[Application of laser rays in surgery (author's transl)]. Some years will have to pass, until there will be evidence, if the application of laser beam in surgery of breastcancer, melanomas or basaliomas will be justified and whether it will be possible or not to interrupt or reduce intraoperative tumor cellspread. As an increasing number of surgeons have started to use laser rays in these cases of illness, results of laser surgery and those of tradional methods could be compared in a couple of years. Possibly other indications for the use of laser than those we have worked out will be outlined in general surgery. Surgeons working with laser beam may discredit the method by putting the indication not rigorusly enough. Greatest care should be taken by everybody who starts working with laser rays. Collaboration with a technician is recommended.


[Cutting results by using the laser beam as a cutting tool (author's transl)]. Partial liver resections were carried out in pigs with a high power Neodym-YAG-laser. By variation of beam parameters different cutting characteristics were obtained and discussed.


[Chronic polyarthritis and erythema anulare centrifugum Darier]. A casuistic contribution considers possible aethiopathogenetic factors of an erythema anulare centrifugum Darrier in a 47 year-old female patient suffering from a seronegative rheumatoid arthritis. The course is traced until the erythema fades and disseminated leucoderma appears.


[Wound healing after surgery by laser, scalpel and thermocautery (author's transl)]. Laser-, thermocautery- and scalpelsurgery when compared in respect to their wound healing procedure have qualified as prepared for clinical application. On minipigs wound healing of skin scissions has been followed up morphologically in light microscopy and by testing the stress resistance of 16 days old scars. The fastest wound healing occurs after scalpel incision resulting in an almost perfect reconstruction of subepethelial tissue architecture at the 20th postoperative day. The initial tendency of laser incisions to dilate, which is still more pronounced in thermocautery wounds, causes a flat funnel shaped deformation of the scars, again more distinct after thermocautery. This is reflected in a still remaining slight disarrangement of the subepithelial collagenous fibres at the 20 postoperative day. Stress resistance is maximal in thermacautery scars, i. e. almost 30% higher than in scalpel and laser scars.


[Clinical picture of the Peutz-Jeghers syndrome and its therapeutic consequences (author's transl)]. Mucocutaneous pigmentation, intestinal polyps and familiar heredity are the 3 most important symptoms of the Peutz-Jeghers-syndrome. 5 own cases are reported. The risk of carcinomatous degeneration of the polyps is slightly increased. Endoscopic and radiologic control of these patients is necessary.


[Cryosurgical treatment of polypi of the rectum and colon (author's transl]. Single cases of genuine colon rectum polypi, histologically adenomatous, adeno-villous and villous tumours have been treated with cryosurgery. Relapses after polyectomy showing malignant degeneration; malignantly degenerated polypi, treatment of the basis of sessile lesions; sessile polypi up to 1 cm in diameter; extensive polyposis--polyposis of the rectum. After an initial regression of the polypous changes growth can be stated and quickly developing degenration leading to the formation of a carcinoma of the rectum and to stenoses of the lumen. It was only partially possible to clarify the cause of the growth in animal experiments. Primary application of low temperatures in polyposis recti and in primarily malignant degenerated polypi have to be avoided.


[Injuries of the ureter (author's transl)]. Topographic particularities relative to the distal course of the ureter which are important for surgery of the rectum are described based on preparations of 53 human beings of both sexes aged from 42 to 95 years. Places of possible injuries above and below the linea terminalis are characterized. The level of the lesion is decisive for reconstructive procedures of the ureter.


[Adjuvant properties of transfer factor preparations from human tonsillar lymphocytes]. Low molecular components (Mol. m below 10 000 dalton) of the extract prepared from the human tonsils lymphocytes produced an adjuvant effect on th formation of tuberculin sensitivity in guinea pigs immunized with BCG. This interspecies adjuvant effect was proportional to the dose  of the "transfer-factor" preparations administered, depended on the method of their preparation, was expressed in administration of the preparations simultaneously with the immunization, before it or after the tuberculin tests, and under definite conditions was replaced by the immunodepressive effect.


[Electron microscopic study of experimental infection. 1. A study of the dynamics of staphylococcal infection]. The dynamics of staphylococcus infection was studied in experimental infection of chick embryo fibroblasts with electron microscopy. It was shown that the antibiotic-resistant forms of staphylococci (strain 79) were capable of invading the fibroblast cytoplasm inducing its gradual vacuolization up to complete destruction.


[Effectiveness of revaccination against measles]. The authors studied the efficacy of measles revaccination in children in whose serum no specific antihemagglutinins were revealed in titration with 1 GAE antigen (the first group) and having no specific antibodies in titration with 4 GAE antigen (the second group). Investigations demonstrated that children in whose blood serum no measles antibodies were revealed in the presence of 1 GAE antigen were subject of vaccination. Repeated vaccination used at present in persons who produced minimal antibody concentrations in response to vaccination is not recommended.


[Anti-infective activity of anti-influenza antibodies from human colostrum]. Antibodies against influenza virus of A, B serological types and PC-virus were detected in the colostrum collected after an epidemic. These antibodies belonged to the secretory IgA form. The secretory antibodies preparation made of colostrum, and its IgA fraction instilled intransally to mice and rats prevented the development of infection caused by 100--10 ID50/0.1 ml of the influenza A virus. The protective action of the antibodies of IgA class was due to its capacity to become fixed on the surface of the cells of the mucosal epithelium of the respiratory tract.


[Classification of Leptospira isolated in Peru]. Antigenic properties of 23 leptospira cultures isolated in Peru were studied by immunological absorption. Two new individual leptospira serovars were classified as huanuco with a reference strain M-4, representing a new Huanuco serological group, and san-martini with a reference strain CT-63 belonging to the Hebdomadis serological group. Besides for the first time in the American part of the world serovar budapest belonging to Icterohaemorrhagiae serological group was recorded; also the first finding of serovar pyrogenes of the pyrogenes serological group was certified.


[Serological method of detecting antirabies antibodies]. The possibility of the determination of rabies antibodies by the serological method has been demonstrated, involving the use of culture rabies virus, strain Vnukovo-32, concentrated and purified by high speed centrifugation, for the sensitization of anserine erythrocytes. The neutralization test in mice and the passive hemagglutination test showed a correlation in rabies antibody titers in the sera of animlas immunized with rabies vaccines. The advantages of the passive hemagglutination test consist in the rapidity of obtaining the results, in a simple and economic method of carrying out the test.


[Activation of student cognitive activities in the process of teaching medical microbiology]. The main trends of methodical work conducted at the chair of microbiology of Orenburng Medical Institute are presented. For the purpose of activation of cognition activity of students during medical microbiology teaching the following methods were applied: presentation of the teaching material, creation of visual teaching methods in a single methodical plan in accordance with the logic structure graphs of the subject as a whole, its individual sections and themes; introduction of problem teaching method, solution of practical tasks of the II and III learning level; introduction of scientific achievements of the chair into the teaching process. Result of evaluation of the efficacy of the teaching-methodical work of the chair carried out demonstrated that knowledge of the principal microbiology problems in the students and interns persisted for long periods of time.


Effect of bromocriptine (CB-154) on oestrogen-induced prolactin release. In order to study the interaction between oestrogens and bromocriptine on PRL release, we evaluated the ability of bromocriptine (CB-154) to counteract the oestrogen-induced PRL release in four hyperprolactinaemic amenorrhoeic women. Bromocriptine acutely administered induced a similar percentage of PRL decrease in the same patient before and after oestrogen administration. When bromocriptine was chronically administered, contemporary oestrogen injection did not affect PRL release. These results show that bromocriptine is able to block the release of PRL induced by oestrogens, suggesting an interaction between oestrogens and DA-mimetic compounds on PRL release.


Thyroid and adrenomedullary reactions during sleep deprivation. The possible influence of a 48 h period of sleep deprivation on the serum concentrations of total and unbound 3,5,3',5'-thyroxine (T4) and 3,5,3'-triiodothyronine (T3), and of total 3,3',5'-triiodothyronine (reverse T3, rT3) was studied in 12 young male volunteers. In addition, plasma concentrations of TSH and the urinary excretion of noradrenaline and adrenaline were examined. Both total S-T4, S-T3 and S-rT3, and unbound S-T4 and S-T3 (unbound rT3 was not calculated) were significantly enhanced following sleep deprivation. P-TSH showed a numerical but statistically not significant increase, while the catecholamines remained unaltered. The results suggest that sleep deprivation provokes enhanced secretion of thyroid hormone(s), supposedly via increased secretion of TSH.


Insulin receptors, insulin secretion, and glucose disappearance rate in patients with periodic hypokalaemic paralysis. In a study of 6 male patients with periodic hypokalaemic paralysis (PHP), we found reduced insulin binding to monocytes as compared with a group of 25 normal subjects (P less than 0.1). The decreased insulin binding was caused by the decreased binding affinity. During induction of paralysis by a prolonged oral glucose load, one patient showed 24-h variations in the insulin binding to monocytes not differing from those observed in normals. After iv administration of glucose, these patients showed an elevated initial insulin response compared with the normals (P less than 0.1). However, the iv glucose tolerance tests revealed normal glucose disappearance rates. We conclude that changes in insulin receptor binding do not appear to be of pathophysiological significance for eliciting the parese attacks in PHP. However, the increased insulin response, following carbohydrate intake, might be of significance in the generation of paralytic attacks in patients with PHP.


Study of glucose tolerance and the dynamic property of insulin secretion. Analysis of intravenous glucose tolerance test with the aid of a control theory. The dynamic property of insulin secretion in relation to glucose tolerance was investigated quantitatively during iv glucose tolerance tests in 237 cases. The following results were obtained; 1) Glucose clearance constant (k-value) was not constant but variable with time and should be expressed as a function of time, K(t). In normal glucose tolerance, K(t) became greater with time. 2) Glucose-induced insulin secretion was expressed as the function of a proportional plus derivative response to glucose concentration. A weighting function of derivative response, reflecting the insulin secretion per unit of rate of change in blood glucose concentration, was calculated from blood glucose concentration (input) and insulin concentration (output) by the deconvolution method. It was clearly shown that the gain in weighting function was small and the response was slow even in the individual whose glucose tolerance was slightly impaired. 3) The greater the weighting function, the larger the change in K(t).


