Effects of superoxide dismutase on the auto-oxidation of 7, 8-dihydroxychlorpromazine in the presence of rat brain mitochondria. 7,8-Dihydroxychlorpromazine 7,8-diOH-CPZ) is known to undergo auto-oxidation when exposed to air. Hydrogen peroxide is formed during this process, and the amount formed can be calculated from the amount of oxygen produced upon the addition of catalase. In the presence of superoxide dismutase the rate of oxidation of the CPZ metabolite is accelerated, accompanied by an increased production of hydrogen peroxide. When similar incubation are carried out with rat brain mitochondria present, hydrogen peroxide production is no longer detectable. The implications of this finding with regard to in vivo hydrogen peroxide production during the auto-oxidation of 7,8-diOH-CPZ are discussed. A preliminary report has been presented (1).


The release of glutamic acid from isolated brain tissues. The glutamic acid and other primary amines released spontaneously and by electrical pulses from rat brain caudate and cortex were measured by the fluorescamine method. Electrical pulses evoked a transient release of glutamic acid which was greater from caudate tissue. Both morphine and reserpine, in vivo, inhibited the spontaneous glutamic acid release but not the loss of glutamic acid due to pulses.


Dopaminergic effects of phencyclidine in rats with nigrostriatal lesions. Phencyclidine produces a dose-dependent ipsilateral rotation in rats with unilateral substantia nigra lesions. This ipsilateral turning is decreased 41% by pretreatment with AMPT and 81% by prior administration of haloperidol. Ipsilateral turning elicited by phencyclidine can also be altered by treatment with cholinergic agents. These findings suggest that phencyclidine may be acting by increasing the availability of dopamine on the intact side of a unilaterally-lesioned substantia nigra rat and that the response can be modulated by alterations in the cholinergic system.


Ascorbic acid levels in chronic psychotic patients. Serum ascorbic acid concentrations, taken from 37 chronically hospitalized psychiatric patients, were found to be similar to those usually encountered in normal subjects.


Radioimmunoassay for desmethylimipramine. This paper describes the production of antibodies against demethyl-imipramine (DMI). By using antisera, a radioimmunoassay was developed capable of detecting 0.2 ng of DMI which is linear up to 25 ng. The assay has been applied for the measurement of DMI in rat plasma and brain. The assay might find application especially when only limited amounts of blood, plasma or tissue are available.


Correlation of chlorpromazine levels in rat brain and serum with its hypothermic effect. The correlation between chlorpromazine (CPZ) levels in rat brain and serum with hypothermia was investigated. Even large differences between brain and serum concentrations of CPZ could be demonstrated at the two dosages of the drug investigated, the groups showed an identical hypothermic effect between 5 to 30 minutes, with maximum hypothermia being reached 1 hour. It also appears that when brain concentrations of CPZ were lower than 1 mug/g, body temperature returned to normal. We could not demonstrate any preferential uptake of CPZ into the hypothalamus, the proposed site at which CPZ acts to cause hypothermia.


The influence of dietary iodine on lithium blood level, serum T4 and thyroid gland weight. Lithium is both antithyroid and goitrogenic. The relationship between lithium and iodine has been assessed in rats fed diets containing different iodine content. Chronic lithium treatment caused increase in thyroid gland weight in animals on low and high iodine diets. A reciprocal relationship surfaced between serum lithium levels and dietary iodine content. Animals on low-iodine diet had lower serum lithium levels. The data support other evidence that lithium likely inhibits organification of iodine by a Wolff-Chaikoff-like effect.


A sensitive GLC method for the determination of imipramine and desmethylimipramine using a nitrogen detector. A sensitive method for determination of imipramine and desmethylimipramine using a GLC system fitted with a new nitrogen detector is described. The lower limit of sensitivity is less than 1 ng/ml with a lower limit enabling quantitation with acceptable precision of 3-5 ng/ml. Data from 20 control subjects given a single oral dose of imipramine are shown.


Paranoid vs hebephrenic schizophrenia: clinical and familial (genetic) heterogeneity. By the use of familial and genetic methods, data are presented which suggest that hebephrenic and paramoid schizophrenia are separate illnesses. The two entities have different clinical pictures and different outcomes. Hebephrenia shows a higher familial risk for schizophrenia than paramoid schizophrenia and most available data reveal that hebephrenia breeds true in the family. The relevance of the possibility that schizophrenia is composed of more than one autonomous illness to some current pharmacological theories and treatment studies is presented.


The current status of research in the catecholamine theories of affective disorders. The catecholamine theory suggests that there is a functional deficit of the catecholamine neurotransmitter, norepinephrine  (NE) or dopamine (DA) at the neuronal synaptic cleft in depression and an excess in mania. Current strategies which are being utilized to investigate this theory involve: 1)studies of DA, NE, their breakdown products and synthetic and degradative enzymes in body fluids and brain tissue; 2) studies of modes of action of drug which can "activate" or decrease manic or depressive symptoms; 3) the study of pharmacological agents which affect specific aspects of NE and DA metabolism, (synthesis, release, receptor sensitivity, and degradation). The total accumlated data seems more compatible with a catecholamine hypothesis of mania than one of depression. The evidence to date does not allow one to differentiate between the importance of DA or NE either in depression of mania.


The effects of lithium carbonate upon subjective state changes induced by sodium pentobarbital. Behavioral and mood changes were measured for 8 normal male subjects after oral administration of sodium pentobarbital (3 mg/kg body weight). This procedure was repeated on three occasions: firstly a drug-free condition; then a condition following two weeks of maintenance 0.7 to 1.2 MEQ/L lithium carbonate; and then another drug-free condition. Intial analyses indicated a lowering of the level of euphoria reached in the lithium pentobarbital condition below that achieved after pentobarbital alone. Examination of this effect showed that the reduction after pentobarbital plus lithium was mirrored by a reduction in the baseline for the same response items due to lithium alone. The lessening of euphoria appeared to result from a general lowering of affect due to lithium maintenance. More detailed analyses showed that the quantitative response to pentobarbital was in no case reduced by lithium condition. Certain reversal effects were also discovered in which lithium plus pentobarbital acted in the opposite direction from pentobarbital alone.


Serotonin (5HT) systems in psychotic states. Lumbar cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid (5HIAA) following probenecid was negatively correlated with prognostic variables in a group of schizophrenic patients. Acute schizophrenic patients had lower CSF 5HIIA was negatively correlated with measured activity and rated agitation in a mixed group of schizophrenic patients. There is compelling evidence that LSD directly inhibits the firing of serotonergic neurons. Individuals who developed prolonged psychotic reactions following LSD ingestion had relatively good premorbid trait histories and a family history of psychosis in 33% of cases compared to 21% for non drug-induced psychotic patients. If central serotonin system in man are mainly inhibitory, our results are consistent with the hypothesis that in some acute psychotic states a primary decreases in sertonergic neuronal activity may contribute to excessive central nervous system arousal.


[Effects of the ashes of the Irazu volcano (Costa Rica) on various insects]. A study of the 1963-1965 eruptions of the Irazú volcano (Costa Rica) showed that the ashes altered the ecological conditions of a great number of insects. Experiments suggest a mechanical action of the abrasive particles on the epicuticle, making it permeable, and thus accelerating dehydration. Other insects, such as the honey bee (Apis mellifera), were not affected externally but through the ingestion of ash-contaminated nectar and by the massive destruction of the vegetation on which they depended. Great destruction of bee populations was observed during 1964 and 1965-66 in the San José area. On the other hand, the volcanic ash apparently favored other insects, especially those protected by a waxy secretion, and by the possible elimination of their natural enemies, to such proportions that they became pests of economic significance.


[Description of an economic and simple methods for the study of karyotyping in serpents]. We describe a method for the preparation of snake chromosomes in metaphase, based on the in vivo stimulation of leucocytes with crude phytohemagglutinin from Phaseolus lunatus and the in vitro blocking of mitosis with colchicine. It has the advantage of preserving the specimen alive without the complications of cell culture, and can be performed under field conditions.


[Hemo and cross dialysis treatment in phalloidin intoxication in the waking rat]. In vitro 14C-Methyl-Phalloidin is found to be well dialysable; in vivo dialysis is less effective. In rats the application of 2 mg/kg Phalloidin i.v. led to death after 106 minutes on the average. Hemodialysis with electrolyte-glucose solution or with plasma protein solution immediately started after Phalloidin injection did not alter the survival time significantly. Only a group of rats which was cross dialysed immediately after intoxication showed a statistically insignificant prolongation of survival time of 16 minutes. The histomorphological findings of the liver were similar in all groups. We found a phalloidinic vacuolisation of the cytoplasm of the lobular periphery, hemorrhagic necrosis and also fatty changes in the periphery of the lobule with small fat droplets and pycnosis of nuclei. Specific Phalloidin effects, too, were found in the liver of both animals used in cross-dialysis, which proves that Phalloidin is dialysable by this method.


[Cardiodepressive action of bencyclan (author's transl)]. In the isolated guinea pigs atria as well as in anaesthetized cats and dogs we studied the cardiovascular effects of bencyclan. The following results were found: 1.) Bencyclan causes a dose-dependent diminution of the force of contraction, the maximal rate of rise of contraction, and the frequency of the isolated atria, while the functional refractory period is prolonged. 2.) The negative inotropic effect of bencyclan can be antagonized in the isolated atria by increasing Ca+++ -concentrations. 3.) In the isolated left atria the effect of orciprenaline is unchanged while the effect of serotonin is diminished by bencyclan. 4.) In the anaesthetized cat 5 mg/kg of bencyclan cause a significant decrease of blood-pressure and contractility. While the fall of blood-pressure is reversed within a few minutes, the contractility is diminished for a longer time. 5.) 2 of 10 cats and 2 of 3 dogs died within a few minutes when 5 mg/kg bencyclan and 1 mg/kg propranolol were injected within an interval of 15 minutes. 6.) Pretreatment with 20 mg/kg propranolol i.m. does not increase the acute toxicity of bencyclan in mice significantly.


