[The problem of rifampicin therapy in pregnancy]. Report on a 24 years old first pregnant woman with chronic pyelonephritis, treated for 1 1/2 years, also during pregnancy, with high doses of rifampicin (1200 mgs/day). After normal delivery in the 42 th. week of pregnancy there were bleedings both in mother and newborn with demonstrable temporary disturbances in liver-function and coagulation system. Especially the coagulation factors produced in the liver were concerned. The complications after rifampicin carried out the conclusion that rifampicin should be given in pregnancy only with exact indication.


[Clinical and x-ray studies on the relationship between interruption of pregnancy and premature labor]. On the basis of the number of premature babies of 1975 the possible interdependence is checked between interruptio of pregnancy and subsequent premature birth and is compared with the dates obtained in 1974. Besides the hysterograms of women with premature birth whose anamnesis indicates an interruptio of pregnancy, are examined with regard to lesions of the cervix demonstrable in roentgenograms. As in the years of 1974 and 1975 the number of premature birth has been approximatively constant we conclude, basing ourselves on the investigations of roentgenograms, that no causal relation may be established between interruptio of pregnancy and premature birth in our material.


[Influence of labor induction using Prostin F2alpha on the cardiovascular system of the fetus]. Conform to its reaction, prostin F2alpha is a useful medicament above all in order to initiate risky deliveries having a state of unripe cervix. We have estimated the labor pains and the fetal state, which did not give proofs for any negative influence by prostin F2alpha in 60 initiations of labor. An intensive supervision system is absolutely necessary.


[The significance of continuous fetal monitoring for further lowering of perinatal morbidity. Pilot study]. By means of a pilot study we tried to calculate the perinatal morbidity after continuous fetal monitoring. From 810 electronical and biochemical monitored high-risk babies in the period from 1971 to 1973 we checked and/or have investigated 685 risk-newborns. Thereby 87 (=12,7%) were premature newborns. From this 685 risk-newborns 14 (=2,04%) appeared conspicuous. Only by 7 of them (=1,02%) we found mental and/or physical retardation. 2 of this children have a cerebral palsy. Causes of retardation with and without cerebral palsy we could lead back in the perinatal period. The causes are discussed. We point to the urgency of comprehensive follow-up studies.


[Psychological aspects following continuous fetal monitoring]. 100 women were examined in labor upon the so-called intensive birth room. In this connection we discovered, that the prevailing number of women to be in labor had a positive position to the surrounding modern implements for the continuous fetal monitoring. Explanation and a corresponding preparation to birth by means of consultations and psychopropylactic methods cut a great figure. Education, profession and social position were factors, influencing the answers in the same form how the position from the mother to the present pregnancy.


[The apgar value of the newborn and its prognostic value for the course of the neonatal period]. The prognostic value of the postnatal Apgar-score to the course of the neonatal period. It is impossible to determine exactly vital functions of the infant postnatal sole with a number. However we are the opinion, that Apgar-score is valid for the first clinical classification of the neonate. We studied 6780 newborn from 6 large towns of the GDR. Two thirds of the cases were selected with risk. The Apgar-score from 1 minute postnatal was correlated to findings of clinical investigation, diagnostic and therapy during the neonatal period from 2 hours postnatal to 8 days. Interesting correlations are found between the Apgar-score from 1 minute postnatal to: color of the skin (pale or pink), cyanosis, type of respiration, stridor, posture, crying, X-ray findings of the lung, need of buffer and oxygen therapy and neonatal death. Summarizing we found correlations of clinical value between the postnatal Apgar-score and the later respiratory function.


[The value of radioimmunological HPL determinations for the evaluation of intrauterine fetal growth during late pregnancy]. In 24 high-risk pregnancies correlation between maternal level of HPL in serum and the weight of the newborn is examinated. Retarded fetal growth was assumed of the weight of the newborn was found below the 5. percentil. Results of statistical sensitivity and specificity of radiommunoassay of HPL are given for this question.


[Total protein and immunoglobulin content of human milk]. The content of total protein and immunoglobulins in the breast-milk has been determined by the biuret-method and radial immunodiffusion. The immunoglobulins IgG, IgA and IgM has been ascertained in all samples. The concentrations of total protein and of immunoglobulins are higher in the colostrum but in the breast-milk.


[Immunoglobulin content of the cervix mucosa in early pregnancy]. The immunglobulins IgA, IgG and IgM in the extracts of homogenised cervical tissue from pregnant women were measured with the help of radial immunodiffusion of Mancini et al. The values of IgA and IgG increased during investigation. The low concentrations of IgM could not be evaluated quantitatively.


[Longitudinal study of the blood protein concentration during normal pregnancy, at the time of delivery and on the 7th post-partum day]. The concentration of serum protein was determined in 227 women during the 11th to 13th, 24th to 26th and 33rd to 35th week of pregnancy as well as immediately after delivery and on the 7th day post partum according to the Biuret method. A small but significant decrease of protein was observed during the second trimester of pregnancy (Ist Trimester x(-) = 7,57; IInd Trimester x(-) = 7,26 g/100 ml). The lowest values was found immediately after delivery (x(-) = 6,86). The mean concentration on the 7th day post partum was increased again (x(-) = 7,37). The values were compared with there of 190 non-pregnant women (x(-) = 7,57).


[Histochemical studies of the secretory capability of myometrial cells during pregnancy]. Investigations of many authors carried out on animals have shown the ability of myometrium cells to synthesize and secrete proteins and glycoproteid products in the period of pregnancy. The author's own studies have been carried out on human and animal material. In the muscles slices of gravid uterus as markers of appropriate cytoplasmatic structures were found out: S-nucleotidase, TPP-ase, succinat dehydrogenase, acid phopshatase and additionally glycogen. On the basis of the results obtained it may be concluded that in myometrium cells of gravid uterus morphological features of Golgi Apparatus (bacilliform, crescent, vesicular and granular structures) and mitochondria as well as the amount of glycogen manifest metabolic activity of these cells. Considering heterogenity of morphological forms of Golgi Apparatus and frequent charateristic polar localization round the nucleus it may be supposed that the cells charakterized by these features may possess the ability of secreting synthesized proteins or other products.


[Lymphogranulomatosis and pregnancy].

[Lymphogranulomatosis and pregnancy]. Four cases in lymphogranulomatosis and pregnancy are presented and compared to the opinions of other authors. Though a lot of questions are unknown yet, it seems that pregnancy doesn't have an unfavourable weight with lymphogranulomatosis.


[A very large luteoma gravidarum].

[A very large luteoma gravidarum]. A case of luteoma gravidarum detected during cesarean section is reported for the first time in German literature. The tumor described is the biggest of its kind so far. By means of this own observation details of origin, clinical behavior, histology and therapy of this odd tumor are discussed. Nevertheless a good deal remains enigmatical and further studies will be as interesting as actual.


[Positive and negative ions influence on the activity of the adrenal cortex (author's transl)]. The cortisol level in the serum of mice, which had been exposed to the influence of negatively or positively ionized air for 30 minutes, was determined by means of competitive protein fixation. Under the influence of both ion moieties, the cortisol level rose to twice the physiological norm (p less than 0,001 in both cases). - Theoretically the inhaled air ions might exert influence on the regulatory cycle hypothalamus - hypophysis - ACTH - adrenal cortex both neurogenically and directly via the circulatory system, thereby changing the cortisol level. For this reason, the determination of ACTH, as well as of cortisol after hypophysis exstirpation, must be regarded as a prerequisite for further investigations.


[Biochemical and psychological examinations of trichloroenthylene exposed volunteers (author's transl)]. Seven healthy volunteers were exposed to approximately 100 ppm (=520 mg/m3) trichloroethylene for six hours daily during a period of five consecutive days. A corresponding group was exposed a placebo in the same manner. -Biochemical and psychological examinations were accomplished in the beginning and the end of each day respectively the whole period. Thereby the intraindividual as well as the interindividual loads were taken to judge the health impairment. - For this purpose trichloroethylene, trichloroethanol and trichloracetic acid were determined in blood, as well as total trichloroethanol and trichloroacetic acid in urine. For the measurement of the biochemical parameters gaschromatography is considered the best method. The combination of the "intern standard" with the synchronous determination of the metabolites of trichloroethylene is described as a new treatment. These time-efficient and practicable procedures are the most important suppositions for "biological monitoring". Results are confirmed as far as known in literature as well as the course of trichloroethylene in blood is described for the first time. The modern methods of psychology applied to tests and standardized questionaires served to quantify the intellectual and psychological conditions of the solvent exposed volunteers and of their corresponding group. The group results were compared. Thereby no significative differences were visible. Altogother the results show that during the 5 days exposition to 100 ppm (=520 mg/m3) trichloroethylene no impairments of the examined persons' mental and psychological capacities could be determined in spite of the biochemically quantified incorporation of the solvent.


Clearance of benzo(a)pyrene from the respiratory tract of hamsters following its intratracheal instillation with or without ferric oxide. A comparative study was carried out on the clearance of benzo(a)pyrene (BP) from the respiratory tract of Syrian golden hamsters following intratracheal instillation of either BP alone or BP attached to ferric oxide particles. Eight series of 18 hamsters each, received a single intratracheal instillation of 0.5 or 1.0 mg BP suspended in 0.9% NaCl solution. In addition, three comparable series of hamsters received in the same way a mixture, of 1.0 mg BP + 1.0 mg ferric oxide suspended in 0.9% NaCl solution. In each of the series the BP content of the respiratory tract was determined at six different points of time viz. immediately after administration of BP or BP + ferric oxide, and three, six and 24 hours, and three and seven days after an instillation. The clearance of BP from the respiratory tract did not appear to be significantly influenced by the presence of ferric oxide. It was concluded that the present study produced no evidence of ferric oxide particles being capable of enhancing the retention of BP in the respiratory tract.


