Drug interactions in the horse: effect of furosemide on plasma and urinary levels of phenylbutazone. Horses pretreated with 6.6 mg/kg of phenylbutazone were injected with 1 mg/kg of furosemide intravenously. Furosemide had no clinically significant effect on either plasma levels or plasma half-life of phenylbutazone. Furosemide reduced urinary levels of phenylbutazone 18-fold to concentrations which may result in inconsistent drug detection in routine screening tests. The results show that it is not possible to monitor compliance with phenylbutazone medication rules by means of urinalysis alone if the use of furosemide is permitted. Furosemide treatment, however, does not interfere with monitoring by plasma level determinations.


Comparison of the drug metabolizing enzymes in the liver and kidneys from homozygous nude swiss, heterozygous normal swiss, homozygous normal Swiss and DBA/2 mice. The hepatic and renal microsomal drug metabolizing enzyme systems were isolated from homozygous nude Swiss (nu/nu), heterozygous normal Swiss (nu/+), homozygous normal Swiss (+/+) and DBA/2 mice. Microsomal protein and cytochrome P-450 concentrations were measured and the activity of ethylmorphine demethylase, aniline hydroxylase, aryl hydrocarbon hydroxylase and UDP-glucuronyl transferase were determined. Hepatic microsomes from both experimental groups carrying the nude gene were able to metabolize aniline and ethylmorphine more rapidly (20% and 36%, respectively) than the DBA/2 or Swiss homozygous normal mice. No difference between test groups was observed for hepatic aryl hydrocarbon hydroxylase or UDP-glucuronyl transferase activity. Kidney microsomes from mice carrying the nude gene had approximately twice the aryl hydrocarbon hydroxylase activity of the other two experimental groups. Renal mixed-function oxidase pathways measured for the homozygous nude mouse showed a higher overall rate of activity than the other three experimental groups. No significant difference in renal UDP-glucuronyl transferase was observed between mouse groups.


Pine oil toxicity in the horse: drug detection, residues and pathological changes. This report concerns the detection and acute toxicity of pine oil (a commercially available disinfectant) after intravenous administration in horses. alpha Terpineol was identified as a major constituent of pine oil. alpha Terpineol was recovered from equine tissues by extraction into heptane and detected by gas chromatography, using either flame ionization detection or pentafluoropropionic anhydride derivatization and electron capture detection. After intravenous injection of 0.1 ml/kg, death due to massive pulmonary edema occurred within minutes. In this animal blood and tissue levels of alpha-terpineol of between 150 and 300 ppm were observed. After smaller doses of pine oil (0.033 ml/kg), horses survived until euthanized up to 48 hours later. Blood levels of alpha-terpineol became undetectable in one of these animals after 2 hours, and no tissue levels were detected at postmortem. Marked histopathological changes were seen in the lungs of animals which survived the initial injection period. It appears that after intravenous injection of pine oil in horses lesions are largely related to the respiratory tract, and the mechanism of death is acute pulmonary edema.


Toxicologic studies of tin needles at the intrathoracic site of mice. Male Marsh mice which received a single intrathoracic injection of 4 mg of tin needles at 3 months of age were compared with controls given isotonic saline. The form and size of most of the tin needles were similar to those of asbestos needles which produced mesotheliomas and lung neoplasms in rodents. Water and food intake was markedly reduced for 24 hrs after the injection of tin. Survival rates (followed for 19 months), pathology of the bladder, liver, and kidney, as well as local and general cancer development were not adversely associated with the tin treatment as compared with the tin treatment as compared with controls. The local reaction to the tin included giant cell phagocytosis, nodular fibroplasia, and capillary formation. The failure of the tin needles to induce local neoplasms may relate to their high density as compared with silicates and/or their lack of the unique potential of the silicate particles to stimulate avascular fibrosis.


A rapid and sensitive method for determination of theophylline in plasma and saliva by high pressure liquid chromatography. A fast and sensitive high pressure liquid chromatographic method for the monitoring of theophylline concentrations in plasma or saliva was developed. Each sample requires only about 15 minutes for the completion of the assay after receiving the plasma or saliva sample. Only 0.1 ml of sample is required, and concentrations as low as 1 mcg/ml can be accurately measured.


Rapid fluorometric analysis of unbound salicylate in whole blood. A method has been developed for the analysis of unbound salicylate by membrane cone ultrafiltration of either whole blood or plasma with quantitation by spectrofluorometry. The method was used to study the distribution of salicylate in whole blood over a wide range of concentrations. It was found that at a concentration of 50 ug/ml in whole blood only 9% of the salicylate is present as free drug in the plasma water, while at a concentration of 500 ug/ml, 23% is free. At concentrations exceeding 500 ug/ml the plasma protein binding sites appear to be fully satrated since the free drug concentration increases linearly with respect to the whole blood concentration. Changes in hematocrit have a relatively minor effect on the ultrafiltrate salicylate concentration. The blood/plasma salicylate concentration ratio was found to vary widely over the blood salicylate range studied, 50-1000 ug/ml.


Effect of propranolol on rat brain norepinephrine in vitro. At a 10(-5) to 10(-3) molar concentration range, 1-, d1- and d-propranolol were equipotent to progressively inhibit the uptake of 3H-NE into chopped rat cerebral cortex tissue. Similar concentrations of 1- and d1-, but not d-, propranolol significantly increased the amount of total deaminated catabolites (deaminated, deaminated-O-methylated) of 3H-NE; however, 10(-3) molar 1-, d1- and d-propranolol were required to increase the release of 3H-NE from rat brain in vitro.


Increased phenytoin metabolism in rabbits after phenytoin pretreatment. The serum half-life of phenytoin in rabbits after a single intravenous dose was significantly shortened by pretreating the rabbits with daily oral doses of phenytoin. This suggests that in vivo phenytoin induces its own metabolism.


Effect of naproxen on protein binding of warfarin in human serum. The effect of the non-steroidal anti-inflammatory agent naproxen on the protein binding of racemic warfarin in pooled human serum was determined by equilibrium dialysis. The free fraction of warfarin in serum increased practically linearly with increasing naproxen concentration. At the highest naproxen concentration tested (400 mcg/ml), the warfarin free fraction was 74% larger than the control free fraction value.


Binding of labeled N-methyl N-nitrosourea to macromolecules of squamous and glandular stomach of rats. The binding of labeled N-methyl-N-nitrosourea (3H-MNU) to macromolecules of squamous and glandular stomach of rats, that were either pretreated with N-methyl-N-nitrosourea (MNU) for different periods or without pretreatment, is studied. The results showed no significant difference in the binding of labeled carcinogen to DNA and RNA of the two portions of stomach. However, a significant increase was noted in the incorporated 3H-MNU in proteins of glandular stomach with or without pretreatment with MNU. From these studies it is implied that carcinogenic effect of MNU may be through interaction with some other molecule(s) rather than with nucleic acids and/or proteins.


Detection of nucleic acid-protein complexes by equilibrium ultracentrifugation. Formation of complexes between yeast phenylalanine transfer RNA and phenylalanyl aminoacyl-transfer RNA synthetase is shown to occur under equilibrium conditions in the analytical ultracentrifuge. The technique of equilibrium sedimentation should be useful for the detection of transient associations between proteins and nucleic acids when only small amounts of unlabeled, but highly purified, materials are available.


Concentration of inactivated swine influenza virus by molecular filtration for use as a vaccine in gilts before and after breeding. Inactivated swine influenza virus was concentrated by molecular filtration for use as a vaccine in gilts before and after breeding. The best serologic response followed the use of two 5 ml doses three weeks apart before breeding. Vaccination with two 5 ml doses two weeks apart after breeding did not result in as marked serologic response. All vaccinated gilts produced detectable hemagglutination inhibition (HI) antibody.


Lactic dehydrogenase of fetal ear fluids under ambient and high-intensity sound. Lactic dehydrogenase (LDH) was determined in the fluids of the inner ear scalae and the middle ear cavity of fetal guinea pigs near term. Scalar dissimilarities in prenatal perilymph and distinctions between fetal and maternal perilymph suggest functional differentiation between the antenatal scalae vestibuli and tympani, elevated glycolytic activity in the prenatal vestibular channel and primarily aerobic processes in fetal perilymph although anaerobic metabolism is also evident. Disparities between fetal middle ear fluid and prenatal perilymph as well as maternal serum indicate that the former medium is probably not directly derived from either of the latter sources. After experimental treatment consisting of the presentation of high-intensity sound to gravid animals, the total LDH activity of the fetal middle ear fluid decreased.


The glycolytic effect of 1-epinephrine and nor-epinephrine on the liver of the chick embryo. The glycolytic effect of 1-epinephrine and nor-epinephrine administered in-ovo for two hours on the liver of the chick embryo is reported. 1-epinephrine was more glycolytic than nor-epinephrine throughout the study. The glycolytic effect of 1-epinephrine was dosage-dependent throughout the study while nor-epinephrine brought about dosage-dependent liver-glycogen-depletion only in the nine day embryo.


Induction of rat hepatic mixed function monooxygenases by levamisole. The effects of levamisole administration (20 mg/kg, i.p. daily for 10 days) on various parameters of hepatic microsomal metabolism in the famale rat were examined. Levamisole pretreatment resulted in significant increases over control values in the metabolism of aminopyrine and aniline in vitro, and in microsomal content of cytochrome P-450 and cytochrome b5.


Prolongation of responses in decentralization supersensitivity. In chronically decentralized nictitating membranes of cats the responses to norepinephrine and to acetylcholine were markedly prolonged. The increased duration was not directly related to the increased amplitude of the contractions. It is likely to be due to a change of the muscle itself.


Effect of chronic glucagon-administration on the digestive and absorptive function of rat small intestine in vivo. Endogeneous hyperglucagonemia is observed in experimental diabetes mellitus and semistarvation, conditions associated with an increased intestinal absorptive function. To examine whether glucagon might exert a similar adaptive response on intestinal digestive-absorptive function like experimental diabetes mellitus the effect of chronic glucagon administration on intestinal transport of 3-0-methyl-D-glucose, water, sodium, potassium, and D-glucose induced transmural potential difference (PD) was examined by an in vivo perfusion technique in rat small intestine. Chronic administration of glucagon (100 mug twice daily) for 5 days resulted in increased absorption of 3-0-methyl-D-glucose, water, sodium and potassium as well as in an increase of D-glucose induced PD. A similar, but more pronounced augmentation of D-glucose induced PD was observed in the jejunum of streptozotocin-diabetic rats. Disaccharidase (maltase, sucrase, trehalase, lactase) and alkaline phosphatase activities were not affected in intestinal mucosa of glucagon-treated rats compared to controls. It cannot be decided from these results whether hyperglucagonemia is responsible for the adaptive intestinal changes observed in experimental diabetes mellitus.


Activity of lecithin: cholesterol acyltransferase in different parts of the circulatory system in man. In 24 patients without liver disease lipids and LCAT activity were determined in the inferior vena cava, the hepatic vein, the pulmonary vein and in the left ventricle. The total cholesterol, free cholesterol and cholesterol ester concentrations are identical and differences in the LCAT activity cannot be demonstrated.


Excretion of liver antigens in the urine of patients with hepatic diseases. Liver antigens were detected in the urine of 4 of 42 patients with various liver diseases. The urine of 25 healthy subjects and patients with diseases not affecting the liver was devoid of antigens in detectable amounts. The presence of hepatic antigens in the urine did not correlate with severity of jaundice and SGOT levels but correlated with parenchymal necrosis and was associtated with a high mortaltiy.


[The value of the thermocouple in the measurement of the gastric mucosal blood-flow. The influence of the occlusion of the celiac artery and prostaglandin E1 on the gastric mucosal blood flow. An experimental study in animals (author's transl)]. The study has been carried out to ensure the positive evidence of the measurement of the gastric mucosal blood-flow with the aid of the thermocouple (heat-clearance technique). The experiments have shown that the suction pressure of 600 mm mercury column which was used to fix the Thermocouple to the mucosa was indispensable in order to assess the blood-flow in the entire depth of the mucosa. Changes in the mucosal blood-flow are measuured at the same rate in all quadrants of the gastric corpus. The measuring of the blood-flow of a well circumscribed area of the mucosa is therefore representative for the entire corpus. Vasopressin led to a significant reduction of the gastric mucosal blood-flow measured with heat-clearance as well aminopyrine-clearance. There was a linear correlation between the results of both methods. Vasopressin selectively reduces the blood-flow of the gastric mucosa but not of the submucosa, the muscular layer and the serosa. Therefore it seems to be probable that changes in mucosal blood-flow selectively can be measured with the aid of the thermocouple. After previous stimulation with pentagastrin neither mucosal blood-flow nor acid secretion of the stomach were influenced by the occlusion of the celiac artery by 25 %. The occlusion of the celiac artery by 50 % reduced significantly the pentagastrin-stimulated gastric mucosal blood-flow whereas the acid secretion was not influenced. Prostaglandin E1 at a dose rate of 2 mug/kg-h increased significantly arterial and mucosal blood-flow as well as acid secretion of the stomach. In comparison PGE1 administered at a dose rate of 4 mug/kg-h reduced significantly gastric mucosal blood-flow and gastric secretion. PGE1 at a dose rate of 8 mug/kg-h did not produce any significant changes in blood-flow and secretion. The results suggested that the changes of gastric secretion observed with PGE1 were the consequence of primary changes in the gastric mucosal blood-flow.


Metabolism of maltose during surgery in patients with diabetes mellitus under general anesthesia. During a surgical operation under general anesthesia, maltose was administered at a rate of 1g/kg BW to 9 diabetic and 18 non-diabetic patients. The disappearance curve of maltose from blood was similar between diabetics and non-diabetics. Blood sugar tended to rise but no significant difference was found between the two groups. Lactic acid and pyruvic acid showed a tendency toward a rise, but the change was non-significant. NEFA and uric acid failed to change. Urinary excretion of maltose was not different between diabetics and non-diabetics. After 120 min., urinary excretion of maltose was similar between the two groups, but excretion as glucose was greater in the diabetic group.


[Changes of triglycerid-fatty acids in healthy volunteers during acute ethanol ingestion with and without blocking peripheral lipolysis (author's transl)]. This investigation decided to answer the question of the origin of fatty acids for the increased synthesis of triglycerides in acute ethanol-induced hyperlipoproteinemia. Healthy persons ingested 0.5 g of ethanol/kg body weight initially and 0,15 g of ethanol/kg and hour for 12 hours. The fatty acids of plasma triglycerides were determined before and after ingestion of ethanol in persons fasting and nourished isocaloricaly, with and without blocking peripheral lipolysis by nicotinic acid and with addition of glucose. The fasting persons triglycerides fatty acids increased to 165.7 % of the initial value after 12 hours of ethanol ingestion, with a preferential increase in palmitic-, oleic- and stearic acid. When lipolysis in adipose tissue was blocked by 0.5 g of nicotinic adic/hour the triglyceride-fatty acids reached only 116.2% after 12 hours, with a decrease in oleic acid, which is present in adipose tissue to a higher degree than in plasma triglycerides. When nourished isocaloricaly, the enhancement of plasma triglyceride-fatty acids could not be suppressed by nicotinic acid. The changes in concentration and pattern of triglyceride-fatty acids announce that the fatty acids used for increased synthesis of triglycerides in fasting persons come from adipose tissue preferentially. In contrast ethanol-ingested hyperlipoproteinemia during ingestion of a food which cannot be suppressed by nicotinic acid, seems to orginate from fatty acids of the food and for de novo synthesis of fatty acids in the liver.


Rat gastric mucosal oxygen tension, ulcer index, plasma gastrin and glucagon following restraint stress. Influence of vagotomy, splanchnicotomy and exogenous secretin. Restraint stress ulcers in rats were developed and procedures evaluated designed at preservation of intact gastric microcirculation (pO2). Neither prior truncal vagotomy, splanchnicotomy nor combined dissection of abdominal autonomic nerves were effective in preventing the stress mediated fall of mucosal pO2 and the rise in plasma glucagon. The ulcer index remained elevated and gastrin essentially was unchanged. Prophylactic injection of increasing doses (1, 2, 4, 8, 16 U/kg secretin maintained microcirculation at pO2-levels subnormal for unstressed animals (Vmax 15.53 mm Hg; Km. 0.99 U/kg), but simultaneously brought about a continuous rise in serum gastrin. Up to 8 U/kg plasma glucagon was higher than in saline control groups reaching a peak value with 2 U/kg when ucler index showed its nadir. Secretin therapy (4, 8 U/kg) markedly improves both mucosal pO2 and ulcer index. It is suggested that breakdown of gastric microcirculation may not be solely responsible for stress ulcer development.


[Transformation of monocytes into fibroblasts in wound healing (author's transl)]. Recent investigations of HELPAP and CREMER 1972 seem to confirm the supposition of COHNHEIM 1867 that monocytes of the peripheral blood are transformed into firbroblasts in healing wounds. The view of VIRCHOW 1871, MARCHAND 1901 and ASCHOFF 1924 that the fibroblasts in healing wounds are of local origin seems to be supported by the invesigation on parabiotic inbred rats of ROSS et al. 1970. We thought that irradiating the whole body of rabbits could be of value in resolving these apparent contradictions about the origin of fibroblasts in healing wounds.


Induction of nephrotoxic nephritis with purified antibody: preparation, properties and assay of antibody. Antibody to rabbit glomerular basement membrane was separated from whole antiserum by adsorption onto and elution from rabbit glomeruli in vitro. The physico-chemical and biological properties were investigated. The preparation had a high specific activity for the GBM and induced glomerulonephritis on injection into rabbits. About 10% of the antibody localised in the kidneys of rabbits and the total in vitro and in vivo tissue binding capacity were comparable. Based on these results a simple in vitro assay for measuring anti-GBM antibody is described.


[On the mechanisms of biliary excretion of the biliary contrast medium ioglycamide in the mini-pig with special regard of the importance of the bile flow (author's transl)]. 16 experiments were performed in order to investigate the mechanisms of biliary excretion of Ioglycamide in the mini-pig. The results confirm the mechanisms known from other species for this experimental animal. Additionally, however, they demonstrate a significant linear correlation between the spontaneous bile flow and the biliary transport-maximum of Ioglycamide. It is concluded that this correlation is due to the fact that the bile flow as well as the transport-maximum represent independent parameters of the excretory capacity of the liver cells. This conclusion is supported by further experiments that were unable to show an improvement of the biliary transport-maximum of Ioglycamide by stimulation of the bile flow during infusions of bile acids and secretin. These results prove the impossibility to enhance the biliary excretion of Ioglycamide by stimulation of bile flow. This, however, indicates that it is possible to dilute or concentrate the biliary Ioglycamide concentration by induced variations of bile flow, a fact that might become important to improve the efficiency of i.v. cholegraphy.


Inactivation of contraction as a determinant of the length-active tension relation in heart muscle of the cat. In isometrically contracting isolated cat papillary muscles, the mechanism determining the reduction in active tension (P) at lengths (L) below the optimal length (Lmax) for maximal tension development (Pmax) was studied. Increasing [Ca2+] from 1.25 to 5 mM, paired electrical stimulation and caffeine augmented P-O/max by 77,61 and 23% respectively, as well as the tension developed at any given length on the ascending limb of the length-active tension relation. To see whether below Lmax the degree of activation is dependent on length, these length-active tension relations were expressed as P/Pmax relative to L/Lmax where Pmax and Lmax in each inotropic state was 100%. These normalized length-active tension relations were not altered by different [Ca2+]o, but shifted upward and to the left by caffeine and paired stimulation. The effects of elevating [Ca2+] on the length-active tension relation suggests that restoring forces and fixed internal loads are not an important factor in decreasing active tension at short lengths. The effects of caffeine and paired stimulation support the view that in cardiac muscle inactivitation of contraction is a major factor determining the fall in active tension at decreasing length.


[Muscle metabolism of glucose, lactate, free fatty acids, and glycerol at rest and during electrically stimulated exercise in the perfused rat hind limb (author's transl)]. The influence of insulin on muscle metabolism at rest and during electrically stimulated exercise was examined in the perfused rat hind limb. Basal glucose uptake of muscle tissue was enhanced threefold both by muscle contraction an by addition of physiological amounts of insulin. A further increase in glucose uptake was seen, when muscle was exercised in the presence of insulin. Lactate production rose 7 - 8fold by contractions. Insulin had no additional effect on lactate production during exercise. The work-induced lactate output exceeded glucose uptake, corresponding to a significantly reduced glycogen content after exercise. Basal lipolysis was not stimulated by muscle contractions. At rest the addition of both corticosterone and thyroxine did not increase the basal lipolysis. Yet, glycerol release rose twofold by the addition of serum to the perfusion medium. It is assumed that in the perfused rat hind limb glycogenolysis will promptly be stimulated by muscle contractions, whereas lipolysis can not be enhanced by exercise alone.


