Clinical trial methodology in intestinal parasitic diseases. The high prevalence of intestinal parasitic infections as an index of underdevelopment, especially in tropical countries, is related to poverty, poor housing, lack of sanitation, malnutrition, and ignorance. The effects are lowered work capacity, physical and mental retardation, leading to recurrences and exacerbations of the parasitism and malnutrition. The most prevalent parasites, methods of detection by specific tests in patients in clinical trials involving antiparasitic drugs are dealt with. How and by whom investigations of new drugs should be undertaken, the need for a basic knowledge of parasitology and techniques of the discipline, of biostatistics, and use of such controls as randomized allotment to treatment groups, placebo administration, and double-blind assessments are emphasized. The justification for undertaking an evaluation of an antiparasitic drug is predicated on the demonstration of safety in exhaustive in vitro and animal studies and of the drug's potential superiority as to efficacy and lower incidence of unwanted side effects, as compared with existing agents. Tolerance and dose-range studies should be conducted in male adult hospitalized patients under close supervision. The evaluation of amebicides in clinical trials, as well as of anthelmintics, is considered in terms of differentiation and reproductive habits of specific causative agents and tests for detecting their elimination to determine improvement under drug therapy. The problem of reinfection, particuarly of nonhospitalized patients under the adverse conditions of life, is stressed.


Sources of information on drug usage in Sweden. Based on sales statistics, prescription habits and figures, interviews, and, in certain instances, on determinations of drug plasma levels, various aspects of drug usage in Sweden are examined. The working of the drug regulatory agency in Sweden is elucidated against the background of the above sources from which drug usage information is obtained.


The background pattern of drug usage in Australia. The pattern of drug usage by urban populations has been studied in two typical Australian cities: Traralgon, Victoria, and Sydney, New South Wales. The study, lasting 1 year, involved questioning of 10% of the residents in households selected by random sampling and records of pharmacists. The questions related to state of health, recurrent or chronic disability, and drug exposures during 2 wk preceding the interview. Figures obtained from the Pharmaceutical Benefit Scheme (a system of partial federal subsidy) and the Morbidity Survey of the Royal Australasian College of General Practitioners showed Australians to be near the top of the world's drug takers, in comparison for example with Americans: between 6 and 7 prescriptions per capita in Australia and between 4 and 5 prescriptions in the United States in 1973. The consumption of over-the-counter drugs (OTC) was estimated from the Commonwealth Statistician's figures by subtracting the expenditure for prescription drugs from the total annual chemist sales--$A450,000,000. This represents a cost of $A33.85 for every man, woman, and child. Of this amount $A19.07 was spent for OTC drugs, analgesics and cough suppressants being the two largest items. Roughly 60% of Australians average two or more doses of analgesics per day, with some patients consuming 12 or more doses a day. An association between this high consumption of analgesics and an alarming incidence of iatrogenic disease--analgesic nephropathy and gastrointestinal hemorrhage--is postulated. It is concluded that this level of drug usage must be symptomatic of underlying stresses and pressures of urban society in that country, along with a cultural factor of ready acceptance of the social use of drugs.


Patterns and problems of drug consumption in a developing country. Delayed and sometimes total lack of communications, lower standards of medical care, low physician: population ratio, absence of monitoring systems affect all phases of drug consumption in developing countries--from procedures for introducing a new drug to its marketing on a broad scale, and ultimate decline. The number of prescriptions and the choice of drug are determined only partly by physicians. Such other factors as medicaments furnished by the government either free or at a small charge, the type of health service, accessibility to paramedical and nonmedical advice, as well as hard-sell marketing practices, often through the mass media, tend to set the pattern of drug usage. The practice of drug storming in "home pharmacies", a phenomenon surveyed by the author, is described and the reasons for it analyzed. In general, the categories of drugs (e.g., antibiotics, cardiovascular, analgesics) consumed are the same in the rest of Europe, the United States, and Latin America. Among the minor tranquilizers, the consumption of meprobamate has risen by about a third, chlordiazepoxide markedly, while phenobarbital consumption has remained about the same from 1969 to 1973. This is said to illustrate the pattern of an upward curve in consumption of a new drug, and the displacement of an old one. The overall rise of these drugs during this period was 72.1% in Hungary. Similar surveys are reported for oral hypoglycemic and antiarrhythmic drugs. Of hypotensive drugs, rauwolfia usage has declined and methyldopa has increased by over 200%.


Culture, morbidity, and the effects of drugs. In the evaluation of drug efficacy, despite the customary device of randomization, regional differences of prevalence of a given disease, unique culturally determined practices in treatment, and differential tolerances to side effects are complicating factors in transcultural pharmacology that must be taken into account in the interpretation of efficacy and toxicity. This thesis is documented by illustrations from psychiatric practice, e.g., prevalence and morbidity of alcoholism, cultural differences as to prevalence, diagnosis, and symptomatology of schizophrenia, even to the point of widely discrepant diagnosis of a given patient, depending upon whether the examination was done by an American or British psychiatrist. Similar differences concerning the existence of disease entities other than psychiatric are cited, e.g., hepatic insufficiently considered common in some Latin populations; low blood pressure a recognized and treatable condition in Eastern Europe. The incidence of side effects from the same drug may also vary in different cultures, making the interpretation of their significance difficult, and cross-cultural comparisons hazardous. To avoid some of these pitfalls, it is essential to recognize (1) the many complexities inherent in trials involving differing cultures and (2) to design the studies insofar as possible to include measurement of population variables.


Variations in disease prevalence in the Americas. Data are presented from North American and Latin American countries of the leading causes of death and death rates, demonstrating the sharp differences based on social and economic development of these respective countries. Whereas ischemic heart disease and malignant neoplasms head the list of deaths in the United States and Canada, infective and parasitic diseases of the gut, with diarrhea very common, are the principal causes of death in Latin America. Nutritional deficiency, the most important contributory cause associated with infections and diarrhea, accounts for the very high infant mortality rate in the latter countries. These pathologic conditions have a direct relationship to the degree of social and economic level of development in Latin America, and constitute a complex public health problem of enormous proportions.


How study of geographic epidemiology of disease can help in detection of adverse drug reactions. The geographic epidemiology of adverse drug reactions can often help in their recognition and in pinpointing the responsible drug. Since different countries often introduce new drugs at varying periods of time and they achieve varying degrees of popularity and use, this information may sometimes aid the epidemiologist in the search for the etiology of unwanted drug effects. Some examples where geography helped unravel the story behind certain adverse drug reactions are presented.


Drug regulation in the United Kingdom.

Drug regulation in the United Kingdom. The British system under the Medicines Act by which new drug applications are evaluated is described in a step-by-step manner from submission of application to the issuance of a clinical trial certificate by the licensing authority. At the end of a period by clinical trials the submission is brought back for a product license. Once a drug is marketed it falls within the purview of the adverse reaction monitoring group of the Committee on Safety of Medicines (CSM). A recent innovation is "monitored release", by which, for a period of time after marketing, case reports are submitted by the pharmaceutical company to the CSM. The advantages of the British system are: (1) the final licensing decisions being made by the academic members of the Committee means that they are insulated from commercial and political pressures, and are additionally reached without undue delay; (2) academic members are not permitted to be retained as consultants to the industry on a long-term basis; (3) evaluation solely on British studies is not obligatory--foreign studies are also acceptable. Weakness in the system are: (1) recruitment of people experienced in pharmacology and therapeutics is difficult; (2) there is an inordinate work load on the academic members of the Main Committee and Subcommittees. Importance of an effective monitoring in the postmarketing stage is emphasized, because the long-term judgement must necessarily be based on wide experience in the field. The multiplication of the same of similar drugs is deplored, and innovative efforts in the quest for new drugs, especially for rare diseases, are to be encouraged.


Regulatory differences and similarities: systems in Japan. The historic steps that led up to the present federal drug regulations in the United States are outlined as a background to the development of the current drug regulatory system in Japan, consisting of the procedures for approval of new drugs, of double-brand naming, by which the same drug under different names can be sold as ethical or over-the-counter (OTC). The more recent provisions for re-evaluation of drugs, the mechanism for monitoring adverse reactions, and the dissemination of the collected information are described. The prescription habits of physicians, the influence of the health insurance systems on these, and the strikingly high level of drug consumption in Japan, as compared with those in other industrial countries, are discussed and illustrated graphically.


Drug evaluation, educational system, and clinical pharmacologic training in a small country. The need for clinical pharmacology as an integral part of medical training is emphasized. The lack of a formal system of educating candidates in this discipline in a small country with limited means of personnel and funds has to be compensated for by close cooperation among practicing physicians, clinical pharmacologists in universities and some hospitals, industry technologists, and the personnel serving on national drug regulation committees. The system of drug regulation in Denmark and its tangential contribution to educating the younger clinical pharmacologists are described. The efficiency as well as the limitations of the system are assessed.


A completely absorbed oral preparation of digoxin. Digoxin absorption was studied in healthy volunteers by determination of peak plasma concentrations, areas under plasma concentration curves, and urinary excretion after single-dose administration. By comparison with an aqueous solution, increased rate and extent of absorption occurred from experimental soft gelatin formulations of digoxin in solution. Enhanced bioavailability of the capsules was not affected by altered volume of contained solvent. Digoxin was considerably better absorbed from capsules than from tablets of moderately high dissolution rate. Mean percentage intestinal absorption was 75% from tablet and 97% from capsules. Reduced between-subject variability accompanied the enhanced absorption from capsules.