The response of the dog colon mucosa one hour's ischaemia. Segments of dog colon were subjected to one hour's ischaemia, and their morphology and function were studied either immediately after the ischaemia or 24 hours later. As functional tests, net sodium transport across the mucosa in vitro, the transport capacity in vitro for sugars and amino-acids, tissue respiration, lactate production, and the liberation of acid phosphatase were applied. Immediately after the ischaemia, all parameters differed significantly from the control mucosa: net sodium transport was abolished; amino-acid and sugar uptake, oxygen consumption and lactate production were reduced; and lysosomal enzyme release was increased. All parameters, except sugar uptake, had normalised 24 hours after the trauma. Histological examinations revealed much variation in the lesions occurring after the ischaemia, varying from slight epithelial desquamation to considerable mucosal destruction. In most cases, the mucosa had almost normalised 24 hours later. Morphometric analysis revealed decreased mean mucosal thickness immediately after the trauma, though 24 hours later, there was again no significant difference with the control group.


[The effect of ascorbic acid on the hypercholesterolemia in experimental cholestasis and aminonucleoside nephrosis (author's transl)]. Hypercholesterolemia was induced in rats by experimental cholestasis and aminonucleoside nephrosis. After ascorbic acid administration the hypercholesterolemia was significantly decreased in both cases. In the case of cholestasis serum choelsterol was normal and in the case of nephrosis serum cholesterol remained above normal.


Single nephron study of intrarenal urea handling in experimental pyelonephritis. Micropuncture experiments were carried out in 20 rats with bilat. experimental chronic pyelonephritis. Inulin and urea concentrations were estimated in the late proximal, early distal and latte distal nephron segment. Proximal urea reabsorption did not differ from that in control animals. Fractional amount of filtered urea in the early distal segment was significantly lower in the pyelonephritic rats, urea reabsorption in the distal tubule approcimated zero. The data indicate that intrarenal urea recirculation is abolished by the experimental lesion, thus determining maximal urine urea concentration. It is suggested that the concentrating defect of experimental pyelonephritis is not only a result of an adaptational increase in individual nephron GFR; an additional intrinsic lesion seems to be present, located in the renal medulla.


Inhibition of pancreatic exocrine secretion by vinblastine. Inbred BALB/c mice were given vinblastine sulfate (VelbeR) and/or pilocarpine hydrochloride (30 mg/kg) intraperitoneally and amylase activity was determined in the pancreas homogenate. When vinblastine was given 5 hours before measuring the pancreatic amylase content it inhibited the pilocarpine stimulated (2 hours) pancreatic secretion in a dosis-dependent fashion at doses 4, 40 and 400 mg/kg. Vinblastine (200 mg/kg) also delayed amylase accumulation during 3 hours in mice given vinblastine 2 hours after pilocarpine stimulation. The results support the hypothesis that faultless function and integrity of microtubules might be a prerequisite of pancreatic acinar cell secretion in vivo. Other effects of vinblastine, such as interference with amino acid metabolism, anticholinergic action, and cell injury must also be considered when interpreting the present findings form the point of view of the secretory mechanism of the pancreatic acinar cells.


Solubilization of human spermatozoa and antigen isolation responsable for agglutination. Spermatozoa were solubilized by cleaving the disulphide bonds with dithioerythrol and protecting the weak antigen responsable for spermagglutination with Na-dodecylsulphate. The fact that spermagglutinating activity could still be absorbed from female sera by solubilized spermatozoa indicates that the antigen has not been destroyed by the applied procedure. By gelelectrophoresis four fractions could be separated. Antibody fraction from four sera and three cervical mucus samples of women with humoral spermagglutinating antibody--activity were used as indicator antbodies in crossed immunoelectrophoresis of solubilized spermatozoa. As negative controls served four sera and two cervical mucus samples. A precipitation line could only be detected in positive cases. The second spermfraction of gel-electrophoresis was found to contain the antigen reacting with the known antibodies from the applied FD-positive sera and cervical mucus samples.


[Exocrine function of pancreas in chronic hypocalcemia. Studies in parathyroidectomized rats (author's transl)]. The influence of chronic hypocalcemia, induced by parathyroidectomy on exocrine function of pancreas was studied in rats. The concentration of total calcium in pancreatic juice was decreased in the PTX-animals, in respect to the flow rate, however no decrease in output was seen. After an initial increase of the secretion of alpha-amylase no differences to normal rats could be observed. The flow rate of PTX-rats was significantly higher than that of normal rats. These results suggest that the exocrine pancreatic function of rats is not changed very much in vivo by chronic hypocalcemia.


[Sylvian stenosis with networks of the Moya-Moya type. Anatomo-clinical observation]. The authors report an angiographic observation, where a stenosis of the left middle cerebral artery, with Moya-Moya networks, is described. The anatomical study has shown an atresy of the middle cerebral artery, and has confirmed the hypothesis of a supplying role played by the Moya networks. Most of their anatomical findings are in agreement with a malformative aspect, which is speculated by the authors to be related to the failure, at the embryon level, of a good development of the middle cerebral artery; in this way, Moya might represent the remaining features of primitive plexiform networks. From this particular anatomical observation, the authors discuss some nosological problems and propose the hypothesis of several groups, which may be related to the moment when the stenosis is suspected to occur.


[Angiographic study of cerebral convolutions and their area of vascularization]. The authors demonstrate the facility with which the principal fissures and sulci of the brain can be angiographically localized by reference to characteristic loops and bends in the courses of the branches of the anterior, middle, and posterior cerebral arteries. The study is based upon dissections of 150 human brains in which the arteries of interest were selectively injected. A propos to this anatomic-angiographic correlation the authors also describe the vascular territories of each cortical branch and propose a simple procedure for the evaluation of these territories during cerebral angiography.


[Familial case of myotonia with muscular hypertrophy, weakness corrected by effort and atrophy of type II fibers]. A 35 years old man has a non progressive muscle disease which appeared when he was 6. Clinically, there is a slight muscle hypertrophy, an important spontaneous myotonia and a curious muscle weakness, quite marked on the first efforts, but disappearing entirely after a few muscle contractions. The E.M.G. is normal but for the myotonic reaction. Muscle biopsy shows a selective atrophy of type II fibers. The disease is a genetic one, a sister and a brother of our patient having noticed the same symptom. The place of this disease among the congenital myotonias is discussed.


[Relationship between circadian rhythms and blood pressure and the pathogenesis of cerebrovascular insufficiency]. Cerebrovascular accidents occur more frequently during the morning, less frequently during the night, whether due to thrombosis or embolism. In cases with hypertension, however, there have been noted a more uniform distribution of these complications throughout the day. The preponderance in the morning of the number of accidents in non-embolic subjects, depends probably on the state of the autonomic nervous system during the night, which gives rise to a dilated and hypotonic microcirculation. Autoregulation is, in this way, reduced and the physiological increase in blood pressure during the morning may induce a break through of autoregulation. In embolic subjects, on the other hand, an important role may be played by heart arrhythmias which occur usually during the waking hours. In hypertensives, the microcirculatory bed is restricted and cerebro-vascular resistance relatively constant. The brain, paradoxically, is thus better defended against any moderate increase in blood pressure and fluctuations in blood pressure throughout 24 hours, which may leave cerebral autoregulation unchanged, which probably explains the more uniform distribution of cerebro-vascular accidents throughout the 24 hour period.


[Controlled study of language re-education in aphasia: comparison between treated and untreated aphasics]. This study was undertaken in order to ascertain the specific effect of language rehabilitation on the oral expression of aphasic patients. The outcome of language disorders has been investigated in 185 aphasics (91 reeducated and 94 not reeducated) submitted to control examination at least 6 months following the first examination. Four of the main variables involved in the recovery process were studied: a) dependent variable, i. e., improvement, and the effects thereupon of 3 independent variables, i. e., a) the time interval between onset of aphasia and first examination, b) clinical type of aphasia on first examination and c) presence or absence of rehabilitation between first and second examination. Age, educational level, etiology and the time interval between first and second examination were controlled in all comparisons. The statistical analysis has established that language rehabilitation has a positive effect on the improvement of oral expression, while the duration of aphasia at the time of the first examination has an equally significant, but negative effect on improvement.


[Oculopharyngeal myopathy. Histochemical observation of the muscles and concentration of immunoglobulins in the serum of an Italian family]. We reported the first Italian family with oculopharyngeal myopathy. Five of six brothers, aged 60 to 76, showed to a different degree ptosis of the eyelids, ophtalmoparesis, hypomimic face, troubles in chewing, swallowing and speaking, some wiggling gait, and a widespread, mainly proximal, muscular hypotrophy and weakness. Characteristic of this disease are its hereditary transmission of dominant autosomic type, its late appearance also after 50 years of age and its slow progression without periods of improvement. Electromyography, histologic and histochemical study of extra-ocular muscles were performed in two patients and showed clear changes of myopathic type. Besides, we found in 3 patients increased serum immunoglobulins, chiefly IgG, as first Russe, Busey and Barbeau demonstrated in a large French-Canadian family.


[Generalised triglyceride lipidosis (triglyceridosis). 1st anatomo-clinical report]. The case reported, known under the name of Lipid Storage Myopathy, occurred in a twenty year old woman. The first symptoms occurred between the age of 14 and 16 years. A complete autopsy was carried out. The entire musculature was involved. There was fatty infiltration of the myocardium as well as marked fatty degeneration of the liver and kidneys. Histological and histochemical examination revealed an accumulation of triglycerides, distributed throughout almost all the organs, this being confirmed by chemical examinations. The latter did not, however, show any changes in phospho-glyco-sulpho-lipid, cholesterol or cholesterol content. Gas chromatography of the total free fatty acids revealed an increase in short chain fatty acids. The authors stress the generalized nature of the pathological process leading to the accumulation of triglycerides, in a disease which up to present time had been considered to be a myopathy and therefore propose the name Generalised Triglyceridosis of Generalised Triglyceride Lipidosis.


