Some assay restrictions on inferences made from determining hormones in horses, cows, and their fetuses. Often in developing hormone assays, hormones that may interfere with the assay by cross-reaction are not available for testing the validity of the assay. For example, horse TSH was unavailable to test for cross-reaction in an LH radioimmunoassay (RIA). The authors devised an indirect means of accomplishing the same goal, and the evidence from the indirect test of cross-reaction was at least as persuasive as a direct test might have been. Other examples are given of experiments where extensive effort was devoted to validation of steroid RIA, but there were substantial quantitative differences in the results among experiments and among laboratories. Differences of this kind probably would be intolerable in an assay used to monitor hormone residues in food-producing animals.


Combined electromyographic and gas urethral pressure profilometry. Combined electromyographic and gas urethral pressure profilometry provide for rapid assessment of urethral function in neurological dysfunction of the detrusor muscle and urethra.


External sphincter spasticity syndrome in female patients. The external sphincter spasticity syndrome is described with regard to diagnosis, etiology, pathophysiology and treatment. Use of urodynamic techniques (especially urethral pressure profile and diagnostic pudendal blocks) and adrenolytic agents and diazepam in the treatment of the dysfunction is discussed. We consider this clinical entity to be much more common than perviously reported.


Pharmacokinetic studies on the hepatotoxicity of luteoskyrin. (III) quantitative determination of luteoskyrin in the liver. A method for the quantitative determination of luteoskyrin in mouse liver is described. Luteoskyrin was extracted with ether from the liver homogenate after acidification with with HCl, purified by thin-layer chromatography and determined by spectrophotometry. Five mug of luteoskyrin added to the liver homogenate which was equivalent to one gram tissue was determined with a recovery rate of 97% and 1 mug, under the same conditions, with a recovery rate of 70%. Luteoskyrin in the amount of 0.5 mug could be detected on the chromatogram, but could not be determined quantitatively. A radioactivity corresponding to 0.92 mug/g tissue of 3H-luteoskyrin in the livers from the mice injected intravenously with this compound was extracted into ether with a recovery rate of 93% and separated on the thin-layer chromatogram with a recovery rate of 81%. The lower limit of quantitative determination of luteoskyrin in one gram of liver was 1 mug. Amounts of luteoskyrin in the livers of mice poisoned with this mycotoxin were estimated. Luteoskyrin was recovered in a large quantity in livers from male mice while detection in the liver of females was nil.


[Modern aspects of thyrotoxicosis in childhood (author's transl)]. 3 children aged 4, 7 and 12 years with severe thyrotoxicosis were observed. Though symptoms had existed for at least 6 months, the disease had not been diagnosed earlier; therefore clinical symptoms and diagnostic possibilities are discussed in detail. Carbimidazole was used for therapy because of the low incidence of side effects. Furthermore, an imidazole type drug allows to control underlying thyroid function during antithyroid drug therapy by measuring the 20 min. uptake (trapping). Results of long term observations are discussed.


[Familial vesicoureteral reflux (author's transl)]. One family with all four children affected by vesicoureteral reflux is reported. The mother of children has shrinking kidneys. The possibility, that the congenital abnormality of vesicoureteral reflux is inherited, is discussed. The awareness, that reflux may be familial, led to search for the abnormality in close relatives.


[Kidney anomalies in Ullrich-Turner-syndrome (author's transl)]. Intravenous urography was performed in fourteen children with Ullrich-Turners syndrome. Renal abnormalities have been noted in twelve cases (85,7%). The most frequent kidney anomalies were malrotations (28,5%), horseshoe kidneys (21,4%) and double kidneys (21,4%). Malformations of kidney are thus a very frequent feature in Ullrich-Turners syndrome. It is therefore recommendable to perform in any case of Ullrich-Turners syndrome an intravenous urography, since these abnormalities are clinically latent.


[Parameters of the elimination of phenolsulfonphthaleine (phenolred) in children (author's transl)]. The elimination of phenol-red was examined in 124 children without renal diseases. The normal values of the kinetic parameters were determined after intravenous injection of 3-4 mg dye per kg bodyweight. The elimination-half-life, which is independent from bodyweight and length was used as measure for the renal tubular secretion. In newborns (85,8 min) and young infants up to the age of 6 months (25,4 min) elimination-half-lives were longer than in older ones. After the second year of life (19,7 min) normal values of adults could be determined. The total clearance of phenol-red is smaller in newborns (185 ml/kg/h) than in children older than one year (643 ml/kg/h). Prematures had a longer elimination-half-life and a smaller total clearance than mature newborns.


[Development after respiratortreatment during the newborn period (author's transl)]. There were 17 survivors of severe neonatal respiratory distress treated with IPPV for more than 24 hours (36-520 hrs, mean duration of IPPV 6 days) followed into the second year of life. 11 of these young children were physically and neurologically normal. 3 were developmentally retarded (3 months or more), 2 had neurological defects without mental subnormality. These defects (Hemiplegia and Diplegia) were correlated with low gestational ages (32 and 33 weeks respectively) 1 child was severely defective. This one was treated because of apnea caused by seizures in postmaturity syndrome (44 weeks gestation). The overall incidence of defects was 3/17 (= 17%).


[Septicaemia in the neonatal and infant period (author's transl)]. The paper reported about septicaemia in the neonatal and infant period. Continuing former investigations by Kienitz in the same pediatric clinic we have got a survey from 1933 to 1974. In the last years we saw increasingly more infections with gram-negative organisms, especially by Pyocyaneus with a severe prognosis. The prognosis did not improve during the last 10 years. The over all mortality was 34-35%. Frequency, symptoms, problems of species and resistance were described. Besides that we reported about an outbreak of enterobacter in our neonatal unit.


[Comparison of the phenylalanine determination by ion exchange column chromatography and the guthrietest in treated phenylketonuric children (author's transl)]. Simultaneous measurements of phenylalanine by ion exchange column chromatography and microbiologal inhibition test according to Guthrie were performed on 22 treated children with phenylketonuria within two years. The results coincide in 40,3% (229 of 569 estimations), in 15,8% the real phenylalanine concentration by the method of Guthrie were overestimated, in 43,9% underestimated. Bacterial inhibition assay is successful in routine screening of phenylketonuria in the newborn, but not suitable for dietary control of phenylketonuria.


[Leptospirosis epidemic (L. grippothyphosa) in the Mainz area, concerning the pediatric age group (author's transl)]. 31 children, presenting with rather uncharacteristic symptoms of an infectious disease and being referred to this clinic mostly because of lymphadenitis of the neck (81%) and/or signs of meningitis (45%), were seen within a period of only eight weeks and proved to suffer from Leptospirosis (L. grippotyphosa). The majority of the patients belonged to the age group of one to six years and lived in rural environs.  Our observation is considered to relate to a Leptospirosis epidemic and suggests, as opposed to the general acceptance, a much higher incidence of Leptospirosis in this country and, moreover, in children.


[Clinical further development of children after surgery for subdural effusions (author's tranls)]. Follow-up examinations of 82 children after surgery for subdjral effusions show a varied degree of retardation of motor- and speech-development. This corresponds to neurologic signs of varying severity. Preoperative EEG findings are improved both in pre-school- and school children. Disturbance of motor and intellectual development as a rule corresponds to severe EEG changes. Among pre-school children 35% had an IQ below 69%, among school-children 36%. But their occupational chances cannot yet be finally assessed. Children with large effusions (over 50 ml) and extensive capsules show a higher percentage of retardation. Present results do not establish relations between site of effusion, frequency of recurrence and mental development.


[Autistic syndrome (Kanner) and vaccination against smallpox (author's transl)]. 3-4 weeks following an otherwise uncomplicated first vaccination against smallpox a boy, then aged 15 months and last seen at the age of 5 1/2 years, gradually developed a complete Kanner syndrome. The question whether vaccination and early infantile autism might be connected is being discussed. A causal relationship is considered extremely unlikely. But vaccination is recognized as having a starter function for the onset of autism.


[Hypomelanosis cutis ITO (author's transl)]. Report on a 9 year old girl exhibiting the typical features of Ito's syndrome: systematized bilateral depigmented nevus associated with various nonspecific dysplasias. The pathogenesis is not known. The syndrome geems to be transmitted by an irregularly dominant gene.


[Bilateral aplasia of the proximal part of fibula (author's transl)]. Report of an infant with aplasia of the proximal part of the fibula on both sides; by our knowledge the second observation in the literature. Furthermore the infant shows an aplasia of the thyroidea, a coarctation of the aorta, an atrial septal defect and an intraperitoneally situated ascending as well as descending colon.


[Purpura fulminans associated with varicella and polyvalent protective inoculations (author's transl)]. We report about a 10 5/12 years old boy, who developed the rare disease of Purpura fulminans following Varicella, after having received the trivalent Poliomyelitis vaccine of Sabin and a diphtheria-tetanus booster during the incubation period of Varicella. The acute stage of the disease was overcome by symptomatic therapy; extensive skin necrosis especially in the lower extremities had to be treated surgically. The etiology of Purpura fulminans has not yet been established. Since diffuse intravascular clotting (DIC) plays an essential part in the pathogenesis of this disease. Heparintherapy is now used as the treatment of choice. At the present state of knowledge we believe that the protective inoculations given in the incubation period of Varicella possibly provoced Purpura fulminans as a rare complication of Varicella.


[Hereditary non-allergic angioneurotic edema and the complement system (author's transl)]. By way of example of a patient and his family and by means of the literature, the present knowledge of pathogenesis and therapy of hereditary non-allergic angioneurotic edema has been reviewed.


[Megaloblastic anaemia in childhood due to vitamin B12 deficiency, report of 3 cases of congenital selective vitamin B12 malabsorption (author's tranls)]. Three cases of congenital selective malabsorption of vitamin B12 (Imerslund-Grasbeck syndrome) are presented. Pathophysiological aspected and clinical symptoms of this disease are discussed together with other megaloblastic anaemias in childhood caused by vitamin B12 deficiency.


Use of vaginal concretions of calcium carbonate to detect ovulation in hamsters. Concretions of calcium carbonate normally appear every third and fourth da of the 4-da hamster cycle da 1 = day of ovulation). We presently found that the 2-da relation between ovulation and concretion formation was maintained even after ovulation was delayed 1 or more da by centrally acting drugs or by exposing the hamsters to constant light. It is therefore possible to identify days of ovulation in vaginal washing records of both normal and treated hamsters by counting back 2 da from each sequence of concretions.


