[Effects of between-item elaboration on incidental memory]. The present study was carried out to investigate the effect of between-item elaboration on incidental memory of words. Between-item elaboration refers to the encoding of relational information to each target item. Forty-four college students were asked to generate free associates to each target in the orienting task which was followed by unexpected recognition and recall tests. Triplets of targets which was known to elicit a converging associate were used. Targets of such a triplet were presented in massed or spaced fashion. Frequency of converging associates generated in the orienting task (free association) was used as an index of between-item elaboration. The proportion of targets correctly recalled for which the converging associates were generated was higher than that of the opposite cases. The above result suggested that the between-item elaboration was effective in retrieval of targets. No effect of types of presentation on free recall performance was observed.


[An examination of Metzger's theory on geometrical illusions by using the illusion of major and minor axes in ellipse]. An experiment with ellipses was conducted to evaluate the validity of Metzger's theory on geometrical illusions (the law of good Gestalt) by examining whether its major axis is underestimated and its minor axis overestimated. If the horizontal or vertical dimension of a circle with a fixed diameter is reduced, " smaller" ellipses with major axes equal to the circle's diameter will be constructed. On the other hand, if the dimension is enlarged, "larger" ellipses with minor axes equal to the circle's diameter will be produced. Ten university students estimated the apparent lengths of such axes. It was found that the major axes were underestimated, while the minor axes were overestimated, irrespective of the relative sizes of the ellipses. The same result was obtained when the orientation of the axis was rotated 90 degrees. These results may be interpreted in line with Metzger's theory to the illusion of major and minor axes in ellipse.


[An examination of self-monitoring as a determinant of compliant conforming behaviour]. The present study investigated the determinant of compliant conforming behaviour from the view-point of the self-monitoring. Subjects, who were classified into High Self-Monitors (HSM) and Low Self-Monitors (LSM), participated in the experiment in which they had a task to distinguish the size of two circles. About the half of subjects performed the task with confederates. In eight of 13 trials, confederates had mistaken distinctions intentionally. The results showed HSM were more conformable to confederates than LSM for male subjects. HSM seemed to conform themselves to confederates easily, because their behaviour was guided by external cues. By contrast, LSM would conform themselves with difficulty, because their behaviour was guided by their internal states. But there were no significant differences for female subjects, and the ability of self-monitoring was considered as the less explanatory determinant for conformity in this experiment.


[Effect of stimulus intensity on visual stream segregation]. Two experiments were performed to examine the effect of stimulus intensity on VISS (visual stream segregation) which is a kind of beta movement first described by Bregman and Achim (1973). Six subjects were required to find the upper threshold of ISI for producing VISS under various conditions of the stimulus intensity in each experiment. The ISI threshold decreased as the stimulus intensity was increased. The result showed that VISS follows Korte's second law of apparent motion. When two of the four lights were flashed in high intensity and the rest in low intensity, the ISI thresholds varied with the arrangement of intensity among the four lights (stimulus intensity pattern). The results suggest that VISS is affected by the factor of similarity resulting from the intensity patterns of the lights.


Maternal tasks of uncertain motherhood.

Maternal tasks of uncertain motherhood. A longitudinal, phenomenological study was carried out to gain understanding of what it was like for women to be in a high-risk perinatal situation. Twenty-seven women participated in the study during which focused, unstructured interviews were conducted throughout their experience. Hermeneutic methods were applied to the 174 interviews and 13 diaries collected. A serendipitous finding revealed that women in high-risk situations work on the same developmental tasks as described by Rubin in 1975. However, these tasks are altered by the uncertainty of attaining motherhood inherent in the high-risk situation. The alterations in the tasks are described in this paper. The importance of Rubin's work as basic clinical research for maternity nursing is underlined by this finding.


Thermoregulation and axillary temperature measurements in neonates: a review of the literature. The theoretical and empirical literature were reviewed to examine the current knowledge about thermoregulation and temperature-measurement techniques in neonates. The results indicate that there is a conflict in the literature regarding the length of time needed to obtain neonatal axillary temperature measurements with glass thermometers and a gap in the literature pertaining to the symmetry of axillary temperature measurements in neonates not exposed to an external heat source. Liquid crystal and tympanic thermometers have been demonstrated to be inaccurate fever detectors. The use of electronic thermometers may offer nurses time-saving alternatives to standard glass thermometers for obtaining neonatal temperature measurements.


Changes in father-infant bonding beliefs across couples' first transition to parenthood. Thirty-five couples expecting their first child served as subjects in a study of changes in beliefs concerning father-infant bonding experienced by individuals and couples across the transition to parenthood. Through a series of open-ended interviews and structured questionnaire measures, it was determined that the typical first-time father and mother undergo significant drops in their beliefs about the importance of father-infant bonding across their first transition to parenthood. Regression analyses were employed to construct models predictive of changes in parents' father-infant bonding beliefs. Results indicate that both prenatal beliefs and circumstances of the delivery predict changes in parents' father-infant bonding beliefs. Implications for childbirth educators, delivery staff, and parent support providers are discussed.


[Hodgkin's disease in childhood].

[Hodgkin's disease in childhood]. Only in these latest years has been possible to consider Hodgkin disease (HD) as a neoplastic syndrome, thank of immunohistochemistry and cytogenetic techniques which have confirmed the monoclonal origin of typical cellular marker of disease: the Reed-Sternberg cell (R-S cell). Interesting associations have been observed between children suffering from HD and the positivity of EBV antigen above all in the socio-economically developed countries. The histopathologic classification of HD is divided in four sub-types, with different incidence in the pediatric age: the nodular sclerosis and the mixed cellularity are more rap-presented than the lymphocyte predominance and mostly the lymphocyte depletion. Histopathologic classification is essential for the prognosis and a correct therapeutic approach to disease. The management of HD is based on chemotherapy and radiotherapy associated; the results of treatment are more and more encouraging with a global survival over 95%. Sequelae of treatment are reduced in modern therapeutic trials: in particularly injury to somatic growth, cardiopulmonary system, gonadal and thyroid functionality is reduced by using low dose and involved fields for the early stage patients. The most important sequela in children treated for HD is the risk to developed a second malignant neoplasm; in particularly acute nonlymphocytic leukemia and non Hodgkin's lymphoma. In patients treated with radiotherapy alone increase the risk to develop solid tumors like sarcomas and carcinomas, which can appears several years after diagnosis.


[The early high-dose immunoglobulin treatment of neonatal autoimmune thrombocytopenia]. The paper reports the case of a neonate suffering from autoimmune neonatal thrombocytopenia whose mother had suffered from previous idiopathic thrombocytopenia purpura. Although asymptomatic, the baby received early treatment with high doses of immunoglobulin G (1 g/kg) in a single dose. Treatment was repeated on day 12 using the same method. No other treatment was associated with IgG. The Authors confirm the good level of tolerability and efficacy of IgG in the treatment of autoimmune neonatal thrombocytopenia without complications.


The effect of leukemia and its treatment on self-esteem of school-age children. The purpose of this research was to investigate the self-esteem of school-age children with leukemia in a clinic setting and to compare it to the self-esteem of healthy children. Thirteen chronically ill children, 6 to 11 years old, who were patients at a midwestern clinic and children's hospital, and 50 school-age children without chronic illness participated in the study. Children were administered the Kinetic Family Drawing-Revised (Spinetta, McLaren, Fox, & Sparta, 1981) to measure their self-image in relation to their family. Children's self-esteem was measured by the Coopersmith Self-Esteem Inventory (SEI) (Coopersmith, 1981). The results indicated that children with leukemia did not differ in self-esteem from healthy children except on one subscale of the SEI. However, children with and without leukemia did differ on components of the self-image measure, a dimension of self-esteem. Implications of the findings are discussed.


[Long lasting conjunctivitis: research of etiological factors]. Forty children with long-lasting or recurrent conjunctivitis were included in this etiological study. It is well known that purulent conjunctivitis is mainly bacterial, with a major source of infection from Chlamydia; recently, however, a greater percentage of viral forms, with the exception of conjunctivitis without secretion, has been reported. The authors focused their attention on the clinical symptoms and on bacteriological studies of the forms of Chlamydia and Mycoplasma conjunctivitis, highlighting their marked sensitivity to antibiotics and the clinical response and recommending the importance of an etiological study in all cases in which conjunctivitis does not resolve within a short period of time.


Quality of life in school-age children following liver transplantation. A descriptive exploratory study was conducted to ascertain the quality of life in school-age children 3 to 6 years following liver transplantation for chronic liver disease. Thirty children were to be included, however only 25 were recruited, and 20 of the 25 children became the study sample. The 20 school-age children ranged in age from 5 years 4 months to 11 years 9 months. The setting for the study was a conference room adjoining a social work office in a 220-bed university-affiliated children's hospital located in a large city in the Northeastern United States. The data were collected through the use of individual interviews, which were audiotaped and transcribed, and the written completion of an 80-item, self-report inventory. Interviews ranged in length from 1 hour 15 minutes to 1 hour 45 minutes. They were scheduled at a time that was convenient to the children's yearly pediatrician follow-up examination. Since the children and their families lived in other states and countries a great distance from the hospital, all communication with the families and scheduling of appointments were coordinated by the secretary of the pediatrician. The children in this study experienced liver transplantation 3 to 6 years prior to the interview for biliary atresia (n = 15), alpha 1-antitrypsin deficiency (n = 3), tyrosinemia (n = 1), and neonatal hepatitis (n = 1). Eighty-five percent of the children (n = 17) experienced liver transplantation before the age of 6 years, and 15 percent of the children (n = 3) experienced transplantation after 6 years of age. Responses from the modified Pigem's test, a projective test of children's values and attributes about self, and from the Zamberlan Questionnaire were content analyzed, then categorized according to the specific areas representative of the children's evaluation of the quality of life. Interrater reliability of the categories demonstrated 87% agreement of the coded items on the interview data. Five categories were derived from analysis of the interview and Pigem's data and included: (a) psychosocial adjustment at school and relationships with peers and family members; (b) internalization of the donor organ, the knowledge of the liver transplant experience, and thoughts about the donor person; (c) changes in physical appearance and physical functioning; (d) emotions, fears, or concerns about rejection and future outcome of the liver transplant(s); and (e) children's satisfaction with present and future life, and thoughts about self as reflected on the Pigem's test.(ABSTRACT TRUNCATED AT 400 WORDS)


[Clinical and cellular studies in a patient with Cockayne syndrome]. Hypersensitivity to the lethal effect of ultraviolet light (UV) and other DNA-damaging agents has been observed in cells from patients affected by Cockayne syndrome, suggesting that this syndrome is deficient in the capability to repair damage in cellular DNA. We report a case showing the main clinical features of Cockayne syndrome in which the clinical and cellular photosensitivity described as typical for Cockayne syndrome is not present. These cytological results suggest that there is considerable clinical and cellular heterogeneity in Cockayne syndrome and that cellular sensitivity to UV might not be as essential for the diagnosis of Cockayne syndrome as previously thought.


