Arrhythmias in the post CCU phase of myocardial infarction: their correlation with the acute illness. To estimate the frequency of potentially life-threatening arrhythmias in myocardial infarction following transfer from the coronary care unit (CCU) and to identify features of the acute illness which predict such events, 66 patients were monitored on-line by means of a computer assisted system. Premature ventricular contractions (PVCs) were detected following transfer from the CCU in 64 patients (97%). In 29 (44%) they fell in classes 2 to 4 of Lown. Accelerated ventricular rhythm was detected in five and ventricular tachycardia in three. The presence of these rhythm disturbances did not correlate with age, sex, infarct location, the occurrence of previous infarction, the level of serum cardiac enzymes, the presence of heart failure, atrial arrhythmias, heart block, or serious ventricular arrhythmia in the CCU. Use of procaine amide or quinidine for persistent ventricular arrhythmia in the CCU was correlated with detection of class 2, 3 or 4 PVCs. Thus, PVCs are nearly universal in the late phase of hospitalization for myocardial infarction. Frequent and complicated PVCs are common and occur most frequently in individuals in whom such events have been persistent in the CCU.


Role of cardiac catheterization in infective endocarditis. The benefits and hazards of catheterization and angiography were evaluated in 19 patients with acute aortic and/or mitral endocarditis and heart failure. In 14 patients (74%), the bedside diagnosis of valvular insufficiency and heart failure was proved correct. In three patients with both aortic and mitral valve disease, angiography (without hemodynamic measurements) was necessary to clarify the diagnosis. Angiography detected four aortic aneurysmal erosions that were unsuspected clinically, but missed three others. After angiography, heart failure worsened in two patients with severe progressive aortic insufficiency and one died. Thus, catheterization-angiography was of greatest value if more than one left-sided valve lesion was present, if extravalvular diseases mimicked heart failure, or if extravalvular infection was present. Patients with isolated, clear-cut mitral insufficiency usually do not need these diagnostic procedures, and they are probably contraindicated in patients with severe aortic regurgitation with rapidly progressing heart failure.


Pulmonary lavage in patients treated with mechanical ventilation. Mucous plugs and secretions in smaller bronchi may be responsible for impaired exchange of gases and abnormal compliance. Conventional therapy is often insufficient for removal of these plugs and secretions, especially in patients treated with mechanical ventilation. Therefore, pulmonary lavage with 237 +/- 6 ml of physiologic saline solution infused through the flexible fiberoptic bronchoscope in patients with respiratory failure was accomplished on 43 occasions to evaluate the therapeutic benefit of this procedure on oxygenation and compliance. Eighty-one percent (35) of the 43 lavages were associated with a significant increase of the ratio of arterial to alveolar oxygen pressures (PaO2/PAO2) (11 +/- 1) hours after lavage; 63% (27) of the 43 lavages were associated with a significant increase in effective static compliance (Cst) at 8 (+/- 1) hours after lavage. There were no persistent complications other than transient decreases in PaO2/PAO2 and effective Cst soon after lavage. The results suggest that this procedure is a useful therapeutic method in selected patients with respiratory failure.


Comparison of three techniques of lung lavage in patients with cystic fibrosis. One hundred fifty-three lung lavage procedures were performed on 81 cystic fibrosis patients during the years 1963 to 1976. Local analgesia was used in 24 lavages done via a rigid bronchoscope and in a group of 73 lavages directed by a fiberoptic bronchoscope. No abnormalities in cardiac rate or rhythm were observed with the lavages directed by fiberoptic bronchoscope. Fifty-six lavages were performed under general anesthesia with 20 cardiac abnormalities being noted among this group. Subjective improvement was noted in 96% of the 56 patients who had lavage under general anesthesia. Objective improvement was apparent in 45% of the 24 patients who had lavage with the rigid bronchoscope and 64% of the 36 patients who had lavage by fiberoptic bronchoscopy. It is concluded that patients with cystic fibrosis of varying stages of disability can more safety (and with good improvement) have bronchial washouts with the fiber-optic bronchoscope than with either of the other two techniques.


Allergic bronchopulmonary aspergillosis in three patients with normal chest x-ray films. Three patients with allergic bronchopulmonary aspergillosis had normal chest x-ray films at the time of dianosis. None had a history of pneumonitis or abnormal chest x-ray films in the past. On the basis of clinical and immunologic data that indicated the presence of allergic bronchopulmonary aspergillosis, bronchograms were obtained, which revealed evidence of proximal bronchiectasis in each patient. These early changes in bronchial architecture were not evident on the plain x-ray films of the chest but were revealed by bronchographic study. The diagnosis of allergic bronchopulmonary aspergillosis may be made even in the presence of normal chest x-ray films.


Death-producing hemoptysis in tuberculosis. Massive hemoptysis in patients with tuberculosis is reported infrequently and then virtually always in association with cavitary disease or aspergilloma. In contrast, we describe herein five cases characterized by hemoptysis on admission, bilateral pulmonary disease, samples of sputum positive for acid-fast bacilli by Ziehl-Neelsen stain, and no obvious cavitary disease. In each, hemoptysis subsided and then suddenly recurred in prodigious amounts, leading to death, probably from asyphyxiation. In patients hospitalized with tuberculous hemoptysis of any amount, with or without an obvious cavity, aggressive diagnostic evaluation, including bronchoscopic examination, may define the site of bleeding, thus permitting rapid surgical intervention if the hemoptysis increases.


Respiratory failure in pulmonary tuberculosis. Of 852 patients admitted to Cook County Hospital with bacteriologically-proved pulmonary tuberculosis, 16 suffered respiratory failure. Of these 16, 5 died and 11 recovered. On follow-up, the survivors demonstrated significant improvement in oxygenation, but continued to show a severe restrictive ventilatory defect. Our patients, unlike those in previous reports, did not show airway obstruction. The principles of management are the same as for other pulmonary patients. Arterial blood gas analyses should be done on patients with advanced tuberculosis so that abnormalities of gas exchange will not be missed.


The effect on expiratory flow rates of smoking three cigarettes in rapid succession. The effect of smoking three cigarettes in rapid succession on maximal and partial expiratory flow rates was studied in ten healthy smokers. The mean decrease in maximal midexpiratory flow and partial midexpiratory and end-expiratory flow was statistically significant. The response was maximal after the first cigarette. These results suggest that the instantaneous midexpiratory flow after 50% of the forced vital capacity has been exhaled is a useful indicator of irritation of the airways. Reduction of partial expiratory flow rates was three times greater than reduction of maximal expiratory flow rates. We suggest the use of partial expiratory flow curves as a screening test for irritants of the airways.


Effect of hypertension on myocardial rupture after acute myocardial infarction. Fifty-three of 4,369 patients with acute myocardial infarction died of myocardial rupture. The incidence of rupture varied directly, among men, with the systolic blood pressure on admission to the coronary care unit (CCU), and the highest systolic pressure while in the CCU. Rupture occurred in 0.3% of the men with systolic pressures on admission to the CCU between 110-129 mm Hg, increasing to 2.0% of men with pressures between 170-189 mm Hg. Similarly, 0.3% of the men with a highest systolic pressure less than 150 mm Hg had a rupture, while 1.6% of those with pressures between 170-189 mm Hg ruptured. Diastolic blood pressure, past history of hypertension, and sustained hypertension after infarction were not related to the occurrence of rupture. Eighteen of the 53 patients who sustained rupture had systolic hypertension (greater than or equal to 150 mm Hg) sometime during the 24 hours before rupture, and 14 had diastolic hypertension (greater than or equal to 95 mm Hg). Hypertension appears to be one of several variables interacting to influence the occurrence of myocardial rupture.


Hemodynamic effects of chlorpromazine in patients with acute myocardial infarction and pump failure. The intravenous administration of chlorpromazine in 12 patients with acute myocardial infarction and altered pump function was followed by a significant reduction in systemic vascular resistance (28.4%) and an increased cardiac index (23.0%). The drug also produced a significant decline in mean pulmonary capillary wedge pressure (38.2%), while the heart rate and mean stroke work index did not change significantly. Although the mean blood pressure decreased by 18.3%, the transymocardial pressure gradient was not affected. A significant reduction in the major determinants of myocardial oxygen consumption, such as arterial blood pressure and left ventricular wall tension, suggested a decrease in myocardial demand for oxygen. Improvement of left ventricular performance was associated with a sedative effect in most of the patients. Intravenous administration of chlorpromazine proved to be of benefit in patients with moderate to severe congestive heart failure and cardiogenic shock.


Silicosis in workers dealing with tonoko: case reports and analyses of tonoko. We found three cases of pneumoconiosis among those workers who had been dealing with tonoko (a mineral powder) for more than ten years at a shop making wooden furniture in Sendai, Japan. In the factory the workers were exposed to tonoko dust and had been inhaling it for a long time. Until now, this disease has not been found in employees of furniture factories; and, furthermore, tonoko has not been regarded as a harmful material. Tonoko is a very fine mineral powder used widely in Japan for filling the grains of surfaces of wooden products. The three workers had scanty clinical symptoms; however, their chest x-ray films revealed disseminated nodulations throughout both pulmonary fields. One of the workers suffered from the complication of active pulmonary tuberculosis. Some of the analyses revealed that tonoko contained about 50% quartz. Accordingly, the disease is strongly suspected to be a sort of silicosis caused by inhalation of tonoko dust.


Recurrent brain abscess: manifestation of pulmonary arteriovenous fistula and hereditary hemorrhagic telangiectasia. A unique case of recurrent brain abscess as the primary manifestation of pulmonary arteriovenous fistula is presented. In the absence of hematologic abnormalities and characteristic physical findings, the diagnosis of pulmonary arteriovenous fistula is particularly elusive. Patients with brain abscess must be carefully evaluated for the presence of pulmonary arteriovenous fistula or hereditary hemorrhagic telangiectasia.


Double coronary arteriovenous fistula.

Double coronary arteriovenous fistula. Coronary arteriovenous fistula is an uncommon, although not rare, congenital cardiac malformation, especially in the adult. Most such reported such cases have involved but a single coronary vessel. This report documents the second case of coronary arteriovenous fistulae involving the right and circumflex coronary vessels draining into the coronary sinus. At the present time the patient is free of definite ischemic symptoms or obvious impairment of hemodynamic function and is being followed-up medically.