Pulmonary infarction following ligation of terminally shunted pulmonary artery. The intracardiac repair of tetralogy of Fallot occasionally is complicated by the presence of a surgically created shunt between a systemic artery and the distal end of a divided pulmonary artery. Rarely, reconstruction of this pulmonary artery at the time of corrective operation is not technically feasible. Usually, this problem has been managed by obliterating the systemic-to-pulmonary arterial shunt, which has not previously been reported to result in complications in the involved lung. Two of our patients underwent intracardiac repair of tetralogy of Fallot, including ligation of a terminally shunted left pulmonary artery. Postoperatively  they developed infarction of the left lung with resulting acute respiratory insufficiency. In both instances, conservative management ultimately achieved resolution of the pathological process and a good clinical result.


False aneurysm of the ascending aorta after surgery for Marfan's syndrome. Report of a case and review of the literature. A case is described in which false aneurysm of the ascending aorta developed following corrective surgery for Marfan's syndrome. During the initial procedure, a dissecting aortic aneurysm and incompetent aortic valve were managed by replacing the valve with a Starr-Edwards prosthesis and the ascending aorta with a woven Dacron aortic prosthesis. Two years later the operation was repeated with the use of antibiotic cover, because the patient developed a paraprosthetic leak following subacute bacterial endocarditis with Staphylococcus aureus. The woman remained well for 6 months, after which she developed a false aneurysm of the ascending aorta and aortic incompetence which necessitated repeating the operation for a third time. The patient remains well one year later. Relevant literature available on false aneurysm of the ascending aorta is also reviewed.


Inhibition of cell growth by near ultraviolet light photoproducts of tryptophan. Exposure of dilute aqueous solutions of tryptophan to near UV light (320 to 390 nm) at subsolar levels yields fluorescent photoproducts capable of inhibiting the growth and differentiation of cultured mouse embryonic fibroblasts and fertilized sea urchin eggs. The ability of these cells to incorporate labelled precursors of protein, RNA, and DNA into their respective macromolecules was markedly inhibited by adding tryptophan preirradiated with near UV light to their incubation media. Thus the inhibition of growth and differentiation of these cells seems to result from a depression of their ability to synthesize macromolecules in the presence of the photoproducts.


[Acute adrenal hemorrhage in newborn infants: the importance of early diagnosis (author's transl)]. Two case reports demonstrate the importance of an early diagnosis for the therapy of adrenal hemorrhage. In the first case with unilateral hemorrhage, the hemorrhage as such was of importance. In the second case with bilateral hemorrhage, the course was dominated by acute adrenal insufficiency with circulatory collapse and major salt loss. The diagnosis was supported by the typical changes in electrolyte levels as well as by radiography, and endocrinological results. With early therapy (in the first instance by surgery, and in the latter by substitution of corticosteroids), both children safely passed the critical period. In the second child ACTH administration did not, in the first phase of the disease, result in a significant rise of plasma cortisol. However, two months later there was a normal rise of the cortisol level following ACTH administration. From this observation we conclude that a favourable regeneration of the adrenal glands has resulted.


Functional polymeric microspheres based on 2-hydroxyethyl methacrylate for immunochemical studies. Co gamma irradiation of 2-hydroxethyl methacrylate in the presence or in the absence of other acrylic monomers was found to constitute an effective technique for the synthesis of hydrophilic functional microspheres in the size range of approxumately 0.3 to 3 mu in diameter. The effect of monomer concentration, steric stabilization, and electrostatic interaction on the particle size was investigated. Experimental conditions were determined to obtain desired particle sizes of relatively narrow distribution. It was shown that particles may be formed without intermediate micelles, i.e., by homogeneous nucleation, and the rate of particle formation is affected primarily by the rate of particle coalescence in the initial stages of the reaction. When covalently bound to antibodies these microspheres were successfully used to label murine and human lymphocytes.


[Growth of children born with low-birth-weight at the age of 10 years (author's transl)]. Values of body height, weight and head circumference in 225 children born with low-birth-weight (LBW) were compared with the same parameters of the control groups. The group of LBW-children was subdivided into 1. "true" preterm, 2. full-term small-for-dates, 3. preterm small-for-dates. At the age of 10 years significantly higher frequencies of individuals with subnormal growth were found in all 3 groups of LBW-children. Severe degrees of growth retardation were found mainly in boys and girls born as small-for-date newborns. The worst impairment of growth was seen in children born as preterm small-for-dates where the retardation of the growth of head circumference was most striking.


Arachidonate-induced cerebrovascular occlusion in the rat. The role of platelets and aspirin in stroke. Unilateral cerebrovascular occlusion was produced in heparinized rats within seconds after injection of microgram quantities of sodium arachidonate into the internal carotid artery. Electroencephalographic activity over the affected cerebral hemisphere became attenuated, and cerebral blood flow decreased by half. A neurologic syndrome, including ipsilateral blindness and contralateral sensorimotor deficits, resulted from occlusion of the microvasculature by platelet thrombi. Although aspirin strongly inhibited arachidonate-induced platelet aggregation in vitro, the drug offered little protection against arachidonate-induced stroke.


Mental symptoms in Parkinson's disease during chronic treatment with levodopa. Mental symptoms increased in frequency among 100 patients with parkinsonism treated with levodopa. Dementia was found in about one-third of patients throughout the 6-year treatment period. Thirteen patients became demented during the study, and dementia worsened severely in seven others. Agitated confusion became increasingly frequent and was observed in 60 percent of patients taking levodopa for 6 years. Withdrawal from levodopa decreased agitation, but not dementia. Ten patients received L-tryptophan along with levodopa, but no change in mentation was observed. In view of previous studies of mentation in Parkinson's disease and reports of widespread neuronal changes in the brain of autopsied patients with parkinsonism, our results suggest that the high incidence of dementia in patients with Parkinson's disease who take levodopa reflects prolongation of the course of the illness rather than a direct effect of the medication.


Malignant atrophic papulosis (Kohlmeier-Degos disease) in childhood. Malignant atrophic papulosis (Kohlmeier-Degos disease) is reported for the first time with pathologic verification of central nervous system involvement in a child. The disease began in infancy with rare recurring skin lesions; the child died at the age of 7, after progressive neurologic deterioration. Diagnosis was suspected clinically and confirmed by biopsy of a typical skin lesion. Recognition of this disorder by its dermatologic manifestations may obviate invasive diagnostic procedures.


Malignant evolution of childhood chiasmal pilocytic astrocytoma. A 27-year-old obese mentally retarded woman showed progression of antisocial behavior with periodic somnolence 18 years after biopsy and irradiation of a large pilocytic astrocytoma of the chiasm and adjacent structures. Visual function, although impaired, had not changed during the long period of postoperative observation. Before she died, the tumor showed angiographic and histologic features of malignant glioma, but neuroradiologic and neuropathologic studies did not establish conclusively that it involved new areas of the brain. This report documents a rare case in which an irradiated childhood optic glioma underwent delayed malignant evolution.


[Prevention of epilepsy in children following birth trauma]. In a group of 120 children with prenatal and postnatal trauma 31 children with epileptic seizures were found who accounted for 25.8% of neuropsychiatric complications in this group. Epilepsy was more frequent in children with a history of asphyxia than after other forms of perinatal trauma. Seizures were observed either immediately after birth or up to the age of 100 months. In children with delayed onset of seizures evidence of abnormal behaviour with excessive motor agitation, sleep and appetite disturbances was found from the very birth. Besides prophylactic measures applied to avoid complications of pregnancy and labour it is indispensable to separate the children with perinatal trauma and group them for further neuropsychiatric observation in outpatient clinics and to begin treatment which may prevent development of frank epilepsy in at least a part of these children and may contribute to better rehabilitation of brain-damaged children.


Spontaneous thrombosis of a giant cerebral aneurysm in five days. Report of a case. This single case report describes a large (giant) left internal carotid aneurysm that showed a very marked decrease in the size of its lumen on reevaluation 5 days after the initial arteriogram. A review of the literature found only 5 cases of spontaneous thrombosis documented by arteriography and only one involved a giant aneurysm. Follow-up arteriography however, may show this rare occurrence and eliminate unwarranted surgery.


[Epilepsy of the developmental age and control of seizure-releasing factors]. On the basis of an analysis of a paediatric material the author discusses the most important elements influencing the pattern of developmental age epilepsy calling attention to the significance of early aetiological diagnosis since in this early period of life many processes can be treated causatively before epilepsy develops into a chronic disease. The dynamic course of epilepsy and classification difficulties resulting from clinical and electroencephalographic variability of childhood epilepsy are discussed explaining these facts by differences in structural maturity and functional organization at the age of development. It is indispensable to know the classification of seizure circuits for selection of possibly effective symptomatic treatment for prevention of seizures and their sequelae in the neuropsychiatric and social aspects. In the clinical course of a given case there are also individual differences between the seizure-releasing factors and their knowledge helps to avoid the critical threshold of seizure readiness releasing seizures in a given child. Acceptance of certain rules for observation in the everyday life of patients permits an individual prophylaxis of seizures. This shows that prevention of epileptic seizures includes not only causative and symptomatic treatment but also the knowledge of individual seizure-releasing factors which cannot be controlled pharmacologically.


Encephalopathy following treatment of chronic pulmonary failure. An encephalopathy may occur following treatment of chronic pulmonary failure and is manifested by multifocal seizures, mild focal motor signs, and coma. The encephalopathy seems to be a multifactorial illness resulting from cerebral ischemica and hypoxia. The more important factors appear to be cerebral alkalosis, administration of aminophyline, and associated hypotension.


Six-year results of treatment with levodopa plus benzerazide in Parkinson's disease. A combination of levodopa and a peripheral dopa-decarboxylase inhibitor, benzerazide (Ro 4-4602), was studied over a 75-month period of observation in 132 patients with Parkinson's disease. The combined therapeutic approach was without biological toxicity, was well tolerated by 95 percent of patients, and was highly effective: 72 percent of patients improved by more than 50 percent on a functional activity scale and the group as a whole improved on an objective battery by a mean of 46 percent. Neurologic side effects of abnormal involuntary movements, falls, and oscillations in performance were not improved over levodopa used alone. The combined therapy is to be preferred over the use of levodopa alone in the symptomatic management of Parkinson's disease.