[Poland syndrome].

[Poland syndrome]. A case of Poland's syndrome in a newborn is described. The syndrome is relatively unknown, especially in its epidemiological and aetiopathogenetic aspects. It's characterized by aplasia of the sternal head of the pectoral major muscle, hypoplasia of the upper extremities and homolateral aplasia of II, III, IV, V finger. Attention is drawn to the importance of reporting diagnosed cases in order to further our knowledge of the syndrome. The Authors are looking with a big interest the correlation between hair treatment and Poland's anomaly.


[Evaluation of the effectiveness of cisapride in the treatment of gastroesophageal reflux]. To evaluate the effectiveness of administration of oral cisapride in patients with gastro-esophageal reflux, we studied 25 children, aged 1 month-7 years (mean 16.2 months) affected with GER. At the time of diagnosis and 8 weeks after treatment, patients were clinically evaluated and underwent a 24-hour continuous esophageal pH-monitoring. After treatment a complete regression of symptoms was observed in 20/25 patients. Moreover we recorded a significant reduction in the percentage of reflux time (p < 0.0001) and in the Jolley score (p < 0.0001), a very accurate scoring system to evaluate the pH-metric tracing, after treatment. It is concluded that cisapride is a useful agent both for the relief of symptoms and for the improvement of pH-metric parameters in children with GER disease.


[The absence of a central lower incisor in a medieval subject from the Norman cemetery of San Lorenzo di Aversa (Caserta)]. The authors describes a case of hypodontia in a male subject aged about 45 years and coming from the medieval necropolis of San Lorenzo of Aversa (Caserta, South Italy), dated to 890-1290 A.D. Hypodontia consists of the absence of a central inferior incisor (probably the left). Radiographic examination excluded the presence of a healed traumatic lesion. For this reason, the authors suggests that the described hypodontia was related to a primary agenesia of the central inferior incisor.


[Psychometric and psychofunctional studies of a group of patients with craniomandibular disorders]. The base myoelectric of masticatory muscles, and their response to stressor, was studied in a group of patients affected with craniomandibular disorders (CMD) and in a control group. Patients suffering from craniomandibular disorders were affected by at least two of these three groups of symptoms: 1) articular and/or muscular pain; 2) articular noise; 3) alteration of mandibular mobility. The psychofunctional investigation was as follows: in order to measure the base myoelectric activity of the masticatory muscles and their response to stress, the Myotron 222 two-channel electromyographs were used, so as to record the activity of four muscles contemporaneously. The research was conducted on the masseter and anterior fascia of the temporal muscles, which are the most readily accessible of the elevator muscles. A non-specific stressor (shot pistol) was administered to the subjects after the base myoelectric level had been established. These factors were evaluated on the electromyograms: base activity before the stressor; the shape of the response to the stressor; the recovery time after the stressor. The minimum activity before the stressor was usually measured as the minimum activity the subject was able to maintain for roughly one minute. The psychometric investigation used "Minnesota Multiphasic Personality Inventory" (MMPI); this is a nonprojective personality test widely used in clinical psychology. The base level of myoelectric activity was higher in patients affected with craniomandibular disorders than in healthy patients, who generally had low initial values.(ABSTRACT TRUNCATED AT 250 WORDS)


[A current update on the etiopathogenesis of palatoschisis]. By means of a review of the most recent literature, the authors report on "state of the art" about etiology and pathogenesis of cleft palate. Epithelial-mesenchymal interactions regulating growth and orientation of palatal shelves, as well as teratogenic effects on such ultrastructural development control by endogenous and exogenous substances, are described.


[A clinical study of the efficacy and tolerance of nimesulide compared to flurbiprofen and sodium diclofenac in the prevention and treatment of postoperative pain and inflammatory symptoms in dentistry]. The efficacy and tolerability of a new pharmaceutical formulation of a non-steroid anti-inflammatory drug, nimesulide were studied in a double blind study in comparison with flurbiprofen and diclofenac sodium, in 150 patients suffering from postsurgical pain-inflammatory symptoms. The three drugs, administered in a dose of one suppository twice a day for 10 days, showed marked anti-inflammatory, analgesic and antipyretic activity and produced a significant, progressive improvement in the typical symptoms of the inflammatory state. Nimesulide evidenced the greatest speed and duration of therapeutic action. Assessment on the efficacy and tolerability as expressed separately by the physician and the patients were positive in almost all cases of the three treatments.


[Roxithromycin in dental infections].

[Roxithromycin in dental infections]. Roxithromicin is a semisynthetic macrolide antibiotic, with similar antibacterial activity to erythromycin. It is characterized by an excellent pharmacokinetic profile and a good tissue penetration. Particularly at the dose of 300 mg per day the dental tissue diffusion is extremely good, and this is important to oppose the oral cavity infections. Oral cavity infections can be either odontogenic or non odontogenic. Odontogenic infections are typically primary and are caused by commensal bacteria (oral Streptococci, Bacteroides sp., Veillonella sp. and Fusobacterium sp.). The antibacterial spectrum of roxithromycin is very large and includes many of the most frequent strains responsible for oral cavity infections. A very interesting characteristic of roxithromycin is its penetration in macrophages (uptake) that allow a more rapid inhibition of bacterial activity. To evaluate the clinical efficacy and tolerance of roxithromycin in the treatment of odontogenic infections, an open study was performed. This study evaluated both the microbiological and clinical aspects. Thirty patients (21 females and 9 males) who had not been previously treated with antibiotic or antibacterial drugs, affected by infective dysodontiasis, gingivitis and periodontal diseases, received 300 mg per day (once a day) of roxithromycin for an average period of 6 days. The symptomatology considered was: intumescence, redness, pain, lymphangitis and presence of trismus. Clinical symptomatology was assessed at the start and at the end of the treatment. The symptomatological improvement due to roxithromycin was rapid and very effective. After 6 days of therapy, the improvement was statistically significant (p < 0.01) compared to basal conditions. No adverse reactions or side-effects were complained during the study. No changement were detected in laboratory parameters.(ABSTRACT TRUNCATED AT 250 WORDS)


[Schwannoma located in the tongue. A clinical case report]. Schwannoma or neurilemmoma and neurofibroma are two tumors of the peripheral nerves originating in the nerve sheaths. Schwannoma account for just over 1% of benign tumors reported in the oral cavity. The tongue is unanimously considered the most frequent site at this level; however, the tip is the least affected part of the organ. The case of schwannoma reported here is the third observed with a lingual localization in 18 years by the Division of Maxillo-Facial Surgery of The Odontostomatological Clinic of the University of Turin. The case is of interest due the rarity of this pathology and the presence of non-significant symptoms for a presumed initial diagnosis. CASE REPORT. A 21-year-old woman was referred to our attention following the appearance two years earlier of a slowly growing swelling on the tip of the tongue. The patient complained of the fastidious presence, disturbance to mastication and phonation and occasional paresthesia of the tip of the tongue. The small mass, which was clearly evident on examination, was covered with normal mucosa. On palpation it had a hard-elastic consistency; it was slightly painful, smooth and partial mobile on surrounding levels. The patient underwent the surgical removal of the neoplasia under anesthesia. The mass was well capsulated and a good cleavage plane was easily found. The neoformation was yellowy grey, oval bean-shaped, measuring 1.9 x 1.3 x 1.1 cm. The histological diagnosis, confirmed by immunohistochemical tests, was benign Antoni's, type A schwannoma. The postoperative period was good an there was no recidivation during the course of a one-year follow-up. DISCUSSION AND CONCLUSIONS. Benign schwannoma, which are relatively rare in the oral cavity, represent a pathology which are often not taken into account during clinical practice. Symptoms which take the form of slight hypoesthesia and vague paresthesia may lead to the suspected diagnosis of this type of neoplasia. The final diagnosis is always made after a definitive histological examination. Differential diagnosis must be made in relation to malignant tumors (on the basis of anamnestic data relating to the speed of growth and clinical appearance of the neoplasia) and, above all, in relation to numerous benign neoformations based on epithelial and connective tissues (lipoma, fibroma, leiomyoma and adenoma). Treatment is always surgical: in the case reported here, the exeresis of the lesion also allowed its histological characterization (excisional biopsy). Surgery was conservative and did not require local or locoregional prophylactic measures. After the final histological diagnosis of schwannoma, the patient underwent a thorough general objective examination to check the presence of other characteristic signs of Von Recklinghausen's syndrome, have a probability of malignant degeneration ranging between 5 and 16%. Isolated schwannoma hardly ever become malignant and in general, if exeresis is complete, no recidivation occurs after surgery.


Neutrophil dysfunction in prepubertal periodontitis associated with Papillon-Lefèvre syndrome. Although prepubertal periodontitis (PP) is often associated with the Papillon-Lefèvre (PLS), the etiopathogenetic mechanism in this disease has not been clarified as yet. A three and half year old female with leukocyte chemotaxis deficiency and decrease of T-lymphocytes is presented. The immunohistochemical evaluation of neutrophils showed a reduction of myeloperoxidase content, whereas ultrastructural studies revealed no particular change. The possible role of such a deficiency in the pathogenesis of the periodontal lesion is discussed.


[Keratoacanthoma of the lower lip. A review of the literature and clinical case report]. The authors report a case of keratoacanthoma localized on the prolabium of the lower lip. They focus their attention on the difficulty of making a correct diagnosis and on the complexity of differential diagnosis with squamous cell carcinoma. After incisional biopsy of the lesion, treatment took the form of the complete excision of the neoplasm which is indispensable for a definitive diagnosis. The keratoacanthoma, although being an absolutely benign lesion, in fact requires complete exeresis in order to perform an histological examination of the entire neoplastic mass and thus definitively rule put the presence of squamous cell carcinoma. If correctly performed, the operation leaves very little scarring and satisfies the patient's esthetic and psychological expectations.


