concentration of K+ and Na+ ions in the extracellular fluid of the parietal cortex of the brain was studied in experiments on rabbits ("chest-head" preparation) by means of selective electrodes during a controlled increase in general venous pressure by approximately 13 mm Hg. A decrease in the concentration of Na+ ions and mild changes in the concentration of K+ ions indicated that the extracellular fluid was diluted due to filtration of water from the blood vessels. In the normal brain this process was reversible, while in a pre-edematous condition the excess filtration of water led ultimately to the development of edema of the brain with the corresponding changes in the function of the plasma membranes and changes in the concentration of K+ and Na+ ions in the extracellular fluid.


[Differential diagnosis of brain tumors and chronic subdural hematomas according to echoencephalographic and electroencephalographic findings]. Examination of 15 patients with tumors of the brain in whom the presence of subdural hematomas could not be excluded and of 27 patients with chronic subdural hematomas revealed that displacement of the M-echo was 8 +/- 0.43 mm on the average in chronic subdural hematomas and 5.6 +/- 0.43 mm in tumors. EEG abnormalities were observed in 100% of cases with tumors and were mostly of a coarse character. In chronic subdural hematomas EEG abnormalities were relatively rare (18.5%) and were less manifested than those in tumors. The statistical significance of the differences evidently allows the sign of the dissociation of the EEG and Echo-EG data in chronic subdural hematomas to be used for the differentiation of the disease from tumors.


[Ultrastructure of cerebral cortical synapses in closed craniocerebral injuries]. The brain of 5 individuals with an open craniocerebral trauma was examined with an electron microscope. Changes in interneuron structures were found. Occasional synaptic vesicles grow in size and move away from the presynaptic membrane. The number of synaptic vesicles decreases and they gather in groups (agglutination). The presynaptic membrane thickens and the synaptic cleft is closed with an electron-dense substance. The mitochondria are damaged. Glycogen granules and lysosomes appear as signs of synapse degeneration.


[Treatment of brain stem tumors].

[Treatment of brain stem tumors]. The results of surgical and combined treatment of 155 patients with tumors spreading to various parts of the brain stem as well as the catamnestic data on 50 of 75 patients dismissed from the clinic were studied. The difficulties of identifying a tumor of the stem are shown and methods of neurosurgical diagnosis necessary for determining the precise character of the process and localization of the tumor are discussed. It is stressed that tumors of the stem attended with the hypertensive-hydrocephalic syndrome must be treated surgically. The treatment should be aimed at partial removal of the tumor or evacuation of the cyst, decompression of the stem, and restoration of C.S.F. drainage by applying bilateral ventriculo-cisternal drainage. It is shown that radiotherapy applied in addition to surgical treatment improves the outcomes.


[State of the vertebral canal in vertebral and spinal cord injuries]. The results of the analysis of 128 patients who had died after trauma of the spine and spinal cord are discussed. Total disturbance of the anatomical intactness of the vertebral canal walls was demonstrated on all specimens. In 85% of patients there were fractures with or without displacement of the injured vertebra; 15% of patients had suffered injury only to the ligamentous-capsular apparatus, the disk included, with no displacement--dislocation of the vertebra. The shape of the vertebral canal was distorted only in cases with displacement of the vertebra. The area of the canal was reduced to almost half the size demonstrated on the radiograms.


Estimation of femoral arterial blood flow from femoral venous oxygen saturation. In six patients in whom a femoro-popliteal vein bypass graft was performed for intermittent claudication, the relationship between the haemodynamic state of the leg and the femoral venous oxygen saturation before and after local vasodilatation was investigated. The study was undertaken with special reference to the known influence of hypovolaemia on the leg blood flow. It is concluded that a femoral venous oxygen saturation below 70%indicates that the leg blood flow is less than 200 ml/min and that the bypass flow is less than 100 ml/min and thus within a range in which the incidence of early thrombosis is high. Furthermore, an increase in femoral venous oxygen saturation of 10% or more on local vasodilatation indicates a state of hypovolaemia, necessitating further blood substitution.


Polycythemia vera as a cause of ischemic digital necrosis. Two patients with polycythemia vera and peripheral gangrene as the only clinical sign of the disease are described. No concomitant arterial insufficiency was present. The need for an early correct diagnosis in such cases is underlined. Reduction of the blood volume and cytostatic treatment are sufficient and no surgical intervention is required.


The iliac compression syndrome.

