[The effect of exogenous gangliosides on the dynamics of the development of prolonged posttetanic potentiation]. In hippocampal slices of rats was studied the influence of different gangliosides on the dynamics of development of long-term post-tetanic potentiation (LPTP) in the pyramidal cell layer of the CA3 area at stimulation of the mossy fibers. Each ganglioside was shown to change synaptic efficiency specifically after the tetanic stimulation. Incubation of hippocampal slices with monosialoganglioside GM1 induced the rapid increase of population spike amplitude in the pyramidal neurons being of higher level in comparison to that of the active control up to the end of the experiment. Disialoganglioside GD1b increased the amplitude of the summary cellular response to a lesser degree than GM1, but contributed to its conservation up the control level in the course of the whole recording period. Gangliosides GD1a and GT1b induced inhibitory action on LPTP decreasing population spike value lower than that of both the control and initial levels, GT1b causing more rapid decrease of amplitudes of cellular responses than GD1a. A conclusion was drawn on the participation of gangliosides in the mechanisms of synaptic plasticity. The differential influence of various kinds of gangliosides on the LPTP dynamics was found out. The possible mechanisms of these reactions are discussed.


[The effect of acute alcoholization on the neuronal activity of the normal ventromedial hypothalamus and in pharmacological actions on the brain monoaminergic and opiate systems]. In experiments on white outbred male rats the specificity was studied of the influence and mechanisms of action of acute alcoholization (30%-solution of ethanol, intraperitoneally, 0.7 g/kg) on the activity of functionally different neurones of the ventromedial hypothalamus. Experimental results showed that the neurones, the activity of which lowered after saturation (I-st type), increased the discharges frequency at administration of ethanol. Nerve cells, the activity of which increased (II-nd type) and did not change (III-nd type) after saturation, had inhibitory character of reaction in response to alcoholization. The increase of serotonin content in the brain elicited by intraperitoneal administration of 5-OTPh (50 mg/kg) blockaded the action of ethanol on the nerve cells of the I-st type and did not change the effect of the alcohol on the neurones of the II-nd and III-nd types. Preliminary lowering of the noradrenaline level in the brain (disulphiram, intraperitoneally, 100 mg/kg) and blockade of opiate receptors (nalorphine, 5 mg/kg) fully eliminated ethanol influence on the activity of all types of neurones.


[The comparative action of relanium and oxytocin on higher nervous activity in lower monkeys]. Effects of relanium and oxytocin on higher nervous activity was studied in four rhesus monkeys (Macaca mulatta) and two baboons (Papio hamadryas). During observation of the animals in enclosure tranquilizing effect was seen only after relanium administration. Under the same conditions oxytocin practically did not change the general behaviour pattern of monkeys. However, steady behavioural transformations were observed under the conditions of competitive food-procuring behaviour and during the operant goal-directed reaction. Decreasing aggressiveness of dominants oxytocin in contrast to relanium had no negative effect upon their general motor activity and sensory perception. Differences in effects of the tranquilizer and the peptide were seen also at the unit activity level of the neurons. The first drug lowered the unit activity level and the degree of the functional connections in neuronal populations in a number of cortical structures. Administration of the second one led to selective shifts of the unit activity mainly in the frontal cortex of the monkeys.


[The behavioral and biochemical sequelae of the removal of the olfactory bulbs in C57Bl/6j mice]. Ablation of the olfactory bulbs in mice C57Bl/6j was accompanied by motor and orienting-exploratory activity augmentation in the "open field" test and deterioration of the learning ability to active and passive avoidance. The most expressed behavioural changes developed in four weeks after the surgery. Chronic administration of antidepressants (amitriptyline, 20 mg/kg; trazodone, 20 mg/kg; imipramine, 10 mg/kg; intraperitoneally) normalized behaviour of bulbectomized animals, trazodone being the most effective. In the biochemical studies the brainstem serotonin level was found to be decreased and the density of 5HT2-receptors in the cerebral cortex increased in bulbectomized mice. Only trazodone was able to correct the biochemical indices. The state of the bulbectomized mice is supposed to serve a model of a depression with hypo-function of serotonergic system of the brain.


[Conditioned-reflex activation of electrical self-stimulation of the brain: a model of a situational craving for narcotics]. Rats with electrodes implanted into lateral hypothalamus were trained to press a lever to obtain electrical stimulation of the brain. After elaboration of self-stimulation (SS) conditioning of morphine-induced activation of SS-response was carried out. Five pairings were performed of morphine (3 mg/kg, i.p.) administration and SS in the box with distinct environmental cues (brightness, color, floor texture, background noise). After morphine withdrawal activation of SS was reproduced after simple placing of the animal in "conditioned" chamber. This effect was naloxone-sensitive. The observed effect is considered to be the adequate model of addictive substances craving.


The sequence of an 8 kb segment on the left arm of chromosome II from Saccharomyces cerevisiae identifies five new open reading frames of unknown functions, two tRNA genes and two transposable elements. The DNA sequence of an 8079 bp ClaI fragment located at 40 kb from the centromere on the left arm of chromosome II from Saccharomyces cerevisiae has been determined. Sequence analysis reveals five new open reading frames, tRNA(Gly) and tRNA(Leu) genes as well as sigma and truncated delta elements. The disruption of the three larger open reading frames shows that they are not essential for mitotic growth.


Efficient electropulse transformation of intact Candida maltosa cells by different homologous vector plasmids. Conditions for efficient and quick transformation by electroporation were developed in Candida maltosa. To investigate the efficiency of transformation with integrative as well as with autonomously replicating plasmids, a series of vectors was constructed for homologous transformation of this species. Transformants were obtained with different plasmids as covalently closed circular molecules and as linearized DNA. The influence of recipient strain and plasmid type as well as of cell number and parameters of the supplied electrical pulse on the transformation efficiency have been investigated. A maximum of 7000 transformants per 100 ng of plasmid DNA was reached. The efficiency of transformation was compared with that of the LiCl method.


Nucleotide sequence of 9.2 kb left of CRY1 on yeast chromosome III from strain AB972: evidence for a Ty insertion and functional analysis of open reading frame YCR28. We report the 9210 bp sequence from a segment of yeast chromosome III cloned from strain AB972 in lambda PM3270. Analysis of this sequence and its comparison with the one derived from the corresponding segment of strain XJ24-24A revealed that the AB972 region contains a duplication of about 2 kb and a Ty element, which are not found in XJ24-24A and cause a quite significant rearrangement of the whole region. We performed functional analysis of YCR28, the largest open reading frame we found in both AB972 and XJ24-24A. YCR28 encodes a putative protein of 512 amino acids with some similarities to yeast allontoate permease. Its disruption does not cause any detectable phenotype on rich medium or on allantoate medium, while we observed a strain-dependent effect on sensitivity to amino acid balance and to 3-aminotriazole, when cells were grown in synthetic medium.


[The electrophoretic typing of rotaviruses in the clinico-epidemiological study of infection]. The electrophoretic study of the RNA of human rotavirus strains (1146 strains) circulating in 9 cities at the territory of the European part of the RSFSR was carried out. The electrophoretic (EP) types of rotavirus were established in each individual area. The study revealed that the most widespread rotaviruses responsible for the majority of gastroenteritis cases are those with the long EP type of RNA, characterized by the joint migration of segments 2, 3 and 7 (the 3rd EP type of RNA). Rotaviruses with the 3rd EP type of RNA much more often induce a severe course of rotavirus gastroenteritis in children aged 8 months to 3 years.


[The effect of acute alcohol administration on auditory evoked potentials in altricial nestlings during the development of natural behavior]. Acute ethanol influence on field L auditory evoked potentials (AEP) was studied in 4-8-days-old altricial nestlings of pied flycatcher. Nestlings were presented with tone pips related with the realization of natural behaviour (2.0 and 5.0 kHz) and bearing no meaning for the behaviour of the young of the age under study (3.0 kHz). Ethanol ingestion was found to reduce the maturity index (MI) of AEP in response to "behavioural" but not to control frequencies; this effect was first observed at day 5, when nestlings eyes opened and defence behaviour appeared, while previously formed feeding behaviour was significantly modified. During the next 2 days alcohol had a greater effect upon the AEP in response to 2.0 kHz tone pips, related with feeding behaviour of increasing complexity than upon the AEP in response to 5.0 kHz, related with the defence behaviour that remained relatively constant. The previous data concerning the effect of alcohol on unit activity are used to support the view that MI increase during the early postembryonic ontogeny is due to the involvement of neurons with newly formed behavioural specializations into the subserving of new behavioural patterns while the decrease of MI under alcohol is due to the depression of activity in these neurons.


[The effect of prolonged ethanol consumption on the physiological status and changes in brain peptidase activity of muricidal (aggressive) rats]. Muricidal and non-muricidal Wistar rats were studied regarding the changes of the body weight, the volume of the liquid intake, the sensitivity threshold to electrical shock, horizontal and vertical locomotor activity during 40-days period of 20% ethanol consumption. The transition to the situation of "choice" (water and/or ethanol) was accompanied by a division of the animals into two groups: "water preferring" and "ethanol-preferring" rats. The angiotensin-converting enzyme and enkephalin-forming carboxypeptidase H activity in different brain regions, hypophysis and peripheral tissues, were defined. The results allow one to conclude that neurochemical mechanisms underlying aggressive behavior (muricidity) and alcohol addiction have originally distinct nature.


[The clinical variants of psychosomatic pathology of the gastrointestinal tract]. Clinico-dynamic and experimental pathological methods were used to examine 650 patients with functional and organic psychosomatoses of the gastrointestinal tract. In the psychosomatic process, four stages were distinguished and described: reactive depression, psychosomatic reactions, formation of the psychosomatic cycles, and characteristic changes. Examination of the given pathology in the log demonstrates that psychosomatoses of the gastrointestinal tract (functional ones in particular) lead to the so-called psychosomatic development of the personality, fairly close to the neurotic development pattern.


