Accident litigants with neurotic symptoms. Experience gained from an examination of 750 consecutive accident litigants leads to the conclusion that the aetiology of neurotic symptoms after accidents is so complex that diagnostic labels implying single causation give a false and oversimplified picture. Terms such as "compensation neurosis", "traumatic neurosis", "Mediterranean back", "postconcussion syndrome" and many others illustrate preconceived ideas of causation which are in most cases not warranted, and it is recommended that this group of patients be considered under the general label of sufferers from "accident neurosis". The many symptoms which occur are discussed, and it is found that they present in such endless variety, and in varying severity from mild to completely disabling; they do not cluster in any consistent way to justify the delineating of discrete syndromes which are artificial and misleading; their existence confuses rather than clarifies our understanding of these unfortunate people.


Drug-induced depression and attempted suicide. Sixty-eight patients who had attempted suicide were matched with non-suicidal patients with similar diagnoses to assess the extent to which excessive drug ingestion by the suicidal group might have contributed to their behaviour. It was found that the suicidal patients were consuming more drugs, particularly those of a potentially depressing kind. The implications of this finding are discussed.


Effect of dose on antibody response to subunit influenza vaccine. In a group of third-year medical students who were given subunit influenza virus vaccine, the haemagglutination-inhibition (HI) antibody response to A/Victoria/3/75, and the boosting of HI antibody to previously circulating A strains of the Hong Kong subtype were independent of the dosage in the tested range. There was minimal boosting of antibody levels to the Asian strains which circulated during the childhood of the volunteers. The antibody responses to the B/Hong Kong/8/73 component were lower and were dose-related. There was no appreciable increase in the HI geometric mean titre to any of the strains after a second dose.


Patterns of tobacco smoking in Australia. 2. Australian smoking patterns have been surveyed in 1974 and 1976. There appears to be a slight downward trend in male smoking and a slight increase in female smoking. Smoking is more prevalent in the cities than in the country, and among blue collar workers than among white collar workers. Usage of "low tar" cigarettes is also increasing.


A normal pancreatogram in three cases of pancreatic carcinoma. Three patients with carcinoma of the head of the pancreas were examined by endoscopic pancreatography and retrograde cholangiography. In each case the pancreatic duct appeared normal. Abnormalities of the common bile duct were found in each case and are described. The use and value of endoscopic pancreatography and other methods of examination are discussed.


Diagnosis of leprosy in Victoria--a non-endemic area of Australia. There have been at least 70 cases of leprosy in Victoria since 1950; the occurrence of 40 of these in the last seven years indicates that the disease is no longer rare in this State. The diagnosis was delayed in most patients, the average period of time between development of symptoms and diagnosis being 28 months. The most common presentations among these patients emphasize the point that a diagnosis of leprosy should be considered in patients who are suffering either from chronic skin diseases which are atypical and have not responded to therapy, of from localized disturbances of skin sensation.


Rupture of right hemidiaphragm after blunt abdominal trauma (report of six cases). Six cases of ruptured right dome of the diaphragm were seen in a district hospital, and a large metropolitan teaching hospital in the last six years. Diaphragmatic rupture on the right side is rare, but is seen more frequently after blunt abdominal trauma, due to increasing numbers of automobile accidents. Emphasis has been placed on the need for a greater awareness of this condition, which will help in making an early diagnosis. A plea is made for careful initial examination, and simple aids to diagnosis are described. The general plan of management is outlined and a few modifications in operative technique have been suggested.


Zollinger-Ellison syndrome caused by a duodenal wall tumour. An isolated benign duodenal wall gastrinoma is reported. The place of conservative gastrinoma excision versus total gastrectomy is briefly discussed in the light of present knowledge and recent advances in management.


The changing pattern of minor analgesic consumption amongst high school students in Hobart. Analgesic consumption by high school students in the Hobart area appears to have significantly declined between 1970-1972 and 1976. The decline has been greater for females than for males. Whereas previous studies of various sections of the Australian community have shown that consumption by females was significantly higher than consumption by males, this was not found to be the case in the sample surveyed, and nor was any significant difference found in analgesic consumption of different age groups.


Obstruction of the gastrointestinal tract by foreign bodies in adults. Foreign bodies may become impacted because of congenital or acquired narrowing of the gastrointestinal tract or owing to unusual physical characteristics of the ingested material. Active intervention is necessary when impaction is complicated by intestinal obstruction or perforation or when the foreign body is composed of a toxic substance.


Medical aspects of the Granville Rail Disaster. The paper outlines the Granville Rail Disaster incident, and the Sydney Metropolitan Disaster Programme which was operational for the first time. The nature of casualties (their triage, resuscitation and evacuation) is discussed, together with a description of the medical response. Difficulties confronting rescuers are mentioned and conclusions are drawn.


Selective vagotomy for duodenal ulcer: a five-year follow-up. The results for the first 101 consecutive patients who had selective vagotomy and a drainage procedure performed for duodenal ulceration between 1967 and 1971 are presented. Seventy-four patients were followed up for five to nine years, 13 patients were lost to follow-up for part of the five-year period, and 14 patients died during follow-up. Six patients developed recurrent ulcers. Five of these recurrent ulcers were observed in patients in whom the vagotomy was not tested for completeness during the operation; this represents a recurrence rate of 10%. One patient, in whom testing was used at operation, developed a recurrent ulcer; this represents a recurrence rate of 2%. There was a statistically significant difference in the rate of recurrence between the group tested during operation and that not tested.


Postoperative recurrent peptic ulcer: the significance of the Zollinger-Ellison syndrome. Twenty-four patients with postoperative recurrent peptic ulcer, presenting to a teaching hospital over a six-year period, are reviewed. The diagnosis was confirmed by endoscopy or surgery in all cases. Four patients (16-7%) were shown to have the Zollinger-Ellison syndrome and were treated successfully by total gastrectomy. This is a significantly higher incidence of Zollinger-Ellison syndrome than in previous reports. Six patients were treated medically, with one death. In the remainder, an inadequate initial operation was considered to be the cause of recurrence. Reoperation, usually involving complete vagotomy and antrectomy, was performed. There was no mortality in this group, and no patients have had further recurrence. The importance of serum gastrin studies in all patients with recurrent peptic ulcer is emphasized.


The general health questionnaire: a valid index of psychological impairment in Australian populations. In recent years a variety of questionnaires has been used to identify subjects with psychological illness in both community and hospital settings. Most questionnaires, unfortunately, lack of clinical validity, and, to date, none has been validated for an Australian sample. The present study describes a validation of the General Health Questionnaire in a sample of general-practice patients in Sydney, and finds this instrument to be an efficient, reliable, and valid index of non-psychotic psychological impairment.


Sclerosing peritonitis after practolol administration. We have recently managed two patients with sclerosing peritonitis who had undergone a course of practolol but had ceased taking it some months prior to presentation. Publication of these cases will help to assess the extent of this complication and will increase awareness amongst surgeons who may be called upon to treat such cases.


General practitioners in the Western Metropolitan Health Region of Sydney. A comprehensive survey of the number of general practitioners in the Western Metropolitan Health Region of Sydney identified 753 general practitioners with one or more practice locations in the region; this was the equivalent of 711 full-time general practitioners, and represented a general practitioner-population ratio of 1:1533.


Experiments with pindolol (Visken) in healthy volunteers. Several aspects of beta-adrenoreceptor blockade in man can be investigated in healthy volunteers. Beta-adrenoreceptor blocking activity was investigated by measuring the influence on isoprenaline-induced tachycardia and on tachycardia due to exercise on the cycle ergometer. In these experiments pindolol was found to be 20 to 40 times more potent than propranolol. The partial agonist activity of pindolol is responsible for its small influence on heart rate under resting conditions, but probably also for its smaller effect on bronchial tone when compared with propranolol. A comparison of the duration of action of different drugs can be made by studying the effects on exercise-induced tachycardia. Two hours after oral administration, 5 mg of pindolol and 100 mg of propranolol were about equally active. The duration of action of pindolol, however, was clearly longer than that of propranolol. This should allow a single daily dose to be given to most patients for the treatment of hypertension. A comparison of beta-adrenoreceptor blocking activity after oral and intravenous administration provides information on the bioavailability of these drugs. In studies with pindolol the activities measured 2 hours after oral and 75 minutes after intravenous administration were about equal. This is in good agreement with the results of pharmacokinetic studies, which show almost complete absorption and a small first-pass effect of pindolol.


[Cephradine in open heart serugery. Concentrations of cephradine in pericardial exudate and serum after cardiac surgery (author's transl)]. The diffusion of cephradine into the pericardial exudate was measured in 19 patients undergoing heart surgery. Every patient received 2 grams of cephradine (=30 mg/kg) during a 20 minute infusion period, before, during, and after the operation, and than at intervals of 6 hours, together 8 grams per day. The highest mean serum level, 10 minutes after the end of the first injection was 150 microgram/ml and after repeated dosages 102.5 microgram/ml, and at the end of the infusion interval 3.2 microgram/ml in the mean. At the time of opening the pericardium the concentration of the substance in the pericardial exudate, 15, 30, 45 and 60 minutes after finishing the first injection, varied from 4.1 to 38.6 microgram/ml in the average. The postoperative maximum levels were higher than 50 microgram/ml and 6 hours after the respective administrations the levels varied between 12.83 and 15.77 microgram/ml in each case. These high concentrations of cephradine in the pericardial exudate could not be attributed to seepage of blood into the pericardium.-At specific "check points" bacteriological materials were taken. Out of 1168 specimens only 6.7% were bacteriological positive. Drains in wounds, the pleura or the pericardium were sterile in most cases. Intravenous catheters were contaminated only in 1%. However the contamination rate rises with period of storage. The results show that cephradine exhibits good diffusion into the exudate of pericardium. With the chosen dosage the concentrations of the antibiotic in the pericardial exudate are higher than the MIC values of most pathogen bacteria.