[Acoustic and semantic disturbances of comprehension in aphasia]. The authors carried out a verbal auditory comprehension test on 115 aphasic patients, 44 patients suffering from a left hemispheric lesion without aphasia and 120 normal subjects used as acontrol group. The test also revealed either disorders in acoustico-phonemic discrimination or difficulities in semantic differentiation. The main aim of the research was to check experimentally the theory propounded by Alajouanine and colleagues (1964) according to which, in Wernicke's aphasia, it is possible to demonstrate a twofold correlation between disorders of comprehension and speech disorders both phonemic and semantic. Only one part of the theory of Alajouanine and colleagues has been confirmed by our experiments for our results have shown that there is a very close correlation between semantic paraphasias and disorders of semantic differentiation whilst no correlation can be found between phonemic paraphasias and disturbances in auditory phonemic discrimination.


[Epileptic attacks in cerebral arterial pathology. Clinical findings]. The authors analyse, with reference to 107 cases, the incidence of epileptic attacks in different types of non-traumatic arterial pathology of the brain. They describe their various clinical and evolutive aspects and attempt to isolate those peculiar to critical manifestations of this type occurring in the course of cerebral vascular accidents.


The effect of air currents on the naso-respiratory mucosa. The direction of air currents through the nose have been studied by many investigators. However, in injury of the nose followed by deformities, a marked change in the nasal configuration occurs. Many patients will present localized areas of crusting and attention is not drawn to this condition until the patient is seen with an epistaxis. In this study, we are interested in the character of the mucosa and their changes as affected by long-term injury from the trauma of the inspiratory and expiratory air currents, which, on sniffling or snorting, may reach hurricane speeds. In the study of the naso-respiratory mucosa from these areas by electron-microspy, it was found metaplastic respiratory epithelium where the cells have undergone mucinous transformation and areas exposed to air jets how metaplastic changes followed by erosion. We wish to thank Nikolajs Cauna, M.D. for his assistance and making available the micrographs used in this paper.


Vidian neurectomy.

Vidian neurectomy. The author presents his experience with vidian neurectomy. 30 cases have been operated; 18 had bilateral nasal-sinus polyposis and 12 vasomotor rhinitis. The results are presented. The patients with bilateral nasal-sinus-polyposis were operated by bilateral polypectomy cleaning the sinuses according to the Ermiro de Lima technique and unilateral vidian neurectomy was simultaneously performed. On this side the results obtained were excellent in comparation with the other one. The surgical technique is explained and some pathogenetic considerations are discussed.


Long term evaluation of "push down" procedures. The "push-down" technique for hump removal, or hump elimination, is just one maneuver of a number of surgical steps to obtain a more functionable and esthetic appearing nose. The maxilla-premaxilla Cottle approach to extensive nasal septum surgery is used, using techniques of his to modify the nasal dorsum. The "push-down" procedure usually eliminates the bony hump. The cartilaginous hump, (the upper lateral cartilage area) remains intact, and produces little trauma to the subcutaneous tissue, the mucous membranes, the periosteum, the perichondrium, and preserves the nerves and blood supply of the area. The amount of "push-down" that can be done depends on the nasal septum, which is the key to the surgical procedure. One must know how to handle part or all of the septum; its reconstruction with the patient's own bone and cartilage, so that saddling and deformity of the external pyramid and lobule may not occur later. In the repair of the roof, all anatomic relationships should be restored. The upper lateral area should be spared, however, if modified, very conservatively done and with little or no shortening. If there is partial removal of the hump, there should also be reparation of the nasal dorsum with crushed septal cartilage. Further "push-down" depends upon the width of the nose, the location and number of lateral osteotomies and intra-septal osteotomies, incomplete or complete separation of the upper lateral cartilage, done chiefly through the intra-septum space; thus, the nose becomes narrower, smaller, and the roof remains an unimpaired insulating organ playing its important physiological role. Secondary nasal revisions were minor in nature and were usually performed as outpatient procedures. The hump removal concept of total excision should be changed to "push-down" elimination of the nasal bones with total preservation of the dorsum.


Closure of a septal perforation by means of an obturator. The surgical closure of a naso-septal perforation is accompanied by many problems which can interfere with the good result. The authors describe a technique by which a naso-septal perforation can be closed by placing an obturator without performing any surgery.


The influence of trauma on the growing septal cartilage. In 34 children biopsies of the nasal septum which had formerly been traumatized by force or surgery, are histologically examined. The long-term reactions of the injured septal cartilage can be described by loss, incomplete and complete regeneration of cartilage. In most cases the regeneratioen of the cartilage is undirected, thus causing deformation of the nasal septum.


Nasal fractures in adults -a brief discussion of principles. A discussion of the management of acute nasal fractures in adults is presented. Repair of the nasal injury should be postponed so the patient can be stabilized and totally evaluated while the surgeon plans and prepares to do the optimum nose operation. Two weeks or more may be allowed for this with a few stated exceptions. Acute nasal fractures are the misguided mobilization phase of a nasal reconstruction. This must be rectified and completed and the nose modifed and repaired in accordance with the principles of functional rhinologic surgery. Some remarks on the fallibility of X-ray diagnosis are included.


Scanning electron microscopy of the human nasal mucosa. Nasal biopsies are taken from normals and from patients suffering from perennial rhinitis, nasal polyps, hay fever or atrophic rhinitis. The biopsies from the inferior nasal turbinate are studied in a scanning electron microscope. In conclusion, allergic reactions have only a slight, direct influence on the ultrastructure of the mucous membrane. Contrary to this, the surface of the nasal mucosa is characteristically altered in atrophic rhinitis. By chance it was observed how flagellated bacteria invades the mucous membrane by fastening to the epithelial cells, which consequently are expelled.


Early diagnosis of maxillary carcinoma.

Early diagnosis of maxillary carcinoma. Problems of early diagnosis of maxillary carcinoma are discussed and symptomatology of early and relatively early cases is fully presented. In cases which might be suspected of being malignant thoughtful attention to all details of examination and careful evaluation of seemingly insignificant symptoms and signs are of greatest importance. All methods of early detection of antral cancer are evaluated. The most valuable from among them are: tomography, including panoramic tomography, and sinoscopy. Measures which should be taken to shorten the interval between symptoms onset and the definite diagnosis of maxillary carcinoma are specified.


Resistance and capacitance vessels in the nasal mucosa. Vernous blood flow from the mucosa of one nasal cavity and changes in nasal patency of the same cavity were simultaneously recorded in the cat. Information about responses evoked in resistance vessels (mainly small arteries and arterioles) and in capacitance vessels (mainly venous vessels ansd sinusoids) could thus be provided. Close arterially administered infusions of angiotensin, noradrenaline, adrenaline and dihydroergotamine elicited constrictions in the resistance as well as the capitance vessels. Analysis of the ratio of the resistance and the capacitance responses allowed an evaluation of the relative effectiveness of the drugs in constricting the two types of vessel.


The mucociliary activity of the upper respiratory tract. A clinical in vivo - in vitro method for functional mucociliary studies via surface-light reflections is described as well as a method for intracellular recording of electrical activities in ciliated cells. Two types of surface-light reflections can be recognized - one from the secretion layer and one from the tops of lashing cilia. Internal and external cell activities als well as muco-rheological factors can be compared under the control of environmental influences such as air temperature, humidity and gas mixtures. The method can also be used for different clinical purposes.


Histology of the mucous membranes of the lateral nasal wall. The preliminary results of investigating the lateral nasal wall are presented. In this study only three strips of mucosa are analysed from histological point of view using serial sections. One strip corresponded to the plane of lateral osteotomy, the second crossed the middle of turbinates and the third corresponded to the vestibular area. The accurate number and distribution of vascular and glandular elements were determined by help of Visopan and micro-photographs.


The frequency of epistaxis in a male population sample. In a population sample consisting of 507 males aged between 50 and 60 years and 120 thirty-year-old sons of these males the frequency of epistaxis and predisposing factors of epistaxis were studied. Only one-third of the subjects had never had epistaxis. One out of ten subjects had been treated for epistaxis by a doctor at least once in his life. About 3 per cent had had nose-bleeds during the previous week. Statistically it was shown that a history of upper respiratory infection and intake of acetylsalicylic acid separately might predispose to expistaxis.


Rhino-rheo-manometric (R.R.M.) nasal provocation test. The nasal provocation test--which has been considered till now too much time-consuming and troublesome for the patient--becomes rapid and simple by the use of the rhino-rheo-manometry. It is possible, by this method, to evaluate the conductance of a single nasal fossa and its reduction after allergen challenge. The results of test performed in patients suffering from extrinsic perennial nasal atopy by Dermatophagoides pt. have proved that the test becomes rapid and not troublesome by using the rhino-rheo-manometry. This method, giving a provocation threshold, may be used both in diagnosis and control of specific immunotherapy.


The importance of the anaerobic bacteria in paranasal sinusitis. The anaerobic examination of the material, obtained by 100 antral punctures, in 66 patients with paranasal sinusitis, showed the importance of the anaerobic bacteria. In 33% we found anaerobes: 12% of the cultures were pure anaerobic, 21% were mixed aerobic-anaerobic. The most frequent anaerobe is the Peptostreptococcus. Anaerobic cultures are more frequently found in the unilateral cases of paranasal sinusitis. The presence of anaerobes does not seem to be dependent on the patient's age, the duration of the sinusitis and the previous administration of antibiotics during the last 3 days. In 76% the anaerobes disappeared after the initial antral puncture and washing.


Parasympathetic control of blood circulation and secretion in the nasal mucosa. The effects of selective parasympathetic nerve activation on the secretory response and the vascular exchange and capacitance sections in the cat nasal mucosa were studied. The vascular events were investigated by measuring the local disappearnce of 125I- and changes in gross pulse rate from 131I- labelled serum albumin as monitored over the nose. A frequency-dependent increase in nasal secretion and local blood content occurred in the range 0.5-12 imp/sec: an increase in disappearance rate was observed at the same time. This indicates that the vascular and secretory responses are activated simultaneously. The secretory responses, but not the vascular events, were shown to be blocked by atropine. The results thus shown that the postganglionic parasympathetic mediator of nasal secretion is cholinergic, whereas the vasodilatation appears to be due to a different mechanism, which is not sensitieve to atropine. The beneficial effect of some antihistamines in vasomotor rhinitis may thus be due to their anticholinergic properties.