[The clinical picture and treatment of chronic inflammatory demyelinating polyradiculoneuropathy]. A study was made of the clinical and electrophysiological data on 33 patients. In all the patients, motor disorders played the leading part. 18 patients manifested distal tetraparesis, 7 diffuse, 3 tetraplegia, and 5 had multiple mononeuropathy. The progressive, recurrent and monophasic types of the disease course were distinguished. The electrophysiological study revealed pathology primarily in muscles of the distal parts of the limbs and local areas of the blocking of excitation conduction in different nerves. The prognosis and treatment of the patients with glucocorticoids, cytostatics and plasmapheresis are under discussion. The catamnesis is 5 years.


[The treatment of the pain syndrome in spinal osteochondrosis]. A method of the treatment of the painful syndrome in spinal osteochondrosis is suggested. It lies in the action on functionally significant points specific for each level of injury. To establish blockades, use is made of the preparations on the basis of snake venom, administered intracutaneously or of nitrous oxide injected subcutaneously. Blockades are made once every 4 days. In the majority of cases, the beneficial effect was attained after 1 to 3 sessions. The maximum number of blockades was 6-7 in patients with a severe pattern of the painful syndrome. Out of 240 patients with spinal osteochondrosis, good clinical effect was achieved in 237 patients. The time of the patients' stay at the hospital reduced from 31.5 to 12-18 bed days. The high efficacy of the method suggested, simplicity of performance and minimal expenditures permit recommending it as one of the methods for the treatment of the painful syndrome associated with spinal osteochondrosis.


[The physiotherapy of patients with lumbar spinal osteochondrosis in the early period after surgical treatment]. Altogether 130 patients with associated lumbar spinal osteochondrosis and the radicular syndrome were placed under observation after operation in the form of laminectomy and removal of hernia of intervertebral discs. On days 2-3 after the operation the patients were given different physiotherapy modalities: sinusoidal modulated currents (SMC), electroacupuncture by sinusoidal modulated currents (EAP) and acupuncture (AP). The control group patients were administered conventional drug therapy. According to the data on the disease clinical picture and the rate of impulse conduction in the motor nerve, the treatment efficacy was higher in patients on physiotherapy as compared to the controls. In patients with the predominance of the painful syndrome, EAP and AP were most effective; EAP was most effective in associated pains and motor losses; SMC appeared effective in isolated motor disorders. The drugs slightly reduced the pains but did not recover motor function.


[The rehabilitation of patients with neurological manifestations of lumbar osteochondrosis under outpatient conditions]. Computer was used to analyze the data on 226 patients with neurological manifestations of lumbar osteochondrosis, who completed the course of rehabilitation treatment at the outpatient center of industrial rehabilitation in Nizhni Novgorod. The authors provide the mean times, cost and outcomes of rehabilitation in groups of patients with different clinical syndromes. Specify indications for the rehabilitation course in a specialized institution for rehabilitation treatment. Analyze errors made in the referral of outpatients to the rehabilitation center.


[The differential diagnosis of lesions of the rotator cuff and of neurological disorders in the shoulder joint area]. Lesions of the rotating cuff is a most frequent cause of disorders in the shoulder joint. However, they are frequently misdiagnosed and their manifestations use to be considered as those of scapulohumeral periarthritis, cervical osteochondrosis, or even brachial plexus palsy. The paper deals with symptoms and signs of rotating cuff lesions that are fairly different from those of the conditions above cited. It is emphasized that the deltoid muscle palsy cannot result in a permanent loss or restriction of active elevation of the arm when the function of the rotating cuff remains undisturbed. 16 patients with ruptures of the rotating cuff and simultaneous axillary palsy (11 cases) or Erb-Duchenne paralysis (5 cases) were successfully operated on by the author. Experience gained with treating lesions of the rotating cuff including surgical repair of the cuff in the above-mentioned cases permitted drawing a table of the differential diagnosis of rotatory cuff lesions and certain neurological and neurodystrophic lesions in the shoulder joint as well as specifying the identification of the level of brachial plexus lesion.


[The assessment of autonomic nervous system function in women with degenerative pathology of the hand]. An all-round study was made of the function of the vegetative tone, responsiveness and supply of the parts of the autonomic nervous system in women with degenerative hand pathology. As compared with the control group, serious disorders were detected in all the parts and properties of the system. The conclusion is made that these mechanisms are implicated in the development of the disease group under study.


[Iatrogenic injuries of the peripheral nerves]. Among 388 patients with mononeuropathies staying at the neurosurgical department, lesions of the nerves in 47 were induced by treatment manipulations. This group of iatrogenic neuropathies was made up of 15 cases of injection neuropathies, 19 cases of postoperative and 13 cases of positional end compression neuropathies. 39 patients were operated on. The interval from the development of neuropathy to operation ranged from 1 month to 15 years and constituted 23.7 months on the average. Complete convalescence was recorded in 13 operated patients, improvement in 22; 4 patients manifested no changes.


[Infantile facioscapulohumeral muscular dystrophy]. The authors describe a 16-year-old patient suffering from facial scapulohumeral myopathy. The given case is regarded as sporadic. The disease was characterized by an early debut and rapid progression of neuromuscular disorders. Marked myasthenia and muscular atrophy of the face, shoulders, thighs, as well as contractures in the knee joints, hands and feet were noted. By 15 years the patient demonstrated a noticeable progress of motor disorders: she was unable to stand up from the chair, experienced difficulties in walking along the ward, and had a waddle gait. The given symptom-complex corresponds with the infantile variety of facial scapulohumeral myodystrophy.


[Computed tomography in the neurological syndromes of spinal osteochondrosis]. Clinical and computer-aided comparisons were made in 96 patients with different neurological manifestations of lumbar osteochondrosis. In the majority of cases, definite correlations were established between the intensity of the clinical symptoms and the degree of disc prolapse. The above correlations were not absolute, which was documented by the catamnesis of certain patients who, at different times, developed neurological symptoms, different in character and intensity, of disc prolapse invariability. The data obtained allowed a conclusion that computer-aided tomography of the spine may appear of the greatest value if there is a necessity of making differential diagnosis with oncological pathology and in cases of the assumed surgical treatment of vertebral osteochondrosis to reveal details of degenerative and dystrophic alterations at the appropriate level.


[The effect of osteochin on the dynamics of the course of the myodystrophic process]. Osteochin (Quinoin, Hungary) efficacy was studied in the treatment of 20 patients with Duchenne's progressive myodystrophy. The drug was administered in a dose of 200 mg a day for a month. A favorable effect of such therapy was observed in all the patients. Osteochin was found to have a correcting effect on Ca-regulating hormone function and to promote stabilization of the myodystrophic process.


[Familial neuralgic amyotrophy].

[Familial neuralgic amyotrophy]. The authors provide the reported data concerned with differential diagnosis of hereditary and sporadic neuralgic amyotrophy. Describe own observations where members of the same family (mother and son) suffered from neuralgic amyotrophy. Attention is concentrated on the fact that in both cases, the disease started at the preschool age and was of recurrent nature. In the mother, an attack of neuralgic amyotrophy occurred in the postnatal period, in the son, successive exacerbation of the disease occurred in the form of 4 consecutive attacks of neuralgic amyotrophy which provoked deep paresis of the muscles of the shoulder girdle and both hands. After 1.5 years the muscles indicated practically regained their power.


[Autonomic disorders in Charcot-Marie neural amyotrophy]. The paper is concerned with disorders of the autonomic nervous system (ANS) in Charcot-Marie amyotrophy. 32 patients were examined. Of these, 21 suffered from the demyelinizing type of the disease and 11 from the axonal one. The status of the peripheral part of the ANS was estimated in the cardiovascular and in the respiration systems as well as in the system of pupil innervation. The patients were distributed into groups with the above-mentioned disease types on the basis of the electroneuromyography data. The relationship was demonstrated between the intensity of vegetative disorders and the genetically determined type of nerve fiber injury--myelinopathy and axonopathy. In the axonal form of Charcot-Marie amyotrophy, the involvement of vegetative fibers into the pathological process was appreciably higher than in the demyelinizing type.


[Nonspecific resistance and the immunological indices in brain contusion]. As many as 55 healthy persons and 69 victims with brain contusion of medium and severe degree were examined. Inhibition of cellular immunologic reactions and attenuation of nonspecific resistance as well as increase of immunoglobulins, immune complexes and cerebral antibodies were revealed. These changes were found to be more pronounced in a severe brain contusion.


[The comprehensive diagnosis of patients with the sequelae of a brain concussion]. As many as 140 patients aged 16 to 75 years with a history of brain concussion were under observation. The observation periods were from 1 to 2 months after the acute period elapse up to 25 years. In addition to neurological examinations, the patients were subjected to echoencephalography, computer-aided tomography of the brain (38 patients), ultrasound tomoscopy of the brain (40 patients and 30 healthy subjects). It has been shown that the use of echoencephalography, computer-aided tomography and ultrasound tomoscopy of the brain makes it possible to identify, in some cases, different disorders on the part of the brain. The role of these methods in the diagnosis of brain concussion consequences increases, provided they are used combined or jointly with the data obtained during clinical examination and observation.


[The clinico-pathophysiological characteristics and functional diagnostic significance of disorders in general sensitivity in patients with an acute myocardial infarct]. Based on the results of a comprehensive investigation of superficial, deep and complex types of sensitivity, certain vegetative functions and the kallikrein-kinin system in patients with acute myocardial infarction (MI) at different stages of the disease, it has been shown that Zakhar'in-Head areas for the heart reflect the status of the sensor system only partially in the pathology under consideration. Correlations were established between disturbances in sensitivity and the course of MI, its clinical versions, complications and blood serum kinin content. According to the authors, the paper is concerned with sensor manifestations of the new (cardial) type of the reactive vegetative syndrome.


[The evaluation of the vasomotor cerebrovascular action of vasoactive substances by using gamma scintigraphy]. A method of assessing relative changes in the head blood content under the influence of medicines is described. The method is based on an analysis of deviations of the equilibrium part of the radioactivity curve recorded with the aid of gamma-scintigraphy and injection in the form of bolus of the radiopharmaceutical agent 99mTc-pertechnetate to the ulnar vein. Changes in the blood content under the influence of nitroglycerin, duzodril, adalate and cavinton were examined in 37 patients suffering from dyscirculatory encephalopathy.