Ontogeny and distribution of immunoreactive gastric inhibitory polypeptide (IR-GIP) in rat small intestine. The ontogeny and distribution of immunoreactive gastric inhibitory polypeptide (IR-GIP) has been studied in the rat duodenum and jejunoileum between day 20 post-coitum and day 150 post-partum by radioimmunoassay following tissue extraction. In foetuses on day 20 of gestation, the content of IR-GIP was 2.0 +/- 0.2 ng/duodenum and 18 +/- 2.0 ng/jejuno-ileum. The IR-GIP content increased during the whole period investigated and a peak of concentration was observed in the first post-natal week in both the duodenum (860 +/- 150 ng/g) and jejunoileum (650 +/- 135 ng/g). In the duodenum, the main increase in IR-GIP content (ng per organ) occurred in the 3rd week of life and the same phenomenon was observed 2 weeks later in the jejuno-ileum. The highest GIP concentration was found in the duodenum and in the proximal jejunum, indicating that the upper small intestine is the major site of IR-GIP storage. It is concluded that the ontogeny of IR-GIP further supports the concept that this hormone is involved in the endocrine regulation of metabolism and suggests that this regulatory process takes place at an early stage of rat development.


Enhanced testosterone in female patients with anorexia nervosa: its normalization after weight gain. In order to elucidate the mechanism of disturbances of gonadal hormones secretion in anorexia nervosa 14 female patients were investigated. A control group also consisted of 14 women of the same age. The serum LH, progesterone, oestrogens: oestrone + oestradiol (Oe1 + Oe2), oestriol (Oe3) and testosterone were determined by radioimmunological methods. In patients with anorexia nervosa the serum testosterone and Oe3 concentrations were dramatically elevated, whereas LH, progesterone and Oe1 + Oe2 were decreased as compared with the control group. Considerable weight gain induced by cyproheptadine treatment caused a normalization of the serum testosterone and Oe3 concentrations in all the patients. A negative correlation between the testosterone level and the deficit in body weight was observed. The mechanism causing the dramatically high serum testosterone concentration in the female patients with anorexia nervosa is discussed.


The concentrations of urinary oestrone-3-glucuronide, LH and pregnanediol-3alpha-glucuronide as indices of ovarian function. Methods based upon the principles of radioimmunoassay have been developed and evaluated for the measurement of oestrone-3-glucuronide, LH and pregnanediol-3alpha-glucuronide in samples of unextracted urine. The procedures have been applied to daily urine (early morning fraction and combined 24 hour collections) from 6 women throughout one complete menstrual cycle and to serial samples from an additional 14 women who only collected early morning specimens. The results showed that there were characteristic, well-defined changes in the concentration of all 3 metabolites in both samples of urine and from all subjects. In addition, there was a reasonable correlation between the concentration of all 3 compounds in samples of early morning urine and the corresponding rates of excretion per 24 hours. These findings suggest that the procedures may be of value for monitoring ovarian function over long periods of time, without the problems of stress and inconvenience to the patient. Furthermore, the ratio of values for oestrone-3-glucuronide to pregnanediol-3alpha-glucuronide may be used to indicate the start and finish of the fertile period.


Intra-amniotic thyroxine (T4) absorption by the premature human foetus. We reported previously on the beneficial influence of intra-amniotic T4 injection in accelerating human foetal lung maturity. Twenty-four h after T4 (250 microgram) intra-amniotic injection, the mean cord serum T4 concentration in 13 premature newborns was 17 +/- 2.1 microgram/100 ml, while the T4 concentration in a matched group was only 11.6 +/- 0.9 microgram/100 ml: in 5 of the infants who received intra-amniotic thyroxine T4 was measured 12 h post-partum and rose from 16.1 +/- 1.8 to 24.3 +/- 2.6 microgram/100 ml. No change in maternal T4 concentration was observed. The mean cord serum T4 concentration in premature newborns delivered more than 3 days following T4 intra-amniotic injection, however, was not significantly different from that of the controls. These data suggest that T4 (250 microgram) injected intraamniotically is absorbed by the premature human foetus. Furthermore, the hyperthyroxinaemia is only transient, and does not prevent the post-natal T4 surge.


Plasma testosterone in male puberty. II. hCG stimulation test in boys with hypospadia. Plasma testosterone was determined by radioimmunoassay in 36 prepubertal boys with hypospadia prior to and 3 days after stimulation with 5000 IU of human chorionic gonadotrophin (hCG). As a control group, 30 boys of comparable age, predominantly with unilateral cryptorchidism, were studied. The increase in plasma testosterone levels after hCG was (median and range) 204 (83-393) ng/100 ml in the control group, whereas in the hypospadiac group a median increase of only 90 (33-272) ng/100 ml was found. The difference between the median testosterone levels after hCG stimulation in the two groups investigated is statistically highly significant (P less than 0.0001). After hCG stimulation, 13 out of the 36 boys with hypospadia did not reach the lowest stimulated testosterone level (87 ng/100 ml) found in the control group. It is concluded that a substantial portion of the aetiologically obscure cases of hypospadia are caused by an endocrine testicular insufficiency.


Acetylcholinesterase in neurons of the rat cerebral cortex. AChE-containing neurons have been demonstrated by electron-microscopical histochemistry in the neocortex of the rat. These cells are mainly located in layer VI. AChE activity is seen in the cisternae of the RER, in subsurface cisternae and in the dendritic membranes.


The effect of digested sludge on the common carp, Cyprinus carpio L. The effects of sewage sludge on the survival of the common carp, Cyprinus carpio, were investigated. It was noted that, when the concentrations of the sludge used for rearing carp exceeded 0.6%, the fish died within 42 days, whereas those reared in 0.2% sludge remained alive and healthy during the trial period. The body and the gills of the dead fish were covered by a veil-like film which looked like coagulated mucus and was formed by the heavy metal ions from the sludge reacting with some constituents of the mucus secreted by the gill. The histopathological symptoms of the various organs further demonstrated that internal injury in liver and kidney was also an important feature of the intoxicants as well as external damage, especially the particles observed around the gills. It was concluded that the optimum concentration of sludge to any species of fish should be determined by testing a series of concentrations before using it as a supplementary fish feed or fish pond fertilizer.


Stress and wound healing.

Stress and wound healing. An experiment was performed to compare the effects of stressors--cold, heat and noise--on primary wound activity (i.e., wound closure in the first 24 h after wound infliction) and on rate of healing in mice. A significant correlation was found between reduced primary wound activity and a faster rate of healing. Conversely, a correlation was found between relatively greater primary wound activity and a slower rate of healing. A possible explanation of this correlation is a compensatory mechanism inherent to the skin healing process. This mechanism is visualized as (1) stress exposure affecting the skin by (a) causing it to become thinner and tauter and (b) causing it to have less elastic recoil; therefore, (2) when a square wound is produced in stressed skin, (a) the wound does not recoil readily or gapes soon after cutting and (b) a longer wound perimeter results. Because there is evidence that rate of healing is governed by cells on the wound perimeter, the greater the perimeter, the greater the number of cells that will undergo rapid mitosis and the faster will be the rate of healing. Therefore, stressed skin will heal at a faster rate, compensating for the loss of elasticity and cellular depletion caused by stress. This study is of interest to anthropology because it deals with dynamic adaptation, trying to grasp the meaning of the elusive endocrine interface between environmental stimulation and a measurable physical entity like healing. This work may have revealed a functional complex that is common to the healing of all mammalian skin, whereby retarding effects of stress on the healing process are obviated.


Cytological changes in the testes of vitamin-A-deficient rats. II. Ultrastructural study of the seminiferous tubules. Ultrastructural study confirmed that, in rats, vitamin A deficiency initially caused the sloughing of some spermatids and spermatocytes into the lumina of the seminiferous tubules around day 3 following the initial decrease of body weight. From days 5 to 10, a considerable number of spermatocytes and spermatids, which still remained in the epithelium, underwent necrosis. Several stages of dying spermatocytes and abnormal spermatids were observed. The latter were distinguished by the presence of chromatin aggregating along the nuclear envelopes and highly vacuolated mitochondria. These cells range from single to multinucleate forms. They were incapable of differentiating further into spermatozoa and ultimately degenerated. Within the same period, Sertoli cells exhibited numerous darkly stained lysosome-like inclusions, and the upper part of their cytoplasm appeared as irregular processes, some of which were broken off and resulted in the thinning of the epithelium. From days 10 to 20, the remaining germ cells comprised mainly spermatogonia and few abnormal spermatocytes. The latter appeared enlarged and were very lightly stained. Their nuclei exhibited unusual blocks of heavily condensed chromatin amidst very highly dispersed chromatin fibers. Though their number was reduced, most of the spermatogonia appeared unaltered. Processes of Sertoli cells became even more irregular and were interrupted at certain sites by large empty spaces. Darkly stained inclusions in their cytoplasm were fewer than observed earlier.


Granule-containing cells in the human superior cervical ganglion. The fine structure of granule-containing cells in the human superior cervical ganglion is described. These cells are larger than the typical SIF cells in mammals and exhibit green-yellow fluorescence. They are characterized by numerous granular vesicles (80-140 nm in diameter) in the cytoplasm, but have many features in common with ordinary ganglion cells. They emit several long processes which form bundles together with ordinary nerve fibers. No synapses are found where the cells are presynaptic, although a few synapses are observed there where nerves are prosynaptic on the perikarya and processes of the cells. No close topographical relations are seen between the cells and blood vessels. It is suggested that the granule-containing cells are a special type of postganglionic aminergic neurons.


[Ligation of the yolk sac circulation and its effect on the yolk sac ultrastructure and development of the rat fetus]. The effect of an interruption of the yolk sac circulation on the rat visceral yolk sac and the development of the fetoplacental unit was examined in the last third of pregnancy. The yolk sac ischaemia was induced by ligating the blood vessels of the yolk sac stalk which connect the vitelline circulation with that of the fetus. A 3-hour ligature caused an extensive swelling of most cell organelles in the epithelial cells and in the capillary endothelia of the yolk sac. Other structural changes were indicative of a cessation of pinocytosis. A 6-hour ligature resulted in a common increase of cell swelling and in a beginning disintegration of the endothelial cells lining the vitelline capillaries. A 15-hour ligature caused severe ultrastructural cell lesions and macroscopical alterations suggestive of a progressive necrolar finding of a nearly complete loss of the amniotic fluid and the death of the fetus, although the maternal blood flow appeared to be still intact in the placenta.