[A case of osteoma of the mandible].

[A case of osteoma of the mandible]. Osteoma is a benign bone tumour with a very slow growth. In the maxillofacial district the paranasal sinuses and the mandible are more frequently involved. This type of tumour is clinically asymptomatic and the signs of its presence are due to the fact that its expansive and centrifugal growth changes the face features. The surgical operation has a double aim: to solve the aesthetic problem and to prevent complications. In fact, obstructions and compressions ab estrinseco may compromise the function of the nearest organs. The aim of our work has been to show a clinical case which is interesting from a clinical, diagnostic and therapeutic point of view.


[Localization of the DNA segment coding for the synthesis of fraction I on the pYT plague pathogen plasmid]. Fragmentation of the pYT plasmid of the plague pathogen by ten restriction endonucleases has been studied. The evidence has been obtained in support of the possible presence of the movable genetic element containing a HindIII site within the plasmid pYT. The gene encoding the I fraction of the plague pathogen has been cloned. The physical map of the pYT plasmid has been constructed with the use of restriction endonucleases BamHI, XhoI, BstEII, SmaI, EcoRI, and HindIII. The fragment of the plasmid DNA coding for the synthesis of the plague pathogen fraction I has been mapped.


[Optimization of DNA blot hybridization conditions for various types of membranes]. A set of experiments has been conducted to choose the optimal conditions for DNA transfer and fixation on two types of the nitrocellulose, three types of nylon membranes and on capron filters. The buffer capillary transfer systems, electroblotting and gel hybridization are analyzed. Two techniques for DNA binding have been tested under different transfer conditions for all the membrane types: a vacuum fixation at 80 degrees C and a UV-exposure. The results indicate the critical dependence of the efficiency of blot-hybridization on the conditions of UV-treatment. The UV-exposure longer or shorter than the optimal one resulted in a loss of the hybridization efficiency. The optimal DNA-transfer and fixation conditions are recommended for all the membranes tested. The dependence of the optimal transfer and binding conditions on the specific characteristics of different membrane types was demonstrated for maximal sensitivity of the blot-hybridization.


[Cloning and expression of the Arthrobacter globiformis fcb genes in Bacillus subtilis]. The fcb genes of Arthrobacter globiformis KZT1 coding for the dehalogenase (4-chlorobenzoate-4-hydroxylase) activity have been cloned. The characteristics of fcb genes expression have been studied. The recombinant strains of Bacillus subtilis 6JM15 (pCBS 311) and 6JM15 (pCBS1) have shown the decreased level of substrate dehalogenation as compared with the one in the parent strain KZT1 and the recombinant strains of Escherichia coli and Pseudomonas putida.


[Preparation of single-stranded E1A-oncogene DNA fragments from simian adenovirus SA7 by endonuclease hydrolysis recombinant phage M13 SS-DNA complexed with oligonucleotides, containing restriction sites]. The ss-DNA of the (+) and (-) chains of Ela DNA fragment was obtained by hydrolysis of the recombinant bacteriophages M13 mp8G and mp9G (where G is 1-1750 bp:, E1a region of oncogene SA7) in complexes with the 16 bp oligonucleotides containing AluI and BspRI sites of restriction and sequences complementary to E1a SA7. The obtained fragments overlap the E1a zones associated with the immortalizing potential of SA7.


[Genetic control of tetracycline resistance in bacteria]. Modern data on prevalence, structural and functional organization of the tetracycline resistance determinants in bacteria are reviewed. The three mechanisms of the antibiotic resistance are the tetracycline efflux, the ribosomal protection and the antibiotic modification. The problems of evolution of tetracycline resistance genes are discussed.


[Cloning and expression of the Clostridium thermocellum gene in cyanobacteria Anacystis nidulans R2 cells]. The XhoI-SalGI fragment of the plasmid pCI DNA was inserted into the SalGI site of the cyanobacterium Anacystis nidulans R2 integrative vector plasmid pIAH4. The fragment incorporates the endoglucanase gene of Clostridium thermocellum cloned earlier within the 6.7 kb DNA sequence. The recombinant plasmid DNA was transformed into Anacystis nidulans R2 cells. The cloned endoglucanase gene was shown to express in the cyanobacterium cells. The enzyme synthesized is accumulated within the cytoplasm of Anacystis nidulans cells and is not secreted into the periplasm.


[Ischemic cerebellar and brain stem lesions in CT findings]. The author analysed CT studies of 117 patients with ischaemic lesions of the cerebellum and brainstem. The clinical appearance in these cases is often unspecific. This was confirmed by false clinical diagnosis in most patients. CT diagnosis is particularly difficult in cases with mass effect which was found in 24.8% of the patients. Follow-up CT studies can help in proper diagnosis. The territory of the superior cerebellar artery was most frequently involved in the cerebellum, while the territory of the paramedian perforating in the brainstem. In 26.5% of the patients ischaemic lesions of the cerebellum and/or brainstem were bilateral, in 39.3% were accompanied by cerebral infarcts. It can be concluded that they are the component of general vascular insufficiency of the whole bain.


[Botulin in the treatment of local dystonia]. Botulin A has been introduced for the treatment of local dystonia especially blepharospasm and torticollis. Three cases of blepharospasm and 5 cases of torticollis were treated with botulin injections directly into the muscles by a method presented in detail. Good effects were obtained in blepharospasm but very poor in torticollis, which may have been due to too low doses of the toxin and inadequate choice of injection points. The method is safe and in only 1 case transient weakness of the masseters was noted.


[Early signs of cognition disorders in children with subacute sclerosing panencephalitis in initial stage]. The purpose of the study was to find some characteristic features of cortical defects in the neuropsychological examination of children with SSPE. These findings could be very useful in early differential diagnosis. We analysed the results of the neuropsychological assessment of 13 children selected from a group of 100 patients. The most frequent defects were found in the visuo-spatial functions. The clinical analysis of the obtained results was studied in view to establish, whether there are the signs of the dysfunction of the right or both cerebral hemispheres.


[The usefulness of clinical signs and selected diagnostic methods in the diagnosis of tuberous sclerosis in children]. 55 children took part in the study. Besides depigmented naevi and epilepsy, echocardiography plays the most significant role in the diagnosis of tuberous sclerosis in children below 2 years of age. In older children, besides dermatologic examination, cranial computerized tomography and abdominal ultrasonography are the most effective methods. This study suggests that the diagnostic effectiveness of different clinical signs and examinations depends on the age of the examined children. An appropriate diagnostic procedure may lead to earlier diagnostic and allows to avoid excessive examinations.


[Expression of surface antigens on lymphocytes stimulated by non- specific mitogens in multiple sclerosis patients]. In studies performed on 30 MS cases, as compared to 16 healthy individuals, significantly higher expression of HLA class II antigens, interleukin 2 receptor and antigens specific for lymphocytes B was observed. In MS patients after stimulation by non specific mitogens increased expression of HLA class II antigens and increased proliferation induced by PMA was found. The obtained results suggest absence of any greater modulation of surface antigens on the lymphocytes stimulated by non-specific mitogens. Our observations indicate that the number of activated T cells, as assessed by expression of Il-2 receptor, is in MS patients relatively low.


[Ultrastructural studies of cells in peripheral blood and cerebrospinal in meningococcal cerebrospinal meningitis]. Cells of peripheral blood and cerebrospinal fluid were studied in cases of meningococcal meningitis, and in peripheral blood of healthy controls. In the acute phase of the disease the neutrophils in cerebrospinal fluid showed evidence of phagocytosis activation with presence, among other signs, of numerous cytoplasmic processes. Stages of degeneration of these cells were observed with cytoplasm bulging into the nucleus, strong concentration of nuclear chromatin. In the light of a comparative assessment of cellular structures it was found that the population of neutrophils in peripheral blood is a more stable population showing no morphotic evidence of degeneration. In cerebrospinal fluid eosinophils three types of specific granules were found evidencing hydrolysis stimulation in these cells. In the acute phase of the disease the monocytes in the cerebrospinal fluid showed evidence of transformation, and during convalescence signs of degeneration appeared. Lymphocytes rarely found in the cerebrospinal fluid had features of metabolic stimulation (increased number of mitochondria, lysosomes and pinocytic vacuoles).


[Traumatic lesions of lower cervical spine]. In the years 1965-1990 in the hospital department for treatment of spinal injuries 1330 patients with spinal lesions at the C5-Th1 levels were treated after admission early after trauma. The most frequent causes of injuries of this part of the spine were falls from horsecarts, jumping into water head first and traffic accidents. The relationship was analysed between the degree of spinal cord injury and the mechanism of spine injury, and also the results were compared of conservative and surgical treatment. The most severe damage to the spinal cord was observed after traumas involving the flexion mechanism. Typical crush fractures of vertebral bodies had be best prognosis. Significant neurological improvement was obtained in over 50% of the treated patients, and it was more pronounced and occurred more frequently after surgical treatment.


[Surgical treatment of brain metastases from non-microcellular lung cancer]. A retrospective analysis is reported of 185 patients treated at the Memorial Sloan-Kettering Cancer Center, New York, in whom in the period 1984-1989 metastases to the brain from non-microcellular lung cancer were removed surgically. The statistical analysis was done by the Kaplan-Meier test. For neurosurgical treatment patients should be qualified without metastases to other organs and with brain metastatic tumor accessible for operation. The median survival was 12 months after operation on the brain, and 27 months after thoracic operation. The patients with cerebellar metastases had the same survival time after the operation as those with supratentorial metastases. Radiotherapy had no influence on the length of survival after tumor removal. Recurrence of brain tumour occurred in half the cases. Reoperation in case of recurrence prolonged the survival by another 10 months.


[Astrocytomas of the cerebellum in children: treatment and results]. Between 1980 and 1987, 113 children with astrocytoma of the cerebellum were treated. The range of the age was 11 months to 15 years. 103 children were treated by surgery only and 10 received surgery and postoperative irradiation. Shunting was necessary in 22% patient with cerebellar astrocytoma. One-year survival for patients with cerebellar astrocytoma was 97%, five-year 89%.


