[Identy crisis and drug abuse in young people]. Nowadays young people during the phase of their puberty and adolescence often show symptoms of a grave crisis of identity which particularly idspose them to drug-abuse. On the one hand this search for one's identity is characteristic of the formative years of a juvenile; on the other hand it is a general problem of the generations which must be seen in the full context of the social, technological, industrial and political development of our time. Lacking possibilities of identification in the context of a general relativism of traditional norms and values, radical changes in the structures of the family and of our society, accompained by over-exaggerated demands on one's personal performance and prosperity, and significant failures of communication as well as the unreflected liberalization of a "permissive society" make young people look for new possibilities of identification which they try to find in sub-cultural groups and fascinating experiences which drugs. Many juvenile drugconsumers show increasing crises in their personalites and farreaching psychological distrubances often followed by a serious development. All these phenomena illustrate the frustrated search for genuine personal identity in an illusionary world of drugs. Only the solidaric and constructive cooperation of the generations can overcome the manifold problems and conflicts of young people which are concentrated in their identitycrises, and only this cooperation can open up new perspectives for a future which is humane and worth living, a future which is the real aim of the subcultural movements and psychodelic experiences.


[Psychosomatic aspects of breast carcinoma]. Psychological differences were compared between 25 female patients with carcinoma of the breast (mamma) and 25 patients with mastopathia cystica fibrosa. Our methods consisted in psychoanalytical interviews and MMPI-tests. We investigated the early childhood-period, the object relationships, the structurs of the personality and the psychological stress before the beginning of the physical illness. Patients with carcinoma of the breast show more frequent broken home situations, and inclination to idealize the past, depressive traits and a tendency to repress inner conflicts. The sexual behavior shows statistically more frequent abortions in the cancer group. In the beginning of the cancer we found statistically more frequent the loss of a meaningful personal relationships (e.g. death of the mother). Several differences between the personal structure were also found in the MMPI-tests.


[Normoplastic interventions in conflict-oriented brief therapy]. A method of brief psychotherapy developed in the clinic for psychogenic and psychosomatic diseases Tiefenbrunn, and suited for patients unable to deal with interpretations is presented. From focal psychotherapy inaugurated by Balint, to which it constitutes a counterpart, the method differs as to mutative interventions, which are specifically directed at the norms determining patient behaviour. The interventions are derived from an analytically oriented assessment of psychodynamics. Their mode of functioning is explained within a psychoanalytic model of psychic functioning. Indications, especially in comparison to Balint's focal therapy are stated. Technique is described.


[Self image and defense mechanisms in young drug addicts]. By our psychological treatment of young drug addicts we composed the results of the personal interviews, a self-report inventory (Freiburger Persönlichkeits-Inventar), the observation of behavior, and the Rorschach-Technique. We found that the investigated individuals showed in their self concept parts of a prejudice concerning drug consumers. This prejudice is an important part of the frame of reference determining the behavior of the young people. Investigating the defense-mechanisms and the strategies of personal existence we found clear differences between the groups of hallucinogene abusers and opiate addicts. In both groups there are different reaction types for avoiding and working up internal and external stress.


[Supplementary remarks on post-traumatic reactions]. The post-traumatic reaction, at least in the group of soldiers under discussion, consisted in the conflict between their courage and moral, on one hand, and the fear of death, on the other. We should consider the great majority of these soldiers as good human and war material, not prone to cowardice or neglect of their duties. In spite of this, it was obvious in their case that human endurance is not unlimited. Their desease was not a subconscious simulation, but a real case of conversion hysteria at some of them, and the anxiety hysteria, accompanied by the nightmares, at the others. The disclosing psychotherapy, started immediately and conducted in concentrated form, led to self-awareness and to complete recovery.


[Critique of ideology and the reality principle]. The article is based upon a thesis of Helmut Dahmer, according to which psychoanalysis has not yet been looked upon as ideological criticism and confronts it with Franz Alexander's statements as counterthesis, which point to the fact that psychoanalysis ought always to be seen as critical of ideology in its approach. In connection with the psychoanalytical theory of creativity, this psychological approach from the view point of ideological criticism--that should always be worked out anew--cannot leave unreflected psychoanalysis itself, not only in its theoretical inventory but also in its practise and in the political significance of the latter. Especially the ideologically critical approaches of the more recent theory of narcissism and transcultural studies as well as their connection with present-day social phenomena, developments and problems, give reason to relativize the "western" Ego and its problem-complex; at the same time the concept of Self, its modifications, its socio-economical and philosophical transformations are given a basic position.


[Inborn orientation procedures during feeding in guillemots (Uria aalge aalge Pont.)]. Guillemots (Uria aalge) swallow fish head first when they are fed, when they pick up fish from the ground and when hunting. The responsible orientation processes in the first two situations are investigated. Experiments on over 300 hand-reared chicks, partly food-naive, showed that when they are fed, swallowing the fish head first results from a combination of orientation processes on the part of the parent and the chick. When picking up fish it results solely from characteristics of the fish. It is explained why the Taxis theory does not seem applicable. Instead of this the study is based on the theory of orientation processes.


[Significance of olfaction in the feeding behavior of toads (Amphibia, Anura, Bufonidae): studies with the natterjack (Bufo calamita Laur.)]. The influence of olfactory and visual prey stimuli on the feeding behaviour of toads was studied as well as their response to lasting olfactory cues. A further aim was to find simple methods for testing olfactory responsiveness in anurans. Subjects were 8 adult specimens of the European species Bufo calamita (natterjack) kept in captivity one year at least. The results point to the rôle of olfaction in these animals.


[Effect of testosterone on the beginning of singing in the zebra finch (Taeniopygia guttata castanotis)]. In young male Zebra finches, singing was advanced in time by injections of testosterone-propionate. The juvenile song, which normally occurs on day 34 to 37, could be shifted to day 18 to 19, when injection took place at the 16th day; either earlier or later injections delayed singing (at 25 to 35 days). The advanced juvenile song differs from the normal one, mainly the rhythm is less mature. There seems to be a point prior to which juvenile song cannot be induced, depending possible on the maturation of central nervous motor centers.


The interaction of stars and magnetic field in the orientation system of night migrating birds. II. Spring experiments with european robins (Erithacus rubecula). To investigate the relative importance of stellar and magnetic cues for the compass orientation of night migrating birds, 45 European robins (Erithacus rubecula) were tested in automatically registering cages with view of the clear natural night sky. One group was tested in the natural local geomagnetic field, the other group in a field pointing to 120 degrees ESE; birds from both groups were additionally tested in a magnetic field the horizontal component of which was compensated. The observed orientation behavior leads to the conclusion that star compass and magnetic compass are not independent, but that they are interlinked in the way that the star compass is established by information from the magnetic compass.


[Flight leadership in flocks of homing pigeons]. Groups of 3-5 homing pigeons individually recognizable by different colours of their plumage were followed by helicopter on their way home. In most cases the animals flew together as a group with frequently changing leadership. Flight formations in terms of leadership were noted every minute. It was examined statistically whether the flight order varies at random or whether there are leading and led birds. In 6 out of 7 experiments with groups of 4-5 pigeons flight order was far from random, one or two pigeons proving to be leaders. In only one experiment leadership did not differ from a random distribution. No correlation could be found between the tendency to lead within a group and homing performance of the single pigeon when released individually.


[Middle and autonomous person- remarks on the anthropological reference system in the analytical psychotherapy of Harold Schultz-Hencke]. Remarks concerning the anthropological reference system in the analytical psychotherapy of Harold-Schultz-Henke. This inquiry points out that the interpersonal and social dimension is insufficently considered in the development of Schultz-Hencke's theory. In my opinion, this is evident in three places in his outline of psychological anthropology. In his anthropological presupposition, he sees the social dimension either only in ontological terms as antinomy between persons or in terms of individualpsychology in its intrapsychic effect and individual ways of control. In accordance with that, he does not analyse, in the term middle man, which processes between individual and reference persons make man a middle man. Finally it appears to me that the interpretation of the being and destiny of man as autonomous person reflects the same content. For this reason, I think it is not accidently that Schultz-Hencke pays so little attention to the object references of Freud, and that he does not give them their own place in his theory. In this respect, the presupposition of Schultz-Hencke must be supplemented. The ontological and psychological approach has to be combined with the discipline of social psychology. A psychoanalytical model of interaction has to be developed. But with that the anthropological goals of his psychological anthropology would also be extended in the interpersonal dimension. Next to the autonomy of the individual would come the interdependence (to use a term of social psychology) between the individual and the reference persons. In other words, the point would no longer be the autonomous self realization of the individual alone, but the autonomous self realization of the individual in interdependence.


[Personality study of lung cancer patients]. Formerly the authors had studied the personality profiles of a sample of chronic patients, using the Rorschach psychodiagnostic method. They had found a set of Rorschach types which were closely associated with the presence of lung- cancer in the patients. This set was called by the authors a syndrome reflecting an overpowering, but latent, unconscious sense of crisis, of a catastrophe ("Catastrophe-syndrome"). The present study was set up and carried out to control and validate this finding and to establish its diagnostic value. The following groups of patients were investigated with the Rorschach test: 125 patients with lung-cancer/verified by biopsy/25 patients suspected, but not verified, lung-cancer, 50 patients with chronic tuberculosis. For control purposes, the authors have investigated 50 healthy individuals, watched with age and socioeconomic status to the patients. The study obtained the same result, the Rorschach syndrome (31 syndrome signs) was found more frequently in the lung-cancer patients, 17 signs were associated with lung-cancer significantly more frequent. This finding can be considered as a contribution to the study of the personality characteristics of the lung-cancer patients. Although this syndrome can not be held for specific for cancer only, it can give some aid in the differential diagnosis of the patients with suspect lung-cancer. This is supported by the clinical experience of the authors in the last few years.


Parturition and related behaviour in the African elephant. The behaviour of a female African elephant before and after paturition was observed and photographed in the Isiolo Game Reserve, Kenya. Birth was very rapid (not actually seen). Post-partum activity was characterized by intensive care-giving behaviour in which a few other animals co-operated with the mother. Observations are compared with the few other accounts on the subject.