Repeated exposure to cyclopentenone vapour: long-term study in Syrian golden hamsters. Effects of cyclopentenone inhalation were examined in a 78-week study with 420 hamsters evenly distributed over two inhalation chambers, one for exposure to air and the other for exposure to the test substance. Cyclopentenone was dosed at a level of 18 ppm (seven hr/day, five days/week) during the first 52 weeks, and at a level of 27 ppm during the last 26 weeks of the study. During the first 52 weeks, part of the animals in both chambers fortnightly received an intratracheal instillation  of benzo(a)pyrene (BP) or diethylnitrosamine (DENA) in saline or saline alone. Exposure to cyclopentenone caused slight growth depression in both sexes, and slightly increased relative liver weights and enhanced development of renal amyloidosis in females only. There was no evidence of cyclopentenonne possessing carcinogenic activity or being a co-factor in respiratory tract carcinogenesis.


[Air and water contamination by road abrasion (author's transl)]. Owing to the abrasion of tar-containing or bituminous road surfaces particles are liberated which contain carcinophilic poly-aromatic hydrocarbons e.g. 3.4-benzpyrenes (BP). The effects of abrasion were determined by comparative measurements alongside a highway section of tar asphalt and one of concrete, both subjected to an identical traffic load. Airborne dust, sedimented dust near the ground and the degree of sewage pollution were measured. The wearing layer of the tar-asphalt surface consisted of TA16: max. grain size 16 mm; bonding agent TB 2000(containing  13 per cent tar pitch and 87 per cent bitumen). With a mean traffic load of 9000 vehicles per day abrasion liberated 15 mg 3.4-benzpyrene per month in winter and in summer 10 mg 3.4-benzpyrene per month and per 1 meter length of a two-laned highway. It was found that in the coarser dust particles the abrasion material containing 3.4-benzpyrene prevails. As a result, the tar asphalt abrasion in precipitated dust contained more than 50 per cent of total benzpyrene, while its share amounted even to 70 per cent of the total load in the floating fraction of waste water.


[Experiments to study paper for its suitability as sterile wrapping (author's transl)]. A description is given of experiments for the testing of germ density of paper intended for use as sterile wrapping. The generally used storage tests are unsatisfactory. The following procedure is proposed for the testing: The paper specimen is cut into pieces of about 7 X 7 cm and steam-sterilized at 134 degrees C. A number of samples is placed on the bottom of Petri dishes and each paper sample is sprinkled with 5 drops of a 0.1 ml suspension of Staph. aureus in distilled water. After drying, the paper samples are placed underside down on the surface of a blood agar plate so as to ensure complete contact. After about 5 seconds the paper samples are removed and the plates are incubated for 16 hours at 37 degrees C.


[On the incidence of Staphylococcus aureus in the throat of medical students (author's transl)]. There have been taken throat swabs of 148 medical students for making inquiries about the carrier rate of Staph. aureus. 106 of these persons could be checked-up after ca. two weeks. A comparison was made with the nursing staff of surgical wards of a university hospital. In view of the medical students Staph. aureus could be cultivated out of the throat swabs in 30%, in view of the hospital staff in 22%. 18% of the medical students were carriers for least two weeks. The Staph. aureus strains isolated from medical students and those isolated from the nursing staff showed on principle the same characteristics towards antibiotics resistance. With regard to the bedside-teaching it should be taken into consideration, that medical students are carriers of Staph. aureus to such a degree as the nursing staff.


[Possible error in interpretation of liquor enzyme activities as demonstrated on the example of lactate dehydrogenase and cholinesterase]. If examinations of the liquor are to give an insight into the metabolic condition of the brain, then it is necessary for all sources of error to be removed. The use fo exact methods requires that the liquor be free of major pleocytosis. In vitro examinations showed that additions of blood caused the activity of LDH to be doubled within thirty minutes, while that of cholinesterase even increased sixfold. It is especially after craniocerebral injuries that extra care must be taken to insure that the liquor used is as clear as water.


[Problem of the angiographic demonstration of subdural empyema in the interhemispheric cleft]. List's falx syndrome is confirmed on the basis of an analysis of six own patients and of a survey of the literature on 16 cases of interhemispheric empyemas. The angiographic diagnosis of interhemispheric empyemas is uncertain, and this is in contrast to opinions expressed in the literature. Negative angiographic results cannot be considered to rule out the possibility of the presence of an empyema in the interhemispheric space. In those cases in which corresponding clinical evidence is available it is recommended to always surgically explore the interhemispheric space subsequent to broad trephination.


[Complications of the operative neurosurgical treatment of trigeminal neuralgia]. The complications after neurosurgical treatment of trigeminal neuralgia of 161 patients treated in the neurosurgical hospital university medical school Bonn from 1971 to 1974 are referred. Emphasis is layed on severe complications. After rhizotomia (Dandys method) 3 patients died, one of them because of a meningitis, one of them because of damage of the superior petrosal vein and one after ligature of an irregular auditive artery. One patient died after electrocoagulation of the ganglion Gasseri (Kirschner's method) after having had an important bleeding during coagulation. Another patient developed hemiparesis after a strong arterial bleeding during electrocoagulation. The damage of importance arterial vessels seems to be decisive. Three proposals in order to diminish the risk of the operations are settled: 1. Preoperative neuroradiological checks by means of contrast. 2. Carefully sparing of vessels, especially when precedent scars had alterated the field of operation, perhaps if necessary by means of the operation mikroscope. 3. Control of the lokalisation of the needle during electrocoagulation by X-rays.


A standardized model of microembolization in the cat brain. A standardized method is described for the experimental reproduction of micro-embolism in the cat brain with obstruction of the cortical capillaries and following "remote" effects in the white matter. The model is useful for reproducing the phenomena observed in human fat embolism. Further results will be published in a future paper.


[A case of pyocele in the sphenoid bone cavity]. A case is reported where the clinical symptomatology as well as the ophthalmological, radiological, endocrinological, and scintigraphic results offered significant evidence in favor of the presence of a tumor in the sellar region. The diagnosis of a pyocele originating in the sphenoid bone could be established intraoperatively only. Cysts originating in the sphenoid bone are described as what is usually called an "orbital inlet syndrome" from which the present case differs in some respects.


[Myxopapillary ependymoma of the os sacrum]. A sacro-presacral myxopapillary ependymoma with a long anamnesis is described. A total of 46 other cases have heretofore been reported in the literature, which were systematized in this paper from a clinical as well as developmental point of view. Surgical interventions performed in the early and later phases of the disease resulted in restoration to health and subjective alleviation, respectively.


[Value of ophthamoneurologic diagnosis in cranio-cerebral injuries of the child]. In recent years, there has been a relatively high incidence of craniocerebral traumas among children. It is essential that careful ophthalmological examinations be made in addition to a general diagnosis, which should preferably be established by surgical means, as well as neurological and roentgenological examinations. The most important criteria of examination are the determination of the absence of external injuries to the eyes, the assessment of the mobility of the eyeball, tests of pupillary reactions, and an evaluation of the eyeground. The results of reexaminations made on 108 children, who had been receiving in-patient treatment, one to five years ago, because of craniocerebral traumas of different degrees of severity, underscore the importance of ophthalmological diagnosis in this particular group of diseases.


[Studies on surgical preparations for the concentration of radionuclides in brain tumors]. A total of 69 surgical preparations were used to determine the tumor-brain quotients of a number of radiopharmaceuticals and compare them with data reported in the literature of which the majority were externally measured values. The increases in activity of the tumor were on average, 2.5 times (131-J-HSA), 2.9 times (99m-Tc-pertechnate), and 3-5 times (197-Hg-Neohydrin) higher than those of the brain tissue. The lowest tumor-brain quotients were obtained for astrocytomas regardless of the radiopharmaceutical used, while high values were found for meningiomas, glioblastomas, and some of the spongioblastomas. In 44 cases tumor-brain quotients could be compared with scintigraphic results of which 36 were positive. Tumors having values less than 1-5 could not be scintigraphed. In the case of a negative scintigram of the brain the size and location relative to the base of the skull played a significant role although the tumor-brain quotient was high.


[Interrelationship between immunologic and neurologic memory: learning ability of rats during immunostimulation]. Studies have been made on the effect of an immunostimulator - the complete Freund's adjuvant - upon the learning ability in Wistar rats for visual discrimination using food-obtaining and avoidance of the electric shock techniques. Injection of the adjuvant significantly increases learning ability provided negative reinforcement technique is used, but inhibits the former under the conditions of positive reinforcement. Analysis of the extinction of the conditioned reflexes yielded similar results. Possible relation of immunogenesis to the formation of memory is discussed.


[Patterns in the binding of cytotoxic neuropharmacologic preparations by early sea urchin embryos]. Early embryos of Arbacia lixula, Paracentrotus lividus and Sphaerechinus granularis intensively bind cytotoxic neuropharmacological drugs, such as antiserotonine indole derivatives, cholinolytics and tricyclic antidepressants. The binding intensity decreases markedly upon quaternization of the drugs. Quantitative analysis indicates that: a)with respect to the drugs, the suspension of living embryos may be described as a single adsorbing system following the Langmuir equation; b) at least two independent binding pools exist in embryos; c) the magnitude of cytotoxic effect of a given drug is not proportional to its binding.


[Variability in several ecologic-physiologic traits of different populations of the Asiatic Arctic suslik Citellus parryi]. In several geographic populations of the Arctic ground squirrel C. parryi, studies have been made on changes in oxygen consumption during decrease of the ambient temperature from 25 to 3-4 degrees, thermal preference, hemoglobin content of the blood and composition of the adipose tissue (both brown and white, subcutaneous and visceral). Significant shifts of these indices were found. In animals from various parts of the species area, different sensitivity to cooling was found, as indicated by determinations of oxygen consumption at different temperatures and the prefered temperature: different hemoglobin content of the blood was also found together with differences in the level of two unsaturated fatty acids - the oleic and linoleic ones. Comparison of these data with similar results obtained on various populations of the Siberian ground squirrel C. undulatus revealed obvious differences between these close species with respect to the indices studied.