[The effect of dopamin on the microcirculation on the pancreas in hemorrhagic-shock (author's transl)]. The influence of Dopamine on microcirculation during hemorrhagic shock was investigated by means of the pancreas chamber technique (HEISIG, 1967). Parameter of microcirculation was the corpuscular flow velocity measured with the "flying spot" method. Simultaneously arterial and venous blood pressure, heart rate, blood gases and pH-status were registered. While a Dopamine-dosage of 5 mug/kg/min did not markedly effect perfusion of the pancreas, application of 10 as well as 20 mug/kg/min Dopamine caused a significant improvement of microcirculation. There was no difference between 10 and 20 mug/kg/min Dopamine. The increase of capillary perfusion can certainly not be explained by the small rise of blood pressure that was found under treatment with Dopamine. The results support the statement of the existence of Dopamine-specific receptors in pancreatic vessels. Compared to a group of animals treated with 5 mug/kg/min Dopamine and an untreated control group, survival rate of animals treated with 10 as well as 20 mug/kg/min Dopamine was significantly increased.


The consequences of ischaemia after mechanical obstruction of the dog ileum. A mechanical obstruction was produced in the dog ileum, and four days later, loop of intestine above and below the occlusion were subjected to one hour's ischaemia. This led to widespread morphological and functional damage of the epithelium, indistinguishable from the response of the normal intestine. The recovery of the mucosa of both loops after the ischaemia followed exactly the same pattern as when there was no occlusion superimposed: The transport capacity for phenylalanine in vitro was entirely restored, whereas that of beta-methyl-glucoside, together with oxygen consumption and lactate production, remained depressed; morphometric examination revealed that the recuperating mucosa had smaller villi, shorter crypts and smaller epithelial cells than the contiguous untouched tissue. These results suggest that the regenerative potential of the crypts could not be obliterated by one hour's ischaemia, either in the presence of a noxious obstruction fluid above the occlusion, or in the atrophic mucosa below it.


[Temperature dependence of metabolic processes in perfused rat liver (author's transl)]. The temperature dependence of various metabolic processes (glycolysis, fructolysis, glycogenolysis, ketogenesis, CO2-production, oxidative decarboxylation of pyruvate and gluconeogenesis) was studied in perfused rat livers. The processes measured differed with respect to their temperature dependence. Moreover, the sensitivity towards changes in temperature differed depending on the temperature range. Q10 values were found between 1,7 and 25 corresponding to values for activation energies between 38 and 216 kJoule/Mol.


Effects of an i. v. injection of ethyl palmitate emulsion on nucleic acids and fat content of the liver. In experiments with rats "chemically" splenectomized by an i.v. ethyl palmitate injection the possible side effects on the liver were followed. In the liver proteins, DNA, RNA, esterified fatty acids, and in blood serum transaminases were assessed. In all examinations the variances were only temporary and could be characterized as manifestations of a metabolic load rather than actual liver damage.


[Reaction of the cardio-respiratory-system following acetylcholine inhalation and the dependency from the body position on anaesthetised dogs (author's transl)]. The bronchomotoric reaction following ACH-aerosol in low concentrations is dependend on the position of the body on dogs. Up till one maximal reaction the increase of the airway resistance is always stronger in the lateral position. Nevertheless the breathing minute volume is constant. Concentration reaction curves will be shown. Arterial blood gases, heart rate, and pressure in the arteria femoralis were also measured. The different strongness of the reaction following ACH-inhalation will be caused by the predominantely unilateral ventilation of the animals in the lateral position.


[Some mechanical properties of the pig aorta (author's transl)]. In a machine for tensile tests the ultimate strength, stress and strain of the aorta ascendens of 47 female pigs (German landrace) at three different regions of the vessel wall were determined. The animals were fattened under identical conditions in a progeny testing station and slaughtered at the same living weight (102 +/- 2 kg). Weak regressions of body weight and age on parameters measured were nevertheless accounted for. The average elastin content of the aorta ascendens diminished with advancing age but was not significantly correlated to biomechanical properties of the three single samples. Maximum load, stress and modulus of vessel wall segment I (stamped out nearer to the heart) was greater than in sample II. These circumferential segments however exhibited highly stronger biomechanical resistance than sample III, which was stamped longitudinally. In samples I and II there was a negative correlation between thickness of the wall and ultimate tensile stress (N/mm2). Freezing of the material prior to test at -18degrees C for one week resulted in a significant rise in ultimate tensile strength and stress. The meaning of these findings for comparative angiology is discussed.


Thrombus formation and microaggregate removal during prolonged extracorporeal circulation using a capillary membrane oxygenator. A scanning electron microscope study. Despite adequate heparinization, thrombus formation occurs at the blood/foreign material interface. Depending on the part of the device, the material and the blood flow, the amount and the components of thrombi vary greatly. This is not dangerous by itself but clots can be expelled downstream and damage the lungs, brain, kidney and retina. Interposition of a filter may prevent risks of embolization. The present paper reports the scanning electron microscope study carried out on the Awad oxygenator after use during prolonged extracorporeal circulation on 13 dogs. No filter has been inserted in the circuit for the first six experiments. A screen filter (4) or a polyurethane foam filter (3) was employed in the following ones.


Estimation of contact time and diffusing capacity for oxygen in the chorioallantoic vascular plexus. The contact time of erythrocyte in the chorioallantioc capillaries of chicken embryos was estimated by referring to the oxygenation rate measured with a microphotometer. The chorioallantioc membrane was excised from an incubated egg and the SO2 of blood in it's capillary was changed by varying the gas composition around the membrane from the venous blood PO2 level to the air space gas. The oxygenation time (te) required to attain the level of arterialized blood SO2 was measured as the contact time (tc) in the capillaries, which resulted in 0.87, 0.74, 0.57, 0.49 and 0.36 sec for 10, 12, 14, 16 and 18 days of incubation, respectively. The obtained te value coincided with the contact time calculated from the CO diffusing capacity referring to the reaction rate of CO with oxygenated erythrocyte. Using the te value, the diffusing capacity for O2 in the chorioallantoic capillary was calculated; 1.1, 2.2, 4.4, 6.0 and 6.6 x 10(-3) ml-min-1 - mm Hg-1 for the same incubation days as above. The capillary blood volume (Vc) was also estimated, which increased from about 16 to 35 mul during development from 10 to 18 days. The values of DO2 and Vc converted per kg weight of embryo at the days near hatching were similar to those per kg body weight estimated in human lung.


Cardiac output determination by simple one-step rebreathing technique. We have developed a rebreathing technique for measuring cardiac output in resting or exercising subjects. The data needed are the subject's CO2 dissociation curve, the initial volume and CO2 fraction of the rebreathing bag, and a record of CO2 at the mouth during the maneuver. From these one can obtain all the values required to solve the Fick equation. The combined error due to inaccuracy in reading the tracings and to the simplifying assumptions was found to be small (mean = 0.5%, SD ;.5%). Cardiac output values determined with this technique in normal subjects were on the average 2% higher than those obtained simultaneously with an acetylene rebreathing method (n = 49, SD = 11%). Among the advantages of the technique are that it requires analysis of a single gas, takes less than thirty seconds per determination, allows one to obtain repeated measurements at rapid intervals, is not affected by the ability of lung tissue to store CO2, and eliminates many of the assumptions usually made in non-invasive measurements of cardiac output.


Stress at the pleural surface.

Stress at the pleural surface. The transmission of forces between the visceral and parietal pleural is modelled as being mediated by two distinct pathways: (a) a contact pressure (Pcon) acting on an area of contact (Acon) and (2) a pleural liquid pressure (Pliq) acting on the area of liquid anfractuosities (Aliq). Summation of the forces yields a new equation relating pleural surface pressure (Ppl) to Pcon, Acon, Pliq, and Aliq. A complete solution of the equation is restricted by present limitations on measurement technology. However, assuming that the volume of pleural liquid is constant during tidal breathing, analysis of the model explains the findings that tidal swings in Pliq (deltaPliq) are sometimes greater than tidal swings in Ppl (deltaPpl). It also predicts that the influence of a change of lung elastic recoil on Pliq may be different in magnitude than its effect on Ppl. Therefore deltaPliq is not necessarily equivalent to deltaPpl.


'Exponential peeling' of ventilatory transients following inhalation of 5, 6 and 7% CO2. The 'exponential peeling' technique has been applied to minute ventilation and tidal volume transients occurring after the abrupt removal of 7, 6 and 5% CO2 in inspired air. These transients, in many cases, were found to be composed of three exponential components, each contributing to the total ventilatory response and each having individual time responses. Gelfand and Lambertsen (1973) have attributed these components to the peripheral chemoreceptors as a group and to two central chemoreceptors. Statistical analysis to determine the constancy of the contribution of the three components over the range of CO2 values studied showed that, although the values for each at the different stimulus levels were not significantly different, the great subject-to-subject variation in the data precluded a firm conclusion about the constancy of the components. Because of a number of considerations it was concluded that exponential peeling of respiratory transients following abrupt removal of CO2 inhalation is not a satisfactory way to approach the problem of the numbers, relative contributions and time responses of the various receptor groups comprising the respiratory controller.


[Anatomoclinical and angiographic study of a case of disseminated thromboangiosis with predominant cerebral manifestations]. The authors describe the case of a patient of 22 with hypertension and livedo reticularis who, after presenting with a left brachial monoparesis became progressively demented over a period of five years and died at the age of 27 from a cerebro-meningeal haemorrhage. Angiographically, diffuse distal obliteration of the cerebral arteries was seen with deep networks of the moyamoya type involving the lenticulostriate arteries; similar changes were present in the upper left limb. Histopathological investigations showed obliterative thromboangiitis affecting not only the cerebrum, the brain stem and the cerebellum, but also the viscera. Analysis of this case and consideration of the theoretical possibilities leads the authors to urge that thromboangiosis together with its cerebral manifestations should be considered a nosological entity.


