Nature of transformation of hydrocortisone by cells incorporated into polyacrylamide gel. The ability of Mycobacterium globiforme 193 cells immobilized in polyacrylamide gel (Paag) to transform soluble and microcrystalline hydrocortisone was investigated under conditions to periodic aeration. It was found that the specific 3-oxosteroid-delta'-dehydrogenase activity of immobilized cells hardly differs from that of free cells and averages 0.06 mumole/mg cells . min; the quantitative and qualitative composition of the transformation products formed by free and immobilized cells was identical. The linear relation between the accumulation of the reaction product, prednisolone, and the transformation time, the absence of an activating effect of SAA [surface-active agents] on the 3-oxosteroid-delta'-dehydrogenase activity, the correlation between enzymatic activity and viability, and the absence of an increase in activity during repeated transformations indicate that the cytoplasmic membrane of Myc. globiforme is not a significant diffusion barrier for the reaction substrate and product. Maintenance of immobilized cells in a viable state is a necessary condition of the retention of enzymatic activity by these cells. "Activation" of immobilized cells is achieved by incubating the granules in nutrient medium. The cause of the "activation," in our opinion, is the appearance of a new surface and, probably, internal cell population.


[Diagnostic and therapeutic problems in tumors of the bones of the hand]. The diagnosis and treatment of tumors of the skeleton of the hand are reviewed. Benign enchondromas were found to be the most common. Primary osteogenetic sarcoma was rare as was malignant degeneration in initially benign tumors and in the bony manifestations of systemic disease such as neurofibromatosis or hyperparathyroidism. Tumors were more common in phalanges and metacarpals than in the carpus and showed their highest incidence in the 4th decade. Diagnosis was aided by angiography and bone-scanning. Some difficulties were encountered in pathological examination. Treatment involved curettage and cancellous grafting in small tumors, en bloc resection followed by osteosynthetic stabilisation in larger instances and radical ablation followed by chemotherapy in malignancy.


The prevalence of periodontal diseases iin urban Israeli youth (14-18 years of age). The purpose of the present study was to obtain current information regarding periodontal diseases. The study was conducted in Israel among ninth to twelth grade students, 14 to 18 years of age, residing in Jerusalem, Tel Aviv and Ramat Gan. A total of 725 school children were examined. During the examination only periodontal status was checked. Periodontal status was recorded according to Russell's Periodontal Index (PI). The mean PI found was 0.52. The results indicate an increase in the mean PI with age. Significant difference was found in the mean PI values between girls and boys. Girls constantly scored lower mean PI values than boys. No significant differences were found in the mean PI scores when studied according to country of origin.


A temporary-permanent splint.

A temporary-permanent splint. A method of temporary permanent splinting has been presented which enables the clinician to stabilize anterior teeth aesthetically and rigidly without resorting to cast restorations. The method utilizes an acid-etch composite technique with T.M.S. Pins and has shown itself to be a rapid, cosmetic and durable alternative to either the temporary intra-coronal wire ligation or the more permanent gold prosthesis.


Gastro-intestinal haemorrhage associated with leukaemic infiltration of the stomach: A report of 2 cases. Two cases of leukaemic infiltration of the stomach are presented. In both patients the dominant presenting sign was gastro-intestinal bleeding. The clinical, radiological and pathological findings are presented together with a brief review of the literature.


Polyploidy, plants, and electrophoresis. Investigations of polyploidy using electrophoresis are at present severely limited by several areas of difficulty which limit all applications of this technique. The technical problems inherent in electrophoresis of plants, namely extraction of active extracts and maximizing resolution of electrophoretic variants through investigation of gel and especially assay conditions, have never been addressed explicitly. No rationale for initiating work on a new species is available. Analytical approaches to defining the conditions which limit resolution are rare. Gel-to-gel variation is poorly controlled, seldom monitored. The individual nature of electrophoretic investigations limits the comparability of data among labs. In short, "hit-and-miss" approaches predominate, and these limit investigation. Techniques are now available which one can hope will greatly improve the experimental situation.


[Jaw reconstruction with fixation plates]. The use of internal fixation plates in the reconstruction of mandibular continuity following serious injury, or resection of mouth floor tumours, is described. When complicated fractures are involved, the combined employment of osteosynthesis with steel wires and fixation plates is advised. Three illustrative cases from a personal series are presented.


[Anatomo-radiological evaluation of the long term results of surgery of large odontogenic cysts]. Long term surgical results in 47 cases of great size odontogenic cysts are examined with an anatomo-radiological method. The reparative osteogenetic process of these great cysts with mandibular localization are compared with those with maxillary localization, following anatomo radiological and clinical-radiological methods. These results are also examined according to the surgical techniques used.


[Preventive therapy in stomatological and maxillofacial surgery. Clinical considerations on the administration of cephaloridine, using a new technic (short-term prophylaxis)]. The "Short term prophylaxis" technique was used in 100 patients who had undergone Stomatologic surgery and Maxillo-facial surgery for post-operative prophylaxis of surgical infections according to analogous researches conducted in other surgical branches by various authors. The results obtained can be summarized as following: 1) a marked reduction in administered antibiotics (cefaloridina); 2) a marked reduction of post-operative fever; 3) a maintainment of average febrile levels at 37,8 degrees-38 degrees. The above tecnique thus allowed a more rapid mobilization of patients who had undergone surgical intervention, a reduction of the recovery period and the therapeutic costs.


[Use of a new cobetalactamine in the therapy of acute and chronic odontogenic processes]. Treatment of 70 patients with acute and chronic odontogenic processes for 5-35 days (mean 10.9 days) with a new cobetalactamine is reported. Rapid resolution was noted in nosological groups marked by the presence of acute infection. Particular interest is attached to the effect of the drug on chronicisting infections, such as apical granuloma, maxillary osteitis, and radicular cysts, since these forms displayed a high degree of vascular isolation, were often sustained by a mixed flora, and had been previously treated with other antibiotics. Follow-up four weeks after the conclusion of treatment showed a low incidence of recurrences that was in all events lower than in earlier experiments with chemical antibiotics. There were no instances of intolerance or allergy.


[An unusual case of generalized amyloidosis with localizations in the oral cavity]. After a brief examination of the most modern conceptions relating to amyloidosis desease a case of sistemic amyloidosis localized in the oral cavity is presented by the authors. An iconografic series of the lesions affecting the mucous membrane of the lips, checks and tongue is meant to contribute to an easier and immediate finding of analogous cases marked by a primary localization in the oral cavity, thus facilitating an early diagnosis of the sistemic desease.


[Myxomas of the jaws. 10 cases and differential diagnostic evaluations]. Ten cases of myxoma of the jaw bones are presented. After an examination of the anatomical-clinical-radiological aspects and the micro- and macroscopic pathological anatomy, the authors present a histopathological differential diagnosis and in particular demonstrate that a diagnosis of myxoma is based upon its localization and the exclusion of any benign and malignant lesions due to myxoid. