Growth hormone secretion in chronic schizophrenia. The GH response to insulin hypoglycemia (insulin 0.1 IU/kg i.v.) was studied under basal conditions and during a course of haloperidol therapy in 19 chronic schizophrenics, 15 hebephrenics and four paranoids (ten men and nine women, age 16--53 years). Haloperidol was given for 30 days, at a daily dose of 6 mg i.m., and the GH response to insulin-induced hypoglycemia was tested twice, before, and 10, 20, 30 days following the initiation of the treatment. The psychopathological features were controlled daily by two psychiatrists and by the ward staff and by the use of a Wittenborn rating scale, rated at the same intervals as the hormonal assays. From the results obtained it appears that in schizophrenic patients, GH secretion and response to insulin stimulus are extremely variable and are unaffected by haloperidol treatment. On the basis of the results obtained, the neurotransmitter-neurohormone regulation of GH secretion in schizophrenics is discussed.


Acquistion and extinction of a conditioned hyperthermic response to a tone paired with morphine administration. Following a 7-day baseline period, five male hooded rats were injected daily with a constant dose (20 mg/kg) of morphine sulfate. Immediately following the injections they were taken to a sound-attenuated room and exposed to a 5,000 cps tone for 90 min. On certain predetermined days of the morphine treatment, rectal temperatures were measured before each injection and 30 min following the onset of the tone. Also, after the 11th, 19th, and 57th morphine-tone pairing, the rectal temperatures were measured before and after a saline injection which was paired with tone. On these days tone presentations by themselves were sufficient to cause a reliable increase in rectal temperature resembling that seen following an injection of morphine. When tone presentations were continued, without further pairing with morphine, the hyperthermic response to the tone was gradually extinguished. However, a significant increase in rectal temperature in response to the tone was again observed following a second set of five morphine-tone pairings.


The effect of plasma from psychotic children on tryptophan uptake in chicken erythrocytes. Ten children diagnosed as psychotic by the DeMeyer-Churchill guidelines were matched for age and sex with ten non-psychotic but emotionally disturbed children. Six of the ten pairs were medication free. In four of the ten pairs, at least one member was medicated at the time of testing. The plasma of the children diagnosed as psychotic caused a significantly (p less than 0.025) greater uptake of tryptophan by chicken red blood cells than did the serum of their control group. This is the same effect on tryptophan uptake as found when the plasma of adult patients with process schizophrenia is incubated with chicken erythrocytes and tryptophan. This finding lends support to the possibility that there is a subgroup of childhood psychotic patients who have a biological disturbance similar to that found in adult process schizophrenia patients.


A genetic study of chronic delusions.

A genetic study of chronic delusions. There is a nosologic difference between the French schizophrenia and the English schizophrenia which include all chronic delusions. A genetic study of chronic delusions, based on the rules of the French nosology, has two goals: two clarify their genetic etiology, and to test those nosologic differences. This study was made on the families of 45 patients with chronic delusions. The conclusions are: the 'délires paranoïaques chroniques' have a genetic etiology and are related to schizophrenia; the 'psychoses hallucinatoires chroniques' are not influenced by the genetic etiology and are not related to schizophrenia. Therefore, the psychoses hallucinatoires chroniques' constitute an autonomic entity according to the French nosology.


A comparison of dietary starch and dietary sucrose in the pig. Seven litter-mate pairs of male crossbred pigs were fed diets in which 50% of the dry weight was either corn starch or sucrose for 1 year. Unlike reports of two similar experiments published since our work was carried out, no lesions of the cardiovascular system were found in any of the animals at the end of the experiment. The sucrose-fed animals differed from those fed starch in the following respects: growth was faster during the first 9 weeks of the experiment, but became significantly slower during the remaining 43 weeks, with a less efficient food conversion. The pancreas was about 30% smaller but with no difference in gross or histological appearance. In the plasma there was a transient increase in concentration of insulin, a decrease in albumin, and a decrease in activities of glutamate-oxalacetate transaminase and lactate dehydrogenase. No significant changes in plasma cholesterol and triglyceride, phospholipid or glucose were observed.


Lipid metabolism of developing central nervous tissues in organotypic cultures. I. Lipid distribution and fatty acid profiles of the medium for rat brain cortex in vitro. The distribution and concentration of lipid components of different media used for organotypic cultures of rat brain cortex have been measured quantitatively. Five cholesterol ester species have been fractionated from chicken embryonic extract. Their fatty acid profiles have been determined by combined gas liquid chromatography-mass spectrometry. The depletion characteristics of medium cholesterol esters and some fatty acids during development of brain cortex were not symmetrical. Polyunsaturated fatty acids of the medium were lowered prior to the saturated and monoenoic fatty acids. The phenomenon of depletion may be correlated with enhanced esterase activity mediated by the tissue.


Lipid metabolism of developing central nervous tissues in organotypic cultures. II. A comparative study of medium and tissue fatty acids in developing rat cerebral cortex and cerebellum. Organotypic cultures of rat cerebral cortex and cerebellum have been supplemented with different media. Fatty acid analysis in incubated media and in tissue explants revealed a characteristic differentiation of three periods during maturation: a posttraumatic repair phase, a synaptogenic period and a synaptic stage. Medium fatty acids are biphysically depleted from the nutrient. Both tissues differ in the depletion pattern of individual fatty acids. The development of tissue fatty acids is mainly observed during the synaptogenic period. Turnover studies of individual fatty acids indicate a tissue-specific and time-dependent characteristic.


The effect of vitamin E deficiency on permeability of mitochondria for phosphate. We have investigated whether the earlier-found decreased unsaturation in mitochondrial membranes in vitamin E deficiency affects the permeability properties of mitochondria. The iso-osmotic swelling technique was used as a measure for the rate of uptake of substrates by these organelles. A significantly slower uptake could be observed of ammonium malate in the presence of phosphate and of ammonium  phosphate. These changes in membrane permeability might give a clue to the mechanism of some metabolic abnormalities as seen in vitamin E deficiency in relating these abnormalities to specific membrane functions, e.g. an affection of carriers; for instance the phosphate carrier.


[Changes in hemoglobin content, erythrocyte count and hematocrit in nickel deficiency]. In a total of four different studies, two of them involving two generations, the essentiality of nickel could be shown by reduced growth in response to a diet with 15 ppb nickel. In 30-day-old self-reared rats, anemia was induced in the Ni-deficient animals despite a high iron supply of 50 mg iron per kg diet. In the F1 generation of the Ni-deficient animals, the erythrocyte count had fallen by 36%, the hematocrit by 37%, and the Hb content by 44%. In the F2 generation in which the animals were given 100 ppm iron, surpassing their requirement three times, the blood parameters of the deficient animals were reduced by 8-10%. At the age of 50 days of the F1 generation the erythrocyte count had fallen 23% compared to the values of the control group, the hematocrit 14%, and the Hb content (16%) from 12.7 to 10.7 g/100 ml blood. An influence on the protein content of the serum and on the catalase activity of the erythrocytes was not observed and only at times was there an influence on the urea content of serum.


Lipid changes in tissues of young boars fed rapeseed oil or corn oil. Fully refined rapeseed oil, Brassica campestris var. Arlo plus Echo, and corn oil were fed at 20% by weight of a basal diet to young Yorkshire boars. A serial slaughter technique was employed whereby 3 boars from each dietary treatment were killed at 0,1,2,3,4 and 8 weeks of the experiment. The fatty acid profiles of heart, liver, adrenals and testes lipids were investigated. The typical fatty acids of rapeseed oil, erucic and eicosenoic acids, were incorporated at different levels into the tissue lipids examined. After feeding the rapeseed oil diet for 1 week, the relative concentration of these fatty acids increased in the adrenals, while remaining similar in the heart, liver and testes. The relative concentration of eicosenoic acid was greater than that of erucic acid in all organs examined, except for the heart which contained equal amounts of these acids. Tissue levels of these acids in boars were compared to those found in rats fed the same rapeseed oil in previous studies.


Studies on liver sulphurylase activity in rats: vitamin-A-deficient and low-protein diets. Studies on the sulphurylation of phenols by livers from normal and vitamin-A-deficient rats showed a significant reduction in sulphurylating activity in the acute stage of deficiency. At the 'plateau stage' of deficiency, decrease in this activity was marginal and was not significant. Rats consuming a 6% casein diet had a significantly lower liver sulphurylating activity when compared to those fed 12 and 18% casein diets. Comparative data on the sulphurylating activity of rats maintained on diets providing poor-quality protein, i.e. ragi (Eleusine coracana) and maize (Zea mays) revealed a higher sulphurylating activity in the maize-fed group showing thereby that the amino acid composition of the protein apparently influences the enzyme activity associated with sulphurylation of phenols. It is thus shown that liver sulphurylating activity is influenced by quantity and quality of protein consumed.


Evaluation of acetate tolerance during highly efficient hemodialysis. Acetate clearance was found to approximate bicarbonate clearance and to be 10% lower than urea clearance under single pass in vitro conditions. Plasms acetate concentrations were significanlty higher in pre-dialysis samples than in control subjects and rose during hemodialysis to a wide range of post-dialysis levels. In 17% of patients plasma acetate exceeded 9.5 mM/L and range to 21.6 mM/L. The cause for this apparent acetate intolerance is probably multifactorial, since severe hyperacetatemia is not a constant finding for any specific patient. Correction of pre-dialysis acidosis may be impaired by acetate accumulation.


Three years' experience with home peritoneal dialysis. Our results to date indicate that home peritoneal dialysis is a sucessful, safe, and simple dialysis treatment which is accessible to virtually all patients who require chronic dialysis treatment.


Hemodialysis at a summer camp.

