A comparative trial of sisomicin therapy by intermittent versus continuous infusion. One hundred and thirty-nine febrile episodes in 120 patients were treated with sisomicin after a combination of carbenicillin and a cephalosporin antibiotic had failed. These patients were randomized to receive sisomicin either by continuous or by intermittent infusion. The response rate for patients treated with sisomicin was 61 percent by continuous infusion and 46 percent by intermittent infusion, which was not statistically significant. Pneumonia, septicemia, and soft tissue infections were the most frequent infections. Most (96 percent) of the identified pathogens were gram-negative bacilli with the most frequent being Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa. The response rate was higher in those patients whose neutrophil count increased or remained the same while on therapy. The worst response was obtained if there was a decrease in the neutrophil count during therapy. The major toxicity of sisomicin was found to be azotemia and occurred in 17 percent of episodes treated by continuous infusion and in 21 percent treated by intermittent infusion. Hearing loss in the high frequency range occurred in five patients. Sisomicin is effective in the treatment of gram negative infections in neutropenic cancer patients.


Daily variations in urinary excretion of luteinizing hormone and follicle stimulating hormone in idiopathic isosexual precocity. The 24-hour urinary excretion of luteinizing hormone (LH) and follicle stimulating hormone (FSH) was determined for 30 days in an 8.3-year-old girl with isosexual precocity and for 25 days in a normal 11.9-year-old girl. The pattern of daily variation in urinary LH and FSH excretion observed in the girl with sexual precocity was similar to that of the normal menstrual cycle. The LH and FSH midcycle peaks were 132.5 IU/24 hours and 26.3 IU/24 hours, respectively. Excluding the midcycle peak, the daily excretion of LH was 28.4 +/- 9.3 (SD) IU/24 hours, and the excretion of FSH was 8.9 +/- 1.9 (SD) IU/24 hours, values comparable to those of normal adult females. In contrast, the daily excretion of LH in the normal 11.9-year-old girl was 6.9 +/- 1.1 (SD) IU/24 hours and FSH excretion was 3.9 +/- 0.9 (SD) IU/24 hours. No LH or FSH surge was observed. The data are consistent with early maturation of the hypothalamic-pituitary-gonadal axis in idiopathic isosexual precocity.


Post-extubation pulmonary function tests in detection of upper airway obstruction in drug-overdosed patients. A relatively high percentage of hypnotic-sedative drug-overdosed (HSDO) patients suffer post-extubation upper airway obstruction. Since early detection and treatment of these lesions is desirable, we studied 20 recently extubated (within 24 hours) as well as 11 non-intubated HSDO patients employing flow-volume loops and spirometry. Abnormalities in tests for upper airway obstruction were common in both groups but only in the four post-extubation patients with clinically suspected upper airway obstruction was an inspiratory plateau by flow volume loops found. In addition, three of these four patients had mid-VC ratios greater than 1.25. We conclude that the Inspiratory flow volume loop and the mid-VC ratio may help in detecting post-extubation upper airway obstruction in lethargic, HSDO patients.


A cytogenic evaluation of long-term colchicine therapy in the treatment of Familial Mediterranean fever (FMF). Thirty-eight patients suffering from Famlial Mediterranean Fever (FMF) and undergoing colchicine therapy for periods varying from one week to three years were examined cytogenetically. Preparations were derived from short-term lymphocyte cultures; mitotic rate, percent tetraploidy, and chromosome breakage rates were determined. Twenty-one patients were examined prior to treatment, 22 during treatment and 5 both before and during treatment and 5 both before and during treatment. No statistically significant differences were observed in the parameters studied between ten controls and the patient groups. An in vitro experiment indicated a direct correlation between increased colchicine concentration and mitotic rate. However, tetrapoloidy or chromosome damage showed no such association with colchicine concentration. Among the patient group, pregnancy occurred in four patients while under treatment; three pregnancies resulted in the birth of normal children while the fourth has not yet been completed. In one preganancy, cultured fetal amniotic fluid cells demonstrated no effect of colchicine on the cytogenetic parameters invetigated. These results indicate no untoward effects on long-term colchicine treatment in FMF with respect to fertility, teratogenicity and chromosomal damage.


Adriamycin cardiotoxicity: endomyocardial biopsy evidence of enhancement by irradiation. Endomyocardial biopsies were examined in 12 patients receiving total doses of Adriamycin from 90 to 445 mg/M2. These patients had also received previous mediastinal irradiation (from less than 600 to 5700 rad) over periods varying from 6 months to 14 years prior to the endomyocardial biopsy. Severity of pathological change in these 12 patients was compared with that of dose-matched control patients who had not received mediastinal radiation. The severity of the histopathologic changes was scored on a scale from 0 (normal) to 3 (marked abnormality). The mean score of the group receiving irradiation (2.0 +/- 0.89) was significantly higher than the score in those not irradiated (1.18 +/- 0.23) (p less than 0.001). Morphological demonstration of a "recall phenomenon" of latent radiation changes by Adriamycin was demonstrated in small intramyocardial vessels. This study indicates that radiation, even if remote, enhances Adriamycin-induced cardiomyopathy. Therefore, Adriamycin must be given cautiously in patients who have received previous mediastinal radiotherapy.


Prognostic significance of tumor emboli in intramammary lymphatics in patients with mammary carcinoma. Approximately 20% of patients with invasive mammary carcinoma who do not have axillary metastases develop recurrent carcinoma within 10 years of initial therapy. There is clearly a need to identify those patients most likely to develop recurrences in this group since they may benefit from adjuvant therapy. This study was undertaken to evaluate the prognostic significance of intramammary lymphatic tumror emboli in patients with invasive breast carcinoma who did not have lymph node metastases. Twenty-three such patients treated in 1974 and 15 from 1964 were compared with matched groups of control patients who did not have lymphatic emboli. About 43% of patients with lymphatic emboli and 4% of those without emboli followed for 5 or more years in the 1964 group developed distant metastases (p less than 0.001). Local recurrences were found in only one study patient and one control in the entire series of 1964 and 1974 patients. The results suggest that among patients without axillary metastases, the finding of tumor cells in lymphatic spaces within the breast is associated with a substantial risk of distant metastases but not local recurrence.


Radiologically occult in situ and incipient invasive epidermoid lung cancer: detection by sputum cytology in a survey of asymptomatic cigarette smokers. Approximately 8000 cigarette-smoking men over the age of 45 have entered into a lung cancer detection program in New York City. Cytologic examinations of sputum were carried out on 4000 subjects and lung cancer was found by this technique in nine men with normal chest x-rays. Seven had in situ or incipient invasive epidermoid carcinoma confined to the bronchus. These seven cases were studied by detailed histologic examinations of the bronchial tree in the resected specimens through sixth generation subsegmental bronchi. It was concluded that: 1) invasive epidermoid carcinoma arises from carcinoma in situ of bronchial surface epithelium or an extension of that neoplastic epithelium in bronchial glands; 2) the site of origin is a segmental bronchus in most instances; and 3) each carcinoma should be considered as unifocal in origin even though there is a continuing risk of another primary lung cancer. It seems unlikely that squamous metaplasia or basal hyperplasia is an essential step in carcinogenesis; rather, we believe that carcinoma may arise in bronchial epithelium without regard to the presence or absence of basal hyperplasia or squamous metaplasia, which should be considered nonspecific reactions to injury that may or may not accompany carcinogenesis.


Pneumonia and empyema caused by Clostridium sordellii. A case of pleuropulmonary infection caused by Clostridium sordellii is reported for the first time. The clinical presentation with acute onset resembling pulmonary infarction, the absence of toxicity, hemolysis and shock, and response to penicillin and drainage was similar to that of patients with pleuropulmonary infection caused by C. perfringens.


Squamous cell carcinoma of the thymus. An analysis of eight cases. Eight cases of squamous cell carcinoma of the anterior mediastinum, most likely derived from the thymus, are presented. Seven were male and one female ranging in age from 39 to 65 years; the average was 55.5 years. There were no cases associated with any paraneoplastic syndromes. They possessed common morphological characteristics. Grossly, the tumors resembled malignant thymoma. Invasion of the lung and metastases to regional lymph nodes were frequent. Often observed microscopically were foci of sharply defined keratinization resembling Hassall's corpuscles, no radial arrangement of tumor cells at the periphery of nests, and broad, fibrotic, or hyalinized stroma. Admixture of a few lymphoid cells and some features transitional to thymoma were also observed in some parts of tumors. However, undoubtedly carcinomatous areas were present in some or large parts of all the tumors, where individual cells possessed a vesicular nucleus and a prominent round nucleolus. These features were distinct from those of bronchogenic squamous cell carcinoma and other thymic tumors, although they appeared to be related to thymoma. Treatment of choice is radical surgery and postoperative radiotherapy, because of relatively high radiosensitivity. Prognosis of patients was relatively good. From analyses of cases it is concluded that squamous cell carcinoma of the thymus should be separated from ordinary thymoma of the epithelial type, and that squamous cell carcinoma involving both the thymus and lungs should be carefully examined for the primary site of growth.


Follicular variant of thyroid papillary carcinoma: a clinicopathologic study of six cases. The clinicopathologic features of six cases of a peculiar variant of differentiated carcinoma of the thyroid composed of follicles with or without solid areas and having a characteristics ground-glass appearance of the nuclei were studied and compared with those of conventional papillary and follicular carcinomas. This variant resembled papillary carcinoma in its biologic behavior and all morphologic features with the exception that papillae were not present. The term "papillary carcinoma, follicular variant" is proposed for this tumor type in order to emphasize its close biologic relationship with the conventional papillary carcinoma.


Plantar lentiginous melanoma: a distinctive variant of human cutaneous malignant melanoma. The neoplastic system of human cutaneous melanoma includes three generaly recognized variants: lentigo maligna, superficial spreading melanoma, and nodular melanoma. Lentiginous melanomas other than lentigo maligna constitute a fourth group, of which plantar lentiginous melanoma qualifies as an anatomic subgroup. Histologically and clinically, plantar lentiginous melanoma (PLM) is characterized by a period of radial growth and often by one or more foci of regression. In 27 of 33 plantar melanomas, a characteristic lentiginous, radial component of melanocytic proliferation was noted. In the remaining six cases, histological material failed to document a radial component. Eighteen of the 27 patients with PLM were blacks, and 18 patients died of distant metastasis. Tumors invasive to level II did not metastasize, but at levels IV and V and in tumors with a high mitotic rate, the prognosis was poor. The presence of lymph node metastases at the time of initial therapy correlated with a poor prognosis group.