[Lactate dehydrogenase isoenzymes in the eye, cardiac and skeletal muscles of several decapods]. Properties of lactate dehydrogenase (LDH) in the eye, heart and muscles of Hemigrapsus sanguineus, Paralithodes camtschatica, Erimacrus isenbeckii, Pandalus latirastrus, Pagurus brachiomastus have been studied with acrylamide gel electrophoresis and kinetics analysis. LDH in all the tissues of all the representatives studied was found to be specific for L-pyruvate and lactate; it migrated in electrophoresis as a single band revealing low mobility towards anode. The isoenzyme from P. camtschatica and P. latirastrus differed from the isoenzymes of other animals studied by higher mobility towards anode that reflected higher negative value of its total charge. The LDH isoenzymes in all the animals studied resembled the A4 (LDH5) of the vertebrates being unstable to the denaturing action of high temperature and being unaffected by high concentrations of pyruvate up to 1.0.10-3M. On the other hand, in conrast to the A4 of mammals, the LDH in question displayed enhancement of the reaction rate and decrease of the Km values upon increase in the NAD+ and NAD.H concentrations both in the presence of high or low lactate and pyruvate concentrations. The isoenzymes displayed catalytic activity also in the presence of NADP, the Km values for pyruvate in the presence of equimolar (2.25 mM) concentrations of NAD.H or NADP.H were practically identical and were found to be within the limits of 14-26.10-5 M. Molecular weight of the LDH studied assessed by the gel filtration method was found to be 130-140,000. It is suggested that the LDH isoenzyme from the representatives of the decapod crayfish studied is homologous in its certain properties to the homotetrameric A4 form of the vertebrates.


[Pathways for the transmission of visual information in the protocerebrum of the drone fly Eristalis tenax]. Studies have been made on the structure of neuropiles and visual pathoways in the brain of the fly E. tenax L. (Diptera, Syrphidae). The retina is projected on laminar structures in the visual ganglia only; other protocerebrum neuropiles lack this projection. All the comissures connecting contralateral visual ganglia, consist of several hundreds of fibers, whereas the binocular zone of both eyes includes more than 4,000 ommatidia. Neither the visual ganglia, nor other protocerebrum neuropiles may serve as a substrate for topographic imposition of projections of the corresponding parts in both retines. The mechanism of binocular interaction in insects presumably differs from that in mammals (primates, carnovores).


[Carbon dioxide fixation in aquatic animals and its metabolic significance]. In experiments on the carp Cyprinus carpio and freshwater lamellibranch mollusc Anodonta cygnea, tissue and organ peculiarities of carboxylic reactions have been revealed together with their relationship to the temperatute and ionic composition of the incubation medium. It was shown that in fish the highest intensity of fixation of CO2 is exhibited by glandular organs with biosynthetic profile of the metabolism (liver), whereas in molluscs it is exhibited in the mantle which plays the key role in the formation of the shell, containing carbonate compounds of calcium.


[Wing receptors of the American cockroach Periplaneta americana]. Wing receptors of the cockroach have been studied using staining technique with methylene blue in living animals. Five types of the receptors were found: trychoid hairs, bristles, complaniform sensillae, chordotonal organs and multiterminal neurons. The majority of the receptors is located at the lower surface of the wing, especially along its ribs. Together with primitive features in the structure (polyneuronal origin of hairs and bristles, poor content of chordotonal organs, absence of distinct groups of companiform sensillae), some specialization of wing receptors with respect to flight function is noted (concentration of proprioceptors along the main mechanical axis of the wing and formation of distinct rows by the companiform sensillae).


[Visual projections in the forebrain of the carp Cyprinus carpio]. In the carp C. carpio, studies have been made on the evoked potentials (EP) in the-forebrain elicited by electrical stimulation of contralateral (with respect to the midbrain tectum) nerve. The most high-amplitude and short-latency EP were recorded in the rostro-lateral part of the forebrain at the depth of 1,000-1,500 mu. According to the topographical nomenclature of cyprinid telencephalon, this region corresponds to the area dorsalis telencephali pars lateralis, whereas according to classic comparative neuroanatomical nomenclature it may be defined as the primordium hippocamp or primordium piriform zone. Comparison of the EP in the telencephalon with those in the midbrain tectum suggests active nature of the former.


[Properties of neurons of the tectal portion of the visual system of the axolotl Ambystoma mexicanum]. In the tectum opticum of the adult neotenic A. mexicanum, responses of single neuronal units to diffuse illumination and moving visual stimuli have been investigated. Of 111 unites investigated, 27 are presented by tectal neurons, their maximum distribution being observed at a depth of 500-600 mu. In superficial layers 9 ipsi-elements were found; their receptive fields are located in the antero-dorsal part of the visual field, at both sides of the body axis. Among the units identified as the terminals of visual fibers, 70% have receptive fields of 5-10 degrees, being localized in general more close to the surface as compared to the units with the receptive field diameter of 40 and more degrees (11%). Visual neurons and ganglionic retinal cells with axons terminating in the tectum, exhibit poor specificity to the size of a stimulus within 5-30 degrees and do not react to stimuli of 2 degrees.


[Coupling of enzymes to modified styrene-maleic anhydride copolymers]. A copolymer of styrene and maleic anhydride is modified with low molecular weight polyoles in a very convenient manner, so that it can be applied as a carried for the fixation of biologically active compounds without further pretreatment. The modified products show storage stability over a long time without loss of coupling capacity. Examples for the fixation of trypsin, alkaline phosphatase and a bacterial glutamate dehydrogenase are given, and some properties of the resulting enzyme products are described.


[Influence of vagotomy on glucose tolerance and on the responses of plasma insulin and exocrine pancreatic function followed glucose load or food ingestion in dogs]. A part of the intrapancreatic nerve fibres of dogs show 1-2 months after bilateral truncal vagotomy a decay of the medullary sheath; in addition, the histochemically demonstrable insulin content of the B-cells is reduced. These animals do no longer react to oral glucose administration or feeding a meat meal with a reflectoric early rise of plasma insulin concentration and of exocrine functional parameters (all the animals were bearing exocrine pancreas fistulas). The glucose tolerance and and the decrease of free fatty acids in serum were restricted. Also, the content of bicarbonate and protein in the pancreatic juice and the insulin secretion of vagotomized animals are strongly reduced in the subsequent test phase (up to 120 min) following oral or i.v. glucose administration and after feeding meat. The inhibition of exocrine volume secretion following i.v. glucose administration was enhanced by the intervention. The findings confirm the involvement of the N. vagus in the mechanisms of the enteroinsular axis that becomes active together with exocrine gastro- and duodenopancreatic reflexes to any kind of physiological enteral stimulation.


[Morpho-functional characteristics of the optic nerve of the steppe turtle Agrionemys horsfieldi]. The optic nerve of the tortoise Agrionemys horsfieldi contains about 400,000 fibers (90% unmyelinated and 10% myelinated ones). the diameter of unmyelinated fibers varies from 0.3 to 1.1 mu, mean value being equal to 0.5 mu; fibers with a diameter 0.4-0.7 comprise 77%. The diameter of myelinated fibers varies within 0.3-3.0 mu, average value being 0.5-0.8 nu; fibers with a diameter 0.5-0.9 mu amount to 62%. Electrogram of the optic nerve consists of two components which are equal in their amplitudes. These components presumably reflect summary firings of modal groups of unmyelinated and myelinated fibers. The velocity of propagation of excitation along the fibers producing the first component is equal to 1.3 m/sec, wheras that in fibers producing the second component - to 0.5 m/sec. The data obtained are compared with those related for the other tortoise - Emys orbicularis.


The mechanism of insulin secretion after oral glucose administration. VII. Exocrine pancreatic function and plasma-IRI in dogs with chronic pancreatic fistulas. During an intravenous glucose test, conscious dogs with exocrine pancreatic fistulas showed a reduction in the secretions of water, protein and of bicarbonate. This reduction is related to hyperglycemia and to IRI increase in the peripheral venous blood. After oral administration of glucose, however, a biphasic stimulation of the exocrine function was observed. During the first 15 minutes when insulin secretion increases independently of the blood glucose increase, all exocrine pancreatic functions are transiently stimulated, too. A second peak of the exocrine secretions is to be observed when glucose absorption and insulin secretion exhibit their maximum.


[Distribution of reticulospinal fibers and theri endings in the lumbar segments of the rat spinal cord]. After stereotaxis lexions in the nucleus reticularis gigantocellularis of the modulla oblongata and nucleus reticularis pontis caudalis, the distribution of degenerating nerve fibers in the lumbar segments of the spinal cord has been studied by silver impregnation methods of Nauta and Fink-Heimer. Degenerating reticulo-spinal fibers and fragments of axonal terminations were found in the area of n. motorius ventro-medialis and n. motorius ventro-lateralis, as well as partly in n. motorius dorso-lateralis close to motoneurons and their dendrites. Mainly they pass into layers VII and VIII. This fact indicates the existence of direct-reticulo-motoneuronal synaptic connections in rats, which coincides with electrophysiological data.


[Hypotonic regulation in marine cladocerans Evadne nordmanni and Podon leuckarti]. At a salinity of the environment of 23-25% (delta degrees being equal to -1.28 divided by-1.39), the depression of hemolymph in E. nordmanni is equal to -0.76 +/- -0.11 degree, in P. leuckarti - to -0.75+/- -0.06 degree. This high level of hypotony persists up to the formation of the head-shild, after which the depression of marsupium fluid becomes equal to that of the external medium. It is suggested that the head-shield is involved into osmoregulation. Similarity of the level of the osmotic pressure of the internal medium in marine cladocerans and marine teleosts which also originated from fresh-water ancestors is noted.


[Reactivity of isolated arteries from hypertensive rabbits]. Isolated vessels (aorta thoracica, a pulmonalis, a. femoralis, a. renalis) of neurogenous-interoceptive and nephrogenous hypertensive rabbits showed a changed sensitivity to several vasoactive agents. An increased reactivity to noradrenaline, histamine, and serotonin in the aorta of neurogenous hypertensive rabbits, in the a. pulmonalis of neurogenous and renal hypertensive rabbits and in the a. femoralis of renal hypertensive animals in comparison with controls could be shown. Also registered was a hyperactivity to BaCl2 and KCl. All vessels of hypertensive rabbits were hyporeactive to angiotensin. They increased vascular reactivity was seen already in the 3rd week after removal of one kideny and pressoric receptors respectively. It is supposed that a "true supersensitivity" of the vascular smooth muscle cells of the hypertensive arteries does exist.