Population control in confined colonies of golden hamsters (Mesocricetus auratus Waterhouse). The mechanisms by which confined colonies of Golden Hamsters regulate the density of their population were investigated. Six experimental populations were established with two males and two females each and allowed to grow freely for 3-8 months. At no time did any population exceed eight individuals. This appeared to be the result of a high rate of infant mortality due to failure of pregnant and parturient females to isolate themselves from the others. Two other populations were then established allowing many more nesting areas and more room for dispersal, but animals continued to crowd together and infant survival did not improve. These results contrast sharply with the large ultimate populations and only slowly developing disturbances seen in rats and mice. This difference in population control appears to be the direct result of a species difference in the tolerance of adults for strange newborns. In two further short-term experiments, the effects of the number and sex of adults in the founding population were systematically examined. The critical density at which no pups survived past the first day was six or more animals; females appeared to contribute more than males to infant mortality.


The role of chemical and visual stimuli in the preferential discrimination of young by the cichlid fish cicblasoma nigrofasciatum (günther). During the parental period, females of the cichlid fish Cichlasoma nigrofasciatum have demonstrated a keen ability to locate and preferentially discriminate their own wiggling young from those of other species on the basis of chemoreception. Males also apparently perceive chemical substances emitted by their young, but their response is weak in comparison to that of the female. There was no apparent perception of chemical substances emanating from eggs until 10 to 15 hours prior to hatching at which time, females began responding to them. No clear nor consistent preference by visual means, alone was shown by pairs of C. nigrofasciatum toward wiggling young of either their own species or those of Hemichromis; however, rapid preferential discrimination, by such means, was shown when a pair's own wiggling young were tested with free-swimming young of a foreign species. Vision apparently serves primarily for orienting the parents to young during their wiggling stage of development, while chemoreception serves primarily a discriminative function, at least, when both chemical and visual  stimuli are present in a given situation. Once the free-swimming stage of development has been reached, parental vision not only continues to mediate orientation to the young, but also assumes an increasing role in discriminating among different  types of young. When combining the chemical stimuli of wiggling young of their own species with the visual stimuli of either these same young or wiggling young of another species, females of C. nigrofasciatum apparently can learn, within 15 to 19 hours, sufficient visual characteristics to show preferential discrimination, at least, for a period of 5 to 7 hours after removal of the chemical stimuli. This result was in sharp contrast to that seen when visual stimuli, alone were tested for the same or longer periods. The interaction of chemical and visual stimuli in young recognition by parental cichlids and the relevance of the present findings to previous studies, dealing with similar mechanisms, are discussed.


[Discordance analysis of monozygotic twin pairs. Case study on psychogenesis]. We performed a discordance-analysis on six pairs of identical twins. They were selected from a large series of neurotic patients who came to visit one of two psychoanalytic outpatient departments. The results of this elaborate case studies are discussed here. The classical twin methods usually will help to clear the question of naturenurture-relation. Contrary to this the aim of discordance-analysis is to proof specific environmental factors which influence development of neurotic illness. The application of this method is rarely possible, because several conditions have to be fullfilled: The patients have to be identical twins; they must be available and willing to undergo psychoanalytic interview; apart from this they must present discordant neurotic complaints.--By a very exact analysis of the early childhood influences we can draw conclusions about psychogenesis of neutotic illness in later life. This method owns extraordinary advantages because of the existence of a control person with identical genetic outfit.


[Influence of prenatal auditory experience on the development of visual attachment in the domestic chick]. Newly hatched domestic chicks learned to prefer the object bearing the same visual characteristics as the environment associated to the initially preferred clucking sound. Domestic chicks chose after prenatal exposure between two different clucking sounds by running towards one loudspeaker and settling there. Then all chicks were individually exposed to two alternating optical stimulus situations of equal length, each of which was accompanied by one of the clucking sounds. Subsequently, in an exclusively visual choice situation, the chicks chose the stimulus that had been associated with the preferred clucking sound.


[Structure development of adults with previous early childhood exogenous psychosyndrome]. The author analysed the structure of grown-ups with organic brain damage in early childhood. The study was based on psychoanalytical exploration or treatment of three patients. Typically the patients showed a "schizoid" defect of perception, which was compensated by strong compulsive mechanisms. The genetic, adaptive and structure aspects were discussed on psychoanalytical point of view.


[A rare type of transorbital brain injury]. Case report of transorbital brain injury from a mortar shot. A bolus of powder particles and iron had penetrated the right orbit and then the roof of the orbit and led to the formation of an intracerebral abscess. Diagnostic and therapeutic approach is described.


[Extensive arterial spasms masking arteriovenous angioma of the posterior cranial fossa]. In the case of clinically evident subarachnoid hemorrhage it is possible for additional complications in the form of cerebrovascular spasms to mask the source of hemorrhage. And if the spasms basally affect all of the cerebral arteries, then the probable site of hemorrhage cannot be concluded from the location of spastic vasoconstrictions. Therfore, it is necessary that all regions of the brain be angiographed during repeated examinations. Being the cause of subarachnoid hemorrhage, infrequently occuring small-size arteriovenous angiomata of the posterior cranial fossa [6,3,5] sometimes cannot be located accurately by methods other than angiotomography.


[Cranial vault meningioma having the angiographic picture of an extracerebral hematoma]. The angiographic symptom of vessels forced away from the cranial vault may, in rare circumstances, be due to a tumor of the meninges. The differential diagnosis of such "pseudosubdural hematomata" is uncertain preoperatively. The anamnesis and clinical findings do not in such cases allow a clear decision to be made.


[Solitary Cysticercus cellulosae racemosus in the fourth ventricle]. A case is reported where it was possible, by surgical intervention, to show a cysticercus in the fourth ventricle to be the cause of a serious increase in intracranial pressure. The difficulties of preoperative contrast diagnosis in the case of space occupying lesions in the rhomboid fossa are described with reference to this particular case. Also discussed is the increasing importance of cysticercosis in our latitudes.


[Osteomyelitis of the frontal bone following exeresis of the N. supraorbitalis]. The paper describes a case of osteomyelitis of the frontal bone after exeresis of the first trigeminal branch, which was postoperatively precipitated probably by chronically relapsing hordeola. General principles of skull-cap osteomyelitis are discussed, and conclusions are drawn form the case describe in the paper.


[Successful extirpation of meningioma of the posterior cranial fossa in a 5-year-old girl]. Case report on a successful removal of an infratentorial meningioma in a 5-year old girl.


[Hydrocephalus and papilledema in caudal tumors]. Another two cases of hydrocephalus and papilledema with cauda tumours are communicated and a multifactorial pathomechanism is discussed. The following recommendations are given to avoid diagnostic and therapeutical mistakes due to an apparently cerebral symptomatology with cauda tumours and only a mild local finding: I. A thorough investigation of the history.--2. An impartial complete neurological examination omitting possible emphasis indicated by the first examiner.--3. A complex diagnostic intergration of single findings (native x-ray pictures, findings of the cerebrospinal fluid) in keeping with the diagnostic survey.--4. A consideration of the differential diagnosis of rare diseases.


[Brain metastases of malignant chorioepithelioma]. The neurological symptomatology, problems associated with diagnosis, and possible methods of treatment are discussed by reference to 28 cases (described in detail in the literature) and 2 cases (from our own patient stock) of intracranial metastases of malignant chorioepitheliomata.


Insulin-binding antibodies in diabetic patients. Dynamic aspects of their formation. Insulin-binding antibodies in serum of two groups of diabetics were followed up for a longer period of time. The first group had never been treated with exogenous insulin and showed a low antibody titer, with negligible changes in their level and diminishing of antibody production during ageing. Patients who had received insulin presented some differences: strong dependence of antibody titer on insulin dose; the very high doses, however, as well as a long period of treatment with insulin were accompanied with lowering of antibody concentration.


The liver in human diabetes. Concentration of some induced enzymes. Since glycogen overloading is one of the outstanding features of the diabetic liver, a series of investigations were undertaken to find an enzymatic explanation of this feature. Three groups of patients were studied: non diabetics submitted to liver biopsy during surgery (group A); non diabetics submitted to percutaneous liver biopsy (group B). In both these groups G-6-PDH, PK and MDH were assayed, all these being adaptive enzymes of intermediate metabolism. Results were expressed as muU/100 mg proteins. The significant finding of the comparison of these two groups was the low concentration of these enzymes in surgical biopsies. The depression was such that for G-6-PDH the concentration was more than 10 times less in surgical specimens as compared to percutaneous ones, whereas for PK it was almost 10 times less. In view of these findings no further surgically obtained biopsy material was used in this study. The third group (C) included insulin-dependent diabetics in good metabolic control from whom percutaneous liver biopsies were obtained for the assay of the same enzymes as above and in order to compare the results with those of group B. All three enzymes were diminished in diabetics, the difference being statistically significant for G-6-PDH and PK, not for MDH in view of the wide dispersion of the values found. Comparison and analysis of these results lead to the conclusion that in view of the low concentration of these enzymes in diabetics, glucose utilization in the liver cell must be presumed to be increased via other metabolic pathways.


Effect of ageing on insulin and insulin-glucose sensitivity tests in rats. Insulin tolerance tests have shown old rats to respond to injection of the hormone by a sharp and lasting drop in blood sugar. The difference between these animals and young and adult ones lies in their inability to restore a normal blood glucose level. Glucose tolerance and insulin-glucose tolerance tests show that glucose uptake under the influence of the hormone is significantly reduced with age in absolute terms. However, the difference in glucose assimilation coefficient in the absence or presence of insulin (deltaK) is comparable in all age groups; thus senile rats were found to be as sensitive even to small doses of hormone as the adult ones, if basal levels are taken into account.


Effects of anesthetics and other drugs on pulmonary vasoconstriction in hypoxic areas of the lung. Experiments in isolated perfused cat lungs and in intact dogs indicate that clinically-used concentrations of inhalational anesthetics can produce a reversible depression of the pulmonary vasoconstrictor mechanism which is believed to divert blood flow away from underventilated (i.e. hypoxic) areas of lung. It is possible that this mechanism may increase arterial hypoxaemia during anesthesia.


Biotransformation and toxicity of local anesthetics. The biotransformation of clinically important ester- and amide-type local anesthetic agents is reviewed with emphasis on their fate in man. Aspects considered include: 1 degree the contribution of biotransformation to overall pharmokinetic profiles and systemic safety; 2 degrees the effect of disease on biotransformation; 3 degrees biotransformation and fate in the neonate; 4 degrees pathways and products of biotransformation; 5 degrees pharmacokinetics of metabolites; 6 degrees pharmacological activity and toxicity of metabolites.


Biotransformation and toxicity of intravenous anesthetics. Metabolism is less important than redistribution as a factor influencing recovery from intravenous barbiturates, but it plays a more important part than was once thought. In contrast with inhalational agents the metabolites of intravenous anesthetics are not the cause of their side effects. The recent reports of hypersensitivity reactions are serious; they show reactions which could be attributable to histamine release and the histaminoid response may be accompanied by bronchospasm. A retrospective analysis of 70 patients suggests that they are more likely to occur in patients with a history of allergy or drug sensitivity or the prior administration of the same drug. The situation is particularly serious in the case of Althesin but it can occur with all drugs.


Cellular toxicity of anesthetics.

Cellular toxicity of anesthetics. Inhalational anesthetics produce a range of side effects in addition to the production of narcosis. These are not uniform for all anesthetics, but show specificity. The side effects are not the result of uniform depression of all cell functions and are themselves highly specific. The basic mechanisms appear to be binding of the anesthetic to hydrophobic sites in macromolecules, with resulting conformational changes which may cause a change of properties. Examples are inactivation of enzymes, depolymerisation of polymers (such as microtubules) and paralysis of motile systems. These effects cause widespread changes such as interference with metabolic processes, cellular motility, micro structure and cell division. Cellular toxicity may also result from the action of biotransformation products including free radicals. These may disrupt membranes and result in autolysis of cells. Immune responses to anesthetics and their biotransformation products have been demonstrated but their clinical significance is not yet known.


Immunological aspects of halothane hepatitis. Possible relevance of biotransformation. The hypothesis that "halothane hepatitis" is related to hypersensitivity to the agent is widely accepted. The hypothesis is based, in part, on reports ostensibly demonstrating cell mediated immunity to halothane in such patients. These reports, however, are open to criticism and have not been confirmed. Halothane is unlikely to be capable of antigenicity in its own right, although reactive metabolites may be involved. We have further investigated cell mediated immunity in patient with alleged halothane hepatitis. Human serum albumin and liver specific protein were chemically trifluoroacetylated and these complexes were used as potential antigens in lymphocyte transformation and leucocyte migration inhibition tests. Using these in vitro indices, cell mediated immunity was not demonstrated in any of the patients studied. It is possible that other metabolites and/or carrier molecules may be involved, and that patients predisposed to autoimmune disease may be particularly at risk.


Biotransformation in man and clinical toxicity of volatile anesthetics. Delayed toxic reactions following general anesthesia are dependent on biotransformation of ansethetic drugs. Up to ten grams of metabolites of the more extensively metabolized volatile anesthetics may undergo irreversible intracellular binding. This could contribute importantly to the incidence of hepatic necrosis. A second important cause of toxic reactions is production of toxic metabolites. Nephrotoxicity with impairment of urine concentrating ability following methhoxyflurane anesthesia correlates best with blood fluoride levels and total urinary oxalate. A possible role of enzyme induction in hepatic and hepatorenal failure following, fluroxene anesthesia is suggested by recent studies in the monkey, which demonstrate that pretreatment with phenobarbital results in increased production of a toxic metabolite and conversion of a well tolerated anesthesia to a rapidly lethal one. Improvement in the safety to general anesthesia can be expected from either of two developments: production of anesthetics which are resistant to biotransformation, or development of drugs which will inhibit biotrasnformation during and immediately following anesthesia when maximum rates of biotransformation tend to occur. An important additional safeguard will have been achieved when a successful method is found to identify before exposure patients who may susceptible to delayed toxic reactions.


Lack of teratogenic dangers with halothane. Chronic exposure of pregnant Sprague Dawley rats to a range of halothane concentrations from 50-3200 p.p.m. for 8 hours a day on days 8-12 of gestation failed to demonstrate significant teratogenicity in terms of foetal loss, growth, or skeletal abnormalities. Exposure to 1600 p.p.m. showed significant changes only in foetal weights, which were slightly decreased.


Working in operating rooms, an unhealthy existance? A literature survey indicates that some complaints occur relatively frequently among anesthetists and nurses working in operating rooms. Pollution of the air in the operating rooms by anesthetic gases is often considered as a possible cause. On account of this the degree of pollution has been determined. Concentrations of nitrous oxide and halothane were measured using an infrared absorption spectrophotometer. In each room the concentrations were measured at several different sites. In naturally ventilated operating rooms the concentrations increased steadily during operation. The measured values lied mostly between 1500 and 3000 ppm (vol/vol) for nitrous oxide and between 15 and 35 ppm for halothane. In mechanically ventilated operating rooms where no recirculation is applied a constant level was found some time after the beginning of an operation. The concentrations varied from about 100 to 500 ppm for nitrous oxide and from 1 to 5 ppm for halothane. In naturally ventilated operating rooms the anesthetic gases were rather homogeneously spread, while in mechanically ventilated rooms there was an inhomogeneous distribution. Scavenging of waste anesthetics is recommended.


Computers in anesthesiology and intensive care. User attitudes to a real-time patient data display system. Wythenshawe Hospital is a large district general hospital, with an important Cardio-Thoracic department. A developed DNTRODUCED into this area and its attendent laboratories two years ago. Six months after hardware commissioning the system was fully operational throughout the whole department and during the past two years most of the additional user requirements, including calculations, have been met. This paper describes the attitudes and acceptance by doctors, nurses, laboratory and para-medical staff to the concept of recording all patients clinical information within this environment, via a computer system. Staff considered that both input and retrieval of information had been improved by computer assistance, and telephone call within the department had been reduced. Nurses and technicians prefered computer assistance to the old system of manual record keeping, but clinicians appeared less decided. However, all groups trusted the computer.


First experiences with a documentation system via display terminals. A documentation and monitoring system has been developed by members of the Department of Anesthesiology and the Department of Medical Data Processing of the Rheinisch-Westfälische Technische Hochschule Aachen. It is conceived in such a way that it should cover all the needs of the department, which is to say that every anesthesia done by a staff member should be documented, supervised and assisted by the computer service. The anesthesiological staff works only with 16 color visual display units, which are installed in the different operation theatres and in the intensive care unit of the department. These devices are used as an inquiry-response system for the dialogue between medical operator and computer. They display both alphanumerics and graphics in four different colors and modes. Information is entered in the system via so-called masks, which contain a larger section of information, and by on-line data recording.


Westminster hospital computer system User attitudes. Development of computer-assisted patient monitoring began at Westminster Hospital in early 1971. The system handles fluid balance measurements from data input to the system by keyboards, and automatically monitors cardiovascular measurements made by standard bedside monitors. Various graphical outputs are available on visual displays at the bedside to assist in the care of the patients, and as hard copy to replace the "traditional" nurses charts. The system was designed to assist the nurses in their daily tasks, and much of its initial success is believed to be due to the  "user oriented" design philosophy.


Use of a small computer with magnetic memory. Simple programming has permitted the use of the program memory of a Hewlett-Packard minicomputer (150 X 80 X 40 mm--300 g) as support of selected information from anesthetist's patient record. Magnetic cards (71 X 11 X 0.2 mm) are used to store patient data. To limit manipulation of magnetic archives, storage is restricted to one card per patient corresponding approximately to one half kilobit. Speed and simplicity of the system frees the anesthetist from external help. Extreme flexibility makes it particularly suitable for preliminary studies and extraordinary low cost permits many trials and errors making an excellent training device of it.


Experience with continuous monitoring of lungcompliance and airway resistance. Recently the Auprem apparatus is developed and enables to compute automatically on line the values of compliance and airway resistance, by means of a pneumotachograph. The application in anesthesiology are manifold. As illustration, a study of enflurane (Ethrane) on respiratory dynamics is described. In a group of 10 patients, we found a slight although not significant decrease of airway resistance by +/- 10% (5.2 +/- 0.5 before enflurane and 4.9 +/- 0.4 cm H2O/1/sec. after enflurane). Elastance was nearly unchanged as well as compliance. Some examples of the study of ventilation patterns are given. In a same patient the Engström respirator 300 and the Servoventilator with constant flow pattern and with increasing flowpattern are compared. When the plateau phase is suppressed, the computed values of airway resistance and elastance differ markedly. The ability to use central venous pressure instead of oesophagial pressure is an important innovation and opens a new research area for studying critical care patients.


A simple and non-invasive method to determine the ventilation-perfusion ratio of the lung and the effective lung perfusion. A method is presented to obtain the ventilation-perfusion ratio non-invasively. To describe the properties of gasexchange over the lung we used the law of mass conservation. The use of sinusoidal changes in the concentration of a tracergas in the inspired mixture results in a simple formulation of the variation in the concentration in the expired mixture over the variation in the inspired mixture. A careful selection of tracergas and cycleperiod of the sinus enables us to neglect the influence of venous return leaving the ventilation-perfusion ratio as sole physiological variable in the formulation. The lungperfusion can be obtained by measuring the total ventilation and correcting this value for deadspace ventilation. The method can be used to evaluate the influences of techniques like positive end-expired pressure and increased carbon dioxyde levels on shunting. It is also suited for monitoring purposes.