Kinetics of high-dose intravenous morphine in cardiac surgery patients. Ten patients received 1.0 mg/kg of morphine sulfate by constant-rate intravenous infusion at 5 mg/min over 9 to 27 min. Multiple arterial blood samples were drawn during the first 30 to 151 min after termination of the infusion, prior to institution of cardiopulmonary bypass. Postinfusion plasma concentrations were fitted by computer to biexponential functions consistent with a 2-compartment open pharmacokinetic model. Mean (+/- SE) pharmacokinetic parameters were: volume of central compartment, 0.09 +/- 0.03 L/kg; total apparent volume of distribution, 1.02 +/- 0.09 L/kg; distribution T 1/2, 0.90 +/- 0.09 min; apparent elimination T 1/2, 137 +/- 14 min; total clearance, 378 +/- 63 ml/min. Thus distribution of morphine is very rapid, but the apparent volume of distribution is only slightly larger than body weight, suggesting limited tissue uptake. Since apparent elimination T 1/2s are similar to those reported after smaller doses, evidence of saturable or capacity-linked elimination is lacking. Total clearances, representing mainly hepatic clearance, averaged about 25% of hepatic blood flow, suggesting clinically important first-pass metabolism of oral morphine.


Kinetics of the oral antiarrhythmic lidocaine congener, tocainide. Tocainide, a primary amine analogue of lidocaine, is effective against some experimental and clinical arrhythmias. Its pharmacokinetic behavior was studied in 6 healthy male subjects. Peak blood levels (CB max) and area under the blood concentration-time curve (AUC) were linearly related to dose with slopes of 0.0067 mcg/ml and 6 min mcg/ml per milligram of dose, respectively. Renal clearance of tocainide averaged 59 ml/min when urinary pH was uncontrolled or acidified, while it was reduced to 13 ml/min during intense sodium bicarbonate loading. Blood levels following intravenous infusion were well described by a 2-compartment open model with a volume of the central compartment of 0.92 L/kg. The t 1/2 beta was 11 hr and total body clearance was 166 ml/min. Loo-Riegelman analysis of the absorption rate did not allow unequivocal assignment of an "order" to the absorption process. Bioavailability approached 100%. Administration of drug 5 min after a test meal suppressed CB max 40% but minimally affected AUC. Approximately 50% of the drug was found to be plasma protein bound at clinically effective concentrations.


Effects of dextroamphetamine on psychomotor skills. Twelve healthy male volunteers were given 0, 5, 10, 15 mg/70 kg dextroamphetamine orally in a randomized double-blind fashion. Blood pressure increased linearly with dose while heart rate was unchanged. Although selected individual tests of stance stability and motor function improved in a dose-related fashion, a generalized improvement in performance was not found. Delayed Auditory Feedback (DAF) failed to show improvement in mental performance after dextroamphetamine.


Absorption of pyrvinium pamoate.

Absorption of pyrvinium pamoate. Pyrvinium pamoate, tablets and suspension, was administered as single 350-mg doses to 12 healthy male volunteers to determine whether there had been any systemic absorption. Six subjects received tablets and 6 received suspension on the first day; on day 8, subjects received the other dose form. Up to 4 days after administration there was no evidence of drug in blood and urine by spectroflorometric assay. Metabolic studies in rats showed minute quantities of drug in the liver and plasma but not of any metabolites.


Plasma concentration of edrophonium in man. The plasma concentration of edrophonium was measured in man after intravenous administration. In 5 patients, the clearance of edrophonium from the circulation during the 1-hr period of sampling was invariably resolved into 2 exponential components. An initial rapid phase of elimination from plasma (T/2 = 0.54 TO 1.92 Min) was followed by a much slower decline (T/2 = 24.23 to 45.00 Min), corresponding to the fall in concentration between 10 and 60 min. In parallel experiments in the rat, the clearance of 14C-edrophonium was resolved into 3 exponential components, although the final component could not be reliably defined until 1 to 3 hr after intravenous injection. It is suggested that the rapid fall in the plasma concentration of edrophonium in both species is not dependent on metabolism or excretion, but is due to the rapid uptake of the drug by the liver and kidneys.


PATER: a program for parenthood diagnosis. Spectacular progress has been made within the last 20 years in the knowledge of the human polymorphism. These data, observed on a father-mother-child triplet provides aid to the decision for the parenthood diagnosis for either the purpose of forensic medicine as the validation of data files in genetic research. This work gives an algorithm of parenthood diagnosis which achieve logical verifications and various calculating while occupying very little place in central memory. We propose a tool for decision-making, the exclusion percentage and we determine the most efficient sequence having the least cost to use these systems sequentially and to stop the verification by a given decision threshold.


An off-line data processing system for biochemistry profiling based on a 2K programmable calculator. An off-line data processing system based on a Hewlett Packard 2K programmable calculator to be used with a biochemistry profiling system is described. The program is in two sections. A Data Acquisition phase calculates results from Auto Analyser II peak heights after corrections for drift and stores them on magnetic tape cassettes. Quality control statistics are produced. A Reporting phase types the profile results on self-adhesive pre-printed labels to be attached to the test-request form and also prepares a laboratory record sheet. The system is routinely used to process up to 2000 peak heights per day. Non-profile heights may also be read using this program.


On-line computer processing of pressure data from cardiac catheterizations. A flexible program system for on-line analysis of pressure data from cardiac catheterizations is described. The programs are implemented on an IBM 1800 computer, equipped with remote oscilloscope/keyboard terminals. The current computer system can handle any combination of up to 4 pressure signals. During catheterization, measurement specifications (i.e. calibration levels or sites of pressure recordings) are entered via the keyboard immediately before each recording. As an option the whole expected measurement sequence may be stored on disk before the catheterization starts. This method will minimize the necessary interaction with the computer when the same catheterization procedure is used on several occasions. Changes from the predetermined scheme may, however, be undertaken before each recording to meet with unexpected events that may arise during the catheterization. After computer detection of calibration levels, the recorded signals are digitized during 20 seconds and analysed beat-by-beat. Calculated values are averaged and presented on the terminal oscilloscope in tabular and/or graphic form. The waveform analysis performed by the program system is validated in a statistical comparison between manually and automatically computed values.


A computer program suitable for fitting linear models when the dependent variable is dichotomous, polichotomous or censored survival and non-linear models when the dependent variable is quantitative. Given a set of measurements of s explanatory variables corresponding to each experimental unit, a computer program, whose methodological background can be found in [2] has been written in FORTRAN IV language in order to perform regression analyses when the dependent variable is: (i) dichotomous; (ii) polichotomous; (iii) censored survival. In the two former the Cox's [6] linear logistic models are used while in the third one it has been resorted to the models suggested by Feigl and Zelen [8]. The statistical estimation procedure is maximum likelihood and among the different algorithms developed to reach this goal, the one published by Van der Voort and Dorpema [3], has been utilized. Furthermore, when the dependent variable is quantitative, the program is suitable to fit any function non-linear in the parameters; the pertinent function and its first and second derivatives must be provided by the user. In the present version, implemented on a Univac 1106 machine, the program fits directly the Gompertz function.


An automated laboratory control system: collection and analysis of behavioral and electro-physiological data. A system of man-machine interactive PDP-11 assembly language programs is described which presents stimuli to a subject and records and analyzes behavioral and evoked potential data. The system was designed for researchers with no knowledge of computer programming and enables the user to create complicated sequences of stimulus presentations ("trials") and sequences of successive trials ("runs"), with no new programming required. The system is written for DEC.s DECLAB 11/40 system.


Quantitative radiocardiography in major pulmonary thromboembolism. Cardiac index (CI) and pulmonary blood volume index (PVBI) were measured by quantitative radiocardiographic studies using radioactive 113mindium and a scintillation probe in 37 patients with confirmed major pulmonary thromboembolism. The mean PBVI was 185 +/- 11 ml/sq m (SE) and was significantly less than normal (310 +/- 5 ml/sq m [SE]; P less than 0.001). Six patients with major pulmonary thromboembilism had a PBVI within the normal range (262 to 358 ml/sq m; mean +/- 2 SD), and the mean pulmonary vascular occlusion was 21 percent in these patients. Eighteen patients (49 percent) died, and the most significant correlate of mortality was CI, which was depressed (less than 2.7 L/min/sq m) in all but two. Twenty-three serial determinations of pulmonary blood volume (PBV) ranging from 1 to 18 days after the initial study showed a mean increase in PBV of 27 ml/day in ten survivors. Quantitative radiocardiographic studies provide a means of diagnosing major pulmonary thromboembolism by measuring decreases in PBVI; it can assess the magnitude of major pulmonary thromboembolism and can assess CI and, thereby, predict risk of mortality; and it provides a means of following the resolution rate of major pulmonary thromboembolism.


Radionuclidic lung-imaging procedures in the assessment of injury due to ammonia inhalation. Clinical, physiologic, and bronchoscopic findings in a young man with acute injury of the respiratory tract due to inhalation of ammonia are described. Six months later, the patient's pulmonary function was reassessed by three radionuclidic lung-imaging procedures, which first revealed the sites and extent of the persisting obstructive disease processes. The diagnostic accuracy of the initial findings with radioactive xenon and aerosol were verified by the results of repeated bronchoscopic examination, bronchographic studies, standard pulmonary function tests, and lung-imaging procedures.


Heart block complicating acute inferior wall myocardial infarction. Heart block was noted in 60 (35 complete and 25 second-degree) of 410 patients with acute inferior wall myocardial infarction. This group with heart block was compared to a control group of 30 patients with acute inferior wall infarction without heart block. The incidences of prior myocardial infarction and hypertension, in addition to the highest level of serum creatine phosphokinase and a maximum degree of ST-segment elevation in the inferior leads, were all greater in patients with heart block, as compared to the controls. The incidences of various complications, including dizziness and syncope, transient hypotension, cardiogenic shock, and congestive heart failure, were also higher in the group with heart block, while sinus nodal distrubances and atrial arrhythmias occurred with equal frequency. The mortality in those with heart block was 28 percent compared to 13 percent for the control. It is concluded that patients with heart block complicating acute inferior myocardial infarction have a greater amount of myocardial necrosis, a higher incidence of complications, and a higher mortality. Insertion of a temporary pacemaker should be considered when  specific indications are present and not routinely.