[Nature of the curves of the cranial vault and their relationship with various brain structures]. A radiometric investigation for various angles of two dry craniums and of the encephalographic or cerebral arteriographic pictures of 250 subjects has revealed the following facts: The architectural lines of the dome of the skull found by orthogonal projection of the profile, from the front, and in vertical projection, are hyperbolic spirals starting from the base of the skull and converging on the sphenoid. These lines join up in the parietal region forming a hyperbole. The frontal spiral is a simple hyperbolic spiral. The temporal spiral is of the lituus type. The axes of these lines converge in a frontal plane on the epiphysis. The axis of the parietal hyperbole on a projection of the profile passes through the epiphysis and is followed by the parietal artery. Central cranio-encephalic formations follow the same spiral path. The contour of the upper edge of the cerebellum is a lituus spiral. The outline of the lower part of the cerebellum is a simple hyperbolic spiral. The right side of the polar origins of a spiral plotted in the plane of the insula coincides with the right side of the opercula. It can always be plotted, in theory, and forms an angle of 22 degrees 30' with the right side of the median frontal spiral. It cuts the axis of the parietal hyperbole at the apex of the insular triange. The bissector of the angle formed by the two right sides of the polar origins bissects the axis of the parietal hyperbole at a point corresponding to the epiphysis. The temporal hyperbolic lituus spiral has its focal point under the anterior, clinoid, at the junction of the segments CII and CIII of the carotid siphon the curve of which follows the convolutions of the temporal spiral. The right side of the polar origins of this curve indicates the mean direction of the posterior cerebral. The contours of the corpus callosum are homothetic with those of the dome of the skull as far as the axis of the parietal hyperbole. The frontal and parietal curves converge according to four types in the main Pacchionian granulations. The sections of the frontal spiral are often marked by bone abnormalities on the internal table. This analytic test is invariably valid whatever the constants of the spirals or the eccentricities of the hyperboles. Combinations between spirals with different constants and hyperboles of various eccentricities amount to very many types which call for separate study.


[Cerebral cystercosis. 3. cases observed in the Paris area in immigrant workers]. The three cases described involve two Portugese patients and a Spaniard working in the Paris are who had presented with epilepsy, being focal in two. Diagnosis was made in two cases as a result of the existence of muscular and sub-cutaneous calcifications; in one case because of eosinophilia of the cerebro-spinal fluid. The clinical and therapeutic features of cerebral cysticercosis are recalled briefly in connection with these cases.


[Amyotrophic lateral sclerosis occuring befor the age of 40 years. Remarks apropos of 25 cases]. Twenty-five cases of amyotrophic lateral sclerosis occurring before the age of 40, collected between 1963 and 1973 in the Neurological Hospital, Lyons, have prompted the authors to make the following observations. -The incidence of disease seems to have been on the increase during this period both in absolute terms and relatively speaking (relative to the total number of patients hospitalized and to the total number of patients hospitalized for amyotrophic lateral sclerosis after the age of forty). -The 25 cases involved mostly women--the opposite of what was found in cases of amyotrophic lateral sclerosis occurring after forty. -Only one was possibly familial. -The onset is mostly with purely pyramidal features or of the topographically circumscribed peripheral type. Development appears to take longer than the average for amyotrophic lateral sclerosis. It would be worth while confirming these findings by analysis of other similar groups.


[Segmental muscular hypertrophy in Arnold-Chiari deformity associated with syringomyelia syndrome]. A case of Arnold-Chiari malformation plus syringomyelic syndrome with hypertrophy of upper left and lower right limbs is reported. The pathogenesis of this muscular hypertrophy is discussed. The authors retain the idea of an added malformation.


[Elimination by heat of false positive reactions during the detection of Australia antigen by passive hemagglutination tests]. The detection of the HB'S Antigen by a reversed passive haemagglutination test (Hépanosticon) in sera previously heated at 56 degrees C for 30 mn, is simple and rapid but gives a relatively high number of false positive results. A simple technique is suggested by heating sera betwen 68 degrees C and 80 degrees C and then by centrifugation at 1.500 g for 15 mn, to eliminate these false positive results. The supernatants are tested in the Hepanosticon technique and only the true positive samples, cheked for specificity by other techniques namely radioimmuno assay (R.I.A.) remain positive. Further research is pursued to confirm these first data and to define the exact degree of sensibility of this technique.


[Post-tranfusional malaria in France].

[Post-tranfusional malaria in France]. A global review of the porblem of malaria accidentally transmitted by blood transfusion is reported in France during these ten last years. Biological and epidemiological studies of malariae are recorded. Among the factors involved in the transmission of malariae by blood transfuction, the persistence of the parasites in the donors is very important. It is often longer than usual in the subjects who have lived in endemic malarious areas for many years or are always travelling in these countries, because they are partly protected by their acquired immunity and may be carriers of asymptomatic infection. The viability of parasites in stored blood, red cells and preparations with platelets, leucocytes or plasma containing a few red cells with parasites is discussed. The prevention depended on the elimination of any blood donor who has ever had malaria appears to be the simplest method but it is also the most failible. The screening of donors by direct microscopy is obviously impracticable because of low density and often submicroscopic level of their parasitoemia. Screening donors by IFA test is the best method. If IFA test is negative four months after coming back from endemic areas and two months after ending suppressive therapeutic, whole blood, red cells, leucocytes, platelets and fresh plasma can be used on condition that the stay of donors in endemic areas had been not too long. If the stay in these countries was very long, blood will be only used for preparing lyophilized plasma, fibrinogen immunoglobulins or albumin.


[Clinical symptoms of transfusional malaria]. Tranfusional malaria in countries located outside zones of endemia is difficult to evidence because it is rarely aparent. The clinic can be compared to that of malaria through inoculation by anophele, but it can be difficult to evidence because of its intricacy with the symptomatology of the affection which justified the transfusion. Usually, it takes the appearance of a febril gastric problem, but it may have other aspects: intestinal, hepato-biliar, neurologic or hematologic symptoms. As soon as the diagnosis is established, it is easy to confirm by a cytologic test on peripheric blood and/or on bone marrow and specially by a sero diagnosis using immuno fluorescence.


[Prevention of post-transfusional malaria by sero-detection of latent Plasmodium carriers among blood donors]. The risks of post-transfusion malaria are becoming a worry and the sero-investigation of latent carriers of plasmodium, among donors, is certainly the only efficient prophylactic measure. This is the result of an investigation carried out between October 1973 and February 1975 in 18 Blood Tranfusion Centres in France. Out of 2.997 sera studied in immuno-fluorescence of malaria, 3 to 5.2% of sero-positivity have been noticed, depending on the antigen used (P. falciparum, P. malariae and P. cynomolgi bastianellii). If the presence of fluorescent antibodies --  especially at weak titers --, does not mean compulsorily that the parasitemia persists, the serologic negativity leads to a diagnosis of exclusion. In this manner, the idea of a latent malaria is eliminated and one can determine precisely which bloods will be transfused without danger. But the required condition is that the sero-diagnosis of malaria be done on homologous antigens, which is, in spite of various technical difficulties, realizable in specialized laboratories. For material reasons, these tests cannot applied to all donors who have lived overseas. In return, it would be indubitably desired that these tests be done, among these donors, on subjects belonging to rare blood groups.


[Trial serologic detection of Plasmodium carriers among blood donors of the Centre de Transfusion Sanguine de Marseiile]. This paper is a survey of possible reservoir hosts of Plasmodium among donors of the blood transfusion Center of Marseille, by IFA test with P. falciparum and P. cynomolgi bastianellii antigens. It was found 15,7 per cent of positivity among 644 sera carefully selected during 6 months. Nord Africa and West Africa were the most dangerous countries, the former because of the great number of donors (332 of 744), the later because of the high rate (15,8 per cent) of positivity. The incidence of the say (frequency and long time) in infested countries and the interval from tate (15,8 per cent) of positivity. The incidence of the stay (frequency and long time) in infested countries and the interval from the last infestation possibility to the IFA test are very important factors. A prevention scheme is proposed: The donors staying during a very long time in infested countries will generally be used only for preparing plasma fractions by ethanol precipitations. For the others donors the blood will be used for preparing whole blood, red cells, fresh or frozen plasma, platelets and leucocytes preparation, in which a few parasites can be present, inly if a IFA test is negative 4 months after their coming back in our country.


[Results of a survey on post-transfusional malaria in France between 1960 and 1974]. This inquire demonstrated that transfusion malaria was not so rare as we thought. So 56 cases have been numbered between 1960 and 1974, and probably they do not reflect exactly the real situation. In our country, plasmodium falciparum, specifically responsible of the most serious accidents, is the form most frequently incriminated and its frequency increases among the years: 76,1% of the infects between 1970 and 1974. At last we have confirmed that a prevent of those accidents must consider as a subject any one having resided in an impaluded country, and that implies a constant knowledge of the epidemiologic map of this parisitism. This prevent will be increased so that the transfusion malaria will not get a illness disease in France.


[Radiation-induced teratogen effects and therapeutic abortion (author's transl)]. Ionizing radiation during the whole developmental phase induces high radiation sensitivity in the human embryo and fetus. Particularly in the phase of organogenesis, increased malformations result in a lower quality of life for the fetus after birth. In a suspected or existing pregnancy, it is, therefore, necessary to limit the indication for examination or treatment of the mother with ionizing radiation or radioactive elements more than in other phases of life. The probability of unfavorably influencing development in the womb by ionizing radiation depends on the dose received by the fetus. For this reason, all measures should be taken to keep the radiation exposure to a minimum. Since up until now no uniform recommendations regarding indication for therapeutic abortion following irradiation have been drawn up in Western Germany, it is advisable to fall back on those recommendations drawn up by Scandinavian countries on the basis of thorough radiobiological knowledge and experience. In cases where the probability of unfavorable effects exceeds 10% and/or the natural malformation rate doubles, a therapeutic abortion should be considered. In a properly conducted examination, this level is generally not reached. A few tips are also presented in regard to the proper execution of the examination during pregnancy.


[Changes of cutaneous blood flow after aortofemoral angiography (author's transl)]. Temperature versus time curves were registered during aortofemoral angiography in 48 patients. The cutaneous temperature was initially reduced in 46 of the patients. This phenomenon was interpreted as a temporary decrease of blood flow and can not be explained by hypertonicity of contrast media, but indicates additional pharmacodynamic effects. Reactive hyperemia depends on pathologic alterations of large and small vessels.