The iliac compression syndrome. The iliac compression syndrome is caused by impaired venous drainage of the left leg, secondary to compression or stricture of the left iliac vein at, or just before, its junction with inferior vena cava. Serious potential complications are deep vein thrombosis, pulmonary embolism, venous congestion, and the resultant incapacity. Nine patients in whom the diagnosis was confirmed by iliac phlebography are described. Iliac pressure determinations were made in 7 patients. Four patinets underwent resection, and retroplacement of the right iliac artery behind the left iliac vein. The operative results were good. This rare syndrome should always be considered in the differential diagnosis of peripheral venous disease, as it can be treated in the early stages. If it is left untreated, there is a risk of pulmonary embolism or incapacitating peripheral vascular disease.


Tuberculosis after intestinal bypass operations. Two cases of tuberculous infections occurred after intestinal shunt operations for obesity among 161 patients observed for more than one year. One died of generalized tuberculosis. Another 2 patients, who before the operation had had tuberculosis, managed well without signs of postoperative activation of the tuberculous infection seems to be unpredictable.


The effect on total antimicrobial consumption and hospitalization time after prophylactic treatment with doxycycline in colorectal surgery. The effect of routine antimicrobial prophylaxis on hospitalization and the total consumption of antimicrobials in colorectal surgery was evaluated in a prospective and controlled study, where the incidence of abdominal wound sepsis was significantly reduced from 41.6% in the control (n = 60) to 8.6% in the doxycycline group (n = 58). Concomitantly, the average number of postoperative hospital days decreased significantly from 23.4+/-17.9 to 16.4+/-8.2 (p less than 0.01). This difference was more prominent in cases with postoperative abdominal sepsis, where the average number was 35.8 days in the control and 22.8 days in the doxycycline group. In the latter group only 19% of the patients required antimicrobial therapy during the postoperative course, compared with 65% of the patients in the control group. The period of exposure to antimicrobials amounted to 48.3% (451 days) of the postoperative hospital stay in the doxycycline vs. 53.3% (747 days) in the control group. Thus, prophylaxis significantly reduced the rate of wound sepsis, the time of and the need for hospitalization, the total consumption of and the time of exposure to antimicrobials.


Bilateral iliacus haematoma with femoral nerve palsy complicating anticoagulant therapy. A patient is reported who sustained bilaterial iliacus haematoma with femoral nerve palsy during treatment with constant intravenous infustion of heparin for deep venous thrombosis. She was promptly treated with operative decompression and recovered completely from the palsy. Daily examinations of the blood revealed that the plasma heparin concentration, activated partial thromboplastin time, APTT, and thrombin time all were above the therapeutic range at the time when the bleeding started, and before the initial symptoms occurred. Early operative decompression is considered to be the ideal treatment in patients who develop this complication during anticoagulant therapy.


Revascularization in mesenteric infarction by reimplantation of the superior mesenteric artery. Report of a case. A case of revascularization in mesenteric infarction by reimplantation of the superior mesenteric artery combined with intestinal resection is presented. The patient had an acute occlusion of the superior mesenteric artery with coincident blockage of celiac axis and inferior mesenteric artery resulting in gangrene and perforation of the small bowel. The good postoperative recovery suggests the usefulness of this method in selected cases.


Liposarcoma of the breast. A case report. Two cases are reported of liposarcoma of the breast, the first in a 62, and the second in a 60-year-old woman, respectively. The tumours were of the poorly differentiated, pleomorphic type and predominantly myxoid type, respectively. Liposarcoma of the breast is extremely rare, and including the present two cases, only 32 patients suffering from the condition have been described. It is difficult to make any prognosis owing to the small number of cases reported. Patient No. 1 in the present work, died 14 months postoperatively, owing to widespread metastatic tumour tissue infiltration of the spine, liver, as well as, the lungs; No. 2 lived for 17 years without signs of recurrence, until she died of carcinoma of the opposite breast.


Total pancreatectomy for acute hemorrhagic pancreatitis. A case report. A patient with acute hemorrhagic pancreatitis treated successfully with total pancreatectomy is reported. Total pancreatectomy is rarely indicated in acute hemorrhagic pancreatitis as suggested by only one surviving patient in the literature so far. Though near total pancreatectomy remains the best surgical treatment in patients with acute hemorrhagic pancreatitis dying from the disease because of failure of nonoperative treatment, total pancreatectomy may be considered as an alternative if circumstances so indicate.


Calcitonin activity of the thyroid gland in primary hyperparathyroidism. The thyroidal content of calcitonin was investigated in patients with euthyroid goitre, patients undergoing laryngectomies or neck operations and finally patients with primary hyperparathyroidism using method of biological titration. Patients with primary hyperparathyroidism had markedly decreased content of calcitonin in the thyroid gland when compared with the content of calcitonin of both groups of patients without calcium metabolism disturbance. Decreased content of calcitonin in patients with primary hyperparathyroidism can be explained by long lasting hypercalcaemia during which the rate of biosynthesis of calcitonin in the C cells does not keep up with the rate of release of calcitonin into the circulation.


