[Observations on the course of leucocytes in cardiac surgery under acupuncture-analgesia (author's transl)]. In 11 cardiosurgical patients leucocyte and differential counts were made performed during and after surgery. In some cases Lymphocyte transformation and migration inhibitiontest was studied. Comparing cases under conventional neurolept anaesthesia with those who had acupuncture Analgesia (electrostimulation) it appeared that the number of leucocytes was rising significantly higher in the latter, although the total number of lymphocytes remained constant. In lymphocyte transformation and mirgration inhibitiontest the observed decrease seemed to be less pronounced. Because a trial applying acupuncture in healthy persons resulted in no change in the number of leucocytes, it is suggested that the surgical trauma and related catecholamine release might be of importance. No definite result could be obtained.


[Electrical stimulation anaesthesia in abdominal surgery in special consideration of selective proximal vagotomie (author's transl)]. 107 abdominal operations were performed using in a combined electrostimulating anaesthesia. Anaesthesia was indued by etomidate (about 15 mg) and fentanly (about 0,2 mg). After administration of pancuronium (5-7 mg) intubation was performed. During continuous intermittent relaxation anaesthesia was maintained by a mixture of nitrous oxide/oxygen 4:2 (in poor risk patients: 3:3) and electrical stimulation at certain body-and ear-points. Electrical stimulation was done using impulse currents with frequencies of 10 to 15 Hz and a current intensity of about 40 mA. During extremly painful periods of operations 30% of the patients showed maximal heart rates and only in 5% of cases did blood pressure exceed preoperative values by about 50%. Especially in poor risk pateints the results of electro-stimulating anaesthesia are excellent. At this time, however, it should not be recommanded as a routine method for general surgery; questions concerning regulating mechanisms need to be answered first.


Adrenal cortical hormones in the spermatic vein of 95 patients with left varicocele. Adrenocortical hormones were measured in the peripheral and spermatic venous blood samples, taken simultaneously at the time of a high vasoligation for left varicocele in 95 patients. Our results do not confirm the hypothesis of MacLeod that the deleterious effects of a varicocele on male fertility are caused by an higher local concentration of adrenocortical hormones, due to venous reflux through incompetent valves. If this is the case it occurs only in a minority of patients.


Kinetics of the male gametogenesis.

Kinetics of the male gametogenesis. The kinetics of the male gametogenesis during the pregonadal period, prespermatogenesis, and "early" spermatogenesis has been described in detail. Concerning spermatogenesis in the adult individual reference is made to the articles of Courot, Hochereau-de Reviers and Ortavant (1970) and of Clermont (1972). The comparison of female and male gametogenesis (Fig. 1) shows that the "gonia stage" (asterisks) of the female germ cells is limited to one proliferation wave only, whereas the "gonia stage" of the male germ cells consists of a first proliferation wave, comparable to that of oogonia, a preparative phase to initiate spermatogenesis, and a second proliferation wave with renewal and differentiation of the spermatogonia. Germ cells in the "gonia stage" are highly sensitive towards ionising radiation and cytostatic drugs.


Comparative cytomorphologic aspects of the male germ cells, especially of the "Gonia". During early development of the human testis the male germ cell first appears as primordial germ cell or gonocyte and enters the prospermatogonial stage after the twelfth week of gestation. Prospermatogonia lack glycogen particles and are connected by intercellular bridges. During the same period in the ovary the female germ cell undergoes its oogonial stage. Prospermatogonial and oogonial development have been studied histologically in three laboratory species (white mouse, Acomys caharhinus dimidiatus. golden hamster). According to the therminolgy of Hilscher et al. (1974) proposed for the rat, prospermatogonia have to be subdivided into M- T (1)- and T (2)-prospermatogonia. In the ovary they correspond to oogonia, oocytes in the prophase of meiosis and oocytes in the diplotene stage.


Longitudinal growth of the seminiferous tubules in LH and FSH treated rats. New born Sprague Dawley rats were injected daily either with 50 (n=8), 100 (9) or 200 (10) mug FSH; with 50 (9), 100 (5), 200 (10) mug LH; with a combination of 50 mug FSH + 50 mug LH (10); or with the vehicle 0.9% saline (10). The animals were sacrificied at an age of 16 days. There was no influence of the hormones on the body weight. FSH caused a dose dependant stimulation of the testes growth (163, 186, 227 mg for the 50, 100 and 200 mug group; control 139 mg; diff. to control P less than or equal to 0.05, 0.01, and 0.01), whereas LH had no effect (123, 154 and 133 mg for the 50, 100 and 200 mug. LH group). The weight of the seminal vesicles was increased slightly by LH only (Diff. to control P less than 0l01). The serum androgen level was not changed by any of the treatments. The stage of the spermatogenesis was not altered by the hormones. There was no significant difference in the diameter of the seminiferous tubules. The higher testes weight after FSH administration was caused by an increase of length of the seminiferous tubules (25 m, 30 m and 35 m for 50 mug, 100 mug, and 200 mug FSH; control 23 m; diff.: P less than or equal to 0.05, less than or equal to 0.01, less than or equal to 0.01). The conclusion is that FSH has a specific effect on the longitudinal growth of the seminiferous tubules in prepubertal rats.


Variation in the stock of testicular stem cells and in the yield of spermatogonial divisions in ram and bull testes. Two types of stem spermatogonia- type A0 and A1 spermatogonia- have been observed in ram and bull testes. Type A0 spermatogonia are present in the impuberal testis. Their total number/testis does not vary greatly during life of bull. Type A0 spermatogonia give rise to type A1 spermatogonia which appear at the onset of spermatogenesis; their total number/testis increases during and after puberty. Total numbers of type A0 and A1 spermatogonia/testis are not correlated in the ram while total numbers of type A1 spermatogonia and Sertoli cells are correlated. Hemicastration performed in impuberal calves induces an increase in numbers of Sertoli cell/type A1 spermatogonia/testis. In adult ram, the total number of A0 and A1 spermatogonia decreases during the non sexual season and increase again in the sexual season. After hypophysectomy performed in adult rams, the number of A0 spermatogonia/testis is not modified while that of A1 spermatogonia decreases. In ram and bull, 6 spermatogonial generations were detected before the germ cells undergo meiosis. In the adult ram and bull, the type A1 spermatogonia originate mostly after divisions of A2 spermatogonia. Few of them arise from A0 spermatogonia. The yield of primary spermatocytes from spermatogonial divisions is very low, one third and one half of the expected number in the bull and ram respectively. In ram, thus yield positively correlated to LH plasma levels (0.5; P = 0.05). In hypophysectomized ram, this yield is nearly equal to zero.


Kinetics of histone and protamine synthesis during meiosis and spermiogenesis in the mouse. The separation of mouse spermatogenic cell nuclei by sedimentation velocity at unit gravity has been used to determine the timing of histone and "mouse protamine" synthesis, and the turnover of basic nuclear proteins throughout spermatogenesis. Animals were injected with 3H-arginine or 3H-lysine and at various time intervals (2 hours post-label or from 1 to 30 days post-label) germinal cell nuclei preparations were separated on the staput. Labelled histones and mouse protamine were extracted from staput separated nuclei with hydrocholoric acid and fractionated by polyacrylamide gel electrophoresis. Results indicate that histones are synthesized in association with DNA replication in spermatogonia and preleptotene spermatocytes, in pachytene primary spermatocytes and in spermatids stages 11-16, simultaneously with "mouse protamine". Experiments are reported showing that histones synthesized in pachytene primary spermatocytes and in spermatids stages 11-16 are retained in epididymal spermatozoa, while histones synthesized before meiosis are no longer detectable onto chromatin after meiosis.


Ultrastructural observations on the differentiation of spermatids in man. Ultrastructural aspects of the normal development of human spermatids are presented. Eight typical pictures of differentiation of spermatids are described based on cytological details of the acrosome, nucleus and tail. The transient appearance of a spindle-shaped body, connected to the principal piece of the tail, is pointed out. In most cases, malformed spermatids have developmental disturbances of only one component of the cell, e.g. of the acrosome, nucleus or tail. Some typical malformations are described.


Soluble proteins of guinea pig seminal vesicle lumen: purification and partial characterization. Luminal contents of guinea pig seminal vesicle were extracted with 0.154 M NaCl and the soluble protein fraction was studied by DEAE-cellulose and Sephadex G-100 column chromatography; anionic, cationic, and SDS-polyarcylamide disc gel electrophoresis; isoelectric focusing; molecular weight determinations by SDS-polyacrylamide disc gel electrophoresis; analysis for neutral carbohydrate; sucrose density-gradient centrifugation for determination of sedimentation coefficients; and amino acid analyses. Four protein fractions (referred to as proteins 1, 2, 3, and 4 in order to elution) were obtained by DEAE-cellulose column chromatography. Proteins 1, 2, and 4 gave single major bands in multiple disc gel electrophoretic systems. Protein 3 gave one major band and one minor component believed to be a fragment of a primary vesicular protein. Protein 1 is very basic and probably represents the clotting protein of guinea pig semen. The three nonclotting proteins could not be detected in serum and are probably intrinsic to seminal vesicle epithelium. All four proteins were found in animals weighing 700 g or more; only two of the three nonclotting proteins were found in more than half of the younger animals. This makes it even more likely that one or more of the nonclotting proteinc could serve as a useful gene marker in studies of androgen mechanisms.


[Animal experimental studies on the effects of noise stress on male fertility]. Psychic stress is able to cause male infertility. Stieve found out aspermatogenesis in executed men. Cockett et al. immobilized 5 Macaca-Monkeys 15 to 40 days in capsule module under simulated space flight conditions and detected severe testicular degeneration. Carosi and Calabro reported about workers exposed to industrial noise over a period of years; the number of offspring was found to be much lower than in non exposed families. We examined the effect of noise on the fertility of 21 male guinea pigs. Sounding of 110 dB lasted 3-5 hours daily over a period of 22-31 days. Histological examination of the testicular tissue did not show any disorder of spermatogenesis. We believe that the negative result is attributed to failings in the test arrangement. Sounding only lasted for a maximum of 31 days. However, the duration of spermatogenesis in guinea pigs is about 40 days. Moreover the sounding maximum was only 5 hours per day, yet the time of recovery took 4-5 times longer every day. Consequently the daily short-term depression of the neuroendrocrinium affected the gonadotropine secretion in similarity to the daily biorhythmic variation. Therefore the expected inhibition of fertility by the neuroendrocrinic way could not be demonstrated. Our experiments also revealed another problem. In noise-exposed guinea pigs there was 8.2 per cent tubuli contorti without complete spermatogenesis. Moreover, in the control group even 9.9 per cent of the tubuli was found to be sperm-free. It is not clear why such a contrary reaction occurred. However, it is possible that hormonal stimulation increased temporarily as a result of noise stress. It should be noted that this effect has also been reported by Arguellis.