[The trigger role of the left cerebral hemisphere in generalizing epileptic activity]. Overall 593 epileptic patients with left hemispheral lateralization of the focus and 46 patients with primary generalized epilepsy were examined. EEG and computerized mapping of cortical biopotentials were used. It has been shown that in right-handed patients, the left hemisphere triggers epileptogenesis whatever the site of the source of epileptic activity. The mechanism by which epileptogenesis is triggered includes the posterotemporal and central cortical areas of the left hemisphere.


[The psychopathology and clinical picture of schizophrenia with a course of paroxysmal and paroxysm-like disorders]. Overall 70 patients suffering from attack-like progressive schizophrenia associated with paroxysmal and paroxysm-like disorders were examined. The clinico-psychopathological aspects of the disease were many and varied. The common signs of the disease included the presence of affective disorders, their considerable portion among other psychopathological manifestations. The dynamics of affective disorders specified in many respects the common character of the disease and the degree of the process progression and, in many cases, it tended to the formation of affective continuity. The common characteristics of the disease also included the presence of early disease signs which occurred long before manifest features, i.e. since the very childhood. The study of the structure of paroxysmal and paroxysm-like conditions revealed their diversity and certain specificities as compared with analogous paroxysms seen in the clinical picture of epilepsy. In addition to the clinical and psychopathological characteristics and the dynamics of personality disorders, this will provide evidence in favour of a special variant of the endogenous process.


[The psychopathological and clinical characteristics of paroxysmal and paroxysm-like states in the course of attack-like progressive schizophrenia]. The author presents the results of examining 70 patients with attack-like progressive schizophrenia. The clinical picture of the disease was characterized by the combination of endogenous disorders and paroxysmal and paroxysm-like disturbances. The study of the structure of paroxysmal and paroxysm-like conditions revealed their diversity and certain specific features as compared to analogous paroxysms seen in the clinical picture of epilepsy. In addition to the clinical and psychopathological characteristics, the dynamics of personality disorders, this study may provide evidence in favour of a special variant of the endogenous process and will make it possible to provide more well-defined criteria, on the basis of which one can differentiate the character of paroxysmal and paroxysm-like conditions.


[The clinical and forensic psychiatric assessment of attack-like progressive schizophrenia with the Kandinsky-Clérambault syndrome]. Overall 200 patients suffering from attack-like progressive schizophrenia associated with Kandinsky-Clérambault syndrome were examined. All the patients underwent compulsory treatment at the psychiatric hospitals. Two varieties of schizophrenia associated with Kandinsky-Clérambault syndrome were distinguished: psychotic (127 persons) and psychopath-like (73 persons). The psychotic variety is characterized by the growth of personality disintegration because of changes to a greater degree in the thinking sphere, whereas the psychopath-like variety is marked by alterations in the affective volitional sphere. The psychopathological mechanisms of socially dangerous action of the patients at the preproductive and productive stages of endogenous process are described depending on the varieties distinguished.


[The therapy of severe forms of acute polyradiculoneuritis: corticosteroids, plasmapheresis or their combination?]. A comparative examination was made of 62 patients with acute polyradiculoneuritis using hormonal therapy (HT), plasmapheresis (PA), their combination (HTPA) and maintenance therapy (MT). All the patients were distributed into 2 groups: group A (requiring artificial ventilation of the lungs--AVL) and group B (incapable of moving). Group A consisted of subgroups HT; HTPA; PA. Group B consisted of subgroups HT; MT; PA. The hormones (prednisolone or metipred) were applied in the doses 1 mg/kg according to the regressing scheme. The duration of AVL, the rate of the recovery of walking to the distance over 5 m both with and without support appeared in group A significantly higher (by 2-2.5 times), using PA alone. The analogous results were obtained in group B. At the same time, no significant differences were discovered between subgroups HT and HTPA (group A) and HT and MT (group B). It is recommended that MT be used in severe forms of acute polyradiculoneuritis in the stage of the increment of the neurological symptomatology. The volumes should not be less than 35-40 ml plasma/kg per operation and 120-160 ml plasma/kg per treatment course. The hormones may exert a "smoothing" action on the efficacy of PA.


[The clinical characteristics of schizophrenia and acute alcoholic hallucinosis occurring with psychopathological phenomena of a homosexual content]. Based on clinico-psychopathological and catamnestic examinations of 118 patients, the authors studied and compared the characteristics of the clinical picture, dynamics and outcome of schizophrenia and acute alcoholic hallucinosis associated with delirious, hallucinatory and pseudohallucinatory disorders of homosexual nature. Base the prognostic importance of psychopathological phenomena of homosexual nature in patients with schizophrenia and acute alcoholic hallucinosis. The rise in the clinical picture of schizophrenia and acute alcoholic hallucinosis of the portion of psychopathological phenomena of homosexual nature, not entering the number of permanent and necessary manifestations of the indicated clinico-nosological forms of psychoses, occurring, however, in the rudimentary form may be viewed as a manifestation of pathomorphism. It has been demonstrated that if schizophrenia and acute alcoholic hallucinosis are associated with psychopathological phenomena of homosexual nature, this may enhance the risk of the committing by the patients of grave aggressive and suicidal actions.


[An experimental psychological study of the changes in mental activity in schizophrenia with different types of defect]. The paper is concerned with experimental psychological studies of disorders in certain parameters of mental activity within the structure of the pathopsychological syndrome in schizophrenic patients with partial and total types defect. The data obtained attest to different determining factors that lie at the basis of the studied types of defect conditions in schizophrenic patients and can be used in the elaboration of psychocorrective recommendations.


[The place of pyrogen therapy in the modern treatment of schizophrenia patients]. The author analyses experience gained with the use of the pyrogenic drugs sulfazin and pyrogenal in the treatment of schizophrenic patients. Pyrogenal and sulfazin were administered to 26 patients with different forms of schizophrenia to overcome psychopharmacotherapeutic resistance and to 11 patients to enhance the sensitivity to insulin during insulin coma therapy. Based on the clinical analysis the author demonstrates the efficacy of the use of the pyrogenic drugs, particularly pyrogenal, in schizophrenic patients in order to overcome the resistance to pharmacotherapy and insulin.


[A comparative clinico-economic study of 2 models of organizational forms of psychiatric care exemplified in schizophrenia]. The authors describe part of the results of a comparative clinico-economic analysis of the functioning of two models of organizational forms of psychiatric services with special reference to Moscow and Kaluga. The purpose of the given research fragment was to make a comparative analysis of expenditures on schizophrenic patients depending on the system of psychiatric services organization on the whole and between different types of services; to specify approaches to optimization of their functioning with the use of a clinico-economic approach. Based on a comparative investigation of the representative groups of schizophrenic patients (386 patients of a mental health center in Moscow and 531 patients of the Kaluga regional psychiatric hospital No. 1), it has been established that as a result of the proper organization and financing of psychiatric services in Kaluga, the "direct" expenditures on one schizophrenic patient per year could be 20% as reduced and the losses of the national income could be lowered more than 2-fold. It should necessarily be mentioned that the financing of extra hospital services in Kaluga exceeded that in Moscow more than 3-fold, reaching about 20.3% of all the expenditures on schizophrenic patients. Apparently, the organizational and financial experience gained in Kaluga with the design of the common complex and many-staged system of psychiatric services may turn fairly instrumental in elaborating approaches to optimization of the functioning of psychiatric services.


[The comparative results of a clinico-economic and socioeconomic study of 2 populations of schizophrenic patients under different organizational forms of psychiatric care]. The paper is a fragment of a comparative clinico-economic study of two models of organizational forms of psychiatric services in Moscow and Kaluga with special reference to schizophrenic patients (386 and 531 patients, respectively). The authors describe the results of computing expenditures on patients depending on the sex, age, disease pattern and social factors including educational and skill levels, family status, and family structure. The values of "direct" and "indirect" expenditures on schizophrenic patients are fairly variable. There are definite significant relationships between the magnitude of these expenditures and clinico-psychopathological and social factors as is their certain stability in both patients' populations examined. The adequately designed psychiatric services, scientifically based financing of the appropriate treatment and social rehabilitation programs may have a noticeable effect on the magnitude and character of losses on the part of the state, connected with schizophrenic patients, decrease expenditures on them as well as markedly improve their social functioning.


[The correlation of endogenous and exogenous factors in the occurrence and course of mental disorders in cerebral atherosclerosis]. The influences of endogenous factors (sex, age, premorbid personality traits, heredity) and exogenous factors (somatogenias, cranial injuries and neuroinfections, intoxications, psychogenias) on the origin and course of psychotic syndromes and dementia were regarded on the basis of clinical and epidemiological studies carried out in 523 patients with cerebral atherosclerosis. The leading risk factors were established for each form of mental disorders due to cerebral atherosclerosis.


[Deviant adolescent behavior in the early stages of the abuse of toxic substances and alcohol]. A study was made of the deviant behavior of 56 adolescents of both sexes with early forms of abusing toxic substances and alcohol. Both quantitative growth of the delinquent and criminal behavior with abstinence appearance and changes in the structure of the deviant behavior related to the adolescents' sex were recorded. Girls with certain forms of abuse characterized by psychic dependence showed up a rise of sexual deviations and autoaggressive manifestations. It is assumed that in aggravation of the deviant behavior structure, of importance is the constitutional and biological factor of organic deficiency of the brain.


Transluminal coronary balloon angioplasty: a useful therapeutic modality in octogenarian patients with severe angina. In this study, the immediate and short-term outcome of 9 consecutive patients aged 80 years or older undergoing percutaneous transluminal coronary angioplasty (PTCA) are reported. Of these 9 patients, 8, despite optimal medical therapy, had unstable Class IV anginal symptoms and 6 had multivessel coronary artery disease. Primary success at PTCA (successful dilation of all attempted lesions without any complications) was achieved in 8 of the 9 (89%) patients. The one patient with unsuccessful PTCA had subsequent successful elective coronary bypass graft surgery. The 8 patients with primary success at PTCA have been followed up for a mean of 27 +/- 15 (range: 6 to 45) months. During follow-up, no patient died, required a further revascularization procedure or had a myocardial infarction. Indeed, 7 of these 8 patients have, following PTCA, remained entirely asymptomatic with no decrease in their activity level. Angina has recurred in 1 patient but it is mild and does not restrict his activities. Based on our encouraging experience we suggest that PTCA should be considered favourably in the treatment of selected octogenarian patients with severe angina poorly controlled by medical therapy.


