Saving the aortic and pulmonary artery valves with total heart replacement. The natural aortic and pulmonary artery valves can be saved with excision of the ventricles and inflow valves. These valves remain functional and unaltered with implantation of an artificial heart, when pumped for 96 and 122 days. The capacity of the artificial heart to meet the physiological needs of the animal, during exercise and body growth, over 3 and 4 mos has been documented. All of the parameters monitored in 2 experiments for 3 mos (and continuing) and 4 mos clearly demonstrates the efficacy of meeting the cardiac needs with an artificial heart.


Chronic evaluations of ventricular ejection phase dynamics during abdominal left ventricular assist device (ALVAD) pumping in the awake, unanesthetized calf. In 1974, between 2 and 8% of the 50,000 adult patients undergoing cardiac surgery in this country succumbed in the early post-operative period from left ventricular failure, despite various methods of pharmacologic and/or mechanical support. Our laboratories have concentrated on the development, modification, evaluation, and validation of an abdominally positioned left ventricular assist device which has the potential of reducing these mortalities. Continuous testing in animals, for periods exceeding 2 mos, satisfied reliability, durability and longevity requirements. The cumulative results of these investigations were reviewed at the National Heart and Lung Institute on August 21, 1975. Authorization for clinical trials of the device according to specific criteria and protocols46 was approved on November 1, 1975. The ALVAD is now in the early stages of clinical testing. The results of the current experiments demonstrate that ventricular outflow impedance and prosthetic inflow impedance are the major determinants of left ventricular assist device hemodynamic effectiveness. By markedly reducing outflow impedance, the ALVAD profoundly lowers ventricular pressure-work and oxygen demands while simultaneously increasing ventricular performance and maintaining or augmenting systemic perfusion. Moreover, our studies indicate that improved device designs (intended for intermediate and long-term implantation) and maximal performance can be achieved by focusing on these central determinants.


Thermodynamics of native protein/foreign surface interactions. IV. Calorimetric and microelectrophoretic study of human fibrinogen sorption onto glass and LTI-carbon. 1. According to a working hypothesis put forward in the previous papers of this series2-4, the initial phases of native blood/foreign surface interactions have been considered within the framework of a physicochemical model of contact activation at the molecular level. The salient features of this hypothesis are: a) the arrival and adsorption of native plasma proteins on a contact surface overwhelmingly precedes that of the cellular blood components; b) the interaction energy that arises between a particular foreign surface and native plasma proteins settling on it, is a characteristic quantity depending upon the effective surface molecular structure as well as the nature of the proteins; c) the "intensity" of native protein/foreign surface interactions can be treated in terms of thermodynamic quantities since these energy terms are independent of the type of forces acting between protein and surface; and d) depending upon the degree to which the adsorption of a native protein is thermodynamically favored by enthalpy and/or entropy factors, the interaction energy can be utilized to induce conformational changes of varying degree in the sorbed protein. 2. Using glass and low temperature isotropic (LTI) carbon adsorbents, i.e., a known procoagulant and a relevant biomaterial, respectively, the adsorption properties and the potential surface-induced conformational changes of high-purity native human fibrinogen (clottability greater than or equal to 92%) were studied, at 25 degrees C, by 3 independent methods. In all of the experiments performed, a) both adsorbents were employed in the form of particles less than or equal to 1.0 mu representing specific surface areas of 9.85 M2/Gm and 27.7 (nominal) M2/Gm for the glass and LTI-carbon powders, respectively, and b) the fibrinogen was absorbed from a standaridized buffer (pH = 7.2, ionic strength 0.05) using the same fixed surface area/protein solution volume ratio with a given adsorbent. 3. The 25 degrees C adsorption isotherms of fibrinogen obtained for both the glass and LTI-carbon powder adsorbents are not amenable to Langmuir type analysis but indicate multilayer sorption with a possible change in binding mechanism after the completion of the first sorbed monolayer. The adsorptivities attained at first monolayer coverage were slightly greater on glass (approximately 0.76 mug/cm2) than on LTI-carbon (approximately 0.52 mug/cm2). 4. Using a custom-built, thermistorized, isothermal-jacketed microcalorimeter routinely capable of resolving temperature changes of 0.00001 degrees C in 100 ml of aqueous sample volume, the "intensity" of interaction between fibrinogen and each of the microparticulate adsorbents was studied by the direct measurement of the net overall enthalpy changes, hI(SLP)25 arising as a result of protein adsorption. From these values, the net heat of protein sorption has been determined...


Synthesis and characterization of blood compatible surfaces. Part I. Dynamic tube test applied to heparinized surfaces. A 3 yr study has shown that this test procedure can monitor subtle differences in surface chemistry with a high degree of reproducibility. Based on the present studies, the test appears to be a valid screening tool for examining materials in a dynamic flow situation without the need for animal sacrifice often associated with blood testing. Also, due to the small amount of blood required, numerous samples can be run on the same animal which is extremely advantageous when comparing treatment methods. In addition, the simplicity of the test should make it easily adaptable to most blood testing laboratories.


The intravascular magnetic suspension of a test device for in vivo hemocompatibility evaluation of biomaterials. To advance hemocompatibility evaluation techniques, a new in vivo method has been developed for the dynamic testing of candidate biomaterials in suitably-sized experimental animals. One of the salient features this method is that the material to be evaluated constitutes the blood contact surface of a slender body of revolution which is coaxially suspended in a large canine vessel by electromagnetic forces only. The insertion site of the specimen is distal and downstream to the test region, reducing the influence of thrombotic tissue substances. These experimental conditions also insure that the only chronically exposed foreign surface is that of the test material, whose interactions with blood components are not affected by contact with the vessel intima. As demonstrated in simulated Circulation Model experiments, macroscopic thromboembolic phenomena induced by the test material can be continuously monitored. Preliminary in vivo trials have verified the validity of the underlying principles; the feasibility of the required surgical techniques, and the adequate performance of the suspension system.


Treatment of bone disease in patients on chronic hemodialysis with dihydrotachysterol. Nine out of 24 patients on chronic hemodialysis were found to have biochemical, radiologic and bone biopsy evidence of moderate to severe bone disease. Two patients had bone pain and muscle weakness, 2 had pseudofractures, and one patient had a pathologic fracture of the neck of the femur. Eight patients were treated with dihydrotachysterol (D.H.T.), 0.25 to 0.37 mg/day initially. Four patients required doses between 0.5 and 1.0 mg daily. The alkaline phosphatase decreased in all patients, returning to normal in 6 patients. The symptoms of bone pain and muscle weakness resolved, and the pseudofractures healed. Repeat bone biopsies were performed in 6 patients 12 mos or more after treatment with D.H.T. The osteoid area fell from 29.6 +/- 22.8 to 11.5 +/- 7.5% (p less than 0.025). Resorptive surface decreased in all patients. D.H.T., in doses of up to 1.0 mg/day, is effective in the treatment of both the osteitis fibrosa and the osteomalacic component of bone disease in patients on hemodialysis.


Measurement of the transmittance coefficient spectrum of Cuprophan and RP69 membranes: applications to middle molecule removal via ultrafiltration. The transmittance coefficients of Cuprophan PT-150 and Rhone-Poulenc AN69 have been defined over a broad MW range. The results can be completely characterized by a simple Gaussian distribution employing 2 parameters, the selectivity and the mean molecular diameter. The selectivities of the membranes studies are identical. The mean MW at 50% cutoff for Cuprophan and RP69 are 2,500 and 11,500, respectively. A membrane model illustrating a semi-empirical correlation between permeability and transmittance has been developed.


Successful use of a totally heparin grafted hemodialysis system in sheep. A total of 33 totally heparin-grafted dialysis systems using HFAK Cordis Dow Models 3 and 4 have been compared to a total of 23 nongrafted systems. The comparison of deltap, flow rate, FBVL and macroscopic inspection showed highly significant differences in favor of the heparin-grafted systems. The antithrombogenic performance of the totally heparin-grafted systems is mainly due to a small leakage of heparin during the experiments. A minimum of 1.35 X 10(-8) Gm/cm2/min of heparin is sufficient to prevent clotting at the blood-polymer interface.


Endothelial-cell development: pressure-flow phenomena. Scanning electron micrographs showed directional orientation and cytoplasmic changes in the seeded cells after 21 days of perfusion. From this evidence it is theorized that human fibroblasts, exposed to physiological pressures and flows, exhibit morphological characteristics similar to arterial endothelial cells. Conceivably, cells other than fibroblasts (i.e., multipotential cells) would show the same response to these pressure and flow conditions.


Treatment of digitalis intoxication by charcoal hemoperfusion (CHP). In the present communication, we demonstrate the removal of digoxin both in vitro and in vivo from digoxin intoxicated dogs by use of hemoperfusion over activated charcoal. In vitro drug removal was 33 ml/min at mean blood flow rates of 160 ml/min. By 30 mins of in vitro perfusion 51% of drug was removed from the reservoir and by 2 1/2 hrs 83%. In vivo clearance in dogs was 55 ml/min at blood flow rates of 150 ml/min. In view of the poor success that has been encountered in the treatment of digoxin intoxication with other modalities, charcoal hemoperfusion may represent an effective method of rapid digoxin removal from blood.


Extracorporeal membrane oxygenation (ECMO) cardiopulmonary support in infancy. We have used prolonged extracorporeal membrane oxygenation (ECMO) in the treatment of 13 moribund infants (including 9 neonates), with 4 survivors (3 neonates). Successfully treated cases include post-operative cardiac failure, infant respiratory distress syndrome, massive meconium aspiration, and persistent fetal circulation. All cases have been managed with veno-arterial bypass at flow rates of 80-100 cc/Kg/min. Carotid cannulation for arterial access and careful control of heparin anticoagulation based on whole blood activated clotting time are among the techniques which have contributed to this success. Progressive pulmonary or cardiac failure has been the major problem in older infants, intracranial bleeding is the major problem in neonates. Both of these problems could be minimized by instituting ECMO earlier in the clinical course, but this awaits development of reliable early predictors of mortality.