Halothane-induced decrease in experimental myocardial ischemia in the non-failing canine heart. The effect of halothane on net myocardial oxygen balance of ischemic myocardium was studied in the non-failing canine heart. Myocardial ischemia was produced by repeated reversible occlusions of a coronary artery; the severity of ischemia was estimated by summating ST-segment elevations (sigma ST) obtained by epicardial ECG mapping at 15 to 18 sites. Control measurements were obtained before and after administration of halothane (0.75 per cent) to six dogs with chloralose-urethane basal anesthesia. Halothane was associated with significant decreases of systemic arterial pressure (P less than .001), heart rate (P less than .01), and the product of systolic arterial pressure X heart rate (P less than .01), an indirect index of myocardial oxygen consumption, while left atrial pressure remained unchanged at normal levels. sigmaST during occlusion was less (P less .001) during halothane (26.5 +/- 7.4 (SD) mv) than before (36.6 +/- 5.4 mv) or after (34.4 +/- 8.2 mv) its administration. Thus, halothane decreased the severity of experimentally-induced myocardial ischemia in the non-failing canine heart. The data suggest that, in the absence of ventricular failure, halothane influences the relationship between myocardial oxygen supply and demand in a favorable direction when coronary blood flow is limited.


Onset of succinylcholine-induced hyperkalemia following denervation. Denervation injuries in baboons were used to define the time course of the hyperkalemic response to succinylcholine. Half-peak increase in serum potassium (2.78 mEq/l) occurred 8.4 days following injury. Peak increase (5.5 mEq/l) appeared 14 days after injury. However, changes in potassium levels begin as early as four days after injury. Succinylcholine or other depolarizing muscle relaxants should not be used after the fourth day following an injury or denervation that involves two or more limbs.


The effects of diazepam on cerebral blood flow and oxygen consumption in rats and its synergistic interaction with nitrous oxide. The effects of diazepam on cerebral blood flow (CBF) and cerebral oxygen uptake (CMRO2) was studied using a 133xenon modification of the Kety-Schmidt (1948) technique in paralyzed, artifically ventilated rats with and without simultaneous administration of 70 per cent nitrous oxide. Diazepam was given iv in doses that induced light to heavy sedation or general anesthesia. When given with 70 per cent nitrous oxide, diazepam in sedative and anesthetic doses lowered CBF and CMRO2 to about 60 per cent of control. In the absence of nitrous oxide all doses of diazepam caused moderate (20-30 per cent) decreases in CBF, but CMRO2 remained unchanged or was only slightly lowered. It is concluded that diazepam interacts with nitrous oxide to produce a reduction in CMRO2 similar to that seen in barbiturate anesthesia, but that alone the drug produces sedation and anesthesia without a comparable decrease in CMRO2.


Sodium nitroprusside: pharmacology, toxicology and therapeutics. Sodium nitroprusside is a potent, effective, and readily reversible direct vasodilating agent. It is broken down by hemoglobin into cyanide, which is in part detoxified by liver and kidney to thiocyanate. Some cyanide, especially in nitroprusside- "resistant" individuals who need large amounts of the drug, appears to remain free to cause cyanide poisoning. Patients requiring inordinate amounts probably should not continue to receive the drug, although maximum dosage limits for long-term therapy are not established. Blood thiocyanate levels do not indicate the extent to which free cyanide is limiting oxygen utilization in essential tissue, nor do blood cyanide levels. Metabolic acidosis, elevated lactate levels, elevated lactate/pyruvate ratios, and elevated mixed venous blood oxygen content are at present the best indications of the presence of cyanide poisoning during nitroprusside administration. Nitroprusside appears useful for induction of hypotension during surgery, and for treatment of hypertensive emergencies from all causes, although continuance for more than a few days is probably unwise. The reductions of cardiac afterload and ventricular filling pressure by nitroprusside appear useful in treatment of severe myocardial failure or infarction, but studies of myocardial cyanide toxicity are needed before complete acceptance of this therapy is warranted. Initial dose rates between 0.5 and 1.5 mug/kg/min are recommended only as starting points for very careful titration. Total projected intra-operative dosage should be calculated as quickly as possible and should not exceed 3-3.5 mg/kg. It is hoped that future studies will reveal the maximum dose of nitroprusside that can safely be metabolized in a 24-hour period, and may indicate that cofactors of rhodanase such as thiosulfate, or cobalamins such as hydroxocobalamin, can be administered with nitroprusside to prevent cyanide poisoning.


A flask for preparation of standards in gas chromatography. An inexpensive modification to the stopcock of a conventional gas-sampling bulb permits convenient preparation of standards for gas chromatography.


Genotype and retention of the ejaculatory reflex in castrated male mice. Genotype proves to be an important factor affecting the retention of sexual responsiveness following castration. Male F1 hybrids between C57BL/6 females and DBA/2 males (B6D2F1) show very prolonged retention. Experiment 1 used a diallelic design using C57BL/6, DBA/2 and BALB/c strains and showed that heterosis per se is not an adequate explanation of the superior retention of the B6D2F1 genotype. Experiment 2 showed that neonatal injections of 100 mug TP to B6D2F1 male mice did not result in better retention of the ejaculatory reflex after castration in adulthood. B6D2F1 males from both experiments who exhibited the ejaculatory reflex for many months after castration went through a 'difficult period' in the first 10 to 12 postcastration weeks. During this time, ejaculation latency increased fourfold, and then returned to the original level. On the other hand, the proportion of males reaching the ejaculatory threshold during this period first declined then increased.


Effects of adrenalectomy on the sexual behaviour of castrated and intact BDF1 mice. Two experiments investigate the effects of adrenalectomy on the capacity of male mice of the BDF1 genotype (C57B1/6Fa male X DBA/2 female) to retain sexual behaviour following castration. Adrenalectomy is without effect and it is suggested that androgens can play no part in the maintenance of sexual behaviour in these castrates.


Postcastration retention of sexual behaviour in the male BDF1 mouse: the role of experience. Male BDF1 mice (the F1 progeny of a cross between C57BL/6 females with DBA/2 males) show a remarkable retention of sexual behaviour following castration. Two experiments were conducted to describe in detail the postcastration copulatory performance of the BDF1 male mouse and to determine to what extent such performance is influenced by experience prior to castration. Experiment I found that castration leads to significant increases  in the number of mounts and intromissions needed to reach ejaculation, and to a significant increase in ejaculation latency. Experiment II found that although precastrational sexual experience is not essential for the performance of the ejaculatory reflex after castration, it does influence the frequency of its occurrence. Furthermore, type of post-weaning social experience influenced the display of ejaculatory behaviour by non-experienced castrates, as those with female social experience were superior to those with social experience with males or no social experience. The interactions of experience, hormones and genotype in the control of sexual behaviour in the BDF1 male are discussed.


Communication and spatial relationships in a colony of common grackles. Most communication among common grackles Quiscalus quiscula occurs at distances of less than a few metres in the noisy environment of a breeding colony. This report examines both the adaptations of communication to these conditions and the effects of communication in regulating individual's spatial relationships. For each of six vocalizations and five action patterns studied in one colony, I consider variation in the form of the display, the circumstances associated with its use, and the responses it elicits. Each individual, male or female, has one characteristic, stereotyped song pattern that would facilitate individual recognition between mates. Variation in the components of vocalizations and action patterns is of two kinds: unidimensional, with either covarying or nested components, or multidimensional, with independently varying components, alternatives that have different implications for communication. The wide-spectrum sounds made by common grackles offer advantages in close-range communication in colonies, because the ease of locating such signals would minimize the cocktail-party effect, although they would have disadvantages in long-range communication. Most vocalizations of common grackles lack assocations with specific responses or external contexts, a situation that should often characterize short-range communication between acquainted individuals. The responses to vocalizations vary with context, especially the initial spatial relationships and identities of the interactors.


The effects of pregnancy on asthma: a prospective study. Forty-seven pregnant asthmatics were studied in a prospective study. Maternal asthma was exacerbated in 43%, most often in the last trimester. Normal physiologic alterations of pregnancy are reviewed as plausable explanations for the course of asthmatic patients during pregnancy.


The impact of chronic asthma on the developing child: observations made in a group setting. Fourteen asthmatic children between 11 and 14 years of age participated in weekly group discussion sessions for nine months. The purposes were to allow open discussion about asthma, to mutually educate the children and staff about the medical and social implications of their disease and to give the patients a chance to deal with adults without fear of reprimand or betrayal of trust. Anger, envy, fear, sadness and guilt were the emotions predominant in the sessions. Group sessions may offer a further modality in the total care of the asthmatic child.


Prolonged bleeding times after aspirin ingestion in patients with aspirin idiosyncrasy. Measurements of the bleeding time after the ingestion of small doses of aspirin in patients with aspirin idiosyncrasy demonstrate a marked prolongation compared with control patients. Confirmation of this finding offers a clue to the pathogenesis of this condition. Despite the prolonged bleeding time, gastrointestinal haemorrhage is an uncommon event in patients with aspirin idiosyncrasy.


Ultrastructural studies of prepubertal porcine uterine tube epithelium. Ultrastructural details of prepubertal porcine uterine tube (oviduct) were studied in normal, growing gilts and compared with observations reported in other species. Tissues from the ampulla region of uterine tube were taken from 6 prepubertal gilts (106 to 139 days old) to determine cytodifferentiation of ciliated and secretory cells. The epithelium consisted of 2 distinctive cells, the ciliated and the secretory cells. Cilia were observed in the uterine tube of prepubertal gilts; however, degeneration of cilia was not observed in the present study. Most prominent observations were the occurrence of fibrous granules in the apical cytoplasm of ciliated cells. These fibrous granules contained electron-dense material and were present near basal bodies. The most unusual feature was the occurrence of procentrioles around a condensation form. These data indicate that ciliated cells are sensitive to estrogen. Intimate morphologic association between fibrous granules and basal bodies indicate that fibrous granules might provide precursor material for the development of cilia and rootlets. The cytoplasm of the secretory cells contained rough endoplasmic reticulum of tubular form and numerous ribosomes. Evidence for synthesis, storage, and release of secretory granules was not apparent. It is suggested that the secretory cells are not sensitive to the low, circulating concentration of plasma estrogen. The ultrastructure of the stromal cells and lymphatic capillary was described for the 1st time. The uterine tube stromal cells were characterized by prominent nucleus and a few cytoplasmic organelles. The lymphatic capillaries were distinguished by the blood capillaries, their much wider lumen, endothelium with an attenuated cytoplasm, absence of basal lamina, and overlapping and interdigitating intercellular junctions. The fine structure of the porcine uterine tube lymphatic capillary generally resembled that of other mammalian species.


Sequential changes of estrogens and progesterone at prostaglandin-induced parturition in the sow. Parenteral administration of prostaglandin F2alpha (PGF2alpha) is efficient in inducing parturition in late pregnant swine. The purpose in the present study was to investigate the sequential changes of progesterone and estrogens at prostaglandin-induced parturition in the sow. Six of 7 sows (86%) treated once intramuscularly with 12.5 mg of PGF2alpha on days 110, 111, 112, or 113 of pregnancy farrowed within 39 hours after the injection. One PGF2alpha-treated sow and 2 sows given placebo injections on days 110 and 111 of pregnancy farrowed 90 to 130 hours later. The injection of PGF2alpha decreased the peripheral plasma concentration of progesterone in a manner similar to that observed immediately prepartum in normally farrowing sows. Estrogen patterns were similar in PGF2alpha-treated and control sows.


Decoquinate in the control of experimentally induced coccidiosis of calves. Decoquinate administered orally in a grain mix at dosages of 0.5, 0.538, 0.7, and 0.8 mg/kg of body weight suppressed oocyst discharge and bloody diarrhea in calves inoculated 3 days later with 100,000 oocysts of Eimeria bovis (experiment 1, n = 12 calves) or with 100,000 oocysts each of E bovis and Eimeria zuernii (experiment 2, n = 16 calves). Doses of 0.1, 0.163, 0.243, 0.3, and 0.362 mg/kg of body weight gave only partial suppression of oocyst discharge and diarrhea. Clinical signs of coccidiosis did not recur for 23 days after the treatment was discontinued.


Changes of biochemical constituents in bovine fetal fluids with gestational age. Serum, amniotic fluid, allantoic fluid, stomach contents, and urine were taken from 141 bovine fetuses 120 to 245 days old. The concentrations of the biochemical constituents were examined in tests to ascertain systematic changes with increasing crown-rump length, i.e., gestational age. As the crown-rump length increased, glucose concentrations decreased in allantoic fluid, amniotic fluid, and stomach contents; creatinine and uric acid concentrations increased in serum, allantoic fluid, and stomach contents; thyroxine concentrations increased in serum and allantoic fluid; potassium decreased in amniotic fluid and stomach contents; and total iron-binding capacity increased in amniotic fluid. The data in the present report can be used to identify the fetal fluid obtained by amniocentesis, to estimate the age of the fetus, and to aid the diagnosis of nutritional or infective processes that might affect the fetus.


Cutaneous hypersensitivity and isoantibody production in cattle injected with live or inactivated Anaplasma marginale in bovine and ovine erythrocytes. Delayed cutaneous hypersensitivity and the production of isoagglutinins against normal bovine erythrocytes were measured in cattle inoculated with erythrocytic preparations containing live or inactivated Anaplasma marginale. The effect of blood group substances versus parasitic components on induction of delayed cutaneous hypersensitivity and isoimmunity was examined by using test antigens derived from normal and parasitized erythrocytes, virulent A marginale in bovine erythrocytes, and attenuated A marginale in ovine erythrocytes. The use of inactivated vaccine of bovine origin induced production of isoantibodies and cutaneous hypersensitivity to both bovine and ovine blood group factors, whereas a similar vaccine preparation of ovine origin stimulated antibodies and cutaneous reactivity only against ovine blood group factors.


Utilization of proteins by the equine species. Protein digestion, nitrogen retention, plasma protein, plasma urea, and plasma-free amino acids were determined for ponies fed 3 different protein supplements. Substitution of casein, corn gluten meal, or corn gluten meal plus lysine for a portion of the cornstarch in a low-protein basal ration increased apparent digestion of protein. Substitution with either casein or corn gluten meal plus lysine produced a significant increase (P less than 0.05) in nitrogen retention, whereas the corn gluten meal substitution did not. Nitrogen retention, expressed as percentage of nitrogen absorbed, was increased significantly (P less than 0.05) by the addition of casein to the basal ration. Significant change in plasma protein concentration did not occur when different sources of protein were added to the basal ration, but plasma urea nitrogen increased significantly (P less than 0.05) in the ponies given the casein variation of the ration. Lysine supplementation resulted in a marked increase in plasma lysine concentration. Seemingly the equine species responds to differences in the quality of dietary protein.


Feline glomeruli: morphologic comparisons in normal, autolytic, and diseased kidneys. Twelve cats were used to study autolytic changes in glomerular morphology and compare these with lesions of naturally occurring feline renal disease. The 12 cats had normal clinical, urinary, and blood features. One kidney (0-hour control) was excised immediately after a given cat was euthanatized, and portions of it were prepared for light and electron microscopy. The opposite kidney (autolytic) remained in situ for selected postmortem intervals, up to 24 hours, at which time it was similarly processed. Renal tissues from 4 additional cats (3 with proteinuria and 1 with diabetes mellitus) were processed and examined for comparison. Zero-hour control kidneys had the following mean quantitations: renal weight was 9.9 g; glomerular diameter, 83 mum; number of cells per glomerulus in 1-mum section was 63; and diameter of cell nuclei was 6.3 mum for mesangial, 6.7 mum for visceral epithelial, and 6.4 mum for endothelial. In comparison with 0-hour control kidneys, autolytic kidneys had increased weight and glomerular diameter, but the diameter of cell nuclei decreased. Basement membrane thickness and glomerular cell numbers did not differ between 0-hour control and autolytic kidneys. Kidneys from 4 diseased cats had increased glomerular diameter and glomerular basement membrane changes characterized by hyalin thickening and dense deposits. These changes are compatible with a lesion diagnosis of membranous glomerulonephritis.


Ultrastructural changes in skeletal muscle of selenium-vitamin E-deficient chicks. Chicks fed a semisynthetic basal diet deficient in selenium and vitamin E for 14 to 22 days developed skeletal myodegeneration and exudative diathesis. Chicks fed the basal diet supplemented with either 0.2 ppm of selenium (as selenite) or 100 IU alpha-tocopherol acetate/kg were protected from deficiency disease, but chicks fed the basal diet plus 0.4% L-cystine were not protected. Pectoral muscles of deficient chicks were red and edematous. Light and electron microscopic study of affected muscles revealed fibers with hyaline and granular degeneration. In hyalinized fibers, the initial ultrastructural alterations were increased density of the sarcoplasm and myofibrils, dilatation of sarcoplasmic reticulum, formation of subsarcolemmal vacuoles, and disruption of mitochondrial membranes. In later stages, alterations in these fibers included myofibrillar disruption and lysis, nuclear pyknosis and lysis, disruption of the plasma membrane with persistence of basal lamina and scattered adhering satellite cells, and eventual invasion by macrophages. In fibers with granular degeneration, the ultrastructural observations included decreased density of the sarcoplasm, prominent mitochondrial swelling and distortion, and multiple foci of myofibrillar lysis that eventually coalesced to produce generalized lysis. Prominent vascular lesions associated with exudative diathesis were present in degenerated muscle but were not considered to precede development of fiber alterations. Affected blood vessels had endothelial cells with mitochondrial damage and accumulations of cytoplasmic dense bodies and areas of endothelial disruption with adhering fibrin thrombi.


Age-dependent resistance of chickens to salmonella in vitro: phagocytic and bactericidal activities of splenic phagocytes. The phagocytic and bactericidal activities to Salmonella pullorum (strain 9-25) or Salmonella senftenberg (strain 99D) were examined in chicken splenic phagocytes from 0-day-old to 2-month-old chickens. The phagocytic activity against S pullorum increased in splenic phagocytes from chickens older than 7 days, but significant changes in activity against S senftenberg were not observed during the experimental period. The bactericidal activity of splenic phagocytes against S senftenberg was higher than that of phagocytes against S pullorum during the same period. Increase of the bactericidal activity against S pullorum was observed with increasing age, but the activity of the splenic phagocytes from 0-day-old chickens against S senftenberg was similar to that of the phagocytes from 2-month-old chickens. Although delayed hypersensitivity was confirmed by delayed wattle reaction in 2-month-old chickens sensitized with living S pullorum, the sensitization did not markedly affect phagocytic and bactericidal activities.


Effect of diethylcarbamazine on indexes of fertility in the male dog. Four nondescript male dogs were given diethylcarbamazine citrate for 6 months at the rate of 13.2 mg/kg/day, twice the daily dose recommended for prevention of heartworm infections; 4 nonmedicated dogs were sham controls. Semen was collected and evaluated weekly or monthly for 6 months. There was no statistically significant deterioration in quantity, morphology, motility, or viability of sperm from the medicated dogs as compared with that of the controls.


Cerebrospinal fluid creatine phosphokinase in the normal dog. Sixty-seven cerebrospinal fluid samples obtained from 44 healthy dogs were assayed for creatine phosphokinase enzyme activity. All samples contained 1 Sigma unit or less of creatine phosphokinase. Temporal variability within individuals was minimal. The biological characteristics and potential use of this enzyme in neurologic disease are discussed.


Serum cortisol (hydrocortisone) values in normal dogs as determined by radioimmunoassay. A radioimmunoassay method was utilized to determine serum cortisol (hydrocortisone) concentrations in normal dogs. The mean value was 2.32 mug/dl (minimum, 0.94; maximum, 3.70; with a coefficient of variation of 29.7%). Samples had been collected in the morning of the diurnal cycle. The cortisol antibody used was highly specific for cortisol and showed little cross reaction with other common physiologic corticosteroids, when they were assayed, using the radioimmunoassay procedure described.


Pharmacology of procaine in the horse: a preliminary report. Rapid intravenous injection of 1 g of procaine hydrochloride in Thoroughbred mares produced variable signs of central nervous system excitation for as long as 4 minutes. Plasma concentrations of procaine were similarly variable and transient, decreasing with a half-life of approximately 25 minutes. In vitro, plasma from freshly collected equine blood hydrolyzed procaine with a half-life of approximately 7.5 minutes. This hydrolysis was apparently due to plasma esterases. Penicillin, when added free or complexed as procaine-penicillin, did not protect procaine against hydrolysis by these plasma esterases at pH 7.4.


Susceptibility of the Mongolian gerbil (Meriones unguiculatus) to Mycobacterium paratuberculosis. Mongolian gerbils (Meriones unguiculatus) were exposed to Mycobacterium paratuberculosis by intraperitoneal and oral routes. Fourteen weeks after exposure, the gerbils were necropsied and tissues were cultured and examined microscopically. Results of the study showed that gerbils can be infected with M paratuberculosis but are not suitable for studies of paratuberculosis.


Esculin hydrolysis by Streptococcus dysgalactiae. In a mastitis control program based on eradication of intramammary infection, it is important to differentiate streptococci. According to earlier reports, Streptococcus dysgalactiae was unable to hydrolyze esculin. Preliminary data from the present study indicated that under optimal conditions, some strains of S dysgalactiae were capable of esculin hydrolysis. In a study of 45 strains of S dysgalactiae, 55.5% were able to hydrolyze esculin. In the past, these organisms would probably have been identified as Streptococcus uberis. Streptococcus dysgalactiae is more sensitive to antibiotics than S uberis, and the infection is easier to eradicate from infected glands.


Extracellular antigens of Moraxella bovis. The extracellular antigens of 2 isolates of Moraxella bovis were isolated by ammonium sulfate precipitation of cell-free culture filtrate, purified by filtration and differentiated by immunodiffusion and immunoelectrophoretic techniques. The extracellular filtrate from rough types had 2 specific extracellular antigens in addition to those in the culture filtrate of smooth-type cells of the same isolate. The extracellular antigens produced by smooth-type cells were identical in all isolates of Moraxella bovis. The serotype-specific extracellular antigens of 2 isolates were serologically identical but were different from those of a 3rd isolate. The possibility of serotyping M bovis isolates, on the basis of their extracellular rough-type antigens, was suggested. Although both serotype-specific antigens were destroyed by trypsin treatment, 1 antigen was also heat-labile and partially destroyed by formalin treatment.


Treadmill stress tests as indicators of presence and severity of coronary artery disease. The configuration, time of onset, and duration of depressed ST segments during and after treadmill exercise testing were evaluated in 269 patients with angiographically proven coronary artery disease and 141 normal subjects. The test specificity was 93% and sensitivity 64%, the latter being influenced by the type of ST response; false-positive responses were rare with depressed, downsloping STs (1 of 123, 1%), occurred more frequently with horizontal ST depression (9 of 60, 15%), and occurred commonly with slowly upsloping STs (15 of 47, 32%). Depressed downsloping STs, ischemic changes appearing in the first 3 minutes of exercise, and those persisting past 8 minutes in recovery were associated with 91%, 86%, and 90% prevalences of two- to three-vessel or main left coronary disease, respectively. It is concluded that attention to configuration, time of onset, and duration of ischemic ST depression aids both in assessing the validity of exercise responses in diagnosing coronary artery disease and in delineating patients with advanced coronary obstruction.


Aspirin-induced ultrastructural changes in human gastric mucosa: correlation with potential difference. Aspirin breaks the gastric mucosal barrier. We studied the effect of aspirin on this barrier, correlating changes in potential difference and ultrastructure. Mean control potential difference for seven subjects was -48 +/- 1.0 mV. Oral aspirin, 600 mg in 100 ml of saline, reduced potential difference to -39 +/- 1.4 mV (P less than 0.001) within 10 minutes. Gastric biopsies were taken during control, aspirin- instillation, and recovery periods. Damage was present in all biopsies after aspirin. Light microscopy showed focal cell disruption, loss of mucous granules, and apical membrane rupture. Transmission electron microscopy showed intact tight junctions. Scanning electron microscopy showed loss of normal cobblestone cell apices, giving a honeycombed surface. Ten minutes after aspirin, 25% of surface epithelial cells were damaged. Marked recovery was noted at 1 hr, with a normal potential difference and only 9% cell damage. We conclude that single "routine" doses of aspirin cause focal damage to normal human gastric mucosa.


Renal vein thrombosis, nephrotic syndrome, and systemic lupus erythematosus: an association in four cases. We report here four cases of systemic lupus erythematosus associated with the nephrotic syndrome and renal vein thrombosis and review six familiar cases previously noted in the literature. Renal biopsy in each of our cases showed changes consistent with the membranous type of lupus nephropathy. We discuss the exclusive appearance of this pattern in relation to renal vein thrombosis in other forms of renal disease. The occurance of renal vein thrombosis in patients with systemic lupus erythematosus and the nephrotic syndrome supports the evidence that the thrombosis is a complication rather than a cause of the nephrotic syndrome. The presence of pleuritic pain in a patient with systemic lupus erythematosus and the nephrotic syndrome should alert the clinician to the possibility of renal vein thrombosis and pulmonary emboli. With appropriate diagnosis and anticoagulation therapy, our patients had a benign course during 7 to 48 months of follow-up.


Erythrocyte filterability and heme catabolism during the menstrual cycle. Erythrocyte filterability, reticulocyte count, total serum bilirubin, and CO hemoglobin percent saturation (COHb) were measured throughout one menstrual cycle in 17 women. The filterability was significantly depressed during the progesterone phase compared with the estrogen phase. The depressed filterability was accompanied  by significant increases in reticulocyte count, total serum bilirubin, and COHb. Significant correlations were seen between filterability, reticulocyte count, and total serum bilirubin. However, COHb did not correlate significantly with any of the other variables studied. This is probably due to increased ventilation during the progesterone phase balancing the increased endogenous production of CO. It is possible that cyclic variations in heme turnover are related to changes in erythrocyte characteristics during the progesterone phase.


Reversible restrictive lung disease stimulating asthma. A young adult woman presented with spontaneous and exercise-induced episodic dyspnea without wheezing. During dyspneic episodes all static lung volumes decreased markedly, the inspiratory capacity fell from 3.0 to 1.1 litres and total lung capacity from 5.3 to 2.6 litres. Airway resistance (Raw) remained normal, and maximal expiratory flows at low absolute lung volume actually increased. Static compliance decreased from 0.153 to 0.077 litre/cmH2O, and the elastic recoil increased from 2.8 to 4.8 cmH2O at 50% of baseline total lung capacity when dyspneic. Upstream airway resistance (Rus) remained unchanged, 1.7 cmH2O/litre/sec. All physiologic variables indicated a reversible restrictive process exists, the origin of which is unclear. It is concluded that the episodic increase in elastic recoil properties results in [1] loss of volume primarily in the alveolar ducts and sacs, [2] preservation of normal Rus by an increase in driving pressure, and [3] maintenance of normal Raw by stabilization of larger airways.


Medicine and mass communication: an agenda for physicians. Because the medical content of the mass media significantly affects public attitudes and behavior, physicians should participate more fully as critics and sources of that content. Attempts to sway audiences with medical information alone are often unsuccessful. Communication is more likely to be effective when it offers people something they want, such as satisfaction of a need or legitimation of an existing value. Except for advertising, the media seldom engineer their impact intentionally. Instead, the producers of news and entertainment rely heavily on sources, critics, and pressure groups outside the communications industry. By mastering the patterns of media impact and the rudiments of public relations, physicians can make the media a useful tool of medicine.


[2 cases of post-radiation stenosis of the main cerebral artery trunks]. Two cases of common carotid stenosis as a late complication of radiotherapy are reported. One of them was treated by subclavian-carotid by-pass. Delayed lesions of medium and large arteries after radiotherapy are reviewed, with emphasis on the neck vessels--and the surgical possibilities.


[Disorders of intracardiac conduction during ankylosing spondylarthritis. Apropos of 19 cases]. The authors have collected 19 cases of ankylosing spondylitis with an alteration of intracardiac conduction. The lesions are usually situated high in the bundle of His, as shown by successive electrocardiograms and endocavitary studies. Progression by regressive acute episodes and the response to anti-inflammatory agents suggests that the disorder of conduction is inflammatory in origin. Syncopal attacks are rare (1 case out of 19) and a pacemaker is rarely indicated. Almost half the patients had aortic insufficiency, one patient had tricuspid stenosis and two patients had heart failure in the absence of any valvular lesion. The associated ankylosing spondylitis is characterised by the severity of the inflammatory signs (average sedimentation rate 50 mm in the first hour) and by the extent of peripheral articular involvement and extra-rheumatological manifestations. Almost one in two patients had iritis, with the same proportion applying to a past history of Reiters syndrome.


[Spontaneous adrenal hemorrhage. Apropos of a case]. Spontaneous adrenal haemorrhages are rare but non exceptional. They mainly occur in elderly men (mean age: 61 years). The main risk factors are: anticoagulant therapy (prescribed for myocardial infarction, occlusive vascular ou thromboembolic disease), hypertension and chronic respiratory insufficiency, as in the present case. The clinical picture is one of abdominal of lumbar pain with abdominal distension, circulatory collapse, often delayed and sometimes preceeded by an hypertensive bout, quite often fever with leucocytosis. Hyponatraemia and hyperkalaemia, are not constant features. The diagnosis is often not made until laparotomy, and it even can be missed there. In fact, plasma cortisol level or, if unavailable, urinary corticosteroid measurements are the best diagnostic procedures, permitting adequate therapy and giving best chances of survival. They must always be made in a patient with abdominal signs falling into one of the above mentioned etiologic categories.


[Renal manifestations of Hodgkin's disease]. The occurrence of renal manifestations of Hodgkin's disease may result from multiple physio-pathological processes: mechanical, by obstruction of the vessels or excretory systems of the kidneys; specific, by lymphogranulomatous infiltration of the parenchyma; immunological, as immunune complex glomerulonephritis or, more frequently, as amyloid disease; infective or metabolic as a complication of long term corticosteroid or immunodepressive therapy. These various causes of renal problems during Hodgkin's disease lead to the observation of three principal clinical pictures: acute renal failure, chronic renal failure and permanent proteinuria with or without nephrotic syndrome. Acute renal failure generally results from a severe infection with toxi-infective shock. More rarely it is related to thrombosis of the renal veins, with a grave prognosis, or to unreteral compression with anatomical or functional exclusion of the contralateral kidney. Chronic renal failure may be caused either by distension of the excretory pathways, progressively obstructed or invaded by the Hodgkin's process and requiring specific therapy to relieve the obstruction (cobaltotherapy, chemotherapy), by specific infiltration of the renal parenchyma or by amyloid disease. Permanent proteinuria, with or without nephrotic syndrome, may be the presenting feature of renal vein thrombosis, amyloidosis or paraneoplastic nephrotic syndrome.


Quantification of intraocular malignant melanoma volume: a preliminary report. Intraocular malignant melanoma size is a significant prognostic indicator. No accurate volume determining technique has been generally utilized. Plastic models and selected geometric formulae were used to demonstrate a technique for volume calculation of intraocular malignant melanomas. The accuracy of geometric analysis is shown to be superior to previous "size" calculations. We believe this increased accuracy would be useful in following patients for tumor growth utilizing A and B scan ultrasonography as well as in quantifying tumor volumes in the histopathology laboratory.


Fluorescein angiography of the fundus after pars plana vitrectomy. In diabetic patients with massive vitreous hemorrhage, fluorescein angiography after pars plana vitrectomy demonstrated varying degrees of vascular involvement depending on the stage of the basic disease process. Arteriolar occlusions, capillary bed drop-out, microaneurysms, and neovascularization were common findings. We concluded that diabetic retinopathy continued its course behind the cloudy vitreous, sometimes leading to retinal ischemia and subsequent spontaneous involution, macular disease, or retinal detachment. In addition, some of these patients were also subject to nondiabetic diseases, such as senile macular degeneration, that could not be detected preoperatively, but that reduced visual acuity postoperatively. In the nondiabetic patients with vitreous hemorrhage, visual acuity after vitrectomy usually depended on the degree of coincident macular disease.


[Taxonomic positions of H2S-Enterobacteria in relation to the genus (Citrobacter) (author's transl)]. This work studies the classification, by numerical procedure, of 111 strains belonging to the family Enterobacteriaceae. Their taxonomic position is discussed, in relation to the genus Citrobacter, Levinea, Enterobacter, to which some appear to be closely associated. The study is based on the usual biochemical and nutritional characters as shown by the utilisation of substrates tested as sole sources of carbon and energy. Six hierarchical classes can thus be defined. Their degree of affinity with members of the Enterobacteriaceae groups or genera is discussed. The diverse origins of the strains examined (human, soil, aquatic) are certainly the cause for the individualization of the new classes.


[Search of some glycosidases in 22 species of (Bacillus) (author's transl)]. Disc-method has been applied in order to bring to light three enzymes: beta-xylosidase, alpha-fucosidase, and alpha-mannosidase in 22 species of Bacillus; an unequal distribution of those enzymes which may be applied to differential diagnosis of some species was so shown.


A study of the capacity of soils to induce nodules in Alnus glutinosa (L.) Gaertn. and Myrica gale L., with special reference to the specificity of the endophytes. One hundred soil samples from sites in North, Centre and West of Spain were examined for their capacity to induce nodules in alder (Alnus glutinosa) and bog myrtle (Myrica gale). Soils from A. glutinosa communities particularly from places where Myrica was absent, were checked for their infectivity towards M. gale. There was a good correlation between the results, since there was not one single sample which could induce nodules in Myrica which did not do the same in alder. The nodules formed on M. gale plants grown in soils collected from alder habitats showed acetylene-reducing activity at a level comparable to that described in the literature, in the case of other Myrica species. Considering together the results now obtained and in previous work, the possibility of cross-inoculation between M. gale and A. glutinosa, is again put forward and it is thus held that no specificity can be assigned, for the time being, to the respective endophytes.


Systemic toxicity of cyclopentolate hydrochloride in adults following topical ocular instillation. A case reported of a 27-year-old white woman who developed systemic toxicity after the local instillation of one drop of 2% cyclopentolate solution in each eye. The usefulness and toxic reactions of this very valuable drug are discussed. It is recommended that every ophthalmologist should warn not only the parents of the children, but also the adult patients about the possibility of systemic reaction before this drug is used and where possible the lowest concentration of solution be used. It is also suggested that a sufficient amount of injectable physostigmine salicylate be kept handy in the office emergency kit.


Vitreochorioretinal degeneration associated with trichomegaly. A 15-year-old white boy had bilateral vitreochorioretinal degeneration associated with trichomegaly. Findings on electroretinography and fluorescein angiography provided additional information on the retinal changes not noted in 3 previously reported cases having these associated features. Although similar on ophthalmoscopy, fluourescein angiography, and by electroretinography, the retinal disease in our patient differed from cases of gyrate atrophy of the choroid and retina in having normal plasma ornithine levels.


Possibility of isoproterenol therapy with soft contact lenses: ocular hypotension without systemic effects. An experimental investigation performed in the rabbit pointed out the possibility of administering isoproterenol at low concentrations with the aid of soft contact lenses presoaked in 0.2% isoproterenol for 60 to 120 minutes. A reduction in intraocular pressure ranging from 23% to 32% was observed in 21 out of 24 glaucomatous patients. Duration of hypotension in 50% of eyes treated was more than 8 hours. Thus, a therapeutic effect was obtained with a concentration (0.2%) approximately 50 times lower than that previously employed clinically (2.4%). No systemic side effects, such as arterial hypotension and increase in heart rate, were noted.


Angle closure glaucoma in a patient with pseudoexfoliation of the lens capsule. Glaucoma with gonioscopically open angles is found in a variable number of patients with capsular pseudoexfoliation. A patient is described who presented with bilateral pseudoexfoliation and unilateral acute angle closure glaucoma. Previously the association of these two clinical entities was thought to be coincidental. Certain characteristics of the present case suggest that pseudoexfoliation may occasionally be casually related to acute angle closure, possibly through the production of a pupillary block phenomenon.


Causes for removal of the eye: a study of 890 eyes. This study is a review of 890 cases of eye enucleations performed over a period of 22 years. The major cause for enucleations was trauma, accounting for 39.7% of the eyes enucleated. Chronic inflammatory diseases accounted for 22.1%, glaucoma for 11.5% and tumours for 9.2% in this group. Retinal diseases were responsible for 5.5% of the eyes; vascular occlusion for 5%; and miscellaneous causes for the remaining 7%. Injuries were everyday tools and small flying missiles caused most of the trauma. Previously planned surgical operations accounted for 15% of the enucleations. Forty-eight of these eyes had epithelial or fibrous downgrowths resulting from inflammation, secondary glaucoma, and phthisis bulbi. A more careful selection of cases and better surgical techniques might significantly lower these statistics. Also, vascular occlusion should be given a high level of suspicion in all intractable cases of glaucoma of unexplained etiology. As a general rule, enucleations should not be performed because of the suspected presence of sympathetic ophthalmia.


Vascular pseudopapillitis: ischemic optic neuropathy. There are two acute ischemic processes of the optic nerve. Vascular pseudopapillitis or ischemic optic neuropathy is characterized by a palid papilledema, followed by an optic atrophy, by a reduction of the visual acuity and fascicular defects of the visual field. Arteritis temporalis is characterized by the same ophthalmologic signs and by a raised erythrocyte sedimentation rate. Histologic examination of the temporal artery permits not only the diagnosis, but also the differentiation between the two diseases, which are due to an involvement of the short posterior ciliary arteries or of the central vascular system or pial system of the optic nerve head.


Recent experiences on the ophthalmologic complications of oral contraceptives. I have added 16 cases to the preciously reported 4 cases where ophthalmologic complications occurred in connection with oral contraceptives. In some cases, occlusion of the central retinal artery, prethrombosis of the central retinal vein, prolonged narrowing of the retinal arteries, perivasculitis, hemorrhage in the macular region, and inflammations of the anterior segment of the eye, resistance to therapy developed, and in some cases, lesions of the optic nerve causing visual loss of different degree and papillitis occurred. In the background of the different clinical entities, common pathologic origin might be supposed,--the disturbance of the chorooretinal circulation. In patients taking the pill for the longest time interval, delicate lenticular opacities developed.


A new concept of the sympathetic pathways to the eye. The sympathetic pupillociliary pathways controlling the dilatation of the pupil in man have been recorded by many authorities as passing via the first and/or second thoracic (dorsal) rami to the lower part of the stellate (first thoracic) ganglion. It has been stated by these and other authorities that the removal of the lower part of the stellate ganglion and/or resection of the first and/or second thoracic rami would produce a Horner's syndrome. This currently accepted concept of the sympathetic pathways to the eye we believe to be incorrect. Our entire clinical experience has consistently contradicted the findings and reports of other investigators. It is suggested that the ability afforded by a new surgical approach to reach, dissect, and exactly control the line of resection without undue trauma to the stellate ganglion has made possible for the first time a definitive statement concerning the entry of the pupillociliary pathways into the sympathetic chain. It is, therefore, postulated that the preganglionic neurons controlling the pupil enter the upper portion of the stellate ganglion by a separate paravertebral route leaving the ventral roots of the eighth cervical, first and/or second thoracic nerves. Our entire clinical experience refutes the concept that these pathways pass via the first ramus communicans to the first thoracic ganglion. This thesis is based on and supported by the results of new surgical approach originally designed to permit a more direct exposure and to overcome many of the deficiencies of current surgical approaches. The anterior transthoracic, transpleural wound employed allows a more direct approach and a more accurate and complete dissection of this segment of the sympathetic supply to the head, neck, upper extremity, heart, and coronary vessels without incurring the undesirable sequela of a Horner's syndrome in 93% of patients.


Anterior uveitis and leptospirosis.

Anterior uveitis and leptospirosis. Seven patients with anterior uveitis due to leptospirosis are presented. The diagnosis was based upon serologic tests and exclusion of other etiologic possibilities. Six patients came from a well-known endemic area of leptospirosis during the time of epidemics and one case came from an area which was not known to be endemic at the time. In 5 patients the uveitis was bilateral. The disease was mild in all but 2 patents who needed systemic administration of steroids. The posterior part of the eye was not involved in any of the cases.


Eyelash tolerated in the anterior chamber and cornea. Cilia may be carried into the eye following a penetrating injury. Such a case of a cilium in the anterior chamber is described. The cilium was discovered years later following an injury. A cilium was noted to extend through the cornea into the anterior chamber barely touching the anterior lens capsule. Although the lens surface directly directly adjacent to the foreign body was clear, an anterior capsule lens opacification and area of posterior syncechia were noted at the 3 o'clock meridian. The eye was quiet with no cell or flare noted. The vision was 20/20.


Experiences with the Björk-Shiley tilting disc valve in aortic and mitral valve surgery. During a four-year period, aortic or mitral valve replacements with the Björk-Shiley tilting disc valve were performed in 114 cases. The series comprises 75 aortic, 34 mitral and 5 double valve replacements. In the aortic valve group (AVR) concomitant resection of the ascending aorta (cystic medial necrosis aneurysm)) was carried out in 5 cases, aortocoronary bypass in 2 cases and closure of a VSD in one case. Antibiotic prophylaxis and postoperative anticoagulant treatment were used routinely. The hospital mortality rates were6 8.0% in the AVR-group (single aortic valve mortality 7.1 %), 8.8% in the MVR-group and 60% in the double valve group. Late mortality in the AVR-group was 2.8%. There were no late thromboembolic complications in this group. Aortography showed grade II--III regurgitation (paravalvular leaks) in 15 % of the cases. In the MVR-group the late mortality was 9.7%. One patient died because of malfunction (thrombosis) of the prosthesis. The thrombotic complication was obviously caused by discontinuation of anticoagulant therapy. The clinically estimated functional capacity NYHA classification) improved considerably, especially in the MVR-group.


Four years' experience of valve replacement with the Björk-Shiley tilting-disc prosthesis. 105 valve replacements with the Björk-Shiley tilting-disc prosthesis have been performed in 99 patients with an overall mortality of 12%. The hospital mortality for 73 single aortic valve replacements was 10%, for 24 single mitral valve replacements 13%, and for 5 double valve operations 20%. One late death (1%) occurred in a case with single aortic valve replacement. The follow-up period of the first patients with aortic valve replacement is 4 1/2 years, and that of those with mitral valve replacement over 2 1/2 years. The most common late complication in patients with mitral valve replacement was a paravalvular leak (19%), whereas in patients with aortic valve replacement slight haemolytic anaemia (4%) and late thromboembolism (3%) occurred most frequently. 84 of the 87 survivors showed manifest clinical improvement in their preoperative status and increased exercise tolerance.


Reemployment related to functional and haemodynamic changes after aortic or mitral valve replacement. The objectives of this longitudinal study were to determine the proportion of individuals who return to work following aortic or mitral valve replacement, and to compare the functional and haemodynamic status in those who return to work with those who do not return to work. The study includes a total of 133 subjects who were all  examined 12--24 months after the operation. Based on this investigation, an overall reemployment rate of 44 % was found. Return to work was more frequent in the younger group than in the older group. Furthermore, while the patient's opinion of the extent of his physical handicap was of some importance when return to work was discussed, there did not appear to be any significant relationship between the working or the non-working group and objective indices of improvement as decrease in heart volume, regression of left ventricular hyperthrophy in the electrocardiogram, increase in cardiac output and decrease in pulmonary wedge pressure. Most important was the observation that the rate of return to work was closely related to the employment status before operations. The conclusion reached was that individuals who return to work were more likely to be those who were employed up to the time of the operation, while return to work after a long period of unemployment before operation was unusual, irrespective of the surgical results.


Closed mitral valvulotomy.

Closed mitral valvulotomy. During an average follow-up period of five years (from 1966 to 1975) 60 patients, 43 females and 17 males, were subjected to closed mitral valvulotomy at the Oulu University Central Hospital. Two patients died when still in hospital, and one died later at home. 25 % of whole series, and 41 % of the patients with atrial fibrillastion presented with a history of preoperative systemic embolism. Intraoperative embolism occurre in one patient, and late embolism in two patients. All these patients survived. Excellent or good results were recorded for 66 % of the living patients. Significant mitral calcification and/or preoperative regurgitation affected adversely both mortality and functional results. Closed mitral valvulotomy still offers excellent palliation with a minor risk for a significant number of carefully selected patients with mitral stenosis.


Haemodilution in cardiopulmonary bypass using a gelatine derivative for priming. The effects of cardiopulmonary bypass haemodilution and a gelatine derivate for priming were evaluated by serial determinations of the acid-base and electrolyte balances, arterial oxygenation, urinary output, postoperative chest x-ray, cardiac rhythm and electrophoresis in 40 patients undergoing open heart surgery. It was noted that the priming solution used provided an excelllent buffer system to stabilize the derangements in acid-base and electrolyte balance without any side effects in oxygenation, urinary output, cardiac function or plasma proteins. The utilisation of haemodilution in cardiopulmonary bypass is discussed.


Scanning electron microscopic study of the organ of Corti in normal and sound-damaged guinea pigs. A method was evolved by which the organ of Corti could be examined in its entirety with the scanning electron microscope, the organ meanwhile retaining its spiral form. This made it possible to assess traumatic effects on the cochlea and qualify lesions in terms of extent, localization and pattern. It was also found possible eventually to cut the same specimen into sections for cellular and subcellular studies. The number of guinea pigs examined totalled 91, divided into three groups. The first group was used to study the anatomy of the organ of Corti with special reference to normal variations and artifacts. Unmistakable indications were found that the longest stereocilia of the inner hair cells are linked to the tectorial membrane. The animals of the second group were exposed to pure tones of high intensity, whereupon, lesions of the organ of Corti were described according to intensity, time, and frequency. Three different types of otologic drills were used to perform mastoidectomies on temporal bones and on the cadaver. The noise produced was analyzed as to intensity and frequency range. It was found that the drill with the lowest rpm (and highest torque) produced the highest noise intensities, at levels which can be traumatic to the human organ of hearing. The animals of the third group were exposed to the amplified noise produced by otologic drills of three different types. The resulting lesions in the organ of Corti were examined by the method described for scanning electron microscopy and compared. In spite of the wide variation in individual lesions, patterns of degeneration of three different types could be distinguished. The high-speed and the very-high-speed drill inflicted less damage on the organ of Corti than the low-speed drill. It is therefore advised to refrain from using the latter drill in prolonged operations.


Rupture and successful repair of the heart following blunt chest injury. A case of cardiac rupture secondary to blunt chest injury and its successful surgical repair is described. A review of the literature based on eleven previous similar cases is given.


Operative treatment of carotid artery occlusion. A follow-up study. One hundred consecutive patients have been subjectes to 134 carotid artery reconstructive procedures. 81 patients had TIA syndrome, 2 had acutely progressing stroke and 17 had symptomless stenosis at the carotid artery bifurcation. In 121 instances a bifurcation endarterectomy was performed, in 6 cases the internal or common carotid artery was resected and reconstructed, in 5 cases allograft- and in 2 cases autologous vein was used for the reconstruction. An intraluminal shunt was used in 93 operations. Operative mortality occurred in 4 patients, one was a case of acutely progressing stroke. Late mortality occurred in 16 patients. A follow-up study was carried out in the remaining 80 patients. According to the patients' own judgement symptomatic relief was good in 52.5 %, satisfactory in 40 % and unchanged in 7.5 %.


Acute coeliac artery occlusion: initial collateral blood flow from the superior mesenteric artery. An experimental study. The collateral blood flow from the superior mesenteric artery after acute occlusion of the coeliac truck was measured in experiments in dogs. Immediately after clamping of the coeliac axis the collateral flow was about 30 % of the original coeliac blood flow. During an observation time of three hours the collateral flow increased, the corresponding value at the end of experiment being about 50 %. At the same time the blood pressure in the coeliac artery rose from a mean value of 20 mmHg to 35 mmHg. The initial collateral blood flow was evidently not sufficient, since after this short occlusion period ischaemic changes, even necrosis, were observed in the liver and stomach in some of the test animals.


Experience with surgery of the heart valves. A review is given of a 15 year experience of valve replacement with Teflon cusps, pericardial cusps, Starr-Edwards, Key-Shiley, Wada-Cutter and Björk-Shiley artificial valve prosthesis. The Björk-Shiley tilting disc valves have shown the lowest gradient and blood trauma and excellent durability in more than 1 000 implantations during a 7 year period. Anticoagulation therapy is considered necessary with all types of artificial heart valves. Thrombo-embolism is negligible after aortic valve replacement (1 episode in 4 000 patient months) but still a problem in the mitral position (4 episodes in 1 000 patient months).


The prognostic factors of arterialized bypass veins in the lower extremities. A follow up study on 251 in situ bypass procedures on the lower extremities is done 3 years postoperatively. Patency of the bypass is correlated to smoking habits, anticoagulant therapy, age at operation and the diameter of the vein bypass. At follow up 13% of the patients had died and 217 extremities in 195 patients were examined. Using the Chi-square test we found that patency of the bypasses was primarily dependent uon the diameter of the bypass vein, and secondly on smoking habits and anticogulant therapy. Age was only of minor importance for patency.


Surgical treatment of arterial embolism. Fifteen years experience. A series of 102 surgical operations for arterial emboli in 85 patients during a fifteen-year period is presented. Seventeen patients were operated upon before the institution of the Fogarty balloon embolectomy catheter. 82 embolectomies using the Fogarty embolectomy catheter were carried out in 68 patients with a mortality of 32%. The amputation rate in the surviving patients was 39%. The most common cause of death was severe underlying heart disease, while the most important reason for amputation after an unsuccessful embolectomy was concomitant occlusive atherosclerosis, and to a lesser degree, a delay in the performance of the embolectomy.


The effect of hepatic dearterialization and re-dearterialization on carcinoid liver metastases. A 48-year-old woman with severe carcinoid syndrome caused by multiple liver metastases was treated by hepatic dearterialization. After the operation, urinary 5-HIAA excretion fell transiently to normal levels and the patient was symptom-free for six months. After one year the symptoms of carcinoid syndrome had recurred and a re-dearterialization was performed. A favourable clinical effect was again achieved, but the relief of symptoms lasted only six months. The changes in urinary 5-HIAA excretion and SGOT, SGPT, bilirubin, alkaline phosphatase, cholesterol, PP activity as well as serum protein levels were uniform after both operations to an astonishing degree. Histological specimens taken at reoperation showed that the carcinoid metastases in the anterior parts of the liver were largely necrotic. The necrotic areas has peculiar features, e.g. the necrosis was partly incomplete and ghost like carcinoid structures could be seen.


The effect of time factors on blood alcohol levels in accident victims. Variations of alcohol involvement (AI) by time as well as the effect of the time interval between the last alcohol intake and accident occurrence, arrival, and specimen collection on blood alcohol concentrations (BAC) were studied in 1012 accident victims. In was found that 53% of accidents on Saturdays were alcohol-related, the corresponding percentage being 39% on Fridays and Sundays and 31% on other days. AI rose from its lowest figure (16%) in the morning to its highest (67%) in the following small and early hours. Most of the alcohol-involved accidents occurred with rising blood alcohol suggesting that this stage of intoxication might have a higher injury risk than the later stage with decreasing blood alcohol. The delay before arrival and specimen collection often led to a drop in BAC values which should be remembered when planning studies on AI in accidents and when interpreting the results of such investigations.


Intussusception of the appendix caused by an adenovillous papilloma. A case of intussusception of the appendix caused by an adenovillous papilloma in the appendix is reported. The condition was combined with acute appendicitis. The different clinical pictures are described. Due to the varied symptoms the diagnosis of intussusception of the appendix is rarely made preoperatively. The aetiology is briefly discussed. The treatment is operative with removal of the appendix or an appropriate resection.


Cardiopulmonary bypass time and renal function. Patients undergoing open-heart surgery were divided into two groups according to cardiopulmonary bypass time: in Group I the bypass time was less than 60 minutes (25 patients) and in Group II more than 60 minutes (25 patients). Renal function parameters were investigated preoperatively, during the operation and for two days-postoperatively. The urine volume and excretion of sodium and potassium increased significantly in both groups during the bypass period compared to the values of the pre-bypass period. Significant differences (p less than 0.001) were seen during the bypass period in free water clearance: -0,8 +/- 0.6 ml/min in Group I and -0.2 +/- 0.2 ml/min in Group II, and in creatinine clearance: 114 +/- 42 ml/min in Group I and 60 +/- 12 ml/min in Group II. The inter-group differences in free water and creatinine clearances were significant (p less than 0.001) from the bypass period to the second day period. In Group II, urine osmolality was significantly lower in serum osmolality significantly higher from the bypass period to the third day period compared to the values of Group I. The excretion of sodium and potassium was higher in Group I during bypass and postoperatively and this was reflected in the serum values of sodium and potassium. According to our results, signs of functional renal impairment were seen in the group with the longer perfusion. In this group, however, the patients were older and had a higher preoperative serum creatinine mean value than the patients with the shorter perfusion. The mechanism of functional renal impairment is discussed.


The effect of nitrous oxide on renal function in open heart surgery. The renal function of 20 patients undergoing open-heart surgery was investigated pre-, per- and postoperatively. The patients were anaesthetized with a combination of morphine, halothane, oxygen and nitrous oxide (the nitrous oxide group), and the remaining ten with a combination of morphine, halothane, oxygen and air (the air group). The renal function tests included urine flow, sodium and potassium excretion, and creatinine and free water clearance. As a consequence of the anaesthesia, the mean arterial pressure declined half an hour after induction, being lower than the preoperative level by 15% (p less than 0.001) in the nitrous oxide group and lower by 11% (p less than 0.05) in the air group. At the same time the urine sodium/potassium ratio was 1.3 in the nitrous oxide group and 1.9 in the air group. Free water clearance was significantly (p less than 0.01) greater in the air group. During the perfusion the sodium/potassium excretion ratio was 1.7 in the nitrous oxide group and 4.1 in the air group (p less than 0.01). On the second day, creatinine clearance was significantly lower in the nitrous oxide group than in the air group (p less than 0.05). On the third day, urine flow was significantly higher and urine osmolality significantly lower (p less than 0.05) in the air group than in the nitrous oxide group.


Effect of castration and long-term oral oestrogen therapy with oestriol succinate on serum lipids. The effects of continuous oestriol succinate therapy (2 mg/day) of three years' duration on serum cholesterol, triglycerides and phospholipids were investigated on 50 women with a mean age of 48 years. In addition, the effects of castration only were investigated in 10 women with a similar mean age. One month after castration the serum cholesterol, triglyceride and phospholipid levels were significantly raised (p less than 0.05). During oestriol succinate therapy the cholesterol level tended to decrease. In the control group without hormone therapy, the cholesterol level showed a tendency to rise during the three years. The serum triglyceride and phospholipid levels remained almost unchanged during the oestriol succinate therapy and differed not from corresponding values of the control group.


The microscopical appearance of the subcutaneously transposed spleen. The microscopical appearance of rat splenic tissue has been examined after subcutaneous transposition of the spleen and after portal vein ligation in rats subjected to splenic transposition. The histological picture was compared to that of control animals. Apart from congested red pulp and capsular fibrosis in the subcutaneous position did not seem to result in serious histological changes in the spleen. In three patients treated with subcutaneous transposition of resected spleen because of portal hypertension, histological needle biopsies from the splenic tissue were made postoperatively. Principally the same histological changes were found in the clinical as in the experimental material.


The host reaction to toxic agents.

The host reaction to toxic agents. The identification of side effects of chemotherapeutic and environmental agents has assumed a central role in current day medical practice. Since 1962, the formal recognition of the functional role of host factors in drug idiosyncrasies has resulted in the delineation of the discipline of pharmacogenetics. This investigative arena deals with inborn errors of metabolism which affect drug metabolizing enzymes or alter the effects of drugs in the body. In addition to relating to an understanding of the molecular basis of drug toxicity, these considerations are relevant to the teratologic role of alcohol and dilantin and to the role of environmental agents in the pathogenesis of neoplasia.


Chronic toxic nephropathies--diagnosis and management. As a result of industrial and medical progress, man is exposed to an ever changing array of chemicals, drugs and biological products. The kidneys are extremely vulnerable to chronic toxic effects of these substances. Although acute renal failure, nephrotic syndrome and renal tubular disorders result from acute nephrotoxicity, chronic renal failure with renal failure and hypertension result from chronic nephrotoxicity. Heavy metals, analgesic agents and antimicrobials are the common nephrotoxic substance producing chronic renal disease. Medical management consists of preventive exposure measures and early detection of nephrotoxicity by modern industrial medicine. In addition, early clinical diagnosis with appropriate management may prevent the need for chronic hemodialysis and renal transplantation.


Correlation between dental maturity, height development and sexual maturation in normal girls. The correlation between the dental maturity and the different measures of sexual development, i.e. the age at menarche, the ages at breast and pubic hair development, and the age of peak height velocity, was found to be low in healthy girls. Multiple regression analyses between the predictors height and growth rate at the chronological age of a certain stage of the dental development and each of the predictands age at menarche, breast development, and age of peak height velocity improved the residual standard deviation significantly in comparison with the standard deviation of the distribution of these variables.


Skeletal maturity of the hand and wrist in Oaxaca school children. Skeletal maturity of the hand and wrist (Tanner-Whitehouse II system) was assessed in a sample of 394 school children 5 to 18 years of age, in the city of Oaxaca, Mexico. The socio-economic background of the sample was relatively poor and the group appeared to have a poor nutritional history (via height and weight measurements). At most ages, the mean skeletal ages of Oaxaca school children are below the British means, and about 60 per cent of the children have skeletal ages below their chronological ages.


Modes of action of toxic agents.

Modes of action of toxic agents. The principal modes of action of toxic agents are discussed in relation to the type of chemical bond formed between the poison and the target constituent of tissues. Alteration of enzyme activity, interference with the binding of poisonous chemicals to proteins, intercalation with nucleic acids, disturbances in electrolyte balance and the disorganization of cellular water and membrane lipids are illustrated as toxic processes involving ionic or van der Waals forces. The reactions of heavy metals with tissue nucleophiles and of exogenous nucleophiles with tissue metals are given brief attention in connection with coordinate-covalent binding. Covalent binding of poisons can arise from the incorporation of an antimetabolite into a larger molecule or reactions of electrophiles or free radicals with tissue constituents. These modes of action are illustrated by chemicals that produce necrosis, allergy or cancer.


The effects of drugs on embryonic development. A review of the literature demonstrated the difficulties in evaluating the teratogenic effect of drugs in man. Since epidemiologic studies provide suggestive rather than definitive data and results of the current drug testing in laboratory animals may not be applicable to man, the need to develop alternative methods of predicting teratogenicity was apparent. To develop such techniques by studying a possible mechanism of teratogenesis, experiments were performed using a teratogenic folic acid-deficiency and antagonism with 9-methyl pteroylglutamic acid in the pregnant rat. Embryos developing abnormally in response ot this regimen consumed oxygen at a significantly decreased rate. Similar significant reductions in oxygen consumption were found both in rat embryos malforming in response to maternal vitamin A acetate administration, and in mouse embryos in response to teratogenic doses of diphenylhydantoin. It was suggested that such measurements of oxidative metabolism or related techniques may have application in predicting drug teratogenicity and could aid present epidemiologic and empiric approaches to identification of human teratogens.


Monitoring for precursors of health impairment from toxic agents. It is essential that one be able to diagnose when disorders are caused by drugs and toxic agents. It is also essential that scientists strive toward the ultimate goal of preventing such disorders. To this end, it is necessary to evaluate laboratory procedures for their capability to detect changes which precede disorders of health impairment. To accomplish this, some knowledge of the relationship between the exposure to a chemical agent and the effect owing to that exposure is required. The complexities of the dose-effect relationship are discussed with regard to the estimation of exposure, the effect owing to the exposure and the population exposed to the chemical agent.


Carriage patterns of Staphylococcus aureus in a healthy non-hospital population of adults and children. Bacteriological examination of healthy school children and adults for Staphylococcus aureus by weekly swabbing of nose, throat and hands over extended periods demonstrated a general transition from persistent to transient carrier status between 10 and 20 years of age. Adult transient carriers were commoner among manual than office workers and frequently yielded biochemically atypical isolates, possibly because of acquired resistance to typical strains. Nasal carriage was commonest, but children frequently yielded the organism from both nose and throat.


Skeletal maturity and the prediction of age at menarche. The regression of age at menarche on the difference between bone age and chronological age was estimated using hand/wrist radiographs taken between the ages of 10 and 15 years of 352 British girls whose ages at menarche were known. The regression was used to determine, in the case of girls who had not yet menstruated at a given chronological age and bone age, (a) the most probable age at menarche, and (b) the age by which 95 per cent would have experienced menarche. The results were compared with predictions made on the basis of chronological age alone. The range of error of predictions based on chronological age only decreases as age increases. This is true also when bone age is taken into account but, at all ages, the error of prediction using bone age as well as chronological age was less than that of prediction based on chronological age alone.


Mechanism of the toxic action of carbon monoxide. Our studies indicate that a high concentration of carboxyhemoglobin (COHb) does not interfere with the O2--carrying capacity of the blood. In dogs, both the transfusion of erythrocytes containing 80 percent COHb and the i.p. injection of carbon monoxide (CO) gas do not produce CO toxicity even though the COHb is above 50 percent. Dogs inhaling CO (13 percent in air) for 15 minutes died within 15 minutes to 65 minutes with an average COHb level of 65 percent. The probable toxic action of CO is on the cellular respiration taking place in the mitochondria when CO competes with O2 for cytochrome a3. The presence of dissolved CO in plasma, which is necessary for CO to enter the tissue, probably occurs when the exchange takes place between alveolar air and the blood in the lungs. When air containing CO is inhaled, there will be a significant CO tension in the blood when it leaves the lungs and when it reaches the organs especially the heart and brain. While COHb level is useful as a clinical measure of CO exposure, the most important mechanism by which CO causes toxicity is its combination with cytochrome oxidase.


Validity of the ultrasonic technique as a method of measuring subcutaneous adipose tissue. Subcutaneous adipose tissue measurements, at abdomen, suprailiac, subscapular, and mid-triceps sites, made with the ultrasonic and skinfold caliper techniques were compared using data from 20 women and 17 men from a pool of subjects of 22 women and 20 men. In addition, comparisons were made between ultrasonic, soft-tissue roentgenographic and skinfold caliper techniques at the suprailiac and mid-triceps sites on 6 women and 12 men. Repeat measurements with the ultrasonic technique produced correlation coefficients of 0-87 and above. Correlations between skinfold caliper and ultrasonic measurements were generally higher among women than men over each of the four sites. A highly significant relationship, r = 0-88, was observed between the ultrasonic measurements and soft-tissue roentgenograms over the mid-triceps site. The correlation between the fat-muscle interface measured on the roentgenogram and ultrasonic measurements at the suprailiac site was 0-78. Multiple echoes and interfaces were observed at the suprailiac site on some subjects.


Pitfalls in iodine-125 digoxin measurement. Pitfalls in Iodine-125 digoxin methods are reviewed. Problems may arise from instrumentation, reagents, methodology, medications and variation in patient specimens. The laboratory has an obligation to avoid these errors and ways are available to accomplish this.


The age of menarche in Nigerian girls.

The age of menarche in Nigerian girls. The median ages at menarche were obtained from a sample of 2029 urban and 328 rural Nigerian girls by the status quo method, and calculated by probits. The median age at menarche for the urban girls was 13-70 +/- 0-03 years whilst it was 14-50 +/- 0-09 years for the rural girls. There were significant differences in the median menarcheal ages of the girls according to the level of education and the occupation of the parents, and their geographical residence. The number of siblings and the birth rank of the girls did not influence the age of onset of menstruation. A secular trend towards earlier menarcheal age at a rate of 5 to 6 months per decade was observed amongst children of the professionally privileged group. The earliest menarche occurred amongst girls with university-educated fathers or mothers; in this group the median was 13-26 +/- 0-06 years, a value comparable with current European medians.


Weight and skinfold variation at menarche and the critical body weight hypothesis. The weight and skinfolds of 36 longitudinally studied British girls were analysed to determine their variability from two years pre-menarche to two years post-menarche. If the critical body weight hypothesis of Frisch and Revelle (1970) is true, a reduction in the variability of these parameters would be expected at menarche compared to times before and after this event. No such reductions in variability were apparent.


The secular trend in age at menarche in the Netherlands. The mean age at menarche of girls in Utrecht city, the Netherlands, in 1971 and 1972 was estimated by probit analysis as 13-37 years with a standard deviation of 1-17 years. This result is compared with similar data obtained in the Netherlands in 1955 and 1965.


Antenatal events and postnatal growth and survival of children in a rural Guatemalan village. The biological features of all pregnant women and newborn infants in a typical rural village of Guatemala have been studied form 1964 to the present; 458 pregnancied have been analysed. The mothers averaged 143.1 cm in height 52.9 kg in weight and 9 mm in triceps skinfold. The diet of most was adequate in percentage protein but inadequate in iron and other nutrients. Infection was common, two or more episodes occurring in 40 per cent of pregnancies. The newborn population had a birthweight averaging 2533 g and length 45.6 cm. Thirty-four per cent were less than 2501 g at 37 weeks gestation or over; seven per cent were pre-term. The infants' growth was followed till age six years. Survival correlated strongly with birth weight and gestational age. Pre-term infants showed the poorest survival in neonatal and postneonatal infancy; but the survivors thrived therafter. The term-small-for-gestational age infants had poor survival in infancy and during the second and third years. Term infants with adequate weight-for-gestational age had the best survival rate. Postnatal physical growth correlated with birth weight and gestational age but pre-term adequate-for-gestational age infants showed a rate of growth as good as that of term infants.


Handedness and the cerebral representation of speech. Hand preferences vary not discretely but continuously and the continuum of preference is closely and reliably linked with a continuous roughly Normal distribution of differences between the hands in skill. Questions about handedness can be usefully formulated in terms of the distribution of differences in skill and in terms of the theshold or criterion which divided those likely to be classified as right handers from those likely to be classified as left handers. A theory of the origin of hand preferences suggests that three factors are involved. The first in non-genetic accidental variation in the development of the two sides of the body in all bilaterally symmetrical species showing limb preferences. The second in a systematic bias to the right hand in man, probably linked with the tendency for the left hemisphere to serve speech. The third is socio-cultural factors affecting the expression of sinistrality. An explanation of the relation between hand preference and cerebral speech laterality requires the assumption that in some individuals the factor biasing speech to the left hemisphere is absent. This would imply that the bias is not a universal species character but that it is subject to genetic variation. Making the simplest possible further assumptions that in the absence of bias, the laterality of handedness and of cerebral speech are independent and each governed by chance, it is possible to account for the distribution of right and left handers with dysphasias following right and left unilateral cerebral lesions.


Developmental correlates of handedness in a national sample of 11-year-olds. Some developmental correlates of hand preference in a large nationally representative sample of 11-year-old schoolchildren were examined. Non-right handedness was found to have slight, but statistically significant, associations with deficits of performance on certain standardized attainment and ability tests; with "poor speech" as assessed impressionistically by teachers in school; and with "poor control of hands" as similarly assessed by teachers. Non-right handedness was not associated with defects of articulation or stammering as assessed by doctors in a medical examination; nor withperformance on a clinical speech test; nor with writing productivity or syntactic maturity. There were substantial sex differences in the frequencies of non-right handedness, but no social class differences.


The rare allele SOD-A(2) in the Italian population. Data are reported on the distribution of SOD-A electrophoretic phenotypes in the Italian population, and on the concentration of SODA-A-2-1 phenotype in a family group of a small village. The frequency of the rate allele SOD-A(2) is estimated and compared with the frequency in other populations. By applying a model of population dynamics for rare neutral genes estimates are derived of the mean first arrival time and mean age, in generations, of SOD-A(2) allele.


Unifactorially inherited attributes of the population of Holy Island, Northumberland. The genetic polymorphisms of the Holy Island population show some differences from a mainland series. The significance of the results is discussed in terms of specialized gene flow and population size. Some interactions between the polymorphic systems are discussed.


A factor analysis of Ethiopian children's measurements. Thirteen anthropometric measurements of Kaffa district schoolchildren in Ethiopia were factor analysed. Two factors emerged which may be interpreted as (a) body size and (b) fat mass.


Age of onset of puberty in urban Argentinian children. A cross-sectional study in La Plata city, Argentina yielded mean ages of onset of breast and pubic hair developments in 504 girls and of genitalia development in 498 boys of 10.8, 11.0 and 11.8 years respectively. These values are close to those reported previously for various other populations.


Thoracic and lumbar spinal curvatures in Nigerian adults. The thoracic and lumbar curvatures of 105 Nigerian adults have been measured with a flexible rule (flexicurve). The lumbar curvature is relatively greater in women. Compared with a previous survey of Europeans, the curvatures in both men and women appear to be about 20 per cent greater in Nigerians. This is likely to be a genetic difference but the Nigerian practice of carrying heavy loads on the head may be a contributory factor.


The genetics of specific reading disability. Members of the immediate families of twenty children with specific reading disability were examined to determine the prevalence of reading disability within the families. A procedure was developed for identifying adults who may have compensated for a disability manifested more clearly in childhood. Forty-five percent of 75 first-degree relatives of the parents were affected and there was a significantly greater number of affected male relatives than females. No single mode of genetic transmission is evident after inspection of the pedigrees. It is suggested that the disorder is genetically heterogeneous and that subgroups of disabled readers should be looked for.


The segregation of human chromosome polymorphisms. The inheritance of C-band and Q-band polymorphisms have been investigated in 32 families. C-band inversion and size polymorphisms appear to segregate in a Mendelian manner, with the possible exception of the very large variant of chromosome number 9 which may be selectively inherited. There is some evidence to suggest a preferential segregation of Brilliant Q-band polymorphisms but it may be that this is an artifact caused by insufficient data and scoring error.