Thoracoscopic lung biopsy in interstitial lung disease. Thoracoscopic lung biopsy has been proposed as an alternative to open lung biopsy for the diagnosis of interstitial lung disease. We performed thoracoscopic lung biopsy under local anesthesia and diathermic coagulation in 33 non-immunocompromised patients with interstitial lung disease. A diagnosis was obtained in all patients. No severe complication was observed. The average time of drainage was 4 days. We confirm that this technique has advantages compared to open lung biopsy.


Large cell anaplastic lymphoma (Ki-1 lymphoma). The "large cell anaplastic lymphoma, Ki-1 positive" is a recently described lymphoma subtype (about 1-8% of all NHL). Distinction from Hodgkin's disease and true histiocytic lymphoma/malignant histiocytosis is not always possible, even by experienced pathologists. It was recently incorporated in the updated Kiel Classification of lymphomas. Classical histologic appearance is a sinusoidal growth pattern in lymph nodes and presence of large bizarre anaplastic cells. Use of cell markers LCA, EMA and Ki-1 or Ber-H2 is essential for diagnosis. The mean age of patients is 50 years. Approximately 50% of patients have an advanced stage (III-IV). Prognosis depends on age and tumor localisations. Cutaneous involvement only is usually associated with a good prognosis. Median survival for patients with extra-cutaneous disease is 13 months. Treatment with intensive chemotherapy is usually needed. Long term remissions are more frequently seen in children and adolescents.


[Tamoxifen in breast cancer: viewpoint of the gynecologist]. It is well established that Tamoxifen is an excellent adjuvant therapy in cases of breast cancer, with very few side effects. After menopause this drug can act as a weak estrogen at the level of the genital tract and cases of endometrial hyperplasia and adenocarcinomas have been reported. During premenopausal years its action depends on the mode of administration:continue or cyclical, during proliferative or luteal phase. The occurrence of ovarian cysts seems more frequent than in a control group. It should thus be advised to consider Tamoxifen as a good antioestrogen at the level of the breast but as an active hormonal substance at the gynaecological level, and to offer the patient the adequate follow-up which seems necessary.


[Extracorporeal gallbladder lithotripsy: technology, practical methods, results and current value]. Extracorporeal shock wave lithotripsy of gallstones is a safe and well-tolerated procedure. Patients are now treated without general anesthesia and, increasingly, on an outpatient basis. Skin petechiae and transient hematuria are the most common side effects. Episodes of biliary colic are common in the follow-up period, but more serious adverse side effects such as cholecystitis and pancreatitis are distinctly uncommon. It is estimated that only 15% to 20% of all patients with symptomatic cholelithiasis are suitable lithotripsy candidates. As our knowledge of the procedure grows, it seems clear that the best results are obtained in patients with solitary radiolucent stones less than or equal to 20 mm, with stone-free rates at 12 months above 80%, for this selected group of patients. Adjuvant oral bile-acid dissolution therapy should be used in conjunction with gallstone lithotripsy. Gallstone recurrence remains to be established by clinical studies. Therapy for gallstones in 1991 has to be reevaluated by an interdisciplinary approach, taking into account not only open cholecystectomy, but also other modalities such as medical dissolution, laparoscopic surgery, percutaneous cholecystolithotomy and extra-corporeal shock wave lithotripsy. The appeal of the laparoscopic approach will substantially reduce the pool of patients for lithotripsy. Nevertheless, lithotripsy will continue to be a viable treatment option for patients with a single radiolucent stone. It is an outpatient procedure and doesn't require any incision or general anesthesia.


Doxycycline and hepatotoxicity.

Doxycycline and hepatotoxicity. The hepatotoxicity of tetracyclines is well known. If microvesicular steatosis due to a high dose of tetracycline has virtually disappeared, it can also be observed with other drugs belonging to the tetracycline family. To our knowledge, hepatotoxicity induced by doxycycline has never been reported. In our patient, the abrupt onset of hepatic failure, five days after the start of doxycycline and the rapid normalization after the drug was stopped, leads to suspect a causal relationship between doxycycline and liver insufficiency. We must however be careful before concluding, because our patient received also acetylsalicylic acid and paracetamol, two other potential hepatotoxic drugs.


[Distomatosis of the bile ducts. Value of retrograde cholangiography. Efficacy of triclabendazole]. A case of chronic biliary fascioliasis is reported, which was confirmed by endoscopic retrograde cholangiography. After unsuccessful attempts of treatment with classic antiparasitic drugs, cure was obtained with triclabendazole the absorption of which was studied.


Low molecular weight heparin for thromboprophylaxis and epidural/spinal anaesthesia--is there a risk? This article reviews the problem of bleeding in connection with epidural/spinal anaesthesia, with special emphasis on the use of low molecular weight heparins for thromboprophylaxis. There are methodological difficulties to studying the problem in a scientifically correct way because of the rarity of the complication. However, from the data in the literature there are no indications of an increased risk in using the combination of low molecular weight heparin in prophylactic doses and epidural/spinal anaesthesia. So far, there is only a single case report, of spinal haematoma, although low molecular weight heparins have been used in combination with epidural/spinal anaesthesia in at least 1,000,000 patients. In controlled studies, at least 10,000 patients have been given the combination without complications.


Adrenaline absorption: effect of pH in mepivacaine and bupivacaine solutions. A clinical study during halothane anesthesia. The effect of the pH of the solution on the rate of absorption into the blood stream of locally-injected adrenaline using an adrenaline solution mixed with either mepivacaine or bupivacaine was investigated. Forty patients undergoing elective craniotomy received one of the following five solutions for subcutaneous and subgaleaic injection in the dose 0.5 ml/kg: 1) mepivacaine-adrenaline (pH = 6.1), 2) mepivacaine-adrenaline (pH = 7.5), 3) bupivacaine-adrenaline (pH = 6.1), 4) bupivacaine-adrenaline (pH = 7.4), or 5) adrenaline (pH = 6.1). Both mepivacaine and bupivacaine added to the adrenaline solution increased the plasma concentration of adrenaline. Alkalinization attenuated the peak concentration of adrenaline in the case of a mepivacaine-adrenaline solution, but not in the case of a bupivacaine-adrenaline solution.


Differential effect of pancuronium at the adductor pollicis, the first dorsal interosseous and the hypothenar muscles. An electromyographic and mechanomyographic dose-response study. Cumulative dose-response curves were constructed from evoked compound electromyographic (EMG) recordings in man to compare the sensitivity to pancuronium of the adductor pollicis, the hypothenar and the first dorsal interosseous muscles. Also, the EMG and mechanomyography-based sensitivity of the adductor pollicis muscle were compared. The EMG and the mechanomyogram were evaluated in random sequence in each of 21 adult thiopental, fentanyl and diazepam anesthetized patients. The EMG-based ED50 were 36-38 micrograms.kg-1 with no differences between muscles. The EMG-based ED90 of the adductor pollicis and the hypothenar muscles were 62-65 micrograms.kg-1 compared to the 60 micrograms.kg-1 of the first dorsal interosseous muscle (P < 0.05). ED50 (34 micrograms.kg-1), and ED90 (56 micrograms.kg-1) obtained from the adductor pollicis mechanomyogram were significantly lower than those based on the EMG (P < 0.05). It is concluded that differences in sensitivity to pancuronium exist between the three muscles when evaluated from the EMG, and that the apparent sensitivity of a given muscle to a muscle relaxant may depend upon whether the response is evaluated using EMG or mechanomyography.


Atracurium-induced neuromuscular block in the isolated arm. A modification of the isolated arm technique was applied in 10 females under opioid-based i.v. anaesthesia for comparison of the offset of an atracurium-induced neuromuscular block in an isolated arm to an arm with maintained circulation. The neuromuscular blocking effect of a bolus dose of atracurium 0.5 mg.kg-1 was measured bilaterally using the integrated adductor pollicis EMG response (integrated T1 EMG response in % of baseline value and T4/T1 ratio) after bilateral ulnar nerve train-of-four (TOF) stimulation. At 10% T1 recovery, one arm was isolated from the general circulation for 20 min by means of a tourniquet cuff (isolated arm), while normal circulation was maintained in the other arm (control arm). In both arms, the TOF response, peripheral skin temperature, mixed peripheral venous pH and plasma concentrations of atracurium and laudanosine were then measured and compared. Core and peripheral skin temperatures in both arms remained stable and normal throughout the study, and mixed peripheral venous pH stayed within physiological limits in both arms in all subjects. In the isolated arm, recovery of the neuromuscular block was markedly delayed compared to the control arm, the integrated EMG T1 response and TOF ratio being significantly reduced in the isolated arm after 20 min of isolation. The decline in plasma concentration of atracurium was less in the isolated arm than in the control arm, whereas laudanosine levels increased in the isolated and decreased in the control arm. Normal peripheral circulation is of major importance for termination of an atracurium-induced neuromuscular block.(ABSTRACT TRUNCATED AT 250 WORDS)


Clinical and pathophysiological aspects of neurological complications in renal failure. A review of the neurological complications presenting in uremia and an account of their presumed pathophysiology is given. With the introduction of different dialytic procedures during the last twenty years, the incidence and severity of neurological complications have declined. Nevertheless, some disturbances related to the uremic syndrome fail to respond to dialytic therapy and these therapeutic measures may even be responsible for the appearance of some new abnormalities. The clinical manifestations of uremic encephalopathy and polyneuropathy are presented. The review of the presumed pathophysiology of these syndromes illustrates the still existing controversies. Nevertheless, some promising new lines of research are reviewed. In addition, some complications of uremic treatment, including dialysis disequilibrium syndrome and dialysis encephalopathy are presented.


Epileptogenesis: contributions of calcium ions and antiepileptic calcium antagonists. The results demonstrate that organic calcium antagonists are able to reduce epileptic activity at the level of single neurons and of neuronal populations. This holds true also for human cortical tissue. Among other observations already published this justifies the hope that calcium antagonistic agents might be useful in the treatment of human epilepsies (28).