Development of the innervation in the chicken pineal gland (Gallus gallus). The innervation of the pineal gland has been studied during the embryonic development and the first 10 days after hatching. On day 17 of embryonic development, the first nerve fibers are observed in the pineal capsule. They appear at the stalk level and rise to locate mostly on the anterior side of the capsule. Some nerve fibers leave these nerve bundles to penetrate the gland and they situate in the connective septa (18 days of development). From day 19 of development onwards, nerve fibers locate only in the parafollicular layer. Cells that may be identified as neurons are found in the pineal parenchyma.


Helical structure of the human umbilical cord. The helical structure of the human umbilical cord has been studied on 528 full-term cords from normal deliveries, 18 cords from aborted and developmentally normal fetuses with a CR length of 1.2-19.5 cm, 10 cords from monozygotic twins. In order to resolve the discrepancy in the nomenclature of the twist direction, a method has been suggested which takes into account the direction to which the fetus must have rotated to produce the twist. The incidence of the right helical pattern was 64.58%, of the left helical pattern 15.15%, and of the mixed patterns 17.43%; the twists were indeterminate in 1.89% and absent in 0.95% of the cords. Details of the mixed patterns are listed. The number of the uniform right twists ranged from 1 to 29 (7.5) and that of the left twists from 1 to 19 (6.7). There exists an exponential relation between the number of the twists and the ratio between length and thickness of the cords. The twists begin to appear during the early part of the 8th week, and their final number is possibly attained soon after the 9th week of development. In view of the absence of concordance in monozygotic twins, the helical nature of the cord is possibly controlled by factors which may be partly genetic and partly environmental.


The primitive course of the internal carotid artery in mammals. In all recent mammals the internal carotid artery at the level of the auditory capsule is derived from the embryonic dorsal aorta. In adults of various groups, the artery lies in positions which are classified as medial or promontory. It is shown that these character states arise by a process of differential growth affecting the relative positions of the dorsal aorta and the cochlear promontory. There is no evidence for separate vessels in the embryo which could give rise to non-homologous internal carotid arteries in the two positions. It follows that the concept of a primitive mammalian morphotype with both a medial and a promontory internal carotid artery in the same individual presents a formidable embryological problem. It is recommended that, in the absence of supporting evidence, the widespread current taxonomic and palaeontological use of this hypothetical morphotype should be regarded with suspicion.


Primary rhabdomyosarcoma of the cerebrum. An ultrastructural study. A case of primary cerebral rhabdomyosarcoma in a 51-year-old female is reported. The histogenesis of this tumor is discussed. The clinicopathological features of 10 previously reported similar tumors of the CNS are briefly reviewed. Histologically the tumor was polymorphic, but composed of poorly differentiated cells interpreted as rhabdomyoblasts without definite cross-striation. Electron microscopy established that the poorly differentiated cells were of rhabdomyosarcomatous nature, compatible with presumptive myoblasts and analogous to developing fetal muscle.


Jimpy mouse myelin revisited with freeze-fracture. Corpus callosum, cerebellum, and spinal cord from Jimpy mice, and control littermates, 15 and 21 days old, were prepared for freeze-fracture in a "cryofract" apparatus. The few myelinated axons in the Jimpy exhibited a striking paucity of particles in myelin P faces, though tight junctions were present. In addition, small maculae of particles were found on these P faces. Peripheral myelin appeared normal, both for the quantity and disposition of particles on their P faces.


[Electron microscopic and neurochemical study of Alexander's disease (author's transl)]. The authors report the results of a cerebral and of a neuromuscular biopsies and of the autopsy findings in another infantile case of Alexander's disease in a girl. They review the 17 previously reported cases of this disease and the various etiopathogenic hypotheses mentioned. The presence of numerous, sometimes abnormal enlarged mitochondria and of abundant membranous cytoplasmic bodies in the astrocytic cytoplasm seems to be unreported elsewhere. Peripheral nerve changes are mentioned for the first time.


Effects of local extraneural application of diphtheria toxin on the sciatic nerves of normal and protein deprived rats. Diphtheria toxin was locally administered around the sciatic nerves of normal and protein deprived rats aged 3, 6, 12, and 26 weeks in order to investigate the permeability of the barriers enveloping the nerves. At all ages the rats developed a reversible hind limb paralysis linked to a severe segmental demyelination, indicating passage of the toxin into the endoneurium. From 6 weeks of age the pattern of reaction differed between the protein deprived and control rats. The differences are interpreted as being partly dependent on less efficient protective barriers of the sciatic nerves of the protein deprived rats.


The fine structure of subcortical neurofibrillary tangles in progressive supranuclear palsy. The fine structure of subcortical neurofibrillary tangles was investigated in pallidum, substantia nigra, periaqueductal gray, pontine reticular gray, and dentate nucleus of 5 autopsy cases of Progressive Supranuclear Palsy. Only tangles due to straight 150 A wide filaments have been detected. These findings, obtained from a large series of cases and areas examined, confirm previous observations on the fine structure of neurofibrillary tangles in Progressive Supranuclear Palsy and suggest that the association between tangles due to straight filaments and tangles due to twisted tubules, so far described in one case, is probably exceptional.


Tight junctions in choroid plexus papillomas. Four cases of choroid plexus papilloma (CPP) obtained at the time of surgical excision were examined by electron microscopy and compared with normal choroid plexus (CP) of mouse and chick. In apical tight junctions fusion of the two outer leaflets of the adjacent cytoplasmic membrane was verified as in CP. This fact suggests that there is a blood-CSF barrier not only in CP but also in CPP.


[The effect of blood-filled meshwork of arachnoid villi in connection with posttraumatic brain edema (author's transl)]. Based on the Kellie-Munro doctrine according to which the intracranial compartments--blood, brain, and CSF--are in a state of pressure and volume equilibrium, we examined if traumatic lesions of the liquor absorption passages could change the intracranial pressure (ICP). Therefore, we reviewed the arachnoid villi and granulations of patients which died as a result of head injuries. In cases of traumatic subarachnoidal hemorrhages the meshwork of arachnoid villi are filled throughout with blood. By microscopical examination we observed findings in the network of spaces of the villi like they are known in prestatic and static conditions of capillary system (clothing of erythrocytes). The pathophysiological significance of the findings, especially with regard to the dynamic of posttraumatic brain edema, is discussed.


Unilateral megalencephaly, cerebral cortical dysplasia, neuronal hypertrophy, and heterotopia: cytomorphometric, fluorometric cytochemical, and biochemical analyses. A 13-month-old boy with intractable seizures, left hemiparesis, and psychomotor retardation due to right unilateral megalencephaly, died in hypovolemic shock 1 day after hemispherectomy. The gyral pattern of the hypermegalic hemisphere was simplified and coarse. The cortical cytoarchitecture was disarrayed by a population of giant neurons. Hippocampus and calcarine cortex were cytoarchitectonically normal, as was the entire left cerebral hemisphere. Neuronal heterotopias were present in the right centrum semiovale and both cerebellar hemispheres. Cytomorphometric study of parietal cortex of each cerebral hemisphere revealed a 4-fold increase in neuronal nuclear, and 11-fold increase in neuronal nucleolar, volume in the hypermegalic hemisphere, whereas glial nuclear volume was only one-third as great, in part because of edema of the left hemisphere. Microfluorometric cytochemical analysis demonstrated a 16% increase in neuronal DNA, 40% increase in total neuronal RNA, 12% increase in glial DNA, and 15% increase in glial RNA on the right. Biochemical analysis of tissue extracts disclosed increases in the right hemisphere of 40%, 56%, and 66%, respectively, for DNA, RNA, and protein. The data suggest heteroploidy of chromosomal DNA and enhanced transcription and translation in the hypermegalic hemisphere. Thus, a defect in regulation of cell metabolism may account for the morphologic and clinical abnormalities.


Squamous cell carcinoma in situ from the uterine cervix to the distal end of the fallopian tube. An unusual case of squamous cell carcinoma of the uterine cervix is described in which spread occurred intraepithelially along the endometrium and one of the fallopian tubes. This marked superficial extension is an example of abnormal spread of a malignant tumour whose prognostic significance is unknown.


A card sort method for pain assessment in gynaecology: a multidimensional approach. This paper considers the problem of measuring the subjective report of pain. In view of the limitations of existing approaches an alternative method of pain assessment is proposed. This approach derives from a multidimensional concept of pain. The test is in the form of pair comparisons and is designed to measure different pain dimensions. Sufficient consensus was found over the meaning and relevance of words describing intrauterine device related pain and primary dysmenorrhoea to allow a standard test to be developed. The reliability of the test was found to be high and its clinical advantages promising. It was not possible to provide an adequate evaluation of the test's validity. In view of these findings a longer-term treatment evaluation study is currently being undertaken in order to establish this.


Multichannel intrauterine pressure recording by means of microtransducers. Intrauterine pressures (IUP) were recorded simultaneously at the fundus, the isthmus, and cervix uteri by means of three micro-transducers (in 20 healthy, nonpregnant women, and in 5 patients with severe, primary dysmenorrhoea). Recordings were performed during the first 3 days of the menstrual cycle. Both incoordinate and coordinated myometrial activity was recognized. When coordination was present, the contraction wave as a rule started in fundus and was propagated towards the isthmus and cervix. Pinching and/or palpation of the cervix elicited retrograde contractions, i.e. the contraction wave started in the cervix and moved towards the fundus. It was frequently observed that during vigorous contractions of the fundus, the pressure increase in the isthmus was small; in some cases even a decrease in pressure occurred in this region. The pressure recording technique functioned perfectly during all recordings and seems to facilitate detailed studies of myometrial activity in the non-pregnant uterus.


