[Radiation in inflammatory diseases of the hand (author's transl)]. Pyogenic infections endanger the function of the hand. X-ray therapy beginning as early as possible has a good effect. From 1960 to 1975 170 inpatients and 250 outpatients were treated in this way. It has to be emphasized that surgical therapy cannot be replaced by X-ray therapy, but early radiation helps to keep disfunction (handruins) low.


[Injuries of the knee joint (author's transl)]. Immediate operative reconstruction of ligament injuries of the knee joint is recommended for the performance age. The optimal operation time is within 24 hours after the accident, it should be done within 72 hours. The important advantage of this early operation in comparison to a non-operative treatment is the possibility of an exact reconstruction of the damaged ligaments and the distinct shortening of the rehabilitation time.


[Conservative or operative treatment of fractures of the head of the tibia (author's transl)]. Whether fractures of the head of the tibia have to be treated conservatively or surgically in an active way depends on the type of the fracture. In cases with small dislocation conservative treatment should be given priority. Only fractures with badly dislocated fragments should be operated on (osteosythesis).


[Fistula carcinoma arising from chronic osteomyelitis (author's transl)]. 224 cases of fistula carcinoma arising from chronic osteomyelitis from literature and 6 own observations are reviewed. This malignancy results in about 1,5% cases of chronic osteomyelitis. The mean age of all patients was 55.7 years. The sex relation male to female was 7.4:1. The time from the beginning of the chronic osteomyelitis up to the diagnosis of the fistula carcinoma was 33.6 years. This time is called "Exposition time". The analysis of this time shows that, the older the patient was at the beginning of the chronic osteomyelitis the shorter was the exposition time.


[Morphological change of lipids in the vaginal epithelium after intrauterine fetal death (lipid test)]. The authors studied the lipid content of the vaginal epithelium of gravida in whom intrauterine fetal death had occurred. Fifteen gravida in the 6th to 10th month of gestation were examined and an unusual, inconsistent with the respective gestation term increase in the intra- and extra-cellular lipid content of the vaginal epithelium demonstrated. This is related to a decrease in the amount of estrogen hormones secreted by the placenta. A cytochemical 'lipid test' based on the above findings has been developed by the authors for the diagnosis of intrauterine fetal death during the second half of pregnancy.


[Changes in the age-specific fertility distribution in the GDR (German Democratic Republic) between 1968 and 1973]. The evolution of the agespecific fertility by its dependence of the order of life-births is analysed in this paper. These terms are further calculated on the basis of life-tables. It became evident that the behavior of reproduction of women of the GDR 1968-1973 is well described by the evolution of the structure of birth-order. It is calculated, that about 5% of all women at the age of fourteen participate the reproduction of the population up to the age of forty five. The trend to 1 respectively 2 children a women was increasely carried in the years 1972/1973 so that we have a real loss by life-births.


[Pilot study on interval gradation for the evaluation of conditions related to the desire to bear children]. The purpose of this investigation was to test the method of Comparative Judgement in connection with the question, which conditions are relevant, if a woman want to give birth to a child. 31 pregnant woman, who intend to get interrupted their pregnancies had to decide by pairs about conditions which relate to health, age, parity, education, calling resp. profession, situation of dwelling and income and to personal or confessional questions. On the basis of the Law of Comparative Judgement (Thurstone 1937) we constructed an interval scale about these conditions.


[Complex therapy of functional sterility]. Discussed are 41 pregnancies following a 6-months successful complex therapy of functional sterility. The patients were transmitted to the centers of prenatal care. The complex therapy enabled an increase in the present successful treatment with Clomiphen from 45 to 65 per cent of cases.


[Obstetric problems--with special reference to cesarean sections--at the University Hospital for Women in Oran (Algeria)]. Report of a 2-years-period of obstetrical work in the maternity-hospital of the Univeristy, Oran in Algeria. Caesarean section as the most important obstetrical operation is examined more closely with regard to the indication and the methods of operation. The incidence of uterine rupture and caesarean hysterectomy is reported. Finally common experiences are mentioned.


[Persistence of right umbilical vein--a rare vascular abnormality of the umbilical cord]. We report on a persistent V. umbilicalis dextra as an extrem rare anomaly of the  vessels of the umbilical cord and its embryological base. The compression of this umbilical cord was responsible for the emergence of abnormal QRS-complexes in the fetal electrocardiogram according to typus 2 by Larks. To detect these anomalies of vessels should be investigated on princip every umbilical cord.


Carbon dioxide fixation in the brain: its relation to glucose synthesis. The incorporation in vivo of radiocarbon from 14C-bicarbonate in blood into relevant metabolites in rat brain is described. The animals, partially hepatectomized and nephrectomized, received the tracer bicarbonate via the intravenous route. The time course of label was followed in CO2 of blood and brain, in the anionic and cationic fractions of brain extract, in aspartate, glutamate, glutamine and in free glucose and in glycogen. From the tracer kinetic data a flux of 0.08 microgram atom fixed carbon min-1.g-1 brain tissue was calculated. Substantial amounts of 14C were found in free glucose, only a few percent in glycogen. The flux of newly synthetized glucose was approximated to 0.5--1.0 percent of the steady state level of glucose in brain tissue. In special experiments the localization of 14C in the carbon chain of aspartate and glucose was examined. 5 min following the tracer injection a practically total randomization of 14C between C-1 and C-4 aspartate was seen. From the radioactivity in glucose 94 percent were found in C-3 and C-4, only 6 percent in residual carbon. This 14C-pattern is typical for the labelling of glucose by CO2 fixation and retrograde Embden-Meyerhof pathway.


On the quaternary structure of leucine aminopeptidase. Small crystals of leucine aminopeptidase were prepared in 2 percent ammonium molybdate. Single molecules were contrasted with 2 percent potassium silico tungstate which gave better contrast and preservation of enzyme activity than ammonium molybdate. The six subunits of the enzyme consist of a spheroidal "head" and some "tail-like" material, which connects the "heads" in pairs. The subunits are arranged at the vertices of either a right triangular prism or of an oblique prism twisted by 42 degree (symmetry 32).


Cathepsin H: an endoaminopeptidase from rat liver lysosomes. 1. Cathepsin H is an endoaminopeptidase belonging to the group of thiol enzymes. It was purified from rat liver lysosomes by gel filtration on Sephadex G-75, chromatography on CM-Sephadex C-50, on DEAE-Cellulose DE-52 and subsequently on an organomercurial absorbent. 2. The molecular weight of cathepsin H was found to be 28,000 and the isoelectric point was estimated to be at pH 7.1 by analytical isoelectric focusing. 3. Cathepsin H has to be designated as endoaminopeptidase, because it catalyzes the hydrolysis of proteins, N-terminal substituted proteins and amino acid derivatives, respectively, as well as of peptides of various chain length and N-terminal free amino acid derivatives. Cathepsin H shows amidase and esterase activity, but it does not show carboxypeptidase activity. The finding of the amino- and endopeptidase nature of cathepsin H has been revealed mainly by the results obtained with inhibitors and by the rather high temperature stability of the enzyme. The chlormethyl ketone of leucine proves to be the strongest inhibitor of the aminopeptidase as well as of the endopeptidase activity, whereas leupeptin endopeptidase activity and endopeptidase substrates inhibit competitively the aminopeptidase activity. 5. Cathepsin H shows highest activity at pH 6.0 in the presence of 1--5 mM GSH and EDTA. 6. The enzyme is stable for several months at slightly acid pH values in a deep frozen state.


[Changes of erythrocyte criteria of the guinea pig under hypoxia]. In the present study the adequacy of erythrocytic criteria for the diagnosis of hypoxia has been investigated in animal experiments. Guinea pigs were exposed to a defined hypoxia (pO2 equals 48 mm Hg approximately equal to 9000 m height) for 24 and 72 hrs. With increasing duration of hypoxia there is observable a distinct rise in reticulocyte count, 59Fe incorporation and the proportion of erythroblasts in the bone marrow. Hematocrit and hemoglobin concentration have increased significantly after hypoxia compared with the control animals. The mean cellular hemoglobin content shows a marked fall with the duration of hypoxia. The density distribution curves show under hypoxia a shift to lower densities and, therefore, appear to be well suited for the diagnosis of hypoxic states. The activities of the erythrocytic enzymes, G-6-PD and GOT, are increased after 24 and 72 hrs of hypoxia. The GOT isoenzyme pattern is shifted with continued hypoxia in favour of the mitochondrial GOT. The changes of enzyme activities are not pronounced enough under hypoxic conditions to be used for diagnositc purposes.


[Influence of static muscle tension on acoustically evoked brain potentials, changes in skin resistance and bioelectric muscle activity]. Auditory evoked brain potentials (AEP), galvanic skin responses (GSR) and auditory evoked bioelectrical muscular responses were recorded in 16 male human subjects during voluntary isometric contraction of m. triceps brachii dexter. The electromygraphically controlled strength of muscular innervation corresponded to 20, 30, 40 and 50% of the maximal voluntary contraction. The trials were organized according to a change-over design. The following results could be obtained: The stepwise increase of the strength of muscular innervation effected an increase of the mean amplitude of auditory evoked EMG responses. The N1-P2 amplitudes of the AEP decreased with increasing strength of muscular innervation. The mean amplitude of the auditory evoked galvanic skin response was not changed significantly by the strength of muscular innervation, however, the spontaneous changes in galvanic skin resistance increased monotonously. Habituation effects were evident regarding amplitudes of AEP and GSR. The results indicate that muscular activity affects sensory information processing.


[Influence of a fat-free diet on the content and synthesis of arachidonic acid in the feto-placental unit of the rat]. In rats receiving a fat-free food throughout the period of pregnancy, the individual fatty acids of total lipids from placenta, total fetus, maternal and fetal serum were determined quantitatively on day 21/22 of pregnancy. Also, the incorporation of 14C-acetate in vitro into placental fatty acids, divided by the number of double bonds, was measured and the rate of synthesis calculated therefrom. The fat-free diet caused a drastic fall of linoleic acid concentration in maternal serum and all fetal compartments. On the contrary, the amount of arachidonic acid remained almost unchanged in fetal serum and total fetus, and even slightly increased in placenta. In the maternal serum, too, the arachidonic acid concentration remained constant under fat-free diet. The observed concentration changes of single fatty acids in the maternal serum are reflected in all fetal compartments and led to a rise in total fatty acids in all sera and tissues studied. The height of rise decreased in the order: maternal serum less than placenta less than fetal serum less than total fetus. The rate of synthesis for arachidonic acid in placenta was on day 21/22 of pregnancy 0.3 (controls) and 0.5 (fat-free diet) micrometer/100 g placenta and hour, being able to cover the placenta's own need to less than one-third. The results suggest that the protection of the feto-placental unit against arachidonic acid deficiency under fat-free diet of the mother is provided mainly by a constant supply of maternal unit with arachidonic acid under normal conditions has to be ensured essentially by the mother.


