The value of panoramic radiographic examination in patients with leukemia before medical management. Panoramic radiographs were completed for patients with leukemia before the start of medical management. The radiographs were taken as part of the patient admission evaluation. Patients were examined and followed throughout the course of their medical management. Panoramic radiographs did not identify pathologic conditions that were not identified clinically or that required management during medical therapy. The radiograph evaluation was of value in correlation with clinical findings and was required before dental treatment. It is concluded that panoramic radiograph evaluation of patients with leukemia is not indicated as part of their routine evaluation and should not be used to screen patients for occult pathosis. The use of these radiographs should be based on history and examination findings.


Salivary hypofunction in patients with familial amyloidotic polyneuropathy. Patients who suffer from familial amyloidotic polyneuropathy frequently complain of mouth dryness and an increased need for dental treatment. The aim of the present investigation was to study saliva secretion rate and composition and other factors related to the risk of dental caries in patients with familial amyloidotic polyneuropathy. Thirty patients with familial amyloidotic polyneuropathy volunteered for the study and were compared with a matched control group. Samples of unstimulated and stimulated whole saliva were collected in a standardized manner. The secretion rates were calculated, and the concentrations of electrolytes, glycoprotein markers, and proteins with antibacterial properties were analyzed. Dental caries and variables related to the risk of dental caries were also scored. The results show that familial amyloidotic polyneuropathy patients frequently have a decreased rate of saliva secretion and that the degree of salivary hypofunction is positively correlated to the progress of familial amyloidotic polyneuropathy. Forty-three percent of the familial amyloidotic polyneuropathy patients in this study had no detectable secretion of unstimulated saliva. A low secretion rate of stimulated saliva (< 0.7 ml/min) was found in 33% of the patients. The concentrations of salivary protein, amylase, lysozyme, salivary peroxidase, secretory IgA, hexosamines, sialic acid, fucose, phosphate, potassium, and the degree of protein glycosylation were higher in the familial amyloidotic polyneuropathy patients than in the control patients. We conclude that patients with familial amyloidotic polyneuropathy have a reduced saliva secretion and are subsequently at risk for increased development of dental caries.


Effect of epidermal growth factor on ulcerative mucositis in hamsters that receive cancer chemotherapy. Ulcerative mucositis is a common, bothersome, and dose-limiting complication of cancer chemotherapy. It has been hypothesized that mucosal susceptibility to the degenerative effects of stomatotoxic drugs is related to the renewal rate of the buccal epithelium. This study was undertaken to evaluate the effect of epidermal growth factor, a molecule known to stimulate epidermal cell division, on the course, frequency, and healing of ulcerative mucositis in an animal model. Golden Syrian hamsters were subjected to a standard mucositis-induction protocol with 5-fluorouracil. Osmotic pumps were implanted into a space between the retractor muscle and the platysma cervicale muscle, and delivered epidermal growth factor or placebo at a constant rate for 7 or 14 days. Epidermal growth factor increased oral mucosal breakdown in the face of antineoplastic therapy. The course and extent of mucositis was influenced by the timing of epidermal growth factor pump placement relative to the initiation of stomatotoxic therapy. These results support the hypothesis that the epithelial basal cell rate is one of the key elements in determining mucosal sensitivity to cancer chemotherapy.


Williams syndrome. Report of a case.

Williams syndrome. Report of a case. Williams syndrome is a rare anomaly consisting of idiopathic hypercalcemia that is normally accompanied by aortic stenosis, moderate mental retardation, and a characteristic elfin face. Because persons with this syndrome have severe dental abnormalities, it is in the dental or orthodontic clinic that the disease can eventually be detected. A unique case of this type is reported.


Clear cell odontogenic carcinoma. A case report with massive invasion of neighboring organs and lymph node metastasis. Clear cell odontogenic carcinoma is a rare and unusual tumor that occurs in the jaws. This tumor is generally considered to be of a low grade of malignancy. We describe a patient with a huge clear cell odontogenic carcinoma that originated in the mandible and exhibited massive invasion into the adjacent tissues and metastases to the submandibular lymph nodes. The ultrastructural and immunohistochemical details are described.


Ameloblastoma arising in calcifying odontogenic cyst. Report of a case. An unusual case of an ameloblastoma with adenoid-cribriform features arising in calcifying odontogenic cyst is reported. A possible relationship between this peculiar variant of calcifying odontogenic cyst and a conventional ameloblastoma is discussed.


Pigmented purpuric stomatitis.

Pigmented purpuric stomatitis. The pigmented purpuric dermatoses are a group of disorders in which there is chronic capillaritis, with pigmented purpuric lesions predominantly on the lower limbs. We report a case with chronic oral lesions that had histologic features most in keeping with the purpuric lichenoid dermatitis of Gougerot and Blum syndrome.


Adenomatosis of minor salivary glands. Report of a case. An account is given of a patient who had multiple canalicular adenomas in the upper lip and adjacent oral mucosa. A few months after these had been excised, several more tumors of the same type developed. Microscopic examination also revealed numerous tiny foci of adenomatous proliferation within otherwise normal salivary gland lobules. We suggest that this phenomenon represents a field neoplastic change although it appears to be benign.


Tissue changes in immature dog teeth autotransplanted to surgically prepared sockets. Tissue reactions in teeth autotransplanted to surgically prepared sockets were investigated by means of microangiographic, enzyme histochemical, and histologic methods. The experimental material consisted of 28 immature teeth in six mongrel dogs. In each tooth, approximately three fourths of the root was formed at the time of transplantation. Ten days after transplantation, a vascularized, well-stained connective tissue was observed in the apical area of the pulp. An ingrowing tissue had reached the pulp horn in all teeth 90 days after surgery. Odontoblasts were not found in any of the transplanted teeth. External root resorption was seen in all teeth but repair usually occurred approximately parallel to the ingrowth of new tissue into the pulp cavity. In a few teeth, however, advanced inflammatory root resorption was observed in cracks in the cervical area. When compared with the results of a previous study, the ingrowth of tissue occurred at a considerably slower rate than in teeth autotransplanted to natural sockets.


Radiographic "working length" revisited. The desired "working length" for the biomechanical preparation and resultant obturation of the root canal system is one of the most important phases of endodontics. Traditionally, radiographs are used to confirm working length of the root length and to evaluate the subsequent obturation of the root canal system. This study attempts to determine if radiographs are an accurate method of root length determination in a period when electronic apex locators are proposed as their replacement. Eight-seven vital and 24 nonvital teeth were accessed and files placed to and the radiographic working length before the file and teeth were extracted for sectioning. Results showed that the radiographic distance of the file from the apical vertex was 0.7 mm shorter than the actual file position. This discrepancy can lead the clinician to try to get closer to the radiographic apex, when in reality the end of the file is closer to the vertex than is suspected. The average distance short of the vertex as established by Kuttler should be increased to lie between 1.5 and 2.0 mm from the apical vertex to prevent overfilling the root canal.


Magnetic resonance evaluation after temporomandibular joint diskectomy. The aim of this study was to investigate the value of magnetic resonance imaging after diskectomy of the temporomandibular joint. Magnetic resonance images were obtained before and 12 months after unilateral diskectomy without disk replacement. Magnetic resonance findings at follow-up were correlated to residual pain. At the follow-up, 20 of 28 patients were free of pain in the joint that had been surgically treated, four patients had mild pain, and four patients had significant residual pain. The magnetic resonance images at follow-up showed that the joint space was filled with soft tissue after diskectomy. In patients without pain at follow-up, this soft tissue had a magnetic resonance signal that was equal or higher than that of the muscles. In the four patients with significant residual pain and in one patient with mild residual pain, the soft tissue in the joint space between the condyle and glenoid fossa had a magnetic resonance signal intensity that was lower than the muscle. On the basis of findings in a previous study, the areas of low signal intensity were interpreted as fibrous adhesions. The study suggests that areas of low signal intensity in the joint space appear to be associated with residual pain and that magnetic resonance imaging could be a valuable tool for assessment of the temporomandibular joint after diskectomy.


Direct digital extraoral radiography of the head and neck with a solid-state linear x-ray detector. A narrow fan beam of x-rays intercepted by a linear array detector was used to acquire transmission data for a radiographic phantom moved across the beam. The digital data were displayed as images representing a variety of extraoral views of the head and neck. Projections investigated include the straight lateral view, two frontal projections, and a half-axial projection. The digital images appear to provide adequate contrast and resolution for common diagnostic tasks. In addition, the use of a scanning linear detector reduces the amount of scatter, which increases contrast relative to images made with an area detector. The system appears to provide a versatile and convenient means for the acquisition of extraoral views relevant to dental practice while it eliminates the logistical difficulties and errors associated with film processing.


Sens-A-Ray. A new system for direct digital intraoral radiography. A new system for direct digital intraoral radiography, Sens-A-Ray, is presented. This system is based on a detector with a charge-coupled device that was designed especially for direct exposure to x-ray radiation. The system also includes interface electronics and an IBM AT-compatible personal computer with a digital I/O with frame memory, a super VGA graphics board, a high-resolution monitor, and software for the exposure, capture, storage, and enhancement of images. An external optical mass storage device is used for permanent storage of images in digital format. A video printer may be used to create hard copies. The system produces radiographic images at a significantly lower exposure than required for E-speed intraoral film. Applications of the system are exemplified, and its basic properties are discussed.


Digital subtraction radiography after stannous fluoride treatment for occlusal caries diagnosis. The material in this study consisted of 38 fully erupted, extracted third molars without clinical cavitation in the occlusal surface. A radiograph was made of each tooth before and after 5, 10, and 20 minutes of stannous fluoride treatment. The radiographs were digitized and subtraction performed between the images obtained after stannous fluoride treatment and the pretreatment image. Two observers assessed the stannous fluoride treated radiographic and the subtraction images on a monitor: 0 = no change, 1 = intensity increase (white area interpreted as a carious lesion) in dentinoenamel area. Caries was assessed on conventional film radiographs made before treatment: 0 = no caries in dentin, 1 = caries in dentin. The presence of caries in dentin was validated histologically. Sensitivity for intensity increase as a sign of caries was overall higher for the subtraction images based on 20-minute treatment than for the radiographic images (0.025 > p > 0.01) but not significantly higher than for the conventional radiographs. However, neither observer gave false-positive scorings in the subtraction images, whereas observer 1 had five false-positive scorings on the conventional films. Observer 2 had none. The subtraction method did not provide a higher sensitivity for dentinal occlusal caries than conventional film radiography, but the intensity increase could be trusted more than the traditional radiolucency as a sign of a dentinal lesion.