Hemodialysis at a summer camp. A successful pediatric hemodialysis program was established at a summer camp. The dialysis campers had an opportunity to develop peer relationships and improve their self image by mastery of new skills and by increasing their sense of independence. Families were able to gain perspective on their child's development. The program will be continued and expanded. Further efforts will be made to determine how a vaction dialysis program aids in the rehabilitation of a dialysis patient,


Cooperation and successful outcomes in home dialysis. Cooperation among those involved in the triad of patient-partner-health professional is associated with desirable patient outcomes and has been demonstrated in 2 studies with consistent results. In the dyad analysis, cooperation between the patient and partner was associated with work and leisure activity. Spouses often encourage and facilitate the patients ability to engage in work and leisure activities and probably can impede activity equally well. The correlations of cooperation in the patient-doctor dyad with physical status and adherence is also of note. Many of the patients who have been on dialysis for several years and are doing well see their doctor for checkups only a few times a year, which might suggest patients' independence of their physicians or at least some distancing due primarily to the infrequency of contacts with each other. On the contrary, the data suggest some that the patient-doctor relationship remains important. Cooperation in the partner-doctor dyad did not relate to any of the patient outcomes; many of the partners and doctors hardly knew each other personally. Whether this is reflected by the data cannot be determined. How accurately triad members perceived each other (mutual perception) was related to adherence and total activity while trust was related to physical status and adherence. Empirical evidence has been presented to support the long held assumption that cooperation among those caring for a patient is associated with selected patient outcomes. The study also provides an alternative to the traditional model for interactions between health care providers and patients, which includes a family member. While the traditional model fits the needs of emergency and acute care situations effectively, the cooperation model is one alternative that may fit the different needs in the long term, self-care, chronic illness situation, which is the greatest health care delivery challenge of today and tommorrow. Patient and family responsibility for treatment and symptom management in home dialysis illustrates an extremely expensive, demanding and highly technological treatment pattern. The success of many of these families to assume this responsibility effectively and to maintain a productive and acceptable life style is a profound example, which designers of services for other chronically ill populations would do well to consider. Inclusion of the patient in establishing his treatment plan within the parameters of his own value system and life style may at times compromise the health professional's own idealistic needs for maximal wellness. The model proposed here would attempt to bring greater congruence between the patient, family and health professional's goals, legitimize the patients' rights to participate in planning and decison making which affect them to the degree which meets their own needs. Health professionals can educate and train patients, provide treatment means to better health, provide support for patient and family responsibility and facilitate informed decision making...


[Determination of the normal limits of various biochemical parameters in a homogenous sub-population]. Within the limits of a program of preventive medicine for the people in working age we have gived started to a proceeding of methods' standardization and definition of the limits of the "normal" variability of any biochemicals parameters. The research, beginned how quality control (day to day control, between batch control, inter-laboratory control) for the instrumentation in use (Autoanalyzer SMA 12/60) is continued defining for 12 bio-chemical constants the normal bounds of the variability in relation with sex and age of the individual subjects and this in prevision of an enlargement of those bounds with the view of the preventing in the local people.


[Studies on the diagnostic value of various enzymatic activties in icterogenic hepatitis of infancy. II. Sorbitol dehydrogenase, guanase and argininosuccinate lyase]. The AA. have determined the levels of argininesuccinatolyase (ASAL), sorbitoldehydrogenase (SDH) and guanase (GUA) in 65 cases of hepatitis of infancy, by comparison with the corresponding levels of transaminases. Of all the enzymes examined, transaminases were the most sensitive sign of liver damage, not only because of their more pronounced rise in the earlier stages of the disease, but also in consideration of their slower regression to normal values. The AA. nevertheless believe that a special significance can be assigned to the determination of SDH for its persistency to levels higher than the normal ones in prolonged hepatitis, and for its quick increase in the recurrences; its regression to normal values may be assumed as an early and clear sign for the demonstration of the stages indicative of recovery.


[Pilot study on the Limulus test and apyrogenic injectable preparations]. After  some notices on the Limulus amebocyte lysate test the AA. expose the results of an investigation for in vitro pyrogen detection in parenteral preparations.


[Double blind study on the effects of automobile driving with automatic and standard transmission on various physiological parameters]. The main factors studied were the overall energy output and, in particular, the effects on the respiratory, cardiac and circulatory systems. The basic result was to demonstrate that while driving there occur more or less marked physiological modifications to these systems, which can be determined as to quantity; it seems clear that during particularly difficult conditions at the wheel or in subjects whose health is less than perfect, this can go as far as pathological situations. The values of catecholamines and their metabolites in the blood and urine were chosen as evaluation parameters. Catecholamines--that is, adrenaline, noradrenaline and dopamine--are substances produced by the adrenal glands; they play an essential part in the "functioning" of the sympathetic nervous system (which has important tasks, such as that of regulating the organism's equilibrium especially in reactions to sudden events or emergency situations) and are a reliable indication of effort and stress. Their action is seen in stimulation of the nervous system, cardiac agitation, an increase in blood pressure and in the production of lactic acid, increases in the basal metabolism, and so on. An excessive amount of these substances in the blood can cause real damage, above all to the heart and brain, especially in organs already affected in some way. The subjects studied were healthy volunteers, ranging in age between 20 and 35 and of comparable height and weight. A sort of "cross-over" experiment was carried out, so that the same subject was first studied driving with one type of gear change and then, two days later, was studied in the same experimental conditions but driving a vehicle with the other type of gear change. Analysis of the blood and urine sample was carried out in "single blind-test" conditions, in the sense that the research worker did not know where the samples came from. The biochemical analyses of the blood were: 1) Gas-analysis; 2) Hemochrome; 3)LDH-SGOT-Alkaline phosphatase; 4)Noradrenaline; 5)Cortisol. The following urine analyses were made: 1)Total catecholamines; 2)Vanillylmandelic acid. Clinical tests included: 1. Measurement of arterial pressure, at the beginning, at the end and during the driving period at the 30th and 90th minute. 2. Measurement of cardiac frequency,at the beginning, at the end and during the driving period at the same times. Blood pressure was measured by the auscultatory method, using an armband apparatus with aneroid capsule; cardiac frequency was measured at the wrist using the simple palpatory method, per 60 seconds.


[Australia antigen and liver diseases. Report on personal cases and review of the literature]. The AA. relate the results of HBsAg and homologous antibody research by count-electrophoresis obtained in 274 patients with several chronic and acute liver-diseases. Moreover, the most important data of literature are discussed trying to relate the different results of the various AA. to the different sensitivity of the detection techniques and to the difficulties of classifying some disease (chronic hepatitis) and also to the factors related to the geographic distribution of Australia antigen. On the basis of this discussion the AA. make some general consideration on the meaning of HBsAg in the liver disease especially in the chronic diseases and in the primary liver cell carcinoma.


A comparative study of free amino acids in coma of different aetiologies. A comparative study of the concentrations of free amino acids in the plasma and cerebrospinal fluid in cases of coma of different origins has been made. Hypotheses are put forward to explain the biochemical steps involved in cerebral metabolism of protein.


Intravenous diazepam narcosis in the treatment of injuries, with doxapram for recovery. The effective use of diazepam for narcosis in cases of injury requiring painful manipulations is dependent on adequate dosage, titrated for each patient. Protection against the risk of occasional respiratory depression from this regime is consistently given by the use of intravenous doxapram, which also gives varying degrees of arousal.


Attempted suicide with a pesticide mixture. An attemped suicide with a pesticide mixture containing pentachlorophenol, benzene hexachloride, dieldrin, metaldehyde  phenoxyacetate esters, paraquat, diquat and petroleum distillates, is reported. The prognosis initially seemed hopeless, but the patient was treated successfully by intensive care with early respiratory assistance.


Comparison of the patient populations referred to the accident and emergency department outside working hours by general practitioners and by their deputizing services. A comparison was made of the characteristics of patients referred to the Accident and Emergency Department of the Royal Victoria Hospital, Belfast outside normal working hours by their own general practitioners and those referred by the general practitioner deputizing service during the same period.


[Super-selective arteriography and embolization of the internal carotid]. The aim of superselective arteriography of the internal carotid is to opacify the small calibre arteries which were only slightly visible or not visible at all previously, to isolate an arterial area and to study its anastomoses and its venous drainage. The use of the balloon probe makes it possible to explore the very winding branches of the carotid siphon and the branches of the Sylvian artery or of the anterior cerebral artery. With a balloon probe pierced at the end, one can inject a contrast substance thereby making it possible to carry out superselective arteriography. With an unpierced balloon probe, a branch of the Sylvian or of the anterior cerebral artery can be temporarily occlused in order to study (in an unanaesthetised patient) the possibility of cutting off this artery without neurological complications when it is supplying a malformation. The various methods of embolisation are reviewed (plastic bells, silicones, detachable balloons) as well as their advantages and their dangers.


[Cerebrovascular accidents. Complete tardive regressive course]. In a consecutive series of 1018 cases of focal cerebro-vascular disease there were 42 cases of stroke followed by a full recovery after a variable time interval from 4 to 60 days. Some clinical features deserve mention: the vascular district involved was chiefly the carotid area; the onset was gradual in many cases; the impairment of consciousness was unusual; motor impairment was in many cases limited to one limb; the EEG and brain scan showed abnormalities in few cases with subsequent recovery; the angiographie examination showed occlusion of the sylvian artery in one case, severe stenosis of the internal carotid artery in one case, absence of visualisation of the terminal branches of the sylvian artery in 12 cases; the follow-up (mean duration years 4,25,SD +/- 2.09) showed a favourable course since subsequent stroke appeared in a minority of cases. The term "stroke with full recovery" and the problem of the sensitivity of the brain to oxygen deficiency is discussed.


[Progressive myoclonic epilepsy: anatomo - clinical study of a sporadic case with a marked cerebellar symptomatology (author's transl)]. A case of progressive myoclonic epilepsy (P.M.E.) is described. The clinical picture consisted of epileptic seizures, myoclonus and slight mental deterioration associated with a severe progressive cerebellar syndrome. The disease had a course of almost 20 years. Histological studies of the C.N.S. showed severe loss of Purkinje cells, sligth regressive changes in both dentate and olivary nuclei, nerve cells atrophy of anterior horn motoneurons, degeneration of Goll's and Burdach's spino-olivary and anterior spino-cerebellar tracts. Features of cellular lipidosis and/or neuronal amiloid inclusions were not seen. The case was therefore classified in the group of degenerative P.M.E. Its peculiar pathologic aspects consisted of slight but diffuse brain stem regressive changes associated with systemic degeneration involving the spino-cerebellar pathways. The clinical features of our patient emphasize the problem of differential diagnosis between. P.M.E. and D.C.M. thought of by French authors to be an autonomous entity both clinically )severe cerebellar syndrome, intentional myoclonus, absence or late appearance of epilepsy, slight or absent mental deterioration) and anatomically (primary atrophy of the dentate system). However there are many cases, similar to the one reported, which have a clinical course suggesting a diagnosis of D.C.M., but which differ neuropathologically from Hunt's syndrome because of the absence of primary atrophy of the dentate system. These borderline cases give supporting evidence to the concept of continuity between classical P.M.E. and D.C.M., as well as to the authors' opinion that 1unt's syndrome must be classified as a varient of degenerative P.M.E.


[Bisynchronous discharge of symmetrical cortical epileptogenic foci and thaurine resistence (author's transl)]. The possible preventive action of taurine administered through a cortical perfusion, has been studied in bilateral and simmetrical foci with bisynchronous discharge. The data obtained showed that: 1)taurine preventive action is less remarkable in bilateral and simmetrical foci; 2) when administered trough the appropriate route, taurine always has a preventive antiepileptic effect. Our data, compared to those of Marcus e al., confirme that bisynchronous discharge, resistant to taurine preventive and terapeutic action, is the obligatory expression of interactions of bilateral and simmetrical foci.


[Verbal comprehension in aphasic and in normal subjects with a shortened version of the token test (author's transl)]. A 36-item version of the token test is described together with its administration and scoring instructions. 215 normal subjects, 130 right brain-damaged patients, 50 non aphasic left brain-damaged patients and 106 aphasic patients were given the test. Years of schooling were found to affect significantly the performance of normal subjects; normal data were therefore examined with reference to individual educational background. Cutting scores differentiating normal from pathological performance were determined substracting 2 standard deviations from the means of normals subjects subdivided into four educational groups. Below these scores fell 4.2% of normal subjects, 14% of right brain-damaged patients, 18% of non-aphasic left brain-damaged patients and 90.48% of aphasic patients. Aphasic patients were classified as suffering from Global, Wernicke or Broca aphasia on the grounds of their performance on a Standard Aphasia Battery and the Token test scores of these three groups were compared. A score of 14 points was found to differentiate Broca from Global aphasics and severe from moderate and mild Wernicke aphasics. Broca aphasics were more impaired than Wernicke aphasics on the Token test. When compared to the Sentence Comprehension Test of the Standard Aphasia Battery, the Token test was found to be far more sensitive to detect impairment in aphasic subjects.


[On a case of Guillain - Barre's polyradiculoneuritis with arterial hypertension (author's transl)]. A twenty year old man affected by Guillain-Barré's radiculopolyneuritis with tetraparesis had high protein and only few cells in the C.S.F., with no cranial nerve involvement or respiratory difficulty. He had high arterial pressure (both diastolic and systolic) for about three months accompanied by episodes of tachycardia and hyperhydrosis. Investigations of renal functionas well as catecholamine and vanil-mandelic acid urinary excretion were normal. Tilting test and carotid sinus reflex were normal. The patient recovered almost completely eight months after the onset of his illness. The presence of arterial hypertension in the Guillain-Barré's syndrome has been rarely reported with no respiratory involvement; however this condition may be less rare than suspected. The pathogenesis of this complication is not easy to explain. According to the authors this condition may be due, in cases, to impairment of the sympathetic system mostly at peripheral level. In some cases of Guillain-Barré's syndrome renal involvement of immunopathological origin might be the cause of hypertension. The authors emphasize the importance of a correct evaluation of symptoms in the prognosis and in the choice of therapy.


General and/or regional anesthesia for vascular surgery. A retrospective evaluation. Two hundred sixty three patients for extrathoracic vascular surgery of the arterial vessels, were evaluated retrospectively in order to assess the role of regional anesthesia in this group. In 33.8% regional anethesia with or without some form of suppletion was considered to be the anesthetic of choice. Regional anesthesia is especially indicated in those patients admitted for intractable ischaemic pain. As an anesthetic for the surgical procedure, it should be considered as a choice possibility as good as general anesthesia and in some cases as a better one.


Effects of environmental lighting on the function of the pineal gland. The pineal has undergone marked changes as vertebrates have evolved from amphibians to mammals. The amphibian pineal is a photoreceptive organ which sends nervous information to the brain via pineal nerves: the mammalian and avian pineal have no direct connections to the CNS and their metabolism is controlled by an indirect pathway involving their peripheral sympathetic nerves. In addition, the pinealocytes of some birds also function as photoendocrine transducers, i.e., they convert a photic input reaching them directly through the skull into a hormone output. Through the secretion of melatonin and of some as yet undefined low molecular weight peptides, the pineal participates in the control of other neuroendocrine rhythms such as seasonal cycles in gonadal function.


Age-dependent changes of uridine nucleotide and RNA metabolism in the brain of normal and hypothyroid rats. The effects of neonatal thyroidectomy on the incorporation in vivo of labelled orotic acid into acid-soluble uridine nucleotides, nuclear RNA and microsomal RNA of the rat brain were studied at 10 and 30 days of age. It was found that the conversion of orotate into uridine nucleotides is high at the earliest stage and does not change upon maturation. At any stage, the neonatal lack of thyroid function does not effect the conversion of orotate into uridine nucleotides. Neonatal thyroidectomy led to a significant decrease in the synthesis of cerebral RNA only at 10 days after birth.


The involvement of androgens in the control of epididymal protein synthesis and amino acid transport in the rat. The effect of androgen withdrawal upon different parameters of the rat epididymis has been investigated, as well as the early response of these to the readministration of testosterone. The weight, protein and RNA content of the epididymides decreased after castration. However, their response to a single injection of 6 mg testosterone propionate in oil administered 24 hr before sacrifice, varied according to the parameter examined. Epididymal weight increased after androgen was given to rats castrated for 3 days or less. The protein content was moderately elevated when testosterone was administered to rats castrated for 3, 6 or 13 days. The RNA content increased sharply after androgen, the magnitude of the response being proportional to the duration of castration. These changes in epididymal trophism were dramatically illustrated by the 50% decrease in amino acid incorporation into acid insoluble material already measurable 24 hr after castration. This effect was reverted by testosterone propionate administered 24 hr before sacrifice. The free alcohol form of testosterone given at the same dose induced a significant increase in this parameter as early as 12 hr after its intraperitoneal injection. Finally, we could demonstrate the existence of active transport of amino acids into the epididymal cells and the stimulatory effect of testosterone upon this function.


Effects of testosterone on bone marrow erythroid cells of normal and nephrectomized rats. Continuous infusions of testosterone for 8 hr exerted a stimulatory effect on the bone marrow erythroid compartment of normal rats. However, simultaneous administration of testosterone with antiserum against erythropoietin resulted in a complete inhibition of the erythropoietic effects of testosterone. In addition, the stimulatory action of testosterone on bone marrow erythroid cells was completely abolished in rats with bilateral nephrectomy. These results suggest that testosterone stimulates erythropoiesis indirectly, through a previous stimulation of kidney erythropoietin production.


Swiss albino mouse brain gangliosides: biophysical studies. The brain gangliosides mixture of Swiss albino mice were studied from a biophysical viewpoint. The value of v found was 0.577 ml/g. The isoelectric point gave a value of 1.50, which is in agreement with the presence of sialic acid groups. The isoionic point, 2.76, is close to the pKa for sialic acid. The number average molecular weight determined in the presence of ions was 229000, while in the absence of ions it was 78000, this weight suggesting a low degree of aggregation. The[eta] value of 3.56 and 4.84 in both the presence and absence of ions would indicate an asymmetrical micelle and/or more solvate than a rigid or impermeable sphere. The value of S020, w in the presence of ions was 9.19, while in their absence it was 7.65, corresponding to a lower molecular weight coincident with that found for Mn. Hydrodynamic relations permit the supposition that the brain gangliosides mixture of Swiss albino mice is not a symmetrical micelle, since the frictional and symmetry ratio found is equal to 1.29, which corresponds to an axial ratio of 6. The value of D is equal to 2.30 X 10(-7) cm2/sec; this fact is even more suggestive that we are not dealing with a symmetrical micelle. It was not possible to calculate the molecular weight using equations under the assumption that gangliosides are a spherical micelle. It was concluded that they might be a prolate ellipsoid of revolution.


[Effect of protein-free diet on sulfobromophthalein hepatic transport (author's transl)]. Initial plasma disappearance rate and biliary excretion of intravenously injected sulfobromophthalein were studied in Wistar female rats fed a normal or a protein-free diet. Proteins and sulfobromophthalein distribution in the liver were studied by a gel filtration method. The results suggest that protein deficiency may produce an impaired sulfobromophthalein transference from plasma to liver cell due to a reduction of total hepatic proteins and of sulfobromophthalein-binding protein fraction responsible for liver uptake.


Carbon monoxide and erythropoietin production in mice. The effects of hypoxemia caused by hypoxia (H-H) and CO (H-CO) on the production of erythropoietin (ESF) in mice were investigated. When mice breathed for 6 hr mixtures of air containing 0.1% of CO or a mixture of air and nitrogen with a pO2 of 52 mm Hg, the tissue pO2 as measured by the gas pocket technique was 16.9 +/- 1.1 and 17.1 +/- 1.4 (mean +/- S.D.), respectively. Plasma ESF content in H-CO mice, however, was twice higher than in the H-H mice. The greater ESF production in H-CO was associated to a significantly less hyperventilatory response as measured by acid-base balance changes and to a lower O2 consumption and was interpreted as the result of displacement of the OHb curve in opposite directions. The ESF organ appears thus to be sensitive to variations in the amount of O2 delivered to the tissues but independent of the arterial pO2.


[Influence of traumatizing factors during captivity on somatic and psychiatric morbidity in former prisoners of war]. This study tries to evidence the effect of past traumatic experiences of the present somatic and psychiatric morbidity of the former POW. One hundred POWs hospitalized at the Ste-Ode Center for former prisonners of war and political prisonners having spent five years in the German and Austrian camps were submitted to a semi-structured interview. The number of traumatic experiences spontaneously reported has been compared with the present score on the Cornell Index form N2. The results show a relation between both data: a former POW who had undergone a minimum number of traumas significantly appears to be anxious, asthenic, nervous, with a predisposition to depression and psychosomatic disorders.


[Psychological resistances of women to the principal female methods of contraception. Clinical classification]. According to the literature and to the experience of the authors gathered at the family department at the Louvain Faculty of Medicine, these psychological resistances may schematically be classified as follows: normative and socio-cultural resistances; medical resistances (wish of pregnancy, personality traits, narcissm, sexual and technical resistances); psychopathological resistances (unspecific neurotic behavior, phobias, hypochondriasis, obsessive-compulsive neurosis, character neurosis); secondary resistances.


[Sexual impotence: clinical and existential context]. A simple classification in global impotence and erective impotence appears closer to reality than more sophisticated but more arbitrary classification. In the majority of cases, impotence reflects a global psychological dysfunction. Psychogenic impotents are most of the time inferiorized subjects alledging organic or other non justified factors to their disorder. Generally, they are peaceful, obsessive, often hypothymic; they express disgust for the body, suffer various somatic dysfunctions due to the sexual stasis; they have difficulties in communicating with things and beings. As compared to erective impotents, it seems that the global impotents have a more rigid father, are among the younger sibblings and have more brothers and sisters. The author describes further some observations of partners and of couples, as well as etiological and prognostic factors.


[Introduction to psychosomatic medicine (author's transl)]. Psychosomatic medicine is a "holistic" conception of pluricausal medicine which has as an objective to study not the isolated disease, but the sick man, that is the humanised patient in his most complete nosological and ecological perspective. Numerous arguments seem to indicate the reality of clinical and experimental links between emotional life, psychic troubles and the dysfunctioning of organs or the apparition of visceral lesions. Anatomical and physiological studies play a capital role at the level of the hypothalamus, limbic system and at different neuroendocrinological systems (pituitary, corticoadrenal and medulloadrenal). On the experimental level, beside confining ulcers obtained by different technics on the laboratory rat, one must insist on the experiments of Weiss who showed that the peptic ulcers of the rat, under certain conditions, depend on two variables: the number of stimuli which the animal must face and the informative feedbacks more or less useful, which it receives in return. The investigations undertaken on the sick man show the importance of functional troubles with respect to anomalies of the autonomic nervous system or anomalies of intramural ganglions, which explain perhaps the notion of target organs for the troubles. Considering the most recent concepts which valorise the role of genetic factors in the determination of psychosomatic diseases, one can conceive that psychological determinants, affective or environmental, are cofactors which integrate themselves with somatic, genetic, constitutional and nutritional factors to produce the final morbid picture.


[The significance of digestive troubles of children in a psychosomatic perspective (author's transl)]. The description of digestive pathology in the child, seen through the psychosomatic angle, shows how this appears to be different from that in the adult. Aside from the rare cases in the scholar period, then later in the adolescent period, this pathology does not shed any light on the morbid entity clearly defined insofar as etiopathology. However, there are a series of alimentary and digestive symptoms. The value of these symptoms must always be understood through double optics of affective characteristics relative to the child of a given age and the characteristics of the personality of the parents, particularly the mother in the case of a very young child. The notion of a somatic basis favoring the trouble in the child appears indissociable from the psychosomatic concept. It is probably this fundamental factor which is of determining value and almost exclusively in the early onset of an ulcer in the child less than two years of age. The gastroenterologist should pay special attention to the affective development of the child; he can hardly predict the evolution towards a psychosomatic pathology insofar as the physiology as well as psychology are labile and plastic and that their alterations are a function of the different variables proper to the child and related to the conditions of the entourage which direct impact and interference are difficult to predict.


[Psychoanalytical nosography and digestive pathology (author's transl)]. The author states that aside from two major digestive psychosomatic conditions, peptic ulcer and ulcero-hemorragic colitis, one only encounters in the adult a widespread psychosomatic pathology, that is to say: 1 degree phenomena of hysterical conversion (gravidic vomiting for example); 2 degrees digestive phenomena concomitant with emotional reactions (diarrhea and anxiety, hypersecretion and anger, constipation and depression etc.); 3 degrees digestive manifestations accompanying anxiety neurosis; 4 degrees authentic functional diseases, such as the irritable colon corresponding to a well defined personality structure. The author concludes this article by some considerations of psychosomatic symptoms observed by the psychoanalyst; he specifically relates the role of the body barrier, the implication of reality and finally the very particular fantasies found in these psychosomatic patients.


[Reflections on supervision problems in a team of psychotherapists]. The author presents some thoughs on the experience resulting from a 3 year individual supervision in the "Centre de Guidance Infantile" (Child Guidance Center) of the University of Louvain. The aim of the supervision is essentially the formation for child and adolescent psychotherapy. This supervision is done inside the Center, to be consistant, but this structure is causing some problems of interference : problems of responsability from the supervisors to the Center, to the patients ; problems of authority for the supervised ; problems of affective relationships between supervisors and supervised. To resolve these difficulties, the supervisors have established spontaneously regulations enabling them to limit as much as possible these interferences.


[Work in child psychiatry teams in the United States of America]. To constitute a treating team with persons whose roles are not well defined and whose goals are often confuse, and however providing an efficient work ; to have a constant approach despite changing needs and milieu ; to adapt new solutions integrating the social dimension of the child : those are the three tasks which US child psychiatry teams are apparently working on.


[Indications for individual child psychotherapy in a Guidance Center]. The aim of this article is to describe how we conceptualise in practical indications of individual psychotherapy in the frame of the consultation of a guidance center. We will not review the literature concerned with this subject. We shall start with the study of the following factors : parents, family, reality features (distance, time, money...). Then, we study the positive and negative features in the child. We explain first all we consider to be the main obstacles in the psychic structure of the child. Then we describe in detail the favorable elements to the psychotherapeutic work. We also recall cases who, without being impossible to treat, require a big experience from the therapist, because of complexity and demand. They are sometimes treated in our unit, according to the disponibility of the therapists. In conclusion, we indicate that the choice of psychotherapy depends not only from the sick child and his familial milieu, but also from the therapist who will involve himself in this type of treatment.


[The gastroduodenal peptic ulcerous disease (author's transl)]. After a brief history of gastroduodenal ulcer since the 19th century, the authors discuss the question of its uniqueness. Upon clinical, biological and genetic grounds, it seems possible to distinguish two different kinds of ulcers. Ulcers situated above the junction between fundic and antropyloric mucosae could possibly be the consequence of biliary reflux, while ulcers situated below this junction would be associated with hyperchlorhydria. Some properties of gastrin, which is responsible for Zollinger-Ellison syndromes I and II, are cited. Presently, gastrin cannot be considered as the primary cause of duodenal ulcer.


[Deprived socio-cultural environment and the work of fragmentation]. The author tries to comprehend the child culturally handicapped, not as a problem in itself, but as an expression of the dominering-dominated relationship in a given society.


[Psychological aspects of ulcerative rectocolitis (author's transl)]. Ulcerative rectocolitis has been known for quite some time as a psychosomatic disease, it is an organic disease occurring in people with a particular personality rendering them susceptible to certain conflicts or stress which would be able to play a causing role in the appearance or exacerbations of the disease. Insofar as the psychological study is concerned, there are two important points to keep in mind: the role of psychological trauma as a stimulating factor and the basic personality. In 90% of the cases observed, psychological factors are found as provoking the hemorrage, as found by Groen and confirmed by the author. The basic personality is generally the obsessional type with a hypersensibility to rejection and hostility, sometimes of a paranoid dimension. The aggressivity is almost always repressed. The doctor-patient relationship indicates an important dependency as well as a passivity on the part of the patient. Furthermore, these patients rarely express their feelings, even if their behavior is indicative of experiencing intense emotion. By further experimentation, it has been established that these patients have a greater neuro-vegetative fragility than controls, thus demonstrating a greater vulnerability to stress. A pathological relationship between mother and child has almost always been proven. Finally, the principal causal psychological factor in this disease seems to be a relational conflict unresolved between specific figures. The role of psychotherapy influences greatly the disease evolution. the author recounts an interesting research of 900 ulcerative colitis patients, undertaken by O'Connor. In order to insure favorable therapeutic results in ulcerative rectocolitis, one must carefully coordinate a psychological and somatic treatment.


[Ulcerative rectocolitis: autogenous training. On serveral serious cases (author's transl)]. Three patients, suffering from severe ulcerative rectocolitis which could require surgery, were significantly improved by standard exercises of autogenous training with a combination of drug treatment. Somatic morbid signs (clinical as well as rectoscopical) were disappearing through the establishment of a better adaptation to reality. The importance of the therapeutic frame is underlined.


[Child of the 4th world].

[Child of the 4th world]. The authors underlines some aspects of the life of children from the Fourth World, which explain their unavoidable failure in the actual scholar system. The social and cultural exclusion experienced in their milieu causes a lack of self confidence in the parents, a fact which disturbs heavily the physical, affective and intellectual development of the children, as well as their socialisation.