[Influence of spasmolytic agents on the cumulative calcium dose-effect curve in isolation-perfused peripheral vascular beds]. The influence of verapamil, theophylline, and papaverine on the cumulative calcium dose-effect curve was studied at the isolated perfused rat tail. The results indicate different changes of the contraction and relexation phase respectively. The findings are discussed in connection with the action mechanism of the drugs and the processes of excitation-contraction coupling.


[Extent and duration of drug-induced stimulation of renal excretion of p-aminohippuric acid]. Repeated pretreatment with p-aminohippuric acid (PAH), probenecide, cyclopenthiazide, and phenobarbital stimulates the renal excretion of PAH. For an interval of at least 6 hrs following i.p. application pretreated rats excrete more PAH excretion than the controls. All the drugs studied were found to stimulate renal PAH excretion within a period of 3 hrs by 50-60% of the control value. The required duration of pretreatment varies with the substance used. With cyclopenthiazide, the excretion of PAH is demonstrable for 2-3 weeks. Phenobarbital has a brief stimulating action. Correlations of a binding of drugs to structures of their tubular cell and the length of the stimulating action are discussed.


[Binding and distribution of chlordiazepoxide (Radepur) and its metabolites in the erythrocyte-plasma and erythrocyte-buffer systems]. The distribution and the free concentration of chlorodiazepoxide, desmethyl-chlorodiazeoxide and demoxepam in the systems erythrocyte-plasma and erythrocyte-buffer is determined. In both systems the substances are bound by erythrocytes. A constant ratio of distribution between erythyrocyte-plasma and erythrocyte-buffer, respectively, is established beyond therapeutic concentrations. The association constants (dual reciprocal plot) of these substances are of the order of 10(4)-1-M-1. They are the same for erythrocytes and plasma. The specific binding of erythrocytes is 20-35 fold less than with plasma proteins. It is concluded that the erythrocytes are a binding intravascular subcompartment for chlorodiazepoxide and its metabolites.


[Temperature dependence of the sedimentation velocity of human erythrocytes]. The sedimentation velocity of yeast cells and human erythrocytes as a function of temperature was studied in a range from 6 degrees C to 40 degrees C. Whereas this function for yeast cells can be described by an exponential function the measurements with erythorcytes show minima at 10 degrees C and 20 degrees C, respectively, and maxima at 13 degrees C and 38 degrees C. Changes of the density or the shape of the cells cannot be the reason for these effects. Viscosity measurements on erythrocyte suspensions as a function of temperature also show deviations from the exponential function between 18 degrees C and 24 degrees C. The results explain that alterations of the membrane viscosity and phase transitions of the membrane lipids influence the sedimentation velocity of erythrocytes.


Blood group H like activity in crude preparations of bovine lung galactan. In crude preparations of bovine lung galactan blood group H-like activity, which does not occur on bovine red cells, has been detected with  heterophile anti-H-like reagents from different origin. These H-like receptors, associated with pneumococcus type XIV cross-reactivity, belong to a glycoprotein fraction and not to the galactan itself.


[Partial pericardiectomy for pericardial tamponade in patients with chronic uremia under dialysis]. Two dialyzed uraemic patients were subjected to partial pericardiectomy because of haemorrhagic pericarditis and pericardial tamponade. Seventeen and nine months, respectively, after the operation the patients have still been under intermittent home haemodialysis.


Effect of truncal vagotomy on the bacterial flora in the duodenal juice on dogs. The qualitative and quantitative changes in the bacterial flora of the duodenal juice after truncal vagotomy have been studied in self-control experiments in dogs. The intervention was followed by a rise in the bacterial count without a change in qualitative composition. It is suggested that the accumulation of microorganisms might contribute to the development of postoperative diarrhoea. The role of several partly clarified pathophysiological processes are pointed out.


[Transurethral resection of bladder neoplasms]. The technique of removal of bladder tumours is discussed on the basis of experience with transurethral resection performed on 200 patients suffering from bladder tumour (113 benign and 87 malignant tumours). The indications for the intervention are as follows. With benign tumours, resection has to be given preference over exposure. When malignant tumours are operable and situated on the mobile part of the bladder, radical surgery is recommended. When the tumour is in some other position, transurethral resection is the procedure of choice.


[Hydatid cyst of the lung (author's transl)]. The authors, in an international collaborative study, report on 257 cases of operated hydatid cysts. The delicate choice between resection and conservative treatment depends on a protocole and/or on experience: in the large series published in the last 10 years the rate of resections has varied between 43 and less than 20 per cent. Cure of the pulmonary hydatid cyst, be it live or ruptured, is presently a well systemized, efficient and safe operation. The authors present their data that correlate well the sparse literature related to the subject in the last decade.


[Reappraisal of the problem of hair transplantation (author's transl)]. Free transplants of hair-bearing scalp as "plugs" or "strips" are an adequate treatment for male alopecia. Cooling the grafts eliminates hematoma and infection and allows successful take and growth of larger plugs. However the result of grafting wide hairstrips is unreliable.


[Acute cholecystitis without stones (author's transl)]. The authors report on ten cases of cholecystites without stones. Two were typhic in origin, six apparently primitive, one postoperative and one posttraumatic. They stress the importance of histologic lesions in each of these etiologies and insist on the high frequency of gangrenous forms in postoperative and posttraumatic cases. Previous antibiotherapy deserves no credit. Emergency cholecystectomy remains the best treatment.


[Ruptured aneurysm of the inferior pancreatic-duodenal artery (author's transl)]. The authors stress the insidious onset of the lesion, which first presented as a hepatic or a gallbladder disease. Diagnosis was established later by an arteriography after the occurrence of a state of shock. Evacuation of the hematoma surrounding the aneurysm appeared satisfactory to re-establish the circulation; this was confirmed by an arteriogram. A review of the literature reveales 18 such cases, with a high mortality rate, up to 100% where surgery was not performed.


[Blunt abdominal trauma. Advantages of the peritoneal lavage (author's transl)]. Among 80 cases of blunt abdominal trauma operated on at the University Hospital of Bavière during the last two years, peritoneal lavage has been performed in 40 cases. In 39 cases, the diagnosis of blunt abdominal trauma has been established by the peritoneal lavage. A case of false negative result has been due to a technical fault. Peritoneal lavage must be considered as a very useful procedure for the diagnosis of hemoperitoneum and visceral lesions from blunt abdominal trauma.


[Late sequellae of a splenectomy (author's transl)]. This is the case of a patient who underwent splenectomy after traumatic rupture of the spleen. After the operation, while on parenteral feeding, the patient presented with fever and septicemia during approximately 2 months; no origin to this could be found. Two months after the accident the patient died of perforation of a subdiaphragmatic abscess into the stomach and the lung. The authors discuss the possibilities of coming to an earlier diagnosis. They recognize the necessity of a more aggressive attitude to establish the diagnosis.


Concentration of thyroxine, tri-iodothyronine and thyroglobulin in the thyroid lymph. Human thyroid lymphatic fluid was collected from 8 patients operated upon for thyroid tumours. All tumours were of small size and localized to one lobe. The lymph was collected from the side opposite the tumour. The levels of thyroxine and tri-iodothyronine in the lymph were determined by a radioimmunoassay technique in 7 of the patients. The thyroglobulin content of thyroidal lymph from one patient was analysed. The results demonstrate higher levels of thyroxine and tri-iodothyronine in the human thyroid lymphatic fluid as compared with those seen in peripheral or thyroid venous blood. Evidence for the presence of thyroglobulin in the human thyroid lymphatic fluid was obtained.


Indications for surgery in the elderly patient with primary hyperparathyroidism. The major symptoms presented by the elderly patient with primary hyperparathyroidism (HPT) were studied in 30 patients, all of whom were over 70 years of age (70-89). Neuromuscular symptoms, fatigue or mental symptoms were the main complaint in 14 patients. Nephrolithiasis, pancreatitis, skeletal changes or thyroid diseases were associated with HPT in 13 patients. Three patients were considered to be asymptomatic. Seven out of the eight patients with neuromuscular symptoms, and two of the three patients with extreme fatigue as the dominant symptom, improved postoperatively. This study indicates that for elderly patients with HPT especially when associated with neuromuscular symptoms or fatigue, surgical therapy is the treatment of choice.


Bilateral fibromuscular hyperplasia in the internal carotid arteries with aneurysm formation. A patient with bilateral fibromuscular hyperplasia in the carotid arteries with development of aneurysms is reported. The patient had no symptoms except for a palpable mass on one side and a bruit on both sides. Surgery was carried out bilaterally, using direct end-to-end suture on one side and a reconstruction with an autologous vein on the other side. It is suggested that fibromuscular hyperplasia may be the cause of some of the internal carotid artery aneurysms reported as congenital or with uncertain etiology. Reconstructive surgery of the carotid artery is recommended due to the obvious hazards of the condition.


The phlebographic pattern of acute leg thrombosis within a defined urban population. The incidence of thrombosis during one year in a defined population of 263 144 city inhabitants has been studied with a new method based upon acute phlebography of all patients with the slightest symptoms of the disease. The roentgenographic pattern of the acute thrombosis has been studied and the size of the individual thrombus has been compared with the duration of the symptoms. The incidence of thrombosis was found to be 0.9 per mille per year. No correlation was found between the size of the thrombus and the duration of the symptoms. The thrombus had its origin in the calf veins in 89% of the patients and its origin in a vein at a higher level in 10% of the patients. In patients with a thrombus confined to the calf veins the contrast medium always entered the deep crural veins. When the calf vein thrombosis had an extension to the popliteal vein or still higher up the contrast medium bypassed the deep crural veins in more than 75% of the patients.


Liver blood flow measurement the interpretation of xenon133 clearance curves. Liver tissue perfusion can be measured by analysis of the clearance of the radioactive inert gases Xenon133 and Krypton85 from the liver. The technique commonly gives rise to multiexponential clearance curves which have previously been quoted as evidence of complex intrahepatic blood flow patterns. The clearance of 133Xe from the canine liver was studied in 17 dogs and by screening out extrahepatic radioactivity it was found that the true intrahepatic clearance is monoexponential. The slower components seen in the multiexponential curve recorded without screening represent 133Xe in tissue other than the liver and much of this activity was shown to originate from 133Xe which accumulates in the stomach and intestines. These findings simplify the interpretation of inert gas clearance curves in the measurement of liver blood flow and therefore encourage further application of the technique in both experimental and clinical situations.