Intranuclear inclusions in paramyxovirus-induced encephalitis: evidence for altered nuclear body differentiation. Intranuclear inclusion bodies (INB) are frequently encountered in viral infections, where they are thought to be accumulations of viral particles. However, for RNA viruses replicating in the cytoplasm, this compartmentalization represents a paradox not consistent with the viral replication cycle. To define the basis for intranuclear paramyxoviral inclusion bodies in astrocytes, natural cases of canine distemper virus subacute encephalitis were examined by light and transmission electron microscopy, and by quantitative confocal immunofluorescence microscopy. Although INB were viral antigen positive, they were not composed of structurally recognizable paramyxoviral nucleocapsids. The structural basis for the INB was instead viral antigen-associated forms of nucleolar development known as nuclear bodies. Three variants of the light microscopic Cowdry type A INB were complex nuclear bodies, giant beaded nuclear bodies (sphaeridia), and nuclear body-associated granulofilamentous matrices. In the latter, the granulofilamentous matrix frequently filled the nucleus, resulting in a fourth morphological INB variant, and was associated with morphological evidence of nuclear degeneration. These findings suggest a novel mechanism of virus-induced cytopathology whereby intranuclear viral protein exerts deleterious effects upon nucleolar differentiation in infected cells and hence altered host cell RNA metabolism.


Ultrastructural and immunohistochemical studies on ballooned cortical neurons in Creutzfeldt-Jakob disease: expression of alpha B-crystallin, ubiquitin and stress-response protein 27. This report concerns ultrastructural and immunohistochemical studies on ballooned neurons of ten patients with Creutzfeldt-Jakob disease (CJD). While abundant ballooned neurons and severe white matter degeneration was seen in six Japanese cases, only occasional ballooned neurons and no white matter degeneration was observed in four cases from the files of Montefiore Medical Center. Ultrastructurally, the ballooned neurons contained granule-coated fibrils of 25 to 40 nm in width and 10-nm neurofilaments. The immunohistochemical studies revealed that most ballooned neurons expressed alpha B-crystallin, with deposits of reaction products observed in the cytoplasm. A similar intracellular staining pattern was also seen with the antibody to phosphorylated neurofilament proteins (pNFP). Although the proportion of stained ballooned neurons was less, a positive reaction was also observed with antibodies against ubiquitin, stress-response protein 27 (srp 27) and synaptophysin, but not with an antibody to srp 72. Our findings suggest that expression of pNFP and synaptophysin by ballooned neurons may reflect axonal impairment and that the presence of alpha B-crystallin, srp 27 and ubiquitin may be related to the degenerative processes that neurons undergo in CJD.


Immunohistochemical studies on the new type of astrocytic inclusions identified in a patient with brain malformation. Immunohistochemical studies were carried out on the new type of cerebral cortical astrocytic inclusions recently discovered in a 20-year-old patient with maldeveloped brain and micropolygyria. The inclusions appeared as eosinophilic structures (hematoxylin and eosin stain) and did not exhibit argyrophilia (modified Bielschowsky method). The inclusions were strongly stained by the antibody against S-100 protein (S 100) and to a lesser extent by the antibody to microtubule-associated protein 1B (MAP 1B). In contrast to Rosenthal fibers, the astrocytic inclusions did not react with antibodies to alpha B-crystallin, glial fibrillary acidic protein and ubiquitin. No positive reactions were obtained with antibodies against heat-shock protein 27 (HSP 27), HSP 72, actin, vimentin, desmin, cytokeratin, myelin basic protein, beta-tubulin, MAP 2, tau protein, paired helical filament, phosphorylated neurofilament protein (NFP), nonphosphorylated NFP, synaptophysin, cathepsin D, alpha 1-antichymotrypsin, alpha 1-antitrypsin and basic fibroblast growth factor. By immunoelectron microscopy, the products of the reaction with the anti-S 100 antibody appeared as heterogeneous granular deposits and with the antibody to MAP 1B they were randomly scattered throughout the astrocytic inclusions. Our results demonstrate that the immunohistochemical profile of the recently described inclusions differs from that of Rosenthal fibers. Whether the novel inclusions are involved in congenital astrocyte dysfunction and cerebral malformation remains to be established.


Effect of cortisol on the secretion of testosterone and estradiol-17 beta by human granulosa-luteal cell cultures. A model system for analyzing hormonal alterations in female athletes. The combination of hypercortisolism and usually low androgen and estrogen levels is frequently observed in female long distance athletes. In order to find a useful model system for studying the underlying mechanisms, the following studies were performed. The effect of cortisol on the secretion of testosterone (T) and estradiol-17 beta (E2) by human granulosa-luteal cells was studied in vitro in cultures of cells recovered from mature follicles of gonadotrophin stimulated women (participating in the IVF program). Following 24 hours of culture in tissue culture medium without hormonal additives, the granulosa-luteal cells were incubated for 6 hours in media with addition of 4-androstene-3,17-dione (A-4) as precursor and hMG and cortisol in different combinations. The secretion of T was significantly stimulated by cortisol but not by human menopausal gonadotrophin (hMG). Cortisol, but not hMG, also increased the secretion of E2, although this effect was not statistically significant. These in vitro findings make a direct effect of cortisol upon ovarian sex steroid secretion less likely as the mechanism behind the subnormal sex steroid levels in female long distance athletes. Instead, inadequate gonadotrophic stimulation, related to hypothalamic amenorrhea, and/or a selective decrease in the adrenal secretion of precursor steroids, may be an explanation.


A birthweight-for-gestation standard based on 4737 twins born in Sweden between 1983 and 1985. To construct a birthweight-for-gestation chart based on a population-based material of twins born during a restricted period of time. Nearly all live-born twins born in Sweden between 1983 and 1985, 4737 all told, were included. Excluded from the analysis were 4.7% of the twins that were not on record at the Medical Birth Registry, 1.8% that died before or during birth, and 8.8% that were without a recorded date of birth or only had information on gestational duration estimated from the first day of the last menstrual period. The standard deviation in birthweight was considerable in most gestational weeks; the range (+/- 2 SD) was 1000-3400 g even if exclusively twins (pregnancies) with estimated date of birth from ultrasound examination early in the second trimester were included. Intra-pair discordance increased with gestational duration, especially for unlike-sexed twins, to reach over 400 g at term. On average, boys weighed 92 g more than girls and twins to multiparae weighed 250 g more than twins to primiparae. Maternal age affected birthweight for twins to primiparae, but not to multiparae. Although the problems with secular trends in birthweight were avoided by using a population-based material during a restricted time period, and only twin pregnancies dated with ultrasound were included, the standard deviation in most gestational weeks was still considerable, reflecting the multiplicity of factors involved in determining the birthweight of twins.


An epidemiological study of obstetric ultrasound examinations in Denmark 1989-1990. To provide an epidemiological description of the use of ultrasound in obstetrics in Denmark and to analyse whether screening per se reduces the mean number of obstetric ultrasound examinations for all pregnant women. Questionnaire study based on hospital records and patient interviews. All Danish hospital departments with delivery services (n = 57). 2268 women who gave birth to a child in a two week period February 1990. The main findings of the study are: 1) Women with an offer of screening had a significantly higher mean number of obstetric ultrasound examinations during pregnancy (1.8) than women without (1.3), no matter at which type of department they had antenatal care and their delivery; 2) 45% of the women without an offer of screening had an ultrasound examination on indication in the interval of 14-20 weeks of gestation--at which time an examination may include what is performed at a screening examination and 3) The study shows great regional variations in the use of ultrasound in obstetrics. The results question the presumption that screening per se will reduce the mean number of ultrasound examinations during pregnancy.


Intervention during labor: risk factors associated with complete tear of the anal sphincter. Among 41,200 consecutive deliveries there were 152 cases of complete tear of the anal sphincter (complete tear). In a case-control design, the association between interventions during labor (forceps, vacuum extraction, use of oxytocin and prostaglandins and mediolateral episiotomy) and complete tear, were evaluated by confounder control using multiple logistic regression analysis. Controls chosen were the patients delivering just before and after the index patient with complete tear. Use of Kielland forceps, mediolateral episiotomy, shoulder dystocia and nulliparity were significantly associated with complete tear. Maternal age, presentation in labor, duration of second stage of labor and the indication for instrumental deliveries and episiotomy had no significant association with complete tear.


Vaginismus--iatrogenic precipitation and maintenance. Four cases of vaginismus are presented. Two of them illustrate an iatrogenic precipitation of vaginismus, one misdiagnosis of vaginismus, and one shows the use of unnecessary hymenectomy as the first choice of treatment of vaginismus. The etiology of vaginismus and the indications of first pelvic examinations are discussed.


An analysis of rapid pad testing and the history for the diagnosis of stress incontinence. Two rapid exercise pad tests, the vitamin B test, and the methylene blue test, are introduced for the diagnosis of urinary stress incontinence. The vitamin B test is entirely non-invasive, takes only a few minutes to perform, and is especially useful as an office test. The methylene blue test has fewer variables, and fits easily into a urodynamic routine. With the methylene blue test, a direct correlation was noted between amount of urine lost and pressure generated by the tests. This conforms to the definition of stress incontinence as a passive process. The sensitivity of the test in a group with mainly mixed symptoms was 89.5%, and the specificity 100%. The test is useful where objective diagnosis of stress incontinence is important. A group of 38 patients with a history (questionnaire) of stress incontinence exhibited a total of 105 positive individual symptoms out of a possible 228 symptoms (6 x 38), comprising a history of leaking at sneezing, coughing, exercise, laughing, walking, or bending. The individual symptoms were analyzed for accuracy and predictability by comparing them with six graded provocative exercises comprising a trampoline test, star jumps, coughing, stepping, bending and hand washing. The symptoms were graded into a hierarchy from the results. A history of stress incontinence was found to be an accurate determinant of stress incontinence, even in patients with mixed symptoms. This allows the questionnaire as presented to be used as a semiquantitative index for assessment purposes.


Urge incontinence history is an accurate predictor of urge incontinence. The reliability of urge symptoms associated with actual observed urine loss was tested using subtracted cystometry, and a hand-washing pad test in a total of 169 patients with urinary incontinence, 70 of whom had a prior history of urge incontinence. Our results showed: 1. that urodynamic or pad tests performed at a single point in time cannot retrospectively confirm a patient's past history of urge incontinence with any reliability; 2. a patient's history of urge incontinence is likely to be accurate.