The hypertension of long-term hemodialysis patients: studies with an angiotensin II antagonist (P113). 1. A P113 Saralasin infusion test was performed in 10 patients on long-term regular hemodialysis. Six patients were considered to have hypertension resistant to dialysis treatment and 4 had their arterial pressure controlled by dialysis. 2. Five out of 6 resistant and 3 out of 4 responsive patients had a positive response to Saralasin associated with a normalization of diastolic arterial pressure. 3. The value of the Saralasin infusion test to pre-select the patients for bilateral nephrectomy is discussed and it is felt that a negative test may be of more value in encouraging more aggressive ultrafiltration in hypertension apparently resistant to dialysis therapy.


[Disease of operated stomach as an aftereffect of resection without sufficient indications and surgical errors]. Poor issues in the most cases concerned were due to gastric resection either not adeqately indicated of performed with technical shortcomings. It is quite possible to reduce considerably the number of poor late results if the resection is performed on strict indications with proper accomplished of its technical details.


[Reutilization of the right-side approach in commissurotomy in recurrent mitral stenosis]. Based on histotopographic studies of heart specimens taken from patients died after commissurotomy with a right-side approach, and the experience with eleven mitral commissurotomies using an access via the interatrial septum repeatedly, it is concluded that a close mitral commissurotomy for reccurrent mitral stenosis with the repeat use of a right-side approach seems to be anatomically grounded and easy to be performed from the point of view of the operative technic. This intervention should be accomplished in patients with recurrent mitral stenosis, previously operated upon with a right-side access. The opportunities of reused right-side approach offer prerequisites for its wider application in primary commissurotomy.


[Use of pleural obturator after pneumonectomy]. The authors suggested and employed in 34 patients a balloon-devise, that is inflated in the pleural cavity following a removal of the lung. This lessens plasma and hemorrhages, thus contributing to the prophylaxis of postoperative empyemas.


[Results of treatment of perforated peptic ulcer by the method of primary gastric resection]. Under observation were 315 patients subjected to primary gastric resection for perforated ulcer. Twelve patients died. Late results were followed up in 171 patients. Good issues were noted in 74.3 per cent, satisfactory--in 23.4 per cent and poor--in 2.3 per cent.


[Does afferent loop syndrome exist?].

[Does afferent loop syndrome exist?]. It is the author's opinion that diagnosis of the "adducent loop syndrome" is unlikely to be correct in patients subjected to Billroth-II gastrectomy. As evidence by the author's observations pains in the right subcostal space, bile vomiting following the gastric resection are mostly due to diseases of the pancreas, bile outflow passages and liver.


[Postoperative complications and mortality in acute intestinal obstruction]. 496 case reports of patients operated upon for various kinds of intestinal obstruction were analysed. Complications were studied in 202 (40.6%) patients. 93 patients died (19.7%). Peritonitis remains to be the main cause of death postoperatively (49.5 per cent to all lethal issues).


[Surgical treatment of injuries of the posterior portion of the pelvic ring]. The technic of surgical treatment of pelvic fractures, elaborated by the author, is described. Totally, 30 patients were operated upon. Late results were studied in 26 patients. In 24 of them a complete recovery was observed, in 2--the capacity for work was found to be reduced.


[Ways of reduction of mortality in femoral neck fractures]. 267 patients with fractures of the femoral neck were observed by the authors. A total mortality was 16.1%. In patients with medial fractures--12.2%, in trochanteric fractures--20.3%. Among patients operated upon during the first two days the mortaliity made 8.5%.


[Use of subnarcotic concentrations of methoxyflurane in children with burns]. A test is described, that makes it possible to determine changes likely to occur in the content of blood sugar after operations in patients with concomitant diabetes mellitus.


Estimation of the developmental age of the ovine fetus and lamb. Fifty-six fetuses and 33 lambs were obtained from a flock of ewes at set gestational intervals between 50 to 180 days after conception. The fetuses and lambs were killed, disected and the sizes and weights of a wide range of skeletal and soft tissues were measured. Five morphological parameters emerged as most suitable for the determination of normal foetal developmental age. By plotting the mean value and ninety-five per cent tolerance limits, the rates of growth and the variability of each parameter were studied. Crown-anus length is useful for determining fetal developmental age from 50 to 100 days gestation; brain weight, long bone length and the number of appendicular ossification centres can be used to determine fetal development age from 50 days gestation until term.


An outbreak of foot-and-mouth disease in Indian elephants (Ellphas maximus). Type O virus has been isolated from a natural outbreak of foot-and-mouth in Indian elephant. The history, symptoms and epizootology of this disease in these animals have also been described.


[Thin-layer chromatographic demonstration of the herbicide zenkor]. Established were the thin-layer chromatography conditions for the demonstration of the herbicide Zenkor as a pure substance and a preparation. Comparative experiments were carried out applying Thomson and Stanley's thin-layer chromatography conditions and the authors' personal ones. Most adequate proved to be the following conditions: sorbent-Kieselgel 60F 254 (Merck); solvent -- chloroform: 1,4-dioxan (9:1); developer -- ultraviolet light (authors' technique). Essential with this method is the preliminary (prior to apply the pure substances on the thin-layer chromatographic plaque) moving of the plaque in the indicated mobile phase (authors' technique). Under these thin-layer chromatography conditions work is made feasible and the method is fast and simple, achieving high sensitivity -- 0.5 mug Zenkor.


[Enzootic dermonecrosis in chickens].

[Enzootic dermonecrosis in chickens]. An enzootic of necrotic dermatosis in hen layers was described. The changes consisted in that they had constant localization and demarkated sites on the skin between the back and the neck. The disease was observed on a farm for 5000 layers in the course of two consecutive years. All birds contracted the disease and in the first year they recovered the 10 months; in second year they recovered for three months. Each bird showed symptoms for 3 weeks. The skin lesions resulted in cicatrization. The etiologic agent (a Pasteurella-like organism) was isolated from the necrotic foci. It proved pathogenic for albino mice and manifested biochemical activity and morphology characteristic of Pasteurella multocida. The disease was successfully reproduced with a broth culture applied on a scarified skin of test birds. Histopathologically, the spontaneous lesions proved undistinguishable from the experimental ones and represented coagulation necrosis of the epidermis, derm, and subcutis. It is supposed that the constant localization was due to the porte d'entrer of the infection, associated with the bad habit of picage on the neck as demonstrated on a large scale by the birds of the infected flock. This is characteristic of some lines of the White Leghorn breed.


[Adenovirus typing and distribution in swine]. Adenoviruses isolated from pigs (RO-KL; SA3; RO; and R10) and the prototypic strain Compton 25R, belonging to the 1st serologic group, are responsible for the formation of intranuclear bodies of the Cowdry-A type, while the virus Ad5 strain (isolated from humans) cause the formation of another variant of nuclear inclusions of the Cowdry-B type known as Central mass. All virus strains propagate in primary cell cultures of pig kidney and calf and rabbit kidney, calf testis, and in the stable cell line PK-15, showing negligible variations. Resistance and stability experiments have demonstrated that the investigated strains posses physico-chemical and morphologic properties that are characteristic of the adenoviruses. The virus strain isolated in Bulgaria, and the strains isolated in Hungary can be classified in the IVth serologic group of swine adenoviruses. The study of serum samples taken in different regions of Bulgaria and Hungary in order to establish adenovirus antibodies have revealed that in about 20.5 per cent of the swine sera in Hungary, and in 19 per cent, on an average, of the sera taken in Bulgaria there are adenovirus antibodies.


[Effect of some trace elements on Heterakis gallinarum invasion]. It was found that sodium chloride at the rate of 0.5 per cent in the mixtures lowers by 25 times the survival of the Heterakis helminths in birds, prevents the manifestation of verminous typhlitis, alters the ratio between the female and the male worms in favour of the latter, contributes to the increase in body weight and rises the level of the total protein in the blood serum, and changes the protein spectrum raising the level of globulins. Positive results at a lower size were established in feeding cobaltinitrite and soduim selenite to birds. Last ranked the effects produced with the offer of zinc sulfate. The admixture of sodium chloride at the rate of 0.5 per cent of birds is suggested both from the standpoint of Heterakis control and prophylaxis and from the point of view of pathogenesis.


[Hygienic studies of frozen ocean fish]. Studied were batches of frozen ocean mackerel (Scomber scombrus L.) and silver hake (Merluccius bilinearis, Mitchill) during storage in a central base and in shops. The evaluation of the fish was made on the basis of organoleptic data, pH values, volatile bases, trimethylamin, volatile fatty acids, the amount of tissue fluids after Kietzmann, luminescence of musculature after Wittfogel, and through microbiologic study of the skin and musculature. It was found that the fish had been frozen in the fishing boats in a very good status. Great variations in the storage temperature are admitted in the central base, no correlation being established between the term of storage and the quantity of the product. The conditions for the preservation of the frozen fish in the shops where fish is especially sold are unappropriate--they contribute to the fast deterioration of the quality and the microbial status of the product.


[Organoleptic changes in beef and pork fats following gamma-ray irradiation]. Studied were bovine and swine fats that had been treated with gamma-rays at the rates of 0.10 to 2.00 Mrad, in the presence of oxygen and in an atmosphere containing no oxygen as well as under storage conditions at 2 to 4degreesC, and -- 18 and up to --20degreesC, for 45 and 90 days, respectively. When doses of 0.25 Mrad were used no changes in the organoleptic properties were observed. Fats that were treated at the rate of more than 0.25 Mrad in the presence of oxygen assumed 'side' smell and taste. If irradiation was carried out in the absence of oxygen no such deviations from the normal taste and odor were noted--at rates of up to 0.70 Mrad for the swine fats, and at rates of more than 0.50 Mrad for the bovine fats. Destruction of the yellow pigment in the bovine fats was observed at treatment with doses higher than 0.70 Mrad. The changes in the organoleptic properties corresponded to the changes taking place with the peroxides, the water soluble fatty acids, and the epihydrinaldehyde. Changes in the organoleptic properties (odor and taste) in the bovine fats took place at lower doses of iradiation than in the swine fats.