[Immunology of the central nervous system and brain tumors]. Treatment of brain tumours, especially poorly differentiated gliomas, by conventional methods is usually unsuccessful. A possibility of improvement of these results could be given by mobilization of immune system mechanisms. This has been made possible by partial insight into the mechanism of this system, its specific relations with the central nervous system, and interaction between the tumor and the immune system. The aim of the paper was a surgery of the state of knowledge concerning the immunobiology of brain tumours.


[Epilepsy and tremor in the XXY syndrome]. Extrapyramidal tremor and epilepsy uncommon in Klinefelter syndrome were found in a 30 year old patient. CT scans revealed partially empty sella and subcortical cerebral atrophy. Chromosomal studies showed the karyotype 47, XXY.


[Contribution to the clinical polymorphism in Huntington's disease]. A family is described in which closely consanguineous parents had Huntington chorea and in their son a severe hypertonic-hypokinetic syndrome with pellagra-like cutaneous changes was present. In two generations of the family in 6 subjects involuntary movements and gait disorders were reported.


[Severe case of basilar migraine treated with flunarizine]. In a man aged 40 years frequent attacks of basilar migraine with consciousness disturbances and signs of central nervous system defects developed due to circulatory failure in the posterior cerebral arteries and cerebellar arteries. The frequency and intensity of migraine attacks decreased only after treatment with flunarizine.


[Transient global amnesia. Case report]. All memory disturbances, especially those developing suddenly, cause anxiety of the patient. Transient global amnesia is a form of amnesia of interest in many aspects. The amnesia was described in 1964 by Fisher and Adams, and as yet about 1000 cases have been reported. Middle aged or elderly patients prevail. The attack of amnesia lasts from several to about 20 hours and begins suddenly being regarded as mental confusion. The amnesia covers recent and remote events in many years. During the attack the patient is not appearing to be ill, but is depressed not knowing what has happened. The awareness of own personality, the ability to solve logical problems and visuospatial functions are preserved. The ability to execute complex activities, e.g. car driving, is normal. The aetiology of the disorder is completely unknown. The hypotheses for explaining the syndrome are: 1. ischaemia in the posterior cerebral arteries region with transient fall of blood supply through the vertebrobasilar system, 2. epilepsy or migraine, 3. disturbed aggregation of platelets in the cerebral vessels leading to loss of vessel patency. The first hypothesis seems least plausible. Attacks of this amnesia were noted after triazolam, after thalamic infarction and cerebral angiography, in brain tumours, hydrocephalus, scleroderma, frontal lobe haemorrhage. After an attack the events occurring in it are not remembered. Recurrence of attacks is very rare. Most authors consider that the disorder is benign and regresses without sequelae or only with slight changes in cognitive functions and memory fixation.


Implementing the framework directive.

Implementing the framework directive. The Management of Health and Safety Regulations will be operative from the beginning of 1993. While duties for employers are similar to those laid out by previous legislation, Gillian Howard suggests that aspects of the new Regulations will see a new role for occupational health practitioners.


[A case of aneurysmal bone cyst of orbit roof in a boy aged 14]. A case of a very rare localisation of aneurysmal bone cyst within orbital roof is presented. The peculiar site of the pathological process caused two-way expansion, i.e. towards the orbit and the cranial cavity. The patient was operated on using the transcranial approach and total cure was obtained.


Industrial audiometry.

Industrial audiometry. Hearing surveillance is a mandatory requirement of new EC Regulations. Dr Stephen Karmy believes that audiometry has an important part to play in a company's hearing protection policy and aids compliance with new legislation.


Facing up to acne.

Facing up to acne. Acne is generally considered to be a trivial condition, confined to adolescents, who are expected to 'grow out' of it by the time they become part of the working population. Dr Andrew Finlay's experience suggests otherwise and argues that acne can affect older sufferers and disable employees who are not referred for appropriate treatment.


[Dissecting aneurysm of the posterior inferior cerebellar artery]. A 23 year old woman with dissecting aneurysm of the left posterior inferior cerebellar artery located distal to the branch feeding medulla oblongata is described. Trapping of the aneurysm with the aid of 2 clips was without any influence on neurological state of the patient and prevented recurrent hemorrhage.


Substance abuse. Taking the lead in workplace policies. The number of companies with alcohol policies is rapidly increasing. This trend has been largely led by health and safety departments in safety-sensitive industries. Helen Kogan believes that the time is now right for OH professionals to re-examine their involvement and take the lead in introducing preventive health care strategies in the workplace.


Moving to a community based curriculum.

Moving to a community based curriculum. The move to a community based curriculum will play an important part in shaping the future of the profession. ANN LOWIS (left), director of nursing at The Robert Gordon University, believes that it will do much to develop professional credibility and recognition.


[Coexistence of colloid cyst of the third ventricle with pituitary dwarfism in a female aged 16]. A 16-year-old patient with pituitary dwarfism is reported, in whom a colloid cyst was found in the III ventricle. The authors believe that pituitary disorder and colloid cyst were a result of developmental anomalies manifesting themselves at various times.


NVQs: where are they leading.

NVQs: where are they leading. Proposed changes in training and development means that it is time to stand up and be counted, writes SOHN chair, JEAN RAPER. She examines the work, to date, on National Vocational Qualifications and asks what affect they might have on the future of occupational health nursing.


[Selected problems in the evolution of scientific examination of the lymphatic system of the larynx and the surrounding region presented for clinical purposes]. The most important results of the morphological research of the lymphatic system of the larynx with surrounding tissues were presented. Based on section specimens of larynx the topography of the lymphatic system was described. We also described changes in the lymphatic system after radiation and after manifestation of squamous cell carcinoma in this region. We concluded that the main causes of our clinical adversities in treatment of larynx cancer were lymphatic stasis, cancer embolism of small nodes between mucosa and deep lymph nodes of the neck. We also studied over the methods of intravital examinations of the neck's lymphatic system.


[Microlaryngoscopy and microsurgery in diagnosis and treatment of laryngopathies]. In the Otolaryngology Clinic of the Medical Academy in Lublin in the 21 year period (1971-1991) there were performed 2488 microsurgical operations of the larynx. The authors analyse their own clinical material paying particular attention to relative precancer states, early diagnosis of laryngeal cancer and an increase of the number of preinvasive cancer (cancer in situ) diagnoses. The authors postulate that indications for clinical diagnostic and therapeutic procedures should be considerably extended in diseases of the larynx. There should be used an operating microscope which will considerably shorten hospitalization period of patients and significantly contribute to an increase of the percentage of early diagnoses of cancer of the larynx.


[Correlation of clinical and histological pictures of precancerous conditions and early-stage glottic carcinoma]. 310 patients were analysed with different pathological changes in the larynx, which are classified as premalignant stages and 114 cases with early cancer of the vocal cords. Out of the 310 cases, 230 cases were with chronic hypertrophic laryngitis, 44 cases with hyperkeratotic papilloma and 36 with juvenile papilloma in adults. Histologic verification of the bioptic and operative material was performed in a series of examinations. This showed that leukoplakia and one-sided pathological changes of the larynx are clinically characteristic for carcinogenesis. In chronic hypertrophy with leukoplakia, cell dysplasia occurred in 12.2% and atypia occurred in 9.8%. Hyperkeratotic papilloma underwent malignant transformation in 70.5% cases. Among the juvenile papilloma in adults with frequent recurrence of the disease, leukoplakia and dysplasia occurred periodically. Idiopathic malignant transformation of juvenile papilloma happened in only one patient. Adequate treatment of the premalignant stages effectively prevents further growth of cancer in 97% of the cases. Surgical treatment of cancer of the glottis in T1N0 and T2N0 gave a 5-year and longer survival period in 82.8%. There results were better than after radiotherapy of about 15%.


[Functional results after supracricoid reconstructive laryngectomy with cricohyoidopexy (chp) and cricohyoidoepiglottopexy (chep)]. The functional results in 61 patients after supracricoid reconstructive laryngectomy with CHP (28 cases) and CHEP (33 cases) performed in the University ENT Department in Szczecin between 1971-1989 are presented. Satisfactory lower airway protection in about 93% and respiration in the natural way in 83% are obtained. It was impossible to decaniulate 11 patients. The voice was socially sufficient in 89%.


[Ultrasonography in the diagnosis of larynx carcinoma]. The aim of our work was the application of sonographic method in the diagnosis 75 patients of larynx carcinoma. Aloka Hellige type SSD 280 LS was used on the examination in real time. The sonographic images were compared with the results obtained in the indirect and direct laryngoscopy, postoperational evaluation and histopathological picture. Sonography may prove to be a potentially useful for expanse of cancer of the larynx.


[On primarily bifocal laryngeal carcinoma and bronchogenic cyst of the neck]. The authors discuss a problem of rarely occurring bifocal carcinomas with the presentation of their own case of laryngeal carcinoma and branchiogenic cyst of the neck. They pay attention to histopathologic features underlying the diagnosis of branchiogenic cyst carcinoma and to the necessity of oncologic alertness in tumors of these kinds.


[Indications and contraindications for tympanoplasty, critical opinion upon this operations]. Indications and contraindications for tympanoplasty and critical opinion upon results of this operations were presented. Attention has been brought to the role of hearing aids in restoration of social useful hearing in patients after tympanoplasty.


[Surgical treatment longstanding, irreversible, peripheral facial palsy]. Authors described the technique of surgical treatment of the longstanding, irreversible peripheral facial palsy. Both neurography and myoplasty were combined. The most functionally effective detail in this method is the substitution of the hypoglossal nerve function with the descending branch of the cervical ansa.