Elastosis in benign sclerosing ductal proliferation of the female breast. Elastosis, an abundance of elastic tissue, is commonly present in breast carcinoma. However, its diagnostic significance remaines an unsettled issue. This study documents 17 cases of elastosis occurring in a distinctive benign sclerosing ductal lesion of the female breast (Fenoglio and Lattes: Cancer 33: 691-700, 1974). Elastosis was characterized by staining reactions and, in several instances, by elastase digestion and electron microscopy. Yellow streaks and flecks may be apparent grossly and probably reflect the increased elastic tissue. Histologically, the lesion is generally stellate with central sclerosis and marked peripheral intraductal and ductular hyperplasia which is often papillary. Elastosis, which may be marked, is a constant finding and is predominantly periductal in location. It is emphasized that the gross and histologic features of the lesion may mimic carcinoma and that elastosis may be found in benign ductal lesions of the breast.


The histogenesis of molluscum contagiosum. In the group of viral induced epidermal hyperplasias, the inverted, follicular, and lobulated pattern of a lesion of molluscum contagiosum is distinctive. The proposed epithelial progenitors have included epidermis, sebaceous glands, and hair follicles. A study of 77 cases of molluscum contagiosum implicates folliclular neogenesis as a primary histogenetic determinant. Areas of hair bulb differentiation are common at the periphery of a lesion of molluscum contagiosum and occasionally are associated with areas of sebaceous gland differentiation. In areas of active viral replication, the neogenetic follicular epithelium expands to form rounded lobules which extrude viral particles and keratinized debris into dilated ostia. In inflamed molluscum contagiosum, the inflammatory response is reminiscent of the invasive--destrictive pattern of cell-mediated immunity.


Very-nearly-closed-circuit anaesthesia. A computer analysis. A simple analogue study of inspired oxygen concentrations in a circle absorber system was made. Good agreement with clinical observations and figures reported by others was obtained. The suggested low-flow regime was nitrous oxide 1 litre/min and oxygen 0.6 litre/min, which provides inspired oxygen concentrations between 35-25%, over a range of oxygen consumption from 150-300 ml/min. The use of such low flows is economical and reduces atmospheric pollution in the operating theatre.


The danger of fatal misjudgement in hypothermia after immersion. Successful resuscitation following immersion for 25 minutes. A case is reported of the successful resuscitation of a 6-year-old child after 25 minutes' immersion in water at 4 degrees C. The difficulties of evaluating vital functions at low body temperatures, with the accompanying danger of fatal misjudgment, are pointed out. It is concluded that low body temperatures indicate that a considerably longer resuscitation procedure than normal should be undertaken, particularly in children, and that if the body temperature is above 30 degrees C rewarming ought not to take place before satisfactory oxygenation and an efficient circulation have been established.


Etomidate in electroconvulsive therapy. A within-patient comparison with alphaxalone/alphadalone. In a group of 31 patients undergoing electroconvulsive therapy, there was no significant difference between the times of return of eyelash reflex, swallowing and respiration following a single induction dose of 0.2 mg/kg of etomidate as compared with an induction dose of 0.036 ml/kg of alphaxalone/alphadalone. The incidence of involuntary movements and increased muscle tone was significantly greater after etomidate than following alphaxalone/alphadalone; but the involuntary movements were never marked. The overall incidence of pain on injection was 15% after etomidate. There was a low incidence of venous sequelae following either drug.


Scleroderma. Complications encountered during dental anaesthesia. A young woman with scleroderma required a dental extraction for which general anaesthesia was considered appropriate. A cyanosed and painful hand followed the intravenous injection of methohexitone, and an oral laceration occurred during the extraction of a molar tooth.


Vacuum stethoscope attached to a tape recorder. A simple device for monitoring respiration and pulse rate. A simple apparatus consisting of a vacuum stethoscope attached to an ordinary cassette tape recorder is described. This can be used for monitoring respiration and pulse rate during paediatric anaesthesia, head and neck surgery and resuscitation of the newborn.


Total intravenous anaesthesia. A technique based on alphaxalone/alphadolone and pentazocine. Two hundred and eight patients were anaesthetised using incremental doses of intravenous alphaxalone/alphadolone (Althesin). Analgesia was provided by supplements of pentazocine, which also helped eliminate the excessive movements associated with pure Althesin anaesthesia. This is a total intravenous technique and consequently eliminates the problem of atmospheric pollution. It provides adequate anaesthesia for most minor surgical procedures.


Galanthamine hydrobromide, a longer acting anticholinesterase drug, in the treatment of the central effects of scopolamine (Hyoscine). Galanthamine hydrobromide, an anticholinesterase drug capable of penetrating the blood-brain barrier, was used in a patient demonstrating central effects of scopolamine (hyoscine) overdosage. It is longer acting than physostigmine and is used in anaesthesia to reverse the non-depolarizing neuromuscular block. However, studies into the dose necessary to combating scopolamine intoxication are indicated.


[Intensive care in rabies. A case report (author's transl)]. A case of human rabies is reported showing a peculiar course in some respects. The lack of a satisfactory history concerning an animal bite 5 months earlier as well as a misleading psychiatric history led to difficulty and delay in reaching a diagnosis. Under intensive care, including mechanical ventilation and cardiac pacing, the disease reached a final stage, which is rarely seen. The clinical course and the pathological findings are described in detail and the etiology and prognosis of the disease are discussed. The latter remains rather hopeless de spite modern intensive care.


Sensitivity to diethyl-ester as a possible cause of repeated cardiac arrest. During induction of ether anaesthesia in a five year old girl with multiple cardiac defects (ASD, VSD and PS) cardiac arrest developed repeatedly. Radical surgery was subsequently performed uneventfully under morphine anaesthesia with cardiopulmonary bypass. Ether appears to be the most likely factor accounting for the repeated arrests.


[A simple apparatus to check ventilation and respiration (author's transl)]. A simple device is described which gives visible and audible warning of interruption of ventilation, whether artificial or spontaneous. A thermistor is incorporated in an adaptor placed between the Y-piece and the endotracheal tube. It responds to a change in temperature before the tube via an electronic system that makes two small green bulbs glow. The sound signal is given 6 seconds after the last optical signal of the bulbs.


Autoradiographic localization of 131I-labelled thyroxine in the tissues of rat. An attempt was made to visualize the sites of localization of 131I-labelled thyroxine in the tissues of the rat by autoradiographic dipping techniques. The maximal uptake of 131I-throxine in rats occurred at 12 hours in all the tissues examined. The radioactivity continued to decrease from 12 to 36 hours after the injection. In the liver and kidney, the decline after 12 hours was rather marked. The radioactivity decreased only slightly from 12 to 36 hours in the spleen. After 3 hours of injection, the radioactivity was consistently higher in the thyroid follicular epithelial cells than in the interfollicular connective tissue. A high concentration of radioactivity was found at the periphery of the colloid areas.


The blood supply of the abdominally-placed vertical sigmoid colon. We have recorded the blood supply to a high or subsplenic sigmoid loop from branches of the left colic and first sigmoid arteries. An accessory middle colic present in this case crossed the region immediately superior to the apex of the sigmoid loop. In this instance it arose from the dorsal pancreatic which also gave origin to inferior pancreaticoduodenal branches. Since the high sigmoid may be retroperitoneal, as in the case described, it would not be readily apparent; it would require lateral views to separate it from the descending colon radiographically.


Anatomical variants of the celiac artery in the sheep, with special reference to the celiomesenteric arterial trunk. The course of celiac artery is described on the basis of studies on the carcases of 28 three-year old merino sheep of both sexes (7 males and 21 females). These investigations have shown that there are two main variants of the celiac artery. Of these, 60.7 percent of the sheep dissected exhibited the first, characterized by a separate issue of the celiac artery from the aorta. The second variant, characterized by the issue of the celiac artery from a celiomesenteric arterial trunk common to the celiac and superior mesenteric arteries, was found in 39.3 percent of the specimens. In the material studies, besides the variability in the course of the celiac artery, individual differences were found in the structure and topography of the neurovegetative vascular plexuses.


[On the venous system in the retroperitoneal region (a contribution to the persistence of the primitive vena cava system) (author's transl)]. A vasal anomaly in the region of the Vena cava inferior is being described in the corpse of a 25-year-old man. 1. In the course of development the V. subcardinalis has not been joined to the Pars hepatica of the V. cava inferior, which originates from the V. hepatis revehens communis. In our case the Anastomosis intersubcardinalis remains and is subjected to a slight retroaortal displacement to the left. 2. Among the Vv. sacrocardinales the V. sacrocardinalis sinistra, which ought to involute after the sixth embryonal week, has been retained together with the Anastomosis intersacrocardinalis. 3. The Vv. supracardinales are connected with the intersubcardinal anastomosis and the intersupracardinal transversal anastomosis has been retained. 4. The Vv. caudales end in the Anastomosis sacrocardinalis at a point before the Sacrum and the Anastomosis intercaudalis has been retained, too. 5. The caudal section of the right lower cardinal vein in its prerenal part is retained with an anastomosis to the right subcardinal vein. 6. The portal blood of the liver is directly distributed to the atrium dextrum after it has passed through three Vv. hepaticae. The Lig. venosum is intrahepatic and is joined to the Vv. hepaticae. 7. The primitive bilateral-symmetric veinous system of the caudal half of the body continues to exist almost completely.


[Experimental studies of the historheology of the liver capsule (author's transl)]. We have performed histomechanical experiments with historheological methods on the liver capsule of men and cattle. The liver capsule is a non linear viscoelastic tissue. The force-extension diagram or the force-time curve under increase in length shows a flat initial part with a large strain reserve, then an arched domain and subsequently a steep increase in force with a coordination of a small increase in length. The hysteresis loop is represented. When the tissue is in a viscoelastic steady state (preconditioned), the force-extension curves respectively the force-time curves are identical one with another and under certain presuppositions reproducible. This is also the case with the static relaxation curve and the force recovery curve (inverse relaxation). With a ramp shaped extension time input function and an additional, superimposed sinus length-time input function we can observe the following dynamical force-time output functions: Non linear dynamical force increase, amplitude increment phenomenon, dynamical force recovery (dynamical inverse relaxation). Various dynamical-statical transients are demonstrated in diagrams. The mechanical properties of the liver capsule are interacting with the ligaments of the liver, with the intrahepatic connective tissue, and with the liver parenchyma. Aspects of the functional anatomy and the tension of the capsule in an acute increase of he liver parenchyma are discussed.