Lesions of conduction tissue complicating aortic valvular replacement. A pathologic study of the cardiac conduction system was performed in 57 patients who died within 30 days after aortic valvular replacement. Histologically, there were old and recent lesions present in 34 (60 percent) and 43 (75 percent) of the patients, respectively. Old lesions did not show meaningful correlation with preoperative electrocardiograms. Although nontraumatic recent lesions were rarely the cause of postoperative abnormal cardiac conduction, traumatic lesions were frequently associated with loss of sinus mechanism. The main cause of trauma to the major cardiac conduction tissue was injury by sutures. The short membranous septum predisposed to injury, while the configuration of the left ventricular outflow tract was not a significant factor in injury. Traumatic lesions of the cardiac conduction tissue were more common in subjects with bicuspid than tricuspid aortic valves.


Incidence and significance of pleural effusion after abdominal surgery. Two hundred patients who had undergone abdominal surgery received bilateral decubitus chest roentgenograms between 48 and 72 hours after surgery to evaluate the incidence of pleural effusion after abdominal surgery. Ninety-seven (49 percent) had some pleural fluid visible on the x-ray films. In 50 patients the thickness of the fluid was less than 4 mm on the decubitus film; in 26, it was between 4 mm and 10 mm; and in 21, it was greater than 10 mm. The incidence of pleural effusions was higher after upper-abdominal surgery, in patients with postoperative atelectasis, on the side on which the surgery was performed, and in patients with free abdominal fluid. Thoracocentesis was performed on 20 patients, and in 16 patients the effusions were exudates. All of the effusions resolved without specific therapy except one. The pleural fluid in this patient was characterized by a low pH (6.93) and positive culture for Staphylococcus aureus. Small pleural effusions are common after abdominal surgery, and most resolve spontaneously within a few days.


Living cytology: A new diagnostic technique for malignant pleural effusions. The efficacy of a new tissue-culture technique for the diagnosis of malignant pleural effusions was contrasted with conventional cytologic methods. The new technique is based on the ability of the tissue-culture medium to transform mesothelial cells into fibroblasts while not sustaining lymphoreticular cells. Against a background of fibroblasts, islets of adenocarcinoma are easily identified. Of 20 patients with pleural effusions and solid tumors, the tissue-culture technique correctly diagnosed eight (40 percent), compated to seven (35 percent) for conventional cytologic methods. Of 27 pleural effusions in patients without malignant neoplasms, there was only one probable false-positive.


Congenital tricuspid insufficiency. Definition and review. Simple congenital tricuspid insufficiency (CTI) has, up to now, been loosely included with the larger Ebstein's anomaly (EA) group. Certain pathologic and clinical features of CTI deserve definition and a place apart from EA. A review of the literature has produced 20 clinical cases for analysis to which we add two cases successfully treated surgically. The high mortality in the neonatal age group (14 of 14) continues to be a formidable challenge, but the older survivors (2 of 8) would appear to have better prospects, based on our limited experience.


Sites of entrance block and impulse formation in intermittent atrioventricular junctional parasystole. The Wenckebach phenomenon of entrance block in intermittent atrioventricular junctional parasystole is reported for the first time in a 40-year-old woman. In this case the presence of dual pathways in the atrioventricular junction is demonstrated. One of them is a pathway without conduction disturbance. The other is a pathway containing both the ectopic focus and the site of second-degree entrance block. This site is located a considerably long distance above the focus. Entrance block occurs also at some site below the ectopic focus, which is a part of the pathway containing the focus. It is suggested that entrance block in this lower site might exist during the whole ectopic cycle.


Ventriculography and coronary arteriography in the acutely III patient. Complications, extent of coronary arterial disease, and abnormalities of left ventricular function. Of 99 patients who underwent "emergency" diagnostic studies, 82 had "unstable angina" (group A), 15 had recent myocardial infarction (group B), and two had intractable congestive heart failure due to acute mitral regurgitation (group C). Two cardiac and two local complications occurred either during the procedure or during the following 48 hours. There were no deaths or myocardial infarctions. Ten (12 percent) patients of group A had "normal" coronary arteries and normal left ventricular function; 13, 26 and 33 patients had one, two, and three coronary arteries involved, respectively. Those with three-vessel disease had a significantly higher left ventricular end-diastolic pressure (LVEDP) and lower ejection fraction (EF) than those with one- and two-vessel disease. Those with previous myocardial infarction had a significantly higher incidence of reduced EF and of wall motion abnormalities than those without a previous myocardial infarction. All patients in group B had significant coronary arterial disease, and 80 percent (12) had abnormal left ventricular function. Their mean LVEDP and EF were significantly higher and lower, respectively, than those found in group A. In conclusion, acutely ill patients were studied with low risk. Most patients had three- or two-vessel disease. Abnormal left ventricular function was related to three-vessel disease and to recent and old myocardial infarction.


The effect of respiratory motion on the echocardiogram. The effects of respiratory movements on the ultrasonic echoes of the cardiac structures were recorded and analyzed in 50 consecutive patients. Deep inspiration in cooperative patients resulted in a considerable increase of dense anterior echoes, with blotting out of any distal or posterior echoes in 12 of 44 patients (group A). In the second or larger series (32 of 44 patients; group B), a posterior displacement of most of the identifiable intrinsic cardiac echoes was seen with deep inspiration, particularly those of the posterior wall of the left ventricle. Forced expiration produced an opposite or anterior displacement of the cardiac echoes. Normal respirations showed similar but smaller excursions.


The role of hypovolemic stress in the production of fat embolism in rabbits. 2. Changes in arterial blood gas levels and static compliance. The purpose of this study was to assess the possible role of hypovolemia as a factor in the production of impaired pulmonary function in pulmonary fat embolizaiton. Iv vivo static lung compliance was measured by inflating the lungs with known volumes of air and recording the transpulmonary pressure, monitoring intraesophageal pressure as an index of intrapleural pressure. Arterial blood was drawn from the central artery of the ear. Embolization was produced by the intravenous injection of homologous fat cells either as the sole experimental procedure or in conjunction with hypovolemic shock. Two types of shock were studied. In one, 20 percent of the blood volume was removed, producing hypovolemia associated with hemodilution, and in the other a tourniquet was applied to induce hypovolemia and hemoconcentration. The results indicate that embolization is associated with significantly greater impairment of pulmonary function if it develops on a background of shock than if it occurs in an otherwise healthy animal. These pathophysiologic findings parallel the results of a morphologic study.


Radionuclide angiocardiographic measurement of left ventricular volume and ejection fraction. In recent years a number of different radionuclidic techniques have been developed to measure left ventricular volume and ejection fraction. Area-measurement concepts have been applied to static and electrocardiographically gated radionuclidic images which have resulted in accurate measurement of left ventricular end-diastolic volume (LVEDV) and ejection fraction (LVEF). Gated (end-diastolic and end-systolic) image analysis has also proven capable of detecting regional left ventricular wallmotion abnormalities in patients with coronary disease. Time-activity curves can be extracted from left ventricular images, and several dynamic techniques have been developed and have also resulted in accurate measurement of LVEDV and LVEF. Radionuclide methods are currently available which are accurate and atraumatic and consequently applicable to the serial study of patients with heart disease. In particular, several of these radionuclide methods are relatively inexpensive and should be able to be performed in most hospitals.


Pericarditis with effusion casued by Actinomyces israelii. Actinomyces israelii is a rare cause of pericarditis. Infection spreads to pericardium from an intrathoracic focus. Branching gram-positive filaments are seen on microscopic examination of clinical specimens. Cultures should be performed under anaerobic conditions. Both surgical drainage and antibiotics (penicillin) are required for treatment. Nocardiosis may resemble actinomycosis in many respects.


Primary diffuse pulmonary amyloidosis with monoclonal gammopathy. A rare case of primary diffuse amyloidosis of the lung with an abnormal monoclonal protein is described. The diagnosis was confirmed by an open-lung biopsy. The different classifications of amyloidosis as well as the relationship between the immunoglobulins and the pathogenesis of amyloid disease is discussed.


Echocardiographic manifestations of aortic cusp rupture in a myxomatous aortic valve. A 16-year-old pregnant black girl who had spontaneous perforation of the aortic valve associated with myxomatous aortic valvular degeneration is presented. The echocardiogram revealed chaotic systolic motion of one of the aortic cusps, diastolic aortic valvular fluttering, and abnormal diastolic echoes in the left ventricular outflow tract. The report illustrates that the echocardiographic features associated with valvular vegetations are not specific for infectious endocarditis.


Total anomalous pulmonary venous return. Successful total correction in a 44-year-old man with subtotal absence of interatrial septum, tricuspid insufficiency, and cardiac dextroversion. A case of total anomalous pulmonary venous return, virtual absence of the interatrial septum, cardiac dextroversion, and tricuspid insufficiency with total correction at age 44 years is presented. Repeat catheterization four months after surgery showed normal hemodynamics and pulmonary vascular resistance. The physiologic and anatomic factors allowing survival and total surgical correction at such a late age are reviewed.


Systolic anterior motion of the mitral valve without asymmetric septal hypertrophy. This report describes a patient with echocardiographic systolic anterior motion of the mitral valve causing the anterior mitral leaflet to contact the septum in systole. At necropsy a normal nonhypertrophied heart with normal-sized ventricular cavities and a normal outflow tract and mitral valve was found. Thus, asymmetric septal hypertrophy and abnormal mitral valvular placement are not requisites for systolic anterior motion of the mitral valve. During systole, a marked forward movement of the anterior mitral leaflet developed in our patient in the setting of hypovolemia and continuous intravenous administration of pressor drugs, suggesting, rather, that systolic anterior motion reflects a small, vigorously contracting ventricular cavity and that such dynamic subaortic obstruction is not pathognomonic of idiopathic hypertrophic subaortic stenosis.