Hearing preservation in acoustic neurinoma surgery. The chances of hearing conservation in patients with acoustic neurinoma increases by early diagnosis of small tumors. An early diagnosis of an acoustic neurinoma is achieved through the application of a minimal diagnostic test battery to evaluate unilateral otological complaints such as tinnitus, sensorineural hearing loss and balance disturbances. This minimal evaluation comprises puretone audiometry and ABR. Patients showing abnormal findings should be pursued with imaging evaluation such as MRI with gadolinium contrast. The choice of surgical approach for removal of an acoustic neurinoma (transtemporal, translabyrinthine or suboccipital) will depend on the size of the tumor and the patients' hearing. The possibilities should be discussed with the patients. Postponing the surgical intervention due to the possibility of facial paralysis or loss of hearing is difficult to rationalise. During the last 15 years, the development in diagnostic and surgical techniques has made it possible to conserve hearing during surgery at least in some patients suffering from acoustic neurinoma. Early diagnosis of small tumors increases the chances to conserve hearing. Therefore, all nonspecific early otologic symptoms should be thoroughly evaluated to exclude the presence of an acoustic neurinoma. Acoustic neurinomas usually arise within the internal auditory meatus and grow further into the posterior cranial fossa. The first symptoms usually are hearing loss, tinnitus and balance disturbance. These symptoms can occur in combination or individually. Accordingly, all cases presenting with one or all of these symptoms in the absence of an obvious etiology, such as posttraumatic hearing loss, require the exclusion of an acoustic neurinoma.(ABSTRACT TRUNCATED AT 250 WORDS)


[Reinke's edema and thyroid hypofunction]. The authors carried out a study of thyroid function determining the levels of thyroxine (T4) and triiodothyronine (T3) in the serum of 60 patients (33 men, 27 women) between 31-79 years with Reinke's edema who had been treated microsurgically and phoniatrically. Hypothyroidism was found in one patient (a teacher, 47 years old, smoker). The study suggests that hypothyroidism is not an aetiological factor in the development Reinke's edema, which is in accordance with what other authors report.


[Qualitative determination of chemical compounds in the tissue of laryngeal cancer by x-ray microanalysis]. The authors presented the results of chemical compounds in the laryngeal cancer tissue in 20 patients with clinically and histologically confirmed plano-epithelial carcinoma using own modification of x-ray microanalysis method. Comparison between the healthy and neoplasmatic tissue showed as follows: 1) both healthy and neoplasmatic tissue showed the presence of Cd, Zn, Fe, Mn, Mg and Si, P, S, Cl, K, Ca, Ti; 2) the neoplasmatic tissue showed the presence of Pb whereas it was not observed in the healthy tissue; 3) both Pb and Cl were irregularly concentrated in the neoplasmatic tissue while in the healthy tissue showed regular concentration. The authors discuss some methodological aspects and try to interpret the obtained data in the view of toxic, mutagenous and carcinogenous role of the Pb.


[On the bacteriostatic or bactericidal function of ceruminous glands secretion]. The authors present the results of their research concerning the bacteriostatic or bactericidal function of the secretion of ceruminous glands of the external auditory duct. In accordance with the statements of the other authors, neither bacteriostatic nor bactericidal function of the ear wax was discovered.


[A simple method of the vocal cord laterofixation]. Six patients were treated by the new method of vocal cord latero-fixation which was the combination of the extra-laryngeal and intra-laryngeal approach. The functional contraindication for this procedure is the anatomic configuration of larynx.


[Septal fascioplasty as the method of surgical treatment of nose bleeding in patients with Rendu-Osler-Weber disease]. The authors describe an own method of surgical treatment of nosebleed caused by Rendu-Osler-Weber's disease. For closure of nasal septal defects we used free graft of fascia lata. In five patients treated by our method, the transplantation ended successful; during the several weeks after operations the fascia lata was covered with epithelium growing from the surrounding tissues. Control examinations did not demonstrate recurrences. In two patients our method was unsuccessful.


[Difficulties in diagnosis of rhinitis in children treated at the Otorhingologic outpatient department of children's hospital in Bialystok]. The aim of this study was an analysis of rhinitis etiology in 105 children treated in Otorhinolaryngology Outpatients Department, Children Clinical Hospital in Białystok. In 58 patients seasonal allergic rhinitis, stimulated by grass antigens, in 37 patients infectious rhinitis and in 10 patients perennial allergic rhinitis stimulated by mites was recognised. The diagnosis in this last group was made using laryngological investigations skin "prick tests" and specific IgE level against mites.


[Ossicular reconstruction of the loss of the superstructure of the stapes]. At 43 patients the full or almost full reconstruction of the sound conductive system of the middle ear has been performed. The colemella from autogenous cartilage was positioned on the footplate of the stapes or the mallens was rotated on the footplate. In the 4 years after operation the negative functional results were found. The applied operations techniques have been criticised.


[The efficiency of vestibular organs in persons addicted to opioids, barbiturates and volatile organic substances examined during the period of abstinence]. Opioids, barbiturates and volatile organic substances are the most common drugs used in Poland by addicts. In the literature there are no data concerning efficiency of vestibular organs of addicted persons examined during abstinence period. 74 drug addicts and 50 healthy persons were subjected to ENG examinations (spontaneous nystagmus, positional ny gaze ny, eye-tracking test, optokinetic test, rotatory test and caloric test were evaluated). ENG showed abnormal records in all tests performed in the addicted persons. This study has revealed that addicts have insufficiency of vestibular organs, which is probably a result of central lesions.


[History of electrophysiological investigations of organs of hearing]. Development of electrophysiological examinations of organ of hearing was examined, starting from Luigi Galvani's discovery of electrical activity of biological tissue, through experimental research aiming at localization of cortical hearing centres. The studies by Wever and Bray, as well as, Ruben's team of Baltimore underline the significance of potentials expressing electrical activity of cochlea and acoustic nerve fibres. Pioneer studies of Hallowel Davis (called "father of ERA studies"--Electric Response Audiometry) and his first wife, Paulina. Several other studies done by his research team were mentioned. Besing on these papers and papers of some other authors, a short description of slow cortical potentials and cochlea potentials was done as they were discovered and introduced to clinical tests. The discussion covered also investigations of Sohmer and Feinmesser, as well, as, those of Jewett and Willistone on systematization of structures generating waves in auditory brain stem responses. The paper is concluded with the description of the recent classification of auditory potentials induced by an acoustic stimulus. The discussion on the development and progress of electrophysiological studies of the organ of hearing is concluded with some remarks on otoacoustic cochlea emission discovered by David Kemp of London in 1978.


[The picture of Polish practicing otolaryngologist at the turn of the 19th century]. The life, scientific, professional and organizational achievements are presented of Władysław Wróblewski (1860-1906), a distinguished Polish otolaryngologist, head of the out-patients department of Protestant Hospital in Warsaw with a wide experiences with the educational medical institutions abroad (especially at A. Politzer in Vienna). Dr. Wrólewski was a well-known Varsovian physician living in the second half of the 19th and the beginning of the 20th century in Warsaw. He was a author of numerous scientific publications. His achievements in rynology and laryngology are presented in more details, particularly those surgical treatment of larynx tuberculosis, the neoplasms of upper respiratory tract, surgical treatment of tonsils. The author discussed his view on certain nose, pharynx and larynx diseases, their diagnosis and therapy. Dr. Wróblewski was a co-editor of the Polish medical periodical "Gazeta Lekarska"; he was also a good teacher of a great number of distinguished laryngologists. The personality traits of this appreciated man were also depicted.


[Chronic granulomatous otitis media with irregular symptoms]. In the ENT Department, Medical Academy of Cracow, the patient with tinnitus synchronized with pulse as a first symptom of chronic granulomatous otitis media was treated. The diagnosis was made on the basis of the CT examination. The tympanoplasty was successfully performed.


[Metastasis of the cancer of mamma in the middle ear]. The rare case of the metastasis cancer of mamma on the middle ear was described. The diagnostic difficulties, treatment and clinical course were also discussed.


[A case of congenital middle ear abnormalities of Siebenmann's type]. There is presented a case of congenital anomalies of the middle ear. TORP (Richards) prosthesis successfully substituted for the aplastic chain of auditory ossicles and made it possible that hearing returned to the norm.


Ethical concerns about noncompliance in the chronically ill patient. This article is a discussion of the research trends concerning noncompliance, ethical concerns about noncompliance with prescribed treatment of chronic disease, requirements for ethical practice concerning noncompliance and chronic illness, and needed research about the relationship between noncompliance and coping with chronic disease. Questions are proposed to guide specific research concerning the ethics and therapeutic regimen compliance of patients with chronic cardiac disease.


Nursing management and rehabilitation of chronic ventricular assist device (VAD) patients. With the increasing number of heart transplants performed annually and the number of available organs decreasing, more patients are being bridged to transplant by mechanical circulatory support (MCS) systems during their wait for a donor organ. The duration of assistance with MCS has also increased due to this shortage of donor organs. The Artificial Heart Program at the University of Pittsburgh, recognizing this changing population, has shifted the focus of care from acute support to chronic support of VAD patients. Providing care directed at long-term support has promoted rehabilitation and helped to improve the overall bridge experience. At the University of Pittsburgh, 34 patients were implanted with MCS devices as a bridge to transplant between June 1987 and September 1992 (Figure 1). Thirteen of these patients were supported for over 60 days. Of these, three were eventually discharged to an out-of-hospital facility six blocks from the medical center. Eleven of the 13 patients supported over 60 days were discharged following successful orthotopic cardiac transplantation. In response to this increasing duration of support in the bridge to transplant patient, the role of the nurse has changed significantly. Nursing care initially focused on acute physiologic monitoring procedures that are restricted to an intensive care setting. Today the role of the MCS nurse encompasses a much broader area including medical care, education, and patient rehabilitation. It is important to realize that these aspects of care begin when a patient is identified as a MCS candidate and continue throughout the acute postoperative phase into the chronic phase of recovery.


Diagnostic uses of epicardial electrodes after cardiac surgery. Dysrhythmias after cardiac surgery are common. The etiologies and treatments are diverse depending upon the origin of the dysrhythmia. An atrial electrogram obtained from epicardial electrodes temporarily positioned at the time of surgery can detect the origin of an anomalous rhythm. This article discusses the diagnostic use of epicardial atrial electrograms after cardiac surgery, types of atrial electrograms, steps to interpretation, and nursing implications. An understanding of their use can facilitate patient management and therapy.