Maternal alcohol and tobacco consumption and their association with nausea and vomiting during pregnancy. Nausea and vomiting during pregnancy (NVP) has been associated with favorable pregnancy outcome, though little is known about factors influencing its occurrence. In this study, information on NVP in 210 patients at a west coast health maintenance organization was obtained. Smoking and alcohol consumption before and during pregnancy were also estimated in two personal interviews during gestation. In all, 72% of the subjects had NVP in the first 4 months of pregnancy. Smokers had significantly less NVP than non-smokers (52% vs. 79%). Furthermore, NVP in smokers was negatively associated with alcohol consumption before and during pregnancy, with the stronger relation being for alcohol reported in the 6 months before pregnancy; only 46% of smokers drinking more than 1/2 fl. oz. of absolute alcohol daily in this period reported NVP, while 68% of smokers drinking less had NVP. For non-smokers, there was no relation between alcohol use in any period and NVP. The risk of NVP associated with pre-pregnancy drinking was not related to any change in alcohol consumption after conception. These results suggest an interaction between NVP, smoking, and reported alcohol consumption. The association of favorable pregnancy outcome with NVP may be in part a reflection of moderation in maternal alcohol and tobacco use.


Red cell 2.3-diphosphoglycerate in pregnancy. In normal, primigravidae red cell 2.3-diphosphoglycerate (2.3-DPG) concentration was found to be increased significantly from the third month of pregnancy. The 2.3-DPG concentration remained elevated throughout pregnancy. Increase in the 2.3-DPG concentration leads to a decrease in the oxygen affinity of the maternal red cells. The combination of low pCO2 and low oxygen affinity of the maternal blood facilitates the transport of oxygen as well as that of carbon dioxide across the placenta. The weight of the delivered children was not significantly correlated to the 2.3-DPG changes, and no significant variation of the measured variables could be detected in 9 women with abnormal pregnancies.


The routine use of oral prostaglandin E2 tablets for induction or augmentation of labour. The use of oral prostaglandin E2 (PGE2) tablets is an effective and safe adjunct to low amniotomy for the induction of labour at term. Routine use of this regimen and the use of oral PGE2 tablets for augmentation of spontaneous labour has shown that the method is very effective in multiparous patients, but much less so in primiparous patients. Success or failure could not be predicted by the pre-induction Bishop score. The incidence of gastro-intestinal side effect is dose dependent, but is low in multiparous patients.


Is there a physiological intravascular coagulation in obstetrical cases? The concentrations of plasmatic fibrinogen and its degradation products (FDPs), and the paracoagulation test using serial dilution of protamine sulphate (SDPS) were determined during the third trimester of pregnancy, labor, and puerperium. Singificant increases in the concentrations of fibrinogen and FDPs were observed throughout the process of pregnancy and birth, combined with both positive and negative SDPS tests. We suggest that these findings do not indicate a process of physiological DIC.


The aetiology and outcome of abruptio placentae. A series of 193 cases of abruptio placentae in a hospital population of 35,217 is described. This is an incidence of 0.55%. In the series both age and parity, but not pre-eclampsia or anaemia, are significant associated factors. The recurrence rate of abruptio placentae was 5.6%. There were no maternal deaths and the perinatal mortality was 35%. Epidural analgesia does not abolish the pain of the abruptio placentae in spite of abolishing the pain of labour.


On improved outcome of twin pregnancies. During the past four years, an attempt has been made in Malmö to reduce the frequency of preterm termination of twin pregnancies. For this purpose, the entire pregnant population of this medium-sized city was subjected to general ultrasonic screening in the second trimester. This detected 88 per cent of the twin pregnancies. The screening has a methodological error of 2 per cent. Eightysix of the women with twin pregnancy were subjected to bedrest in hospital for more than two weeks in the second half of gestation. The incidences of twins born with birth weight below 1 500 g and of twins light-for-gestational-age were reduced compared with those a decade earlier. Also the group of twins born before the 37th week decreased, and the perinatal mortality rate fell to the same level as in singleton pregnancies. Early detection of twin pregnancies followed by rest for the pregnant women seems to contribute to an improved outcome of these gestations.


Perinatal death due to abruptio placentae in an African city. Abruptio placentae was a common cause of perinatal death in Addis Ababa, Ethiopia in 1974-1975 with a frequency of 5.5/1000 births. This disorder had its peak frequency at term. No abnormalities were found in the placentas to explain the placental abruptions but there were other clues to their genesis. There was a strong association of the fatal abruptions with severe poverty in the mothers. These poor mothers were both undernourished and malnourished during pregnancy. Their fetuses and neonates who died had multiple evidences of undernutrition including a relative undergrowth of adrenals, spleens and livers and a relative acceleration of lung maturation. These findings support observations in more prosperous nations that poor nutrition of the gravida may have an important role in the genesis of abruptio placentae.


Neurobehavioral response of infants after paracervical block during labour. 30 parturient women were randomized into a group receiving paracervical block (PCB) and a control group. The infants were tested by a neurobehavioral examination immediately after birth, after 3 hours and 3 days. The examiner was unaware of the obstetrical management of the patients. No clinically significant differences could be detected between the two groups. Arterial and venous pO2, pCO2 and pH from the umbilical cord showed no differences between the groups.


Body weight in parous women: is there any alteration between successive pregnancies? In 50 women who had five successive pregnancies the difference was studied between the mean maternal weight at the 20th week of gestation and six weeks post partum. The difference changed from a weight loss to a weight gain in the fourth and fifth pregnancies. The maximum weight increment occurred between the end of the first pregnancy and the 20th week of the second, especially in obese multiparae.


The peroxidase content and the antibacterial activity of the amniotic fluid. A possible relationship between the antibacterial activity of amniotic fluid and its peroxidase content was examined. Antibacterial activity, assessed by counting colonies of S. aureus following 24 hour incubation, was present in 76% of the samples studied. It was not related to gestational age. Peroxidase activity, assessed by the O-dianisidine method, was not found in any of the amniotic fluid samples examined.


Early successful pregnancy following tuberculous endometritis. Successful pregnancy following proven endometrial tuberculosis is rare. Such a case is reported where conception occurred within three months of finishing treatment. It is suggested that rifampin may offer a better prospect of subsequent fertility than other chemotherapuetic agents.


Emotional distress in morning-after pill patients. The self-administered SCL-90 test was utilized to collect emotional distress data on 120 female patients requesting morning-after pill pregnancy interception. SCL prescores were significant in anxiety, guilt and depression factors. The 2-week post-treatment results showed a significant decrease in these factors. This test provides reliable measurement of emotional distress factors in gynecologic GYN patients. The results must be considered supportive for the use of DES interceptive therapy in spite of other clinical considerations relative to its safety.


Plasma and urine levels produced by an oral dose of ampicillin 0.5 G administered to women taking oral contraceptives. Earlier studies have shown that ampicillin produces 50% lower-and therefore very likely less adequate-plasma levels in pregnant than in nonpregnant women. The present investigation compares levels of ampicillin in plasma and urine produced by a single oral dose administered to 10 healthy women taking oral contraceptives on the 21st and on the 28th day of the menstruation cycle. Plasma levels of ampicillin were lower on the 21st day than on the 28th, i.e. a difference in the same direction as between pregnant and nonpregnant women although the difference was not significant. Contrary to what was found for pregnant women the dose of ampicillin to women taking oral contraceptives does not have to be doubled in order to compensate for lower plasma levels.


Hyperthecosis syndrome. Clinical, endocrinologic and histologic findings. Five patients were found to have hyperthecosis ovarii as evidenced by the presence of large lipid containing thecal cells in the ovarian stroma. The clinical picture was similar in all of them, featuring mild virilization, obesity and oligomenorrhea, with refractoriness to clomid therapy. Plasma FSH levels were low normal, while LH levels were slightly elevated. Urinary 17-ketosteroids levels were elevated, and plasma testosterone concentrations were upper normal. The response to dexamethasone suppression and HCG stimulation is discussed. The effect of wedge resection on the clinical and endocrinologic pictures is evaluated.


Some adverse effects of copper-IUD.

Some adverse effects of copper-IUD. Perforations and extraction problems in some 30 700 women wearing a copper intrauterine device (Cu-IUD), either a Cu-7 or Cu-T have been studied. Perforations were very rare. Judging from the literature and the present investigation, in cases of perforation the Cu-7-IUD has a tendency to penetrate the uterine wall and the Cu-T-IUD the cervical wall. Retracted and detached strings were observed somewhat more often in women wearing Cu-7-IUD's. The number of such cases was, however, not large enough to warrant a statistical comparison. The cause of retention, investigative procedures and recommendations in the removal of lodged Cu-IUD's are discussed.


Mental factors influencing recurrence of stress incontinence. At a recent follow-up of 51 women operated on for stress incontinence, there was an astonishingly high discrepancy between symptoms claimed by the patients and signs found by the physician. To examine the influence of certain mental factors on the recurrence of stress incontinence, the patients in the above-mentioned follow-up were tested with the Eysenck Personality Inventory test and the Sabbatsberg Depression Self-rating Scale test. The women with symptoms but no objective signs of stress incontinence showed a higher degree of both neuroticism and depression than the women of perfect health. Thus, in this group, it may be a question of aggravation of symptoms, which cannot be helped by a reoperation. Instead, these women might need psychiatric attention to relieve their psychosomatic symptoms.


Fetal growth retardation associated with inadequate haemodilution in otherwise uncomplicated pregnancy. The Hb level during pregnancy was followed in 113 non-anaemic women with uncomplicated pregnancy and birth weight of the baby above the 2.5th percentile. There was an inverse correlation close to statistical significance between the birth weight of the baby and the lowest Hb level reached during pregnancy as well as the Hb level in late pregnancy (38th week). A group of seven non-anaemic women with birth weight of the baby below the 2.5th percentile had a significantly higher (p less than 0.001) Hb level in late pregnancy than the normal group. Four of these cases had a statistically significant higher Hb level already in the second trimester. Trends in the reproductive history, complaints in the present pregnancy as well as results of hormone assays and the condition of the baby indicated that the seven cases represented a pathological group with fetal growth retardation. None of the women in the two groups were treated with diuretics. All had iron supplementation in high doses.