Pathophysiology of adult respiratory distress syndrome. We have studied 45 patients with adult respiratory distress syndrome (ARDS). Pathological studies were performed on 30 open lung biopsies and 15 autopsies. Concomitantly the physiologic characteristics of the hypoxemia in response to different inspired oxygen fraction (FIO2) and Positive End Expiratory Pressure (PEEP) were determined. These studies allowed categorization of ARDS into 3 groups. Group I had the most severe hypoxemia and a severe fixed shunt at all PEEP and FIO2. Pathologically, there was extensive acute edema, hemorrhage, and exudation to the point of consolidation. Group II had less severe hypoxemia which improved moderately but slowly in response to PEEP and shunt increased with decrease in FIO2 indicating diffusion disturbances or severe ventilation-perfusion abnormalities. Pathology showed severe fribrosis. Group III had least hypoxia which rapidly and markedly improved with PEEP. Shunt also increased with decrease in FIO2. Pathology showed acute changes similar to but less severe than group I. Prognosis was best for group III with 10 of 21 long term survivors (one after ECMO or extracorporeal membrane exygenation). In group I only 2 of 11 survived after prolonged periods of ECMO. In group II, 3 of 13 survived (one required ECMO) with satisfactory pulmonary function despite biopsy evidence of severe fibrosis during the acute illness. These pathological and physiologic studies are useful to better understand ARDS, to optimize respiratory care and for prognosis.


Capnography: a sensitive method of early detection of air embolism. Seven capnograms are shown demonstrating the invariable fall in the level of expired CO2 which occurs during the operation for the insertion of a Pudenz-Heyer drain for hydrocephalus. The fall occurs when contrast medium is injected down the heart catheter after withdrawal of the guide but never after subsequent injections unless air is present in the syringe. The effect is shown not to be due to a difference in temperature between the contrast medium and the body. A comparison is made with a capnogram recorded during the setting up of an I.V. transfusion in an infant in which a small quantity of air was seen to enter the circulation along the tubing of the butterfly needle. It is concluded that the fall in the capnogram seen during Pudenz-Heyer operations is due to air embolism. The severity of its effect is shown to be proportional to the volume of air injected in relation to body weight. The value of the capnograph as a sensitive monitor of air embolism is emphasised together with the fact that the fall in the capnogram precedes that of the blood pressure or any other recordable effect.


[Resuscitation of patients poisoned by organo-phosphorus neurotoxic agents]. Poisoning by Neurotoxic organo phosphorus products is frequent problem in Iran. Reanimation of these patients depends on the following: 1 - To begin reanimation rapidly. 2- Usage of atropine and special anticholisterasics antidotes. In case of need for surgical intervention, the use of succinylcholin is prohibited and other muscle relexants should be used with most care.


[Serological data on rabies in foxes studied in Iran]. During the epidemiological research of zoonoses, the authors have studied the rabies of wild animals: fox. For the serological tests, the blood was taken by heart puncture of foxes. 193 specimens were tested and 26 (13.5%) of the foxes had neutralizing antibody in their blood. This study confirms that during the rabies epizooty, the Vulpin population, may contract a non-fatal disease and produce the neutralizing antibody. Thus, the fox has a real place in the epidemiology of rabies in Iran.


Studies on clinical, haematological aspects and pathological changes of gastric mucosa in geophagia. 1) Geophagia characterized by, severe, anaemia, dwarfism, hypogonadism and hepatosplenomegaly is sometimes seen in young patients (and children) in Iran. 2) Haematological aspects of the syndrome are those of, severe, iron deficiency anaemia. 3) Gastric biopsies and histological findings revealed superficial or atrophic gastritis showing some resemblance to those seen in pernicious anaemia. 4) Haematological features, anaemia and many of the clinical signs of the syndrome were improved after appropriate iron therapy. 5) Histological changes of gastric mucosa improved, in 5 patients, 6 months after correction of the anaemia.


Bilateral stenosis of the internal carotid artery, associated with aneurysm of the basilar trunk. 1) A case of bilateral stenosis of the internal carotid artery with aneurysm of basilar trunk is reported. 2) Via femoral angiography confirmed the diagnosis which is strongly recommended in diagnosing such cases. 3) No surgical treatment is considered. 4) No similar case has been reported in literature.


Foreign bodies of the tracheobronchial tree and esophagus. Report of 850 cases of foreign bodies in the air and food passages is presented. The incidence of the accident was more in children between the age of 1-6 years than others. No sex difference was noted for the incidence of the accident. The presence of leech as a foreign body in this report is of interest. General anesthesia is recommended in the case that foreign bodies are present in the air way of children. In these cases bronchoscopy with oxygenation by insulfation in brochoscope or Ventury 50 or other similar techniques is recommended.


Incidence of phobias in Iranian psychiatric patients. During 1972 a study was undertaken in Roozbeh Mental Hospital of Tehran University to investigate the prevalence of phobias among the patients suffering from one type or another of mental disorders. It was found that about 10 percent of the total patients visited in the hospital were suffering from phobia. Moreover, darkness, corpse, crowd, pet animals, fear from cancer and syphilis accounted for 79% of the most common phobias, among the 655 recorded cases.


[Genetic control in the mouse].

[Genetic control in the mouse]. Spontaneous mutations and environmental variations are responsible for the biological instability of inbred strains of mice. As far as possible, all external factors should be kept constant in a modern animal house. Several techniques to analyse part of the genome are available. Due to this limitation, it would be useful to have several laboratories participating to the genetic control.


Feline congenital erythropoietic porphyria associated with severe anemia and renal disease. Clinical, morphologic, and biochemical studies. A feline erythropoietic porphyria was studied in an affected female Siamese cat and 2 male offspring. The principal elevated porphyrins were Type I isomers of uroporphyrin and coproporphyrin; the porphyrin precursors, porphobilinogen and sigma-aminolevulinic acid, were also detected. Porphyrins were present in the blood and in all the viscera, teeth, bones, and excreta. There was severe macrocytic hypochromic anemia, hepatomegaly, splenomegaly, and uremia associated with a renal disease characterized by mesangial hypercellularity and proliferation (resulting in narrowing of glomerular capillaries) and ischemic tubular injury. There was thickening of tubular basement membranes and tubular epithelial lipidosis, degeneration, and necrosis. Electron microscopic studies of bone marrow and kidney revealed the presence of membrane-enclosed lamellar bodies 150 to 1000 nm in diameter in cytoplasmic and extracellular locations.


Irreversible myocardial injury in anoxic perfused rat hearts. Isolated rat hearts were perfused at 37 C on a double reservoir, nonrecirculating Langendorff apparatus. For aerobic perfusion, Krebs-Henseleit medium containing 10 mM glucose was gassed with 95% O2-5% CO2; for anoxic perfusion, glucose was replaced with 10 mM mannitol, a nonmetabolizable substrate, and the medium was equilibrated with 95% N2-5% CO2. Heart effluent was serially collected during perfusion for creatine phosphokinase activity (CPK) analysis. Fixation was with 1% glutaraldehyde for morphologic studies. With aerobic control perfusion, hearts continued contracting, released no CPK, and were morphologically normal by light and electron microscopy examination after 120 minutes. With anoxic perfusion, contractions soon ceased, and by 60 minutes a sustained slow release of CPK was first observed. By electron microscopy, cells at 60 or 90 minutes were swollen and contained amorphous matrix densities in mitochondria; a few cells showed breaks in cell plasma membrane. When anoxic hearts were challenged with reoxygenation, there was a sudden change in color to a pale opaque appearance, CPK was rapidly released, and there was massive cellular swelling. By electron microscopy, damaged cells showed contraction bands, clumping of nuclear chromatin, both amorphous densities and granular dense bodies in mitochondria, and prominent disruptions of cell plasma membranes. The number of damaged cells observed increased as a linear function of time between 30 and 55 minutes of anoxia. The results show that anoxic perfusion in vitro produces irreversible myocardial injury and that this injury is closely associated with loss of cell volume control, release of intracellular enzymes, and striking structural defects in the plasma membrane of the sarcolemma. Reoxygenation accelerates the development of lesions in irreversibly injured cells but protects reversibly injured cells.


The relationship of actin and myosin filaments within myocardial zonal lesions. Cross sections, including serial sections, of myocardial zonal lesions in right vetricular papillary muscles of cats subjected to hypovolemic shock were examined by electron microscopy. It was determined that the basic structure of A and I bands was retained even in severe zonal lesions with herniation of A and I bands through the intercalated disc into adjacent myocytes. The herniated A and I bands, together with accompanying mitochondria, were enclosed in membranes, apparently the unspecialized portion of the intercalated disc. Since the longitudinal orientation of myofilaments is retained in zonal lesions, this study indicates that intact A and I bands must slide past one another during the supercontraction of sarcomeres which is characteristic of zonal lesions. This study also presents evidence that the nexus may become involved in zonal lesions.


Mast cell phagocytosis of red blood cells. The prevalence of mast cells infiltrating bone marrow of different rats varied widely, as did the staining properties and size of their cytoplasmic granules. Bone marrow mast cells from several rats revealed large membrane-limited inclusions which stained metachromatically or orthochromatically and resembled inclusions in some macrophages. Ultrastructurally, mast cells varied widely in content of uniform dense granules or enlarged granules with less dense, fine grained content. Some of the large inclusions observed ultrastructurally in mast cells were heterophagic vacuoles which contained erythrocytes or reticulocytes, or remnants from other phagocytized cells, possibly neutrophils or unidentified homogeneous material. Smaller bodies, interpreted as fragments of erythrocytes, lay extracellularly near mast cells and occupied small, membrane-limited, heterophagic vacuoles in some mast cells. In other mast cells, communal vacuoles enclosed several specific cytoplasmic granules in various stages of disruption. The communal vacuoles occasionally opened to the extracellular space. A few large indeterminate vacuoles in mast cells contained amorphous flocculent matter which apparently derived either from coalescence of cytoplasmic granules through fusion of granule membranes or from endocytosis.


[Pseudo-tumoral lesions of dense conjuntival tissue. Attempt at pathogenic interpretation]. The histogenesis of pseudotumors of dense connective tissue has been studied. These lesions may be classified as mucoid (synovial cyst and periungueal myxoma), collagenous (desmoid tumor, desmoid fibroblastoma and fibromatosis colli), elastic (elastofibroma dorsi), cellular (fibroblastic: fibromatosis, fasciitis and myositis; histiocytic: giant-cell tumor of tendon sheath, fibrous histiocytoma and atypical fibroxanthoma), metaplastic (ossifying fasciitis, ossifying myositis and juvenile chondroid fibroma) and hamartomatous nature (fibrous hamartoma). It must be emphasized that these lesions show a variable and polymorphouse cellular composition and then can simulate sarcoma.