[Modalities of therapeutic approach to marginal milieux]. The present work focuses on a longitudinal study of 15 families, followed by the social service of the "Ecole de plein Air" where these children were placed. The social workers were thus accepted with a sense of trust. They could continue the relation with the school but farther help on the pedagogic level, which showed that they could share. The psychiatrist and the psychological service have only provided the specialised information as well as supervision. Underestimation and defense reactions regarding usual criteria dissuade individual care for children of such circles, which always were failures. The unity of life in a school and educative setting has to be the reinforcing attitude along with familial action.


[Therapeutic approach in psychosomatic gastroenterology (author's transl)]. The therapeutic approach in psychosomatic medicine requires the somatician to keep psychological factors in mind and the psychiatrist to recall the somatic complaint. The therapeutic attitude will be different according to the psychofunctional problem or an authentic psychosomatic disease. However, in every case, the total patient must be considered and a good doctor-patient relationship must be established. Thanks to this relationship, the doctor can better understand the emotional and intellectual aspects of his patient and therefore plan his therapeutic purposes. Thus it takes into consideration the following: 1. reducing the anxiety by explaining to the patient the possible correlations between his complaints and emotional factors; 2. adopting a supportive attitude; 3. offering to the patient the possibility to explain verbally certain repressed ideas (ventilation psychotherapy); 4. manipulating, if necessary, the milieu in which the patient lives (treatment centered on the environment); 5. starting a deep rooted psychotherapy in certain cases. The problem of psychosomatic diseases in gastro-enterology, like duodenal ulcer and hemorragic ulcerative colitis, is discussed in more details. Concerning duodenal ulcer, one can distinguish between two levels of psychotherapy: 1. psychological approach for the gastro-enterologist with a proper background in the psychological approach of patients; 2. psychotherapy. Anyway, the treatment of this disease is always multidimensional, utilizing both psychological and drug treatment. Concerning hemorragic ulcerative colitis, supportive psychotherapy is crucial during the acute phase. It takes effect by an entire affective relationship with the patient and the all therapeutic team. During a remission, the therapist must provide the patient with the type of relationship he desires, and be available to the patient. In some cases, a deep psychotherapy should be used, even in conjunction with somatic care.


[Primary prevention in the school environment]. School failure are massive and related to social class. This situation requires a new conceptual and methodological frame. Indeed, more and more studies are unable to explain psychopathologically or sociologically on individual or familial cultural characteristics. Short term interventions require to take into account pedagogical and institutional mechanisms which convert cultural differences into school failures. In particualr, evaluation criteria utilised in de testing school inadaptation or to controle knowledge, play an important selective role. Among other interventions aimed maximising the educational process, realised in a national research, the author presents an attempt in mastery learning applied to fundamental education in first class. In this prespective, all children are asked to perform well defined operational objectives. The formative evaluation (as opposed to the normative evaluation) is totally integrated in effects of schooling. This type of intervention is not presented as a "model", but as a possibility to limit school failure. The mastery learning is one of the strategies which could be invested in a more global project where primary prevention and real democratisation of education would be simultaneously conceptualised.


[Methodological problems in the search for the causes of school failure at the elementary teaching level]. In France, these failures are massively found in children from the working class. For a better understanding of the causes of failures, and their genesis, the studies of Cresas are essentially based on maternal school (2-6 years). The research is directed in three concordant directions : analysis of the institution, analysis of the various social milieu of children, psychological evolution of the children facing school. The team of the working group "cognition and school adaptation" focuses on the relationship between cognitive development, socio-cultural background and school adaptation. During five years of work, the team has recognised various methodological problems such as : questioning of comparative studies, attempt to approach children predisposed to group active learning failures, implication of researchers in a school, difficulties on the pedagogic organisational and institutional levels. The conclusions insist on questioning the concept of social handicap by considering the examination situation relating factors regarding the children's background, school action and the researchers position itself. Finally, there is an important comment to situate the problem : the notion of social handicap is related to the political and economic organisation.


[Problems of reception in a guidance center]. The aim of this communication is not to criticise the work of guidance, but to analyse its efficiency and validity in order to formulate concrete proposals. One can distinguish three periods in the evolution of the work in a guidance center. In the first period, it is a methodological concern which presided to this type of work. In the second period, one thought that there was to many preliminary investigations and it was decided to take the child in treatment more rapidly. During the third period, the attention has primarily be centered on the child's problems. The author suggests some solutions. He considers it is necessary to abandon the multidisciplinary approach. He advises to always consider one case at the time within a therapeutic and diagnostic frame. Therapy has to be conducted by one person, even if this person has to treat the whole family.


[Team and education and the Centre Universitaire de Guidance infantile at Woluwe (Brussels)]. Description of the center for child guidance at the University of Louvain where take place supervision and training role games, as described in the next three articles. It is a new center, specialised in postgraduated training for doctors and psychologists in the area of child guidance, analytical individual psychotherapy for children and family therapy. The training programmes are being described.


[Structuralizing role playing in training]. The role playing utilised in the training of members of a guidance team, especially during technical seminars, may require a structure which protects participants and liberates their personality. A first part describes the spirit and technics most used, of the type "laboratory of human relations". A second part analyses by point differences between structured role playing and therapeutical psychodrama.


[Importance of role playing in a professional training group]. Role playing constitutes a precious instrument in training responible people for help relations. It permits to by-pass defense mechanisms through induced avoidance in group situation. It makes personal involvment easier, for efforts as well as for representations, and permits to confront reality in the other person. Under the control of the animator, the player has always the right to limit his personal involvment within the boundaries he wishes : this combination of facilitation and involvment framing is especially interesting.


[Role playing and training for individual psychotherapy: some disadvantages to avoid]. The author first describes briefly the outcome of a session. He then indicates some positive aspects of this method : better understanding of the patient's attitudes ; desinhibition of the spontaneity of the psychotherapist and better self-understanding, increase in facility in gesture and nursing ; questioning of psychotheapeutic ideals not yet integrated. The second part of the communication is devoted to inconveniences to avoid : alienation in new group psychotherapeutic goals, increase to tendencies to "voyeurisme" and absence of analysis of transferential processes. The advantages of the method outrange the eventuel inconveniences, especially when it is possible resove them.


[Clucagon].

[Clucagon]. Only in 1969 reliable information about glucagon and its different forms was acquired. Some factors are already known to increase or diminish the production both of pancreatic glucagon (nesidioglucagon) and of enteroglucagon. There are various methods for their study. In the present report some results are dealt with that may be of clinical interest, and the possibility of measuring those two kinds of hormones is pointed out as a diagnostic help in reactive and functional hypoglycemic syndromes. Information about glucagon in clinical medicine, however, is still -- on the whole -- scarce and insufficient to throw light on its several physiological and physiopathological aspects.


[Somatotropic hormone].

[Somatotropic hormone]. A dosage of the somatotrope hormone (HGH) is carried out whenever a deficiency or excess in hormone secretion is suspected. An  insufficient hormone production is one of the causes of hypophysary nanism; a series of tests must be carried out, however, before dosing the hormone, in order to ascertain whether other growth-retarding factors are present. This dosage must be carried out not only in fasting conditions, in order to know the basal value of the hormone, but also in stimulation conditions. The laboratory data obtained in the different tests must be carefully evaluated and compared with the clinical data. It is thus possible to ascertain, for instance, whether a hypophysary nanism is induced by a peripheral resistance as well as by a deficient secretion. The HGH therapy is effective only in the cases of  nanism induced by a deficient somatotropine secretion. This hormone is still seldom available. A reliable diagnosis of the type of hypophysary nanism is therefore deemed necessary.


[Gastrin].

[Gastrin]. Gastrin is released by food rich in proteins and by vagal mechanisms. HCI and possibly secretin and glucagon inhibit gastrin release. In the wide range of actions of  gastrin, stimulation of gastric acid secretion is the most important. With the advent of radioimmunochemical methods for the determination of gastrinaemia, it has been shown that gastrin exists in a number of forms of different molecular weight. To estimate the validity of gastrin radioimmunoassay it is necessary to demonstrate that decrease in antibody-bound labelled antigen is unrelated to non-specific interference by unknown substances present in serum samples, and that the antiserum reacts with endogenous hormone in an identical manner. Heterogeneity of gastrin in serum  may affect the validity of the radioimmunoassay. Hypergastrinaemia associated with hyper-normochlorhydria occures in gastrinoma, hyperplasia of antral gastrin cells, diseases with delayed gastric emptying, retained antrum, short bowel syndrome,renal failure. Hypergastrinaemia associated with hypo-achlorhydria occurs in atrophic gastritis without extensive antral lesion and after vagotomy. Gastrin radioimmunoassay can be used for the mass screening of subjects with atrophic gastritis, a high risk group for gastric cancer.


[Renin and aldosterone].

[Renin and aldosterone]. The radioimmunological dosages of renin and of aldosterone are used nowadays in clinical practice for research purposes only. The measurement of activity of plasma renin may be considered a significant indication of the concentration of the enzime in plasma and, indirectly, of its secretion. Several  factors take a part in the regulation of renin secretion (mean arterial pressure, introduction of sodium and potassium, the sympathetic nervous system, ADH and concentration of angiotensin II in plasma). In pathological conditions such factors may cause alteration of the renin-angiotensin II system, thus determining hyperreninisms and hyporeninisms, whether associated with arterial hypertension or not. Several factors take a part on aldosterone secretion too (ACTH, sodiaemia, potassiaemia, renin-angiotensin II system). In pathological conditions the alteration of the regulation system may lead to hyperaldosteronism or to hypoaldosteronism of primary or secondary type. A survey of recent research on the physiopathology of the renin-aldosterone system is also given.


[Reflections on the psycotherapeutic approach to patients in the day hospital for epileptics at Creteil]. After recalling some of the characteristics of the Day Hospital, the autor explains her position as a psychotherapist in this institution, her considerations on the patients and expresses some psycho-analytic and psychosomatic reflexions in the present perspective of epilepsy.


[Post-schizophrenic depression].