Detection of scar dehiscence at delivery in women with prior cesarean section. Transcervical examination of a prior cesarean scar after vaginal delivery is commonly advised. A retrospective study of 1023 parturients with prior cesarean delivery was undertaken, 475 of whom delivered vaginally. Thirteen cases of scar dehiscence were found at laparotomy, and only one case was discovered by transcervical examination. The value of routine postdelivery examination of uterine scar is doubtful.


Primary vulvar lymphoma presenting as a clitoral tumor. We report a case of malignant large cleaved cell vulvar lymphoma predominantly affecting the clitoris, in a 60 year-old woman. In a review of the literature, female genital tract lymphomas of vulvar location are exceptional. Histologically, these tumors must be differentiated from pseudolymphomatous lesions. In the present case (Stage IE), response to chemotherapy was good and the patient remains asymptomatic after three years of follow-up.


Acute hernia of Bochdalek during pregnancy. Hyperemesis for the first time in a third pregnancy? A rare case of a patient with right-sided diaphragmatic hernia during pregnancy is described. Knowledge of this disorder offers the possibility of early diagnosis on clinical, ultrasound, and radiographic criteria before serious complications develop. Operative correction must be performed, with timing dependent on clinical presentation and period of gestation.


An unusual uterine tumor resembling sex-cord-tumor of the ovary with papillomatous features. Immunohistochemical and electron microscopic observations. An unusual uterine tumor resembling a sex-cord-tumor of the ovary with papillomatous features is described. The tumor was polypoid and attached to the endometrium. Light microscopical immunohistochemical- and ultrastructural examinations gave support to an endometrial origin.


Benign abdominal multicystic mesothelioma. The benign abdominal multicystic mesothelioma is a rare disease. Usually a malignancy of the ovary is suspected prior to and during surgery. The histological diagnosis and the clinical course however are benign. Three cases are reported. Diagnosis, treatment and follow up are discussed.


Puerperal inversion of the uterus.

Puerperal inversion of the uterus. Puerperal inversion of the uterus is very rare but dramatic and life-threatening. Prompt treatment is necessary. A case is reported and the literature reviewed.


Pre-term delivery and the growth of the eye. An oculometric study of eye size around term-time. Refraction and axial eye dimensions, evaluated by ultrasound measurements, were investigated in 101 pre-term infants and 25 full-term controls. Gestational ages in the pre-term group ranged from 25 to 34 weeks, birth weights from 728 to 2480 g. All were seen in the eye clinic due to risk of developing retinopathy of prematurity. Age at examination was 36-54 weeks (gestational/conceptional) in the pre-terms and 37.3-50 weeks in the term infants. Adjusted to a 40 weeks axial length value (based on an assumed average eye elongation of 0.14 mm per week) the term-values were similar, 17.02 and 17.03 mm in the two groups. Within the premature group, however, the 40-week adjusted axial lengths were shorter, the shorter the gestational age. The study demonstrated more foetal anterior segment proportions, with flatter anterior chambers and thicker, more spheroid lenses in the preterm infants. Probably this explains the early preponderance of myopia in that group, at feature eventually to disappear, and not to be confused with myopia of prematurity. As compared to the full-terms a correlational disturbance by pre-term delivery was further indicated by the absence of the usual correlation between axial length and refractive value.


Capillary and cavernous hemangioma of the optic disc. Echographic and histological findings. The ultrasonography features of optic disc hemangioma have been described in various reports but the extreme rarity of this ocular tumour makes any univocal interpretation of echographic findings difficult. The two cases of hemangioma of the optic disc described here, one of capillary hemangioma and the other of cavernous hemangioma, presented different echographic patterns. In the capillary hemangioma B-scan showed a mass lesion with smooth anterior border, acoustic solidity and no choroidal excavation. With A-scan there was an initial high spike with low/medium internal reflectivity. In the cavernous hemangioma, B-scan showed an elevated dome-shaped mass, with an anechoic area inside, and no choroidal excavation. With A-scan there was a high initial spike and irregular reflectivity. The eyes were enucleated for intractable neovascular glaucoma. Histological examination of the lesion explained the different echographic patterns. Ultrasonography is useful in the differential diagnosis of capillary and cavernous hemangioma.


Unusual echographic form of retinoblastoma. A case of an 8-year-old girl with unilateral retinoblastoma is presented. The clinical picture was dominated by inflammatory signs and retinal detachment. Ultrasonographic A/B-scan showed a funnel-shaped total retinal detachment and a thick solid mass with similar shape just behind it. The main characteristics of the mass were: irregular inside echo pattern, medium high internal reflectivity, no sign of vascularity, no after movements following a sudden ocular movement, and no shadowing of the scleral or orbital tissues behind it. The vitreous cavity in front of the retina and behind the mass was ultrasonographically clear. The described funnel-shaped echographic pattern might be typical of the diffuse infiltrating retinoblastoma.


An unusual ophthalmic tumour in a 5-year-old boy. A rare tumour in a 5-year-old boy is presented and discussed. In time and location the story had two parts (Fig. 1): 1) a conjunctival granuloma at the nasal limbus of the right eye was surgically removed. 2) a few months later a huge lesion presented in the posterior segment of the same eye. Was it an ocular tumour with extension to the orbit or an orbital process with impression or invasion of the eye? Repeated surgical biopsies have indicated nodular scleritis of the posterior eye segment as the definitive diagnosis.


The relation between the sagittal and transversal diameters in eyes with retinal detachment. Using A-mode ultrasonography, the axial length and the width (transversal or equatorial diameter) of both eyes--fellow and affected--have been measured in patients with retinal detachment. For comparison, the same measurements have been performed in healthy controls. The patients have been divided into different groups. It was found that there are some changes in the relation between the axial length and the width of the eyes in patients with retinal detachment, according to the comparison with healthy people, in most cases.


Sophisticated instrumentation and ophthalmic ultrasonography. Formerly, ophthalmic ultrasonography was leading in view of high-performance apparatuses and transducer probes: e.g., the first array-scanner in the world was built for ophthalmic use. Within the past 2 decades, however, high-tech innovations were merely developed for other medical specialties. These were studied in view of their use for ultrasonography of eye and orbit. The combination of B-scan and Doppler techniques facilitates detection of orbital vessels. The resolution of ophthalmic digital B-scan video images proved poorer than crt-B-scans. A digital memory, however, is advantageous. But one high-resolution crt-type B-scan needs more than one disc storage capacity. "Frontline digitalization" could help to reduce the amount of data. Array transducers are now available in small sizes and could better show structure movements, but they were not yet adapted to ophthalmic use. This applies as well to annular arrays and dynamic focusing. Different methods of 3-dimensional scanning and (Pseudo-) 3-dimensional imaging might renew Baum's and Coleman's early work.


Ultrasonographic three-dimensional scanning for determination of intraocular tumour volume. Important prognostic information may be gained from knowing the volume and the rate of growth of intraocular tumours, such as choroidal melanomas. An ultrasonographic 3-D scanning system based on rotation of a commercial sector scanning transducer applied directly onto a closed eyelid was designed to measure such volume. Control of movement, data acquisition, and image analysis are accomplished by means of a microcomputer and application-specific software. The elapsed time for scanning and digitizing 20 cross-sectional images is about 1 sec. Outlines of specific structures are traced manually. The system var tested through repeated measurements of known volumes of meat. The mean variation coefficient of these measurements was 2.8%. The traced volumes were linearly dependent on gain setting of the system requiring a fixed setting for accurate estimates. The procedures of scanning and tracing contributed about equally to the total variance. This method allows repeatable, reliable, and easily generated quantitative measurements of volume with a great potential for use in the diagnosis of malignant tumours and control of the effectiveness of radiotherapy.


Echographic differentiation of intraocular melanomas by computer analysis. The aim of this study was to assess the differentiation of histologically different types of choroidal melanomas by means of clinical and quantitative acoustic/texture parameters of echograms. Clinical parameters were graded by morphological, kinetic and quantitative statements about the A- and B-mode echograms by a skilled diagnostician. Acoustic/texture parameters were obtained by processing and analysing radio frequency, AM-demodulated and FM-demodulated echograms. The latter data were preprocessed to remove influence induced by beam diffraction and focusing. The best set of four clinical echographic parameters enabled a retrospective classification of spindle type melanomas vs. mixed+epithelioid type melanomas with an accuracy of 77% (area under the ROC-curve of 86%). The discriminant analysis performed with the best four acoustic/texture parameters (n = 30) yielded a sensitivity of 89%, a specificity of 92%, and an area under the ROC-curve which corresponds to a probability of correct classification of 96.6%. When using these data prospectively to classify tumours of unknown cell type (n = 21), this classification could be performed in 86% of cases.


An application of ultrasonic tissue characterization to the diagnosis of cataract. From a therapeutic and pathological point of view, it is important to classify types of cataract and to identify their stages. However, accepted criteria for quantitative diagnosis have not been established. On the other hand, based on the experience from tissue characterization applied to other clinical fields, the attenuation characteristics of the lens are expected to change according to the stage of disease and the type of cataract. In this study from echo signals we tried to measure the attenuation coefficient of the lens with the purpose of quantitatively diagnosing the cataract, and at an early stage. It is shown that the attenuation of the cataractous lens is larger than that of the normal lens and its value depends on the type of the cataract, an indication of the possibility of using tissue characterization in the evaluation of cataract.


Computer simulations of ultrasonic heating for ocular therapy. Computer simulations are being performed to model the temperature patterns produced during ultrasonically induced hyperthermia of ocular tumours. The software package for these simulations incorporates operator interaction and uses tissue geometry obtained from B-mode data. Previous studies used geometric approximations for the incident beams used for hyperthermia. In the current study, these beams were computed using diffraction analysis to obtain more realistic simulations of clinical exposures.


Real-time sonography of orbital tumours, Colour Doppler characterization: initial experience. Fifty-seven patients with orbital tumours were examined with 3.5 MHz and 5 MHz real-time sector sonography. The lesions were evaluated for their echomorphology, relationship to anatomical structures of the orbit, and extra-orbital extension. Twenty-two patients were further evaluated by Colour Doppler Flow Imaging (CDFI). The lesions were located to four compartments, namely intraocular, intraconal, extraconal and extraorbital. An attempt was made to provide a histological diagnosis on the basis of clinical features and sonographic morphology. Colour Doppler flow patterns in 22 patients were correlated with the presumed or proven histological diagnosis in an attempt to detect and classify any specific patterns. Real-time US is an excellent screening procedure in the evaluation of orbital mass lesions. CT/MRI should be added in selected cases where extra-orbital extension requires evaluation. CDFI of tumours still being in its infancy it seems promising and may help in providing a more precise pre-operative histological diagnosis non-invasively.