The role of bronchial arteriography and therapeutic embolization in hemoptysis. A case is presented which demonstrates the value of bronchial arteriographic studies in localizing and treating hemoptysis. The patient was bleeding from an old post-tuberculous bulla and for several reasons was not a candidate for surgery. Bronchial arteriographic studies demonstrated both hypervascularity in the region of the cavity and also a mycotic aneurysm of a bronchial artery. After therapeutic embolization with gelatin (Gelfoam), the hypervascularity and aneurysm were no longer opacified. Active bleeding abruptly ceased and, except for a single mild recurrence, has not recurred during the three months since therapeutic embolization. The major theoretic risk of bronchial arteriographic study and therapeutic embolization is spinal injury. It is believed that permanent injury can almost be avoided, providing proper technique is used.


Tracheal hamartoma.

Tracheal hamartoma. We present the findings in a man with longstanding airway obstruction attributed to chronic obstructive bronchopulmonary disease. After hospitalization, a tracheal hamartoma was found and resected, without complications. Symptoms of chronic airway obstruction can cause the physician to treat medically a surgically curable lesion.


Dissimilar atrial rhythms in a patient with the Wolff-Parkinson-White syndrome. In this report, we present the findings in a patient who had paroxysmal supraventricular tachycardia and atrial flutter associated with the Wolff-Parkinson-White syndrome. During atrial flutter, localized atrial fibrillation was recorded in the coronary sinus (dissimilar atrial rhythms), near the accessory pathway; and during 90 minutes of observation, ventricular activation occurred solely over the normal pathway. We postulate that localized atrial fibrillation repetitively invaded the accessory pathway and rendered it refractory to conduction by flutter impulses.


Spontaneous thymic hemorrhage in an adult. Acute hemorrhage in a normal thymus in neonates and infants has been reported in the literature. These patients were known to have an antecedent cause or defects in coagulation. The case of an adult who developed acute hemorrhage in a normal thymus and who was known not to have any defects in coagulation, hypertension, or other underlying cause is reported.


Familial congenital bicuspid aortic valve: secondary calcific aortic stenosis and aortic aneurysm. A patient with an aneurysm of the ascending aorta and calcific stenosis of a congenital bicuspid aortic valve, whose brother also had a stenotic congenital bicuspid aortic valve, is described. Predominant aortic stenosis at cardiac catheterization and the presence of an aneurysm distal to and not including the aortic valvular ring made the initial diagnosis of Marfan's syndrome unlikely. Cystic medial necrosis present in the aneurysmal wall probably arose as a consequence of poststenotic dilation. Adequate noninvasive evaluation of the ascending aorta requires echocardiographic studies, as well as a chest x-ray film.


Bronchiectasis and spontaneous pneumothorax in Marfan's syndrome. A Chinese girl with Marfan's syndrome had spontaneous pneumothorax and bronchiectasis. Spontaneous pneumothorax is not an infrequent pulmonary manifestation of Marfan's syndrome, but bronchiectasis is rarely reported to occur. So far, it has not been reported that both bronchiectasis and spontaneous pneumothorax can occur in the same patient with Marfan's syndrome.


Suspected superior vena cava syndrome: the role of the Swan-Ganz catheter. The use of the Swan-Ganz flow-directed catheter in establishing the diagnosis of the superior vena cava syndrome in two patients (one with Hodgkin's disease and the other with carcinoma of the lung) is described. A pressure tracing showing elevated pressure above the obstruction without respiratory or cardiac fluctuations is characteristic of obstruction of the superior vena cava.


Primary carcinoma of the trachea: physiologic diagnosis and review of the literature. A patient with primary carcinoma of the trachea is described. The diagnosis was established physiologically by employing maximal expiratory flow-volume loops obtained while the patient was breathing air and a mixture of helium and oxygen.


Echocardiography in Lutembacher's syndrome. The findings in a patient with surgically proven Lutembacher's syndrome (coexisting mitral stenosis and atrial septal defect) are presented. In addition to a typical pattern of mitral stenosis, the preoperative echocardiogram revealed paradoxical septal motion, thereby providing, prior to cardiac catheterization, a basis for the suspicion of an associated lesion due to diastolic overload of the right ventricle.


Tuberculous pneumonia with the syndrome of inappropriate secretion of antidiuretic hormone: cause of the adult respiratory distress syndrome. Bilateral tuberculous pneumonia with the syndrome of inappropriate secretion of antidiuretic hormone was the cause of the adult respiratory distress syndrome in an elderly patient. Early recognition and prompt therapy enabled the patient to make a complete recovery without the necessity for mechanical ventilation. With the shift of care of tuberculous patients out of the sanitorium, the practicing physician should be aware of the varied manifestations of tuberculosis.


Endocarditis due to Hemophilus aphrophilus: report of a case with possible transmission from dog to man. A 44-year-old man was treated for bacterial endocarditis due to Hemophilus aphrophilus. The characteristics of the organism are reviewed, along with other cases of endocarditis. There is an association of this organism with dogs and a potential for transmission from this source to man.


A selective comparison of psychological, developmental, social, and academic factors among emotionally disturbed children in three treatment settings. This study was undertaken to determine whether there were significant differences among three groups of emotionally disturbed children in Massachusetts: children in private residential schools; children in private day schools; and children in special classes for the emotionally disturbed in public schools. The subjects involved in the study consisted of three groups of children who were evaluated as being emotionally disturbed and whose initial enrollments in the respective programs were accomplished during the 1972 to 1973 school year. This represented 129 children enrolled in private day schools, 72 children enrolled in private residential schools, and 309 children enrolled in public school special classes for the emotionally disturbed. Data for these populations were obtained from the records for each of the children on file at the Massachusetts Department of Education, Division of Special Education. This included data on psychiatric diagnosis, IQ, parental separation, geographical location, family income, family social position, and assessment of the child's physical well-being. In addition, two tests were administered to all subjects: The Rutter Child Behavior Scale was completed by each child's classroom teacher, and the Wide Range Achievement Test was administered by the professional having the responsibility for psychometric testing in the respective school.


Brief therapy for monocular hysterical blindness in childhood. A case report of monocular hysterical blindness, a rare form of childhood conversion reaction, is presented. A brief description of the treatment is included, which utilized a team approach and short-term management. An attempt is made to compare this patient's motivation with other cases of conversion reactions and to identify a possible dynamic mechanism for monocular hysterical blindness.


Coping in the barrio: case studies of Mexican-American families. This paper reports preliminary finds of a study of coping abilities of Mexican-American families. The purpose of the study was to identify variables related to styles of behavior that can be characterized as adaptive. A complex of factors differentiated families who were judged to be dealing effectively with their environment ("copers") from those who were not ("noncopers"). The factors included the health status of the children, various child-rearing attitudes and practices, and patterns of decision making as they related to a more general ability of parents to conceptualize and organize time.


The price of privacy in the social dynamics of child abuse. Under certain conditions, family isolation serves as the catalytic agent for child abuse. Privacy that excludes intrusive kinship and neighborhood networks can be a danger to children.


Alcoholism: early identification and intervention in the social service agency. Alcohol-related problems are often basic--though concealed--in families seeking aid through social service. The social worker aware of this can use techniques to achieve early identification and effective intervention.


A community reentry model.

A community reentry model. This model for an interagency program to facilitate the transition of multiproblem adolescents from the institution back into the community may be readily applicable to noninstitutional settings.


A behavioral-psychodynamic approach to day treatment for emotionally disturbed children. A low-cost, short-term day treatment program for emotionally disturbed children that combined behavioral and psychodynamic techniques proved successful in returning the children to public school classes.


[The thoracic stomach. Etiology--diagnosis--therapy]. Congenital, acquired, and traumatic defects of the diaphragm are reported. Special consideration is given to positional changes of the stomach due to the above lesions. Clinical examples are used to point out the diagnostics and surgical possibilities of reparation.


[Positional anomalies of the intestine in adults]. Anomalous intestine positions arise during embryologic development. They are rare in adults and cause uncharacteristic but chronic discomforts. They can produce life-threatening complications at any time. They are thought of too rarely, and radiologically shown anomalies are easily misinterpreted. Frequently they are discovered only during operation. The 178 anomalous intestine positions are here analyzed partly newly named and discussed to facilitate detection, to prevent complications, and to make rational treatment possible. There are 24 different typical forms, which are explained by disturbances of the embryologic rotation, growth, or fixation of the intestine.


[Current status in the diagnosis and therapy of meconium ileus]. Meconium ileus is in most cases difficult to diagnose preoperatively; however, aganglionosis should be excluded in every case (rectal double-suction biopsy, manometry). In cases of uncomplicated meconium ileus (no perforation, no further intestinal obstructions) lysis of the meconium by a Gastrografin enema is tried first. In case of no relief, an intraoperative puncture of the bowel and Gastrografin instillation is performed. If there is no relief a small bowel resection is performed and a Bishop-Koop anastomosis or a chimney anastomosis established. A distinction must be made between meconium ileus, meconium disease, meconium plug syndrome, and curd obstruction. Results show a survival rate of 80%.


[Mathematical-physical deliberations over the development of artificial-anus prolapse (and the therefrom derived attachment technic for the artificial anus)]. It is established that most colostomies which lead to prolapse because of imperfect operative technique are shaped like a truncated cone. Mathematical-physical considerations show mechanisms which in such cases can produce prolapse of the colostomy. Considering these criteria and recent clinical experience, a suitable colostomy is described.


[The medullary (C-cell) carcinoma of the thyroid. A therapeutic dilemma]. Medullary carcinoma originates from the parafollicular cells (C-cells) of the thyroid. Significant for these cancers are early metastases in thyroid and in the regional lymph nodes. Total thyroidectomy combined with local excision of any palpable metastases is the procedure of choice. Radioiodine therapy of metastases as in papillary and follicular carcinoma is not possible because C-cells do not metabolise iodine. This tumor is also resistant on X-ray therapy. Follow-up and early diagnosis of medullary carcinoma is possible by determination of calcitonin in serum. The local recurrence or metastases in lymph nodes should be surgically removed.


[Orthograde, free, femoro-popliteo-crural, venous bypass]. A new method of autologous vein bypass with the nonreversed free transplanted great saphenous vein is described. By this technique, 53 patients received long femoropopliteal and 10 patients femorocrural bypasses, between March, 1973, and March, 1976. Patency rate was 88% after 1 year and 84% after 3 years. Operative procedure and results are reported in detail.


