The dependence of the visual numerosity limit on orientation, colour, and grouping in the stimulus. Visual numerosity judgements were made for tachistoscopically presented arrays of dots. The arrangement within the arrays was either linear or such that dots could be easily perceptually subdivided into two groups. Subdivision was either in terms of an orientation difference, a colour difference, or a spacing difference in the centre of the array. For a large difference in orientation between the two 'arms' of the array (90 degrees), or a large central space (three times the interdot interval) up to 8 dots were accurately perceived. This numerosity limit was twice that found for equivalent linear arrays, with no grouping. Although in terms of accuracy it seems that in these conditions the two groups within each array can be counted independently, there is no evidence for independent processing in terms of response times. From the results of a subsidiary experiment it seems likely that the slow response times in the subgrouping conditions are due to the necessity of processes other than counting (such as judgements of symmetry). For arrays where subgrouping was in teems of a colour difference, or an orientation difference of between approximately 45 degrees and 90 degrees, or a small central space of twice the interdot interval, there was an improvement in accuracy compared to equivalent linear arrays, but no evidence of independent processing, up to a limit of 4, in each of the subgroups. From these preliminary results, tentative proposals concerning 'numerosity' units and their properties are made.


Implicit-shape constancy: a cross-cultural comparison. A group of Scottish schoolchildren were tested on a task intended to measure the effect of implicit-shape constancy, and the scores were compared with those obtained from African samples. It was found that both groups were influenced by the implicit-shape constancy although the influence was less in the African sample. The relationship of these findings to other published reports of cross-cultural research into pictorial perception and susceptibility to illusions is discussed.


Model-driven interpretation in intelligent vision systems. With a constructive knowledge-based theory of perception as its foundation, this paper starts with a review and critique of some artificial-intelligence programs that purport to see. It is then argued that these computer programs for scene analysis offer the hope of providing a more adequate account oo the current psychological theories. This thesis has several aspects. The one emphasized here is that those programs have explored a variety of methods of incorporating a priori knowledge of objects through the use of models. After outlining the range of models used, presenting a set of criteria for evaluating the use of model information, and sketching some psychological theories, the various proposals are contrasted. This discussion leads to two new proposals for exploiting model information that involve elaborations of an existing program, POLY.


Pituitary dwarfism in German shepherd dogs: additional evidence of simple, autosomal recessive inheritance. Previous observations suggested that pituitary dwarfism of German Shepherd dogs is due to simple, autosomal recessive inheritance, but own data were insufficient to test the hypothesis. The total material now includes six dwarfs from five litters. Omitting the proband litter, a total of 21 dogs from four litters, each with one dwarf, were relevant for testing goodness of fit. The observed segregation ratio was in agreement with that expected and thus supported the genetic hypothesis. According to this hypothesis it was possible to point at various heterozygous carriers among ancestors of the dwarfs within a pedigree comprising 13 generations.


Lung lesions at slaughter: associations to factors in the pig herd. A survey was made of available data files to gain a preliminary insight into the association between environmental factors and the prevalence at slaughter of lung lesions. Herd size was the factor that showed the most predominant association with the prevalence of lung lesions. This was largely independent of the recruitment system for weanlings. There was a moderate trend toward positive association between the prevalence of lung lesions and the prevalence of other lesions. Lung lesions were weakly but significantly associated with the occurrence of infectious diarrhoea in the herd. The investigation demonstrated the feasibility of and the need for continuous epidemiological studies to identify disease determinants. Studies of the nature reported here makes it possible to define essential health factors with an accuracy that could never be achieved through clinical observations in a few herds.


Zinc as a possible causal factor in the sterilizing sperm tail defect, the 'Dag-defect', in Jersey bulls. The zinc content was determined in semen samples from four young Danish Jersey bulls showing the typical 'Dag defect' (greater than 50% strongly coiled or bent sperm tails). Two of the bulls were half brothers. Semen samples from 14 normal fertile Jersey bulls served as controls. The normal material showed a zinc content in the centrifuged sperm of 190 +/- 15.8 mug/g d.w. and in the seminal plasma 81 +/- 31.2 mug/g d.w. In the four abnormal bulls the following elevated values were found: in the centrifuged sperm 310 +/- 109.5 mug/g d.w. and in the seminal plasma 137 +/- 75.2 mug/g d.w. (see figs. 1 and 2). One of the Dag defect's main localizations, the outer dense tail fibers, has a very high zinc content and this fact together with the heredity of the defect make further studies most promising.


Epidemiology of mycotoxic porcine nephropathy. Mycotoxic porcine nephropathy is a renal disorder caused by ingestion of feed-borne secondary fungal metabolites, possessing nephrotoxic properties. The disease is present endemically in all areas of Denmark, but unevenly distributed, with frequency varying from 0.6 to 65.9 cases per 10,000 pigs in 1971. Epidemics were encountered in 1963 and 1971, apparently associated with excessive climatic conditions. The highest frequency of the disease is found among pigs from the smaller farms. Ordinarily the same farm delivers cases during only one year. Female pigs contract the disease more frequently than male (castrated) pigs. The epidemiology of mycotoxic porcine nephropathy shows similarities with the epidemiology of endemic Balkan nephropathy.


A study of skin diseases in dogs and cats. II. Microflora of the normal skin of dogs and cats. A study of the microflora of the normal skin was undertaken in 10 dogs and 10 cats. Swabs were taken from the surface of the skin at 7 different sites (Fig. 1). Micrococcus spp., alpha-hemolytic streptococci, and Acinetobacter spp. were found consistently in both species. Staphylococcus aureus was isolated from 9 dogs and 4 cats, and staphylococcus epidermidis from 7 dogs and 5 cats. Beta-hemolytic streptococci, Corynebacterium spp., Bacillus spp., Escherichia coli, Proteus mirabilis, Pseudomonas spp., and Alcaligenes spp. were found sporadically.


[Isotope study of the effects of a nitrate derivative on pulmonary blood volume. Application in the treatment of cardiogenic pulmonary edema]. Isotopic study of pulmonary and ventricular blood volumes after the ingestion of 5 mg of isosorbide dinitrate showed that cardio-pulmonary blood volume decreased by 380 ml without any change in total circulating blood volume. The demonstration of this effective "internal venesection" explains the fall in capillary pressure seen after the administration of nitrate derivatives. It justifies their use in the treatment of acute pulmonary oedema or refractory cardiac failure and explains the results observed.


[Severe hyperkalemia in cardiac patients]. Hyperkalaemia with severe myocardial consequence may complicate the treatment of heart failure. In five patients who developed kalaemia ranging from 6.5. to 8.6. mEq/l, the ECG showed altered auriculogram and/or widened QRS, the latter change being associated with ST segment elevation and very large T wave in one case. Such hyperkalaemia cannot be termed iatrogenic, although it is promoted by diuretic-induced hyponatraemia and dehydration. The essential part is played by an aggravation of the haemodynamic status, responsible for acute renal insufficiency with oligoanuria, and by the attendant metabolic acidosis. The correction of this metabolic acidosis promotes diuresis, causing potassium depletion and the rapid regression of electrocardiographic abnormalities. Parenteral alkalinization with sodium bicarbonate, associated with furosemid to prevent sodium overload, instituted in emergency, is the only way to prevent asystole or ventricular fibrillation when kalaemia exceeds 8 mEq/l.


[Effect of a polyvitamin preparation on the immune response to antibodies. Demonstration of the immunostimulating activity of propylene glycol]. Humoral antibody to sheep erythrocytes was studied by plaque forming cell and hemagglutinin assays in mice receiving a polyvitaminic preparation containing vitamins A, D, E, and C. A statistically significant increase in PFC on days 6, 12 and 18 after immunization, and an increase in hemagglutinin titers was observed in animals treated with this vitamin containing solution. These results are interpreted as an immunostimulating activity of the preparation. Nevertheless, as shown by the results obtained with each component injected separately, a major proportion of the immunostimulating activity seems to be related to propylene glycol, a simple compound contained as an hydrodispersant in the preparation. Further studies of the immunostimulating properties of propylene glycol are now in progress in our laboratory.


[Testicular secretions of androgens after prolonged physical effort in man]. Variations in plasma testosterone, dihydrotestosterone. delta 4 androstenedione, LH, FSH and cortisol were measured before and after 6 succesive effort tests in 11 male subjects. Testicular secretion and the extra-hepatic consumption of androgens are increased by the haemodynamic conditions of effort but plasma levels of testosterone and dihydrotestosterone fall with repeated effort, indicating a progressive imbalance between production and consumption. These variations suggest that the testis, rather than glucocorticoid function of the adrenal, might play a major limiting role, psychological and metabolic, in tolerance of prolonged effort.


[Water consumption in Saharan nomads. A remarkably reduced and constant consumption]. The writer has carried out two studies of the Western Sahara (Missions UNESCO-Institut Scientifique Cherifien 1961 and 1964) bearing upon the consumption of water by the Saharan nomads. In spite of their environment, the consumption appeared to be remarkably low and constant. Very strict dietary practices, the salinity of the water, and special behavioural customs seemed to be the basis of this strict economy of fluid intake. Genetic factors could also, of course, be partly responsible. The dietary practices are characterised essentially: 1) by a regime which in general contains the minimum of protein: milk foods, cereals, and sugars, and 2) by the habitual exclusion of salt in the preparation of meals; the sodium necessary for water/sodium balance deriving solely from the salinity of the water. Water with little or average salt content (total 2-3 g/l) seems to meet the normal needs of the body - there is no need for the salt pill - and, moreover, to quench the thirst more effectively than pure water (Paque, 1964) - presumably by making good the deficit (cf. Stricker, 1970). On the other hand, saltier water (total 4-8g/; Na 1 g/l or more) appears to pose more complex physiological problems for which the prime solution is to apply the Saharan rule, i.e. that no supplementary salt should be added to the diet (Paque, 1963). In desert life there are thus certain rules which must be obeyed. As for the matter of behavioural customs influencing water balance, they consist in the main of habitually limiting the frequency of water intake (often just twice daily, sometime only once daily) together with a careful choice of clothing and the wearing of the veil. Finally, genetic factor could result in a more efficiently controlled loss of water (and of salt?) VIA THE SKIN.