Enzyme histochemistry studies of transverse and longitudinal incisions in the common bile duct in rabbits. The healing process of longitudinal and transverse incisions of the common bile duct in rabbits was studied by identification of 10 different enzymes in the duct wall at various times after the operation. Bile was deviated during the healing. An almost complete disappearance of the subepithelial alkaline phosphatase activity was noted early after longitudinal incisions in contrast to unchanged alkaline phosphatase activity after transverse incisions. Transversely incised ducts almost uniformly developed stricutre formation. The size of the lumen after longitudinal incisions was generally normal. The difference in enzyme pattern following the two types of lesion might reflect a different response of the tissues to the two different types of trauma.


170 patients five years after selective gastric vagotomy--with an uncontrolled comparison of ulcer recurrence following either Heineke--Mikulicz or Finney pyloroplasty. The study concerns 170 patients treated for duodenal ulcer by selective gastric vagotomy and either HM- or FP. A 5-year follow-up showed a 4% recurrence rate. Insulintest 2-3 months after surgery was Hollander negative in 78%, late positive in 17% and early positive in 5%. 72% of the tests were unchanged after 5 years. 25% had moderate severe dumping. In the HM-group of 84 patients, 6 patients displayed ulcer recurrence. In the F-group of 86 patients, one displayed recurrence. All patients with recurrence (and one without) in the HM-group had operatively demonstrated pyloroplasty stenosis. None of the patients in the F-group had clinical symptoms of gastric stasis. The only variable in the treatment of the patients was the pyloroplasty method, and it thus seems reasonable to implicate the pyloroplasty method in the incidence of recurrence. The difference in recurrence between the two groups was not, however, statistically significant, and the value of a prospective randomized study of patients treated by selective gastric vagotomy and different pyloroplasty forms is pointed out.


A comparison of small intestinal transit time between the rat and the guinea-pig. The small intestinal transit was compared in rats and guinea-pigs. A radioactive test substance (polyvinylpyrrolidone labelled with I125) was given directly into the duodenum and the distribution of the isotope in the small bowel was recorded. The small intestine was removed 10 and 20 min after the injection and deep frozen. The frozen intestine was later cut in 20 segments of equal length and the amount of isotope within each of the intestinal segments was recorded by means of a gamma counter. For each animal a propulsion diagram was constructed showing the relative percentage of isotope distributed in the 20 bowel segments. After 20 min the isotope peak was found in the ileo-caecal region in the guinea-pigs whereas 50% of the isotope had passed only half of the small intestine in the rats during the same period of time. The length of the intestine in rats passed by 75%, 50% and 25% of the isotope after 20 min was the same as that found in guinea-pigs 10 min after the injection of the isotope into the duodenum. Thus, there seems to be a marked difference in propulsive activity between rats and guinea-pigs.


Aneurysm of the pancreaticoduodenal artery. A case report. A case of an aneurysm of the pancreaticoduodenal artery is reported, together with a short review of the literature relating to this condition  Because of its rarity the diagnosis is often overlooked even when typical changes are found on X-ray. The possible relationship between obstructive jaundice and aneurysms in the vicinity of the galltree is discussed. Surgical treatment is recommended by most authors once the diagnosis of an intra-abdominal aneurysm has been made, mainly because of the risk of rupture.


Prolonged recovery after extended right hepatic lobectomy in a patient with severe blunt liver injury and laceration of the vena cava. A report of case with special references to autotransfusion and complications of biliary decompression. A patient with severe blunt liver injury and laceration of the vena cava who underwent a successful extended right hepatic lobectomy is reported. The use of autotransfusion unit saved the patient from exsanguination. His postoperative course was complicated by renal and hepatic failure, bile leakage, and persistent jaundice due to cholangitis. Prolonged choledochal drainage via T-tube obviously acted as a source of infection. The use of autotransfusion, choledochal drainage and the proper timing of its removal, the treatment of vena cava lesions and jaundice due to cholangitis in patients with severe liver trauma are discussed.


Clinical picture of diabetic osteoarthropathy. On the basis of data from pertinent literature and of a thorough examination of 23 cases observed by himself the author illustrates findings concerned the occurrence, clinical picture and interrelations of clinical and radiological symptoms in diabetic osteoarthropathy. These alterations occur most frequently in middleaged or elderly diabetic patients with unstable metabolism or poor control, usually after a long duration of diabetes. Clinical symptoms are divided into 4 groups. Neurological symptoms (group I) are detectable at every stage of the process. Sometimes bone destruction is concomitant but neurological changes are the sole symptoms. Loose joints and articular swelling (group II) are frequently premonitory signs of bone alterations. Plantar ulcers (group III) are often associated with bone changes. Detectable foot deformities (group IV) are mostly an indication of the end stage of the process.


Inhibitory effect of clofibrate on arginine-induced insulin secretion in chemical diabetes. Clofibrate 3 g/die for 10 consecutive days, significantly reduced arginine-induced IRI release in chemical diabetics and in normal controls, whether of normal body weight or obese. Blood glucose levels were not affected by clofibrate. In agreement with previous findings, it would appear that clofibrate, administered for short periods does not lead to a decrease in glucose tolerance. However, studies relating to the effect of chronic clofibrate administration in chemical diabetes are needed in order to be sure that prolonged inhibition of IRI secretion does not lead to overt diabetes.


Acute self-poisoning with phenformin.

Acute self-poisoning with phenformin. The case is reported of a non-diabetic young woman who attempted suicide by ingesting 2,500 mg of phenformin. The most marked clinical and laboratory findings during the first 24 hrs included nausea, vomiting, anxiety, agitation, polydipsia, polyuria, increased appetite, tachycardia, tachypnea, persistent lactic acidosis, hypoglycemia and hypokalemia. Treatment at the ICU 10 hrs after ingestion of the overdose was essentially symptomatic and included measures to correct acidosis and hypoglycemia. The patient recovered completely.


Insulin-induced hypoglycemia: 24-h variation. The hypoglycemic effect of i.v. insulin injected at 4 different times of day was studied in normal volunteers. It was found that the glucose fall induced by this treatment was quantitatively different, with the maximum effect observed at 18(00) and 24(00). The circadian variation of the insulin-induced hypoglycemia depends on the time recovery from the glucose fall rather than on lower circulating glucose levels attained following hormone injection. These results underline the importance of considering circadian variations when planning either experimental designs or insulin therapy.


Observations on morning and afternoon glucose tolerance: differences between sexes. One hundred non-obese and non-diabetic individuals, 50 men and 50 women, were submitted to oral glucose tolerance tests performed in the morning and in the afternoon on different days. Although great individual variations were noted in both sexes, in men the mean blood sugar (BS) values did not significantly differ between the two tests; in women, however, the mean values after glucose loading were significantly higher during the afternoon test. By dividing the test population into those aged 50 and below and those over 50 it was found that only the group of younger women showed significant differences between the two tests with higher mean BS values during the afternoon test.


Some metabolic and hormonal effects of salbutamol in man. The effect of i.v. infusion of a beta-adrenergic stimulant, salbutamol on blood insulin, glucose, lactate, phosphates, potassium and NEFA was studied in 9 normal subjects. The effect of the drug on the blood sugar and insulin response to i.v. glucose was also examined in 4 subjects. Salbutamol was followed by increases in insulin, glucose and lactate, and a fall in blood phosphorus and potassium. NEFA values did not change significantly. These effects of salbutamol were abolished by propranolol and may thus be attributed to its beta-adrenergic stimulating action. Salbutamol also induced a reduction in glucose tolerance, in spite of the presence of enhanced blood insulin levels.


Intestinal digestion and absorption of sucrose in experimental diabetes. Intestinal sucrose hydrolysis and absorption of monosaccharide products was studied in vivo utilizing the segmental perfusion technique in diabetic and control rats. The proximal jejunum was perfused with 20 mM sucrose, 140 mM NaCl and 0.5% PEG with 14C-PEG, as the nonabsorbable marker. Rates of sucrose hydrolysis and adsorption of monosaccharide products (fructose, and glucose) were determined. There were no statistically significant differences between the diabetic and control rats. This indicates that the previously reported increase in sucrase activity in diabetes does not correlate with enhanced rates of sucrose hydrolysis. Several possibilities for the interpretation of these results are discussed.


Australia antigen in diabetic subjects.

Australia antigen in diabetic subjects. The sera of 766 diabetics and 730 blood donors have been tested for Australia surface antigen (HBsAg). Subjects with a history of an episode of jaundice were excluded from both groups. The two groups did not differ as to the frequency with which HBsAg was found 1.64% in blood donors, 1.56% in diabetics.


Stimulation of 3H-uridine incorporation into ribosomal ribonucleic acids by insulin. Ribosomal RNA was extracted from hepatic ribosomal subunits of rats treated with alloxan or with alloxan and insulin and additionally injected with 3H-uridine. Sedimentation of the extracted RNA through sucrose, gradients with registration of the optical density and with measurement of the radioactivity of rRNA reveals reduction of uridine incorporation after the induction of diabetes of diabetes mellitus. If alloxan-diabetic animals are substituted with insulin, this decrease in uridine incorporation is reversed to incorporation rates which even exceed uridine incorporation of control animals. With regard to the reduction of protein synthesis in diabetes mellitus this finding of reduced rRNA synthesis is suggested to be an additional factor in the reduction of ribosomal aggregation.


Maternal diabetes and congenital malformations among live births in Hawaii. The frequency of congenital malformations in 187,266 live births in Hawaii from 1956 through 1966, was found to be significantly higher among offspring diabetic mothers (0.0175) than in offspring of non-diabetic mothers (0.0086) or mothers with no complications of pregnancy (0.0074). However, the frequency of malformations in offspring of diabetic mothers was not significantly higher than in offspring of mothers with heart conditions of hypertension.