Carcinoid tumors, vascular elastosis, and ischemic disease of the small intestine. Ischemic enteritis or infarction occurred in four of 15 patients who had carcinoid tumors of the small intestine. All four, in addition, had elastic vascular sclerosis of the mesenteric vessels. Both arteries and veins were involved, and the change occurred in the region of tumor deposit. In none of the cases was the tumor occluding the lumen of the vessels, nor was there any evidence of thrombosis. Similar elastosis is seen in cancers of the colon, stomach, and breast, and occurs also with thermal injury and irradiation. The findings of the present study would suggest a direct rather than a humoral effect. It would appear that cancer cells exert an inductive effect on the fibroblast or smooth-muscle cell in vascular walls, with excess production of elastic tissue.


Age-related impairment of tumor-associated lymphocytotoxicity in patients with colonic adenocarcinoma. The in-vitro lymphocytotoxic responses of 27 preoperative colonic-carcinoma patients and 61 healthy volunteers were correlated with age by linear regression analysis. Cytotoxicity obtained with leukocytes from the colonic-cancer patients on the colonic cancer cell line decreased with increasing age. In contrast, cytotoxicity obtained with leukocytes from the control group on the same cell line did not correlate with age of the donor. Furthermore, the decline in cytolysis in the patient group could not be attributed to more extensive disease. These observations suggest that increasing age is an important factor associated with the decline in ability of colorectal cancer patients to generate a disease-related cytolytic reaction.


The results of treatment for complete prolapse of the rectum in the adult patient. A method of anterior fixation of the bowel in complete prolapse of the rectum is described. The treatment is based on the concept that abdominal pressure should be directed on the bowel against the pubis rather than directly onto the perineum. The results have been universally successful, without mortality and with excellent functional results.


The study of anorectal disease by colposcopy. The incidence of significant, but otherwise nonapparent, perianal and anal disease in mildly symptomatic patients in this series was 6 per cent. Colposcopy helped define these lesions. Because perianal and anal neoplasms develop slowly and become manifest late, diagnosis is difficult. Colposcopy allows easier and earlier detection in patients with vague early complaints.


Leiomyosarcoma of the anus: report of a case. We have presented an unusual case of leiomyosarcoma of the anus. On reviewing the literature, we did not find a similar case. This tumor metastasizes mainly to distant organs through the bloodstream. We treated the tumor by wide excision, followed by chemo-immunotherapy, hoping to sterilize possible microemboli. Since this type of lesion is very aggressive, we strongly suggest that any mass in the perianal region be excised and biopsied.


Leiomyosarcoma of the rectum: radical vs. conservative therapy and report of three cases. Three cases of leiomyosarcoma of the rectum are presented. A review of the literature appears to indicate that there is little relationship between Broders' pathologic classification and survival. Size of the tumor, presence of ulceration of the rectal mucosa, and fixation of the lesion appear to have a significant relationship to survival. In appropriately selected patients (no ulceration or fixation, small size), local excision appears to offer as good a chance of survival as abdominoperineal resection.


Presacral myelolipoma: report of a case and review of the literature. A benign presacral tumor composed of adipose and hematopoietic tissue was found in an asymptomatic 47-year-old woman. Due to the patient's associated medical conditions the tumor was diagnosed by transanal biopsy and was not removed. Only three similar cases have been reported.


Procidentia of the rectum after the pull-through operation: an unusual complication and report of two cases. Procidentia or complete prolapse of the rectum following the pull-through operation is unusual, if not altogether rare. It appears to be a late complication of the procedure. A multitude of factors may be implicated in its genesis, and certainly the inadequacy of the pelvic floor is principal among them. Though the exact mechanism is not entirely clear, we favor an intussusceptive process for the reasons and observations cited. It is surmised that its late appearance is primarily due to the formation of adhesions that effectively fix the bowel to the sacrum. The process of aging and ensuing laxity of tissues subsequently detract from this protective factor. Perineal repair was used in both cases but, in the ultimate analysis, the procedure of choice should be individualized, based upon the surgeon's own judgment and experience and particular circumstances attending procidentia.


An unusual complication of the teflon-sling repair of rectal prolapse: report of a case. A previously unreported late complication of the Teflon-sling repair for rectal prolapse is described. Two years after operation the Teflon had eroded into the lumen of the bowel. Avulsion of the sling was effected by gentle traction. There has been no further complication or recurrence of the prolapse.


Recurrent colonic ulcers in celiac sprue, an unrecognized fatal complication: report of a case. In a patient who had celic sprue intractable to a gluten-free diet, volvulus and jejunal and colonic ulcers developed. Following segmental colonic resection, these ulcers recurred at the site of the previous anastomosis, and proved a fatal complication because of colonic perforation. Since no obvious etiology of colonic ulcers could be identified in this case, it is possible that they may represent an unrecognized intestinal complication of celiac sprue similar to jejunoileal ulcers.


Colitis cystica profunda: report of a case in which differentiation from rectal cancer was difficult. Colitis cystica profunda is a benign condition that has been confused with carcinoma. This rarely recognized condition is characterized by submucosal cysts. Macroscopically, the ulcerated character of the mass suggests carcinoma. Microscopically, attenuation of the innocuous-appearing cyst linings may give the false impression of a mucus-secreting carcinoma. A case of colitis cystica profunda in which the macroscopic appearance was so suggestive of malignancy that operation was carried out is reported.


Implementation of laboratory screening procedures on a short-term psychiatric inpatient unit. A health maintenance screening procedure was done on blood and urine specimens on 636 patients admitted to short term adult psychiatric ward. The data obtained was assessed by laboratory test and by its effect on the subsequent work-up and diagnostic thinking about those patients who had unexpected abnormal findings. The overall incidence of unexpected abnormal tests was low (3.0%). Similarly the incidence of new disease found by these procedures was low (between 2.2% and 8.5%). In no case was an underlying medical cause for the mental disorder for which the patient was admitted detected by the screening procedure. The authors conclude that these routine blood and urine screening tests add very little to the care of psychiatric inpatients.


Marital status, anomie, and forms of social isolation: a case of high suicide rate among the widowed in an urban sub-area. This study examines the high suicide rate among the widowed in a census tract population in Flint, Michigan, and identifies the social psychological factors of anomie, actual social isolation, and future social isolation as etiologic factors in widow suicide. Explanations of widow suicide are discussed, and recommendations are made for the reduction of the suicide rate.


Brain injury and criminality. A retrospective study. This follow-up study elucidates the incidence of criminality among brain injured persons. All the 1930 Finnish veterans who survived a penetrating brain injury during World War II were included in the study. The follow-up covered a period of 32-37 years. Five hundred randomly selected non-injured veterans of the same war were used as controls. A comparison of the frequency of convictions for crimes punishable by imprisonment among the injured and non-injured groups revealed no statistically significant difference between the two groups. This result shows, in accord with several reports on this subject published in the last two decades, that criminal behavior is not a sequela of injury to the brain.


Normal pressure hydrocephalus and hypertensive cerebrovascular disease. This report compares the clinical and post mortem findings in a case of normal pressure hydrocephalus (NPH) syndrome occurring in association with hypertensive cerebrovascular disease, with the only two such previously reported autopsied cases. The presence of hypertension and focal neurological findings in a patient with otherwise classic clinical and radiologic features of NPH syndrome should alert one to the possibility of hypertensive cerebrovascular disease as the cause of the syndrome. Transient improvement occurred following shunting in two, and none in the third case. All died within three years of illness. It appears shunting is not of significant benefit in these patients.


Hemiballismus-hemichorea treated with dimethylaminoethanol. An elderly lady with subacute onset of disabling hemiballismus experienced sustained remission on dimethylaminoethanol 150 mg/day. Two exacerbations followed interruption of therapy. Remission followed resumption of therapy. No undesirable side effects occurred with this treatment. A lady age 85 experienced a very favorable sustained reduction of hemiballismus when treated with dimethylaminoethanol (DMAE or Deanol). Her age and hypertension made the risk of thalamotomy unacceptably high. DMAE was tried because of reports of reduction of chorea, and other dyskinesias with this drug.


Hypnotic elucidation of isolation and displacement following a sexual assualt. A 19 year old girl was physically beaten and her life endangered during an abortive sexual assault. The repressed emotional components of the experience were retrieved during hypnosis 10 years later, and displacement of affect in relation to the event was also clarified. The psychological issues involved in these circumstances were related to weight reduction efforts by the patient and for which she was seeking help.


Butaclamol in newly admitted chronic schizophrenic patients: a modified fixed-dose dose-range design. In a double-blind placebo controlled study of newly admitted chronic schizophrenics, an attempt was made to further evaluate the safety, acceptability, and effectiveness of BT in doses of 10, 20, and 40 mg. Significant dose related responses occurred on several behavioral variables by the first week of treatment. Maximum clinical response appeared to be at the 20-40 mg. dose level. Extrapyramidal signs occurred at all doses, but with greater severity at higher doses. Excessive daytime drowsiness occurred in all groups but with longer duration and greater intensity in the 20 mg. group. Rebound insomnia occurred after the abrupt withdrawal of BT at all dose levels suggesting the desirability of further study of its hypnotic properties.


Tolerance to an effect of ethanol on post-tetanic potentiation in Aplysia. Repetitive electrical stimulation of an identified synapase in the abdominal ganglion of Aplysia californica results in post-tetanic potentiation (PTP) which decays with a single exponential time course. The rate of decay of PTP is accelerated by the initial perfusion of the abdominal ganglion with 0.8 M ethanol in seawater . Each subsequent exposure to ethanol has progressively less of an effect on the rate of decay of PTP such that, upon the fourth application (on the average), ethanol no longer accelerates the decay of PTP. If the perfusion with 0.8 M ethanol is not accompanied by stimulation of the identified synapse, tolerance does not develop. Evidence is presented which suggests that the initial exposure to ethanol accelerates the decay of PTP through fluidization of critical components of the pre-synaptic membrane. Arguments suggesting that tolerance is a compensatory change in the composition of the synaptic membrane are discussed.