The individualities of bronchioles of the upper and middle lobes in the lung of guinea pig. The bronchiole variation found in Guinea pigs is important for our understanding of the individualities of the upper lobe and middle lobe bronchioles. The upper lobe bronchiole of the Guinea pig can be divided into three sorts, namely, the well developed, ill developed and completely absent ones. Generally the right lung as the upper lobe bronchiole, while the left lung lacks the upper lobe bronchiole in many cases.


Ectopic lungs in a human fetus with Klippel-Feil syndrome. The hyperplastic lungs protruding out of the thoracic cavity are described in a full term still-born male cotwin having Klippel-Feil syndrome, single umbilical artery, dextrocardia and a right sided aorta. Both lungs herniated into the abdomen through bilateral defects in the diaphragm. The righ lung, in addition, herniated superiorly toward the base of the skull. The pulmonary herniation appears to be due to spinal retroflexion which reduces the capacity of the thoracic cage. The various anomalies observed can be attributed to the disturbances caused by single umbilical artery.


The effect of laser on the developing and adult rodent retinas and brains. The effect of laser on the retinas and brains of the neonatal and adult rodents were studied by employing monoamine oxidase histochemistry and K+ concentration study. No significant difference was found in the neonatal retinas and brains after irradiation when compared with control. But significant differences were found in the retinas and brains of the adult rodents after irradiation.


[Theoretic considerations on the vibration of human skulls (author's transl)]. Using a computer program for the evaluating of free eligible rotation-symmetrical cylinder shells the number of magnitude of the natural-frequencies were estimated. Assuming the skull of being annulary fixed the calculated values doe in the same range as those got from deat bodies or macerated skulls respectively. Modeling the vibration conditions for the non-fixed border of the skull, the mode shifts into a singulaer point on the rotations axis. In fact the mode in exactly known basis fractures tends to go to the vertex.


[On the estimation of the vibration of human skulls (author's transl)]. The skull as a biosystem capable vibration shows characteristic oscillation modes with specific Eigen-frequencies. For the calculation of the these values we used a test method. The 4 lowest Eigen-frequencies are in the range of 1-3 KHz(f1 = 1,03 +/- 0,35KHz;f2 = 1,71 +/- 0,13KHz;f3 = 2,16 +/- 0,12 KHz and f4 = 2,57 +/- 0,11 KHz;n = 13). The shifting of the vibration mode is of diagnostic value in estimating of skull-basis-fractures.


[Characteristic Biomechanical values for the hip joint (author's transl)]. Four human hip joints which had been fixed informaldehyde taken from human corpses (average age at death: 72 years) were subjected to pressure along defined axes and tested for static strength and elasticity, the hip joint being regarded as a system. The stress-strain curve reveals no definite linearity. The deviations from Hooke's elasticity found in this way have been explained by the fact that not only completely elastic bone, but also plastic components (cartilage of the joint) were tested. The maximum breaking strain, the modulus of elasticity and the elasticity coefficient were also determined. Only about 50% of all fractures observed on the test set-up were diagnosticised radiologically. The parameters which have, in the past, been determined only on models have thus been replaced by experimental results obtained on actual hip joints.


Nerve supply for anomalous ocular muscle in man. Of the orbitas of 85 humans examined, the same type of anomalous ocular muscle was found in 5 orbitas from three men and a woman. The anomalous ocular muscle, which originated the belly or the proximal part of the M. levator palpebrae superioris to attach to the Sclera, Trochlea and neighbouring tissues, was identical to the M. tensor trochleae described by Budge (1859) was innervated by the Ramus superior of the N. oculomotorius. Two main branches from the R. superior of the N. oculomotorius for the M. rectus superior united to form common loop before supplying the M. levator palpebrae superioris. The loop had a few branches of which the thick one supplied the M. levator palpebrae superioris and smaller ones innervated the anomalous ocular muscle from the ventral and sometimes dorsal sides.


[Comparison of the three-dimensional behaviour of the relief of the enamel crown and dentine crown in the permanent dentition in the mole (author's trnasl)]. 1. As an example for the dentition of the insectivores, the teeth from 20 wholly conserved skulls of moles were investigated and measured before and after electrolytic decalcification. Every crown was described and photographically registered in the calcified and decalcified states. 2. The relief of the enamel crown was compared to that of the dentine crown. Almost without exceptions, the form of the dentine crown narrowly corresponded to that of the enamel crown. 3. The 3rd lower premolar can be an exception: in one case, its dentine crown showed two cusps while its enamel crown demonstrated only one of them. 4. The form of the crown is determined by genetically fixed and not by functionally induced growth-factors.


A pattern formed by preferential orientation of tangential fibres in layer I of the rabbit's cerebral cortex. 1. The tangential organization of layer I has been studied in frozen sections impregnated according to a modified Liesegang method and in Bodian impregnated paraffin sections cut tangentially to the dorsal surface of the rabbit's cerebral cortex. 2. It is shown that sublamina tangentialis of layer I contains a system of parallel nerve fibres forming a distinct pattern in the tangential plane. 3. This pattern has been reconstructed for a large region of the dorsal surface of the cerebral cortex including the striate areas as well as the peristriate, parietal and precentral agranular regions and parts of the retrosplenial area. 4. In most parts of the region investigated, the tangential fibres of layer I are oriented in an antero-medial to postero-lateral direction, forming an angle of about 50 degrees with the sagittal plane. 5. Deviations from this pattern are found in the furrows formed by the lateral sulcus and the frontal impression and also in the caudal part of the retrosplenial area. In these regions, which are characterized by comparatively steep changes of the cortical relief, the fibres course in a more sagittal direction.


The fine structure of the ependymal surface of the recessus infundibularis in the rat. The surface of the recessus infundibularis of the third ventricle has been studied with the scanning and transmission technique in normal and experimental material. Surface specializations such as microvilli, craters and areas of discontinuous lining are described. Supraependymal cells and fibres have been found; some of these cells form wide-meshed networks. The supraependymal fibres may be regular or varicose; the former seem to perforate the ependyma. With the transmission electron microscope the supraependymal cells are divided into three categories; nerve cells, lymphocytes and "dense cells". Two fibre populations are distinguished: thin profiles (nerve fibres) and thick profiles (nerve terminals). Axosomatic and axoaxonic synapses are described. Synapses between supraependymal fibres and ependyma cells have also been found.


Artificial neural induction in amphibia. I. Sandwich explants. 1. Embryonic tissues (ectoderm, neural plate) of Ambystoma mexicanum and Tritus were killed with hot water and implanted into ectoderm sandwiches. They induced the ectoderm to form neural tissue, lentoids and unspecialized epidermis. Neural tissue always showed retina character. Egg pigment was eliminated and gathered at the outer retinal surface or in the centre of rosettes. Neural crest cells like mesenchyme or melanophores were completely lacking, retinal pigment did not develop. 2. The thus induced living retina tissue was reimplanted into fresh ectoderm after 2 days. It continued histogenetic and morphogenetic differentiation and formed ocular vesicles with numerous eye cups. It induced the enveloping ectoderm to again form retina, lentoids and unspecialized epidermis without neural crest derivatives or RPE. 3. This inductive process can be reproduced several times.


Intercellular gap junctions in the developing retina and pigment epithelium of the chick. Gap junctions are found in the pigment epithelium, between retina and pigment epithelium and in the retina of 5-14 day chick embryos, they are identified using block staining and extracellular tracer techniques. In the pigment epithelium gap junctions are found between cell bodies and interdigitating processes and many change their position during development. Gap junctions between retina and pigment epithelium are only made by undifferentiated retinal ventricular cells and may provide intercytoplasmic pathways important for photoreceptor differentiation. Retinal gap junctions are found in an outer zone next to the pigment epithelium and inner zone near the vitreous, they are only seen between ventricular cells but may provide pathways for ganglion cell specification. The role of gap junctions in the generation of retinal neurons is discussed.


The postnatal development of rat dentate gyrus and the effect of early thyroid hormone treatment. The postnatal development of the dentate gyrus and the effect of 5 microgram/day triiodothyronine treatment was examined by means of tritiated thymidine autoradiography. The polymorph layer of the dentate gyrus is a secondary germinal layer and forms cells for the granular layer. The cell formation in the dentate gyrus was found to be nearly completed on the 21st day, but development ended only in adulthood. Thyroid-hormone treatment did not affect significantly the postnatal cell formation of the dentate gyrus, but resulted in the appearance of a great number of pycnotic cells in the granular layer.


Genetic polymorphism of eserine resistant esterases in canine plasma. Six plasma eserine resistant esterase phenotypes were observed in a population of 1438 dogs consisting of 38 breeds. Analysis of parentage records of the dogs examined revealed that the phenotypic variation of eserine resistant esterases was controlled by 3 codominant alleles ESA, ESB and ESC at one autosomal locus. The gene frequency of ESB was high in most of the breeds examined. Allele ESC was only seen in 5 Japanese native breeds, Akita, Shikoku, Hokkaido, Shinshu-Shiba and Mino-Shiba, and in a Spitz dog. Allele ESA has a low frequency in Japanese breeds but a higher frequency in some of the European breeds tested.


Isoenzymes of creatine phosphokinase in acute myocardial infarction. Serial determinations of creatine phosphokinase (CPK) isoenzymes were performed in 400 patients with definite acute myocardial infarction (AMI). The findings were correlated with the clinical course and the findings in another 300 cases of increased CPK levels. MB-CPK, the cardiac fraction, was present in all 400 cases of AMI and in only 5 cases of the 300 patients with high CPK due to causes other than AMI. Based on the magnitude and time course of the total CPK in relation to the MB-CPK, five different patterns are described which correlate with the clinical course. Our findings thus suggest that the determination of CPK isoenzymes can be a most helpful diagnostic tool in the care of the cardiac patient.