Plasma medroxyprogesterone acetate levels following intramuscular or oral administration in patients with endometrial adenocarcinoma. The concentration of medroxyprogesterone acetate (MPA) in plasma samples taken 24 h after intramuscular or oral administration of 100 mg daily doses of the drug to patients with endometrial adenocarcinoma was measured by radioimmunoassay. In general, a plasma level of about 4 ng/ml was found 24 h after the dose, independent of the route of drug administration. However, in three of the patients to whom intramuscular MPA was given, considerably higher values were found. A maximal plasma level was achieved three hours after ingestion of 100 mg MPA. This was followed by a rapid decline to 20-25% of the peak value after about 12 h. A rather small day-to-day intraindividual variation was found in daily blood samples taken just before administration of the next dose. However, considerable differences were found between individuals and it is concluded that this variation in plasma levels may be reflected in the clinical efficacy of the treatment. Thus further studies in which plasma values and clinical effectiveness are correlated seem to be indicated.


Variations of lens thickness in relation to biomicroscopic types of human senile cataract. The results are reported of 38 ultrasonographic in vivo mensurations of intraindividual differences in axial thickness between a cataractous lens in one eye and a biomicroscopically clear or slightly cataractous lens (incipient deep cortical opacity) in the other. Obviously intumescent cataractous lenses were excluded. In general, the cataractous lens was thinner than the contralateral clear or slightly cataractous lens. Large decreases in lens thickness appeared in lenses with the capsule-near opacities of posterior subcapsular cataract (PSC) + anterior capsular/subcapsular opacity (ACSCO). PSC was more closely correlated to lens thinning than was ACSCO. Nuclear cataract very often occurred in thin lenses, but did not appear to cause lens thinning per se. Deep cortical opacity was not associated with lens thinning. The present results contributed to our argumentation that the decrease in lens thickness is due to a leak of lens material through the "lens membrane" beside a possible cessation of growth of the lens fibres.


The ultrastructure of the normal conjunctival epithelium of the guinea pig. I. The basal and intermediate layers of the perilimbal zone. The present paper on the perilimbal zone of the guinea pig conjunctival epithelium describes the ultrastructural organization of the basal cell layer, including basal epithelial cells, melanocytes and small lymphocytes, as well as the intermediate cell layers consisting of polyhedral cells and processes from the melanocytes and the small lymphocytes. Particular attention is paid to those cell features that might be associated with phagocytosis, autophagy, and transport mechanisms.


The ultrastructure of the normal conjunctival epithelium of the guinea pig. II. The superficial layer of the perilimbal zone. The ultrastructure of the superficial cell layer of the perilimbal zone of the guinea pig conjunctival epithelium as seen in transmission and scanning electron micrographs is described. The major interest is focused on the apparatus of vesicles, vacuoles and cysts and their possible significance in connexion with transport functions and autophagocytic processes. The importance of the cell surface components and the role of the microfilaments in phagocytosis are also discussed.


Pulse-induced intraocular pressure variation and retrobulbar anaesthesia with and without adrenaline. The intraocular pressure (IOP) and pulse-induced IOP variation (IOPV) were registered before and five min after retrobulbar anaesthesia (RBA) in 34 operations. The every second operation the anaesthetic (bupivacaine or lidocaine) was supplemented with adrenaline (epinephrine). Both IOP and IOPV were significantly lowered compared with the unanaesthetised fellow eye. The change in IOP was 16,8% with adrenaline and 15.1% without it. IOPV decreased 50.6% with adrenaline and 36.2% without adrenaline. It is concluded that RBA reduces the intraocular blood supply and this is probably one reason for the IOP lowering influence of RBA. Although to a smaller degree, this vascular effect is also achieved without adrenaline.


Ant-egg cataract. A study of a family with dominantly inherited congenital (ant-egg) cataract, including a histological examination of the formed elements. A family with "ant-egg" cataract in three generations is described. The cataract is congenital, probably of autosomal dominant inheritance. Light microscopy of the ant-eggs showed that they are made up of a peripheral zone of lens material and a large almost homogenous centre. Element analysis by X-ray spectrophotometry showed a high content of calcium and phosphorus in the centre. The cataract has been easy to operate on and the postoperative visual results have been good.


The effect of oxazepam on ocular readaptation time. The readaptation time (RAT) is the interval during which a person exposed to a bright intense light flash cannot perceive a given target. In this study the target used was an optokinetic pattern and the elicited nystagmus (OKN) was registered with electrooculography (EOG), thus giving an objective registration of RAT. Oxazepam in therapeutic doses was given to five healthy subjects and the RAT and serum concentrations of the drug were registered simultaneously at different time intervals. An almost parallel increase of RAT and serum concentration of oxazepam was recorded. This suggests that RAT reflects the depressant effect on the CNS of this drug and it may be used as an objective method of following the clinical effect of a depressant drug as a function of time after intake.


A simple routine for optic disc photography through a natural pupil. Short communication. A simple device is described which made it possible to obtain usable fundus pictures in ca. 95 per cent of 2000 eyes without dilatation of the pupil. The camera is set to the patient's refraction by means of a scale on the camera extension.


Human traumatic cataract. A quantitative microradiographic and electron microscopic study. Six cases representing different stages of cataract formation secondary to eye trauma were subjected to quantitative microradiographic or electron microscopic examination. Anterior and posterior subcapsular cataracts were found to contain extensively swollen lens fibers in the subcapsular cortex. Microradiographic measurements revealed a reduced concentration of dry mass in the subcapsular cortex around the whole circumference of the lens. The inner cortex and the nucleus appeared normal both microradiographically and electron-microscopically. Two of the examined cases had an opaque-cataract membrane and one had a Soemmerring's ring. The opaque membranes consisted of irregular masse of degenerated lens fiber material as well as regenerated lens epithelial cells. A wide range of dry mass concentration was found in the opaque membrane that was studied microradiographically. Alterations in morphology and dry mass concentration are more than sufficient to explain the development of opacification in traumatic cataract.


Late complications of 7-0 polyglycolic (Dexon) sutures in cataract surgery. The late complications of corneo-scleral wound healing after the 15th postoperative day were recorded in 108 routine adult cataract operations using 7-0 polyglycolic acid (Dexon) sutures and compared with 80 routine adult cataract operations using 9-0 monofilament nylon (9-10 Ethilon Nylon) sutures. In 37 eyes of the 7-0 Dexon group filtrating blebs, gaping of the corneoscleral wound, anterior chamber collapse, or decrease in the intraocular pressure were observed compared with one filtrating bleb in the 9-0 nylon group. The majority of late complications occurred 22 to 42 days after surgery. Ten filtrating blebs remained after a 5 months' follow-up period. The most probable cause of the late complications in corneo-scleral wound healing was discussed.


Changes in pupillary dynamics in young men during prolonged severe exercise. Infrared pupillography has been performed on 9 male cadets taking part in a combat course lasting for 5 days. The combat course involved lack of sleep, strong physical exercise and caloric deficit. During the course pupillary size was determined after rapid adaptation to darkness and the rate of concentration and the rate of dilatation after stimulation of the opposite eye with light was determined. Dilatation time increased by 50% towards the end of the course and pupillary size before light stimulation was reduced by 14%. On day 3 and 5, but not on day 1, small amplitude pupillary oscillations were observed. The speed of contraction was, however, unchanged.


Relationship between blood flow velocity in the choroid and intraocular pressure in rabbits. By using thermistors for calorimetry to monitor blood flow velocity in the choroid of the anaesthetized rabbit, it was found that an elevation of intraocular pressure reduced the choroidal blood flow. The relationship between the ratio of perfusion pressure to intraocular tension (x) and the reciprocal value of the percentage of blood flow velocity (l/y) showed a curve convex towards the pressure axis. On a log-lin scale the graph was linear. A significant linear correlation with a coefficient of 0.965 was obtained. The regression equation was found to be log l/y = 0.48x-1.98 +/- 0.29. From the present experiments it is concluded that the vascular bed of the choroid in the rabbit is a passive one with no sign of autoregulation. The observations are discussed from the point of view of blood supply and possible damage to the optic disc.


Pilocarpine medication in open-angle glaucoma. A study using pilocarpine eyedrops and an ocular therapeutic system. Two modes of topical pilocarpine therapy were applied to sixteen patients with open-angle glaucoma. A pilocarpine drop medication (2% solution four times daily) was compared to a constant and continuous supply of pilocarpine by a therapeutic delivery system (Ocusert P-40). The pressure reducing efficiency was studied in the morning and in the following four hour period of an ordinary drop medication regimen. The results indicate about equal pressure reducing properties in both high and low pre-treatment pressure values. However, compared to pilocarpine drops, we found a statistically significant lower pressure in the morning after the Ocusert unit, especially in glaucomatous eyes with high pre-treatment pressure.


Capillary haemangioma of the optic disc. A case report. A case of capillary haemangioma of the optic disc is reported. The ophthalmoscopic and fluorescein angiographic characteristics of the different varieties of haemangioma of the optic nerve head are discussed and the problems of treatment of photocoagulation outlined.


Helicoidal peripapillary chorioretinal degeneration. A family with helicoidal peripapillary chorioretinal degeneration is described. This is a rare bilateral fundus affection--only seven more or less typical cases have been reported in the literature. 21 patients from the same family in four generations were examined, 10 men and 11 women. Seven men and six women showed a helicoidal affection. Of this number, there were 11 children aged from 4-17 years, six were girls of whom three had helicoidal fundus and five were boys of whom two were affected. General examination revealed nothing of particular interest. We have here a congenital hereditary fundus anomaly or minor malformation in four generations--young people with normal visual acuity who develop with age a clear tendency to invasion of the macular region by a degenerative process. This is most dangerous for the visual acuity when the atropic helicoidal wings lie in or near the macula region.


Axial length of the emmetropic eye and its relation to the head size. The results of the ultrasonographic measurements of the ocular components in 40 emmetropic eyes from men of nearly the same age are presented and the possible relation between the axial eye length and the head size is discussed. A significant correlation was found between the axial eye length and the head circumference (P less than 0.001), between the axial eye length and the head length (P less than 0.01) and between the axial eye length and the head breadth (P less than 0.02). A significant correlation was also found between the axial eye length and the height of the subjects (P less than 0.01). It is suggested that such a correlation can explain not only the wide individual range of axial eye lengths in emmetropic eyes, but also the existing difference in axial eye length between the sexes. The mean eye length was 23.82 mm in 40 men and 23.02 mm in 10 women; both sexes were of the same age (20-30 years).