Ethanol and acetaldehyde metabolism in the pregnant mouse. Liver aldehyde dehydrogenase (ALDH) activity was found to be two-fold greater in pregnant (days 16-20 of gestation) mice than in non-pregnant controls. A subcellular fractionation revealed that the increase in ALDH  activity was confined to the cystosolic fraction of the liver. Kinetic characterization of partially purified liver ALDH revealed similar Km values for either acetaldehyde or propionaldehyde in pregnant and non-pregnant animals. The similarity of apparent Km values suggests that the increase in cytosolic ALDH may involve induction of normally present ALDH isozyme, rather than originating from synthesis of a new enzyme. Induction of liver ALDH was found to significantly decrease blood acetaldehyde concentrations in pregnant mice receiving 2.0 or 3.0 g/kg ethanol when compared to the respective control (non-pregnant) animals. However, differences in blood acetaldehyde levels measured in pregnant and control animals were not apparent when blood ethanol concentrations were below 40 mumol/ml.


Inhibition of epinephrine-induced myocardial necrosis in rats by administration of single doses of ethanol. The oral administration of single doses (0.5-6.0 g/kg) of ethanol to rats, shortly before injecting them with a large dose (3.0 mg base/kg) of epinephrine subcutaneously, significantly reduced the severity of the myocardial damage produced by the epinephrine. The larger the dose of ethanol, the greater was the protective effect. The results were the same, regardless of the method used to determine the degree of cardiac injury. Experiments employing various agents to determine the mechanisms of ethanol action have tentatively suggested that a platelet de-aggregating or an osmotic effect of alcohol may be involved.


[Treatment of pseudomonas infection with the new ureidopenicillin, azlocillin (author's transl)]. Azlocillin, in vitro four to eight times more effective against Pseudomonas aeruginosa than carbenicillin, was administered to 30 patients severely ill and having an additional pseudomonas infection. The drug was given at a dose of 4-6 g, in one case 8 g, per day, sometimes together with an aminoglycoside. Treatment was effective in 20, improvement occurred in five and failure only in four. In one instance the effect of the drug could not be evaluated. Results were particularly striking in septicaemia and necrotising external otitis. Pulmonary and wound infections in patients with circulatory disturbances did not respond so well. There were no serious side effects. The drug should not as yet be used at too high a dosage.


Behavioral effects of salsolinol and ethanol on mice selected for sensitivity to alcohol-induced sleep time. Two lines of mice, selected for differential sensitivity to alcohol, were tested following intracisternal administration of salsolinol, a compound putatively formed following ethanol ingestion. Both lines showed dose-dependent decreases in activity following salsolinol. When injected with ethanol, alcohol-insensitive short-sleep (SS) mice increased in activity while alcohol-sensitive long-sleep (LS) mice showed no change. Measures of coordination, taken following ethanol, demonstrated that LS mice were more incapacitated than SS mice. Salsolinol effects are discussed with reference to possible adrenergic blocking actions. Genetic differences in sensitivity to the incoordinating effects of alcohol were found.


Effects of initial tolerance on acquired tolerance to alcohol in two selectively bred rat strains. The extent to which initial sensitivity to alcohol influences acquired tolerance was investigated in two selectively bred rat lines. These two lines have been selectively bred for differences in initial sensitivity to alcohol. The most affected (MA) line shows about a 90% reduction in motor activity following a 1.5 g/kg dose of alcohol compared with only a 40% reduction in least affected (LA) animals. In an initial investigation using stabilimeter activity, MA animals demonstrated increased tolerance following regular alcohol exposure, while LA animals showed little change from their initial levels of tolerance. In a second study following a similar intubation procedure, tolerance was assessed by sleeping time. Both MA and LA rats evidenced increased tolerance to alcohol, although MA animals did not approach the levels of tolerance shown by LA animals. In both studies the amount of initial tolerance was correlated with the degree of acquired tolerance. The potential for using these animals in the study of the underlying mechanisms of tolerance is discussed.


Possible involvement of acetaldehyde, norepinephrine and their tetrahydroisoquinoline derivatives in the regulation of ethanol seld-administration. In this study, we examined the possible role of acetaldehyde in the mediation of the reinforcing properties of ethanol. We also examined the possible interaction of acetaldehyde and brain norepinephrine in this mediation. We found that rats will self-administer acetaldehyde delivered into the cerebral ventricles, and that this operant behaviour can be attenuated by injections of a dopamine-beta-hydroxylase inhibitor. The results are discussed in terms of a role for tetrahydroisoquinoline alkaloids in alcoholism.


[Reactions to inactivated influenza vaccines (alorbat and begrivac s) (author's transl)]. Possible side effects to two commercial influenza vaccines (Alorbat and Begrivac S) were investigated in 893 adults (18-60 years). Both vaccines, administered by jet injections, were similarly tolerated. About 90% of vaccinated subjects had neither subjective nor objective reactions. Swelling or pain at the site of injection was reported by 11.5% of those vaccinated by Alorbat, 4.5% complained of not feeling well but only 1.1% had verifiable disorders. Local reactions occurred in 12.4% of those receiving Begrivac S, with 7.7% systemic reactions of which 1.1% were verifiable. Those re-vaccinated had a similar incidence of side reactions to those with primary vaccinations. Reactions which did occur were obviously due to the vaccination method. One person had urticaria and oedema, possibly due to reaction to foreign protein; this would suggest that the degree of purity of the vaccine should be checked by the manufacturers.


[Secondary hyperparathyroidism: comparison of clinical findings with the degree of early parathyroid hyperplasia (author's transl)]. Among 580 consecutive nonselected necropsies there were 145 cases of secondary hyperparathyroidism. In 74 instances blood concentrations of Ca2+, PO4(3-), urea, creatinine, total protein, albumin and alkaline phosphatase were available for comparison with the histomorpholgical degree of parathyroid hyperplasia matched with a control group of 32 patients with normal parathyroids. Analysis of variance revealed a significant difference in the levels of PO4 (3-) and creatinine between the normal group and that with minimal hyperplasia. Minimal and moderate diffuse parathyroid hyperplasia was associated with significant difference in calcium, phosphate, urea, creatinine, and total protein concentrations.


[Cutaneous myiasis caused by the larvae of the fly Dermatobia hominis (author's transl)]. A case of cutaneous myiasis is reported, caused by larvae of the fly Dermatobia hominis, found in South and Central America where the disease was contracted during a journey. With the spread of air travel such parasites may be carried to Europe and elsewhere. There are also fly species in Central Europe whose larvae could potentially cause myiasis.


["Hypothyroid" goitre in puberty treated with a combined T3/T4 preparation (author's transl)]. After administration of combined T3/T4 preparations (ratio of 4 : 1) to juveniles with goitre, size II-III (WHO), and hypothyroid T4 or PBI levels, the T3 value reached hyperthyroid levels 7-8 hours afterwards. The increased T3 level with normal T4 blood levels can lead to iatrogenic T3 hyperthyroidism. Serial tests demonstrated that at increasing doses a raised T3/T4 ratio, which is observed with low T4 values, can return to normal but with increasing doses this ratio, caused by T3 rise, can again become elevated. For this reason one should reconsider treatment with T3/T4 preparations and, if necessary, replace it by monotherapy with L-thyroxine.


[Appearance and persistence of rubella-specific IgM antibodies (author's transl)]. In order to investigate the validity of rubella-specific IgM antibodies for current or recent infections serum samples of 103 persons were investigated after natural infection or immunisation. 41 patients with natural infections and 7 immunised persons could be observed until complete disappearance of IgM antibodies. In all cases rubella-specific IgM could be demonstrated up to 10 weeks after infection. The percentage of positive findings decreased gradually thereafter. Lower concentrations of rubella IgM were demonstrable for several months after infection in some cases and for as long as 379 days in one case. The concentration of specific IgM antibodies was shown to be very high for the first 50 days after infection whereas only low concentrations were found after the 80th day.


[Prolymphocytic leukaemia: a new clinical entity (author's transl)]. A 67-year-old woman, at first diagnosed to have acute lymphocytic leukaemia, developed all the characteristic signs of so-called prolymphocytic leukaemia, namely severe general symptoms of illness, marked hepatosplenomegaly in the absence of lymphadenopathy, extreme leukocytosis (at times more than 1000 x 10(9)/l). Prolymphocytic leukaemia is now considered to be an especially unfavourable form of chronic lymphocytic leukaemia.


[Late-onset cutis laxa (generalized elastolysis)]. Cutis laxa is a heterogeneous disease of elastic fibres, divided into three congenital and two acquired forms. Its aetiology is unknown except for the X-linked recessive form. A late form with slow progression in a 52-year-old woman and a probably postinflammatory form in a 29-year-old woman are reported. In both cases histological examination revealed severe damage of the elastic fibres of the skin, in the first one also calcium deposits and (electronmicroscopically) damage to collagen fibres. Treatment is entirely symptomatic, but in severe cases plastic surgery may help cosmetically.


[Changes in aminophenazone metabolism with acute hepatitis in children (author's transl)]. Serum half-life of aminophenazone was measured in 23 children with acute viral hepatitis and children with normal liver biopsy of matched ages. In acute hepatitis the value was 6.71 +/- 3.34, significantly longer than in the normal controls (2.79 +/- 0.53). Two hours after oral intake of the drug the serum concentration was higher in healthy children than in those with hepatitis, but the difference was not significant. Especially in children with intercurrent acute hepatic disease account must be taken of impaired metabolism during long-term drug treatment.


[Intravascular coagulation in anorexia nervosa (author's transl)]. Hypercoagulation and intravascular coagulation developed a nearly 12-year-old girl with a one-year history of typical anorexia. Because of extreme cachexia she had been treated with numerous drugs elsewhere, among them ACTH an infusions of amino-acids. At the end of the second week of hospitalisation acute venous thrombosis of the right leg developed which was treated with heparin. Severe disseminated intravascular coagulopathy and thrombosis of the right leg were diagnosed on admission, the previously administered heparin was neutralised and streptokinase given for 60 hours, heparin was then given for several days, and the cachexia then treated. Both the local and general condition of the patient having been cured, the emotional state has also very much improved during the last year.


[Fibroadenoma of the breast (author's transl)]. Among 412 female patients with fibroadenoma 30 (7.1%) were shown to have considerable epithelial proliferations, 7 (1.7%) carcinoma in situ (n = 4) or carcinoma (n = 3). All patients with carcinoma or carcinoma in situ in the fibroadenoma were older than 40 years of age. Differentiation of coarse or fine granulation of microcalcifications did not improve the accuracy of mammography. In 32% of fibroadenomas with epithelial proliferations similar changes were also found in the adjacent area of the breast whereas only in 8.8% of fibroadenomas without proliferative changes could epithelial proliferation be observed in adjoining areas. With increasing age the risk of carcinomatous degeneration in fibroadenomas rises to 17%. In multiple fibroadenomas only one of them may show carcinomatous changes whereas the others may appear unremarkable. This necessitates excision of all such tumours. In the same way as carcinomas fibroadenomas are most frequently found in the upper outer quadrant of the breast. Total resection including a surrounding layer of healthy tissue remains the treatment of choice.