[Treatment of type II familial hypercholesterolemia by portacaval anastomosis]. Termino-lateral porto-caval anastomosis seems at present to be the most effective treatment for severe familial hypercholesterolaemia. The mechanism by which it acts has not been determined and its long term results are not known. One success and one failure confirm the immediate action of anastomosis in a condition with a fatal prognosis.


[Myocardial and coronary lesions in anterior and posterior myocardial infarction. Comparative macroscopic anatomical study]. Comparative anatomical macroscopic study of two groups of 24 cases of recently fatal first myocardial infarction (anterior or inferior) confirmed certain classical notions: higher age in females (p less than 0.02), inferior necrosis less extensive (p less than 0.05), higher occurrence of rupture of the myocardium in the case or an anterior lesion, and less frequent rupture but more often involving the septum in the case of inferior infarction. Furthermore the study showed the virtually constant presence of an intracoronary thrombus responsible for the infarction, the wider extent of atherosclerotic lesions in the right coronary system, and, above all, a fairly direct opposition between stenotic lesions most often proximal, and affecting the single anterior trunk (75%), in the case of anterior infarction, whilst significant atherosclerotic occlusion of the anterior (87%) and left (67%) systems were seen in the case of inferior infarction due to complete occlusion of the right coronary artery. These anatomical findings indicate the need for routine coronary arteriography after inferior infarctions, the recurrence of chest pain being related not to changes "in sity" but rather to significant occlusion of another coronary system.


[Immunologic evaluations during prolonged and chronic hepatitis. Significance for diagnosis and prognosis. 100 cases]. This retrospective study illustrates the valuable contribution of immunological studies carried out during the third month of hepatitis. The persistence of HBs antigen at this stage of the disease considerably increases the risk of chronic hepatitis though not necessarily implying progression to cirrhosis. The latter should be feared if there is a marked increase in gamma globulins and in the presence of a high level of anti-smooth muscle and antinuclear antibodies. Amongst the other immunological features, an increase in IgA and IgM also indicates the possibility of progression from chronic hepatitis to cirrhosis. Comparative study in chronic active hepatitis of HBs antigen and various antibodies indicates essentially three types: - CAH with Ag HBs without auto-antibodies - Auto-immune CAH without Ag HBs - CAH without auto-antibodies nor Ag HBs. Progression to cirrhosis appears to be less frequent in the first group than in the second.


[Does chronic psychosis due to amphetamines abuse exist? Study of 25 drug addicts]. The development of a psychotic process was noted in seven amphetamine addicts who had been seen over a period of several years before onset of the psychosis and who had no psychotic tendencies before the addiction. This group was compared with two from the standpoint of the symptomatology of acute psychosis; i.e. acute psychotic episodes under the effects of amphetamines in individuals who were not psychotic before addiction and who were cured at present, and acute psychotic episodes under the effects of amphetamines in individuals who were psychotic at the time of becoming amphetamine addicts. This comparative study attempts to define the signs which precede the development of a chronic psychosis and includes a discussion concerning the clinical picture and its correlation with the pre-existent personality.


[Cervical ribs. Therapeutic deliberations apropos of 10 cases]. The authors report ten cases of cervical ribs operated upon in 7 patients. The predominantly neurological symptoms and signs were associated with vascular problems in 3 cases, with intermittent compression of the sub-clavian vessels. Treatment consisted of resection of the cervical rib and the first rib via an extra-pleural axillary approach using the technique described by Roos. It gave 10 good results with a follow-up of 6 months to 3 years. The authors emphasise the fact that this pathology falls within the context of compressive syndromes of the root of the upper limb or thoracic outlet syndrome. Such a conception justifies associated resection of the first rib which should give better long term results than simple resection of the extra rib.


[Disorders of hemostasis during partial hepatectomies. Study of 20 cases]. Changes in blood coagulation have been studied during and after 20 elective hepatic lobectomies, most of them for tumors necessitating extensive resection (17 right lobectomies, 10 of which were extended to the medial segment of the left lobe). In addition, 9 unresectable tumors, as proved by exploratory laparotomy, were taken for controls. Before operation, hemostasis in essentially normal except a hyperfibrinogenemia and a slight increase of fibrinogen split products in half the cases. Factor VIII antigen levels are consistently increased. During mobilization of the liver an increased fibrinolytic activity and soluble complexes are frequently observed. Fibrinolysic activity spontaneously returns to normal at the end of the operation, except in cirrhotic patients. No bleeding disthesis is observed and haemorrhage appears to be related to technical problems. On the other hand, there is no clinical evidence of thromboembolism after operation. Therefore any specific therapy either pro or anti-coagulant, appears unjustified, apart from the eventual and transient administration of antifibrinolytic drugs in cirrhotic patients. In the post operative period, blood clotting factors synthetized by the liver (prothrombin complex and antithrombin III) slowly return to normal. Rapid correction of hypo-accelerinaemia reflects the onset of liver regeneration. A simplified method for surveying hemostasis during and after liver resection is proposed.


[Hepatic puncture biopsy by the transjugular route]. The authors report their experience of transjugular liver biopsy, a method which consists in taking a liver specimen with a needle placed in a hepatic vein. This method was used in 13 patients in whom conventional liver needle biopsy was contraindicated because of massive ascites or bleeding tendency. In 10 of these patients, a liver specimen was obtained; in patients with cirrhosis or chronic active hepatitis, the liver specimens were more or less divided into small fragments, which prevented correct assessment of liver architecture in three of them. The examination was well tolerated. The authors conclude that transjugular liver biopsy is not technically difficult in centers where hepatic vein catheterization is available and that this method is indicated in patients in whom conventional liver needle biopsy is contraindicated.


[Pregnancy in women with atrioventricular block. 13 cases]. Thirteen women aged between 18 and 37 years and suffering from atrio-ventricular block had 36 pregnancies. Foetal prognosis was excellent and the pregnancy quite unaffected by the block in 9 cases. In 4 women, Stokes-Adams attacks occurred. In one case from some time ago therapeutic abortion was necessary. Temporary pacing at the time of delivery was used in one case and a permanent pacemaker in one patient. The problems posed by the insertion of a pacemaker in a woman of childbearing age are discussed.


[Combination chemotherapy in the treatment of polymetastic breast cancer. Comparison of therapeutic effects of 2 methods of sequential drug administration. Role of adriamycin in these combinations]. One thousand and twenty four patients with disseminated breast cancer were submitted to combination chemotherapy. Fifty one patients (group I) were sequentially given VCR, CPM and 5 FU, and seventy three patients (group II) were given ADM, VCR, CPM and 5 FU. The general and haematological tolerance was good and comparable in the both groups of patients: we observed only two severe infectious complications. Bonemarrow hypoplasia, six myocardial ischemia (two of them were lethal) in each group of patients, without any predominance in the group of patients treated with adriamycin. The percentage of objective regression in both groups was respectively: 72% and 71%. The mean duration of response was eight months. The median survival time was 420 days for patients of group I; for patients of group II the median is not obtained at 480 days. This study confirms that responders to chemotherapy significantly increase the mean duration of survival time. However, in this group of responders the presence of the liver metastases is worse prognosis than all other visceral metastases.


[Value of radionuclide imaging for the emergency diagnosis of pulmonary embolism. 27 cases]. The urgent nature of certain cases of pulmonary ambolism limits the examinations possible to a minimum which should be rapid, immediately interpretable, absolutley harmless and of proven reliability. We reviewed 27 cases of patients referred fro possible embolectomy in a cardiovascular surgery service from 1968 to 1975. Infusion scintigraphy was carried out in all the patients and 20 underwent surgery. Retrospective study of these cases indicates that infusion lung scintigraphy confirmed the diagnosis in all 27 and indicated the need for medical or surgical treatment. The problems which were posed by certain scintigraphic images obtained using a scanning apparatus with iodine mabelled macro-agregates have disappeared with current techniques: the use of microemboli labelled with Technetium, a short-life low energy isotope, together with a scintillation camera which gives rapid AP and lateral views, the latter being essential in the determination of the topographical distribution of the defects.


[The small left colon syndrome. 3 cases]. In the light of three cases of neonatal obstruction related to a small calibre descending colon, the authors review the main clinical and radiological signs and compare them with the data in the literature. This functional disturbance is related to immaturity of the intrinsic innervation of the colon which is especially common in low birth weight neonates or of diabetic mothers. Diagnosis is dependent upon enema using diluted uroangiographic hydrosoluble iodine contrast medium, which shows a disparity in calibre at the left colic angle. The differential diagnosis lies with Hirschsprung's disease. Functional ileus in premature infants, meconium ileus and the "small left colon syndrome" are related to the same pathogenisis: functional immaturity of the colon.


Diagnosis of superior vena caval obstruction without syndrome. Ten patients with known malignant intra-thoracic tumors and no evidence of superior vena cava syndrome were evaluated by means of scintillation camera superior venacavograms. Four of the ten patients proved to have unsuspected involvement of the superior vena cava or its tributaries. The scintillation camer superior venacavogram provides a quick, safe, and accurate method of evaluating the patency of the SVC and its tributaries. We suggest that it should be routinely performed on all patients prior to beginning radiation therapy for malignant intra-thoracic tumors.


[Changes in perfusion and blood flow distribution following normo- and hypothermic ischemia of the kidneys]. Experimental examinations were performed in 22 dogs to find out the mechanism which leads to a permanent or a reversible damage of the renal parenchyma after normo- and hypothermic ischemia. For this reason the perfusion and the distribution were examined with 133Xe, the vascular changes by angiography, and the parenchymal function with 131I-Hippuran. After normothermic ischemia a short-term reactive hyperemia appeared, which however could not compensate the damage of the renal tubular cells and the resulting excretory insufficiency. After hypothermic ischemia the perfusion was reduced, probably as a consequence of a vasconstriction by cold, however, the function of the tubular cells remained intact, because of the protective mechanism of the hypothermia. The importance of these findings for the development of the so-called "shock-kidney" (acute tubular necrosis) and for the conservative renal surgery in hypothermia is discussed and the application of measures beneficial to perfusion, are suggested.