Color Doppler imaging of the eye and orbit. A synopsis of a 400 case experience. Color Doppler imaging (CDI) is a recent advance in ultrasonography that allows simultaneous two-dimensional imaging of structure and blood flow. Doppler information is superimposed in color over a conventional gray-scale ultrasound image. Using this technique we have examined 400 eyes. The central retinal artery, posterior ciliary arteries, ophthalmic artery, the central retinal vein and the vortex veins could be located in all normal eyes. Using the color image as a guide, Doppler spectral analysis is used for quantitative assessment of blood flow velocity in these vessels. We also studied patients with intraocular tumors, arterial and venous retinal occlusions, orbital vascular anomalies and tumors. Color Doppler imaging is a new and promising modality for the study of ocular and orbital hemodynamics.


Colour Doppler flow imaging of the orbital veins. Experience is given from 79 orbital lesions examined by Colour Doppler Flow Imaging (CDFI) Dec. 1990 to Febr. 1992. We further examined 167 ocular tumours, or tumour-like lesions, and 32 ophthalmic cases groups as 'various'. Here, our experience is summarized concerning the flow patterns demonstrated in orbital veins, pathologic and normal. Adding dynamic and quantitative information to the clinical evaluation CDFI proved superior to conventional B- and A-mode echography. The method is essential in assessing and establishing the diagnosis of low flow dural malformations of the cavernous sinus. Pulsed Doppler appears helpful for the decision of therapy (embolization) and its optimum timing.


Diagnosis and treatment control of choroidal melanomas--the role of B-scan and Doppler-technique. B-scan guided pulsed Doppler ultrasonography was applied in 62 patients with unilateral malignant melanoma. Prior to radiotherapy Doppler frequency shifts were detected in all but one neoplasm. The average systolic tumour blood flow velocity was recorded as 18.8 +/- 7.6 cm/s. Frequency shifts after radiotherapy are described. Probably the methods will find a place in the evaluation of indeterminate fundus lesions and in the follow-up of irradiated ocular melanomas.


Estimation of blood flow in the carotid artery and intraorbital ophthalmic artery by color pulse Doppler ultrasonography. Blood flow velocity was estimated in the orbital part of the ophthalmic artery and in the carotid artery, by way of pulse Doppler ultrasonography. The equipment was a Toshiba SSA-270A machine. The material comprised 12 glaucoma patients (20 eyes, all with open angles) under satisfactory IOP control, mean age 52 years, and 28 healthy controls (mean age 40 years; 54 eyes). Systolic flow velocities of 46 cm/sec and 103 cm/sec, in the ophthalmic and carotid artery respectively, were found in the normal subjects. With mean values of 42 and 116 cm/sec in the glaucoma group there was no significant difference between groups. The same applied to the average flow velocities. A considerable interindividual variation was found.


Duplex and color Doppler ultrasound in the differential diagnosis of choroidal tumors. There is paucity of data on the value of neovascular blood flow measurements in the differential diagnosis of human choroidal tumors, mainly due to difficulties in quantitating tumor vascularity in vivo. Color Doppler imaging and Duplex ultrasound, the combination of B-mode ultrasound and pulse Doppler analysis, were used to quantify tumor blood flow in 103 untreated tumors of the choroid. Pulsatile blood flow was detected at the tumor base of 62 choroidal melanomas (tumor height (TH) 3.1-11.7 mm) with a mean peak systolic frequency (MPSF) of 0.98 kHz (range 0.3-2.7 kHz). Compared to melanomas pulsatile neovascular flow in choroidal metastases (TH 2.1-6.5 mm, n = 12) was significantly higher (MPSF 1.87 kHz, range 0.8-3.5 kHz). No Doppler signals were elicited from age-related macular degeneration (n = 9), choroidal nevus (TH 1.5-2.1 mm, n = 18) and choroidal osteoma (n = 2). The results indicate that the quantitative measurement of tumor blood flow by duplex and color Doppler ultrasound may serve as a new diagnostic tool in the evaluation of intraocular tumors.


Ultrasound biomicroscopy in glaucoma.

Ultrasound biomicroscopy in glaucoma. Ultrasound Biomicroscopy is a newly developed high resolution imaging method that uses high frequency ultrasound (50-100 MHz). Tissue penetration is about 4 mm. This method allows detailed observation of anterior and posterior chamber anatomy in the living eye, and is thus a useful tool in both clinical assessment of glaucoma, and research into causes of various glaucoma types.


High resolution B mode echography and colour Doppler (CDFI) of the macula. Based on experience from 30 patients the usefulness of high resolution B-scan echography and colour Doppler flow imaging for evaluating lesions of the macula is discussed. With B-scan there is a high detectability of even very flat lesions (less than 1 mm) but fluorescein angiography still gives more detail regarding specific diagnosis. In lesions thicker than 2 mm the Doppler imaging technique adds valuable information about vascularity, to make the assessment of differential diagnosis more exact. The results are considered preliminary; obviously focused ultrasound transducers of high frequency (20 mHz and above) will increase the possibilities of the method.


Our experience in the diagnosis of intraocular tumours by a B-scan computerized system and angiodynography (Doppler). Preliminary results. The authors compare the ultrasound diagnostic results of intraocular tumours by A/B-scans (Sonomed B 3000, Sonocare, Sonovision STT-100) with images obtained using computerized B-scan (Sonocare, Sonovision STT-100, Acoustic Tissue Typing ATT) and angiodynopgraphy systems (Quantum Philips). The Sonovision uses a computerized ultrasound spectrum analysis to assess the probability that a given lesion is a certain tumour, rather than another. The ATT system provides diagnostic probability for type B and type E melanoma, for haemangioma and metastatic carcinoma. The Quantum ultrasound equipment was developed for studying the heart and the major blood vessels. It is a colour Doppler that simplifies the Doppler technique, allowing it to study small anatomical parts such as tumour-like lesions of the eye. The Doppler technique ascertains the presence and the velocity of blood flow in the tumours. In presenting the preliminary results with the new techniques the authors are aware that the ATT system is not designed for some of the lesions under study (melanomas after conservative radiotherapy).


Orbital tumours--the importance of standardized echography. In a survey the diagnostic usefulness of standardized echography in orbital disease is demonstrated. Considering differential diagnoses it is stressed that ultrasonically determined location and size of the orbital lesion will not do alone. The main object is to achieve a specific diagnosis by way of tissue differentiation. The method is based on standardized A-scan supplemented by contact B-scan and Doppler sonography. Middle and posterior orbit is examined by transocular techniques. A paraocular approach is used for more anterior lesions. From personal experience from more than 300 orbital tumours examples are forwarded illustrating quantitative echography (internal structure, reflectivity, sound attenuation), topographic echography (borders, shape, location), and kinetic echography (consistency, mobility, vascularity). The combination of all nine criteria gives important guidelines concerning the specific lesions met in the orbit and paraorbital regions. The correlation between acoustic and histopathological features is stressed.


Standardized A-scan echography and the normal optic nerve. Experience with the new Mini A equipment. The potential of making differential diagnosis in optic nerve disease with standardized A-Scan echography has been well established. With this technique it is possible to differentiate 'solid' and 'fluid' thickening. A few years ago a new standardized A-scan equipment was built: The Mini A. With this equipment, it is possible to distinguish spikes coming from the pia, the arachnoid, and the dura around the optic nerve, and to measure the thickness of these structures with a precision of 0.03 mm. We found dura distance 4.0-5.3 mm, arachnoid 3.2-4.0 mm, an pial diameter 2.8-3.4 mm. In this paper the authors discuss their preliminary findings in a normal population.


The retinal pigment epithelium in clinical echography. The resolution of the Triscan (Biophysic Medical) and the Cooper-Alcon 2000 equipments proved sufficient for depicting three separate curvilinear echostructures from the back of the eye. The anatomical counterparts are the inner limiting membrane of the retina, the pigment epithelium, and the inner surface of the sclera. Imaging will be impeded due to sound dispersion if the sound beam is directed through the lens, or via the cornea and the pars plicata of the ciliary body, respectively. The potential of the method is discussed.


Choroidal metastases. Echographic experience from 42 patients. Over an 18 year period 42 patients with ocular metastases, age 30-75 years, 27 female and 15 male, were evaluated echographically. The right eye was affected in 18, the left in 17, and both eyes in 7. The most frequent primary tumours were carcinomas from breast (n = 25), lung (n = 6), and urinary bladder (n = 2). The choroidal metastases appeared mainly flat-infiltrating or dome-shaped, on B-scan. A-scan generally revealed high or medium reflectivity, however with important exceptions. Atypical cases are discussed. Usually eyes with metastases should not be enucleated. Accordingly, ultrasonic evaluation and follow-up is of obvious importance.


Comparison between echographic and histological findings in choroidal malignant melanomas. Echography is crucial in making a diagnosis of malignant melanoma when ocular media are opaque. Even with clear ocular media, standardized echography is important to confirm or to rule out a malignant melanoma in the eye. In this study the reflectivity in 27 cases of malignant melanomas has been evaluated and compared to cell type, pigmentation and number and size of blood vessels. No significant correlations have been found.


The pathology of after-cataract. A minireview. After-cataract can be defined as the retropupillary, non-vitreal opacification of the lens remnants occurring after extracapsular cataract extraction (ECCE) leading to disturbance of transparency and impairment of vision. The synonymous secondary cataract is confusing, since it is also and more frequently used as cataract secondary to ocular diseases (Duke-Elder 1969). The synonymous opacification of the posterior capsule is, in fact, a misnomer, since histological observations revealed that after-cataract is not proven to be the result of changes in the remaining posterior capsule itself, but is caused by proliferation of lenticular epithelial cells, fibroblasts, macrophages and even iris-derived pigment cells on the posterior capsule (Fig. 1).