Metastatic teratocarcinoma following chemotherapy. Maturation to a mass pathologically indistinguishable from a mediastinal enteric cyst. A case of testicular teratocarcinoma metastatic to a mediastinal lymph node and associated with a mediastinal lesion indistinguishable from an enteric cyst is presented. It is postulated that the mediastinal enteric cyst-like lesion resulted from histologic maturation of metastatic teratocarcinoma after intensive chemotherapy. The basis in the medical literature for this postulate is detailed.


Coronary arteritis in systemic lupus erythematosus. Acute myocardial infarction in systemic lupus erythematosus may be due to an atheromatous or arteritic process. Confirmation of the latter etiology has previously been made only at postmortem examination. A 45-year-old white woman with known systemic lupus erythematosus developed anginal pain and multiple episodes of acute myocardial infarction. During this period, there was serologic but no other clinical evidence of active systemic lupus erythematosus. Serial coronary angiographic studies were strongly suggestive of an arteritic process based upon (1) a saccular aneurysm with no obstructive lesions in a coronary artery supplying an area of recent transmural myocardial infarction and (2) the development of significant obstructive lesions in a previously normal coronary artery over a period of 18 days. This case illustrates the difficulties in distinguishing between atherosclerosis and arteritis using a single coronary angiographic study. The distinction is significant because of the different therapeutic interventions required.


Comparative studies of the activity of ciclacillin and dicloxacillin. The penicillins ciclacillin and dicloxacillin demonstrate marked similarities in biological activity but, as far as can be determined, differ substantially in respect to the degree of protein binding, which is relatively low for ciclacillin and relatively high for dicloxacillin. In mice infected with Staphylococcus aureus Smith, ciclacillin is considerably more active than dicloxacillin, although both drugs are similarly effective in vitro and similarly absorbed and eliminated in vivo. The high degree of protein binding exhibited by dicloxacillin could therefore very probably explain its relatively low chemotherapeutic activity. Moreover, the in vitro and in vivo findings of the study are inconsistent with the tenets of the tau/2 thesis.


Antibacterial susceptibility testing by the dip-slide technique: a methodological evaluation. Antibacterial susceptibility testing of urine specimens by the dip-slide method was compared to the standardized disc diffusion method. A boarder line of 12 mm inhibition zone on the slide could be used to select strains resistant to sulphisadimidine, ampicillin, nitrofurantoin or nalidixic acid. In the case of the sulphonamide, the results were grewtly influenced by composition of the medium. Susceptibility testing with the dip-slide method seems to be a useful test to differentiate strains likely to respond to therapy from resistant strains.


In vitro and in vivo studies of the action of rifampicin, clofazimine and B1912 on Mycobacterium marinum. Rifampicin (RMP) and two riminophenazine compounds (B663 and B1912) suppressed the growth of Mycobacterium marinum in vitro and in a mouse footpad infection. At appropriate concentrations and dietary dosage, all three drugs showed bactericidal activity in vitro and in vivo. On the basis of minimum inhibitory concentration, RMP was considerably more active than the other two substances in vitro. However, the rate of bactericidal effect was similar for all three drugs. In vivo, the minimum bactericidal dietary dosages of RMP, B663 and B1912 were 0.03, 0.03 and less than or equal to 0.01%, respectively. Results suggest that these drugs may be of value for the treatment of clinical M. marinum infections.


Cytological and cytochemical analysis of the effects of cis-dichlorodiamino platinum (II) on chick fibroblasts cultivated in vitro. Chick embryo fibroblasts cultivated in vitro and treated with cis-dichlorodiamino platinum (II) have been analysed by cytological and cytochemical methods. Morphological alterations (in the nucleoli, in the chromatin and in the cytoplasm), inhibition of DNA and RNA syntheses and of cell multiplication have been noted. Under some conditions, cells are blocked just before entering into mitosis (G2 block) and can become polyploid. A high degree of cell degeneration has also been observed.


Bacteriostatic and bactericidal activity of two trimethoprim-sulfonamide combinations. Sulfamoxole (SDMO) has the same half-life of elimination from human plasma as sulfamethoxazole. Its antibacterial properties, however, are often inferior to those of co-trimoxazole. Its less pronounced antibacterial effect, especially against gram-negative pathogens, also becomes evident in the combination with trimethoprim (TM). The inhibition zones are often smaller around discs containing the same amount of the components SDMO/TM as those with co-trimoxazole and the inhibitory concentrations needed are frequently 2-4 times higher, especially against gram-negative bacteria, such as Escherichia coli and Proteus vulgaris. Accordingly, the curative doses 50% of the new combination are 2-3 times higher than those of co-trimoxazole in experimental infections with E. coli and P. vulgaris in mice. The bactericidal action in human urine, collected after a course of treatment with the combination SDMO/TM in the planned lower dosage, is not only often retarded, but also frequently incomplete in comparison with that in urine after co-trimoxazole in standard dosage. Clinically, this might lead to increased development of resistance or to an increase of recurrent infections.


Responses of hyperactive boys to a behaviorally focused school attitude questionnaire. The Teacher Approval-Disapproval Scale was administered to three groups of elementary school boys: those considered by a teacher as hyperactive and referrable; those considered as among the most active but not referrable; and normoactive classmates. The three groups of boys differed significantly in their responses to 8 of 11 individual scale items, which ask the child about the amount of teacher approval and disapproval directed toward himself personally or about the frequency of his own happiness and unhappiness in the classroom. The three groups of boys differed significantly on only 2 of 11 countepart class items, which ask the child about teacher behaviors toward the class as a whole or about the happiness and unhappiness of the entire class. The hyperactive boys said they received significantly less approval from m teachers from academic, motivational, and social behaviors than did the normoactive boys and significantly more general disapproval. The present study is among the few that report differences between hyperactive and comparison groups on self-report questionnaires. The results suggest that what appears to be greater teacher disapproval of boys than of girls may in fact be simply greater teacher disapproval of children with disruptive behavior problems, most of whom are boys.


Coping with fatherhood: the first year.

Coping with fatherhood: the first year. Fantasy (thinking back to prebaby times) and holidays (going out alone with the wife) are examined here as methods of coping with parenthood for 93 white, first-time fathers. Results suggest that only the holiday coping mechanism is associated with maintaining or improving marital satisfaction. The use of fantasy actually decreases marital satisfaction. These data suggest that the discrepancies in the conclusions of previous "parenthood as crisis" studies may be accounted for through the analysis of coping mechanisms that various fathers utilize.


Embryonic mania.

Embryonic mania. It has been previously hypothesized that hyperactivity may be one childhood form of manic-depressive disorder. The authors contend that it is unlikely that hyperactivity in general is a childhood form of manic-depressive disorder. However, included in those considered to be hyperactive may be youngsters exhibiting an embryonic form of mania. A case of a 5-year-old boy, originally thought to be hyperactive, is presented as evidence for the existence of an embryonic stage of mania. The clinical and research necessity for differentiating between hyperactivity and embryonic mania is stressed.


Some comments on the significance and development of midline behavior during infancy. With the waning of the tonic neck reflex beginning with the 8th to 12th week, and disappearing, in most instances, by the 16th week, the infant begins to become bilateral and makes symmetrical movements and engages his hands in the midline usually over the chest while in a supine position. The developmental significance of such behavior is considered--for example, its participation in the emerging sense of self and its role in the consolidation of emerging ego skills. Consideration is given to the possible implications of faulty midline behavior for development, and to whether failure to engage in an optimal amount of midline behavior, in interaction with other factors, can be used to alert observers to possible future developmental disturbances.


Perception as a possible source of conservation: evidence for length conservation. In conservation problems, it is commonly assumed that equivalence judgments are not facilitated by observation of the stimuli following transformation. The reverse is usually assumed to be the case. These assumptions were tested in a training experiment. Perceptual counterparts of a series of conservation of length tests were presented to subjects who were catagorized as conservers or nonconservers on conservations of length pretests, and to conservers and nonconservers given conservation of length training. Perceptual performance of the untrained nonconservers was significantly worse than that of the other 3 groups, that is, trained nonconservers, untrained conservers, and trained conservers. These findings are interpreted as consistent with the hypothesis that conservation is attained with the support of perception, not in spite of it.


Birth order and sex of sibling as determinants of mother-infant interaction. Mother-infant interaction was assessed on 32 first- and second-born siblings when each was 3 months old. Data were colleted during 2 6-hour naturalistic home observations using a modified time-sampling technique. The sample consisted of 4 equal-size subgroups of same and opposite sex sibling pairs. Results suggested that interaction between a mother and her infant varied depending on the birth order and gender of the infant. Mothers spent significantly less time in social, affectionate, and caretaking interaction (except for feeding activities) with their second borns than they had with their firstborns; this difference was greater if the second born was female. Certain patterns of maternal behaviors appeared to be stable from one sibling to the other. Different types of interaction between the mothers and their younger infants were related to attention-seeking behavior in the firstborn male and female siblings.


Infants' responses to strangers: midget, adult, and child. Infants respond differentially, and at times with fearlike behavior, to unfamiliar persons. This study was designed to see how infants discriminate among strangers. Since it has been shown that infants respond differently to children and adults, the physical characteristics of persons used to make such differentiations were of interest. Facial configuration and height were systematically varied as 4 different strangers--a male and female child, a female adults, and a small female adult the same height as the children (midget)--each approached 40 different infants. The infants responded as if there were 3 classes of persons--adult, child, and small adult, suggesting that both size and facial configuration cues were used. Infants as young as 7 months of age reacted to the size-facial configuration discrepancy of the small-adult condition.


