Cellular pathway(s) of antigen processing and presentation in fish APC: endosomal involvement and cell-free antigen presentation. Studies were conducted to address further the role(s) of antigen processing and presentation in the induction of immune responses in a phylogenetically lower vertebrate, specifically a teleost, the channel catfish. In particular, studies were aimed at determining the subcellular compartments involved in antigen degradation by channel catfish antigen-presenting cells (APC) as well as ascertaining the reexpression of immunogenic peptides on the surfaces of APC. The results showed that exogenous protein antigens were actively endocytosed by APC as detected by flow cytometry. Use of radiolabeled antigen and subcellular fractionation protocols also showed that antigen localized in endosomes/lysosomes. Furthermore, there was an apparent redistribution of antigen between these organelles and the plasma membrane during the course of antigen pulsing. Functional assays for the induction of in vitro antigen-specific proliferation of immune catfish peripheral blood leukocytes (PBL) showed that membrane preparations from antigen-pulsed autologous APC were highly stimulatory. The magnitude of responses elicited with such membrane preparations was very similar to that of PBL cultures stimulated with native antigen-pulsed and fixed intact APC or prefixed intact APC incubated with a peptide fragment of the nominal antigen. Current data further corroborate our previous findings that steps akin to antigen processing and presentation are clearly important in the induction of immune responses in lower vertebrates like fish, in a manner similar to that seen in mammalian systems. Consequently, it would appear that many immune functions among the diverse taxa of vertebrates are remarkably conserved.


Serum amyloid P component (SAP)-like protein from botryllid ascidians provides a clue to amyloid function. The HA-1 lectin isolated from Botrylloides leachii has an amino acid composition similar to that of mammalian serum amyloid protein (SAP). SAP is a universal component of mammalian amyloid deposits. Like SAP, HA-1 has a disc ultrastructure, and antibody to HA-1 binds both (a) to amyloidlike fibers deposited between rejected Botrylloides colonies and (b) to cerebral amyloid deposits in Alzheimer's disease brains. Deposition of protochordate amyloid within rejection sites and surrounding fouling organisms implies that these fibers function as barriers to allogeneic and infectious challenge. Similarly, mammalian amyloid may also function to contain inflammatory lesions and to limit the spread of certain infections. Pathological amyloidotic conditions in humans, such as Alzheimer's disease, may result from unregulated expression of this primitive encapsulation response.


Communication deviance in families of schizophrenic and other psychiatric patients: current state of the construct. High levels of parental communication deviance may represent risk markers for the onset of severe psychiatric disorders in vulnerable offspring, and are associated with markers of vulnerability among schizophrenic patients and among at-risk children. Future research that proceeds in the direction of further clarifying the longitudinal association between CD and the onset of severe psychiatric disorders, and the relation of CD to genetically-based vulnerabilities, may result in determining constellations of individual and family attributes that are powerful in identifying high-risk populations.


Felodipine pharmacokinetics and plasma concentration vs effect relationships. Felodipine was completely absorbed from an oral solution (OS), as well as from the conventional (CT) and extended release (ER) tablets. The time to peak plasma concentration increased in the order OS < CT < ER. Peak plasma felodipine concentrations were significantly lower and trough concentrations higher when felodipine was administered in the ER-tablet compared with CT and oral solution. The variability in plasma felodipine concentration during the dose interval, expressed as the fluctuation index, increased in the order ER o.d. < CT b.i.d. < CT o.d. The distribution of the AUC of plasma felodipine concentrations vs time determined in 140 individuals was unimodal, indicating that genetic factors are unlikely to influence the metabolism of felodipine to any clinically significant extent. With increasing age the plasma concentrations and the terminal half-life of felodipine increased, whereas the plasma clearance and the ratio of the AUC of the primary pyridine metabolite to that of unchanged drug decreased. The time to maximum plasma felodipine concentration, the bioavailability and the volume of distribution were not consistently influenced by age. Body weight, body mass index and concomitant intake of beta-blockers had negligible influence on the pharmacokinetics of felodipine. The pharmacokinetics in the limited number females did not differ substantially from that of the males in our investigation. No consistent effect on blood pressure was seen in healthy subjects after administration of felodipine. In hypertensive patients, however, there was a good relationship between plasma felodipine concentration and antihypertensive effect. There was no hysteresis for the reduction in blood pressure. The relationship between plasma felodipine concentration and antihypertensive effect could, in most patients, be described by a modified Emax model. The average Emax value was estimated to be approximately 30 mmHg. Placebo correction decreased the magnitude of the blood pressure reduction. The Emax estimates increased with increasing initial blood pressures whereas age had a negligible effect. Patients with high and low plasma felodipine concentrations had similar Emax values. The EC50 values were not influenced by any of these factors. The Emax model used was less suitable for patients with low initial blood pressure levels. The plasma concentration vs time profile of felodipine is modified by using different pharmaceutical formulations, without loss of bioavailability. As a group, the elderly have higher total concentrations of unchanged felodipine in plasma compared with young individuals. The variation in plasma concentrations between individuals is, however, only partially explained by age. There is a good and direct relationship between felodipine plasma concentrations and antihypertensive effects in hypertensive patients.(ABSTRACT TRUNCATED AT 400 WORDS)


Dietary lipid content influences the clinical and intestinal adaptive responses to islet transplantation in diabetic rats. Nutrient absorption is increased in rats with streptozotocin-induced diabetes mellitus (DM). This intestinal adaptive response is modified by isocaloric manipulations of the dietary content of fatty acids, and separate studies have shown a normalization of the enhanced uptake of glucose and lipids when DM rats are treated with transplantation of 3000 syngeneic pancreatic islets of Langerhans. These studies were undertaken to test the hypothesis that modification of the type of fatty acids in the triglycerides in isocaloric semisynthetic diets (S, saturated fatty acids from beeftallow; or F, polyunsaturated fatty acids from fish oil) fed to DM recipients influences the ability of syngeneic transplanted islets to normalize the clinical indices of glycemic control and the intestinal adaptive response. A suboptimal number of islets was transplanted (1200) under the renal capsule, so that the clinical parameters of diabetic control would be modestly abnormal and so that any possible beneficial influence of this dietary manipulation might better be able to demonstrate a further improvement of clinical endpoints. Adult Male Wistar-Furth rats were rendered diabetic, transplanted with 1200 syngeneic islets, and were then fed for 6 weeks a chow or a isocaloric semisynthetic diet enriched with either S or F. Islet transplantation reduced the diabetes-associated abnormalities in food consumption, body weight gain, intestinal weight, urine glucose concentrations, urine volume, oral glucose tolerance, hemoglobin A1c and blood urea nitrogen concentration; these changes were all similar in transplanted animals fed S, F, or chow. Plasma concentrations of cholesterol and triglycerides were significantly elevated in transplanted rats fed S as compared to those fed F or chow. Transplanted DM rats had reduced in vitro intestinal uptake of stearic, oleic, linoleic and linolenic fatty acids, and cholesterol as compared with untreated DM rats, but the uptake of lipids was similar in transplanted DM rats fed S, F, or chow diets. Feeding rats S prevented the decline in the value of the jejunal maximal transport rate (Vmax) and apparent Michaelis affinity constant (Km) observed in transplanted DM rats fed F, but the lack of difference in glycemic control in transplanted DM rats fed F was likely due to their higher ileal Vmax for glucose uptake. Thus, intestinal adaptive function and clinical glycemic control are influenced by the type of fatty acids fed to syngeneic islet-transplanted DM rats.


Acute and chronic effects of dexfenfluramine on glucose and insulin response to intravenous glucose in diabetic and non-diabetic obese subjects. Fenfluramine improves glucose tolerance in obese subjects independently of its anorectic effect. Increased insulin action has been reported, but such an effect may be secondary to reduced hyperglycemia following augmented insulin secretion. For this reason, we investigated whether the dextro-enantiomer of fenfluramine (dexfenfluramine, dF) has a direct effect on insulin secretion using the glucose infusion test, a technique that can also be used to indirectly evaluate insulin action. Ten lean controls (BMI 21 +/- 0.4 kg/m2), 9 non-diabetic obese subjects (BMI 32.3 +/- 1.1) and 10 obese mild non-insulin dependent diabetics (BMI 36 +/- 2.6, fasting plasma glucose (FPG) 7.9 +/- 0.9 mmol/l) were studied with a random, double blind cross-over protocol. Each subject received 15 mg dF (or placebo) twice daily for 3 days prior to glucose infusion; 30 mg dF (or placebo) were given 90 min before the test. Obese control and diabetic subjects continued treatment with either dF or placebo for one month after which they were retested. There was no significant change in weight or fasting plasma glucose or insulin in any group. Biphasic insulin secretion was demonstrated in both non-diabetic groups, whereas a complete lack of first-phase and a delayed and reduced second phase insulin response was demonstrated in the diabetic subjects. There was no acute or chronic (obese subjects) effect of dF on insulin secretion in any group. In lean control subjects, plasma glucose curves during glucose infusion were unchanged by dF, whereas in non-diabetic obese subjects the glucose slope was improved after both acute and chronic dF, implying augmented glucose disposal. In diabetic patients, no significant acute or chronic effect of dF on glucose response was registered. When all obese subjects were re-grouped according to fasting plasma insulin levels (FPI) and not glucose tolerance, those with relative fasting hyperinsulinemia (> 100 pmol/l, mean +/- SE = 144 +/- 12 pmol/l) showed significant improvement of insulin action after dF, whereas those with low FPI (< 100 pmol/l, mean +/- SE = 65 +/- 7 pmol/l) did not. These findings, together with previously published results of improved insulin action in diabetics during hyperinsulinemic clamps, suggest that dF-mediated improvement in glucose clearance may require substantial plasma insulin concentrations.(ABSTRACT TRUNCATED AT 400 WORDS)


Streptozotocin-induced diabetes and the effects of endurance exercise training. The purpose of this investigation was to determine if endurance exercise training would alter the degenerative effects of streptozotocin diabetes on cardiac function and alter the responses of streptozotocin diabetic rats to induced myocardial ischemia. Diabetic rats experienced a significant (p < 0.05) reduction in cardiac function as evidenced by left ventricular peak systolic pressure (LVPSP), maximal time rate of change of pressure (+dP/dTmax), rate pressure product (RPP), and heart rate (HR). Exercise training apparently reduced the effect of diabetes since the function of non-ischemic hearts from trained diabetic rats was not different from that of non-diabetic rats. It also was not different from the sedentary diabetic rat hearts. Training did not alter the response of the hearts of either group of diabetic rats to induced myocardial ischemia.