Prevalence of pinguecula in Greenland and in Copenhagen, and its relation to pterygium and spheroid degeneration. The prevalence of pinguecula has been studied by slit lamp examination of 659 Eskimos in South Greenland and 810 Caucasians in Copenhagen. The overall prevalence was found to be 56 per cent in Greenland against 41 per cent in Copenhagen (P less than 0.001) and to rise with increasing age, though with a fall after the age of 60 among Greenland women. Pingueculae (measured by their vertical height) are largest among Greenlanders, and larger in males than in females. They increase in size with increasing age. They are generally located nasally in Greenlanders and temporally in Copenhageners. The prevalence of pinguecula in almost 1 1/2 times higher among Greenlanders than among Copenhageners, while that of spheroid degeneration and that of pterygium are 3 times and slightly over 10 times higher respectively. The incidence of pinguecula and spheroid degeneration are correlated per site and per subject in the two geographically different series. Pterygium is not correlated with regard to site, this being always located nasally. Pterygium practically never harbours spheroid degeneration, neither in its body nor in its head (81 pterygia). Pinguecula and pterygium are therefore to be regarded as two different disorders, while spheroid degeneration is related to pinguecula.


A clinical and neurophysiological investigation of a Danish kindred with heterozygous familial hypobetalipoproteinemia. A three-generation transmission of under five percentile values for serum low density lipoprotein and low density lipoprotein cholesterol typical of heterozygous familial hypobetalipoproteinemia was demonstrated in a Danish family. Slight clinical signs of CNS abnormality were found in 4 of the 8 subjects with heterozygous familial hypobetalipoproteinemia, but did not resemble the neurological findings in abetalipoproteinemia nor in the previously described patients with familial hypobetalipoproteinemia. There were no signs of myelin dysfunction in the central nervous system as judged from the normal latency of visual and somatosensory evoked potentials.


Dietary habits and serum lipids during first 4 years of life. A study of 95 Danish children. Early infant feeding habits, current dietary intake and serum lipids were investigated in 31 infants, age 6--10 months and 64 children, age 3--4 years. In the infants there was a correlation between serum lipid levels and the amount of saturated fat and the P/S ratio of the diet. No such correlation was found in the 3--4 year old children. Neither was there any correlation between the type and duration of early infant feeding and subsequent serum lipid levels. In both the infants and the 3--4 year old children serum cholesterol concentration correlated with the serum cholesterol concentration in each of the parents.


H2 breath tests during diarrhea.

H2 breath tests during diarrhea. The peak rise in breath hydrogen and the volume of excess pulmonary excretion of hydrogen in response to a 10 g dose of the non-abosorbable disaccharide, lactulose, was significantly lower in children with active gastroenteritis and diarrhea than in nondiarrheal controls. Thus, despite the fact that the H2 breath test is a convenient, noninvasive technology for use in children, it cannot be recommended for measuring carbohydrate malabsorption in individuals with active, on-going episodes of diarrhea.


Renal functional changes in acute glomerulonephritis in children. A one-year follow-up. Renal function was studied in three patients with post-streptococcal, four patients with IgA and one patient with non-streptococcal proliferative glomerulonephritis (GN) at the onset of the disease and two, six and 12 months later. Renal biopsies were performed at the onset of the disease and 12 months later. Standard clearance techniques were used for the functional studies. The latter were performed during hydropenia and continuous isotonic saline infusion. During hydropenia, the GFR was uniformly depressed shortly after the onset of the disease, but it normalized during the following two months. The filtration fraction was depressed in poststreptococcal GN at the onset and it normalized with the GFR. In IgA GN, the filtration fraction remained within normal limits during the entire course of the illness. The natriuretic response to isotonic saline volume expansion was low in all patients at the onset of the disease, but normalized in post-streptococcal and IgA GN during the one-year follow-up. In spite of normalized renal function, biopsy findings in IgA GN were unchanged 12 months later. An episode of macroscopic hematuria in one patient with IgA GN at the six-month investigation had no apparent effect on renal function.


A survey of 164 Finnish children and adolescents with hypertension. A retrospective analysis was performed on 164 children and adolescents with persistent hypertension. Among the unselected 115 patients with hypertension seen within the last three years 47 (41%) exhibited renal disease, 37 (32%) coarctation of the aorta, 10 (9%) miscellaneous associated causes and 21 (18%) no associated cause (essential hypertension). A substantial number, 53/164, had a primary disease potentially curable by surgery, and in 37 patients the blood pressure was normalized postoperatively. The outcome depended mostly on the basic disease and the availability of chronic hemodialysis. 11/164 children have died, all because of terminal basic disease, and one with simultaneous hypertensive crisis. We thus recommend a thorough investigation in the case of a child with persistent hypertension.


Free and bound tryptophan in human plasma during the perinatal period. The concentration of tryptophan and the degree of binding of the amino acid to protein were examined in human plasma during the perinatal period. Both total and unbound (free) tryptophan were higher in cord vein plasma than in the maternal circulation, the concentration gradient being approximately 1 : 2. The proportion of the total plasma tryptophan concentration that was not bound to protein was less in cord vein plasma than in the maternal circulation. After birth the proportion in infant plasma fell significantly. Both total and free tryptophan fell during the first 24 hours of postnatal life. Total tryptophan returned to the cord vein plasma level 6--8 days after birth whilst free tryptophan failed to increase during the period of the observations. In premature infants total and free tryptophan also declined in concentration 12--24 hours after birth, suggesting the phenomenon to be related to birth rather than to gestational age. Phenylalanine remained unchanged whilst tyrosine increased in concentration during the first 80 hours of postnatal life. Thus, the availability of tryptophan to the tissues appears to decline during the immediate postnatal period and the results suggest that the requirement for tryptophan during this time may exceed the supply from standard artifical milk preparations.


Benign paroxysmal torticollis in infancy. Benign paroxysmal torticollis is a condition characterized by attacks of head-tilting often accompanied by lateral curvature of the trunc. The first onset of these attacks usually occurs during the first months of life and they recur with a remarkable periodicity for 6--12 months after which time they gradually subside in intensity and frequency. As a rule the attacks have ceased completely before the age of 2 years but in some cases they continue in a modified form as attacks of ataxia. The aetiology is unknown and there is no evidence of bilateral peripheral vestibular disturbances as has been suggested in earlier reports. The ataxia seen in some cases rather suggests a dysfunction of the cerebellum or of the vestibulo-cerebellar connections. Four own patients with this syndrome are presented and discussed.


Myotonia congenita (Thomsen's disease). Early diagnosis in infancy. A family with myotonia congenita. (Thomsen's disease) is reported in which the father and his two offspring are affected. The course was characterized by the early onset of clinical manifestations in both the father and his two children. In one child, a clinical and electrical diagnosis of the disease was made as early as two weeks of age. Early manifestations were breathing difficulty and eye closure myotonia. The importance of early recognition of the disorder is emphasized.


Early detection of preschool health problems--role of perinatal risk factors. To evaluate a perinatal risk-grouping system, 1 262 4-year-old children went through a comprehensive health examination. A total of 41.5% of the newborns were included in the wide criteria of risk, which were more common among boys and among children of the youngest and oldest mothers. Among the 4-year-old, the frequency of significant physical health problem was 15.8%, including 10.1% visual disturbances and 2% neurological disorders. In some combinations of risk groups and later health problems there were statistically significant correlations, e.g. regarding prematurity and cerebral irritation vs. cerebral palsy, but not sufficient to serve its purpose as a screening instrument. Even the accumulation of especially serious events in the perinatal period gave no clue to later neurological disorders. The addition of low socioeconomic status as a perinatal risk did not influence the outcome either. The reasons for the weak correlation between perinatal risk factors and later outcome of health disorders and handicaps are discussed, and it is concluded that to detect children with health problems, there seems to be no acceptable alternative to a comprehensive health surveillance as part of a general health service programme of all children, including clinical examinations and screening procedures by well trained personnel.


Plasma and red blood cell folate in breastfed infants. We have studied growth, red blood cell status and folate concentrations in plasma and red cells in a group of 35 breastfed infants during the first year of life. Folic acid supplementation was not given to the mothers during pregnancy or lactation, and none of them developed megaloblastic anaemia. The growth and red blood cell status of the infants were both normal. At birth, and throughout the period of observation, the folate concentrations in plasma and red cells were significantly higher than in the adult reference material. A positive correlation between plasma and red cell folate was demonstrated. During the latter part of pregnancy and lactation the foetuses and infants seem to be protected against folate deficiency. We regard the folate status of normal breastfed infants as optimal. The optimal supply of the vitamin in artificial nutrition should be the amount of folate necessary to maintain plasma and red cell folate concentrations similar to those found in breastfed infants.


The effect of feeds of differing composition on entero-insular hormone secretion in the first hours of life in human neonates. Little is known on the enteral stimuli for gastro-intestinal hormone release in newborn infants. We have compared the effect of the first feed of human breast milk (5 ml/kg) or 10% dextrose (5 ml/kg) on blood glucose and plasma gastrin, enteroglucagon, Gastric Inhibitory polypeptide (GIP), pancreatic glucagon, and insulin in 21 full-term infants at 4--6 hours of age. The first feed of human milk caused a rise in blood glucose and plasma insulin, gastrin and enteroglucagon, but no change occurred in GIP or pancreatic glucagon. The 10% dextrose feed did not stimulate enteroglucagon release, although similar changes occurred in blood glucose and plasma insulin and gastrin. We conclude that the composition of the feed influences the pattern of gastro-intestinal hormone release during the first hours of life and that the entero-insular responses to feeding differ in the neonate and the adult.