Continual determination of acetylcholinesterase inhibition following organophosphate poisoning using an auto analyzer. A modification for continual monitoring of the blood acetylcholinesterase activity in the rat on an auto analyzer system was described. With using this technique, inhibition of the enzyme in vitro with O-ethyl-S-(2-dimethylaminoethyl)-methylphosphonothioate was determined. Bimolecular rate constant and I50 values were 1.66-10(6) M-1-min-1 and 1.4-10(-8)M, respectively. Rats treated i.m. with 0.043 mg/kg of this compound showed fast and rapid inhibition of the blood acetylcholinesterase after intoxication. The bimolecular rate constant of inhibition in vivo, calculated analogously as that in vitro was 1.37-10(6) M-1-min-1. On the presumption that both rates of inhibition (in vitro and in vivo) are identical, the concentration of organophosphate producing inhibition effect in vivo was 82% of the dose administered.


[Concentration of p-aminohippuric acid in the serum and kidney tissue during stimulation of renal excretion of foreign materials]. The renal excretion of p-aminohippuric acid (PAH) can be stimulated in adult rats by repeated applications of probenecid, cyclopenthiazide, and phenobarbital. The present studies have shown that this pretreatment significantly shortens the half-life for PAH too. In pretreated animals the PAH concentration decreases in the renal tissue more rapidly than in the control animals. These results were obtained in adult animals only but not in 5-day-old rats, in which the pretreatment had no effect upon the rate of renal PAH excretion. The pretreatment did not change the renal weight of 5-and 55-day-old rats.


Plasmalogens in arterial wall.

Plasmalogens in arterial wall. Plasmalogens have been determined in blood plasma, arterial and myocardial tissue of rats intubated with an atherogenic diet (vitamin D2 + cholesterol). These lipids are significantly decreased in arterial tissue after the administration of these substances for 5 consecutive days. Folic acid involved in the synthesis of plasmalogens and a powerful inhibitor of xanthine oxidase, on the contrary, increases enormously the concentration of plasmalogens in arterial tissue even with an atherogenic diet.


Localization of ribosomal protein S2 in rat liver ribosomes by immune electron microscopy. For small subunits of rat liver ribosomes three binding sites for antibodies specific for protein S2 have been proved: one in the head region and the two others in the neck region, suggesting that protein S2 has an elongated structure in the small subunit.


Changes in serum zinc during and after surgical procedures. Serum zinc was followed in 49 patients during and after minor and major surgery. Serum zinc decreases significantly after major operative trauma such as SPV and cholecystecotomy whereas no change can be seen after minor surgery such as hernia repair. The drop is most pronounced 6 hours after the operation. Serum zinc gradually returns to normal level in 2--3 days. In older patients the decrease is more pronounced but return to normal serum zinc level occurs as quickly as in young patients.


Changes in cardiac output distribution after liver dearterialization in the rat. The changes in cardiac output distribution in rats have been studied after hepatic artery ligation and additional ligament division. These procedures resulted initially in a marked decrease in the arterial blood supply to the liver and this effect was pronounced still four weeks after the operation. Evidence was found that the decrease in liver blood supply induced by the procedure was in part counterbalanced by arteriovenous shunting in the preportal region. Furthermore, a temporary redistribution of cardiac output with reduced fractions to colon and spleen was found two weeks after these operations.


Long-term observation of thyroid function after surgical treatment of thyrotoxicosis. During the 10-year period from 1960 to 1970 a total of 213 patients with diffuse or nodular toxic goitre underwent subtotal thyroidectomy. A short-term preoperative treatment with antithyroid drugs and iodine was given systematically. The observation period ranged from 5 to 15 years, average 9 years. A total of 203 patients (95%) were traced and followed up. The concentration of se-T4, se-T3, and se-TSH was measured and in selected cases a TRH test and BMR was carried out in addition. All thyroid specimens were re-examined by the same pathologist for histological grading. It was found that 85%  of the patients had been rendered euthyroid for 5 years or more. The recorded incidence of thyroid hypofunction was 6% and the incidence of recurrent thyrotoxicosis was 9% of the series. Se-TSH was found to be elevated in 17%. The correlation between elevated se-TSH and se-T4 values was calculated and found to be fairly reasonable (r = -0.66). It is concluded that subtotal thyroidectomy preceded by short-term antithyroid drug therapy supplemented ultimately with iodine offers significant advantages in the management of thyrotoxicosis by rendering 85% of patients euthyroid on long-term surveillance.


The role of the parathyroids for the adaptation to a low calcium intake. 5. The long-term effect of parathyroidectomy on the adaptation to a low calcium intake in adult rats with special reference to the metabolism of vitamin D. One-year-old selectively parathyroidectomized rats showed a normalization of their plasma calcium level to above 4.1 mEq/l in 38% within 18 weeks on a normal dietary intake of calcium and inorganic phosphate but low in vitamin D. On a low level of dietary calcium, normalization did not occur in any of the parathyroidectomized animals. The conversion of 25-hydroxycholecalciferol into the active metabolite of vitamin D, 1,25-dihydroxycholecalciferol, by the kidneys was stimulated by a low dietary intake of calcium in intact animals and the accumulation of this metabolite was increased in small intestine mucosa. This adaptory increase in the level of intestinal 1,25-dihydroxycholecalciferol was not disturbed by selective parathyroidectomy, nor the synthesis by the kidneys. The synthesis reached a limit above which no further increase occurred despite the prevailing hypocalcemia possibly through an influence of the concomitant hyperphosphatemia. The renal synthesis and intestinal accumulation of 1,25-dihydroxycholecalciferol were directly related to the intestinal net absorption of dietary calcium, which we have reported on previously. Although increased, the endogenous level of 1,25-dihydroxycholecalciferol was too low to accomplish mobilization of skeletal calcium necessary for adaptation to a low calcium intake, as we have reported elsewhere. Thus, for adaptation skeletal calcium reserves must become mobilized through stimulated parathyroid activity with resulting osteoporosis. The parathyroids were found to have no direct regulatory influence upon the synthesis of 1,25-dihydroxycholecalciferol.


Aplasia of the gallbladder with common duct stones. Aplasia of the gallbladder with common duct stones has been reported in only 22 cases. In order to actualize this condition another case is reported with a discussion of heredity, diagnostic criteria and frequency.


Advanced hyperbilirubinemia simulating obstructive jaundice after choledocholithotomy. Report of a case. A case of intrahepatic cholestatic jaundice of unclear etiology and unusual course is described. A male patient underwent choledocholithotomy after PTC, showing a normal immediate postoperative recovery, but after a few days developed a severe cholestatic jaundice despite normal postoperative cholangiograms. The liver function tests showed a biphasic picture. Bilirubin was maximally 770 mumol/l and a lower level was obtained after blood exchange and subphrenic abscess drainage. It was, however, not until prednisolone treatment was induced that a slow continuous decrease of bilirubin was seen.


Chronic relapsing pancreatitis in a child--endoscopic diagnosis. A case report. A case of idiopathic, chronic relapsing pancreatitis in a 14-year-old boy is described. With the help of endoscopic, retrograde choledocho-pancreaticography (ERCP), the final diagnosis was made. The boy has been free from symptoms two years, after a pancreatico-jejunostomy side-to-side. The etiology, incidence, diagnostics and treatment of this rare disease are discussed.


Acute gastric volvulus with necrosis of the stomach and the left lower pulmonary lobe. Acute gastric volvulus in a young patient with a known chronic torsion of the stomach is reported. Unfamiliarity with the condition resulted in delayed admittance for surgery where a necrotic stomach and left lower pulmonary lobe were removed. The pathogenesis and treatment of this uncommon disorder is discussed.


The chronogenetics of caries in primary dentition. A chronogenetic analysis of caries has been carried out in a sample of 100 twin pairs (27 MZ, 64 DZ, 9 UZ) aged 3-8 years, taking into account the number of decayed teeth and the intensity and severity of caries. Heritability estimates, calculated for each of the various parameters considered, support the hypothesis of a genetic control of the time of onset of caries.


Genetic selection and equilibrium stability. The problem of the equilibrium stability of a phenotypic selection process, with a single pair of autosomal alleles, has been numerically studied, on the basis of previously established reproduction differential equations.


47XX, + 13/46,XX mosaicism: a case report. We described a D1 trisomy syndrome patient who had a normal 46,XX cell line and 15.4% of lymphocytes with a 47,XX, + D chromosome constitution as an occasion to review normal trisomy 13 mosaicism.


Urinary mucopolysaccharides in acheiropodia. Urinary mucopolysaccharides from three patients with acheiropodia were qualitatively and quantitatively analysed by agar gel electrophoresis coupled with enzymatic degradation. Although no abnormal pattern was characterized, eventual metabolic dysfunction detected only in bone/cartilage tissues could not be ruled out.


Serum haptoglobin phenotypes and duodenal ulcer. Serum haptoglobin phenotypes were studied in 100 Greek patients suffering from duodenal ulcer by vertical starch gel electrophoresis. A sample of 2026 healthy subjects served as control. No statistically significant differences were found in Hp phenotypes and gene frequencies between patients and healthy controls.


Epidemiology of chronic liver diseases.

Epidemiology of chronic liver diseases. In the GDR mortality from liver cirrhosis decreases in contrast to most other countries though the alcohol consumption of the population is continuously increasing. In Capital Berlin and in the industrialized districts mortality from cirrhosis is higher than in the rural areas. Within a period of 6 years the number of inpatients with chronic liver diseases has risen from 11.600 to 14.200. From the epidemiologic point of view, virus hepatitis is not the main source of liver cirrhosis. The total recovery rate of acute hepatitis has increased from 80% to 94% over a period of some 8 to 10 years, liver cirrhosis was found to have developed only in 0.3%. 70% of cirrhotic patients did never suffer from virus hepatitis, as their anamnesis revealed. 73% of 1.8 million blood donors that were subjected to SGPT and HBAg-screening tests showed histologic changes of the liver. With the use of these screening methods it has been possible to register 7% persons with liver diseases among these blood donors. Early recognition and treatment of chronic liver diseases seem to result in a reduction of mortality from liver cirrhosis.