Comparison of psychologic stress responses in patients and spouses ten weeks after a cardiac illness event. A stress scale that is brief and easy to administer would be clinically useful to assess patients' and spouses' psychological stress responses to a cardiac illness situation and provide objective data for health care recommendations. The purpose of this study was to: a) develop and test an instrument to evaluate the stress or difficulties associated with the recovery process after a cardiac event; and b) assess the similarities and differences between patients' and spouses' perceptions of stress. Stress was conceptualized to be reflected by two broad dimensions, namely environmental stress and individual stress. A correlational survey design was used to examine patients' (n = 180) and spouses' (n = 168) stress responses 10 weeks after the cardiac event. The findings suggested that the tool demonstrated satisfactory reliability and validity in measuring the patients' but to a lesser extent the spouses' stress responses. The three most significant stresses reported by most patients were uncertainty about if and when the illness might recur, not being able to participate in work or retirement activities, and adopting a low cholesterol diet. For the majority of spouses, the three most significant stresses were uncertainty about the husband's illness, increased demands within the marital relationship, and assuming more family roles. For those individuals trying to quit smoking or who quit immediately prior to the cardiac event, smoking was the most stressful change for patients and the second most stressful for spouses. Educational programs for cardiac patients and spouses need to provide information related to these stresses to offset the potentially adverse impact of stress and promote adjustment.


Preservation of urinary continence and potency after cystoprostatectomy. Between 1980-1989 a total of 349 patients underwent one-stage radical cystoprostatectomy and an orthotopic bladder substitution. 278 patients underwent the Camey I bladder replacement and in 71 patients a detubularized ileal loop was utilized (Camey II). 75 patients underwent a potency-sparing cystectomy (32 patients of the Camey I and 43 patients of the Camey II groups). All patients were followed at least one year and had continence and potency assessment. Among the patients who underwent the Camey I procedure, 66% achieved daytime continence and 21% night-time continence 6 months after surgery. One year after surgery 86% of patients had normal continence during the day and 47% was continent during the night. 14% of patients had episodes of day-time incontinence one year after surgery. Among the patients who underwent the Camey II bladder replacement 86% achieved day-time continence and 59% night-time continence 6 months after surgery. At one year after surgery 91% was continent during the day, 72% was dry during the night and only 9% had episodes of diurnal incontinence. Potency was achieved in 24 of 32 patients (75%) with the Camey I bladder substitution, and in 34 of the 43 patients (79%) with the Camey II bladder substitution. Our data demonstrate that excellent rates of continence and potency are achievable in the post-cystectomy population. Patients with the Camey II bladder replacement achieve continence earlier than patients with the Camey I bladder substitution. Diurnal continence is slightly better after the Camey II procedure, one year after surgery, but the difference is not statistically significant. Nocturnal continence is significantly better with the Camey II bladder substitution.


Role of lymphadenectomy in renal cell carcinoma. A retrospective analysis of 97 consecutive patients with renal cell carcinoma, observed between 1983 and 1989, was performed. All patients underwent radical nephrectomy followed by extensive retroperitoneal lymphadenectomy which included hilar, laterocaval/lateroaortic, and interaortocaval lymph node dissection. Lymph nodes and distant metastasis accounted for 6.2% and 7.2% of the cases respectively. A statistically significant correlation between the stage and the grade of the tumor and the frequency of lymph nodes (p < 0.01) and distant metastases (p < 0.05) was found. In patients with no lymph nodes or distant metastases, the 5-year survival rate was 100%, 79%, 68%, and 50% for stage T1, T2, T3, and T4 respectively. No statistical difference in survival between stage T1, T2, and T3 was found. The size and histological grade of the tumor significantly affected the survival rate at 5 years. In fact, < 5 cm, 5-10 cm, and > 10 cm tumors had 93%, 52%, and 65% survival rates respectively, while G1, G2, and G3 tumors had 75%, 68%, and 21% survival rates respectively. In patients with nodal metastases and distant metastases the 5-year survival rate was 25% and 0%. Survival appears to be significantly influenced by the presence of lymph node and distant metastases, while retroperitoneal lymphadenectomy does not improve the survival of patients with lymph node metastases.


Patterns of ploidy in renal cell carcinoma. In a prospective study the patterns of ploidy in 119 kidneys from patients with renal cell carcinoma were analyzed by flow cytometry. A rate of DNA aneuploidy of 53% was observed in the investigated tumors. However, in 4% of the kidneys aneuploid cell distributions were also proven in macroscopically intact tissue far away from the tumor. Although we do not know at present, if these were benign, premalignant or malignant cell alterations, this observation should be considered for decisions regarding conservative renal surgery.


Flow cytometric analysis and motility response to laminin and fibronectin of four new metastatic variants of the human renal cell carcinoma line RC43. Using subrenal capsule implantation (SRC) in nude mice we have isolated 4 new sublines (RC43MSP, MBO, MLI, MDI) from the human renal cell carcinoma line (HRCC) RC43. These sublines exhibit an enhanced metastatic ability and a faster doubling time after subcutaneous (SC) transplantation in vivo, when compared to the parental line. With the aim of a better characterization of these new sublines we have performed a flow cytometric analysis (FA) of the DNA content and studied the motility response (MR) to laminin and fibronectin. FA results. The RC43 parental line showed a tetraploid pattern (DNA index: 2.08). Also the variant lines RC43MLI and RC43MDI were tetraploid (DNAind: 2.05 and 2.07, respectively). With RC43MDI a second peak in the tetraploid range was evident. The RC43MSP and the RC43MBO sublines both showed a hypertetraploid pattern (DNAind respectively 2.21 and 2.11). MR results. Motility studies showed that all RC43 lines, including the parental line, were stimulated to migrate in response to either laminin or fibronectin both from rat and human sources. There were no significant differences between the parental line and its variants in this respect, however. We conclude that by the use of FA at least two of the sublines (MSP and MBO) can be distinguished from the parental RC43 cell line, suggesting a different clonal origin of the various sublines. As all sublines, as well as the parental line, showed a large but similar response to migration-stimulating agents (such as laminin and fibronectin) determination of MR could not be used to obtain a further discrimination between the different sublines.


Impaired immune response by isoniazid treatment during intravesical BCG administration in the guinea pig. At present, isoniazid (INH) is being used prophylactically to reduce the side effects of intravesical BCG therapy for superficial bladder cancer, although it is not clear whether or not this reduces the antitumor efficacy of BCG. In this study the impact of INH treatment on the immune response after repeated intravesical BCG administration was investigated in guinea pigs. INH was given during 3 days starting on the day prior to the BCG administration. It was found that the administration of INH severely impaired the immunological effects of BCG. The induction of mononuclear cell infiltration in the bladder wall was reduced. Enlargement of the regional lymph nodes (weight and number of cells), and increase of Major Histocompatibility Complex (MHC) class II expression on the lymph node cells, normally observed after intravesical BCG administration, were inhibited by INH. Systemic immunity, measured by the DTH reaction in the skin to PPD, was also diminished due to the combined treatment of BCG with INH. A five-fold increase of the dose of BCG did not overcome the effect of INH. INH probably did not exert a direct suppression of the immune system of the guinea pig as the DNCB skin reactivity was not influenced. Although INH concentrations in the urine were high at the onset of the instillation, in vitro experiments indicated that the effect of INH was probably not caused by killing of the BCG organisms shortly after application in the bladder. In conclusion, our data in guinea pigs suggest that the use of INH may impair the immune response to intravesical BCG. As this response may be important for the antitumor effect of BCG, urologists should be cautious with the prophylactic use of INH. The influence on the antitumor efficacy is now investigated in man.


Disease-modifying anti-rheumatic drugs: strategies for screening. Rheumatoid arthritis, a disease of unknown aetiology, has a multifactorial pathogenesis which may result in irreversible connective tissue destruction and loss of joint function. The search for drugs which offer more than symptomatic relief is a long term, largely unachieved aim of many pharmaceutical companies. This review briefly outlines those features of the aetiopathogenesis which appear to offer targets for therapeutic intervention and the structured strategy and test systems that can be used to detect drugs which may be capable of halting disease progression.


1-Beta-arabinofuranosylcytosine in therapy of leukemia: preclinical and clinical overview. Although the mechanisms of therapeutic efficacy of cytosine arabinoside (Ara-C) are multifactorial, the pharmacodynamic basis for its cytotoxicity and therapeutic efficacy lies in its intracellular metabolism and the retention of the active metabolite, Ara-C triphosphate (Ara-CTP), which is a competitive inhibitor of DNA polymerase. Additional determinants of tumor cell sensitivity include Ara-CMP incorporation into cellular DNA, the size of the competing normal metabolite, deoxycytidine/5'-triphosphate pool, and the heterogeneity in growth kinetics of tumor cells, S-phase vs cells in other phases of the cell cycle. With high-dose Ara-C, substantial amounts of Ara-CTP are formed in phases of the cell cycle. The presence of high intracellular concentration with prolonged retention of Ara-CTP could lead to the inhibition of cell growth of the cells entering S-phase as a consequence of inhibition of DNA-polymerase and/or incorporation into cellular DNA, resulting in a chain termination. Pharmacokinetically, Ara-C is rapidly eliminated from plasma. In mice, pharmacokinetic parameters of Ara-C are not sufficient predictors for the observed differences in their in vivo antitumor activity. Although these mice were bearing different tumor types (L1210 Ara-C sensitive or P-388 relatively more resistant), the observed differences in tumor response were achieved under identical plasma Ara-C concentrations and area under the concentration time curve. The observed antitumor activity in L1210 cells is primarily associated with higher Ara-CTP pools and retention (T1/2 > 4 hr) in tumor cells as compared with normal bone marrow cells. In the least responsive tumor (P-388), although Ara-CTP pools were sufficiently high, retention of the drug in tumor cells and in normal cells is poor with a T1/2 < 2 hr. Thus, unlike mice bearing leukemia L1210 cells, alteration of the mode and dose of administration of Ara-C in mice bearing P-388 could only result in increased host toxicity with no therapeutic gain. Similarly in patients with acute nonlymphocyte leukemia (ANLL), there is no significant correlation between plasma Ara-C concentration and the intracellular concentrations or retentions of Ara-CTP. In some patients the highest Ara-CTP pools in leukemic myeloblast cells are achieved at a lower level of plasma Ara-C and decrease further with the increase of plasma Ara-C. Thus, in the in vivo model system and in ANLL patients with no prior chemotherapy, Ara-CTP retention is a critical factor associated with response to this agent, in particular its direct association with duration of complete response.(ABSTRACT TRUNCATED AT 400 WORDS)


Preclinical and clinical perspectives on the use of estramustine as an antimitotic drug. A variety of cell biological, pharmacological, crystallographic and clinical approaches have indicated that the antimitotic drug estramustine has interesting and unusual properties. Although designed as an alkylating agent, the marked stability of the carbamate linkage to the steroid carrier molecule prevents the formation of alkylating intermediates. The affinity of the parent molecule for microtubule associated proteins and the concomitant antimicrotubule activity have cytotoxic consequences in tumor cells. Both preclinical and clinical studies of estramustine in combination with other antimicrotubule agents have shown that this approach has great potential to achieve therapeutic advantage, especially in disease states such as hormone refractory prostate cancer.


Electrophysiology of cerebral blood vessels. In spite of the relatively large amount of in vitro and in vivo data indicating that, in a number of ways, cerebral arteries are pharmacologically different from peripheral arteries, the mechanisms responsible for these differences are far from clear. An understanding of these mechanisms is particularly important for a rational approach to the treatment of disorders of the cerebral circulation including migraine, hypertension and the responses of cerebral vessels to subarachnoid haemorrhage. This review outlines electrophysiological data which are available from cerebrovascular smooth muscle cells, including the possibility that inwardly-rectifying potassium channels, active at potentials close to the resting membrane potential, are intimately involved in the changes in smooth muscle tone which couple blood flow to regional changes in nerve cell activity. The membrane potential changes in response to perivascular nerve stimulation, noradrenaline, 5-hydroxytryptamine and endothelium-derived hyperpolarizing factor are also described, together with the underlying membrane mechanisms and their relationship to smooth muscle contraction and relaxation.


S-adenosylmethionine decarboxylase as an enzyme target for therapy. The polyamine biosynthetic pathway has attracted much interest as a therapeutic target. Many studies have shown the potential value of inhibitors of the first enzyme in the biosynthetic pathway, ornithine decarboxylase, which forms putrescine. In order to convert putrescine into the polyamines, spermidine and spermine, the aminopropyl donor, decarboxylated S-adenosylmethionine, is needed. Therefore, S-adenosylmethionine decarboxylase (AdoMetDC, EC 4.1.1.50) is essential for polyamine synthesis. Early studies of the inhibition of this enzyme were carried out with compounds such as methylglyoxal bis(guanylhydrazone) that lack specificity and also lack potency since they are competitive inhibitors whose effects are overcome by a compensatory increase in the amount of the target enzyme. Recently, powerful irreversible inhibitors of AdoMetDC have become available including 5'-([(Z)-4-amino-2-butenyl]methylamino)-5'-deoxyadenosine, an enzyme activated inhibitor and 5'-deoxy-5'-[(3-hydrazinopropyl)methylamino]adenosine which binds to the active site and forms a covalent bond with the pyruvate prosthetic group. This review describes the current state of knowledge of the structure and properties of AdoMetDC, the available inhibitors of this enzyme, their mechanism of action and their effects on polyamines and on the growth of tumors and protozoan parasites. These effects indicate that AdoMetDC inhibitors may be of therapeutic value either alone or in combination with ornithine decarboxylase inhibitors and that further trials of these compounds should be considered.


[Psychophysiological characteristics and metabolic indices of neurotransmitter metabolism in patients ill with endogenous depression]. Research was conducted upon 28 patients with a diagnosis of endogenous depression after their pharmacological treatment with imipramine or chlorimipramine. The investigation considered the interrelationship between psychophysiological parameters (heart rate, respiration rhythm, postural muscular tension) and the indices of the cholinergic and adrenergic systems (kinetic parameters of choline transport in the blood; Vmax, the activity of plasmic pseudocholinesterase, Che; blood acetylcholinesterase AChE, monoaminoxidase in blood platelets, MAO; and dopamine beta hydroxylase DBH). The results indicate that during relapse of endogenous depression there occurs an imbalance in the cholinergic-adrenergic systems which may be the result of some somatic symptoms typically found in the depression syndrome. The appearance, after pharmacotherapy, of a correlation between the indices of the activity of the cholinergic system with the respiratory rhythm suggest that the part played by the cholinergic mechanism in the regulation of autonomic processes normalizes itself during the course of successful therapy. The appearance of characteristic correlations between the activity of the cholinergic and adrenergic systems and the psychophysiological parameters in the presence of relatively low psychological stress seems to accompany successful treatment with imipramine and chlorimipramine.


[The analogous self-rating scale of affect as a tool in the assessment of change of clinical status of patients with endogenous depression syndrome. A comparison with the Hamilton depression scale]. The authors compare the results of the analogous self-rating scale of affect with self report of affect (Hamilton Scale) in 57 patients with depression during the course of affective disorder. The ASRA seems to be particularly useful in the assessment of improvement in patients with slight or moderate depression.


[Disability among patients with affective disorders]. In a group of patients with affective disorder it was found that the frequency of formal handicap occurred in 29.8% of those subjects. This was observed mainly in women and mostly with those diagnosed as bipolar affective disorder (43.6%). Patients with an alcohol problem more often were on social security pension.


[Awareness of illness in affective psychosis]. On the basis of analyzed clinical material several observations were attempted which were related to the patients' awareness of one's own affective psychosis. It was discovered that patients with endogenous depression considered themselves to be ill, but only in relation to depression. They usually do not perceive in themselves any psychotic illness. It was noticed that in depression past achievements appeared to be foreign to the patients. This was described in among other terms as "emotionally empty judgments". Analyzing the clinical picture of hypomanic states, stress was placed on the notion of the coexistence of logical thinking (and in some cases these thinking patterns are concerned with a feeling of heightened cognitive ability) with thinking styles based on logical errors. In all patients hypermnesia appears more important than other factors. The above mentioned phenomena are the subject of further research.


[The psychological health of offspring of patients suffering from endogenous affective disorder (II a follow-up study)]. In the off-spring of patients with affective disorder various psychological disorders were found in 25% subjects. In the off-spring of healthy persons only 10% were found to have psychological disorders.


[Selected demographic and clinical characteristics of patients with affective disorder treated in the Tworki Hospital in the years 1919- 1938 and 1947-1990]. On the basis of medical records of 353 patients with affective disorder from the years 1919-1938 and 1947-1990 it was found that some demographic and clinical changes occurred. Amongst others there was observed a rise in the percentage of patients with depression from 1/3 to 2/3 and a fall in the number of patients suffering from mania.


[Carbamazepine in the treatment of depressive syndromes]. Carbamazepine treatment was used with 54 patients suffering from endogenous depression and organic depression. The anti-depressive effect was found to be the best in those patients with organic depression, while in endogenous depression it was better with bipolar affective disorder and with irregular EEG recordings.


[Chronic hospitalizations in Poland from 1980 to 1989]. The aim of the following research was to present and try to explain the features of chronic hospitalizations in psychiatric hospitals in Poland during the 1980's. According to the definition adopted when working with inpatients, patients hospitalized for over one year are regarded as chronic. The percentage of chronic patients in the general patient population was found to be 8% of all hospitalizations. The largest number of chronically hospitalized patients was found among those diagnosed as mentally retarded (29%) and schizophrenic (15%). The least number of chronic hospitalizations was found among patients with a diagnosis of alcoholism (1%) and among the non-psychotic patients (4%). In the years 1980 to 1989 there was a systematic fall in the previously increasing rate of chronic hospitalizations of people diagnoses as non-alcoholic psychotic and mentally retarded to about 70% of the number registered at the beginning of the decade. The fall in the rate of increase of chronic hospitalization is mainly due to the fall in the rate of growth of the chronically hospitalized group. This fall is not significantly connected with the movement of patients to community based services or with the increased mortality rate during the 1980's. The causes of this phenomenon remain unanswered. It may be the result of the better and more accessible forms of treatment, such as intermediate treatment, which are an alternative to long-term hospitalizations. Another reason may be the more effective forms of hospital treatment and the fact that psychiatric hospitals are using the "revolving door" strategy.


[A study of involuntary treatment in psychiatric hospitals]. Research revealed that the only documented form of forced treatment was the use of mechanical restraining of patients. The frequency and circumstances of restraining patients were highly dependent on, among others, the structure of employment of hospital personnel. Research was conducted on 6962 patients from 6 psychiatric hospitals. It was revealed that during a month mechanical restraint was used with 5.5% of the patients. This percentage wavered from 1.6% to 8% in different hospitals. Isolation was not used at all. The frequency and circumstances of using force was significantly related to age, sex, marital status, the length of hospitalization and the diagnosis of the patient. Furthermore, the number of staff and the structure of employment in particular hospitals was important.


[Autism, infantile: diagnostic aspects]. Autism is a rare disorder, whose frequency varies according to research from 0.7 to 4.5 per 10,000. The results of 40 children examined in the Out-patient Rehabilitation Union for Autistic Children showed that according to the DSM-III-R criteria 3 children suffered from autism. The authors suggest that the DSM-III-R criteria are either not known to the diagnosticians or are not used in the diagnosis.


[A follow-up study of adolescents after suicide attempts]. Young persons who in the past attempted suicide show the following characteristics: 1. they unwillingly make contact with an agency which they had consulted or had been treated due to their suicide attempt, 2. often maintain suicidal thoughts (11 of 37), 3. they have a higher estimation of their psychosocial situation then an objective assessment would indicate, 4. their psychosocial functioning does not improve with time.


[An attempt to formulate prognosis for anorexia nervosa on the basis of follow-up data]. Follow-up data in the form of questionnaires were collected from 38 patients (36 women, 2 men) who had been treated for anorexia nervosa at the First Clinic of Mental Diseases of the Academy of Medicine in Gdansk from 1972 to 1988. The period of time of the follow-up was from 3 to 16 years. Adequate information was received from 16 patients (42%). One of the patients died and one was found to have developed a schizophrenic process. The 14 female patients were divided into 2 groups. Group 1 (7 persons) included patients whose anorectic symptoms abated. Three patients married and had children, five worked professionally. In group 2 (7 persons) anorectic symptoms persisted in a lesser degree. Two patients married and had children, five worked and two were on disability pensions. An analysis of both groups revealed that factors associated with poor prognosis in group 2 were: low motivation for accepting treatment, personality disorder partly due to organic factors, the use of laxatives and diuretics, continuing conflictive situations.