Oestrogen treatment and subsequent pregnancy in two patients with severe hypergonadotrophic ovarian failure. This report describes in detail the histological and hormonal findings in a patient with Turner's syndrome (45,XO) and a patient with premature menopause (46,XX), who both conceived after withdrawal or reduction of substitution therapy with oestrogens. The aetiology of severe hypergonadotrophic ovarian failure is discussed, and theories regarding a possible relationship between the oestrogen treatment and subsequent pregnancy are hypothesized.


Sex differences in catecholamine content in discrete brain nuclei of the rat: effects of neonatal castration or testosterone treatment. Dopamine and norepinephrine levels were measured in individual brain nuclei in normal adult male and female rats and in adult male rats castrated on day 1 of life and in adult female rats given 1.25 mg testosterone propionate on day 4 of life. Normal adult males showed higher concentrations of dopamine than females in the caudate, tractus diagonalis and arcuate nuclei and in the median eminence. Day 1 castration of males reduced the dopamine levels of the arcuate nucleus and nucleus of the tractus diagonalis, while neonatal administration of testosterone to females elevated the dopamine concentration of the arcuate nucleus and nucleus of the tractus diagonalis. Normal adult males had higher concentrations of norepinephrine than females in the preoptic-suprachiasmatic, paraventricular, periventricular, and arcuate nuclei and in the median eminence. Neonatal endocrine manipulations (neonatal male castration and female testosterone treatment) failed to alter significantly these sex differences. The results suggest a sexual dimorphism in the catecholamine innervation of certain discrete areas of the brain and that the dopamine concentration in the arcuate and tractus diagonalis nuclei is influenced by perinatal androgen.


Dissociation of plasma and CSF prolactin heterogeneity. Plasma and cerebrospinal fluid (CSF) specimens from 3 patients with suprasellar extension of a pituitary tumour were fractionated by column chromatography. "Big" and "little" prolactin were found in plasma but only "little" prolactin was found in CSF. Prolactin containing CSF from 2 of the patients was incubated with prolactin-free plasma and chromatographed. The elution patterns demonstrated a striking shift toward the [125I]albumin marker resembling the "big" and "little" prolactin pattern seen in native plasma. In addition, [125I]h prolactin was incubated with prolactin-free plasma and rechromatographed. A substantial early eluting peak of radioactivity occurred in the zone of albumin elution. The presence of only "little" prolactin in CSF and the conversion of CSF "little" prolactin to "big" prolactin by exposure to plasma suggest that "big" prolactin is not a prohormone but results from binding of "little" prolactin to plasma proteins or aggregation of "little" prolactin in the presence of plasma.


A heterologous radioimmunoassay for avian prolactin: application to the measurement of prolactin in the turkey. A specific heterologous double-antibody radioimmunoassay has been developed to measure turkey prolactin (PRL) using a guinea pig anti-hPRL antiserum and 125I-labelled ovine PRL [125I]oPRL. Turkey pituitary prolactin and serum give parallel dose-response curves and no cross-reaction is seen with turkey growth hormone, LH or FSH, or mammalian LH, FSH, TSH, GH or placental lactogens. The RIA is accurate and precise and is sufficiently sensitive to measure PRL in all physiological situations investigated in the turkey. The RIA will measure PRL in several avian species including the chicken, duck, goose, pheasant, pheasant X chicken F1 hybrid, pigeon, quail and rock. Plasma PRL concentrations in laying and broody turkey hens were not significantly different (46.5 +/- 2.5 vs. 39.7 +/- 3.8 ng/ml) but both were significantly higher (P less than 0.001) than in non-laying turkey hens (4.6 +/- 0.7 ng/ml). Oestradiol injection into laying hens did not alter PRL levels while the same injection in non-laying hens caused a significant three-fold increase in plasma PRL levels.


Fine structure of rat prolactin cells after treatment with a long acting depot contraceptive. Adult intact female rats were injected with norethisterone oenanthate (NOe), with or without simultaneous administration of CB-154, or with oestradiol benzoate (OeB). The ultrastructure of prolactin (PRL) cells due to the various treatment regimens was investigated and compared with the situation found in controls. Both after treatment with NOe or NOe plus CB-154, the number of PRL cells increased and displayed various ultrastructure signs of stimulation. The determination of serum PRL levels coincides with these morphological findings. In all treated animals mammary gland DNA content was significantly increased. The results presented indicate that proliferative changes in the rat mammary gland depend predominantly on the presence of progestogenic activities additionally to PRL, whereas the effect of oestrogens was regarded as an indirect effect via their PRL-stimulatory action.