[Osteoclastic inclusions in Paget's disease of bone]. An electron microscope study of 35 bone biopsies from patients with Paget's disease confirmed the constnat presence of intra-nuclear and intracytoplasmic inclusions, which seemed to be the most specific anomalies of the osteoclasts. The presence of these inclusions leads to their comparison with other inclusions described in certain affections for which the viral etiology is at present under discussion.


[Circulation in bone in Paget's disease. General review and personal results]. On the basis of a review of work concerned with the circulation in bones affected by Paget's disease and from their own results, the authors show that the vascularization of affected by Paget's disease is completely different from that of normal bone. The periostal vessels are abnormally developed and result in a high flow in the affected limb. The cortical vessels are numerous and of all types, forming a system of canalization of considerable volume. On the other hand the medullary circulation is encumbered by stasis, oedema, and fibrosis. The earliness of the vascular lesions makes it possible to envisage a vascular theory in connection with Paget's disease.


[Ultrasonic study of the brain circulation in patients with Paget's disease. Preliminary results]. The authors present a preliminary study on ultrasonic measurement of flow rate, using the Doppler effect, in patients suffering from Paget's disease of the cranium. In the 12 patients studied there was external carotid hypervascularization with a continuous flow in the superficial temporal artery. Even though only a few cases have been studied, there seems to be a close correlation between the levels of hydroxy prolinuria and of alkaline phosphatasaemia and thus between the evolution of the disease and the index of resistance. The value of this non-traumatic method in the therapeutic surveillance of Paget's disease of the cranium is beyond doubt.


[Unusual aspects of bone fractures in Paget's disease]. Because of their specific biological and vascular condition, bones affected by Paget's disease require special treatment in case of fracture. Observations on four patients are reported because of their originality; the two first involved a rare type of pelvic fracture, one ischiatic, the other iliac. One of the others was a deformation that required amputation. The last patient, a victim of a diaphyseal femoral fracture, had to undergo centromedullary pinning; but because there was massive destruction of the periostial and medullary circulations during the operation, extensive osteonecrosis due to ischaemia occurred which was very painful and disabling. Thus, in spite of an over abundance of vascular tissue, such circulatory repercussions must be avoided in surgical treatment of fractures of bones affected by Paget's disease.


[HL-A and Paget's disease].

[HL-A and Paget's disease]. In a study on 43 patients suffering from Paget's disease the authors grouped them within the HL-A histo-compatibility system. Twenty-nine antigens in this system were investigated. Comparison with the distribution in the population of France did not show a significant difference. Nevertheless, there appeared to be a greater frequency of the HL-A 5 and perhaps of W 22 antigens in patients suffering from generalized Paget's disease.


[Histological aspects of the sarcomatous degeneration of bone in Paget's disease]. After a critical review of the literature and an enquiry based on 70 cases, the author confirms that osteogenic sarcomas and fibrosarcomas constitute the usual means of sarcomatous degeneration in bones affected by Paget's disease. Giant-cell tumours present a distinct group. The problems posed by the initial stages of the malignant transformation and the osteosarcomas with multiple centres are then discussed.


[Sarcomas associated with Paget's disease]. The authors report 12 cases of Paget's disease with sarcomatous degeneration that were observed among 311 patients with Paget's disease hospitalized in the Montpellier Rheumatology Clinic. They compare their experience with information they were able to extract from the literature in French and English. The frequency of such degeneration in cases of Paget's disease is difficult to determine but did not appear to exceed 1%. Degeneration rarely occurred before the age of 50 years, affected men twice as frequently as women, and occurred particularly in cases of diffuse Paget's disease, mainly in the femur or the humerus; the rachis was rarely affected. Pain was the main symptom, was practically constant, was remarkable because of its permanence and its intensity. Tumefaction was frequently seen. Pathological fractures were seen in almost a third of the patients with sarcomas of the long bones. Radiculo-medullary compression characterized the rare cases with involvement of the vertebral column or the sacrum. Radiography showed rupture of cortical layers with invasion of the soft parts without any periostal reaction. Histological investigation confirmed the diagnosis by demonstrating one of the three types of osteogenic sarcoma: osteosarcomas were the most frequent. Less frequently giant-cell sarcomas or reticulosarcomas were found. The affected patients nearly always died, survival at five years being rare. Treatment, amputation or radiotherapy, was disappointing.


[Benign giant cell tumors associated with Paget's disease. Apropos of 1 case]. The authors report the observation of two benign giant-cell tumours that developed in the cranium of Paget's disease patients. The two tumours were resected and cure was complete. Eighteen other cases of benign giant-cell tumours were found in the literature. All were discovered in relation to tumefaction occurring in an affected bone in a patient with generalized Paget's disease, often unrecognized. The tumours were usually unique although multiple tumours were found, with particular predilection for the bones of the cranium and the face. The radiological signs consisted of an osteolytic zone in an affected bone; there were no specific characteristics and it was not possible to distinguish the tumours from a malignant tumour. Diagnosis was based upon an anatomo-pathological examination. In the 18 cases in the literature, the benign caracter indicated by the biopsy was confirmed by the favourable evolution. In contrast in 17 other cases the atypical nature of the stroma, the irregular arrangement of the giant cells together with the occurrence of atypical mitoses and the abnormal character of the vascularization indicated straight away the malignant nature of the lesions, which was regularly and rapidly fatal.


[Arthropathies due to bismuth poisoning]. Encephalopathies caused by intoxication with bismuth are liable to be complicated by arthropathies of the shoulder, on one or both sides, of an osteolytic, and probably osteonecrotic, type involving to a greater or lesser extent the humeral head and/or by destruction of articular cartilage with ateration and flattening of the heumeral head. The relation between these arthropathies and bismuth intoxication appears certain but is not yet understood. The strict electivity of the condition for the shoulder is not understood either. Certain analogies indicate similarity with metabolic arthropathies.


[Test for hypocalcemia due to calcitonin in the normal subject and in patients with osteoporosis or Paget's disease. Preliminary results]. The authors report the variations in calcaemia and in circulating immunoreactive PTH produced by the intramuscular injection of 5 units of porcine calcitonin in normal subjects and in patients suffering from osteoporosis or Paget's disease. After having determined the levels of 25-hydroxy-vitamin D circulating in the different groups, the authors note that comparison of these variations makes it possible to regroup the different types of reaction following the injection of the hypocalcaemic hormone. In patients suffering from pure osteoporosis, hypocalcaemia was slow to appear, was of moderate intensity, but was prolonged. The osteoporo-malacia patients did not produce a specific reaction and certain of them appeared "insensitive" to calcitonin. Results obtained in patients with Paget's disease confirm the hypocalaemic action of calcitonin even at a low dosage. With this test, the authors hope to contribute to studies of demineralizing affections and to overcoming them.


[Lumbar arachno-epiduritis. Study of 20 cases]. The authors report twenty cases of lumbar arachnitis, from the clinical, biological, and neuroradiological points of view; a discussion is developed in connexion with various etiological factors centred, on the one hand, on the responsibility of the contrast media used in neuro-radiology and, on the other hand, on that of the act of surgery, a factor that was encountered in half of the cases reported. The possibilities of therapy are also discussed.


[Primary hyperparathyroidism. 50 personal cases]. On the basis of a study of a series of 50 personal cases, the results of which are reported, and of a series of 2800 cases from the literature, the authors describe certain radiological and clinical aspects of primary hyperparathyroidism and the conditions under which this disease may appear. They emphasize the value of the different laboratory investigations for determining disturbances in phosphorus-calcium metabolism and of the study of bone histology, particularly the quantitative study of iliac bone biopsies. They discuss the various aspects of their methods of surgical treatment (pre-operative location of the tumour, surgical problems, early and later sequelae) and finally describe the indications for surgery.


[Analysis of disorders of the principal pathways of calcium metabolism in Paget's disease. Effects of calcitonin administration. 26 cases]. Analysis of the principal routes of calcium metabolism by means of calcium-45 in 26 patients suffering from Paget's diseases sometimes showed, in agreement with data from the literature, a considerable increase in the common stocks of calcium in 25 cases, and an elevation in the anabolism (Vo+) in bone and in the catabolism (Vo-) in bone in all cases. The calcium balance was sometimes equal, but often clearly positive (10 cases) or negative (10 cases) and the level intestinal absorption of calcium was usually within the normal limits. An elevation in the endogenous fecal calcium (Vf) noted in half of the cases, although no value was below normal, seemed to represent an metabolic anomaly of abnormally high frequency in patients with Paget's disease, even though this fact has never been emphasized before. Statistically significant correlations were shown between the values of different kinetic and metabolic parameters in the group of patients studied. A second kinetic study carried out after several weeks of treatment with porcine calcitonin showed a statistically significant diminution in the values of Vo +, Vo -, endogenous fecal calcium, calciuria, hydroxyprolinuria, and in alkaline phosphatasaemia, as well as significant variations in the calcium balance in a positive direction. The common calcium stocks did not show a significant diminution, contrary to the findings of other authors. The level of intestinal absorption of calcium increased more often than it decreased, but the magnitude of the variations was slightly less than the level of statistical significance.


[Disintegration of condition episodes of paranoid behavior. "Nonsensical actions" according to Conrad]. Proceeding from an interactional basis - psychopathology practized as interactional psychophology - the insenate acts as defined by Conrad are interpreted as an expression of decay of situation. As the stage the paranoid undergo teaches a stabilisation and a preleminary end by the decay of situation, it is - in difference to Conrads interpretation - a matter of a comparatively remote period of progress. The thematically open, e.g. not defined situation of the paranoid, experiences a consolidation through the decay of situation by making it possible for the patient to come to a renewed settlement of an agreement interaction by an autonomous choice of the basis of communication.