Evoked otoacoustic emission: behaviour under the forward masking paradigm. The behaviour of evoked otoacoustic emission (EOAE) has been studied in normally hearing adults under the conventional forward masking paradigm. The clicks and tone pips served as signals, and the noise bursts were used as maskers. At noise burst levels, defined as psychoacoustic masking thresholds of signals (postmasking threshold), attenuation of EOAEs was just noticeable but did not occur in all records. The EOAEs were not completely eliminated even at noise levels exceeding the post-masking threshold by 30 dB. Central or neural and peripheral or receptor mechanisms are suggested to be the constituents of the masking phenomenon. The receptor mechanism effectively joins the neural one at masker levels, well exceeding the thresholds of psychoacoustic masking. The increase in masker duration and decrease in interval between masker and signal seem to accentuate the neural mechanism. As a result, the difference between masker levels, leading to psychoacoustic masking of the signal and having marked attenuating effects upon the EOAEs, respectively, is increased.


Development of the endolymphatic sac in chick embryos, with reference to the degradation of otoconia. The endolymphatic sac of chick embryos (from embryonic day 7 to 1-day-old chicks) was studied light- and electron-microscopically. At stage 30-31 (embryonic day 7-7.5), the epithelial cells of the endolymphatic sac were cuboidal to columnar in shape. Microvilli were relatively well developed. The intercellular space was wide. In the endolymphatic space of the endolymphatic sac, varying shapes and sizes of otoconia-like bodies were often observed. Intracytoplasmic phagosomes containing these bodies were rarely found. After stage 37 (embryonic day 11), otoconia-like bodies in the endolymphatic sac decreased in number and size. They were almost the same as the otoconia in the macular organs, ultrastructurally. These findings indicate that the endolymphatic sac of the chick embryos may possess the function of otoconial degradation and removal of calcium from otoconia.


Cell membrane polarity of the epithelial cells in the endolymphatic sac of the guinea pig. The epithelial cells of the endolymphatic sac (ES) were studied in order to characterize their glycocalyx composition. Colloidal thorium and cationized ferritin were used as electron-dense markers to visualize the glycocalyx as well as the basement membrane. In addition, enzymatic digestions were performed to identify the reactive components of the glycocalyx responsible for colloidal thorium labeling. The results indicate that the glycocalyx of the ES epithelial lining is very rich in sialic acid. Furthermore, a marked polarity in glycocalyx reactivity is present between the apical and basolateral membranes, whereas difference in glycocalyx reactivity between the light and the dark cells are not obvious. We speculate that the specific composition and the apparent polarity of the ES epithelial cell glycocalyx are of importance to the equilibrium of electrolytes in the ES lumen.


Sudden sensorineural hearing loss induced by experimental iron deficiency in rats. The relation between iron deficiency (ID) and sudden sensorineural hearing loss (SSHL) was evaluated in the growing rats of three different experimental groups. Fourteen rats of 132 (10.61%) that were raised on a basic ID diet showed SSHL in varied extent, from moderate to profound. By contrast, none of 128 standard control and 126 anemic control rats that were fed with the final iron-supplemented diet showed any degree of SSHL. The main cochlear correlates of SSHL in ID rats were synchronous abnormalities of the iron-containing enzymatic activity in the whole cochlea, a significant reduction of spiral ganglion cells and a rapid involvement of stereocilia of the outer and inner hair cells. The results suggest that ID can play a major role in the pathogenesis of SSHL.


Diagnosis of the ossicular chain in the middle ear by high-resolution CT. This study was conducted to assess the usefulness and limitations of high-resolution CT for diagnosing the ossicular chain in the middle ear. The CT images in this study were obtained in as much detail as possible and 2 direction images. Preoperative CT findings of the ossicular chain were compared with operative findings in 26 patients with ossicular defects. Preoperative detection of the complete defect of the malleus head and the body and long process of the incus by high-resolution CT was possible in all cases, while detection of the defect of the manubrium of the malleus and superstructure of the stapes could be made in 33.3 and 60%, respectively. The defect of the incudostapedial joint (1 case) and partial defect of the stapes crus (2 cases) could not be diagnosed correctly by preoperative estimation.


Stapedial reflex in Parkinson's disease. In 27 patients with Parkinson's disease (PD), stapedial reflexes were measured using impedance audiometry and compared with those of 11 age-matched control subjects. The reflex threshold of PD patients was lower than that of control subjects. A prolongation of contraction time (C50) and relaxation time (D50) was revealed. Between patients with and without L-dopa, there was no significant difference for any reflex parameter. But, the D50 of patients without anticholinergic drugs was longer than that of patients with anticholinergic drugs. The authors could not find any relationship between the severity of PD and the reflex parameters. The authors assume that the prolongation of reflex parameters might be attributed to the hyperactivity of the indirect pathways of the stapedial reflex.


Infrared laser tissue ablation: holmium:YAG laser surgery. The in vivo tissue ablation characteristics of a pulsed holmium:YAG laser (lambda = 1,980 nm) were studied. The laser energy was coupled onto nylon fibers 400 and 600 microns in core diameter. Laser incisions were made on white rats at different sites of the tongue and of the mucous membranes of the oral cavity. Power settings of 500 and 1,000 mJ/2.5-ms pulse at 5 pulses/s were used and the tissue responses examined by light microscopy. Wound healing was studied over a 6-week period. The results of this study are promising for future application of the holmium:YAG laser in otorhinolaryngology.


Quantitative DNA measurements in malignant and benign lesions of the upper aerodigestive tract. Thirty-six patients underwent biopsy of clinically suspicious lesions of the mucosa of the upper aerodigestive tract. The biopsy material was evaluated histologically and cytologic smears out of the same lesion underwent quantitative DNA analysis using a numerical index derived from the single cell DNA content. In 30 patients, histologically diagnosed squamous cell cancer was confirmed by DNA analysis with the malignancy grade correlating with the morphologic differentiation of the tumor. Six lesions were histologically benign: i.e. dysplasia (n = 3), hyperplasia (n = 2) and chronic inflammation (n = 1). DNA analysis confirmed the benign nature in 4 cases, but in 2 cases of dysplasia, a diagnosis of malignancy was made. From these results, there appears to be an excellent correlation between DNA analysis and the histologic diagnosis of malignancy. It remains to be proven if this technique of DNA analysis will prove to be a more accurate determinant of malignant potential in premalignant conditions and a method to determine aggressiveness of behavior. An added advantage is that this technique can be performed on cytologic smears, without the need for incisional biopsy.


Indispensability of mediastinoscopy in intrathoracic tuberculosis. An analysis of 33 patients with histologically confirmed intrathoracic tuberculous lymphadenopathy was made. Tuberculosis could have been diagnosed without mediastinoscopy only in 3 patients: 2 had positive bronchial cultures and 1 simultaneous cervical lymph node tuberculosis. Bacteriological confirmation is conclusive, but seldom possible. Mediastinoscopy provides the best method to obtain tissue samples, and consequently, it is still necessary in the diagnosis of intrathoracic tuberculous lymphadenitis.


Labyrinthine anomalies with normal cochlear function. Three cases of labyrinthine anomaly confirmed by polytomography and CT scan are reported. They showed similar dysplasia of the bony labyrinth: dilation and fusion of the lateral semicircular canal (SCC) and of the vestibule with a normally shaped cochlea and other SCCs. One side was involved in 2 cases and both sides in 1 case. The 1st case showed normal hearing levels with markedly reduced response to caloric stimulation in the affected ear. The 2nd case showed conductive hearing loss due to cholesteatoma with normal bone conduction hearing levels and normal caloric response. The 3rd case showed bilateral conductive hearing loss of unknown cause. The classification of labyrinthine anomalies and labyrinthine functions is discussed. Labyrinthine anomaly detected by CT scan and polytomography can be present in patients with normal cochlear and/or vestibular function.


Penetrating wounds of the ear with oval window fistulas. Reports of 2 cases. In 2 patients with penetrating wounds of the ear lesions involved the tympanic membrane and the ossicular chain. The long process of the incus was lying on the fallopian canal and the stapes was deeply depressed into the vestibule. In spite of a large oval window fistula, cochleovestibular signs were minimal. The fistula was sealed with adipose tissue and the stapes replaced by a Teflon-platinum piston prosthesis. The incus was repositioned and supported by a fat graft placed between the fallopian canal and the long process. This original technique of reconstructing the ossicular chain gave satisfactory functional results in both patients.


Study on the mechanism of an experimental immunological intrahepatic cholestasis model. Tuberculin-sensitized guinea pigs were intravenously injected with heat-killed Propionibacterium acnes followed by an intravenous injection of purified protein derivatives 7 day later, resulting in the induction of intrahepatic cholestasis. Using this experimental model, the following results were obtained: (1) Both uptake and release of bile acid were inhibited in the hepatocytes prepared from the cholestasis guinea pigs. (2) The results of the erythritol clearance method indicated that the decrease in bile flow observed in the cholestasis guinea pigs was mostly attributable to the reduced bile excretion from the canaliculi. (3) The decrease in the formation of bile acid independent bile flow was the cause of the decrease in bile flow observed in the cholestasis guinea pigs. (4) There was no change in the permeability of the interhepatocellular tight junction in the cholestasis guinea pigs.


Effects of metallothionein on mutagenicity and oxidation of quercetin. The effects of four types of Zn/Cd-metallothioneins on the mutagenicity of quercetin in Salmonella typhimurium TA98 were studied. The four types of Zn/Cd-metallothionein used in this experiment were metallothionein I, metallothionein I/II and metallothionein II from rabbit liver and metallothionein I/II from horse kidney. All four of the metallothioneins enhanced the mutagenicity of quercetin. Metallothionein II from rabbit liver, in which Zn content was the highest of the four metallothioneins, enhanced the mutagenicity of quercetin most effectively. Metallothioneins as well as Zn/Cu-SOD prevented quercetin oxidation under aerobic conditions. The action of these metallothioneins, which enhances the mutagenicity of quercetin, was fairly proportional to the activity which prevents quercetin from being oxidized. Reduced glutathione did not enhance the mutagenicity of quercetin although it did inhibit the quercetin oxidation. These results suggest that metallothioneins have superoxide (O2-) scavenging ability and act as "SOD-like" proteins in vivo. A simple and reliable system to detect biological substances which have antioxidant activity for the superoxide (O2-) was devised.


Clinical evaluation of interventional radiology for renal cell carcinoma in 100 patients. One hundred of 160 patients with renal cell carcinoma (RCC) were treated by interventional radiology (IVR) in the period from 1978 to 1989. The number and kind of interventions done each year were classified retrospectively. More than half of the patients underwent therapeutic arterial embolization or intraarterial infusion of anticancer drugs during the first half of the period. More recently, about half of the patients have had nephrectomies without IVR. One patient with advanced RCC by IVR 18 times lived 8 years and three months after diagnosis, but that was exceptionally long. IVR has been more effective against hepatocellular carcinoma than RCC, for several reasons.


Serum immunoglobulin and complement C3 levels in workers exposed to lead. Serum immunoglobulin and complement C3 levels were measured in workers exposed to lead at a secondary lead refinery and a solder factory. In the first survey, significant correlations were found between blood lead and IgA with a correlation coefficient of 0.296, and between blood lead and IgE with a correlation coefficient of 0.314. No other significant correlations were found among the indicators of lead exposure and humoral immunity. In the second survey, no significant correlations were found between blood lead and IgG and IgA. A significantly higher number of subjects with IgE of more than 400 IU/ml was found in the group with blood lead of more than 60 micrograms/100 g.


A spigelian hernia in an infant.

A spigelian hernia in an infant. The case of a two-month old Japanese girl with a left side Spigelian hernia that developed during the course of recovery from the surgical treatment of a meningomyelocele and ventriculo-peritoneal shunting (V-P shunting) is reported on. At this time, to our knowledge, 20 cases involving infants and children have been reported on in world-wide medical literature. Of these cases, 4 cases were caused by trauma, 1 by abdominal surgery, and the others had no evident causes. Our patient had a meningomyelocele, and underwent a V-P shunting. However, a cause and effect relationship between the Spigelian hernia and the treatment of the meningomyelocele followed by V-P shunting is inconceivable. We doubt any relationship between the preceding neurosurgery and the development of the hernia. This is the first case of infantile Spigelian hernia reported on in Japan.


Treatment of scaphoid fractures with carpal instability. Since 1981, I treated 81 scaphoid fractures: 14 wrists (group A) with acute unstable fracture, 37 (B) with ununited fracture accompanied by dorsiflexed intercalated segment instability (DISI), and 30 (C) with ununited fracture without DISI. The methods and results were evaluated retrospectively. Bone union occurred in 100% of group A wrists, 92% of group B, and 90% of group C. By a modification of Cooney's clinical scoring chart, mean scores were 91 in group A, 84 in group B, and 87 in group C. In 43% of group A, a scapholunate gap remained after surgery. Of 21 wrists in group B treated by bone graft and screw fixation, union was not achieved in one; in another 13, the R-L angle was corrected to within 10 degrees of the unaffected side. In group C, DISI did not develop if bone union occurred. There was correlation between shortness of the scaphoid and DISI remaining. The clinical scores of wrists with and without DISI were not different, except for patients who did hard manual labor, in half of whom the score was poor when DISI remained. Cineradiography of ununited fractures was done before and after surgery. For three wrists in group B, plain X-ray films showed that DISI improved, but cineradiography showed that DISI was present; even without static DISI, there may be dynamic DISI. Treatment of acute unstable fractures of the scaphoid by reduction and internal fixation generally gave satisfactory results. Perhaps when ligament injury may have caused instability, ligament repair or reconstruction is needed. For ununited fractures with DISI, correction of the DISI was needed as well as bone union. If union occurred with the scaphoid shorter than normal, DISI was present, so restoration of the length of the scaphoid during surgery is mandatory.


Sensitivity to relative and absolute motion. The threshold of sensitivity to movement could be governed by mechanisms that are sensitive either to change in spatial position, or directly to the movement itself. The use of spatially complex patterns (random-dot patterns) has been suggested to eliminate the former strategy allowing examination of the movement detecting mechanisms in isolation. By means of such a technique, thresholds for directional judgements were determined for patterns which underwent either a simple displacement or a shearing displacement. Thresholds for shearing motion were found to be around one half of those for simple motion, suggesting that relative, rather than absolute, motion governs performance for small displacements. This contrasts with previous experiments which showed that absolute motion governs performance for much larger displacements.


Motion over the retina and the motion aftereffect. The motion aftereffect (MAE) was measured with retinally moving vertical gratings positioned above and below (flanking) a retinally stationary central grating (experiments 1 and 2). Motion over the retina was produced by leftward motion of the flanking gratings relative to the stationary eyes, and by rightward eye or head movements tracking the moving (but retinally stationary) central grating relative to the stationary (but retinally moving) surround gratings. In experiment 1 the motion occurred within a fixed boundary on the screen, and oppositely directed MAEs were produced in the central and flanking gratings with static fixation; but with eye or head tracking MAEs were reported only in the central grating. In experiment 2 motion over the retina was equated for the static and tracking conditions by moving blocks of grating without any dynamic occlusion and disclosure at the boundaries. Both conditions yielded equivalent leftward MAEs of the central grating in the same direction as the prior flanking motion, ie an MAE was consistently produced in the region that had remained retinally stationary. No MAE was recorded in the flanking gratings, even though they moved over the retina during adaptation. When just two gratings were presented, MAEs were produced in both, but in opposite directions (experiments 3 and 4). It is concluded that the MAE is a consequence of adapting signals for the relative motion between elements of a display.


Higher-order factors influencing the perception of sliding and coherence of a plaid. The effect of several new stimulus parameters on the perception of a moving plaid pattern (the sum of two sine-wave gratings) were tested. It was found that: (i) the degree of perceived sliding is strongly influenced by the aperture configuration through which the plaid is viewed; (ii) the chromaticity of the sinusoidal components affects coherence in that more sliding is observed when the plaid components differ in hue, and there is less sliding when they are of the same hue; (iii) equiluminant plaids made of components equal in color almost never show any sliding; and (iv) sliding increases with viewing time. The coherence-sliding percept must therefore be influenced by color, by global interactions, and by adaptation or learning effects, thus suggesting a higher-level influence. These results are most easily modelled by separating the decision to carry out recombination from the process of recombination.


The Poggendorff illusion and apparent interparallel extents. An explanation of the Poggendorff misalignment effect in terms of apparent contraction of interparallel extent resulting from the Müller-Lyer illusion was tested in three experiments. Three of the eight stimulus figures had oblique transversals outside the parallels in the usual way, three had them inside, and two were controls consisting of the transversals only. Müller-Lyer forms were differently delineated between the parallels for the inside-transversal and outside-transversal figures, and were not delineated in the control figures. In the first experiment apparent misalignment occurred in four of the six parallel-line figures and in neither of the controls. In the second experiment oblique extent between the parallels was underestimated in six of the eight figures and right-angle extent was overestimated in all of them. The results of the third experiment showed that right-angle (horizontal) extent between the parallels without transversals is estimated without significant error. The data from the three experiments do not support the interparallel-extent explanation of apparent misalignment. Instead, the results are interpreted in terms of independent perceptual compromises, one involving alignment of the transversals and the other the distance between them.


The reversed Müller-Lyer illusion and figure-ground organization theory. When the shaft is shortened and reaches neither of the vertices of the two pairs of wings, a reversed Müller-Lyer illusion is observed: a shaft between inward-pointing wings appears to be longer than a shaft between the outward-pointing wings. In this paper it is examined whether this illusion can be explained in terms of figure-ground organization. A circle was used as the focal area, instead of a shaft or a pair of dots, so that the figure-ground character could be seen more definitely in this focal area. The apparent size of the focal circle was measured under different conditions with three variables (enclosure, wings direction, and depth). The focal circle appeared to be largest in the condition where the circle should appear most readily as a hole, ie in the single, wings-in, space condition. The circle appeared to be smallest in the condition where the circle should appear most readily as a disc, ie in the separate, wings-out, object condition. This is consistent with an explanation of the usual, as well as the reversed, Müller-Lyer illusion in terms of figure-ground organization theory.


Amodal completion versus induced inhomogeneities in the organization of illusory figures. An analysis is presented of a phenomenological model of illusory contours. The model is based on amodal completion as the primary factor giving rise to the illusory figure. In the experiment, conducted by the method of paired comparisons, the same parameter was manipulated in two series of equivalent configurations. The first series yielded examples of amodal completion, the second examples of illusory figures. Three groups of subjects evaluated the magnitude of completion, the brightness contrast of the illusory figure, and the contour clarity of the illusory figure. A control experiment was conducted, which demonstrated that in these configurations amodal completion and amodal continuation behave in the same way. Line displacement did not influence the brightness or the contour clarity of the illusory figures, though it influenced the magnitude of amodal completion. These results are in agreement with the energetic model developed by Sambin.


An exploratory study of syncretic experience: eidetics, synaesthesia and absorption. Synaesthesia and eidetic imagery are both syncretic experiences entailing a dedifferentiation of perceptual qualities. In this paper the correlation between synaesthesia and eidetic imagery is explored. Ten subjects selected for possible eidetic and/or synaesthetic ability were tested in a battery of tasks that tap structural and typographic eidetic imagery, and colour-hearing and colour-mood synaesthesia. It was found that both structural and typographic eidetic imagery were correlated with measures of synaesthesia, indicating a relationship between the two phenomena.


Changes in infants' ability to switch visual attention in the first three months of life. The abilities of 1-month-old and 3-month-old infants to shift their gaze from a central target to a peripheral target were compared in four experiments. In experiment 1 targets matched in mean luminance to the background were presented to infants in the periphery at varying levels of contrast. The contrast thresholds for target detection were found to be significantly different for 1-month-olds compared with 3-month-olds. With targets set close to these contrast thresholds, correct refixations and the latency for shifting attention were examined in experiment 2. Two conditions were used: a peripheral target was presented against a homogeneous background (noncompetition); and in the second condition, the patterned target appeared at one of two lighter peripheral windows set against a darker background (competition). Although there was no difference between the two age groups in the latency for shifting visual attention, 1-month-olds were found to make more directional errors in the competition condition. The competition effect of two potential targets on latencies was examined in experiment 3. In the competition condition, two identical peripheral patterned targets were presented to the infants. The 3-month-olds refixated more quickly to one of the double targets in the competition condition than to a single peripheral target, whereas 1-month-olds were slowed down by a double target display. Finally, in experiment 4 the ability of the infants to process and disengage from a central stimulus and to refixate towards a similar peripheral target was examined. This type of competition disrupted both the direction of the first eye movement and the latency to shift attention in both age groups. However, the effect was significantly greater for the 1-month-olds. Taken together, the results of these experiments demonstrate the greater disruption of fixation-shift behaviour in 1-month-olds compared with 3-month-olds when competing visual stimuli are used. This developmental change is explained in terms of maturation of executive cortical orienting systems over the first months of life.