Acute viral hepatitis in Italy. Results of a collaborative study. The etiological and clinical aspects of viral hepatitis were evaluated by a retrospective survey of patients hospitalized in 1972, 1973 and 1974 in 12 specialized medical centers scattered throughout Italy. The data refer to 2788 patients suffering from acute viral hepatitis who were hospitalized during the initial 10 days of jaundice. The majority of patients (90%) had not been treated with steroids. For each case, the clinical and biochemical data were recorded, coded, computerized and statistically analyzed. In our patient population viral hepatitis was more frequent among younger patients. We observed a high frequency of HBsAg positive hepatitis (40.7%) which was seldom associated to a history of parenteral exposure and showed an irregular geographical distribution. HBsAg positive hepatitis was similarly distributed between males and females. It was more frequent in patients older than 30 (60%) than in children (18-23%) and younger patients (42%). In our series, the frequency of HBsAg hepatitis found in surgeons (81.8%) and nursing personnel (66.3%), but not in physicians (41.2%), was greater than that of the entire sample due to their exposure to blood.


Sequeale of acute viral hepatitis type B. In 1976 we undertook to evaluate the incidence of chronic liver lesions in 161 patients treated in hospital during the years 1970-1975 for their serologically established acute viral hepatitis type B (AVH-B). At systematic control examination mode in 1976, after a period from 1-5 years since the acute onset of disease, it was established that in 133 individuals (82.6%) the antigen HBs had disappeared from blood and the BLT had become normal. Persistent HBs antigenemia was established in 20 (12.4%) individuals. In 15 (9.2%) patients persistent HBs antigenemia was accompanied by pathologic BLT, in 5 (3.1%) cases liver function became returned to normal yet with the persistent HBs antigenemia after their recovery from A VH-B. In 8 (4.9%) patients pathologic BLT persisted although HBsAg had disappeared from blood. Among 28 persons with persistent pathological BLT or with persistent HBs antigenemia out of a total of 161 patients who had had A VH-B, there were 11 (6.8%) cases with the bioptically proved CPHf, 8 (5.0%) cases with CPH, 5 (3.1%) cases with CAH, while 4 (2.5%) patients showed fatty liver metamorphosis or had by light microskopy completely normal liver. CAH was established only in cases with persistent BHs antigenemia and pathological BLT. The incidence of the chronic liver lesion and of the persistent antigenemia was among our patients who had had A VH-B in inverse ratio to the intensity of their initial infection. Our study suggests that no prodisposition for persistent HBs antigenemia is created by the prednisolone therapy.


Total fatty acids of human liver in relation to age, sex and pathology. Lipids were extracted from 28 "normal", 3 fatty and 2 cirrhotic adult livers removed at necropsy as well as from 4 newborn and infant organs. The total fatty acids were processed, the methyl esters submitted to gas chromatographic analysis and the acid differences ascertained relative to age, sex and pathology. Among other significant findings, the unsaturated acids ranged higher than the saturated homologs and were even greater in the fatty liver lipids. The latter showed an increase in 18:1 and depressions in 18:0, 22:0 and 24:0 as compared to the "normal" specimens and the same changes in 18:0 and 18:1 as contrasted to the cirrhotic lipids.


Serum 25 -- hydroxyvitamin D3 levels in patients with liver disease. Serum 25-hydroxyvitamin D3 levels were determined in chronic hepatic diseases by a radioreceptor assay and correlated with serum albumin, calcium and anorganic phosphate, 25-hydroxyvitamin D3 serum levels were significantly lower inall chronic hepatic diseses compared to normals. The low levels are correlated with the degree of parenchymal damage, not with the etiology of hepatic disease. In alcoholic liver disease thus 25=hydroxyvitamin D3 levels are significantly lower when cirrhosis is present than in mere fatty liver. Anorganic phosphate and calcium were close to the lower range of normal and significantly lower than in the control group studied.


Investigation of reserve functional ability of small intestine by xylose test after food loading. D-xylose test in control group and in subjects with proximal chronic enteritis and colitis was carried out in three modifications: after fasting according to conventional method, after preliminary meat loading, and also after glucose loading. Meat caused considerable rise of xylose absorption that was much greater in control group than in subjects with chronic enteritis. In subjects with chronic enteritis the deviation from the norm after meat loading was observed more often than in the conventional test. Glucose reduced D-xylose absorption. In moderate enteritis the reduction was less obvious than in the control group. Double xylose test after meat and glucose loading is recommended as a method of functional investigation of small intestine.


The gastrointestinal myoelectric response to 13-Nle-motilin infusion during interdigestive and digestive states in the conscious dog. Gastrointestinal myoelectric activity was studied in three conscious fasted dogs with electrodes surgically implanted in the stomach and small intestine, during separate and combined intravenous infusions of 13-norleucine motilin (13-nle-motilin) and pentagastrin (PG). Basal recordings confirmed the presence of regular interdigestive myoelectric complexes (MC's). 13-nle-motilin infusion below 50 ng/kg-h was without effect: higher doses up to 400 ng/kg-h resulted in the interpolation of one or more MC's in the spontaneous sequence. The rate of aboral transit of 13-nle-molitin-induced MC's did not differ significantly from that of spontaneous MC's. When MC's were abolished by feeding or PG infusion, simultaneous 13-nle-motilin administration was without effect on spike activity, but slightly attenuated the accelerating effect of gastrin on the gastric pacemaker frequency. The myoelectric events triggered by 13-nle-motilin suggest that in the conscious dog the polypeptide may not act directly on the smooth muscle cell, as it does in vitro, but through an extra-enteric neural control mechanism which is uncoupled by gastrin.


Magnesium and gastric acid secretion.

Magnesium and gastric acid secretion. This study examined the modifications of acid gastric secretion caused by magnesium oxide, peroxide, silicate and sulphate in 805 patients with duodenal ulcers; The calcium-magnesium antagonism on the one hand and the acetazolamide - magnesium synergia on the other, were also investigated. Our results show that administration of magnesium, either oral or parenteral, does not significantly modify gastric acid secretion, either basal or stimulated by maximal histamine. Administration of un infusion of calcium gluconate 15 mg/kg body weight, significantly increases gastric acid secretion as compared to basal secretion. Addition of a dose of magnesium sulphate to the infusion antagonises the effect of  gastric acid secretion caused by calcium. Administration of 1.5 gr magnesium oxide along with 25 mg acetazolamide per kg/body weight, strengthens the inhibitory effect of acetazolamide upon gastric acid secretion, increasing the proportion of significant inhibitory effects up to 98% of the cases under investigation. Addition of magnesium to the classical therapy antagonises the noxious effects of calcium compounds; the presence of magnesium in the composition of antacid powders proves necessary.


25-hydroxycholecalciferol serum levels in patients with Crohn's disease. In 37 patients with Crohn's disease the 25-hydroxycholecalciferol (25-HCC) serum level, serum concentration of calcium and inorganic phosphate, and the enzyme activity of alkaline phosphatase were measured. Furthermore the activity index of Crohn's disease was determined in every patient. There was no statistically significant difference of 25-HCC serum levels in these patients compared to a healthy control group. Correspondingly most patients showed normal alkaline phosphatase enzyme activity and normal serum concentration of calcium and inorganic phosphate. No correlation between 25-HCC concentration and site of inflammation or activity index was found.


[Tumorous diseases of the lymphatic system (in 2 parts)]. Diagnostic approaches in the management of Hodgkin's Disease and Non Hodgkin Lymphomas are discussed. The importance of recent histological classifications in Non Hodgkin Lymphomas is emphasized particularly with respect to the differentiation between lymphomas of "low grade" and "high grade" malignancy. Complication in the course of treatment in these patients are reviewed and the therapeutic implications of particular organ involvement are summarized.


[Clinical experiences with Nepross C-02 dialyzer]. During 50 haemodialyses procedures with the Nephross C-02 coil dialyzer in a RSP-system clearance, effectivity and ultrafiltration were investigated. With a blood flow of 200 ml per minute clearance for urea, creatinine and uric acid were 88.3, 76.1 and 69.9 ml per minute respectively. Considering these results, our findings 2 hours after starting dialysis must be taken into account that clearance values measured in the recirculation-single pass-system (RSP) are about 30% lower than the results with the use of the single pass-system. The maximal ultrafiltration rate was 600 ml per hour. Overhydration therefore, is the main indication for the use of the Nephross C-02 coil dialyzer.


[Cardiac pacing in tachycardiac arrhythmias]. Cardiac pacing may be useful in the management of supraventricular and ventricular tachycardias. Prophylactically, recurrent ectopic tachycardias may be prevented by atrial or ventricular pacing for a sustained period at a rate faster than the spontaneous rate, but slower than the rate of the tachycardia being suppressed. Moreover, the pacemaker permits the dosage of antiarrhythmic agents to be increased until the recurrent arrhythmias are completely controlled. Therapeutically, supraventricular tachycardias may be terminated by (1) overdrive suppression, (2) delivery of a single stimulus or two serial stimuli or repetitive stimulation at a rate slower than the tachycardia (competitive stimulation) and (3) orthorhythmic stimulation. Today, implantable units exist. Advantages and disadvantages as well as risks of pacing in patients with tachycardias, are discussed.


[Myocardial infarct with a normal coronary angiogram]. The present report describes a case of a massive transmural anterior wall myocardial infarction in a woman with angiographically normal coronary arteries. The possible mechanisms of production of myocardial infarction in the presence of normal coronary arteriograms are discussed. With the increasing application of coronary arteriography, such diagnostic problems will undoubtedly become more frequent.


Halothane anaesthesia ans suxamethonium II. The significance of preoperative gallamine administration. Preoperative administration of gallamine was evaluated during inhalation anaesthesia with nitrous-oxide and halothane with two administrations of suxamethonium 1 mg/kg body weight, 5 min apart. Sixty healthy patients were randomly divided into three groups and preanaesthetic gallamine, 0.3, 0.4 or 0.5 mg/kg body weight, respectively was administered intravenously 3 min before induction, according to the allocation. Just before induction of anaesthesia the patients were examined for signs and symptoms of partial curarization. After induction of anaesthesia by nitrous-oxide-oxygen-halothane, suxamethonium 1 mg/kg was given intravenously. Exactly 5 min later the same dose was repeated. ECG was monitored continuously and serum potassium, Pao2 and Paco2 were measured at appropriate intervals. It was found that none of the examined doses of gallamine gave any reliable protection against serious bradyarrhythmias after repeated doses of suxamethonium. Furthermore the higher doses of gallamine caused an unacceptably high frequency of patients with tachycardia and signs and symptoms of partial curarization.