[Long-term development of neurotic and reactive disorders. Catamnestic study on the influence of social factors]. This study enters into the framework of long term catamnestic researches realised at Hopital de Cery in Lausanne. In this work, the evolution of neurotic and reactionnal disorders in old age has been studied through the direct catamnestic examination of 35 patients who outlived 65 years of age. The accent has been particularly put on social and psychological evolution in regard to 15 variables responding to 2 fondamental hypotheses; it is the conducting clue of the work. After discussion concerning the working method and the selection of survey material, the author is analysing the 35 patients' main caracteristics at the time of their first hospitalisation. He is also taking interest on the patients' social surroundings during their childhood until they were 15. The notion of "broken-home" is largely discussed. The various evolutive aspects are firstly treated apart and then all together in regard to 15 mentioned variables. The various results are making the subject of statistic validation.


[Mental disorders of women from a psychotherapeutic viewpoint]. On the basis of experience in the consulting-room of the psychiatrist's practice the author has attempted to show how in frank discussions hurtful privations of women patients become comprehensible when considered in the light of their life-histories. Psychic disorders of women may be investigated on the level of their own experience. The insecure longing for individual recognition and esteem in the emotional sphere appears to be particularly important. In these conversations the patient is helped towards self-understanding and real independence.


[Mental disorders in women. An epidemiologic-social psychiatric view]. The author first refers to the previous absence of a comparative psychiatry of sexual differences. He then describes in particular epidemiological and clinical experience relevant to the predisposition of women to psychic disorders and their treatment. The beginnings of an explanation of such findings are discussed and then taken up in the theses expressed in conclusion. Above all it is emphasized that women's increased proneness to such disorders is not to be explained by their constitution or hereditary pathology, but is presumably attributable to a different upbringing of the sexes and specific conflicts of women's roles.


[Psychiatry today and psychiatry tomorrow]. In the light of present knowledge the author examines the courses which psychiatry of the future could follow. In the fields concerning secondary or tertiary prevention it seems probable that psychiatry of the future is situated in a line of continuity in relation to psychiatry of the present, while affirming and complementing it. On the other hand, primary prevention still requires to be found, the operational models of the past and present being manifestly inadequate.


[Future prospects in psychiatry].

[Future prospects in psychiatry]. A questionnaire on the future aspects of psychiatry was submitted to 234 psychiatrists, 111 other doctors and 78 nonmedical persons, that is to a total of 423 people. These were further classified according to their principal activity in private practice, clinical work, research or other fields. It was found that opinions did not differ materially within these subdivisions. It was particularly notable that over two-thirds of those questioned regard the future with optimism. Similarly, some two-thirds take an interest in futurology. There was general agreement that in 1985 the greatest problem in psychiatry will be psychosomatic disorders, neuroses and toxicomania, in that order. Biochemistry and pharmacology were considered decisive for progress in psychiatry. Over one half of those questioned also thought that in 1985 the most important method of treatment in psychiatry would be pharmacotherapy. More than two-thirds of those polled think that in 1985 a computer will be standard equipment in any research hospital and that, by 1985, psychiatry's standing will be improved as compared with today. As a corollary, the investigation was aimed at establishing to what extent the future-oriented and those-not-so-oriented differed in this opinion poll. Our working hypothesis that of the recipients of the questionnaire those with children are more future-oriented than those without children was not confirmed. But the future-oriented differed from those-not-so-oriented mainly in that they regard the future with optimism.


[Outline of a sociological approach to the psychopathology of women]. It will only be possible to understand and explain the facts peculiar to the psychopathology of women if they are related to the specific characteristics of the positions occupied by women in various domains of society. Women's place therein is discriminated against or deemed inferior in several respects, whether in the family, the profession, the periods of education or social participation. Their image in society as well as certain cultural values and norms are evidence of and confirm this situation. It is clear that identical factors are behind the minor deviations in the form of limited maladjustment, the cases of more profound maladjustment and the psychopathological facts noted. The processes of adjustment of the latter as well as the psychiatric treatment vary greatly according to the social class to which the patient belongs. The specific traits of the psychopathology of woman incorporate and express at the same time her social status, her image and the characteristics defined and attributed to her by culture.


Considerations on the metastatic tumours of the brain with reference to a statistics of 1217 cases. In 1217 patients with metastatic tumors of the brain (MTB) (13% of the 1935-1973 endocranial tumour statistics of the Neurosurgical Clinic, Bucharest) the lung was, found to be the most frequent location of the primary tumour in males and the breast in women. The MTBs preponderantly affected males (65%); the most frequent cases (63%) were aged from 41 to 60. In 46% of the cases the metastatic tumour was solitary while in 80% it was supratentorial located in the frontal (37%), parietal (31%), temporal (23%) and occipital (9%) lobes. The latent period varied from a few days to 16 years but mostly from one month to one year. The onset of the symptoms was chiefly the slowly progressive one (71%). The initial symptom by frequency order was raised intracranial pressure, epilepsy (especially focal) and motor loss. Symptoms at acme and clinical forms are reviewed also. The paraclinical investigations which proved the most contributory were scintigraphy and ventriculography. The most therapeutic step proved to be total ablation, single metastatic tumours being removed even before the primary one. Immediate postoperative death rate was 17% while the rate of a 6- to 8-month survival after surgery was 70%, though cases were also recorded which survived several years quite satisfactorily. Having long been neglected by specialists, the metastatic tumours of the brain (MTB) received attention especially in the past two decades. Their frequency, diagnosis and therapy prove as important as those of any other brain tumour.


Pilot-study on large-dose alternate-day steroid therapy in multiple sclerosis. Twenty-one patients with multiple sclerosis (MS) were given on alternate day larger doses of dexamethasone (4-8 mg) for 1 to 4 cycles and were followed up for an average of 5 months. In the group of 11 patients with relapsing course slightly better improvement was found immediately after first 5 weeks course of alternate-day intensive steroid therapy (ADST) (mean score -1.6 in numerical rating) than in 11 patients taking azathioprine (-0.9). The difference between these two relapsing groups tended to reach the level of statistical significance (p less than 0.10). Long-term effects of ADST or azathioprine treatment in patients with acute relapses were completely negative. The rate of relapse per patient-year was 0.45 in the ADST group and 0.80 in the azathioprine group. This difference was also not significant. Mild side-effects of ADST were found only in 4 patients (19%). Although the number of patients is small and the period of follow-up is limited, it can be assumed that immediate clinical effects of intensive ADST in acute relapses of MS are slightly superior to that of azathioprine. However, ADST did not affect the overall rate of clinical deterioration.


[A new observation of crossed aphasia in a right-handed man]. The observation of a crossed aphasia is presented in a right handed man. These troubles of the language appeared, following an anterior right temporal lobectomy for ablation of an oligodendroglioma. They are in accordance with the classic data of the litterature as much as by their clinical features than by their evolution.


[Giant cell arteritis and the CNS. Summary of special considerations in two separate cases]. This is a report on two fatal cases of giant-cell arteritis (GCA) with isolated involvement of intracranial arteries. The peculiarities as observed by the author in two 42-year-old male patients from his own material, are the relatively young age of these patients, the duration of illness amounting to six weeks and 14 months respectively, which is unusually short for vascular processes; and substantial cerebral circulation disturbances caused by inadequate oxygen supply. The symptomatology, the special clinical and neurological findings, the distribution patterns of the extra- and intracranial vascular involvement, including the dysfunctions as caused therby, as well as pathogenesis, aetiology, and considerations concerning the differential diagnosis are reported and compared with those to be found in the literature.


[Neurologic aspects of cranial arteritis]. This study describes 44 cases of cranial arteritis (41 of whome had been established by arterial biopsy). Special attention has been payed to the type and the significance of initial symptoms. The majority of the patients were from 65-80 years, the youngest 55 years old. The frequency was slightly higher in the male than in the female. All the patients except for two suffered from pain in the area of the head or the face. Ocular disorders had been found in 62% of the cases, commonly represented by blindness of one eye, decreased vision, papillar edema and eventually by occlusion of the retineal artery. The sedimentation rate of red blood cells showed acceleration between 32 and 130 mm after 1 hour. In the average a laps of time of one month was noted between the appearance of the first subjective symptoms and the moment when diagnosis was made. The administration of 60-80 mg Prednisone daily was followed by a decrease in the clinical signs within a few days to 3 weeks. It is important that therapy be started with a high dosis of Prednisone and that it should be reduced to smaller doses given during several years.


[The method of joined multi-center studies in clinical psychopharmacology]. Joined multicentered studies are of interest more and more growing up in the field of clinical psychopharmacology. Only such studies should be carried out which have a high scientific value to avoid unnecessary waste. According to this fact the preconditions are greater than such required for a single-center study. Also long-term studies require more preconditions than short-term studies. Pilot studies with clinically more or less unknown drugs should be avoided in multicentered studies for the same reasons. Of great importance is the selection of subjects. The single centers should have well comparable groups of patients. Nevertheless the number of selection criterias should be as few as possible, because also with only some few simple criterias the total number of patients is greatly restricted. The most likely group would consist of patients with acut diseases either recently admitted to the hospital or outpatients who conform to some good defined criterias. Of great importance is the control group. Ethical problems are playing an important role in this field. In view of the fact that the precise action mechanism of drugs is unknown at present, the randomization method will appear to be the best available selection method at the moment. The cross-over-method in mentally ill patients seems hardly suitable out of diverse reasons. Considering the dosage it seems that a limited and fixed dosage is a practicable compromise. Of greatest importance naturally is the good documentation and quantification of the results. Rating-Scales therefore are more suitable than check-lists. Some well introduced and validated rating-scales are existing and mentioned. As important instruments as the rating-scales are the self-rating-scales. Furthermore of great interest in such studies can be the multicentered additional measuring of some psychophysiological variables, for example with the polygraph.