[Tick-born encephalitis in southeastern Bavaria (F.R. of Germany) (author's transl)]. In 1976 blood samples from 748 patients were tested for complement fixation antibodies against the virus of tickborne encephalitis. Of these, 38 had antibodies in a serum dilution of 1:8, 18 also in a dilution of 1:32 or higher. Clinical symptoms, laboratory results, time and place of illness are presented in more detailed analysis for 14 cases. From these data, it appears than tick-borne encephalitis is more wide-spread in southeastern Bavaria than has been previously supposed. In most of the cases, tick-borne encephalitis was not suspected because the patients generally did not have a bi-pattern of illness, only 6 of the 14 had a definite history of a tick-bite, and, moreover, atypical features frequently occurred in addition to CNS symptoms. The number of juvenile patients (4 out of 14) was also unexpected. Attention is drawn to the present situation with regard to passive and active immunization.


[Heart size and left ventricular function in coronary artery disease: I. Heart size, exercise tolerance, cardiac output and filling pressures (author's transl)]. The possible relationship between the cardiac volume, as determined radiologically in the supine position in 119 patients with angiographically proven coronary artery disease, and the results of ergometry and balloon catheterization was investigated. There was no relationship between the heart size on the one side and the maximum exercise tolerance and the maximum cardiac output on the other, except for the fact, that these parameters tended to decrease with increasing heart size. This was especially true in patients with angina. The maximum cardiac output of patients with angina was always below the value of patients without angina but comparable heart size. Reduced cardiac output under exercise (exertional cardiac insufficiency) was present in 50% of patients with enlarged hearts but already in 22% of patients with heart volumes in the lower range of normal. The diastolic pulmonary artery pressure, determined under exercise, was the only parameter with a significant relationship to the heart size: The larger the heart size, the higher the diastolic pulmonary artery pressure. On the other hand: the diastolic pulmonary artery pressure at rest was abnormal with significant frequency only, when the heart was enlarged. Our data suggest, that the hemodynamics are determined by 2 factors: Myocardial scarring secondary to infarction and coronary insufficiency (ischemia). Of these two factors only the former influences cardiac size. Therefore, determination of the heart volume helps evaluating the respective role of these two factors in individual cases.


[Heart size and left ventricular function in coronary artery disease. II. Heart volume, coronary morphology and laevocardiogram (author's transl)]. We have investigated the possible relationship between the radiogically determined cardiac volume and the coronary angiogram and laevocardiogram. There was no relationship between cardiac size and coronary angiogram. Independently from the number of coronary vessels involved, we found normal sized hearts in patients without ECG-evidence of myocardial infarction, and enlarged hearts in patients with ECG-evidence of myocardial infarction. There was a significant, though loose relationship between the cardiac volume and the endsystolic and enddiastolic volumes (r=0.73 and 0.55 respectively) and the ejection fraction (r=0.69) as determined by laevocardiography. The critical value of the cardiac size, about which one encounters an increased number of abnormal volume parameters, was the upper boundary of 1-SD. Using this value we found a specifity of 81% and a sensitivity of 74% for the heart volume as a predictor of a pathological ejection fraction. On the other hand, using the upper boundary of 2-SD as a critical value, there was a sensitivity of only 58%, but a specificity of 92%. Only 11% of the patients with a cardiac size in the lower range of normal or below had an ejection fraction below 50%. Therefore the radiologically determined heart size is a simple, in daily practive acceptable method to assess and follow up left ventricular function in coronary patients.


[Sudden death from coronary disease in younger women (author's transl)]. Eleven sudden deaths from coronary disease were studied in women aged 29--44 years. These cases occured between 1971 and 1976 in the Institute for Forensic Medicine, University of Cologne, BRD. Postmortal morphological examinations resulted excessive stenosed coronary arteries caused by arteriosclerosis in all cases, in eight combined with acute obstructing thrombus. Our study group is not representative of the incidence of fatal coronary disease in the community. The prevailing conclusions about influence of sex hormones from oral contraceptives upon the development of arteriosclerosis, hypercoagulability and thrombosis demonstrate contrary evaluation. Our reflections about aetiology and pathogenesis from the pathomorphological findings don't substantiate a proof correlation between coronary disease or coronary thrombosis and oral contraceptions. Many other factors are equal important. The opinion of increased incidence and risk for death from coronary disease in users of oral hormonal contraceptions is not evident for us.


[Lithium-powered cardiac pacemakers. A survey of 3 years' clinical experience (author's transl)]. In addition to the lithium-iodine cell which has been in clinical use since 1972, the following lithium-based power sources for cardiac pacemakers are available: The lithium-silver chromate cell (SAFT), the lithium-thionylchloride-battery (G.T.E.), the lithium-cupric sulfide cell (DuPont) and the lithium-lead iodide cell (Mallory). These batteries differ not only in their energy providing chemical reaction and their components (liquid electrolyte or not), but also in their capacity and discharge characteristics. Out of 244 lithium-powered pacemakers implanted during the past 3 years, 5 pulse generators had to be removed due to electronic circuit failure, whereas battery failure has not been observed up till now. Sensing problems were registered in 8 cases probably due to the specific properties of the entrance filter and entrance resistance of the pacer. In some cases, however, they were caused by poor electrode position. One pacemaker model, powered with the WGL702 cell, frequently gave rise to skin necrosis, Newer models have more favourable dimensions and lower specific weight. The capacity of their batteries is sufficient for middle to long-term stimulation when using current saving electrodes. Because of the well-known advantages of the lithium-cells in comparison to conventional Mallory batteries, together with the favorable clinical results, only lithium-powered pacemakers have been implanted in our hospital since 1977.


[Hemoperfusion with coated activated charcoal for treating acute poisoning by remedies, plant protectants, and fungi. III. Fungi (author's transl)]. Four patients with foudroyant liver dystrophy due to ingestion of fungi of the Amanita phalloides species were treated by hemoperfusion with coated activated charcoal. Three patients survived the poisoning. One patient died in a coma due to hepatic disintegration with cardiac and respiratory insufficiency. One female patient suffering from hemolytic syndrome and acute anuresis due to ingestion of fungi of the Paxillus involutus species recovered completely after treatment of combinated hemodialysis and hemoperfusion. The first hemoperfusion in the patients with Amanita phalloides poisoning were performed two to three days after ingestion of the fungus. At that time there were only traces of amanitines in the blood of one of the surviving patients. These Amanita phalloides toxins were only detected in the first 24-hour urine in the other 3 patients. It is thus not to be expected that toxicologically relevant quanities of the toxins will be eliminated from the blood by hemoperfusion carried out two to three days following ingestion of the fungus, Amanita phalloides. No coherence of restitutio ad integrum and hemoperfusion could be pointed out in the female patients suffering from hemolytic syndrom and anuresis due to Paxillus involutus.


[Extra-cardial rise of the CPK in the screening of urgent diagnostic (among others, a case of anaesthesia induced myoglobinuria and a case of malignant hypertermia) (author's transl)]. Tests are being carried out on 37 patients and healthy volunteers, to differentiate the various, from heart independent, creatin-phosphokinase (CPK) increases, in order to recognize anaesthesia-endangered patients. A rise of the serum-CPK-level, dependent on trauma is insignificant for the anaesthesia. A significant rise of the CPK during a gener al anaesthesia and particularly extreme high values after 24 hours, (example, more than 10 000 U/l) is reason to think of a course of a malignant hyperthermia or myoglobinuria in a subclinical form. Relatives of hyperthermia- or myoglobinuria suspected families are in all cases anaesthesia-endangered, even with a very small rise of CPK-values. The knowledge of these connections is highly important also for internal medical spheres.


[Decholedochoduodenostomy - indications and operative technique (author's transl)]. 21 cases of decholedochoduodenostomy are reported. The reinterventions were necessary because of narrowing of the anastomosis, choledocholithiasis, developement of a blind-sack in the retroduodenal choledochal duct and because of intolerance of the duodenal-biliary reflux. In one case a broncho-biliary fistula was treated. In all cases an ascending cholangitis was observed. The indication for relaparotomy is decided on the basis of the anamnesis. The operative technique for decholedochoduodenostomy is described.


[Bilio-bronchial fistulae caused by rupture of an hydatid cyst of the liver. Experiences with a modified method of operation (author's transl)]. In this study, bilio-bronchial fistulae caused by the rupture of an hydatid cyst of the superior surface of the liver to the bronchi of the middle or lower lobe of the right lung, are discussed. Bilio-bronchial fistulae are treated surgically at one stage, through thorako-abdominal or separate abdominal and thoracic incision in combination. The radical treatment of the hydatid cyst of the liver consists in partial cystectomy and capitonnage, followed by common bile duct drainage. The radical treatment of the thoracic lesions consists in excision of the empyematic sac and lung lobectomy or segmental resection if necessary. The results are compared with those of former surgical management.


[Hyperbaric oxygenation in a large hyperbaric chamber (author's transl)]. Hyperbaric Oxygenation has been used routinely with 503 persons (1100 compressions) in a large walk-in hyperbaric chamber. An optimal interdisciplinary teamwork and mastering of the transportation problems by helicopter is mandatory to make this treatment accessible for patients in distant hospitals as an additional conservative management. In 51 operations under pressure (28 congenital heart disease cases) the luxury oxygenation was a protective measure. The procedure can be done safely with plenty of working time.


[Comparison of the antitussive effect of two different drugs regarding frequency and strength of cough attacks (author's transl)]. The antitussive effect of two different drugs A (Codeine, Phenyltoloxamine) and B (Dihydrocodeine, Remedacen) was compared in a double blind clinical trial by measuring the frequency and strength of cough attacks for 7 hours. The cough attacks were measured by a pressure-monitoring device which was externally fastened to the throat. Drug B suppressed the strenght and frequency for at least 9 hours after application while the effectiveness of drug A lasted only for about 6 hours after application. In any case the respiratory drive was unaffected.


[D-Penicillamin for treatment of sarcoidosis (author's transl)]. The pharmacological qualities of the D-Penicillamin and the data of immunology and especially of the collagenous metabolism of the sarcoidosis justify an investigation of the therapeutical effect of D-Penicillamin. An account is given of six patients who were suffering from sarcoidosis and of whom an effective influence over the X-ray findings was stated after a three months' dose at least. It seems to be a continuous success because after a one-to-three years' obse-vation a relapse has not occurred.


[Medullary carcinoma of the thyroid (author's transl)]. The medullary carcinoma of the thyroid plays a special role among the thyroid carcinomas due to his histiogenesis and endocrinologic behaviour. The symptoms like familiar occurrence, simultaneous pheochromocytoma, calcitonin-production, para-neoplastic syndroms with ACTH-production and the commonly associated diarrhea are discussed. The biological behavior of the tumor is presented reviewing the literature.