Secondary cataract. An in vivo model for studies on secondary cataract in rabbits. Secondary cataract formation is the most common postoperative complication following cataract surgery. To study different methods preventing the secondary cataract formation a relevant animal model is required. An in vivo rabbit model for studies on the prevention of secondary cataract formation is presented. The lens nucleus and cortex were removed by phacoemulsification, and two months later the growth of the secondary cataract was estimated by scoring on a scale from 0-4, both central and peripheral, and by measuring the wet mass of the dissected secondary cataract. The model seems to be a relevant way to study different concepts for the prevention of secondary cataract formation.


Anterior capsule opacification: a cell culture model. We cultured the human lens epithelial cells with attaching anterior lens capsule using surgically removed capsular flaps obtained in intraocular lens implantation. The capsular flap was placed with cell side down in a small culture well. In phase contrast microscopy, an anti-meniscus plate was placed on the bathing medium to avoid optical aberration. The human lens epithelial cells showed outgrowth which ceased after 3 to 4 weeks of incubation. The cells under the capsule lost distinctive cell margin. The cells outgrew from the capsular edge both onto the anterior capsular surface and the well bottom. The outgrowth length and Bromodeoxyuridine uptake indicated a low proliferative potency of the human lens epithelial cells.


Lens cytoskeleton and after-cataract.

Lens cytoskeleton and after-cataract. Lens epithelial and other ocular cells contain complex arrays of actin filaments which might be expected to allow them to migrate following injury: specifically into the capsular sac in cases of extracapsular cataract extraction or traumatic cataract. To test the possibility, a culture system was developed using a melanotic strain of mice, in which migrating cells are often 'marked' by melanosomes. Injured lenses were cultured on permeable membranes in contact with nutrient medium, and surrounded by iridial tract fragments. After study by light and electron microscopy, it was established that both pigmented and unpigmented cells migrated from the surrounding explants, apparently along the substrate meniscus, to the outside of the lens capsule and then through the wound to the capsule interior. This study suggests a source of cells in development of after-cataract syndrome.


Adhesion and junction molecules in embryonic and adult lens cell differentiation. The expression of the neural cell adhesion molecule NCAM and its polysialic acid (PSA) moiety was documented during embryonic development and adult differentiation of chicken lens cells. In both the embryo and adult, NCAM is predominantly found in the epithelium and the zone of young elongating cells of the annular pad. NCAM abundance drops markedly in the cortical fibers and is further reduced in the lens nucleus. Epithelial cell NCAM is more highly poly-sialylated in the adult than in the embryonic lens. Three isoforms of NCAM at 180, 140, and 120 kDa were detected in the lens and predominantly associated with the unit membrane-enriched plasma membranes of fiber cells. The distribution of NCAM relative to MP26 and the adherence junction-associated glycoprotein N-cadherin suggests that NCAM could influence the formation of fiber cell gap junctions and adherence junctions.


The control of lens growth: relationship to secondary cataract. A lens growth factor was identified that is present in the anterior chamber of the embryonic chicken eye. The mitogen is similar to an embryo-specific activity found in embryo serum. Several purified growth factors, applied singly or in combination, did not stimulate cell division in embryonic lens cells. The serum mitogen is a protein which does not bind to heparin-Sepharose. The possibility is presented that the lens epithelium contains two distinct cell types, the proliferating cells of the germinative zone and the mitotically quiescent central epithelial cells. It is proposed that only cells in the germinative zone are capable of responding to normal lens growth factors. It is likely, therefore, that these cells present the greatest risk for secondary cataract formation.


Reactive formation of hyaluronic acid after small and large lens injury. The reactive production of hyaluronic acid was studied in the rabbit lens following a 4 mm in diameter anterior lens wound, and following a large lens wound (extracapsular cataract extraction). Furthermore, human post-mortem after-cataract specimen were also studied. The hyaluronic acid was localized histochemically using a new specific technique. Hyaluronic acid in the small wound was localized in the primary sealing plug that precedes the reepithelialization and new capsule formation. In the large wound hyaluronic acid was found around the cells proliferating on the posterior capsule. The same was true in the human after-cataract specimen. It was concluded that the primary wound sealing and the posterior capsule cellular outgrowth constitute similar cellular responses.


The lens capsule and zonulae.

The lens capsule and zonulae. The embryology and natural history of the lens capsule and the zonular apparatus have been described according to the present knowledge of the subject. Clinical evidence pointing towards an active turnover of lens capsule material is presented.


Polymeric debris from absorbable polyglycolide screws and pins. Intraosseous migration studied in rabbits. The migration of polymeric particles during degradation of absorbable implants made of polyglycolide was investigated in the cancellous bone of distal rabbit femur by using a transverse osteotomy model. The osteotomy was fixed either with a 4.5 x 25 mm screw or with two 1.5 x 30 mm pins. The histologic sections obtained at 3, 6, 12, and 36 weeks were morphometrically analyzed using polarized-light microscopy. The migration of the polymeric debris into the host-tissues showed two different patterns. On the one hand, particles were in all specimens seen lying intracellularly in phagocytic cells in a regular front close to the original tissue-implant boundary. In addition, in several specimens there occurred expansions filled with largely extracellular polymeric particles that bulged into the hematopoietic bone marrow up to 2.8 mm from the original implant cavity. This kind of particle migration over long distances could not be explained by cellular transport, but may have been caused by an increased osmotic pressure that developed within the implant cavity during depolymerization of polyglycolide.


Responses of the solitary olfactory receptor cell of the guinea pig. Olfactory receptor cells were isolated from the nasal mucosa of the guinea pig, using enzymatic digestion and mechanical dissociation. Under a phase-contrast microscope, the cells can be readily distinguished from other tissues, because of morphological characteristics. The intracellular free calcium ion concentrations ([Ca2+]i) of these cells were determined using the Ca2+ sensitive dye fura-2 and digital imaging microscopy. In the presence of 1 microM ionomycin, calcium-ionophore, there was an irreversible increase in [Ca2+]i in all the cells. During prolonged stimulation by 10 mM n-Amyl acetate under standard conditions, 16 of the 40 isolated olfactory cells responded with [Ca2+]i. There was no evidence of any increase in [Ca2+]i in the olfactory receptor cells in nominally Ca2+ free solution and stimulated by amyl acetate. When 3 mM CaCl2 was added, the [Ca2+]i increased remarkably. When cells were stimulated with amyl acetate in a CaCl2-depleted extracellular fluid supplemented with 10 microM verapamil (an L-type voltage-dependent calcium channel antagonist), no change occurred in [Ca2+]i. The addition of CaCl2 to this fluid did not elevate [Ca2+]i, in any cell. This would suggest that the [Ca2+]i increase in the presence of amyl acetate may mainly depend on the influx of calcium from the extracellular space. Our finding that the influx of extracellular calcium into cells was suppressed by verapamil suggests that the calcium channel, which is opened by amyl acetate, is a voltage-dependent L-type Ca2+ channel.


Alpha- and beta-adrenergic receptors in children with essential hypertension. Platelet alpha 2- and lymphocyte beta-adrenergic receptors were examined in eight children aged 10-16 years with essential hypertension, and in 11 age-matched normotensive children. Both alpha 2- and beta-adrenergic receptor concentrations showed no significant differences between children with essential hypertension and normotensive children. According to other studies, physiological fluctuations in catecholamines determine lymphocyte beta-adrenergic receptor concentrations, although down-regulation in platelet alpha 2-adrenergic receptors has not been observed. The present findings suggest that there may be no abnormalities in alpha 2- and beta-adrenergic receptors in essential hypertension in childhood, although a hyperadrenergic state has been reported to be of some relevance to the pathogenesis of essential hypertension in young adolescents.


[Preparation of milligram quantity of vitamin D3 isomers by a two-step high performance liquid chromatographic method]. The preparation of milligram quantities of three vitamin D3 isomers, previtamin D3, lumisterol3 and tachysterol3, were carried out in a laboratory scale first by irradiating 7-dehydrocholesterol in a phototherapy chamber equipped with UVB lamps, followed by using a two-step high performance liquid chromatography (HPLC) with a semi-preparative normal phase column and an analytical reverse-phase column. The final products obtained were identified by UV spectrophotometry and HPLC. According to the detection limits for the three isomers, no contamination with any other isomers was detected in the previtamin D3, lumisterol3 and tachysterol3 preparations, except that a very small amount of vitamin D3, constituting no more than 0.25% of the product, was found in previtamin D3 preparation.


Effect of new-breviscapine on fibrinolysis and anticoagulation of human vascular endothelial cells. Cultured confluent human umbilical vein endothelial cells were incubated with new-breviscapine (NB), a flavonoid consisting of 4-OH-scutellarin-7-O-glucuronide (C33H30O18) and FeCl3, MgCl2, and CaCl2, which is first extracted from Erigeron breviscapus (Vant) Hand-Mazz in China, 0, 6.25, 12.5, 25, 50, 100, and 1,000 micrograms.ml-1. The releases of tissue-type plasminogen activator (t-PA), and epoprostenol (Epo) from endothelial cells were stimulated by NB, but no significant effect of plasminogen activator inhibitor (PAI) activity was seen. NB 25-1,000 micrograms.ml-1 induced a production of thrombomodulin (TM) within the cells, an expression of TM on the surface of the cells, and a release of TM from the cells. Our data provide a new evidence that NB is a stimulant to fibrinolysis and anticoagulation of endothelial cells.


ESR-measurement of production of oxygen radicals in vivo before and after renal ischaemia in the rabbit. This study describes a spin trap technique to determine production of oxygen radicals in rabbit kidneys after ischaemia and reperfusion. OXANOH was infused intra-arterially. When exposed to oxygen free radicals OXANOH is oxidized to the stable radical OXANO(.). The concentration of OXANO. in samples of renal venous blood was determined by ESR. Production of oxygen radicals was calculated from the amount of OXANO. in the venous blood and the blood flow which was determined by an ultrasound technique. The radical production at reperfusion after ischaemia was expressed as a per cent of the pre-ischaemic value. A drastic increase in radical production was observed during (60 min) reperfusion after 60 min of ischaemia. Pretreatment with oxypurinol (20 mg kg-1) before ischaemia and before recirculation almost completely abolished the rise in radical production at recirculation. Similar results were obtained when oxypurinol was given before recirculation only.