[Cytological investigation of needle aspiration and endoscopy samples using stain-covered glass slides (author's transl)]. Early morning sputum (n = 46), sputum and bronchial secretion obtained by aspiration (n = 87), pleural, ascitic, and pericardial fluids (n = 53), and pulmonary aspirate and gastric wash-out fluid (n = 10) were investigated cytologicallly using stain-covered glass slides (Testsimplets, Boehringer Mannheim). It was shown that the method was equal to classical cytological stains (Pappeheim and Papanicolaou) when exudates and biopsy material were investigated. The method is suitable for diagnostic purposes in hospitals and practice.


[Triamterene in the treatment of hypertension with hydrochlorothiazide and propranolol (author's transl)]. In 36 patients with essential hypertension the action and side effects of hydrochlorothiazide (25 mg/d), hydrochlorothiazide-triamterene (25 and 50 mg/d) and propranolol (160 mg/d) were investigated. Hydrochlorothiazide and hydrochlorothiazide-triamterene led to an average decrease of the systolic blood pressure by 21 and 30 mm Hg and of the diastolic pressure by 11 and 18 mm Hg. Propranolol alone decreased the systolic pressure by 35 mm Hg on average in 8 out of 16 patients. The diastolic pressure was lowered by 20 mm Hg. In the remaining 8 patients the systolic pressure, when propranolol was used alone, decreased by 21.3 mm Hg, the diastolic pressure by 11.3 mm Hg. Addition of hydrochlorothiazide-triamterene lowered pressures by a further 22.5 (systolic) and 10.6 (diastolic) mm Hg. No disturbances of the potassium or acid-base balance were observed using hydrochlorothiazide-triamterene.


[Secundum atrial septal defect with prolonged atrioventricular conduction: an autosomal dominant hereditary cardiac defect (author's transl)]. Secundum ASD was diagnosed in five members of three generations of one family. Three of them had prolonged A-V conduction. These findings and those reported in the literature suggest that the combination of secundum ASD with prolonged A-V conduction is an autosomal dominant hereditary disease.


[Paralysis, organic brain syndrome, and cardiac dysrhythmias caused by chronic laxative abuse (author's transl)]. A 39-year-old woman developed generalised paralysis, reversible organic brain syndrome, and cardiac dysrhythmias after 15 years of laxative abuse. Under continuous and cautious administration of potassium the cardiac rhythm became normal within four days and two days later the paralysis and organic brain syndrome almost disappeared. The cause of the psychiatric symptoms is thought to be cerebral potassium deficiency and an abnormal sodium/potassium equilibrium. Other clinical signs and symptoms due to extreme potassium depletion are presented. The importance of Na+/K+-activated membrane ATP-ase in myocardium and CNS is discussed.


Changes in estrogen receptor levels during deciduomata development in the pseudopregnant rat. The presence of a cytoplasmic estradiol receptor with an affinity constant of 10(10)M-1 has been demonstrated in the differentiated fibroblasts comprising the deciduomata in pseudopregnant rats. The receptor had a sedimentation coefficient of 6S in sucrose density gradients containing a physiological concentration of salt, and estradiol binding was completely abolished by a hundred-fold excess of unlabeled estradiol. During the early stages of decidualization (days 2 and 3), the decidualized uterine horn or isolated deciduomal tissue contained a concentration of receptor comparable to that in non-gravid uteri from rats ovariectomized at estrus. By day 5 of decidualization, the concentration of estradiol binding in deciduomal tissue decreased to about one-half the concentration measurable at days 2 and 3 of decidualization despite continued tissue growth until day 7. By day 7 of decidualization, estradiol binding had decreased to about 20% of the concentration on days 2 and 3 of decidualization. Cytosol from untreated uterine horns of rats bearing deciduomata bound the same amount of estradiol through day 7 as that in uteri of rats ovariectomized at estrus. These observations are discussed in terms of steroid hormone involved in deciduomal growth and regression.


Changes in progesterone receptor levels during deciduomata development in the pseudopregnant rat. A specific cytoplasmic progesterone receptor has been identified and quantified in the deciduomata of the pseudopregnant rat. The receptor had a sedimentation coefficient of 6-7S on sucrose density gradients and was inactivated by proteolytic enzymes, sulfhydryl blocking agents and elevated temperature. The equilibrium association constant for the binding of progesterone by the deciduomal receptor was determined to be approximately 10(9)M-1. The concentrations of progesterone receptor sites in cytosols prepared from deciduomata on day 3 and 5 of decidualization were 3.4 +/- 0.3 X 10(-10)M and 3.6 +/- 0.4 X 10(10)M, respectively, when normalized to a protein concentration of 1 mg/ml. These concentrations of progesterone receptor sites were similar to that measured in the uterine cytosol of estrous rats or in the contralateral untreated uterine horn of rats undergoing decidualization. Following day 5 of decidualization the concentrations of progesterone receptor sites decreased linearly so that by day 7 the concentration was approximately one-half that at days 3 and 5. The physiological significance of the progesterone receptor and the decrease in its concentration with time are discussed with regard to their influence on the decidualization reaction.


Ovine placental lactogen induces somatomedin: a a possible role in fetal growth. Ovine placental lactogen (oPL) and bovine growth hormone (bGH) increase the circulating concentration of somatomedin in hypophysectomized rats. This finding indicates that some of the somatotropic properties of oPL may be due to the induction of somatomedin and raises the possibility that oPL has a role in the control of fetal growth.


beta-Endorphin secretion of arginine vasopressin in vivo. The effect of beta-endorphin upon plasma arg8-vasopressin release was studied in vivo in rabbits and in vitro in rat neural lobes. Following intravenous administration of 200 mug/kg synthetic beta-endorphin plasma AVP rose significantly by five minutes after injection and remained elevated for twenty-five minutes compared to controls. In contrast beta-endorphin had no significant effect on AVP release from isolated rat neural lobes in vitro. beta-Endorphin stimulates AVP secretion in vivo, but this is not due to a direct action upon the neural lobe.


Suppression of serum follicle stimulating hormone in intact and acutely ovariecomized rats by porcine follicular fluid. Sham ovariectomy (SOV) or ovariectomy (OVX) was performed at 0800h of metastrus; porcine serum (PS) or porcine follicular fluid (PFF) was injected intraperitoneally at 0830h and/or 1130h, with terminal blood samples collected at 1700h. Fluid from medium and large follicles in porcine ovaries, charcoal extracted to remove steroids, significantly reduced serum FSH, in a dose-dependent manner. Futhermore, the SOV rats were more sensitive to PFF with respect to serum FSH lowering than the OVX rats, although when enough PFF was injected, both groups showed the same level of suppression. Since serum LH was very low, the possible effect of PFF on this hormone could not be assessed.


Further evidence of the presence of progesterone-binding proteins in female rat hypothalamus. Utilizing techniques of Sephadex G-200 column chromatography, sucrose density gradient ultracentrifugation and dextran-coated charcoal adsorption, the characterization of progesterone-binding proteins was attempted in cytosols obtained from the medial basal hypothalamus including the median eminence, the remaining hypothalamus and the cerebral cortex of ovariectomized estrogen-primed rats. Ater incubation of the medial basal hypothalamic cytosol with 3H-progesterone in the absence or in the presence of various unlabeled steroids, a specific progesterone-binding protein was found in the 7 S region with its binding capacity of approximately 2 X 10(14) moles per mg protein and dissociation constant of approximately 6 X 10(-9) M. No specific binding was, however, found in the remaining hypothalamus and the cerebral cortex.


Immune complexes in diabetes insipidus syndrome of rabbits immunized with vasopressin. Rabbits immunized with lysine-vasopressin bovine serum albumin conjugate showed the diabetes insipidus syndrome intermittently manifested by polyuria and polydipsia with various degrees of peaking from the eighth to fourteenth day post injection during boosters. The antibody-antidiuretic hormone immune complexes which may interfere with the action of the endogenous vasopressin on the kidney were found in the diabetes insipidus rabbits. However, the degree of the polyuria was not necessarily related to the quantities of the formed immune complexes, the titer, nor the affinity of the antiserum. It is suggested that the degree of the polyuria is related not only to the binding ability of the antiserum to the endogeneous vasopressin, but also to other factors.


Immunological stability in vitro and in vivo of eel calcitonin. The immunological activity of eel calcitonin was more persistent than that of porcine and human calcitonin when incubated in vitro with rabbit serum, human serum, liver homogenate or kidney homogenate, respectively. Both eel and human calcitonin were more stable than porcine calcitonin when injected iv into rabbits.


Effect of vagotomy on hyperinsulinemia in obese rats with hypothalamic lesions. With the purpose of investigating the pathogenesis of obesity and hyperinsulinemia in rats with hypothalamic lesions (HTL), HTL were made in vagotomized rats, and the development of obesity was serially followed up to 15 weeks as well as the changes of plasma triglyceride and immunoreactive insulin (IRI) levels. Even in vagotomized rats, obesity developed after HTL and plasma triglyceride and IRI levels increased significantly. However, obesity was slightly less in grade and occurred later as compared with sham-vagotomy-HTL rats. Plasma IRI levels in vagotomized rats significantly correlated with the body weight, Lee's index, the weight of adipose tissue and plasma triglyceride level. Similar results were also obtained in rats with HTL which were pair-fed following vagotomy. These results suggest that the hyperinsulinemia in obese rats with HTL may be involved not only by hypersecretion of insulin mediated by hypothalamo-vagal nerve system but also by some insulin-antagonistic factors such as increases of adipose tissues and plasma lipids.