[Post-schizophrenic depression]. The post-psychotic depression is a very controversial subject in psychiatry. Among the authors who have dealt with post-psychotic depression there is no general agreement on the topic ; their point of views can be summarized as follows: -- It is a phenomenon which can be regularly observed and which is a phase of psychotic evolution. -- It can be considered only as a phase which is secondary neuroleptic administration. -- The depressive mood as one which had always been present but hidden by the acute psychotic phenomena and thus not observable. -- It is a consequence of an intensive psychotherapeutic approach. This paper summarizes the literature concerning the above-mentioned point of views.


[Adoption and its psychiatric aspects].

[Adoption and its psychiatric aspects]. Adoption has changed in history, in different cultures, in law, in its goals, its functions, its modalities. The study of the adoptive condition is worthwhile for theoretical research (psychopathology, genetics, etc.) and for clinical practice (prevention, selection and motivation analysis of adopting parents). It is dangerous and too simple to explain pathology by adoption. However, there is a specific psychopathology of adoptees : 1. by maternal deprivation and abandonnement pathology (more frequent and more important), 2. by the adoptive situation condition itself. We review some hypotheses, particularly the concept of "Family romance". The adopted child undergoes more frequent examinations, both pediatric and psychiatric, than the ordinary child (this may be explained by parental anxiety and child acting out behavior). Certain American statistics on this appear to be significant. On the other hand, there is a silent pathology (the majority ?) : we found it frequently in the youngest children in France. We discuss the problem of psychiatric selection of adoptive parents and adoptive children, its legitimacy, its methodes ; psychopathology and motivations of the adoptive patents ; the problem of the revelation of adoption to the child ; the problem of sterility (it is often incompletely explored and treated). Adoption may not be the best solution for most of the abandonned children and sterile couples.


[Psychopathological study of parents who abuse their children]. After recalling the studies of French authors, especially those of P. Parisot and L. Caussade at the Congress of Legal Medicine in Nancy (1929), and more recent, those of the Nancy school, and, in Paris, those of P. Straus and A. Wolf, of L. Kreisler and P. Straus, the author studies Anglo-Saxon research on subject, particularly that undertaken in the U.S.A. The study by Steele and Pollock on the psychology of parents of battered children has shown anomalies with an infantile characteristic in the psychology of some parents (apparently having no problems and living in easy circumstances, but demanding of their children a constant reassurance which the latter are unable to give, hence a permanent frustration leading to agressivity and actual tormenting. Eight observations are presented, covering the whole range of clinical forms observed with parents of battered children: psychopathic personality with perverse sado-masochism, affective immaturation with decompensation during pregnancy, lack of psycho-affective balance with aggression upon some of the children (target-children), a need for domination in the form of tyrannical matriarchate, nevropathy with aggressive perfectionism, and finally subnormal personality with nevropathy, the latter categories leaving a hop for a possibility of attaining transformation through analytical psychotherapy, such as practised by the author in one of his cases.


[Pedophrenia].

[Pedophrenia]. Among childhood psychoses which are so polymorphous and so liable to modifications because of the development of the personality, a rather special place can be given to a form which we intend to call "Pedophrenia". It corresponds roughly to hebephrenia, but occurs before adolescence, sometimes even as early as the first months of life, as it can be a continuation of a precocious autism. Furthermore, it also involves the classic discordances, rites, stereotypies, etc... Because of the age, the communication processes are expecially affected, malleability is greater than in hebephrenia, but the prognosis remains serious.


[Annual activity cycle of ants parasited with Dicrocoelium lanceolatum (Rudolphi, 1819) metacercaria (author's transl)]. The object of this study is to predict the period of appearance and the amount of risk of fluke parasitism in Limousin sheep flocks. A perfect knowledge of the ethology of ants parasited with metacercaria (definitive source of host infestation) is necessary. The particular behavior of these vector insects has been only little studied.


Somatic and visceral growth, and adiposity in the pig after partial small bowel resection. I. - Variations according to the kinds of operations, to the specific location along the intestinal tract and to the sex of the animals. The effects of small bowel resection were studied in 123 pure-bred Large White pigs, during 2 separate experiments. The first one aimed at studying the somatic growth in 60 castrated male pigs during a 16 weeks-period, following either a (I) laparotomy, (2) proximal or distal double transsection, or (3) proximal or distal resection of 25 p. 100 of the total small intestine length. Operations were performed at the age of 91 days and 26 kg live weight. Secondly, both grwoth of 63 pigs operated at the age of 97 days and at 28 kg live weight, was studied during a 16 weeks-period, in order to assess the effects of resection of 4m of distal jejunum (i.e. 25 p. 100 of the small intestine), according to the sex of the animals. After slaughtering visceral measurements and indirect measurement of carcass adiposity were made. It appeared that laparotomy was detrimental to continuation of normal growth, whereas resections or sham operations allowed better performances although less than that of control pigs. In short-term studies, proximal resections allowed better results than distal ones; the reverse conclusion could be drawn from long term studies. Small intestine tissue weight was not changed after laparotomy, and was slightly increased after transsection. Sixteen weeks after resection, tissue weight of residual small intestine was not very lower than that of entire small intestine in control pigs. This compensation was better after proximal resection, the apparent local hypertrophy being greater after distal resection. Concerning the sex-dependent effects after partial resection of distal jejunum, there was an improvement of performances (growth/food intake), and a true body growth acceleration in female and castrated male pigs. The morphological compensation of tissue loss was very good in residual small intestine of female pigs, partially assumed by large intestine in normal male pigs, and poor in castrated male pigs. The greatest hypertrophy was always noted in the ileal segment below the resected area. Carcass adiposity (specific gravity) was not significantly modified by the various operations in castrated male pigs, whereas it was significantly decreased after resection in entire male or female pigs.


[Effect of squirting before or after milking and of teat dipping on udder infections (author's transl)]. Three trials are carried out within one experimental herd in order to study the effect of squirting before and after milking and of teat dipping on new infections in lactation. Experiment Mastitis III (M III) compares 10 cows as controls, 10 cows squirted after milking, 10 cows teat dipped and 10 cows squirted and teat dipped after milking. Experiment Mastitis IV (M IV) compares 17 cows as controls and 17 cows squirted before milking. Experiment Mastitis V (M V) uses 21 cows as controls and 19 cows squirted after milking. The evolution of infections is followed by sampling every two weeks. The number of new infections is decreased to 1 by squirting after milking for M III and to 8 for M V; the figures for control groups are 15 and 18. The total number of infections is also decreased between the beginning and the end of the trials, from 12 to 7 for M III and from 17 to 13 for M V, while it increases in the control groups from 10 to 15 and from 8 to 10. Squirting before milking has no effect on new infections (8 vs 9 for the control group in M IV). Teat dipping lowers the number of new infections (5 vs 15 for the control group of M III), but the association of squirting and teat dipping gives no better results (6 new infections). The pathogenesis of these results is discussed. It is more economical to use squirting, but there may be some practical difficulties. Automatization of squirting is suggested as related to automatic quarter-take-off devices.


[Toxinogenic moulds of silage. IV. - Patulin production in liquid medium using fungus species isolated in silages (author's transl)]. The toxinogenesis of 18 strains of Byssochlamys nivea, 4 of Byssochlamys fulva, 7 of Paecilomyces varioti, 2 of Aspergillus clavatus, I of Aspergillus terreus, and I of Penicillium urticae, isolated in ensilaged forages, is tested at 26 degrees C in Czapek's enriched liquid medium (8 p. 1000 glucose + 2 p. 1000 yeast extract). 100 p. 100 of Byssochlamys nivea strains, 75 p. 100 of Byssochlamys fulva and 12 p. 100 of Paecilomyces varioti strains produce patulin after 9 days of culture. Mycotoxin concentrations recovered range from 0.5 to 1 120 p.p.m. Only highly toxinogenic strains when they invade silage cutting fronts, would be able to develop detectable amounts of patulin.


[Toxinogenic moulds in silage. V. - Production of byssochlamic acid in liquid medium with by Byssochlamys nivea Westling, Byssochlamys fulva Olliver and Smith and Paecilomyces varioti Bainier isolated in forages (author's transl)]. The toxinogenesis of 10 strains of Byssochlamys nivea, 4 of Byssochlamys fulva and 8 of Paecilomyces varioti is studied in Czapek's enriched liquid medium (8 p. 1000 glucose + 2p. 1000 yeast extract) at 26 degrees C. 60 p. 100 of Byssochlamys nivea filtrates, 100 p. 100 of Byssochlamys fulva filtrates and 37 p. 100 of Paecilomyces varioti filtrates contain byssochlamic acid after 60 days of culture at 26 degrees C. The concentrations observed vary from 40 to 540 p.p.m. In these moulds, patuline-production ability has also been tested (Escoula, 1975 c). There seems to be no relation between the production of patuline and of byssochlamic acid in these three species.


[Toxinogenic moulds in silage. VI - Effect of propionic and formic acids on the production of patulin and of byssochlamic acid by Byssochlamys nivea Westling (author's transl)]. A strain of Byssochlamys nivea is cultivated for 5 months at 26 degrees C on kernels of wet corn previously treated with three doses of formic acid (1, 5, 3, 6 p.1000) and three doses of propionic acid (0.5, 1, 2 p. 100). As related to the control lot, the addition of these acid results, in the first two doses, in a decrease and slowing-down of the growth of the mould and the production of its two mycotoxins (patulin and byssochlamic acid). In the presence of 0.6 p. 1000 of formic acid, and especially with 2 p. 100 of propionic acid, Byssochlamys does not develop during the trial period. This inhibition may be annulled when the mould is put on a medium (Czapek) containing no acid.


[Effect of DL-lactic acid on voluntary food intake in sheep (author's transl)]. Previous experiments indicate that changes in duodenal fluid concentration of DL-lactic and volatile fatty acids (VFA) influence flow rate of ingesta and may also be a regulating factor of food intake in ruminants. The present experiment was designed to determine the sensitivity of the duodenum to DL-lactic acid and VFA in relation to diets of hay, dried grass or concentrates. On a diet of hay, administration of small amounts of either DL-lactic acid or VFA into the duodenum had no effect. On a diet of dried grass or concentrates the same amount of VFA had no effect but that of DL-lactic acid (12 mM/h) halved the dry matter intake. In animals on a diet of hay and after administration of 40 g of propionate into the rumen, duodenal perfusion of the same quantity of DL-lactic acid produced a similar reduction of food intake. It was concluded that duodenal DL-lactic acid acts as a regulator of food intake possibly via the propionate metabolism pathway.


[Delay and magnitude of plasma and bone responses and of stable, residual, leachable hair fractions to two different levels of K, Na, Ca, Mg, P intake in rat (author's transl)]. Two groups of 20 adult female rats are fed ad libitum with two diets differing in K, Na, Ca, Mg, P content, being for the first diet (in g/kg) : 14.9, 0.5, 6.3, 0.82, 1.25, respectively, and for the second : 1.6, 8.3, 2.4, 0.17, 5.76, respectively. Five rats of each group are killed after 1, 2, 3, 4 months. This study compares the delay and magnitude of plasma and bone responses and of three different hair fractions to the two levels of intake. Hair is not clipped in order to estimate the delay in response of already grown hair to mineral intake modification. The three following hair fractions are analyzed : a) leachable fraction, determined in the solution used for washing hair (equal parts water-ethanol-ether) ; b) stable hair fraction, determined in hair obtained after the previous washing ; c) residual hair fraction, determined in hair washed with a non-polar detergent. The following results are observed : 1) K : A plasma variation is obtained as early as month 1 (P less than 0.005). The leachable fraction is modified from month 3 (P less than 0.001) and the stable hair fraction on month 4 (P less than 0.025). 2) Na : There is no variation at the plasma level. The leachable fraction response appears as early as month 1 (P less than 0.001) and the hair stable fraction at month 2 (P less than 0.025). 3) Ca : There is no variation at the plasma level. The leachable (P less than 0.025) and hair stable (P less than 0.01) fractions show a response from month 3. 4) Mg : A rapid and intense variation is observed at the plasma level as early as month 1 (P less than 0.001). The hair stable fraction shows a response at month 2 (P less than 0.05) and the leachable and residual fractions at month 3 (P less than 0.05). Bone Mg is modified as early as month 1 (P less than 0.005). 5) P : Plasma response at month 4 (P less than 0.05) is weak and late. An important variation is observed from month 2 in the leachable fraction (P less than 0.005) and at month 3 in the hair stable fraction (P less than 0.005). Residual hair fraction provides no valuable information. Consequently, the more common method of washing hair with a detergent should be excluded, at least for the nutritional exploration of the minerals involved in this study.


Electromyographic investigations in torticollis. In 13 patients with torticollis, the electromyographic (EMG) activity in the neck muscles at rest was investigated before, during and after stimulation of the H1 bundle (in horizontal torticollis) and inner part of oral ventral nucleus (in the rotatory form), as well as after coagulation. Three EMG types of torticollis-spasmodic, myoclonic and mixed - could be differentiated. During the 8-, 25- and 50-Hz stimulations, a diminution in the amplitude and frequency of muscle potentials, followed by electric silence, was most often obtained; in general, the electric silence was preceded by a rhythmic activity of grouped potentials. Following coagulation, no spontaneous EMG activity was any longer recorded in the neck muscles, in the majority of the cases.


Physiological Postrotatory Nystagmus.

Physiological Postrotatory Nystagmus. Nystagmus elicted by means of rotatory stimuli has been studied in 55 healthy subjects. In each case, 5 different end-velocities have been employed and each postrotatory nystagmus has been quantitatively evaluated by measuring various parameters of its quick phase. The mean values that could be considered as normal were searched for by means of a statistical study, but a great variability in the responses was found. Likewise, the responses of both labyrinths have often been rather asymmetrical. Therefore, such a functional asymmetry of the oculomotor responses, due to a variety of central factors, seems to be a serious diffculty for the practical use of postrotatory nystagmus as a clinical test. The particular meaning of the number of beats is discussed.


Physiological postrotatory nystagmus 11. Stimulus response relationship and meaning various parameters. Nystagmus elicited by means of rotatory stimuli has been studied in 55 healthy subjects. In each case, 5 different end-velocities have been employed and each postrotatory nystagmus has been quantitatively evaluated measuring various parameters of its quick phase. The relationship existing between the magnitude of the stimulus and that of the response has been carefully studied for all the parameters. A significant relationship was found in only a limited number of cases. The most reliable parameter to analyse this relationship is the total amplitude. The parameter that varied less with changes in stimulus intensity was duration. The different factors determining and modifying the nystagmic response are analysed and the meaning of this nystagmic response is considered in relation to vestibular function and, therefore, in its application to clinical diagnosis; In a previous article [16], the authors analysed the normal values of various parameters of postrotatory nystagmus in healthy subjects and the differences existing between clockwise and counterclockwise rotations. In this paper, we study the relationship between the intensity of the stimulus and the magnitude of the response. We also investigate which parameters are the most adequate to define the nystagmus.


Lateral facilitation of Hoffmann-reflexes prior to voluntary movement in a choice reaction time task. Hoffmann reflexes (H reflexes) were elicited from both legs simultaneously in human subjects at varying intervals after a reaction signal (RS) in a binary choice reaction time task. A left light RS required a rapid plantar flexion of the left foot and a right light RS required a similar rapid response of the right foot. A large faciliataion of reflex amplitude occurred only in the muscle involved in the movement (right of left soleus). The timing of the facilitation indicated that a decision about the status of the RS occurred within 200 msec and probably was completed somewhat earlier. Furthermore, the facilitation of the H reflexes was shown to be closely linked with the organization required for the contractions of the responding muscle. The results are considered in the light of hypothesized mechanisms regulating voluntary movement.


[Ultrastructural study of the pseudopregnant rat luteal cell following the effect of luteinizing hormone and of 2 inhibitors of synthesis (amino-glutethimide and cycloheximide)]. Incubation of ovaries from pseudopregnant rats have been performed with the gonadotropin LH and with two inhibitors, aminoglutéthimide and cycloheximide for periods comprised between 1 and 6 hours. Then the luteal cells have been studied with electron microscope. Measurements in have been used to express the variations in volume of two organels, mitochondria and lipid droplets. The principal modifications induced by these compounds bear on the mitochondria. Treatment with LH is followed by an increase in the volume of individual mitochondria resulting probably of fusion of organels. Treatments with the inhibitors are followed by reduction in the volume of individual mitochondria and in the total volume of mitochondrial apparatus. Mixed treatments using LH and an inhibitor allow to obtain organels of intermediate size. Volume of lipids is increased by incubation with LH and probably decreased by the inhibitors. Smooth endoplasmic reticulum shows rearrangements with the various treatments. It seems not convenient to extend incubations over 4 hours in order to avoid cytolysis.


[Cytochemical ultrastructural study of the glycoproteins in the rat hypothalamo-post-pituitary complex]. The results obtained with various methods applied to the cytochemical detection of carbohydrates at an ultrastructural level, confirm the existence of glycoproteins in neurosecretory material in the neurohypophysis as well as in the hypothalamic magnocellular nuclei. This glycoproteic component, however, is not present in all the secretory granules and, according to their cytochemical behaviour, it is possible to distinguish two types of neurosecretory fibres: one where all the granules respond negatively; the other where most of the granules are reactive. The existence of two types of neurons corresponding to these two fibres cannot yet be asserted, but seems very likely, perhaps connected with the hormonal duality of the magnocellular nuclei. The reactions are also positive on the Golgi apparatus, in accordance with its function in glycoprotein synthesis. But the difference of reactivity between the Golgi cisternae and the neurosecretory product suggests that glycoprotein synthesis is still going on in the neurosecretory granules outside the Golgi area.


Effect of a calcium rich environment on the ultimobranchial gland of Rana tigrina. Thirty two specimens of Rana tigrina were divided into four equal groups : group I = controls; group II = injected with Vitamin D2 and placed in a 0.8% aqueous solution of CaCl2; group III = injected with Vitamin D2 and kept in tap water; group IV = placed only in a 0.8% CaCl2 solution. The experimental specimens exhibited varying degrees of hyperactivity of their ultimobranchial gland. Specimens from all the groups were X-rayed. The experimental ones showed different intensity of calcium deposit in their paravertebral lime sacs. The results indicate that prolonged challenge of high calcium induces hyperactivity of the ultimobranchial gland to produce larger quantity of calcitonin, to counteract the experimental hypercalcemia.


Macular amyloidosis with localized amyloidosis of upper air passages. A patient with primary amyloidosis of the upper air passages was found to have cutaneous macular amyloidosis. A review of the literature indicates that this may represent the first report of these two uncommon forms of amyloidosis occurring in the same individual. Biopsy material from the nasopharynx, tonsillar areas, larynx, trachea, and skin showed amyloid in the tissue sections. Special stains were used and polariscopic studies were performed, and the hyalin material met the established criteria for amyloid. Studies of tissues from other parts of the body of this patient failed to demonstrate amyloid.


Keratoacanthoma centrifugum marginatum.

Keratoacanthoma centrifugum marginatum. A keratoacanthoma centrifugum marginatum measured 20 X 14 cm at the time of surgical intervention. This lesion is characterized by continuing peripheral extention and central healing. Attention is drawn to the occurrence in the healing edge of a distinctive type  of individual cell necrosis, which has been described by others in the more usual forms of keratoacanthoma. The findings are of interest, since this same mode of cellular death has recently been shown to be involved in the regression of various tissues, normal as well as abnormal.


Toxic epidermal necrolysis associated with allopurinol administration. Allopurinol, now established as a standard form of therapy in hyperuricemia and gout, may be associated with life-threatening skin reactions. This study reports the occurrence of toxic epidermal necrolysis TEN) in three patients receiving Allopurinol. The patients receiving allopurinol. The patients had complicated medical illnesses and were receiving various other medications, but the most apparent common denominator was allopurinol ingestion. Two other cases of TEN and five cases of severe hypersensitivity reactions with vasculitis and extensive skin manifestations, secondary to this drug, have been described in the recent literature. Allopurinol has several unique biochemical and metabolic properties that may increase its ability to cause hypersensitivity or toxic skin reactions.


Multiple sequential skin cancers. The risk of skin cancer in patients with previous skin cancer. We reviewed all reports of skin biopsies that had been performed at the Miami Veterans Administration Hospital within a three-year period. A total of 1,115 biopsy specimens of basal cell and squamous cell carcinomas were identified for 558 patients. Patient names, diagnosis, and dates of biopsies were tabulated for computer analysis. We determined that 121 patients (22%) developed at least one new or recurrent skin cancer during the average follow-up period of 1 1/2 years. From a computer review of clinic appointments, we determined that half of the 558 patients were unavailable for follow-up during that three-year period. Thus, the true rate of new and recurrent skin cancer in patients who had at least one skin cancer is no less than 22% and may approach 50% in the first 18 months. This high rate of new occurrences and recurrences of basal cell and squamous cell carcinomas emphasizes the need for repeated examinations of all patients with a history of skin cancer.


Chemical analytic approaches to the definition of uremic toxins. In this preliminary research we have started a systematic study of substances present in uremic but non in normal serum. Methylguanidine has been examined by the new single method of ion pair extraction and has been found in higher concentration in uremic plasma than in normal, but in lower concentration than previously described with less selective method and used in experimental animal intoxication. We did not find a correlation of Methylguanidine concentration and uremic symptoms and complications as pericarditis, neuropathy and uremic coma. Using the high spead gel filtration method comparative analyses of uremic and normal fluids and many substances have been registered a 9 peak serie. Peak 7 seem to be the most interesting. It is less prominent in normal plasma, increases in uremic patients and decreases after dietary treatment, peritoneal dialysis and hemodialysis. Furthermore it is formed by middle molecular weight substances (approximately 1300).


[Dialysis of methylguanidine and hypothesis on the middle molecules]. The formulation of "Methilguanidine (MG) hypothesis" started from previous researches that showed that uramic symptoms in dogs intoxicated by MG were present. Being a low molecular weight molecule, MG as Urea (U) and Creatine (CR), should not be considered an "uraemic toxin" according with the "middle molecules hipothesis". We have studied, during peritoneal and various hemodialysis schedules, MG "in vivo" and "in vitro" clearance, post-dialytic rebound, plasmaaproteins binding, intra and extracellular distribution. "In vitro" MG clearance is intermediate between U and CR, but "in vivo" MG clearance is lower than U and CR: what is explained by MG prevalent intracellular distribution and by the increasing plasm proteins binding during hemodialysis alkalinisation. 12 hours after high efficiency dialysis MG has an higher rebound than U and CR because of the slow and constant MG flow from intracellular fluid to plasma. On the other hand a continuous equilibrium between intra extracellular MG happens during the longer and less efficient peritoneal dialysis: MG plasma level 12 hours after peritoneal dialysis is the same that after high efficiency hemodialysis; on the contrary U and CR plasma levels are higher after peritoneal than after hemodialysis. In spite of the low molecular weight MG dialysis is different than U and CR. Good clinical condition of patients on peritoneal and low-flow-dialysis which represented the basis of the ""MG hypothesis": infact MG removal is the same during peritoneal and hemodialysis.


[Adequate dialysis (author's transl)].

[Adequate dialysis (author's transl)]. The lack of peripheral neuropathy observed in peritoneal dialysis patients gave rise to the hypothesis that peritoneal membrane removes toxic solutes of larger dimensions than cuprophane membrane. Several "in vitro" and "in vivo" dialysis strategies have been selected. In the present paper the importance of residual renal function and the strategy of reduced dialysis schedule have been discussed. A trial with dialysis has been applied to 7 patients one of them treated for 20 months. the well being of peritoneal dialysis and low flow dialysis patients, confirm that the accumulation of small molecules, within certain limits, is not dangerous. On the other hand the middle molecules hypothesis has never been confirmed by observing a real toxicity of that solutes in dialysis patients.


Preliminary results obtained with short dialysis schedules. The results regarding the treatment of 55 patients, 6 of them treated for, at least 10 months, with 1 sq. meter disposable dialyzers and a dialysis strategy of 3 hours every other day or 4 hours trice weekly have been presented. Clinical indexes especially regarding erythropoiesis and peripheral nerve status will be discussed. Th results show that this new method of treatment is feasible and may become in the future a routine strategy for chronic intermittent dialysis.


Rationale for the use of the acac microcapsule artificial kidney for the treatment of patients with chronic renal failure. The A C A C microcapsule artificial kidney is prepared to have 300 gr. of albumin-coated cellulose nitrate microincapsulated activated charcoal with a total area surface of 2,5 m2. The membrane thickness is 0,05 micron, at least 100 times thinner than the standard hemodialysis membrane. By Albumin microencapsulation it is possible to prevent charcoal embolism, hemolysis, platelet and fibrin consumtion. The resistance to blood flow is smaller than in the kill artificial kidney. We have carried out a clinical trial in uremic patients, in 3 of them up to 8 months; their general feeling of well-being after two hours of AC A C microcapsule hemoperfusion is better than after 6 hours hemodialysis, in case of water and electrolyte retention one run of 6 hours hemodialysis a week was required, Reticolocyte, platelet count and hemoglobulin level improved appreciably. Clearance of middle molecules is much higher than in standard hemodialysis and preliminary reports show a lower middle molecules peak after hemoperfusion. It would appear that the present microcapsule artificial kidney, if supplemented with further development for the removal of water and electrolyte, may eventually become a compact inexpensive, simple way of treating uremic patients.


[Membrano proliferative glomerulonephritis (author's transl)]. 128 cases of Membrano proliferative glomerulonephritis have been divided in two groups, the first one (84 cases), with subendothelial deposits, the second one (44 cases) "with dense intramembranous deposits". Streptococcal infections more frequently precede the membranoproliferative glomerulonephritis with dense intramembranous deposits (20% and 11%). In this group there is a rapid onset and macroematuria is more frequent (36% and 18%). Nephrotic syndrome has the same frequency in the two groups (more than 80%). Because of the more frequent association "dense deposits" and crescents this group show a more frequent evolution toward renal failure (43% and 35%).


[Idiopathic nephrotic syndrome with minimal glomerular lesions in children (author's transl)]. Minimal glomerular changes were found in 80% of the cases of nephrotic sindromes in children. 5 groups can be separated under light microscopy. Electron microscopy always shows foot processes fusion. 80% of the children show edema, one third has transient hematuria, proteinuria is selective for small molecules, plasma B 1 C globuline levels are normal. According with the International Study of kidney disease in children, prednisone therapy gives positive results in 84% of all cases (Early responders) but many of them relapse (Frequent relapsers); the long-term prognosis with steroid is poor in the majority of cases. Cyclophosphamide therapy (2,5-3 mg/kg/die for 6 week and for a maximum of 60-80 days) gives better results and lesser relapses, but caution is needed because of an higher toxicity.


[Plasma insulin-binding capacity of diabetes mellitus patients with labile and stable courses]. Clinical picture of diabetes mellitus in the patients treated with insulin is characterized by a labile or stable course. It is supposed that of significance in the character of diabetes mellitus were antibodies formed in response to the exogenous insulin. Results of determination of the insulin-binding capacity of the blood plasma and of the antibody indices to insulin in the patients with a labile form of the disease antibodies with a low insulin-binding capacity circulated in the blood. Stable diabetes was characterized by the appearance in the blood of antibodies with a high insulin affinity, this being confirmed by an increase in the insulin-binding capacity of the blood plasma.


[Blood levels of lead and erythrocyte ALA-dehydrase in 200 employees of a Turin metallurgical plant. Analysis of variables connected with alcohol drinking and smoking habits]. The relationships between blood value of Pb and activity of Ala-dehydrase erythrocyte enzyme were studied in relation to the following variables: age, activity, residence, smoking habits, drinking habits. 200 adults, subdividable into occupationally exposed were examined. The data obtained showed a relationship between smoking and Aladehydrase; a relationship was also found to exist between alcohol and blood Pb and inhibition of Ala-dehydrase activity.


[Circulation and anesthesia].

[Circulation and anesthesia]. In this paper a survey is given on the group of risk in patients with diseases of the circulatory system under the stress of anaesthesia with special regard to arterial hypertension, chronic ischaemic heart disease, disturbances of cardiac rhythm and global heart insufficiency besides the generally acknowledged therapeutic principles for cardiological patients of risk. On the conditions of a surgical intervention the author adopts a definite attitude to the partly still contrary problems of the preoperative antihypertensive treatment and to the prophylactic therapy with glycosides. The most important diagnostic and therapeutic facts concerning the necessary interdisciplinary cooperation between internist, anaesthesist and operator in preparation and performance of an operative intervention in patients with circulatory diseases are described.


[Therapy of diabetes mellitus today].

[Therapy of diabetes mellitus today]. The therapy of diabetes mellitus is always connected with the observation of an adapted diet, the aim of which is the obtaining of the optimal weight. Still more intensive concentric educational measures for patients and persons endangered by diabetes are necessary, in which cases muscular action is of increasing importance. Sulfonylureas furthering the secretion of insulin are to be used only as far as necessary. Peripherally acting anti-diabetics, such as biguanides have an indication in diabetes mellitus which is exactly defined and to be observed. Also with regard to the combat against adiposity their influence on the lipometabolism needs further clarification. Metabolic and immunologic insulin resistance are complications of the insulin therapy. The extensive technical preparation of the human synthetic insulin may contribute to the improvement of the prognosis of diabetes. At present the introduction of artifical beta-cell-systems is a problem of the diminishing of the apparatuses. The genetic consultation for diabetics is important and in many cases possible.