The hemodialysis-induced reaction in patients with leukemia. The white blood cell count response was documented in various patients following transfusions of 500 ml of autologous or unrelated donor blood that had been subjected to 10 minutes of dialysis with 15 minutes of stagnation. Patients studied included 1 patient with acute nonlymphocytic (ANLL) and 2 patients with chronic lymphocytic leukemia (CLL). The control group consisted of 4 patients with renal failure. The ANLL patient showed a normal two-phase reaction after administration of donor's blood. It is possible that even under conditions of severe disturbance of hemopoiesis the general dependence on normal humoral regulation remains. The CLL patients showed a marked drop in circulating WBC in the first descending phase of the hemodialysis-induced reaction (HDIR). All blood cell types including lymphocytes and blast cells took part in this decrease of blood count; this suggests a cell-nonspecific effect. It is presumed that leukocytes that leave the circulation do not return into the blood and the procedure may be considered as a form of leukophoresis in vivo, with possible therapeutic value.


Ovarian cancer in children and adolescents: a review of 15 cases. Fifteen patients, admitted between 1961 and 1975, from 8 to 19 years of age, with malignant ovarian tumors were reviewed. The histology was: dysgerminoma in 5, common "epithelial tumor" in 5, immature teratoma in 4, granulosa cell tumor in one. Of the 15 patients, 5 are alive and well, 4 of these had dysgerminoma, 1 had a papillary cystadenocarcinoma. Of 3 patients with dysgerminoma in Stage III, 2 are among the survivors. Dysgerminoma, in contrast with other types of germ cell tumors, may be curable even in advanced stage.


Clinical evaluation of Asaley.

Clinical evaluation of Asaley. Asaley is an L-leucine derivative of sarcolysin which is more active against some rodent tumors. Studies in the USSR demonstrated activity in patients with ovarian and breast carcinoma, Hodgkin's disease, and multiple myeloma. This study in 73 evaluable patients indicated that an appropriate oral dose for patients with adequate bone marrow is 800 mg/M2/day X 4 days at 5-6 week intervals. The most common toxicities were myelosuppression, nausea, and vomiting. Antitumor activity was observed in 2 of 24 evaluable patients with melanoma, and stabilization of previously progressive disease was observed in patients with adenocarcinoma of the colon, multiple myeloma, lymphoma, breast carcinoma, and thyroid carcinoma. Responses were minimal and of short duration but most of the patients had received extensive prior therapy.


Selective iodine imaging using K-edge energies in computerized x-ray tomography. Iodine is commonly used as a contrast material in computerized x-ray tomography. In some cases the determination of the iodine distribution in the image may be prevented by the presence of bone or tissue variations within the tomographic slice. This paper describes a method for quantitative selective imaging of the iodine concentration in the slice. The method employs scans using three heavily filtered x-ray beams, two having mean energies which straddle the iodine K edge (33 keV) and another at a slightly higher energy. The results are independent of tissue and bone over a broad range of projection path lengths. It is shown that, for separation of iodine from one other material, a two-beam K-edge approach requires less integral dose than a two-beam technique at conventional CT energies for slice diameters up to 30 cm. For selective iodine imaging in the presence of more than one other material, the three-spectrum K-edge technique is a necessity. Exposure requirements and beam-hardening corrections are discussed in detail and a computer-simulated CT image generated by the proposed scheme is presented.


A simple source of fluorescent x rays for the study of radiographic imaging systems. The properties of a simple source of fluorescent x rays were investigated with regard to its suitability for the study of radiographic imaging systems. The source, consisting of a diagnostic x-ray tube, fluorescent targets, and filters, was found to yield highly monoenergetic x-ray fluxes with intensity sufficient to allow the speed of medium- and high-speed screen-film systems to be studied as a function of x-ray energy.


Silicon diode detectors used in radiological physics measurements. Part I: Development of an energy compensating shield. Silicon diode detectors have the advantages of high resolution, large signal, and fast response, but lack the flat energy response of the Farmer ion chamber. A study was undertaken to develop a compensating shield for a diode which would make it suitable for use in the spectrum of energies produced by a high-energy radiation beam at depth in a phantom. The energy response of the unshielded diode was quantitated over a range of energies from 18.5 keV to 8 MeV. Shields of different thickness, density, and design were tested experimentally. A partial shield of high-Z material over a diode with miniaturized contacts produced a probe which duplicated the relative dose measurements of the Farmer chamber with less than 1% variation. Typical central axis depth-dose curves and a beam profile, measured with the chamber and the shielded and unshielded probe, are illustrated.


Silicon diode detectors used in radiological physics measurements. Part II: Measurement of dosimetry data for high-energy photons. Initial calibration of a linear accelerator requires physics instruments to measure accurately central axis depth-dose and off-axis data, both in and out of the beam. These data for an 8- MeV unit were first measured using film, a Farmer 0.6-cm3 ion chamber, a 0.3-cm3 ion chamber, and a 0.1-cm3 silicon diode. Both small probes and film gave a high response compared to the Farmer probe, which has a uniform energy response. Measurements with the diode interfaced to an X-Y recorder required only a fraction of the time required with the chambers, minimizing error due to change in machine output, and permitted resolution of isodose lines in the penumbra. However, corrections required at points in depth due to nonuniform energy response of the unshielded diode were laborious. Construction of a partially shielded diode which duplicates the response of the Farmer probe eliminated the necessity for corrections, permitting rapid accumulation of a wide range of depth-dose and off-axis data.


The long-term stability of metallic materials for use in joint endoprostheses. In orthopedic implants, metals are permanently incorporated into bones and tissue. Usually the metals are not in the electrochemical equilibrium state immediately after implantation. The metal oxide forms itself only after hours up to weeks. In the meantime the metal releases ions into the tissue, much more than in the equilibrium state. On the other hand a passive layer can interchange mechanically with bones and implanted components. The resulting destruction of the surface leads equally to an increasing release of ions. As a consequence of these facts, perfect metals for application in implants must have a short repassivation period and mechanically indestructible surface oxides. To what extent the applied metals perform these conditions is tested for the stainless steel type 316 L, the multiphase alloy MP-35 N and TiAIV. A comparison of the rates of corrosion resulting from damage to, or destruction of, the passivating oxide layers, with the rates that can occur in connection with local forms of corrosion, shows that in joint implants, it is merely the repassivation properties of the metals employed that determine the concentration of ions in the tissue.


Energy dependence of correction factors for some low-energy direct-reading pocket dosimeters. The energy dependence for each of five models of low-energy direct-reading pocket dosimeters was characterized through an examination of the exposure correction factors determined over the diagnostic x-ray range (0.4-4.1-mm Al HVL) for many samples of each model. The results of an analysis of variance performed by model on the correction factors are reported as mean correction factors for the x-ray beams evaluated, the relative standard error being less than 0.8% in all cases. Energy-dependence curves for the dosimeter models are given, and their use is described.


The specification and design of a substitute medial collateral ligament. In this paper attempts are made to define the properties necessary for a substitute medial collateral ligament (MCL). The boundaries that envelope the desired load-extension curve of the MCL are extracted from existing research results and are complemented by in vivo experiments on a knee analyzer. A substitute MCL is designed, manufactured, and tested. The element mimics the action of the natural tissue and it produces a load-extension curve that fits within the prescribed boundaries. Proposals for the fixation design and the further testing of the substitute ligament are made. The possibilities for the application of the material as a substitute for other ligaments are discussed.


Effects of red cell shape and orientation on propagation of sound in blood. In this paper, the red blood cell (RBC) is assumed to have an oblate spheroidal shape and the same volume (87 micrometer3) and about the same sphericity index (0.7) as a typical human RBC. The acoustic field is assumed to be either parallel or perpendicular to the axis of symmetry of the spheroid, and a wave equation is formulated for a dilute RBC suspension. Because of the small density difference between the RBC and plasma (about 5%), the assumption of spherical shape of the RBC suffices for computation of the velocity and the scattering of sound in blood. For all practical purposes, scattering of sound in blood follows Rayleigh's law of scattering. However, the viscous absorption coefficient at 1 MHz for a spheroidally shaped RBC oscillating broadside and edgewise to an acoustic field is about 40% and 136%, respectively, of that for a spherically shaped RBC. These results illustrate the significant effects of RBC shape and orientation on the viscous loss of sound energy in blood.


Biological evaluation of biomaterials for cardiovascular applications: some current results. The proper biologic evaluation of biomaterials for blood-contacting applications must include considerations of hemorheologic parameters, species-related differences, and damages to the reticuloendothelial system. Although there are no materials currently available that are completely blood compatible, several smooth-surfaced polymers are quite tolerable in the physiological environment. These include chemically grafted polyacrylamide hydrogels, glow-discharge polymers of silica-free hexamethldisiloxane, and ethyl cellulose perfluorobutyrate.


Radiation dose to the lungs from ventilation studies with 133Xe. The radiation dose to the lungs from 133Xe in lung air is directly proportional to the time integral of 133Xe concentration; i.e., the cumulated concentration in the lungs. Using kinetic models developed to fit clinical observations, we have studied the effect of retention on cumulated concentration in lung air. The models studied were (1) equal exponential washin and washout rate constants, (2) unequal exponential washin and washout rate constants, and  (3) single-compartment washin and two-compartment washout. Our results show that the radiation dose varies greatly with the model chosen. A simplified method for calculating the average dose to the lungs from activity in lung air is presented. Although we have applied this method only to studies where xenon is rebreathed at constant volume and then washed out, the technique can be adapted to other protocols.


Platelet adhesion to solid surfaces. The effects of plasma proteins and substrate wettability. Platelet adhesion tests were performed using protein-free washed pig platelet suspensions in conjunction with a simple open-static method on smooth, well-defined protein-coated glass and polymer surfaces and bare glass and polymer surfaces. A normalization technique was introduced in an attempt to correct day-to-day variations in platelet reactivity. Protein coatings reduced platelet adhesion (to glass as well as polymer surfaces) to such a low level that the platelet density on one protein/substrate combination could not be distinguished from that on any other protein/substrate combination. Specifically, albumin and fibrinogen behaved identically regardless of the substrate on which they were coated. The addition of albumin and gamma-globulin to the platelet-suspension also significantly reduced platelet adhesion to glass surfaces. Whereas the extent of platelet adhesion from protein-free suspensions to bare glass and polymer surfaces depended on their wettability, the presence of specific chemical groups in the proteins, such as (-CONH-), may have an overriding effect on platelet adhesion to solid surfaces.