Haptic dominance in form perception: vision versus proprioception. An experiment placed vision and touch in conflict by the use of a mirror placed perpendicular to a letter display. The mirror induced a discrepancy in direction and form. Subjects touched the embossed tangible letters p, q, b, d, W, and M, while looking at them in a mirror, and were asked to identify the letters. The upright mirror produced a vertical inversion of the letters, and visual inversion of the direction of finger movement. Thus, subjects touched the letter p, but saw themselves touching the letter b in the mirror. There were large individual differences in reliance on the senses. The majority of the subjects depended on touch, and only one showed visual dominance. Others showed a compromise between the senses. The results were consistent with an attentional explanation of intersensory dominance.


Perceiving tongue position.

Perceiving tongue position. Two experiments on perceiving the tongue position were conducted in which naive human subjects pointed to gingival targets, or to extensions of their fingertip, with their tongue. The aim in experiment 1 was to inquire about the existence and accuracy of the perception of the horizontal position of the tongue inside and outside the mouth, and whether kinesthetic elements other than the skin might contribute to perceiving tongue position. Vertical positioning and the calibration of the sensory map that can be presumed to underlie position sense in the tongue were examined in experiment 2. It was found that position sense is equally good in the presence and absence of anesthesia of the mucosa, suggesting that the muscles, tendons, and corollary discharge contribute to position sense in the tongue. Perception of the tongue position both inside and outside the mouth is accurate, with the error in tongue positioning being about 2 degrees. Feedback improved naive subjects' accuracy very little.


Finding locations in the environment: the map as mediator. When an observer (O) uses a map (M) whose orientation does not correspond to the orientation of the environment (E) in which performance occurs, substantial errors occur: these are called map alignment effects. Much of the prior research on map/environment (M/E) alignment has involved maps of simple paths, although alignment effects have also been demonstrated for you-are-here (YAH) maps. A study is reported in which simple YAH maps were used to test the hypothesis that errors with misaligned maps would fall into categories predictable from the application of inappropriate cognitive operations to the misaligned maps, as demonstrated earlier by Rossano and Warren. Further, performance under conditions of M/E misalignment was compared with performance under map/observer (M/O) misalignment, the situation in which the map is sideways or upside-down with respect to the observer. The major hypothesis was supported: predictable errors occurred under conditions of M/E misalignment. Errors under conditions of M/O misalignment were significantly smaller. Furthermore, when given the choice of using M/E or M/O alignment, each at the expense of the other, the overwhelming choice was to retain M/E rather than M/O alignment. This pattern of results occurred even when environmental features were represented by words rather than by lines and shapes on the map. The results underscore the robustness of map alignment effects.


Characterization of acetylcholine- and endothelin-induced calcium entry in cultured human ciliary muscle cells. We characterized the effects of acetylcholine and endothelin on cultured human ciliary muscle cells, using the calcium-sensitive dye fura-2 to measure intracellular calcium and intracellular microelectrodes to measure the membrane potential. Both agonists, endothelin and acetylcholine, had a typical biphasic effect on the intracellular calcium concentration. Calcium peaked initially, because of its release from intracellular stores, and then reached a plateau, owing to entry of extracellular calcium. Endothelin-induced calcium entry was almost completely blocked by addition of extracellular La3+ (50 mumol/l) and Ni2+ (1 mmol/l). Acetylcholine-induced calcium entry was likewise almost completely abolished by La3+ and Ni2+. Both endothelin and acetylcholine led to an initial transient hyperpolarization with a subsequent depolarization. The hyperpolarization of the membrane potential had a time course similar to the initial calcium peak, while the depolarization occurred parallel to the calcium plateau. The depolarization induced by both agonists was reduced in the presence of La3+ and Ni2+. Verapamil (10 mumol/l) had no effect on either the calcium entry or the depolarization. Acetylcholine did not induce a [Ca2+]i peak when it was applied during the endothelin-induced [Ca2+]i plateau and vice versa. The [Ca2+]i plateau was not higher with concomitant than with single application of acetylcholine or endothelin. Thus, calcium entry and membrane depolarization induced by acetylcholine and endothelin seem to be mediated by a common La(3+)- and Ni(2+)-sensitive but verapamil-insensitive mechanism.


The effect of arachidonic acid on the M current of NG108-15 neuroblastoma x glioma hybrid cells. The M current, IM, a voltage-dependent non-inactivating K+ current, was recorded in NG108-15 neuroblastoma x glioma hybrid cells, using the whole-cell mode of the patch-clamp technique. We studied the effect of arachidonic acid, other fatty acids and inhibitors of the arachidonic acid metabolism. In relatively high concentrations (25-50 microM) arachidonic acid first increased and later decreased the current, Ih, which holds the membrane potential at -30 mV and mainly flows through open M channels. It shifted the midpoint potential, Vo, of the relation between M conductance, gM, and membrane potential, V, to more negative values and decreased the maximum conductance gM and the time constant tau M. In smaller concentrations (5-10 microM) arachidonic acid merely decreased Ih and gM with little effect on Vo and tau M. Eicosatetraynoic acid and docosahexaenoic acid acted similarly to arachidonic acid whereas stearic acid had no effect. Of the three enzyme inhibitors studied, nordihydroguaiaretic acid acted similarly to arachidonic acid. i.e. caused a biphasic change in Ih. Indomethacin and quinacrine caused, respectively, a pure increase and a pure decrease of Ih and gM. Possible explanations are build-up of internally produced arachidonic acid, depletion of eicosanoid products or an inhibitory effect unrelated to arachidonic acid metabolism.


Evidence against brain stem cooling by face fanning in severely hyperthermic humans. To achieve a hyperthermic state 11 subjects exercised at 35 degrees C air temperature in a water-impermeable outfit, until their oesophageal temperature (Tes) exceeded 39 degrees C. Changes of brain stem temperature were assessed by the interspike intervals of auditory evoked potentials, which depend on brain stem temperature. These were recorded at rest before exercise (condition A), after exercise during a period when heat loss from the face was prevented by covering the head with a plastic hood (condition B), and again during face fanning (condition C). An increase in Tes from 37.14 +/- 0.25 degrees C to 39.05 +/- 0.15 degrees C (A to B) produced a significant reduction in interspike intervals, indicating an increase in brain stem temperature. Changing from conditions B to C, Tes and interspike intervals remained constant, indicating no change of brain stem temperature in spite of face fanning. Thus, even in severely heat stressed humans face fanning is not able to lower brain stem temperature significantly below that of the rest of the body core.


Evaluation of mag-fura-5, the new fluorescent indicator for free magnesium measurements. The new fluorescent indicator, mag-fura-5, was evaluated for its ability to measure accurately physiological changes in cytosolic free magnesium. The apparent dissociation constants (Kd) of the fluorochrome for Mg2+, Mg2+/EGTA and Ca2+/EGTA solutions were 14.7 mM, 15.4 mM, and 1.8 mM respectively. The calculated difference in the fluorescence ratios and in the resulting pMg between the standards with low-Ca2+ or low H+ backgrounds and the corresponding samples with approximately physiological levels were not significant. In contrast, the changes due to an increased Ca2+ or H+ content were statistically significant, with mean pMg differences of 0.10 +/- 0.09 (P < 0.02) and 0.33 +/- 0.26 (P < 0.01) respectively. Repetitive measurements on 3 consecutive days yielded comparable data with differences not exceeding 4%. Because of the good reproducibility, it is suggested that the new fluorescent probe may be suitable for free cytosolic magnesium determinations in isolated cells.


Nucleotide diphosphates activate the ATP-sensitive potassium channel in mouse skeletal muscle. Patch-clamp techniques were used to study the effects of internal nucleotide diphosphates on the KATP channel in mouse skeletal muscle. In inside-out patches, application of GDP (100 microM) and ADP (100 microM) reversibly increased the channel activity. In the presence of internal Mg2+ (1 mM), low concentrations of ADP (< 300 microM) enhanced channel activity and high concentrations of ADP (> 300 microM) limited channel opening while GDP activated the channel at all concentrations tested. In the absence of internal Mg2+, ADP decreased channel activity at all concentrations tested while GDP had no noticeable effect at submillimolar concentrations and inhibited channel activity at millimolar concentrations. GDP [beta S] (100 microM), which behaved as a weak GDP agonist in the presence of Mg2+, stimulated ADP-evoked activation whereas it inhibited GDP-evoked activation. The K+ channel opener pinacidil was found to activate the KATP channel but only in the presence of internal GDP, ADP and GDP [beta S]. The results are discussed in terms of the existence of multiple nucleotide binding sites, in charge of the regulation of the KATP channel.


Modulation of rat olfactory bulb mitochondrial function by atrial natriuretic peptide. Atrial Natriuretic Peptide (ANP) and receptors for ANP are widely distributed in many tissues and cell types in vertebrates. ANP has been shown to be internalized into the cytoplasm in several cell types and thus it raises the possibility that it may act on intracellular receptors. Displacement experiments of [125I]-ANP binding to rat olfactory bulb mitochondrial fraction demonstrated the presence of high affinity (Kd < 10(-9)M) binding sites (Bmax, 112 fmol/mg protein) in this preparation. The addition of ANP (10(-8) M) to this mitochondrial preparation resulted in a 25% increase in TPP+ accumulation, signifying a striking hyperpolarization of the mitochondrial membrane. In contrast ANP did not increase TPP+ uptake to liver mitochondrial preparations. This direct effect of ANP on Olfactory bulb mitochondrial membrane potential may underly the known effects of this hormone on steroidogenesis.


Progressive predominance of 'skeletal' versus 'cardiac' types of excitation-contraction coupling during in vitro skeletal myogenesis. Simultaneous recordings, in the presence or absence of cadmium, of current and contraction of skeletal muscle cells in primary culture (myoballs) showed that the relative part of contraction depending on calcium current progressively decreases with the age of cells whereas the cadmium-insensitive component becomes predominant. The coexistence of "cardiac" and "skeletal" excitation-contraction coupling mechanisms in developing muscle and its developmental regulation are consistent with recent molecular data showing the expression, in newborn animals, of an abbreviated isoform of the alpha 1 subunit of the DHP-receptor of muscle cells.