Influence of intravenously administered ephedrine on splanchnic haemodynamics and clearance of lidocaine. The effects of a 20 mg i.v. bolus of ephedrine sulphate on haemodynamics and plasma lidocaine concentrations were evaluated in eight volunteer subjects receiving a constant i.v. infusion of lidocaine HC1 (2 or 4 mg-min-1). Injection of ephedrine caused a significant increase in mean arterial blood pressure, which preceded an elevation of heart rate by about 2 min. Cardiac output and hepatic blood flow, measured at 10 and 20 min after injection, were also increased significantly, while there was a decrease in total peripheral resistance and no change in splanchnic vascular resistance. There were no significant circulatory alterations over the same period in a control group of four subjects on receiving the lidocaine infusion. After ephedrine, the mean splanchnic extraction ratio of lidocaine fell from 0.76 to 0.66 at 10 min, then rose again to 0.71 at 20 min, and these changes were accompanied by a 9% increase in its splanchnic clearance. Extraction and clearance remained unchanged in the control group. The implications of these findings are considered in relation to the use of ephedrine to prevent or treat hypotension after peridural block with local anaesthetic agents.


Inadvertent thoracic duct catheterization during transjugular central venous cannulation. A case report. An aberrant placement of a central venous catheter into the upper part of the thoracic duct with loop formation in the left innominate vein was observed on catheterizing via the left internal jugular vein. The misplacement, which did not have any deleterious effects, was caused by the atypical insertion site of the thoracic duct at the dorsocaudal wall of the left innominate vein and, possibly, by its incompetent closing valve. The stiffness of the nylon catheter used may also have been a contributory factor. The possible causes of this complication of central venous catheterization are discussed. The preferential use of the right internal jugular vein is stressed.


Catheter technique in axillary plexus block. Presentation of a new method. A flexible, disposable intravenous catheter can be introduced into the neuro-vascular sheath in the axilla and used for injection of local anesthetic solution to block the axillary brachial plexus. The technique is described and the results of the first 137 consecutive catheter blocks are reported and compared to a similarly evaluated series of conventional axillary blocks. The catheter method constitutes an interesting alternative to needle techniques and offers the possibility of a continuous axillary block.


The blocking effect of epidural analgesia on the adrenocortical and hyperglycemic responses to surgery. The adrenocortical and hyperglycemic responses to hysterectomy were studied in five groups of patients receiving: general anesthesia (group I), general anesthesia + epidural analgesia extending from Th10-S5 (group II), general anesthesia + epidural analgesia extending from Th8-S4--5 (group III), general anesthesia + epidural analgesia extending from Th4--6-S5 (group IV) and epidural analgesia extending from Th4-S5 without general anesthesia (group V). The results showed that the cortisol response was abolished in group V, inhibited in group IV and normal in groups II and III. The hyperglycemic response to surgery was inhibited in groups II, III and IV, and abolished in group V. Epidural analgesia from Th4 to S5, preventing the adrenocortical and hyperglycemic responses to hysterectomy, and possibly also inhibiting other components of the endocrine-metabolic response to surgery, may have important applications in further studies of the physiologic significance of the endocrine-metabolic response to surgery.


Postoperative pulmonary function in obese patients after upper abdominal surgery. The pulmonary course after jejuno-ileal by-pass operation in six massively obese patients (mean weight 130.2 kg) was followed for the first 5 postoperative days by means of arterial blood gas analysis and measurements of forced vital capacity (FVC), forced expired volume in the first second (FEV1.0) and peak expiratory flow rate (PEFR). The patients were extubated in the operating room and were breathing spontaneously in the postoperative period. Pao2 and FVC reached their minimum values in the first 24 postoperative hours (respectively, 74% and 45% of their preoperative values), but were almost restored in 5 days. PEFR had at this time reached 77% of its preoperative value FEV1.0% (FEV1.0%in per cent of FVC) did not change from the pre- to the postoperative period, but remained about 70%.


Pulmonary function in obese patients scheduled for jejuno-ileostomy. Preoperative pulmonary parameters were evaluated in 37 extremely obese but otherwise healthy patients. They were on average 100.9% overweight. X-ray of the chest, electrocardiograms, and residual volume, vital capacity, total lung capacity, maximum breathing capacity, forced expired volume in 1 second, and related ratios were all within the normal range. The alveolar-arterial oxygen gradient and the arterial carbon dioxide tension were also within the normal range. The only abnormal finding was a substantially reduced arterial oxygen tension. It is suggested that the measurement of functional residual capacity, closing volume, and the slope of the alveolar plateau (phase III in the single breath nitrogen washout technique) might give more valuable information.


Amyotrophic lateral sclerosis in Finland. I: An epidemiologic study. The prevalence of ALS and its distribution in Finland was investigated on the basis of prevalence numbers by counties. On the prevalence day, 1 January 1973, 168 ALS patients were found alive. They were collected from hospital records and the registers of the National Pension Institute. The prevalence was 3.56 cases per 100,000 populations, 4.25/100,000 for men and 1.92/100,000 for women, which gave a male to female prevalence ration 1.5 to 1. The distribution of the disease was uneven in the country being more frequent in the southeastern counties. The disease was contracted earlier (at 51.9 years of age) and its course was slower (3.7 years up to the prevalence day) in the prevalence material than in cases derived from the mortality statistics (58.0 years at the onset and duration of 2.6 years, respectively). This is explained by the dropping out of some of the younger and/or more benign cases from the mortality statistics. This seems to be true also in other countries.


Amyotrophic lateral sclerosis in Finland. II: Clinical characteristics. The clinical characteristics of ALS in Finland were investigated. The study was based on the hospital records of 255 patients. No correlation was found between the disease and other previous illnesses. Muscular weakness was the most frequent complaint of the patients as their first symptom (149/255, i.e. 58 per cent). The duration of the disease was shortest (1.9 years) in male cases with the first symptoms in the bulbar area, and it was longest (3.4 years) in females with a spinal onset of the symptoms. The duration of the disease was in inverse relation to the age when it was contracted. Progressive muscular atrophy with fasciculations was considered the most important clinical sign of ALS. It was most frequently observed in the upper extremities including shoulders. Sensory disturbances were absent, sphincter abnormalities were reported in only three cases, bed sores did not exist, and there were no reports of impotence in the male patients. Two families with two familial cases in each were found, altogether two men and two women. Their disease did not differ from that of the rest of the series. The ALS patients soon became too disabled to work; 56 per cent bacame permanently disabled in less than 1 year's time,  and only 9 per cent retained their working capacity for more than 2 years. The average length of stay at hospital was 32 days for ALS and 37 days for MS patients, but the later group was hospitalized 2-3 times more frequently than the former. Gastrostomy or tracheostomy and artificial respiration did not lenghten the lives of the patients.


Effects of neonatal thyroidectomy on thymidine metabolism and deoxyribonucleic acid synthesis in the developing rat cerebellum. Thyroid deficiency at birth caused a temporal decrease of the DNA content in rat cerebellum during the periods from 7 to 21 days of life as compared with the normal. At 2 h following the subcutaneous injection of [3H]-thymidine, the specific radioactivity of cellular dTTP in thyroid deficient rats was apparently increased on the 14th and 21st days, although the endogenous pool sizes of dTTP did not significantly differ between the normal and thyroidectomized rats throughout the entire ages studied. The ratio of incorporation of thymidine into cerebellar DNA was initially determined by the specific radioactivity and then expressed as the ratio of [3H]-DNA to [3H]-dTTP, the relative specific radioactivity of DNA. The age peak of incorporation occurred at 7 days in the normal; on the other hand, the specific activity of DNA in thyroid deficiency attained a maximum at 14 days and the relative specific activity appeared to be prolonged up to 14 days. The corresponding changes were observed in the formation of dTTP, suggesting that a transient retardation of cerebellar DNA synthesis taking place by neonatal thyroidectomy may be in part attributable to the variance of phosphorylation of thymidine. Indeed, thymidine kinase activity that regulated salvage pathway for DNA synthesis displayed a parallel variation in thyroid deficiency to characteristic age dependence of DNA synthesis.


[The Bouttier test. Significance of resistance to pressure for neurological diagnosis (author's transl)]. In 1922 Bouttier described the "pressure test". With reference to later works by Bouttier, not published at the time, the author demonstrates the role which the Bouttier test can play in the differential diagnosis of various neurological diseases (tumours of the cerebellum, the cerebellopontile angle or the pituitary; frontal tumours, cerebral atrophy, pseudobulbar palsy, Parkinson's disease). The physiological mechanisms which could play a part in these reactions are briefly considered. (Acta Neurol. Belg, 1977, 77, 193-201).


Radiation myelopathy of the lumbo-sacral spinal cord. The clinical findings in four cases of radiation injury to the lumbosacral spinal cord and cauda equina, occuring after radiotherapy of malignant testicular tumours with radiation doses of 1597-1670 ret, are reported. The main feature in each case was a flaccid paraparesis, without sensory loss in three cases, while one patient presented a doubtful sensory deficit. Symptoms of sphincter dysfunction were absent. In all cases the symptoms caused a marked and persistent incapacity. It is suggested that the principal site of radiation injury is the proximal parts of the lower motor neuron.


Electrophysiological findings in gastrectomized patients with low serum B12. Thirty-eight patients with vitamin B12 deficiency after gastric surgery for a benign peptic ulcer were examined electrophysiologically. Thirteen (34 per cent) had electromyographical signs of peripheral nerve involvement and the amplitude of the sensory potentials of the median nerve at wrist (16 patients) was diminished, whereas sensory and motor conduction velocities were normal. Six patients had clinical signs of polyneuropathy. The electrophysiological findings are compatible with slight loss of myelinated nerve fibres. None of the patients had clinical or electromyographical signs of myopathy.


Spontaneous buccolinguofacial dyskinesia in the elderly. Buccolinguofacial dyskinesia consists of repetitive, non-rhythmic abnormal movements which occur at the speed of normal voluntary movement. To the observer they do not suggests a normal activity of mastication or phonation. This type of dyskinesia was evidenced in 88 patients out of a total of 240 elderly examined. It is more frequent in females than in males. Incidence does not increase with age. Frequency is highly variable individually. Every subject seems to have a comparatively stable frequency of his own. Dyskinesia is reduced or suppressed by neuroleptics, whereas stereotyped movements of the limbs are not affected. Individualization of bucolinguofacial dyskinesia from other abnormal movements should consequently rest on both its clinical features and its pharmacological sensitivity.


Spinal tumours associated with increased intracranial pressure. Report of two cases and a discussion on the pathophysiology. Two cases of increased intracranial pressure associated with lumbar intraspinal tumours are reported. On the basis of protein investigations and constant flow infusion manometric tests, the pathophysiology of the increased intracranial pressure is discussed. It is demonstrated that protein macromolecules leak from the tumour into the cerebrospinal fluid and suggested that these are responsible for mechanical obstruction of the outflow channels for the cerebrospinal fluid.


Chronic relapsing experimental allergic encephalomyelitis. Studies in vascular permeability changes. The vascular permeability in the nervous system to Evans blue-albumin and horseradish peroxidase was studied in chronic relapsing EAE in strain 13 and Hartley guinea pigs. The disease was induced by single sensitization of immature animal and was characterized clinically by remissions and relapses. Recent and old demyelinating plaques in the spinal cord were present. These showed an increased permeability to the protein tracers. The blood-brain barrier in these plaques are therefore disturbed and also in this respect the condition is similar to the multiple sclerosis lesions.


Sub-plasmalemmal linear density: a common structure in globoid cells and mesenchymal cells. Sub-plasmalemmal linear densities of variable length (0.1 approximately 1.0 mu) were found to be a constant feature of globoid cells in human as well as in canine globoid cell leukodystrophy (GLD). Similar densities were also observed in experimental globoid cells and epithelioid cells in chronic granuloma but not in glial cells. The linear densities always appeared without any relation to basal laminae. These observations together with the other reports of similar structures in lymphoma, fibroma and sarcoidosis suggest that the sub-plasmalemmal density is a structure frequently observed in mesenchymal cells, and may be another supporting feature for possible mesenchymal origin of globoid cells.


Rotational cerebral injuries near the superior margin of the brain. Traumatic lesions near the superior margin of the brain frequently are caused by an anterior or posterior blow to the head. The injuries consist of disruptions of one or a few (with subdural bleeding) or of numerous or all (with instant death or immediate unconsciousness and later death because of simultaneous brain stem injuries) parasagittal bridging veins. Cerebral injuries close beneath the superior margin of the brain occur either alone or together with disruptions of parasagittal bridging veins. These injuries consist mainly of subcortical, perivascular or larger, hemorrhages and of injuries to the white matter. No extensive complete necrosis occurs. The lesions are most frequently found in the posterior part of the superior frontal gyrus and the central gyri and often are combined with brain stem injuries. By reconstruction of trauma events the injuries seem to be caused by a rotational acceleration of the head. By model experiments and simulations it is shown that a rotational acceleration of the skull leads to an "inner deformation" of the brain tissue. This deformation may be the explanation of the subcortical injuries, which are therefore designated rotational cerebral injuries (RC-injuries).


Peripheral nerve changes in thiamine deficiency and starvation. An electron microscopic study. Electron microscopic investigations on sciatic and plantar nerves of thiamine deficient and starved rats show a distally pronounced axonal degeneration. The changes are present in starved and thiamine deficient animals, but the deficient animals are more severely affected. The earliest alterations consist of an increase of mitochondria and a proliferation of vesicular elements of the endoplasmic reticulum. They are followed by loop formations of the axon membrane, clustering and disintegration of neurotubules and neurofilaments, axonal shrinkage and finally myelin disruption. The distal accentuation of the early changes indicates a dying-back mechanism of axonal degeneration.


delta-aminolaevulinic acid dehydratase activity and focal brain haemorrhages in lead-treated rats. Mothers were fed a diet containing 2% lead acetate acording to the Pentschew-Garro model for inducing lead encephalopathy in young rats. At 20-22 days of age the young lead-treated rats had a mean brain Pb of 2.8 microgram/g and liver Pb of 11 microgram/g. The ALA dehydratase activity decreased 29% in brain and 69% in liver compared to controls, suggesting that the enzyme activity is related to the tissue lead level. Mothers that had received lead prior to conception gave birth to pups with a significantly raised mean blood lead level (44 microgram %). The ALA dehydratase activity in brain and liver was unchanged, suggesting that low blood lead levels may be insufficient to inhibit this enzyme in the rat. Focal haemorrhages were present, however, in the cerebral cortex of some of the pups from the lead-treated mothers. It is concluded that damage to the rat brain vascular system is a better index of lead toxicity than measurement of the lead sensitive enzyme ALA dehydratase.


Paraplegia due to actinomyces viscosus infection in the cat. In a 3 year old female domestic cat a suppurative, granulomatous lesion of the tail and sacral area penetrated into the epidural space, causing paraplegia. A viscosus was isolated from the inflammatory tissues. A comparative light and electronmicroscopic study of the bacterial elements and the architecture of the granules (Drusen) show that the latter are in-vivo microcolonies of the agent.


Hereditary multi-infarct dementia. Morphological and clinical studies of a new disease. A family is described in which for three subsequent generations numerous individuals were affected with a progressive neuropsychiatric disease with pyramidal, bulbar and cerebellar symptoms, relapsing course and gradually evolving severe dementia. Post-mortem studies performed on three siblings afflicted with the disease suggest that the remarkably uniform macroscopic picture of the cerebral changes consisting in multiple small cystic infarctions, particularly localized to the central grey and white matter and pons as well as the cortical and central brain atrophy, is caused by an occlusive disease of small intracerebral and leptomeningeal arteries and arterioles. Collected pertinent information concerning the affected family members shows that the illness begins in early adulthood (at 29--38 years of age), affects both sexes and generally lasts for 10--15 years. The only exception so far noticed was a second generation descendant of one of the siblings. This patient died about 5 months after clinical onset of the disease in massive cerebral haemorrhage and showed similar vascular changes as the older members of the family. The disease is considered to be genetically caused and transmitted as a dominant autosomal character. For this apparently new nosological entity the eponym "hereditary multi-infarct dementia" is suggested.


[Cytophotometric investigations of the nuclear DNA content in ependymomas and plexuspapillomas (author's transl)]. Report on Feulgen-cytophotometric DNA investigations in 10 ependymomas and 2 plexuspapillomas. All ependymomas represent in their karyograms aneuploidic stem lines. In most of them one observes duplication peaks (G2 cells) as expression of proliferation behaviour. The histological benign ependymomas exhibit stem lines between the hyperdiploid and hypotetraploid values. With increasing malignancy the stem lines are elevated in higher ploidy levels and a reduction of a predominant stem line is recognizable. One of the ependymomas represents a distribution of DNA values like in a "mosaic" tumour. The measurements in the plexuspapillomas in good conformity with the histologic picture reflect the DNA distribution of a benign euploid neoplasm.


[Unmyelinated nerve fibers in senile nerves and in late thalidomide neuropathy: a quantitative electron microscopic study (author's transl)]. Sural nerve biopsies of four patients, aged 54--76 years, with a predominantly sensory type of neuropathy following high dosages of thalidomide were examined by light and electron microscopy. The present study includes a qualitative and quantitative evaluation of unmyelinated nerve fibers. Despite severe neuropathy, increased numbers of small unmyelinated axons per endoneurial area were noted in all patients. This numerical increase appeared to be independent of aging, since it was not seen in two senile controls, studied at the age of 83 and 88 years. The increase in the endoneurial density of unmyelinated axons, especially of small sized fibers, is likely to be related to regeneration following degeneration of unmyelinated axons although endoneurial shrinkage secondary to loss of large myelinated fibers could have caused an additional increase in the number of axons per endoneurial area. Axonal sprouting, despite degeneration of large numbers of myelinated and unmyelinated fibers, appears to be consistent with some of the characteristic clinical features of thalidomide neuropathy such as paresthesias, hyperesthesia for pain and temperature, and disturbances of autonomic functions. On the other hand, a variable number of empty Schwann cells (bands of Büngner) and pockets at the surface of many Schwann cells noted in the four patients with neuropathy were also seen in both senile controls with no signs of neuropathy. Thus, it is obvious that pockets and empty Schwann cells may be related to aging or other causes of slow axonal wasting with Schwann cell proliferation and are not necessarily associated with clinically manifest neuropathy.


Convergence of ampullar and macular inputs on vestibular nuclei unit of the rat. 181 vestibular nucleus neurons were examined for their responsiveness to rotation about the vertical axis and static tilts in roll and pitch planes in the rat. 68 of these units were sensitive to rotation and tilts (canal-otolith cells). In other words, 41.0% of the neurons responded to rotation (68/166). There was no significant difference in percentage of canal-otolith cells in type I and II neurons, which were 48.6% and 37.0% respectively. Vertical axis rotation when the head was tilted produced a simultaneous stimulation of the canal and otoliths. Using this stimulus method, the bias effect was observed in 72.5% of the canal-otolith cells (29/40). Furthermore, since vertical axis rotation with the head tilted elicited vertical canal responses, the rate of ampullary convergence was estimated by analysing response profiles obtained such rotations. The results obtained in the rat were compared with those in other species.


Optokinetic test comprising both acceleration and constant velocity stimulation (ACV-OKN test). Normal subjects were exposed to two kinds of optokinetic stimulation, viz. at speeds of 60 degrees/s and 90 degrees/s preceded by acceleration at 6 degrees/s2 and 4.5 degrees/s2, respectively. In most subjects the speed of the eye in the slow nystagmus phase equalled the speed of the rotating device during the acceleration at velocities up to about 60 degrees/s. The eye then lagged behind the speed of the optokinetic stimulus. The upper limit for linear increase in the eye speed of the slow nystagmus phase has been named the "optokinetic fatigue threshold". A new clinical test permitting quantitative assessment of the optokinetic response has been introduced. The maximum eye speed in the slow nystagmus phase has been found to be the most appropriate parameter. Presentation of the results in the form of special charts, named optokinograms, is recommended. Optokinetic disturbances of varying kinds were noted mostly in patients with CNS disorders, but also in patients with diseases of the inner ear.