Growth hormone and prolactin in tissue culture of pituitary adenoma. Pituitary adenomas obtained from 6 patients with acromegaly and 8 patients with chromophobe adenoma were subjected to the tissue culture to correlate in vitro secretion of growth hormone (GH) and prolactin (PRL) to preoperative in vivo endocrine studies and endocrinilogical manifestations. Tissue culture demonstrated that all of the acromegalic tumors secreted large amounts of GH for 2-4 weeks and some of the PRL-secreting chromophobe adenoma without any clinical and endocrinological evidences of GH secretion secreted considerable amounts of GH; however, no recognizable GH secretion was noted in the remaining chromophobe adenomas. PRL was secreted in vitro in large amounts by tumors obtained from patients with hyperprolactinemia with and without acromegaly. It is interesting to note that tumors obtained from 2 patients who showed very slight elevation of plasma PRL of less than 40 ng/ml secreted large amounts of PRL in vitro. This finding suggests that PRL-secreting adenoma could not be ruled out in patients with mild hyperprolactinemia. The duration of in vitro PRL release was longer than that of GH and its rate of decrease was slower than that of GH.


Effect of LATS, TSH and cholera toxin on the thyroid gland in nude mice. Three thyroid stimulators; LATS, TSH, and cholera toxin, have been tested by bioassay using congenitally athymic homozygous mice (nu/nu), nude mice and control littermates (nu/+) possessing normal thymic function. nu/+ Animals showed a response to LATS similarly to normal white mice of the ddN strain. The assay response to LATS in nu/nu animals was about half that in normal mice. TSH also showed a less stimulating action in nude mice. Cholera toxin made a long acting response similarly to LATS. The response to cholera toxin in nude mice was about half that of normal control mice. The thyroid of nude mice has a receptor for LATS-immunoglobulin, TSH or cholera toxin, which is similar to that of normal mice.


Stability of [Asu1,7]-eel calcitonin and eel calcitonin in vitro and in vivo. Stability of [Asu1,7]-eel calcitonin was compared with that of eel calcitonin by the radioimmunoassay method. [Asu1,7]-Eel calcitonin cross-reacted with anti-eel calcitonin antisera. [Asu1,7]-Eel calcitonin was as stable as eel calcitonin in rabbit liver or rabbit kidney extracts when incubated at 37 degrees C. Disappearance curves from the plasma of [Asu1,7]-eel calcitonin and eel calcitonin following iv injection in rabbits were quite similar.


Relationship between the follicular cells and marginal layer cells of the anterior pituitary. In the anterior pituitaries of adult rats of both sexes, follicular cells resemble marginal layer cells in fine structure. Numerous occurrences of cilia were electronmicroscopically confirmed on the free surface of both cells. The absence of secretory granules, the poor development of endoplasmic reticula and abundant free ribosomes and polysomes are the other coincidental cytological properties between both cells showing the immaturity. Thus, the two cells seem to be intimately related. The follicular cells may play an important role in the mitotic activity of the gland. Cilia and microvilli on the free surface of follicular cells are not easily changed by some experimental conditions.


Studies on some unusual lipids of the preputial glands of rats and mice and their hormonal influence. Major neutral lipid fractions of the preputial glands of mice have been identified by analytical and preparative thin layer chromatography (TLC) and gas liquid chromatography (GLC) as wax esters, neutral plasmalogen, alkyl diglyceride, triglyceride and cholesterol. An unusual lipid fraction between wax esters and neutral plasmalogens was identified as alkyl acetate, which has been reported earlier to function as sex attractant. The lipid pattern of the preputial glands of rats in both sexes was similarly studied. Three unknown bands of lipids were identified by TLC between wax ester and alk-1-enyl diglycerides, which on further analysis by GLC and infrared spectroscopy gave preliminary indication of aliphatic diester waxes. Administration of androgen stimulated the biosynthesis of these substances.


Pentose phosphate pathway and testicular steroidogenesis in rats following oxythiamine treatment. Suppression of delta5-3beta-hydroxy steroid dehydrogenase (delta5-3beta-OHD) and glucose-6-phosphate dehydrogenase (G-6-P-D) activities along with concomitant stimulation of succinic dehydrogenase (SDH) activity were observed in the rat testicular tissues following treatment with oxythiamine HC1, an inhibitor of pentose phosphate pathway. The same treatment also resulted in an accumulation of cholesterol and ascorbic acid in the gland associated with a decrease in the weights of seminal vesicle and prostate. The results suggest a diminution in testicular steroid biogenesis following an alteration of pentose phosphate pathway.


Effect of testosterone on estrogen-induced accumulation of intrauterine fluid in rats. The effect of various doses of testosterone propionate (Tp) (twice 0.01 to 10 mg i.m. in two days) on the accumulation of intrauterine fluid produced by various doses of estradiol benzoate (Eb) (twice 0.2 to 200 microgram i.m. in two days) was studied in ovariectomized adult rats. A small dose of Tp (0.01 mg) augmented the effect of a moderate dose of Eb (2 microgram). Higher doses of Tp inhibited the effect of Eb. The inhibition of the smallest Eb dose (0.2 microgram) began with a lower dose of Tp (0.1 mg) than the inhibition of other Eb doses (for 2 microgram and more EB 1 mg was necessary). There is a similarity of the action of Tp to that of progesterone.


The oestrogenic activity of danazol in the female gerbil (Meriones hurrianae Jerdon). Antifertility and estrogenic effects of Danazol have been studied in female gerbils. Danazol brings about supression of ovarian weight, presumably by inhibiting gonadotrophin secretion. Enlargement of uterine horns and well defined vaginal keratinization was seen in Danazol treated ovariectomized animals. The results were similar to that of oestradiol dipropionate confirming the oestrogenic activity of Danazol.


Oestradiol receptors and histogenesis in normal female breast of Holtzman rat. This paper embodies observations on the specific oestrogen receptor concentrations and histogenesis in the breast tissues of female Holtzman rat from day 10 of birth to day 260. It is noted that up to day 60, even though the normal differentiation and morphological growth of mammary tissue is in progress, oestradiol receptors are not detected. On the contrary, during this period maximum receptor concentrations have been observed in another target tissue viz. uterus. After day 60, it is the uterus which shows minimal amounts of receptors, while the breast tissue has appreciable amounts of receptor proteins. During this period, the morphological growth of the breast is maximum and this ceases apparently by day 90. Repeated estimations fail to reveal any receptors between days 73 to 87 and this phenomenon cannot be explained at present. Similarly from day 140 onwards no oestradiol receptors are evident. This probably is the cut off point for the receptors in the normal rat breast tissue.


[The effect of glucocorticosteroids on sex differentiation in rats]. The influence of two glucocorticoids (hydrocortisone and dexamethasone) on the somatic sex differentiation of female rats was investigated. During the time of sexual differentiation of their foetuses, pregnant rats were given dexamethasone (0.1-0.3 mg/day) or hydrocortisone (20-200 mg). Both compounds interfere with foetal development by virtue of their strong growth-inhibitory activity which manifests itself in reduction of the body weight, the crown-rump length, the length of the genital folds and the genital cord. The inhibition of growth seems to be reversible. Only hydrocortisone acts teratogenically as it causes a shift of the differentiation of the female genital tract into male direction. This virilisation consists of partial stabilisation of the Wolffian ducts, the suppression of mammary nipple development and a male-type differentiation of the urogenital sinus. The relevance of these findings for human beings is briefly discussed.


The sensitivity of sugar receptors--analysis in adult animals of influences exerted at neonatal age. Rats treated once with glucosamine at neonatal age show a long-lasting decrease in blood sugar level, and a permanent increase in insulin level, as well as a decrease in body weight. Glucuronic acid and mannose give rise to similar significant changes which were quantitatively less than the changes seen following pre-treatment with glucosamine. Taken together with earlier experiments, it seems likely that receptors are "plastic" at neonatal age and may be influenced by substances resembling the hormone or inducer, but differing from these to some extent.


[Isolation of growth hormone from swine hypophysis]. The present work describes a procedure for the isolation of a highly purified growth hormone from fresh-frozen porcine pituitary glands. With regard to the similarity of the primary structure and the physicochemical behaviour between the hormone molecules of canine and porcine it was possible to use a method for the isolation of the growth hormone from canine pituitaries according to a direction of Wilhelmi, carried out by a partially modified technique. The concentration and further purification was performed by a fractionation with ammonium sulfate and ion-exchange chromatography on diethylaminoethylcellulose. Porcine growth hormone was obtained in a yield of 1,43 mg per g fresh weight of glands. With the aid of a double antibody radioimmunoassay for porcine growth hormone 0,78 mg hormone per 1 mg of the purified product could be determined. The disc-gel electrophoretic patterns contained besides the typical double band of growth hormone no mark of any other protein component.


A possible mechanism of the puberty-delaying effect of hippocampal lesions in female rats. Untreated female Wister rats and females in which advancement of the onset of puberty was induced by bilateral lesioning of the medial preoptic area or the ventromedial-arcuate region, or by the daily s.c. injection of 0.05 microgram oestradiol benzoate/100 g b.w., were bilaterally lesioned in the anterior part of the ventral hippocampus at 21 days of age. Irrespective of the applied treatment, a significant delay of vaginal opening and of the first puberal ovulation resulted from the hippocampal lesions. This delay of the onset of puberty was consistently associated with a retardation of the body weight increase, so that the stage of body development necessary for the occurrence of spontaneous or precocious puberty was reached at later ages in these rats. The results suggest that a normal function of the hippocampus may be necessary for adequate somatic development during sexual maturation.


Maturation of the oestrogen-dependent LH-stimulating activity of the mediocortical amygdala in female rats. Immature female Wistar rats were unilaterally implanted with oestradiol benzoate (OB) into the anterior (AMAN) or posterior part (PMAN) of the medial amygdaloid nucleus, or into the central part of the cortical amygdaloid nucleus (CCAN) at different ages. Autopsy was performed 56h after implantation, and the LH concentration in the plasma was estimated by radioimmunoassay. A significant rise of the LH level resulted from implantation of OB: into the PMAN at 21, 26 and 32 days of age, into the AMAN at 32 and into the CCAN at 26 and 36, but not at 32 days of age. The conclusion was drawn that the medial amygdaloid nucleus may be involved in the maturation of the positive oestrogen feedback mechanism. The prepuberal change in the oestrogen-dependent LH-controlling activity of the cortical amygdaloid nucleus indicates that this nucleus may participate in the control of the onset of puberty.


Some observations on gonadotropin inhibitor (anti-LH) for human urine--with discussion on its possible source of origin. Physicochemical characteristics of an anti-LH substance, partially purified from human urine, has been determined. It is an acid-precipitable, sialic acid containing glycoprotein with a molecular weight of 162,000. This substance on mg to mg basis has a 50 fold biological potency when compared to that of the crude gonadotropin inhibiting material. Dialysed human pineal protein extracts also showed anti-LH activity which was not attributed to sialidase activity. Polyacrylamide gel electrophoresis of such pineal extracts revealed a glycoprotein component with the same mobility as that of the urinary anti-LH protein. These observations suggest a possibility that the human pineal gland may be associated either with secretion or storage of this gonadotropin inhibiting entity.