Primary sensory symptoms in parkinsonism. Forty-three of 101 outpatients with parkinsonism reported that they regularly experienced primary sensory symptoms, i.e., spontaneous abnormal sensations not caused by somatic disease. This is in contrast to similar symptoms reported by only 8 percent of a control population. The most striking and severe symptom was burning of the trunk and proximal extremities, occurring in 11 patients. Twenty-nine patients reported spontaneous pain; a variety of other paresthesialike sensations, e.g., tingling, numbness, and formication, occurred in 32 patients. These subjective sensory phenomena were not associated with sensory loss or autonomic or motor signs. In 20 percent of affected individuals (9 percent of the total), sensory symptoms preceded the onset of the movement disorder, causing difficulty in diagnosis. It is concluded that at least some sensory symptoms originate within the nervous system as a manifestation of the disease process and are not secondary effects of the motor disorder.


Piribedil: its synergistic effect in multidrug regimens for parkinsonism. Piribedil, a dopamine agonist, was administered to 13 patients with long-standing Parkinson's disease whose major symptoms were not well controlled on levodopa, anticholinergics, alpha-methyldopa, amantadine, or a combination of these agents. Twelve of the 13 clearly benefited from the addition of Piribedil although side effects precluded long term use in two cases. Beneficial results were obtained by using a combination of Piribedil, levodopa, and anticholinergic drugs. Side effects (hallucinations, confusion, dyskinesias) were frequent, but were usually reversible by lowering the dosage of levodopa or the accompanying anticholinergic medication. The synergistic effect of Piribedil and other antiparkinsonian drugs emphasizes the need for careful titration of all available medications in difficult cases and demonstrates the usefulness of dopamine receptor stimulators when drugs acting presynaptically have failed.


Migraine attacks. Alleviation by an inhibitor of prostaglandin synthesis and action. Twenty-six patients with migraine attacks were treated for 3 to 16 months with flufenamic acid (125 mg four to six times per attack), an inhibitor of prostaglandin synthesis and action. In 25 patients the drug afforded symptomatic relief in 195 of 200 treated attacks. Side effects observed were mild dyspepsia (eight patients) and severe upper gastrointestinal symptoms (two patients). None of the eight patients treated with placebo reported any relief (20 attacks). The "common" antimigraine drugs afforded symptomatic relief in 12 of the patients, partial relief in seven, and no relief in seven. Treatment with flufenamic acid was based on the hypothesis that prostaglandins are involved in migraine attack and that the drug relieves migraine by inhibition of the vasoactivity of prostaglandins.


Optic nueritis in hypoparathyroidism.

Optic nueritis in hypoparathyroidism. Disk swelling in patients with hypoparathyroidism has often been attributed to papilledema but rarely to optic neuritis. Although we are reporting a patient with hypoparathyroidism in whom optic neuritis developed, a causal relationship is not yet clear. The patient may have had ischemic optic neuropathy concomitant with hypoparathyroidism or caused by tetanic vasospasm or calcification of optic nerve nutrient vessels.


Alexia without agraphia.

Alexia without agraphia. This typical case of alexia without agraphia, caused by an astrocytoma, is the first recorded case in the literature of alexia without agraphia with a right homonymous hemianopia caused by a tumor. This case differs from previously reported cases of the syndrome by its fluctuating clinical course and its slow progression. All but one of previously reported cases had been of vascular or surgical etiology. This course and the associated radiographic findings should differentiate the neoplastic from the vascular etiology of this most fascinating syndrome.


Familial motor neuron disease. Evidence for at least three different types. Based on a clinical, pathologic, and genetic study of 14 families, at least three types of familial motor neuron disease can be distinguished, all apparently of autosomal dominant transmission. The first is characterized by rapid, progressive loss of motor function with predominantly lower motor neuron manifestations and a course lasting less than 5 years. Pathologic changes are limited to the anterior horn cells and pyramidal tracts. The second type is clinically identical to the first, but at autopsy additional changes are found in the posterior columns, Clarke's column, and spinocerebellar tracts. The third type is characterized by a much longer survival usually beyond 10 and after more than 20 years in affected family members but is otherwise similar to the second type.


Central nervous system aspergillosis in two young adults. Unusual and unique features were present in the cases of two patients with central nervous system aspergillosis: One had a previously unreported complication of aspergillosis, extracranial internal carotid artery thrombosis documented by angiography, and in the other patient, cerebral granulomas developed from Aspergillus fumigatus in association with intravenous narcotic abuse. The latter etiologic mechanism was suggested once before. Neither of these patients showed other underlying disease. A detailed neuropathologic examination correlated the salient clinical findings with formation of aspergillosis cerebral granulomata, basilar meningitis, and arterial occlusion. Diagnostic and therapeutic methods in this disease are limited.


Amino acid abnormalities in cerebrospinal fluid of patients with parkinsonism and extrapyramidal disorders. Free amino acid determinations in the cerebrospinal fluid of patients with Parkinson's disease or other extrapyramidal disorders showed that in both groups most amino acids were increased. Significantly increased amino acids were neutral and basic amino acids. Amino acid clusters were present and corresponded with the grouping of amino acids in accordance with amino acid transport systems. The amino acids within the clusters showed a remarkable degree of correlation, and there was a notable correlation between the clusters both in the parkinsonian group and in the group of extrapyramidal disorders, but not in a control group. Our data suggest that in a number of extrapyramidal disorders, Parkinson's disease included, a more generalized abnormality exists than neuronal loss only and, in addition, that patients with these neurologic conditions have a common biochemical defect in their amino acid transport systems.


Phenytoin-induced dystonia and choreoathetosis in two retarded epileptic children. Similar movement disorders developed in two 8-year-old retarded children while they were receiving phenytoin. Seizures subsequent to a diphtheria-pertussis-tetanus immunization had developed in each child at 1 to 2 months of age. A static encephalopathy ensued, characterized by mental retardation, ataxia, spasticity, and a mixed seizure disorder. Intermittent dystonia and choreoathetosis developed insidiously while serum phenytoin concentrations were in the therapeutic range. Sustained dystonia and choreoatheosis developed 2 hours after an oral provocation with phenytoin. The baseline abnormalities on the electroencephalogram remained unchanged during the choreoathetosis. Recognizable metabolic abnormalities known to be associated with similar movement disorders were excluded. It was concluded from these studies that the movement disorder is secondary to phenytoin and can occur at therapeutic serum concentrations. Phenytoin is a central anticholinergic agent and a central stimulant of serotonin, and may induce movement disorders as a result of altering these neurotransmitters in the brain. The variable expression of these movement disorders may relate to the nature of the preexisting striatal insult.


[Criteria for intensive treatment of hepatic coma]. Results observed over a period of two years in the intensive care of hepatic coma at the University of Genova surgical pathology department are briefly surveyed. A set of practical suggestions is offered for the management of patients whose prognosis is not open to change by the administration of conventional forms of treatment. A critical appraisal of the results achieved is presented along with the general series.


Routine amnioscopy at term.

Routine amnioscopy at term. A controlled study for the management of antepartum meconium-stained amniotic fluid (MSAF) detected by amnioscopy performed in a total of 508 patients is presented. The incidence of antepartum MSAF was 2.2%, while intrapartum MSAF was found in 15% of cases. A significant incidence of depressed neonates was found in the latter group. Patients with antepartum MSAF had no perinatal losses, whether managed expectantly or by oxytocin induction. Immediate operative intervention (ie, cesarean section) is not warranted. Observations on FHR patterns, fetal pH, and Apgar scores of these patients are presented.


The nurse and industrial hygiene.

The nurse and industrial hygiene. In summary, the occupational health nurse and the industrial hygienist have much in common. Each must recognize the value of the other and work together for the good of the employee. Occupational health nursing is frequently what the nurse makes it. Her competency, interest, and motivation, and the demands of the job determine her role. To function effectively, every occupational health nurse should have a thorough working knowledge of the fundamentals of industrial hygiene. This knowledge can be acquired in several ways: through practical experience, by attendance at professional meetings and short courses, by participation in academic training, and through personal research.


A profile of industrial nursing practices in North Dakota. The background and tasks of occupational health nurses in North Dakota vary considerably. Those entering the field have little or no previous exposure to occupational health nursing and must develop skill through seminars, corporate training or area associates. In most instances, the nurse represents the occupational safety and health program for the firm and must take on additional roles such as safety director or assistant plant manager. In addition, the occupational health nurse performs numerous in-plant medical services ranging from emergency medical care to counseling and education. The occupational health nurse in North Dakota generally does not record family histories, take throat cultures, take routine x-rays, make hospital or home visits nor perform air sampling or noise level measurements.


Argon laser iridotomy: an experimental and clinical study. Iridotomies were made in rabbit and human eyes using a continuous wave argon laser. Several of these have been studied histologically to determine the short- and long-term effects on the iris, cornea, lens and retina. Thirty-three eyes of patients with angle-closure glaucoma were treated by argon laser iridotomy and followed for periods of up to twelve months. In two eyes, planned cataract surgery was performed shortly after the laser iridotomy and histologic specimens of the iris were examined. From the experimental and clinical studies, an evaluation was made of the complications and clinical usefulness of the continuous wave argon laser as a means to produce iridotomies for the treatment of angle-closure glaucoma. Further long-term controlled studies are recommended to document the role of laser iridotomy.


Immediate fundus complications after retinal scatter photocoagulation. I. Clinical picture and pathogenesis. Fifty diabetics with severe background retinopathy or early proliferative retinopathy underwent retinal scatter photocoagulation with either the argon laser or the xenon arc photocoagulators. Choroidal detachment, exudative retinal detachment, shallowing of the anterior chamber, and secondary angle-closure glaucoma were observed. Exudative retinal detachment and choroidal detachment subsided in two days to 2-1/2 weeks. Glaucoma secondary to choroidal detachment with angle closure was observed in 11 eyes, three of which required medical treatment, although surgical therapy was not needed. This secondary glaucoma was detected in the first two days and subsided in subsequent days, with intraocular pressure reaching pretreatment values at the fifth day. No long-term sequelae were observed in these complications, except in one eye that developed macular edema that lasted for four months with decreased visual acuity; nevertheless, vision returned to the pretreatment level one year after photocoagulation.


Pesticide residues in total diet samples (IX). During the ninth year of the Total Diet Study, pesticide residues remained at the relatively low levels reported previously. Thirty market baskets were collected in 30 cities which ranged in population from less than 50,000 to 1,000,000 or more. Averages and ranges of residues found are reported for the period August 1972 through July 1973 by food class. Lead, selenium, and zinc data are included for the first time. During this period, the individual items used in making up the dairy and meat composites in four market baskets were analyzed for pesticides and the results are included. Results of recovery studies within various classes of residues are also presented.


Patterns of differentiation in various sympathetic efferents induced by hypoxic and by central thermal stimulation in decerebrated rabbits. The patterns of regional changes of sympathetic efferent activity evoked by thermal stimulation of the spinal cord and by arterial and primary tissue hypoxia were investigated in decerebrated, anesthetized and immobilized rabbits. Decerebration was performed either at the mid- or infracollicular level. The responses of the decerebrated rabbits evoked by spinal thermal stimulation were the same as those of intact rabbits, i.e., splanchnic and cardiac sympathetic activity increased and cutaneous sympathetic activity decreased during warming, while the reverse response was elicited by cooling. It is concluded that the typical thermoregulatory response pattern of the sympathetic nervous system can be produced also after the loss of hypothalamic integration, i.e., by integrative mechanisms in the lower brain stem and the spinal cord. In contrast, the responses of decerebrated rabbits to arterial and primary tissue hypoxia differed from those of intact rabbits in that they consisted in an overall activation in all investigated sympathetic branches. It is confirmed by this result that suprabulbar integration is essential for the generation of the inhibitory components in the differential sympathetic responses to hypoxia, which typically consist in cutaneous and cardiac sympathetic inhibition with splanchnic activation during arterial hypoxia and in cutaneous sympathetic inhibition with cardiac and splanchnic sympathetic activation during primary tissue hypoxia.


Alteration of shivering threshold in cold- and warm-adapted guinea pigs following intrahypothalamic injections of noradrenaline and of an adrenergic alpha-receptor blocking agent. The role of adrenergic receptors in the central thermoregulatory pathways controlling the shivering activity has been studied in groups of cold-adapted (CA), warm-adapted (WA) and newborn (NB) guinea pigs, which show quantitative differences in shivering threshold. In the CA and NB animals, which normally start to shiver at lower mean body temperature levels than the WA controls, microinjection of noradrenaline (1 mug in 1 mul) into the noradrenaline-sensitive area of the anterior hypothalamus elicited shivering at higher body temperatures at which normally only WA animals start to shiver. Similar injections into the hypothalamus of WA animals did not induce any further shift of the shivering threshold. Microinjections of the alpha-receptor blocking agent phentolamine into the same brain area shifted the shivering threshold in all groups of animals to lower body temperatures, the shift being proportional to the injected dose of phentolamine. The CA and NB animals required higher doses of phentolamine to produce a change in shivering threshold. It is concluded that adrenergic alpha receptors are involved in the central thermoregulatory mechanisms which adjust the thresholds for the thermoregulatory reactions.


Time-dependent reaction of human red cell deformability on sphering agents. The viscosity of samples with normal and normovolemic sphered erythrocytes was tested, using high- and low-shear capillary viscometry, paper filtration of packed red blood cells, and low g-value centrifugation. Incubated serum, pure lysolecithin and bile were used as sphering substances. The initial reaction of the red blood cells with the sphering agents was accompanied by increased viscosities of the blood samples especially at low shear rates. Prolonged storage of the erythrocytes in these media lead to full restoration of normal flow properties.


Measurement of Krogh's diffusion constant of CO2 in respiring muscle at various CO2 levels: evidence for facilitated diffusion. Krogh's diffusion constant for CO2, KCO2, was determined in respiring muscle tissue at various levels of tissue PCO2, between 10 and 160 torr, using a technique described previously (Kawashiro et atl, 1975). With increasing mean tissue PCO2, KCO2 declined towards an apparently asymptotic value. The relationship between KCO2 (10(-9) mmol-cm(-1)-min(-1)-tor(-1)) and PCO2 (torr) at 37 degrees C could be approximated by the equation KCO2 = 17.3 [1 + 1.72 - exp(--0.027 - PCO2)]-At PCO2 = 0 torr KCO2 exceeded the asymptotic value, which was virtually attained at PCO2 = 100 torr, by more than a factor of two. Thus CO2 diffusion in muscle appears to be facilitated in the low PCO2 range. Specific CO2 production rate of tissue, which was determined simultaneously, did not vary with CO2 in the PCO2 range studied. Effects of facilitated CO2 transport on CO2 exchange in muscle are assessd using simple models. In the presence of CO2 facilitation muscle PCO2 is reduced, particularly during exercise.


Biological balance of sodium and potassium: a control system with oscillating correcting variable. The rhythm of renal sodium and potassium excretion was measured in 4-h-intervals in 12 subjects. Each person exhibited clear circadian variations of each variable with a maximum between 8 a.m. and 4 p.m. In each subject and for both circadian rhythms the oscillation mean was correlated to the range of oscillation (amplitude). Increase in sodium or potassium excretion during 1 day resulted in an increase of oscillation range. The oscillation means of sodium and potassium periodicity did not correlate. The properties of biological control systems with oscillating correcting variables are comparable to those of technical control systems. The significance of circadian rhythm for the control of electrolyte balance is indicated.


Evidence for the existence of different receptor sites for algesic agents at the endings of muscular group IV afferent units. The hypothesis that different receptor sites for algesic agents exist at free nerve endings in skeletal muscle has been tested by administering bradykinin and 5-hydroxytryptamine (5-HT) repeatedly in anaesthetized cats and evaluating the response behaviour of single group IV afferent units from the gastrocnemius-soleus muscle. Repeated intraarterial administration of bradykinin at intervals of 1 and 2 min usually elicited fibre responses without tachyphylaxis. Injections of equieffective doses of 5-HT, however, given in the same manner evoked fibre reactions that were strongly tachyphylactic. In units responding to both bradykinin and 5-HT a refractoriness to 5-HT could be induced by repeated injections of this agent without impairing the stimulating potency of bradykinin on the same nerve ending. Such a lack of cross-tachyphylaxis seems to apply also to the effects of histamine on one side and bradykinin or 5-HT on the other. These findings suggest that bradykinin, 5-HT and probably histamine exert their excitatory action on muscular group IV afferent units via different receptor sites.


Regional distribution of vascular resistance in two models of experimental renovascular hypertension. The regional distribution of the peripheral vascular resistance was studied in normotensive and hypertensive Wistar rats. Two models of experimental hypertension were investigated: (I) in 32 animals the right renal artery was constricted by a silver clip (two-kidney Goldblatt hypertension); (II) in 46 animals the left kidney was removed and the right renal artery was clipped as in the first group (one-kidney Goldblatt hypertension). The normotensive control group comprised 61 untreated animals of the same strain and age. The distribution of cardiac output to 14 tissues was determined by means of the particle distribution technique. The resistance was increased in all regions investigated, a decreased or unchanged resistance was not observed. For most of the investigated tissues the regional resistance was increased exactly in proportion to the total peripheral resistance (TPR). Exceptions to this were found in 2 regions where the change of local resistance deviated from that of TPR: the splanchnic area and the skeletal muscle. In both cases the 2 models differed from each other. In the two-kidney model the increase of resistance in the splanchnic circulation was more intense than in other organs. In contrast, in the one-kidney model the local change of resistance was less than that of TPR. The change of skeletal muscle resistance was not significantly different from the change of TPR in the two-kidney model, while in the one-kidney model the increase of local resistance was significantly higher than that of TPR. It is concluded that the etiology of the abnormal resistance is different in the 2 models investigated and that known extrinsinc pressor factors may play a role in the two-kidney, but not in the one-kidney Goldblatt hypertension.


Superiority of developed over total pressure for heart contractility indices in dogs. The independence of indices of contractility to Starling effects was tested in 6 closed-chest dogs. After vagal and beta-receptors blockade, indices calculated with total left ventricular isometric pressure (TP), were shown to be strongly dependent of rises in end-diastolic pressure (LVEDP) induced by dextran infusion. At LVEDP of 14.6 +/- 1.5, 22.2 +/- 1.1 and 32.8 +/- 1.5 mm Hg (+/- SEM), the peak value of velocity of the contractile elements calculated with total pressure (peak VCE, TP) diminished by 21, 40 and 50%, and the extrapolated value of VCE, TP at zero total pressure (Vmax, TP) diminished by 15, 30 and 44%. In contrast, indices calculated with developed pressure (DP = TP-LVEDP) at the same LVEDP were much less influenced, particularly the extrapolated value of VCE, DP at zero DP (V max, DP5) and (peak dP/dt)/DP did not significantly change. During angiotensin infusion, expected decreases in TP indices secondary to LVEDP rises were partially masked by simultaneous increases in contractility, and DP indices tended to rise. On the  other hand, with minimal changes in LVEDP, as during calcium injection and paired stimulation, increases in TP and DP indices demonstrate inotropic effects equally well. Our study also shows that, besides Vmax calculated with DP, the instantaneous ratio of peak dP/dt and DP can also be proposed as a simpler and thus more convenient index of contractility independent of volume changes.


Effect of prolonged infusion of maximal and supramaximal doses of pancreozymin on pancreatic enzyme secretion in the rat--exhaustion or inhibition? Secretion of trypsin, chymotrypsin, lipase and amylase was measured in male rats under urethane anaesthesia using a method of continuous perfusion of the duodenum. Prolonged infusion of cholecystokinin-pancreozymin (CCK-PZ) over a period lasting 200-360 min was administered either alone or together with a submaximal dose of secretin (1 unit/100 g - 10 min). Infusion of CCK-PZ was carried out using maximal doses (1--1.5 unit/100 g - 10 min) with and without secretin. Supramaximal doses of CCK-PZ (2 and 4 units/100 g - 10 min) were used only in combination with secretin. In all experiments secretion of enzymes showed a triphasic pattern including an initial peak followed by a plateau secretion after 10--20 min (phase 1), a decreasing second phase and finally base-line secretion (phase 3), thus demonstrating exhaustion of enzyme output from the gland with time. With increasing and supramaximal dose of CCK-PZ the cumulative output of enzymes from start to baseline secretion decreased progressively. Under the same conditions the levels of peak and plateau secretion were lower, the duration of plateau secretion was longer and the decreasing phase of secretion was shortened. These features indicate inhibition of secretion with increasing supramaximal doses of CCK-PZ infusion. Whereas the  proteolytic enzymes and lipase reacted in a parallel way always amylase secretion was sustained on a higher level, implicating an alternative pathway for secretion.


