[Evaluation of blood glucose concentration during exertion. 6. Effect of anemia on the glucose regulation capacity of domestic swine in standardized running exercise]. Individual mean blood glucose values and the scatter of individual values were determined in six healthy and six anaemic pigs before, during and after ten minutes of exercise on a belt moving at 78 m/min (environmental temperature 22-24 degrees C, relative humidity 55-65%). The glucose regulatory capacity of anaemic pigs was inferior to that of healthy pigs. Blood glucose regulation was related to haemoglobin content and to the increase in rectal temperature during exercise.


Cardiac evaluation of a physical rehabilitation program for patients with ischemic heart disease. A reconditioning exercise program that was applied to group of 12 coronary patients resulted in an increase of their tolerance to physical work and of their maximal working capacity. In some instances the improvement in physical condition was accompanied by changes in indicators of cardiac function which suggest that an improvement in myocardial performance also occurred. Although some evidence of this has been presented, more studies are needed for substantiation. It is believed, on the other hand, that to explain the improvement of the patient, it is not necessary to invoke an improvement of myocardial performance. An improvement of patient's tolerance to physical work may also be explained by extracardiac mechanisms that produce changes in arterial peripheral resistance, regional blood flow distribution, overall mechanical efficiency, muscle capillarization, fiber size and mitochondrial enzymatic activity, patterns of sweating, adaptation between pulmonary ventilation and circulation, work of breathing efficiency, autonomic nervous system balance and in the adaptive responses of the neuroendocrine system which mediate between psychic and physiological behavior. All of these changes have been observed in healthy individuals submitted to physical training. It is plausible to assume that they may also occur in the patient with ischemic heart disease. What is to be shown is which one or which ones of these mechanisms prevail in a given individual.


The neurological examination: advancements in its quantification. For the past decade, our group of neurologists, biomedical engineers and statisticians has developed objective tests to quantify apropos neurological functions (cognition, strength, steadiness, reactions, speed, coordination, sensations, fatigue, gait, station and selected skills of daily living). Instrumented tests have been extensively evaluated and used in several randomized double-blind trials in multiple sclerosis and Parkinson's disease. Our long-term goal is to bring to clinical neurology a type of quantification of the nervous system which does not exist. In this report, a brief overview of test development, personnel training, test administration and selected situations for using the clinical quantitative neurological examination (CQNE) are discussed. In addition, 57 tests are illustrated and described.


Quantitative examination of neurological function: reliability and learning effects. During the last five years, a battery of tests measuring neurological function called the Quantitative Examination of Neurological Function (QENF) has been greatly expanded. To evaluate more effectively the efficacy of clinical trials, the results of a study on reliability of test measures and on long- and short-term effects of learning are reported. Of the 113 test measures that were evaluated using 18 young adult normal subjects, only the fatigue and error measures, the vibration sense and two simulated activities of daily living tests were found unreliable. With respect to learning, the largest improvements in performance were found for arm-shoulder pursuit tracking, followed by many of the tests of coordination, particularly those requiring manual and/or finger dexterity. Only slight changes were found for tests of vision, strength, and speed of hand and foot. There were no important differences between short- and long-term learning. Considering this and other studies, patients are not likely to improve their performance appreciably by learning in a clinical trial.


Heating patterns produced in humans by 433.92 MHz round field applicator and 915MHz contact applicator. Temperature distributions produced by a round field applicator operating at a frequency of 433.92 megahertz (MHz) are comparable to those produced by a 915 MHz cooled contact applicator in human volunteers with less than or equal to 1 cm or greater than or equal to 2 cm of subcutaneous fat. The major difference between the two applicators is the temperatures produced on the skin surface and in the subcutaneous fat in humans. The circulating coolant of the 915 MHz contact applicator keeps skin surface temperatures much lower than those produced by the round field applicator in thick and thin subjects. It also tends to cool the superficial subcutaneous fat layer in thin subjects but doesn't affect the deeper subcutaneous fat layer in subjects with greater than or equal to 2 cm of subcutaneous fat. The 915 MHz contact applicator gives the ability to control by cooling the temperatures produced in the superifical tissues. By regulating the temperature of coolant and time of cooling, temperature gradients can be modified so the highest temperatures may be found in the muscle. However, the superficial tissue temperature cannot be regulated with the present application of the 433.92 MHz applicator. When the two applicators were compared, it was shown that the 433.92 MHz round field applicator did not surpass the heating ability of the 915 MHz contact applicator. Therefore, at this time, there is no reason to legalize the frequency of 433.92 MHz for diathermy use in the United States.


Training procedures and biofeedback methods to achieve controlled partial weight bearing: an assessment. Limiting weight bearing to a prescribed level is clinically desirable when patients use crutches or canes or wear prostheses. Several training methods currently being used in clinical settings were tested. These included the use of bathroom scales, and several more sophisticated feedback systems, to train normal subjects to limit weight bearing on a protected limb to a target load. It was found that such training was of limited value since subjects, during training and after, often exceeded target loads by 50% or more. Any retained learning was found to diminish rapidly on the first and second days after training. Even when using continuous auditory feedback, overshoot of the target load seemed inevitable due to the time lag between auditory perception and motor response, and the rapid rate of loading of the extremity.


The frequency of sexual intercourse during pregnancy. Reports of day-by-day sexual activity for the previous week were collected from a total community sample of over 900 pregnant and nonpregnant Thai women of childbearing age during a fertility survey in 1967-1968. About 13% of the women were pregnant. Examination of the women's intercourse frequencies at various stages of pregnancy revealed a downward trend as pregnancy progressed. However, a difference between the mean frequency for age-matched, nonmenstruating, nonpregnant women and that during any stage of pregnancy was not statistically significant at the p = 0.05 level (t test, two-tailed) until the seventh month. Much individual variation existed among the women. Complete abstinence from intercourse during the previous week reached a peak of 72.7% in the ninth month. The increase in abstinence with the progression of pregnancy appeared linear. The importance of these data lies in two methodological facts: they were collected from a total population sample and are therefore unbiased by sample selection; the women were not asked to report their "average" frequencies for some time period in the past. Reports of behavior on each day of only the preceding week were the basis for the conclusion. Although the women are from a different culture, lay and professional advice concerning intercourse during pregnancy is similar to that in the United States. Because intercourse may be discouraged, particularly in the third trimester, it is difficult to attribute the observation of the gradual decline in frequency to a "physiological" reason. This tempting hypothesis, however, is worthy of further study.


Heterosexual interest in homosexual males. Androphilic, ephebophilic, and homosexual pedophilic males were compared on heterosexual interest and arousal potential. The former was measured by the subjects' retrospective reports and the latter by penile responses to pictures of females. The penile responses of the ephebophilic and homosexual pedophilic groups to pictures of physically mature females were not different from those of androphilic males. In the present study as well as in an earlier one, the ephebophilic males responded significantly more to physically mature males than to physically mature females. Homosexual pedophilic males showed little difference in responses to physically mature males and females. In retrospective reports of heterosexual interest and experience and of development of homosexual interest and activities, there were only two differences among the groups: as opposed to androphilic males, a relatively greater number of ephebophilic and homosexual pedophilic males indicated that up to age 15 or later they had felt attracted exclusively to females and that they had been seduced in childhood or early adolescence by a male. These results will have to be replicated before being accepted as reliable. As in some earlier studies, there was a weak but significant correlation of degree of "feminine gender identity" with age at onset of homosexual interest and with heterosexual interest or experience. A higher degree of feminine gender identity went together with less heterosexual interest and experience and with an earlier onset of homosexual interest and experience.


Dhat syndrome: a culture-bound sex neurosis of the orient. The Indian Dhat syndrome is a culture-bound symptom complex. The clinical picture includes severe anxiety and hypochondriasis. The patient is preoccupied with the excessive loss of semen by nocturnal emissions. There is a fear that semen is being lost, and mixed in urine. A study was carried out to investigate the cultural basis of the Dhat syndrome. One hundred and seven respondents from the general public were interviewed. A vignette describing an individual having nocturnal emissions was read aloud to the respondents. Attitudes toward nocturnal emission, its causes, and its management were investigated. A large segment of the general public from all socioeconomic classes believed that semen loss is harmful. Seminal fluid is considered an elixir of life both in the physical and in the mystical sense. Its preservation guarantees health, longevity, and supernatural powers. This belief is more frequent in lower socioeconomic classes. The susceptible individual reacts to the prevalent belief system and to the fears of semen loss. The symptoms usually disappear if the misconceptions about semen loss are effectively dealt with. It is expected that with increasing literacy and progress in sex knowledge the syndrome will become less common.


Plasma testosterone in male patients with sexual dysfunction. Plasma testosterone values were established by the protein-binding method in 45 married patients who at the age of 36-55 were examined for sexual disinterest and/or disturbances of penile erection. The control group consisted of 108 men whose ejaculate was normospermic and who reported adequate coital activity. The average values of male sex hormone in all age subgroups of patients with functional sexual disorders were lower than those of the control group. However, in patients with a pathological somatosexual finding (chromatin-positive men, patients with a varicocele), where the plasma testosterone level was approximately the same as in patients with functional sexual disorders, similar coital activity was found as in the control group of normospermic men.


The rechargeable cardiac pacemaker. A clinical evaluation in 25 patients. After five years of laboratory development and in vivo testing, a rechargeable cardiac pacemaker with R-wave inhibited demand circuitry was introduced into clinical use in February 1973. We have used the rechargeable pacemaker in 25 patients in the past 1 1/2 years. The series includes 14 women and 11 men, with an age range of 38 to 80 years. Eleven of the patients had the rechargeable system implanted as a replacement for a failing or a failed conventional pacemaker. These 11 patients accounted for 26 previous pacemakers. The rechargeable pacemaker is smaller than conventional pacemakers, and it promises to obviate the need for periodic pulse generator replacement. Our initial experience with the rechargeable pacemaker has been favorable, and patient acceptance has been good.


Renal arteriovenous fistula treated by endofistulorrhaphy. A renal arteriovenous fistula responsible for diastolic hypertension was repaired without sacrificing renal parenchyma by endofistulorrhaphy, a unique surgical technique. The fistula site was localized preoperatively by selective renal arteriography. The renal artery was incised and the ostium of the efferent venous channel suture-ligated from within the depths of the artery. The fistula was successfully interrupted, and the patient has remained normotensive. Postoperative arteriography confirmed the absence of the fistula. Vascular surgical procedures sparing renal parenchyma are relatively new, as the most common treatment for this condition had been nephrectomy.


Definitive diagnosis of pulmonary lesions in leukemia and lymphoma. The supportive role of thoracic surgery. As therapy for leukemia and lymphoma has improved, secondary pulmonary disease has become a major cause of death. In this review of 225 patients with leukemia or lymphoma, six possibly preventable deaths resulted because progressive pulmonary infiltrates were treated without tissue diagnosis. Four other patients died of undiagnosed second primary lung tumors. When pulmonary infiltrates were diagnosed by open lung biopsy examination, appropriate therapy in nine patients resulted in seven survivals from potentially lethal infections. Of six patient with either primary lung tumor, leukemic infiltrate, or lymphomatous nodule, bronchoscopy and brush biopsy examination revealed bronchogenic tumors, leading to appropriate surgical therapy and survival in three. In three others, bronchoscopy and mediastinoscopy suggested exacerbation of the primary disease, which was treated satisfactorily by radiotherapy. Thus, when pulmonary disease develops in patients with leukemia or lymphoma, aggressive therapy based on tissue diagnosis may avert untimely death.


Serious complications after umbilical artery catheterization for neonatal monitoring. Umbilical artery catheterization in critically ill neonates caused major complications, including five deaths, in 15 of 165 infants with respiratory distress syndrome who underwent autopsy at the UCLA Hospital during the past eight years. Arterial occlusion leading to visceral infarction occurred in 12 patients, and vascular perforation caused hemoperitoneum in three patients. Repeated catheter manipulation and protracted catheter use were common factors identified in patients in whom complications developed. Restricted indications for catheter use, routine roentgenographic confirmation of catheter tip location below the kidneys, low-dosage heparin sodium infusion, use of cannulas with decreased thrombogenicity, avoidance of catheter manipulation, and vigilance to remove catheters when no longer required should reduce the incidence of this iatrogenic neonatal complication while still permitting arterial pressure and blood gas monitoring when clinically indicated.


Phytohemagglutinin-stimulated immune response. Assay in colorectal carcinoma patients. Tritiated thymidine incorporation by peripheral human lymphocytes stimulated with phytohemagglutinin (PHA) was investigated in 18 colorectal carcinoma patients (seven with localized tumor and 11 with metastatic tumors). The effect of sera obtained from these patients on lymphocytes from control patients was also studied. The mean mitotic index of PHA-stimulated versus nonstimulated lymphocytes from all tumor patients was 29.2; from patients with localized tumors, 23.0; from patients with metastatic tumors, 26.0; and from controls, 29.4. In the presence of sera from tumor patients, the mitotic index in all tumor lymphocytes was 47.1; from localized tumor patients, 53.7; from metastatic tumor patients, 43.8; and from control lymphocytes, 47.4. No substantial difference in mitotic index was detected in normal compared to tumor patient lymphocytes with or without normal or tumor serum.


Serum calcium responses to exogenous secretin. Increasing attention is being focused on the relationship between gastrointestinal hormones and calcium metabolism. While it is apparent that some relationship does exist, the exact nature and significance is as yet undefined. Information regarding the effect of secretin on serum calcium has been both sparse and contradictory. Boot's secretin, 3 units/kg, was given to a group of 44 patients consisting of normal controls and patients with duodenal, gastric, and marginal ulcers; primary hyperparathyroidism; and pernicious anemia. Six serial serum specimens were obtained from each patient at ten-minute intervals for calcium determination by atomic absorption spectrophotometry. Using two-way analysis of variance, no significant changes in postsecretin serum calcium values were observed. It is unlikely that physiologic levels of secretin exert any effect on serum calcium.


Breast cancer genetics and cancer control. Tumor association. Verified breast cancer was present in a father, his mother, and his daughter. His sone had a brain tumor (by history) and his grandson, (ehs sone of the affected daughter), had a histologically verified rhabdomyosarcoma. This familial aggregation of cancers (except for leukemia, which is absent) is consistent with a newly described familial breast cancer syndrome. A single pleiotropic, dominantly transmitted gene, possibly interacting with carcinogenic factors, such as an oncogenic virus, may be the cause. A cancer-control potential exists for tumor associations such as those exhibited in this kindred, as well as for other cancer genetic syndromes where careful consideration is given to all histologic varieties of cancer.


Subcutaneous angiolymphoid hyperplasia (Kimura disease). Report of a case. A subcutaneous mass removed from the cheek showed histologic features of subcutaneous angiolymphoid hyperplasia (Kimura disease) at its early stage. The condition shows a wide spectrum of pathologic changes. At its early stage, the main findings consist of active vascular proliferation with plump endothelial cells and varying degrees of lymphocytic, histiocytic, and eosinophilic infiltration. The lesion at its later stage features hyperplastic blood vessels with inconspicuous endothelial cells, well-formed lymphoid follicles, and varying degrees of lymphocytic and eosinophilic infilitration. Blood eosinophilia is frequently seen. Review of the literature and study of our own case strongly suggest that this disease is a distinct clinical and pathologic entity.


Experience with infected aneurysms of the abdominal aorta. Seventeen consecutive patients with abdominal aortic aneurysms were treated during a 14-year period. Fever was the most common symptom first to appear (12 patients), either as fever of unknown origin or in association with other symptoms. Several factors raise the suspicion of an infected aneurysm: positive blood cultures, erosion of lumbar vertebrae, lack of aortic calcification, aneurysms found in female patients or after a prolonged illness of bacteremia. Staphylococci (41%) and Salmonella (18%) were the most common organisms. Aneurysms with Gram negative organisms exhibited a greater tendency toward early rupture than those with Gram-positive organisms (84% vs 10%), and were associated with a higher mortality. Delay in making the diagnosis adversely affected the death rate. "Infected aneurysm" is suggested as a better term than "mycotic aneurysm," since fungi are rarely involved.


Prognostic indicators in femoropopliteal reconstructions. The incidence of early failure in 115 vein femoropopliteal grafts has been analyzed for the presence of reliable prognostic indicators of such failures. One hundred twelve patients had preoperative Doppler ultrasound assessment; 98 had intraoperative graft flow measured. Early graft failure was more prevalent in patients with rest pain and gangrene and in patients with poor runoff. Neither of these two findings had predictive value. Ninety-one percent of patients with a pressure index (ankle systolic pressure/brachial systolic pressure) less than 0.20 had early graft thrombosis. This suggests that arterial reconstruction is futile in this group. Measurement of vein graft flows intraoperatively was of value. Grafts with basal flows less than 70 ml/min uniformly thrombosed. There was significant correlation between ankle pressure index and intraoperative vein graft flow (r=.52). Both ankle pressure index and intraoperative vein graft flow provide prognostic indications of graft failure and should be of value in selecting patients for femoropopliteal reconstructions.


Carotid endarterectomy for nonhemispheric transient ischemic attacks. Fifty carotid endarterectomies were performed in 46 patients with nonhemispheric transient ischemic attacks. There was no mortality. Three patients had temporary strokes postoperatively. Ninety-five percent of the patients were improved and remained so at follow-up examination. Clinical improvement was not related to the presence or absence of vertebral or subclavian stenosis. In retrospect, the two patients who were unimproved had been improperly selected.


Aortorenal arterial autografts.

Aortorenal arterial autografts. Forty-nine iliac artery autografts were used in the treatment of renovascular hypertension in 45 patients, including six children. The pathological process was fibromuscular dysplasia in 42, atherosclerosis in two, and Takayasu arteritis in one. The internal iliac artery was used as a graft in 39 patients. The common iliac bifurcation was used in two patients, and the external iliac artery in four patients. Common and external iliac artery continuity was restored with Dacron prostheses. Forty-three patients with 47 autografts have been followed up from one to ten years (average three years). Hypertension was cured or improved in 96% of the patients. Serial follow-up arteriograms as late as ten years after surgery have been obtained in 50% of the patients. No late occlusions occurred. Slight autograft dilation occurred seven years postoperatively in one child. Normal growth of the autograft was exhibited in the remaining five children. No evidence of dilation, aneurysm formation, or stenosis appeared in any other grafts, although one patient developed a new lesion distal to her graft.


Renal artery aneurysms. Significance of macroaneurysms exclusive of dissections and fibrodysplastic mural dilations. Seventy-two patients (39 females and 33 males), 9 to 84 years in age, exhibited a total of 94 renal artery macroaneurysms. Solitary aneurysms affected 53 patients, and multiple aneurysms occurred in 19 patients. Arteriosclerotic changes, observed in nearly 30% of aneurysms, were considered secondary rather than primary processes in most instances. Renal artery fibrodysplasia was an associated finding among 27 patients. In 57 hypertensive patients, evidence supportive of renal artery aneurysms contributing to elevated blood pressure was meager. Two patients experienced frank aneurysmal rupture. Covert rupture into renal veins occurred twice. Aneurysmectomy was performed on 31 occasions. Nephrectomy, partial as well as total, was performed 17 times. No operative mortality occurred. Potential for rupture and an association with functionally important renal artery stenoses support surgical intervention in selected patients with renal artery macroaneurysms.


Surgical repair of the incompetent femoral vein valve. Incompetent femoral vein valves are identified by reflux femoral phlebography in selected patients with postphlebitic syndrome. In addition to conventional stripping of varices and subfascial interruption of communicating veins, 14 patients with 17 involved extremities have undergone surgical repair of an incompetent valve in the superficial femoral veins. Pathologic condition of the valve consisted of elongation of the cusp edge. Repair was achieved by a series of tucking sutures shortening the cusp and restoring competence to the valve. Healing of ulcers and relief of swelling occurred in 90% of the patients. This rate was maintained up to seven years. These cases demonstrate the feasibility of surgery on the femoral vein valve. The relative importance of conventional stripping, subfascial communicating vein interruption, and femoral valve repair will have to be established by way of further clinical experience.