Effect of rabbit duodenal mRNA on phosphate transport in Xenopus laevis oocytes: dependence on 1,25-dihydroxy-vitamin-D3. Expression of Na(+)-dependent transport of phosphate (Pi) was analysed in Xenopus laevis oocytes after injection of poly(A)-rich RNA isolated from the duodenal mucosa of rabbits with increased levels of 1,25-(OH)2-VitD3 (injection of vitamin D3 or low-Pi diet) or from control animals. In parallel, the effect of elevated levels of vitamin D3 was studied in isolated duodenal brush-border membrane vesicles. In brush-border membrane vesicles, the rate of Na(+)-Pi cotransport was found to be doubled after 1,25-(OH)2-VitD3 injections while Na(+)-D-glucose cotransport (measured as a control) was not altered. In X. laevis oocytes, Na(+)-dependent Pi uptake was increased after injection of poly(A)-rich RNA isolated from duodenal mucosa of animals with increased levels of 1,25-(OH)2-VitD3 but not after injection of poly(A)-rich RNA isolated from control animals; between the two groups of mRNA no difference in the expression of the Na(+)-D-glucose transport system was observed. Sucrose density gradient fractionation suggests that mRNA species related to the increased Na(+)-dependent Pi uptake are of average chain lengths between 2 x 10(3) and 3 x 10(3) bases (2-3 kb). It is concluded that in duodenal enterocytes 1,25-(OH)2-VitD3 increases the content of mRNA species of 2-3 kb that might be involved either directly in Na-Pi cotransport or at least in controlling its activity.


Divalent cations activate small- (SK) and large-conductance (BK) channels in mouse neuroblastoma cells: selective activation of SK channels by cadmium. Effects of Cd2+, Co2+, Fe2+ and Mg2+ (1 microM and 100 microM) and Pb2+ (1 microM and 90 microM) on single-channel properties of the small-conductance (SK) and large-conductance (BK) Ca(2+)-activated K+ channels were investigated in inside-out patches of N1E-115 mouse neuroblastoma cells. Cd2+, Co2+ and Pb2+, but not Fe2+ and Mg2+, cause SK channel opening. The potency of the metals in enhancing the SK channel-open probability follows the sequence Cd2+ approximately Pb2+ > Ca2+ > Co2+ >> Mg2+, Fe2+. The four metals that cause SK channel opening are equipotent in enhancing the opening frequency of SK channels. The BK channel is activated by Pb2+ and Co2+, whereas Cd2+, Fe2+ and Mg2+ are ineffective. The potency of the metals in enhancing BK channel-open probability, open time and opening frequency follows the sequence Pb2+ > Ca2+ > Co2+ >> Cd2+, Mg2+, Fe2+. The results show that SK channels are much more sensitive to Cd2+ than BK channels and indicate that Cd2+ is a selective agonist of SK channels. It is concluded that the various metal ions bind to the same regulatory site(s) at which Ca2+ activates the SK and BK channels under physiological conditions. The different potency sequences of metal ions with respect to BK and SK channel activation indicate that the regulatory sites of these Ca(2+)-activated K+ channels have distinct chemical and physical properties.


Ca2+ dependence of small Ca(2+)-activated K+ channels in cultured N1E-115 mouse neuroblastoma cells. Single-channel properties of Ca(2+)-activated K+ channels have been investigated in excised membrane patches of N1E-115 mouse neuroblastoma cells under asymmetric K+ concentrations at 0 mV. The SK channels are blocked by 3 nM external apamin, are unaffected by 20 mM external tetraethylammonium (TEA) and have a single-channel conductance of 5.4 pS. The half-maximum open probability and opening frequency of SK channels are observed at 1 microM internal Ca2+. Concentration/effect curves of these parameters are very steep with exponential slope factors between 7 and 13. Open-time distributions demonstrate the existence of at least two open states. The mean short open time increases with [Ca2+]i, whereas the mean long open time is independent of [Ca2+]i. At low [Ca2+]i the short-lived open state predominates. At saturating [Ca2+]i the number of long-lived openings is more enhanced than the number of short-lived openings and both open states occur equally frequently. The opening frequency as well as the open times of SK channels are independent of the membrane potential in the range of -16 to +40 mV. The results indicate that activation of K+ current through SK channels is mainly determined by the Ca(2+)-dependent single-channel opening frequency. BK channels in N1E-115 cells are insensitive to 100 nM external apamin, are sensitive to external TEA in the millimolar range and have a single-channel conductance of 98 pS. Half-maximum open probability and opening frequency of the BK channel are observed at 7.5-21 microM internal Ca2+. The slope factors of concentration/effect curves range between 1.7 and 2.9. As the BK channel open time is markedly enhanced at raised [Ca2+]i, the Ca2+ dependence of the current through BK channels is determined by the single-channel opening frequency as well as the open time. SK as well as BK channels appear to be clustered and interact in a negative cooperative manner in multiple channel patches. The differences in Ca2+ dependence suggest that BK channels are activated by a local high [Ca2+]i associated with Ca2+ influx, whereas SK channels may be activated by Ca2+ released from internal stores as well.


Effect of increased distal sodium delivery on organic osmolytes and cell electrolytes in the renal outer medulla. Sodium absorption in distal tubule segments was stimulated by increasing the distal delivery via infusion of hypertonic saline. In these animals, and in control rats, electrolyte concentrations in thick ascending limb cells, light and dark cells of the collecting duct in the outer and inner stripe of the outer medulla and in cells of the proximal straight tubule (outer stripe only) were studied. The measurements were performed by electron microprobe analysis of freeze-dried cryosections of the outer medulla. In addition, organic osmolytes (glycerophosphorylcholine, betaine and myo-inositol) were measured by high performance liquid chromatography in cortex and outer medulla. Augmented delivery of sodium chloride to the distal tubule was associated with increased sodium concentrations of thick ascending limb cells both in the outer and inner stripe and of medullary collecting duct light and dark cells in the outer stripe. While the sum of organic osmolyte concentrations was 28% higher in the outer medulla of the salt-loaded animals compared with controls, this value was unchanged in the renal cortex. These findings indicate that the primary event underlying stimulation of sodium absorption along the thick ascending limb during increased distal sodium delivery is enhanced entry of sodium across the apical cell membrane. This would be expected to lead to higher cell sodium concentrations and stimulation of basolateral active Na-K-exchange. The enhanced transport activity of outer medullary tubules may be associated with increased interstitial tonicities and intracellular retention of organic osmolytes.


Effects of endurance training at high altitude on diaphragm muscle properties. The biochemical, histochemical, and structural changes induced by endurance training and long-term exposure to high altitude were studied in the diaphragm muscle of rats exposed to simulated altitude (HA: n = 16; Pb = 62 kPa, 463 Torr; 4000 m) and compared to animals maintained at sea-level (SL: n = 16). Half of the animals in each group were trained (T) by swimming for 12 weeks, the other half were kept sedentary (S). Except for a small decrease in type I fibres in the HA-S group (-7%, P < 0.05), in favour of type IIab and type IIb fibres, neither high-altitude exposure nor endurance training had an overall affect on fibre type distribution. The mean fibre cross-sectional area was found to be unaffected by altitude and/or chronic exercise. Capillary density was shown to be increased by both high-altitude exposure (P < 0.02) and training (P < 0.001), whereas capillary growth, estimated by the capillary/fibre ratio, was unaffected in both cases. Following endurance training, a modest increase in citrate synthase was shown to occur to the same extent in the HA-T and SL-T groups (+15% and +16% respectively, NS). Hexokinase increased following training (P < 0.05) and high-altitude exposure (P < 0.001). In normoxic and hypoxic animals, endurance training enhanced the ratio of the heart-specific lactate dehydrogenase isozyme LDH1 to total LDH activity (+59%, P < 0.01; +92%, P < 0.05 respectively). It may be hypothesized that the increased glucose phosphorylation capacity observed in diaphragm muscle contributes to the reduction of glycogen utilization during exercise.


Subcellular gradients of intracellular free calcium concentration in isolated lacrimal acinar cells. The spatial distribution of intracellular free calcium concentration ([Ca2+]i) was measured in small clusters of isolated rat lacrimal acinar cells by imaging the fluorescence of the Ca(2+)-sensitive dye fura-2. In the absence of extracellular Ca2+, stimulation with acetylcholine (ACh) caused an increase in [Ca2+]i, due to release of intracellular Ca2+ stores, which was maximal at the luminal pole of the cell. In contrast, the organellar Ca(2+)-ATPase inhibitor 2,5-di(tert-butyl)-hydroquinone caused an increase in [Ca2+]i, which was most marked in the basolateral region of the cell. When the cells were stimulated with ACh in a medium containing Ca2+, the gradients of [Ca2+]i (with [Ca2+]i most elevated at the luminal pole) were maintained for the duration of agonist stimulation. The possible implications of these results concerning the location and identity of intracellular Ca2+ stores, and the location of the sites that underlie agonist-stimulated Ca2+ influx, are considered. In particular, it seems likely that intracellular inositol-1,4,5-trisphosphate (InsP3) binding sites may be concentrated in the luminal region of the cell. It is not clear, however, whether this implies that there is a distinct luminally located InsP3-sensitive organelle.


Microelectrode determination of oxyntic cell pH in intact frog gastric mucosa. Effect of histamine. Intracellular pH (pHi) of acid-secreting cells was measured in intact gastric fundus mucosa of Rana esculenta with double-barrelled pH microelectrodes. Tissues were mounted, serosal side up, between two half chambers and individual cells were impaled after microsurgical removal of the serosal muscle layer. Transepithelial potential difference (Vt) and resistance (Rt) as well as serosal cell membrane potential (Vs) and pHi were continuously recorded at rest (0.1 mmol/l cimetidine) or during stimulation (0.5 mmol/l histamine). During chamber perfusion with HCO3-/CO2-buffered Ringer solution of pHo = 7.36, Vt and Rt were -21.7, SD +/- 6.0 mV and 229 +/- 83 omega cm2 (n = 17) while Vs and pHi averaged -57.3 +/- 6.9 mV and 7.4 +/- 0.11 (n = 25). The latter value is considerably more alkaline than all recent pHi measurements obtained with microspectrofluorometric techniques on isolated cells, glands or intact tissue. The difference may in part be explained by use of HCO3(-)-free solutions in most of the previous studies because we observed that such solutions decrease pHi to 6.89 +/- 0.18 (n = 4). Again, in contrast to recent literature, application of histamine in HCO3-/CO2-buffered solution led to further transient alkalinization by 0.12 +/- 0.05 pH unit (n = 8). Since in accidental punctures of the gastric gland lumen we noticed that H+ secretion only began approximately 5 min after histamine application, we conclude that the histamine-induced initial alkalinization does not reflect stimulation of the H+/K+ ATPase pump.(ABSTRACT TRUNCATED AT 250 WORDS)


Identification of an ATP-sensitive K+ channel in rat cultured cortical neurons. To determine whether membranes of mammalian central neurons contain an ATP-sensitive K+ (KATP) channel similar to that present in pancreatic beta cells, the patch-clamp technique was applied to cultured neurons prepared from the neonatal rat cerebral cortex and hippocampus. In whole-cell experiments with hippocampal neurons, extracellular application of 0.5 mM diazoxide (a KATP channel activator) elicited a hyperpolarization concomitant with an increase in membrane conductance, whereas application of 0.5 mM tolbutamide (a KATP channel blocker) induced a depolarization with a decrease in conductance. Similar results were obtained with cortical neurons. In outside-out patch experiments with cortical neurons, a K+ channel sensitive to these drugs was found. The channel was completely blocked by 0.5 mM tolbutamide and activated by 0.5 mM diazoxide. The single-channel conductance was 65 pS under symmetrical 145 mM K+ conditions and 24 pS in a physiological K+ gradient. In inside-out patch experiments, this channel was demonstrated to be inhibited by an application of 0.2-1 mM ATP to the cytoplasmic surface of the patch membrane. These results indicate that the membranes of rat cortical neurons contain a KATP channel that is quite similar to that found in pancreatic beta cells. It is also suggested that the same or a similar K+ channel may exist in membranes of hippocampal neurons.