Determination of placental blood flow by external monitoring of 113In. A simple and noninvasive technique was developed to evaluate the blood perfusion rate within human placenta. The method is based on monitoring the accumulation of the isotope 113mIn in the placental intervillous space using a single detector as a measuring device. The result was expressed as an accumulation index calculated from the tracer appearance curve. The In accumulation index was significantly lower in preeclamptic patients than in the controls, but with a marked overlapping. The In index was significantly correlated with the simultaneously recorded maternal minute volume, 24-hour estrogen excretion and birthweight. No correlation was found with the placental weight or Laakso's perfusion index. Uterine contractions induced a significant decrease in the In index. The authors conclude that the In accumulation index can be used as an objective measure of the placental blood flow.


Characterization of an intravenously injected bolus. A study of some parameters affecting the time activity histogram of an intravenous bolus injection of radioactivity was performed. A scoring system for bolus compactness was attempted. A score of 2 and above was considered to be a satisfactory bolus. Volumes less than 1 ml tended to result in a satisfactory bolus. The nature of the radiopharmaceutical injected, different injecters and age of the patient did not affect the score. Thyrotoxic patients gave the best bolus score.


57Co-hematoporphyrin accumulation by experimental tumors. The in vivo distribution of 57Co-hematoporphyrin in adenocarcinoma BW10232-bearing mice has been studied. Tumor-bearing and normal animals exhibit similar patterns of radioactivity accumulation. Twenty-four hours after the administration of the radiocompound the ratios tumor to blood and tumor to muscle indicate a potential value of this radioactive porphyrin for the detection of some types of tumor.


Mechanism of 67Ga accumulation in normal rat liver lysosomes. 67Ga accumulates in various malignant tumors and parenchymatous tissues. It was found to be associated with the soluble fraction of lysosomes (11). The present work investigates the mechanism of 67Ga accumulation in normal liver cells. Lysosomes were isolated from rat liver after intravenous injection of carrier free 67Ga. The soluble lysosomal fraction was obtained by sonication followed by centrifugation at 105,000 xg for 2 hrs. Gel filtration on Sephadex G 25 superfine was carried out on the soluble lysosomal fraction in order to investigate the stability of the 67Ga-protein complex within the lysosomes under EDTA treatment. After treatment with 1 mM/l EDTA a considerable amount of the protein bound radioactivity was found to be liberated. In further experiments the 67Ga binding lysosomal proteins were fractionated by electrophoresis on 7% polyacrylamide gels (0.5 cm x 5.5 cm). After staining with Coomassie blue 18 separated protein bands were apparent. 67Ga distribution within the gels was assessed by direct counting of radioactivity in gel slices. A considerable amount of the intralysosomal protein bound radioactivity migrated with a relative mobility of 0.36 corresponding to a protein band of molecular weight 85,000--90,000. This peak corresponded to the peak of 67Ga-labelled purified transferrin in control gels. These data were confirmed by immunoelectrophoresis combined with autoradiography: within the soluble lysosomal fraction a slight transferrin line could be identified. We conclude that 67Ga which is transported in the blood by transferrin (23) and taken up by the hepatic cell through endocytosis (32) is accumulated in the lysosomes associated with transferrin and its degraded fragments.


Malabsorption of vitamin B12 in homozygous beta-thalassemia. Schilling tests were performed in ten children and 5--12 years suffering from homozygous beta-thalassemia. 57Co labelled vitamin B12 values excreted in the urine have been found much lower than normal and remained low when the same procedure was repeated with the addition of intrinsic factor. The possible factors responsible for this malabsorption of vitamin B12 seemed to be liver damage and folic acid deficiency.


The influence of antidepressive drugs on the level of acetylcholine and on the acetylcholinesterase activity in the brain of rats. Rats were treated ip with MAO inhibitos (MAO-I): nialamid (NL), pivalylbenzylhydrazine, tranylcypromine, pheniprazine (Ph) or pargyline, and the leve of total, free and bound acetylcholine (Ach) as well as the acetylcholinesterase (Ach-E) activity were estimated in four parts of rats brain 2 or 16 hr after the treatment. These parameters were estimated also after the treatment with tricyclic antidepressants: desmethylimipramine (DMI), amitriptyline, or protriptiline, and in the conditions of the reversal of reserpine-like syndrom. MAO-I, 2 hr after their application and the reversal of reserpine like-syndrom have not changed the level of measured fractions of Ach in parts of the brain. DMI increased the level of all Ach fractions in the striatum. NL caused the decrease of bound Ach level in all parts of the brain with no changes of free Ach level, 16 hr after the treatment. Ph, 16 hr after the treatment, decrease both fractions of ACh only in the cortex. All studied drugs affected evidently ACh-E activity in various parts of brain. It is concluded that:1) Cholinergic mechanisms in the rat brain are involved in the central action of DMI and of some MAO-I., 3) Cholinergic function of the brain may be modulated by the adrenergic activity, 2) Individual parts of the brain have different susceptibility to the influence of different MAO-I on the ACh-E activity.


Gel with nystatin for treatment of lung mycosis. A method of preparation of the gel with nystatin for a local treatment of lung mycosis is described. Physico-chemical properties and the stability of this preparation have been investigated.


Haemodynamic changes accompanying lung oedema produced by iv injection of adrenaline or vasopressin into rats. The blood pressure was investigated in the common left carotid artery (LC), in the left atrium (LA), in the pulmonary artery (PA) and in the right atrium (RA). After adrenaline injection the blood  pressure rised rapid and simulatneously in all four regions. After vasopressin injection the blood pressures rised sequence in LC, in LA and PA. The blood pressure in RA in this time was unchanged. These results indicate that primary causes of the lung oedema after adrenaline or vasopressin are different.


Spectrophotometric and chromatographic determinations of kanamycin A in pharmaceutical preparations. Acid hydrolysis of kanamycin A gives 5-aminomethylfurfural which can be determined quantitatively colorimetricaly by the colour complex with orcinol and FeCl3. This method gives results which correlate with the results of microbiological assay. Kanamycin B, tobramycin kasugamycin did not produce this colour reaction.


Effect of processing technique of different dosage forms on dissolution rate of caffeine and salicylamide. The dissolution rate of caffeine (Cf) and salicylamide (SA) from the mixtures of powders, granulate and tablets, obtained by the direct compression and wet granulation methods, has been investigated. The results presented in plots show, that the dissolution process of Cf and SA follows the first-order kinetics. The kinetic equations are used for the calculation of the dissolution rate contants (K) for the compounds of different solubility. Chromatography did not give an evidence for the formation of an adduct of Cf and SA in the granulate and tablets prepared by the wet granulation method.


Effects of manganese on substrate oxidation and oxidative phoshorylation in rat liver mitochondria. In vitro Mn2+ decreases respiration at metabolic state III and at the uncoupled state. Pretreatment with Mn2+ decreased also ADP to oxygen ratio in rat liver and brain mitochondria. The mechanism of manganese toxicity involving suppression of substrate oxidation and decrease of oxidative phosphorylation efficiency in brain mitochondria is discussed.


A search for new anticonvulsant compounds among 3-aryl-5-benzylidene derivatives of 2-thiohydantoin. 13 New 3-aryl-5-benzylidene-2-thiohydantoins were obtained by condensation of 3-o-tolyl- and 3-m-tołyl-2--thiohydantoin with aromatic aldehydes. The structure of the obtained compounds was confirmed by IR spectra. Derivatives of 2-thiohydantoin 1-13 show weak anticonvulsant activity in pentetrazole test and show no protecting activity against the maximal electric shock.


Marihuana use. Biologic and behavioral aspects. More than 70 male chronic marihuana users were studied under research ward conditions for a 31-day period consisting of 5 days of baseline assessment, 21 days of marihuana availability, and 5 days of postsmoking assessment. Biological findings were for the most part within normal limits. Blood chemistry studies showed no abnormalities. Plasma testosterone levels for all subjects at all times during the study were well within normal limits, suggesting that previous reports of testosterone suppression by marihuana may have statistical but not biologic singificance. A significant reduction in baseline vital capacity was observed in six subjects, a compromise in pulmonary function similar to that characteristically produced by chronic inhalation of substances, such as tobacco smoke, which are irritants to the lung. Increased caloric intake and weight gain occurred in virtually all subjects and were causally related to marihuana smoking. The weight gain may be attributable to water retention as well as increased caloric intake. Behavioral findings indicated that no uniform alteration in mood is produced by marihuana smoking--all subjects reported becoming "high", but experienced no consistent degree of euphoria. Mood changes which occurred were relatively mild and were largely dependent on group determinants rather than individual experience. No relationship could be established between marihuana use and motivation to work or engage in socially desirable activities. Evidence that pulmonary function may be compromised as a function of marihuana smoking suggests the need for alerting individuals to this potential health hazard. As was true of cigarette smoking, the eventual public health consequences of marihuana use may become apparent only after large numbers of individuals have smoked marihuana for two or three decades.


Adaptation to chronic illness.

Adaptation to chronic illness. Adaptation to chronic illness is making the best of a bad bargain. The patient who deals successfully with chronic illness is the one who continues to live and function as fully as possible until death is appropriate and inevitable. Good medical care can help, but only if the patient meets the challenges of adaptation--acceptance, the sick role, compromise, and dying. Sometimes the patient can adapt to a new role but the family cannot; denial or nonacceptance on the part of a spouse or family can constitute a tremendous adaptational complication. Ironically, the healthy helpers around the patient, including the physician, may also fail to recognize the magnitude of the challenge of compromise and too easily criticize the patient for meeting it with difficulty or only partially.


Psychologic adjustment to coronary artery disease. As improvements in therapy have extended the survival rate of patients with ischemic heart disease, increasing attention to the quality of survival has resulted in an appreciation of the profound effect of psychologic factors on the patient's life. A multidisciplinary approach, including evaluation and management of pertient psychologic factors, should be part of the treatment of all patients with coronary heart disease. Ischemic heart disease often requires both patient and family to make difficult changes in personality and life-style. As soon as the physiologic stress begins to subside, the physician should begin to provide sympathetic, specific guidelines toward acceptance of the disease and accommodation to its limits. Potential problems and their management are discussed within the framework of the three stages of chronic illness.