Horizontal polyacrylamide gradient gel electrophoresis for the simultaneous phenotyping of transferrin, post-transferrin, albumin and post-albumin in the blood plasma of cattle. A simple method of horizontal polyacrylamide gel electrophoresis was described for the simultaneous phenotyping of transferrin, post-transferrin, albumin and post-albumin in the blood plasma of cattle. A step gradient gel of 8, 4, 12 and 14% acrylamide concentration was used. The method enabled the detection of a new protein polymorphism in the post-transferrin region. Two alleles were observed. The transferrin phenotypes involving D1 and D2 alleles were clearly separated. The resolution of the post-albumin fractions was also better than described by earlier methods.


Haemolytic anaemia in Basenji dogs. 2. Partial deficiency of erythrocyte pyruvate kinase (PK; EC 2.7.1.40) in heterozygous carriers. Congenital nonspherocytic haemolytic anaemia (HA) in dogs of the Basenji breed is inherited as a simple, autosomal recessive trait. Previous results of pyruvate kinase (PK) assays suggest a causal relationship between the anaemia and PK deficiency in erythrocytes. In the present investigation assays of this enzyme have been performed on haemolysates from 45 Basenji dogs, comprising 3 anaemic and 42 non-anaemic individuals of which 13 were known heterozygotes. The PK activity in haemolysates from the 42 non-anaemic dogs exhibited a bimodal distribution corresponding to the genotypic classes: heterozygotes and normal homozygotes. The results indicate that heterozygotes have a partial, detectable enzyme deficiency, not reflected in clinical disease, and thus give evidence of a gene dosage effect in agreement with observations in man. The proposed genotypes PK PK, PK pk and pk pk refer to normal homozygotes, heterozygotes, and anaemic individuals, respectively. The findings strengthen the genetic hypothesis of recessiveness of the anaemia by direct detection of heterozygosity of parents of affected individuals. Moreover, the results are of value in comparative studies and they have practical application in connection with eradication programmes.


Taste sensitivity in the embryo of the domestic fowl. Two experiments were carried out to investigate the sense of taste in embryos of the domestic fowl. In the first, four taste substances; NaCl, HCl, glucose and SOA were diluted with distilled water and the response was compared with that to distilled water alone. No significant effects of taste were found. In the second experiment five taste substances: HCl, fructose, NaCl, KCl and quinine were diluted with fluids normally imbibed by the embryo: amniotic and/or allantoic fluid taken from other eggs. These solutions and also distilled water were compared with egg-fluid alone. A highly significant effect of the five solutions was found showing that the taste system becomes functional before the time of hatching. Distilled water produced on an unexpectedly large response in the embryo; possible reasons for this are discussed.


[Electrometric determination of urinary ammonia using a continuous-flow automatic method]. A critical study has been designed to evaluate the application of an electrometric method to the assay of ammonia in urine. The use of NH3-gaz permeable membrane electrode with a continuous flow system seems to have solved most of the problems evoked by former studies. The results obtained show that the method is reliable for the use in clinical routine. The simplification of the ammonia measurement procedure thus achieved will allow an important increase in the number of renal function tests that a clinical routine laboratory can handle in a hospital.


[Characterization of the thio-dependent hemolysin of Bacillus alvei]. Bacillus alvei hemolytic toxin has been characterized in five main steps from a 18 hours culture supernatant fluid. 50% ammonium sulfate precipitations are followed by Sephadex gel filtrations. After that we proceed to an isoelectric focusing in a narrow pH gradient (from 4 to 6). A final step consists in a gel filtration allowing to separate sucrose and ampholins from toxin preparation. The homogeneity of the alveolysin preparation is controlled on double immunodiffusion, immunoelectrophoretic analysis and polyacrylamid gel electrophoresis. From this study we can conclude that B. alvei hemolysin has a molecular weight of 45,000 and an isoelectric point of 5.1. 80 ng/HU of cholesterol represent the 50% inhibitory dose for the hemolytic activity of the alveolysin. Lethal dose calculated on mice is found to be 300 HU.


[Study of 50 strains of Aeromonas hydrophilia isolated from fishes]. A bacteriological survey of the healthy Goldfish (Carassius auratus) demonstrated the frequent occurrence of A. hydrophila. The biochemical characters and the sensitivity to 29 chemiotherapics and 15 antiseptics of 50 fish originating strains were studied and compared with a number of strains, implicated in human pathology. The results of this study indicate a good agreement for the biochemical characters and the sensitivity to chemiotherapics between the fish and the human strains. Owing to this statement, the author suggests to bear in mind the potential hazard which could result in the introduction of ornamental fishes in the hospital environment.


[Conductometric microdosage of blood and urine urea by use of a semi-automatic analyser]. The authors present the principle of a new method of urea estimation based on conductimetry. Its results are compared with those given by the colorimetric method using diacetylmonoxime. Correlation of the results was satisfactory. With the apparatus studied, it was possible to estimate very simply plasma and urinary urea with low volume samples 10 microliter). The titration took 30 seconds.


[Pathology of the cardio-hiatal sector]. Authors give rational rules for therapy of these anomalies, based on their samp physiopathology. Special attention is given to quality of gastro-esophageal reflux, which in cases of gastric hyperacidity can be the cause of complications in this disease. A wide study made in different groups of these patients, and comparison with a normal group and others affected with a probable duodenal ulcer, is sufficiently significant for accepting this possibility. Postural therapy for gastric ectopias and cardiac-esophageal dilatations in the first months of life are proposed. In case of bad evolution or presentation of a gastric hyperacidity on approaching one year of age, a surgical intervention is indicated. Big hernias should always be operated. As a surgical technique they propose an anatomical correction in order to return a normal physiology to the affected region.


[Determination of weight concentration of dusts using automatic sample-collecting devices based on beta absorption and on the Tyndall effect]. Some automatic sample-collecting sets for measuring the ponderal concentration of dust have been tested. Such apparatuses are based on two different principles: beta ray absorption, and Tyndall effect. It is shown how, through the beta absorption apparatus, it is also possible to carry out absolute measurements, after evaluating obviously the possible matrix effects. Furthermore it is shown how the sample-collecting sets, based on Tyndall effect, open new prospects in their employement on machinery drainage processes, or in following the behaviour of dust phenomena. The two types of apparatus thus tested integrate each other, where an automatic control, particularly in working environments, is needed.


[Asbestos minerals: their recognition and determination]. Fibers of amphibolic and serpentinic asbestos may be optically distinguished by the method proposed by the AA. The method is based on the observation at the microscope in reflected fluorescence of fibers of asbestos previously treated with a fluorochrome colouring agent; it can be applied for the individual counting of fibers on the filters used for checking the environmental air and has already been applied with good results in asbestic cement factories.


[Tumours of chiasmatic and hypothalamic regions in children (author's transl)]. 31 cases with tumours in chiasm and hypothalamus are presented. 21 cases had glioma of chiasma (the tumor continued along one or both optic nerves), six cases had craniopharyngioma and four cases had astrocytoma in the hypothalamus. All of these tumours represent 19% of intracranial tumours observed in our service over a period of eleven years. Russell's syndrome was usually seen in cases of gliomas of chiasm. Visual alterations were observed in a high average of patients with any type of the tumours. Skull in lateral view was a positive proof in all the three types of tumours showing "omega" sella turcica in gliomas of chiasm, supra or retro-sellar calcifications in croniopharyngiomas and large sella turcica in astrocytomas of the hypophalamus. Neumoencephalography and angiography were very positives proofs in all types of tumours. Gammagraphy was specially possitive in gliomas of chiasm. Computed axial tomography is very useful in all types of tumour, but our experience is still limited in comparison with other methods. Most effective treatment for gliomas of the chiasm was radiotherapy with shunt in cases with hydrocephalus and total or partial extirpation in astrocytomas of the hypothalamus and in craniopharyngiomas. Survival rate among patients with these types of tumour is high but presence of visual and endocrinological secuelae is very high too.


[Vertebral and basilar arterial oclusions in children. A case report and review of literature (author's transl)]. A nine-year-old boy with thrombosis in the right vertebral artery is presented. When child was 20 months old symptoms began suddenly with loss of consciousness, hemiparesia in the left side and later on psychomotor involution. The various aspects of the vertebral and basilar occlusions are discussed when they happen before the age of fourteen, of which there are 19 other cases published already. Etiology of this affection is very mixed in children and frequently unknown. There are more than one obstruction in 50% of patients and very often the nearest one is located at the level of the axis. Evolution is better in children than in adults, being dependant on such factors as the type of initial symptom, location of occlusion and quantity of collateral circulation present.


[Noise in a foundry: measurement and evaluation]. The results of the noise measurements obtained in three foundries, two of cast-iron and one of aluminium, are reported. Because of noise level variations, a level recorder and a statistical distribution analyzer have been used in addition to a sound level meter, and thus equivalent continuous sound levels (Leq) both with factor q = 3 (European Code) and with factor q = 5 (OSHA) have been calculated. The results obtained with these two different criteria of evaluation are discussed.


[Determination of the acidity of particulate matter in the urban and industrial atmospheres]. A new method is described for the determination of the strong acidity of particulate matter. The method consists in the volumetric titration of an aqueous extract by means of a strong acid. The titration is performed potentiometrically using a glass electrode and the end point is obtained by extrapolation using a Gran's plot. The lowest concentration of strong acid detectable in a sample is about 0.5 microgram/ml expressed as H2SO4. The method has been applied for the determination of the strong acidity content in airborne particulate matter samples and in dusts emitted from industrial sources.


[Fetal alcohol syndrome (author's transl)]. A case of fetal alcohol syndrome is reported in a intrauterine growth retarded female newborn with dysmorphic features and congenital cardiopathy whose mother suffered from a chronic ethylism during pregnancy. Authors compare this case findings with the reported revisions of other authors.


[Determination of acidity of urban aerosol]. The determination of the particulate acidity by the Commins method has been evaluated in order to examine the influence of sampling conditions on the results of the measurements. This method, which requires controlled and restricted sampling conditions, has been used for the determination of acid particulate in Rome over a period of one year. The monthly average concentration of the acid particulate are related to the suspended particulate and atmospheric precipitation.