[Surgical treatment of varices (author's transl)]. Basically three possibilities are available for the treatment of the varicose symptom complex: 1. Varicosclerozation, 2. Surgery, 3. Compression. Dermatologists and internists understandably prefer varicosclerozation; surgeons, surgery. The best success, in my opinion, is achieved with all three possibilities of treatment are used in combination and adjusted individually to the vascular findings of each case. There is no effective varicosclerozation and no surgical treatment without subsequent compression. In no case, can treatment by medication be more than supportive for other effective measures. The goal of this article is to provide information regarding the present status of surgical treatment. Unavoidably, the indication for the other methods of treatment was also established.


[Significance of inhalation and perfusion scintigraphy for the diagnosis of pulmonary embolism (author's transl)]. Inhalation and perfusion scintigrams, general radiological examination of the thorax and an EKG were done on 43 patients with clinically suspected pulmonary embolism. In 11 cases, the clinical diagnosis could be confirmed on the basis of the scintigraphic examination. In the remaining 32 patients, an embolich event could be excluded by pulmonary scintigram, radiological examination and later the clinical course. A synopsis of clinical observations, X-ray and scintigraphy, therefore, permitted a basically reliable diagnosis of pulmonary embolism; selective pulmonary angiography should be used only in exceptional cases.


[Comparative study of xeroradiography and filmradiography (2700 statistically evaluated tests) (author's transl)]. Bases on more than 2700 statistically evaluated, comparative filmradiographic thoracic organs, abdomen and vascular and lymphatic system, the value of xeroradiography was analyzed by a standardized process. We came to the conclusion that, in certain cases, xeroradiography is superior (example: head-neck-soft tissues), equal (example: cranial area) or inferior (example: abdomen) to conventional X-ray film techniques. The xeroradiographic procedure has advantages for the radiologist if he does not try to use it as a substitute for the conventional X-ray film technique.


[X-ray protection zones during x-ray examens in intensive care (author's transl)]. For x-ray examens in intensiv care units is shown that in a distance of 1,5 m or 2,0 m the registered doses are so low that the x-ray protection zones could be limeted to this area.


[Joint manifestations of Yersinia enterocolitica infections]. Different recent studies, notably Scandinavian studies, have described a "rheumatism" caused by Yersinia enterocolitica infection. The picture usually seen is that of a subacute, febrile oligoarthritis predominantly in the lower limbs, associated with diarrhoea and hyperleucocytosis, polynucleosis, and a marked increase in the sedimentation rate. Benign carditis may also be associated. The diagnosis rests on the discovery of the organism by coproculture and on serodiagnosis. Evolution is favourable within several weeks or several months. Treatment includes antibiotics and antinflammatory preparations.


[Joint manifestations of carcinoid tumors of the digestive system]. The joint manifestations of carcinoid tumours become integrated into the carcinoid syndrome, the totality of the symptoms occurring at a distance from the tumour and linked to the metabolites secreted by the tumour. These arthropathies have been the subject of only a very limited number of publications. They consist of arthralgia, sometimes with swelling, predominantly in the extremities of the upper limbs, and linked to activity. The radiological picture includes a "band" of demineralization, and less frequently destructive joint lesions. The sedimentation rate is always increased. These arthropathies can be related to their origin only by knowledge of, and demonstration of, the other elements of the carcinoid syndrome and of the tumoro-metastic syndrome. Laboratory diagnosis rests on determination of the 5-hydroxyl derivatives of tryptophane.


[Arthrotic sciatica caused by radicular compression of osteophytic origin in the lateral recess. Apropos of 18 cases]. The authors report 18 cases of arthrosic sciatica due to toot compression in the lateral recess by posterior corporeal and/or posterior apophyseal osteophytosis. The authors study the clinical and radiological characteristics that may indicate the diagnosis and discuss the different mechanisms by which vertebral arthrosis can lead to radicular compression. When surgery is necessary because of the persistent nature of the sciatica, a broader approach should be undertaken than that required for excision of the disc, in order to explore fully the roots, the multiplicity of possible compression sites being one of the essential characteristics of these cases of arthrosic radiculopathy. Study of the literature and of the series of sciatica patients operated upon by the authors shows that although discal hernia is far from being the most frequent cause of common sciatica, arthrosic compression is a cause that cannot be ignored, especially in aged subjects.


[Patellar malposition, its incidence in patellar chondropathy and in a control population]. Patellar disequilibrium consists of either external malpositioning of the patella (EMP) or external hyperpression (EHP), which are clearly visible on a 30degrees axial radiograph of the knee. Does this disequilibrium play a role in the development of patellar chondropathy? The authors have based their comparisons on a series of 40 subjects more than 60 years of age (average age: 68 years) who were free from pain and arthrosis of the knee. In this group they found 2 cases of EMP (5 percent) and 3 of EHP (7.5 percent). In their series of cases of patellar chondropathy (43 cases) there were, after correction for the cases with a double etiology, 8.5 cases of EMP (20 percent) and 7 of EHP (16 percent). The differences between these figures and those for the control series are statistically significant for the number of cases of EMP (P less than 0.05), but not for the number of cases of EHP, the etiological role of which is probable but for which proof would require a larger series of patients. From this work the following findings emerge: (1) The frequency of latent patellofemoral arthrosis in the aged control subjects with knee problems. 7 cases out of 47, or 12.5 percent. (2) The frequency of patellar chondropathy apparently associated with the two etiological factors: out of 43 patients, 22 suffered from patellar disequilibrium (10 EMP and 12 EHP) but in 13 cases there was another associated possible cause of deterioration: traumatism or stress on the knee associated with work or sport. This methodological difficulty is discussed and resolved empirically. The importance of patellar disequilibrium in the development of degenerative patellofemoral affections derives not from the etiological importance but from the fact that they represent the only factor for which therapy may be given: elective internal rehabilitation or surgery (section of the external wing of the patella or transposition of the anterior tuberosity of the tibia).


[HL-A and chronic juvenile polyarthritis]. The authors determined the HLA groups in 1000 blood donors, in 62 subjects suffering from ankylosing spondylarthritis, and in 32 subjects suffering from chronic juvenile polyarthritis. The results confirm those of other authors as regards the occurrence of W27 antigen in ankylosing spondylarthritis. The examination of the subjects suffering from chronic juvenile polyarthritis made it possible to subdivide this population into 4 groups: (1) Chronic juvenile polyarthritis evolving towards ankylosing spondylarthritis; (2) Chronic juvenile polyarthritis with sacroilitis; (3) Chronic juvenile polyarthritis without sacroiliac involvement; and (4) Rhematoid juvenile polyarthritis. They showed that the presence of W27 antigen was very high in groups (1) and (2) and very low in groups (3) and (4). Determination of the presence of W27 antigen makes it possible to place the patient in one of these groups and the future will show whether this classification is of any therapeutic consequence.


[Quantitative bone biopsy and primary hyperparathyroidism, its role in diagnosis. Apropos of 45 cases]. Iliac bone biopsy, including a quantitative study, was carried out in 38 patients with primary hyperparathyroidism (34 surgical patients, 4 with typical syndromes based on laboratory analysis). A second biopsy was carried out in 7 cases. By studying both the surface resorption of the strands of the spongy tissue and periosteocyte osteolysis (an indirect measure by assessment of the surface aera of the periosteocyte lacunae), it is possible to arrive at a histological diagnosis of hyperparathyroidism in 98 percent of cases: surface resorption is increased in 82 percent of cases; the periosteocyte lacunae are enlarged in 91 percent of cases; the two criteria together give a positive result in 44 cases out of 45 (98 percent). This morphometric study is particularly valuable in those cases in which the qualitative histological appearance is not very informative.


[Study of circulating 25 hydroxyvitamin D]. The levels of circulating 25 OH-D were determined by a direct radio-competition methods both in normal subjects and in subjects with various pathological conditions. In normal subjects, the average level of 25 OH-D was higher in summer (42.3 ng/ml) than in winter (29.1 ng/ml), P less than 0.005. Monthly variations in the 25 HO-D levels were found in relation to insolation The level of 25 OH-D was practically normal in osteoporosis (28.9 ng/ml), clearly lower in the mixed forms called "osteoporomalacia" (13.5 ng/ml, P less than 0.005) and very low in osteomalacia (5.8 ng/ml, P less than 0.001). In cases of cortisone osteopathy the average level was 22.8 ng/ml (NS). The level of 25 OH-D was also found to be lower in hepatic cirrhosis (11.7 ng/ml, P less than 0.01), in subjects treated with anticonvulsants (P less than 0.01), and in the course of hyperparathyroidism (P less than 0.002). There was no corelation between the level of 25 OH-D and calcaemia, phosphoraemia, circulating immunoreactive parathyroid hormone, or the relative osteoid volume. In contrast, there seemed to be a good correlation with the level of alkaline phosphatasaemia. The level of 25 OH-D was also determined in 4 subjects with vitamin-resistant osteomalacia: in 3 cases hepatic hydroxylation seemed normal, indicating the possibility of a subsequent disorder of vitamin D metabolism; in one case the absence of hepatic hydroxylation was noted.


[Intermittent treatment of Paget's disease of bone with calcitonin: histological study]. The authors report the results of a semi-quantitative histological study of bone carried out in 6 patients with Paget's disease treated with salmon calcitonin (about thirty injections of an average of 50 MRC units) over 8 to 14 weeks. The treatment led to a decrease in the resorption surfaces, in the number and the nucleation of the osteoclasts, and in the level of hydroxyprolinuria. Cessation of treatment led to an increase in these parameters, but starting from the fifth month after the cessation renewed improvement was noted, concerning in particular the hydroxyprolinuria and the nucleation of the osteoclasts and this lasted until the tenth month. The possibility of a prolonged action of calcitonin indicates that discontinuous therapy of Paget's disease should be considered (4 months per year, for example).


[Further observations on the presence of iron in the articuler synovial membrane]. In 1971, a study of 66 synovial biopsy samples indicated that the presence of ferric deposits in the subintimal synovial tissue was of real semiological value in the diagnosis of rheumatoid synovitis. In 1975, a study of 228 synovial biopsy samples led the authors to reconsider this finding: the presence of ferric deposits in the subintimal synovial tissue was far from being a constant feature in rheumatoid synovitis and it was seen with similar frequency in other forms of chronic inflammatory rheumatism and also in several other joint conditions. The origin of the synovial iron and the influence it may have on the development of the rheumatoid processes remain obscure.