Alp and valley cattle: exercise in cold, hot and high environments. Two groups of cattle, one kept on an alpine pasture (1700--2600 m altitude) for 5 summer months and the kept in a barn at 400 m, were subjected to treadmill exercise for 15 min at a speed of 2 km/h in environments of 15 degrees C, -10 degrees C, 35 degrees C (all at 400 m) and at simulated altitude of 3500 m (at 15 degrees C). In the resting conditions, the alpine cattle had higher respiration rates and body temperatures at an air temperature of 35 degrees C than the valley cattle which was attributed to a greater hair insulation and possibly a low responsiveness of the sweat glands. At 3500 m, the alpine animals had higher resting heart rates than the valley animals, which was attributed to a greater blood volume. After exercise, heart rates in the alpine cattle were from 10--19 beats/min lower than in the valley cattle, due to exercise conditioning in the former animals. This training effect on heart rates in the alpine animals was paralleled by reduction in intrinsic heart rates (using atropine and propranolol as blocking agents). Atropine blockade also indicated that exercise-trained cattle have a lower vagus tone compared to non-exercise-trained cattle.


Variability of cortical evoked responses in man related to slow wave activity. Acoustically evoked responses were recorded from subdural and intracerebral electrodes chronically implanted in man. It was found that during slow wave activity especially the negative component at about 100 ms latency varies in form and amplitude. If the stimuli were presented during increasing cortical negativity, the amplitude of the 100 ms component of the evoked responses was generally larger than in the case of stimuli presented during decreasing negativity.


Permanent catheterization of aorta and pulmonary artery in the dog. A method is presented for permanent catheterization of the aorta and the pulmonary artery in dogs. The preparation of single vessel catheters and double catheters for simultaneous arterial and venous sampling is described. The catheters, made of S-50-HL Tygon tubing, are introduced into the aorta and the pulmonary artery through the omocervical vessels, leaving the cerebral circulation intact. Removal of the catheter by the dog, thrombophlebitis and vascular embolism have not been observed. The catheters have remained functional for up to one year.


Slow inward current and action potentials of papillary muscles under non-steady state conditions. 1. The relationship of the contractile response of cat papillary muscles and of the slow inward current, recorded under voltage clamp conditions (single sucrose gap), has been studied. The preparations were driven at a rate of 30 per min at 31 degrees C. Both variables were recorded during a train of 7 identical clamp depolarizations (for 1 s from resting potential to -15 to +40 mV). The contractility increased severalfold and reached the steady state within 5-6 consecutive depolarizations. 2. The voltage-dependence of slow inward current was confirmed: maximum was found at depolarizations near 0 mV. On repetition of clamp pulses the slow current gradually diminished in amplitude and was more slowly activated and inactivated. The shift of the current-voltage curve indicated a decrease of the reversal potential. 3. Under non-steady state conditions the amplitude of the slow current was found to correlate closely with the magnitude of the contractile response at any given level of depolarization. The relation was linear with negative slope. The largest contractile response was not found at voltages which elicited maximum slow current. 4. The progressive decrease of the slow current during repetition of voltage clamp depolarizations is not significantly affected by inadequate time for recovery of slowly changing conductances, since it occurs also at stimulation frequency 15 per min and the slow current remains virtually unaltered after 20 s period of quiescence. 5. The course of total ionic current during phase 1 and 2 of action potential was reconstructed from a family of current curves obtained as a response to clamp depolarizations to various voltages, respecting the contractility-dependence of the current. The resulting course was correlated with the first derivative of action potential. A general conformity was ascertained. 6. The correlation of slow inward current with action potential configuration indicates that the rate of its activation determines the depth of the notch separating spike and plateau, its magnitude determines the voltage of the plateau phase and its rate of inactivation affects repolarization. 7. It is concluded that the described simultaneous changes of mechanical and electrical phenomena might be due to increased [Ca]i, which is responsible for more intense activation of the contractile proteins on the one hand, and decreased driving force of the slow inward current, carried by Ca ions, on the other.


Oxygen uptake of rats at different work intensities. An adaptation of a standard activity wheel has been used to determine oxygen uptake of rats prior to and during exercise at 7 different speeds (16-67 m/min). Pre-exercise oxygen uptake was 2.42 +/- 0.10 (S.E.) ml (100 g x min)-1. Oxygen uptake increased linearly with work intensity (running speed). At 16m/min oxygen uptake was 6.44 +/- 0.16 ml (100 g x min)-1 and it increased to a maximal value of 9.51 +/- 0.14 ml (100 g x min)-1 at a running speed of 53.6 m/min. Increasing running speed to 67 m/min did not produce any further increase in oxygen uptake. Some comparisons of exercise intensity between rats of various studies and rats and man can be made from these data.


Activation of tubulo-glomerular feedback by chloride transport. To define the luminal agent(s) responsible for the reduction of nephron filtration rate following increases of loop of Henle flow rate early proximal flow rate (EPFR) during loop perfusion with 17 different salt solutions were compared to the non-perfused tubules. During orthograde microperfusions a reduction of EPFR as indication of a feedback response was noted with a number of monovalent Cl- and Br- salts (LiCl, KCl, NaCl, RbCl, CsCl, NH4Cl, choline Cl, NaBr, KBr), with Na+ salts except Na acetate (NaHCO3, NaNO3, NaF, NaI, NaSCN), and with CaCl2 and MgCl2. These latter 2 solutions where used in a concentration of 70 mM while all other solutions had a concentration of 140 mM. During retrograde perfusion from the distal to the proximal end of the loop of Henle EPFR fell significantly with Cl- and Br- salts with percentage changes of EPFR ranging from -8.0 to -44.3%. In contrast, Cl- free salts and Cl- salts of divalent cations were associated with percentage changes of EPFR ranging from +7.1 to -6.2%, significance being reached only during perfusion with NaSCN. When furosemide (5 x 10(-4) M) was added to NaBr or KBr a feedback response was not observed. During orthograde perfusion with NaNO3 distal Cl- concentrations were 44.2 +/- 5.08, mM (mean +/- S.E.) at a perfusion rate of 10 nl/min and 59.1 +/- 3.93 mM at a rate of 40 nl/min. CaCl2 perfusion induced a marked elevation of distal Cl- concentrations to levels higher than 140 mM. Loop chloride handling was normal during RbCl perfusion. The magnitude of the feedback response during retrograde perfusion was not changed by lowering NaCl concentration from 140 to 60 mM, but fell when NaCl concentration was further reduced. In contrast to orthograde perfusions it was insensitive to changes in flow rate. Our results are compatible with the thesis that feedback responses depend critically upon the rate of Cl- transport probably across the macula densa cells. Br- ions can replace Cl- because they appear to share a common transport pathway which can be inhibited with furosemide. Unspecificity of feedback responses during orthograde microperfusions is due to presence of Cl- ions in the macula densa region even when solutions are initially Cl- free. Cl- salts of divalent cations do not elicit a feedback response because Cl- transport is severely curtailed.


Effects of chronic treatments upon the brown adipose tissue of young rats. I. Cold exposure and hyperthyroidism. 1. The gross composition, triglycerides and phospholipids of brown adipose tissue were studied in young and adult rats chronically treated with cold or thyroxine. 2. Cold induced an increase of the total water, protein and phospholipid of tissue while the main effect of thyroxine treatment was an accumulation of triglycerides. Thyroxine treatment prevented the cold-induced increase of phospholipid percentage in the tissue. 3. Cold exposure altered the fatty acid pattern of phospholipids, whereas thyroxine had smaller and different effects. 4. The differential effects of cold and hyperthyroidism upon triglycerides and phospholipids of brown adipose tissue are briefly discussed.


Phosphate, calcium and magnesium fluxes into the lumen of the rat proximal convoluted tubule. In order to study fluxes of phosphate (Pi), Ca and Mg into the rat proximal tubule, a modification of the split-droplet microinjection technique was used. Injected fluids were isotonic solutions containing no Pi, Ca or Mg. The initial NaCl concentration of the injectates was either (a) 115 mM(l (which resulted in net fluid entry into the lumen), (b) 125 mM/l (no net fluid movement) or (c) 150 mM/l (net reabsorption of fluid). Injected droplets were subsequently collected from the nephron and their ionic concentrations determined using electron probe analysis. All 3 ions entered the tubular lumen. For the 115 mM and 125 mM NaCl injectates, Pi concentration increased for the first 15 s, then reached steady values of 2.07 mM/l and 2.30 mM/l respectively. Using 150 mM NaCl as injectate, Pi concentration increased for only 10 s, and then reached an average value of 2.04 mM/l. Ca and Mg concentrations in reaspirated droplets showed no correlation with time, indicating that entry into the lumen was almost immediate. The mean Ca concentration using 115 mM NaCl injectate was 1.63 mM/l, higher than with equilibrated or reabsorbed injectates (1.01 and 1.15 mM/l respectively). Mg concentration following injection of 115 mM NaCl solution (0.45 mM/l) was lower than with the other 2 injectates (0.92 and 0.85 mM/l). It is suggested that Pi and Mg enter the proximal tubular lumen from the tubular cells, while Ca entry may be transtubular and take place via intercellular pathways.


Creep after loading in the relaxed and contracted smooth muscle (taenia coli of the guinea pig) under various osmotic conditions. 1. Experiments to investigate the creep phenomena of the taenia coli were performed in hypotonic (207 mosm) and hypertonic (447 or 463 mosm) media, in the relaxed (Ca2+-depletion + verapamil) as well as in the contracted (K2SO4-depolarized) state. They were compared with earlier results in isotonic media. The samples were standardized with respect to their volume (weight) before the beginning of the experiment. 2. Neither in the relaxed, nor in the contracted state was there a statistically significant difference in mean total length observed within each test series after loading with 9928 dyn for 2000 s (about 33 min) in the different osmotic media. We define total length as unloaded initial length lo + initial pure leastic extension lE + creep N. 3. In the contracted state the mean total lengths attained by elastic extension and creep are significantly greater than in the relaxed state in both hypotonic and isotonic media. The greater variance in the data for hypertonic solutions makes any statistical decision of this kind impossible. 4. The typical time course of creep (N) and particularly the hyperbolic dependance of N and dN/dt stated in an earlier paper could also be observed here under varied osmotic conditions. 5. The results suggest that the viscosity of the cell plasma is not significant for the time course and extent of creep in smooth muscles of vertebrates. Creep probably takes place in the solid structures of the cells: most particularly the contractile proteins may be involved.