[Schizophreniform conditions in adolescent drug users differentiation possibilities using objective personality inventories]. The authors report on schizophreniform states in juvenile drug consumers. The following psychodiagnostic instruments have been used in this investigation: a list of complaints, a self-estimation scale, a psychosis-depression-neurosis inventory (v. Zerssen), the Freiburg personality inventory (FPI, Fahrenberg, Selg and Hampel). According to clinical-psychopathological data in the course of psychosis, three groups of patients (N = 21) have been formed and defined as schizophrenia-, borderline-, intoxication-psychosis-groups. The report describes the procedure of two discriminant analyses by which the said three groups have been selected. In addition to methods of a cross section approach, the necessity of longitudinal observations is discussed by means of an own clinical example, considering also observations described in the literature.


[Treatment in a psychiatric day-care center]. This paper describes in detail a psychiatric Day-Center (Day hospital) in Lausanne, together with its way of working. The emphasis is put on the psychotherapeutic care of the patients. The author points out the importance of maintaining a good relationship with the members of the patient's family. At last, the classical indications for admitting patients to a day hospital are fully discussed and examined with nicety.


[Group therapy with schizophrenics. Introduction and theory of body-centered group psychotherapy with schizophrenic patients]. After a short review of group psychotherapies with schizophrenics the actual situation concerning the therapy by means of physical movements (Bewegungstherapie) in Swiss psychiatric hospitals is described and noted that programs and experiences of the specific therapeutic effects of physical exercises are still lacking. Based on earlier clinical experience, some psychoanalytic views and an experimental study (about depersonalisation and disturbances in body-experience) the bodily-centered (korperzentrierte) group psychotherapy is proposed and its therapeutic value discussed in 4 cases. Definitive conclusions are not yet reached in this pilot-study. Finally there is refered to a bigger experimental study that will follow.


[The genesis of religious delusions--a "Karel Gott delusion"]. In one case the psychodynamic cause of believe and (religious) delusion is discussed: the Kohut's conception of the primary narcissism seems to explain it. In spite of this common source profound differences were found. In delusion the are: loss of tradition, incapability of dialogue, disharmony with the environment, loss of trust and independence.


A single-use clinical thermometer.

A single-use clinical thermometer. A disposable clinical thermometer, based on heat-sensitive crystals, was tested in 200 subjects and its performance compared to the available bedside instrument and an accurate British Standard thermometer. It was found to be accurate and reliable and its convenience and ease of reading made it readily acceptable to patients and staff. It has the overwhelming advantage of severance of a link in the chain of hospital cross-infection and merits widespread clinical trial.


Inhibition of cell proliferation in renal failure and its significance to the uraemic syndrome: a review. The effect of acute and chronic renal failure on cell proliferation in rapidly dividing tissues has been examined in man and animal models. The evidence reviewed supports the hypothesis that renal failure results in a general inhibition of cell proliferation. Cell population kinetic studies of gastrointestinal and skin epithelia in experimental acute renal failure show a prolongation of the cell generation cycle. Less detailed investigations of other proliferative cell systems indicate an inhibitory effect on proliferation within the generative compartment of the erythroid series, lymphoid tissue, seminiferous epithelia and wound granulation tissue. This inhibition appears partly responsible for anaemia and impaired wound healing and may contribute to the abnormal immune responses, gastrointestinal tract lesions and male sterility found in renal failure.


Total synthesis of crystalline glucagon by the method of solid phase condensation of fragments. Protein Synthesis Group, Shanghai Institute of Biochemistry, Academia Sinica. Looking back at the experiences of our own and of others in the past decade or so on the total synthesis of proteins and polypeptides, we have analyzed the inherent contradictions of the two alternative methods of synthesis on the basis of the dialectical viewpoint of "one dividing into two". Either the solid or the liquid-phase synthesis is fraught with difficulties when the target exceeds 100 amino acid residues. A new synthetic strategy has been developed which we believe can resolve the contradictions inherent in the synthesis of larger peptides--the solid phase stepwise condensation of peptide fragments instead of amino acids. Following repeated practice guided by the spirit of independence and self-reliance, we have succeeded in synthesizing first of all a new supporting resin layer which provisionally meets our requirements. We shall describe in the present paper the successful total synthesis of the nonacosapeptide glucagon using this supporting resin layer. Four peptide fragments (5, 6, 9, 6), synthesized with the aid of classical methods, have been coupled stepwise to a resin-bound tripeptide, with an efficiency of over 95% for each step. After treatment with hydrogen fluoride and purification twice by means of column chromatography, rhombic dodecahedral crystals of glucagon have obtained which are identical with natural products in respect of amino acid compositions, chromatographic and disc-electrophoretic behaviour, etc. The overall yield is about 17%. In view of the characteristic abundance in glucagon of various kinds of functional groups which form unfavourable obstacles to the course of synthesis, this relatively high yield and the ease with which crystalline products can be obtained testify to the potential of the new technique in the eventual total synthesis of larger proteins.


Studies on a new pathogenic lung fluke--Paragonimus hueit' ungensis sp. nov. This paper records the discovery of a new pathogenic lung fluke Paragonimus hueit'ungensis sp. nov. in Hueit'ung County of Hunan Province. The salient features of the adults of this lung fluke, its first and second intermediate hosts, rediae, cercariae, metacercariae and the results of feeding experiments on laboratory animals (albino rats, cats, and dogs) are described and compared with the relevant species of lung flukes already known. Biopsies of the migratory subcutaneous nodules done in 2 pediatric cases seen in the endemic area of Hueit'ung County have both shown the presence of immature adolescent lung flukes, whose morphological features agree in general with those obtained through feeding experiments in laboratory animals. But the reproductive organs of these biopsied adolescent flukes are poorly developed; and they do not produce eggs in the human body where they appear to migrate blindly from one place to another, indicating that man is not a suitable final host for this parasite, in spite of its pathogenic implications. Hence one has to be careful not to confuse clinical cases of this new form of paragonimiasis with those due to paragonimiasis szech'uanensis. Studies on the different aspects of this new lung fluke are obviously of practical importance in the early diagnosis, treatment, and prevention of the disease in the localities concerned.


Cervical cancer screening in a Johannesburg family planning centre. The results of cervical smears done on the first 15 000 women screened by the cytology laboratory established in the Johannesburg clinic of the Transvaal Family Planning Association in July 1972, are recorded. Analysis indicates a high cytological detection rate of severe dysplasia and carcinoma in situ (20,2 per 1 000), and of microinvasion and frank invasion (1,8 per 1 000). The total positive pick-up rate was thus 22 per 1 000 women screened. Many potentially progressive atypias and mild-to-moderate dysplasias requiring cytological follow-up have also been disclosed. An analysis of the race, age and parity profiles of women in the positive group is recorded, and details of treatment and subsequent follow-up are noted. The results of this programme are compared with other published studies. It would appear that a family planning clinic population is an ideal target for anticipated mass screening programmes in this country.


Some side-effects of alpha-methyldopa.

Some side-effects of alpha-methyldopa. Three different regimens of drug treatment for hypertension were compared with regard to the development of undesirable side-effects in a group of 53 patients attending a hypertension clinic. The combination of alpha-methyldopa and chlorthalidone produced the highest incidence of side-effects. Weakness and impotence were most frequently encountered. In contrast, the combination of chlorthalidone, hydralazine and propranolol, and chlorthalidone alone, produced fewer side-effects. It is recommended that alpha-methyldopa should not be a first choice in the treatment of hypertension.


Basal serum gastrin levels in normal subjects and in various gastro-intestinal conditions. A total of 1 035 routine serum gastrin investigations was undertaken with a commercially available kit. Levels in 49 normal subjects were similar to those found in 200 patients with duodenal ulcertaion, in 42 patients with gastric ulcers, in 9 patients with carcinoma of the stomach, in 55 patients with chronic alcohol-induced pancreatitis, and in 27 with iron deficiency anaemia. Significantly raised levels of serum gastrin were found in 32 patients with megaloblastic anaemias, where the rise in serum gastrin concentration correlated with a fall in maximal acid output, and in 14 patients with complete vagotomies. It is suggested that a level of less than 2 mEq/h of acid after insulin and a raised serum gastrin level are useful criteria of completeness of vagotomy.


In search of a curriculum.

In search of a curriculum. The curricular needs in the continuing education of general practitioners can be assessed by means of surveys which utilise practice profile data. In constructing the practice profile, we have made use of disease classification fata and factors involved in practice management. So far, the results of a survey in which 100 practitioners are participating indicate that the method will yield valuable results.


Skull thickness of Black and White races. The skull thickness in Black and White adults of both sexes was studied in Rhodesia by two methods. White women have the thickest, and White men the thinnest skulls. The skulls of women are thicker than those of men in both ethnic groups. The differences are shown to be statistically significant.


Cannabis-related acute brain syndrome following major trauma. An acute brain syndrome in a cannabis-dependent patient, who sustained multiple injuries, is described. Points of difference between this syndrome and delirium tremens are discussed. Recommendations are made regarding the treatment of this complication, which may follow multiple injuries or operative procedures.


Psychotherapy and the aged.

Psychotherapy and the aged. Psychotherapy for ageing or old people is defined and described, and certain theoretical and practical aspects are dealt with. Special emphasis is laid on the direction and movement of a series of therapeutic encounters, so as to make clear, even to the non-specialist reader, what the patient might expect to gain from these.


[The mycelial wall of Trichophyton mentagrophytes; ultrastructural study of its constitutive layers following the use of a method to demonstrate polysaccharides]. The ultrastructure of T. mentagrophytes hyphal walls was studied after the use of a cytochemical reaction for polysaccharides. The sections showed a wall composed of 3 layers viz: an external, poorly reactive one with a microfibrillary structure; a medium, fairly reactive one, with a periodic structure and an internal, intensivly stained layer, not observed in old cells. Other observations suggested that the septal medium layer should be differentiated from those cited above. The results are compared with previous data and a synthetic scheme of the Trichophyton mentagrophytes hyphal wall is proposed.


The morphology of colony variants of three species of Candida. The colonies of 12 isolates of 3 Candida spp. with variant colony forms were studied by scanning and transmission electron microscopy. Small colonies were formed by 4 isolates each of C. albicans and C. parapsilosis and by 1 of C. tropicalis. These had an abnormally high proportion of degenerate yeast cells with an associated increase in granular cytoplasmic material intercellularly. The increased matrix in these small colonies formed a thick superficial coat over the organisms. Rough colonies were formed by 1 isolate each of C. albicans, C. tropicalis and C. parapsilosis. The convoluted regions of these colonies contained many pseudohyphal cells but few degenerate cells and little granular or fibrillar material in their intercellular matrices. The shape of colonies of Candida spp. may be altered by variations in the viability or the morphology of the organisms.


Carboxylic activity of giant cells of human granuloma produced by Paracoccidioides brasiliensis. The carboxilic activity of giant cells of human granuloma produced by P. brasiliensis was studied. The enzymatic activity was revealed by reddish-brown, purple red, and indigo-blue cytoplasmic precipitate, using the substrates alpha-naphthyl-acetate, naphthol-AS acetate and 5-bromo-4-chloro-indoxyl acetate respectively. The giant cells were intensely positive in all cases studied. We believe this esterasic activity is related to the lytic, lisosomic activity of the macrophages and giant cells in response to the activity by the P. brasiliensis in tissue.


Retention of albino and brown phenotypes of Histoplasma capsulatum by liquid nitrogren refrigeration. Pathogenic differences between albino (A) and brown (B) phenotypes of Histoplasma capsulatum for experimental animals, and serological differences between A- and B- derived histoplasmins or yeast-phase antigens, necessitate the retention of these phenotypes in culture for diagnoses and epidemiologic studies. Selected strains of A and B types were frozen in liquid nitrogen (LN) and stored for 6-9 months in the vapor phase of a LN refrigerator (-165 degrees C). The strains were tested by using Berliner's method for differentiation of these two phenotypes. The results have proved that the LN refrigeration can be used for long-term conservation to prevent the conversion of B type into the A type in vitro.


Bovine fetal cerebral absidiomycosis.

Bovine fetal cerebral absidiomycosis. Only 1 case of fetal cerebral mycosis was found in 4015 aborted bovine fetuses. Absidia corymbifera was associated with vasculitis, thrombosis, abscessation and cavitation of the brain. Antibodies against A. corymbifera and other fungal antigens were not detected in fetal serum by immunodiffusion techniques. Immunoglobulin G (IgG) in excess of the normal was detected in the fetal serum by radial-immunodiffusion assay.


Actinomycotic mycetoma due to Streptomyces somaliensis: report of a case in South Africa. The etiology of mycetomas due to aerobic actinomycetes in southern Africa is still not well understood. Martin and Berson (1973) have suggested that trauma plays an important initial part in this and several other subcutaneous mycotic infections but adequate documentation is often sadly lacking. The following case report is the first known for southern Africa in which Streptomyces somaliensis has been shown by culture and by histology to be the casual organism, and one of the few where the history is well known.


In vitro degradation of human hair by Hendersonula toruloidea. The in vitro ability of 5 Hendersonula toruloidea and 1 control Microsporum gypseum strain to degrade human hair has been studied by analysis of culture medium and microscopy. H. toruloidea was able to utilize human hair as a source of nutrients but the extent varied according to the isolate and in all cases degradation was less marked than with M. gypseum.


Phoma (Peyronellaea) as zoopathogen.

Phoma (Peyronellaea) as zoopathogen. Two case reports add to the rare recorded instances of infection of man and other animals by Phoma or Phoma-like molds. Phoma cava was consistently cultured from aural dermatitis of a white-tailed deer (Odocoileus virginianus), and tissue sections of the ear revealed fragments of apparent pycnidial walls, as well as many septate hyphae. In the second instance, numerous Phoma-like pycnidia occurred in and upon the hairs of a young child, in a lesion initiated by Trichophyton infection.


Reporting of suicide: Canadian statistics. This limited study based on publicly available statistics provides strong support for the belief that underreporting of suicide in Canada may be considerable. If this is true, it immediately justifies a greatly increased effort to refine and upgrade the ascertainment procedures so as to make the recorded statistics of more value in assessing the size and epidemiological relationships of the public health problem. From this study has also emerged the idea that, if any given community, there may exist some "general tendency" to violent and unrestrained behavior-a tendency that influences the rates for both suicide and comparable accidents in a similar direction. To explore this and similar concepts adequately requires greater refinement and reliability of the basic statistical data.


Family dynamics, childhood depression, and attempted suicide in a 7-year-old boy: a case study. Overt suicidal behavior in children is uncommon. The few papers discussing this area include only minimal descriptions of family dynamics and do not, in general, utilize the concept of childhood depression in the formulation of this behavior. This paper reviews the literature in the two areas of suicidal behavior and depression in children  and presents in detail the family dynamics surrounding a suicidal attempt in a 7-year-old boy. The case is formulated in terms of childhood depression, and the course of treatment is discussed.


Self-poisoning with follow-up considerations. One hundred patients who in 1963 had attempted self-poisoning and were subsequently admitted to the intoxication ward of a psychiatric hospital were studied twice: immediately after the attempted self-poisoning and 8 years after the attempt. It was found that within the follow-up period a total of nine patients had died, four of whom had committed suicide. The risk of suicide per years is .5%. According to the literature the range of the annual suicide risk is .9% to 2.5%.


Police suicides revisted.

Police suicides revisted. Between January 1, 1934 and January 1, 1940, 91 New York City policemen committed suicide. Dr. Paul Friedmann, in the only previously published account describing this special group, speculated that the high suicide rate for those years was due, in part, to the turbulence caused by changes in New York City's political administration attendant to Tammany Hall's fall from political hegemony as a result of the 1933 election of Fiorello H. La Guardia. The purpose of this paper is to reexamine the original police files and case histories, now residing in the Zilboorg-Friedman Archives, and to offer new comments and speculations concerning these police suicides. Involved in this examination will be (a) the use of the "psychological autopsy" in assessing several equivocal deaths; (b) the use of statistical techniques to analyze both previously unpublished archival material and recently acquired police suicide data from other cities in America and England; and (c) a discussion of the impact of Tammany Hall politics on the police department, including an assessment of the effects of the La Guardia election in 1933.


A discriminant function procedure for identifying abusing parents. From 60 abusive parents was selected a sample of 15 males and 18 females, each identified as the primary abusive parent in the home. The Minnesota Multiphasic Personality Inventory of each was subjected to a series of discriminant function analyses. Recognizing that sex is an important determinant in understanding and predicting child abuse, separate scales were derived for males, females, and sexes combined. A graph is included that allows for estimating the probability of an individual's being an abusive parent. Using these scales in conjunction with clinical interviews and medical history, there is thus an increased probability of identifying parents "at risk." Content analyses of the scale items reflect specific conflict areas for males and females that make for increased understanding of the psychology of child abuse.


The epidemiology of life-threatening events. This paper explores the epidemiology and impact (both short- and long-term) of acute life-threatening experiences among a youthful population. Interviews were conducted with 649 individuals between the ages of 13 and 30. Thirty-four percent of these respondents reported a total of 290 analyzable, subjectively perceived death confrontation experiences. An estimate of over 2 1/2 million living ex-suicide attempters, under age 30, was derived, and suicide was found to be a significantly unique form of death confrontation. In contrast to earlier work, panic and fear were found significantly to describe the majority of impacts reported, while avoidance appears to be the modal long-term effect. Differential impacts and effects are reported by mode of event, and results are discussed in relation to their impact for crisis counseling.


On the association of sex and violence in the fantasy production of college students. This paper investigates whether there is an association between sexual imagery and violent imagery in stories produced in response to ambiguous Thematic Apperception Test stimuli. In addition, two commonsense assumptions about sex and violence are examined: (a) do men have more sexual imagery than women? and (b) assuming men are more aggressive than women, do they produce fantasies with more violent themes? Thematic Apperception Test protocols administered to 80 college students as part of a study conducted at Syracuse University in the late 1950s were examined using two scoring systems--one for sexual imagery and one for violent imagery. An association between sex and violence was found for men only. The conventional wisdom that all men ever think about is sex was undermined by the finding that men and women do not differ in the production of sexual imagery. In terms of production of violent imagery, men and women also do not differ. The fact that females are less aggressive than men is overt behavior may be a function of social and cultural forces which operate differentially on men and women.


The anticipation of death by violence: a psychological profile. College students (n = 172) completed Cattell's personality factor questionnaire, Rotter's locus of control scale, Speilberger's trait anxiety measure, and Sabatini and Kastenbaum's self-completed death certificate. Comparison of profiles for subjects anticipating sudden violent death (SVD, n = 59) with those anticipating natural death (ND, n = 113) disclosed that the SVD group was characteristically more anxious and socially isolated. A sex-by-type of death interaction occurred for locus of control, with SVD females being the most external, suggesting that this group was more likely to "give up" in response to stress. The data support Shneidman's concept of subintentioned death in disclosing that several personality factors may be associated with violent death.


Hopelessness: an indicator of suicidal risk. In a sample of 87 hospitalized suicide attempters, a hopelessness scale was found to be significantly better than a depression inventory as an indicator of suicidal risk. Hopelessness also correlated better than depression with self-ratings of the attenuation of the desire to go on living.


Risks of mortality of suicide attempters compared with psychiatric and general populations. This study compares mortality risk among suicide attempters, psychiatric patients, and members of the general population using demographic data from the Monroe County (New York) Psychiatric Case Register for 1960 to 1970. During this 11-year period there were 172 deaths reported for the suicide attempt group, 6, 108 for the Psychiatric Register population, and 58,542 for the general population. The relative risk of death from all causes of the suicide attempt group was nearly twice that of the general population and slightly higher than that of the psychiatric group. High risks of mortality were differentially associated with several demographic and treatment variables. Implications for predictive criteria and interventive strategies are discussed.