[Puttman-Reye syndrome and ekiri. Neuro-anatomical study and attempt at classification]. The authors report two cases of Puttman Reye syndrome: one, classical, involving a young child with a fatal encephalopathy with visceral fatty infiltration, the other, less typical, not showing any signs of visceral fatty degeneration. Both cases were subjected to complete anatomical examination of the brain, revealing marked cerebral oedema, in localised areas or in a laminar distribution, with degenerative changes in the neurones and slight demyelinisation. The authors, on the basis both on the classical appearances of the first case as well as the atypical features of the second, envisage a clinical, anatomical and biological link between the Puttman-Reye syndrome,. Thai encephalopathy and Ekiri, which they consider to represent a single entity.


[Ultrastructure of a sacral chordoma].

[Ultrastructure of a sacral chordoma]. The ultrastructural findings in a sacrococcygeal chordoma are presented. The tumor cells showed various types of vacuoles. The presence of two types of membrane-bound dense bodies and an intracellular fibrillar material were other striking features of the tumor. Most of the present findings are in agreement with other studies and suggest a double differentiation of the tumor cells, epithelial and mesenchymatous. It is believed that the extracellular substance forming the tumor matrix is produced by mature tumor cells. Despite the pleomorphism and the variation of cell components, it is suggested that the stellate, intermediate and physaliferous cells, constitute the same cell at different stages of maturation.


[Distribution of volatile fatty acids in digestive tract contents of rabbit. I.--Rabbits fed with lucern and oat (author's transl)]. The distribution of volatile fatty acids (VFA) in digestive tract contents of Rabbits was studied using gas chromatography. VFA concentration in the posterior zones of the digestive tract were very high and comparable to values for ruminants. The distribution of the three principal VFA was different from that found in polygastric as well as monogastric animals. In Rabbits, butyrate concentration is higher than that of propionate. A selective absorption of butyrate, resembling an active transport, has been shown in the colon.


[Distribution of volatile fatty acids in digestive tract contents of rabbit. II.--Rabbits subjected to fasting (author's transl)]. Volatile fatty acids (VFA) were measured by gas chromatography in the digestive material of Rabbits subjected to:--alimentary fast for 48 hours;--stercoral fast for 96 hours. A 48 hour alimentary fast caused a substantial drop in VFA in the digestive tract, butyric acid was the most affected, its concentration falling below that of propionate. Fasting for 48 hours did not cause a total cessation of fermentation. Stercoral fasting did not diminish the quantity of VFA in the digestive tract. VFA production was even augmented in the posterior parts (caecum and colon).


[Toxicity of ochratoxin A. II.--Effects of treatment on the progeny (F1 and F2) of intoxicated rats (author's transl)]. A group of pregnant rats is given a total of 5 mg/kg of ochratoxin A orally for two (lot A) and four (lot B) days. Treatment begins at day 8 post coitum for both lots. The progeny of these females are recorded and studied (F1 and F2). A description of litter size and ponderal growth of F1 individuals shows the results of the effects of the treatment of the mothers on this generation: reduced litters and late growth. Moreover, there is a high proportion of hydrocephalus which affects only the males. Finally, no effect was observed on F2 animals.


[A loop technique for permanent exteriorization of bile flow in rats (author's transl)]. A technique of chronic deviation of the bile flow without affecting either hepatic or pancreatic function is described in the rat. Two silastic tubes are inserted into the bile duct via a single incision, one directed towards the liver and the other towards the duodenum. Using a trocar, the two tubes are brought forward subcutaneously, exteriorized over the frontal region and connected by a polythene U-tube. They are encased in a plastic cylinder firmly fixed to the skull with dental cement, and fitted with a cap. This permits repeated sampling and simultaneous measurement of flow and pressure of bile in unrestrained animals for a least one month. The entero-hepatic bile salt cycle and the animal's weight are unmodified by this procedure.


[Contribution to the antigenic study of influenza viruses in animals. II.--Antibodies, antineuraminidase in horse: conditions of apparition and importance (author's transl)]. In the first part of this paper the conditions for a specific titration of antibodies against the neuraminidase (N) of each of the two horse virus subtypes are defined. The antigens used are: the H72Neq 1 recombining agent to measure the anti Neq1 antibodies and the A/Duck/Ukraine/63 strain for the anti Neq2 antibodies. The immunity response to neuraminidase appears after the natural disease; this response is studied in two foci, one due to a virus belonging to the A equi I subtype (Loire 73 strain), the other to a virus of the A equi 2 subtype (SHN 73 strain). The kinetics of apparition of anti N antibodies is mostly comparable to that of antihemagglutinin antibodies. The vaccination also induces an immunity response to neuraminidase: the intensity of this response gives an additional information for studying and checking the efficiency of equine i influenza vaccines.


[The nature and importance of weight loss during restraint stress in the growing rat (author's transl)]. From general considerations on pig farming, we have noted the experimental advantage presented by the analogy between the pig and the rat concerning the reaction to restraint stress. This sort of stress undergone during transportation results in an appreciable increase in the weight loss in pigs and the purpose of this study was to show that the same applies to the rat. By direct weighing in one hand by measurement of the gaseous exchanges between the animal and its surroundings atmosphere in the other hand, we observed an increase of about 45 p. 100 in the weight loss after 3 hours restraint. 80-90 p. 100 was due to the cutaneous and respiratory emission of water vapor, the remainder was due to the difference between the weight of carbonic gas expired and that of oxygen inspired. Over a 7-hour period of stress the intake of oxygen increased by 60 p. 100 whereas the respiratory quotient decreased more rapidly than in rats not restrained. These results are discussed with relation to the various metabolism involved in stress reaction.


[Intra-ungual linear opacities in psoriasis. Apropos of 10 cases]. Out of 145 patients with psoriasis, the authors observed in 10 cases linear opacities within the nails. They were not found in 128 controls of the same age. The routine was of X-ray films without a screen permitted their demonstration. These radio-opaque lines found in psoriasis may be the result of topical substances applied to the keratin of the psoriatic nail.


[Hepato-erythrocytic porphyria. A new type of porphyria]. A case of porphyria with symptomatology beginning in early infancy with peculiar biochemical features is described. There were crops of blisters, an extraordinary hypertrichosis and scarring of the exposed skin. The porphyrin examination showed an abnormal excretion pattern of urinary porphyrins with large amounts of 5-COOH carboxyle porphyrins and the protoporphyrin level of the red cells was raised. There was fluorescence of the erythrocytes and erythroblasts. The porphyrin excretion pattern of the stools was similar to those of the PCT. This case is closely similar to another published by the authors in 1969 and to 2 published by Schneider and Simon. The authors consider that could represent a new type of porphyria.


[Structure and pathogenic interpretation. Acquired dystrophies of the hair]. The size and form of a segment of a hair are two relatively constant parameters. Their homeostasis reflects precise regulation of the size and form of the matrix (therefore of the papilla), of the proportion of cells normally involved in the cycle of cell division and of the duration of this cycle and of the increase in the average volume of cells during differentiation. Any disturbance in this precise pattern causes dystrophies. Some of these acquired abnormalities in hair structure have been examined by scanning electron microscopy. Two malformations arising from indentation of the papilla were compared: pili gemini and pagothrix. Their cuticular organisation does not appear to be impaired and remains independent of the fusion and separation of the hair shafts. In addition to these dystrophies due to abnormal formation of the matrix, there are other malformations, bayonet hair and the Pohl-Beau line, which are secondary to temporary disturbances in other volumetric control parameters. Their pathogeny appears similar and their varying aspect is the result of graduated cellular response to the inductor. The structure of the cuticlar of these hairs varies according to their volume: a narrow segment shows a corresponding decrease in the free surface of the cuticular cells; on the other hand, an increase in the volume of the hair causes less overlapping of cuticle cells. The hair generally breaks where there is constriction. These fractures are transversal due to concentration of normal constraint and resemble trichoclasia or trichoschisis in normal or peladic hair. They never occur in the form of a trichoptilosis affecting normal or permed hair.


[Cutaneous manifestations of chronic atrophic polychondritis and their relation to aphtosis]. A young woman aged 23 showed the clinical feature of relapsing polychondritis. This disease included recurrent inflammation of right ear, nasal rib and larynx cartilages. She had also arthritis of ankle and wrist. She never had aphtosis before her cartilaginous disease. Buccal and genital erosions similar to aphtae occurred before each recurrent attack of cartilage inflammation. In one instance aseptic vesiculo-pustular and erythema nodosum like lesions occurred. This case raises the question of whether this is a never reported association of two diseases or relapsing polychondritis may have dermatological symptoms bordering aphtosis. The latter hypothesis is supported: firstly by the fact that skin symptoms of aphtosis had been reported separately in cases of relapsing polychondritis (buccal aphtae, pustular eruption, erythema nodosum, recurrent thrombophlebitis); secondly by a case very similar to our (Thivolet, see text) showing a typical feature of relapsing polychondritis with a complete dermatological aspect of aphtosis.


[Dynamic telethermography in dermatology]. Dynamic telethermography permits direct observation of the emission of infrared rays from the skin of the human body. A certain number of dermatological diseases are liable to modify this emission and then show more or less localised hypo- or hyperthermia, e. g. malignant melanomas which represent the best indication for this new means of paraclinical investigation which has the advantage of being strictly atraumatic. The other black tumours of the skin, the skin carcinomas, certain hematodermias, cutaneous metastases and pre-cancerous conditions, radiotherapy lesions and burns, and hemangiomas may also benefit from this method. In fact, the latter may give some information on their degree of spread and their extension and response to treatment.


[Migrant eruptions in lupus erythematosus. Apropos of a case of lupus erythematosis gyratus repens]. Rare cases of migrant circinated eruptions occurring during the course of lupus erythematosus have been published so far. They have been classified in two categories: 1) supposed toxicodermias due to antimalarials; 2) real cases of erythema annulare centrifugum, mostly inaugurating the L. E. In an exceptional case, a migrating eruption looking like an erythema annulare with a complicated pattern on the trunk, neck and limbs, took place between two rashes of typical L.E. The exact nature of this eruption, clinically and histologically atypical, and its relation with the L.E. itself, have been discussed.