[Estimation of the performance spectrum of healthy adolescents by using the PWC 170 (Physical Work Capacity)]. On 10 persons we performed maximal rectangular-progressive bicycle-test, with measuring of VO2max and maximal work in Watts (Wmax), including the working time at the last step. In 18 other young people, we all together made 29 tests without spirometry. In addition to Wmax, the PWC 170 was figured out, once with two higher ergometer steps and once with two lower steps. We found a high correlation between Wmax and VO2max on the one side and PWC 170 and Wmax on the other. If, for the PWC 170 will be utilized, two steps with heart-rates of greater than 140 on the lower and 160 to 170 on the higher step, the PWC 170 seems to be exactly sufficient for estimating the maximal physical working capacity for routine testing of healthy young people.


[Early recognition of bone metastases (comparative study between bone scintigraphy and x-ray examination)]. The examination shows, that in search for skeletal metastases the bone scintigraphy marks the bone-process in 45% while the X-ray is still silent. Therefore, we believe that the first examination in quest of skeletal metastases must first be a whole-body scintigraphy and then secondly, an X-ray examination with tomography, inasmuch as scintigraphy cannot give an exact differential diagnosis (degeneration, inflammation or destruction).


Influence of anesthesia on autoregulation of the cerebral blood flow. Autoregulation of the cerebral blood flow is a wellknown fact. In normal man the arterial pressure can vary from 80 mm Hg to 150 mm Hg without a change in the normal cerebral blood flow of 50 ml/100 g/min. The mechanism which is responsible for this autoregulation is not clearly understood. Several theories were proposed to explain this phenomenon. 1. The tissue pressure increases with an increase of the arterial pressure. A mechanical process should neutralize an increase of the cerebral blood flow. 2. The metabolic theory says that a decrease of the blood pressure, without a change of metabolism, involves an increase of the PaCO2, and a decrease of the PaO2. Those two factors provoke a decrease of the vascular tone. 3. The myogenic theory explains autoregulation by the fact that a change of the transmural pressure in the small vessels, involves a change in the activity of the smooth muscles of the vessels. 4. The exact mechanism of the autonomic nervous system in the autoregulation of the cerebral blood flow is still obscure. In some pathological conditions autoregulation is completely lost or is functioning not optimal: hypoxia, hypercapnia and brain contusion. We have measured the cerebral blood flow before and after an intravenous injection of 5 mg thiopental (Pentothal) on occasion of a carotid angiography in man. We noticed a decrease of the cerebral blood flow and at the same moment a decrease of the arterial pressure. We thought that maybe barbiturates could influence autoregulation. Our results could not prove this hypothesis. For ethical reasons we could not make the necessary measurements to prove or to reject this hypothesis (i.e. intracranial pressure, deep controlled hypotension). In the literature there are arguments which support this hypothesis although most workers found an intact autoregulation after a barbiturate anesthesia. Some workers saw that the increase of the cerebral blood flow by increasing the PaCO2 was depressed by barbiturates and exhausted by halothane and cyclopropane. As autoregulation is a more vulnerable mechanism than CO2 reactivity as seen in clinical situations, it could be true that anesthetics do influence autoregulation.


Pneumothorax during anesthesia with changes in ECG. A patient known to suffer from CNSLD was to undergo cervical lymph node dissection for gingival carcinoma. Pneumothorax developed immediately after introduction of anesthesia. In addition to the usual physical diagnostic signs, an abrupt decrease in amplitude of the QRS- complex and T -waves was observed in the ECG on the scope, the sensitivity of which remained unchanged. The ECG changes disappeared after abolition of the pneumothorax.


A method to exhaust anesthetic gases when using the Loosco system for children with an expiratory valve according to the Waters' principle. A description is presented of a method to eliminate anesthetic gases when using the Loosco system for children with an expiratory valve according to the Waters' principle. From practical experience we have gained the strong impression that this convenient device meets the requirements we have formulated. Exact gas-chromatographic determinations are still in progress, and the results will be published as soon as possible.


[Affective perception of the body in neurotics. Its relation to anxiety, depression, and various types of defense]. This study compares and relates affective bodily perception (ABP), anxiety, depression, and the utilisation of some defense mechanisms in 25 neurotic women (16 depressives, 9 hysterical) and 25 normal women. ABP is evaluated according to satisfaction and anxiety (Body cathexis scale), distorsions (Body distortion questionnaire) and body conscience (Body prominence). Anxiety is measured with Cattell questionnaire, depression through Zung and Hamilton scales, and defense mechanisms by the Firo Form Cope of Schutz. Neurotics have a ABP more negative and are more depressed and anxious than normals; they use more regression while controls tend to use introjection. In comparison with depressives, hysterical women have higher scores in body distortion, mostly in the feeling of boundary loss; they express more masked anxiety and react more often through projection. Among neurotics, those who have a very disturbed ABP are more anxious, more depressed, and more prone to denial, projection, and regression in comparison with the others. In both samples, anxiety and depression have a negative correlation with body satisfaction and a positive one with body distortions and somatic anxiety. In the control group, body satisfaction is inversely related with feeling of dirt. Somatic anxiety is also inversely related to unusual feelings of body and skin obstruction. The intensity of body consciousness is related to using isolation and distortions are negatively related to using denial. In neurotics, denial is in opposition with the intensity of body awareness and is linked to somatic anxiety. The intensity of body awareness is also correlated to various forms of anxiety. Distortions are positively related to regression. The comparison of both samples shows a degradation of ABP in neurotics. The study of correlations clarifies several relations between deficient ABP anxiety, depression and the use of some defense mechanisms.


[Mental health community centers in the United States]. After defining the concept of the Community Mental Centers and giving an overview of the principles, the author describes the five most needed ways for the operationalization and the implementation of the community approach in mental health care. The results, i.e. the successes, of the community mental health programme in the USA are discussed and also the various shortcomings: private psychiatrists and general practitioners are not integrated enough; overestimation of the need for the number of psychiatric beds; need for cost analysis of the consultation and education part of the programmes in connexion with the need for adequate reimbursement; an evaluation programme should have been built in from the beginning; with the tremendous increase in personnel costs and the general inflation of cost price, some parts of the programme are not financially competitive with the private psychiatric practice; two parallel systems still emerge, the CMHC and the State hospitals, frequently with not enough collaboration; and finally, the "yavis" phenomenon with neglect of the unwanted, difficult, chronic patient, especially the defected schizophrenics.


Safety and efficacy of prolonged treatment with Tremblex (dexetimide), an antiparkinsonian agent. A controlled study. The trial involved 69 female, long-stay inpatients of the Voorburg mental hospital, of a median age of 50 years. Two groups were formed at the start of the trial. The first group (51 patients) on a maintenance therapy with orphenadrine, were now put on oral dexetimide. Individually adapted dosages ranged from 0.5 to 1.5 mg daily. The control group (18 patients) of antiparkinsonian agents did not take any in the course of the study either. After three and six months (end of trial) biochemical and haematologic parameters were assessed. Clinical evaluation of extrapyramidal symptoms was made in the dexetimide group. All patients of the control group and 47 of the dexetimide group completed the trial. Both groups were shown to be comparable with regard to all parameters. Statistical analysis showed significant improvement in dexetimide-patients with regard to gross motor tremor, facial inexpressiveness, parkinsonian gait (after two weeks) + dyskinesia (after six months).


A retrospective evaluation of long-term fluspirilene (IMAP) treatment. Fluspirilene proved to be a very useful drug in the basic maintenance therapy of 21 chronic schizophrenic patients (ages 16-71 years), who received individually adjusted doses weekly during their hospitalization and during the subsequent follow-up period. The follow-up data analysis showed that the antipsychotic efficacy of the drug after prolonged (8-21.5 months) treatment was nicely maintained, that the patients' socio-professional integration had improved significantly, while a small decrease in dosage proved possible in several cases. The incidence of side-effects remained low, and no signs of accumulation or toxicity could be detected.


[Clinical study of Haldol at high doses in chronic schizophrenia]. The authors have studied the action of high doses of Haldol in chronic schizophrenics in a study lasting more than five months and compared their results to a study done at the Eastern State hospital of Williamburg in Virginia (U.S., Howard). The daily doses of 75 mg caused a remission in 4 schizophrenics, and 19 patients were improved in a sample of 38 patients. The medication was given to a group exposed to neuroleptics only, without differences between the two groups. The authors have carried out the study for more than one year without observing changes in biological tests, using a dayly dose of 60 mg. Five patients out of nine were improved and could be discharged to return to their family or society with the appropriate affective follow-up.


[Lithium salts in manic-depressive psychoses (cyclophrenia)]. In psychiatry, lithium salts are used alone, or in combination with neuroleptics, in the treatment of manic states and in the prophylaxis of manic or melancholic relapses in cyclophrenia. They are also used by some clinicians to prevent relapses of melancholia. To be efficient, the blood level of lithium must be between 0,8 and 1,2 mEq/liter in chronic treatment, and much higher in acute treatment. Side effects can be present, but do not warrant to stop the treatment; meanwhile there are signs of intoxication which necessitate immediate treatment interruption. This medication should be given to motivated patients, of normal intelligence, suffering from repeated states of mania or melancholia, because it is a long term treatment requiring constant supervision.


[Contingent negative variation and mental disorders]. This work, dealing with negative contingency variation (NCV) in mental patients, is in the general frame of research aiming at establishing correlations between biological phenomenons and psychic entities. The results can be examined in three different directions. 1. In the electrophysiological perspective they have individualized a series of physiological forms and brought a real nomenclature. 2. In an electro-clinical perspective, they have allowed to oppose normal curves (NCV, type I, responses to sensory stimulations type A, B, C and motor potential type N) and abnormal curves (NCV zero or type III, IV, responses type D and motor potential type P). One must however stress that this distinction is only valid if one studies adult subjects and awaken, and contributes only an index of non specific morbidity. Furthermore, considering two more electrophysiological criteria--the mode of combination of various curves and the stability of NCV--can help establishing a severity scale and modeling the above data. 3. In a physiopathological perspective, they have lead to discussing two hypotheses concerning the functional signification of prolonged NCV; one being a prolonged state of awaiting, the other a mode of particular reaction to imperative stimulation, and to demonstrate that it is not possible to consider only one and same system to explain all clinical categories. Thus, in this new area of slow cerebral potentials, as in clinical electroencephalography, is illustrated the teaching of the functional electroencephalography through the school of Paris where similar electric patterns have different significations when present in opposed psychological organisations.