Metabolic control following transfer from mixed bovine-porcine insulin to human insulin in subjects with IDDM: influence of the presence of insulin antibodies. Although no distinct advantage of Human insulin (HI) over mixed Bovine-Porcine insulin (BPI) including antigenicity has been noted, initiation of therapy with HI in subjects with new onset IDDM as well as changeover from BPI to HI regimen even in subjects with well controlled DM with BPI has recently become a routine clinical practice. In this study, we assessed metabolic control by determination of fasting plasma glucose and HbA1C levels as well as serum cholesterol and triglyceride concentrations in 12 men and 2 women (ages 43-74 yrs) with uncontrolled DM while receiving BPI and again at the end of 6 months following changeover to HI with identical insulin regimen in terms of the type of insulin as well as the dosage. The subjects were divided into two groups according to the presence of antibodies to insulin of both bovine and porcine forms in their sera. Metabolic control improved significantly in 6 subjects, with positive antibody titers to bovine-porcine insulin as reflected by lowering of all metabolic parameters (p < 0.05 of all comparisons). However, the remaining 8 subjects with negative antibody titers failed to show a significant change in any of the parameters. Therefore, this study suggests that a changeover from BPI to HI maybe recommended in subjects with presence of BPI antibodies and not in all DM subjects treated with BPI regimen. Moreover, it may be feasible to initiate therapy with BPI regimen in new onset IDDM and change later to HI on occurrence of BPI antibodies; since if HI regimen is used at onset and antibodies to HI develop; the only option available then, may be the increased dosage of HI.


[The present status and perspectives of the University of Zagreb Medical School]. Ranked as the leading school of medicine in Croatia, University of Zagreb School of Medicine has succeeded to maintain the continuity of the high quality teaching process despite of the heritage of the socialist educational system and the harsh times of war. With the introduction of the six-year curriculum, where the "problem-solving" method is given prominence to, the school has fulfilled its requirements to meet the European standards of medical education. Teaching of the basic medical sciences is faced predominantly with the problems of obsolete equipment, whereas the quality of the education of the clinical subjects has not yet reached the desirable standards in all segments. Scientists from the University of School Zagreb of Medicine contribute to the overall scientific output of the Republic of Croatia with 10 to 20%, in addition to appearance of significant number of papers published in the international periodicals. According to the latest faculty roster, the number of full professors with teaching appointments is much too excessive. The University of Zagreb School of Medicine sees its main goal in the improvement of the quality of the teaching process. This goal is to be accomplished through introduction of the new courses (molecular biology, neuroscience, emergency medicine, ecology, medical economy etc.), improvement of the teaching methods, as well as through high standards of teaching the elective courses. Overall number of exams is also to be reduced in due time, whereas the future curriculum should provide a comprehensive medical teaching, with students actively participating in the teaching process through the first-hand experience with patients.(ABSTRACT TRUNCATED AT 250 WORDS)


[Reconstructive surgery in war injuries of the bones and joints]. The basic problems of bone-and-joint surgery with special emphasis on war injuries and the role of reconstructive surgery in relieving the gravest consequences of war injuries are discussed. Since bone and joint injuries rank high among the war injuries with a share of over 70% including more than 30% of fractures, they pose not only a serious medical and surgical but also a major public health problem. The economic and social consequences of these injuries are further aggravated by the necessity for prolonged treatment and multiple surgical interventions. The basic preconditions which must be fulfilled for bone healing to take place are discussed in the light of the ultimate goal of all therapeutic efforts. i.e. restoration of full functional ability of the injured extremity. The importance of bone fragment immobilization for the process of bone healing is emphasized. Impaired bone healing, resulting from insufficient immobilization or inadequate reposition of bone fragments, is a common problem with war fractures, mainly because of the great forces involved and extensive destruction of bone and all other surrounding tissues. One of the main features of war fractures is delayed bone healing caused by massive circulatory defects in the injured bone. Some special problems attending war injuries, such as pseudarthroses and associated defects, soft tissue infections and defects, may only be effectively solved by cooperation with a plastic-vascular- or neurosurgeon. In one and joint surgery profound understanding of the physiology, pathophysiology and biomechanics of bone healing, knowledge of modern methods of osteosynthesis, skill in the management of bone and other infections as well as knowledge of the latest developments in postoperative care are essential for achieving satisfactory therapeutic results. Availability of various implants and a wide range of surgical instruments is a precondition which needs no further discussion. It is only in this way that the most promising course of action can be selected for each wounded person individually, a course of action which will, in the shortest possible time and the most convenient manner, lead to the desired therapeutic goal, i.e. restoration of satisfactory bone and joint function.


[Electrocardiographic changes in children with surgery for defects of the atrial septum]. Electrocardiograms obtained prior to surgery, after surgery and in the period between 6 months and 2 years following the surgery were analyzed in 44 children operated because of atrial septal defect. The following electrocardiographic parameters were selected: the P wave, PQ interval, QRS complex and right bundle branch block The P wave narrowing developed gradually, i.e. not earlier than the follow-up period, and it was statistically significant (p = 0.001). The duration of the PQ interval decreased significantly right after the operation (p = 0.001). No changes were seen in the width of the QRS complex neither following the surgical procedure nor in the later postoperative period. The number of children with right bundle branch block decreased significantly immediately after the surgery (p = 0.0108). Willson's right bundle branch block disappeared gradually after operation (p = 0.0282).


[The significance of low levels of total proteins, albumins, globulins and complement factors in ascitic fluid and the development of spontaneous bacterial peritonitis in patients with liver cirrhosis]. Spontaneous bacterial peritonitis is one of the most common complications of ascitic fluid in patients with liver cirrhosis. The aim of this study was to investigate the role of total protein, albumin, globulin and complement ascitic fluid concentrations in development of spontaneous bacterial peritonitis in patients with liver cirrhosis. In patients with liver cirrhosis and spontaneous bacterial peritonitis (n = 8) the ascitic fluid total protein, albumin and globulin concentrations were significantly lower than in patients with sterile ascites (n = 11) (p < 0.01). The ascitic fluid complement C3 and C4 concentrations were significantly lower in patients with spontaneous bacterial peritonitis than in patients with sterile ascites (9.1 +/- 3.1 mg/dL to 22.9 +/- 17.4 mg/dL, p < 0.01; 3.8 +/- 5.9 mg/dL to 8.2 +/- 5.9 mg/dL, p < 0.01, respectively). The ascites total protein, albumin, globulin and complement concentrations in cirrhotic patients with spontaneous bacterial peritonitis were significantly lower than in patients with sterile ascites demonstrating the importance of those factors in ascitic fluid defense against secondary bacterial infection.


[A comprehensive program in the fight against chronic non-infectious diseases in a basic population group--the Belec Study. IV. The interventional model]. As part of a comprehensive programme aimed at the struggle against chronic non-infectious diseases in basic population groups, an intervention model in the rural community Belec has been set up. The development, application and evaluation of this intervention model with an emphasis on positive experiences and difficulties connected with such a model have been described. The role of important parts of the programme has been emphasized--the work of the Health Committee and Guidance Clinic of Elevated Blood Pressure. The results show that there is necessary and possible to efficaciously involve the population of the community into the priority assessment, planning, application and follow-up of such a programme. However, the close cooperation with the local health service and other community sectors and their support is indispensible. It is also stressed that the economic and social development of the rural community is the prerequisite for the continuous intervention measures to be carried out and health care system promoted.


[Respiratory function in glass blowers]. The prevalence of chronic and acute respiratory symptoms and diseases and changes in lung function in a group of 80 glass blowers have been investigated. In addition a group of 80 not exposed workers was used as a control group for respiratory symptoms and diseases. In glass blowers, there was significant increase in prevalence of chronic bronchitis, nasal catarrh, and sinusitis than in the controls. Glass blowers exposed for more and less than 10 years had similar prevalences of respiratory symptoms. A large number of glass blowers complained of acute across-shift symptoms. Significant increase in FVC, FEF50 and FEF25 was documented at the end of the work shift. Comparison with predicted normal values showed that glass blowers had FVC and FEF25 significantly lower than predicted. RV and RV/TLC were significantly increased compared with the predicted normal values. DLCO was within the normal values in most glass blowers. It is concluded that work in the glass blower industry is likely to lead the development of chronic respiratory disorders.


[Follow-up of respiratory symptoms and pulmonary ventilatory function in jute textile workers]. The acute and chronic effects of exposure to jute dust on respiratory function was studied in a group of textile workers over a 19-year period. During the initial study the prevalence of all chronic respiratory symptoms was higher among the exposed workers compared with the controls. These differences in the prevalence were statistically significant at the time of the follow-up study, 19 years later. Four textile workers developed symptoms of occupational asthma during exposure to jute dust. Measurement of ventilatory capacity at both surveys demonstrated small but statistically significant mean acute reductions of FVC and FEV1 over the work shift. The values for FVC and FEV1 measured at the time of the follow-up study were significantly lower than the predicted normal values. The mean annual decrease for FVC and FEV1 was 35 ml/year what is greater than expected. Our data suggest that exposure to jute dust may in sensitive workers lead to the development of respiratory symptoms and diseases with less pronounced changes in ventilatory capacity.


[Toxocariasis in children].

[Toxocariasis in children]. Ten children with toxocariasis are presented. All were admitted because of high eosinophilia accompanied by minor and non-specific disturbances of the general health condition. There were 6 girls and 4 boys in this series; the age ranged from 21 months to 9 years. Three of the children practised geophagia. Toxocariasis was confirmed by the enzyme-linked immunosorbent assay (ELISA). The absolute number of eosinophils in the peripheral blood was 592-29784 per mm3, median 6007 per mm3. Treatment consisted of thiabendazole, 30-50 mg/kg b. i. d. for 5 days. Immediately following the treatment there was an impressive fall in the absolute eosinophil count (142-10660 per mm3, median 837/mm3). However, 2-8 weeks thereafter the eosinophilia rose to high levels again, although somewhat lower than the pretreatment ones. Toxocariasis should be included in the differential diagnosis of high peripheral eosinophilia. The patients are commonly in a good general condition, although an occasional massive invasion may necessitate prompt and vigorous treatment.