Influence of sex steroids on the secretory function of the epididymis in castrated rats. Secretory response of the epididymis to exogenously administered testosterone, estrogen and progesterone was investigated using the levels of sialic acid and glycerylphosphorylcholine as indices. Testosterone was found to be most potent in stimulating the (GPC) secretory function of the organ. An enigmatic finding of the present study was that while estrogen showed the ability to stimulate both sialic acid and GPC levels, progesterone exerted its influence only on sialic acid. Studies on the accessory genital organs (weight of seminal vesicles and ventral prostate and fructose level of coagulating gland) also revealed a stimulatory effect of the steroids.


Adrenal testis inter-relationship in male Indian palm squirrel Funambulus pennanti Wroughton. The present work attempts to study adrenal-testes relationship in a seasonal breeder, Indian palm squirrel, Funambulus pennanti. To assess the functional status of the adrenals, its two major components i.e. cholesterol and ascorbic acid were estimated biochemically and the results related with testicular functioning and its cholesterol concentration. In addition, histological studies of the above tissues were also carried out. Variation in adrenal function is clearly manifested by fluctuations in its cholesterol and ascorbic acid contents. However, no alteration in adrenal histology was discernible. Testicular recrudescence starts in January and peak activity is reached in April and May when adrenals are most inactive. End of June markes the beginning of testicular regression and maximal regression is reached in October.


Radioactivity in pituitaries and cerebrums of neonatal rats following [3H]-estradiol administration. The uptake of radioactivity by the pituitary, cerebrum and muscle of female and male neonatal and prepuberal rats 1 hour after administration of [3H]-estradiol was measured by liquid scintillation. Tissues were homogenized and aqueous, lipid, and protein-nucleoprotein fractions were separated for quantification of radioactivity. No significant sex differences in the radioactivity associated with the pituitary fractions were noted at any of the ages studied.


Testicular degeneration and necrosis induced by chronic administration of cannabis extract in dogs. 1. Daily administration of cannabis extract (12.5 mg/kg body wt. for 30 days) produced a complete arrest of spermatogenesis in dogs. Distinct degenerative effects were produced in the form of extensive fibrosis and exfoliation of the seminiferous elements. 2. RNA, protein and sialic acid contents of the testis and epididymides were reduced after cannabis extract administration, whereas, testicular cholesterol and enzyme phosphatase were elevated. 3. Serum transaminases were slightly elevated, whereas the alkaline phosphatase and haemoglobin/haematocrit values were in normal range. 4. Histophysiological examination of the liver did not show any damage. 5. Reduced androgen production was reflected in low levels of sialic acid in the testis and epididymides, and shrunken Leydig cell nuclei and luminal epididymal epithelium. 6. Cannabis extract at 12.5 mg/kg body wt. dose level did not cause severe damage to the vital organs but it produced an effective inhibition of spermatogenesis in male dogs in 30 days and thus induces an antifertility state. The possibility of an adverse effect of frequent marihuana use on male reproductive organ functioning in man is alarming.


Protective role of hydrocortisone on galactosamine-induced hepatitis into rats. The effects of hydrocortisone administration in rats intoxicated with one injection of 75 mg galactosamine i.p. per 100 g of body weight are described. Hydrocortisone was given at two schedules; according to the first schedule it was given at the dose of 150 microgram per 100 g of body weight i.p. 1 min before galactosamine administration and after 6 hours at half this dose, while according to the second the animals were pretreated for 24 hours before galactosamine injection at 6 hour intervals four times at the dose of 150 microgram. Both treatments diminished significantly liver cell necrosis induced by galactosamine and lowered serum transaminases activities (P less than 0.001). Liver glycogen depletion and excessive fatty accumulation found in the animals that had received galactosamine alone did not exist after hydrocortisone treatment. The protective hydrocortisone effect is briefly discussed, the present findings remaining unknown.


Electrocardiographic abnormalities in hypothyroidism before and after exercise. Eleven men and 50 women with severe hypothyroidism were studied. All patients had a serum PBI less than 3.0 mug/100 ml, 131I 24 hours uptake less than 13% and a a photomotogram contraction and half relaxation time of 380 msec or more. Before exercise the mean +/- SE heart rate was 68.39 +/- 3.26/min, the PR interval 17.08 +/- 0.37 csec, the QRS voltage (sum of the QRS amplitude in leads I, II and III) 16.44 +/- 0.89 mm (10mm = 1.0 mV) and the T wave amplitude 0.06 +/- 0.15 mm. A significant correlation (p less than 0.05) existed between the PBI values and the QRS voltage. Following exercise there was a significant acceleration of the heart rate (+ 23.39/min, p less than 0.001), shortening of the PR interval (-0.66 csec, p less than 0.02) and T wave elevation (+ 0.40 mm, p less than 0.001). ST segment changes were not observed in any case. Replacement treatment in 7 cases resulted in a significant change in the resting heart rate (+ 11.86/min. p less than 0.025), PR interval (-3.28 mm, p less than 0.025) and T wave height (+ 2.50 mm, p less than 0.01). These findings suggest that exercise may be used in the differentiation between hypothyroidism and coronary heart disease. The theoretical importance of these findings is also discussed. An increase in cardiac energy demands during exercise may be the cause for some of the ECG changes observed on exertion.


Ovarian changes during the first spontaneous ovulation in intact and indomethacin treated rats. Ovarian events during first spontaneous ovulation were studied and compared with those during later ovulations in adult rats. During the period of ovulation, from 24.000 hours to 04.00 hours, the pubertal ovaries showed, probably because of disappearance of marked interstitial oedema, a decrease in weight not observed in the adult animals. The preovulatory follicles showed prior to ovulation a similar increase in size in the pubertal and the adult animals. However, in the pubertal animals follicles were smaller and showed characteristic structural features. A group of pubertal rats received indomethacin (2.5 mg/rat) at prooestrus. This treatment reduced the increase in ovarian weight normally developing in the period before onset of ovulation, 17.00 hours at 24.00 hours. Indomethacin caused furthermore a greater increase in size of the preovulatory follicles during this same period and led to ovulatory processes at which only few eggs left the ovaries, the majority either remaining trapped in the follicles or being released into the ovarian stroma.


Fiberendoscopic monitorised dilatation of oesophageal strictures in children. Oesophageal dilatations were performed 55 times in 10 children aged 2 months to 8 years presenting with acquired strictures of several origins. Classical bougienage with rubber material and newer technique with the Eder-Puestow's metallic olives system were used successively. The conjunction of the latter with systematic use of fiberendoscopy enhances considerably the safety of the procedure and permits better functional results.


Duodenal mucosal damage associated with chronic use of anti-inflammatory drugs. As duodenofiberscopy becomes popular, duodenal mucosal damage associated with aspirin ingestion has come to draw more attention than before. Duodenal mucosal injury, with or without gastric lesions, related to long-term use of anti-inflammatory drugs such as aspirin, indomethacin, ibuprofen, diclofenac or others are reported in three patients, in which the diagnosis was confirmed by emergency endoscopy after hematemesis. Some possible explanations for pathogenetic mechanisms are discussed.


"Plunging biopsy": a new aimed bioptic technique. A new technique for aimed bioptic sampling is described, by which it is possible to obtain satisfactory tissue fragments also with front view instruments and normal forceps in those areas, such as the esophagus and gastric prepyloric lesser curvature, where the bioptic material obtained is often unsuitable for histologic diagnosis.


Duodenoscopic guided biopsy of the biliary and pancreatic duct. First experiences with duodenoscopic guided biopsy of the biliary and the pancreatic duct on 11 cases using a special designed forceps showed that this method gave good and representative results in the biliary duct and from the papilla. However, in the present stage of development guided biopsy from the pancreatic duct does not aid exact differential diagnosis of benign or malignant lesions. In 3 out of 4 cases with pancreatic cancer the histological diagnosis was false negative. The biopsy specimens are very small and need an exact preparation and great experience of the histologist. Cytologic criteria must be relied on more here as in other areas of the GI-tract. However, the criteria of malignancy rest not in the nature of the individual cell but in the manner of proliferation, namely the infiltration of the deeper layers. This is the advantage of guided biopsy compared to cytological examination. Complications of the method may be avoided by exact guiding of the forceps and by limiting the numbers of specimens.


Endoscopic choledochoduodenostomy for choledocholithiasis through choledochoduodenal fistula. A new endoscopic method for treatment of choledocholithiasis in patients with choledochoduodenal fistula is described. In 2 patients with common bile duct stones a choledochoduodenostomy was performed by means of a diathermy snare. In both patients the calculi passed into the duodenum within some days. No complications occurred. It is concluded that the described technique may be helpful when surgery is contraindicated and when endoscopic papillotomy is difficult to perform.


The ultrasonically guided puncture of the gallbladder in amimals. A new methodological procedure for a simple and non-surgical collection of gallbladder bile. In 4 piglets the gallbladder was punctured under sonographic control threetimes during a period of 46 days. Each puncture was proved by X-ray controls after application of 2-4 ml of a water soluble contrast medium. One day after the third puncture all animals were killed in order to look for macroscopic or microscopic lesions of the gallbladder, the adjacent liver tissue and the peritoneum resulting from the experimental procedure. The results indicate that the ultrasonically guided puncture of the gallbladder represents a procedure to obtain pure bile samples in the piglet or animals of similar size in a simple and non surgical and, therefore, most physiological manner.


A new chair support for flexible endoscopes. A new chair support for flexible endoscopes simplifies sigmoidoscopic endoscopy. The endoscopist sits on a stool with a moveable support for the endoscope. This allows working without much fatigue and the endoscopist can insert and move the endoscope himself. We examined 50 patients in the described technique. We reached an average depth of intubation of 45-50 cm and the average examination took less than 5 minutes.


Endoscopy in lye burns of oesophagus and stomach. Upon ingestion of lye and its compounds severe corrosive lesions may develop not only in the oesophagus but also of the stomach. These are frequently not recognized until life-threatening complications have set in. Two case histories are reported to point to the need for early endoscopic examinations. Brown-black discoloration of the mucosa of the stomach signifies necrosis through the thickness of the wall which is an indication for immediate resection.