Arterial-hepatic vein glucose differences in normal and diabetic man after a glucose infusion at rest and after exercise. The role of the liver in the elimination of infused glucose during recovery after exercise was studied in 5 normal and 4 juvenile diabetic males. The results were compared with those of a resting experiment. The subjects exercised on the bicycle ergometer at a work rate requiring about 70% of their max. Vo2. 0.5 g glucose per kg body weight was infused as a single injection 15 min after the cessation of exercise. Arterial-hepatic vein (a-hv) glucose and lactate differences were measured repetitively both during exercise and throughout the 79 min recovery period. During exercise the a-hv glucose differences were negative and increased more than sixfold in the diabetic subjects and more than tenfold in the non-diabetic subjects. After the glucose infusion the a-hv glucose differences were still negative in the diabetic subjects, indicating a continued net release of glucose from the liver in spite of elevated arterial glucose concentrations. In the non-diabetic subjects there was a small uptake of glucose, accounting for about 0.5% of the total glucose load given. The a-hv lactate differences were larger in the diabetic subjects, indicating a greater dependence upon gluconeogenesis as compared with the non-diabetic subjects. It is concluded that the liver is of no importance in the diabetic subjects and of only slight importance in the non-diabetic subjects for the disposal of infused glucose during the initial hour of recovery after exercise.


Factor VIII (AHG) levels in 1016 regular blood donors. The effects of age, sex, and ABO blood groups. Factor VIII (AHG) activity was assayed in the plasma specimens from 1016 regular and controlled blood donors. Age and ABO blood groups had highly significant effects on factor VIII concentrations, whereas the effect of sex was not significant. The median in the donors of blood group O rose from 87% at the age of 20 to 119% at the age of 60 years, and the median in blood groups A and B+AB of corresponding ages rose from 108 to 147%. An interaction effect of age and blood groups was present only at the 5% level of significance. The present data and the previous findings of others suggest the existence of an association between high factor VIII levels and thrombotic states.


A simple method for measurement of angiotensin II in plasma. A simple radioimmunological (RIA) method for the determination of angiotensin II in 0.5-1.0 ml samples of plasma is described and carefully evaluated. Before RIA was performed, the interfering plasma proteins were eliminated by ion exchange chromatography, and recovery from every column was checked with a small amount of [125I]angiotensin II. The sensitivity of the method was 4.0 ng/l; the coefficient of intra-assay variation was 10.0% and that of inter-assay variation 12.1%. Accuracy was studied both by adding various amounts of angiotensin II to plasma samples and by diluting plasma containing angiotensin II with the RIA buffer. Both studies gave very good correlations between found and expected values (r=0.998 and r=0.987). In a normal material (n=36), the mean angiotensin II concentration at 8 a.m. after 2 h ambulation 42.4 +/- 12.8 (S.D.) ng/l. Because the present method is accurate, precise, and practical, and allows measurement of angiotensin II in small samples, it seems useful for routine as well as for research work.


Conductometric determination of CO2 in air samples. A new procedure enables the CO2 concentrations of air samples to be determined and automatically registered. The CO2 contents of the air samples are absorbed in an Sr(OH)2 solution. The resulting decrease in electrical conductivity of the solution is automatically registered by a d.c. strip-chart recorder in such a way that the decline of the curve is proportional to the amount of CO2 absorbed. In each analysis, quantities of CO2 up to about 8 mumol can be determined with an error of less than 0.02 mumol, and, accordingly, CO2 quantities of 2 to 8 mumol contained in samples of at least 150 ml of fresh atmospheric air or about 1 ml of carboxygen or expired air can be analysed with an accuracy of better than +/- 1.0% of their CO2 content.


Metiamide inhibits canine gastric acid secretion evoked by sham feeding. A continuous intravenous infusion of metiamide markedly inhibited the gastric acid secretory response to sham feeding in two dogs provided with Pavlov pouches and gastric fistulae. The results show that an antagonist of histamine H2-receptors is capable of inhibiting a vagally activated secretion evoked by sham feeding, which may be considered a physiological vagal stimulus.


Nephrotic syndrome in ulcerative colitis. Complicating disorders in various organs outside the intestinal tract are common in ulcerative colitis. This report deals with the occurrence of nephrotic syndrome in two patients with long-standing ulcerative colitis. In the patient studied in most detail, 2 episodes have taken place, the first developing into uremia. After colectomy had been performed, rapid improvement of renal function took place. The morphological changes in kidney biopsies were compatible with the presence of focal glomerular sclerosis. Activity in the complement system and a favorable response to steroid treatment indicate that humoral immune mechanisms are of pathogenetic importance with regard to the renal disease in these two patients. To our knowledge nephrotic syndrome has not previously been described as a complication to ulcerative colitis.


Intraluminal pressure in the sigmoid colon. I. Method and results in normal subjects. A modified method for measurement of pressure activity in the sigmoid colon is presented, using open-ended tubes and measurement of pressure activity for 30 minutes after intravenous administration of 0.5 mg of neostigmine. The motility index in 12 normal persons was found to have median 597 with a range of 125-1169. Variation among persons exceeded the day-to-day variation significantly. Error in reading the curves was negligible.


Intraluminal pressure in the sigmoid colon. II. Patients with sigmoid diverticula and related conditions. Patients with lower abdominal symptoms, indicating colonic disorder, were classified into predefined clinical syndromes. Two important syndromes were colicky sigmoid syndrome and chronic diverticular disease. The first one, characterized by presence of colicky lower abdominal pains but absence of colonic diverticula, probably covers what is generally referred to as 'irritable bowel syndrome'. The second one was characterized by presence of lower abdominal colics and of colonic diverticula. The results showed a significant correlation between the presence of lower abdominal colics and a high pressure activity in the sigmoid colon after intravenous neostigmine. There was, however, no correlation between the presence of diverticula and a high pressure activity. The generally accepted theory of a high pressure activity as the dominant factor in the pathogenesis of colonic diverticula, therefore, was questioned, as was the equally accepted theory of a gradual development of chronic diverticular disease from the adiverticular colicky sigmoid syndrome.


Incorporation rate in vitro of choline and methyl-methionine into human hepatic lecithins. In order to evaluate the quantitative role of cytidinediphosphate-choline and phosphatidyl-ethanolamine-methylation pathways in the synthesis of phosphatidylcholine in human liver tissue, the incorporation rate of [14C]choline and [14C]methyl-methionine into liver lecithins was determined. Liver biopsy was taken in 27 patients operated upon for uncomplicated gallstone disease. Linear incorporation into lecithin was achieved for N-methyl-methionine during 4 hours' incubation and for choline from 7.5 min to 60 min of incubation but with a significant positive Y-intercept. This Y-intercept was directly proportional to the concentration of choline in the medium and might be explained by a rapid base exchange between free choline in the medium and bases in phosphoglycerides. Fertile women showed significantly higher incorporation rate of methyl-methionine than postmenopausal women. Bile acids in the incubation medium did not influence the incorporation rate of thesebation medium did not influence the incorporation rate of these precursors into hepatic lecithin: The results indicate that the contribution of the methylation pathway in the synthesis of human liver lecithin accounts for about 10-15 per cent of that of the CDP-choline pathway.


Washing and direct vision brush cytology in the diagnosis of gastric carcinoma. The diagnostic significance of direct vision brush cytology and simple washing cytology was studied in 3 series with gastric carcinoma verified at operation. Direct vision gastroscopic biopsy was performed in all patients. Both brush and washing cytology markedly increased the diagnostic reliability of gastroscopic biopsy. Wrong negative results (Papanicolau I-II) were found in 13% with brush cytology and in 34% with washing cytology. Direct comparison revealed that brush cytology was definitely superior to washing cytology in the diagnosis of gastric carcinoma. The results suggest a routine use of brush cytology in connection with gastroscopic biopsy.


Dynamics of atrophic gastritis in male and female subjects after partial gastric resection -- an evaluation by stochastic analysis. Forty-two subjects (33 male and 9 female) were examined 17 to 18 years after partial gastrectomy due to gastric or duodenal ulcer, with regard to morphological state of gastric body mucosa, specimens obtained by direct gastroscopy technique being evaluated by our scoring system. Our stochastic analysis was applied to the findings to obtain the "age-adjusted score' (AAS), representing the degree of progression of chronic gastritis with reference to a random population, independent of the subject's age. Higher susceptibility of males than females to progressing chronic gastritis, and higher than that of both males and females of the random population, was noted. The atrophic changes in males after gastrectomy showed no dependence on age.


Coenzyme-A-dependent esterification of cholesterol in rat intestinal mucosa. Rat intestinal mucosa contains an enzyme which catalyses the esterification of cholesterol. The enzyme is CoA-dependent and probably an acyl-CoA: cholesterol acyltransferase (ACAT) (E.C.2.3.1.26). Maximal activity in vitro is obtained when long chain acylcarnitines, CoA and carnitine palmityltransferase are used as an acyl-CoA generating system. The enzyme is localized in the microsomal fraction, has a pH optimum between 6.4-7.2, and oleate is the preferred acyl group. The activity of the enzyme is highest in the proximal jejunum, and has a capacity that can account for all cholesteryl esters found in intestinal rat lymph.


Early unconjugated hyperbilirubinaemia after paracetamol overdosage. A rapid increase of predominantly unconjugated bilirubin in the blood -- which was not due to haemolysis -- was observed in 38 of 60 patients who had taken an overdose of paracetamol. Studies in the rat given an overdose of the drug showed that within 24 hours there was a striking reduction in the activity of bilirubin glucuronyl-transferase and the content of cytochrome P.450 in the liver. It is suggested that such early damage of the hepatic endoplasmic reticulum contributes to the hyperbilirubinaemia of paracetamol poisoning.