The effect of a slightly acidic somatomedin peptide (ILAs) on the sulphation of proteoglycans from articular and growth plate chondrocytes in culture. Chondrocyte cultures were prepared from rabbit growth plate (GPC) and articular (ARC) chondrocytes. These two cell types have distinct morphological characteristics. The cells reached maximum numbers by days 10 and 21 for ARC and GPC, respectively. The proteoglycans (PG) contained in the cellular pool were extracted and purified by DEAE cellulose chromatography. The effect of a partially purified somatomedin peptide with insulin-like activity on [35S]sulphate incorporation into PG was evaluated. In both ARC and GPC a significant stimulation of [35S]sulphate uptake into PG subunits was obtained with 1 ng Eq./ml of somatomedin peptide. In order to obtain the same stimulatory effect with porcine insulin, a 1000-fold greater concentration was required. The electrophoretic patterns of the PG subunits on acrylamide-agarose electrophoresis were identical on control incubations and after stimulation with the somatomedin peptide. These data demonstrate in vitro biological activity of this peptide on well differentiated articular and epiphyseal growth plate chondrocytes in culture. These cultures appear to provide a sensitive biological assay for somatomedin peptides.


Urinary excretion of thyroxine, triiodothyronine, 3,3',5'-triiodothyronine (reverse T3) and renal function in human newborns. The urinary excretion and serum levels of thyroxine (T4), triiodothyronine (T3) and 3,3',5'-triiodothyronine (reverse T3) was estimated in a longitudinal study of human newborns. The maternal and cord blood was also studied. Neonatal renal function was evaluated using endogenous creatinine clearance. In cord blood serum T3 was found to be lower than in maternal blood, but reverse T3 highly elevated. During the first 5 days of life serum T4 and T3 increased with maximum at 48 and 24 h in contrast to reverse T3 which remained high and then declined rapidly after 4 days. Creatinine clearance during the first 3 days of life increased from 5.3 to 21.9 ml/min/1.73 m2. In the same period the urinary T4 excretion increased from 79 to 281 ng/24 h, urinary T3 excretion from 16 to 44 ng/24 h and urinary reverse T3 from 4 to 15 ng/24 h. The renal excretion of thyroid hormones, corrected for body surface, was decreased compared to adult controls, corresponding to an immature renal function. The lack of ability to excrete thyroid hormones involved primary T3 and reverse T3 suggesting particular immaturity of tubular secretion of these hormones during the neonatal period.


Regulation of pancreatic glucagon secretion during a continuous glucose infusion in early and overt diabetics. The pancreatic glucagon (IRG) secretion pattern was studied during a 2 h glucose infusion test (12 mg/kg/min) in 21 controls as well as in 44 subjects showing different degrees of carbohydrate intolerance. The fasting IRG levels increased significantly from controls (98 +/- 7.6 pg/ml) to chemical (144 +/- 9 pg/ml) and mild maturity-onset-type diabetics (166 +/- 12.2 pg/ml). During artificial hyperglycaemia the glucagon concentrations decreased slightly in all groups, but they remained at a higher level in early and overt diabetics). The molar IRI-IRG ratios have been found to be diminished in patients displaying a disturbed carbohydrate tolerance. There was not any correlation between insulin and glucagon concentrations in the blood. The findings suggest that abnormalities of alpha cell function may be present in early and overt diabetes independent of beta cell responsiveness. The causal relationship of A and B cell function in glucose intolerant subjects has to be cleared in follow-up studies.


The hormonal regulation of hepatic microsomal 11beta-hydroxysteroid dehydrogenase activity in the rat. Hepatic microsomal 11beta-hydroxysteroid dehydrogenase activity is higher in male than in female rat liver. Gonadectomy on day 25 of life only affects the activity in the adult male animal, causing a decrease towards the normal female level. Administration of testosterone to gonadectomized rats of either sex causes the induction of typical male activity levels. On the basis of these experiments, this enzyme activity may be classified as an drogen-dependent. However, 11beta-hydroxysteroid dehydrogenase differs from other known androgen-dependent activities in that administration of oestradiol to gonadectomized animals of either sex causes a further significant repression of the activity to levels close to the limits of detection. Hypophysectomy on day 50 of life does not affect the activity in 75 day-old male rats, but causes the appearance of typically male activity levels in females. These results indicate that the hypophysis exerts a repressive influence on hepatic 11beta-hydroxysteroid dehydrogenase in female rats. The facts that this activity is not influenced by androgen or oestrogen administration once the pituitary has been removed demonstrates the obligatory role of the hypophysis for sex hormone action.