Results of new air caloric testing method among normal subjects. II. Monophasic testing. A new caloric irrigation method is described. In the new method, the temperature of a continuous aural irrigation is switched between hot and cold values at precisely specified times. The durations of hot and cold pulses have been calculated to produce specific caloric stimulation intensities based on known heat transmission characteristics of the labyrinth area. A brief "washout" irrigation is used to eliminate promptly all caloric stimulation effects at the conclusion of each test. The present study concentrated upon the question of how long the "washout" pulse should be in order to obtain optimum results. Repetitive application of a uniform stimulus intensity to 6 normal subjects indicated that short inter-test intervals can be used without causing vestibular habituation. Prompt removal of the caloric stimulus can be accomplished by proper timing the "washout" phase of the new technique.


Horseradish peroxidase acute ototoxicity and the uptake and movement of the peroxidase in the auditory system of the guinea pig. When guinea pig cochlea was perfused in vivo with a solution of 1% horseradish peroxidase (HRP) in artificial perilymph, the enzyme was found in the basilar membrane, spiral limbus, some outer and inner hair cells and some supporting cells and it was gradually cleared away with time. Acute signs of cell damage included swelling, vacuolization and diffuse labeling of some hair cells, but stereocilia remained normal in configuration. Albino melanocytes of the spiral ligament were also damaged, and vacuolization of Reissner's membrane occurred after 10% HRP. Both concentrations caused a gradual decline in CM, showing that HRP is acutely ototoxic but its mode of action is unknown. No retrograde transport of HRP to spiral ganglion cells or to brain stem neurons occurred, but some brain stem neurons took up HRP from the neuropil following diffusion from the cochlea.


Slow evoked cortical responses to linear frequency ramps in subjects with cochlear lesions. Slow evoked cortical potentials in response to linear frequency ramps of a continuous pure tone with a 1 kHz base frequency have been recorded from ten relatively young subjects with hearing loss of cochlear origin. At small frequency ramps, the N1-latency of their responses to the three ramp durations studied (20, 100, 500 msec) was significantly longer than those of a group with normal hearing. As the ramps are made larger, the difference between the latencies of the pathological group and the normal group becomes smaller; above a certain rate of frequency change, the latency of N1 becomes smaller in the pathological cases than in the normal group. This crossover occurs at frequency change rates around 1-3 kHz/sec. It is concluded that recording of evoked cortical responses to frequency ramps may provide an additional tool in the differential diagnosis of hearing disorders.


The influence of perilymphatic pressure on the displacement of the tympanic membrane. A quantitative study on human temporal bones. A model study on human temporal bones was performed. A microflow method was used in order to assess the possibility of making indirect recordings of changes in the inner ear pressures. Changes in the perilymphatic pressure were recorded as displacements of the tympanic membrane, the stapedius reflex being artificially elicited by forces applied briefly to the stapedius tendon. Changes in the perilymphatic pressures in the range of +/-15 cm H2O affected the position of the tympanic membrane and the "stapedius reflex response". The microflow method used seems suitable for the clinical recording of changes in the intralabyrinthine pressure.


A note on development of Corti's organ.

A note on development of Corti's organ. The structure and postnatal transformation of Kölliker's organ in the cat were studied by means of both light and electron microscopes. Kölliker's organ, which is located in the inner sulcus area of the cochlear duct during embryonic development of the kitten, appeared to undergo a major transformation during the first 30 days after birth. On the level of the organ as a whole the possible nature of this transformation is briefly discussed. On the cellular level, the transformation of this organ was found to involve a process of cellular autophagocytosis. Kölliker's organ consists of numerous tightly packed, tall columnar cells filling the inner sulcus. Autophagic vacuoles containing cell organelles were observed in these cells in all stages of transformation of the organ. Cellular autophagocytosis reduced the number of cells present in each section from approximately 50 in the newborn, to approximately 12 in the 30-day-old kitten. The apparent transformation of Kölliker's organ was observed as progressing from base to apex and from the limbus to the inner hair cell. The relationship of the tectorial membrane to Kölliker's organ and that of the tectorial membrane to the area in and around the inner hair cells are discussed.


Variables affecting the drill-generated noise levels in ear surgery. The manner in which the variables rotation speed, type of burr, burr size and site of drilling influence bone-conducted, drill-generated noise levels in ear surgery, has been investigated. From the results obtained, the following conclusions can be drawn. 1. The noise levels were primarily influenced by the size of the burr. The 6 mm cutting burrs gave a noise level of 88-108 dB, the use of a 4 mm one resulted in a reduction of 1-6 dB and the use of a 2 mm one, 5-16 dB. The mean noise levels of the diamond burrs were 5-11 dB lower than the mean noise levels of the cutting ones. 2. Variations in rotation speed had only a slight influence on the noise levels produced (0-5 dB). 3. Three different types of cutting burr were tested. All gave noise levels of about the same order of magnitude. 4. The noise levels around the cochlea were only slightly influenced by the localization of the drilling within the ear (less than 1.8 dB). 5. Drill-induced noise levels in ear surgery cannot be reduced to any great extent. Possible noise traumas to the inner ear can only be avoided by minimizing the duration of drilling and thus, the duration of harmful noise exposure to the cochlea.


Long-term results after stapedectomy.

Long-term results after stapedectomy. 296 cases of stapedectomy accomplished by vein grafting plus polyethylene tubing with a primary (one-year) result of a greater than 10 dB improvement in Air Conduction (AC) threshold in speech frequencies have been tested with pure tone audiometry 1-12 years postoperatively. The AC threshold of the operated ear increased by about 1 dB per year for both low and high frequencies. In the high frequency range this increment can be ascribed to normal aging; in the low range the reason is probably progressive conductive loss. There is no evidence to support the assumption that the operation impairs the sensorineural function of the operated ear. The AC threshold of the unoperated ear also increased--by more than that of the operated ear, for both low and high frequencies. In the low range this was ascribed to progressive stapes fixation; in the high range to stapes fixation plus normal aging. The progression for the non-operated ear is relatively slow, about 2 dB per year.


Enzymatic activity of inner and middle ear fluids in fetal guinea pigs under ambient and high-intensity sound presentation. The enzymes in perilymph of the inner ear scala and within fluid filling the middle ear cavity were investigated in the fetal guinea pig near term. Perilymph lactic dehydrogenase (LDH) exhibited differential activity between fetal scalae vestibuli and tympani, and LDH, aldolase, phosphohexose isomerase and creatine phosphokinase in perilymph of particular fetal scalae were elevated in activity in activity in comparison to corresponding maternal values. Moreover, LDH displayed different isozyme patterns for antenatal and gravid perilymph. In the middle ear fluid, all of the above enzymes were encountered but varied somewhat from the quantities determined for either prenatal perilymph or maternal serum. After gravid guinea pigs were exposed to a tone of 4 kHz, 100 dB SPL for 2 hours, LDH of the fetal middle ear fluid was reduced in activity 24 hours later. The metabolic significance of the fetal distinctions in the ear fluids and the clinical implications of the current work are discussed.


[New data apropos of a case of oculomandibulodyscephaly with hypotrichosis (Hallermann-Streiff syndrome). ORL examination and anthropometry]. According to the authors, a valuable study of dysmorphy can only be made with the use of anthropometric observations. To stress that point of view, a case of oculo-mandibulo-dyscephaly with hypotrichosis is studied. Furthermore a complete ENT study of this case is performed. At the same time, the heredity of the syndrome is discussed.


Sympathetic nerve pathways to the nasal vasculature of the cat. The sympathetic nerve pathways to the nasal vasculature were examined in 8 cats by recoding the effects of section of the orbital nerves on vasoconstriction produced by cervical sympathetic nerve stimulation. No sympathetic fibres were found in the sphenopalatine and infraorbital nerves. The majority were conveyed by either the Vidian or ethmoidal nerves, the remaining fibres are believed to reach the nasal cavity by the periarterial plexus.


Experimental studies of Neodym-YAG-laser microsurgery of the vocal cords in dogs. In animals the endolaryngeal application of Laser rays of the Nd: YAG-Laser MediLas was tested under microsurgical conditions, the early and late alterations of the vocal cords were endoscopically observed and histologically studied. Laser surgery has the special merit of permitting a touchless and bloodless operation. The experiences with the Nd: YAG-Laser MediLas encourage us to use this procedure in clinical tests for the therapy of benignant squamous epithelium hyperplasia of vocal cords.


Studies on the capacity of human tonsillar lymphocyte subpopulations to produce interferon. Tonsillar lymphocytes produced classical interferon (Type I) in response to NDV infection and produced immune interferon (Type II) in response to PHA, PPD or histo-incompatible antigens. Lymphocytes having higher specific gravity and having a greater proliferative response to mitogens or antigens produced more interferon than lymphocytes having lower specific gravity. There was no difference between heavy and light small tonsillar lymphocytes in regard to their sensitivity to the protective effects of interferon. As for the interferon produced in association with a cellular immune response, the peak of interferon production tended to appear earlier than the peak of 3H-TdR incorporation. It is suggested that tonsillar lymphocytes play an important role in human host defense against virus infections.


Cochlear potentials of the pigeon inner ear recorded with microelectrodes. The CM-intensity function (i.e. the relation between the amplitude of the cochlear potential (CM) and the sound pressure level) of the avian ear has previously been shown to deviate from the mammalian ear with respect to the slope of the linear part of the function. The lower slope values found in the perilymphatic space of the avian ear have been interpreted to indicate a damping influence of the tegmentum vasculosum on the mechanical vibration of the basilar membrane. In this study the CM-intensity function has been examined on either side of the tegmentum vasculosum of the pigeon ear using microelectrode technique. The slope of the linear part of the CM-intensity function in scala vestibuli was found to be a function of the sound frequency approaching unity at higher frequencies. In ductus cochlearis the slope of the linear part of the CM-intensity function was close to unity at most frequencies except the best frequency for the electrode position. At this frequency (3-4 kHz) the slope value was low. These findings from the ductus cochlearis are similar to findings in scala media of the mammalian ear. Thus the influence of tegmentum vasculosum on CM in scala vestibuli may be due to passive electrical properties of the tissue and not to the mechanical vibration of the basilar membrane.


Comparison of arteriolar blood flow in the hamster cheek pouch at two different oxygen tensions. Red cell velocity and diameter were measured in arterioles of the hamster cheek pouch microvasculature. The cheek pouch tissue was exposed to two different oxygen tensions, PO2 less than 30 mmHg and PO2 greater than 150 mmHg. Blood flow was calculated from velocity and diameter measurements and was found to be significantly reduced (44%) when cheek pouch was exposed to room oxygen superfusant. This reduction was the combined result of a significant decrease in both diameter (17%) and red cell velocity (17%) as compared to the measurements during the initial low oxygen period.