Intravital microscopical studies of the tubular urine flow in the conscious rat. A method was developed which allowed microscopical observation of the kidney in conscious and anesthetized rats. The left kidney was freed from surrounding tissue and placed in a plexiglas chamber with a protecting window which was sewed into the skin of left flank. During the experiments the covering glass was removed. Tubular transit time was measured in the conscious state and during inactin anesthesia in control rats as well as in unilaterally nephrectomized rats with compensatory hypertrophy. Transit time of lissamine green within proximal convolutions and Henle's loop increased significantly in both series during anesthesia. Luminal and outer diameters of proximal tubules in control rats were evaluated from microphotogramms of the kidney surface, they did not change due to anesthesia. The results could be mainly explained by a decrease in glomerular filtration rate due to anesthesia. Possible mechanisms are discussed which could explain the observed transit time in Henle's loops and distal convolutions in control and uninephrectomized rats.


Interactions between furosemide and vasopressin on hemodynamics and on water excretion by the isolated dog kidney. The effects of furosemide were studied on isolated dog kidneys in the absence and in the presence of vasopressin. In the latter condition, furosemide did not modify renal blood flow and glomerular filtration rate while both parameters were decreased by the drug in the absence of vasopressin, as they were also reduced by vasopressin alone. This would indicate direct vasoactive effects of furosemide, depending on the previous tone of the vasculature. In the absence of vasopressin, furosemide decreased free water clearance through inhibition of sodium reabsorption in the ascending limb of Henle's loop. On the other hand, in the presence of vasopressin, furosemide increased free water clearance, presumably through reduction of water reabsorption in the collecting duct by enhanced distal tubular flux.


Dye absorption changes in single muscle fibers: an application of an automatic balancing circuit. It is very difficult to record small potential changes in the presence of a large background voltage that drifts. This is particularly true in recording optical changes during excitation of nerve and muscle because the optical changes are usually very small compared with the background. We describe a convenient circuit, which is useful under these circumstances. This circuit automatically balances the background drift. Using this circuit we recorded light absorption changes during excitation of single muscle fibers stained with a fluorescence dye merocyanine 540. The optical change consists of three components. The first component presumably reflects the action potential of the surface membrane and the T-system. The second and the third components are perhaps the movement artifacts from latency relaxation followed by contraction.


Plastic properties of vertebrate smooth muscle (taenia coli of the guinea pig). After extension and creep due to a constant load the taenia coli of the guinea pig shows plastic deformation. The deformation is partially abolished by complete unloading: to 51% in the relaxed and to 83% in the depolarized = contracted state. The quantitative relations between creep (N) and its time derivative (dN/dt) as well as those between stress relaxation (R) and dR/dt stated in our previous papers, remain valid if plastic deformations have occurred during these processes.


Immunologically mediated lung diseases. Extrinsic allergic alveolitis and allergic bronchopulmonary aspergillosis. Early recognition and treatment of immunologically mediated diseases of the lung are vital to prevent irreparable damage. Extrinsic allergic alveolitis and allergic bronchopulmonary aspergillosis are often confused but should not be difficult to distinguish. The former is nonatopic and is marked by chills, fever, chest pains, cough, dyspnea, and restrictive pulmonary function. The immunologic hallmark is the presence of precipitating antibody to the suspected antigen. Allergic bronchopulmonary aspergillosis is atopic and is marked by low-grade fever, obstructive pulmonary function, markedly elevated serum IgE levels, and positive immediate and late response on skin tests. Both diseases respond well to early corticosteroid therapy. Prophylactic measures are also important in controlling extrinsic allergic alveolitis.


Some chemical and pharmacological properties of 2-methyl-5H(1)benzopyrano(2,3-b) pyrid-5-one. The synthesis of the mentioned compound, their N-oxide and N-oxide 7-nitro derivative is described. The reactivity of the CO, N-oxide groups and heterocyclic N atom was investigated. Of the obtained new compounds 2-methyl-5-(3'-dimethyl-aminopropylidene)-5H-(1)benzopyrano [2,3-b] pyridine 4 acts on central nervous system.


Steroid synthesis by ovarian follicles in response to LH and PGF2alpha. Ovarian follicles isolated from bovine ovaries at the 16th and 17th days of the estrous cycle were minced, pooled, and incubated in Krebs-Ringer bicarbonate buffer at 37degrees for 2 hr. Samples were analyzed for testosterone, estrogens, and progesterone by radioimmunoassays. Incubation alone failed to cause an increase in testosterone (12.1 vs 29.3 ng/g of tissue; P is greater than 0.05). Additions of 5 mug/ml of bovine LH or prostaglandin F2alpha caused increases in testosterone synthesis to 125.0 (Pis less than 0.01) and 103 ng/g (P is less than 0.01). Estradiol synthesis was also stimulated by LH (P is less than 0.01). However, stimulation due to addition of PGF2alpha (5.1 to 15 ng/g) was not significant (P is greater than 0.05). PGF2alpha also caused a slight but nonsignificant increase in estrone secretion. Incubation failed to increase the progesterone concentration (623 vs 774 ng/g of tissue; P is greater than 0.05). There was no increase in progesterone synthesis due to addition of either LH or PGF2alpha (P is greater than 0.05). The results show that bovine follicles produce much more testosterone than estrogen and that both LH and PGF2alpha significantly stimulate testosterone synthesis in bovine follicular tissue without increasing net progesterone biosynthesis.


Effects of chlorpromazine on avoidance and escape responding in humans. The effects of chlorpromazine on shock avoidance and escape responding were determined using four human subjects lever pressing on a modified free operant avoidance schedule. Doses of chlorpromazine ranging from 50 to 100 mg and shock levels ranging from 0.35 to 3.0 mA were used. In general, the results showed that chlorpromazine suppressed avoidance responding at doses which did not suppress escape responding.


Extinction-induced mirror responding as a baseline for studying drug effects on aggression. Pigeons worked individually in a chamber containing a response key and a mirror. Responding on the key was controlled by a multiple schedule in which a brief period of continuous food reinforcement alternated with a 5 min period of extinction. Under baseline conditions, aggressive behavior (responding on the mirror) occurred at the onset of each extinction period. After 10 saline control sessions, 5 mg/kg of chlordiazepoxide was injected IM 30 min presession for 60 daily sessions. The drug initially produced a marked decrease in aggressive behavior but had little or no effect on key pecking. The aggressive behavior generally remained suppressed during the chronic drug regimen and returned to control levels when the drug was withdrawn. It was concluded that the technique of extinction-induced mirror responding in pigeons provides a stable, sensitive and recoverable baseline for objectively assessing selective drug effects on aggression.


Disruption of diurnal feeding patterns of rats by heroin. Adult male rats receiving 5 or 20 mg/kg heroin HCl by single injections (08:00 or 20:00 hr) or in 3 equal injections (8 hr intervals) showed a disruption in the normal diurnal pattern of behavior. Initially, heroin abolished feeding for several hr after the injection, reduced the total daily food consumption in a dose-related manner, due primarily to decreased night-time feeding, and prevented or slowed weight gain. Subsequent heroin injections led to a phase of vigorous feeding following the period of depression. Magnitude and duration of the depression decreased, but the stimulatory phase of feeding became more pronounced as tolerance developed. Total daily food intake and body weight returned towards control levels, but the proportion eaten during daylight hr became elevated. Sporadic feeding occurred on the first withdrawal day with abolition of the stimulatory phase which had followed each heroin injection. Subsequently, the normal diurnal pattern of behavior gradually returned. Close measurement of 24 hr food consumption may be a sensitive and valuable measure of the disruptive effects of narcotic analgesics.


Rate dependent drug effects: possible state dependency. Of 6 rats given extensive experience responding on a fixed-interval reinforcement schedule after injections of 1 mg/kg d-amphetamine, 3 showed significant rate dependent changes in responding when presession saline was substituted for d-amphetamine. Low rates were increased and high rates decreased by the change from d-amphetamine to saline, a result commonly found when d-amphetamine is first introduced. This indicates that rate dependent changes in fixed-interval responding may be state dependent phenomena.


Cycloheximide-induced amnesia for taste aversion memory in rats. Male hooded rats were conditioned in one trial to avoid saccharin by pairing saccharin drinking with an intragastric injection of LiC1. A 24 hr water-saccharin preference test showed that conditioned rats exhibited a very low preference for saccharin whereas rats injected intraventricularly with cycloheximide (CXM, 400 mug) 5, 7, or 9 hr before training exhibited a greatly increased saccharin preference which differed significantly from NaC1 injected controls. This 24 hr amnesia was found to be dependent upon the time of administration of CXM, since injection at 1, 3 or 17 hr before training did not confer amnesia. The nature of the task, a control measure and a control experiment indicate that the CXM-induced change in saccharin preference at 24 hr is not due to a CXM-induced aversion, nor a loss in drinking ability nor an inability to retrieve information whilst under the influence of CXM.


Urethral syndrome in women.

Urethral syndrome in women. The pathological changes in the female urethra, para-urethral glands, and bladder neck, which manifest clinically as urethral syndrome, produce radiological signs which are recognizable but for which the authors have not found previous reports. The radiographic manifestations of this disease are clearly demonstrated by excretory urography. These changes are shown to correlate closely with the findings of cystography.


Plasma concentrations of 13,14-dihydro-15-keto-prostaglandin F during pregnancy in sheep. A specific and sensitive radioimmunoassay is decribed for 13,14-dihydro-15-keto-prostaglandin F in ovine plasma. Using this assay it has been shown that, in sheep, jugular venous 13,14-dihydro-15-keto-prostaglandin F concentrations increase at parturition and correlate well with concentrations of prostaglandin F in the utero-ovarian vein. It is suggested that uterine prostaglandin F production under these conditions may be assessed by measuring peripheral venous 13,14-dihydro-15-keto-prostaglandin F, thereby avoiding the need for chronic utero-ovarian venous catheters.