Experience with a new low dose oral contraceptive: norgestimate & ethinyl estradiol. Experience with cyclic administration of 0.125 mg of norgestimate plus 0.035 mg of ethinyl estradiol indicates that this new combined oral contraceptive is clinically effective and well tolerated. There were no unintended pregnancies in 3,026 cycles of use among 161 women. Patient acceptability of a relatively high cycle incidence of spotting (16.7%) was remarkable; only five patients withdrew from the study because of this irregularity. Breakthrough bleeding was infrequent (0.9% of total cycles). No other side effects were reported and amenorrheic cycles were not observed. In particular there were no complaints of gastrointestinal disturbance. Weight remained unusually stable. Laboratory findings remained within normal limits over 6 months of drug use. However, serum cholesterol and serum glutamic pyruvic transaminase levels declined and protein bound iodine increased significantly from pre-treatment levels.


Demonstration of human chorionic gonadotropin during the second half of the menstrual cycle in plasma of regularly menstruating women users of copper IUds. An attempt has been made of demonstrating the beta subunit of HCG in the plasma of 13 regularly menstruating women wearing a copper IUD. Eighteen menstrual cycles were explored with a total of 94 specimens obtained at 3-day intervals starting from the 16th day of the cycle. A cross reaction with LH was excluded by simultaneous assay of this hormone. Progesteron was also assayed so as to exclude anovulatory cycles. Five out of 12 ovulatory cycles yelded positive results with HCG values ranging from 171 to 692 mIU per ml. We therefore agree with the hypothesis according to which copper IUDs do not interfere with fecundation but with subsequent stages, specifically about the time of nidation of the blastocyst in the uterus.


Sterilization of a non-scrotal mammal (Suncus murinus L.) by intratesticular injection of cadmium chloride. The testis of the musk shrew is resistant to subcutaneous administration of cadmium chloride. In contrast, a single intratesticular injection of cadmium chloride (0.01 to 0.03 mM/kg body weight) caused total destruction of germinal epithelium; Leydig cells, however, regenerated after an initial phase of atrophy. Unilateal injection of the drug induced degenerative changes in the injected testis only; the contralateral testis appeared normal macroscopically and histologically. The factors responsible for the differential response of the testes of this non-scrotal mammal to the two routes of administration of cadmium chloride are discussed.


Chronic prostato-vesiculitis and sperm-cell mobility in male infertility. The purpose of this research has been to value the importance of chronic inflammation of the prostatovesicular apparatus in sterile patients. The authors wish to underline the high incidence of chronic inflammation if this apparatus in such patients, the low incidence of bacterial forms and the high frequence of association with bradycinesia. The therapy of such forms gives excellent results.


Measurement of regional hepatic blood flow by scintiphotosplenoportography. A new technique for estimating regional hepatic blood flow using the inert gas washout technique and scintillation camera following injection of 133Xe into the spleen is presented. This technique is easily, rapidly and repeatedly performed and permits the measurement of nutrient hepatic tissue blood flow. Measurement of regional hepatic blood flow in right and/or left lobes was performed in 28 patients. In all but one patient the right lobar flow value was equal to or greater than the left one. The right lobar flow was 86.20 +/- 12.83 ml/100 gm/min in 3 patients without liver disease, 75.12 +/- 14.54 ml/100 gm/min in 12 with chronic hepatitis and 51.24 +/- 17.13 ml/100 gm/min in 11 with liver cirrhosis. This result suggests that hepatic tissue blood flow is significantly decreased in patients with liver cirrhosis. Scintillation camera images of initial xenon distribution in combination with monitor of washout curves over the liver also provide more informations on the presence of extra-and intrahepatic shunts. Therefore, this technique appears to be clinically useful in evaluation of hemodynamic phenomena associated with liver diseases.


Urinary excretion of D-glucaric acid, total glucuronic acid and total porphyrins in porphyria cutanea tarda. The urinary levels of D-glucaric acid, which is an index of hepatic microsome induction, and the excretion of glucuronic acid and porphyrins were measured in nine patients with Porphyria Cutanea Tarda (PCT) and twelve normal controls. The excretion of D-glucaric acid and glucuronic acid were respectively 3.5 and two times higher in PCT patients compared to controls. A statistical correlation could be demonstrated between urinary excretion of total porphyrins with that of glucaric and glucuronic acids. These findings indicate that microsomal function and porphyrin metabolic derangement are strictly related in PCT.