Serial habituation in two-, three-, and four-month-old infants. Serial habituation of visual fixations in 2-, 3-, and 4-month-old infants was investigated through a design permitting cross-sectional, within-subject longitudinal, cohort longitudinal, and time-lag analyses. The components of the standard stimulus were displayed individually before and after successive exposures of the standard for familiarization. Relative saliencies of the components for each child were indexed by magnitude of responding to these parts in the initial presentation. Comparisons of the pre- and postexposure fixation times suggest that for all ages habituation was under way to the parts of the stimulus in orders of the relative saliencies. The nature of the data in general did not appear to be influenced significantly by any 1 methodology.


A study of the "inversion of intensity" between newborn and preschool-age behavior. To test the inversion of intensity interpretation based on negative  relations between newborn and preschool intensity behaviors (Bell, Weller, & Waldrop 1971), 106 normal children were examined at the neonatal and preschool periods. Data analyses were carried out in 2 parts: Part I was an attempt to reconstruct the same measures of intensity Bell et al. used at both periods, and Part II was a broader factor analytic analysis using all measures conceptually related to intensity in the neonatal and preschool periods. In Part I, several correlations were in the direction consistent with inversion, but only 1 of 20 correlations reached significance. In Part II, several significant correlations between intensity behavior at newborn and preschool periods were obtained, indicating intense newborn behavior to be related to low levels of socially negative behaviors. Interpretations of intensity behaviors at both periods and their longitudinal relations are discussed.


Body size and form of black and white female youths measured during 1974-1975 at Columbia, South Carolina. From original data at age 13 years on 386 North American females (201 black and 185 white), statistics are presented for 10 somatic variables. The 2 ethnic groups yield similar means for standing height, arm girth, and leg girth; the black females, contrasted with their white peers, are shorter in sitting height, longer in lower limb height, and narrower in hip width. The Columbia subjects are compared with black and white females studied in North America several decades ago, and with black and white females studied recently in other parts of North America and in Australia, Europe, Africa, and the Lesser Antilles.


Self-evaluation, social reinforcement, and academic achievement of black and white schoolchildren. Black and white male schoolchildren covertly evaluated their own performance at a verbal task administered by black and white male experimenters. It was hypothesized that academically successful children would be predisposed to appraise themselves favorably, whereas relatively unsuccessful pupils would be biased toward self-criticism. The covert self-evaluations were assumed to represent at internalization of early experiences of predominantly positive or negative social reinforcement from adult socializing agents. The predicition for self-criticism was upheld in the white experimenter condition but not in the black experimenter condition. Relationships consistent with the theory were found between subjects' self-appraisals and their retrospective reports of positive and negative reinforcements received from parents and teachers in various typical situations. These relationships were more evident for black subjects than for white subjects. The extent to which children's self-praise and self-criticism mediated affect was assessed by means of a color conditioning technique. Contrary to predicition, possibly due to the easy nature of the experimental task.


The effects of cooperatively and competitively structured learning enironments on inter- and intrapersonal behavior. This study examines the effects of cooperative versus competitive goal structures on the subsequent intra- and interpersonal behavior of fourth-grade children. 2 situational variables were operating in each situation: first, the variable of working on a project as a group versus as an individual; and second, the variable of public reward. Results indicate that the effects of competitively structured environments differ for winners and nonwinners and for boys and girls. Girls, both winners and nonwinners, adopt the evaluations of the experimenter and generalize worthiness or deservedness to other situations as evidenced by their prize giving to self and others. After failure to win, girls also refrain from taking a toy away from the winner. After failure to win, boys behave competitively by taking a toy away from the winner and rewarding self more relative to others. The data also suggest that boys may not have experienced cooperative winning as success.


The influence of moral reasoning on behavioral choices. This study examined the ways in which exposure to moral reasoning statements affected the subsequent behavioral choices of 144 seventh-, eighth-, and ninth-grade boys at different stages of moral judgment. The subjects were divided among 4 experimental conditions, each of which attempted to isolate and relate behavioral choice and reasoning in specific ways. The presentation of reasoning had different effects on the behavioral choices of subjects at 2 different stages. The findings were considered in terms of their implications for developmental change as well as for a developmental analysis of the relationship between moral reasoning and moral behavior.


Children's perceptions of deviance and disorder. First-, fourth-, seventh-, and eleventh-grade boys and girls were interviewed on the topic of deviant behavior among their peers. They were also asked to make deviance judgments on 2 story characters whose behaviors exemplified qualities that typically evoke an attribution of psychological disorder on the part of adult judges. 1 story described loss of control and aggression, the other a distorted and paranoid perception of social reality. The pattern of reaction to the stories was consistent with age-related shifts in the basic for deviant status. First graders largely failed to think in terms of group norms. The transition from the middle grades to adolescence was marked by greater emphasis on social consensus--both in psychological perspective and group behavior.


Continuous vowel discrimination in normal and at risk infants. The present study investigated vowel discrimination in 2-week-old infants using a nonnutritive, high-amplitude sucking measure in a habituation-dishabituation paradigm. Infants were presented with pairs of vowel stimuli differing in equal logarithmic steps along the /i/ to /I/ continuum. Stimulus pairs of equal acoustic differences were selected to be either within or between the adult phonetic categories. Infants were divided into 3 experimental stimulus shift conditions: within category, between category, and control. Using a scoring system to asses perinatal events, half the infants in each condition were categorized as being at "higher risk" for developmental (p less than .05) were found between the control and both the within and between phonetic category conditions. No effects due to risk score population differences proved to be significant. These results indicate that 8-week-old infants discriminate the vowels /i/ and /I/ in a continuous as opposed to a categorical manner. Some differences were noted in response patterns between high- and low-risk score infants.


Effect of different training methods on perceptual learning in impulsive children. The effectiveness of different training and transfer test conditions in promoting perceptual learning in impulsive kindergarten children was investigated. Interproblem variability was found to be more effective than intraproblem variability, and a differentiation training procedure was found to be more effective than a matching training procedure. The results provide guidelines for designing effective training methods for improving discrimination learning and problem solving in impulsive children.


Effects of exposure duration on part-whole perception in children. Drawings of familiar objects arranged to suggest more general wholes (e.g., a beast made of pieces of fruit) were presented to 128 children aged 3-12 years, using 4 exposure durations. The ability to see both parts and wholes together improved with age, confirming earlier studies. In addition, the results suggest that limiting viewing time affects the ability to see both parts and wholes together (in a sequential, nonintegrated fashion) more in young children than in older children. The results further suggest that for younger children duration does not affect the ability to see parts and wholes in a hierarchical relationship. These results are interpreted as suggesting that at least 2 different processes mediate part-whole perception in children.


Children's ability to recognize other children's faces. Facial recognition ability was studied with 288 children from 4 grades--first, second, third, and sixth--who also varied by sex race, and school type, the last being segregated or integrated. Children judged whether each of 40 pictures of children's faces had been present in a set of 20 pictures viewed earlier. Facial recognition ability increased significantly with each grade but leveled off between ages 8 and 11. Blacks' performance is significantly better than whites', and blacks are better at recognizing faces of whites than whites are at recognizing blacks. Children from an integrated school show smaller differences recognizing black or white faces than children from segregated schools, but the effect appears only for children of the integrated school who also live in mixed-race neighborhoods.


A multivariate study of the effects of high-risk factors on performance on the Brazelton Neonatal Assessment Scale. The Brazelton Neonatal Assessment Scale was administered to 52 newborn infants. A factor analysis revealed 2 main factors, 1 along an attention-orientation dimension, the other relating to temperament arousal. A stepwise multiple linear regression analysis showed that the attention-orientation factor was related to birth weight, age of the mother, and sex and race of the baby. The only variable related to the temperament-arousal factor was 5-min Apgar scor. The study, although exploratory, demonstrates the use of multivariate techniques in the assessment of influences on newborn behavior.


Neonatal nutritive sucking: effects of taste stimulation upon sucking rhythm and heart rate. The sucking behavior and heart rate of 22 full-term newborns were recorded. Half of the infants sucked for 9 minutes in 3 blocks of 3 minutes, first receiving a 0.02-ml drop of 5% sucrose for each criterion suck, then no fluid contingent upon such sucks, and finally a 0.02-ml drop of 15% sucrose for each suck. The other half received these conditions in reverse order. Regardless of the order in which the 2 nutrient conditions were administered, intersuck intervals were longer under the sweeter condition, but heart rate was also higher. Possible interpretations include a hedonic explanation suggesting that sucking rate is modulated to facilitate savoring of the sweeter fluid.


Developmental changes in the scanning of faces by young infants. 6 1-month-old infants and 6 2-month-old infants each viewed 3 faces (his mother's, a strange woman's, and a strange man's) while his eye movements were recorded by corneal photography. The 1-month-olds fixated away from the faces most of the time, and they looked at their mothers even less often than at the strangers. When they did fixate a face, they usually chose a limited portion of the perimeter. By constrast, 2-month-olds fixated the faces most of the time, looked at more features, and were more likely to look at internal features, especially the eyes. This scanning resembles that reported previously for 2-dimensional shapes, although in some respects it appears unique to faces.


Individual differences in habituation rates and object concept performance. The scores from object concept tasks for 15 infants at 14 months of age were analyzed with respect to their habituation rates at 4 months of age. Partitioning of the data according to subjects categorized as fast and slow habituators brought some organization consistent with the notion that the former are more advanced than the latter. Statistical differences between groups did not obtain, but a significant correlation between ranked task scores and habituation ratios offers some support to the interpretation. The possibility of using habituation rates or ratios as an index of differences in processing, perhaps with some predictive value, may be considered if further evidence of relations to later cognitive performanceis found.


Baby drops the rattle: asymmetry of duration of grasp by infants. Infants of mean age 2.7 months maintained grasp of a rattle for a longer mean duration with the right than the left hand, developmentally the earliest instance of asymmetry of manual dexterity and/or preference.