[Cancer of the female sex organs in Baranja: 1985-1990]. Over a 6-year-period (January 1, 1985 to December 31, 1990) 86 women with cancer of genital organs were detected in the region of Baranya. According to the census of the year 1981, 27416 women have lived in Baranya, and in the above mentioned period 23533 examinations were done at the Women Welfare Clinic of the Health Centre Beli Manastir. In the period from 1985 to 1989, the average frequency of cervical cancer was 63.1%, uterine corpus cancer followed with 19.7%, ovarian and tubal with 13.1%, vulvar with 2.6% and vaginal with 1.3%. In the period from January 1 to December 31, 1990, cervical cancer accounted for 45.4% of all cancer cases, corpus cancer for 27.2%, ovarian and tubal cancer for 18.1%, without detection of any vulvar or vaginal cancer cases. In the observed period mean annual incidence of genital cancer was 52.9 per 100,000. According to organ sites mean annual incidence of cervical cancer was 32.1, corpus cancer 10.9, ovarian and tubal cancer 7.3, vulvar 1.2 and vaginal cancer 0.7 per 100,000. During the six year period cervical cancer incidence was reduced from 43.8 in 1985 to 18.2 per 100,000 in 1990. Corpus cancer incidence in 1985 was 14.6 as compared to 10.9 in 1990. Ovarian and tubal cancer incidence in 1985 and 1990 was 10.9 and 7.3, respectively. In the observed period preinvasive lesions of genital organs were discovered in 208 women, 201 (96.6%) of whom had cervical lesions--mean incidence here is 122.2 per 100,000. The overall proportion of preinvasive to invasive cervical lesions in the observed period was 79.1% to 20.9%.(ABSTRACT TRUNCATED AT 250 WORDS)


[Granuloma of the oval window after stapedectomy]. A case report is presented of a female patient who underwent stapedotomy with bad functional results Reoperation revealed a dislocated prosthesis and there was no successful hearing. Besides conduction deafness perceptive deafness occurred as well. The second reoperation disclosed reparative granuloma around the prosthesis, while histological analysis showed foreign-body granuloma. Foreign-body granuloma by stapedectomy is extremely rare and it was the first case in our 810 surgically treated ears.


[Adenomas of the thyroid gland--criteria for pathohistologic diagnosis]. Adenomas are the frequent tumors of the thyroid gland, which have different histological types, distinct criteria for pathohistological diagnosis, and distinct criteria for differentiation the follicular adenoma from follicular carcinoma of the thyroid gland. Authors have analyzed 63 patients with follicular adenomas of the thyroid gland which were diagnosed and treated at the Central Institute for Tumors and Allied Diseases in Zagreb in the period from 1986 to 1987, and on which had been done serial cuttings of the tumors for pathohistological diagnosis.


[Pulmonary edema following obstruction of the upper airway]. The development of pulmonary edema after the relief of upper airway obstruction in two patients is described. Pulmonary edema in those patients was the result of increased negative intrapleural and intra-alveolar pressure during forceful inspiration and in the course of upper airway obstruction. An increase in the venous return occurs and the established transpulmonary pressure gradient promotes transudation into the interstitium and alveoli. Consequent alveolar hyperventilation results in hypoxia and acidosis. All patients developing pulmonary edema should be treated with positive pressure ventilation within 24-36 hours. The aim of this study was to alert physicians that besides know factors for the development of cardiogenic and noncardiogenic pulmonary edema there are also other significant mechanisms that cause the accumulation of fluid in pulmonary tissue.


[Inner ear injuries in breath-holding divers]. Five breath-hold divers with inner ear barotrauma due to the diving to 10 meters of depth have been treated at the Department of Otorhinolaryngology, Pula Medical Centre during 1990. Because of eustachian tube dysfunction, a negative middle ear pressure is transmitted into the inner ear over the round and oval window causing a lower hydrostatic pressure of the inner ear fluids and consequent delay in microcirculation of the inner auditory artery. Together with a hypoxia in apnea the oxygen demand is increased and the inner ear neuroepithelium damage is more severe. All treated divers had irreversible sensorineural hearing loss of the attacked ear on frequency range higher than 2000 Hz to 70-80 dB.


[Methods of monitoring health care needs of the aged]. The Monitoring of Healthcare Needs (MHN) of the elderly was begun in the Republic of Croatia in 1989, with all healthcare data linked to the patients identity card numbers. Such an approach is the usual basis of healthcare planning in developed countries. Another innovation in MHN is that, as well as information about healthcare, records are compiled on the functional states of the elderly, which is a precondition for the efficient provision of healthcare services appropriate to the needs of the patients. Among the people (3709 in total) covered by the MHN scheme at the end of 1989, 2760 people of average age 77 years were living in long-term care institutions in Zagreb. It is found that this people become ill more frequently than people who are covered by the general healthcare programme and do not live in long-term care institutions. Because of a change in functional state, one third of elderly people require specific permanent in-patient healthcare, while from time to time almost one quarter of people covered by the scheme and living in long-term care institutions need such treatment. On the basis of the MHN scheme, it is possible to appropriately promote and organise primary healthcare for the elderly.


[The Zagreb Medical School from the "Croatian spring" to the first multi-party elections]. Schools of Medicine are institutions for an integrative approach to diseases and health, comprising at the same time scientific, teaching and treatment aspects of the nosological entities. These three functions are optimal only when academic freedom and sufficient financial support are satisfied. The authors analyze the last twenty years of academic performance of the University of Zagreb School of Medicine which were considerably influenced by the external political demands imposed by the so-called self-management phase of former communist regime. The constant restructuring of the internal organization, lower investments in science and quantitative expansion in all the activities of the School were the major characteristics of this period. International comparisons, especially in the light of recent development of molecular biology, demonstrate that this was rather growth than development of the oldest School of Medicine of Croatia. The authors emphasize the importance of academic freedom and strong international cooperation for the development and maintenance of quality of teaching schools.


[Comparative analysis of pathomorphologic changes in the adrenal glands using ultrasound and computer tomography]. A prospective study of the possibilities and achievements of ultrasonography of the adrenal glands is presented. The adrenal glands of 146 patients with abnormalities suspected clinically were examined with ultrasound. Patients were also evaluated with computed tomography where there are firm criteria for the evaluation of adrenal pathology. Positive findings were detected by ultrasound in 46 patients, whereas computed tomography disclosed pathologic changes in 65 patients. In 81 patients, the finding of computed tomography was normal. With ultrasound, false positives were obtained in 3 cases and false negatives in 19 cases (14 hyperplasias, 5 tumors). Ultrasound findings were additionally compared with angiographic and clinical tests as well as with pathohistologic results of surgery and autopsy.


[The role and importance of an elemental diet in the treatment of Crohn's disease in children]. Crohn's disease plays an important role in children's pathology. There is an increase in its incidence last decades. The etiology of Crohn's disease isn't yet known. The aim of therapy is to induce remission of the symptoms and disease's activity. Drug treatment as well as surgical procedures according to the side-effects and short-lasting effect have not shown to be satisfactory so far. Very important feature of Crohn's disease is growth retardation as well as puberty delay what is even emphasized by corticosteroid therapy which these children are quite long on. Recent research has shown that an elemental diet is as effective as corticosteroid therapy in inducing remission. Its positive effect on growth has been especially emphasized. It is not still certain how the elemental diet acts. It is supposed that its useful effects are achieved by its complete absorption without the need for extra digestion, by bowel rest, hypoallergenicity, changing in intestinal microflora, by caloric intake and reducing protein exudation by a direct influence on the mucosa of the small intestine. Because of all previously mentioned the elemental diet is recommended as a treatment of choice, especially for the nonstenositing features of Crohn's disease of the small intestine.


[A critical report on drugs in 1991].

[A critical report on drugs in 1991]. Principal changes in the drug field in this country in 1991 were caused by the armed aggression committed against Croatia and the succession of disturbances that this aggression induced. Abroad as many as 13.6% of drugs could be ranked as category A. Here dominate some drugs for AIDS, which is a significant problem in medicine, but also some drugs for rare diseases ("orphan drugs"), like Gaucher's disease, precocious puberty etc. In this country (until the sovereignty was reached on October 8, 1991) 13.8% of drugs belonging to category B were approved. In category C ranked were 83.0% of drugs, abroad 75%. Two in this country (rutoside and creatinephosphate), one abroad (ditiocarb) were classed in category D. At preparing new Drug Law of independent Croatia, caution is necessary over numerous details which will enable us to become, in this field too, as soon as possible a part of the developed Europe. The latest List of Drugs that is paid by the Croatian Health Insurance is discussed. It comprises up to 230 generic names, excluding those that are--unjustifiably--most prescribed. The List's aim is to rationalize drug therapy, allowing other modes of prescribing improvement. To a large degree drug prescribing is not rational. The latest data (1990) have shown that only 4 out of 10 most prescribed drugs in Zagreb are undoubtedly efficacious, 9 out of 10 in Ljubljana, 5 out of 10 (1989/90) in former Yugoslavia, and abroad ("in the world") all 10. The characteristics of drug filed in war are reviewed as well as problems connected with drug donations. The importance of concern that "aimed" donations replace those that are not optimally used is stressed. The article ends with the question of the importance of objective information sources in drug field.


[Analysis of the use of digitalis in a sample of the geriatric population]. Rationality of digitalis use in 20 elderly patients in long term-care institution was analysed using the method of correlation of the past medical history, clinical examination and basic laboratory findings. After consultation of clinical pharmacologist, general practitioner and medical biochemist it was possible to stop the digoxin therapy in 6 (30%) of the patients. Four (20%) patients were hypersaturated with digoxin. Lack of indication was the reason for stopping the digitalis in one of them. Therapy was modified in 3 patients. Use of digitalis was rational in 10 (50%) of the patients. The results suggest that digitalis was prescribed too often in this sample of the elderly patients.


[Diagnostic criteria in multiple sclerosis]. Almost all the neurological diseases can imitate multiple sclerosis. No strictly specific laboratory test has become as yet available for its diagnosis. Information obtained by clinical examination of the patient--dissemination of different symptoms at the same time and the same symptom in various periods--supplemented by neuroradiological, neurophysiological and biological supplementary tests allow making diagnosis of multiple sclerosis with about hundred percent certainty.