Radiation from the uranium collimators of the Varian 4-MeV accelerator. The uranium collimator of the Varian 4-MeV accelerator produces a dose rate of 100 mR/h near the collimator opening. It can be decreased to 4% by a 6-mm Lucite shield at the level of the collimator opening. A better solution is a lead glass-mylar (EM) shield which decreases the uranium radiation to less than 3% and also provides better skin sparing during treatment than the open collimator.


On the mechanical testing of some implants and materials. This paper discusses the proliferation of medical devices and focusses its attention on the rapid development of orthopedic implants and the attempts by federal authorities to provide standards and recommended practices. The very important aspect of implant assessment based on mechanical testing is discussed and shown to be completely lacking. Current attempts to maintain quality and safety of orthopedic implants are discussed. One test configuration for femoral components of total hip replacement is offered as an example of methods that should be established to verify a particular design in conjunction with efforts to control material composition.


Design of total hip prosthesis: the femoral stem. This report is a summary of the research carried out in an effort to improve the reliability of total hip replacement procedures. The current state of knowledge of hip mechanics was examined and found adequate in its description of the normal hip, but totally lacking in any but qualitative terms in its description of the diseased hip, or the load transfer between prosthesis and bone in reconstructed hips. The mechanics of the hip joint and femur indicate that the positioning of the femoral head is crucial in achieving a correct balance between muscle force and joint load. Consequently, it is recommended that a great deal more attention be devoted to the positioning of the prosthesis at hip surgery. Experimental and theoretical studies were directed to one aspect of total hip replacement - the design of the femoral stem. Results indicate that all current designs should be adequate if set in acrylic, and provided subsequent bone resorption is small. Further results indicated satisfactory load transfer from a long thick prosthesis stem, fitted without acrylic cement.


Mapping of restriction sites in the attachment site region of bacteriophage lambda. A find structure map of the EcoRI fragment containing the lambda attachment-site region has been constructed. 38 different restriction endonucleases have been employed and 170 sites located in this fragment. In addition, sites in adjacent regions have been determined for several enzymes. Complete cleavage maps of the entire lambda genome have been obtained for endonucleases BglII, BluI, KpnI, SacI, SacII, SalI and XbaI. The strategy employed for mapping included comparison of deletion and substitution mutants, analysis of mixed digests, and detailed analysis of subfragments.


Electron microscopy of DNA: determination of absolute molecular weights and linear density. The molecular lengths of several phage DNA's and one plasmid DNA have been measured and the molecular linear density of double stranded DNA under standard conditions has been determined. This determination was possible since the absolute molecular weight for phi X 174 DNA has become known from sequence work. RF DNA of phi X 174 phage consists of 5375 +/- 20 basepairs equivalent to a molecular weight of (3.558 +/- 0.013) x 10(6) dalton and since the length of this DNA has been determined to be 1.71 +/- 0.02 micrometer the molecular linear density of double stranded DNA prepared for electron microscopy under the conditions described is (2.08 +/- 0.03) x 10(6) dalton micrometer-1. These data have been used to determine the molecular weights of several phage DNA's and of the plasmid DNA PML 21. The latter DNA exhibits a remarkable heterogeneity with respect to its size.


Genetic identification of cloned fragments of bacteriophage T4 DNA and complementation by some clones containing early T4 genes. Bacteriophage T4 DNA containing cytosine has been obtained from cells infected with phage mutant in genes 42, 56, denA and denB. This DNA can be cut by a number of restriction endonucleases. Fragments obtained by digestion of this DNA with EcoRI have been cloned using the vector plasmid pCR1. Clones containing T4 DNA were identified by hybridization with radioactive early and late T4 RNA. A simple marker rescue technique is described for the genetic identification of the cloned T4 fragments. Some of the T4-hybrid plasmids which contain entire T4 genes can complement temperature sensitive and amber mutants of T4.


The ribosomes of Drosophila. Normal and defective ribosome biosynthesis in Drosophila cell cultures. The assembly of proteins and RNA into mature ribosomal subunits has been studied in Drosophila cell cultures by pulse-chase experiments. Pulse labeled rRNA has a transit time of 3 h, while the transfer of ribosomal protein occurs completely within 30 min. Inhibition of protein synthesis by cycloheximide results in an almost immediate cessation of ribosome assembly, a result which indicates that no large pool of free ribosomal proteins exists in the cell. Substituting pre-ribosomal RNA with the analogue 5-fluorouridine (5-FU) results in a cessation of ribosome muturation. Under these conditions at least three large subunit proteins continue to accumulate on pre-existing cytoplasmic subunits, indicating an exchange. A portion of ribosomal subunit proteins synthesized in the presence of 5-FU can be recovered in cytoplasmic subunits once the effect of 5-FU has been reversed. This is most easily interpreted in terms of their stabilization on substituted pre-rRNA within the nucleolus, and subsequent utilization on unsubstituted RNA.


[Electron microscopic demonstration of viruses in the nasal secretion from infants]. Authors examined the nasal excretion of newborn and infant for the demonstration of viruses using negative-stain-electron-microscopic technique. The nasal cavity was rinsed with physiologic saline solution and the latter was examined. The negative stain technique is a relatively quick methode for the demonstration of viruses to support the suspition of the viral aetiology of a disease until serological diagnosis is available. Authors demonstrated Orthomyxoviruses, Adenovieuses, and Herpes-viruses in the nasal cavity.


[The value of the newest results of blood group research in the study of hereditary diseases]. Authors discuss the recent development of chromosome-research, particularly problems concerning gene-localization and the role of blood group research in it. Blood-group Xg and its significance for the construction of the genetic map of human X chromosome and delineation of the pattern of inheritance of the X-linked disorders are described. Results of observations carried out on 178 pairs of twins of similar sexes in order to determine zygozity are shortly reviewed. The DZ : MZ ratio have been found 45 : 55.


[Placental vascular changes in maternal diabetes mellitus]. Uniform pathological changes characteristic for the diabetes mellitus in the placenta were not revealed. In 63 per cent of the 22 cases morphological changes in the small- and middle vessels were observed. The most severe pathological changes were seen in the media in form of concentric fibrosis. It caused narrowing of the lumen, although the intima remained undamaged. It was not possible to detect a correlation between the severity of damage to the placentar vessels and groups described by White.


[Causes of death in cancer patients].

[Causes of death in cancer patients]. Causes of death of 260 tumorous patients autopsied in 1974 were analyzed. Most common causes were inflammation and tumorous and non-tumorous organ insufficiencies; the others, in order of decreasing incidence, massive tumorous dissemination, infarct and haemorrhage. Pneumonia was predominating over the inflammatory causes although peritonitis and sepsis were also not rarely encountered. Death due to inflammation occurred most frequently in cases of myeloid-lymphoid, urogenital and gastro-intestinal tumours and in postoperative states. The incidence of insufficiencies due to tumorous or non-tumorous origin differed but slightly. Of the various organ insufficiencies, massive hepatic metastases, occlusion of the biliary duct and cardiac failure were the most common. In cases of tumors of the small pelvis, compression of the ureters led most often to death. Massive dissemination was observed most of all in breast and ovarian carcinomas. Myeloid-lymphoid tumors led to death through extensive organ infiltration in about one thirds of the cases. After hearth infarction, venous thrombosis was often followed by pulmonary embolism, however, coronary occlusion was also not rare. Death due to haemorrhage originated from acute or chronic ulcers of the gastrointestinal tract or from vascular invasion of tumors in the head and neck regions or from thrombocytopaenia induced by cytostatics.


[Bilateral papillary cystadenoma of the epididymis]. One case of bilateral papillary cystadenoma of the epididymis without the development of Hippel--Lindau disease is reported. This rare, benign tumour should be considered in the differential diagnostics of the enlargment of the epidimdyis in young and middle aged males. Histological picture of the tumour described seems to evidence, that it originates from the ductuli efferentes.


[Unusual cases of maternal death caused by amniotic fluid embolism]. Five cases of amnion fluid embolism are reported. In the first case the cause of the death was the obstruction of the lung-vessels. In the lung tissue calcium embolia could also been detected. In the second case embolization started--at unruptured amnionsac--with ecclampsia-like convulsions, later it was followed by coagulopathia. In the third case amnion fluid embolism was complicated by coagulopathia. In the fourth case in addition to amnion fluid embolism endometritis purulenta complicated by endotoxinaemia and coagulopathia were also present. In all four cases rupture of the uterus was revealed. In the fifth case amnion fluid embolism developed without the rupture of the uterus. At the autopsy of cases of maternal death the possibility of amnion fluid embolism should always be considered. Although macroscopic changes seen at amnion fluid embolism are not pathognomic, when clinical and pathological symptoms of haemorrhagic diathesis are present, there always arises the suspicion of amnion fluid embolism. Since lungs are relatively resistant to putrefaction amnion fluid embolism in optimal cases can be diagnosed histologically even in exhumated lung specimen. Reliable diagnosis of amnion fluid embolism in cases of sudden maternal death gives possibility to exclude medical negligence.


[Clinicopathological experiences in oncologic diseases]. Authors on the base of the study of clinical history and autopsy protocols of 260 patients died in 1974 in the Institute of Oncology of Hungary from oncological diseases established, that the proportion of decised younger 30 years and the number of those older 70 years increased in comparison with 1964. In the autopsy material the most frequent were tumours of the lymphoid-myeloid system, then followed the frequency of the tumours of the breast and urogenital tract, the least frequent were the tumours of the gastrointestinal tract. Number of the primary multiplex tumours during the last 10 years increased from 1,5 per cent to 5,5 per cent. In 23,5 per cent of the cases medica negligence or that of the patient itself could be proved. The clinical and the pathological diagnosis did not correlate in 35,9 per cent of the cases studied. The most common unrecognized complication was pneumonia. Surgical treatment appeared to be most effective in cases of the cancer of the breast. The average age of the patients suriving for a longer period after the operation was 62,8 years, which seems to evidence, that prognosis of oncological diseases in older ages is better than in younger. In comparison with the data in 1964 number of cases with five year surviving increased by 3,7 per cent. This was striking first of all in cases of lymphoid-myeloid tumours.


[Vascular lesions in mucosal leishmaniasis]. In 20 our of 52 cases of mucosal- leshmaniasis vascular lesions of the exudative type were observed. Arteria and vena were equally involved. These lesions are characterized by oedematous imbibition of the vascular wall, formation of fibrinoid and fibrotic proliferation of the intima. In addition fibrin thrombus and inflammatory vascula lesions were also detected. In the development of vascular lesions authors emphasize the role of immunological processes in which immune-complexes and/or membrane-reactive autoantibodies have an importance.


Abnormality of a thiamine-requiring enzyme in patients with Wernicke-Korsakoff syndrome. We studied a thiamine-requiring enzyme in cultured cells from four patients with the Wernicke-Korsakoff syndrome to determine whether these patients have a genetic predilection to thiamine deficiency. Transketolase in fibroblasts from the patients with the syndrome bound thiamine pyrophosphate less avidly than control lines. The apparent Km for thiamine pyrophosphate was 195 +/- 31 micron for transketolase in extracts of the patients' cells as compared to 16 +/- 2 micron in six control lines (means +/- S.E.M.: P less than 0.001). The ranges were 146 to 281 micron for the patients and 12 to 20 micron for the controls. The abnormality in transketolase persisted through serial passages in tissue culture in cells grown in medium containing excess thiamine and no ethanol, indicating that the aberrations were genetic rather than dietary. The abnormality of transketolase in this syndrome would presumably be clinically unimportant if the diet was adequate. These patients appear to have deleterious inborn enzymatic abnormalities of a type originally postulated by Garrod.


Effect of low-dose propantheline on food-stimulated gastric acid secretion: comparison with an "optimal effective dose" and interaction with cimetidine. We evaluated the widely held notion that anticholinergic drugs must be used in near toxic doses to inhibit gastric acid secretion effectively. Nine patients with duodenal ulcer were studied after a low dose (15 mg) and after a near toxic dose (averaging 48 mg) of the anticholinergic, propantheline. Mean (+/- S.E.) inhibition of food-stimulated acid secretion was identical with the two doses of propantheline: 29 +/- 10 and 29 +/- 11 per cent, respectively. In addition, when 15 mg of propantheline was combined with the histamine H2-receptor antagonist, cimetidine, acid secretion was suppressed to a greater degree than with either drug alone. A low dose of propantheline is as effective as a near toxic dose in suppressing food-stimulated acid secretion and augments the inhibitory effect of cimetidine.


[S-Methylmethionine content in plant and animal tissues and stability during storage]. The content of S-methylmethionine SMM in the extracts of 53 plant and 13 animal products by means of ion exchange clean-up procedure followed by two dimensional thin layer chromatography has been investigated. It was found that the richest plant SMM sources (in mg/100 g) are cabbage (53-104), kohlrabi (81-110), turnip (51-72), tomatoes (45-83), celery (38-78), leeks (66-75), garlic-leafs (44-64), beet (22-37), raspberries (27) and strawberries (14-25). The animal products are poor in SMM. The control of the plants rich in SMM during a storage for 6 months (autumn, winter) in the soil showed average decreases as follows: celery 38%, kohlrabi 39%, turnip 43%, and leeks 32%. A storage of cabbage with uncontrolled temperature resulted in a decrease of 62%, in a storehouse (0-1 degrees C) of 34% SMM.


[The biological value of fats].

[The biological value of fats]. Integral characteristics of animal development (weight increase, maturing of biological systems) used to date are not adequate to the requirements of detailed biological evaluation of dietary fats. The linoleic acid content in the dietary fat and the eicosatrienoic acid - eicosatetraenoic acid ratio (20:3/20:4 = HOLMAN coefficient) in the organism alone are also inadequate criteria. For this reason, the author attempted to establish metabolism-relevant law-like relationships between the fatty acid pattern of dietary fats and tissue lipids.


[The effect of solids from pig manure as food components in rations for fat bulls, heifers and calves on the crude nutrient and amino acid content of the longissimus dorsi muscle]. In continuation of our studies on the use of pig manure in ruminant feeding, the present paper is concerned with the investigation of the effects of solids from semi-liquid pig manure as ration components on the crude nutrient and amino-acid contents of the longissimus dorsi muscles of bulls, heifers and calves from experimental and control groups each including 6 animals. There was no difference in the crude protein, pure protein and crude ash contents between the control and the experimental groups. On the contrary, the data on dry matter and crude fat in the longissimus dorsi muscle were significantly lower in the experimental animals than in the control animals. This difference is explained by the fact that the energy content of the experimental ration (containing solids from semi-liquid pig manure) is lower than that of the standard ration. The results obtained from the analysis for 17 amino acids show that the change in amino-acid content of the muscle protein is not determined by the use of solids from semi-liquid pig manure.


[Amino acid composition of the unresorbed peptide fractions of the distal part of the small intestine in rats. II. Feeding of field-bean protein isolate with and without the addition of dialdehyde starch and of protein texturates from it]. Rats were fed diets containing 20% protein in the form of casein, protein isolate from sunflower seeds, protein isolate from field beans, model protein texturate made from field-bean protein isolate or model protein texturate made from field-bean protein isolate treated with dialdehyde starch and a nitrogenfree diet. The content in the distal small intestine of the rats was collected 3 hours after feeding, and the amino-acid compositions of the TCA-precipitable and TCA-soluble peptides (after separation of free amino acids) of the content were studied. The comparison of the amino-acid compositions of the two peptide fractions with the respective dietary protein showed no agreement. On the contrary, the comparison of the amino-acid compositions of the two peptide fractions determined after protein-free diet with those found after protein ingestion were in good agreement, independently of the kind of dietary protein. The comparison of the two peptide fractions with one another revealed an increased degree of proteolytic decomposition of the TCA-soluble peptides. As compared to the other protein-containing diets and to the protein-free diet, diets containing field-bean protein caused an increase of TCA-precipitable peptides and an increase of glycine in both fractions. This was also observed in model protein texturates containing only 30% field-bean protein. Treatment with dialdehyde starch produces certain alterations of the basic amino acids and their accumulation in the fractions of undigested peptide.


[Enzymatic examination of citrate-isocitrate accumulation in yeasts]. The activities of the enzymes citrate synthase, aconitate hydratase, isocitrate dehydrogenase and isocitrate lyase in cell homogenates of n-paraffin grown citrate plus isocitrate accumulating yeasts (C. lipolytica high rate accumulating strain and C. guilliermondii low rate accumulating strain) were determined. It is shown that the activities of the enzymes decline after transition from tropho- to idiophase and remain constant with exception of isocitrate lyase which diminishes slowly. The decline in activity of the isocitrate lyase was greatest in the cells of C. guilliermondii. It is discussed that the differences of the enzymatic activities in the tropho- and idiophase, resp. may be artefacts due to changes in the structure of cellular envelope, but that the decline of lyase activity in the idiophase could be one factor determining the rate of citric- and isocitric acid overproduction. The diminishing of isocitrate lyase in the course of idiophase is interpreted as example of a disappearing enzyme no further needed for normal function of the cells.


[Effect of protein content and thyroid hormone on body composition in growing rats]. The effects of an isocaloric control diet of high-protein and low-protein diets (in which protein amounted to 16, 62 and 2% of total calorie content, respectively) with and without simultaneous administration of Thyreotom or methylthiouracil on total body composition have been studied in growing male Wistar rats. In spite of higher average Kcal intake (per day and 100 g of body weight), the rats on the high-protein diet were weighing less than the control animals at the end of the experiment. As compared to the control animals, the rats on the high-protein diet as well as those on the low-protein diet showed a greater relative weight of the thyroid gland. The protein percentage of the body was not significantly increased by an increase in protein supply; likewise, it was not significantly reduced by a decrease in protein supply. The body fat content was by 2/3 lower in the rats on the lowprotein diet than in the control animals. This difference was statistically significant. Thyroid hormones (1 mug liothyronine + 4 mug levothyroxine/100 g body weight, administered orally for 3 weeks) produced a slight increase of body protein in the rats on the high-protein diet; they increased it significantly in the rats on the low-protein diet. Body fat was correspondingly reduced. Methylthiouracil reduces the body fat content in the control animals and in the rats on the high-protein diet; it increased the body fat content in the rats on  the low-protein diet. Our  results confirm the partial findings of human pathology and demonstrate clearly that nutritional diseases, especially protein deficiency, worsen considerably in case of concomitant disorders of thyroid hormone metabolism.


Protein, amino acid contents and protein efficiency ratio of Egyptian buffalo meat under different biological conditions. The effect of age, sex, season and cut variations on the protein, amino acids contents and protein efficiency ratio (P.E.R.) of Egyptian Buffalo meat was studied in 128 samples. Statistical analysis for the data obtained showed significant difference at 0.01 level for protein in relation to cut (abdomen and thigh, respectively), male in relation to season and dry season in relation to sex. There is also significant difference at 0.05 level in case of green season in relation to sex. Protein shows a significant difference at 0.1 level due to sex variation. There is a difference in the amino acids content of young and old animals during dry season in both cuts. Young animals show higher values than old ones in most of the amino acids investigated. There is also an obvious difference in the amino acids during green season between male and female animals, and also between both cuts. P.E.R. of Egyptian Buffalo meat as 10% protein level ranges between 3.02 and 2.35 according to seasonal, cut and age variations.


[Heavy metals in food--analytical control in Austria]. Cadmium, lead, mercury and arsenic were determined by means of atomic absorption spectrophotometry. The procedures used for digestion, extraction and concentration and the measuring technique are described. Nearly 1500 determinations of lead, 1200 determinations of mercury and arsenic, respectively, and 800 determinations of cadmium in foods permitted to calculate (taking into account the food habits) the dietary loads on the Austrian population. The loads per individual and month were: 5.9 mg lead (infants aged from 1--12 months: 0.18--2.5 mg), 2.02 mg cadmium (infants, 0.04--0.61 mg), 0.2 mg mercury and 0.9 mg arsenic. Whereas the cadmium intake was somewhat greater than the maximum value established by the FAO/WHO (1.6--2.0 mg/individual and month), the intakes of lead, mercury and arsenic were considerably lower than the maximum values.