[Interdigital spinocellular epitheliomas of the foot]. The authors draw attention to the relative commonness of spinocellular epitheliomas located in the 4th and 3rd interdigital spaces of the feet. These epitheliomas, 22 cases in 19 patients, occur chiefly in women (12 cases) and in agricultural workers, secondary to lesions of intertrigo and of "soft corns" present for 2 to 20 years. The principal aetiological factor seems to be continual maceration due to the use of rubber boots, rather than trauma. With this in mind, particular attention should be paid to chronic interdigital lesions of the feet, with the use of wide deep biopsies.


[Kaposi's disease. Ultrastructural study of 4 cases]. An ultrastructural study of Kaposi's disease showed often immature vascular proliferation bordered by large globular or fusiform endothelial cells. Other cell types participated in this proliferation: inflammatory cells, pericytes and fibroblasts. These various cell types are the site of active erythrophagocytosis. It is reasonable to accept that the disease is the result of reticulo-endothelial proliferation with multiple morphological types and predominant vascular differentiation.


[Plasmacytic reticulosis].

[Plasmacytic reticulosis]. The authors observed one case of plasmocytic reticulosis which was noticable by its strictly left unilateral localisation, involving the face, the underscapular region, the shoulder and the elbow, the leg with an important augmentation of the left foot. Histologically, dense plasmocytic infiltration can be observed without anomalies. Electron microscopy confirmes the presence of plasmocytes at any stage of activity without monstruosities. This observation can not be classified in the forms that are actually described: Klüken's and Simonis' plasmocytic reticulosis, plasmocytomas with osseous and medullar lesions, extramedullar plasmocytoma.


[Geographic lip and folded lip. A new association]. In a typical case of geographical lip, the authors discovered the presence of parallel vertical grooves on the mucosal side of the lips and believe these are similar to those observed in folded tongue. They concluded that there is a possible association "geographical lip and folded lip", comparable with the association "geographical tongue and folded tongue". They then carried out a histological study and proposed an etiopathogenic explanation for the folds in the lip in comparison with the fissures of the tongue, dysembryoplasia due to heterotopy of the gustatory or lymphopoietic grooves.


[Antileukocyte antibodies. Synthetic review and experimental data]. An account is given about the results of investigations carried out in repeatedly transfused patients. We observed an increased presence of the antileucocyte antibodies in relation to the repeatedly transfused patients. The work was extended also to the repeatedly pregnancies; in this research it was also observed a sensibly increased presence of the antileucocyte antibodies in relation with the number of the pregnancies.


[Studies on enzymes (transaminases, OCT) and Au Antigen in infectious hepatitis]. The Authors, after reviewing the problem of Au antigen, recalling the numerous theories thereabout, making reference to the sure datum that the blood containing Au antigen is infecting, and that the Au antigen is synthesized in liver, report the data of laboratory remarked in some epidemic episodes of infectious hepatitis. Besides the Au antigen, 2 enzymes were compared (transaminase and OCT), as liver is particulary rich in enzymes in comparison to other organs: the glutamico-oxalacetic and glutamico-piruvic transaminase in cytoplasmic seat and ornithine-carbamyl-transferase in mitocondrial seat; such enzymes shoud also have a specific meaning and indicate precociousness. From the study of the different episodes, and particularly from the 82 cases resulting positive with one, two or three parameters, they draw the conclusions that the research of the three parameters proved useful from the epidemiologic standpoint, as well as for prevention and timely diagnosis according to the conception of investigations in theme of public health.


[Unusual reaction in an adult after revaccination against smallpox]. The Author explains some anomalous reactions in adult, after revaccination smallpox, represented by delay in the loss of the crust and in the lack of the cicatrice.


[Case of autochthonous subcutaneous dirofilariasis in man]. An autochthonous case of dirofilaria infection observed in Italy is described. The parasite was an unidentified species of dirofilaria removed from a subcutaneous nodule of a patient. The most recent data about epidemiology and geographical distribution of the parasite in Italy are briefly discussed.


[Characteristics of various NAG vibriones isolated in Italy]. In this paper are reported the results of a comparative study of 4 "NAG" vibrio strains isolated in Italy and the vibrio biotype "E1 Tor" responsible of the 1973 outbreak. The "NAG" vibrios were practically identical with the "E1 Tor" vibrio in biochemical properties, polypeptide composition, enteritogenic activity in rabbit ileal loops and showed various antigenic similarities in gel precipitation and indirect immunofluorescence tests. The possible pathogenic role of the "NAG" vibrios is briefly discussed.


[Strains of Salmonellae isolated at the District Laboratory for Hygiene and Prevention in Verona from 1966 to 1974: identification of various rare strains]. The Authors have reported the isolation of stocks of Salmonellae from 1966 to 1974 in the District Laboratory for Health and Prophylaxis of Verona, remarking a higher frequency in the latest period and a larger range of types than in the past, as a demonstration of the formerly remarked greater diffusion of such germs, which may be due to the type of food, increase in ill animals, touring exchanges between the different countries, and also import of foodstuffs from foreign countries. The Authors, moreover, point out the presence of rarer stocks, such as S. takoradi and S. saint paul isolated from coprocultures; S. agbeni isolated from a zootechnic fodder is a very rare stock, and seems to be the first isolated in Italy, according to the typing done by the Upper Institute for Health.


Polypeptide analysis of a "Leishmania donovani" strain isolated during an outbreak of visceral leishmaniasis in northern Italy. The results of the analysis of the polypeptide composition of a strain of Leishmania donovani isolated during an outbreak of kala azar in northern Italy are reported.


[Neonatal hypotonias with congenital disproportion of various types of muscular fiber, especially type I fibers. Demonstration of the familial character of this new entity]. Two sisters presenting with benign congenital hypotonia are reported. In both cases the muscle biopsies demonstrated the same pathological pattern, consisting in an abnormal size disproportion between the two main cytoenzymological types of muscle fibers. Their father, exhibiting a slight and diffuse muscle weakness, showed a closely related histological aspect. These three cases bring the first evidence of a familial transmission of this new entity. Its relationship with the other types of "congenital myopathies" is discussed.


[Hydranencephaly. Major cerebral lesions with normal neonatal neurologic behavior]. Case report of an 8 days old girl who had a discrete increase in head circumference associated with moderate EEG abnormalities. Familial and obstetrical histories were negative. Skull transillumination, contrast ventriculography and carotid arteriography led to the diagnosis of hydranencephaly. The cerebral lobes whose blood supply is dependent from the internal carotids were missing and were replaced by cavities. The normal neonatal neurological behaviour which did not change till death at 3 months, is a stiking phenomenon.


[Plasma estorgens and testosterone in the normal young girl before and during puberty]. Base levels of estrone (E1), estradiol-17-beta (E2) and testosterone (T) were measured by radio-immunoassay. Results were classified according to the stages of puberty (Tanner scale) in 89 normal girls ranging from 1 to 22 years of age. Fourty-three pathological cases were studied. In 22 cases of ovarian agenesis E2 and T were most often low. In 7 cases of isolated breast prococity, 4 cases of isolated pilous precocity, one case of isolated genital hemorrhage and 5 cases of hypopituitarism, E1, E2 and T levels were similar to those of impuberal girls. Levels of oestrogens were increased in 4 cases of true precocious puberty.


[Radioimmunologic determination of thyroxine in dried blood taken on blotting paper. Application ot neonaltal detection of hypothyroidism]. A blotting paper technique may be used for mass screening of neonates for hypothyroidism. The discovery of hypothyroidism in a newborn who did not have any of the classical clinical or radiological features of the condition, is reported in support of the value of the proposed method.


Improved deformability of crenated red cells in hyperosmolar human blood by adenosine. Under hyperosmolar conditions the flow properties of fresh human blood and erythrocytes are markedly impaired. This can be demonstrated in-vitro using a standardized microrheological 8 mum-filter system.-After the addition of small doses of adenosine to human hyperosmolar blood and subsequent incubation, the impaired flow properties of the red cells could be significantly improved. The flow of erythrocytes through the 8 mum capillaries within a given time was increased as compared to the control (blanks). From these results we must assume that the increased ATP-level in the erythrocytes reduces the hyperosmolar alteration of the red cell membrane after the adenosine incubation. These results show, that the flow properties of fresh human red cells can be improved biochemically.


Effect of low molecular dextran on the microrheological properties of erythrocytes. The beneficial effect of low molecular dextran (Rheomacrodex) on the impaired micro-circulation was said to be the consequence of a decrease in the viscosity of blood due to hemodilution. In the present paper we report about the role of low molecular dextran on the flow properties of erythrocytes in-vitro. Blood samples of healthy volunteers were introduced in a standardized 8 mum-filter system and the flow rate through these filters was measured. Additional rheological measurements were performed simultaneously. In other blood samples different parts of the plasma were replaced by a iso-osmolar, iso-oncotic and iso-viscous Rheomacrodex solution. It was clear visible that the number of erythrocytes flowing through the 8 mum-filter within a given time had markedly increased when low molecular weight dextran was present in the suspension medium. Even when the equal parts of the natural plasma was replaced by undiluted 10% Rheomacrodex solution the filtration of erythrocytes had significantly increased, inspite of the higher viscosity of the whole blood compared to the blanks.- We are certain that this new microcirculatory effect is the consequence of an increased deformability of the red cells. The theoretical and clinical significance of these results have been discussed.


Critical diffusion ranges for oxygen and glucose in tumor tissue considering Michaelis-Menten kinetics. The supply conditions for O2 and glucose in tumor tissue distinctly deteriorate with increasing tumor mass. As a result retardation in growth, lysis and necrosis take place because critical diffusion ranges are partially surpassed in heavier tumors. Applying in vivo-data to a special analogue computer it is possible to investigate the supply conditions including the range of very low O2 tensions and glucose concentrations. Using a definite arrangement of blood vessels it can be shown that the supply conditions only for one of the limiting substrates, i.e. for O2, are better than assumed hitherto. However, even the more realistic model reveals that regional failure in glucose and O2 obligatorily occurs during tumor cell proliferation.