Unusual cause of gastric bleeding: Cronkhite-Canada polyposis. A 39-year-old male presented with melena and sideropenic anemia. Gastric barium meal showed multiple feeling defects and gastric endoscopy showed in the antrum several polypoid lesions that histopathologically were consistent with Cronkhite-Canada polyposis. Studies on intestinal absorption were within normal limits.


Lymphangioma of the duodenum. (Diagnosis by endoscopic resection). Submucosal lymphangiomas of the gastrointestinal tract are extremely rare entities. A case of a lymphangioma of the duodenum in a 66-year-old woman is reported. Diagnosis was made by endoscopy and tumor excision with a diathermy snare. The patient complained of crampy upper abdominal pain which only partially was referable to an gastric ulcer and stopped after polypectomy. Endoscopically, compressibility of the tumor is a characteristic sign. Roentgenographically, it may be easily overlooked.


Effects of 8 weeks' endurance training on skeletal muscle metabolism in 56-70-year-old sedentary men. The effects of 8 weeks' endurance training on muscle metabolism at rest and after a submaximal bicycle ergometer exercise were studied in 31 previously sedentary men, aged 56-70. Training consisted of 3-5 one hour exercise bouts per week including walking-jogging, swimming, gymnastics and ball games. The effects of training were similar to those previously reported for younger men. Mean maximal oxygen uptake increased (11%), as did the resting values for muscle glycogen concentration, the enzymes representing aerobic energy metabolism (malate dehydrogenase, succinate dehydrogenase), and also some of the anaerobic enzymes (creatine phosphokinase, lactate dehydrogenase). Lactate production during submaximal work decreased. The enzyme activities were lower following acute exercise both before and after training.


Peripheral and central inputs to the effort sense during cycling exercise. The relationships between some physical and physiological events, and perceived effort were studied at several equivalent work outputs (W) at two pedalling rates (30 and 60 rev-min-1). Subjects judged effort throughout a 4 min exercise bout. After 4 min at any W it was always more effortful to pedal at 30 rev-min-1 even though there were no differences in VE, VO2, or integrated electromyography per minute (IEMG-min-1) between pedalling rates. Effort was related to VO2 and IEMG-min-1 but it was more effortful to pedal at 30 rev-min-1. Effort was also related to pedal resistance and IEMG of single contractions but was influenced by pedalling rate after 4 min of exercise. At any resistance it was more effortful to pedal at 60 rev-min-1, however, when effort was plotted as a function of resistance after 15 s, there was virtually no effect of pedalling rate. The rate effect grows with time from the onset of exercise and appears to be related to the central signal to the effort sense. The interaction of peripheral and central signals suggests a model of the effort sense during exercise.


Validity of the W170 test for predicting maximal oxygen intake. Recent research has related pedalling frequency to perceived exertion, indicating that subjects pedalling at higher frequencies tend to perceive lower levels of exertion. If tests administered at higher pedalling speeds are valid, then more accurate data on extremely low fit individuals might be possible. The purpose of this study was to determine the validity of the Wahlund-Sjostrand W170 test administered at 50 and 80 rpm. Maximal oxygen intake was determined for thirty male volunteer college students using standard open-circuit techniques. W170 tests were administered at 50 and 80 rpm using standard test protocol. The results indicated a differential effect of pedalling speed upon the validity of the W170 tests. Validity coefficients of rxy = 0.73 and rxy = 0.64 were found for the 50 and 80 rpm tests, respectively. Maximal oxygen intake predicted from the W170 test administered at 80 rpm was significantly different from both the criterion maximal oxygen intake and the W170 prediction at 50 rpm. This difference was attributed to a significantly higher heart rate response to 80 rpm tests at the lower workload of 600 kpm/min. It was concluded that more valid W170 tests are attained at the conventional pedalling speed of 50 rpm.


Physical exercise after induced alkalosis (bicarbonate or tris-buffer). The influence of bicarbonate and Tris-buffer infusions on the performance capacity for maximal, brief exercise (400 m run) was studied using 10 normal males in their twenties. Run time, maximal lactate concentration and heart rate remained unchanged after the buffer infusions. As a result of the induced elevated buffering capacity, the average pH after exercise was about 0.1 unit higher. Corresponding values for base excess and standard bicarbonate were found. The arterial pCO2 was higher after infusion as a result of the active respiratory compensation. Since the reduction in the work-related metabolic acidosis by the buffering substances caused no improvement in performance, the importance of pH as the performance-limiting factor must be questioned because the investigation gave no evidence for alterations of intracellular pH.


Loss of body weight and fat during exercise in a cold chamber. Ten men spent one week in a cold climatic facility performing a simulated arctic military exercise demanding an energy expenditure of 13-16 MJ-day-1. Although the ration pack was adequate, extensive plate wastage led to a negative energy balance of 2.2 MJ-day-1. Fluid intake was also insufficient, with a 3.25% decrease of body weight, and a 9.7% decrease in skin thickness over the cold exposure. Extensive fat mobilization was indicated by a decrease of skinfold thicknesses, an increase of body density, and associated ketonuria and glycosuria. The fat breakdown far exceeded the calculated energy deficit, and it is postulated that much of the "surplus" energy was required for synthesis of additional muscle protein. In the arctic environment, both energy and fluid balances are better maintained because there are few distraction from the simple pleasure of preparing and eating meals.


The use of pedometer and actometer in studying daily physical activity in man. Part I: reliability of pedometer and actometer. The purpose of this study was a critical evaluation of pedometer and actometer for estimating daily physical activity. Both instruments were tested for reliability on a carriage with movements in different directions. To obtain comparable data of different pedometers it was necessary to adjust the spring tension very carefully. The reliability of the individual actometer was satisfactory, but there are large differences between the watches. Therefore, a correction factor (C.F.) was introduced. Some experiments were carried out on a treadmill. 9 Children (aged 5-6 years) and 6 young adult males (aged 21-31 years) walked and ran at different speeds. The energy expenditure was calculated from formulas. The pedometer overestimates the actual step rate with 0.1-0.3 counts per step during fast walking (6-9 km-h-1) and fast running (15 km-h-1). It underestimates the actual step rate with 0.2-0.7 counts per step, while walking slowly. It was shown that the pedometer does not reflect the differences in energy expenditure levels at different speed very well. The actometer units per step increases more or less proportional to the speed of walking and running. In contrast to the pedometer results the actometer results are more related to the energy expediture levels at different speed. The results of this study suggest that the actometer might be a valid indicator of the daily physical activity in terms of energy expenditure.


The use of pedometer and actometer in studying daily physical activity in man. Part II: validity of pedometer and actometer measuring the daily physical activity. The validity of the pedometer and actometer for estimating the daily physical activity was evaluated by means of an observation study. The physical activity in a classroom of 11 pupils of a kindergarten was assessed by means of a pedometer, actometer and by observation. Besides this an activity questionnaire was completed by the infant-quide. On basis of the individual observation it is clear that the infant-guide can give valuable information about the activity of the children at school. The results of the pedometer attached to the waist and the actometers attached to the ankle were significantly correlated with the results of the observation method. The wrist actometer showed a smaller but still significant correlation with the other variables. Implications of this findings are discussed in regard toward the physical activity. The pedometer results point out that when the percentage of intense activity is high the pedometer tends to underestimate the level of activity. The actometer results indicate that such a motion recorder gives a reliable estimation of activity in children. The findings are discussed in terms of the practical applications of the actometer in the research of daily physical activity and the physical rehabilitation treatment of certain diseases.


Glucose tolerance and physical fitness: an epidemiologic study in an entire community. A modification of the Harvard Step Test was administered to approximately 4700 males and females, age 10-69 in Tecumseh, Michigan. Heart rate response to this standardized exercise test is an estimate of capacity for muscular work. A blood sample was drawn 1 h after a glucose challenge on the same day the exercise test was given. Four skinfolds were measured as an index of body fatnes. It was the purpose of this analysis to study the relationship of glucose tolerance to heart rate response to exercise. All analyses were done in age and sex-specific sub-groups. The correlation coefficients are low but positive in all but one sub-group and half of the coefficients are statistically significant. This suggests that poor fitness for work (high heart rate in response to exercise) was related, albeit weakly, to lowered glucose tolerance. However, there is a positive relationship between body fatness on the one hand and serum glucose and heart rate response to exercise on the other. When the effect of body fatness was eliminated the relationship of heart rate response to exercise ahd glucose tolerance remained about the same; low but statistically significant in some age groups.


Repetitive and non-repetitive sequences in the transcript in vitro of porcine thyroid chromatin. Purified pig thyroid chromatin has been transcribed in vitro with Escherichia coli RNA polymerase. The transcript, analyzed by DNA-RNA hybridization, shows two major kinetic components: 40% of the transcript is copied by repetitive sequences present 100 times per haploid genome; another 25% anneals to DNA with a rate constant Kh 10-4 M - S-1, typical of single-copy sequences. The transcript annealed at cot = 40 M - S to fractions of 2000-nucleotide DNA, when banded in neutral CsCl gradient only hybridizes to the heavy side of the main band. At cot = 3000 M - S, another hybridizing fraction appears on the light side of the main band of the gradient. The reassociation properties of these fractions show that the heavy DNA fraction is reiterated about 100 times per haploid genome, whereas the light DNA appears as a unique sequence, associated to small repetitive elements. The transcript, analyzed by formamide/sucrose gradient, shows two peaks with sedimentation coefficients of 10 S and 4 S, respectively. The 10-S RNA, hybridized to native 2000-nucleotide-length DNA, has a Kh of 10-4 M - S-1 and a cot1/2 of 10(3) M - S, typical of single-copy sequences.


Purification, crystallisation and preliminary X-ray studies on avian pancreatic polypeptide. A pancreatic polypeptide with some hormonal properties has been purified from chicken and turkey pancreas using acid-ethanol extraction, gel filtration and anion-exchange chromatography. The material has been crystallised. The crystals are monoclinic with space group C2. Preliminary isomorphous replacement experiments have so far provided a single-site derivative with Hg(NO3)2. A low-resolution electron density map phased with this derivative using anomalous scattering considered together with Patterson function calculations suggest that the molecules are partly helical and are arranged as a compact dimer about the crystallographic two-fold axis. The structure and association of these molecules are compared with those of insulin and glucagon, pancreatic protein and polypeptide hormones respectively, which have been studied in great detail.