Hyperbilirubinaemia and idiopathic hypopituitarism in the newborn period. Two infants with idiopathic panhypopituitarism presented with severe neonatal hypoglycaemia, hepatomegaly and hyperbilirubinaemia (direct and indirect). Abnormal liver function tests returned to normal over a 5--8 month period. The growth rate in the absence of detectable growth hormone was 50% of normal during the first 6 months. The effect of growth hormone on somatomedin levels and growth rate during the first year of life in one of the infants is described.


Hypoglycaemia and congenital adrenal hyperplasia. We report the case history of a child with congenital adrenal hyperplasia which was complicated by recurrent hypoglycaemic episodes during common infections. There are few reports in literature on the association of hypoglycaemia and congenital adrenal hyperplasia. In accordance with others, we believe that hypoglycaemic attacks in adrenal hyperplasia are perhaps more frequent than recorded in literature.


"Stress" polycythaemia and peripheral facial palsy complications of severe hypertension. An 11-month-old boy had an episode of generalized convulsions followed by a right peripheral facial palsy, which resolved gradually within 3 weeks. Three months later he had another similar episode of convulsions followed by a left peripheral facial palsy. On both occasions it was found that he had polycythaemia. A careful physical examination discovered that the child had severe hypertension. Extensive laboratory investigations did not reveal a cause for his hypertension. Haematologic investigations showed that the polycythaemia was due to a contracted plasma volume as a result of the hypertension. The peripheral facial palsy most probably was due to a blood clot in the facial canal, below the origin of the nerve to m. stapedius, as audiograms were normal and lacrimation preserved. Control of the hypertension resulted in resolution of the facial palsy within 4 weeks and normal haematocrit readings within 6 weeks. It should be stressed that every patient with peripheral facial palsy should be examined for hypertension.


The acidification defect in the syndrome of renal tubular acidosis with nerve deafness. An 8-year-old boy with renal tubular acidosis and nerve deafness, has been followed for seven years. Repeated studies of his renal acidification defect showed that until the age of six years the tubular defect was mixed, proximal and distal (type 1,2 hybrid). After that age the defect of proximal acidification disappeared and the patient only presented a distal renal tubular acidosis type 1. When this is associated with nerve deafness, it is considered a distinct nosological entity.


Sequential ultrastructural changes in vinblastine-induced cell death of secretory ameloblasts of rat incisors in vivo. Secretory ameloblasts in the continuously growing incisors of the rat were used to study the sequential changes in a mature cell type degenerating after administration of vinblastine at a dosage of 2 mg per kg body weight. In less than half an hour nearly all microtubules vanished. This was succeeded by progressive displacement of the nuclei and disorganization of the cytoplasmic structure. After 1 to 3 hours attached and free polyribosomes were converted into monoribosomes. All these cytoplasmic changes were seen in viable as well as in necrotic cell. Between 5 and 61/2 hours after application of the drug degeneration of nuclei began; these changes from the outset indicated that a particular ameloblast had been drawn into a sequence of events which would ultimately lead to its death. The progressive alterations of the nucleus and cytoplasm of the degenerating cells and the concurrent fragmentation and elimination of the fragments are described.


Nuclear segmentation in goitre aspirates. Nuglear segmentation was studied in fine needle aspirate smears from toxic and atoxic goitres. The smear technique implies a flattening of the nuclei on a slide, which facilitates detection of nuclear segmentation. Such segmentation was found in 2.2% of the nuclei in toxic goitres and in 0.9% in atoxic goitres. The difference was highly significant p less than 0.001. The segmented cells were usually of uniform appearance with one large and one small segment. Only very rarely were more than two segments seen.


Ultrastructural features of cultured human glia and glioma cells. The fine structure of three lines of human normal glial cells and eight established lines of malignant glioma cells are described. The glial cell lines were ultrastructurally very similar whereas the glioma cell lines differed greatly from one another. In sparse proliferating cultures there were no consistent findings which distinguished the glioma cell lines as a group from the normal glial cells. Only in post-confluent cultures could the consistently irregular cell surfaces and ruffling, both at the cell periphery and centrally on the upper cell surface, with associated pinocytosis, distinguish the glioma from the post-confluent glial cultures, which did not possess these properties. The common attributes of post-confluent glioma cells reflect the cells' continued proliferation. The glioma lines did display individual ultrastructural characteristics which appear to be stable, the glioma lines having retained these during a number of years of continual passage.


The fine structure of growing human glia and glioma cells. Whole cell preparations. Three lines of normal human glia cells and eight established lines of malignant glioma cells have been studied in the electron microscope (E.M.), using preparations of critical-point dried whole cells, sparsely grown on formvar-coated, E. M., gold grids. The malignant cell lines showed a very varied morphology, almost every line having its peculiarities as compared to the essentially identical normal glia lines. The major differences noted concerned the form of the leading lamellae, number of microspikes and the distribution of organelles such as secondary lysosomes and mitochondria. No single consistent finding made it possible to differentiate the glioma cells as a group from the glia cells in sparse cultures. The findings of this study show some of the individual glioma cell lines to have characteristic cell-surface structures. They were found to be identical with the findings in previous SEM studies, suggesting the peculiarities of the individual malignant glioma lines to be stable and retained, despite continual passage.


Tumours in Iceland. I. Malignant tumours of skin--a histological classification. Four hundred and eighty-five primary malignant skin tumours submitted for histological diagnosis in Iceland during the period 1955--1974 were typed according to the WHO histological classification. The incidence of these tumours, age-adjusted to the "World" population, was 12.6/100.000 in males and 11.0/100.000 in females. These are very low figures for a white population. The distribution by type among males was: basal cell carcinoma 66.8%, squamous cell carcinoma 22%, malignant melanoma 7.2% and others 4%. Among females: basal cell carcinoma 66.9%, malignant melanoma 20.8%, squamous cell carcinoma 10.2% and others 2.1%. The exposed areas of the body were affected much more frequently than other areas. The results support the theory that intensity of solar radiation is of major aetiological significance.


Ultrastructure of lipogranulomas in human fatty liver. Lipogranulomas from severe fatty livers due to alcoholism, diabetes or overweight were examined in the electron microscope. When a fat droplet protrudes through the cell membranes of a liver cell histiocytes and lymphyocytes settle around it, and a lipogranuloma is formed. Remnants of the liver cell may be seen between the fat droplet and the histiocytes. It is confirmed that the fat droplets are situated extracellularly in the fully developed lipogranulomas.


The variation of pathological changes in the liver evaluated by double biopsies. In two simultaneously-taken needle biopsies of the liver from 70 consecutive patients, a number of changes were evaluated semiquantitatively and compared in n x m tables. The lesions examined were steatosis, Mallory's hyalin, alcoholic hepatitis, cirrhosis and cholestasis; furthermore the size, amount of inflammatory cells, connective tissue and bile-duct proliferation of the portal tracts and finally focal necroses and acidophilic bodies in the lobules were recorded. Cirrhosis, cholestasis and steatosis showed a high correlation, while the agreement between the two interdependent biopsies, especially concerning acidophilic bodies and bile-duct proliferation, was low. Possible reasons for the variation in the agreement of the lesions are discussed.


Carcinoma-in-situ of testis in testicular feminization syndrome. A light microscopical study of an excised testis from a 14 1/2-year-old girl with incomplete type of testicular feminization syndrome revealed a carcinoma-in-situ pattern in a part of the gonad. An identical histological pattern has repeatedly been demonstrated in infertile men who developed gross testicular germ cell tumours. It is suggested that germ cell carcinomas in patients with testicular feminization syndrome may be preceded by this characteristic intratubular germ cell abnormality.


Synthesis of 3H-acetylcholine in the rabbit lacrimal gland and its release by electrical field stimulation. Electrical field stimulation was applied to the rabbit lacrimal gland during incubation in vitro with 3H-choline, after which the efflux of tritiated metabolites was studied. In the presence of physostigmine 3H-acetylcholine was released into the incubation medium when the gland was stimulated electrically. The identity of the 3H-acetylcholine synthesized by the preparation was established by its identical ion exchange chromatographic properties to native acetylcholine. The tissue contents of 3H-acetylcholine and 3H-choline were 14.4 and 3.6%, respectively, of the total activities found in the gland. This study demonstrates that the rabbit lacrimal gland is innervated cholinergically. It is suggested that the method developed might be of value for studying effects of drugs on cholinergic neurotransmission in this organ.


Correlation between fluid reabsorption and proximal tubule ultrastructure during development of the rat kidney. Parallel functional and ultrastructural studies were performed in maturing rats in order to elucidate factors determining the development of proximal tubular fluid reabsorption. Three groups of hydropenic animals, which were 22 to 24, 28 to 32 and 40 to 45 days old, were studied. Nephron function was evaluated at the single nephron level by micropuncture technique. The ultrastructure of the developing proximal tubules was analysed by morphometric techniques following fixation of single nephrons. Kidney weight, proximal convoluted tubule length and diameter increased during postnatal development. SNGFR increased from 2.98 to 8.57 and to 20.5 nl/min in respective group of rats whereas proximal tubular fluid reabsorption Jv (a) increased from 0.15 to 0.22 and 0.34 micron3.micron-2.s-1. Parallel to the functional development the relative area of lateral and basal cell membrane increased, resulting in a constant relationship between net fluid reabsorption and the lateral and basal cell membrane area during the fourth postnatal week and then only a slight increase in this relation during the further development. The results suggest that net fluid transport during hydropenia is determined by the amount of available lateral and basal cell membranes where the transporting enzyme for sodium is located.


Ventilatory and occlusion pressure response to CO2 and hypoxia with resistive loads. Steady-state responses to hyperoxic hypercapnia and eucapnic hypoxia were measured both as minute ventilation (VE) and as inspiratory mouth occlusion pressure (P0.1) with and without 25 cm H2O/I/s added resistance (R). Reduction in slope of the ventilatory response to CO2 with R was highly significant in all 3 subjects whereas the response to hypoxia was barely significantly reduced in 1 subject and not significantly decreased in two. Although P0.1 was higher with than without R under all conditions, the slope of the P0.1 response to CO2 with R was not increased in two subjects and only slightly increased in the third. The slope of the P0.1 response to hypoxia was significantly greater in all subjects with R. Expiratory reserve volume was increased with R but the change was the same with hypoxia and hypercapnia. We conclude that ventilation is better maintained with resistive loading during hypoxia than during hypercapnia and that this results from a greater force output of inspiratory muscles as reflected by a higher P0.1. This suggests a greater neural output to these muscles.