[Pathologic mechanisms in the development of psoriatic lesions]. Psoriasis is a chronic recessive disease of unknown etiology, insufficiently explained and with a rather complex pathogenesis. In this paper the role of polymorphonuclear leukocytes, products lipids (arachidonic acid, leukotriene, 12-hydroxyeicosatetraenoic acid and the others) has been considered, as well as some immunological moments and the role of complements and platelet activating factor. It has not been explained up to now which one of these factors has the main role in the psoriatic lesion development. The primary defect in this genetically determined disease is unknown. All the elements listed in the sequence of events have secondary or tertiary significance.


[The cancer morbidity of workers in rubber manufacture]. The report discusses the results of the first study of cancer morbidity undertaken in the former USSR in a cohort of rubber workers versus length of service. Certain groups of occupations revealed high risk for malignant tumors of the oral cavity, throat, stomach, pancreas, large and rectal colon, lung, brain, lymphatic and hemopoietic tissue. Relatively high risk of tumors of the larynx, gallbladder, biliary tracts, ovary and vulva was found in females working under hazardous conditions. Agreement of the results with those reported aboard points to elevated risk of cancer in domestic rubber production, too.


[The effects of endothelin on various tissues]. The aim of this paper was to describe effects of endothelin on smooth muscles of different species. Endothelin was studied as a vasoconstrictor, neuromodulator and modulator of neurotransmission. Especially was described mechanism of action and role in different pathophysiologic processes.


[The immunomodulating role of indomethacin in the chemoradiation treatment of inoperable patients with lung cancer]. The immunocorrective effect of indomethacin in the course of chemoradiation treatment for inoperable lung cancer was established in a group of 117 patients. It manifested itself in an increase in T-lymphocyte level, normalization of their membrane structure and improvement in immunoregulatory function mainly due to a rise in T-helper/inductor level. Blood plasma-circulating immune complex concentration returned to normal. The concomitant administration of indomethacin during chemoradiation therapy improved subjective status of patients and tumor response but failed to increase survival.


[Ultrasound in the diagnosis and therapy of collections of fluid in the abdomen]. The procedure of percutaneous, echosonographicaly guided puncture and drainage of localized abdominal fluid collections by use of fine-needle and catheter is described in this review. The care prior to and after the puncture is also reported. This diagnostic as well as therapeutic modality can delay or make unnecessary surgical intervention resulting in a complete improvement. Twenty patients were treated with this procedure and we describe three cases in whom this treatment was successfully applied.


[The adjuvant chemotherapy of breast cancer]. A clinical trial undertaken at Surgical Department No. I of the Institute included the data on 569 cases of stage I-III breast cancer treated in 1985-1989. Adjuvant CMF or TMF chemotherapy failed to improved 5-year survival (chemotherapy 2--285.2%, no chemotherapy--84.8%) in patients with stage I-IIa (TO-2NOMO) disease. Adjuvant treatment with adrioblastin proved superior over CMF and TMF in terms of 5-year overall survival in patients with stage III (T3NO-IMO; TO-3N2MO) cancer (71.0 and 55.0%, respectively).


[Diabetic maculopathy].

[Diabetic maculopathy]. Diabetic maculopathy is a leading cause of decreased vision from diabetic retinopathy. It is usually encountered in older non-insulin-dependent diabetics with mainly nonproliferative diabetic retinopathy. Diabetic maculopathy can be divided into three main types, exudative (focal), edematous (diffuse or cystoid) and ischemic. Many reports do not distinguish among the various forms of diabetic maculopathy, but only discuss the diabetic macular edema which is the first and the most dominant sign of diabetic maculopathy. No drug therapy has shown to have therapeutic effect in diabetic maculopathy. Photocoagulation, although, symptomatic, is of benefit in edematous and exudative diabetic maculopathy, in the sense that it produces an improvement or maintenance of the clinical picture and visual acuity. Thereby, good glycemic control and the treatment of potential systemic diseases such as hypertension and renal failure are recommended. Photocoagulation is focal, applied directly at microaneurysms and areas of fluorescein leakages and in a "grid" pattern for diffuse macular edema. Fluorescein angiography is necessary to discover the areas of fluorescein leakage, and is helpful in the follow-up of treatment results.


[The erythrocyte functional status and phospholipid composition in breast cancer patients]. A study of the osmotic resistance of both red blood cells and phospholipids of whole blood and isolated red blood cells showed breast cancer with symptoms of metastasis to involve perverted influence of calcium ions on osmoerythrograms. It is also characterized by similarly high levels of lysophospholipids both in whole blood and in isolated red blood cells and phosphatidylinositol levels which are lower than in metastasis-free cases. Red blood cells from cases of metastatic spreading revealed relatively lower values of the phosphatidylcholine/phosphatidylethanolamine ratio, too.


[Age-related changes in the reaction of the adrenal cortex to surgical stress in cancer patients]. 11-Oxycorticosteroids levels were determined in 371 patients with breast, stomach and rectal cancer in the process of surgical treatment. More pronounced reaction of the adrenal cortex to surgical stress and/or time-delayed restoration of the hormone level within the next few days were found in older patients. Resistance to inhibition by dexamethasone in stomach cancer patients was accompanied by elevated cortisol levels during operation. It is concluded that age-related decrease in hypothalamo-pituitary complex sensitivity to inhibition by corticosteroids may be a cause of hypercortisolemia in the course of surgery.


[The dynamics of the hormonal and tumor marker levels in response to adrenaline administration in lung cancer patients]. CIA, ferritin, ACTH, cortisol, TTH, T3, T4, insulin, CT and PTH levels were assayed radioimmunologically in the blood serum of 227 patients with lung cancer, stages I-IV, 134 cases of chronic nonspecific diseases of the lung, 28 patients with benign tumors of the lung and 30 healthy subjects. Adrenaline tests were carried out in 160 of them. Similar shifts were observed in hormone profile in both cancer and non-cancer patients. The predictive value of the hormone tests for stage I-II cancer appeared higher than in those for CIA and ferritin. However, the diagnostic value of a single test of marker proved insufficient for its practical use. Adrenaline tests identify fine disturbances in endocrine regulation and considerably raise the predictive value of such indicators as ACTH, insulin, TTH, T3, T4 and calcitonin. To assure high effectiveness of the use of basic radioimmunological data, a combination of indexes should be prepared for each case, and it should include, apart from basic levels of markers, their post-test values and indexes of reactivity.


[The enhancement of the efficacy of adriamycin by using hepatoprotectors of plant origin in metastases of Ehrlich's adenocarcinoma to the liver in mice]. It was shown that the use of an anthracycline antibiotic--adriamycin in mice with metastatic involvement resulted in pronounced liver dysfunction, as suggested by a sharp increase in blood transaminase levels. In the same model, a hepatoprotector of plant origin--Rhodiola rosea extract--was shown to inhibit tumor dissemination. Combined application of adriamycin and the extract proved no inferior in terms of antimetastatic efficacy and nearly free from toxicity.


[The effect of peripheral cholinergic blockers on the cocarcinogenic action of an experimental influenza infection]. The cocarcinogenic effect of chronic influenza infection was shown to be mediated by M-cholinergic structures. Administration of a M-anticholinergic agent in low dose at the key stages of chronic influenza infection development was followed by a nearly complete suppression of its cocarcinogenic action. N-anticholinergic agents failed to exert such effect.


[Interclonal and interpopulational differences in the frequency of spontaneous karyotypic changes in cell populations of transplantable rat rhabdomyosarcoma RA-2]. Rat organospecific transplantable RA-2 rhabdomyosarcoma substrains RA-2H (high metastatic potential), RA-2L (low metastatic potential) and RA-2T (thermal resistance) were investigated using single cell cloning technique for frequency of micronucleated cells (FMC). Significant interclonal and interpopulational differences were established. Average FMC for RA-2H was 2.96 +/- 0.13%; 5.94 +/- 0.24% for RA-2L and 1.89 +/- 0.12% for RA-2T. Clones showed 5-10 times differences in FMC in each substrain. FMC versus growth time and clone size was studied in RA-2H: average FMC dropped from 2.7% on day 9 to 0.5% on day 20 after administration and the lowest values were recorded in larger clones at each stage. Perspectives of FMC studies in tumor cell populations are discussed.


[The rehabilitative treatment of children with bone sarcomas]. The paper deals with the experience gained in carrying out rehabilitative surgery in 33 infant patients (37 operations) with bone sarcoma within 12 months to 12 years after combined treatment of primary tumor. Twenty-two operations using procedures of compression-distraction osteosynthesis were performed in 18 patients for post-surgery development of bone deformities and shorter limbs. shortening. Advantages of compression-distraction procedures are discussed since their application allows to make incisions and remove bone in areas outside the zone of radiation injury and permanent monitoring of exposed soft tissue condition. Twenty-two infants survived 5 years after orthopedic treatment. Four children died from metastases into the lungs 1-4 years after orthopedic rehabilitation.


[A method for making up the cost pricing of clinico-diagnostic studies in oncology]. The functioning of the present-day system of public health is largely determined by the extent and effectiveness of the use of resources. The saving of resources is reflected in the costs. The research was concerned with development of methods of calculating the costs of clinical laboratory tests. Due account of costs offers means for evolving new patterns of self-reliance accounting and paid medical services.


[The lack of knowledgeability of men about testicular tumors as a cause for the late diagnosis of this disease]. Five hundred and sixty-two males, aged 15-50 years, were questionnaired to assess their knowledge about testicular cancer, its early symptoms, treatment and role of self-examination in early diagnosis of tumor. Only 25 (4.5%) respondents answered all 9 questions correctly whereas 93 (16.6i%) failed completely. On the average, each respondent gave a correct answer to four questions out of nine. The study pointed to very poor knowledge about testicular cancer among young males. This calls for making educational effort to improve the situation.


[The rate of antipyrine metabolism in cancer patients administered specific therapy]. Liver monooxygenase (MO) activity was evaluated in 31 children with oncological diseases. The enzyme activity was assessed by measuring the saliva half life of the test drug antipyrine. It was shown that MO activity is reduced in hepatitis, metastatic lesions of the liver, after long-term chemotherapy, combined treatment or progress of disease. Considerable individual variations in MO activity were observed even in cases of comparable pathologies during examinations. It is suggested that therapeutic response in patients with low MO liver levels could be optimized by appropriately stimulating said enzyme system prior to chemotherapy.