Psychiatric aspects of chronic organic brain syndrome. In chronic organic brain syndrome, or dementia, the patient generally retreats to simple, familiar situations and resists involvement in others. The symptoms represent both organic deficits due to brain damage and psychologic reactions to the deficits. Some causes are treatable. Because of progressive change in the total behavior of the patient, major rearrangement of life-style is often necessary. The physician should guide both patient and family in this process. Medication may also be helpful.


Cardiology. acute severe mitral regurgitation. Acute mitral regurgitation occurs as a complication of myocardial infarction in perhaps 1% of cases. The characteristic clinical findings include a new systolic murmur occurring in the setting of sudden development of acute congestive heart failure, hypotension, and shock. S3 and S4 gallops and sinus rhythm usually are present, and gross left ventricular or left atrial enlargement usually is not evident radiologically. The immediate and long-term prognoses for patients with acute severe mitral regurgitation are poor without treatment. Although medical therapy can reverse temporarily some of the hemodynamic aberrations, it does not influence survival or eliminate the need for surgical treatment. Surgery consisting of mitral valve replacement and possibly simultaneous coronary revascularization appears to offer some hope in increasing the survival rate among these patients. When acute severe mitral regurgitation is secondary to rupture of chordae tendineae in circumstances other than coronary artery disease, the outlook is not as grim. These patients may show signs and symptoms of congestive heart failure for a few weeks or, at times, many months. Again, sinus rhythm usually is present, with slight left ventircular enlargement, a relatively normal left atrial size, and markedly elevated left atrial and pulmonary arterial pressures. This constellation of findings is indicative of a large mitral regurgitant flow with preservation of left ventricular function and suggests that the patient is likely to benefit greatly from surgical treatment. The prognosis for such patients is much better than it is for the patients with acute mitral regurgitation secondary to coronary artery disease.


Office treatment of eye injury. 2. Injury from sharp instruments or blunt trauma. Eye injuries caused by sharp instruments range from superficial scratches of the corneal epithelium to serious lacerations of the globe of the eye. Scratches, conjunctival lacerations, and some eyelid lacerations can be dealth with by the primary physician in the office, but damage to the globe requires immediate referral to an ophthalmologist. Among possible results of blunt trauma to the area of the eye are ecchymosis, hyphema, blow-out fracture, subluxation or dislocation of the lens, or retinal detachment. Most of thes require thoroguh ophthalmologic examination and specialized treatment. The primary physician may be the first to examine a patient with serious head injury. For future reference the status of each eye should be carefully documented as soon as possible after injury.


Acute acid-base disorders. 2. Specific disturbances. Evaluation of the acid-base status of the body requires measurement of bicarbonate (total carbon dioxide) concentration, pH, and partial pressure of CO2 in arterial blood. Calculation of standard bicarbonate and base excess or deficit is not necessary. The normal concentration of free hydrogen ions (H+) is approximately 40 millimoles/liter, which is equivalent to a pH of 7.4. The normal load of fixed acids is 50 to 80 millimoles in 24 hours. A steady state is maintained by excretion of an equal amount of H+ by the kidneys, which at the same time regenerate bicarbonate to replenish buffer stores. Renal excretion of H+ is in the form of titratable acid and ammonium. Synthesis of ammonia can increase severalfold under the stimulus of acidosis. This is the chief mechanism of long-term compensation. Metabolic acidosis can be due to an excessive acid load (endogenous or exogenous), impaired renal excretion of H+, or bicarbonate loss. Determination of the "anion gap" (unmeasured anions) helps to establish the mechanism of acidosis. Acidosis with a normal anion gap is due to either bicarbonate loss or ingestion of certain chloride salts. A gap larger than normal indicates the presence in the body of acids other than acidfying chloride salts. Management of metabolic acidosis requires accurate diagnosis, clear understanding of the mechansim, and individualized treatment. Metabloic alkalosis is due to loss of H+ (usually from stomach or kidneys) or ingestion of alkali. Measurement of urinary chloride helps establish the mechanism of alkalosis. In saline-responsive alkalosis, the urinary chloride level is very low. This is usually due to gastric loss of H+, and the condition responds to administration of saline solution. When the urinary chloride level is only moderately low, the alkalosis is probably not due to gastric loss of H+. This form of alkalosis (saline-resistant) does not respond well to administration of saline solution and requires use of potassium in treatment. Apprpriate compensatory responses to acidosis or alkalosis are critical to survival. Compensation for metabloic acidosis consists of hyperventilation and enhanced renal excretion of H+, chiefly as ammonium. In metabolic alkalosis, compensation is mainly renal excretion of bicarbonate. Respiratory acidosis is due to alveolar hypoventilation. In chronic situations, a compensatory rise in serum bicarbonate concentration is expected. Management consists of treatment of the cause of hypoventilation. Respiratory alkalosis is due to hyperventilation. Treatment requires identification and correction of the cause of hyperventilation.


Cold agglutinin disease.

Cold agglutinin disease. Development of the Coombs test has led to rapid progress in the recognition of various autoimmune hemolytic anemias. Cold agglutinin disease, a relatively rare disorder, occurs in idiopathic and secondary forms, the latter often in association with diseases that alter the immune status. The higher the titer of cold agglutinin, the greater is the thermal range of its activity. One of the characteristic clinical manifestations of the disease is striking cyanosis in acral areas on exposure to cold, which abates quickly on warming. This parallels the accelerated hemolysis at cold temperatures, which is reversible as heat is applied. In some patients, however, the disease is covert and is discovered only incidentally. The report of such a case is included.


Genetics of ischaemic heart disease.

Genetics of ischaemic heart disease. Coronary heart disease, especially when it affects younger individuals, tends to cluster in families. Known risk factors occur in 50-75% of patients with myocardial infarction. Yet commonly occurring risk factors are not strongly inherited, and the familial aggregation of coronary heart diseas may not be attributable to familial resemblance in serum cholesterol and blood pressure levels. Alternatively, such aggregation may be due to unknown familial risk factors. Nevertheless, screening of relatives of individuals with evident risk factors is of importance, and environmental manipulation is likely to be of value in prevention of coronary heart disease.


Exertional hypotension due to postganglionic sympathetic blocking drugs. Debrisoquine, guanethidine and bethanidine may produce troublesome hypotensive symtoms related to exertion. Thirteen patients with such symptoms were exercised on a treadmill and the response of blood pressure and heart rate was compared to that of thirty patients without these symptoms, who were exercised to the same extent. There was a slight drop of systolic and diastolic pressures on standing in both groups, but after exertion there was a significantly greater drop of systolic pressure in the group with symptoms than in the asymptomatic group. The diastolic pressure after exertion was significantly lower in the group with symptoms. It was impossible to predict from the standing blood pressure levels at rest which patients would develop hypotensive symptoms after exertion. All three drugs had a similar negative chronotropic effect at rest and on exercise. It is suggested that patients are exercised during control of hypertension in order to identify those prone to exertional hypotension. Patients with such hypotension should be exercised on each attendance before the blood pressure is measured. Treatment other than postganglionic sympathetic blocking drugs should be employed whenever possible in patients with milder hypertension.


Pregnancy following poliomyelitis.

Pregnancy following poliomyelitis. A review of forty-nine pregnancies in thirty-seven patients who had previously suffered from poliomyelitis found that obstetric complications were proportional to the clinical disabilities of the patient. A simple test of unilateral weight-bearing gives a good clue as to whether pelvic asymmetry is present.


Levamisole treatment of a child with severe aphthous stomatitis and neutropenia. The treatment of a 12-year-old girl with a lifelone history of recurrent infections and aphthous stomatitis is reported. A profound neutropenis, first noted at the age of 2 years, occurring at least every month was observed together with multiple mouth ulcers a sore throat and swelling of the jugular glands. Levamisole, originally described as an anthelmintic, has a beneficial effect on the symptoms of recurrent aphthous stomatitis. After levamisole treatment aphthous stomatitis was milder and in the 1-year follow-up period the patient was asymptomatic several times during a phase of obvious neutrophil depression. The child no longer complained of a sore throat with swelling of the jugular glands and the recurrent staphylococcal infections of the skin disappeared. After therapy a marked increase in monocytes at the moment of neutropenia was observed.


Acute coronary insufficiency with normal coronary arteriograms. Two patients presenting with apparent symptomatic and electrocardiographic evidence of acute coronary insufficiency and found to have normal coronary arteriograms are documented. The patients remain symptom free at follow-up 9 and 14 months later although one requires 160 mg propranolol daily. The electrocardiographic, myocardial metabolic and haemodynamic data in 413 patients with angina and normal coronary arteriograms are reviewed and the suggested aetiologies documented. Follow-up of patients in these series indicates a good prognosis for symptom-free survival.


Giant cell arteritis presenting as subclavian artery occlusion. A report of two cases. Two patients with the aortic arch syndrome and biopsy-proved but asymptomatic temporal giant cell arteritis are described. Corticosteroid treatment was followed by the return of peripheral pulsation in these two patients after an interval of a few months. A review of the literature suggests that of patients where giant cell arteritis causes subclavin obstruction there is an undue predominance of women, compared to the sex ratio found in giant cell arteritis overall.


Pulmonary oedema in meningococcal meningitis. Two cases of meningococcal meningitis complicated by pulmonary oedema are described. The pulmonary arterial wedge pressure was raised in the one case studied. Profound sympathetic over-activity may be the cause of the pulmonary oedema occurring in this situation. If this is so, adrenergic blockade would appear to be a rational approach to therapy.


Pulmonary oedema during treatment of acute water intoxication. Acute water intoxication with deepening coma and uncontrolled epileptiform seizures in a 25-year-old previously fit male schizophrenic was treated with hypertonic (2 N) saline and a 20% mannitol solution. This improved his neurological state but precipitated severe pulmonary oedema. Intravenous frusemide increased his urinary output sufficiently to clear the pulmonary oedema. In acute water intoxication the use of hypertonic solutions may thus precipitate left heart failure by expanding the intra-pulmonary blood volume beyond the capacity of even a healthy left ventricle to compensate. Simple water restriction will produce a slower but perhaps safer improvement.


Contraceptive pill-induced porphyria cutanea tarda presenting with onycholysis of the finger nails. A case of porphyria cutanea tarda induced by oral contraceptive pill therapy is reported, and its unusual presenting sign of onycholysis of the finger nails is noted. Reference is made to the rarity of nail changes in porphyria and the regression of the onycholysis in the patient following therapy is outlined.


[Pulmonary complications of azotemia. A case of uremic lung]. The authors studied the problem of pulmonary complications in acute and chronic uremia. They recalled the main characteristics of haemodynamic oedemas which can accompany the periods of left ventricular insufficiency during the evolution of uremia. They analized the characteristicsof the classic uremic lung representing in fact only a variety of lesional oedema in which the toxic effect of urea is controversial. Ventilatory consequences of chronic uremia were briefly exposed.


[Congenital isolated unilateral absence of the left pulmonary artery with dextrorotation of the aorta (2 cases)]. In connection with two cases of congenital absence of the left pulmonary artery with dextro-rotation of the aorta, the authors recall the clinical and radiological signs of this rare abnormality, explaining it by the theory of failure in partitioning of the troncus arteriosus. They particularly insist on the normal pulmonary venous return.


[Treatment of bronchial hypersecretion. Demonstration of polyanionic mucins-eprazinone interactions]. The study of therapeutical agents for "mucolysis" enables a classification of these drugs from their mode of action at the trachea-bronchial level (pharmacodynamic agents, enzymes, reducers, mucoregulation). The affinity of a piperazine derivative, eprazinone, for polyanionic bronchial mucins, was shown in vitro by spectrophotometry. Because of this property, eprazinone (Mucitux) might modify the fibrillar structure of bronchial mucus. This mode of action would differentiate this treatment from the mucolytic agents used today clinically.


[Aspiration-drainage of an emphysematous bulla in a patient with severe respiratory insufficiency]. The authors report the case of a patient with severe alveolar hypoventilation, with a large emphysematous bulla in the upper part of the right pulmonary field. The drainage aspiration of the bulla as a life saving technique greatly improved the respiratory function. Blood gases reverted to normal and the bullae disappeared. Literature reviewing. Discussion of radiological and functional criteria of compressing the pulmonary parenchyma around the bulla.


[Respiratory distress in evolutive tuberculosis (6 cases)]. The authors reported six cases of respiratory distress of tuberculous origin over a 3 year period. They underlined the failure to recognize the etiology despite a typical symptomatology and, on the opposite, the diagnostic difficulties met in a former tuberculous patient with chronic bronchitis. They insisted on the persistance of evolutive tuberculosis as a cause of respiratory distress, on the importance of any associated infection and on the little use of assisted ventilation.


The surgical treatment of hyperhidrosis. The diagnosis of primary hyperhidrosis is one of exclusion, but it is not a difficult one to make. It is a common, embarrassing and even disabling condition. If it does not respond to simple conservative therapy, the practitioner should not hesitate to advise sympathectomy for hyperhidrosis of the upper or lower limbs, or some simple local operation on the affected skin area for localized excessive axillary sweating.


A new waist-length lightweight elastic stocking. This trial has clearly demonstrated that the new waist-length lightweight elastic stocking introduces advantages over the normal thigh-length lightweight elastic stocking, with regard to comfort and appearance, and over support tights by applying greater pressure. Since they conform to current fashion they are more easily accepted by women patients, who preferred them to the present thigh-length elastic hosiery.


[Changes in 2,3-diphosphoglycerate Levels in Blood and Brain Tissue after Craniocerebral Trauma and Cardiac Surgery]. The response of the 2,3-diphosphoglycerate (DPG) levels in the blood and brain tissue to a craniocerebral trauma of varying severity was studied in anaesthetized rats. A trauma producing cerebral contusion was followed within two hours by a highly significant rise in DPG concentration in the blood as compared with the control animals or only mildly traumatized rats. The DPG levels in the brain tissue showed no significant differences. Similar changes in DPG concentration were observed in the blood of patients with craniocerebral injuries. The DPG-mediated increased release of oxygen to the tissues represents a compensatory mechanism and is pathognomic for craniocerebral trauma. Patients undergoing surgery with extracorporeal circulation lack this mechanism for counteracting hypoxaemia; already during thoracotomy the DPG concentration in the blood fell significantly and did not reach its original level until 72 hours after the operation. In stored, ACD stabilized, blood the DPG concentration gradually decreases. Estimations carried out over 28 days showed a continuous statistically significant loss of DPG. After 24 hours the DPG levels in stored blood had already dropped to the lower limits of normal - a fact that has to be taken into account in massive blood transfusions.


[Isoimmune antibody formation after blood transfusions]. During February 1973 to October 1974 950 inpatients of the Department of Surgery, Erlangen, were tested for the presence of iso-antibodies before and after blood transfusions. Irregular antibodies were demonstrable in 0.95% of the patients before they received a blood transfusion. In 2.73% of the cases blood transfusion resulted in sensitization with the formation of specific blood group antibodies. Identification of the 26 iso-antibodies showed a prevalence of anti-Kell and anti-E (7 cases each). In view of the frequent occurrence of these two antigens tests for their presence are advisable before a blood transfusion is given. Persons who are re-admitted to hospital should also be tested to the presence of irregular antibodies to ensure that sensitization has not occurred during the intervening period.


[Clinical hemodilution].

[Clinical hemodilution]. Acute hemodilution has been performed in 46 patients immediately before major gastrointestinal surgery. Clinical, hemodynamic, respiratory and metabolic parameters have been studied and compared with results in 66 patients, submitted to similar operations under equal conditions without hemodilution. Two kinds of hemodilution have been used: normovolamic hemodilution by bloodexchange with 5% human albumin and moderate hypervolamic hemodilution by bloodexchange with equal parts of Dextran 60 and PPL. 1. The first mentioned kind of hemodilution and method of blood-exchange was superior in regard to stability of cardiovascular behavior. 2. The general tolerance of anesthesia and surgical trauma was superior in the nonhemodiluted group, but was good or tolerable also in the hemodiluted group in 82,6%. Side effects, more frequently and more pronounced in the hemodiluted group concerned to hypo- and hypertensive reactions, vasoconstriction, hypokaliemie and cardial arrhythmics. Exclusively in the hemodiluted group ST-lowering in the EKG has been stated in some patients. These reactions have been estimated as a sign of marginal compensatory capacity in the individual cardial situation and were reversibel by blood transfusion. These observations strengthen the necessity for accurate monitoring in hemodiluted patients. Moreover it is recommended to restrict hemodilution in the level of Hk 27-28%. Under these conditions acute normovolamic hemodilution is recommended further for a wider clinical use.


[Clinical uses of ultraviolet light radiation]. The main use of ultraviolet light radiation in hospitals is for the disinfection of the air. A study was made of the disinfecting efficiency of indirect ultraviolet radiation (lifts, cleaning of bedding), direct irradiation of rooms overnight or after use, ultraviolet curtains (irradiation of the whole width of passages, doorways and entrances) and ultraviolet irradiation of the filter of air-conditioners. The results are analysed. With the exception of the barrier technique ultraviolet light irradiation did not substantially reduce the number of micro-organisms in the air. Knowledge of the limitations and side-effects of this technique, control of the intensity of ultraviolet irradiation and bacterial counts are regular intervals are some of the factors that determine the success of this mode of disinfection. Detailed studies of the acceptable upper limits of the number of micro-organisms in the air of hospital wards and operating theatres is of prime importance for evaluating the effectiveness of air-disinfection by ultraviolet light irradiation.


[Succinyldicholin sensitivity resulting from genetically determined serumcholinesterase variants]. Prolonged apnea after succinyldicholin is a pharmacogenetic phenomenon. Estimation of genetically determined cholinesterase variants of patients with a prolonged apnea after succinyldicholin or in patients with cholinesterase deficiency respectively are described. The importance of atypical cholinesterase phenotypes in anaesthesia and the possibility of a therapy of prolonged apnea are mentioned. Biochemical data of atypical cholinesterase variants as cause of the prolonged degradation of succinyldicholin as well as formal genetic aspects of cholinesterase polymorphism are discussed.


[Damage of teeth by oral airways].

[Damage of teeth by oral airways]. Oral Guedel airways do not necessarily protect the patient's teeth during inhalation anesthesia. This is contrary to the general opinion. Because of the anatomical structure of the human teeth and the dynamic forces on teeth occlusion during postanesthetic excitation the applied chewing-pressure is concentrated by a Guedel airway at a few front teeth only. Under this abnormally forceful, localized pressure especially capped teeth and teeth in gums with paradentosis may easily break. Therefore, the use of nasal airways should be preferred in these cases.


[Simplified monitoring by ultrasound for anaesthesiology]. This is the description of a simplified method to assist the anaesthesiologist in monitoring and/or detecting venous and arterial diseases (i.e. stenosis) by ultrasound. The main problem for the anaesthesiologist is to monitor and measure the low blood pressure of new-borns during intra- and post-operative phases. In most cases it is difficult to localize the systolic pressure. We have developed a new device which, in connection with an analogic ratemeter, displays the heart rate based on the ultrasound doppler effect. Technique, application and first results are described.


[Rewarming of infusions with the haemotherm]. A rewarming device for blood called Haemotherm from the firm Bosch was proofed for efficiency. This device working on the base of microwaves was able to warm up cold solutions to a certain temperature within two to three minutes. The effect of rewarming disappeared during the passage through the infusion tube. To get bodywarm solutions at the end of the infusion tube was impossible with this arrangement.


[Use of pancreatic lipase for determination of the glyceride composition of rice lipids]. The triglyceride composition of rice lipids was investigated, using methods of thin-layer chromatography, enzymic hydrolysis by pancreatic lipase and gas-liquid chromatography. The major portion of triglycerides were tri- and di-unsaturated glycerides. The content of trisaturated glycerides was not more than 0.86%. The data obtained allow the conclusion that unsaturated acids occupy 2-positions in the triglyceride molecule of rice oil and oil of other plants.


[Microbiologic transformation of microcrystalline cortisone acetate into prednisone]. The process of transformation of microcystalline acetate cortisone by two mycobacteria (Mycobacterium album and Mycobacterium globiforme) has been studied. Optimal conditions for the process have been established: amount of biomass of both cultures, concentration of the initial substrate and required concentration of the surfactant--antifoamsilane. The anzymic activity of the cultures reaches maximum if the following three requirements are met: utilization of cells separated from the medium, substrate in the microcrystalline state and surfactant of the antifoamsilane type.


[A quantitative method of determining lecithinases and lipases in microorganisms]. The paper presents a method for quantitative assay of lecithinases and lipases in microorganisms. The method is based on the assessment of changes in the composition of lipid components of yolk media under the influence of corresponding enzymic systems of bacteria. The technique involved lipid extraction from yolk media after cultivation of the microorganisms tested, chromatographic separation by thin-layer chromatography on silicagel into individual fractions, development in iodine vapours and quantitative measurement of lipid components.


New developments in ultrasonic fish tracking. A range of small, long-life ultrasonic fish tags is described and their use illustrated with an improved system of fixed hydrophone tracking stations. A boat-mounted hydrophone system giving bearing and range estimations for use in open-water fish tracking is described together with a portable hand-held unit for simple location of tagged fish in rivers, etc. Typical results based on intensive use of these systems are given.


Production of larval tanypodinae (Insecta: Chironomidae) in the mud at Loch Leven, Kinross. Life histories and production of the five common species of Tanypodinae (Pentaneura monilis, Procladius simplicistilus, P. crassinervis, P. choreus and Psilotanypus rufovittatus) in the mud at Loch Leven were measured from March 1971 to March 1972. The methods used to identify each species of larva are described. All were univoltine except Pentaneura monilis which had two generations per year, but the seasonal patterns of the life cycles were different. The average density of third and fourth instar Tanypodinae was 3100/m2 and densities of individual species exceeded 2500/m2 for short periods in Procladius crassinervis and P. choreus. Net annual dry weight production by this subfamily was 2-6 g/m2 (57 KJ/m2), with individual species ranging from 1-1 g/m2 (P. crassinervis) to 0-16 g/m2 (Pentaneura monilis). These results are discussed briefly and compared with production estimates for other zoobenthos.


Rumen micro-organisms in red deer, hill sheep and reindeer in the scottish highlands. The micro-organisms in rumen samples from Red deer, hill sheep and reindeer grazing their natural pastures in the Scottish Highlands were examined at different seasons over a number of years. The total counts of bacteria and protozoa varied with the seasons, and were lowest in winter when fermentative activity was also at its lowest. As is usual in roughage-fed ruminants, viable counts were only a very small proportion of the total counts. The reindeer rumens had the highest concentrations of bacteria. There were no consistent differences in the types of bacteria between seasons, but although there were no bacteria peculiar to any animal species the balance of predominant types varied between the species. The principal types of bacteria were similar to those found in domesticated ruminants. The numbers of protozoa in the Red deer were higher than those in the sheep, and the concentrations in reindeer were higher than those generally reported for domesticated cattle or sheep. A number of species of protozoa were found in each animal and the predominant species differed in the different animals.


Simultaneous bilateral pyeloplasties.

Simultaneous bilateral pyeloplasties. A technique is described which gives excellent results in the treatment of unilateral hydronephorsis and allows for simultaneous bilateral pyeloplasties. The advantages for the patients with bilateral hydronephrosis are a single admission to hospital and a single anaesthetic and operative procedure. The exposure is superior to that achieved by a loin incision, allowing the surgeon to perform the pyeloplasties more rapidly and with less traction on the renal vessels. Over a follow-up period of 1-7 years no subsequent pyeloplasty or nephrectomy has been required and all 11 patients are well and symptom free.


Cross-tolerance between inhaled cannabis and intraperitoneal injections of delta9-THC. Male and female rats were exposed to Cannabis smoke or placebo once every second day for 32 days. Following these 16 trials all animals were injected once intraperitoneally with 4 mg/kg THC. After every third inhalation trial and after the injection the rats were placed on a movement sensor for 3 min. Cannabis smoke significantly reduced activity, relative to baseline scores, during the first 10 inhalation trials but by the thirteenth exposure, tolerance was evident. When the animals were injected with THC, the male rats who had been exposed to Cannabis smoke significantly increased their activity whereas the females did not alter their activity relative to the last inhalation trial. In contrast rats of both sexes that had been exposed to placebo smoke significantly decreased their activity following the injection. This intermodal cross-tolerance is discussed in terms of the role of conditioning in the development of tolerance.


Action of di-n-propylacetate on the spontaneous and acquired behaviour in goldfish, mice and rats. The action of n-dipropylacetate (nDPA) is related to the dose. In low doses, nDPA improved the number of conditioned responses with negative reinforcement. In higher doses, the drug inhibited spontaneous  and conditioned behaviour. An nDPA produces an increase in gamma-aminobutyric acid (GABA) brain level, results are discussed in relation to the inhibitory action of GABA in the central nervous system.


Anteroventral third ventricle site of action for angiotensin induced thirst. The central site of action for angiotensin induced thirst was investigated in rats. Subfornical organ lesions resulted in a temporary abolition of drinking induced by lateral preoptic or lateral ventricle microinjections of angiotensin but drinking to anteroventral third ventricle microinjections of angiotensin (or carbachol) was unaffected. Drinking to elevated systemic levels of angiotensin was attenuated but not abolished by subfornical organ lesions. When spread of injected angiotensin via cerebrospinal fluid circulation was controlled by placing plugs at selected locations in the ventricles, drinking was elicited only when intracranial microinjections of angiotensin gained access to anteroventral third ventricle. It was concluded that subfornical organ is not the exclusive dipsogenic receptor for angiotensin, rather angiotensin exerts at least part of its dipsogenic effect by spread through the ventricular system to receptors in the vicinity of the anteroventral third ventricle.


The relative importance of dopamine and noradrenaline receptor stimulation for the restoration of motor activity in reserpine or alpha-methyl-p-tyrosine pre-treated mice. Two animal models of Parkinsonism have been employed to investigate the role of noradrenaline in the motor effects of levodopa. Pretreatment with reserpine or alpha-methyl-p-tyrosine (AMPT) causes cerebral amine depletion and reduction of motor activity, which can be reversed by levodopa. The effect of inhibitors of noradrenaline (NA) synthesis and antagonists of NA and dopamine (DA) receptors on the action of levodopa have been studied. For comparison, the effects of such treatments on apomorphine action has been investigated. Reversal of reserpine (10 mg/kg) induced akinesia in mice by levodopa (200 mg/kg) plus the peripheral decarboxylase inhibitor MK 486 (L-alpha-methyl-dopahydrazine; 25 mg/kg) was inhibited by prior administration of phenoxybenzamine (20 mg/kg), haloperidol (1 mg/kg), pimozide (1 mg/kg) or the dopamine-beta-hydroxylase inhibitor FLA-63 (bis [4-methyl-l-homopiperazinylthiocarbonyl] disulphide; 15 or 25 mg/kg). Apomorphine (2 mg/kg) reversal of reserpine akinesia was similarly inhibited by haloperidol (1 mg/kg) and pimozide (2 mg/kg) but not by phenoxybenzamine (20 mg/kg) or FLA-63 (25 mg/kg). Apomorphine (5 mg/kg) reversal of reserpine akinesia was enhanced by simultaneous administration of the noradrenergic agonist clonidine (1 mg/kg) and this effect was not significantly altered by prior administration of FLA-63. Clonidine, however, reversed the FLA-63 induced inhibition of the levodopa effect on reserpine akinesia. Levodopa reversal of akinesia induced by AMPT (200 mg/kg) was also inhibited by FLA-63, pimozide and haloperidol. Phenoxybenzamine, however, was without effect, but produced a different pattern of behaviour. Similarly, pimozide and haloperidol blocked apomorphine reversal of AMPT induced akinesia; FLA-63 was without effect but phenoxybenzamine produced marked inhibition. The results suggest that full restoration of motor activity in reserpine or AMPT pretreated animals requires stimulation of both DA and NA receptors.


Effect of hypnotics on mice genetically selected for sensitivity to ethanol. It was previously shown that the rate of disappearance of blood ethanol was identical for two lines of mice selectively bred for differences in sleep-time after ethanol administration. The ED50 values for the loss of righting response with ethanol were significantly different at 3.64 g per kg for the SS line and 1.65 g per kg for the LS line. In the present study the mean sleep time is 367 sec for SS mice and 9342 sec for LS mice. The ED50 values remain essentially the same as previously reported. Unchanged LD50 values for ethanol, however, are not different at 4.8 g per kg for the SS and 4.5 g per kg for the LS line of mice. The ED50 value for loss for righting response following administration of methanol, butanol and t-butanol is approximately 2 fold greater for the SS line of mice than for the LS line. The ED50 values for sodium pentobarbital or ether in the 2 lines of mice for loss of righting response are virtually identical. In addition, the sleep-time values obtained after the administration of pentobarbital, chloral hydrate, trichloroethanol and paraldehyde are not significantly different. These data indicate that while the SS and LS lines of mice differ in central nervous system sensitivity to ethanol, methanol, butanol and t-butanol it is implied that they do no differ in central nervous system sensitivity to other hypnotic agents tested. Proof of this latter suggestion awaits determination of metabolic rates, and brain levels of these other depressants.


Intracerebral implantation of the anti-estrogen CN-69, 725-27: Effects on female sexual behavior in rats. Ovariectomized adult female rats were stereotaxically implanted with double walled cannulas (22 ga outer and 27 ga inner) and tested for sexual receptivity (lordosis behavior) following SC estradiol benzoate and progesterone priming. Implantation of the anti-estrogen CN-69,725-27 (c. 65 mug) immediately after the first of 3 daily estrogen injections produced a dramatic inhibition of sexual receptivity when these implants were placed in the preoptic and anterior hypothalamic areas. CN-69,725-27 implants had no effect on receptivity when implanted in the middle hypothalamus, mesencephalon or frontal cortex. All inhibitory effects of the anti-estrogen were reversible within one day after removal of the CN-69,725-27 cannula from the brain.


Amino acid transport inhibition: brain and behavioral correlates. In vivo inhibition of uptake 14C-L-valine by brain following subcutaneous administration of either of two gamma-glutamyl cycle enzyme inhibitors, 2-imidazolidone-4-carboxylic acid (ICA), or, L-methionine-S-sulfoximine (MSO) is documented in C57BL/6J mice. Dose related decrease in exploratory activity, impairment of memory for foot shock, and reduced operant responding for food reinforcement parallels the time course for interference with uptake of a large neutral amino acid by these two compounds previously shown to inhibit different enzymes in the gamma-glutamyl cycle subserving active amino acid transport.


Are central cholinergic paths involved in habituation of exploration and distraction? Experiment 1 tested the generality of Carlton's hypothesis that central muscarinic cholinergic pathways are involved in habituation of exploration. The effects of 3 muscarinic antagonists were tested in a holeboard, under 2 test conditions, i.e. with objects absent or present. Both the frequency and the duration of head-dipping were used as measures of exploration. Scopolamine prevented habituation only of the frequency of head-dipping, and only when objects were present. Atropine and benzhexol did not impair the habituation of either frequency of duration of head-dipping in either test condition. The impairment of habituation seemed therefore to be specific to scopolamine, and to the more complex test condition, and thus there was little to justify the suggestion that central cholinergic paths were generally involved. Experiment 2 investigated the effects of muscarinic antagonists on habituation of distraction. None of the drugs affected the distraction to tones, nor the subsequent habituation to these stimuli. Central cholinergic paths do not therefore seem to be involved in habituation of this behavioral response.


Automated system for acquisition and reduction of startle response data. A system specifically designed for the acquisition and reduction of startle data is described. It is able to (1) sample startle responses from 5 animals simultaneously during a specific time band after the eliciting stimulus; (2) convert the analogue startle amplitudes into 2-digit numbers; (3) print the digital results of each startle in each animal; (4) add up the startle amplitudes for each rat over a preset number of stimuli and print the totals; (5) print the interstimulus interval and (6) code for up to six diferent types of trials. A non-technical description and complete wiring diagrams are provided.


A simple method for quantifying tremor in rodents. A simple and accurate device to evaluate frequency and intensity of involuntary tremor is described. Discrete and quantifiable measures of tremor could be obtained in terms of vertical (i.e., absolute effects at a given time) and horizontal (i.e. temporal) changes. The technique was evaluated employing dosages of physostigmine 0.1-0.7 mg/kg. Applications to other behavioral indices, such as locomotor activity and wet-dog shakes, are discussed.


Time dependent action of pimozide on deprivation-induced water intake: evidence for a direct drug effect. Time-response curves were established for the effect of 3 doses of pimozide, a potent and specific dopamine receptor blocker, on deprivation-induced drinking in rats. Injections occurred once every 3 days at intervals of 2, 4, 8, and 16 hr prior to the daily 15 min drinking period. Pimozide produced a significant attenuation in the amount of water normally consumed (on nondrug days) whose degree varied with the proximity of the injection to the drinking period. Only the 2 higher doses (0.5 and 1.0 mg/kg) produced a significant dose dependent effect which was strongest at the 2 hr interval and which gradually weakened by the 8th post injection hr. The relevance of these findings for a direct versus an indirect action of the drug on water intake is discussed.


Noise stress and the effects of viloxazine (Vivalan), a new antidepressant, on open field activity in rats. The effects of different types and levels of background noise on the response to Viloxazine (Vivalan) were studied in rats. The results showed that increasing the level of noise produced changes in activity which were dependent on its mode of presentation (type). The drug appeared to enhance these changes.


Repeated acquisition of behavioral chains: effects of methylphenidate and imipramine. A method involving repeated acquistion of behavioral chain was used to assess the effects of methylphenidate and imipramine in individual animals. Pigeons obtained food for completing a 4-response chain, which was changed from session to session. Learning was defined by the decrease in errors across trials within a session; overall accuracy was measured by total errors per session. For comparison, the drug tests were also conducted under a performance condition, in which the 4-response chain was the same from session to session. In general, both drugs increased total errors per session as a function of dose under both the learning and performance conditions. The error-increasing effect was greater with imipramine than with methylphenidate and was detected at lower doses under the learning condition than under the performance condition. Under the learning condition, the higher doses of both drugs decreased the rate of within-session error reduction. Although neither drug enhanced accuracy at any of the doses tested, the lower doses of methylphenidate slightly decreased total trial time under both the learning and performance conditions.


Synthesis of some phthalazine derivatives chemically related to hydralazine. The potent antihypertensive properties of hydralazine and dihydralazine prompted the synthesis of sixteen new phthalazine derivatives with thiosemicarbazide or beta-propionamide residues to investigate their possible antihypertensive activity.


Synthesis of certain spiro compounds.

Synthesis of certain spiro compounds. The synthesis of certain N-substituted azaspirodiones and azaspiranes is described. Fusing equimolecular amounts of 2-oxaspiro [4.4]nonane-1.3-dione with a number of amino compounds afforded the corresponding N-substituted azaspirodiones. However, with certain o-substituted anilines, no condensation took place. Reduction of the N-haloaryl azaspirodiones gave the corresponding oxygen free compounds. Other azaspiranes were isolated as the quaternary methiodides. Applying the Mannich conditions to 2-azaspiro[4.4]nonane-1.3-dione yielded the N-Mannich bases.


Argentometric titration of procaine hydrochloride with zero current bipotentiometric indication using pretreated silver electrodes. A new procedure for the quantitative estimation of procaine hydrochloride is given based on the argentometric titration of its hydrochloride content, and using a zero current bipotentiometric indication. For this purpose two differently prepared silver electrodes are used. Quantitative data concerning precision are also given.


The in-vitro adsorption of some antirheumatics on antacids. The adsorption of sodium salicylate, salicylamide, acetylsalicylic acid, paracetamol, mefenamic acid, flufenamic acid, phenylbutazone, oxyphenbutazone, phenazone, aminophenazone, indometacin and methiazinic acid on some antacids was studied. The antacids used were magnesium trisilicate, magnesium oxide, aluminium hydroxide, bismuth oxycarbonate, calcium carbonate and kaolin. Magnesium oxide, followed by aluminium hydroxide and bismuth oxycarbonate showed a fairly high adsorptive capacity for salicylates, mefenamic acid, flufenamic acid, methiazinic acid, indometacin and to a lesser extent for phenylbutazone and oxyphenbutazone. On the other hand, magnesium trisilicate exhibited a tendency to adsorb phenazone, aminophenazone, indometacin and methiazinic acid. Kaolin was found to be a good adsorbent for anthranilic acid derivatives, indometacin and methiazinic acid. Calcium carbonate showed a weak adsorptive capacity for all drugs tested. The adsorption of phenylbutazone and salicylates on magnesium oxide, aluminium hydroxide and/or bismuth oxycarbonate obeyed the Freundlich adsorption isotherm. Elution study showed that salicylates and anthranilic acid derivatives were tenaciously held by magnesium oxide while magnesium trisilicate showed an intermediate retention power for phenazone and aminophenazone. Sodium hydrogen carbonate solution gave, in general, a higher eluting power than hydrochloric acid solution. A marked reduction in the apparent partition coefficients of all drugs tested was observed in the presence of magnesium trisilicate or aluminium hydroxide. Careful in vitro and in vivo testing of drug availability is advisable prior to the concomitant administration of antirheumatics with antacids or other adsorbents.


Neuroendocrine studies of depressive illness. Interest in possible neuroendocrine disturbances in endogenous depression is prompted by two lines of evidence: (1) clinical features of the illness suggest hypothalamic dysfunction; (2) the brain neurotransmitters implicated in depression also regulate neuroendocrine function. Our research reveals a marked, sustained hypersecretion in cortisol in severe depressive illness, which is apparently unrelated to stress and sleep disturbance, and which is associated with a distortion of the 24-hour cortisol secretory pattern. The hypersecretion is manifested primarily in the late afternoon, evening, and early morning hours, when cortisol secretion is normally inhibited. Growth hormone responses to hypoglycemia (but not to L-dopa) are also significantly reduced in endogenous depression, even when factors of age and the menopause are controlled. Postmenopausal depressed women appear to secret significantly less LH than normal postmenopausal women. Since all of these hormonal abnormalities can be reproduced by depletion of brain noradrenalin, the findings provide support for the the hypothesis of reduced functional noradrenergic activity in certain forms of depression.


Clinical and biochemical parameters during neuroleptic treatment. I. Investigations with haloperidol. 26 patients with a paranoid-hallucinatory syndrome were treated with a fixed daily dose of haloperidol. Psychopathological symptoms and parkinsonism were studied before and during the treatment. HVA and 5-HIAA concentrations in CSF were determined immediately before and after 5 or 15 days of treatment. After 5 days of treatment a slight effect was observed on psychotic symptoms and on the extrapyramidal motor system, as well as an elevation of HVA and 5-HIAA concentrations in CSF. After 15 days of treatment the extrapyramidal and antipsychotic effects were significant, but the rise of HVA was smaller than after 5 days of treatment; 5-HIAA remained unchanged. These different time courses of the neuroleptic effects on psychopathological symptoms, on extrapyramidal system and on monoamine metabolites concentration in CSF could be interpreted as a development of drug tolerance in relation to the biochemical parameters.


Clinical and biochemical parameters during neuroleptic treatment. II. Antipsychotic effect of haloperidol in patients with chronic organic brain damage. The time-course of psychopathological symptoms, of extrapyramidal side effects, and of changes in cerebrospinal fluid (CSF) concentration of homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) were simultaneously studied during Haloperidol treatment of 14 psychotic patients with chronic organic brain damage. After 15 days of treatment significant antipsychotic effect was found, while Parkinsonism scores in clinical and experimental tests increased only slightly. CSF concentration of HVA increased significantly by 150% compared to the baseline value (p less than 0.05) and 5-HIAA remained unchanged. No correlation was found between the clinical and biochemical variables studied. The comparison of these results with those obtained in patients without brain damage suggests that different psychopathological and extrapyramidal responses to neuroleptics are not strictly associated with specific HVA changes in CSF.


Clinical and biochemical parameters during neuroleptic treatment. III. Primitive reflexes during neuroleptic treatment. Palmomental reflex, glabellar reflex and oral responses were studied in the course of a treatment with Haloperidol in 14 psychotic patients with a chronic organic brain damage. An increase of the three responses was found; maximum intensity and frequency of the primitive reflexes were reached during the first 5 days of treatment. There was no correlation found between the intensity of primitive reflexes and changes of psychopathological symptoms, of extrapyramidal scores and of homovanillic acid (=HVA) and 5-hydroxyindoleacetic acid (5=5-HIAA) concentration in cerebrospinal fluid (=CSF). The presence of primitive responses is interpreted as a "decompensation phenomenon" induced by neuroleptics, probably in relation to an effect on the central nervous system (=CNS) dopamine receptors. It is suggested that the appearance of several definite, primitive reflexes during neuroleptic therapy may have some diagnostic and prognostic significance.


Psychotropic drug use in family practice. In an attempt to assess the precision of an illness-treatment "fit" between dispensing and actual need for psychotropic medications, the present study examined the dispensing patterns to consecutive attenders of private general practice. "Conservative" use of psychotropic drugs was indicated insofar as patients were seldom dispensed medication in the absence of emotional problems, and the presence of emotional problems frequently was not accompanied by the dispensing of medication. In addition, specific social and illness factors were located which could differentially predict either the presence of emotional problems, the use of psychotropic drugs, or both of these variables. The potential for constructing a more precise illness-treatment fit was considered.


[A comparison of the tranquilizing effect of fluspirilene and diazepam (author's transl)]. Over a period of 8 weeks we compared the tranquilizing effects of the longterm neuroleptic Fluspirilene to those of Diazepam in a series of 28 patients. Both drugs showed good effects on somatization, anxiety and depressive mood. Fluspirilene, however, proved to be the more mood elevating and more activating agent without being hypnotic. The indications for both drugs are being discussed emphazising the new therapeutic perspectives of a long acting tranquilizer.


Evaluation of the lithium RBC/plasma ratio as a predictor of the prophylactic effect of lithium treatment in affective disorders. 62 patients with affective disorder, 31 unipolar, 22 bipolar and 9 cycloid psychotics who had received prophylactic lithium therapy for 0,3 to 7,5 years were studied. Lithium in plasma, lithium in red blood cells (RBC) and the lithium ratio (RBC/plasma) were estimated. The lithium ratio does not seem to be of predictive value in determining for which patients prophylactic lithium therapy will succeed.


Lithium carbonate prophylaxis of depression in three subtypes in primary affective disorder. Multiple indices of depression were used to evaluate the prophylactic efficacy of lithium carbonate versus placebo in a 4-year, double-blind study of unipolar, bipolar I, and bipolar II patients diagnosed according to strict criteria. Our data indicate lithium prophylaxis of depression on several indices in all three subtypes of affective illness. Additional studies are needed, comparing tricyclic antidepressants alone, monoamine oxidase inhibitors alone, or either drug combination with lithium carbonate for prophylaxis in clearly defined depressive subtypes.


Maintenance therapy of depression.

Maintenance therapy of depression. This paper summarises findings from a study of maintenance treatment in predominantly neurotic depressive responding to initial treatment with amitriptyline. Patients were continued on amitriptyline for eight months, withdrawn double-blind to placebo after two months, or withdrawn overtly to no medication, with and without individual psychotherapy from social workers in the factorial design. Continuation significantly reduced early relapse and symptom return, compared with either condition of early withdrawal. Psychotherapy improved social adjustment after eight months in patients who did not relapse, without any significant interactions. Side effects were minimal, except for carbohydrate craving. These findings suggest that tricyclic antidepressants should be routinely continued for several months after drug-induced remission.


How long should prophylactics be continued in affective disorders? The article traces the historical development of the prophylactic drug treatment of affective disorders. Prior to the introduction of lithium, standard anti-depressant drugs were used for maintenance treatment. Historically, lithium did not introduce prophylactic treatment. It did, however, dramatically advance the concept and administration of the prophylactic treatment of affective disorders. Specific criteria must now be developed to determine the duration of prophylactic treatment in terms of individual illness profiles. Therapeutic goals and clinical problems in the administration of treatment represent a main part of the paper.


Therapeutic control of plasma concentrations and long-term effect of nortriptyline in recurrent affective disorders. Based on the evidence that therapeutic plasma concentration range in fact exists for the tricyclic antidepressant drug, Nortriptyline (range 50-150 ng/ml), three different investigations were under taken in order to clarify some clinical pharmacological problems during long-term treatment with this drug. The possible prophlactic effect of the drug in recurrent affective disorders was specially examined in a group of patients with a high risk of episodes in their unipolar manic-depressive disease. The results highly demonstrate the value of monitoring plasma levels in achieving therapeutic control. Depressive relapses during treatment, for months and years, were only related to therapeutic insufficient plasma levels of the drug.


Effects of short-and long-term administration of tricyclic antidepressants and lithium on norepinephrine turnover in brain. The findings summarized in this paper show that norepinephrine turnover in brain is decreased after acute administration of imipramine or desmethylimipramine but tends to increase during chronic administration of these tricyclic antidepressants. Similarly, it appears that there also may be important differences between the effects of acute and chronic administration of lithium salts on norepinephrine turnover in the central nervous system. Such changes in norepinephrine turnover that develop gradually over the course of long-term drug administration may help to explain the need for chronic administration of tricyclic antidepressants or lithium salts in the treatment of patients with affective disorders.


Absence of correlation between spin-lattice relaxation times and water content in human tumor tissues. With a view to ascertaining the possible role of water content of the cells in the reported elevated values for proton spin-lattice relaxation time (T1) in malignant tissues, measurements of percent water content as well as T1 were undertaken in 68 cases of normal and concerous tissues from diverse sites in human patients. T1 values for the uninvolved samples were found to lie in the range of 400-1000 msec while the corresponding range for the involved samples was from 450-1520 msec. Water content of both normal and uninvolved tissues mostly lay in the narrow range of 70-90%. Occasionally samples with large T1 values showed lower water content as well. Data obtained weakens the case for characterization of tumor cells on the basis of their water content alone.


Diamagnetic levitation in the fractionally superconducting bile cholates. Diamagnetic levitation similar to that seen in metallic superconductors has been observed in organic compounds; namely, the bile cholates. Levitation phenomena, with forces exceeding 400 lbs/in, occurred in repeated experiments at transition temperatures extablished by susceptibility and resistivity measurements. With crystalline phase change ruled out by X-ray diffraction studies, the observed levitation must be regarded as due to superconductive effects occurring in small domains randomly dispersed throughout the insulating bulk of the investigated cholates. The transition temperatures observed in some of these compounds were higher than those seen in the metals.


Allosteric linkage and phase transition. The thermodynamics of allosteric linkage are observed to be analogous to those of a phase transition. When a phenomenological theory of phase transitions is applied to the allosteric interactions in hemoglobin, a generalized Hill equation is arrived at, including an explicit dependence on temperature. This result is in good agreement with experiments.


Xanthelasma: follow-up on results after surgical excision. Xanthelasma palpebrarum is the most common xanthoma and is associated with other xanthomas or hyperlipemia syndromes in only 5 percent of the patients--even though one third of the affected patients have an elevated serum cholesterol level. Surgical excision is simple, safe, leaves minimal scarring, and will be definitive in more than half of the patients being treated for the first time. Reexcision may still be worthwhile if the xanthelasma recurs. However, recurrence is to be anticipated if all 4 eyelids are involved, if there is an underlying hyperlipemia syndrome, or if there has been more than one previous recurrence.


Mechanism of upper lid ptosis in the anophthalmic orbit. The occurrence of upper lid ptosis in 66 patients in the anophthalmic state was 18 percent, despite an adequate prosthesis. The commonly cited causes for this entity do not hold up under examination. A detailed review of the anatomy of the levator mechanism and of the anatomy of an enucleation suggests that the etiology is really based on the production of a mechanical imbalance in the levator apparatus. Suggestions for management and for the timing of the correction (in relation to other surgical procedures) are made.


Spherical contracture of fibrous capsules around breast implants. Prevention and treatment. A follow-up of 82 patients who had had augumentation mammaplasties is reported. Though the number of patients having had each form of ancillary treatment is small, we believe that intraoperative instillation of triamcinolone and postoperative "expansion exercises" are of value in decreasing the incidence of capsular contracture around the implants. When such spherical contracture does occur, the capsule can usually be ruptured simply and quickly by external pressure with the surgeon's hands. This is usually done as an office procedure, without anesthesia. The results are so beneficial that we believe this should be done on many patients. In some it may need to be done repeatedly.


Secondary correction of the too-high areola and nipple after a mammaplasty. Two cases of nipples placed too high by reduction mammaplasties have been corrected by a combination of maneuvers--including (1) shortening the distance from the nipple to the inframammary line, and (2) repositioning of the areola-nipple component or putting in an implant to make the main projection of the breast directly behind the nipple.


Compression treatment of hemangiomas.

Compression treatment of hemangiomas. Compression therapy appears to be a safe and effective modality for treating involuting and non-involuting hemangiomas. Compression may induce earlier mature resolution in involuting hemangiomas, and may reduce the size of non-involuting hemangiomas--at least temporarily.


Soft tissue response to blood-impregnated Proplast. The effects of Proplast implants on the soft tissues of rats were studied. The effects from Proplast implants which had been impregnated with blood, plasma, or saline were compared to the effects from implants which had received no pretreatment. No significant differences were found.


Triphalangeal thumb.

Triphalangeal thumb. In the last 6 years, I have seen 29 patients (37 hands) who had an additional phalanx between the two other phalanges of their thumbs. These triphalangeal thumbs can be divided into opposable and nonopposable thumbs. The epiphyseal plate of the first metacarpal is at the proximal end in the opposable triphalangeal thumb, at the distal end in the nonopposable triphalangeal thumb, at both the distal and proximal ends in the complicated split hand, and at the proximal end in the complicated preaxial polydactyly. Treatment of these cases is described, as well as theories about the origin of the deformity.


Pseudoxanthoma elasticum: a dermal elastosis with surgical implications. We discuss the condition of pseudoxanthoma elasticum and its differential diagnosis, and we present a patient who had this illness. The redundant skin was surgically removed from her axilla and thigh.


Benign symmetrical lipomatosis. Case report. We present a patient who had benign symmetrical lipomatosis. He was treated surgically (6 operations), and the results were satisfactory. we discuss various factors in this disease and suggest the possibility of a nonsurgical treatment being developed in the future.


Microsurgery in the prevention of traumatic tattoos. We were able to remove most of the foreign body particles from a fresh wound caused by a gunpowder blast to the face, using microsurgical techniques. This prevented a subsequent serious dirt tattoo.