[The examination of mental status of children with multiple sclerosis]. Assessment was conducted on 50 children with multiple sclerosis ranging in age from 3 to 16 years. The aim of the study was to the discover how they deviate from the norm in their mental status. It was concluded that the most frequent symptoms in this group of children, were various disorders in the impulsive--emotional sphere. It was noted that with time the chance of organic pathology increases.


[Norms of EEG sleep patterns for healthy Polish population aged from 20 to 59]. Norms of sleep EEG patterns for a healthy population aged from 20 to 59 years are presented from which it was concluded that this age group forms a relatively stable pattern during the ontogenesis of sleep. The collected data were compared with data found in the literature.


[Program fo the eradication of Cochliomyia hominivorax in Northern Africa]. The New World Screwworm (NWS, Cochliomyia hominivorax) is an obligate parasite of warm-blooded animals. The female lays up to 300 eggs in any break in the skin, and the resulting larvae (screwworms) burrow into surrounding living flesh. Infested animals frequently die, while the annual cost of controlling the pest in domestic animals is about US $10 per head. NWS is endemic in tropical Latin America. In 1988, it was detected in Libya, presumable introduced with imported sheep. By 1990, the infestation had spread to an area of 25,000 km2 containing some 2 million livestock. In early 1991, an internationally funded eradication programme was undertaken by FAO, using sterile insects. Each week, 40 million pupae were flown from a production plant in Mexico, and the emerged adults were distributed by over the infested area. Within a few months, the infestation has been eradicated. Whereas 12,000 infested animals were found in 1990, only 6 were detected in 1991. The programme involved the shipping and distribution of 1.3 billion sterile insects, animal inspections totalling 40 million and laboratory examination of 280,000 trapped flies. While the programme cost close to US $75 million, a benefit/cost ration of 50:1 has been estimated.


[Rift Valley fever in Madagascar in 1991. Sero-epidemiological studies in cattle]. Rift Valley fever (RVF) virus was detected for the first time in Madagascar in 1979, but without any impact on human and animal populations. However, in 1990 and 1991, several outbreaks with massive cattle abortions were described. Since that period, seroepidemiological surveys have been conducted on the East coast and in the highlands (outbreak areas), in the high cattle density regions, and in the national slaughter house in Antananarivo. A high RVF IgM antibody prevalence was detected in the outbreak areas during the epizootics. This IgM prevalence thereafter decreased and was followed by an IgG high prevalence in all tested regions. Hypotheses on the occurrence of the virus in Madagascar, outbreak origins and virus circulation on the island are discussed.


[Asymptomatic carrier state in Creole goats and cattle after recovery from Cowdria infection in Guadeloupe]. Creole goats and cattle in Guadeloupe can be carriers of cowdriosis (heartwater: Cowdria ruminantium) after recovery for a period as long as 11 months in goats and 2 months in cattle. The carrier status was demonstrated by feeding Amblyomma variegatum nymphs on recovered animals and the resulting adult ticks on susceptible goats. Cowdria ruminantium was not detected permanently during the carrier status.


[Will electroconvulsive therapy induce seizures: magnetic brain stimulation as hypothesis of a new psychiatric therapy]. This study presents a hypothesis of a new psychiatric therapy. Deep, low-rate transcranial magnetic stimulation is theoretically able to evoke the same therapeutic effects as electro-convulsive therapy but in a softer mode/painlessly and without a motor seizure.


Salmonella enteritidis infection in the Sudan. Twenty-one Salmonella enteritidis isolates were recovered from several poultry farms in three states in the Sudan over an eighteen-month period. The infection was disseminated from a distributing company which had imported infected fertilized eggs and parent stock. The Sudan S. enteritidis epidemic which devastated many poultry farms during 1990 was attributable and concurrent to that in Europe in particular and throughout the world in general.


Biotypes and sensitivity screening Yersinia enterocolitica as an infective agent in man and swine in Nigeria. Diarrhoeic faecal samples from 210 humans and 192 swine were screened for Yersinia enterocolitica in 1990. Ten and 8 Y. enterocolitica strains were isolated from pig and man, respectively. The isolates were found to belong to Wauter's biotypes 1, 2, 3 and 4. Biotype 2 was isolated mainly from human stool samples. Biotype 3 was found only in swine while biotypes 1 and 4 were isolated from both man and swine. All the 18 strains showed varying degrees of sensitivity to antibiotics used in this investigation. The organisms were consistent in their resistance to ampicillin and penicillin.


[Epidemiology of poultry parasitic disease in village breeding in Niamey area, Niger]. An inventory of poultry parasitism in hens and Guinea fowls in village breeding was conducted from May 1985 to April 1987 in the Niamey department. About 1,200 post-mortem examinations and haematological tests, as well as 6,000 faecal egg counts were performed. The internal polyparasitism was observed in two thirds of the cases. Guinea fowls were more infected than chickens. Cestodiasis was frequent in both species. The omnipresent spirochaetosis made a potential danger for the improved flocks. Ectoparasitoses were mainly represented by argas and scaly-legs, which affected one chicken out of ten.


[Altered states of consciousness: a history of research]. A history of studies on altered states of consciousness is described and divided into five main periods. Contemporary descriptive and psychophysiological research are reviewed.


Evaluation of mono- and polyclonal antibody-based antigen detection immunoassays for diagnosis of Trypanosoma evansi infection in the dromedary camel. Two enzyme-linked immunosorbent assays (ELISA), one based on a mouse anti-Trypanosoma brucei group-specific monoclonal antibody and the other on rabbit anti-Trypanosoma evansi polyclonal antibodies, have been evaluated for their ability to detect circulating trypanosome antigens in camel sera as a means for the diagnosis of T. evansi infections. All 91 sera from a negative control camel herd from Kenya gave negative antigen-ELISA results in the monoclonal antibody-based ELISA and only 2 of them (2.2%) gave false positive results in the polyclonal antibody-based ELISA. In subsequent analyses of sera from infected camels (as determined by mouse inoculation), the monoclonal antibody-based ELISA detected antigens in 90 (83.3%) out of the 108 sera tested. This percentage was lower for the polyclonal antibody-based ELISA which was able to detect antigens in 67 (60.9%) out of the 110 sera tested. The two tests detected probably different antigens and when the results were combined, 99 out of 107 (92.5%) sera were shown to be ELISA positive. In a survey involving 316 camels from the Gao and Nara areas, in Mali, a high proportion of animals tested were antigen positive (43.5 and 42.9%, respectively for the mono- and polyclonal antibody-based ELISA) compared to only 22 (7.0%) diagnosed by the parasite detection techniques. Thus, these immunoassays were at least six times more sensitive than the haematocrit centrifugation technique. As a large proportion of cases may be antigen positive but parasite negative, these two of "surra" immunoassays should be used in routine diagnosis in addition to the parasite detection techniques in the dromedary camel.


[Trypanosomiasis and trypanocidal treatments in Ndama calves in a glossina infected area (the ranch of Madina-Diassa in Mali)]. This work aims at contributing to the knowledge of trypanosomiasis epidemiology in calves of trypanotolerant breeds and at defining an appropriate treatment to improve the survival of such calves in a tsetse infested area. The first study was a parasitological survey of 100 calves from the day of birth to the age of one year. According to the results of this survey, the period from birth to three months is a "critical" moment in the life of the calves, due to a high infection rate and mortality related to trypanosomiasis. The purpose of the second study was to investigate the possible interference of early trypanocidal treatments with the further expression of trypanotolerance. For this purpose three groups of over one-year old animals were established. The groups had different trypanosomiasis history due to the different treatments they had undergone during their first year of life. All the animals had been exposed to trypanosomiasis without treatment and followed up parasitologically and clinically during the second year. The results showed no interference of early trypanocidal treatments (including preventive ones) with the expression of resistance in potentially trypanotolerant animals.


Decrease of phosphofructokinase activity in relation to the pathogenesis of triorthocresyl-phosphate-induced delayed neuropathy. The in vivo effect of a single dose of the neuropathic compound triorthocresyl-phosphate (TOCP) on phosphofructokinase (PFC, E.C. 2.7.1.11) and its relation with the initiation step (inhibition and aging of neuropathy target esterase, NTE) in the TOCP-induced delayed neuropathy have been studied. Hens were treated with a neurotoxic dose of TOCP (500 mg/kg, p.o.) and with a protective compound (Phenylmethanesulfonyl fluoride, PMSF, 30 mg/kg s.c.) in different combinations: TOCP, TOCP + PMSF, PMSF + TOCP and PMSF. PFK activity was determined in brain and sciatic nerve 1, 3, 7 and 15 days after treatment. PFK activity decreased in sciatic nerve 15 days after dosing with TOCP or TOCP + PMSF. When animals were dosed with the protective agent (PMSF) alone or before administering the neurotoxic compound, PFK activity was unaltered and clinical signs of neuropathy were absent. The data presented here suggest that phosphofructokinase is involved in the pathogenesis of the neuropathy induced by TOCP.


Differential effects of two alleles of the dy locus on the pituitary-testicular axis of mice. Testicular function was studied in vivo and in vitro in adult male dy/dy and dy2J/dy2J dystrophic mice. The results demonstrate that testicular function in dy/dy mice is more affected. The basal levels of pituitary hormones measured were normal in dystrophic mice, except for the presence of hyperprolactinemia in dy/dy mice. In dy/dy mice testicular weight was diminished and a deficient transduction of the gonadotropic signal is present in vivo, accompanied by reduced efficiency of 17-hydroxylase and 17-hydroxysteroid dehydrogenase. In dy2J/dy2J mice the signal transduction is normal and the reduction in enzyme efficiency is limited to 17-hydroxysteroid dehydrogenase. The in vitro HCG-induced increases in production of testosterone (T) and estradiol (E2) were reduced in dy/dy/mice, and the data indicate a reduction of enzyme activity rather than in efficiency. In dy21/dy21/mice, HCG-induced T synthesis was increased, HCG-induced E2 synthesis was normal, but basal media E2 levels were reduced, with the in vitro efficiency of aromatase being suppressed under both basal and HCG-stimulated conditions, when compared to their normal littermates.