[Familial-populational studies of endometrial cancer: segregation and genetic dispersion analyses]. A clinico-genealogic investigation was carried out in 216 patients with endometrial cancer. Familial accumulation of endometrial and other cancer incidence was established. The segregation rates appeared to be lower than those expected from simple Mendelian models (2-11%). A multifactorial nature of endometrial cancer in overall susceptibility to the disease was found to be at 61%. A genetic correlation analysis showed endometrial cancer to share common genes with breast and gastric cancer in females. Tables of recurrent risk of the disease for relatives were prepared to be used in medico-genetic counseling.


[The mucin profile in the mucosa of the large intestine in neoplasms]. Qualitative and quantitative changes in secretion of goblet cells of large bowel mucosa in adenomatous polyps (60), adenocarcinoma (30) and bioptates of adjacent transitional mucosa (30) were studied. As neoplasia progressed, mucin profile appeared to follow a certain pattern: it reached its peak in moderate dysplasia in polyps containing predominantly sulphomucins; subsequently both sulphomucin and sialomucin levels decreased. Adenocarcinomas showed a sharp drop in glycoprotein level, and an insignificant build-up of sialomucins was registered in some cases only. Enhanced abnormal secretion was observed in mucinous carcinoma and adenocarcinoma characterized by the presence of large mucinous areas. Also, qualitative changes were identified in transitional mucosa adjacent to tumor.


[The glutathione enzymatic redox system in the blood of patients with lymphoproliferative diseases]. The study deals with an evaluation of activity of cellular antioxidative system enzymes such as glutathione reductase and glutathione: H2O2 peroxidase in blood plasma, leukocytes and lymphocytes of healthy subjects and patients with lymphoproliferative diseases such as Hodgkin's disease, acute leukemia ana lymphosarcoma. A decrease in enzymatic activity in blood and glutathione redox-system dysbalance was identified in the patients group.


[The lithium carbonate promotion of urothelial tumors in rats induced with N-butyl-N-(4-hydroxybutyl)-nitrosamine]. The effect of lithium carbonate on promotion of N-butyl-N-(4-hydroxybutyl)-nitrosamine-induced bladder tumors in rats was studied. Lithium carbonate acted as promoter in bladder carcinogenesis resulting in a 6-fold increase in the tumor occurrence as compared to controls. The experiments with sequential injection of the agent showed its promoting effect to be most apparent within 3-6 months following exposure to the carcinogen.


[The optimization of sample preparation for the analysis of the content of carcinogenic polycyclic aromatic hydrocarbons]. Issues in preparation of samples of the environment for benzo(a)pyrene level assay are discussed. Certain procedures of sample preparation are described. A new method allowing better extraction of polycyclic aromatic hydrocarbons from solid samples is suggested.


[The potentials of computed tomography in assessing the spread of lung cancer]. The paper presents the results of a complex examination of 198 cases of lung cancer, using computed tomography, which provided additional data in 52.3% of cases. These data were used to assess the tumor spreading to the mediastinum, pleura and thoracic wall. The computed tomography-related features of lymphatic nodes of the mediastinum, both normal and metastatically involved, are discussed.


[The effect of prednisolone on the efficacy of the diagnosis of pulmonary cancer and tuberculosis]. The report describes a test intended to increase the efficacy and precision of cytologic diagnosis of lung cancer as well as bacterioscopic diagnosis of pulmonary tuberculosis. The test is run during examinations of sputum and pleural exudate. It uses prednisolone, per os, 30 mg daily, for 3 days, then sputum and pleural exudate are tested for cancer cells presence and/or mycobacteria of tuberculosis. A 100% diagnostic specificity of the test in diagnosing cancer and tuberculosis and unsophisticated procedures involved make the case for its application in all oncological, pulmonological and tuberculosis controlling institutions.


[The surgical treatment of cancer of the middle lobe of the lung]. The immediate and long-term results of surgical treatment for cancer of the middle lobe of the lung in 84 patients are discussed. Radical procedure was used in 65 (77.4%) patients. Postoperative lethality was 6.1% (4 cases out of 65). 30.2% survived over 5 years. Regional lymphatic node involvement was found to significantly affect the end results. At zero involvement, 5-years survival was 38.7% whereas at involvement 1-2, it dropped to 8.3%. With regional nodes intact, midlobectomy was survived for more than 5 years by 20.0%, bilobectomy--71.4%, and pneumonectomy--35.7%. Maximal advantage is assured by bilobectomy since it allows for adequate lymphadendissection, midlobectomy being not radical enough for surgical treatment of lung cancer.


[Echography in primary malignant liver tumor in clinical and practical medical disability expertise]. The results of 8936 abdominal ultrasonographies were analysed. Primary hepatic cancer was detected in 27 (0.3%) patients of whom 8 (28.6%) showed concomitant chronic hepatitis or cirrhosis. Ultrasonographic signs of primary carcinoma as well as their clinical features were evaluated. The reliability of ultrasonography proved 85.7% which assures better treatment and ability assessment.


[The lung cancer morbidity of the population of the Noril'sk industrial district]. The report is concerned with an analysis of lung cancer morbidity (1979-1986) in the population of the Norilsk industrial region versus age. In the 50-59 and 60-69 years age groups, it was found to be 2.1-2.5 times the national and Krasnoyarsk regional levels. Carcinogenic hazards involved in processing ores of different metals contribute to such morbidity.


Operative laparoscopy for tubal pathology. Tubal pathology has represented in the last years, the main indication to operative laparoscopy, mainly as a consequence of the widespread use of this technique in the treatment of the ectopic pregnancy. Furthermore, operative laparoscopy has been widely applied to the treatment of the distal tubal pathology for infertility, when IVF/ET failed or was not accepted. The Authors discuss the rationale for these applications of operative laparoscopy and also the possibility of performing by laparoscopy demolitive interventions on the tubes.


Effect of MK-801 on dopamine release evoked by hypoxia combined with hypoglycemia. [3H]dopamine ([3H]DA) release was measured from rat striatal slices under normoxic and hypoxic conditions. In some experiments hypoxia was combined with glucose withdrawal. Hypoxia increased the evoked release of dopamine without affecting resting release. Hypoglycemia itself increased only the resting release of [3H]DA. In the absence of glucose hypoxia provoked a dramatic rise in both resting and stimulation-evoked release of dopamine. This effect was partly reduced by Ca2+ withdrawal, and was abolished in the presence of tetrodotoxin (1 microM). The NMDA-receptor antagonist MK-801 (3 microM) attenuated the effect of hypoxia and hypoglycemia on [3H]DA release. It was suggested that activation of NMDA receptors is involved in dopamine release during hypoxia and energy deprivation.


Effect of acetylcarnitine treatment in oligoasthenospermic patients. Acetylcarnitine (AC), present in human spermatozoa and seminal fluid, plays an important role in sperm metabolism. To further investigate the effect of AC on sperm quality, AC (4 g/day) was given to 20 patients with idiopathic oliogasthenospermia for 60 days. AC had no effects on sperm density and total motility, but it did significantly increase progressive sperm motility (mean +/- SEM: 21.7 +/- 3.2% vs 38.2 +/- 4.7). The increment in sperm motility was sustained ( > or = 40%) in 12 patients (mean increment 2.7 fold). This parameter returned to basal value 4 months after therapy discontinuation. Five pregnancies occurred during treatment and only 2 during the 4 months follow-up ensuing therapy discontinuation.


Therapeutic effect of gonadotropins with and without a GnRH analogue (D6-tryptophan) in male infertility due to idiopathic oligoasthenospermia. The authors evaluate the response to treatment with gonadotropins alone and in association with D6-tryptophan (a Gn-RH analogue) in a group of infertile men affected by idiopathic oligo-asthenospermia. An improvement of fast straight motility of spermatozoa at second hour from ejaculation have been observed in our patients, even if a larger number of cases is necessary to make definitive conclusion.


CRF-dependent and CRF-independent mechanisms involved in hypophysial-adrenal system activation by bacterial endotoxin. The immune system and the hypothalamic-pituitary-adrenal (HPA) axis play important role in the overall inflammatory response. The mechanism through which lipopolysaccharide (LPS, endotoxin) stimulates the HPA axis is not well understood. In order to clarify the role of hypophysiotropic peptides of paraventricular origin in the effect of LPS on ACTH and corticosterone secretion, the effect of LPS was studied on rats with lesions of hypothalamic paraventricular nucleus (PVN). It was shown that 90 min after 2 mg/kg LPS i.p. the ACTH, but not the corticosterone response was effectively blunted in PVN-lesioned rats, as compared to sham operated animals. However, in PVN-lesioned rats 240 min after treatment with LPS a significantly higher plasma ACTH and corticosterone level was monitored. It is, therefore, suggested that in response to LPS activation of HPA both CRF(s)-dependent and CRF(s)-independent mechanisms are involved, even a direct effect of the adrenal cortex should be taken into account.


Growth of the alimentary tract with aging in chickens. There is a mathematical model supporting that when growth rate of the chickens is maximized and not constrained by the food-availability, the optimal relationship between body mass and alimentary tract mass should conform to a two-segmented straightened line with different slopes. In the present work we have studied the model using the mass of the intestines as an indicator of growth of the alimentary tract of the Gallus gallus domesticus L. We have observed the slope change of the two segments around a body weight of 90 g that corresponded to two-week-old animals and, at this age it was supposed that the differentiation of the intestine reach the maximum.


Operative laparoscopy for uterine pathology. In the first years of its use, operative laparoscopy for uterine pathology was employed in the surgical treatment of myomas and in the correction of uterine retroversion (hysteropexy). More recently the technique has been employed for the laparoscopically assisted hysterectomy or for subtotal laparoscopical hysterectomy using the Semm Kit. Also radical hysterectomy has been performed in advanced centers by laparoscopy. In this paper, the Authors discuss the indications, the counterindications, the risks and complications of the operative laparoscopy in the different forms of ovarian pathology.


Phospholipids and fatty acids in human brain tumors. Phospholipid and fatty acid composition of human brain tumors is presented. The white matter contains a greater amount of phosphatidylinositol and a very low level of lysophosphoglycerides, as compared to the grey matter. Glioma and meningioma tumors contain a greater amount of phosphatidylinositol, sphingomyelin, and lysophosphoglycerides, as compared to normal cortex tissue. A significant rise in oleic, linoleic and arachidonic acid content in tumor tissue was observed. It is suggested, that changes in lipid composition, may play a role in structural and functional membrane perturbations in neoplastic cells.