[Determination of tin in food products using pyrocatechol violet]. Some incorrect points are referred to of Part II of Bulgarian State Standard 6853-74 "Canned fruits, vegetables, meat, and meat-and-vegetables. Determining the content of stannum with the use of pyrocatecholviolet" rendering difficult the analytic process and leading to false results. Another method for the evaluation of the stannum content making use of pyrocatecholviolet has been applied instead as suggested by the International Federation of Chemists. It makes feasible the determination of even small amounts of stannum (0-30 mug) which are usually encountered in the food products. A mathematic and statistical processing of the results obtained has been made.


[Comparative diagnostic studies of epididymitis in rams caused by Brucella ovis]. Semen samples taken from 21 rams with pronounced pathologic changes were studied in a complex way to establish the etiology contributing to the deterioration of the semen quality. The complement-fixation test was applied with blood serum and semen plasma along with the microscopic study of the semen for the excretion of Brucella ovis organisms and a clinical examination. The following results were obtained: 1. The semen plasma of 90.5 per cent of the rams was positive for Brucella ovis. A total of 80.9 per cent were CFT-positive, and the same per cent of the animals were positive for the excretion of Brucella ovis organisms with the semen. The three diagnostic methods give equally positive results in 84.2 per cent of the cases. 2. The clinical examination revealed gross lesions in the genital apparatus in 33.3 per cent of the investigated animals, which coincided with the results obtained through the above-mentioned three methods in 85.9 per cent of the cases. 3. The simultaneous application of the blood serum and semen CFT, the bacteriologic investigation of the semen, and the clinical examination makes it possible to establish the etiology responsible for the defective spermogram of the rams studied.


[Clinical and endocrinological studies of the puerperium in cows]. A total of 85 cows were used to study the clinical course of the involution processes in the genital tract following calving. According to the season of calving the animals were divided into two groups: 1st group consisting of 29 cows whose calving and puerperium had taken place during the spring/summer period; IInd group of 56 cows with which these processes were observed in the autumn/winter period. Seven cows of each group were subjected to endocrinologic studies for the evaluation of the pituitary gonadotropic hormones (FSH, and LH) in the blood plasma, applying Brown's method and Parlow's method, respectively. The following conclusions were drawn: 1. The intensity of the involution processes in the sexual apparatus of cows depends on the season. In the spring/summer period they usually last 34.3 days, and in the autumn and winter -- 37.5 days. 2. Fast involution of the uterus has been observed during the first two weeks after calving. This process is considerably delayed during the third week. 3. The yellow body regresses in the course of 14 days following calving. Up to the 35th day this has been established only im 3.5 per cent of the cows. Clinically, follicles in the ovaries are established as early as the 15th day after calving. 4. The FSH and LH level in the blood plasma during the first days after calving has been low -- 73.7 mg/% for FSH, and 7.04 mg/% for LH, both showing a rising trend. The peak values have been established between the 15th and 40th, and the 22nd and 28th day, respectively.


[Artificial embolization of cerebral arteriovenous aneurysms via the vertebro-basilar system]. Data are presented on artificial embolization of arterio-venous aneurysms of the brain via the vertebro-basilar system in 12 patients. In one case the embolization was performed by way of vertebral artery catheterization through the axillary artery, in the remaining II cases--through the femoral artery. The embolization was carried out with the aid of polystyrene balls, 2 to 3 mm in diameter, numbering 8 to 40. In some cases the needed direction of the emboli movement was achieved by applying a magnetic field. No complications were encountered in the embolization via the vertebral system.


[Changes in total hemodynamics of central genesis following removal of basal meningiomas]. The removal of basal intracranial meningiomas in 54 patients, even under general anesthesia with neuro-autonomous blocking, was accompanied by cardiovascular reactions caused by both reflex effects and direct excitation of brain stem structures. These reactions were always of a pressor nature only. Postoperatively, the vascular reactions were also of a pressor nature and presented themselves as components of either a non-specific stress response or a developing diencephalo-catabolic syndrome. Taking into account that the leading cause of the vascular disorders in stress responses and the diencephalo-catabolic syndrome is the irritative process in the brain stem structures, it is important for the prevention and management of these disorders to suppress by pharmacological means the irritation of the median formations with simultaneous blood replacement and conduction of maintenance cardiac therapy.


[Total and cranio-cerebral hypothermia in patients subjected to surgery for brain tumors]. The paper is based on the authors' personal experience in the employment of general and craniocerebral hypothermia in 90 patients operated on for brain tumours. The most rational level of hypothermia is that of 30-31 degrees C body temperature. Craniocerebral hypothermia induced by the "Holod-2F" apparatus permits to reduce the cortical temperature to 26-28 degrees C, maintaining that of the body within 30-32 degrees C. Such temperature gradient permits to avoid the danger of ventricular fibrillation. In the majority of cases, surgery under craniocerebral hypothermia is free of brain oedema. The postoperative course is also free of brain oedema and pneumonia. Tabulated statistical processing presents the data on the speed and degree of cooling in different parts of the body with reference to the age and body weight of the patient, to the method of cooling, and to the temperature of the cooling fluid.


[Radioisotope encephaloscintigraphy in the diagnosis of acoustic nerve neurinomas]. The results of the employment of radiopharmaceuticals in a group of patients with acoustic neurinomas for diagnostic purposes are described. High diagnostic efficacy of the method of radioisotope encephaloscintigraphy is emphasized, the method permitting to obtain extended diagnostic information. An important advantage of the method consists in its safety and absence of contraindicaions.


[Dynamics of spinal cord motor neuron excitability in epileptic patients following surgical elimination of seizures]. H-reflex testing in epileptics with frequent seizures reveals both an increase and decrease of the activity of the spinal cord motoneurons. A surgical removal of the epileptogenic focus and the disappearance of seizures is followed by a significant elevation of the H-reflex induction threshold, which may be a reflection of the compensatory process. The dynamics of the stimulation EMG data pertains to the H-reflex alone, and is not true in case of the tendon reflexes. In this connection a dystony of the supraspinal regulation of the alpha- and gamma-motoneurons is suggested in epilepsy with a prevailing involvement of the alpha-cells.


[X-ray anatomy of the superior cerebellar artery (1)]. The anatomic and angiographic variants of the superior cerebellar artery were studied in 50 macro-preparations of the cerebellum and in 100 normal angiogrammes. The authors distinguish five angiographic variants of the superior cerebellar artery, and emphasize the necessity of their differentiation for proper identification of its branches in interpreting the angiogrammes. Quantitative characteristics is given to the segments of the superior cerebellar artery and their angles, which permits a more precise assessment of the displacement of the superior cerebellar artery.


[Assessment of the severity of grave cranio-cerebral injury and its outcome according to the state of energy metabolism in the brain]. A dynamic study of the arteriovenous oxygen and lactic acid content difference, as well as a study of the CSF content of the lactic acid in patients with a severe craniocerebral trauma permitted to evaluate the severity of the pathological process and the results of its treatment. A growing production of lactic acid by the brain and its progressive accumulation in the CSF to a high level as 45-50 mg%, and a sharp dissociation between the increasing lactate level in the CSF and its growing concentration in the venous blood flowing from the brain is a prognostic sign of an unfavourable course and outcome of the disease.


[The dynamics of accumulation of trans-isomers of unsaturated fatty acids in the organs and tissues of animals and their use by the organism]. Tests were conducted with two groups of growing albino rats kept on a ration with hydrogenated fat containing 62 and 26 per cent of non-saturated fatty acids transisomers. The latter were found to accumulate in the lipids of the animal organs and tissues reaching their maximum level by the 4th week of the experiments. On switching the rats to a ration containing no transisomers their exponential fall in the lipids of the organs and tissues was recorded. From these investigations it follows that the non-saturated fatty acids transisomers taken up by the organism together with edible fats become involved in metabolic processes and are utilized by the organism alongside with other fatty acids.


[Sequelae of diathermocoagulation of cerebellar arteries and veins in normal rabbits and rabbits sensitized to brain antigen]. Electrocauterization of an artery or a vein on the surface of the posterior lobe of the cerebellum may cause no focal changes in the bed of the occluded vessel, or result in varying severity and extension of lesion of the posterior cerebellar lobe. In occluding an artery a focus of complete necrosis or oedema is formed in its bed, while in occluding avein a focus of oedema is formed that may be accompanied by erythrocytic extravasation. In the group of animals sensitized with brain antigens a tendency towards oedema enhancement, and a vascular permeability increase is noted, neuronal changes are more frequent at a distance from the occluded vessel's basin. However, the importance of sensitization is, as a rule, masked by individual peculiarities of the collateral supply or venous return in the bed of the occluded vessel.


[The effect of pectin and cellulose on the metabolism of lipids and complex carbohydrates under experimental conditions]. Experiments conducted with albino rats have evidenced that under the effect of an atherogenic ration the level of lipids and cholesterol in the blood plasma and hepatic tissue and of sillac acids in the blood plasma increased. In the aortic intima the content of acid mucopolysaccharides was rising, this being attended by a concurrent swelling of the main interstitial substance and of the collagen fibers in the subendothelial layer. An addition of apple pectin or of cellulose to the atherogenic ration deferred the development of the mentioned changes.


[Ultrastructural changes in the subcellular membranes of hepatocytes during the early periods of starvation]. Ultrastructural changes in the membranes of subcellular structures of the liver in rats were studied with the help of electron microscopy at early periods (48 hours) of fasting. In the hepatocytes of fasting animals the authors found a disrupted structure of the nuclear membranes (an increased lumen between membranes and enlargement of pores) and of mitochondria (changed shape and a significant diminution in the number of cristae) along with vacuolization and degranulation of the rough endoplasmatic reticulum. At the same time, the hepatocytes demonstrated a drastic hypertrophy of the GERL zone characterized by a rising number of the Golgi apparatus dictyosomata, of the smooth endoplasmatic reticulum cysterns and of primary lysosomes. All this was accompanied by a sharp intensification of the processes of autophagy, finding its expression in a significantly increased numbers of secondary lysosomes of the autophagic type. Emphasis is laid upon the fact that while the revealed ultrastructural changes in the cellular and mitochondrial membranes, as well as in the endoplasmatic reticulum may with high degree of probability, be interpreted as manifestations indicative of functional disorders occurring in these organelles, the hypertrophy of the Golgi apparatus, a rise in the number of primary and secondary lysosomes and their activation appear as an adaptation reaction of the cell to conditions created by the organism switching over to a forced endogenous alimentation.


[Assessment of the protein quota in the ration of patients with the nephrotic syndrome according to balance studies]. From data derived from equilibrium investigations in patients with the nephrotic syndrome a negative nitrous balance which indicates the presence of a chronic protein deficiency developing in the organism of these patients was revealed. Observations showed that an increased quota of protein in the ration of patients with the nephrotic syndrome is quite justifiable. The quantity of protein comprising 1.5--2 g per kg of the patient's body weight per day, of which 3/4 is protein of animal origin, is optimal for this category of patients. Possible improvement of the protein supply in patients with the nephrotic syndrome is largely determined also by the qualitative composition of the protein in the ration.


[The morphofunctional state of the gastric stump in patients with the dumping syndrome and its significance for the formulation of diet therapy]. In 42 patients with the dumping syndrome. the mucosa of the resected gastric stump was examined histologically. Bioptic materials were obtained by applying fibrobiopsy and aspiration biopsy under roentgenological control. The great majority of the  examined demonstrated some or other degree of the glandular atrophy attended by a fall of the secretary function. In spite of a considerable time lapsed since gastric resection the gastric glands remained intact and the secretary function of the stump continued to be normal. According to the authors the severity of the dumping syndrome does not depend on the nature of morphological changes in the gastric stump mucosa. A sizable proportion of the examined patients demonstrated various changes in the motor function of the stump, more often an accelerated evacuation. The listed changes in the morphological-functional condition of the gastric stump were given due consideration in compiling a dietary pattern for patients with the dumping syndrome.


[Absorption of essential amino acids in patients with chronic enteritis]. Continuous perfusion was applied in studying the absorption of essential amino acids in the duodenum and the proximal part of the jejunum in healthy persons and in patients with chronic enteritis of the land ii degrees of severity. All the patients demonstrated a reduced rate of absorption. The degree of the absorption derangement increased parallel with the severity of the affection. In the duodenum the absorption proceeded slower than in the upper portion of the jejunum.


[An objective index of quality and prognostication of the storage time for cod liver oil]. Through a series of tests an objective indicator of the degree of the cod oil oxidation-the content of aldehydes reacting with benzidine-has been established. Mathematic processing of experimental data helped determine the limits of the aldehydes content in the oil of different quality, while the maximum permissible standards were fixed following biological tests carried out by the Institute of Nutrition of the AMS of the USSR. These data and investigations into the quality of the oil during its preparation and subsequent storage under different conditions formed a background to be establishing maximum permissible content of aldehydes in the half-finished and final products. Through experiments there were found the increment of aldehydes and the fall of the A-vitamin activity over a storage period of one month in large bottles of 9 1 capacity at temperatures of 10+/-2 and 20+/-2 degrees. The available data enabled it to deduce a formula for fixing approximate storage periods for medicinal oil both on shipment from the production site and at the time of control checking of its quality. The maximum permissible content of aldehydes in the medicinal oil and the method of establishing storage time are recommended to be included into the corresponding intem of the state standards-GOST, or in the pharmacopeia.


[A laboratory study of the possibility of benzpyrene penetration into wheat germ using different means of drying the products of combustion]. Possible accumulation of benzpyrene in wheat grain during its drying by means of a heat-carrying agent (air diluted combustion products) containing this carcinogen was studied in a laboratory set-up. With benzpyrene contained in the heat-carrier in an amount of 0.12 gamma/m3 this carcinogen was amassing in the grain with all conditions and methods of drying under study. An increased benzpyrene content in the grain by comparison with the background one was noted under optimal conditions of drying in a solid layer, boiling layer and in a suspended state by as much as 23, 11 and 3 times respectively. On the basis of these and literature data a conclusion is drawn that grain may be dried in suspended state (recirculation dryers) under definite, parctically realizable conditions without accumulation of benzpyrene therein.


[The effect of malnutrition during the early period of postnatal ontogenesis on the amylolytic and invertase activity of the small intestinal mucous membrane of growing rats]. Acute experiments demonstrated that undernourishment caused during the first half of the lactation period of development (8 days of life) by keeping 16 young ones per each lactating female-rat or by 16-hour long weaning of rattlings from their mothers results in a drastic reduction of both specific amylolytic and invertase activity in different sections of the small intestine and in that of the latter's weight. This phenomenon becomes apparent not only at the time of undernourishment, but also during a fairly long period following putting the animals on an ordinary dietary regimen.


Incidence of viral hepatitis after administration of factor IX concentrates. A high frequency of viral hepatitis has been reported after treatment with the human factor IX concentrate 'Konyne'. Clinical trials with 'Konyne' and a similar factor IX concentrate, called 'Preconativ', was started in Sweden 1969. During the first 2 years, 26 patients were treated with either one or both preparations. Nine patients developed viral hepatitis within 6 months after treatment. 'Preconativ' alone was introduced on the Swedish market in 1971. During the period 1971-1974, another 26 hemophiliacs were treated but only two cases of hepatitis have occurred. Selection of donors and screening for hepatitis B surface antigen in donor blood used for the manufacturing of 'Preconativ', might be contributing factors to this low hepatitis incidence.


[Sources of information for terminology in the area of nutritional science]. In response to inquiries that reached the group of information at the Institute of Nutrition of the AMS of the USSR sources of information for terminology in the science of nutrition were educed. The paper brings forward the results of this work, viz. information on manuals, terminological and parallel glossaries, standards and other publications carrying information on terminology in the said and related sciences. The paper covers sources published during the past 15 years in Russian, English, German and French.


Detection of hepatitis B antigen in blood donors by radioimmunoassay and three reverse passive haemagglutination techniques. In a comparative study 5,569 sera from voluntary donors were tested simultaneously for hepatitis B antigen by three reverse passive haemagglutination (RPHA) techniques (Auscell, Hepanosticon, Hepatest) and the radioimmunoassay (RIA) (Ausria II). Among the three RPHA methods, no significnat differences could be found as far as sensitivity is concerned. The percentage of positive sera detected by these RPHA methods varies from 0.43 to 0.56%. Eleven sera were detactable only by Ausria II. Except for two, all these sera had low counts per minute in the RIA.


Influence of counting statistics on borderline detection of hepatitis B antigen by a solid-phase radioimmunoassay. The detection of hepatitis B antigen by a solid-phase radioimmunoassay technique is by now well established, particularly where transfusions are concerned. However, it would appear that the use of systematic procedures leading to positive detection, such as the "cutoff" method (mean counts per minute of the negative controls multiplied by a coefficient of 2.1), are open to criticism if elementary precautions concerning the time span and the statistical accuracy of radioactivity counting are not taken. The method may even prove inaccurate in a certain number of borderline cases studies in relation to plasma and different sera, especially if subjected to a single screening process over a large number of samples analyzed by computer. These deficiencies can be avoided by correcting the positive coefficient in relation to the mean counts per minute of negative controls, the statistical accuracy (relative standard deviation) and the distribution of counting times.


[Controlled study of an abbreviated form of the Hamburg-Wechsler Intelligence Test for Adults (HAWIE, Dahl's WIP) in a heterogenous clinical group]. The "reduzierte Wechsler-Intelligenztest für psychiatrische Kranke (WIP)" by Dahl, a short form of the German version (HAWIE) of the Wechsler-Bellevue Intelligence Scale, comprising the subtests Information, Similarities, Picture Completion and Block Design was applied in a replication study to a heterogeneous group of 420 mental patients. Results show a sufficiently high level of agreement (multiple correlation) between the present test and the HAWIE-IQ. With this result and a sample independence of the correlation, two of the requirements of board clinical application of the WIP are met. On the other hand Dahl's assumption that the WIP represents the optimal (quadruple)combination of subtests of the full scale was not confirmed. Criticisms of the WIP in the literature are discussed. On the basis of previous studies and the present investigations it is held that the WIP is a useful contribution to measurement of general ability in a clinical setting.


["Behavior-analytical" treatment in severely defective schizophrenic patients]. The troublesome symptoms of the seriously defective schizophrenics depend sometimes upon their unexpected sensitive experiences, which are not reported verbally and are guessed merely through the precise observations of the behaviour. By the treatment of the disturbances so found, the troublesome symptoms disappear. As an example of this "behaviour-analytical treatment" an old, defective schizophrenic with incontinence and negativism was introduced in this report, whose background suggested an intensive mysophobia, and was treated successfully. Some forsaken inmates of the asylums might be helped in this way.


[Psychoanalysis and group dynamics as a method of socialization]. The troublesome symptoms of the seriously defective schizophrenics depend sometimes upon their unexpected sensitive experiences, which are not reported verbally and are guessed merely through the precise observations of the behaviour. By the treatment of the disturbances so found, the troublesome symptoms disappear. As an example of this "behaviour-analytical treatment" an old, defective schizophrenic with incontinence and negativism was introduced in this report, whose background suggested an intensive mysophobia, and was treated successfully. Some forsaken inmates of the asylums might be helped in this way.


[Remarks on configuration frequency analysis]. The "Konfigurationsfrequenzanalyse" (KFA) is a method proposed by Lienert to detect syndromes. Using examples we criticize the definition of a syndrome used for a KFA, and we thus criticize the interpretation of the results of a KFA. Furthermore, we describe briefly a backward selection procedure of multiplicative models for contingency tables. This procedure may be used to find simple patterns of association for several symptoms.


[Situation definition and its significance for diagnosis, therapy, and rehabilitation]. Diagnostic and therapeutic proceeding involves usually that physician/psychologist became the subject and patient/client the object in a rational process. - Exactly this can cause disturbances of this process, especially in cases of psychosomatic diseases and emotional disturbances. It will be considered (a) whether a more flexible relationship between physican/psychologist and patient/client can be established, (b) whether reflection of the concordance (or discordance) in "defining the situation" leed to new aspects of physicans/psychologists proceeding. (c) Implications for training, methods, therapy and rehabilation will be discussed.


[Subjective stress and childhood memories in patients with essential hypertension]. A group of essential hypertension patients (n equals 168) and a group of unselected controls (n equals 302) completed a questionaire constructed to measure perceived threat and rating-scales to judge the emotional atmosphere of personal childhood experiences. The patients do not regard their present life-situations as more threatening than the controls and they report more pleasant childhood memories than the controls. These results contradict those obtained in previous work which may be due to the relative lack of emphasis placed on coping variables in the present study.


Long term evaluation of allogenic veins as arterial grafts. Ten pairs of mongrel dogs had bilateral femoral artery reconstruction using the femoral veins from the other of each pair. Four grafts failed in the first two weeks and 16 grafts failed in pairs within two to four weeks of each other up to 15 months. Five dogs died with patent grafts between 15 and 42 months and five dogs were sacrificed at 42 months with patent grafts. Aneurysmal degeneration did not occur. Normal architecture of the vein was destroyed by fibrous replacement, but a few smooth muscle cells and adventitial elastic fibers persisted. Gross and microscopic mural thrombi were present in half the grafts indicating continued endothelial instability at 42 months. Osseous metaplasia was found in five grafts. Allogenic vein is an acceptable substitute when autogenous vein is lacking for femorotibial bypass and urgent femoropopliteal bypass.


Pulmonary artery dissection and rupture in Eisenmenger's syndrome. A patient with ventricular septal defect and pulmonary arterial hypertension (Eisenmenger's syndrome) associated with aortic coarctation with follow-up for 19 years, and with rupture of an aneurysmatic pulmonary artery is described. An incident of extreme fright with a possible transient systemic hypertension may have precipitated the dissection of the pulmonary arterial intima and the rupture.


Popliteal aneurysms.

Popliteal aneurysms. Eighty-six popliteal aneurysms in 52 patients have become limb threatening. Popliteal aneurysms should be sought for and when found elective replacement should be considered.


Reconstruction of the cardiac valves with autologous tissue. A rather long and extensive experience with tissue reconstruction in patients with mitral valve disease, and a much less extensive one with oartic lesions, has convinced us of the superiority of the presented techniques of reconstruction, and of the preferability of fascia lata over all other tissues so far tried for this purpose. Despite an early increment of shrinkage of the order of about 30% of each linear measurement, late studies of fascia lata removed from reconstructed valves after several years (over five) indicate no loss of cellularity and no measurable loss of tissue strength or flexibility. Late calcification was not observed in any of our baboons, although it appears to be a consistent development in dogs. It has been seen in only one patient (after four years) to date. It is now believed that we can offer prolonged clinical benefit approaching actural "cure" to many of the younger patients who otherwise would have no recourse but to prosthetic palliation. It is true that recently Willen, Dubiel and Johansson (50, 51), Gersbach and Wegmann (52), and Senning and Rothlin (53) have demonstrated that repetitive deposits of fibrin upon the surfaces of fascia lata implanted within the cardiovascular chambers lead to progressive encapsulation with organizing connective tissue (scar). At some time period following surgery, closer to 10 years than to 5, degeneration of the fascia takes place, presumably due to "strangulation" by the organized exudate which interrupts the "normal" mechanism of its nutrition which is based upon diffusion from the flowing blood. The recent contributions of Sullivan, Harken and Gorlin (54), Weily and Genton (55), and Harker and Slicter (56) to our understanding of the role of the platelets in initiating such fibrinous deposition now provide us with a way to prevent such late degeneration of valves made of fascia lata. The regular administration of platelet dispersing agents (aspirin, Persantin, or inderol) in ordinary therapeutic dosage would seem to be completely protective. Undoubtedly, anticoagulant therapy would be equally effective. However, the permanent maintenance of a proper level of "anti-coagulation" such as is usually deemed necessary following implantation of a prosthetic heart valve is a heavy psychological and biological burden for a patient to bear. Many such individuals live precariously between the risks of thromboembolism and the risks of hemorrhage. Thromboembolism really only represents a farther point along the spectrum of the readiness of fibrin accumulation following initial platelet aggregation and deposition. Since frank thromboembolism appears "never" to follow intracardiac implantation of fascia lata, it would seem that platelet dispersive therapy sould suffice in such cases.


[Immunopathology and pathogenesis of chronic erysipelas polyarthritis of swine]. Several immuno-pathological aspects of polyarthritis following experimental infection with erysipelas in pigs were studied for two years. Aseptic and specifically pathogenfree animals were infected subcutaneously and intravenously-intraarticularly with living erysipeals bacteria (erysipelothrix rhusiopathiae) of serotype B. After an initial febrile phase a progressive polyarthritis and disco-spondylitis developed. Some animals also developed thrombo-endocarditis. Hypergammaglobulinemia and high titers of specific antibodies were observed during the whole experimental period. Antiglobulin factors, however, were not detected in the serum or the synovium. In some animals collagen antibodies were demonstrated in synovial tissue. Bacterial examination of the synovium showed that erysipelas bacteria were present in arthritic joints for months. Living erysipelas bacteria were isolated 24 months after the experimental infection from synovial tissue of two pigs. The polyarthritis was characterised by exudates rich in fibrin, villous proliferation, pannus formation, cartilage erosions, and peri-articular fibrosis. IgG and specific erysipelas antibodies were demonstrated in plasma cells from synovial tissue by immuno-histological methods. The findings emphasize the morphological resemblance of the erysipelas induced chronic polyarthritis in pigs to human rheumatoid arthritis.


[Postoperative prophylaxis of thromboembolism. Present position.(author's transl)]. Only anti-coagulators and aggregation-stoppers may be said to be the medicamental prophylaxis of thromboembolism. The Cumarin-Indandion group is burdened with continuous laboratory controls. Contraindications excluding a general prophylaxis for this group as well as for Heparin and ASS exist. Infukoll, which is virtually always applicable, has the disadvantage that it has to be infused. Heparin- and Dextranspreparations however can already be used preoperatively, which means that a further decline of the coagulation complications can be expected.


[Does Raynaud's disease really exist? (author's transl)]. In a follow-up study of 35 patients with Raynaud's disease attacks of multilocalized vascular disorders were detected in every case, which made the different etiologic definitions of this disease doubtful. We beleive, that a further improvement of our diagnostic facilities, such as pharmacoangiography, will contribute to finding-morphologic disorders in every case of Raynaud's attacks.


[Cardiac pacemaker therapy. Experiences at the Surgical University Clinic Duesseldorf 1961 up to 1974 (author's transl)]. The development of pacemaker technology, indications, and the surgical techniques of implantation are shortly reviewed. The surgical group reports about clinical experiences with 3273 operative procedures using cardiac pacemakers of different manufactors from 1961 until 1974. The last period of pacemaker therapy (1970-1974) is specifically analyzed. A differentiation of the operative procedures was carried out: 804 new implantations, 818 exchange and 239 revision operations. A series of possible complications is listed up. The analysis of 100 patients (1973/1974) with a complicated course demonstrates definitely that most of the resulting problems of this very important method of medical management are caused by the surgical procedure and by the leads.


[Thymectomy in myasthenia gravis (author's transl)]. 10 myasthenia patients were treated surgically during a four year period, 1970 TO 1973. Thymectomy was only resorted to in the most severe cases of the disease. A sternum splitting incision was preferred. Postoperative diffculties were usually avoided by routine use of a volume-controlled respirator. Oro-tracheal intubation was preferred to tracheostomy in order to avoid infection. In 9 patients it was possible to reduce the daily dose of medicine. Clinical improvement, sometimes delayed, occurred in 8 patients. All the patients had been incapacitated preoperatively but in 6 cases they were able to return to work. The mortality rate was nil. There was one case of postoperative pneumonia and one delayed sternal union.


[ Intermittent, longterm polychemotherapy in combination with radical operation of bronchial carcinoma (author's transl)]. A preliminary evaluation of a randomized, prospective clinical study of combined polychemotherapy in bronchial carcinoma is presented. The comparison of survival-curves shows a positive tendency in favor of the treatment and justifies the continuation and extension of the study. The data presented are based on the findings of 106 patients who underwent radical surgical operations due to bronchial carcinoma and of 114 patients as a comparison who in addition received aftertreatment with high doses of cytostatics applied intermittently. The importance of the influence of the clinical symptoms on the prognosis and on the effect of the Chemotherapy is emphasized.


[Local cold injuries; symptoms and therapy]. Etiology, pathophysiology, and clinical picture of local frost-injuries are described. By aid of literature, and by proper experiences in 49 patients, who had been treated at the University-Hospital of Innsbruck during the year of 1966 to 1973, therapy of local frost-injuries is discussed. Moreover the advantage of surgical therapy on the sympathicus over conservative treatment is pointed out.


[Pyogenic infections of the hand].

[Pyogenic infections of the hand]. Thanks to modern antibacterial methods pyogenic infections of the hand, including their complications, will have a favourable prognosis. The experiences of many decades have proved that the principles of treatment worked out by Kanavel [6] and Zur Verth [12] are still valid, and that local processes require immediate surgical intervention. Individual and detailed proceedings are explained giving up-to-date therapeutical directions and improved incisions. The aim of all actions is to preserve the function of the hand.


[Accurate reconstruction of traumatic bony contour defects of periobital area with prefabricated silastic]. The silicone inlay method of prefabricating subcutaneous and bony implants for congenital and acquired defects of the maxillofacial area was used in 25 cases. Heat vulcanized Silastic 372 or 373 was used, and seems to be satisfactory. The method is presented as a useful addition to the surgical restoration of subcutaneous and bony defects, particularly complex contours of the periorbital area when autogenous tissue is unavailable. Complications seem to be less common when the implant is immobile and secured to bone. The method is evolving, and modifications can and should be made in the technique.


[Delayed rupture of the spleen].

[Delayed rupture of the spleen]. From 1964 to 1974 14 patients affected with a delayed rupture of the spleen, were operated in the Surgical Clinic of the University of Mainz. 12 of these 14 patients had a polytrauma. Head-, brain- and thorax injuries were prevalent. Because of the risk of a delayed spleen rupture each blunt trauma has to be  hospitalized and observed under clinical conditions. In unconscious patients and in all doubtful cases a peritoneal lavage should be done. If a spleen rupture is caused by an intraabdominal bleeding, Splenectomy is the therapy of choice as further complications can be avoided by this measure.