Modulation of desynchronized sleep through microinjection of alpha 1-adrenergic agonists and antagonists in the dorsal pontine tegmentum of the cat. Noradrenaline is involved in the regulation of the sleep/waking cycle by acting through various receptor types. In previous studies we investigated the role of beta- and alpha 2-adrenergic receptors through local microinjections of various drugs into the dorsal pontine tegmentum (DPT) of the cat. This region is known to be crucially involved in desynchronized sleep execution. In this study we examined the role of alpha 1-adrenergic receptors. The alpha 1-agonist methoxamine and the alpha 1-antagonist prazosin were injected into the DPT of freely moving, unanaesthetized cats. We found that methoxamine notably reduced desynchronized sleep, and that this effect was both dose-dependent and site-specific. These effects were prevented by the subsequent injection of prazosin. On the other hand, the injection into the DPT of prazosin alone produced scarce or inconsistent effects on the sleep/waking cycle.


Sodium-activated potassium current in sensory neurons: a comparison of cell-attached and cell-free single-channel activities. Single-channel currents from Na(+)-dependent K+ channels (KNa) were recorded from cell-attached and inside-out membrane patches of cultured avian trigeminal ganglion neurons by means of the patch-clamp technique. Single-channel properties, such as the high elementary conductance and the occurrence of sub-conductance levels, were unchanged after the patches had been excised from the cells, indicating that they are not under the control of soluble cytoplasmic factors. In cell-attached recordings at the cell resting potential the degree of KNa activity, measured as the probability of the channel being open, Po, was low in most cases (around 0.01) and similar to that observed in the inside-out configuration when the bath solution contained concentrations of Na+ around 30 mM and of K+ close to the physiological intracellular levels. However, in some cell-attached patches Po was high (around 0.2) and comparable to the values measured in cell-free recordings with high Na+ concentrations in the bath (100 mM). The excision of a high-activity patch in the presence of 30 mM Na+ resulted in a fall of Po in about 20 s, which is consistent with the wash-out of a soluble cytoplasmic molecule. After the excision, all KNa displayed a similar Na+ sensitivity, irrespective of the degree of activation observed in the cell-attached mode. In inside-out patches the Po values observed in the presence of either low or high concentrations of Na+ in bath solutions were not modified by internal Ca2+ (0.8-8.5 microM).(ABSTRACT TRUNCATED AT 250 WORDS)


[MR imaging of degenerative lumbar disc disease emphasizing on signal intensity changes in vertebral body]. Magnetic resonance imaging was performed in 400 patients with degenerative disc disease. Signal changes and their sites in the vertebral body were classified and referred to narrowing of the intervertebral disc space. MR findings were compared with those of plain roentgenograms of the lumbar spine. Signal changes in the vertebral body were noted in 83 cases (102 vertebral bodies). Low-intensity abnormality on both T1- and T2-weighted images (WI) was the most common finding, and was most frequently seen at the end plate and/or the angle. These changes were correlated with narrowing of the disc space and osteosclerosis on the plain roentgenogram of the lumbar spine. Signal changes occasionally occurred in the inner region of the vertebral body, and these lesions tended to show a high-intensity abnormality on T1-WI. We conclude that signal changes in degenerative disc disease are not specific, but are sometimes difficult to distinguish from the signal changes in other conditions such as spinal tumor or bone marrow disorder.


[Diagnostic imaging of polysplenia syndrome in the adult]. Polysplenia syndrome is a congenital disorder of situs that is characterized by the presence of multiple spleens and a variable combination of thoracic and visceral anomalies. We present three adult cases of polysplenia syndrome with emphasis on the diagnostic imaging findings. Computed tomography could best determine the exact location and shape of the anomalous organs. The visceral anomalies observed in our patients included multiple spleens, interruption of the inferior vena cava (IVC), azygos or hemiazygos continuation, left-sided IVC, symmetrical liver, anomalous fissure of the liver, anomalous lobe of the liver, median location of the gallbladder, short pancreas, inverted stomach, gallbladder and pancreas, and intestinal malrotation.


[Semidiscoid lateral meniscus].

[Semidiscoid lateral meniscus]. We propose a new entity known as "semidiscoid lateral meniscus" of the knee. The diagnostic criteria for semidiscoid lateral meniscus is the appearance on a thin-sliced axial 3-D image of a crescent-shaped meniscus whose transverse width is within 11.6 mm to 14.3 mm on the coronal image. These numerical values were calculated by discriminant analysis. A retrospective review of MR examinations of the knees revealed 15 patients (15 knees) with this entity. These patients were our subjects. Of these 15 patients, complicated lateral meniscal tears were seen in only three cases. Nine knees were free from complications, and five were asymptomatic. Six patients were examined with MR on the contralateral side, and discoid lateral menisci were revealed in all cases. Thus semidiscoid lateral meniscus shows a cross-relationship with discoid menisci.


[Abnormal chest shadow on CT in immunosuppressed patients]. An abnormal chest shadow was observed on CT scans in 25 cases of 23 immunosuppressed patients. Pulmonary disease was pathologically confirmed to be pneumocystis carinii pneumonia (PC pneumonia) in four patients, cytomegalovirus pneumonia (CMV pneumonia) in one, bacterial pneumonia in seven, fungal infection in three, miliary tuberculosis in one, leukemic infiltration in two, lymphangitis carcinomatosa in three, drug-induced pneumonitis in three, and ARDS in one. In almost all patients, especially those with infectious diseases such as PC pneumonia, CMV pneumonia, and bacterial pneumonia, the abnormal shadow was wide and visible in the bilateral lung fields. We presumed that such findings as lobular shadow, centrilobular shadow, and mosaic pattern reflected the extension of disease via the respiratory tract, and that those findings are typical of infectious diseases. Because such findings as abnormal linear shadow and swelling of a broncho-vascular bundle were very frequently recognized in patients with lymphangitis carcinomatosa and frequently recognized in those with drug-induced pneumonitis, these diseases may be distinguished from other diseases. An area of slightly increased density was frequently recognized in patients with PC pneumonia, bacterial pneumonia, and drug-induced pneumonitis. Such lesions were pathologically confirmed to be located in the interstitium and/or alveolus. CT was extremely useful in comprehending the character and extension of particular diseases among various diseases. As the number of patients studied was small, the utility of CT in immunosuppressed patients requires further investigation in a larger number of patients.


[MR imaging of pericallosal lipomas].

[MR imaging of pericallosal lipomas]. Eight cases of pericallosal lipomas were studied by MR imaging at 1.5 Tesla. All were located around the splenium of the corpus callosum, and were classified as the curvilinear type. Corpus callosal abnormalities were detected in the six of these eight cases, and included two cases of short corpus callosum and four of thin splenium. The larger lipomas tended to have greater abnormalities of the corpus callosum. T1-weighted sagittal images were the most useful pulse sequences for diagnosing pericallosal lipomas and corpus callosal abnormalities. On review of the literature we found that the curvilinear type of pericallosal lipoma is more frequently observed by MR imaging than the tubulonodular type.


[MR imaging evaluation of plica synoviallis mediopatellaris of the knee joint]. To evaluate the diagnostic ability of MR imaging for plica synoviallis mediopatellaris (PSM), we retrospectively reviewed the MR imaging findings of patellofemoral space in 20 knee joints of 11 patients. In all 20 knee joints, arthroscopy and MR imaging were available. MR imaging was performed with a 1.5 Tesla Magnetom (Siemens) using a round surface coil. Pulse sequences were SE (TR 600 ms/TE 26 ms), SE (TR 200 ms/TE 26, 70 ms) and FLASH (TR 450 ms/TE 15 ms/FA 90 degrees). In six of the 20 knees with PSM proved by arthroscopy, a low intensity band was shown above the medial condyle of the femur on both T1- and T2-weighted MR images, and on FLASH images this band was shown as intermediate intensity. In the other 14 knees with no PSM observed by arthroscopy, the low intensity band was not shown on MR imaging. In all 20 knees, a similar low intensity band was shown about 1 cm cranial to the medial condyle of the femur. This should not be diagnosed as PSM. The low intensity band seen on T1- and T2-weighted MR images and its anatomical relation to the medial condyle are important in diagnosing PSM.


[CT of intestinal injuries following blunt trauma]. We retrospectively reviewed 53 CT scans in 42 patients with surgically proven intestinal injury following blunt abdominal trauma. Free air and localized low density fluid were specific signs of intestinal injury. Free peritoneal fluid without a known source, thickened bowel wall, and thickened mesentery were non-specific ones. Specific and non-specific findings were demonstrated in six (22%) and 23 (85%) of 27 CT scans performed within four hours following trauma, and 19 (73%) and 26 (100%) of 26 CT scans performed after four hours, respectively. CT is useful for the diagnosis of blunt intestinal injuries, but early diagnosis is difficult because of the lack of specific signs.