Surgical treatment of popliteal artery injuries. Twenty-seven patients with injury to the popliteal artery and associated structures were operated on during the past 15 years. There was no operative or hospital deaths. The limb salvage  rate was 56%; the amputation rate was 44%. Those patients with penetrating injuries were found to have a much better salvage rate (85%) than those with blunt trauma (29%). Preoperative arteriography and immediate repair of the popliteal artery by either end-to-end anastomosis or a vein graft is advocated for these patients. Popliteal vein injuries should be repaired when possible by lateral suture or end-to-end anastomosis. Fasciotomy is advocated on a selected basis.


Unusual manifestations of penetrating cardiac injuries. Penetrating cardiac injuries frequently first appear in an unusual and insidious manner, and their diagnosis may not be immediately obvious. In a series of 20 cases of cardiac injury, ten cases were indicative of such subtle symptoms, several of which were life-threatening. These unusual manifestations can be categorized as early, intermediate, or late. Early problems of four patients included the following: (1) sudden onset of shock during laparotomy, performed due to apparent abdominal trauma; (2) cardiac arrest on arrival in the emergency room; and (3) cerebral air embolus and mimicked symptoms of possible irreversible anoxic brain damage. The intermediate manifestations of cardiac injury are usually discovered in the early recovery period, and include myocardial infarction with cardiogenic shock and bullet embolus to a peripheral artery. Intermediate manifestations were observed in two patients. Four patients had late complications that included pseudoaneurysm, ventricular septal defect, valvular damage, and recurrent pericarditis. These late complications were observed between one month and 21 years after cardiac injury. This indicates the necessity of long-term follow-up of these patients.


Patient selection for cardiac surgery in left ventricular power failure. Nineteen patients in acute left ventricular power failure following acute myocardial infarction were given support with intraaortic balloon pumping and underwent cardiac catheterization. Hemodynamic response to disastolic augmentation, results of left ventriculography, and observations of selective coronary arteriography were evaluated to determine which patients could survive without operation, which would require operation to survive, and which could be predicted not to survive operation. Of ten patients who underwent operation, three were long-term survivors. Two patients predicted to have a good prognosis without surgery did survive. Of three patients who had been determined to require operation but not undergo it, two died in the hospital and one a month later. The four patients whose conditions were considered inoperable died in the hospital. The results indicate that current methods of predicting the need for corrective surgery are relatively accurate and that the rate of survival in surgically treated patients may be increased.


Topical myocardial cooling. An intensive laboratory investigation. To better understand efficacy of topical cooling in myocardial protection, three groups of 12 dogs each were studied. Group 1 dogs had systemic cooling to 30 C; group 2 had cooling to 30 C and outside cooling of left ventricle; group 3 was cooled in the same way as group 2 was but also had inside of left ventricle topically cooled. Measurements were taken of left ventricular function curves, regional blood flow distribution to the subendocardium, sequential pH, PCO2, PO2, and lactate and serum glutamic oxaloacetic transaminase (SGOT) levels. Lower midseptal and subendocardial temperature (means, 11 and 7 C, respectively) in group 3 correlated with higher survival and greater preservation of left ventricular function. Lower levels of SGOT and lactate in coronary sinus efflux, and higher regional flow to subendocardium postoperatively, also correlated with minimal evidence of subendocardial necrosis in group 3 dogs. Rapid of cooling of subendocardium was noted as achieving maximum preservation of left ventricular function.


Experimental evaluation of coronary infusates in dogs. In a study involving dogs, a coronary infusate containing a variety of substances including cardiac substrates, metabolic inhibitors, membrane stabilizers, electrolytes, and anticoagulants was evaluated in terms of protection afforded to the myocardium for up to 90 minutes of normothermic anoxic arrest. Electron microscopical studies and tissue adenosine triphosphate measurements revealed this coronary infusate to be considerably beneficial to the myocardium. Infused myocardium was better preserved compared to myocardium that was not infused or infused with two other "control" infusates. The individual components of our infusate are known cardiac preservatives. The rationale for combining a number of them in our infusate is to produce an additive or synergetic effect through beneficial intervention at several points in the cardiac metabolic cycle. This objective appears to have been fulfilled under the conditions of the present experiment.


The Blalock-Hanlon procedure. Simple transposition of the great arteries. Between 1959 and 1975 at St. Louis University Medical Center, 71 patients underwent surgery with the Blalock-Hanlon technique. Thirty-nine had simple transposition of the great vessels. The mean age at the time of operation was 3.4 weeks. Sixty-four percent were less than 1 month of age. Eighty-five percent survived the operation. In 11 the Blalock-Hanlon procedure was performed after failure of ballon septostomy. Arterial saturation was increased from a mean of 47% to 73%. There were three late deaths prior to Mustard repair (intra-atrial baffle procedure). Sixteeen patients underwent Mustard repair at a mean age of 4 years and a mean follow-up of 2 1/2 years. There were three deaths after surgery and three late deaths after the Mustard procedure. The Blalock-Hanlon procedure achieves prolonged palliation, avoiding an emergency Mustard procedure in infancy with its risk of late vena caval obstruction.


Surgical treatment of atrioventricular canal defect. Fifty-nine patients with congenital anomalies of the atrioventricular canal underwent operation and all survivors were followed up. In 42 patients with partial atrioventricular canal defects, ten had preoperative congestive heart failure. Three, or 7.1%, died of endomyocardial fibroelastosis, high pulmonary vascular resistance, and severe mitral regurgitation. A fourth patient later died of Wolff-Parkinson-White syndrome and fibrilation. Reoperations in five patients were all successful. No patients had persistent atrioventricular blocks, and all patients are asymptomatic. Two of these subjects continue to receive digoxin therapy, and one of them is believed to have substantial mitral insufficiency. Of the 17 patients who had complete atrioventricular canal defects, 13 had a divided common anterior leaflet attached to the septum by chordae tendineae, and four had undivided and unattached anterior leaflets. Two had previously undergone pulmonary banding, and nine were treated for congestive heart failure. Six died after operation. There were no reoperations. No patient presently has required a pacemaker. Two subjects have persistent cardiomegaly.


Prosthetic valve replacement in children. Reported clinical experience with prosthetic valve replacement in children have suggested a high operative mortality. We placed 25 valves in 24 children with one operative death. There has been one late death related to pacemaker malfunction, but the remainder of the patients have generally done extremely well. The children have not undergone elective anticoagulation, and the long-term embolism rate has not exceeded the incidence of systemic embolization in adults who have been controlled on warfarin sodium (Coumadin) therapy. The objective of prosthetic valve replacement is myocardial preservation. We believe that valve replacement with currently available prostheses should be undertaken in any child with valvular malfunction who is not well controlled with good medical management.


Aortic insufficiency secondary to aortic root aneurysm or dissection. Twenty-four patients with aortic regurgitation secondary to aortic root aneurysm (13 patients) or dissection (11 patients) were operated on, utilizing a variety of surgical procedures to cope with the varied pathological findings. These ranged from primary repair of the ascending aorta without any prostheses in patients with acute aortic dissection to replacement of the valve and the entire ascending aorta for aortic root aneurysm. In four patients with Marfan syndrome the right coronary artery was transplanted to the ascending aortic graft, allowing an extension of the graft to the valve anulus and excision of the entire aneurysmal aorta. The immediate and late results have been most encouraging.


Regional myocardial infarction at operation. An automated system of identification. The difference between normal and infarcted myocardium at operation cannot always be defected by inspection or palpation. Infarcted myocardium may be identified by a decrease in the amplitude of the ventricular bipolar electrogram. Although this method is reliable and reproducible, it requires a second observer's visual analysis and interpretation of the electrogram signal. This method is therefore subject to the vagaries of human observation, analysis, and accounts of rapidly changing data. We have designed and built an automated instrument to simplify the recognition of transmural infarction.


[Experience in the use of electrified stands in the teaching of anatomy courses]. The paper reports the principles of arrangement and the estimation of efficiency of electrified training stands elaborated at the department. The work of the stand "Conducting pathways" is based on utilization of a distributing device which, due to different length of plates on the rotating disc, switches on a successive chain of lamps imitating conducting pathways. The stand "Human skeleton" is based on the principle of direct searching with use of a decade step-by-step switch (D55-100). The most complex in arrangement and efficient in use is the stand "Muscular system". The ruling diode matrix of this stand consisting of 450 diodes makes the electric impulse travel in the given strictly restricted direction. A special device permits controlling and estimating the process of learning the material.


[Effect of visual deafferentiation on the ultrastructure of synapses of the rat visual cortex]. Electron microscopic study and quantitative analysis of the visual cortex synapses in 14, 30 and 60-day-old rats were performed after bilateral enucleation of newly-forn rats. A great amount of synapses of other functional systems was shown to be functioning in the area striata in addition to the synapses formed by specific visual afferents. Alterations in the synapses of the area striata of blind rats are developing gradually, achieving the greatest pronouncement in 60-day-old rats. These changes develop according to the type of atrophic process in connection with dysfunction. The atrophic alterations of the synapses were found both in axo-somatic and axo-dendritic synapses on the dendrite trunks and on the thorns. The alterations of synapses being concentrated in layer IV. The quantitative ratio of different kinds of atrophied synapses in the cross-section of the visual cortex was different suggesting the following conclusion about the distribution of the visual afferents. In layers I and III the visual afferents formed mostly axon-thorn contacts and less amount of axo-somatic and axo-dendritic synapses on the dendrite trunks. In layer IV they mainly formed axo-somatic and axo-thorn synapses and less amount of axo-dendritic ones on the dendrite trunks. In layers V and VI they mainly contact with the dendrite trunks and with the nervous cell bodies and more rarely with thorns.