Lymphokine 'skin reactive factor' (SRF) and the nephrotic syndrome. Lymphocytes from N.S. patients, in culture and stimulated by PHA or Con A, release a lymphokine which increases vascular permeability; this factor is not present in normal subject and in control supernatants. Pharmacological and biological properties of this factor are similar to the guinea pig S.R.F. (PICK, TURK, MAILLARD). Modifications observed with meclofenamate, DTTC and addition of N.H.S. suggest that it could be an activator of the kinin system. Physicochemical studies show that it is a protein migrating as albumin. We have also recently demonstrated (unpublished data) the relationship of this factor with proteinuria: injections of active supernatants in rats renal artery is immediately followed by increase in proteinuria from 0,8 mg/h to 3,5 mg/h. Up to date, lymphokines have been studied in animals but seldom in human. Our results show that in human, variations in lymphokine production may be present. Pathogenic implications are now under study.


Cyclical shock with hyperglobulinemia.

Cyclical shock with hyperglobulinemia. Two personal cases are compared with CLARKSON's case, enabling one to describe a syndrome arising in adults without a family history, and characterised by episodes of repeated shock (cyclical shock) with hemoconcentration and hypoproteinemia. The physiopathological mechanism is an acute hyperpermeability. Two cases out of three took a fatal course, with a negative autopsy. In the three cases, the presence of light kappa chain IgG type monoclonal dysglobulinemia was proven. The diagnosis of multiple myeloma can be excluded. Comparison of this syndrome with periodic disease and primary amyloidosis can be envisaged.


Influence of surface-active substances on the flow properties of hyperosmolar blood. Hypertoneous (hyperosmolar) conditions of human blood are known to increase the viscosity of blood and to decrease the deformability of red blood cells. Due to the dehydration of the erythrocytes, their shape is crenated and their passage through smallest capillaries is impaired. The data presented here shows that the addition of small concentration of surface active drugs to hyperosmolar blood samples is able to reduce both, blood viscosity and the rigidity of red cells. Measurements have been performed by several rheological and by a microrheological 8 mum-filter system. This new phenomen seems to be of theoretical and clinical interest.


Distribution of 67Ga in organs of mice with lymphoid leukaemia. Distribution of 67Ga in different organs of A/H mice bearing a lymphatic leukaemia was examined. Mice received 10(6) leukaemia cells intravenously and groups of 6 mice were sacrificed every other day. Twenty-four hours before sacrifice, the mice received intraperitoneal injection of 67Ga. Spleen, lymph nodes, liver, left kidney, lung, left femur, and a sample of blood were taken, to determine their radioactivity. The maximum of 67Ga uptake was on the 7th day after transplantation of the leukaemia, whereas before death it declined to the values observed in control mice without leukaemia. The changes are interpreted in terms of the ability of leukaemia cells and of macrophages to bind 67Ga.


Effect of uninephrectomy on tissue kallicrein concentration of the remaining kidney. Compensatory renal hypertrophy has been induced in rats by uninephrectomy. Tissue kallicrein concentration of the remaining kidney was evaluated 5, 10, 15 and 20 days after operation. The previously removed kidneys were used as controls. In the hypertrophic kidney the kallicrein increases progressively up to 20 days after uninephrectomy. Since kallicrein generates kinins, potent vasodilators, it is suggested that the increase in renal blood flow observed after uninephrectomy might be promoted by an overproduction of kinins.


Arginase activity of human erythrocyte ghosts in uremia. Arginase activity of erythrocyte membrane fragments has been determined in normal subjects and in two groups of uremic patients: 1) those having a blood urea concentration of 100 mgm/100 ml or higher and with an elevated erythrocyte sodium concentration and 2) patients with a blood urea concentration of 100 mgm/100 ml and higher and a normal erythrocyte sodium concentration. No statistically significant difference was detected between the normal subjects and the uremic patients. It is concluded, therefore, that the effect of uremia on the magnesium dependant, Na and K activated adenosine triphosphatase of erythrocyte membranes is not applicable to all enzymes of the erythrocyte.


[Repeated extracorporeal irradiation of rabbit blood (RECIB). Effect on lymphocytes]. Haemotological data are described after repetitive extracorporeal irradiation of blood (RECIB) is rabbits for two hours a day, five days a week. Cesium 137 can deliver 125000 rads/hour, i.e. a cummulative dose equivallent to 1.25 X 10(6) rads/week. The blood lymphocytes were investigated in detail, lymphopenia was obtained after 15 days and remain stable after the third week.


Improved serum lipoprotein electrophoresis procedure in polyacrylamide gradient gel. A method based based upon polyacrylamide gradient gel for the electrophoretic separation of lipoproteins prestained with the diformazan of nitroblue tetrazolium is described and evaluated. It gives accurate characterization of the different lipoproteins, good separation between chylomicrons and very low density lipoproteins and can be also applied to the diagnosis of type III hyperlipoproteinemia without need for ultracentrifugation.


Delayed hypersensitivity to mono-azobenzene-arsonate-N-acetyl-L-tyrosine. I. Induction of cellular sensitivity in the rat. In the guinea pig, mono-ABA-Tyrosone (ABA-Tyr) has been extensively studied as a hapten capable of inducing delayed type hypersensitivity in the absence of circulating antibodies. This model has been extented to the rat, and cellular sensitivity has been assessed both "in vivo" (skin reaction) and "in vitro" (cellular proliferation and lymphocyte migration inhibition). All the reactions studied follow a reproducible pattern with maximal positivity between 4 and 13 days, and negative responses after 20 days. Circulating antibodies were not detectable at any period after immunization. In view of the original properties of ABA-Tyr, and of the advantage of the rat as an experimental animal, the proposed model can be expected to facilitate further studies on the cellular mechanisms of delayed hypersensitivity.


Distinction between hereditary and acquired angioneurotic oedema according to the complement system. It is often impossible to make a clinical distinction between acquired and hereditary acute angioneurotic oedema. Investigation of the complement system is indispensable for this diagnosis to be established. The value of total complement and C4 and C2 are lowered in the sera in the hereditary form (44 cases) and normal in the acquired type (68 cases). The use of tests for the activation of C1 esterase "in vitro" is useful to distinguish these two types of oedema as has been demonstrated by the formal measurement of C1 esterase inhibitor.


A new beta-chain variant in human milk.

A new beta-chain variant in human milk. Investigation on the genetic polymorphism of human casein at the population level resulted in the identification of a new variant within the beta-casein system. This discovery throws new light on the type of genetic control applicable to beta-casein.


Fluctuation of 5-hydroxy-indole compounds in the urine of migrainous patients. In 14 migrainous patients during different clinical phases the urinary excretion of 5-hydroxy-tryptamine (5-HT) and its main metabolite, 5-hydroxyindoleacetic acid (5-HIAA) were followed. In the course of headache attack a significant increase in 5-HIAA excretion rate was found; at the same time the excretion of 5-HT was not significantly changed. After migraine attack a very pronounced lowering in excretion rate of both 5-hydroxy-indoles occured. The reserpine provocation test was followed by an intensive enhancement of urinary 5-hydroxyindole excretion, but the decrease thereafter was less expressed than after spontaneous attack. These findings lend support to the theory of an abrupt fall in total plasma 5-HT as a trigger mechanism for the painful phase of migraine.


Putrescine shortens the S-period in human fibroblasts. Previous results have indicated that addition of putrescine to cultures of human fibroblasts stimulates cell proliferation. It is shown in the present paper that this is mainly due to a shorteining of the cell cycle. In the presence of added putrescine the cell cycle was 4 hours shorter than in the control. This result was obtained both from analyzing the fraction of labeled mitoses (FLM) curves and from counting the mitoses in synchronous cultures. The FLM curves further revealed that the shortening of the cell cycle was caused mainly by reduction in the length of the time required for DNA synthesis. It was about 30% shorter in the presence of added putrescine than in the control. The fact that addition of putrescine results in shortening of the S-period, and that this is to a great extent responsible for the increased rate of cell proliferation, distinguishes putrescine from other known growth factors.


Measurement of hepatic blood flow in the unanesthetized rabbit using 198Au and 125I Rose Bengal clearance technique. Hepatic blood flow was measured in the unanesthetized rabbit using the clearance technique of 198Au and 125I RB. The values are: 71.82 +/- 16.24 ml-min-1-kg-1 for 198Au, and 60.21+/-9.94 ml-min-1-kg-1 for 125I RB (P less than 0.01). The overestimation of HBF with colloidal gold is probably due to extra splanchnic sequestration which has been estimated to be 15+/-3%. The week extraction of RB limits the use of this dye for measurements of HBF. HBF is easier to measure with 198 Au.


Platinum electrode potentials and blood redox balance in the kidney during renal ischemia. Potentials recorded with a platinum electrode inserted in the cortex and in the medulla of the right kidney "in situ" were compared with the log (Pyruvate)/(Lactate) in the arterial blood and in the blood of the right renal vein, during clamping of the entire pedicle or the renal vein alone. There is no correlation between potentials and log (P)/(L) when the renal blood flow is unimpeded. The medullary potentials correlate with the log (P)/(L) in the renal vein at the time of the removal of the clamp after clamping of the renal vein alone. There is a close correlation between the changes of tissue potentials and the changes of log (P)/(L) in the renal vein between the initial values and values at the time of the removal of the clamp. Thus, it seems possible to estimate by continuous electrical recordings the state and variations of the oxido-reduction balance of a tissue "in vivo".


"In vitro" mucin biosynthesis by human gastric mucosa biopsies. A method is described for the study of the "in vitro" biosynthesis of mucins by human gastric biopsy samples. 14C-glucose was incorporated in the biopsies obtained from the fundus and antral regions of four normal human donors during a four hours incubation period. Labelled glycoproteins (mucins) were released in the medium and were also retained in the tissue-residue. Neutral sugars, fucose, protein and DNA determinations carried out on the tissue homogenates indicated that significant information on mucin biosynthesis can be obtained by this biopsy procedure which is particularly suitable for the exploration of gastric pathology.