[Hysteria and psychosomatic disorders in Portuguese immigrants]. Seventy patients presenting symptoms of hysteria (49 women and 21 men) were selected among patients observed at the Institute Minkowska during the year. This work is part of a research work on socio-cultural and environmental factors which can change mental status of immigrants. These are all portugese workers presenting for the first time atypical mental troubles called by the author: "bastard hysterical syndrome of the immigrant" and characterized partly or totally by the following symptoms: fatigue, anxiety, sense of suffocation, dyspnea, coughing, unilateral chills or generalized chil, abdominal or gastric pains, headaches and "diffused pains", paresthesia, aching back, tears and sorrow, fear of dying or having a cancer, asthenia, leg paresthesia and contractions, vomiting, diarrhea, cardiac pains, palpitations, dizziness and collapsing. These troubles appear sometimes without apparent motives but they are almost always due to a precipitating cause expressed by the patient: a delivery, a familial death, a homosexual proposition, a trauma without importance, a working conflict etc... But the most frequent cause invoked is "the french climate" without knowing precisely what the word "climate" means: atmospheric conditions, athmosphere or reception milieu? This latest interpretation seems more likely after months of psychotherapy. Most patients are not french speaking and cannot write; their origin is rural (familial villages well structured regarding their food and sexual economy), and people well "armed" by a system of defense mechanisms and well adopted conditioned reflexes. In this work, hysteria of the portugese immigrant is compared to childhood hysteria. As the hysterical burst of the child is aimed at calling attention, love of the mother, at finding a solution to a familial or social conflict, the hysterical burst of the immigrant is aimed at the absent family or at its substitutes, the bos, social security, the doctor. Furthermore, the attitude of the hosting Country--wanting and rejecting--is very ambivalent; "tenderness" at the time of reception, followed by indifference. Early attentions are followed by constant interdictions (threat of unemployment, false statements on sexual dangers of the immigrant etc;..). The immigrant, like the hysterical child, is periodically controlled (work and visit cards), supervised (supervisors), The narcistic satisfactions of being called a good worker can be followed by threats of firing in economic crisis. The society of the hosting country requires the immigrant to be identical to this society: language, physical appearance, food. The real paradoxical situation to which the immigrant is confronted and the real or hypothetical fears constitute conditions of experimental neurosis, to which portugese immigrants react very often by a bastard symptomatology of hysterical type, characteristic of displaced man. These preliminary studies are the frame for a future epidemiological survey in this specific population.


A note on the relative prevalence of phobic reactions in an Iranian psychiatric population. Ths study was undertaken to investigate the prevalence of phobic reactions among the patients referred to the University of Teheran Psychiatric Hospital during 1975. It was found that about 10% of the total population studied manifested symptoms of phobia, which of course indicate different therapeutic modality to be considered in their treatment. One could easily notice that this proportion is much higher than what has been reported by Marks. It was further found that darkness, nyctophobia, necrophobia, ochlophobia, ailurophobia and pet animals and fear of cancer and syphilis accounted for 79% of the phobic cases studied.


Stability of mammalian tuberculin PPD.

Stability of mammalian tuberculin PPD. Six lots of PPD prepared in 1937 met the requirements when tested in guinea pig potency assay in 1974. Reading of the skin reactions at 48 hr gave more consistent results than the 24 hr reading. Data were evaluated by analysis of variance and by a quick method developed for the estimation of identity of the standard and the test preparation. Although less sensitive than the analysis of variance, the quick method has been found suitable for estimation of the potency of tuberculin preparations.


[Application of a geriatric evaluation scale to patients of a closed psychiatric hospital]. The geriatric scale of Stockton (SGRS) was applied to 135 subjects aged 60 or more (women in a closed psychiatric hospital). This scale differentiates between organic states (dementia) and other diagnoses. The scores are not correlated to subjects' age in dementia. The SGRS also furnishes interesting indications on aging according to various diagnostic groups.


Decreased cellular immune response of germ-free mice. Cellular immune response to intracerebral lymphocytic choriomeningitis infection was studied in mice belonging to an identical strain but different in breeding conditions. In consequence of the cellular immune reaction on the leptomeninx, lymphocytic choriomeningitis developed and caused death in 100% of conventionally bred mice, whereas 80% of germ-free and 15% of mouse-pathogen-free mice failed to display lymphocytic infiltration of the leptomeninx and survived the infection as chronic virus carriers. This finding pointed to a deficient cellular immune response of germ-free and mouse-pathogen-free mice. The under-development of the lymphoid system due to the antigen-poor breeding conditions might be responsible for the deficiency.


Studies on the lymphoid system of mice with lethal acute toxoplasmosis. Acute toxoplasmosis was induced in CFLP mice by infecting them intraperitoneally with the 25 x 10(3) multiplicity of the virulent RH strain of Toxoplasma gondii. The lymphoid system of mice succumbing to acute toxoplasmosis showed characteristic changes. Significant spleen hypertrophy (spleen index: 1.76), severe thymus atrophy (thymus index: 0.27) and a striking decrease of the lymphocyte count in blood (86%) was found as compared with the uninfected controls.


Leukocyte migration inhibition by a specific antigen in human typhoid fever. Cellular reactivity to heat-killed Salmonella typhi antigen was investigated by the leukocyte migration inhibition (LMI) method in 33 S. typhi infected patients and in 32 control persons. In the typhoid group a statistically significant LMI was observed as compared to the members of the control group. A correlation was found between the level of the cellular sensitivity and the time elapsed between onset of the disease and performance of the test. Previous typhoid vaccination had no influence on the LMI. No correlation was found between the agglutinin titres and the sensitivity demonstrated by the LMI test. The value of the method in studies of cellular immunity in typhoid fever is discussed.


[Psychodynamic aspects of personality of patients with Parkinsonism]. After reviewing the literature on personality and Parkinsonism and recalling the two concepts which conflict on the etiology of their personality, the author has examined Rorschach charts of 20 Parkinsonians. This was done through formal analysis and content analysis in order to show the various dynamic aspects of personality, the psychic mechanisms preferentially used and the possible relations between psyche and soma. The results reveal a modification of personality in the direction of global narrowing, on ideas and affect, a reduction of relational investments, a narcissitic and hypochondriac retrieval and an important reduction of affects. Two different types of personality appear out of this common branch. The first is characterized by rigidity and stereotipy, the second characterized by some smoothness and a wider opening toward the external world. The psychodynamic study reveals that personality reorganization takes place through libidinal retrieval, through defensive and narcissisic move. After the completion of the study, the somatopsychic hypothesis remains most produce; however the premorbid personality and in particular the aggressive problem can integrate with the behavioral modifications due to Parkinson's disease in order to finally bring a original psycho-affective picture.


A progress in electroconvulsive therapy: the non-barbiturate anesthaetic drug etomidate. Forty-six female patients (19-72 years) requiring ECT for psychiatric indications received 0.5 mg atropine, followed by 0.1-0.4 mg/kg bodyweight of etomidate. Subsequently 50 mg of suxamethonium were injected and ECT was applied. The etomidate-ECT combination proved very suitable and was well tolerated.


The development of the connective tissue in the human orbit. The development of the mesenchymal structures of the human orbit was studied using 10 mu or 60 mu serial sections of orbits of foetuses of 35 to 320 mm stages (C.R. length; 2-9 months). The ontogenesis of the orbital walls, the eye muscles, the blood vessels and the connective tissue was compared. This comparison revealed that the eye muscles and their fasciae together with the adventitial layers of the larger blood vessels and nerves develop first, closely linked in time to the progress of ossification and growth of most of the orbital bones. Only the (endochondral) ossification of the ethmoid starts much later. The orbital connective tissue septa development commences later, i.e. from the third month onwards, concurrently with the development of special mesenchymal condensations, a particular capillary system and adipose tissue. About five months later the adult configuration is attained.


Functional anatomy of the musculature of the trachea. The smooth musculature of the human trachea was studied and compared with earlier observations in the rabbit. The results may be summarized as follows: 1. The annular m. constrictor tracheae, previously observed in the rabbit, has also been identified in the human trachea. 2. Longitudinal muscle fibers outside the constrictor musculature were observed in man. These fibers are rudimentary and appear to be of no functional importance. 3. From a functional point of view, it appears justified to regard the outer tracheal musculature largely as a constrictor musculature. 4. The main function of the outer musculature of the trachea and the elastic cartilaginous arches is to maintain the stability of the tracheal wall. 5. The variation of the lumen of the trachea is mainly controlled by the m. trachealis in the pars membranacea.


[Development of the intestines. Human embryos]. In the present study an attempt was made to think over anew the development of the peritoneal situs, guided by the comparison of the "root-area" (the connective tissue area free of peritoneum between the left and right transition line of the peritoneum parietale to the peritoneum viscerale) of the so-called "primitive mesentery" of an embryo (10 mm CRL) and of an older fetus (250 mm CRL). The following results were obtained: The so-called primitive sagittal mesentery cannot be regarded as the anlage of the adult mesentery, in the sense that the latter develops out of the former dy displacement of rotation. The original "root area" widens with the broadening of the back and can still be demonstrated as an homogeneous "root area" of the "intestinal bulge", after the typical adult situs has developed. There is a connection between the development of the mesenteries and the formation of the folds of the embryonic serosa. Their position is determined through the recesses of the intestinal bulge. They exist because of the foldings and are therefore secondary characteristics. Under these aspects it is possible to consider the development of the situs as a uniform folding process of the embryonic serosa, without references to as yet unproved secondary adhesions of the peritoneal layers.


Effect of long photoperiod on the maturation of ovary of the catfish, Mystus tengara (Ham.). A study has been made of the effect of photoperiodism on the ovarian maturation of fresh water teleost, Mystus tengara (Ham.). The magnitude of ovarian recrudescence is more during maturing virgin phase as compared to during immature virgin and preparatory virgin phases in long photoperiod (14 hours/day) treated fish. Thus, the response of the ovary to long photoperiod increases with the approach of natural spawning period. The mature eggs are more in long photoperiod treated fish than in controls exposed to 12 hours/day photoperiod. In long photoperiod treated fish, prespawning period is reduced considerably. During spawning and post-spawning periods, the ovaries are refractory, since long photoperiod is ineffective in maintaining gravid ovaries beyond spawning period and the ovarian regression during post spawning period sets in regardless of nature of photoperiod treatment.