[Comparative morphology of the cerebellum of the seal (Pinnipedia, Mammalia)]. The work describes the anatomical structure of the cerebellum of the caspian seal (Pusa caspica Gmelin) and Greenland seal (Pagophoca groenlandica Erxleben). The shape of the cerebellum, the disposition of the main lobes and convolutions are characterized. The schemes of three projections of the cerebellum of both species are presented. The figures of the cerebellum size, its absolute and relative weight and the surface of the cerebellum and its portions in seals have been obtained. The well-developmed flocculo-nodular portions and paraflocculuses and relatively poorly developed lobulus paramedianus are pointed to be one of the characteristic features of the structure of the seal cerebellum. An attempt is made to explain great dimensions of the flocculo-nodullar portion and paraflocculuses by specific features of the seal locomotion in water.


[Time of origin of cells in the histiogenesis of the spinal cord]. In order to establish the moment of appearance of neuroblasts and ectoglia of the spinal cord the autoradiographic study with the use of H3-thymidine and C14-thmidine injected to pregnant mice with the intervals between injections 121/2 or 24 hours was undertaken. It was establised that spinal neurons were removed from the nervous tube beginning from the 10th up to 13th days of embroyogenesis. The motoneurons of the anterior horn were the first to appear (10th-12th days), the neurons of the intermideate zone were the next to appear (11th - 12th days) and the last were the neurons of posterior horn (13th day). Beginning from the 13th day of embryogenesis there appeared the ectoglia which migrated following meurblasts two days later. The saturation of the grey matter with glial cells and the saturation of the white matter with Schwann cells was brought about by means of additional multiplication at the site of the glioblasts removed from the nervous tube. The main function of the matrix layer neuroepithelium of the nervous tube as a provider of cells to the spinal cord terminated on the 15th day of embryogenesis.


[Structure of the perineurium of the peripheral nervous system]. The structure of the perineurium in different parts of the peripheral nervous system of rats, rabbits and cats was studied by light-optical and electron microscopic methods. The structure of the perineurium in all the animals studied is sim8lar and consists of different number of the epithelial type layers of the perineural cells, with bundles of cooagnous fibres between them. The greatest anount of layers is found in the perineurium of the sensory and vegetative ganglia, their amount being less between the nerve trunks and bundles. Solitary sensory mielinated nerve fibres are surrounded with a perineural etui consisting of one or two cellular layers. The thickness of the perineural cells varies from 300 to 1500 A and only in the nucleus field it is equal to 1-2 mu. Every layer of the perineural cells is surrounded by a basal membrane. In their cytoplasm there are many pinocytic vesicles in addition to main organells. Between the perineural cells there exist close contacts. The internal layer of the perineurium is the place of origin of intraganglionic septa and in certain distance surrounds the vessels entering the ganglion. Ultrastructurally the perineural cells are similar to the endothelium of the vessels.


[Evaluation of structure of the large arteries in man as elements of a hydraulic system]. The study of large arteries carried out in 30 corpses and the comparison of the parameters and outlines of these vessels with those recommended in applied hydraulics have shown correspondence between the arteries structure and the principles used for criation of optimal conditions of the liquid current in hydraulics.


[Histochemical study of fibroblasts and fibrous structures of the derma of rats in the process of postnatal development]. The histochemical data on the protein and carbohydrate exchange of fibroblasts in the period of intensive formation of fibres of the rats derm in the process of postnatal development are presented. The interrelationships between the size, the content of RNA, polysaccharides, proteins, the fibroblast enzyme activity and their fibreforming function is shown.


[Epithelial-mesenchymal interactions in the differentiation of odontoblasts and adamantoblasts]. In the present study we report experiments which indicate that the adamantal epithelium (inner dental epithelium) plays a specific role in the initiation of differentiation and in the initial maintenance of odontoblasts. The preodontoblasts do not differentiate in the pulps cultures alone or in association of pulps with no specific epithelium. The early stages in the process of odontoblasts differentiation are labile and dependent upon their environment. The odontoblasts and the ameloblasts cannot differentiate in advance in the isochronic and heterochronic associations. A previous maturation of these cells or of their environment is indispensable.


[Dimensions and alveolar surface of the ineralveolar septa of the rat lung]. The dimensions of the alveolar surface of interalveolar septa were studied in albino rats. The mean thickness of certain septa range from 3,1 to 6,2 mu, the mean thickness of the septa in different individuals being factually the same. A part of the alveolar surface of the septa represents the air-haematic barrier which occupies 51-64% of the total alveolar surface in different rats. The mean values of all the parameters in the animals studied are very close. It shows that the interalveolar septa are standard structures in their organization and dimensions both in the same animal and in different animals of the same species.


[Ultrastructural changes in the proper layer of the mucous membrane of the duodenum following general gamma-irradiation]. The work has been performed on mature male Wistar rats which were irradiated in a "Gamma-Sell-220" apparatus in the dose of 1000 r, with thepower 42 r/sec. It has been shown that in early terms after irradiation (1-6 hours) slightly pronounced destructive changes were observed in cellular and fibrous structures of the stroma of theproper layer of the duodenum membrane in addition to pronounced exudative changes. Further, the latter increased and became maximum within 24 hours. The edema extends into the basal part of enterocytes and between the stroma cells giving rize to desorganization of all mucous membran elements. Seventy two hours after irradiation the destructive changes in cellular and fibrous structures of the mucous membrane layer proper became predominant. The authors make a conclusion that the changes in the stroma aggravate dysfunction of the epithelium injured by the irradiation energy.


[Effect of low temperatures on the level of nucleic acids and protein in the nuclei of early bird embryos (cytophometric study)]. The content of DNA and protein in the nuclei was determined cytophotometrically as well as DNA and RNA in nucleoli of chicken embryos of different gastrullation stages after 3 days of storage at +6 degrees, +2 degrees and - 2 degrees C. It was established that the response of embryos to cold at the cell level became apparent in inhibiting the protein synthesizing system (under effects of suboptimal and extreme temperature). inhibiting the migration processes of nuclear RNA into the nucleoplasm and nuclear proteins into the cytoplasm and a certain alteration in the nucleus ploidy (under extreme conditions). The reaction of each stage under study and different cellular layers of the same differentiation stage were shown to have certain specificity.


[Reaction of sustentocytes and glandulocytes of the testis to irradiation]. The Sertoli's and Leidig's cells (sustentocytes and glandulocytes) exposed to ionizing radiation were studied cytologically and histochemically. The experiments were made on white male mice which were irradiated in dosage from 50 to 400 r. The DNP of the nuclei of sustentocytes and glandulocytes were investigated at different periods of the spermatogenesis cycle and under hormonal loading. The irradiation was established to result in changes in the chromatine state of both types of cells, the Sertoli's cells being more resistant to radiation. Injection of testosterone at different periods after irradiation causes a decreased dissociation of DNP. Inspite of the apparent morphological stability to ray effects the sustentocytes and glandulocytes are highly reactive elements.


[Destruction and division of cells of the mesenchyma of the intestinal tube during the period of histogenesis]. The mesenchyma of the intestinal tube of chicken's and crocodile's embryos was studied light-optically. In order to study the mitotic activity and signs of the cell degeneration the cells were counted per mille by the same method in both objects. According to our ovservations the character of relationships between processes of proliferation and death of cells permits the effects of necrosis processes on the mitotic activity of mesenchyma cells to be supposed.


[Synapsoarchitechtonics of the parietal and acoustic regions of the cerebral cortex of cats]. The synapse architecture of the simcipital and auditory cortex of the cat (fields 7 and 22 after M. O. Gurevich and oth., 1929) was studied electron microscopically. In the both areas of the cortex there are much more axo-dendritic synapses that axo-somatic ones. In the upper layers the synapses are more often formed on small dendrites and thorns, while in layers IV-VI they often occur on the main trunks of large dendrites. The synapses on small branches and thorns of dendrites contain spherical vesicles, and the synapses on on large dendrites are formed by the terminals of two kinds-with flattened and spherical vesicles. The amount of axo-somatic synapses increases towards the lower layers of the cerebral cortes. The synapses on the soma and apical dendrites of the pyramid neurons always contain flattened vesicles; on the stellate neurons there occur perisynaptic terminals with sperical vesicles as well.


[Study of some neurohistologic objects by the method of scanning microscopy]. With the aid of a scanning measuring microscope (R. E. Bykov et al., 1972) different biological microobjects were measured in particular the nuclei of neurons and gliocytes at differnt levels of the spinal cord under normal and experimental conditions. The nuclei of the rabbit hypothalamus were stimulated by graded electrical current in order to induce neurogenic visceral dystrophies. Investigation of the square surfaces of cross sections of the neuron and gliocyte nuclie in different terms permitted establishment of progressing diminishing of the size of the square surface of the neuron nuclei against the background of a relatively steady state of steady state of wquare surfaces of the cross section of the nuclei of the adjacent glial cells. The obtained data are of interest not only for studying transneuronal changes in disturbed trophical function of the nervous system, but may be taken into consideration in clinical practice when elaborationg prerequistites for purposeful neurovegetative blocade in neurogenic dystrophies of the central genesis.


[Development of arterial and lymphatic collaterals under the action of a UHF magnetic field]. The work performed in 48 experimental and 24 control rats dealt with the development of arterial and lymphatic collaterals of pelvic extremities under effects of magnetic field of ultra high frequency (15 and 30 vt) in terms from 2 up to 6 weeks after surgery and exposure to magnetic field. The methods of investigation were arterio- and lymphoroentgenography and dissection. It has been established that formation of arterial collaterals in experimental rats takes place in all zones during the second week after cutting femoral arteries. The rate of the development of arterial collaterals was accelerated as compared with control animals. The lymph outflow after exposure to the influence of magnetic field of UHF goes mainly along superficial collaterals to groin nodes. The influence of the magnetic field of UHF appears to be accompanied by stable dilatation of super ficial lymph vessels, and due to this the lymph outflows along these vessels.