Delayed hypersensitivity to mono-azobenzene arsonate-N-acetyl-L-tyrosine. II. An operational model in the mouse. Immunization of the mouse by free mono-ABA-Tyrosine (ABA-Tyr) in complete Freund's adjuvant leads to a specific sensitization. This can be assessed by increase in ear thickness after challenge with ABA-Protein conjugates. The intensity of the skin reaction is directly related to both the antigen dosage and the amount of BCG incorporated in the adjuvant. A close correlation has been shown between delayed skin reaction and "in vitro" lymphocyte proliferation in the presence of either ABA-Protein or free ABA-Tyr. In both "in vivo" and "in vitro" tests, sensitization is detectable from day 5 with a maximum on day 7. Contrasting with this strong cellular response, no antibody can be found. Thus, mouse sensitization with ABA-Tyr provides an operational model for pure cellular immunity. The extension of ABA-Tyr model to mouse may vacilitate the analysis of the involved cell populations.


[Change in rabbit blood lymphocyte count after repeated extracorporeal irradiation with cesium 137. Comparison of heparin and acenocoumarol effects]. During repetitive extracorporeal irradiation, heparin treatment is responsible for a very high lymphocytic peak which does not last more than two days. This peak is not observed after using acenocoumarol as anticoagulant. That is why the degree of lymphocyte depletion after RECIB is to be interpreted in function of the anticoagulant used. This peak is temporary. No matter the anticoagulant used, lymphopenia is obtained after 15 days. The level of lymphocytic depletion is independent of the initial lymphocytosis.


Plasma galactocerebrosides in multiple sclerosis. Plasma cerebrosides were examined in 12 cases of multiple sclerosis which were compared to normal controls and patients with cerebrovascular accidents. A screening was performed so as to select patients with levels above to normal by means of thin-layer chromatography of the lipid extract. Glucose seems to be the only hexose to be found normally in plasma cerebrosides. The presence of galactocerebrosides may be a biological test for demyelination, as their presence seems to be related to the evolutionary state of multiple sclerosis. In a severe cerebrovascular accident, galactocerebrosides were also found.


Effect of treatment with cyclophosphamide on the electrophoretic mobility and mitogen responsiveness of mouse thymus cells. Two days after a single intraperitoneal injection of cyclophosphamide (CY) in a dose of 300 mg/kg of body weight, the cellularity of the thymus from adult female CBA mice was reduced to 17% of its normal value. The electrophoretic mobility (EPM) analysis of the surviving cells revealed a decrease in the proportion of the slow-moving cells together with a significant diminution of their mean EPM. The proportion of fast-moving cells, which were shown to correspond to the hydrocortisone-resistant and mitogen-responsive pool of mature thymocytes, was correlatively increased by 2-3 fold. Despite this enrichment in cells with a high surface charge, the thymocytes from CY-treated mice exhibited a diminished reactivity "in vitro" to both concanavalin A and phytohemagglutinin. The possible significance of theses results is discussed with reference to the known mitostatic properties of CY.


Effects of exercise-induced stress on platelet aggregation. In order to determine if the stress of a standard exercise test will affect the propensity for platelets to aggregate, platelet aggregometer studies were performed before and after a double two-step Master's test in 19 patients with angina and in 19 normal controls. The response of platelet-rich plasma to 0.1, 1 and 10 muM of ADP and 1 and 10 muM of epinephrine were tested in a Chrono-Log aggregometer. Prior to exercise there was no significant difference between the number of patients and controls responding with irreversible aggregation to any of the five tests. Immediately following exercise, no significant differences in the number of irreversible aggregation responses were seen in the control group. In the group with coronary artery disease, the incidence of irreversible responses was significantly higher after exercise on test with 1 muM ADP (p less than 0.05), 1 muM epinephrine (p=0.02), and 10 muM epinephrine (p less than 0.05). It is concluded that exercise increases significantly the tendency of platelets to aggregate among patients with coronary artery disease. It is possible that this effect may play a role in myocardial infarction induced during stress.


Bigeminal ventricular tachycardia with Wenckebach exit block. A patient is presented in whom repeated attacks of ventricular tachycardia occurred. His last and fatal attack revealed an alternation or coupling of the cycle lengths of the ventricular beats. A large left ventricular wall aneurysm was found, which probably accounted for the unusual arrhythmias.


The effect of external pressure diastolic augmentation on regional myocardial perfusion in experimental myocardial infarction. The effect of external pressure diastolic augmentation on the distribution of coronary blood flow following coronary occlusion was studied in 36 dogs using radionuclide tagged macroaggregated albumin and an electromagnetic flow meter. Collateral flow, approximately 30% of normal flow immediately following occlusion, increased spontaneously by approximately 50% over the first 4 h. Two and 4 h of immediate, maximal external pressure diastolic augmentation resulted in only slightly greater mean increases in collateral flow than that which occurs spontaneously during the same time period. Reduction of the level or delay in onset of diastolic augmentation resulted in even less increase in collateral flow to the ischemic area. Mean coronary flow increased only 6% with external pressure diastolic augmentation. Since neither distribution of coronary blood flow nor total coronary blood flow was significantly altered by external pressure diastolic augmentation, this technique appears to be relatively ineffective in improving oxygen delivery to acutely ischemic myocardium in the dog.


Immediate haemodynamic effects of verapamil in man. The effect of the antiarrhythmic drug verapamil (Isoptin) on circulatory dynamics and myocardial contractility was studied in six patients in sinus rhythm: three patients were control subjects and three had underlying rheumatic valvular disease. The drug was given as an intravenous bolus (10 mg) and measurements made in the control state and repeated 1, 3, 5 and 10 min after administration of verapamil. Left ventricular (LV) systolic pressure fell by 18% 1 min after intravenous verapamil (p less than 0.01) and returned twoards the range of normal after 10 min. Heart rate increased and cardiac and stroke index were not altered 5 and 10 min after administration of the drug. Peak LVdp/dt and Vmax were reduced while LV end-diastolic pressure increased reflecting a decrease in LV contractility. The hemodynamic effects were similar in digitalised and nondigitalised patients.


Surgical management of acute subdural hematomas. Acute subdural hematoma, local cerebral laceration and severe brain edema must be diagnosed at the earliest possible stage preferably by angiography and must be treated promptly by craniectomy of an adequate size in order to cope with all the blood clot, the lacerated brain tissue and the swollen brain.


A complicated case of cortical deafness in a child. Overall motor retardation and clumsiness; bilateral pyramidal signs; extensor plantar responses; extra pyramidal symptoms; central hearing loss; perception disorders almost exclusively for linguistic items; diffuse E.E.G. abnormalities with focal maxima in both temporal regions.


Persistent posterior fossa ependymomas. Two case reports with unusual long survival. Two patients are described who survived respectively 33 and 21 years after partial surgical excision of a posterior fossa ependymoma and who at the time of autopsy were proven to harbor persistent tumour tissue in the same location.


Striato-nigral degeneration and Shy-Drager syndrome (idiopathic orthostatic hypotension). The present paper reports on a case which evolved clinically with a Parkinson syndrome and attacks of orthostatic hypotension. Dystrophic lesions were found in the substrantia nigra, putamen and autonomic bulbo-medullary axis. This case demonstrates that striato-nigral degeneration of the Adams, van Bogaert and van der Eecken type and the Shy-Drager syndrome (orthostatic hypotension with neurologic syndrome) are part of the same pathiologic entity respesenting nervous multisystem degeneration developing in the presenium.


Radioimmunoassay specific for amino (N) and carboxyl (C) terminal portion of parathyroid hormone. A radioimmunoassay specific for the amino (N) terminal portion of the parathyroid hormone (PTH) molecule (N-PTH radioimmunoassay) has been developed by iodinating synthetic 1-34bovine PTH (1-34bPTH) and using commercially available bPTH antiserum. A radioimmunoassay specific for the carboxyl (C) terminal (C-PTH radioimmunoassay) has been carried out by adding enough amount of 1-34bPTH to the PTH radioimmunoassay system. The data obtained from N- and C-PTH radioimmunoassay were compared with those obtained from the PTH radioimmunoassay. It was observed that plasma levels of N-PTH, indicating biologically active PTH, were only one 8th to 32th to those of PTH and those of C-PTH were almost equal to those of PTH. These data corresponded well with those reported previously by using the antiserum specific for each terminal of the PTH molecule from the other laboratory. The half life of plasma N-PTH and C-PTH determined following the removal of parathyroid adenoma was less than 10 min and about 45 min respectively. These data indicate that the N-PTH radioimmunoassay can be done by iodinating 1-34bPTH and using commercially available antiserum.


Responses of plasma insulin C-peptide and proinsulin-like components to glucose and glucagon in the pig. This study was undertaken to evaluate the relative contribution of insulin, proinsulin-like components (PLC) and C-peptide toward plasma levels of immuno reactive insulin (IRI) and C-peptide immunoreactivity (CPR) in the pig and to elucidate the mode of secretion of PLC in the early phase of insulin release. Following the intravenous glucose loads, the concomitant secretion of CPR with that of IRI occured rapidly and the maximum plasma level of IRI was observed at an earlier time than that of CPR. Following the intravenous glucagon injection, the maximum plasma levels of IRI and CPR were observed at the same time in the early phase. After the gel filtration of acid alcohol extracts of plasma in a fasted state, a very small amount of PLC and a small amount of C-peptide as well as a small amount of insulin were detected. The results obtained from the gel filtration of extracts revealed that the increased amounts in IRI and CPR after the injection of glucose or glucagon consisted mostly and respectively of insulin and C-peptide in the pig, because the concentration of PLC increased only slightly in the early phase. In fact, plasma levels of CPR and IRI were essentially and respectively paralleled to those of insulin and C-peptide which were assayed after the gel filtration of extracts. In addition, the slight elevation of PLC in the early phase after these stimulations indicated that PLC was elicited into blood circulation at the same time of the secretion of insulin and C-peptide.