Operative laparoscopy for pelvic and extrapelvic pathology. The treatment of pelvic adhesions has been the first and more successful indication for operative laparoscopy. Frequently this intervention is the first step of others laparoscopic procedures. The different modalities of these interventions, i.e. by electrocautery or by scissor, or by laser are discussed. Among indications of operative laparoscopy for pelvic pathology the treatment of endometrial implants has been considered. In this paper less frequent indications for operative laparoscopy as pelvic abscess, or complementary operation as appendicectomy and colecistectomy are also discussed.


The effect of thyroidectomy and thyroxine on the reactivity of rat diaphragm muscle to electrical stimulation in vitro. The effect of thyroidectomy and thyroxine on the reactivity of diaphragm muscle to electrical stimulation was studied in adult albino Wistar rats. Thyroidectomy significantly affected the contractility of the diaphragm muscle. The result shows that thyroidectomy predisposes the muscle of the diaphragm to fatigue.


Influence of endotoxin on experimental post-alcoholic liver injury. The morphological and biochemical changes of the liver after endotoxin intake were analyzed in rats receiving 20% ethanol during 60 days. Besides morphological changes, concentration of serotonin and histamine in liver homogenates, the activity of asparagine and alanine aminotransferases (AspAT, ALAT), gamma-glutamyltranspeptidase (GGTP) and alcohol dehydrogenase (ADH) in blood serum were determined, too. The most extensive morphologic changes of the liver were seen in group of animals intoxicated with 20% ethanol during 60 days and single dose of endotoxin E. coli 0127:B8 intraperitoneally. These changes included necrosis most hepatocytes, focal steatosis of liver parenchyma, considerable hyperemia and parenchymatous degeneration of the liver cells. The cells lining liver sinuses showed considerable swelling as well as necrotic changes. Figures of cell division and haemorrhagic focuses were seen, too. The clusters of mononuclear cells, surrounding necrotically changed hepatocytes were seen in the central part of the liver lobule. Among the inflammatory mediators estimated in liver homogenate only serotonin reached a high level in the group of experimental animals receiving only endotoxin. Increased activity of aminotransferases AspAt and ALAT were associated with these morphologic and biochemical changes in liver tissue observed in animals receiving ethanol and endotoxin.


Ovarian heterotopic pregnancy after IVF and contralateral tubal ectopic pregnancy after GIFT. One case of ovarian ectopic associated with twin intrauterine viable pregnancy after in vitro fertilization, and one case of contralateral tubal ectopic pregnancy after gamete intra fallopian transfer performed with normal fallopian tubes, are reported. The possible pathogenesis and the management are discussed. The risk of ectopic pregnancy after assisted conception can be present even when the fallopian tubes are apparently normal.


Effects of AET and MEA on the lysosomal hydrolase activities in the mouse organs. The adult male Swiss mice were injected intraperitoneally with AET (2-aminoethylisothiouronium Br.HBr) or MEA (cysteamine HCl), in a toxic dose of 400 mg/kg body weight. The acid phosphatase (E.C. 3.1.3.2) and arylsulphatase (E. C. 3.1.6.1) activities in crude homogenates of liver and kidneys were assessed every fourth hour throughout a 24-h period. Different patterns of temporal changes in the acid phosphatase and arylsulphatase activities in liver and kidneys expressed in nkat per 1 mg of protein, 1 g of fresh tissue and per the whole organ weight, were found. The extent and timing of the alterations in the activity of each of the lysosomal hydrolases were dependent on the particular organ chosen and aminothiol compound given.


[The importance of medical psychology in the initial years of study (physician-patient relationship and clinical training)]. The teaching of medical psychology as early as the first years of the training of the students in the medical school seems to us something essential. We think this teaching would have to be early be conducted in little group and integrate the fact of the hospital first experiences they have to undergo. That several elements will be studied now in this communication.


[The creation of a new pathology in Paris. The case of deinstitutionalized patients]. The development of attitudes towards the mentally ill, the progress of psychotherapeutic care and medicines, allowed the looking after of psychotic patients outside of the hospital institution, while keeping their social links with their personal environment. The setting up of alternative structures in the context of the communitary psychiatry was supposed to enable the reinsertion of the stabilized psychotic patients. In Paris, the lack of such structures, and the difficult socio-economic context condemn these patients to drifting aimlessly, locked out of any institution, which worsen their pathological state. These "deinstitutionalized" patients cause a serious problem for the Health system.


[Romain Gary or the faded Raja].

[Romain Gary or the faded Raja]. We try to show the function of pen names for Romain Kacew, who was twice rewarded by the Goncourt prize, under two pseudonyms, Romain Gary, then Emile Ajar. We make the hypothesis that to put into reality the fantasy which is the basis of his being, leads the subject R. Kacew to commit suicide. It seems, from our point of view, that there is a correlation between this fantasy, which could be subsumed by: "a toy maker", and the enigma of his mother's desire, supported by the significant "Mermont" (Sea berg).


[Dependency scale in the MMPI and dependent personality in DSM-III]. We tested a dependency rating scale issued from MMPI (considered relevant for DSM-III dependent personality disorder) on 33 males who met this DSM-III personality disorder. There is no significant difference between our subjects and the standard values reported in the literature. Some hypothesis about this negative results are discussed.


How well do internal medicine faculty members evaluate the clinical skills of residents? To determine the accuracy of faculty evaluations of residents' clinical skills and whether a structured form and instructional videotape improve accuracy. Randomized, controlled trial. Twelve university and community teaching hospitals. A total of 203 faculty internists. Participants watched a videotape of one of two residents performing new patient workups. Participants were assigned to one of three groups: They used either an open-ended evaluation form or a structured form that prompted detailed observations; some participants used the structured form after seeing a videotape showing good evaluation techniques. Faculty observations of strengths and weaknesses in the residents' performance were scored. An accuracy score consisting of clinical skills of critical importance for a competent history and physical examination was calculated for each participant by raters blinded to the participants' hospital, training, subspecialty, and experience as observers. When observations were not prompted, participants recorded only 30% of the residents' strengths and weaknesses; accuracy among participants using structured forms increased to 60% or greater. Faculty in university hospitals were more accurate than those in community hospitals, and general internists were more accurate than subspecialists; the structured form improved performance in all groups. However, participants disagreed markedly about the residents' overall clinical competence: Thirty-one percent assessed one resident's clinical skills as unsatisfactory or marginal, whereas 69% assessed them as satisfactory or superior; 48% assessed the other resident's clinical skills as unsatisfactory or marginal, whereas 52% assessed them as satisfactory or superior. Participants also disagreed about the residents' humanistic qualities. The instructional videotape did not improve accuracy. A structured form improved the accuracy of observations of clinical skills, but faculty still disagreed in their assessments of clinical competence. If program directors are to certify residents' clinical competence, better and more standardized evaluation is needed.


SPECT instrumentation.

SPECT instrumentation. The sensitivity of conventionally collimated SPECT systems is essentially fixed by the number of resolution elements desired. A variety of collimation methods are proposed or in use that distribute sensitivity and resolution differently among the various projection elements, but the effects on image quality have not really been documented. Of the many existing systems, the camera-based systems, which are useful for both head and body imaging, will be most useful in a clinical environment. For brain imaging, it is clear that fan beam collimation offers a large performance advantage over parallel collimation. However, comparison of the various instruments based on specifications alone is difficult if not impossible, and careful 3-dimensional imaging studies are an absolute necessity. In view of the fairly healthy price of dedicated brain instruments, it is interesting to speculate on their role in nuclear imaging. Their cost is from $50,000 to $200,000 less than a multi-headed general purpose system, and they have excellent resolution and sensitivity for brain imaging. They cost from $175,000 to $300,000 more than a single head camera-computer system yet offer 3 to 4 times the resolution-adjusted sensitivity. This suggests that a special purpose instrument would need to be heavily utilized or located (physically or politically) where the body imaging capability of a two or three-headed system would not be used. A good case might be made for locating a dedicated instrument in a neurological ICU in order to avoid transporting critically ill patients out of the unit. The various non-conventional imaging methods show promise for exceeding the sensitivity limit of regular collimators. At present it is speculative as to how much can be gained and whether it will be worth the added complexity and/or cost. Nevertheless, they are very interesting and certainly justify additional research.


Positron emission tomography instrumentation: a review and update. Positron Emission Tomography (PET) has evolved into a powerful modality for in vivo functional imaging of the brain and the heart. Developments in PET technology and instrumentation have occurred rapidly during the last 20 years and have been driven by the requirements for improved resolution and image quality necessary for clinical and research applications. Clinical applications of PET have now been validated for the heart and the brain, and new research in the mapping of receptor density in the brain is being explored. PET cameras have developed into sophisticated imaging devices capable of both clinical and research applications. This review article updates the previous overview on PET instrumentation written by the authors with an added emphasis on performance evaluation of PET cameras. A short summary of current PET cameras available commercially is included for the purpose of comparing some important specifications between different systems.


Magnetic resonance imaging of brain function. New techniques for imaging of brain function are described, which utilize magnetic resonance imaging. Echo-planar imaging (EPI), the preferred method, is introduced and technical issues are discussed. Two recent approaches for measurement of blood flow are explained: contrast agent bolus tracking and black blood perfusion. An intrinsic contrast technique, which utilizes the paramagnetism of deoxyhemoglobin, is presented. Results from experiments on functional imaging of the human brain are shown, and the specific advantages of MRI for this purpose are discussed.


Advances in contrast echocardiography: intraoperative perfusion assessment. Contrast ultrasound techniques provide on-line assessments of regional tissue perfusion. Intraoperative clinical studies of cardiac revascularization and renal transplantation have been performed and are currently under active clinical investigation. The potential to diagnose and manage patients through the use of contrast ultrasound techniques is just beginning to be realized. With continued development of the contrast agents and improved computer-aided software analyses programs, the future of the real-time perfusion imaging looks bright.


Topographic mapping of brain electromagnetic signals: a review of current technology. Topographic mapping of brain electromagnetic signals has become increasingly popular in recent years both as a clinical tool and as an area of research in its own right. The capabilities of existing computerized systems for displaying such maps and for performing localization of current sources in the brain have continued to expand. In this paper we review some of the methodological and technological issues concerning topographic mapping. These include issues of choice of interpolation algorithm, what to map, head geometry, EEG reference location, and scaling. We also discuss characteristics of clinical databases for patient comparison and the usefulness of quantitative EEG (which includes mapping) for the diagnosis of nervous system disorders. Finally, we compare five representative systems in terms of their topographic mapping capabilities. The overall conclusion is that future developments must make use of integrated data from other neuroimaging technologies such as MRI, PET, and SPECT, and determination of the normal limits of topographic parameters must be more carefully examined.