[Intrapulmonary deposition of submicron-size particles]. Inhalation studies of ultrafine aerosol particles are described. Chambers with controlled atmospheres have been built, in which known volumes of clear air and aerosol particles are introduced. By means of an electrical mobility analyzer the size distribution of the aerosol in the chamber determined down to a mean diameter of 0,01 micron. Such aerosol is inhaled by the subject and exhaled into an identical chamber, previously filled with clean air. The size distribution of the resulting aerosol is determined with the same measuring system. The particle number distributions of inhaled and exhaled particles are then suitably correlated and compared. In this paper data are reported based on the retention of cigarette smoke referred to male subjects in the age group from 24 to 44 years old. These results are compared with the experimental data which appeared most recently in the medical literature. A standardization is proposed of the experimental conditions for measurements of intrapulmonary deposition of inhaled particles. This is because of the importance that the results of such studies might have in the field of prevention and industrial hygiene, in particular in the nuclear field.


[Klinefelter's syndrome with 48,XXYY (author's transl)]. This paper describes a case of Klinefelter's syndrome with 48,XXYY. Patient had mental retardation and dysmorfic face. Although mental retardation may be recognized early in life, it is difficult to establish a clinical diagnosis of Klinefelter's syndrome before puberty when small testes, gynecomastia and other phisical stigmata may become apparent.


[Determination of the pneumoconiosis hazard in the cork industry]. The AA. have carried out an epidemiological investigation in order to control the prevalence of chronic respiratory diseases on a group of 385 people working in several cork industries in North Sardinia. At the same time an environmental investigation has been carried out. Standard questionnaire (CECA questionnaire) for chronic bronchitis and pulmonary emphysema, standard chest X-ray film, spyrographic investigation, ECG and sputum analysis for acid resistent bacteria have been used for epidemiological investigation. Environmental dust concentration and individual dust exposure, environmental concentration of sulphur oxides, nitrogen oxides, carbon mono- and dioxide, ammonia nad microclimatic conditions have been studied. Examination of medical data shows only a low degree of respiratory pathology in contrast with results of other authors, probably because of different methods used for epidemiological investigation and data interpretation and because of different environmental and working conditions.


[Environmental dust in a plant for the production of polyvinyl chloride]. The results of an investigation on environmental dust concentration and individual dust exposure in a drying and sacking section of an "emulsion" and "suspension" PVC plant are reported; data on environmental concentration and individual dust exposure have been obtained by gravimetric techniques using similar personal and static dust samplers. Morphology and particle size distribution have been studied by electron microscopy on airborne dust specimens. Morphological analysis showed remarkable differences concerning shape and size between particles sampled in the "suspension" polymer and "emulsion" polymer sacking sections. Remarkably high mean values concerning dustness have been observed: 1.30 mg/m3 (min. 0.15; max. 18.4 mg/m3) for environmental concentration and 5.39 mg/m3 (min. 0.28; max. 45.6 mg/m3) for individual exposure.


[Atmospheric pollution and chronic respiratory diseases in the blast-furnace areas of iron-works]. An epidemiologic research together with a study on the environmental pollution were carried out in order to evaluate the risk of chronic respiratory diseases of blast furnace workers. The environment study was performed mainly using personal samplers given to workers with different jobs. Observations on 222 work shifts have shown that the total dust concentration to which cast workmen, maintenance men and blast furnace service men were exposed, marginally exceed the TLV values. Furthermore the level of respirable dusts for blast furnace service men was found slightly excessive. The average SO2 concentration was largely below the TLV values. However this gas could be found in excess for very short periods during the work. The epidemiologic study, conducted on a cohort of blast furnace area workers against a control group cohort, indicated a moderate prevalence of pneumoconiosis and chronic bronchitis amongst blast furnaces workers. The clinic and radiological pictures do not seem to go beyond the initial stages.


[Hazards involved in the working stages of a plant for the manufacture of cement-asbestos]. During a research into a factory for the manufacture of cement-asbestos pipes and slabs in which 533 workers were employed the AA. have taken an interest, over all, in the working risks related to dusts, suggesting the more suitable defence principles in various working places. We can consider the remarks, though effected in different conditions, sure in the environment conditions (of atmosphere, work and materials) in which they were carried out. More reliable results could be obtained with various measurements taken from time to time. About the entity of the dust risks and especially in relation to a priority production of preventive measures, we must consider, before all, the dusts of asbestos, then the ones of cement-asbestos and at last, the ones of cement; naturally for the dusts of the same type the greatest risk is tied to the manufactures that produce them in greater amount.


[Evaluation of atmospheric pollution in industrial environment using gas-chromatographic technics]. Several analytical techniques for the evaluation of different classes of air pollutants that can be found in working places are described. Particularly an automatic apparatus for monitoring total organic substances less methane, and one, employing specific detection and selective columns for the automatic and continuous determination of light sulfur compounds, are described. An analytical procedure for trapping and selective analysis of organic substances is presented. This includes the description of trapping and enriching devices and of a semi-automatic apparatus for the gaschromatographic analysis of the samples trapped. Some applications of these analytical techniques are described.


[Separation and determination, using a gas-chromatographic method, of vinyl acetate, methyl acetate and methyl alcohol in industrial environments]. The AA. have defined a simple and rapid method for sampling and subsequent simultaneous determination of ppm of vinyl acetate, methyl acetate and methyl alcohol present in work environments. The methods for drawing air and for performing the gaschromatographic analysis by two columns are illustrated.


[Determination, using gas chromatography, of acetonitrile and acrylonitrile in the air]. This paper deals with sampling and analysing acetonitrile and acrylonitrile pollutants in the work environments. The sampling procedure in the air is based on -15 degrees C cooled adsorbing solution (water/methanol 65:35 v/v). The quantitative analysis is made by gaschromatograph equipment with Porapak Q 50 divided by 80 mesh column.


[Methods for the sampling and tracing of caprolactam monomer dispersed in the air]. The problem of hygiene in the production of epsilon-caprolactam is very important; pollution of work room air is possible when the substance is stored, transported or packed in bags. In this work toxic and irritant properties of epsilon-caprolactam are described. Infrared spectroscopic, gas chromatrographic and spectrophotometric methods used by us, for the determination of epsilon-caprolactam traces, are also described.


[Gas chromatographic determination of biphenyl and 2-phenylphenol in the environmental air of dyeing-plant rooms of the textile industry]. A report is made on a method of sampling and analysis of biphenyl and 2-phenylphenol which are present in the environmental air of the dyeing plant rooms of the textile industry. The sampling is carried out by filtering environmental air through small pipes containing two layers of Porapak Q 80-100 mesh, the first one of 150 mg for the analysis and the other, of 50 mg, for the control, with a flux of about 1 l/min. The report includes the description of some tests concerning shifting and displacement with various fluxes, as well as the recovery of known quantities and the stability of the sampling. The saturation for the mixture of the two pollutants was about 130 mg/g of biphenyl and more than 100 mg/g of 2-phenylphenol. The gaschromatographic analysis was carried out on 2 ml of cyclohexane; methylacetate 80:20 by which was obtained the absorbent used for the sampling. An analytical column was used with 3% Apiezon L, 1% phosphoric acid, 2% Carbowax 20 M on Chromosorb W HP 80-100 mesh. These results were also confirmed by other two reference columns. This method was applied successfully to the analysis of the air of the work environment under examination.


[Noise generated from driving-in foundation piles]. Results of sound pressure measurements during driving-in of foundation piles are reported. The results are then compared with latest recommendation from the standpoint of hearing impairment due to continuous or impulsive noise.


[Determination of organic phosphate plasticizers and solvents in the environmental air of the shoe industry]. We have carried out a laboratory research with the purpose of evaluating the absorbing capacities of various commercial active coals, equipping therefore a room where we have maintained a constant concentration of solvents in the air. We have determined through a gaschromatographic method the conditions of dimension of the test tube, the quantity in weight of coal and the speed of the flow to secure at least 4 1 of sampling. Using test tubes of 10 mm of inner diameter, 70 mm long containing 0.8 g of active coal, 20-35 mesh, with diameter from 0.33 to 1 mm2, subjected to an aspiration of 0.35 l/m, we have diluted the solvents with CS2 and determined their quantity through gaschromatographic analysis. We have completed a research of trycresyl phosphate and other plasticizers upon 54 different types of cement used in 30 shoe factories in the comprehensory of Lastra a Signa. On the cement samples and glues it has been done the mineralization with sulphonitric mixture. It has been observed that the presence of the phosphorus in the samples of the cement is not always due to the presence of phosphorganic plasticizers. We have then carried out a distillation from the cements with n-hexane and a thin layer chromatographic analysis using as comparison commercial trycresyl phosphate. The various cements examined did not contain plasticizers.


[Aromatic polycyclic hydrocarbons in plants using bituminous materials]. In recent years bituminous materials have been frequently used in several industrial works for waterproofing, protection and insulation of many amterials such as paper, (asphalted) cardboard, wood, etc. Constant components of these materials are the polyciclic aromatic hydrocarbons (PAH), of which we know the biological activity and, for some of them, the cancerogenic effects. The aim of this work is to evaluated the possible risk from exposure to polycicilic aromatic hydrocarbons for workers in operations with bituminous materials. By an analytical method for the determination of PAH, we have examined the polycicilic aromatic hydrocarbons in asphalt, air-blown asphalt, tars and, then, in fumes from hot treatments of those materials. After analysing the fumes developed under controlled conditions, in laboratory, and those taken from work-environment, we have reported the results of our search.


[Determination of antimony from environmental air in the working area using flameless atomic absorption with a graphite furnace]. Particulates of antimony present in area of plants producing a catalyst containing iron an antimony have been determined. The environmental aereosol, filtered through micropore filters, is analyzed in the form of stabilized aqueous suspension by atomic adsorption flameless graphite furnace. The limit of air revealability permitted by the method is 0.2 mcg/m3. With the above mentioned revealability limit it is possible to perform very rapid drawings of environmental air, so that noxiouslity of even very short-time processing can be controlled.


[Identification, using x-diffractometry, of chromium, lead and zinc compounds in pigments of protective paints]. The application of diffractometric techniques for the identification of crystalline compounds which are contained in paint pigments and are important from the hygienic point of view, is described. Particularly, it is possible to identify lead and zinc chromates either on untreated pigments, or on filters of air samples of work-places used for spray painting.