Pneumonia associated with Torulopsis glabrata in an aborted bovine fetus. The second case of bovine abortion caused by Torulopsis glabrata observed in examining more than 5000 fetuses is reported. The yeast was cultured from fetal abomasal content and fetal lung; attempts to isolate viruses and bacteria were unsuccessful. The yeast was seen in association with diffuse fetal pneumonia characterized by presence of polymorphonuclear leukocytes and macrophages within bronchioles, alveolar lumina and alveolar septa. Macrophages containing many yeast cells were observed within bronchioles.


Is Arthroderma simii the perfect state of Trichophyton Quinckeanum? Gymnothecia with asci and ascospores developed repeatedly and in abundance whenever Trichophyton quinckeanum isolates X-392 and IMI 140691 were paired with Arthroderma simii 678 A. However, repeatable fertile crosses did not occur when all of our 19 isolates of T. quinckeanum were paired with 10 other isolates of A. simii comprising A and a mating types. Additional crosses between these 19 isolates of T. quinckeanum with A. simii and with A. benhamiae revealed that 11 of the 19 isolates of T. quinckeanum produced fertile gymnothecia only when crossed with A. simii 678 A but not when crossed with another isolate of A. simii of the A mating type nor when crossed with mating type a. All 19 isolates mated with A. benhamiae mating type A; therefore, all of our T. quinckeanum isolates were of the a mating type. Study of asci and random ascospores, selected with a micromanipulator, from crosses between several isolates of T. quinckeanum and A. simii 678 A revealed irregularities in the maturation of ascospores, poor ascospore germination, and a predominance of the A. simii phenotype and mating type for those ascospores that germinated and produced mature colonies. All these reactions are characteristic of interspecific crosses. In contrast, ascus analysis of the F1 progeny of crosses between these same isolates of T. quinckeanum with A. benhamiae revealed regular maturation of ascospores, better germination, and essentially a 1:1 segregation of mating types and parental phenotypes. This study confirms the concept that T. quinckeanum is not an independent species and that it is best considered to be a variety of T. mentagrophytes, as reported by Ajello, Bostick & Cheng (1968). Furthermore, our data indicate that T. mentagrophytes var. quinckeanum appears to be more closely related to A. simii than the granular variety of T. mentagrophytes, since fertile gymnothecia resulted from crosses between T. mentagrophytes var. quinckeanum and A. simii but not between T. mentagrophytes var. mentagrophytes and A. simii. Further implications of this study suggest the importance of extensive ascospore analysis when investigating the perfect states of fungi in order to avoid creating unwarranted new species.


Conidiogenesis in pathogenic hyphomycetes. I. Sporothrix, Exophiala, Geotrichum and Microsporum. Conidium formation in 5 species of pathogenic hyphomycetous fungi, Sporothrix schenckii, Exophiala salmonis, E. sp., Geotrichum candidum and Microsporum canis were examined using light and scanning electron microscopy. The fungi, grown in pure culture on potato dextrose agar under defined conditions, demonstrated 4 kinds of conidiogenesis. The taxonomic value of the developmental characters in the classification of the Fungi Imperfecti is discussed.


Fine structure of the dogfish egg case: a unique collagenous material. The fine structure of the dogfish egg case is described with special reference to the highly ordered, unique, collagen-containing fibrils. The outer layer of the case wall contains densely packed, amorphous granules, rich in tyrosine while approximately 98% of the thickness of the case is built up from orthogonally stacked laminae of closely packed, collagen-containing fibrils. These fibrils show a paracrystalline three-dimensional construction. A model for the structure of the B band of the fibril is proposed, based on appearances in transverse sections of different thickness and on two projection seen in longitudinal sections. The transverse projection of the unit cell appears to be a square lattice with sides approximately 110 A possibly containing a pseudocell with sides (see article). The structure  of these fibrils is discussed in relation to those of rat tail tendon collagen.


The value of relative organ weights.

The value of relative organ weights. It is accepted practice in presenting organ weight data to express the results relative to the animal's body weight. The data presented suggest that in rats no benefits are obtained from this method either in reducing the variability of the data or in removing bias due to different body weights. By using simulated data it is further shown that relative weights can lead to erroneous conclusions and misinterpretation of drug effects and it is concluded that workers should present their results in absolute as opposed to relative weights.


The toxicity of brominated sesame oil and brominated soybean oil in miniature swine. Miniature swine were fed brominated sesame oil at dietary levels of 0, 5, 25, 50 or 500 mg/kg of body weight for 17 weeks and brominated soybean oil at levels of 0, 5, 50 or 500 mg/kg of body weight for 28 weeks. Growth rate and food intake were decreased only at the high dose level in the brominated sesame oil study. In both studies, signs of lethargy and ataxia occurred in pigs fed the highest dose, and were probably due to a dose-related increase in serum bromine concentrations. Marked elevations in lactic dehydrogenase (LDH), serum glutamic-oxalacetic transaminase (SGOT) and serum glutamicpyruvic transaminase (SGPT) values were seen at the highest dose level with both substances and these enzyme activities were increased at the 50 mg/kg dose level in the brominated sesame oil study. Histopathologic lesions were confined to animals given the highest dose level of either oil. Marked fatty degeneration of the hepatic plate cells and renal tubular epithelial cells were seen in both studies. In the brominated sesame oil study, neutral fat was moderately increased in the myocardium of the pigs fed 500 mg/kg. However, marked diffuse accumulation of LDH, marked diffuse fatty degeneration and focal degeneration, and/or necrosis of individual or small groups of cardiac muscle fibers were seen in the group fed brominated soybean oil at 500 mg/kg. A moderate to marked testicular atrophy was also observed in this group. A dose-related accumulation of total and hexane-soluble bromine was observed in all tissues examined in both studies; the highest concentrations occurred in adipose tissue of the pigs given the highest dose level. Kidneys, livers, hearts and thyroids of these groups also contained large amounts of bromine. In pigs given the 50 mg/kg dose level, total and hexane-soluble bromine concentrations were higher in the brominated sesame oil study than in the longer brominated soybean oil study and may be responsible for the elevations in LDH, SGPT and SGOT activities in this group.


Detrusor activity and outflow resistance in stress incontinence. The successful treatment of urinary stress incontinence in females dependends on a careful study of urodynamics. Pre-operative measurements of urine flow rate and residual urine can be useful only in differentiating compensated from deconpensated micturition. However, some selected problems require a more detailed investigation. Therefore synchronous cine/pressure/flow/cystourethrographic studies were performed in 20 stress-incontinent women. In some of them, an increased outflow resistance was thus demonstrated. Any type of operation for stress incontinence which raises outflow resistance must be avoided in these cases. Long-distanced urethrocystopexy which permits to avoid an unwanted increase of outflow resistance with following retention of urine should be preferred.


Reflex electrical stimulation for urinary incontinence. Our previous observations have shown that the electrical stimulation of muscles is prevalently reflex. One of the advantages of reflex stimulation is that it activates not only a limited number of motor units, but rather a number of muscles connected by the same reflex from a single stimulation site. Consequently, it is not necessary to place electrodes into the muscle to be activated. They can be put elsewhere provided that the same effect is obtained and that it is more convenient for the patient. Such an opportunity arises when treating urinary incontinence which involves not only the urethral sphincter but also the group of synergistic muscles of the pelvic floor. Our experiments with several patients suffering stress incontinence have shown that indirect stimulation of the levator ani with a vaginal stimulator and especially of the anal sphincter with an anal stimulator affects the urethral sphincter in the same way as direct stimulation. These findings are significant since they enable us to use external instead of implantable stimulators. External stimulation is worth trying in all cases of stress incontinence where conservative measures have failed. In our cases, the results have been very satisfactory.


Estrogenic sensitivity of alpha-receptors in the urethra musculature. Estrogene has a tonicising effect upon urethra musculature. There is also the same demonstrable influence of alpha-receptor stimulating drugs upon the urethra pressure profile. After preliminary treatment with estrogene, there is a considerably stronger tonicising effect of alpha-stimulating drugs than without such a treatment. So the combination of estrogene and alpha-stimulating drugs seems a useful addition to the conservative treatment of stress incontinence.


Model of the proximal urethra: measurement of the urethral stress profile. Research on the activity of the urinary tract has led to the creation of a theoretical mechanical model where elastic forces, affecting rigid segments represent the living tissue of the urethral walls whereby it is assumed that the tissue acts as an elastic material. Such a model provides a clearer picture of changes in the physical parameters of the elastic walls of the urethra and facilitates better analysis of measurement errors. Artefacts make it exceptionally difficult to accurately measure the urethral pressure profile. The known methods have a measurement error of at least 30%. We have been trying to eliminate the basic error caused by the size of the measuring sensor. The methods involves measuring the urethral pressure profile in one patients using several sensors of varying diameters. The problem was defined mathematically. By extrapolation of measuring points, the value of elastic force under normal conditions can be obtained. Preliminary results of pressure profile measurements in our patients are much more accurate than those of other currently known measuring techniques. It is too early, however, to predict the extent of increased objectivity in the results of the new method for measuring urethral pressure profile, with and without functional electrical stimulation. The parameters of stimuli produced by our electrical stimulators will be based upon these findings.


A concept of urinary continence.

A concept of urinary continence. Urinary continence exists provided urine has no other outlet than through a section of the urethra where pressure at all times, except during normal micturition, is higher than it is in the bladder. Closure pressure, the difference between maximal intra-urethral pressure and simultaneously existing bladder pressure, normally remains above zero also during vigorous physical stress, such as coughing, mainly because intraabdominal pressure is readily transmitted not only to the bladder, but also to the upper urethra, which is above the urogenital diaphragm.


Is the intrinsic bladder pressure a reliable parameter? Simultaneous pressure recording in different organs shows that voluntary movements as straining, Valsalva maneuver, cough, are easy recognizable. Spontaneous pressure waves in the rectum may give the impression of uninhibited bladder contractions if subtracted from the total bladder pressure.


Species and hybrid differences in frequencies of play and agonistic actions in canids. Developmental changes in the frequency of occurrence of some 23 action patterns were studied in pairs of coyotes, wolves, dogs and their hybrids. Over 4,300 entries were recorded from days 24--42 (85.5 h observations in toto). All subjects showed a decrease in contactual behaviors from 24--30 days, and a subsequent increase in play fighting and chasing. In all species, with the exception of the coyotes, the bite was inhibited and play behavior was recorded from 24 days onwards, but only after the 30th day in the coyotes. Species differences in occurrence and frequency of certain action patterns were evident in the wolves, coyotes and dogs, and these differences were also reflected in their hybrids.