Suicide behavior: community attitudes and beliefs. A survey of community attitudes and beliefs concerning suicidal behavior is reported, in which women from two suburbs differing widely in their rates of hospital treated self-poisoning and self-injury were interviewed. Sympathetic attitudes to suicidal behavior and to those who engage in it were significantly more prevalent in the low-risk area. Community beliefs regarding lethality, etiology, and ability to distinguish suicide and "attempted suicide" are reported, and the relationship of these beliefs to attitudes is discussed.


The vulnerability of young Japanese women and suicide. Young Japanese females had the highest suicide rate in the world until the end of the 1960s, and it is still extremely high. This paper attempts to explain this phenomenon primarily in terms of vulnerability-in their personalities, social conditions, and role conflicts. Concomitant psychological traits and social conditions are discussed. The cultural conflict of young Japanese women is explicated in terms of psychological and historical information. In addition, the reasons for the differences between the suicide rates among females in the Tokyo area and the Kytot-Osaka area are explored largely in terms of concepts relating to authoritarianism and its correlates.


Transcultural attitudes toward homocide and suicide. Using the concept that homicide and suicide are complex sociopsychiatric phenomena clearly influenced by cultural norms and values that define which behaviors are viewed as deviant, the investigators constructed a small sample model to determine relevant qualitative attributes of public opinion. A stratified factorial sample of 258 subjects distributed among eight large cities throughout the world was selected for interviewing. The 2,603 resulting statements were then subjected to content analysis and categorization. Results indicated that people in cities, regardless of location, are most concerned about crimes of violence, especially homicide, and those against property. Other kinds of life-threatening offenses such as arson, war, and suicide are seldom seen as important "crimes." Many people endorse a problem-solving approach to dealing with crime and criminals, but a reservior of traditional, punitive attitudes clearly remains among the less educated, lower socioeconomic classes. A commonality of many attitudes in these various urban centers does suggest that modern communication techniques may well have a modulating effect on culture-bound orientations toward crime.


Is there a biochemical predictor of suicide? There is a need for additional instruments to alert the clinician more effectively to the high self-destructive potential of some of his suicide-risk patients. In this study it was found that suicides-to-be tended to have higher plasma cortisols than suicidal patients who did not subsequently commit suicide within two years of the test. The article discusses the possible mechanisms involved and reviews some of the literature indicating that there may be a biochemical substratum that may play a significant role in some suicides.


[Effects of the cobalt ion on the in vitro growth of mouse fetus fibroblasts (author's transl)]. The effect of cobalt II (CoCl2.6 H2O) on growth and plating efficiency of an established line of BALB/c mouse embryo cells was examined. The degree of inhibition of cell proliferation was dependent on both cobaltous ion dose and duration of treatment. Plating efficiency was enhanced by low doses and/or short time of exposure, but was reduced by treatment with higher doses or of longer duration.


[Evidence of an intrinsic defect of lymphocyte reactivity in AKR mice (author's transl)]. Like their AKR/J parent, (CBAT6T6 X AKR/J)F1 mice are carriers of endogenous G-MuLV and present a high incidence of spontaneous lymphoma. However, the F1 hybrids do not present the immunological deficits seen in pre-leukemic AKR/J mice since they respond normally to in vitro PHA stimulation and to in vivo LPS immunization. These observations suggest that there is probably no direct relationship between the presence of MuLV and immunological impairment. Studies have been carried out to ascertain whether the altered immunological reactivity seen in AKR/J mice is related to factors intrinsic to the immunocompetent cells or to environmental inadequacy. Thus, (CBAT6T6 X AKR/J)F1 mice were thymectomized, irradiated, reconstituted with syngeneic bone marrow and simultaneous transplant of CBAT6T6 and AKR/J thymus, and their lymphocyte response to PHA was assayed. In addition, antibody production following LPS immunization was studied by transferring AKR/J splenic cells to irradiated CBA6T6 or (CBAT6T6 X AKR/J)F1 mice, and vice-versa. The results of these investigations indicate that an intrinsic lymphocyte hyporeactivity is present in AKR/J mice and environmental factors do not modify the reactivity of the transferred immunocompetent cells.


[Congenital fibrosarcoma (author's transl)]. A case of congenital fibrosarcoma is described and analyzed together with 27 other cases reported in the literature. The rather favourable biologic behaviour justifies conservative therapy based on complete and early surgical resection.


[Correlations between clinical control and histopathologic findings in breast cancer after irradiation and radical mastectomy (author's transl)]. 154 cases of breast cancer (30 T1-52; 124 T3-54) treated by irradiation followed by radical mastectomy were subjected to histological revision in order to check the efficacy of radiotherapy in the local control of cancer and to seek correlations between the histological findings and the clinical course of the disease. The tumor disappeared completely only in 24% of cases, the percentage being higher in the initially smaller tumors; the axillary lymph nodes showed disappearance of the metastases in a still smaller proportion of cases, namely 15-20%. Only in 16 cases (10% of cases) were the histological findings negative both at mammary and axillary levels. X-ray therapy and cobalt therapy were of equal value in the local control of the disease, despite the higher doses of cobalt. The patients operated on after radiotherapy had a decidedly better survival rate than those treated with irradiation only, since the former were selected because of their better clinical course and operated on because of this. Of the operated patients those whose axillary histology was negative presented a higher survival rate (75% of patients living) than those whose findings were positive (53%). Factors of negligible importance prognostically were: complete sterilization at mammary and axillary level after radiotherapy, persistence of florid cancer tissue at mammary level and histiocytosis of the axillary lymph nodes. In short, the result of locoregional therapy, even when successful, was not crucial in the general control of the disease, especially in advanced locoregional breast cancer (T3-T4 with axillary metastases).


[Convoluted cell lymphoblastic lymphoma (author's transl)]. The recent identification among non-Hodgkin's malignant lymphomas of a high-grade malignancy entity of possible thymic origin and defined as lymphoblastic convoluted-cell lymphoma allowed the morphologic and radiological diagnosis of nine cases of this disease. Males outnumbered females (6/9) and the age ranged from 6 to 54 years. The histologic diagnosis relied upon the characteristic non cohesive cellularity as well as upon the peculiar cribriform nuclear structure, the convoluted appearance of the nuclei, the anisokaryosis, the paucity of the cytoplasm and the minimal size of the nucleoli. The anatomical distribution of the disease was ascertained in the lymph nodes, spleen, liver and several other extranodal sites. Bone marrow invasion was observed in seven cases and presence of lymphoma cells in the peripheral blood in six. A thymic mediastinal mass was present radiologically in seven cases and lymphography was positive in five. Follow-up data revealed death of four patients within 10 months and survival of two up to 17 months. The cellular morphology of the malignant lymphoma seems to be sufficiently diagnostic. This entity deserves an autonomous position within the classifications of malignant lymphomas as it appears in the functional one proposed by Lukes and Collins (21) as well as in the Kiel classification (13).


[Prognosis of melanoma of the vulva (author's transl)]. From 1930 to 1972, 27 cases of melanoma of the vulva were treated at the National Cancer Institute of Milan. Prognosis was evaluated in relation to the therapy, the anatomical site, the lymphnodes metastases and the classification according to Clark. The median survival was 20 months and the 4-yr survival was 19%. The authors reached the following conclusions: site and T of melanoma have no prognostic value; survival is strictly related to the lymphnodes metastases and to Clark's classification: no N+ patients survived longer than two years while 62% of N-- patients are still alive after four years. No survival after 2 years was observed in IV-V class of Clark while a 54% survival after 4 years was observed in II-III class of Clark. Surgery gives the best results while radiotherapy as single treatment is useless and its role as adjuvant postoperative therapy is still uncertain.


[Mechanism of action of progestins in the treatment of hormone-dependent breast cancer (author's transl)]. The in vitro interference of some gestagens with the binding of 3H-17-beta-oestradiol to cytosol specific receptors was investigated with a view to elucidating the mechanism of action of progestins in the treatment of human hormone-dependent breast cancer. A decrease (up to 85%) of oestradiol binding capacity was observed with high concentrations of progesterone, clogestone and medrogestone. These findings are in good agreement with those previously obtained by the same progestins in our laboratory on rat uterine estrogen receptors in vitro or in vivo. These results provide the support for the hypothesis that the mode of action of  progestins in the therapy of mammary and perhaps uterine carcinomas is to some extent related to the inhibition of oestradiol binding to cytosol specific receptors.


Histology of chemically induced mesotheliomas in MRC-Wistar rats. Two peritoneal mesotheliomas were induced in rats during a carcinogenicity study of 1-nitroso-5,6-dihydrouracil (NO-DHU) injected intraperitoneally. A review of literature concerning experimental induction of such tumors indicated that they seldom produced with organic compounds and rarely occur spontaneously. In the present study, several reports of chemically induced mesotheliomas of the testes are analyzed and the diagnoses critically reviewed along with other differential diagnoses.


Value of the NBT test in the diagnosis of bacterial infection in untreated cancer patients and in those on radio- and/or chemotherapy. As the first step in the study, the results of the NBT test in 83 patients with various untreated neoplasms, including 20 lymphomas, without bacterial infections and in 35 neoplastic patients with this complications were compared with the results obtained in control groups. No significant differences in the results were found between the groups of neoplastic patients without or with bacterial infections and the controls. To evaluate the NBT test during radio- and/or chemotherapy, especially in neutropenia, 45 patients were NBT-monitored. During the study of 102 episodes of neutropenia 43 infections occurred and 30 were NBT-confirmed. In remaining 13 cases it was impossible to perform the test because of extremely low neutrophil count (below 500/mul). All 20 infections in patients with normal neutrophil count were NBT-positive. These results confirm the usefulness of the test for infection screening in untreated with malignancies, as well as in patients receiving radio- and/or chemotherapy. However, the test can be taken only in patients without severe neutropenia.