[Paralysis of the accessory nerve following operations in the lateral triangle of the neck]. In the last 3 years we had to express our opinion on 11 cases which after operations in the neck resulted in a paralysis of the N. accessorius. In 8 cases we had to state a fault of the operating surgeon. More exactness is apparently required in the operations.


[Osteomyelitis, therapy and prognosis (author's transl)]. The application of antibiotics at the treatment of osteomyelitis resulted in a rise of the permanent successful treatment rate. This is especially true for the acute hematogenous osteomyelitis, to a certain extent also for the chronic exogenous one, at which even today the antibiotical therapy is not as important as a surgical intervention. Under consideration of the generally accepted therapeutical principles the special importance of a much individualized treatment adjusted to the clinical picture and disease stage is pointed out. The advantages and disadvantages of an application of antibiotics at the osteomyelitis are mentioned and we try to explain the reasons for occasional therapy failures. A special chapter is devoted to the methods of filling and sterilization of the osteomyelitis bone hollows. Our own experiences with an operative combination process are reported.


[Problems in diagnosis and therapy of malignant genital tumors in childhood]. After description of 4 cases of mesenchymal malignant tumors in childhood diagnostic and therapeutic aspects are discussed. The late diagnosis is an essential problem. Surgical treatment is difficult and therefore a speciality of gynecology.


[Clinical picture of gonadal dysgenesis in the children's and adolescents' consulting hours]. Report on 34 patients with gonodal dysgenesis and chromosomal aberrations ranging in age from 4 to 28 years. The observation time amount to five years on the average. 23 urological examinations revealed 12 kidney malformations (=52,2 percent). Special pathological x-ray findings on hands and writs were significantly more frequent in Turner's disease than in normal population. In T.S. the average value of conspicicous dactyloscopic findings was about 3,0 patient, (in family members it was 0,9 test person). In the most of all cases the psychological examination resulted in dependence and less of contact. Sexuell inclinations are denied. The hormonal substitution was carried out with "Mestranol" or with "Sequenz-Ovosiston".


[Problems of premedication in pediatric gynecologic consultation hours]. It is reported about the behavior of 300 children, which were examined and treated gynecological after premedication, which was performed with Elroguil, Faustan, Lepinal, Myocuran, Sinophebin liqu. The sedative effect was not good in all cases. A premedication is not generally indicated, but in some of the cases the situation of examination is better.


[Extragenital diseases in geriatric-gynecological surgical cases]. Of the surgical cases accumulated in 18 departments of Obstetrics and Gynecology in West Berlin from 1960 through 1969 6662 major procedures were performed on women of at least 60 years of age. In 282 cases (4,2%) surgery was carried out for primarily extragenital gynecological disorders: 119 malignant tumors, 16 benign tumors, and 147 other diseases of extragenital orgin. The postoperative mortality of these patients (89 deaths; 29,8%) was markedly higher than that observed for the whole group (7,7%). This difference may have been caused by the greater extensiveness of the underlying disease in the former group as well as the unsatisfactory utilization of preoperative diagnostic procedures found in some instances. The cooperation with surgeons prior to and during surgery may still be improved upon. In 98 patients (1,5%) operative procedures for additional surgical disorders were performed simultaneously. Especially in those cases where additional appendectomies were carried out, it appears that total abdominal hysterectomy and bilateral salpingo-oophorectomy might have been the treatment of choice for the underlying disease.


[Experiences with Ketalar anesthesia in gynecological and obstetrical operations]. The authors' experience with Ketalar anaesthesia applied in 483 cases has been described. The effect of the narcotic on the cardiovascular system, respiration and acid-base household is analysed in details. As stated by the authors, the narcotic is well applicable in obstetrical and gynecological small operations. By appropriate preparation the occurence of side effects can be reduced. With Shirodkar operations increase of the uterine tonus can be prevented by protective premedication. Ketalar is not recommended for the introduction of anaesthesia in cases of Caesarean section as it may increase the incidence of neonatal asphyxia.


[Changes in the serum lipoprotein spectrum after gynecologic operations especially after castration]. The authors have studied the changes of serum lipoproteins spectrum after various operations in 50 women. They found different changes that can be explicated with operation stress, bleeding or fasting. After the interventions with bilateral ovarectomy they found a dyslipoproteinema with an early and rapid increase of low density lipoproteins.


[25 years without reactions to a grown-in laparitimy gauze]. We report the remarkable history of a case with intraperitoneal retention of a gauze sponge, left in place for 24 years without any symptoms. The foreign body was removed in a selective operation after being detected by routine gynecologic examination. The rare and unusually fortunate course is discussed.


[Results of surgical treatment of descensus and urinary incontinence by means of selective abdomino-vaginal technic]. On 155 patients with vaginal descensus and urinary stress incontinence an vaginal-anterior and posterior colporrhaphy (Kelly)- or abdomino-vaginal operation--vaginal hysterectomie combined with colporrhaphy (Kelly) and Marshall-Marchetti-Krantz-had been performed regarding the lateral Cystorethrogram. The combined operation increased from 12,9% to 55,9%. The results with 13,9% recurrent stress incontinence are encouraging considering the results of severe vaginal operation with 20,4% recurrent stress incontinence. A good plastic result was obtained in 96,2% of the patients.


[Conservative treatment of descensus and genital prolapse by means of pessaries from permanent-soft plastic]. Clinical experience with soft synthetic pessary in the conservative treatment of genital prolapse is discussed. No local inflammation or laceration of the vagina, or cervix was seen.


[Influence of ethinyl estradiol sulfonate on the decreased urinary bladder tonus in the menopause]. In 40 women with hypotonic urinary bladder the influence of 17alpha-Athinyl-3-isopropyl-sulfonyloxy-Ostradiol (Athinylöstradiol) (3 X 15 mug/die without weekend) was examined concerning the intravesical pressure; The cystotonometry has been done just before as well in intervalls of 2 months during half year's period of treatment. The authors used the fill-up-cystotonometry of Hartl. The intra-vesical pressure rose significantly by the influence of Athinylöstradiolsulfonat after 2 months treatment already. In comparison to the hypotonic value before treatment there was an average normotonic urinary bladder after application of Athinylöstradiolsulfonat past 4 and 6 months. Incidence on clinical relevance of these results.


[Semiquantitative evaluation of isotope nephrograms in long-term continuous intake of contraceptive steroids]. The renal function of a total of 137 women without renal diseases taking contraceptive steroids continuously but for different periods of time (up to a maximum of 8 years) was investigated by isotope nephrography. Checking is done by using the semiquantitative evaluation prameters according to Zum Winkel. The results show that the application of hormonal contraceptives does not induce significant changes of renal function in the isotope nephrogram.


[Isotope nephrography in the 2d half of pregnancy]. 166 Women were investigated after 26 weeks of pregnancy, divided into 4 groups (normal pregnancy, after urinary tract infection, with cystopyelitis and with toxemia). Renography is a very sensitive method. Only 6,6% women had bilateraly normal function. Unilateral pathology was detected more often on the right side (17,6% versus 2,9%) and the damage was on the right side also more intensive (30% versus 8%), and present as early as in the 7. to 8. month of pregnancy. The damage of the secretion phase of the renogram in pregnancy is mostly sequal of the disturbed drainage following compression of the ureter trough varicosal veins and the pregnant uterus.


[Isotope nephrography in pregnancy].

[Isotope nephrography in pregnancy]. Emptying disturbances demonstrated by the isotope nephrogram are frequent during pregnancy. For the obstetrician, however, they have only importance, if he can differenciate between changes only due to pregnancy and disturbances with a genuine pathological value. On hand of mean - value curves of radio - nephrograms for each of 50 cases of healthy pregnant women at different ages of pregnancy we try to make a specific judgement of the curves by the introduction of a so-called "Drain-rate A" and attempt to classify the disturbances occurring during normal pregnancy under the term "Gravidity-ING" in order to distinguish them from those with a pathological value.


[Tissue microcirculation in patients with reflex neurodystrophic syndromes of cervical osteochondrosis]. In 62 normals and 70 patients with reflex vertebrogenic syndromes the authors studied tissue clearance (the time of resorbtion--50% and 80% isotope, the mean rate of elimination in percentage) by radioisotope indications. The study determined as well the informative value of radiogramm indices. The data reveal distinct disorders of tissue microcirculation in the affected areas. It was also possible to establish a correlation between the capillarotissue metabolism and the duration of the disease, duration of the exacerbation, stage of the disease and some other factors. The authors followed the development of microcirculation in the process of treatment. The obtained results indicate the diagnostical significance of the method of radioisotope indication and the possibility of its application for the prognosis of the disease and evaluation of treatment methods of reflex neurodystrophical syndromes of cervical osteochondrosis.


[Somatosensory evoked brain potentials in discogenic compressions of the lumbosacral roots]. In 16 patients with discogenic lumbar-sacral radiculitis the author studied somato-sensory evoked potentials from the vertex area in response to electric stimulation of the peripheral nerves corresponding to the affected radicle on the side of the compression and on the intact side. It was established that in discogenic compressions of the radicles there is an expressed drop in the amplitude of early components of evoked potentials II1, H1, especially if the compression leads to disturbances of tacticle, double-range and deep sensitivity. The degree of changes in evoked potentials corresponds to the severity of the compression and may serve as one of the criteria for evaluating the effectiveness of conservative therapy and determination of indications to surgical treatment.


[Neuralgia of the trigeminal nerve].

[Neuralgia of the trigeminal nerve]. On the basis of clinical observations of 314 patients with neuralgia of the trigeminal nerve and a number of studies conducted on them (EEG, REG, tomography of the intraorbital canal, a morphological study on neurovascular fascicli removed during the operation of neurotomy and etc.) the authors discuss some problems of the etiology, pathogenesis, clinical picture and treatment of neuralgia of the trigeminal nerve.


[Pterygopalatine ganglion syndrome].

[Pterygopalatine ganglion syndrome]. An examination of 75 patients with the syndrome of pterygopalatine ganglian established that in out-patient practice such disorders are frequently incorrectly diagnosed. As a rule the disorder is seen at young and middle age after general infections and local inflammatory processes. Acute and subacute development is expressed more frequently in a neuralogical form of the disease while the chronic development corresponds more commonly to a neurotic affection of the ganglion. Clinical criteria in the diagnosis of the pterygopalatine ganglion syndrome are pain attacks with a certain localization and its irraidiation, accompanied by vegetative vascular and secretory changes of a parasympathical character. An important sign in the differential diagnosis is an arrest of the attack by a cocainization of the mucous in certain parts of the middle nasal passage.