[Autoimmune cell reaction following the administration of an allergen from Ambrosia pollen]. Data are presented pointing to the principal possibility of using micromodification of the local hemolysis test (suggested by Klemparskaya) for the purpose of characteristics of pollen allergens. In administration to male mice, weighing 18 to 20 g of 0.25 ml of the allergen prepared from a 3% suspension of ambrosia pollen in water-salt Evans-Cock fluid there was a sharp rise in the spleen of cells synthesizing antibodies against own erythrocytes of these animals on the 4th-6th day after the immunization. The water-salt solution included into the composition of the allergen promoted to some extent stimulation of these processes. The allergen possessed a high allergenic activity in the skin test on man and contained 0.3 ml of protein nitrogen per 1 ml. A possibility of autoimmune influence of these preparations in hyposensitizing therapy of man is supposed.


[The effectiveness of amantadine (midantan) in the treatment of the parkinsonian syndrome]. The author treated 83 patients with parkinsonism by analouges of amantadin--the Soviet preparation midantan and Swiss preparation simmetril. Twenty patients received only Amantadin and 63 Amantadin in combination with other antiparkinsonic drugs. Optimal doses of other antiparkinsonic drugs were determined prior to amantadin treatment. The preparation exerted a higher influence on such symptoms of parkinsonism as akinesis and rigidity and less on tremor. In 1/3 of the cases a positive effect of the treatment was temporary and disappeared altogether after 2--4 weeks despite the continuation of therapy. The preparation was well tolerated. Side effects observed in 32 of the 83 patients were usually expressed very midly and disappeared without special treatment. The author compares such preparations al 1-Dopa and Amantadin (Midantan).


[Trophic disorders in ganglionitis of the superior cervical sympathetic ganglion under experimental and clinical conditions]. The paper is concerned with a clinical study of 9 patients where ganglionitis of the upper cervical sympathic node proceeded with an atrophy of the soft tissues in the form of facial hemiatrophy. Besides in experiments on 18 guinea pigs the authors either removed or irritated the upper cervical sympathic node and then after a certain period during 30 days performed histological and histochemical studies of the soft tissues of the animal muzzle. It was possible to mark a prevalent lesion of the skin and subcutaneous fatty tissue. In the early periods of the experiment there was a more expressed change in the metabolic reactions and less-structural disorders which developed eventually and had a secondary character due to disorders of metabolic processes. These data permit to consider that such changes take place in the faces of patients with ganglionitis of the upper cervical sympathic node.


[The role of catecholamines, acetylcholine and cholinesterase activity in the development of the cataleptic action of triftazin following repeated administration]. Catalepsy occurring in rats in a singular and repeated introduction of triftasine has a manifold mechanism, the main components of which are related to the metabolism of dophamine, acetylcholine and cholinesterase activity. A change in the intensity of catalepsy in a multiple introduction of the preparation is due mainly to cholinergic influences.


Incidence and nature of horse-riding injuries. A one-year prospective study. A prospective one-year study of horse-riding accidents was performed in an area with a very high frequency of amateur riding. Totally 174 patients with riding injuries were registered--66% children--making an incidence of only 0.7 per thousand riding occasions. However, many of these injuries were of a severe nature, one leading to death and 27 of the patients reporting persisting symptoms at follow-up one year after the accident. Eleven per cent of the accidents lead to cerebral injuries and 44% to fractures, mainly of the upper extremities. Eleven per cent required hospitalization and 17% operation under general anaesthesia. Clarification of the circumstances concerning the accidents indicated that many of the severe injuries could probably have been avoided by use of better safety equipment.


Incidence of intermembrane alterations in human heart mitochondria: a preliminary ultrastructural study. An alteration consisting of widening of the inner membrane space (approximately 240 A) of the human heart mitochondria was studied and compared in surgical and autopsy material. The presence of these changes in well-preserved surgical material suggests that it may be a morphologic manifestation of an unknown biochemical alteration.


Overriding tricuspid valve: echocardiographic and angiocardiographic features. Eight cases are presented in which the diagnosis of overriding of the tricuspid valve was made during life and the electrocardiographic, echocardiographic and angiographic features of the defect are presented. Four of the patients had dextrotransposition of the great arteries, three had normally related great arteries and one had corrected transposition. In each case there was hypoplasia of the right ventricle and a ventricular septal defect of the atrioventricular (A-V) canal type. The electrocardiogram in the cases with d-transposition was characterized by diminished right ventricular forces, left ventricular forces, left ventricular hypertrophy and a superior leftward frontal plane axis. The echocardiogram in seven cases demonstrated a septal leaflet of the tricuspid valve opening posterior to the septum into the left ventricle. In four cases the anterior leaflet of the tricuspid valve was shown crossing the plane of the interventricular septum as it opened in diastole. The diagnosis in five cases was made angiographically by a left ventricular injection in the left anterior oblique projection. In this view the septum was viewed tangentially and in diastole the negative silhouette of the tricuspid valve was seen straddling the interventricular septum. The presence of an overriding tricuspid valve can greatly complicate repair of intracardiac defects. The diagnosis of this A-V valve anomaly can be accurately made with the use of echocardiography and selective left ventricular angiography.


The onset of testicular differentiation in the rat: An ultrastructural study. The structure of developing rat testes was studied by light and electron microscopy. Ultrastructural differentiation of Sertoli and Leydig cells was followed from 14 days of gestation through birth. Specialized morphology in Sertoli cells was first seen at 16 days of gestation. In these cells the rough endoplasmic reticulum increased and became organized as numerous short cisternae loaded with a homogenous material. Typical Leydig cells were found among the stromal cells, around day 17 of gestation. There is good correlation between the time of appearance of ultrastructural specialization and published data on secretory capacity of the fetal testes, in respect to the inhibition and differentiation of the Müllerian and Wolffian ducts.


Light cells within the limiting membrane of rat seminiferous tubules. Light-staining cells, distinct from myoid cells, were identified in electron micrographs of the limiting membrane of rat seminiferous tubules. While these cells were also found free in the interstitial space, they were observed mostly in the myoid cell layer of the limiting membrane but were never seen within the seminiferous epithelium itself. The light cells were characterized by a pale-stained cytoplasm containing a spheroidal Golgi apparatus next to a polymorphous often kidney-shaped nucleus, a few cisternae of rough endoplasmic reticulum and some granules of various types including a multivesicular bodies. In hematoxylin-stained whole mounts of dissected tubules, these light cells were readily identified under the light microscope by nuclear morphology and light-staining juxtanuclear Golgi apparatus. The incidence of these cells, per unit surface area of tubular wall, was calculated, taking into consideration the stages of the cylce of the seminiferous epithelium with which they were associated. Distributed along the entire length of seminiferous tubules, their number varied significantly during the cycle. Low numbers were found in stages II-IV and XIII of the cycle while high numbers were found in stages IX to XII and XIV-I of the cycle. These observations indicate that the seminiferous epithelium may exert an influence on the population of light cells present in the tubular limiting membrane.


Availability of folates from some foods. Availability of folic acid from seven commonly used Indian foods and from yeast was studied in normal human subjects. The method consisted of measuring urinary excretion of folate after the ingestion of a known amount of food folate. The mean availiability of folic acid from different foods was more than 50%, except from brewer's yeast wherein approximately only 10% of folate was available.


Breast milk composition in Ethiopian and Swedish mothers. I. Vitamin A and beta-carotene. The vitamin A and beta-carotene contents of breast milk were determined at different stages of lactation in three population groups: nonprivileged Ethiopian, privileged Ethiopian, and Swedish mothers. In addition, a fractionation of vitamin A giving the proportion of retinol was performed. The concentrations of retinol-binding protein (RBP) and (in part of the material) beta-carotene and prealbumin in plasma were also measured. The mean concentrations of vitamin A and beta-carotene in the milk from the Swedish mothers (period 0.5 to 6.5 months) were in the range of 40.0 to 53.1 and 16.3 to 20.8 mug/100 ml, respectively. For the privileged Ethiopian mothers (period 0.5 to 3.5 months) the corresponding ranges were 36.2 to 36.4 and 26.2 to 28.1 mug/100 ml and for the nonprivileged Ethiopian mothers (period 0.5 to 6.5 months) 28.1 to 33.1 and 23.9 to 25.6 mug/100 ml. Only the nonprivileged Ethiopian mothers were examined during a later stage of lactation (6.5 to 11.5 and 11.5 to 23.5 months). The concentrations of vitamin A and beta-carotene in their milk showed a downward trend. The proportion of retinyl ester (percentage of total vitamin A content) was significantly higher in the milk of Swedish mothers than in privileged and nonprivileged Ethiopian mothers. In the Swedish mothers retinol constituted 3.5% of the total vitamin A content of the milk; in Ethiopian mothers it was 15 to 30%. Determination of RBP in plasma showed normal values for Swedish mothers and lowered values for Ethiopian mothers--particularly the nonprivileged, in whom 14 of 81 values were below 20 mug/ml. RBP was demonstrated in colostrum, but only in a low concentration (in the order of 5 mug/ml).


Anti-drug-related antibodies in nonthrombocytopenic cardiac patients. Drug-related antibodies (quinidine, hydrochlorothiazide, and digoxin) were studied using the 51Cr platelet lysis test and a recently introduced simplified platelet factor 3 assay in a total of 109 patients admitted to a coronary care unit. Quinidine antibodies were found in 16 (14.7%), hydrochlorothiazide antibodies in six (5.5%) and digoxin antibodies in two (1.8%) of 109 patients. All patients had normal hematologic data, including platelet counts. There was a significantly high incidence of quinidine antibodies in male patients (p less than 0.02), despite the previous report that quinidine-induced purpura was seen predominantly in female patients. Ten patients (9.2%) had antiplatelet antibodies. The simplified platelet factor 3 assay can easily be done in most laboratories and appears as sensitive as the 51Cr platelet lysis test. The high incidence of drug-related or antiplatelet antibodies in hematologically asymptomatic patients may indicate the presence of an insidious, compensated thrombolytic state in many patients.