[Contribution to the migration and toxicology of 2-(2'-hydroxy-3'-tert-butyl-5'-methylpheny)-5-chlorobenzotriazole]. Studies on the use of an ultraviolet-absorbing agent based on hydroxybenzotriazole for commodities of low-pressure and high-pressure polyethylene and polypropylene show that the migration is only slight in aqueous and acidic foods and in foodstuffs with low alcohol content. Sunflower oil, n-heptane (as a fat-stimulating test solution) and 50% ethanol as test solutions yielded higher migration values. Gas chromatographic, polarographic and thin-layer chromatographic methods were used to determine the ultraviolet-absorbing agent. Concerns about a possible photosensitizing effect of 2-(2'-hydroxy-3'-tert-butyl-5'-methylphenyl)-5-chlorobenzotriazole were experimentally tested and turned out to be unfounded. From the viewpoint of safety, there are no contraindications to the use of polyolefines in packing materials for most foods. As to fat-containing and strongly alcoholic foodstuffs, the authorization should be conditioned on the circumstances of use.


[Method for the control of (rat) liver functions by means of 14C-acetate for the toxicological analysis of foreign substances]. The authors present a test procedure which permits to obtain, by means of a single carbon-14-labelled compound as structural element in a series of essential substances, a survey of important fields of liver function. Special attention was paid to cholesterol. Methodical studies resulted in an optimization of the application under in vivo and in vitro conditions, and of the isolation of carbon-14-labelled cholesterol, ester cholesterol and glucose as well as of carbon-14-labelled phospholipids, triglycerides, bile acids, proteins and nucleic acids as groups. A comparison of the experimental techniques demonstrated the advantages of in vivo application. The method and its validity are illustrated by an example (DDT). Its use in studies on various active principles will be dealt with in future communications.


Location and bond type of intermolecular contacts in the polymerisation of haemoglobin S. The solubility of 14 hybrid haemoglobins composed of alpha chains with a single substitution and beta chains from HbS was compared with that of sickle haemoglobin. A substantial reduction in the insolubility of native deoxyhaemoglobin S results from surface mutations in certain regions of the alpha chain while changes in other areas have no effect. Also, the chemical nature of the substitution is decisive an points to the type of intermolecular bonding at several loci.


Biochemistry of the bacterial catabolism of aromatic compounds in anaerobic environments. Methods of aerobic degradation of aromatic compounds in the biosphere are well understood, but it is only relatively recently that it has been shown how some bacteria can also degrade these substrates in the absence of molecular oxygen. This occurs by photometabolism (Athiorhodaceae), nitrate respiration (Pseudomonas and Moraxella sp.) and methanogenic fermentation (a consortium) in which the benzene nucleus is first reduced and then cleaved by hydrolysis to yield aliphatic acids for cell growth. These methods may be used by microbial communities to catabolise man-made pollutants.


Nature of lethality of t mutations in embryos. Mutations in the genes of the T complex in mice can lead to death at various stages of embryogenesis. It has been suggested that the T genes specify cell surface antigens which are essential for normal organisation of certain cells within the embryo. But, there is now evidence that at least some of these T complex mutations are simply generalised cell lethals.


Behavioral frequency: relationship between conditioning and extinction. Operant conditioning data pertaining to bar pressing in rats show that (1) different schedules of reinforcement during training lead to differential behavior during extinction as measured by number of responses, but not as measured by number of response units and (2) animals show a response frequency/unit of time which is directly proportional to the response frequency/unit of time acquired during training.


Effects of pentazocine on the intestine and biliary tract of the rabbit in vitro. Pentazocine impairs peristaltic activity and relaxes longitudinal muscle in the colon and in the ileum. The circular coat is excited in the colon, while in the ileum pentazocine exhibits both excitatory and inhibitory effects depending on the concentration employed. Pentazocine does not exert a spasmogenic effect in the smooth muscle of terminal bile duct but instead reduces the electrically-induced contraction. The effect of pentazocine does not seem to involve endogenous acetylcholine or catecholamine release.


Effects of diazepines and barbiturates on hippocampal recurrent inhibition. The effects of two diazepines (diazepam and Ro 11-7800) and 3 barbiturates (thiamylal, pentobarbitol and phenobarbital) on GABA-mediated recurrent inhibition were assessed on single hippocampal pyramidal cells and on population spikes using extracellular recording techniques. Recurrent inhibition was evoked in spontaneously active CA1 pyramidal cells by stimulation of the fimbria or the alveus with single shocks. Microiontophoretic application of Ro 11-7800 or systemic application of diazepines or barbiturates resulted in an increase of the duration of the inhibition and in a concomitant depression of the spontaneous firing in most neurones tested. When the firing rates were kept constant artificially, using excitant amino acids, a prolongation of the recurrent inhibition was observed with barbiturates but not with diazepines. The duration of the inhibition, which was assessed from CA1 population spikes elicited by double shocks to the fimbria, was prolonged following systemic application of diazepines or barbiturates. It is concluded that both diazepines and barbiturates are able to potentiate GABAergic recurrent inhibition in the hippocampus. The demonstration of this effect appears to depend critically on certain experimental conditions.


Studies on the characterization and inhibition of rat brain phenylethanolamine N-methyltransferase. The existence of phenylethanolamine N-methyltransferase (PNMT) activity in the rat brain and spinal cord was confirmed using both substrate specificity and selective inhibitors of the adrenal enzyme as biochemical tools. The enzyme was not generally localized throughout the central nervous system but was found primarily in the brain stem and spinal cord with lesser amounts occurring in the midbrain. No significant PNMT activity was found in markedly inhibited both in vitro and in vivo by low concentrations (doses) of SK&F 64139, a potent inhibitor of the adrenal enzyme.


Effects of simple indoles, noradrenaline, nicotine, and tyramine on action potential and contractility of the isolated guinea-pig papillary muscle. 1. Simultaneous recordings of both the transmembrane action potential and the contractions were made in isolated electrically driven papillary muscles of the guinea pig in order to compare the effects of 6-methoxyindole (6-MOI), 3-methylindole (3-MI) and 5-methylindole (5-MI) with those of noradrenaline (1.2 - 10(-6) M), nicotine (2 - 10(-5) M), and tyramine (5.8 - 10(-6) M). 2. Noradrenaline, nicotine, tyramine and 6-MOI (5.4 - 10(-4) M) enhanced the contractility whilst 3-MI (3.8 and 7.8 - 10(-4) M) and 5-MI (1.9 and 3.8 - 10(-4) M) had only irregular effects. The active compounds shortened and time-to-peak tension and increased the rate of relaxation. 3. The duration of the action potential was prolonged by noradrenaline, nicotine, and tyramine, but shortened by 3-MI, 5-MI, and 6-MOI. 4. The results showed that the effect of drugs on the action potential are not necessarily linked to those on contractility.


Localization of d-tubocurarine in rat liver lysosomes. Lysosomal uptake, biliary excretion and displacement by quinacrine in vivo. In the rat d-tubocurarine is taken up by the liver and excreted in bile. A fraction of the drug is taken up very rapidly by lysosomes. This lysosomal localization of the drug was demonstrated by purification of Triton WR 1339 loaded lysosomes ('tritosomes') on a sucrose density gradient by flotation; 3H-labeled d-tubocurarine was accumulated in the same fractions as acid phosphatase activity. Lysosome-bound d-tubocurarine is not available for biliary excretion and remains in the lysosomes even when the cytosolic concentration decreases to very low levels. The biliary excretion rate was linearly related to the amount of d-tubocurarine present in the cytosol. Lysosomal uptake of d-tubocurarine was decreased or prevented by the basic drug quinacrine in vivo. The lysosomal storage of d-tubocurarine is discussed in relation to its relevance for the clinical use of this and related drugs.


Structural identification of p-dioxane-2-one as the major urinary metabolite of p-dioxane. Analysis by gas chromatography (GC) of the volatile compounds present in the urine from rats administered dioxane, a hepatic carcinogen to this species, revealed a major metabolite. The appearance of the metabolite was pH-dependent, undetectable at high pH; reacidification of the urine sample brought about the reappearance of the metabolite. The amount excreted was dose-dependent and time-dependent, reaching a maximum between 20 and 28 h after dioxane administration. Diethylene glycol administered to rats gave rise to the same metabolite. When isolated and purified from lyophilized urine by preparative GC, the metabolite exhibited an intense carbonyl band at 1750 cm-1 in the infrared spectrum. Nuclear magnetic resonance spectrum showed two triplets and one singlet with equal intensity at delta 3.85, 4.48 and 4.37, respectively. GC-mass spectrometric studies indicated a parent peak at m/e 102. The metabolite was identified as p-dioxane-2-one. Synthetic reference compound exhibited identical IR, NMR, and GC-mass spectra as the metabolite. The tentative pathway and the biological significance of dioxane metabolism are discussed.


[Reactions of neurons of the secondary somatosensory cortex of awake cats to electrocutaneous and acoustic stimulation]. In chronic experiments on alert cats the discharges of neurons in the secondary projection zone of the somato-sensory cortex to click and electrical stimulation of contralateral paw were investigated. 57% of neurons responded to "specific" stimulation by increasing the discharge frequency, 18%--by weakening or stopping the background activity, while 25% did not react at all. 30% of neurons responded by activation to the "non-specific" stimulation (click), 25%--by inhibition and 45% were unresponsive. An investigation of intersensory convergence by sending signals from different analyzer systems showed that bimodal responses are peculiar to most neurons (55%) of this zone. 18% of neurons with a response only to the "specific" or "non-specific" stimuli were found. It is suggested that polysensory convergence on the neurones of the somato-sensory cortex is important for the cortical area in the process of closing of conditioned connections.