[Expandable metallic stent therapy for SVC syndrome--effects on local venous pressure, vascular diameter, symptoms, and these correlations]. To evaluate the efficacy of Z-stent therapy for SVC syndrome, we studied changes in the pressure, the diameter of stenotic lumen and the symptoms in the cases of SVC syndrome with higher pressure than 30 cmH2O at distal to the stenosis. The symptoms were classified and graded to be scored up. Immediately after the Z-stent placement into the stenotic lesions, the venous pressure distal to the stenosis decreased from 36.0 +/- 3.4 cmH2O to 12.0 +/- 12.0 cmH2O (p < 0.001), the diameter of stenotic lumen increased from 3.3 +/- 3.4 mm to 14.0 +/- 3.4 mm (p < 0.01). According to the remarkable symptomatic improvements the averaged score decreased from 6.7 to 1.3 (p < 0.01). The pressure, the diameter and the symptom scores were highly correlated each other (magnitude of gamma not equal to 0.9). Among two cases with the right atrial pressure increase by 2 cmH2O after the placement one suffered transient cardiac in compensation due to overload by reperfusion. Conclusively, the Z-stent therapy was very effective on the SVC syndrome in reducing abnormally elevated venous pressure due to the stenosis, and relieving the symptoms, while the pressure monitor was necessary.


[The effectiveness of radiotherapy for Merkel cell carcinoma]. Merkel cell carcinoma is a high-grade malignant tumor of the skin that tends to extend locally and metastasize to regional lymph nodes. Surgical resection is the treatment of choice, and the effectiveness of radiotherapy for this disease has not yet been established. We report two cases of biopsy-proven Merkel cell carcinoma effectively treated with radiotherapy. Histopathological examination of the resected specimens after radiotherapy of 50 Gy and 38 Gy, respectively, using 6 approximately 15 MeV electrons showed no malignant cells in either case. No evidence of recurrence or metastasis has been noted in 11 to 21 months after radiotherapy. To our knowledge, no case of Merkel cell carcinoma in which complete cure was obtained by radiotherapy alone has been reported previously. It is considered that preoperative radiotherapy would contribute to the management of this locally invasive but radiosensitive tumor.


[Biological effects of static gradient magnetic field on cultured mammalian cells and combined effects with 60Co gamma-rays]. The biological effects of a static gradient magnetic field and its combined effects with ionizing radiation on FM3A cultured cells were investigated. The magnetic strength of the center of the field was 5.8 x 10(-2) T esla, the mean gradient of the magnetic filed was 0.6 T esla/m. The magnetic field influenced cell cycle. The relative amount of cultured cells in G1 phase decreased for eight hours after exposure. The growth rate of the cells was slowed by about 5%. Following exposure to the magnetic field, the survival rate of cells decreased to about 20% less than that of the non-exposed control. The combined effect of 60Co irradiation with exposure to the magnetic field showed a greater effect than a simple additive one. The combined effect was influenced by the interval between 60Co irradiation and exposure to the magnetic field. The biological effects of the magnetic field may be related to age-dependent cellular damage in the cell cycle, blockage of cell progression in the cell cycle, and increased repair from radiation damage.


[Hormone therapy using tamoxifen in unresectable carcinoma of the pancreas--preliminary study]. In 1981 Greenway and co-authors reported the existence of estrogen receptor in tumor tissue of the pancreas. We have tried hormone therapy using tamoxifen in 4 of 11 patients with unresectable carcinoma of the pancreas in whom expandable metallic stents were inserted for the palliation of obstructive jaundice. The mean survival period in these 4 patients was 235 days, and 2 of them had a remarkably long survival of 321 and 463 days respectively. On the other hand, the mean survival was 128 days in 7 control patients. We therefore evaluated this new therapy with tamoxifen as effective in patients with unresectable carcinoma of the pancreas.


[Experimental study of indirect lymphography with iodinated starch]. Opacification of lymph nodes on CT was attempted by means of indirect lymphography with iodinated starch (IS). Sixty percent solutions of two different molecular weights of IS were prepared (5,000 mol wt and 70,000 mol wt in average). After subcutaneous injection of IS solutions to the pedal area of dogs, CT scans were performed to evaluate opacification of the popliteal lymph nodes. The lymph nodes began to be opacified from 10 min after the injection of each solution. The high molecular weight IS showed higher attenuation and longer duration of opacification than did the low molecular weight IS. Homogeneity of opacification was better with latter. The optimum molecular weight for this purpose is considered to be between 5,000 and 70,000 mol wt.


[Transjugular intrahepatic portosystemic stent shunt (TIPSS) with use of Rösch-Uchida transjugular liver access set--evaluation by CT and its clinical application]. Appropriateness of the Rösch-Uchida transjugular liver access set designed for TIPSS procedure was confirmed, especially about the catheter angle and effective length of the 20 G puncture needle, by CT analysis on three dimensional vascular anatomy of the liver. Clinically, TIPSS using the set was successfully made for two patients, connecting superior right hepatic vein with right portal vein in one patient and middle hepatic vein with left portal vein in another patient with hypoplastic right portal vein. Prior to TIPSS procedure, verification of vascular anatomy on CT images is the key to success of TIPSS in safe.


[Fatty acids: their biochemical and functional classification]. Fatty acids (FA) constitute the main component of phospholipids, triglycerides and cholesterol esters. FA are acidic, monocarboxylic linear chains of variable length: short-chain FA (2-4 carbon atoms), medium-chain FA (6-12 carbon atoms), long-chain FA (14-18 carbon atoms), very long-chain FA (derived from parental 18-carbon molecules). They can be further subdivided into saturated (no double bond), monounsaturated (one double bond) and polyunsaturated (two or more double bonds). They are all involved in energetic, metabolic and structural activities. Short-chain FA act as growth factors; medium chain FA are readily available as energy source; saturated long-chain FA constitute a source of energy but may be implicated in the development of the atherosclerotic process; unsaturated long-chain FA include oleic acid and the essential fatty acids (linoleate and linolenate), and are all implicated in fundamental metabolic processes; very-long chain FA are the most characteristic molecules in biologic membranes. From recent works it is clearly established that the physiological role of FA depends on the chain length, and that the very-long chain molecules could determine the quality of human development. A functional classification of FA today must be based not only on the rate of unsaturation, but also (and most importantly) on the chain length.


[Fatty acid metabolism and requirements in childhood]. The metabolism of fatty acids (FA) has a profound impact on the development of the human being. In fact, the lipidic composition of membranes may be modulated by the relative concentrations of available FA. During the last months of the fetal life, an increasing concentration of polyunsaturated very long-chain (VLC) FA is observed from the umbilical cord to the liver and the central nervous system, where they contribute to the qualitative development of the nervous membranes. Therefore, the preterm baby is at particular risk of polyunsaturated VLCFA deficiency. Among polyunsaturated VLCFA, 20:4 n-6 and 22:6 n-3 carry on fundamental roles respectively for cellular growth and visual development. The accretion of VLCFA in the human body is intense also in the term infant during the first months of life. In the period of exclusive milk-feeding fat represents 50% of the daily caloric intake, and the ketonic bodies, resulting from the incremented beta-oxidation of FA, are readily utilized as source of energy by the developing brain. Weaning is now object of study to precise both metabolic needs and dietary intakes of FA families. Recent surveys have revealed that in this period the intakes of linoleic and linolenic acid are at the lower limits of the recommended levels. No upper limit for saturated FA is advisable for the first two years of life.(ABSTRACT TRUNCATED AT 250 WORDS)


[Fatty acids in prevention and therapy in pediatrics]. Fatty acids (FA) are involved in both physiologic and pathologic biochemical pathways. Saturated FA (mainly 12-C and 14-C) are implicated in the development of hypercholesterolemia and early atherogenesis. On the contrary, monounsaturated and polyunsaturated FA (mainly 18:2 n-6 and n-3 very long-chain FA) have been claimed to have hypocholesterolemic and protective effects. In particular, oleic acid (18:1 n-9) seems to lower only the atherogenic fraction of circulating cholesterol (the low-density lipoproteins), leaving immodified the level of the protective fraction (the high-density lipoproteins). Polyunsaturated very long-chain FA have been recently studied for the prevention and therapy of atopic and cutaneous disorders, with conflicting results. In this respect, the 20:4 n-6 acts as proinflammatory agent, while the n-3 very long-chain FA could act as modulators of the immuno-allergic and inflammatory reactions. However, attention must be paid to the high peroxidative potential of the more unsaturated FA. Very recently, VLCFA have been considered for the therapy of some inherited disorders of metabolism. Monounsaturated very long-chain FA have been used in the treatment of x-linked adrenoleukodystrophy. A dietetic deficiency of polyunsaturated very long-chain FA has been observed in treated phenylketonuric children. Some inborn errors of metabolism could represent an useful model for better understanding the biochemistry of FA.


[Dietary sources of fatty acids in childhood]. The first oral supply of fatty acids (FA) is provided by human milk. It contains a large variety of FA, perfectly adequate to the newborn's metabolic needs. Saturated and monounsaturated chains derive from the local mammary gland synthesis, while polyunsaturated very long-chains come from the hydrolysis of circulating lipoproteins and are more dependent on the maternal dietary habits. Trans FA have been shown in human milk too. The fat content of human milk progressively increases during the breast-feeding period; it varies during the day and from feed to feed. Infant formulas contain a very narrow range of FA. No commercially available formula contains the very long-chain polyunsaturated FA. Formulas for pre-term babies enriched with these molecules have been recently studied. The role of medium-chain FA in the early diet of the pre-term infant must still be defined. With weaning, green leafy vegetables become a balanced source of essential FA, while animal foods (both meat and fish) supply not only saturated but also polyunsaturated very long-chain FA. Analogously, vegetal oils are a fundamental source of monounsaturated and essential FA, animal fats (butter, lard) are a rich source of saturated fats and fish oils contain a mixture of n-3 polyunsaturated very long-chain FA. Correct dietary habits for children should provide a rich variety of foods, to reach a balanced supply of all the families of FA. Oleic acid should represent the main FA in the diet.(ABSTRACT TRUNCATED AT 250 WORDS)


[The diagnostic approach to and clinical study of 23 children with an obstructive sleep apnea syndrome]. 23 children, aging from 3 to 13 years, affected by chronic upper airway obstruction, were studied. The clinical suspicion was "obstructive sleep apnea" (O.S.A.). In this study was found a significantly different frequency, in O.S.A. group, if compared with controls, of the following symptoms: nocturnal snoring (100%), mouth breathing when awake (69%), and during sleep (91%), abnormal restless movements (69%), behavioral disturbances (60%). Clinical evaluation revealed: pectus excavatum (82%), enlarged tonsils and adenoids (82%), failure to thrive (39%). Chest index was 0.72 +/- 0.07 significantly higher (p < 0.001) than controls. The authors also carried out in all patients and controls pCO2 venous blood determination during sleep, to screen subjects with high risk of cardiopulmonary dysfunction. Data obtained showed that threshold value of pCO2 was 45.6 mmHg.