Four- and six-month-old infants' visual responses to joy, anger, and neutral expressions. 24 infants, 12 4-month-olds and 12 6-month-olds, were repeatedly shown slides of 3 facial expressions. The expressions were previously judged by obervers to be indicators of joy, anger, and no emotion, respectively. The duration of the first visual fixation to each presentation of the slides was monitored for each subject. The data indicated that the infants looked at the joy expression significantly more than at either the anger or neutral expressions. The results suggest that infants are capable of discriminating emotion expressions earlier in their development than previous studies have implied.


Variations in intra-oral stimulation and nutritive sucking. Sucking records were made from 24 infants, aged 3-4 days, fed small amounts of their usual formula from nipples of different sizes (5/16-, 8/16-, and 11/16-inch diam). Polygraphic and observer measures showed that the large nipple elicited fewer sucks and a slower sucking rate; 5 infants seen on 2 successive days showed a more marked nipple preference on the second day. The results show that intra-oral stimuli control sucking for a nutriment in much the same way as they have already been shown to control nonnutritive sucking.


Moral reasoning from the perspective of others. A questionnaire study was conducted to examine the ability of adolescents and college students to deliberate about moral dilemmas from social perspectives (roles) other than their own and to display different levels of moral judgment in these different perspectives. 30 subjects at each of grades 9, 10, 12, and college were administered a moral reasoning questionnaire and asked to respond 3 times--once for each of the social roles of self, average policeman, and average philosopher. Results showed that across roles and with increasing age there was an increase in individuals' tendencies to choose principled moral issues to resolve dilemmas. More important, there was an increase with age in differentiation among social roles--with the college students evidencing the greatest differences in the level of moral issues chosen as a function of social role.


Order of information presentation and children's moral judgments. It was hypothesized that age differences in use of intent information in children's moral judgments might be due to a recency effect in the judgments of younger children. A study was conducted to examine the effect of order of stimulus presentation on children's moral judgments. The information was presented to children, ages 4-5 and 8-9 years old, through stories with either normal information order, intent-consequence, or reversed order, consequence-intent. It was found that order has a significant impact on children's moral judgments. In addition, memory data were gathered which indicated that the pattern of forgetting was parallel to the pattern of information preference for the younger subjects. The findings suggested that younger subjects' relative neglect of intent in the normal order of information was based, in part, on their failure to remember the material correctly rather than on differential weighting of the 2 cues.


Motor activity, anticipated motor activity, and young children's associative learning. The purpose of this study was to determine whether motor activity, previously assumed necessary to induce imagery in young children's associative learning, actually has to be executed. The results of our experiment with kindergartners clearly suggest not: In conditions where subjects simply planned to the potential motor activity (without executing it), learning was enhanced. Further, the temporal proximity of the planning to the potential motor activity did not prove to be important. These results, combined with those from 2 follow-up experiments, give rise to the speculation--among others--that young children can be "tricked" into imagery generation through appropriately worded instructions.


Chromosome organisation in the Australian plague locust, Chortoicetes terminifera. 1. Banding relationships of the normal and supernumerary chromosomes. In Chortoicetes terminifera, G-banding, produced by the trypsin treatment of air-dried slides followed by Giemsa staining, leads to light staining gaps at the secondary constrictions on autosomal pair 6 and regions proximal to the centromere on the long arms of pair 4. The variable short arms of two of the three smallest pairs were usually flared and lightly stained after treatment. In contrast to the relatively minor response of the normal chromosome set to G-banding, the large supernumerary chromosomes of C. terminifera show a spectacular series of dark bands alternating with lightly stained gaps. Two G-band variants of the B-chromosome were found in a laboratory stock. These patterns of G-banding are discernable both at mitosis in adults and embryos of both sexes and at all stages of male meiosis. Some regions which are gaps after G-banding appear as dark bands after C-banding. Consequently the supernumerary chromosome is mainly darkly stained with C-banding. In addition the centromeres and some telomeres are C-banded along with narrow interstitial bands and polymorphic heterochromatic blocks.--C-banding was not always successful, the technique often yields a mixture of G- and C-banding. The disparity of banding between the normal complement and the B-chromosome implies that whatever the source of origin of the B it has undergone spectacular changes in organisation since its origin.


Haplo-diploid locust embryos arising by accidental thelytoky in Chortoicetes terminifera investigated by G-banding. Two mosaic sibling embryos of the Australian plague locust, Chortoicetes terminifera are reported with haploid and diploid cell lines in widely differing proportions. One small chromosome pair involved in the two cases has alternative morphology and a B-chromosome is present in one. In addition, G-banding identifies two medium-sized chromosome pairs and alternative states of a second small pair. Using these markers it is clear that both diploid cell lines are homozygous for the chromosomes of the corresponding haploid line. These embryos have thus developed by accidental parthenogenesis from haploid cells, some of which were duplicated by endomitosis after development began.


Prolongation of replication time after doublings of the DNA content of polytene chromosome bands of Chironomus. Using 3H-thymidine autoradiography, labeling frequency of homologous asynapsed chromosome bands of the hybrid of Chironomus th. thummi and Chironomus th. piger has been studied. In a number of these bands the DNA content of the thummi bands if 2, 4, 8 or 16 times as large as that of the homologous piger bands (Keyl, 1965). Those bands of CH. TH. thummi which show one doubling of their DNA content in comparison with the homologous piger bands are also labeled two times more frequently than piger. In contrast to this such a correlation between increase of labeling frequency (i.e. prolongation of replication time) and doubling of the DNA content is not observed, when thummi bands have 4, 8 or 16 times more DNA than their homologues in piger. In these cases replication time is also prolonged after each doubling. Duration of DNA synthesis increases linearly but always by a smaller factor as the corresponding DNA content is increased.


A comparative analysis of the karyotypes of Cricetus cricetus and Cricetulus griseus. This study presents a comparison of the mitotic chromosomes of the two species of hamsters Cricetus cricetus (European hamster) and Cricetulus griseus (Chinese hamster), which have the same chromosome number of 2n=22.--G-banding procedure reveals striking similarities in both karyotypes and gives the possibility to analyse structural changes so that two examples for Robertsonian rearrangement can be observed.--A remarkable kind of difference between the two karyotypes becomes obvious after C-banding procedure. While Cricetus cricetus shows a large amount of predominantly centromeric heterochromatin, in Cricetulus griseus C-bands are less conspicuous, and a few chromosomes do not exhibit any centromeric heterochromatin at all.


Anastomotic recurrence after anterior resection for carcinoma: Lahey Clinic experience. A retrospective study of 152 patients who underwent anterior resection for carcinoma of the rectum and rectosigmoid from 1963 to 1969 is presented. Eighteen anastomotic recurrences (two benign) were observed. Factors associated with high recurrence rates are discussed, and a scheme for identification of those patients in high-risk groups is presented. The value of this study lies in facilitating decisions involving operative and postoperative management of distal colonic lesions.


Nonsuture colonic anastomosis.

Nonsuture colonic anastomosis. Methyl-2-cyanoacrylate was used for nonsuture end-to-end anastomosis of the ascending colon in 35 male Sprague-Dawley rats. The results were studied in seven sacrificed rats and eight rats that died after the procedure. The mortality rate was 22 per cent in a six-month period. Twenty animals are being observed for further studies  of the anastomoic site and possible late carcinogenic activity of the monomer. The local histotoxicity of methyl-2-cyanoacrylate, the strong binding capacity, the abundance of scar tissue, and the distraction of the mucosa, as pointed out by several earlier investigators, were confirmed in this work. Also, it was strongly evident that the age of the glue has a significant influence on survival. The use of tissue adhesives as a substitute for standard suture technique or as a reinforcement of an inadequate suture line requires further study. Investigations designed for improving properties of these monomers appear warranted.


Prevention of urinary retention by fluid restriction following anorectal operations. In a carefully controlled prospective randomized study of 500 patients, the postoperative catheterization rate following anorectal surgical procedures was dramatically reduced by a combination of severe dehydration of the patients and reorientation of the nursing personnel to delay catheterization until the bladder is distended. The effectiveness of fluid restriction was clearly demonstrated.


Drug-induced pseudomembranous enterocolitis: a new etiologic agent. Pseudomembranous enterocolitis is an iatrogenic illness resulting from the oral or intramuscular use of broad-spectrum antibiotics. It is characterized by diarrhea, mucosal inflammation, and pseudomembrane formation in the gastrointestinal tract. The diagnosis is established by an index of suspicion in individuals who have been on antibiotic therapy, proctosigmoidoscopic examination, stool smears, cultures, and sensitivity. Treatment should be directed to eliminating the etiologic factor and replacing the physiologic abnormality.


Scleroderma of the colon with obstruction: report of a case. A case of a patient who had colonic obstruction caused by scleroderma is described. The obstruction initially was treated by means of a colostomy, and later subtotal colectomy was carried out. This is the fifth report of a patient with symptomatic colonic scleroderma successfully treated by colonic resection. A review of colonic scleroderma is included.


Perianal endometrioma: report of five cases. One of the gynecologists' commonest findings at pelvic laparotomy is endometriosis. Despite the fact that the presence of endometrial tissue in ectopic locations is commonplace, the finding of a perianal endometrioma is no more than a surgical curiosity. Very few cases have been reported. The present report describes five such verified cases. Interestingly enough, only two of the five cases were diagnosed preoperatively. The pathogenesis of endometriosis has been, and continues to be, controversial. The prevailing theories include 1) transtubal regurgitation of menstrual blood, 2) the coelomic metaplasia doctrine, 3) lymphatic dissemination, and 4) hematogenous spread. Pathologically the lesions may vary grossly from red-blue to yellowish-brown implants, ranging in size from microscopic to 1-2 cm in diameter. The definitive histologic diagnosis requires two of the following three features-glands, stroma, and hemosiderin pigment. The clinical manifestations depend upon the functional activity of the involved tissue and may range from an asymptomatic mass to the classic presentation of a mass increasing in size and becoming acutely painful during menstruation but subsiding in size and decreasing in tenderness between menstrual periods. These protean manifestations are readily illustrated by the cases presented. Anatomically the lesions are usually found in old episiotomy scars. Because these lesions are usually readily accessible, and because their exact nature is frequently not known preoperatively, the treatment of choice is local excision. Complementary hormonal therapy has been suggested, but the value of such treatment is not yet proven. Ovarian ablative therapy is also considered.