[Intramodal and interaural specificity of the human slow auditory evoked potential]. Parameters of slow auditory evoked potentials (SAEPs) evoked by monotonal monaural stimuli were compared with those evoked by a series of tone stimuli of different frequencies. In one version of polytonal stimulation the side of sound application was alternately varied. In the case of polytonal stimulation the amplitude of SAEPs was consistently greater than that in the case of monotonal stimulation. The maximal amplitudes were obtained during alternating polytonal stimulation. In the case of polytonal stimulation, together with the amplitude increase, a regular decrease in its variability was noticed. SAEPs recorded during polytonal stimulation were also characterized by greater peak-latency values. It is concluded that SAEPs possess intramodal and interaural specific properties. It is proved that the tonotopic and bilaterally symmetric organization of SAEP generating system is better manifested at lower sound intensities. The data demonstrate that neuron populations of the SAEP generating system which perceive slightly different sound stimuli overlap each other more than those which perceive more different sounds. The data on intramodal and interaural specificity of SAEP are discussed from the point of view of extralemniscal origin of this potential.


[Responses of neurons of the posterior ventral and ventrolateral thalamic nuclei to stimulation of the reticular nucleus of the thalamus]. Responses of 72 ventral posterior (VP) and 116 ventral lateral (VL) thalamic neurons to electrical stimulation of the thalamic reticular nucleus were studied in cats immobilized with d-tubocurarine. All investigated neurons were identified according to their responses to stimulation of the first somatosensory (SI), first motor (MI) cortical zones, medial lemniscus (LM) and nucleus interpositus (n. INP) of cerebellum. It was shown that to reticular nucleus stimulation responded predominantly those VP and VL neurons (73.7% and 86.2%, respectively) which responded to stimulation of MI and n. NIP. 19.8% of VL neurons responded to R stimulation with antidromic spike (latency 0.5-2.0 ms) and 46.6% with orthodromic excitation. The latency of 23% of orthodromic excitatory responses was 0.9-3.5 ms and of 77% of them 4.0-21.0 ms. 19.8% of VL neurons responded to R stimulation with inhibition. Among registered IPSP only one could be considered as monosynaptic (the latency 1.0 ms). A suggestion is made that most of R neurons are excitatory and that inhibition developing in VL neurons in response to R stimulation is mainly connected with the excitation of inhibitory interneurons located outside R.


[Transthalamic conduction of visual impulses into the cortex and subcortical portions of the turtle forebrain]. Thalamic structures relaying impulses originating from optic stimulation of the retina and electric stimulation of the tectum on the way to the general cortex, hyperstriatum dorsal ventricular ridge and striatum were studied in turtles Emys orbicularis. Anodal polarization of the n. rotundus temporarily, and the lesion of this nucleus irreversibly, suppressed the main negative component of responses evoked by tectal stimulation and light flashes in the dorsal ventricular ridge without affecting them in the general cortex. Polarization and lesions of the lateral thalamic region, including nucleus geniculatum lateralis produced an opposite effect. A conditioning single stimulation of the tectum or n. rotundus suppressed flash-evoked potentials in the hyperstriatum. However evoked potentials and single unit responses appeared following stimulation of the lateral thalamic region. They exhibited blocking interactions with the tectum-evoked responses. A conclusion is made that in the turtle the main pathways conducting visual information to the cortex and hyperstriatum are different: in the former case it is relayed in the lateral geniculatum region in the latter--in n. rotundus, although an overlap of the projections in dorsal ventricular ridge and striatum can be suggested.


[Activation of reticulospinal neurons of the medulla oblongata by pyramidal fiber collaterals]. The responses of medullar reticulospinal neurons evoked by collaterals of pyramidal fibres were investigated in cats anesthetized with nembutal (40 mg/kg) or mixture of chloralose (45 mg/kg) and nembutal (15 mg/kg). Experiments were performed after preliminary electrolytic destruction of contralateral red nucleus and section of ipsilateral dorsolateral funiculus in C4. It was shown that pre- and postsynaptic effects evoked in neurons of gigantocellular nucleus by stimulation of cortex and DLF are mediated by collaterals of pyramidal fibres. Only excitatory responses were recorded from reticulospinal neurons after stimulation of DLF. The analysis of EPSPs had showed that they could be evoked by collaterals of both fast and slow pyramidal fibres.


[Activity of propriospinal neurons in cats during the scratch reflex]. In the thalamic cats immobilized with flaxedil, the tactile stimulation of the pinna evoked fictitious scratching, i.e. rhythmical activity of the hindlimb motoneurons with a pattern of discharge typical of the actual scratching. Activity of propriospinal neurons from the segments C1--C2 and Th4--Th7 was recorded during such scratching. The neurons were identified by the antidromic response to L1 stimulation. Most neurons did not respond to the pinna stimulation, but some neurons did. They were tonically active during fictitious scratching. The neurons from cervical segments responded also to some other peripheral stimuli, but neurons from thoracic segments did not. Their activity could be inhibited by stimulation of the contralateral pinna. A role of propriospinal neurons in the activation of the spinal mechanisms of scratching is discussed.


[Neuronal organization of ganglia in the lumbar region of the cat sympathetic chain]. Neuronal organization of the isolated III--VI ganglia in the lumbar sympathetic chain of the cat was studied by means of intracellular recording. Most of the ganglionic neurons (66%) receive synaptic inputs simultaneously from sympathetic B1-, B2- and C-preganglionic fibres (conduction velocity 12.0 +/- 0.7; 4.4 +/- 0.3 and 1.0 +/- 0.1 m/s respectively). The rest of neurons are activated only by fast-conducting B1- and B2-fibres (24%) or only by slow-conducting C-fibres (10%). The main preganglionic input to the ganglionic neurons comes through the white rami of the rostral segments, the less effective inputs--through the other ones. A part of neurons receive preganglionic C-fibres coming into the ganglia through the grey rami.


[Changes in the electroretinogram and concentration or rhodopsin in the Hunter strain of rats during development of hereditary retinal degeneration]. Electroretinographic changes as well as rhodopsin content in the isolated retina and the eye cup in Hunter rats were studied during inherited retinal degeneration. The concentration of rhodopsin in the eye cup increases for the first 45 days after birth and then decreases slowly; the visual pigment concentration in the retina reaches its maximum by the 25th day and drops abruptly after the 35th day. The amplitude of the electroretinographic b-wave evoked by near-threshold and saturating stimuli decreases evenly till 35th day. After this day the threshold drastically increases and a-wave disappears. Thus, the 35th day is crucial in the degeneration process. The possible role played by abnormal rhodopsin metabolism in the changes observed is discussed.


[Functional features of the locomotor muscles of the locust]. The ultrastructure of muscle fibres, membrane electrical constants and synaptic membrane responses to microapplication of l-glutamate were investigated in longitudinal flight muscle and flexor tibia of Locusta migratoria migratorioides. The sarcomers of the flight muscle (fast) were smaller then those of the leg muscle (slow). The effective resistances (Ro) of the flight and leg muscles were (2.25 +/- 0.54)-10(5) omega and (1.65 +/- 0.57) X 10(5) omega. The specific resistance (Rm), space constant (tau) and time constant (lambda) in the same muscles were 774 +/- 106 omega-cm and 2583 +/- 119 omega-cm-2; 7.3 +/- 1.7 ms and 17.5 +/- 1.1 ms; 093 +/- 0.22 mm and 1.98 +/- 0.42 mm. When l-glutamate was applied iontophoretically to muscle fibres depolarization was recorded only in localized parts of the membrane. Microapplication of acetylcholine to intact and denervated muscle fibres of the slow leg muscle was uneffective. It is suggested that l-glutamic acid is the excitatory transmitter both in slow and fast insect muscles.


[2 types of neuromuscular junction in the pharyngeal retractor muscle of snails]. The pharyngeal retractor muscle of Helix lucorum is innervated by two symmetrical nerves which contain axons of two types forming myoneural junctions with the muscle cells. Type I junctions correspond to thick axons. These axon terminals which contain a large number of spherical, clear vesicles (41 +/- 5 nm) and a smaller number of dense-cored vesicles (67 +/- 3 nm) make contacts mainly with noncontractile sarcoplasmic processes of muscle cells. Type II junctions correspond to thin axons containing many of granules. Their axon terminals contact with contractile parts of muscle cells and contain a heterogenous population of vesicles: small spherical clear vesicles (44 +/- 2 nm), dense-cored vesicles and numerous irregularly outlined granules with fine-granular content (135 +/- 5 nm). Space between muscle cell is usually wide (50 nm and more) with the exception of sarcoplasmic processes where the gap may be less than 10 nm.


[Identification of sodium channels in vitro]. The membrane fraction isolated from cattle brain and vagal nerve was treated by ultrasonic irradiation in the presence of 22Na. It was shown that 22Na was trapped in vesicles formed from sonicated membranes in an osmotically active forms and slowly released into a nonradioactive solution. The efflux of 22Na from vesicles was studied in the presence and in the absence of substances which change the sodium conductance of excitable membranes. The local anesthetics (procaine, dibucaine) and tetrodotoxin at concentrations blocking electrical excitation in vivo decreased the sodium efflux from the vesicles. Veratrine, an activator of sodium channels, increased this efflux. The results are interpretated as an indication of the presence of functionally active sodium channels in the isolated membrane fragments.


[Effect of electrical stimulation of nodes of Ranvier on the rate of sodium channel modification by batrachotoxin under conditions of potential fixation]. Voltage clamp experiments were carried out on Ranvier nodes treated with steroidal alkaloid batrachotoxin (BTX). It is shown that the electric stimulation of voltage clamped Ranvier node with depolarizing pulses strongly increases the rate of BTX-Na channel interaction providing that two conditions take place simultaneously: sodium channels are not inactivated at the holding potential and applied pulses are large enough to activate Na channels. It is supposed that BTX interacts only with open sodium channels and that BTX-channel reaction is reversible. The electric stimulation is the way to obtain a marked fraction of modified channels in experiments even with low BTX concentrations (100--500 mM) and to achieve an equilibrium for BTX-Na channels reaction for a short time.