[The micro-ESR with the capillary tube inclined to 45 degrees in the "sepsis screen" of neonatal infection due to beta-hemolytic B-group Streptococcus]. The authors describe the advantages of a new method to determinate the erythrocyte sedimentation rate (micro-ESR) during neonatal GBS infections. They utilize a capillary tube placed at a 45 degrees angle and have the results of this test only after 15 minutes. The micro-ESR is proposed as a simple and quick method of sepsis screen in term and preterm newborns.


[Treatment with low-dose methotrexate in intractable juvenile chronic arthritis]. 14 patients suffering from Juvenile Chronic Arthritis unresponsive to NSAIDS were enrolled in this open study. There were two patients with a systemic form, nine patients with polyarticular form. All patients received methotrexate administered orally in one or two divided doses; the dose was 0.3-0.5 mg/kg/week. Clinical improvement occurred in most of the cases; remission was achieved in 5 out of 9 polyarticular form, in one out of the two systemic form and in two out of the three pauciarticular form. All patients showed a significant improvement in the clinical parameters except one with a pauciarticular form (duration of morning stiffness, number of swollen joints and number of painful joints). The effects on laboratory indexes were a decrease in ESR and CRP in about 50% of the cases, an increase up to the normal value of hemoglobin in about 30% of the cases. Two patients experienced a transient gastrointestinal discomfort and 3 had a mild elevation of serum aminotransferase levels which were restored after a reduction of the drug. In conclusion our data confirm that methotrexate at low dosage is more effective than other second-line agents and has fewer side effects. In our opinion methotrexate can today be considered the first choice for Juvenile Chronic Arthritis unresponsive to NSAIDS.


[The correlation between the genotype and the clinical expression of cystic fibrosis]. The authors report a phenotype-genotype correlation in a population of patients from center and south Italy affected by cystic fibrosis (CF). Thirteen (21%) of patients with pancreatic insufficiency (PI) were homozygous for delta F508, seventeen (27%) were delta F508 heterozygous with an associated unknown allele. Two other described mutations (N1303K, G542X) were also found in a heterozygote status and associated with a severe clinical expression of disease.


[IgA-class antigliadin antibodies in the screening and follow-up of celiac disease patients]. IgA antigliadin antibodies (IgA-AGA) have been determined with an enzyme immunoassay in 2.141 pediatric patients. High levels of IgA were found in 98% of 53 celiac patients (1st biopsy), in 81% of 16 celiac patients after gluten challenge, while high levels of these antibodies were not found in 200 patients on gluten-free diet. Moreover high levels of IgA-AGA were found in 29% of 48 patients with normal jejunal biopsy and in 4% of 1.824 patients with gastrointestinal problems other than celiac disease. Our results confirm the data report in literature about the sensibility and the specificity of the IgA-AGA dosage as a screening test for celiac disease, but the possibility of false pathological and false normal values confirms the intestinal biopsy, as the main procedure for the diagnosis of celiac disease.


[Bone density in swimmers].

[Bone density in swimmers]. Bone mineral density of the non-dominant forearm was measured by single-photon absorptiometry at a proximal site (PBMD) and at a more distal site (DBMC) in 9 competitive male swimmers, aged 18 to 23 years, who had been training for 12 +/- 2 years, 10.3 +/- 5.6 hours a week. The results were compared with 25 age-matched controls. PBMD was m +/- SD 0.57 +/- 0.02 g/cm2 in the swimmers and 0.57 +/- 0.05 g/cm2 in the controls. DBMD was 0.45 +/- 0.02 g/cm2 in the swimmers and 0.45 +/- 0.03 g/cm2 in the controls. No difference was found between the two groups. We can therefore conclude that swimming, in absence of gravity, didn't provide our athletes with an effective mechanical load capable to increase bone density of the forearm.


[Asthma due to Dermatophagoides in children. Peroral desensitization]. At present current knowledges on OIT are controversial. We studied the effectiveness and the possible immunological mechanisms of this therapy. We followed a group of 56 children affected by allergic asthma due to Dermatophagoides during their treatment with OIT. Many clinical parameters were investigated and also immunoallergological and spirometric values in a subgroup. We observed a particularly satisfying clinical and respiratory improvement, while immunoallergological parameters did not suffer significant changes.


[Antireflux plastic repair of the cologastric anastomosis in a female patient operated on by retrosternal esophagocoloplasty]. Esophageal atresia without fistula is a rather uncommon malformation (about 8% of all esophageal atresias); its surgical correction is sometimes difficult because of the long gap between the two pouches. When a delayed anastomosis cannot be performed, it is necessary to perform a colon interposition. In one patient operated with retrosternal esophageal-colon-plasty a second operation was needed to correct a symptomatic reflux causing dysphasia and severe aspiration pneumonia. The distal end of the colon was tapered around a chest tube; then a submucosal gastric tunnel was prepared, and the tapered colon was pulled through it and anastomosed to the gastric lumen. The child showed no evidence of gastrocolic reflux in the three years following the operation and is today healthy. Radiologic and scintigraphic examinations, performed ten months after the operation, showed the good canalization of the interposed colon and the continence of the antireflux anastomosis.


[Multiple sclerosis in childhood: a report of 2 clinical cases]. Multiple sclerosis is a rare finding in pediatric age. The onset of the disease may be in adolescence or pre-adolescence. It is important that pediatricians know the diagnostic criteria and clinical course of multiple sclerosis in childhood. We describe the case reports of two children, a 11- and a 14-years-old girls and review the literature of the last 5 years on multiple sclerosis in childhood.


[Superoxide dismutase activity of erythrocytes and their osmotic fragility]. Blood samples were obtained from 15 diabetic patients (type I) and 10 healthy subjects. Erythrocyte superoxide dismutase activity, Heinz bodies and osmotic fragility were determined. Our results suggest that decreased activity of erythrocyte SOD predisposes to denaturation of haemoglobin (Heinz bodies) and haemolysis (increased osmotic fragility).


[Chickenpox and Schönlein-Henoch purpura: a report of a case with nephropathy]. Authors describe a child affected by chickenpox, Schönlein-Henoch purpura and nephropathy. The ecchymotic lesions were diffused in buttocks and legs and they were associated with vesicular haemorrhagic injury in the back of hands and in pavilions of the ears. They suggest that varicella-zoster virus can play a "trigger" role in etiopathogenesis of Schönlein-Henoch purpura and that this syndrome worsens the renal failure. Steroids don't improve the renal disease in the acute phase but they seem to reduce the relapses.


[Accessory Mahaim atrioventricular pathways as the probable cause of sudden death in an infant]. A 26-day-old infant dying suddenly and diagnosed as sudden infant death syndrome (SIDS). Conduction system abnormalities were found, consisting of accessory atrioventricular (AV) pathways of Mahaim type, which can be regarded as arrhythmogenic in nature.


[Effects of furosemide, propranolol and nifedipine on urinary excretion of Tamm-Horsfall protein in patients with arterial hypertension]. In 65 hypertensive patients the influence of 10 day treatment with furosemide (24 subjects), nifedipine (21 subjects) and propranolol (20 subjects) respectively on urinary Tamm-Horsfall protein (U-THP), sodium and potassium excretion, 24 hour urinary volume and blood pressure was determined. In 23 control subjects the above mentioned parameters were assessed only under basal conditions. In hypertensive patients urinary THP excretion was not different from controls. In all examined groups a significant positive correlation was found between urine volume and urinary THP excretion under basal conditions. Such a correlation was absent after nifedipine or propranolol therapy respectively, but still existed after furosemide administration. No correlation was found between urinary THP and Na and K excretion respectively. In contrast to nifedipine and propranolol, a 10 day treatment with furosemide caused a significant increase in U-THP. Urinary THP excretion in hypertensive patients did not differ from U-THP in healthy subjects. In contrast to propranolol and nifedipine, treatment with furosemide caused an increase in THP urinary excretion.


[Urinary excretion of Tamm-Horsfall protein by patients with acute renal failure]. Urinary excretion of Tamm-Horsfall protein (THP), sodium and potassium was assessed in 12 patients 5, 8, 11, 14, 17, and 22 days after the onset of acute renal failure (ARF) and in 23 control subjects. In patients with ARF at the oliguric phase urinary excretion was significantly reduced but significantly increased (when compared with controls) at the onset of the polyuric phase. In contrast to healthy subjects in patients with ARF no significant correlation was found between urine volume and urinary excretion of THP. Normalization of THP excretion was noticed prior to normalization of serum creatinine level. Results obtained in this study prove absence of the physiological relationship between urinary excretion of THP and urine volume in patients with ARF.


[Crohn's disease: comments on a case].

[Crohn's disease: comments on a case]. Crohn's disease, regarded, up to a short while ago, a rare illness, with a higher rate of incidence, after the second ten years of life, in the last years underwent an increase in its frequency, mostly in the earliest years. In accordance with these observations, the Authors considered an interesting solution to quote a case of Crohn's disease, which had been watched by them, over a patient of tender age.


[Platelet aggregation during the recombinant human erythropoietin (rHuEPO) treatment of patients with uremia]. Patients with uraemia have a defect haemostasis caused by severe anaemia and disturbances of platelet/vessel wall interactions. Recombinant human erythropoietin (rHuEPO) treatment not only corrects anaemia, but also shortens the bleeding time. There are few reports dealing with changes of haemostasis during the first month of rHuEPO treatment. We studied platelet function after 1, 2, 4, 8, and 12 weeks of rHuEPO treatment. Erythropoietin was given to 19 dialysed patients with chronic uraemia in a dose of 2000 u subcutaneously 3 times a week. Bleeding time showed a significant fall as early as after the first week of rHuEPO treatment (p < 0.05). After the first month the bleeding time became normal in most of the patients. A significant rise in ristocetin-induced platelet aggregation was observed from the first week of therapy. It showed a strong correlation with the shortening of the bleeding time. Collagen-induced aggregation followed the same pattern but the changes were not striking. There was not significant difference in platelet adhesion, platelet aggregation in the whole blood and those induced by ADP and arachidonic acid. Platelet serotonin concentration was also showed to increase during rHuEPO therapy. We conclude that rHuEPO improves haemostasis by influencing platelet aggregation possibly involving a serotoninergic mechanism but on the other hand may increase a tendency to thrombosis.