[Effect of certain professions on the structure of the cervical portion of the spine]. The roentgen-anatomical study of the cervical portion of the vertebral column (fluorography and roentgenography in 2 projections followed by morphometrical treatment) was performed in 603 representatives of different professions: turners, milling-machine operators, craftsmen, mechanicians, jugglers, engineers and constructors. The following facts were established: asymmetry of bodies CIV and CV of vertebra in turners and milling-machine operators; differently pronounced cervical lordosis in persons of different professions; specific features in the architectonics of the spongy substance of the cervical vertebra bodies.


[Effect of general hypokinesia on the blood vessels of the medulla oblongata, pons and midbrain of the rabbit]. The work was performed on 40 rabbits. After injection of the blood system with Gerota's mass 120 mu horizontal sections were cleared after A. M. Malygin and stained with hematoxylin and eosin after Van Gieson. It was shown that within 1--3 weeks of staying in small cages the animals had dilated vein all areas of the brain under investigation. Within 4-12 weeks there appeared deformity, sharp sinuosity, disorders in usual orientation of vessels. Within 13-16 weeks of hypokinesia both qualitative and quantitative changes in blood vessels became more pronounced. It was also shown that readaptation for 1--3 weeks after 4--13 weeks of hypokinesia failed to repair the normal structure of blood vessels of the brain and that in all the parts under study the reactions of the circulatory bed structure to hypokinesia were of the same type.


[Morphology of the wall of some main arteries normally and in limited motor activity]. Effects of different periods of hypokinesia upon the structure of the main arteries wall and the microcirculatory bed of the aorta adventitia were studied in rabbits by histological methods. It was shown that hypokinesia lasting more than 4 weeks resulted in the atrophy of the medical sheath and dystrophy of the elastic framework in the wall of main arteries. In the microcirculatory bed of the aorta adventitia there occurred blood stagnation, the integrity of the microvessels wall (mainly capillaries, postcapillaries and venules) was broken. The degree of the above morphological changes depends on duration of hypokinesia.


[Microcirculatory bed of the pericardium under hypokinetic conditions]. The pericardium microcirculatory bed of rabbits was studied under conditions of hypokinesia of different duration. The state of hypokinesia was obtained by keeping the animals in small cages. The used methods were silver nitrate impregnation after Kuprijanov and injection of the vessels with the Parisian blue. Hypokinesia caused certain anatomical changes in all links of the microcirculatory bed. Disorders in the capillary-venular link were the first to appear. The alterations found should be considered as adaptational to effects of the extreme factor--hypokinesia.


Effect of hypokinesia and the combined action of gravitational load and hypokinesia on the structure of the hepatic portal system. General hypokinesia during 1--6 weeks resulted in dilatation of the interlobular veins. sinusoids and central veins. The sequence of alterations corresponded to terms of hypokinesia. After exposure to "gravitation stress--hypokinesia for 1--6 weeks" stagnation in the portal system of the liver was less than after exposure to hypokinesia alone, but unevenness of lumens in the interlobular veins and sinusoids was more pronounced. The foci of the vessel spasm were determined. The signs of stagnation in the system of the portal vein and unevenness of the width of all the links of the portal bed were most pronounced after combination "hypokinesia for 1--6 weeks-- gravitation stress".


[Effect of gravitational loads and hypokinesia on the structure of the blood vessels of the tongue in the rabbit]. The vessels of the tongue were studied in 120 rabbits in 5 series of experiments methods of injection, clearing, rentgenography, silver nitrate impregnation after V. V. Kuprijanov and a histological method. The animals were rotated in a centrifuge with a 1 m radius. For hypokinesia the animals were placed in small cages. Gravitation stress mainly caused changes in the capillary-venous part of the circulatory bed (dilatation of vessels). Under conditions of hypokinesia morphological changes were most pronounced in terminal portions of the arterial part of the bed, arterioles and precapillaries. Successive exposure to both factors caused no specific changes. Preliminary training to stressess failed to prevent the appearance of considerable morphological changes in blood vessels of the tongue.


[Effect of special training for loads acting in the thorax-spine direction on the vessels of the endbrain]. The work was performed in 42 male rabbits which were trained for gravitation stress in a centrifuge of 2 m diameter according to two special schedules. The vascular system of the brain was injected with staining substances and studied in cleared sections. The training was established to increase the animal's resistance to stress of transversal direction and to result in adaptation of the vessels of the terminal brain to stress. Morphological changes under these conditions were not great. Of the two schedules the first one (without a preliminary "limbering" rotation) was more favourable. Four weeks after the cessation of the training cycle the animal's resistance to gravitation stress became considerably less.


[Effect of training for loads in the ventrodorsal direction on the blood vessels of the sympathetic trunk of the rabbit brain]. Thirty six rabbits underwent special training to get a state of being trained. In a centrifuge with a 1 m radius 18 animals got ventro-dorsal gravitation stress according to schedule N 1 (with limberung-up) and 18 animals according to schedule N 2 got gravitation stress without limbering-up. After training the animals had a 2, 3 and 4-week rest. Then a part of animals was killed and served as control and the others were subjected to a single exposure to stress of the same direction (10 units for 40 min). This stress was unendurable for untrained animals. By means of injection, clearing, measuring the vessels and histologically it was shown that the trained state was reached according to schedule N 2 and retained for 3 weeks. It was also confirmed by survival of animals and the state of the vessels of the sympathetic trunk. Training according to the 1st schedule resulted in cumulation.


[Effect of gravitational loads of a training nature on the blood vessels of the rabbit spinal cord]. Three series of experiments were performed in 47 rabbits. The cerebral vessels were studied by methods of injection and clearing. In the first series under study were vessels after exposure to stresses of a training type. The picture of the circulatory bed under these conditions was close to normal in morphological parameters (diameter of vessels, amount of visible vessels, distinctness, evenness of the contours pronouncement of networks etc). In the 2nd and 3d series the results of training were checked by a single exposure to a series of stresses or a solitary stress. The data obtained suggest increased resistance in majority of trained animals to the following hypergravitation and better morphological parameters of the spinal cord circulatory bed as compared with not trained animals. Hence, certain adaptation to the following hypergravitation can be obtained in rabbits by means of repeated rotations in a centrifuge according to a special schedule of training.


[Effect of transverse gravitational loads on the vessels of the retinal membrane of the rabbit eyeball]. Changes in the eye ball retina were studied in 3 series of experiments in cleared preparations after exposure of the animal to gravitation stress of transversal direction. Prolonged single functionally endurable stress of ventro-dorsal direction (10 units/3 min) caused dilatation of the retina vessels, worse filling of peripheral parts of the circulatory bed, uneven staining of the vascular wall, constriction and dilatation along the course of the vessel. More continuous exposure to the same value of stresses (10 units up to the animal's death) resulted in a pressor effect; qualitative changes in the vessels increased. Within 1,5 hour after a 3-minute-long exposure to stress the vascular bed still remained unchanged. The diameter of vessels approached normal while the general quantity of vessels was decreased and qualitative changes were well pronounced.


[Effect of longitudinal gravitational loads on the structure of the wall of the vertebral artery]. A single exposure to the greatest endurable gravitation stress causes such changes in the wall of the vertebral artery as division into layers, oedema, vacuolization of smooth muscle cells. Repeated exposure according to a training schedule resulted in reconstruction of the vascular wall (division of the medial sheath of the artery into several muscular layers). Concentration of smooth muscle cells in "layers" increased when training was after a "cumulative" schedule. Under conditions of increasing cumulative effect the collagenization of the media and dystrophy of the muscular and elastic tissue began. The greatest changes in the arterial wall took place in the upper parts of the vertebral artery at the level of the 2nd and 3d cervical vertebra.


[Effect of gravitational loads in different directions on the structure of the lymphatic bed of the pelvic extremities in the rabbit in vivo]. The method of lymphorentgenography was used in order to study alterations in the lymph vessels of pelvic extremities of rabbits at different terms (from 1 week up to 6 months) after exposure to gravitation stresses of different directions, value and duration. After exposure to stresses of cranio-caudal direction the amount of vessels increased. They had weel pronounced sinuosity and clearly protruding valves. The diameter of the vessels was more than normal and was equal to 0,3-0,8 mm. Popliteal lymph nodes were also increased up to 12,6-6,7 mm. Within 6 months after stresses these changes retained. Stresses of caudal-cranial direction during all periods of observation (from 1 week up to 6 months) caused dilatation of vessels (0,3-0,6 mm), their sinuosity and enlargement of popliteal lymph nodes up to 10,5-6,2 mm. All these changes returned to normality within 6 months. Thus, most pronounced and resistant morphological changes of the lymphatic bed were caused by greatest endurable stresses of cranio-caudal direction.


[Effect of ultrasound of high intensity on the intraorganic vessels of the liver]. Under study was the influence of a single 3-minute-long exposure to ultrasound of high intensity (2 wt/cm2) upon intraorganic vessels of the liver in albino rats. The circulatory bed was examined 10 min., 5, 15 and 30 days after treatment with ultrasound. Methods ox injection, rentgenography, claering and histology revealed an unfavourable effect of ultrasound causing local construction of arteries and veins in early terms, uneven filling of the capillary bed with the injected mass, dilatation and deformity of capillaries. The above changes grew more pronounced during 15 days, by the end of the month they diminished but not disappeared.


[Effect of ultrasound on the formation of arterial and lymphatic collaterals in the rat pelvic extremities]. Pronounced morphological alterations combined with destruction of muscular tissue make their appearance in intact arterial and lymphatic bed of pelvic extremities in rats after treatment with ultrasound of high intensity. Ultrasound of low intensity failed to cause morphological changes either in the arterial or the lymphatic bed of extremities. A course of exposure of injured arterial and lymphatic bed of rat's pelvic extremities to ultrasound of small intensity considerably accelerated processes of formation of the arterial and lymphatic collaterals.