Biochemistry of drugs XXIII. Substance with antineoplastic acitivity LX. Pharmacokinetics of cis-beta-4-pentoxybenzoyl-beta-bromoacrylic acid (cis: Br, H)-3H (Penberol-3H). After oral administration of Penberol-3H to mice with mammary gland adenocarcinoma HK, within 4 days 50% of the administered radioactivity was excreted in the urine, and 36% in the faeces. In dogs the excretion rates were slower. It was found that after oral administration of Penberol-3H to rats, radioactivity was excreted in the bile. After oral administration of Penberol-3H to mice with mammary gland adenocarcinoma, high specific radioactivities (per gram of tissue) were found in the liver, kidneys, lungs, and ovaries. Besides, it was found that after oral administration of Penberol-3H to nursing female rats the radioactivity was little eliminated in the milk, and in pregnant females its penetration into the fetuses was negligible.


Effect of cyclophosphamide on the course of cutaneous wound healing. The healing process of cutaneous wounds has been followed with the aid of mechanical tests, autoradiographic investigation of fibroblastic reaction in the wound and method of electron microscopy. Cyclophosphamide has been found not to have any substantial effect on the favorable course of healing of the surgical wound, hence, surgical intervention combined with postoperative administration of Cyclophosphamide does not jeopardize the healing process.


Comparative investigation of DNA from mouse and Ehrlich ascites tumor cells. Mouse DNA and DNA of Ehrlich ascites tumor have been comparatively studied in the search for changes in DNA during tumor progression. No differences were found in kinetics of homologous (mouse X mouse) and heterologous (mouse X tumor) DNA reassociation; in thermal stability of homologous and heterologous duplexes of repeated, unique and satellite DNA; in percentage of hybridization with mouse liver heterogenous nuclear RNA; in thermal stability of the RNA.DNA hybrids. The negative results suggest that the considerable evolution of transplantable tumors (both in biological properties and in karyotype) has not been accompanied by alterations of the genome which could be detected by the now available methods of molecular hybridization for studying DNA divergence. In the light of the results obtained the functions ascribed to the mouse satellite DNA are discussed.


Recovery from x-ray induced damage in human cells grown in culture. Cells from an established human cell-line, NHIK 3025, originally derived from an early stage of cancer of the cervix, were tested for recovery capacity when irradiated with X-rays under aerobic (equilibrated with air) and extremely hypoxic conditions (O2 content less than 4 ppm). The dose-response curve obtained under aerobic conditions had a D0-value of 130 rads and an extrapolation number of 3.8. The corresponding curve obtained with a first dose exceeding that of the shoulder region of the survival curve followed 3 hours later by graded second doses, had a D0-value of 130 rads and extrapolation number 2.2. The curve obtained by measuring the survival after two equal doses of 330 rads, each with variable time intervals between the doses, showed a time dependent radiosensitivity. The dose-response curve obtained by irradiating the cells under extremely hypoxic conditions was well fitted by an exponential line up to about 2500 rads followed by a downward bend. Recovery from sublethal damage was not observed in split-dose experiments where the total doses were less than 2500 rads. For a total dose of 4200 rads, however, a split-dose effect was observed (SDR = 1.6). This split-dose effect is probably not due to Elkind repair, but is rather a consequence of the technique used.


Cellular evaluation of hypersensitivity to 2,4-dinitrochlorobenzene. A suitable modification of the "skin window" method makes it possible to evaluate hypersensitivity reaction to 2,4-dinitrochlorobenzene at cellular level. Probands are sensitized by epicutaneous application of 0.2 ml of 1% solution of the tested substance, and after 14 days 1 drop of this solution is applied in the same manner on a freshly scraped area of the "skin window". An imprint preparation is taken 48 hours later and examined microscopically. Presence of lymphoid elements, eosinophils and basophils points to a normally developed hypersensitivity reaction. Presence at the same time of rather great amounts of large monocytogenic macrophages and neutrophilic granulocytes is an expression of an unspecific inflammatory reaction taking a normal course. Suitability of the described procedure for routine application is discussed.


Chromosomal characteristics and non-random distribution of sister chromatid exchanges in lymphoblastoid cell lines isolated from acute leukemias. Serial cytogenetic characteristics of four lymphoblastoid cell lines derived from the peripheral blood of four patients with acute leukemia are presented, including G and C banding techniques and the analysis of sister chromatid exchanges by means of FPG technique. One of these lines turned into predominantly diploid although originally pseudodiploid, while the other three changed from diploid to heteroploid ones during prolonged cultivation, with the appearance of a marker chromosome in one of them. The mean number of sister chromatid exchanges per mitosis (9.6) did not differ from the control value obtained in short-term cultivations of lymphocytes of healthy subjects. All lines showed a significantly increased number of sister chromatid exchanges in the B group chromosomes. The contribution of FPG technique for the study of cell kinetics is briefly discussed.


Cytologic diagnosis of malignant melanoma. Cytology in malignant melanoma of the skin is a useful method, which alone yields in many cases enough diagnostic informations for a therapeutical approach. It is of a special importance in cases with marked anisocytosis of cells and with large, sometimes polynuclear cells and with cells with melanotic pigment. In cases with middle-sized apigmented cells of epitheloid appearance it should be always completed by biopsy, which, in these cases predominates over cytology. Combination of both methods brings a more substantial elucidation of diagnosis.


Estimation of StilbostatR treatment efficiency in breast cancer by thermography. Administration of Stilbostat to postmenopasual women with advanced breast cancer markedly improved the clinical state in about 65% of the cases and concomitantly decreased the cutaneous thermic values at the level of the lesions showing a tendency to equalize the values recorded for the symmetrical healthy cutaneous zones. The thermographic test is proposed as a means of estimating the Stilbostat treatment efficiency in breast cancer.


Phenacetin abuse and chronic pyelonephritis. A history of phenacetin abuse has been found almost three times more frequently among subjects diagnosed on clinical and functional grounds as suffering from chronic pyelonephritis than among those suffering from other renal diseases or among non-renal controls. The chronic pyelonephritis in subjects admitting phenacetin abuse has been usually characterized by a more frequent intense bacteriuria and leucocyturia, by a slightly more frequent haematuria, history of renal colic, presence of stones and more rapid downhill course of glomerular filtration rate than in subjects without phenacetin abuse. A sterile lesion also without any past evidence of infection was observed only in subjects with the heaviest analgesic abuse. The discontinuation of the abuse in 5 subjects led to an improvement of the renal function.


Insulin resistance in uremia: amino acid metabolism. After infusion of 250 ml of essential L-amino acids, plasma levels of alpha-amino nitrogen (alpha-AN2) in six chronic renal failure (CRF) patients were not different from those in six carefully matched control (CON) subjects. Plasma insulin increments increased significantly within both groups but were higher in the CRF group (p less than 0.05 at 40 min, p less than 0.005 at 55 min). Growth hormone levels were also higher in the CRF group. Previous studies have shown delayed clearance of plasma alpha-AN2 after casein hydrolysate infusion, despite similarly increased insulin and growth hormone levels in CRF patients. We conclude that essential amino acids are probably more easily metabolized than casein hydrolysate in uremic subjects, but that normal metabolism occurs at the expense of higher plasma levels of insulin and growth hormone.


Hereditary xanthinuria: report on three patients and short review of the literature. Three patients with hereditary xanthinuria are presented and the pertinent literature is reviewed. In two siblings the disease has been asymptomatic; in the third urolithiasis has developed. Xanthine stone formation is the clinical hallmark of the disease. Hereditary xanthinuria seems to be relatively prevalent in Lebanon.


[Cholecystosis].

[Cholecystosis]. Cholecystosis conditions include those diseases of the gallbladder whose aetiopathogenesis is to be sought in a hyperplasia of the tissues making up the cholecystic wall (hyperplastic forms) and in an overload of this wall on the part of organic substances or minerals such as lipides or calcium salts (thesaurismosic forms). After discussing the classification, pathological anatomy, aetiopathogenesis, frequency, symptomatology, laboratory and radiological examinations, prognosis complications and treatment of these conditions, a personal series of 36 surgically treated cholecystoses is reported.


[Study of suprarenal cysts. Apropos of a case of cystic lymphagioma of the adrenal glands]. Following a review of the literature on the incidence and characteristics of suprarenal cysts, the case of a young woman who was suffering from bland urinary symptomatology is reported. On the basis of anatomopathological study, the case was classified as a cystic lymphangioma of the suprarenal gland arising on a malformative base.


[Surgical treatment of dermo-hypodermic sclerosis and varicose ulcer by Martorell's method]. A surgical therapy model for dermohypodermic sclerosis and varicose ulcer of the lower extremities is presented. This consists of extending the method described by Martorell in 1955 to cases  of inveterate ulcer. The pre-, intra- and post-operative colour diagrams and figures presented show the validity of the method without superseding lengthier and more complex methods.


[Recurrent varices of the lower limbs. Etiologic and clinico-therapeutic study]. The latest findings in varicose relapses of the lower extremities are described, and the most significant bibliographic data discussed. The most frequent causes, the anatomo-topographical distribution and the causal therapy are examined. It is also point out that recurrent varices occur much less frequently than some years ago, the reason being knowledge of the disease's aetiology and hence of the most rational, radical treatment for it. In presenting 25 operations, 15 of them for post-operative recurrence and 10 for recurrences following sclerosing therapy, it is pointed out that out of 518 cases of varicose veins operated on in the Department since 1971, no case of varicose recurrence has ever been encountered. This is attributed to the eclecticism and rigour of the surgical technique. Stress is laid on the words of Martinet and Tubiana in 1950 "...treatment of varicose veins is far from being as simple as many believe...". Treatment must in fact be chosen case by case.


[Duodenogastric reflux and stress ulcer]. Duodenogastric reflux in 14 patients in an intensive care unit was compared with that in 12 healthy controls. In addition, intragastric bromsulphalein concentration was measured up to 60 minutes after intravenous administration. Reflux was much more frequent in the intensive-care patients and correlated with the incidence of gastric erosions and stress ulcers. Reflux is apparently one of three factors (in addition to ischaemia and HCl) which synergistically lead to stress-induced lesions of the gastric mucosa.


[Problems in emergency surgery: acute mesenteric vascular occlusion]. Twenty-one cases of acute mesenteric occlusion are presented. Stress is laid on the difficulty of reaching a diagnosis in time to enable disobstruction to be carried out. In the reported series, diagnosis was established 1-8 days after the onset of symptoms. When radical surgery was performed (extensive resection occasionally coupled with right hemicolectomy), postoperative mortality was high and transit and nutritional problems brought about by the shortness of the residual gut were encountered.