The importance of the intestinal countercurrent exchanger for 85Kr absorption from the feline gut. The rate of 85Kr absorption from the feline gut was studied at varying intestinal blood flows induced by i.a. infusions of a vasodilator drug or by lowering arterial inflow pressure. The effects on rate of absorption of distending the intestine by increasing intraluminal pressure from 0-1 to 5-7 cm H2O as well as of augmenting the rate of luminal perfusion of the 85Kr solution were also investigated. Distending the small bowel increased rate of 85Kr absorption at all levels of intestinal blood flow except at the very low and the very high blood flow rates. Decreasing blood flow by lowering of arterial perfusion pressure decreased the rate of absorption from the distended gut while it had no effect in the collapsed small intestine. Increasing the rate of luminal perfusion enhanced the rate of 85Kr absorption at all blood flow levels except at the lowest ones. The results are discussed with regard to villous hemodynamics, intestinal countercurrent exchange and intraluminal concentration gradients in the lumen. It is concluded that the countercurrent exchanger represents, under physiological conditions, the major limiting factor for the absorption of lipophilic solutes such as 85Kr.


A simple radioenzymatic procedure for the determination of choline and acetylcholine in brain regions of rats sacrificed by microwave irradiation. A rapid and sensitive radioenzymatic method for analysis of choline (Ch) and acetylcholine (ACh) concentrations in rat brain regions is described. The ACh content is obtained as the difference in Ch concentration between a hydrolysed and an unhydrolysed tissue sample. The ACh content was 16+/-1.0 nmol/g in the cortex and 76+/-2.4 nmol/g in the striatum, and the corresponding Ch values were 23+/-2.5 and 33+/-1.2.


Reflex plasma hyperglycemia and hyperosmolality evoked by unloading of the carotid baroreceptors. Hemorrhage is usually accompanied by a considerable increase in the plasma osmolality and glucose concentration due to an augmented release of glucose from the liver. In the present cat experiments an attempt was made to investigate the possible role of different vascular receptors in mediating this hyperglycemic (hyperosmolar) response. Bilateral vagotomy or stimulation of the carotid chemoreceptors by perfusion of the carotid sinus with venous blood at normal pressure only slightly increased the arterial plasma glucose concentration. On the other hand, when the sinus nerves were cut in the vagotomized animal, thereby simulating complete unloading of the carotid baroreceptors, the arterial plasma glucose concentration rose by about 8 mM/L and the arterial plasma osmolality by about 10 mOsm/kg H2O. Perfusion of the carotid baroreceptors with arterial blood at different levels of hypotension showed that the baroreceptor-induced hyperglycemia was graded in relation to the pressure level. Regional hypotension of the liver, pancreas, intestine, kidneys or brain did not significantly affect plasma glucose concentration or osmolality. We conclude that the reflex release of glucose from the liver during hemorrhage mainly is initiated from the unloading of arterial baroreceptors.


The role of intramural noradrenaline in the potassium induced contracture of non-estrogenized smooth muscle. The influence of intramural noradrenaline on potassium induced contractures was studied in isolated preparations of the uterus and the portal vein of the rat. Uterine strips of oophorectomized rats responded with contraction followed by transient relaxation when immersed in a medium containing 127 mM potassium chloride. Reserpinization or blockade of beta-adrenoceptors with propranolol greatly diminished the transient relaxation. In the isolated portal vein, both noradrenaline depletion with reserpine and alpha-adrenoceptor blockade (phentolamine) reduced the active tension produced in response to the isotonic potassium solution. These results suggest that intramural noradrenaline plays a significant role in the development of contractures evoked by potassium in the uterus and the portal vein of the rat. In the uterus, the released noradrenaline counteracts the development of active tension, whereas in the portal vein, noradrenaline has a contractile effect which is added to that of potassium. Estrogen treatment reduced (portal vein) or abolished (rat uterus) the contractile effects of intramural noradrenaline. The adrenolytic effect of estrogen is possibly due to reduction in the release of noradrenaline from the sympathetic nerve-endings.


Effects of intraventricular 6-hydroxydopamine on cerebrovascular CO2 reactivity in anesthetized rats. Regional cerebral blood flow was measured by the 14C-ethanol technique in anesthetized rats before and after intraventricular injection of 6-hydroxydopamine. This treatment reduced the fluorescence of the central noradrenaline and dopamine nerve terminals, as well as of the perivascular nerve terminals in cerebral vessels. The administration of 6-hydroxydopamine had no significant effect on cerebral blood flow at normocapnia. The cerebrovascular reactivity to hypercapnia was significantly increased in the 6-hydroxydopamine treated animals. The results indicate an involvement of central catecholamine pathways in the cerebrovascular reactivity to hypercapnia.


Effects of ethanol on urinary arginine vasopressin excretion in two rat strains selected for their different ethanol preferences. The effects of ethanol on urinary excretion of arginine vasopressin (AVP), sodium, and potassium were investigated in two rat strains specially selected for their different alcohol preferences. The alcohol preferring (AA) strain excreted more AVP and the water preferring (ANA) strain more urine and sodium during six hours after ethanol intubation (2.4 g/kg b.w.; 20% v/v). The data is insufficient to establish a causal relationship between differences in water and electrolyte metabolism and voluntary ethanol consumption.


The effect of indomethacin on renal blood flow distribution during hemorrhagic hypotension in dog. The effect of indomethacin in hemorrhagic hypotension (HH) on total renal blood flow (RBF) and cortical flow distribution was studied in 9 pentobarbital anesthesized dogs. Local blood flow was measured as hydrogen clearance by 6 platinum electrodes in outer and inner cortex. RBF was recorded by electromagnetic flowmeter. Injection of indomethacin (3-5 mg/kg b.wt.) to inhibit prostaglandin synthesis, reduced renal blood flow only a few percent in control period. After the pretreatment with indomethacin, bleeding to mean arterial pressure 50 mmHg decreased RBF abruptly to 25% of control flow. Thus a renal vasoconstriction is observed both in early and late periods of bleeding in contrast to the initial vasodilation observed during the first half an hour of HH when prostaglandin formation was not blocked. Local blood flow in outer cortex decreased proportionally to flow in inner cortex during bleeding in both the indomethacin treated as in the untreated group, indicating an equal vasodilatory effect of prostaglandin in all parts of renal cortex during early periods of HH.


Release of thiamine and formation of a methylthiamine-like substance in the phrenic nerve-diaphragm preparation of the rat. An increased formation of a radioactive methylthiamine-like substance (MTLS) in the end plate region of the rat diaphragm muscle and a release of radioactivity chromatographed as thiamine into the bath medium after a subcutaneous injection of 35S-thiamine were found after stimulation of the phrenic nerve. There was also an increased formation of the radioactive methylthiamine-like substance in the denervated diaphragm preparation incubated with radioactive acetylcholine (ACh) in comparison with the innervated diaphragm.


Influence of age on sensitivity and effector mechanisms of the carotid baroreflex. In 30 healthy subjects aged 20--48 years the hemodynamic response to carotid sinus stimulation (neck suction -40 mmHg) was studied. Heart rate, arterial pressure and cardiac output (dye dilution technique) were measured. In order to evaluate the effect of age on carotid sinus function the material was subdivided into two arbitrary subgroups, aged up to 30 years (n = 15) respectively 30 years and above (n = 15). Carotid sinus stimulation induced a significantly greater reduction in mean arterial pressure in the younger group compared to the older group. The heart rate reduction was, on the average, slightly greater in the younger group though the difference was not significant. In both groups a significant decrease in cardiac output contributed to the demonstrated reduction in mean arterial pressure. As the decrease in cardiac output was, on the average, slightly smaller in the younger group, the results indicate that the greater blood pressure response in the younger group was due to a greater reduction in peripheral vascular resistance. This is further supported by the finding of a significant correlation between changes in total peripheral vascular resistance, elicited by carotid sinus stimulation and age.


Choline acetyltransferase activity in the denervated urinary bladder of the rat. After extirpation of the pelvic ganglia the choline acetyltransferase activity decreased markedly indicating that most of the postganglionic cholinergic neurones of the bladder take this route. A small decrease in the activity of this enzyme was found after section of the hypogastric nerve, showing that these nerves contribute to some extent to the cholinergic innervation. The residual enzyme activity found after a combination of the two surgical procedures suggests that neurones relay distal to the level of the section of the hypogastric nerves and pass outside the pelvic ganglia and (or) that neurones pass the pelvic ganglia and relay distal to them. Electrical stimualtion of the hypogastric nerves after extirpation of the pelvic ganglia and the use of blocking drugs showed on the existence of cholinergic neurones passing outside the pelvic ganglia, some of them relaying distal to the point of stimulation.


Capillary permeability to albumin in normotensive and spontaneously hypertensive rats. Transcapillary passage of plasma proteins is enhanced in man's primary hypertension and it is debated whether this reflects increased permeability or merely a raised capillary pressure. To elucidate this problem, maximally vasodilated hindquarters of spontaneously hypertensive rats (SHR) and normotensive controls (NCR) were perfused in parallel at constant flow with dextran, horse serum or mixtures of the two, using labelled albumin as indicator of capillary permeability to macromolecules. By equal increases of venous pressure modest filtration was maintained during one hour, after which the edema and its albumin content were determined.--There was less edema in SHR, reflectin a slightly lower postcapillary resistance and a much higher precapillary resistance compared with NCR, which here resulted in a lower capillary pressure in SHR. In both SHR and NCR the presence of dextran slightly enhanced the capillary filtration coefficient but increased albumin permeability up to tenfold, also after antihistamine drugs. However, for each perfusate the SHR capillaries were, if anything, slightly less permeable to albumin than the NCR ones.--The results suggest that the enhanced transcapillary passage of plasma proteins in primary hypertension reflects an increased capillary pressure in some circuit(s), probably mainly skeletal muscle, resulting from the functional balance in vivo between the pre- and postcapillary resistances.