Computed tomography with monochromatic x rays. Recent advances in the development of synchrotron facilities that provide high-energy and high-flux x-ray beams allow the use of monochromatic x rays at a < 0.5% energy bandwidth (i.e. energy width of < 500 eV at 100 keV) for computed tomography (CT) of humans. Such CT systems will consist of a fixed, horizontal, low-divergence fan beam and a seated subject rotating about a vertical axis. Compared to conventional CT, the new system should significantly improve contrast resolution of the image and provide better image quantification because of its lack of beam-hardening effects and its efficient implementation of energy-selective imaging methods such as dual-photon absorptiometry and K-edge subtraction with high-atomic-number (high-Z) contrast-enhancement elements. Further, the nearly parallel synchrotron x-ray beam geometry minimizes patient-to-detector scattering when the detector is positioned far from the patient. The design considerations and the expected performance of monochromatic CT are described, in particular those of the CT being developed at the National Synchrotron Light Source. The potential applications of the method in neuroradiology, cardiac and vascular imaging, bone densitometry, lung imaging, and radiotherapy are discussed. The future of monochromatic CT in research and in clinical diagnostics is also reviewed, as are the prospects for development of compact sources of x rays with narrow-energy bandwidths.


Brain imaging of an alcoholic with MRI, SPECT, and PET. A medically healthy chronic alcoholic without evidence of neurological and neuropsychological impairment was studied with magnetic resonance imaging (MRI), single photon emission computerized tomography (SPECT), and positron emission tomography (PET). An age-matched normal volunteer was evaluated with the same scans for comparison. The MRI of the alcoholic revealed prominent ventricles and mild cortical atrophy. SPECT and PET revealed predominant involvement of the frontal cortex as shown by decreased frontal blood flow and metabolism. This case illustrates the sensitivity of brain imaging techniques in detecting cerebral abnormalities even in the absence of neurologic and/or neuropsychological impairments.


Knowledge-based multi-modality three-dimensional image analysis of the brain. With the recent advances in medical imaging, three-dimensional anatomical and metabolic images of the brain are now available through MR/CT and PET/SPECT imaging modalities. Computerized multi-modality three-dimensional brain image registration and analysis can provide important correlated information for improving diagnosis and studying the pathology of disease. Such analysis may also provide help in planning brain surgery. Further, an anatomical model based quantification and analysis of internal structure can be used to develop a computerized anatomical atlas. Conventional anatomical atlases provide rigid spatial distribution of internal structures extracted from a single subject. The proposed computerized anatomical atlas provides probabilistic spatial distributions which can be easily updated to incorporate the variability of brain structures of subjects selected from pre-defined groups. This paper first presents a review of the current trends in knowledge-based segmentation, labeling, and analysis of MR brain images and then describes the Principal Axes Transformation based registration of three-dimensional MR brain images to develop composite models of selected internal brain structures. The composite models can be used as a computerized anatomical atlas in model-based segmentation and labeling of MR brain images. Three-dimensional labeled MR images of the brain can also be registered and correlated with PET images for analyzing the metabolic activity in the anatomically selected volume of interest. On the other hand, a volume of interest can be selected using the metabolic information and then analyzed for correlated anatomical information using the registered MR-PET images.


Utilization statistics and diagnostic accuracy of a nonhospital-based positron emission tomography center for the detection of coronary artery disease using rubidium-82. A retrospective analysis has been carried out to determine utilization and diagnostic accuracy of positron emission tomography of the heart with rubidium-82 at a nonhospital-based center. Utilization statistics were derived for the first 27 months of operation of the center from a total of 1,670 patients scanned. Diagnostic accuracy for detection of coronary artery disease was assessed using three readers, blinded to the clinical information, who read 225 rest and dipyridamole-stress scans of patients that had a coronary angiogram. Utilization statistics show that the center averaged 64 patients per month, 66% were males, 38% of the patients scanned had a coronary angiogram, 25% had a history of myocardial infarction, 12% had coronary artery bypass graft surgery, and 18% had percutaneous transluminal coronary angioplasty. Sensitivity was 82%, 96%, and 100% for myocardial regions perfused with greater than 67%, 84%, and 100% diameter stenosis, respectively. Specificity was 91% for all normal regions of the heart. Accuracy was 89%, 93%, and 93% for regions with greater than 67%, 84%, and 100% diameter stenosis, respectively. These results compare well with published results from major hospital based centers.


Application of magnetic resonance imaging to physiologic and morphologic characterization of renal artery stenosis before and after angioplasty. This study describes the application of dynamic gadolinium-enhanced magnetic resonance (MR) imaging and MR angiography in the diagnosis and evaluation of the physiology of renal artery stenosis (RAS) before and after angioplasty. The MR imaging findings are discussed and compared to those of renal arteriography. MR time intensity curves of the renal cortex and medulla are obtained. Dynamic gadolinium-enhanced and angiographic MR data were abnormal in the setting of RAS and improved after angioplasty. The diagnosis of RAS could be made by visual inspection of MR dynamic images or MR angiographic images alone. Dynamic MR provides cross-sectional physiologic imaging data that compliments MR angiographic data. The role of dynamic gadolinium-enhanced MR in the evaluation of renovascular hypertension requires further investigation.


A radioimaging technique for quantifying regional myocardial blood flow. We developed a radioimaging technique for measuring regional myocardial blood flow (rMBF) in 5 mm2 myocardial tissue using canine closed-chest models. RMBF was measured in three groups: (1) total occlusion of left anterior descending (LAD) coronary artery with microfibrillar collagen, (2) fixed stenosis of LAD with angioplasty balloon, and (3) comparison of clinical dose response of adenosine (AD) and dipyridamole (DP) on rMBF. In these studies, rMBF in every 5 mm2 tissue was measured throughout the epicardium and endocardium. In groups 1 and 2, rMBF was also measured during adenosine-induced coronary hyperemia (ADICH). In group 1 (n = 7), rMBF measured at 6 hours post-LAD occlusion in epicardial infarct center (IC), peri-infarct (PI) and normal zone (NZ) were 17 +/- 7, 55 +/- 8, and 132 +/- 12 ml/min/100 tissue, respectively. The area and location of infarct seen in TTC staining matched with rMBF images. During ADICH, the corresponding rMBF were 16.2 +/- 13.9, 98.3 +/- 53.0, and 226.0 +/- 103.6 ml/min/100 g tissue, respectively. RMBF measured during ADICH in group 2 (n = 4) in areas of LAD stenosis (LS), surrounding stenosis (SS), and no stenosis (NS) were 120 +/- 58, 249 +/- 123, and 432 +/- 181 ml/min/100 gm tissue, respectively. In group 3, rMBF measured during 3 min into 0.14 mg/kg/min adenosine infusion in areas perfused by LAD, circumflex (CX) and right coronary artery (RCA) were 244 +/- 22, 238 +/- 19, and 215 +/- 19 ml/min/100 g tissue, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)


Scintigraphic evaluation of duodenogastric reflux: significance in the diagnosis of acute cholecystitis. Duodenogastric reflux (DGR) as seen on hepatobiliary scintigraphy has been reported as a useful secondary sign for the diagnosis of acute cholecystitis. We evaluated the association of reflux with cases of acute cholecystitis as compared to those with chronic cholecystitis or other conditions. Thirty-six of 198 patients referred for hepatobiliary imaging showed DGR (18%). Among 26 patients with acute cholecystitis, 6 (23%) had DGR as compared to 9/40 (23%) cases with chronic cholecystitis, 3/12 cases with acute pancreatitis, 4/13 cases with previous cholecystectomy, and 3/8 cases with duodenal ulcer. No statistically significant differences were found between the prevalence of DGR in cases with acute cholecystitis and those with chronic cholecystitis or other nonacute cholecystitis diagnostic categories. Although acute cholecystitis is a condition frequently associated with DGR, such reflux is a nonspecific finding and should not be considered as a secondary sign of acute cholecystitis when interpreting hepatobiliary scans.


Development of the scintillation camera. It is clear that, aside from the tremendous development in radionuclides and radiopharmaceuticals, the one thing that has had the largest impact on the practice of nuclear medicine has been the introduction of the stationary imaging device known for so long as the Anger Camera. It has evolved from a relatively simple system which many users could repair themselves, if the need arose, to an exceedingly complex and versatile tool of diagnostic medicine. As was stated in the introduction, the practice of modern day nuclear medicine without the scintillation camera is inconceivable.


Ultraviolet A transmission by modern sunscreens: is there a real risk? In recent years it has been realized that ultraviolet A (UVA) is capable of inducing many of the same deleterious events as UVB. In addition to erythema, UVA can cause connective tissue damage and is photocarcinogenic. Recently, concern has arisen that new, higher potency sunscreens allow dangerous amount of UVA to reach the skin, because they allow prolonged outdoor exposure. Such concerns are unfounded. The problem lies in a misunderstanding of the concept of sunlight protection factor. This is purely a multiplication factor and does not indicate that the effect of transmitted UVR is due to UVA or UVB. Action spectra show that UVA is less, but certainly not more injurious to skin than UVB. There is no reason to believe that higher potency sunscreens enhance exposure to dangerous amounts of UVA.


Sunbathers' application of sunscreen is probably inadequate to obtain the sun protection factor assigned to the preparation. The sun protection factor (SPF) is a ratio that estimates the protective efficacy of a sunscreen against sunburn. The generally accepted methods used to determine the SPF of a sunscreen require that the formulation be applied in a thickness of 1.5 mg/cm2 (Deutsches Institut für Normung) or 2 mg/cm2 (US Food and Drug Administration). The applied thickness of a sunscreen is important for the degree of photoprotection. Forty-two volunteers on a beach applied their own sunscreen all over the body. The amount of the applied sunscreen was on average 0.5 mg/cm2. This indicates that the labelled SPF is probably considerably higher than the obtained degree of protection against sunburn.