[Atmospheric concentration of mercury in chlorinated sodium carbonate plants and their vicinity]. The mercury control in the chloroalkali plants is a "routine method". The air is above all sampled in the chloroalkali electrolysis rooms and in the rooms under them. Already in a previous paper we had pointed out a method for the sampling and determination of the metallic mercury in these work rooms. Atmospheric samples are passed through a small glass tube containing fine spongy particles of metallic gold. As far as particle mercury sampling and analysis are concerned, environmental air is filtered by micropore filters placed on the top of the small tube filled with the gold sponge (on the same sampling line). The present work has been made with the purpose of verifying the percentage of metallic and particle mercury of the chloroalkali plants and nearby the industrial perimeter of these plants. The results have been obtained from data of two plants with different capacity, different topographic location and different microclimatic conditions. It has been noticed that the air concentration of mercury in the surrounds of the plants is higher than the basal values in incontaminated areas and the ratio between metallic mercury and particle mercury in the surroundings of chloroalkali plants is casual. The obtained data have been explained at the light of the microclimatic observations and exactly: speed and direction of winds, temperature, humidity and rainy precipitations.


[Changes in the building stones of Venice: action of atmospheric sulfur on carbonic rocks]. Analytical investigations were carried out on alteration crusts of "Pietra d'Istria" used for the construction of "Palazzo Papadopoli" in Venice. The chemical and mineralogical analyses of the microstructure showed that alteration process in mainly caused by the transformation of calcium carbonate into calcium sulphate and that the greatest damages are due to the subsequent detaching of sulphatic crusts according to a weakness surface. The isotopic analyses showed that sulphur present in the crust is mainly derived from the combustion of hydrocarbons. The investigations on the climatic conditions showed the meaningful importance of the climate parameters on described alterations.


[Toxicity of aliphatic halogenated hydrocarbons containing fluorine]. The fluorinated propellers have a certain cardiotoxicity. They cause disturbances to the intraventricular conduction, to the inotropisme and to the arterial pressure. Such disturbances show up in the laboratory rat due to a concentration in the air that once was thought innocuous for this specie. We have analysed doses of 15%-30%-60% of CCl2F2 in the air on the tracheotomysed and curarised animals. The vagotomy protects in part from the occurence of marked alterations ECG, but not from the alterations of the cardiac mechanigram and of the arterial pressure. The arterial pressure is the cardiocirculatory parameter which remains inhibited longer when the animal is again breathing air without Freon. After breathing air without Freon for ten minutes, rats submitted to a successive dose of gas are rapidly intoxicated. Low doses of CCl2F2 in the air (5%) make rabbits ipersensitive to the "arythmies-producing" effects of the adrenaline.


[Toxic polyneuropathies in shoe factories: preventive aspects]. An investigation was carried out concerning 19 shoe factories of Marches province, where 32 cases of polyneuropathy, upon 1264 workmen, have been verified. After examination of qualitative and quantitative risk factors the following conclusions can be deduced. Under the etiological aspect the syndrome can be attributed to poisoning caused by environmental pollutions and thus relating to aliphatic hydrocarbons (exane-cicloexane). Under the quantitative aspect the tecnopatic risk has a multifactorial origin which can be summarised as follows: 1) lack of poor efficiency of environmental purification systems; 2) lack of hygienic-environmental elements; 3) lack of sanitary precautions; 4) poor work organization. A strong preventive therapy is necessary to avoid or at least to reduce the polyneuretic tecnopathy incidence.


[Determination of urinary lead through optic emission spectrography using the double-arch method]. A new method for the determination of urinary lead by means of the emission spectroscopy is described. The sample is concentrated by lyophilization and the homogeneous dust obtained is analysed using the "double arc" method. The matrix effects and the source unstability are compensated by the use of the internal standard. The influence of the volatilization of the elements of the analytical pairs are studied and the pair thallium-lead is selected. The method is reproducible and the detection limit is 5 microgram/l of urinary lead.


[Determination of metals in biological fluids]. The AA. show the analytical methods which can be used to determine the presence of metals in the biological liquids by means of the atomic absorption spectroscopy. For some metals the analysis can be directly achieved by means of atomisation of the biological liquid in a flame or in a graphite furnace; for other metals it is necessary a treatment of the sample to separate the metal from the rest of the matrix, which can be: calcination, microcalcination, mining. In the final part of this paper, a table is showed with the concentration values in urine, blood, serum of occupationally exposed subjects and not, for the following metals: Al, As, Cd, Co, Cr, Fe, Mn, Hg, Ni, Pb, Cu, Zn.


[Pollutants in biological fluids].

[Pollutants in biological fluids]. The AA. report the gaschromatographic determination of some metal hazards encountered in the environment, as berylliu, chromium, manganese, cobalt, nickel, tin, lead, mercury and others. They develop the rapid method by Hansen et al. for the analysis of sub-nanogram amounts of chromium with the formation from blood of chromium trifluoroacetylacetonate Cr(tfa)3 and quantitation of this chelate using electron-capture GLC. Particularly different samples of chrome tanning workers blood are tested. Informations are provided concerning the equipment, operating parameters, sensitivity, interferences and the approximate time required for this method and the correspondent using the atomic absorption spectrometry.


[Biochemical evaluation of damage due to lead: importance and significance of erythrocyte zinc-protoporhyrin IX and urinary amino acid determination]. The early detection of lead intoxitation needs practical, simple, reproducible and diagnostically valid screening test. The determination of ALA-D (delta-amino-levulinic acid-dehydratase) in erythrocytes is one of the most reliable test for the evaluation of the occupational exposure to lead. However this test is difficult to standardize, sensible to lead contamination of laboratory glassware and the activity of enzyme decreases rapidly if stored. The determination of erythrocytes ZPP (zinco-protoporphyrin IX) was proposed as useful, alternative test. The protoporphyrin IX is a metabolic intermediate in heme biosynthesis; in erythrocytes is present as free form and zinc-boundend compound. The ZPP give high values only in lead intoxication and sideropenic anemia. The ALA-D and ZPP in erythrocytes were measured and compared in a group of workers exposed to lead. We have shown a good correlation between these two biochemical parameters. Aminoacid excretion in urine from workers exposed to lead was measured and compared with other biochemical parameters of intoxication. All lead workers examined had excessive urinary CP (coproporphyrin) and ALA (delta-amino-levulinic acid) excretion. An abnormal excretion of glycine was present in eight workers (32%), whereas in other four (15%) the glycinuria was at limit of normal values. An abnormal excretion of lysine was present in six workers (21%). The last data appear very interesting because the action of lead in lysine metabolism was not known.


[Urinary kallikrein and risk of lead poisoning]. Urinary kallikrein is an enzyme, probably originated in the kidney, which acts on plasma kininogen to produce kallidin, the decapeptide precursor of bradykinin, and appears to be implicated in various forms of arterial hypertension. It is significantly decreased in workers exposed to lead showing no hypertension or other clinical signs of lead poisoning. In respect to measurement of ALA or other heme precursors the determination of urinary kallikrein seems to be able to detect a different, and perhaps in certain cases earlier, effect of lead intoxication on enzyme functions.


[Vibration and noise control in working areas using a restrained-layer dampening system]. Propagation principles of vibrations from machines and possible damages to operators are described. The author points out how to limit and avoid any possible harm. The restrained layer damping system is taken into account, its advantages and peculiarities are examined in particular.


[Measures for the reduction of environmental noise in the mechanical industry]. The present report describes how the problem of noise at the "Nuovo Pignone" has been solved. The many improvements carried out and the consequent reduction of sound pressure levels on the workers as well as on the environment surrounding workshops, foundries and tank construction, are described. The technical importance of the control of noise at the gas turbine testing units is also stressed.


[Improvement of pollution produced by chemical agents in the mechanical industry]. In outdoor factory environments many defiling substances are produced by different working processes. Reclamation operations must, therefore, be directed to the single types of pollution involved. A series of corrective operations, aiming at the elimination of fumes, frinding powders, solvent vapours, paint pigments and hydrocarbon vapours, are described.


[Reduction of lubricating-oil aerosol concentration in the weaving room]. In this work the authors describe a weaving work room where they had determined particulate oil aerosol above TLV. The reduction of the oil aerosol has been obtained with the construction of an extraction and immission air suitable system.


[Influence of working conditions on the health status of the female worker]. The AA. examines different aspects concerning the health of female workers. The following aspects are taken into consideration: sex distribution, general and specific morbidity, work pathology, work accidents, sickness and maternity absences, family life. The AA. recalls the importance of appropriate preventive measures, such as organization of apprenticeship and health education programs. In this connection, the AA. puts forward some proposals which might be useful for a new regulation in the matter and, as a conclusion, stresses the importance of an efficient Public Health Service expecially in this field.


[Preliminary comparison of 2 indices of the microclimate: correct effective temperature and SWBGT (Swedish wet-bulb-globe temperature index)]. The CET and the SWBGT indices have been jointly assessed in 200 working places of 17 mechanical engineering shops and factories in Northern Italy. In the climatic conditions that have been met in the investigation (low air velocity, medium-high humidity, moderate to medium thermal stress with significant radiant heat), the indices proved to be correlated (r = 0.81) by the following regression equation: SWBGT = 0.99 CET -- 1.67, and the scattering of individual values was rather narrow. The SWBGT appears to be of more practical application than the CET and it reflects more adequately the adverse effects of low air velocities, therefore improving the adequacy of the index especially in humid environment. However, including a unique correction factor for low air velocity, it does not fit well with climatic conditions where air velocity approaches 0.5 m/s. The SWBGT requires that all four climatic parameters be determined without spending more time for the analysis than the WBGT. In different combinations of climatic conditions from those which have been met in the investigation the results may differ; however, from these preliminary observations it is suggested to further the comparison with the assessment of metabolic load and physiological response.