Dependence on external calcium for the noradrenaline contractility of the resistance vessels in spontaneously hypertensive and renal hypertensive rats, as compared with normotensive controls. Isolated hindquarters of rats were perfused at constant flow with a plasma substitute so that pressor responses to various concentrations of noradrenaline (NA) could be measured in consective sections of the vascular bed with normal (greater than 1.5 mM) or low (0.2 mM) Ca2+ in the perfusate. The animals used were 6-week-old spontaneously hypertensive rats of the Okamoto strin (SHRy), normotensive controls of the same age NCRy); 6--7-month-old SHR (SHRA) and NCR (NCRA);  and rats made hypertensive by clipping of one renal artery (RHR) plus matched normotensive controls (NCRR). Concentration-response curves to NA showed that constrictor responses to NA become more dependent on external calcium as one proceeds peripherally in the vascular system in both SHRA and NCRA,  with responses in proximal vessels being least and small pre- and postcapillary vessels being most dependent in both cases. In low calcium SHRA retained their responses better than NCRA, whereas RHR retained their responses to NA poorer than did NCRR. No significant differences in responses in low calcium were observed in SHRY compared to NCRY though a trend in the same direction as in SHRA could be traced. It is concluded that there is no evidence that altered handling of calcium initiates vascular hyperreactivity in SHR, but that the handling of vascular calcium in SHR differs from RHR and both differ from NCR.


Vascular responses to mechanical stimulation of the mucosa of the cat colon. Mechanical stimulation of the mucosa of the proximal colon evoked a hyperemia which also could be elicited when severing the autonomic fibres to the colon. Mechanical stimulation of the distal colon produced a hyperemia which, on the other hand, was abolished by cutting the pelvic nerves. Afferent pelvic nerve stimulation evoked a response similar to that seen when stimulating the distal colon. Adrenergic and cholinergic receptor blockers did not affect the studied colonic vasodilations. Dihydroergotamine, given in doses abolishing the vascular effects of i.a. injected 5-hydroxytrptamine, abolished the hyperemia to mechanical stimulation of the proximal colon but not that of the pelvic stimulation. It is concluded that a local nervous vasodilator reflex exists in the proximal colon similar to that earlier demonstrated in the small bowel (Biber et al. 1971) and that the reflex vasodilatation evoked by mechanical stimulation in the distal colon is mediated via the pelvic nerves. Hence, the vascular control differs in the proximal and in the distal parts of the colon.


Side-effects of lithium.

Side-effects of lithium. An account of the side-effects of 30 patients treated with lithium at Athens University Department of Psychiatry during the last two years is presented. The most frequent side-effects were: tremor of bands, polydipsia, polyuria, increase in appetite, dryness of mouth, general muscular weakness and memory reduction. Most side-effects were infrequent, mild and in no case necessitated discontinuation of treatment.


[Neuropsychological study of mental troubles in normal pressure hydrocephaly and their short term evolution after spinal fluid derivation (author's transl)]. Starting with 8 neuropsychological detailed observations, the author has studied mental deterioration resulting from normal pressure hydrocephaly and the short term evolution of mental troubles after apinal fluid derivation. The presurgical mental troubles are characterized essentially by short term memory troubles, by behavioural troubles relating to the two poles of the frontal syndrome and by distrubances in writing and calculus. The modification of the state of consciousness, the visual constructive troubles, attention and concentration troubles, verbal language troubles and psychomotor retardation are also frequent. Aphasia and alexia are rare. Generally, postsurgical evolution is immediate and global; the troubles of consciousness, mental deterioration and behaviour disorders are parallely reduced. Globaly, three out of four troubles disappear. Memory troubles and difficulties in concentrating, although improving, are still maintained six month after ventricular drainage.


The stress-related emotional lability syndrome. 1. Definition, psychophysiological mechanisms and a pilot experience with Orap. Patients suffering from stress-related emotional lability are in our modern life a common phenomenon. The diagnosis is difficult by the atypical symptoms (body complaints who are suggestive for a neurosis and becomes apparent on careful questioning revealing fear of failing, rigidity and similar character traits. Also, certain tests indicate increased fear of failing and the MMPI reveals high scores for psychiasthenia. Those patients starts from a high "baseline (endogenous) stress level. Our experience with pimozide indicates that this drug reduces the latter baseline stress level and therefore adds a valuable contribution to the treatment of such patients.


The stress-related emotional lability syndrome. II. A multicentre evaluation of Orap. This four-week study included 336 patients aged eleven to 80 years with complaints suggestive of stress-related emotional lability, and was intened to discover a possible relationship between the effects of pimozide and the initial psychic defence phenomena in this condition: the discouragement type of reaction was registered in 243 cases, overcompensation in 80, and a mixture of the two in the remaining 13. In most cases, the daily dose of pimozide remained close to the initial 2 mg, and treatment could be entirely discontinued after three-four weeks in five patients. Control evaluation after two and four weeks revealed a significant improvement of all pathological scores of a 17-item questionnaire, but failed to show any susbstantial difference between the three subgroups. No side-effects were reported.


Lymph drainage from the vulva and the foot as demonstrated by 198Au. From the central part of the labium majus the lymphatic transport of 198Au is invariably bilateral to inguinal and pelvic lymph nodes. Thus, bilateral inguinal and low pelvic lymph-adenectomy is logical in the treatment of carcinoma of the vulva. 198Au injected subcutaneously and Lipiodol injected intralymphatically in the dorsum of the foot were transported exclusively to ipsilateral inguinal and pelvic lymph nodes. Thus, there is no need for contralateral lymphadenectomy in malignancies on the dorsum of the foot.


Isotope nephrography in carcinoma of the uterine cervix stage I B. Isotope nephrography was performed in 90 cases of carcinoma of the uterine cervix stage I B before radical hysterectomy with pelvic lymph node dissection. Ureteric involvement was indicated in 15 patients, 10 of these had metastases to the pelvic lymph nodes. The overall metastases detection rate was 55 per cent.


Pipamperone (Dipiperon), a useful sedative neuroleptic drug in troublesome chronic psychotic patients. In 13 chronic schizophrenic patients (age range: 22-61 years) with troublesome behaviour and/or dysthymia, who were on maintenance treatment with a combination of incisive neuroleptics and sedative drugs, the sedative therapy was abruptly replaced by pipamperone. Dosage was gradually increased from 80 mg/day to an optimal level of 160-320 mg/day. The patients' condition was assess by Overall's "Factor Construct Rating Scale" and a 4-item questionnaire for sleep disorders. Pipamperone proved to be very rapidly effective in patients with prominent sleep disorders and/or agitation. Improvement was also significant for various other items of the two rating scales. No pipamperone-related side-effects were observed or reported.


Cerebrospinal irradiation of Burkitt's lymphoma. Failure in preventing central nervous system relapse. Twenty-two patients with Burkitt's lymphoma in complete remission induced by either cyclophosphamide or a combination of cyclophosphamide, oncovin and methotrexate were randomized to receive or not to receive prophylactic cerebrospinal irradiation. Six of 11 irradiated patients relapsed with tumour of the central nervous system as compared to 4 of 11 controls. Relapse frequency appeared to be related to stage of disease on admission. It is concluded that irradiation does not prevent relapse.


Effect of radioprotective aminothiols on the induction and repair of single-strand breaks in the DNA of irradiated mammalian cells. The effect of cysteamine and 2-mercapto-propionyl-glycine on the induction and repair of single-strand breaks in the DNA of Chinese hamster cells by irradiation in vitro in the presence of oxygen or in anoxia was investigated. The substances protected against the formation of breaks by irradiation both under oxic and anoxic conditions. The substances also exhibited a toxic effect which resulted in degradation of DNA. Cysteamine inhibited the rejoining of breaks after radiation exposure.


Cell migration following irradiation of the skin in mice. Effect of shielding minute areas. In hairless mice, dorsal skin flaps were exposed to 15 kV roentgen radiation. Thin metal wires were stretched across the field. At eight different intervals, up to 6 days, and following Colcemid injection, the number and location of mitoses in the epidermis were recorded. The regeneration observed in the irradiated parts of the epidermis seems to be due to migration of cells from shielded areas, the rate during the first 6 days being about 1/6 mm per day. Migration takes place along the basal membrane of the epidermis before any increased loss of cells in superficial layers has occurred.


Effect of clinically relevant irradiation regimes on human malignant melanomas grown in athymic nude mice. Human tumors grown subcutaneously in the thymus deficient nude mice are used as a model system to compare the effectiveness of clinically relevant irradiation regimes. Procedures for local irradiation of the tumors with 60Co radiation are described in detail. A preliminary test of the regression of two malignant melanomas, following three clinically relevant fractionation schedules, is performed. The overall treatment time and the nominal standard dose (NSD) are kept equal for the irradiation regimes chosen.


Effect of radiation therapy on the mitogenic response of in vitro irradiated human lymphocytes to phytohaemagglutinin. Irradiation of human peripheral lymphocytes in vitro reduces their capacity to be triggered to DNA-synthesis by PHA in a two-dose shaped fashion suggesting the presence of one relatively radiation sensitive and one relatively resistant cell population. Intracavitary and external radiation therapy for carcinoma of the uterus and vagina, which reduced the lymphocyte counts by approximately 66 per cent, did not significantly change the ratio of these subpopulations, indicating that PHA-reactive cells cannot be grouped into radiation sensitive and resistant subpopulations.


Effect of finite exposure slits in determination of the line spread function and modulation transfer function. The modulation transfer function of radiologic imaging systems is commonly obtained by determining the line spread function (LSF) of the system and computing its Fourier transform. Ideally, LSF should be obtained with infinitesimally narrow slits. The use of finite slits for obtaining the LSF is analyzed theoretically. An expression for the MTF of a finite rectangular slit is derived. Slit width correction of observed MTF is discussed as well as the correction for any generalized slit configuration.


Effects of medial and dorsal prefrontal ablations on a go left-go right time discrimination task in dogs. Normal dogs were trained on a go left-go right time discrimination task involving 10 and 30 s of bodily restraint. The performance deteriorated after medial prefrontal ablations, whereas dorsal damage produced no effect. The impairment in this task is unrelated to the delayed response deficit, which has been reported to follow dorsal but not medial lesions. It is suggested that kinesthetic processes are involved in time discrimination performance, and that the medial prefrontal cortex mediates spatial responding based on kinesthetic cues.


Pimozide (Orap) in patients with pseudo-neurotic behaviour. Pimozide 2-12 mg (median 4 mg) was tried for ten weeks in 44 pseudo-neurotic patients. Unsuccessfully used tranquillizers were continued and the use of the antiparkinsonian agent dexetimide was allowed if needed. By the end of the study, a considerable improvement was observed for the vast majority of the items of the Wittenborn psychiatric scale. Their socio-professional adaptation showed a similar tendency. Dexetimide was required in four patients who received high doses of pimozide.