Differences in renal and submaxillary renin release after stimulation with isoprenaline and noradrenaline. It is confirmed that while noradrenaline stimulates release of submaxillary as well as renal renin, isoprenaline only stimulates renal renin release. The effects of these two adrenergic agonists differ in several other ways. The kidneys respond to isoprenaline with a dose dependant renin release. As a contrast the submaxillary glands respond to noradrenaline by no or by non-dose-dependant release. After single doses of the agonists the isoprenaline induced renin release is of short duration, contrasting with a prolonged renin release after injection of noradrenaline. The kidneys are able to respond to repeated doses of both agonists, while the submaxillary glands most often only respond to the first dose. While the effect of noradrenaline is blocked by pretreatment with phenoxybenzamine, this blocker is without effect when given after noradrenaline. The two agonists do not provoke any increase in plasma renin in mice which have been both sialoadenectomized and nephrectomized.


Gastric acid secretion and water balance in the marine teleost Gadus morhua. Gastric acid secretion was measured in unanaesthetized codfish surgically equipped with a catheter draining the stomach. The pylorus was ligated. Without perfusion of the intestine, or during perfusion with pure sea water (100% SW) or slightly diluted (67%) SW, gastric acid secretion was low ( less than 10 mumol H+/kg.h) and the fishes became dehydrated during the experiment. Perfusion of the intestine with 50% or 3% SW enabled the fishes to compensate for the water loss to the environment and greatly enhanced gastric acid secretion. Acid secretion was elevated also in fishes in which the dehydration was prevented by an intra-muscular infusion of saline. Perfusion of the intestine (8.5 ml/h) decreased the hourly effluent volume ('drinking rate') from the stomach to almost zero within 2 h. The effect was independent of the degree of dilution of the perfusing SW, but was less pronounced when the perfusion rate was lowered. Intra-muscular saline also depressed 'drinking rate'. The acid secretion prevailing during perfusion of the intestine with SW at a dilution preventing dehydration--suggested to represent the basal acid secretion of the codfish--was inhibited by atropine, hexamethonium, and metiamide.


Synaptosomal accumulation of intracerebrally injected amino acids. The distribution of the labels of [35S]taurine, [3H]lysine, [14C]glutamate and [14C]norleucine in mouse brain subcellular fractions was followed after intracerebral injection in vivo. [35S]taurine, [3H]lysine and [14C]glutamate and its metabolites accumulated in the nerve terminals, lysine and glutamate also occurring in the synaptic vesicles, while remained mainly in soluble synaptoplasm [14C] nor leucine penetrated the brain cell membranes slowly, but was still bound to the synaptic vesicles to a greater extent than taurine.


Interrelationships between skeletal muscle adaptations and performance as studied by detraining and retraining. The effects of 15 days of detraining and 15 days of retraining were studied in 6 well-trained runners. Detraining resulted in significant decreases in the mean activities of succinate dehydrogenase (SDH) and lactate dehydrogenase (LDH) of 24% and 13% respectively, but no significant increases in these enzymes activities occured with retraining. Maximal oxygen uptake (VO2 max) decreased by 4% with detraining (p less than 0.05), and increased by a similar amount with retraining. Performance time in an intense submaximal run decreased by 25% (p less than 0.05) with inactivity, but still averaged 9% below the initial level after retraining. Maximal heart rate and peak heart rate during the performance run were higher after detraining by 4 and 9 beats per min, respectively (p less than 0.05). With retraining, these heart rate values were decreased by 7 and 9 beats per min (p less than 0.05). Blood lactate concentrations after the VO2 max and performance run were approximately 20% lower after detraining and retraining (p less than 0.05). Muscle fibre areas for three subjects tended to be larger in biopsy samples taken after detraining and retraining. These data suggest that even short periods of detraining result in significant changes in indices of physiological capacity and function in subjects near their upper limit of adaptation, and that a longer period of retraining is necessary for muscle to re-adapt to its original trained state.


Transcapillary passage of albumin, effects of tissue cooling and of increases in filtration and plasma colloid osmotic pressure. 'Initial' clearance of radiolabelled serum albumin was measured in the perfused, maximally vasodilated muscle vascular bed of rat hindquarters during tissue cooling, during increases in filtration and during changes in serum colloid osmotic pressure. Albumin clearance during ordinary serum perfusion at isogravimetry amounted to 0.03 ml/min times 100 g, increasing linearly with filtration rate to some 0.07 ml/min times 100 g at 0.5 ml/min times 100 g of filtration. During cooling from 36 degrees C to 14 degrees C both CFC and initial albumin clearance at isogravimetry decreased some 40%, in due proportion to the increased viscosity of the fluid. Increases of the colloid osmotic pressure of the perfusate correspondingly increased both the isogravimetric capillary pressure and 'initial' albumin clearance during isogravimetry.--It is concluded that even during isogravimetry the transmicrovascular albumin passage is to about 70 per cent due to filtration, and only some 30 per cent of transport at ordinary serum colloid osmotic pressure takes place by diffusion, both events presumably via 'large pores'. There was no evidence that transendothelial vesicular transport should to any significant extent contribute to the passage of albumin from vessels to tissue.


In vitro effects of growth hormone on protein synthesis and amino acid transport in the rat diaphragm after acute hypophysectomy. The effects of growth hormone (GH) in vitro on phenylalanine-14C incorporation to assess protein synthesis and on alpha-aminoisobutyric-1-3H accumulation to measure amino acid transport in the diaphragm muscle of the rat were investigated 2, 6 and 24 h after hypophysectomy or sham-operation. In hypophysectomized animals protein synthesis was depressed. GH in vitro was without effect 2 h after hypophysectomy but stimulated protein synthesis 6 and 24 h after the operation. Six hours after hypophysectomy amino acid transport was enhanced and further stimulated by GH. After 24 h amino acid transport was depressed but was stimulated to normal levels by GH. Six hours after sham-operation protein synthesis was depressed, but was stimulated by GH. After 24 h protein synthesis was normalized and GH was without effect. GH did not influence amino acid transport after sham-operation. Plasma levels of GH were undetectable after hypophysectomy, markedly depressed 2 and 6 h after sham-operation, but normal after 24 h. It is concluded that tissue responsiveness to GH develops a few hours after hypophysectomy.


Metabolic effects of blood flow restriction in adipose tissue. The metabolic effects of blood flow restriction were studied in isolated blood-perfused canine subcutaneous adipose tissue. Blood flow restriction (on the average to 20 per cent of control flow) was caused by either mechanical clamping of the arterial inflow or by i.a. injections of methoxamine or angiotensin. Glucose uptake in the adipose tissue was reduced during blood flow restriction. This was partially compensated for by a period of increased glucose uptake following restoration of flow. Blood flow restriction also caused an increase in the venous lactate/pyruvate ratio. The basal lipolytic rate was decreased during blood flow restriction. Lipolysis induced by brief (5 min) sympathetic nerve stimulation (4 Hz) was not inhibited by blood flow restriction as the total amount of glycerol released from the tissue was unaffected. The outflow rate was reduced during blood flow restriction, but glycerol trapped within the tissue was apparently not reutilized by the fat cells as it was released upon flow restroation. FFA outflow following nerve stimulation was, however, inhibited suggesting increased reutilization of FFA within the tissue. This increased reutilization may ultimately be caused by the observed change in red./ox.-balance and/or by the limited carrier capacity (albumin) available during blood flow restriction. Three main conclusions may be drawn from the present results. Firstly, plasma levels of glycerol and FFA do not necessarily reflect adipose tissue lipolysis at a given moment. Secondly, the decreased adipose tissue blood flow seems to be a major cause of the lowered FFA-levels during hemorrhage. Thirdly, in contrast to hemorrhage, even severe reduction of adipose tissue blood flow is insufficient to cause irreversible ischemic damage.


Predictive scales for parasuicide repetition. Further results. A six-item predictive scale for parasuicide repetition was retested on a second sample of Italian parasuicides. All the patients firstever admitted after a deliberate self-harm to the psychiatric department of a general hospital during the period April 1973-March 1976 were interviewed and followed-up after an interval of 1 year. The scale showed the same predictive power found in the first sample (1970-73) and gave a range of probability of repetition within 1 year of 15% at a score of 0 up to 44.8% at the scores 3, 4, 5, and 6. Moreover it discriminated between repeaters and non-repeaters at a significant level. Only two items (diagnosis of sociopathy and change of domicile in the last year) of the five items which discriminated repeaters from non-repeaters in the first study were still significantly associated with repetition, while four additional items (previous in-patient psychiatric treatment; previous parasuicide resulting in hospital admission; unemployment; criminal record) appeared as new discriminating factors. In spite of these changes the rate of repetition remained constant over the years at around 26%.


Attitudes towards criminal and other patients. Staff attitudes towards mentally abnormal offenders were investigated on a forensic psychiatric assessment ward as reflected in a drug trial. The attitude towards drug trials was negative in 79% of the personnel, in contrast to 71% positive in three Swedish mental hospitals. Of the respondents 75% considered that drug treatment did not benefit the patients. Then the attitudes of 21 general physicians towards assessment and drug treatment of mentally abnormal offenders as well as towards 10 illnesses were measured by self-rating scales employing a 10-cm line technique. Both the assessment and drug treatment of mentally abnormal offenders were the least favoured as  compared with somatic illnesses. Other neuropsychiatric disorders ranked with them were also very significantly (P less than 0.001) less favoured than pneumonia. They considered that these attitudes were shared in general by medical and nursing staff


Types of attempted suicide (parasuicide). The clinical usefulness of a typology of parasuicide, reported in a previous paper, has been improved. A finer grained classification, using six instead of only three clusters, has proved itself to be clinically highly realistic. By a new method of cluster analysis which examines 80 attributes in each of 350 patients, the following types of parasuicide emerge: (1) operant, not alienated; (2) repeaters; (3) depressed with high life endangerment; (4) operant and alienated; (5) wristcutters; (6) undifferentiated. This more detailed typology may offer some advantages for clinical management and research.