[Technics for the measurement and evaluation of industrial noise]. In the present report a method for the practical noise measurement in the factory environment is developed. The acoustic noise present is normally composed of the noise emitted from several machines more or less simultaneously and the measurement problem often consists in determining an average noise level that is then compared with some accepted noise criteria and on the basis of this comparison decisions may be taken as to necessary changes in the environment. The method extends the dynamic referred to as "impulse" use, that is a characteristic meter response which closely approaches the rise time of the human ear and stores, averages and forgets the short duration signal in a way similar to that of the human brain. The measured average noise level gives a better explanation of the audiometrically detectable occupation noise-induced hearing loss.


[Aspects of industrial hygiene in occupational exposure to the hazards of laser light]. The AA. outline the environmental hazards by the laser light taking into account the characteristics of this stimulated emission and the properties of the biological substrate to be damaged. They illustrate the optical and functional behaviour of the eye in order to demonstrate the peculiarities which make it the most important "critical organ" as regards the laser light. They furthermore propose some criteria for the analysis and the registration of the data necessary to individuate the hazards. They indicate the industrial hygiene measures to be adopted in the different exposure conditions and point out some aspects apt to individuate the levels for minimal reactive dose from which it is possible to define the threshold limit values. They conclude with the proposal to normalize as much as possible the rules of hygienistic protection in this new technological field.


[Calibration of selective samplers for respirable dust]. The AA., after a short introduction on the concepts of respirable dust consider the double stage selective samplers in the literature. They suggest three of them, which are all characterized by different suction flows; the features of separation of the dust in the air are documented by means of calibrated mixtures of aerosol. As to the penetration ACGIH curve, satisfactory results are obtainable fro the 12 mm sampler with a 10 l/min flow and for the 25.4 mm sampler with a 70 l/min flow. The tests achieved with the Dorr-Oliver 10 mm metal sampler do not agree with the above mentioned curve for a capacity included between 0.7 and 2.5 l/min.


[Tolerance of ligation and of aseptic thrombosis of deep cerebral veins in man. Apropos of 4 cases]. Classically, ligation of the deep cerebral veins is incompatible with survival in man. The authors report four cases, three surgical and one medical, of thrombosis of these veins, confirmed by angiography and well tolerated. This tolerance may be explained by anatomical study of collateral systems and corroborated by clinical and experimental findings.


[Pyrithioxine: a new basic treatment of rheumatoid arthritis. Open study of 60 cases with a follow-up of 6 months]. Pyrithioxine, a chemical compound with several points in common with penicillinamine, was used for six months as the basic treatment in a series of 60 cases of rheumatoid arthritis, in a dose of 600 mg per day. The results were favourable in 60 per cent of cases, with a marked fall in articular index, a return to normal of sedimentation rate and, less commonly, negativisation of the Rose-Waaler reaction. Side effects were essentially cutaneo-mucosal (pruitus, rash) and necessitated the interruption of treatment in 16.5 per cent of cases. No complications were seen. Compared with penicillinamine, pyrithioxine appears to be less effective but better tolerated. The place of this new basic drug in the basic treatment of rheumatoid arthritis remains to be precisely determined.


[Ambivalence and diachrony].

[Ambivalence and diachrony]. The temporal analysis of ambivalence is based on an account given by two schizophrenic patients and the study of Samuel Becket's "The Nameless One". The narrative process corresponds to a creative expression in which discordance is part of the differences between verbalisation and sensitive phenomenous. Splitting of personality is linked with temporal ambivalence: the immediate past encroaches on the near future, giving an impression of synchronization in the simultaneous interplay of similarity and dissimilarity. The passing of time, disturbed in its accumulative cursus in the schizophrenic patient, results in a conflict between contradictory phenomenous in the same moment. This synchronization of dissimilar perceptions brings together disjunctive and conjunctive categories dominated by such coordinate conjunctions as "and... and", in the living diachronic discordance.


[Speech of neurotic and psychotic subjects according to Rorschach test responses]. The authors have studied in Rorschach's test the syntaxic structures of fifty neurotics subjects and fifty psychotics subjects. They have particulary remarked that phrases determinated by situation of test are more frequent in neurotic protocols than psychotic protocols. They note also the importance of verb with detriment of nominal syntagm for the latter.


[SKF 28,175: preliminary study of a new antidepressant]. This is a preliminary report concerning a new antidepressant, SKF 28,175 which is neither an IMAO nor does it have the usual tricyclic structure, retaining the CF 3 at the number two position on the ring. It was studied in 27 male and female patients. The drug was highly effective, within 4-7 days for the most part, as confirmed by statistical analysis of the Hamilton Rating Scale. There were relatively few side effects. Only one dosage per day, in the evening, was required.


[Microheterogeneity of R plasmid coded beta-lactamases in analytical isoelectric focusing (author's transl)]. Analytical isoelectric focusing of plasmid-coded beta-lactamases in polyacrylamide gels gives rise to several satellite bands in addition to one major active band (microheterogeneity). When the R plasmids are transferred by conjugation into 4 different bacterial species (Escherichia coli, Klebsiella pneumoniae, Salmonella typhi-murium, Proteus mirabilis) the position of the main band remains constant, but the number and position of the satellite bands are changed. Furthermore, the minimal inhibitory concentrations of several beta-lactamines are also changed when the plasmids are transferred between these different host strains. These facts suggest that the bacterial host might modify the physical structure and the activity of plasmid-determined beta-lactamases. They also suggest that identification of beta-lactamases and comparison of their isoelectric focusing patterns should always be carried out using the same bacterial host strain.


Ultrastructural observations of an unusual osmiophilic body in the hyphae of Sporothrix schenckii and Ceratocystis stenoceras. Electron microscopy of 8 strains of Sporothrix schenckii and 1 strain each of Ceratocystis stenoceras, C. pluriannulata, C. ulmi, and C. minor revealed the presence of unusual osmiophilic structures (EOB) which appeared as normal organellar components of young cells of these fungi. In S. schenckii and C. stenoceras, these structures were markedly osmiophilic, reacted strongly with thiocarbohydrazide, could be partially solubilized with the lipid solvent sodium methoxide, and appeared to possess lipase activity. On subsequent cellular ageing, lipid bodies were commonly seen in intimate association with the EOB. Eventually, the EOB underwent degeneration and extensive vacuolization. It is suggested that these structures are composed in part of lipoidal material in possible association with a protein matrix, and may be in some manner involved with lipid metabolism of mechanisms of lipid storage.


Identification of Orthopox virus by isoelectrofocusing in a granulated gel. Twenty strains of Orthopox viruses (vaccina (3), cowpox (2), monkeypox (2), variola major and minor (7) and whitepox (6)) have been tested by electrofocusing in a granulated gel. From our preliminary results, it appears that there is a clearcut distinction between smallpox and whitepox. If our results are confirmed, it will be the first real genetic marker identified because other in vitro or in vivo test have heretofore failed to differentiate between smallpox and whitepox. Further work is now in progress, to evaluate of the test and it is hoped to find and explanation for the observations now reported.


Study on the stability of a measles vaccine. With live measles freeze-dried vaccine, accelerated storage test provides more information than does a titration of residual moisture. From our results, it appears that there is a good correlation between storage at 37 degrees and the tests usually required by the manufacturer, i. e. storage for 1 year at refrigerator temperature. The accelerated test in neither tedious nor expensive and is recommended for routine use.


[Redescription of d'Apatemon (Apatemon) graciliformis Szidat, 1928 (Trematoda: Strigeidae) with a preliminary note on its life cycle (author's transl)]. Apatemon (Apatemon) graciliformis Szidat, 1928 is redescribed from specimens obtained experimentally in the domestic duck; the larval stages develop in Biomphalaria glabrata in Guadeloupe (French West Indies).


[The oncomiracidium of Ancyrocephalus paradoxus Creplin, 1839 (Monongenea, Monopisthocotylea), parasite of Sander lucioperca (Teleostei, Percidae)]. The distribution of ciliated cells and the oncomiracidium chaetotaxy in Ancyrocephalus paradoxus Creplin, 1839 (Ancyrocephalidae) parasite of Sander lucioperca (Teleostean, Percidae) are described for the first time as well as the larval ciliated cells in Dactylogyrus extensus (Dactylogyridae) parasite of Cyprinus carpio. Also is given a description of the larval haptorial armature of Ancyrocephalus paradoxus which shows some original features in our region. The ciliated cell pattern and chaetotaxy are compared among Ancyrocephalus paradoxus (Ancyrocephalidae) Ergenstrema mugilis (Ancyrocephalidae) Dactylogyrus extensus (Dactylogyridae) Tetraonchus menenteron (Tetraonchidae) and Euzetrema knopffleri the systematic position of which is still to be defined. As a result it appears that an unitary pattern occurs in the ciliated cell arrangement and chaetotaxy in the larvae of Ancyrocephalus paradoxus, Ergenstrema mugilis and Dactylogyrus extensus. Yet they are easy to distinguish. Tetraonchus monenteron reveals some affinities with these Dactylogyroïdea but further investigations have to be undertaken again while Euzetrema knoepffleri proves to be very different. In the armature of the larval haptor of Ancyrocephalus paradoxus intraspecific variations appear which seem to be of a biogeographic order. Also the same variations are reported in the larvae of Diplectanum aequans.


[Results and problems set by the introduction of Zonitidae snails in some biotopes of Lymnaea trancatula Müller in Indre and Haute-Vienne, France (author's transl)]. Systematic placing of Zonitidea snails: Zonitoides nitidus and Oxychilus draparnaudi alone or in groups, in different series of habitats of Lymnaea truncatula in Haute-Vienne, France (1974-1976) shows: --the elimination of Lymnaea truncatula is entire after two years in temporary habitats covered with grass just mowed at the beginning of summer drying. The presence of stones, which make shelters, increases numbers of surviving snails. --predators-placing without previous grass-mowing is effective only on banks of rivers.


[Demographic development of Lymnaea (Galba) truncatula Müller in Haute-Vienne, France. About observations on 4 years (1973-1976) (author's transl)]. Notes on the influence of shallow drainage and predation by Zonitoides nitidus on Lymnaea truncatula populations in 4 types of habitats. The populations of snails are observed with large and perceptibly constant numbers by the regular maintenance of drainage. Irregular maintenance is followed by a gradual fall of numbers of snails with their rapid increase in the year following autumnal ditch-digging. Grass-mowing of swampy meadows at the beginning of summer drying distinctly restricts numbers of snails, when Zonitoides nitidus lives in the habitats.