Diffuse villous adenomatosis of the colon: report of a case. A 62-year-old man had symptons of congestive heart failure precipitated by chronic blood-loss anemia. Barium-enema studies were consistent with diffuse polyposis of the colon. A total colectomy followed by ileoproctostomy was performed. Histologic examination of numerous polyps showed them to represent villous adenomas. Despite diffuse involvement, electrolyte depletion did not occur. Follow up is planned because of the possibility of future villous adenomas in the small bowel.


Serpiginous (geographic) choroiditis.

Serpiginous (geographic) choroiditis. The rare pathological condition of serpiginous choroiditis is discussed on the basis of four observations. The authors discuss the different views advanced in the literature in regard to the aetiology. They advance arguments in favor of an inflammatory pathogenesis. The problems of the differential diagnosis are also considered in some detail.


Pathogenesis of papilloedema.

Pathogenesis of papilloedema. There appear to be 3 factors in the development of papilloedema - an arterial shunt to the prelaminar tissue and a raised venous pressure in the absence of a raised intraocular pressure, which are passive effects, and an overspill of pial autoregulative vasodilatation which is not passive. In addition the arterial shunt may lead to excessive local autoregulative effects. The engorgement of the fine vessels of the prelaminar tissue, the loss of the spontaneous venous pulse on the disc and the venous overfilling are thought to indicate increased supply and blood flow rather than the reverse. The other general causes of papilloedema can also be explained by the autoregulative mechanism or its breakdown as they involve hypercapnia, tissue anoxia or severe hypertension.


The essentials of data sources in eye epidemiology. The extensive literature on eye epidemiology was selectively reviewed to provide a concise and comprehensive summary on the current status of available data sources. The topics being covered were epidemiologic data evaluation, data handling, card registration, computer analysis, geographic factors, socio-economic conditions, personal attributes, genetic backgrounds, twin analysis and laboratory procedures for host defense factors including humoral and cellular immunity. Also, the scope of this article encompassed such major practical issues as glaucoma, cataract and other blinding diseases as well as traffic and occupational hazards. Epidemiologic information thus obtainable through data searching may prove tobe instrumental in the identification of any potential preventive measures in ophthalmology and public health.


Sensorial anomalies in strabismus. (suppression, anomalous correspondence, amblyopia). Some concepts regarding suppression, anomalous correspondence and amblyopia are revised according to the sensorial findings obtainable from esotropic patients directly in casual seeing (with the aid of the striated glasses test) and by grading a sensorial dissociating effect (with the aid of a bar of optical filters). The following points are emphasized: 1. Suppression appears to be minimal in small angle strabismus where diplopia seems mainly to be avoided by an anomalous correspondence mechanism. On the contrary, suppression is the prevalent mechanism in large angle strabismus. 2. The anomalous correspondence mechanism may lead to a weak type of anomalous binocular vision which is easily interrupted by light optical filters or by dissociating tests. 3. The subjective space of patients with anomalous binocular vision resembles that of normal binocular vision in some aspects. 4. The development of amblyopia is interpreted in the light of these new concepts on suppression and anomalous binocular vision. 5. Postoperatively, anomalous correspondence rapidly re-adapts to the smaller angle deviation and may normalize if the deviation is completely eliminated. This is evident only in casual seeing; for a certain time, dissociating tests reveal the preoperative correspondence status. This behaviour of correspondence in casual seeing has led to attempts at normalizing anomalous correspondence by prism therapy. Newly observed sensotio-motorial obstacles, however, have been found to frequently hamper treatment in casual seeing.


Experimentally induced variations in the dark adaptation functions of a severe strabismic amblyope. Dark adaptation curves were determined for an amblyopic and a normal control subject following a variety of preadaptation conditions. Sizable between-eye differences were found in the dark adaptation functions of only the amblyope; the magnitude of such differences varied with this subject's distance from the light preadapting screen and with the effective size of his pupils during the light preadaptation period. Marked differences were also found between the dark adaptation functions of both eyes of the amblyopic subject and those of the normal subject. The preadaptation-dependent changes in the dark adaptation function of the amblyopic subject are hypothesized to result from anomalies of amblyopic eye light adaptation which are referable to disturbances of retinal receptor alignment.


Sensorio-motorial anomalies in strabismus: (anomalous movements). The attempts at treating anomalous correspondence by prisms in esotropia have led to the observation that frequently the angle of deviation increases with prismatic correction. The convergent movements induced by base-out prisms in esotropic patients resemble normal fusional movements in some aspects; they are provisorily called 'anomalous movements' and the objective differences between anomalous movements and normal fusional movements are reported. The strength of 'anomalous movements' are investigated with prisms. This with the aim of better understanding this sensorio-motorial sequela of strabismus and possibly selecting those patients who are more apt for prismatic therapy. The main criteria adopted today for eliminating anomalous movements and the residual postoperative deviation related with them are listed. Finally, the way anomalous movements may interfere with surgery is discussed.


[Muco-serous otitis media- a frequently missed disease of the middle ear (author's transl)]. Muco-serous otitis media (muco-serotympanon) is one of the most frequent otological diseases not only among children but increasingly also in the adult age group. In addition to microscopic otoscopy tympanometry is most relevant for diagnosis. Tympanometry is based on measurement of acoustic resistance at the level of the tympanic membrane. In cases of muco-serous otitis very characteristic types of tympanometric curves are obtained. Paracenlastic tube through the tympanic membrane are recommended for therapy.


[Prenatal diagnosis of globoid-cell leukodystrophy (Krabbe's disease) (author's transl)]. Amniocentesis in the 17th week of pregnancy in a 23-year-old woman who had previously lost a child with enzymatically proven Krabbe's disease revealed normal activity in cell-free amniotic fluid. But in two amniotic cell cultures a 25% defect of cerebroside-beta-galactosidase was found. The prenatal diagnosis of Krabbe's disease was subsequently confirmed after abortion of the fetus by enzymatic and morphological examination (globoid cells in the spinal-cord sections).


[HL-A histocompatibility antigens in children with coeliac disease (author's transl)]. HL-A antigens were determined in 41 unrelated coeliac children and in clinically healthy parents and siblings of 40 of these patients using a lymphocyte microcytotoxicity test. 58.5% of the coeliac patients had phenotype HL-A 8 compared with an HL-A 8 frequency of 16.6% in a control group of 320 unrelated individuals (P less than 0.0005). Excluding five patients not of pure German origin HL-A 8 frequency increases to 63.9%. The increase of HL-A 1 frequency in coeliac patients is attributed to linkage disequilibrium between HL-A 8 and HL-A 1. The haplotype HL-A 1.8 frequency was significantly increased in coeliac children (P less than 0.0001) with frequency elevation also in parents (P approximately 0.025) but not in siblings. Furthermore, an increase in frequency of HL-A 12 and a decreased frequency of HL-A 7 and HL-A 9 was found in coeliac patients. Five clinically healthy siblings had the same HL-A haplotypes as their affected sisters and brothers.


[Electrocardiographic changes after surgical manipulation of the carotid arteries (author's transl)]. Seven patients showed deep symmetrical T wave inversions in their electrocardiograms after bilateral carotid endarterectomy. There was no evidence for myocardial ischaemia. These changes reversed completely within three months. Similar disturbances of repolarisation were seen in rats after bilateral denervation of the carotid sinus. These changes are probably of neurogenic origin, like those seen with central nervous system disorders. Their origin seems to be correlated to the acute imbalance of the autonomic innervation of the heart after surgical disturbance of baro- and chemoreceptors.


[Urinary excretion of hydroxyproline in acromegaly (author's transl)]. Urinary excretion of hydroxyproline was examined with the Hypronosticon test in 25 patients with acromegaly (13 men, 12 women) and 15 healthy persons. At the same time, plasma levels and urinary excretion of phosphorus and calcium were also measured. Patients with active acromegaly had a significantly higher urinary hydroxyproline output (32.55 +/- 8.68 mg/24 h m2) than healthy persons (12.12 +/- 2.33 mg/24 h-m2). They also excreted considerably more hydroxyproline than patients with successfully treated acromegaly. Effective treatment was proved by STH levels and good suppressibility by 100 mg glucose. Unsucessfully treated patients, on the contrary, had a raised urinary excretion of hydroxyproline (31.23 +/- 16.61 mg/24 h-m2) and high fasting plasma levels of somatotropic hormone. Hydroxyprolinuria proved, therefore, of value in assessing the development and treatment of acromegaly.


[Treatment of cardiogenic shock after acute myocardial infarction with intra-aortic balloon counterpulsation (author's transl)]. Intra-aortic balloon counterpulsation (IABP) was used in 20 patients with acute myocardial infarction and cardiogenic shock, after four hours of drug treatment. In all instances the abnormal haemodynamic state had been demonstrated. Four patients were successfully treated and finally discharged home. In two with post-infarction ventricular septal defect and cardiogenic shock, IABP also successfully reversed the shock state, while in seven the shock state was reversed but they died 2-8 days after IABP had been stopped. IABP failed in seven patients who died during its application. In those in whom IABP failed there had been no significant fall in pulmonary-artery pressure and no significant increase in stroke volume. The post-mortem examinations demonstrated that cardiogenic shock was irreversible where more than 50% of the left ventricular myocardium had been infarcted.