[A kibbutz group].

[A kibbutz group]. Kibbouts-group: three therapeutic or growth factors together: manual work, community life and group technics (group dynamic, Gestalt, psychodrama, bio-energetic) during two weeks. The work of growing and therapy is becoming more concrete and facilitated by the absence of difference between members and leader who share the work and the community life. Important and rapid changes are frequent: a particular attention is given to the "unmedicalisation" of symptoms (fatigue) and to the "unpsychiatrisation" of conflicts. A sample and authentical life style, together with a high degree of communication, favor the desinhibition of attitudes, the clarification of conflicts and the reenforcement of the personality.


Character neuroses and behavioural disorders in children: their treatment with pipamperone (Dipiperon). A clinical study. Dipiperon drops 30-180 mg/day were given for eight weeks to 29 children with character neuroses and behavioural disorders. A 16-item rating-scale covering several features of behaviour disorder was completed by a psychologist and a teacher independent from each other. The individual number of pathological scores showed a decrease already within the first treatment week and a further decrease by the end of the trial, especially for the items of capriciousness, obstinacy, irritability and restlessness. The therapeutic benefit was not accompanied by an adverse effect on the school performance of the children. No side-effects were reported or observed.


Antidepressive properties of I-glutamine. Preliminary report. A brief review of the literature on this topic, and a comparison of the results obtained in children by administrating l-glutamine with those obtained by other antidepressive drugs, is primarily presented. Having been tested in a sampler of 43 adults, affected by different forms of depressive, neurasthenic and dissociative illnesses, 1-glutamine is indicated as owning clear anti-depressive properties, and the asthenia as target-symptom for its therapeutical use. Out of the endogenous depression with slowed-down motor activity, indeed good results were found in all cases, in which a "vital" level had been reached by the illness. Since 1-glutamine is noticed being a precursor of GABA, this fact itself could explain its antidepressive properties, but it is necessary to remember that they very complex metabolism of the drug is still mostly unknown.


The abnormal upper gastrointestinal vagovagal reflexes that affect the heart. The clinically important upper gastrointestinal-cardiac vagovagal reflexes are mainly those initiated by swallowing and rapid gastric distention. Pre-existing-heart disease has little to do with determining susceptibility to upper gastrointestinal stimuli. The dangerous cardiac repercussions concern diminished coronary artery flow and the arrhythmias. The latter can be subcategorized as swallow tachycardia, pharyngeal disease with arrhythmia, glossopharyngeal neuralgia with swallow syncope, spontaneous swallow syncope and swallow bradycardia. Iatrogenic arrhythmias are particularly tragic potential hazards of all pharyngoesophagogastric manipulations.


Endoscopy of the upper gastrointestinal tract. Fiberendoscopy of the upper gastrointestinal tract recently has become a routine diagnostic procedure. This is due to its broad spectrum of applications and to its "reputation" of simplicity and innocuousness. The possible complications of fiberendoscopy, however, are similar to those of rigid endoscopy. Most of these complications can and must be avoided by strict adhesion to elementary precautions: adequate teaching and supervision of endoscopists in training; emphasis on all stages of the patient's preparation, psychological and pharmacological, each adopted to the individual patient and constant awareness of the possibility of complications.


Diagnosis of gastric prepyloric and antral lesions: comparison of fiberendoscopy and gastric biopsy with radiology. Fibergastroscopy and direct-vision gastric biopsy were performed in 47 patients who had a prepyloric or antral gastric lesion on barium meal (single-contrast) examination. Of 27 cases with a radiological diagnosis of prepyloric or antral ulceration, five cases (18.5%) had evidence of ulceration, 12 cases (44.4%) had acute or chronic gastritis and eight cases (29.6%) had normal gastric mucosa, on fibergastroscopy. Multiple gastric biopsy confirmed the presence of acute-on-chronic gastritis (ACG), chronic gastritis (CG) and chronic atrophic gastritis (CAG), with or without intestinal metaplasia (IM) or epithelial atypia (Aty), in 24 cases (89%). Normal gastric mucosa was found in three cases (11%) and malignancy in none. Of 15 cases with a radiological diagnosis of prepyloric or antral malignancy, only three cases (20%) had evidence of adenocarcinoma on endoscopy and biopsy. One case had rounded nodules seen on endoscopy and gastric biopsies showed malignant lymphoma. In two cases with endoscopic suspicion of malignancy, gastric biopsies showed ACG in one and CAG in the other. Gastric biopsies showed histological changes of CG (+/- IM) or CAG (+/- IM) in 11 cases (73%). In five cases with a radiological diagnosis of various prepyloric or antral lesions, endoscopy and biopsy revealed CG (+/- IM) in all and malignancy in none. It is concluded that fiberendoscopy and gastric biopsy are superior to the single-contrast barium meal in the diagnosis of prepyloric or antral gastric lesions. Direct-vision gastric biopsy should be done in all cases since it increased the diagnostic accuracy of fiberendoscopy.


Treatment of protein-losing gastropathy with atropine. Protein loss from the gastric mucosa with hypertrophic gastric folds and hypoalbuminemia has been associated with low, normal and elevated gastric acid output. A case of protein-losing gastropathy with slightly elevated gastric acid output is described. Associated findings were hypertrophic gastric folds, hypoalbuminemia, hyperlipidemia, lymphadenopathy, edema, ascites and venous thrombosis. Oral administration of atropine resulted in a cessation of gastrointestinal protein loss and correction of hypoalbuminemia.


Biliary excretion and concentration of cefazolin. The excretion of cefazolin into the human biliary tract in health and disease was investigated in 34 patients undergoing surgical procedures. The patients included: I. Four controls. IIA. Eleven patients with cholelithiasis and/or cholecystitis and a radiological visualized gallbladder. IIB. Nine patients with cholethiasis and cholecystitis and a radiologically nonvisualized gallbladder. III. Five patients with obstructive jaundice. IV. Five patients with a T-tube in the common bile duct. Two dose regimes: 1. A single dose of 500 mg and 2. four doses each of 500 mg. given every six hours, were used. Samples of serum, gallbladder bile, common duct bile and gallbladder tissue were assayed for antibiotic activity by the cylinder plate method with Bacillus subtilis. Following administration of four doses of the antibiotic, the mean level of the drug in the gallbladder bile, in controls was 127.0 mug/ml. In the group with cholelithiasis and cholecystitis and a gallbladder that is visualized, a similar high level was noted (mean = 132.2 mug/ml.). In the presence of a nonvisualized gallbladder or obstructive jaundice, the levels in bile were lower. Two hours following a single injection of the drug, the level in the common duct bile reaches a peak of 10 mug/ml and at eight hours falls to less than one mug/ml. In the absence of obstruction cefazolin reaches a significantly high level in bile and could be valuable in treatment of biliary infections.


The pancreatic involvement in disseminated "collagen" disorders. Studies of pancreatic secretion in patients with scleroderma and Sjögren's "disease". In this study of 66 patients with Sjögren's syndrome and/or scleroderma abnormal pancreatic secretory patterns were observed in 43 patients, 17 of 23 with Sjögren's and 19 of 31 with scleroderma. Pancreatic insufficiency was often associated with depressed gastric secretion and/or abnormal gallbladder function. While in both disorders digestive complaints are attributable to one or more dysfunctions, the pathogenetic factors in scleroderma appear to be more varied and require careful investigation for complete elucidation. Antibiotics, antimetabolites and steroid therapies are also additional causal factors involved in the initiation of gastrointestinal dysfunction and pathology.


Electrocoagulation biopsy of aberrant pancreas of the stomach. A case of aberrant gastric pancreas. Histopathological diagnosis of submucosal tumors of the stomach has been difficult by conventional examination, e.g. roentgenography, gastroscopy and/or routine biopsy procedure. When endoscopic diagnosis of submucosal tumor is made, surgery is generally performed for tissue biopsy. We have been attempting to avoid such exploratory laparotomy to determine the histologic nature of small asymptomatic submucosal tumors of the stomach by a technic of endoscopic biopsy followed by electrocoagulation. With such a procedure, we have been able to diagnose a case of aberrant pancreas of the stomach. Our experience suggests that this technic is a safe and useful diagnostic tool.


Meckel's diverticulitis due to Schistosomiasis mansoni. An unusual case of schistosomal Meckel's diverticulitis is presented. Parasites were subsequently found in either stool or rectal biopsies of three siblings. The possibility of serious sequels makes the early diagnosis of Schistosomiasis mansoni often by simple stool and rectal biopsy examination particularly valuable.


Brunner's gland adenomas associated with high-output congestive heart failure. Brunner's gland adenoma in the third portion of the duodenum is rare and only two such cases have been reported previously. A 35-year old man presented with high-output congestive heart failure. Profound iron deficiency anemia was corrected by transfusion, allowing detection of a duodenal tumor, which proved pathologically to be a Brunner's gland adenoma.


The clinical recognition of dissecting aortic aneurysm. The clinical, roentgenologic and laboratory findings in 124 patients with dissecting aneurysm of the aorta are reported. In 53 patients the dissection occurred in the ascending aorta ("proximal" dissection), and in 71 patients the site of origin was the descending thoracic aorta ("distal" dissection). Certain distinct clinical differences between the groups were apparent. Although hypertension was an important predisposing factor, it was significantly more common in distal dissection, as was atherosclerosis. Back pain and hypertension on hospital presentation characterized patients with distal dissection. Conversely patients with proximal dissection were younger and had a significantly higher incidence of Marfan's syndrome, cystic medial necrosis, anterior chest pain, pulse deficits, neurologic compromise, aortic insufficiency and congestive heart failure. In both groups, syncope appeared to correlate well with the occurrence of cardiac tamponade. Chest roentgenograms almost always showed an abnormal aortic contour. Aortic angiography, when performed, was usually confirmatory of the diagnosis.