Lower esophageal sphincter in reflux esophagitis. Lower esophageal sphincter pressure (LESP) was studied by intraluminal perfusion-manometry in the resting state and after graded intravenous doses of pentagastrin in 12 healthy subjects and 27 patients with reflux esophagitis. These patients were classified as having ulcerative (11) or non-ulcerative esophagitis (16) by histological examination and endoscopic appearance of the inflamed mucosa. The length of the LES was similar in patients and controls. A correlation was found between the magnitude of mean basal end-expiratory (mbe) LESP reduction and the grade of esophageal mucosa inflammation. The most reduced mbe LESP value was shown in patients with ulcerative esophagitis. It was significantly different from that of patients with non-ulcerative esophagitis (t = 3.37, p less than 0.01). Both values were significantly reduced from that of the controls (t larger than or equal to 0.0125). The responsiveness of the LES to intravenous pentagastrin was quantitatively reduced throughout the whole range of the dose-response curve in patients with ulcerative esophagitis, whereas patients with non-ulcerative esophagitis only differed in the maximum mbe pressure value from the controls. Four patients showed a paradoxical pressure decrease to intravenous pentagastrin, resulting in a LESP reduction to 8% of the mbe LESP. Intravenous secretin or CCK led to a similar reaction of the LES in these patients.


Reversible activation of proactivator (factor B) of the alternative pathway without cleavage of the molecule. The serum of a patient (M.C.) with chronic glomerulonephritis and renal deposits of IgA, C3, and properdin converted C3 on overnight exposure of 0 degrees C. The cold reaction was dependent on immunoglobulin, initiating factor, Factors B and D, and magnesium but not on properdin. Factor B, the C3-cleaving enzyme in this reaction, was used in zymogen form. After participation in this rection, Factor B zymogen in M.C. serum could be fully activated by cobra venom factor (CVF) at 37 degrees C. That activation without fragmentation was not due to an abnormal form of Factor B was shown by its typical cleavage on incubation of MC. serum with CVF or C3b or after depletion of C3b inactivator. The evidence indicates that in the cold reaction only the initial C3 convertase of the alternative parhway is formed and that this enzyme is responsible for the observed C3 consumption.


PHA-induced activation of suppressor cells in normal human peripheral blood lymphocytes. Normal human peripheral blood and tonsil lymphocytes can be stimulated to proliferate by phytohemagglutinin (PHA). When cells cultured with this mitogen for 3 days were transferred fo fresh autologous lymphocytes in fresh medium with PHA, the mitogen response of the fresh lymphocytes was suppressed. The suppression required the presence of viable cells, in that culture supernatants alone were not inhibitory and cell extracts showed only marginal inhibition. Approximately equivalent numbers of previously stimulated cells were required to produce optimal suppression of the PHA response of fresh cells. Cells irradiated after PHA stimulation were as effective as nonirradiated cells is causing suppression. PHA-stimulated cells also inhibited concanavalinA-induced proliferation and a mixed lymphocyte reaction. However, PHA-stimulated cells only partially inhibited the response to pokeweed mitogen. The suppressive effects were fully retained by a nylon-wool-enriched T-cell fraction but not by a B-cell-enriched fraction.


Immune complexes in human melanoma: a consequence of deranged immune regulation. Circulating immune complexes were detected in 62 individuals with malignant melanoma by precipitation with isolated human C1q and polyclonal rheumatoid factors. In 56 patients the C1q deviation assay showed low to moderate levels of complexes, with increased amounts with advancing stage of disease. Both heavy (greater than 19S) and intermediate (7S to 19S) varieties were present, and complexes containing tumor antigen-antibody or antibody-anti-antibody were identified. Complexes were found in the kidneys of one patient with malignancy and the nephrotic syndrome and in two further patients with melanoma in whom there were no clinical manifestations of nephrosis. Serial determinations in 51 patients showed slow cyclic variations in the levels of complexes and fluctuations in response to therapy. The coexistence of anti-antibodies, immune complex disease, and anergy in melanoma patients may indicate a deranged immune regulation consequent to chronic antigenic stimulation by the tumor.


[Comparative study of long-term mortality in the mentally ill]. The mortality in mental illness has been studied after an average follow-up period of 3-4 decades in a material of 5661 former in-patients of the Psychiatric University Hospital of Lausanne (Switzerland), from which 3520 probands were dead at the date of reference. By use of an improved method, the calculations showed in all diagnostic groups, and generally more marked in women than in men, a 1,34 to 9,72 times higher mortality than in the general population, increasing in the following order: head injuries, psychogenic and psychopathic disorders, manic syndromes, schizophrenia, depressions, mental retardation, alcoholisme, other psychosis, epilepsy, general paralysis, other cerebro-organic conditions. Several possible explanations of these results are discussed.


[The problem of the linguistic and scientivic position of psychopathology in the framework of current psychiatry]. An attempt has been made to explain on the one hand the significance of the psychopathological terminology. In contrast to the "dynamic psychiatry", where the language has preponderantly an anticipating, finalizing character with regard to the therapeutical process, it is here being made clear that the cognition of the full existence requires a defined analysis in case of a psychic distrubance. A conceivable aspiration for orderliness thus opens the way to impartial objectiveness. To a special extent the psychiatrist here appears to be obliged to the word itself, particularly within the framework of transcultural psychiatric research, that is, both in regard to philosophical and cultural-historical conditions. The figurative and symbolic character of the language seems to be necessary in psychopathology to make clear the existence of a psychopathological state of mind for lack of another system of definition. On the other hand, it should be shown that also psychopathology - without being subjected to foreign infiltration of a philosophysing medical doctrine - must be embedded in the philosophical way of thinking, if it will not evade an answer to the all important question of a finiteness or infiniteness of man beyond all positive ways of thinking by the fact of the psychophysical problems amid its science and the unique irrationality thereof.


Psychopathometry and homogenous syndrome dynamics. The principle of homogeneous dynamic of syndromes means that diminishing of single psychic functions or the severeness of syndromes is correlated to the total syndrome. The validity of this principle was alleged for reversible physically founded psychoses and for cyclothymic depressions. Various empirical investigations confirm the validity of the principle of homogeneous dynamic of syndromes. These findings suggest practical benefit for the development of psychopathometric procedures: constructions of short tests. Perhaps the range of validity of the principle of homogeneous dynamic of syndromes may be extended on cyclothymic mania, too. Empirical investigations will prove this question.


[Anorexic syndrome and depression. Considerations from a case history]. A connection between anorexic syndrome and depression has been the object of psychoanalytic as well as psychiatric considerations for a long time now. We report the case of a 45-year-old woman suffering from anorexia nervosa and depression. Biographically-anamnestic aspects are shown in connection with depth-psychological and psychiatric ones, thus trying to achieve a synopsis.


[Pseudoparalytic myasthenia gravis. Diagnostic and therapeutic aspects in 60 separate cases]. Based on 60 of our own cases and on the medical literature the authors discuss the diagnostic, pathophysiological and therapeutic aspects of myasthenia gravis. Myasthenia is suspected in cases of motor weakness of changing intensity, diminishing by rest. The weak muscles are innervated by different peripheral nerves. At the beginning a weakness of upperlid-muscles, external eye muscles and bulbar muscles is particularly frequent. There is no sensory loss or other neurological symptoms. A transitory disappearance of motor weakness after an intravenous dose of Edrophonium (Tensilon) is a typical diagnostic sign. The effect is less evident with eye-muscle weakness. A typical appearance of potentials after repetitive stimulation of peripheral nerves as well as other characteristics in electrophysiological testing of muscles are of high diagnostic value. This allows differentiation from other types of muscle weakness. In the pathogenesis of myasthenia an autoimmune process related to a persistent thymus gland plays an important part. This leads to an ultrastructural change in the postsynaptic membrane of the muscle fibre. The postsynaptic membrane no longer reacts in a normal way to acetylcholine as a transmitter substance at the level of the motor endplate. Therefore the first step in the treatment of myasthenia consists of cholinesterase-inhibitors, specially Neostigmin (Prostigmin) and Pyridostigmin (Mestinon). Thymectomy is advised in all cases of myasthenia with the exception of the pure ocular form and of myasthenia in patients older than 60 years. The thymus gland is practically always persistent or hypertrophic in myasthenia. The suprasternal access is recommended. A thymoma should always be operated upon because of the danger of malignancy. In cases where thymectomy is not performed or not successful and if cholinesterase-inhibitors are not sufficiently efficient, treatment with corticosteroids or ACTH is recommended.


E1Socio-economic data concerning the early childhood and the actual life-situation of psychiatric out-patients. By means of a standarized social psychiatric questionnaire which was developed from the AMP-system and which forms the basis for a standardized case history used in our outpatient clinic, a random sample of 500 ambulant patients from the years 1970 and 1971 were examined concerning their socio-economic data. Patients of the age group of 20-24 years were overrepresented (p less than 0,05) as well as patients of the lower socio-economic classes and patients whose parents were less than 20 years old at the time of the patients' birth. The structure of the family in childhood showed significant differences concerning patients with different social contacts and different diagnoses. Patients who grew up in big families have themselves a relatively large number of children and vice versa (p less than 0,01). A significant correlation (p less than 0,01) consists also between the number of siblings of the patients and the socio-economic class they belong to: Patients from the underprivileged socio-economic classes mostly grew up in big families.


[Drug abuse and suicidal tendencies].

[Drug abuse and suicidal tendencies]. 66 juvenile drug-consumers--development-crises (32%), neurotic developments (30%), abnormal juvenile personalities (38%) - with a predominantly polytoxicomanic drug-anamnesis of several years are examined as to their suicidal development. The quantitative and qualitative progression of drug-abuse, the duration of drug-anamnesis, frequent broken-home-situations, grave educational deficiencies together with lacking possibilities of identification, a distinct social decline and chronic conflict-situations indicate the serious degree of the suicidal development. Different suicidal syndromes are worked out which in the form of death-phantasies or suicidal thoughts and horror trips directly derive from drug-abuse or are accompanied and reinforced by a continuous and frequently increasing drug-consumption, and which extend from an increase in depressive irritations, further psychological disturbances and personality changes, doubts about one's personal value and a sense of guilt to the "sickness of death".


[Neuropsychological study of an autonomous aged population]. In order to adjust the tests used in a study on degenerative dementia a group of independent aged volunteers has been formed and submitted to neuropsychological tests on instrumental functioning. Among them: 25% obtained normal results - 55% showed light instrumental deficiencies which were however not significant of brain damage - 22% had a global impairment of instrumental functions but without memory troubles. This relatively high percentage of impaired old people posed the problem of the normality of the sample chosen. As it mostly came from elderly communities it is possible to think that these gather more or less psychically or socially disfavoured aged people. The frequency of cortical impairments urges to think that they should be followed up to determine whether these symptoms are normal or if these are the signs of a degenerative evolution; in which case the neuropsychological approach would no longer be selective.