[Diagnostic and prognostic value of electrophysiologic studies in patients with peripheral paralysis of the facial nerve]. An analysis of the period and degree of restitution of the functions of mimical muscles in peripheral paralysis of the facial nerve depending upon changes of the motor and reflectory responses of the orbicular muscle of the eye, the type of changes in the main curves of electroexcitation and the development of all these changes during the first 3 weeks of the disease served as a basis for the determination of an early diagnosis and the level of facial nerve lesions. The study revealed an increase of the latent period of motor and reflex responses of the orbicular eye muscles testifies to disturbances of the myeline structures of the facial nerve. The authors suggest that a low electroexcitability of the stem of the facial nerve is associated not so much with the axonal degeneration, as with the process of demyelinization.


[Skin temperature and the hot water test in the diagnosis of injuries to the median, ulnar and tibial nerves]. In 289 patients with a complete anatomical interruption of the median, ulnar and tibial nerves from 1 month to 2 years following the trauma the author determined the skin temperature in the autonomous zone and in the one of a maximum drop of sensibility. Anesthesia, a temperature drop on the average from 1.4 +/- 0.5--2.2 +/-0.5 degrees C, the absence of skin folds and a pinck color in thermal tests clarify the diagnosis of a complete anatomical interruption of the median or ulnar nerve. In lesions of both nerves, especially in combination with lesions of the arteries, the skin temperature is lower than that in an isolated damage of one of the neves. In most of the patients with an interruption of the tibial nerve the skin temperature in the autonomous zone is higher and there are no skin folds in the autonomous zones in thermal tests. Skin temperature measurements and thermal tests are simple objective methods in the diagnosis of nerve lesions.


[Diagnostic significance of electrocortical responses to rhythmic and solitary photic stimuli in patients with hepato-portal encephalopathy]. In order to clarify some diagnostical criteria of latent hepato-portal encephalopathy in 57 patients with intrahepatic forms of portal hypertension the authors studied the character of driving response in photorhythmical stimulation. In 9 patients the development of evoked potentials depending upon the significance of the stimula was studied as well. The studies confirmed the prognostical significance of a slowing down the mean frequency of rhythms in the EEG in relation to the development of acute encephalopathy and a certain tendency to the shift in the spectrum of driving responses to low frequency and a worsening of driving responses in slowing down the medium rhythm frequency of EEG. In patients with changed resting activity in the Background EEG there was a drop in the amplitude of late components of evoked potentials.


[Composition of cerebrospinal fluid protein in children with nervous system diseases according to disc-electrophoresis in polyacrylamide gel]. The author studied the fractional content of proteins in the CSF in 105 children with different disorders of the nervous system and 35 children of a control group (aged 2-13 years) with the aid of disc-electrophoresis in polyacrylamide gel. The proteins of the CSF were studied in encephalitis, polyradiculoneuritis, cerebral arachnoiditis, brain tumors and epilepsy. The content of total proteins in the CSF in 42% of the studied children did not differ significantly from the usual age norm. More distinct changes were found in proteinogramms of the CSF where 14 protein fractions were singled out. It was established that a change in the content of separate fractions, their intercorrelation depended on the character of the pathological process.


[Use of acupuncture in lumbosacral radiculitis]. The author gives a comparative assessment of the results of treatment of the Krasnodar Worsted Cloth Combine workers with sacro-lumbar radiculitis. The comparative study was concerned with generally used methods and acupunctures in out-patient conditions. It was possible to establish some criteria of the effectiveness of acupuncture therapy. According to the data of the author there was a significant improvement in the group of patient who received only acupuntures (87.2%) and somewhat less (70.2%) in the group treated with the conventional methods.


[Results of remote follow-up of depressive psychoses at the involutional age]. The author performed follow-up studies of 82 female patients with the onset of the disease at 55-64 years and diagnosed as involutional depression. Subsequently the disease acquired an attack-like character. An analysis of the development and repeated attacks permitted the author to consider most of the cases as late schizophrenia and manic-depressive psychoses, while the remaining part of the cases as organic and reactive disorders. A retrospective analysis demonstrates that in the majority of the cases behind an expressed pathoplastical age-specific features even during the first admission there may be seen signs of a schizophrenic process. Taking this into consideration a correct evaluation of the premanifest period may facilitate a more correct diagnosis. Long-term catamnestical observations revealed the existence of a relatively small group of singular psychoses, which according to their clinical characteristics should be considered as special age-specific disorders.


Characterization of charge isomers of yeast phosphoglycerate kinase. Evidence for intracellular differences. Three electrophoretic components of phosphoglycerate kinase have been isolated from baker's yeast. The isoionic point of the major component is 7.18 at 10 degrees C. Corresponding values for the minor ones are 6.91 and 7.48, respectively. There is a difference of one charge-unit between the isomers 1 and 2, and between the isomers 2 and 3. The release of component 3 from the yeast cells appears in contrast to the isomers 1 and 2 to be promoted by an organic solvent, thus suggesting this component to be bound to the cell-membrane. The amino-terminal amino acid residue appears to be N-acetylated serine in each of the three cases. The carboxyl-terminal ends seem to be identical also with -(Ala, Leu, Val, Lys)- Ala-Lys as the ultimate sequence. From the circular dichroism spectra the contents of alpha-helix and beta-structure were estimated to 15 and 40-50%, respectively. Factors have been determined for transformation and comparison of the specific activities as determined under the various conditions used at different laboratories.


Preparation of porcine pancreatic lipase free of co-lipase activity. Porcine pancreatic lipase LB was purified and released from co-lipase activity by reduction with beta-mercaptoethanol in the presence of guanidine chloride. The amino acid and carbohydrate composition of the enzyme is presented. The following physical constants were measured or calculated: Molecular weight 52 000, sedimentation coefficient (s degrees 20, w) 4.0 S, diffusion coefficient (D degrees 20, w) 6.7 X 10(-7) cm2 s-1. Stokes' radius (r) 30.3 A, partial specific volume (v) 0.72 cm3 g-1, frictional ratio (f/f0) 1.23 and isoelectric point (pI) 5.18.


The influence of borate and calcium on the gel formation of a sulfated polysaccharide from Ulva lactuca. The water-soluble, sulfated polysaccharide isolated from Ulva lactuca, forms a soft gel when dialysed against sea-water, provided the polysaccharide concentration is 1% or higher and the pH above 7.5. The components of sea-water needed for this gel formation are boric acid and calcium ions. At concentration normally found in sea-water, neither borate nor calcium ions alone produce a gel. It is assumed that the gel formation involves the formation of borate-polysaccharide complexes leading to intermolecular linkages which are stabilized by calcium ions in an unknown manner. This assumption is supported by experiments with extraction of this polysaccharide from the dry seaweed and by the results obtained with the isolated polysaccharide. Agreement between these experiments leads to the conclusion that the sulfated polysaccharide (in vivo) most probably occurs as a gel stabilized by the borate and calcium ions in sea-water.


Antagonistic compensation as a function of reduced weight bearing. The principle of antagonistic compensation was presented by RIESENFELD in 1966 to explain the relative shortening and broadening of hypofunctional bones. Few studies have concerned themselves with this phenomenon, even though the causative agent(s) have not been delineated. In this study, RIESENFELD induced the hypofunction by complete unilateral bilateral forelimb amputation. The resulting hypofunctional condition may be attributed to the lack of muscle function or to the lack of weight bearing or both in combination. In the present study weight bearing was eliminated in such a manner as to preserve muscle functioning. This was accomplished by two techniques: (1) unilateral forearm amputation and (2) unilateral humeral resection. Statistically significant differences in interindividual scapular length and breadth as well as humeral and ulnar lengths are reported. In all cases, the bones of the operated side were shorter than those of the unoperated side and the scapular breadth of the unoperated side was relatively greater. This confirms the hypothesis that weight bearing is, at least, partially responsible for the morphological changes induced by hypofunction and described by the principle of antagonistic compensation. However, as the reduction in length was of a lesser magnitude than that reported by RIESENFELD, the input of muscle function cannot be ignored. Rather, as both muscle functioning and weight bearing induce compressive force on long bones (including the scapula), both may serve to initiate the observed morphological changes through the vehicle of reduced compression.


Study on the fibre arrangement of the dorsal nerve root and its cellular constituents in the mouse fetus. The fibre arrangement of the dorsal nerve root was studied in the mouse fetus during early stages of development and was found to consist of two bundles at their exit from the dorsal root ganglion. This separate arrangement of the fibres could be traced along the course of the dorsal nerve root as far as the pial ring. Moreover, neurolemmal cells and neuroblasts were found dispersed along the whole course of the dorsal nerve root. Aggregations of neuroblasts surrounded by a thin fibrous capsule along the dorsal nerve root near the dorsal root ganglia were described as intermediate ganglia.


Isolation of single osteons and osteon lamellae. Single human osteons were isolated by propagating fractures along their natural boundaries. Furthermore, decalcified osteons were mechanically manipulated to expose their interlamellar interfaces, making possible the study of collagen fibers by means of scanning electron microscopy (SEM). Isolation of single osteons of a wide range of lengths, as described in this paper, makes possible for the first time the study of their mechanical properties in all possible modes. SEM studies of exposed lamellar interfaces reveal that collagen fiber orientations are more complex than previously suggested and suggest further studies in an effort to solve past controversies on collagen fiber orientations in human bone.