[Prazosin--a new antihypertensive agent (author's transl)]. 40 patients with essential hypertension of varying degrees were treated with prazosin for up to 6 months. Both in severe (n=10) and in moderately severe (n=28) hypertension a significant decrease of the systolic and diastolic blood pressure was observed after only one month of treatment. This effect was even more evident after 3 and 6 months. 18 patiets showed orthostatic disorders at the beginning of treatment which in all cases disappeared after several weeks. No side effects were observed which could be attributed with certainty to prazosin.


[Clinical use of NPH insulin (author's transl)]. NPH Insulin-Retard Leo has an even action spread over about 20 hours. Despite this long duration of action, single daily injections proved to be adequate in only 9-12% of diabetic patients. Twice daily injection provided a highly favourable fasting blood sugar level in all instances. Because of the small initial effect, the addition of regular insulin proved necessary in some of the patients. 50:50 mixture of regular and NPH Insulin-Retard Leo is available as Insulin Initard Leo, a 30:70 mixture as Insulin Semitard Leo. There remains a group of diabetics who should mix them to their own individual requirements. There were no local reactions when using highly purified components, as long as it was the first time that the patients used such insulin or were changed over from other reaction-free preparations. Diabetics with cutaneous allergies due to other forms of insulin had the same response to NPH preparations as to highly purified insulins of other forms.


[Treatment of metastasising melanoma with a combination of cytostatic agents (author's transl)]. In a prospective phase-II study of 16 patients with melanoma in stage III, the influence of a combination of cytostatic drugs on tumour growth was studied. All patients had extensive metastases in soft tissues, intestines and, some of them, in bone. The treatment consisted of brief infusions of 2 mg vincristine, 200 mg carmustine and 600 mg dacarbazine per m2 body surface for six days, repeated at seven week intervals up to six times. Two of the 16 patients had complete and two had partial remission, while two remained in status quo for four and five months, respectively. In the remaining ten patients the combined therapy had no influence on the progression of the disease: the more extensive the tumour spread and the worse the general condition of the patient, the less successful was the treatment.


[Lowering of pulmonary-arterial pressure with nitroprusside in mitral stenosis and cor pulmonale (author's transl)]. Nitroprusside was infused intravenously (20, 40, 80 and 200 mug/min) in nine patients with pulmonary hypertension due to mitral stenosis (group I), nine with precapillary pulmonary hypertension associated with primary lung disease (group II) and nine with normal pulmonary-arterial pressures (group III). The mean pulmonary-arterial pressure was markedly reduced at a rate of 20 mug/min in group I and II, while higher doses were necessary in group III to produce a similar effect. Mean arterial pressure was decreased in all three groups and was dose-related. Heart rate rose, stroke volume fell during nitroprusside administration, while cardiac output remained unchanged. Pulmonary vascular resistance was reduced on 20 mug/min in group I, but only on 200 mug/min or more in group II, and unchanged at all dosages in group III. Peripheral vascular resistance declined in all three groups on nitroprusside infusion, which is apparently of value in the short-term lowering of pulmonary hypertension.


[Congenital saccharase-isomaltase deficiency: a six-year survey (author's transl)]. Saccharase-isomaltase deficiency was discovered in five children. The diagnosis was made on the basis of an abnormal oral saccharose loading response and demonstrating decreased activity of intestinal saccharase and isomaltase in the presence of normal small-intestinal mucosa. Three children failed to thrive, and all had recurrent diarrhoea. The diagnosis was made in children aged six to twenty-two months. Treatment consisted of saccharose-free diet or feeding with an enzyme preparation, Bi-Myconase. Saccharose-containing foods were increasingly tolerated beyond the second year of life so that children aged 2 1/2 to 3 1/4 years no longer required special treatment.


[Middle-level medical training in Cuba]. The background, evolution, and prospects for training middle-level medical technicians in Cuba are reviewed, with emphasis on the relationships existing among socioeconomic structures, the education sector, and the health sector. Developments since the revolution of 1959 may be divided into three periods--1959-1964, 1965-1969, and 1970-1975--which reflect a clear policy progressing from the quantitative to the qualitative. A description is given of the health and education systems and subsystems that have emerged as a result of changes in the social, political, and economic system and have made it possible to develop new approaches to teaching, including work-study programs and integrated training.


[The planning of higher or university education and the concept of politics, strategy and planning]. The phenomenon of mass education and the crisis of university education in Latin America, in particular in the 1960's, are broadly analyzed. From the facts that characterized the period in question, two conclusions may be drawn: (1) that the basic role of the university must be redefined on the basis of new principles and different content; and (2) that a university must be administered by a system other than improvization. The concepts of policy, strategy, and plan are considered in depth and then explained as they apply to curriculum planning and design.


[Considerations on the admission policy for the medical school of the university of Costa Rica]. A study conducted by the University of Costa Rica examined the ratio between the total national population and the number of physicians, as well as the variations that might occur in this ratio depending on population growth, annual number of graduates from the School, incorporation of foreign medical graduates, and deaths in the physician population. The purpose of the investigation was to give the school sufficient information to formulate admissions policy that would take into account the needs of national health programs and the demand for medical care services.


[Activities and strategy of an office or department of medical education]. About eight years ago medical education offices or departments began to be established in the medical and health sciences schools in Latin America. These units have endeavored to solve the problem common to so many of the schools of lack of coordination in activities related to the planning of the various aspects of the teaching/learning process. Many of them have succeeded in doing so and have also been able to interest the university community in the continuing evaluation and improvement of curriculum. The main activities of a medical education office are summarized: educational development (assistance in defining objectives, curriculum organization, teaching methodology, evaluation systems, training of and pedagogical assistance to faculty members); investigation of the factors that enter into the teaching/learning process; and preparation of teaching material and bibliographic information. Clearly the activities of the medical education office or department must be coordinated with those of all the sectors in the school, and it must be open to proposals and suggestions from the entire community.


[Population studies of Gm (a)].

[Population studies of Gm (a)]. The author carried out her own studies of Gm (a) on 2816 persons, in whom a factor frequency was found in 33.3% and gene frequency--0.1833. She summarized all published in Bulgaria up to now population studies in respect to Gm (a) (1838), in whom the mean factor frequency was 38.67% and gene frequency--0.2129. The theoretical probability for excluding fatherhood only by Gm (a) in our country was 10.23%.


[Histomorphological changes in the lymphoid and internal organs of adult guinea pigs in anaphylactic shock, induced 8 months after thymectomy]. Anaphylactic shock was induced in adult guinea pigs eight months after operative thymectomy. It was established that thymectomy caused depletion of lymphoid tissue with atrophy of lymphyc follicles and disappearence of germinative centers in the spleen, mesenterial lymph gland and intestinal lymph tissue. There was no anaphyactic shock in 81.2% of the thymectomized animals as a result of the inhibited immunoallergic reactivity, but dystrophic and inflammatory changes in their parenchymatous organs were more frequent and graver in comparison with the nonthymectomized animals.


[Total protein and serum protein fractions in atherosclerotic animals treated with a protein hydrolysate]. The changes in the metabolism of oranism of animals with experimental atherosclerosis show not only disturbances in the lipid, but early changes in the protein metabolism as well. The author examined total protein and serum protein fractions of 61 male guinea pigs with a weight of 350 to 500 gm. There was marked disproteinemia reduction of albumin and an increase of globulins in the animals with experimental atherosclerosis (which received a diet with 0.3% of cholesterol of the food, disolved in 25% of cow butter for a period of 140 days)...


[Effect of adepren on the behavior and brain catecholamines of rats in an open field setup]. The authors carried out experimental studies with the Bulgarian preparat on Adepren on the behaviour of rats in open field procedure together with parallel electroencephalographic studies and examined the changes in the content of cerebral catecholamines during acute and chronic administration. The preparation after single application had depresive effect on both components of the motor activity: horisontal and vertical. The horizontal component of the motor activity surpassed the norm with almost 20% at the end of the experimental period after chronic administration. There was desynchronizing effect in the KEG recordings. Adepren after acute and chronic application elevated significantly the level of noradrenaline and dopamine in the brain. The obtained results gave a foundation to the authors to suggest that the examined preparation and maoinhibiting effect.


[Electrophysiological aspects in the mechanism of action of some psychotropic drug agents]. On the basis of the experiments on animals the author made an attempt to find out the place of the action of some psychotropic drugs on the central nervous system and to discover the changes, which occurred in the functional state of various cerebral structures. He used drugs Imupramine (Psychoforin) and Diazepan (Valium), administered localy in some structures of the lymbic system and reticular formation of the cat cerebrum, using stereotaxic technique. The evaluation of the occurred changes was made by the changes in the spontaneous and induced cerebral activity, using the method of double stimuli. The obtained results gave foundation to state that drugs with antidepresive action (Imipramin) inhibited amigdalic complex and the structures connected with it, but benzodiazepines (Diazepam) revealed this action also on the mesencephalic reticular formation as the structures, brocked by the antidepresants, were not affected. In conclusion an electrophysilogic argumentation was made for the combined application of both groups of preparations in neurotic patients.


[Role of calcium ions in the contractile effects of acetylcholine (experiments on the guinea pig vas deferens)]. The authors carried out experiments on isolated vasa deferentia, obtained from a guinea pig. Recordings of the isotonic contractile activity was made by means of a strain gauge. Ink records were made on graduated tape of miliampermeter Tesla. Acethylcholine was used in a concentration of 1 X 10(-5) M, but serotonine-in a concentration of 1 X 10(-5) M. Growing reduction of the values was observed very regularly in all experiments both in the serotonine and acethylcholine contractions of vas deferens after diminution of the content of calcium in the Krebs solution from 0,9 to 0,15 mM. Gradual recovery of the value of the spastic effects of the examined substances was observed after placing the isolated organ in Krebs solution with a normal content of calcium. In analogous role of calcium in the spastic effects of the two mediators there were also some differences in the dynamics on which this role was manifested. The authors discussed the significance of the external calcium for the realization of the contractile effects of acethylcholine and serotonine on vas deferens of a guinea pig.