[Comparative study of 2 groups of paranoid syndromes appearing at different ages]. Clinical study of two groups of females beyond age of 65, institutionalized for delusional manifestations of schizophrenic nature and presenting also, at the time of examination, a pronounced paranoid state. In the first group: the manifestations had arisen before the age of 45. In the second group, after the age of 65. This study has demonstrated certain psychopathological characteristics suggesting the presence of personality problems definitely more profound in patients of the first group: autistic state, asthenia, thought disorder, incoherence and vagueness of delusional subjects, ordinarily much more unreal are characteristics of the first group in comparison to the second. This seems to bring evidence that these two paranoid states (paranoid schizophrenia in adult age and paranoid state in senility) are, at first sight, pathological entities based on personality problems of very different intensity.


[Malpractice in psychotherapy].

[Malpractice in psychotherapy]. Two cases of malpractice in psychotherapy are described. In one case there was a psychiatrist involved, in the other a non-medical psychotherapist. The legal aspects of malpractice in the view of Swiss legislation are shortly discussed. A legal liability for damages caused by the psychotherapist might arise if the following conditions are fulfilled: A deviance from the generally accepted standards of care in psychotherapy, a damage to the patient as a consequence of this deviance and a negligence on the part of the psychotherapist. Furthermore, there has to be an adequate causal nexus between malpractice and damage done to the patient. By some case reports the author tries to exemplify what can be understood by the term of generally accepted standards of care in psychotherapy.


[Differential diagnostic question: traumatic unconsciousness or amnestic episode?]. Traumatic twilight state on the one and amnestic episode (transient global amnesia) on the other side are as a rule easy to differentiate from the patient's age, his behavior during the acute state of disease and the kind of its improving. Contrary to other authors' opinion, differentiation is not just possible by diagnosing an injury or its absence. In minor skull traumata preceding the traumatic twilight states injuries are often not manifest and otherwise amnestic episodes occasionnally occur after minor traumata. In a 64 years old woman an obviously typical amnestic episode appeared in direct connection with a probable fall on the back of the head. A 28 years old man underwent a five-hour amnestic episode whereas the EEG showed normal curves. The episode occurred 15 minutes after striking hard upon the ground with the back of the head during a ground roll without following unconsciousness. In both cases traumatic twilight states were not involved. In account of the interval of 15 minutes the trauma of the second case seems not be be the direct cause for the manifestation of amnestic episode. It also shows that the aspect of the disease in the rare occurrence in younger or middle-aged persons is on principle not different from that in old ones. Since a special medical examination during the acute state is only possible as exception the patient's amnestically seizable behaviour obtains greatest importance in differential diagnosis. For the rare coincidence the trauma is given no pathogenetic relevance in amnestic episodes.


The clinical classification of ceroid-lipofuscinosis. A statistical approach. A revision of 108 published cases from the last ten years has been made, of patients suffering ceroid-lipofuscinosis, which includes two cases studied in our department. The statistical analysis of the initial symptoms, the age of onset and the disease's duration, permits us to conclude that possibly there exists, within this syndrome, four different forms in accordance with the age of onset. Each one of them has a typical clinical pattern. Our classification was compared with previously existing ones.


[Etiology and clinic of status epilepticus]. In the presented study we examined 110 patients who suffered from status epilepticus. Total 148 status were analysed with regard to etiology, releasing factors, course and treatment. Causes stressed were head injury with brain damage and intracranial space occupying, especially in the frontal region. Head injury with opened dura mater showed more tendency for development of status than closed ones. In a quarter of all cases  origin couldn't be found. All these, with exception of one case, developed intercurrently. Isolated or initial always was consequence of brain lesion, the origin of which was or has been detected. No trend with reference to distribution of age in the particular forms of status were found out. In a third part of all a releasing factor could be discovered. Most the question in these cases was failure in medicamental treatment. We couldn't draw one's interferences about pathogenesis from etiology, age of patient, place in course and form of status. About in a quarter of all status we found defective neurological sequels, in 12% also psychical disturbances. 16 patients died during the period of observation, but only 2 within 24 hours, all together 8 in the first 14 days in deap coma. Immediately cause of death were above all complications of the heart, circulation of blood and respiration tract. In the most cases the treatment consisted in a mixture of anticonvulsive medicaments. The predominant rate of status epilepticus could be inhibited within 24 hours, only 20 lasted a longer time.


Narcolepsy and hypersomnia: review and classification of 642 personally observed cases. In this paper the author gives a survey and a classification of 642 cases of narcolepsy and hypersomnia which he himself studied in the course of 26 years. 368 cases were classified as narcolepsy, 274 as hypersomnia. The author further classifies narcolepsies according to their etiology, clinical form and pathophysiological mechanisms of origin. Hypersomnias are divided by the author into the symptomatic and the functional groups. According to the author it is useful to distinguish "short cycle hypersomnia", i.e. those with short duration of sleep attacks (hours) and intervals, from "long cycle hypersomnia", i.e. those with long attacks (days or weeks) and intervals. The author goes on to describe different forms of symptomatic and functional hypersomnias, such as idiopathic hypersomnia, neurotic hypersomnia, the Pickwickian syndrome" and its variants as well as different varieties of periodic long cycle hypersomnias. Finally the author makes a brief mention of the syndrome of insufficiency of wakefulness.


[Modern images of womanhood and their relationship to fetishism]. The image of womanhood accepted by society has changed from the corseted lady at the beginning of the 20th century to the emancipated and booted woman of today. The dictates of fashion in clothing correspond to unconscious wishes nurtured by men; the present fashion enables latent fetishist tendencies to work themselves out within the social framework and is directed at creating the "phallic woman". The boot and leather fetishism masquerading under the guise of a fashionable trend sheds light on unconscious sexual behaviour in the male, the underlying psychodynamics of which are further illuminated by the -for the moment, at least- still "private" model of rubber fetishism. Similar arguments apply to the current wave of transvestism and pseudo-transvestism. An analysis of certain comic strips and television serials renders such tendencies even more clearly apparent. Both decorative art and the pop show business are showing signs of a trend towards an exchange of roles between the sexes; and ambisexual image valid for both sexes is now emerging.


[The psychopathology of early and chronic psychotic symptoms in young drug-users]. Among the psychotic symptoms in juvenile drug-consumers one can find autonomous, i.e. drug-independent developments, whose connection with the drug-abuse is to be assessed in differing ways. A beginning psychosis can be modified in its actual symptoms by drug-consumption. On the other hand one must consider the manifestation of a latent psychosis or purely symptomatic psychosis, which, in its symptoms, can hardly be distinguished from schizophrenia. Finally drug-induced personality-changes can develop together with secondary psychotic symptoms. Psychotic symptoms are determined and influenced in a varying degree by drugs. Both after short drug-consumption and after a longer drug-anamnesis with polytoxicomanic symptoms psychotic syndromes can be discovered. Even the initial psychotic symptoms can hint at an adverse development and a bad prognosis. Sometimes the drug-experiences conceal the autonomous development of the psychosis, which, as a rule, shows predominantly schizophrenic symptoms. In addition to a quick change of the actual symptoms, acute states of confusion and depressive-suicidal syndromes, flash-back and horror-trip phenomena, closely connected with the psychotic experience, and a schizophrenic colouring of affective psychoses can be found as frequently drug-induced modifications of the psychotic symptoms. Furthermore one finds an increase of symptoms and of the psychotic episodes in the case of psychoses of the schizophrenic variety which have already begun. Grave personality changes with psychotic symptoms after chronic drug-abuse can cause differential-diagnostic difficulties.


[Necrophilia in a 17 year old girl].

[Necrophilia in a 17 year old girl]. Case report of true necrophilia in a seventeen-year-old girl, which is the first description of such a behaviour in a woman. The possible development of the abnormal behaviour is discussed. A complete theory of necrophilia semms to be not yet possible because of the few cases described.


Ultrastructural changes in cartilage after intra-articular administration of osmium tetroxide and the sodium salts of fish oil fatty acids (Varicocid). A clinical and experimental study was carried out on knee joints of rabbits and in humans. In one knee joint of each rabbit 0.3 ml 1% osmic acid or 0.3 ml 5% Varicocid was injected, the remaining uninjected joints serving as controls. The animals were killed after 1 and 24 hours, 15, 45 and 90 days. Study with the electron microscope after osmic acid injection revealed necrosis of the chondrocytes in the superficial layer and upper middle zone. The articulations injected with Varicocid exhibited only slight lesions of the chondrocytes in the upper layer, consisting of dilated rough endoplasmatic reticulum, mitochondria lacking matrix and christae; the electron density of the layer seemed to be diminished. Biopsy of the non-weight-bearing cartilage of the lateral femoral condyle was performed in 4 patients with Rheumatoid Arthritis and arthritis of the knee in the onset stage. Two of these patients received one intra-articular injection of 10 ml 1% osmic acid, 5 ml 2% xylocaine and 50 mg hydrocortisone and the other 2 patients 6 ml 5% Varicocid. Biopsy of the cartilage in the areas adjacent to the site of the first biopsies 1 and 3 1/2 months after treatment with osmic acid and 2 and 3 1/2 months after treatment with Varicocid showed in the first two cases necrosis of the chondrocytes in the superficial layer and upper middle zone of the articular cartilage and depletion of the mucopolysaccharides in the ground substance, revealed by PAS and alcian blue staining. No lesion of the knee joint cartilage was observed in the other two cases. In view of the results obtained, chemical synovectomy with Varicocid can be considered as having received further support.


The effect of non-specifically acting transfer factor component on cellular immunity in juvenile rheumatoid arthritis. A chromatographically purified component of human dialysable transfer factor with a non-specific stimulatory effect on the expression of immune response was used in a therapeutic trial in 8 cases of juvenile rheumatoid arthritis. Enhancement of the delayed type of immune response, measured by skin testing, was seen in all cases, but in vitro reactions to test antigens were unaltered. Clinical improvement was seen in all patients with acute history and in 2 of the 5 chronic cases, but it is not certain whether this was caused by the improved immune reactivity, or whether this reflected the known variable natural history of the disease.