Cholinesterase activity in some human lymphatic organs. (1) Cholinesterase activity was investigated in some human lymphatic organs (palatine tonsil, 'normal' spleen, 'bilharzial' spleen, thymus, lymph node and appendix) using GOMORI'S modification of KOELLE and FRIEDENWALD'S thiocholine iodide method, hydrolyzing acetylthiocholine iodide and butyrylthiocholine iodide. (a) Acetyl- and butyrylcholinesterases seemed to be different enzymes; but when they have the same pattern of activity, the latter generally offers a weaker reaction. (b) All the lymphatic follicles of the tonsil, those found in the cortex of the cervical lymph nodes as well as those present in the appendix, were stainable with both acetyl- and butyrylcholinesterase. (c) Acetylcholinesterase activity was not demonstrated in the Malpighian bodies of the 'normal' spleen, but the reaction was strongly present in the blood vessels (including the central arterioles) as well as in the capsule and the different components of the trabecular system. (d) In 'bilharzial' splenomegaly a relatively strong activity started to appear in the Malpighian corpuscles, manifested as a brownish precipitate in their centres. Also some patchy positive areas began to make their appearance in the tissue of the red pulp and had a particular arrangement around the Malpighian corpuscules, in such a way as to 'wall them off' from the tissue of the red pulp. (e) In the thymus no acetylcholinesterase activity was encountered, except in Hassal's corpuscles and in the trabeculae between the thymic lobules. (2) The data obtained in this work were discussed in relation to previous works in other laboratories and it seems that a species difference exists. (3) Cholinesterases may be present in the lymphatic tissue in order to get rid of some potentially toxic esters resulting from the necrobiotic phenomena accompanying the high mitotic activity found especially in the germinal centres of the lymphoid follicles. (4) There are many unanswered questions about the coexistence of the phosphatases and cholinesterases in the same places; their concomitant association in the lymphatic tissue may represent a special case within the framework of a more general mechanism.


Degeneration in the adult rat spinal cord following systemic treatment with 6-hydroxydopamine. Light-microscopic study. 3 and 5 days following intravenous injection of 6-OHDA (100 mg/kg) in adult rats, the Nauta technique demonstrated sparse axon degeneration in laminae V, VII, IX and X of Rexed in the mid-thoracic spinal cord and also in the lateral and ventral white columns. This showed that in adult rats 6-OHDA may pass the blood-brain barrier at the level of the spinal cord. An unexpected finding was the absence of degeneration in the laminae dorsal to lamina V, where noradrenergic nerve terminals are known to occur.


Pregnancy and progeny in rats treated with prostaglandin A. The effects of long-acting prostaglandin A1 upon pregnancy and fetal development were investigated in Long-Evans rats. The animals were treated by the intrauterine route either on gestational day 14 with 25 mug PGA1 or with 50 mug on day 17 of gestation. The incidence of fetal resorptions was significantly increased compared to the controls following treatment on gestational day 17. A significantly high incidence of nonspecific malformations was also induced in the offspring as a result of the treatment. There were no significant differences between experimental and control fetal and placental weights. The total protein content of fetal liver following treatment with PGA1 was not significantly reduced. Microscopic examination of placentas showed a consistent decrease in the thickness of the decidua basalis following treatment with 25 mug PGA1 on day 14 of gestation. The ovaries and umbilical cords showed no changes. In addition, treatment of rats daily with 200 mug PGA1, administered subcutaneously, on gestational days 9-12 or 12-15 did not affect the development of the conceptuses.


Mechanism of action of alpha-chlorhydrin on the testes and caput epididymidis of rat, gerbil (Meriones hurrianae), bat and mouse. Chronic administration of alpha-chlorhydrin caused lesions of rat, gerbil and bat testicles selectively. The seminiferous epithelium became systematically depleted of spermatogenic elements. alpha-Chlorhydrin did not produce lesion of the caput epididymidis. Sloughing of the epithelial lining did not occur. No obstruction of the lumen of the epididymal duct was seen. The growth of androgen-dependent organs, i.e. seminal vesicles, epididymis and levator ani muscles was suppressed. alpha-Chlorhydrin caused no response directly on the epididymides. Subcutaneous or oral administration of alpha-chlorhydrin for a period of 3-5 weeks caused no response in the testes and epididymides of the mouse.


Effect of malononitrile dimer on RNA concentration of neurons as demonstrated by azure B staining. Malononitrile dimer was administered to mice by single or by chronic (40 day) injections. The concentration of RNA in neurons of the brain was determined on histological sections by means of azure B staining. The nucleolus and Nissl substance of the several types of large neurons studied had a significantly higher concentration of RNA in the drug-injected than in the control animals.


[Histoautoradiography of the DNA in trophoblast giant cells of the mouse placenta. A contribution to the problem of metabolic DNA]. The trophoblast giant cells of the mouse placenta are mitotically inactive. Nucleolar RNA synthesis is apparently at a standstill. The high nuclear DNA contents of these cells shown by 3H-thymidine marking is conceived by us to be a synthesis of metabolic nuclear DNA. Thus protein synthesis in trophoblast giant cells has been taken over by a metabolic DNA.


Comparative ultrastructure of vallate, foliate and fungiform taste buds of golden Syrian hamster. A fine-structure study of the hamster fungiform, foliate and vallate taste buds was undertaken for comparative purposes. All three taste bud types shared in common composition of the dark cells, light cells, basal cells, nerve fibers and nerve endings and undifferentiated peripheral cells, but morphological difference existed among them. The foliate and vallate taste buds were quite similar in their ultrastructural morphology. Their dark cells displayed long apical necks, long apical microvilli, apical osmiophilic secretory granules and an abundant rough endoplasmic reticulum. The dark cells of the fungiform taste buds, however, showed no neck formation and lacked apical osmiophilic granules. They had short apical microvilli and relatively scant rough endoplasmic reticulum. There was no difference in the fine structure features of the light cells, basal cells and neural elements of different types of taste buds. Both light and dark cells were much more readily distinguishable in foliate and vallate buds than in fungiform buds at both light-and electron-microscopic levels. Foliate and vallate buds demonstrated homogeneous dense substance within the taste pores while fungiform pores were frequently empty. It is speculated that the differences in taste bud morphology may be due to their different lingual locations and/or may be a reflection of the differences in the inductive influences from different nerves. Furthermore, structural differences may be responsible for varying thresholds to different taste modalities.


Embryonic and postnatal growth of rat and mouse. IV. Prenatal growth of organs and tissues: age determination, and general growth pattern. (1) Data on the embryonic growth of several organs and of many different types of tissue in the mouse and rat are presented. (2) The concept developmental age is introduced, because it leads to an age estimate that is better correlated with the developmental stage. (3) The general growth pattern of the organs and tissues studied agrees with that found for the whole animal, consisting of phases with exponential growth separated by breaks. In the majority of the organs the breaks occur at the same time as in the whole animal. (4) The decrease in the growth rate at the end of phase E II is definitely smaller in the majority of the organs than in the whole animal. (5) Breaks occurring at other times than those found in the whole animal seem to take place in a few organs, and in the mouse at the embryonic age of about 17 days in a large number of organs.


So-called "vascular headache of the migraine type": one or more nosological entities? The dispute about whether migraine and cluster headache are one disorder--the "unified theory"--or two facets of a spectrum of "vascular headache" has not yet been settled. The author discusses various clinical features that unite or divide migraine and cluster headache in this respect: so-called "mixed forms" of vascular headache, corneal indentation pulse amplitudes, partial Horner's syndrome and possible aberrations in histamine metabolism. Evidence is presented showing that there may exist subunits of cluster headache, such as chronic paroxysmal hemicrania (C.P.H.) and a hitherto unreported type that co-exists with recurring bouts of retrobulbar neuritis and a partial factor XII deficiency.


A new standardized and effective method of inducing paralysis without administration of exogenous hormone in patients with familial periodic paralysis. A prolonged glucose loading test is described. When used in five patients with familial periodic paralysis it brought them into a state of massive hypopotassaemic paralysis at the first attempt, without the use of exogenous hormone. Three normal persons were subjected to the same glucose loading without exhibiting hypopotassaemia or muscular weakness. There were no essential differences in serum glucose levels between the two groups of individuals. The efficacy of previous methods of inducing paralysis, hormonal as well as non-hormonal, is reviewed, and the advantages of this new method are pointed out.


Diagnostic possibilities for the nuchal evoked potential. As a response to stimulation of the arm nerves an evoked potential can be recorded in the posterior neck region in man. This nuchal evoked potential (NEP) was recorded in three selected patients with A) cervical rib, B) syringomyelia, and C) prolapse of cervical intervertebral disc. Patients A and C had low-amplitudic NEPs with increased latencies when the affected side was stimulated and "normal" NEPs when the unaffected side was stimulated. Patient B had grossly abnormal, polyphasic NEPs (regardless of the side stimulated) but the simultaneously recorded somatosensory evoked potential was "normal". No systematic differences in the parameters of the NEP due to different recording locations on the neck could be observed.


A possible association between migraine and post-operative epilepsy in patients with intracranial aneurysm. There are various overlaps between migraine and epilepsy and another is suggested here in patients who develop seizures following surgery for intracranial aneurysm. Of a group of 37 who had this complication, three with a personal history of migraine and three with a family history of the disorder all developed post-operative seizures.


The effects of rigidity of internal fixation plates on long bone remodeling. A biomechanical and quantitative histological study. The effect of rigidity of internal fixation plates on long bone remodeling was studied using two types of plates with considerable differences in stiffness. The plated bones were subjected to bioengineering quantitative histological, and cortical thickness studies after 9 and 12 months. The biomechanical results, together with the quantitative histological measurements of the macroscopic architecture, showed that tissue characteristics of the plated bones were similar. However, because of the larger cortical area, the less regidly plated femora can sustain significantly higher loads and energy before failure. Cortical thickness measurements also showed that rigid plate immobilization results in thinning of the cortex of the underlying bone. The experimental results suggest that cortical bone remodels according to functional stress demands, and the osteoporosis secondary to rigid plate protection is consequent to thinking of its cortex.


The influence of freezing on the maximum torque capacity of long bones. An experimental study on dogs. The strength of bone has often been measured in previously frozen samples and the freezing and thawing effect on the strength properties has been considered negligible. By means of a specially constructed torsion machine and a new method for rixing the test bone into the machine, previously frozen bones have been compared to fresh controls. The previously frozen samples were significantly weaker, with an average difference of -- 4.6 per cent.


Experimental measurement of maximum torque capacity of long bones. By means of a new method with high precision (error 3.1 percent), the maximum torque capacity of an entire long bone from an experimental animal was measured under standardized conditions within 10 minutes after sacrifice of the animal.