[Ultrastructure of the follicular epithelium in the ovary of the domestic duck during the period of slow growth of the oocyte]. The work describes ultrastructural changes in the follicular epithelium and ooplasm in the period of the slow oocyte growth. The morphology of follicular cells (well-developed endoplasmic reticulum, numerous free ribosomes) is considered as evidence of their synaptic activity whereas the morphology of ooplasm indicates to its accumulative function. It is supposed that at this stage nutritive substances enter the oocyte through the intercellular spaces and their absorption is brought about by means of microvilli on the oocyte surface. A specific organelle of the avian egg -- so called transosome, is described. Their structure, transposition and possible function are discussed.


[Giant cells in the placenta of the bactrian camel in the fetal period of development]. Polyploid giant cells resulting from differentiation of normal cytotrophoblast cells were found in the composition of the placenta cytotrophoblast of the Bactrian camel. In the placenta of the Bactrian camel the transformation of cytotrophoblast cells into multinuclear giant cells is realized via endomitotic polyploidization and distinctly reflects active synthetic processes occurring in these cells related with the trophic function of the placenta. It may be supposed that giant cells of the placenta of female Bactrian camels also participate in the endocrinous function of the placenta. Their histolitical function is completely excluded.


[Morphological characteristics of the structures delimiting the residual cavity of the hypophysis in rats after electrocoagulation of the median eminence of the hypothalamus]. By means of light and electron microscopy it has been shown that the remnant cavity of the hypophysis of intact and sham-operated rats on the side of the intermedial lobe is restricted with a continuous layer of epithelial cells with a well pronounced basal membrane. On the side of the frontal lobe the covering epithelium has peculiar "fenestra" through which adenocytes have free contacts with the remnant cavity. After electrocoagulation of the rostral area of the medial eminence, especially in remote postoperative terms, the remnant cavity enlarges up to gigantic size, contains a great amount of colloid, erythrocytes, fragments of cells of the anterior lobe of the hypophysis and secretory granules. The anterior epithelium is lacking on considerable areas and hence adenocytes are disposed in the cavity directly. All their organoids are preserved though a little changed, the cytomembrane is absent. On the apical surface of the posterior epithelium there appear large cytoplasmic protrusions which having separated enter the remnant cavity. The main provider of the "raw material" for colloid is likely to be the anterior lobe of hypophysis.


[Analysis of the structural parameters of the blood flow pathways in the microcirculatory system]. The reconstruction of the mesenterium microcirculatory bed was performed intravitally in albino rats and cats after biomicrophotograms. The number, length and caliber of arterioles, pericapillary arteriolec, capillaries, postcapillary venules and venules of the mesenterium were measured. According to these data summary indices of the cross section, surface and volume of the vessels of various functional subdivisions of the microcirculatory bed were calculated. The blood volume entering the microcirculatory system of the albino rat's mesenterium is distributed in the vessels as follows: 8,4% -- arterioles, 10,2% -- pericapillary arterioles, 41,9% -- capillaries, 22,1% -- postcapillary venules and 17,4% -- venules. Similar correlations were found in the cat. The working surface of capillaries is 60--70% of the working surface of all the vessels of the mesenterial microcirculatory system. The evidence of the functional variability of the microcirculatory bed geometry depending on the tissue needs in blood supply is presented.


[Microcirculatory disorders in the connective tissue structures of certain organs in traumatic shock with acute hemorrhage]. The present work is a fragment of the author's complex study of replantation of an extremity in experiment. Experiments on reproduction of the model of traumatic shock with acute loss of blood under conditions of muscle relaxation proposed by Yu. V. Kiprenski were performed in 15 dogs and 10 cats. It was established that in animals dead as a result of shock there appeared severe disorders of microcirculation in tissues and organs. They were characterized by a pronounced spasm of the vessels of the arteriolar link and dilatation of the venular and lymph collectors of the microcirculation bed. Simultaneously a great number of arterio-venular anastomoses were opened through which the arterial blood was shunted partly to avoid constricted capillaries. In the vessels of the venular link of the microcirculatory bed there appeared aggregations of formed elements of blood and microemboles. In absence of specific complex therapy, as it was in our experiments, the animals die of shock within the period from 17 min to 5 hour 20 min.


[Reactive changes in the retroperitoneal brown fatty tissue in rats after adrenalectomy]. Histological, histochemical, electron microscopic and biochemical methods were used to study the ability of retroperitoneal brown adipose tissue to steroidogenesis in 54 normal and adrenalectomized adult albino rats. The activity of glucose-6-phosphate-dehydrogenase in the adipose tissue of "brown" type was established to increase as well as the content of compounds with active carbonyl groups. The size of mtochondria was sharply increased. Biochemical analysis of the brown adipose tissue determined considerable concentration of corticosterone equal to one fifth of the average concentration of this hormone in the adrenocortical tissue. The obtained data indirectly confirm the hypothesis of possible formation of steroid hormones in the retroperitoneal brown adipose tissue in rats.


[Retinocerebellar relationships in the cat]. In order to study structural changes in the cerebellum the eye balls were enucleated in 6 adult cats. After unilateral and bilateral ablation of the eyes additional nerve fibres were found connecting the retina with the cerebellum. The retino-cerebellar accessary fibres come to the cerebellum mainly via the medial pedicle, solitary degenerated fibres were found in the medial and inferior pedicles of the cerebellum. Retino-cerebellar fibres were detected in the corklike, roof and dentate nuclei of the cerebellum. Retino-cerebellar straight fibres are projected into the white substance around the vermis as well as into the hemispheres of the cerebellum. No reticular-cerebellar fibres were found in the nucleus globosus.


[Intracraneal cerebral hernia].

[Intracraneal cerebral hernia]. Intracranial cerebral herniations occurring in 420 brains from consecutive necropsies are studied. They were present in 65 brains; in 23 there was secondary lesions in the upper brainstem. Temporal herniations in one or both sides, was the most frequent finding. Terminal anoxia is believed to be one of the most important factors. There was decrease of the secondary lesions of the brainstem after 60 years of age.


[Electroenecephalogram in cranio-cerebral injuries]. The 551 electroencephalograms of 387 patients with head injury are analysed. The electroencephalographic findings are correlated to the following clinical data: age, time after the trauma, duration of unconsciousness, presence of localizing neurological signs, existence of open wounds or hematoma, bloody cerebrospinal fluid and post-traumatic epilepsy. The autor came to the following conclusions: 1--there is a clear correlation between the electroenecephalographic abnormalities and the degree of cerebral injury characterized by the duration of unconsciousness, presence of localizing neurological signs, presence of bloody cerebrospinal fluid and post-traumatic epilepsy; 2 - slow wave activity over the parieto-occipital area is more frequent in the age group up to 10 years; 3 - the proportion of abnormal electroencephalograms decreases particularly after the 1st month post-trauma; 4 - diffuse or focal slow activity decreased principally after the 1st month post-trauma; 5 - paroxysmal abnormalities increase proportionaly after the 6th month post-trauma; 6 - patients with intracranial hematoma present great proportion of abnormalities, particularly depressions. This study demonstrates the importance of electroencephalographic tracings as a complementation to the clinical evaluation of head injury cases, chiefly early, and late follow-up tracings.


[Adverse effects and errors in antieplieptic therapy]. Reporting 6 cases of patients who presented many psychiatric and somatic symptoms consequently to different antiepilectic treatments, the authors demonstrate that the careful changing of the therapeutic avoided these inconvenients, without jeopardizing the control of the epileptic seizures. The necessity for the specialists to be attentive to these side effects is emphasized. Based on their own experience the authors suggest a few rules to prevent and correct these inconvenients.


[Spontaneous recovery of function in central nervous system lesions]. A rewiev of the mechanisms responsible for the spontaneous recuperation of function in patients with lesions of the central nervous sistem is made. The spontaneous reorganization theories of the nervous structures and the vicarious function are also referred to. In the last two decades experimental contributions have been accentuated, specially the one conducted by the group of researchers directed by Windle and Guth, who had shown the possibility of regeneration in the central nervous system, as well Lawrende and Kuypers, Brodal, Goldberger and others, which defended the vircarious function as the probable mechanisms of recuperation.


[Rubinstein-Taybi syndrome. Report of 2 cases]. Two non-inbred cases of Rubinstein-Taybi syndrome is two non-related sibships with a total of 16 sibs are reported. Clinical features are those classicaly reported. One of the patients (case 1) presents left post-axial polydactily and a history of hydramnion. The cariotype is normal in the other patient (case 2). Nothing is added in this paper as regards the etiology of the syndrome.


Arachnoid cysts involving a portion of the intraorbital optic nerve. Two patients were seen. One had chronic monocular choked disc, visual loss, and optociliary veins; the other had optic atrophy and a left-sided frontotemporal porencephalic cyst. Both patients were found on pathologic examination to have arachnoid cysts involving a localized segment of the intraorbital optic nerve.


Hypertrophy with hyperpigmentation of the retinal pigment epithelium. Fifty-two patients (one bilateral) exhibiting hypertrophy with hyperpigmentation of the retinal pigment epithelium (RPE) are described. Visual acuity was not affected, and the patients were asymptomatic. There was no correlation with systemic diseases, family history of eye disease, associated fundus lesions, anterior segment abnormalities, or intraocular pressure. Field defects were rarely demonstrated using standard clinical techniques. There were three characteristic locations and four characteristic pigmentary variations that occurred alone or in any combination. The lesions were gray, black, or brown. The clinical characteristics and histopathology suggest that hypertrophy with hyperpigmentation of the RPE and congenital grouped pigmentation are different expressions of a similar condition, with the former being focal and the latter multifocal.


Myotonic pupils in Charcot-Marie-Tooth disease. Successful relief of symptoms with 0.025% pilocarpine. Twenty-seven members of a family with dominantly inherited Charcot-Marie-Tooth disease (CMTD) were examined. Fifteen members had CMTD and 13 of these had varying amounts of myotonic pupillary abnormalities similar in some ways to Adie tonic pupil syndrome. Those with graver neurologic disease showed greater pupillary abnormalities. Ten of the 15 patients had pupillary constriction with methacholine chloride (Mecholyl) and some of these had extensive iris atrophy. Several affected patients received symptomatic relief from 0.025% pilocarpine. Seven other patients with CMTD who were not related to our initial family were checked for myotonic pupils; two had findings similar to our initial family. Pupillary abnormalities in certain patients with CMTD appear secondary to a parasympathetic denervation of the iris sphincter and ciliary muscle, as shown by a positive methacholine test, and probably represent part of the autonomic nervous system dysfunction associated with the polyneuropathy in CMTD.


Congenital grouped pigmentation of the retina. Histopathologic description and report of a case. Gross examination of an eye removed at autopsy from a 4-year-old child with congenital heart disease revealed typical grouped pigmentation of the retina. Routine light microscopy and flat preparation of the retinal pigment epithelium demonstrated the lesions to consist of focal areas of increased concentration of pigment granules in otherwise normal retinal pigment epithelial cells. The pigment granules were large and football shaped. The overlying photoreceptors showed no abnormalities, possibly explaining the clinical features of normal visual acuity and visual fields in this patient. We believe that this is the first histologic description of congenital grouped pigmentation reported in the English literature. A differential diagnosis and brief review of the pertinent literature are also presented.


Visual loss as the initial symptom in Hodgkin disease. Involvement of the visual system in Hodgkin Disease generally occurs late in the course of the illness. A 43-year-old man was seen at the Johns Hopkins Hospital complaining of monocular visual loss. Clinical observations and neuroradiologic examinations suggested a chiasmal mass lesion, and the patient underwent a frontal craniotomy with biopsy of the chiasm. The biopsy specimen was diagnosed as a spongioblastoma of the optic chiasm, and the patient underwent a course of radiotherapy. Shortly after craniotomy, the patient developed evidence of a systemic illness and died eight months after onset of visual symptoms. Autopsy revealed extensive systemic involvement by Hodgkin sarcoma. Microscopical examination of the optic chiasm revealed no evidence of optic glioma but revealed diffuse infiltration by Hodgkin sarcoma. Reexamination of the original biopsy specimen confirmed that initial visual symptomatologic findings were secondary to intracranial Hodgkin disease.


Ocular penetration of pilocarpine in rabbits. Aqueous humor pilocarpine hydrochloride concentration was measured at 15, 30, 60, and 120 minutes after instillation in the rabbit eye of a radioactively labeled 2% pilocarpine solution in various vehicles. Maximum concentrations were found with a vehicle containing 1.67% polyvinylpyrrolidone and other water-soluble polymers (Adsorbotears) and 1% hydroxypropyl methylcellulose. These produced pilocarpine concentrations during the first two hours after administration three times greater than those found with either saline, 1.4% polyvinyl alcohol, or 0.5% hydroxypropyl methylcellulose. Benzalkonium chloride, 0.01%, enhanced pilocarpine penetration into the aqueous by as much as 50% at all time intervals. The vehicle viscosity was unrelated to efficacy of pilocarpine penetration into the aqueous. The equally effective 1% hydroxypropyl methylcellulose and Adsorbotears have viscosities of 112 and 20 centistokes, respectively, while 0.5% hydroxypropyl methylcellulose (13 centistokes), 1.4% polyvinyl alcohol (3 centistokes), and sodium chloride solution (0.85 centistokes) are much less efficacious.


[The development of the dysplastic hip joint after conservative treatment (author's transl)]. The roentgenograms were evaluated of 220 patients (159 female, 61 male) with 61 luxations, 77 subluxations and 203 dysplastic hip joints which were a maximum of 2 years old during treatment and had been under observation for between 2 and 17 11/12 years. The CCD-, CE- and Ac-angles were measured. 1. The CCD-angle develops relatively independent of the therapy for the first few months. In the long term, the abduction treatment leads to a straightening up of the femoral neck. Here a physiological component apparently has an effect which reduces the straightening after several years. 2. The CE-angle rapidly becomes enlarged during the first few months, later the rate is slower. Three years after treatment began, the CE-angle was normal in 83.6% of the patients. 3. The Ac-angle decreases rapidly during the first 6 months. Three years after the beginning of treatment, 65.7% of the patients had a norm of less than 20 degrees. 4. All angles show a positive correlation of their beginning and end values i.e. light dysplasias have the best prognosis. 5. The monotherapy with a spreader pant showed a particular advantage over the combination treatment and plaster fixation. 6. The best result was achieved with treatment beginning before the age of 6 months. Boys showed a better tendency to heal. A difference in sides could not be shown.


[The electromyographical behaviour of gluteal and adductive musculature in the arthrodesis simulation test of the hip joint (author's transl)]. It has been demonstrated through special arthrodesis simulation tests that in the area of monarticular muscles of a stiffened hip joint criteria are reflected electromyographically for various arthrodesis positions, above all in the frontal plane, in addition to those criteria for inactivity atrophy. As our arthrodesis simulation tests have shown, these changes are demonstrable immediately after stiffening occurs.


[Continuous lengthening of the femur with intramedullary stabilisation (author's transl)]. Experimental studies on an intramedullary device for lengthening the femur by continuous distraction are reported. The hydraulic distractor is placed in a modified interlocking nail. Lengthening up to 8 cm--under certain circumstances up to 16 cm--can be achieved with this method.


[Surgically treated malleolar fractures--results after 3 to 4 years under special consideration of the talus profile (author's transl)]. An account is given of 216 cases of fracture of the ankle joint treated with the AO method. 167 patients with 168 fractures could be controlled personally 3-4 years after operative treatment. In 90% we found a good or satisfactory result. The result depends on the anatomical reconstruction of the congruity of the joint and the primary defect of the cartilage. The arthrosis seen in X-rays must not show a bad clinical function. Contrary to the experimental results the form of the talus is not important to the clinical course.


[Lunatomalacia therapy. I. Conservative treatment (author's transl)]. The results of the conservative treatment of 12 patients with lunatomalacia are reported on. If we take into consideration the subjective data as well as the clinical and roentgenological evidence, only 2 can be considered "good". On the other hand there were 5 "fair" and 5 "poor" results. In spite of the predominance of disappointing results, the conservative treatment can lead to very good late results. The comparison with operative measure about which there will be reports later, shows these operations have no real great advantage.


[Early experiences with ultrasound osteosynthesis. Preliminary report (author's transl)]. The authors report their first results and experiences with a new method of osteosynthesis, which was introduced by soviet authors in 1973. A mixture of cyanacryl and bonepowder is used under the influence of ultrasonic waves for union of bones. Technological and animal experiments are being carried out at this time.


[Infected tibial shaft pseudarthroses, treatment and results (author's transl)]. In a follow up study of 47 patients with infected pseudarthrosis of tibia therapy and results are declared. The most important matter in therapy is the osteosyntesis with compression of the pseudarthrosis. In the majority of cases externe stabilisation is used; seldom compression plate or medullary nailing is indicated. Such cases require much experience in the therapy of bone infection, although if the stabilisation with the fibula is tryed. Flush drainage, suction drainage, antibiotic therapy and cancellous bone grafting are necessary for localisation and decreasing of infection and for induction and acceleration of bone union. In some cases amutation can't be prevented. With correct judgement and consequent treatment in the majority of cases bone union will be obtained.


[Osteosynthese in scapula fractures (author's transl)]. Fractures of the scapula can be mostly conservativly. Dislocated fractures can be easily adjusted by suitable approaches. Rigid fixation allows early mobilisation, which is of very importance for the shoulderjoint. Some dislocated cases have been described and the problems of conservatively treated fractures have been discussed. Follow-up of some with stable fixation treated scapulafractures show that it is possible to gain a perfect functional result and a painless shoulderjoint in some hopeless cases.


[The importance of magnification angiography as an investigation for the arterial supply of the femoral head after medial neck fracture (author's transl)]. In observing the development in 20 patients who had been operated upon for fracture of the neck of the femur a significant interrelation between the angiographic result and the formation of a necrosis of the head of the femur has been ascertained. The magnification angiography enables the terminal arterial region of the femoral vessels to be assessed with a still higher degree of certainty and thus appears to be a valuable diagnostic measure for the prognostic assessment of the medial fracture of the femoral neck.


[Interaction between construction and fixation of knee endoprostheses (author's transl)]. The two completely different total knee-endoprostheses (hinge type and sled or runner type) have been compared concerning construction and ability for take up or transmission of forces and moments. The difference to the real knee joint are described. The reactions on fixing of endoprostheses in the bone caused by the construction are emphasized. By a systematic analysis of the so called sled-prostheses is to be shown to differantiate between real sled-prostheses with rotation and sliding mobility and pseudo-sled-prostheses (better rotation-segment-prostheses). They have only one possibility of rotation to realize the knee bending. The kind and number of existing "degrees of freedom" are used as a significant characteristic to differentiate the various endoprostheses principles and their variants. This study should mainly inspirate for a systematic comparison of efficiency of the different types of knee-endoprostheses. This should give the operating surgeon for a length of time an objective aid to decision.


[Contribution to the technique of acetabular implantation in total hip arthroplasty (author's transl)]. An operative technique for total hip arthroplasty is described which does not require a guiding instrument to obtain the necessary angles for the acetabular part. Instead, the acetabular rim serves as a guide. The result was examined in 159 cases on the basis of a standard X-ray of the entire pelvis from which the angular relations of the acetabulum could be read or calculated. The values found corresponded to the normal anatomical distribution. The technique is simple and safe. The influence of the angular relationships on the danger of a prosthetic luxation on the one hand and on mobility on the other hand is discussed.


[Rare developmental disorders of the hip (author's transl)]. Authors report on rare developmental disorders of the proximal end of the femur and of the acetabulum. The following cases are described: 1. Peculiar high situation of acetabular roofs. 2. Quadrangular proximal femoral epiphyseal nucleus. 3. Dysplasia epiphysealis capitis femoris. 4. A notch in the proximal femoral metaphysis. The significance of these developmental disorders is shortly discussed.


[To the trauma of the pisiform bone, a contribution to the rare injuries of the hand (author's transl)]. Fractures and especially luxations of the pisiform bone are rare injuries of hands, of which X-ray pictures are very important. The few points and cases in the literature some own cases are added; a hitched luxation of the pisiform bone with operative reposition and fixation is exactly described.


[Therapy of fracture of epicondylus medialis humeri (author's transl)]. The fracture of the medial epicondylus humeri is an injury tipical for the age of growth. It is a preliminary stage of the luxation of the elbow, which again is associated with one third of the fractures of the medial epicondylus humeri. We report about 27 own patients with fractures of the medial epicondylus humeri. 15 cases were treated conservatively, 12 cases underwent operative treatment. Operating procedure: extirpation, reinsertion or fixation with tension band principle. In all but 3 cases the results were good. These 3 patients had concomitant injuries. Immobilisation lasted for 4.1 weeks on the avarage, full motility was attained after 2.2 months on an avarage. Based on the good results in the mentioned patients, we recommend indication for operative resp. conservative therapy as follows: 1. Conservative: If the joint is not injured and If dislocation is less than 3 mm. 2. Operative: if dislocation is 3 mm or more, or if the fracture includes the articular surface. An absolute indication for operation is given if there is an interposition of fragments into the joint or a lesion of the nervus unlnaris.


Computer-retrievable surgical pathology files. A low-cost, shareable system. Reading descriptions of computer-retrievable surgical pathology files, the tissue pathologist might like to institute a similar system, but faces two problems. He finds little cost information and, without either the time or the skill for computer programming, he is unable to proceed with system development. We have a system that was developed to maximize cost efficiency. All of the programs are written in FORTRAN so that the system will run on almost any time-sharing computer. There is a need for computer-retrievable systems in pathology, and after careful consideration of affordability and shareability, computerization is workable.


Growth of a plasma cell myeloma in lathyritic mice. Growth of a plasma cell myeloma (Adj PC-5) was studied in mice made lathyritic by the administration of beta-amino-proprionitrile (BAPN). The number of bones that had their medually cavities filled with tumor cells was notably decreased compared with tumor-bearing mice not treated with BAPN. Other aspects of tumor growth were the same. BAPN caused some retardation of tumor growth in the medullary cavity, but also caused osteoporosis and decreased tensile strength of collagen that allowed expansion of tumor growth outside the bones to proceed as usual. Additionally, the tumor-bearing mice showed some inhibition in their response to BAPN. This agrees with previous work that has shown that the response to BAPN treatment is greatest in animals that otherwise are healthiest.


Neonatal necrotizing enterocolitis. Occurrence secondary to thrombosis of abdominal aorta following umbilical arterial catheterization. A patient had neonatal necrotizing enterocolitis (NNE), secondary to aortic thrombosis following umbilical arterial catheterization. The thrombus occluded the ostium of the inferior mesenteric artery. A review of cases reported in the literature with complications following umbilical arterial catheterization revealed four instances of NNE or NNE-like lesions due to thrombosis of the abdominal aorta or one of its major branches. Thrombosis of the aorta, with occlusion of one or more of its major abdominal branches following umbilical arterial catheterization, should be considered as a potential etiologic factor in certain cases of NNE.


Mucoceles of the appendix. Their relationship to hyperplastic polyps, mucinous cystadenomas, and cystadenocarcinomas. Sixty-four cases of hyperplastic polyp, mucinous cystadenoma, and cystadenocarcinoma of the appendix were studied in relation to the development of mucocele and "pseudomyxoma peritonei." Thirty-three cases were examples of hyperplastic polyps. In 11, the appendix was transformed into a mucocele; eight were associated with mucinous cystadenoma and one with mucinous cystadenocarcinoma. The hyperplastic polyp alone was the cause of mucocele formation in two. Thirty-five cases represented examples of mucinous cystadenoma; 32 resulted in mucocele formation. Rupture with localized pseudomyxoma peritonei was found in six; generalized pseudomyxoma peritonei was encountered only once. In four of the five cases of mucinous cystadenocarcinoma, the appendix was grossly transformed into mucoceles. The histological features of mucinous cystadenoma are identical to villous adenoma of the large bowel and probably represent its counterpart within the appendix.


Studies on the inhibition of synthesis of the tyrosine-rich proteins of wool. Three treatments known to produce weak wool were imposed on sheep, and the effects on the synthesis of high-tyrosine wool proteins were noted. The treatments were: intravenous infusion of the amino acid mimosine (a potential chemical defleecing agent), intravenous injection of the synthetic steroid Opticortenol (dexamethasone-21-trimethylacetate), and the abomasal infusion of methionine into sheep consuming a diet of wheat. All three treatments caused a partial suppression of high-tyrosine protein synthesis. The inhibition caused by mimosine could not be prevented by the simultaneous infusion of tyrosine or phenylalanine, suggesting that in this system mimosine is not acting as a tyrosine antagonist. The role of phenylalanine in controlling the synthesis of the high-tyrosine proteins in wool was also investigated. Although the infusion of an amino acid mixture minus phenylalanine reduces the level of these proteins, supplements of phenylalanine or tyrosine do not stimulate their synthesis, irrespective of the initial level in the fibre. The improtance of aromatic amino acids in the regulation of the high-tyrosine proteins is therefore uncertain. Suppression of the high-tyrosine proteins is usually accompanied by a stimulation in the synthesis of the ultra-high-sulphur proteins, although there does not seem to be a simple stoichiometric relationship between the two protein types.


Dependence upon bile volume of the biliary excretion of bromocresol green and amaranth in the anaesthetized rat. The kinetics of the biliary excretion of both bromocresol green and amaranth are better described in terms of rate equations that are functions of the cumulative volume of bile excreted rather than of time. The rate of disappearance of bromocresol green from the liver also appears to depend on the volume of bile excreted rather than on time. It is proposed that bromocresol green, and probably also amaranth, rapidly equilibrates between the hepatic and biliary compartments as a result of reabsorption from the biliary tree and that the rate-limiting factor in the biliary excretion of these dyes is the removal of dye from the biliary tree by bulk flow. Six methods for the graphical presentation of excretion data are examined and their use in the characterization of the kinetics of an excretion system is discussed.


Studies on monotreme proteins. VI. Amino acid sequence of the beta-chain of haemoglobin from the platypus, Ornithorhynchus anatinus. The amino acid sequence of the 146 residues of the beta-chain of the major haemoglobin from the platypus has been determined. The soluble peptides derived from the chain by tryptic digestion were isolated by paper ionophoresis and chromatography. The amino acid sequences were determined by the dansyl-Edman procedure or by further digestion with other enzymes. The tryptic peptides were aligned by homology with other beta-globins. There were 14 changes in sequence compared with echidna beta-chain. The number of changes in sequence compared with human beta-chain is 34 which is less than the 39 changes between human and platypus alpha-chains. Generally there are more changes between beta-chains; there are only three other examples reported where there are more changes between alpha-chains than beta-chains, these are of echidna, rabbit and dog globins. By comparison with the 'contact sites' in horse haemoglobin there is one change in beta-haem contacts, three changes in beta1-alpha1 contacts and no changes in beta2-alpha1 contacts. The date of divergence of the monotremes from the other mammals was estimated at 132 +/- 33 million years, based on the number of amino acid differences between species and allowing for multiple mutations during the evolutionary period. This estimate differs widely from the estimate given by similar treatment of the alpha-chain sequences and the significance of this discrepancy to the validity of the method is discussed.


A kinetic approach to defining the role of chemically modifiable residues at the active sites of enzymes. Initial velocity studies can be used to define the function of chemically modifiable residues in the active site of a multisubstrate enzyme. Since the method relies on measuring biological activity, it has the advantage that it can be used with small amounts of relatively impure enzyme, but requires that modified enzyme molecules have some residual catalytic activity. The kinetic analysis of the modified enzyme can be carried out in the presence of some unmodified enzyme molecules. Consideration of examples of single- and multisubstrate enzymic reactions shows that interpretation of changes in apparent Km and apparent V values following chemical modification, in terms of effects on substrate binding or catalysis or both, requires a detailed knowledge of the kinetic reaction sequence. In the case of multisubstrate enzymes, it is necessary to ensure that, during the kinetic investigation, the concentrations of the non-varied substrates remain at near-saturating levels. For this reason, and because modification may induce changes in the rate-limiting step, a full kinetic analysis of the modified enzyme is advisable.


Influence of nutrition on the crimping rate of wool and the type and proportion of constituent proteins. When the nutritional level of sheep is restricted, the staple crimp frequency of the resultant fleece increases substantially whereas the cystine and high-sulphur protein contents decrease. This is in marked contrast to the direct relationship between crimp frequency and cystine content among sheep. These observations can be reconciled by assuming that variations in crimp frequency are attributable solely to a combination of follicle shape and fibre length growth rate without recourse to the more generally accepted theories relating to the proportion and distribution of ortho- and paracortical cells in the firbre cortex. The major portion of the decrease in the cystine content of high-crimp wools is due to the decreased synthesis of a specific protein fraction (ultra-high-sulphur protein) as would be expected from the results of dietary supplementation experiments. Low-crimp wools do not appear to contain this protein fraction and in this respect they may differ from high-crimp wools.


Extra-ovarian effects of bovine prolactin and growth hormone on the vagina of the mouse. Hypophysectomized-ovariectomized mice receiving oestrogen and progesterone were treated with and without bovine prolactin and growth hormone (GH). Prolactin significantly increased vaginal weight and vaginal sialic acid content, but had no effect on vaginal sialic acid concentration, an indicator of vaginal mucification. Growth hormone significantly increased all three vaginal parameters. For vaginal sialic acid content and concentration, the synergism between oestrogen and progesterone was found to be greater in the presence than in the absence of GH and the maximum response to GH was obtained when between 20 and 100 mug GH was administered daily. It was concluded that GH but not prolactin has an extra-ovarian effect on vaginal mucification in the mouse.