[Observations on the second moult of the larvae of Ascaridia galli (author's transl)]. In Ascaridia galli larvae artificially hatched after 11 and 12 days of incubation at 25 degrees C, in larger frequency than in larvae hatched either after 10 and after 14 days of incubation, two different cuticles detached from their bodies were observed. These two detached cuticles indicate that such larvae had undergone two moults before hatching and, consequently, that the infective stage of A. galli is the third larval stage.


[Tentative classification of the nematodes Trichostrongyloidea (author's transl)]. Taking into consideration the evolution of different characters, and mainly the evolutionary pattern of the "synlophe", we propose to divide the Trichostrongyloidea into 8 families: Ollulanidae, Dictyocaulidae, Strongylacanthidae, Amidostomatidae, Molineidae, Heligmosomidae, Heligmonellidae and Trichostrongylidae.


[A new Typhloceras from Tunisia (author's transl)]. Typhloceras favosus benrachidi ssp. nova, parasitic on Apodemus sylvaticus ssp., can be separated from all others Typhloceras, by the morphology of segments VIII and IX in the male.  Synonymy with T. f. asunicus Jordan, described on female only, is discuted.


Inoperable and recurrent carcinoma of the rectum and rectosigmoid. Aspects of radiation treatment and prognosis. 35 patients treated with radiotherapy for recurrent (23) or primarily inoperable (12) rectal or rectosigmoid carcinoma are presented. The radiation treatment was delivered in 28 cases with megavoltage equipment, in two cases with a conventional X-ray unit and in seven cases with intracavitary radium or cathetron applications. 17 of the patients (49%) lived for more than one year. Six patients from the recurrent cases lived (26%) for more than two years, and four patients (17%) survived three years. Relief of symptoms was observed in at least 20 cases. The importance of early diagnosis of recurrent tumor is stressed especially in the follow-up of Dukes' A and B groups.


Coagulation disorders in severely and critically injured patients. Forty-five patients with multiple injuries treated at an intensive care unit were studied prospectively. The patients were divided into two groups: the severely injured (no mortality) and critically injured (56% mortality). Treatment was started within two hours from the accident in all cases. The following coagulation parameters were measured for eight days: euglobulin lysis time (ELT), thromboelastography (TEG), vecalcification time (RECA), partial thromboplastin time (PTT), factor V, factor VIII, Normotest, Thrombotest, thrombin time, fibrinogen and platelets. Severe coagulation disorders were observed in one-third of the patients 12-48 hours after trauma. The abnormalities were more pronounced in patients who had sustained very severe injuries and arrived in a state of shock. The ELT was shortened 0-6 hours after the accident and accelerated coagulation was indicated simultaneously by decreased PTT, RECA, and r-values as well as by elevated Thrombotest and factor VIII values. The factor V and fibrinogen levels were initially lowered. Low platelet values at 2-4 days, prolonged thrombin and r-times, secondary decrease of fibrinogen FV, FVIII, and low Thrombotest values suggested disseminated intravascular coagulation associated with complications, such as fat embolism and "shock lung" syndromes. General bleeding tendency with high mortality was observed in 16% of the patients.


Intensive physical therapy after fractures of the femoral shaft. 22 patients with fractures of the femoral shaft were divided into 2 groups. One group (12 patients) were given the standard postoperative physiotherapy and the remainder (10 patients) received intensive physiotherapy. Clinical examination of the knee joint was performed 2, 4 and 9 weeks postoperatively. The patients' mean age was 31 years; 15 of them were men. The fractures in 18 patients were treated with intramedullary nailing, 2 with a long-shanked Jewett nail and 2 with AO-nailing. Mobilisation and quadriceps atrophy of the injured limb of the patients given intensive physiotherapy appeared to improve faster than in the patients of the routine physiotherapy group. Nine weeks after  the operation the range of knee movement had normalised in the cases given intensive physiotherapy. The flexion strength of the knee in the operated limb was close to the values for the normal limb after nine weeks, but the extension strength was still 40-66% below the values for the healthy limb. The greatest increase in muscle power occurred during the first four postoperative weeks. Intensive physiotherapy seems to hasten the recovery of quadriceps strength of the patients with fractures of the femoral shaft, and to shorten the duration of sick leave of the patients operated on by closed intramedullary nailing.


Acquired eventration of the diaphragm--results of surgery. Results of surgical repair of acquired diaphragmatic eventration are reported. The series consists of nine adult patients studied pre- and postoperatively with clinical, radiological and lung function investigations. The repair was performed in all cases by a thoracic approach and plication of the diaphragm. The operative procedure was well tolerated in all cases. On follow-up seven patients were found to be improved and in two transient or no improvement occurred. Subjectively, gastrointestinal symptoms were alleviated most often by the operation. Radiological studies showed that although the immediate postoperative position of the diaphragm was very good in all cases, the diaphragm began to stretch and elevate gradually during the first year. In one case rupture of the repaired diaphragm developed 2 years after plication. Reoperation was performed with success. In one case the anatomical end result was no better than before the repair, in the others it was partially or completely improved. Plate atelectasis was observed no longer after the operation. Preoperative lung function studies showed a slight to moderate restrictive defect in 8 cases and a marked one in one case. 37% of the total lung perfusion was distributed to the affected side. On the average no significant changes could be found between the pre- and postoperative values.


Simultaneous occurrence of ovarian torsion and gangrenous strangulation through a congenital opening in the mesosalpinx. A case of simultaneous occurrence of ovarian torsion and gangrenous strangulation through a congenital opening in the mesosalpinx is presented. This case closely resembles that of intestinal strangulation through a mesosalpingeal defect, which is also very rare. 1) The condition was recognized at laparotomy performed for symptoms and signs of "an acute abdomen"; 2) the patient was a pregnant woman; 3) the final outcome was good after prompt surgical intervention.


Circulatory responses to laryngoscopy and endotracheal intubation in patients with and without cardiovascular disease. Effect of prophylactic practolol. The effect of small intravenous doses of practolol (0.2 mg/kg body weight) on the circulatory response to laryngoscopy and endotracheal intubation, when administered with atropine (0.01 mg/kg b.w.) prior to anaesthesia was studied in 39 patients with and without cardiovascular disease. Practolol diminished significantly the rise of mean arterial pressure and pulse rate affected by laryngoscopy and endotracheal intubation when performed under thiopentone-succinylcholine anaesthesia. Arrhythmias were also less frequent through the statistical significance could not be ascertained in this small series. The small practolol dose used had no adverse circulatory effects. It is suggested that the administration of a small prophylactic dose of practolol is useful in preventing the excessive cardiovascular response due to laryngoscopy and endotracheal intubation.


The effect of anaesthesia and total hip replacement on the phytohaemagglutinin and concanavalin A responses of lymphocytes. Cell-mediated immunity as a part of the immune host defence mechanisms was studied in 12 patients undergoing total hip replacement surgery. The combined anaesthesia used did not lower the phytohaemagglutinin (PHA) and concanavalin A (Con A) responses of lymphocytes in whole blood culture during the first hour of anaesthesia before the beginning of surgery, but a clear decrease occurred after the beginning of the operation. The mitogenic responses started to recover immediately after the operation, but complete recovery was not obtained during the follow-up of 9-14 days.


The effects of paraoesophageal structures and vagotomy on the canine lower oesophageal sphincter function. The effects of paraoesophageal structures and vagotomy on lower oesophageal sphincter (LOS) function were studied in the dog using modern oesophageal manometric technique. The isolation of the gastro-oesophageal junction from surrounding structures by a stiff-walled Silastic-tube led to a slight decrease in LOS pressure, but the difference was not statistically significant. LOS response to abdominal compression also decreased slightly, but the difference was without statistical significance. Bilateral transabdominal, transthoracic and cervical vagotomy did not produce any marked changes in resting LOS pressure, whereas a statistically significant decrease in LOS response to abdominal compression occurred after each type of vagotomy. The results suggest that the mechanism intrinsic to the gastro-oesophageal junction, the LOS, is mainly responsible for the maintenance of gastro-oesophageal competence, and the effect of extrinsic paraoesophageal structures is of minor importance. The vagus nerves apparently have no major role in the maintenance of resting LOS pressure. LOS response to increased intra-abdominal pressure seems to represent a genuine increase in LOS tone, to which extrinsic mechanical factors add only a small contribution. This response seems to be mediated by a vagal reflex arc, the afferent part of which has its origin below the diaphragm.


LH and FSH (basal values and pituitary responses to GnRH) in hyperthyroidism. Gonadotropin behaviour (basal plasma values and pituitary responses to GnRH) in hyperthyroid patients was studied. LH values (both basal and pituitary responses) higher than the controls were documented. Thyroid hormones seem to modulate pituitary response to GnRH for LH only in hyperthyroid patients of both sexes. In order to explain the mechanism of the action of thyroid hormones, rather than the possibility of peripheral effect on binding capacity of the proteins for circulating steroids, a central interaction at medial eminence level is suggested.


Phenylthiocarbamide (PTC) taste sensitivity in selected populations of the Isle of Man and Cumbria. PTC taste thresholds were determined using a modification of the Harris and Kalmus sorting technique for 854 Cumbrian schoolchildren and 699 individuals from the Isle of Man. A non-taster frequency of 19.7 percent was observed in the Cumbrian sample compared with a frequency of 27.8 per cent in that from the Isle of Man. Analysis of taste threshold distributions revealed significant variability, both within and between these two samples. Evidence of significant regional heterogeneity was detected in Cumbria but not in the Isle of Man. Finally, these two series were compared with data from neighbouring regions of the British Isles and Scandinavian populations.


Urinary hydroxyproline, creatinine and urea excretion during the growth of five siblings. Urinary excretions of hydroxyproline, creatine and urea in 24 h specimens from 5 siblings have been determined monthly from 1971 to 1976 together with the measurements of body height and body weight. Changes with age in the urinary levels of these substances are in good agreement with those from cross-sectional studies in various age groups of children. Wide fluctuations of excretion levels occurred. The creatinine coefficients did not remain constant even over short periods. Menarche was observed shortly after the peak of hydroxyproline excretion at puberty. The hydroxyproline excretion pattern is similar to that of hydroxyproline index proposed by Whitehead, and it is quite different from that of hydroxyproline ratio.