Protoporphyrin photosensitivity cannot be attenuated by oral N-acetylcysteine. The photodermatosis in erythropoietic protoporphyria (EPP) is caused by the accumulation of photosensitizing protoporphyrin (PP) in the skin, due to a defect in ferrochelatase, the enzyme that inserts ferrous iron into PP to form heme. Hydroxyl radical (.OH) and singlet oxygen generation with subsequent lipid peroxidation are thought to play a major role in the pathogenesis of the photodermatosis in EPP. Hydrogen peroxide (H2O2) can generate .OH in the Haber-Weiss as well as the Fenton reaction, and is thus a potentially harmful intermediate in the photoreduction of O2. The use of oxyradical scavengers, such as beta-carotene, has been reported to be beneficial in the treatment of EPP photodermatosis. In this study, N-acetylcysteine (NAC) 1800 mg/day was used for 3 reasons: (i) its -SH groups directly scavenge H2O2; (ii) ferrochelatase can be activated by sulfhydryl groups; (iii) NAC was reported to upregulate the glutathione redox system, which is a major endogenous anti-oxidant system. However, in a double-blind crossover placebo controlled study on 6 EPP patients, we could neither demonstrate an effect through photosensitivity tests, nor on light hypersensitivity as reported by the patients. This dosage of NAC could not increase reduced glutathione and did not affect the red blood cell PP content nor the excretion of PP in the feces. Neither were adverse effects observed. We conclude that the oral administration of NAC, in the relatively low dose used here, is not effective in the treatment of photodermatosis in EPP.


The effect of ultraviolet B irradiation, cis-urocanic acid and tumour necrosis factor-alpha on delayed hypersensitivity to herpes simplex virus. Previously it has been shown that ultraviolet-B (UVB) irradiation or cis-urocanic acid (cis-UCA) treatment of mice before infection with herpes simplex virus (HSV) suppressed the delayed hypersensitivity (DH) response when the mice were subsequently challenged with inactivated virus. In the present study, the time course of the elicitation phase of the DH was examined, and it was found to be biphasic with one peak 1 h following challenge and a second at 24 h. Both UVB irradiation and cis-UCA treatment of mice before infection with HSV significantly suppressed the DH at 1 h as well as at 24 h. The role of tumour necrosis factor-alpha (TNF-alpha) in the suppression was tested by injecting mice intraperitoneally with neutralizing TNF-alpha antibodies 2 h before UVB irradiation or cis-UCA treatment followed by infection with HSV. This had no effect on the suppression of DH to HSV induced by cis-UCA but significantly reduced that generated by UVB exposure. Thus, the mechanism of suppression of DH induced by UVB irradiation or cis-UCA may be different.


[The morphofunctional characteristics of the adrenal cortical substance after exposure to an adrenocorticolytic agent]. The administration of dioxidine to 1-month-old rats (200 mg/kg i.p.) results in destructive alterations of adrenocorticocytes, damage of their mitochondria, dramatic reduction of activity of succinic- and 3 beta-ol-steroid dehydrogenases. The abolition of the drug is followed within 6, 12, 30 days by progress of alternative changes, inhibition of growth of the adrenals which results 30 days later in atrophy of the whole gland and the cortical substance.


The role of histamine-like receptors in immunosuppression of delayed hypersensitivity induced by cis-urocanic acid. The cis-isomer of urocanic acid (UCA) has been shown previously to mimic the effect of ultraviolet B (UVB) irradiation in suppressing delayed hypersensitivity (DH) responses to virus in a murine model of herpes simplex virus (HSV) infection. Cimetidine, an H2 receptor antagonist, and terfenadine, an H1 receptor antagonist, abrogated the suppression of DH to HSV induced by cis-UCA, leading to the suggestion that histamine-like receptors may be involved in the mechanism of action of cis-UCA on immune responses. In the present study, cis and trans-isomers of 4 UCA analogues (1- and 2-imidazoyl-acrylic acid), and (2- and 3-pyridyl-acrylic acid) were tested for their ability to suppress DH to HSV in infected mice, and only cis-2-pyridyl-acrylic acid was effective. Second, an H2 and H3 agonist were similarly tested: the former was suppressive and the latter had no effect. Third, an H3 receptor antagonist, thioperamide, did not seem to abrogate the suppression of DH induced by cis-UCA. These results substantiate a role for H1 and H2-like receptors, but probably not H3 receptors, in cis-UCA induced immunosuppression.


Spectral effects in activation of the human immunodeficiency virus promoter by psoralens plus ultraviolet A treatment. The effects of PUVA treatment on HIV promoter activation and cell killing in HIV cat/HeLa cells were studied using two UV sources, a UVASUN sunlamp and a UVAR Photoactivation Chamber. A 4 to 5 times higher dose of ultraviolet radiation was required from the UVASUN lamp than from the UVAR lamps: 1) to activate the HIV promoter in the presence of 0.1 or 1.0 microgram/ml 8-MOP and 2) to reduce cell survival to a level of 10%, in the presence of 0.1 or 1.0 microgram/ml 8-MOP. In addition, exposures performed with a fixed dose of 20 kJ/m2 at varying concentrations of 8-MOP, required a 4.7 times higher combined PUVA dose from the UVASUN lamp than from the UVAR lamps. Two possible sources of these differences were analyzed: (1) the presence of UVB + UVA2 (280-340 nm) in the radiation emitted by the UVAR, but not the UVASUN lamp, and its potential biological activity independent of 8-MOP, and (2) the difference in the overlap of the emission spectra of the two lamps with the absorption spectrum of 8-MOP. The area of overlap was higher for the UVAR lamp than for the UVASUN lamp by a factor of 4.6, which is close to the difference between these two lamps in induction of the HIV promoter and killing HeLa cells. This indicates that the effectiveness of a particular UVA source used in combination with 8-MOP can be predicted by its congruence to the absorption spectrum of the photosensitizing drug.


[The morphofunctional characteristics of the pulmonary air-blood barrier in rats breathing gas mixtures with a high content of hydrogen sulfide]. The influence of gas mixtures with high concentration of pure hydrogen sulphide and natural gas of the Astrakhan deposit (NGAD) upon the morphofunctional state of the aerohematic barrier (AHB) and the surfactant system of the lungs was studied in 80 albino Wistar rats of 180-250 g body weight. The influence of both hydrogen sulphide and NGAD results in the appearance of morphofunctional alterations in the AHB and surfactant system of the lungs. However, if the action of hydrogen sulphide in concentrations of 300-330 and 600-700 mg/m3 is followed not only by pathological manifestations but also by mobilization of certain compensatory-adaptational mechanisms such as reinforcement of pinocytosis, the action of NGAD with the similar concentration of hydrogen sulphide seems to be too toxic, surpassing the possibilities of compensation, and there occurs the development of purely pathological phenomenon--pulmonary edema.


An estimation of squamous cell carcinoma risk from ultraviolet radiation emitted by fluorescent lamps. The risk of squamous cell carcinoma (SCC) from ultraviolet radiation (UV) emitted by unfiltered fluorescent lamps was assessed. The assessment employed a mathematical power model based on human epidemiological data, which relates the SCC incidence in the United States white population to ambient solar UV. The annual numbers of new SCC on anatomical sites chronically exposed to solar UV (head/face/neck and hands) were estimated for indoor workers. Then the number of SCC that may be caused by additional UV exposure from indoor fluorescent lighting was estimated: the lifetime exposure of indoor workers to typical fluorescent lighting (if unfiltered) may add 3.9% (1.6-12%) to the risk from solar UV, resulting in the induction of an additional 1500 (600-4500) SCC per annum in the United States. This calculated projection must be compared with the 110,000 SCC caused by solar exposure. Thus, this analysis suggests there may be a small increased risk of SCC from exposure to UV-emitting fluorescent lamps.


[The architectonics and ultrastructure of the chorionic vessels of the human placenta]. By means of injection, corrosive, histological methods, light microscopy with elements of morphometry, electron (transmissive and raster) microscopy, 260 preparations of the human placenta have been studied. The notion on the order of villi branching, on intraorganic architectonics has been expanded, intrarelations of the vessels with the villous stroma have been verified, the notion on the syncytiocapillary barrier has been widened. The terminal type of the arterial branching in the chorion has been determined up to 8-9 orders, as well as appearance of vascular continuity, that is arteriolo-arterial, veno-venular and arteriolo-venular anastomoses, mainly at the level of intermediate and terminal villi. Large vascular anastomoses are found in the placental areas with massive depositions of fibrinoid.


[The correlation of the segments of the extremities as a biomechanical constant in man and mammals]. The length of human extremity segments at different stages of age development, beginning from newborns up to far-advanced age, was studied. Under examination there were 1505 humans. In addition, bone segments of the extremities were studied in 100 human skeletons and 225 skeletons of mammals from 8 orders. On the basis of a functional analysis of the length of bone segments and the detected high correlative dependence two homogeneous (homodynamic) pairs in extremities of the man and animals were identified mainly performing the supporting, static and repulsive functions. An equality between the length of these pairs was established called the biomechanical constant. The biomechanical constant regulates the proportionality of bone links as a mechanical lever in the process of age development of man as well as in the process of evolution of mammals in changing the types of locomotion from foot-walking up to phalanx-walking.


Photoprotection in the infrared radiation range. The solar spectrum reaching the earth contains a portion of wavelengths corresponding to the infrared range. Along with ultraviolet radiation, infrared radiation contributes to the biological effects of sunlight on the skin. In recent years several sunscreens have appeared that claim to protect against infrared radiation. We have evaluated the immediate erythema induced by infrared radiation, and the protection offered by such sunscreen. We found it offered a minimal but real protective effect against infrared-induced erythema.


[The localization of neurons in the nodose ganglion of the cat that innervate the rostral portion of the duodenum]. The method of axonal transport of horseradish peroxidase was used for studying the sites of localization and morphological features of sensory neurons of the vagus nerve in the left and right ganglion nodosum innervating the rostral part of the duodenum. Animals under nembutal narcosis were given 90-100 mcl of 33% solution of horseradish peroxidase ("Olaine", Riga RZ 2.7) injected into a limited area (1 x 1 sm) of the muscular layer of the duodenum. Horseradish peroxidase labelled neurons were found bilaterally in the both ganglia. The number of neurons in the left ganglion was 91 +/- 23, in the right one--115 +/- 24. The sensory cells are mainly of the ellipsoid form and of different sizes. Areas of sections of the neurons vary from 100 to 1300 mkm2, most on them having the area from 300 to 700 mkm2. The distribution of neurons according to the sizes of their areas have no substantial differences in the left and right ganglia. It was found that 65% of neurons in the right ganglion and 67% in the left one are localized in its caudal half.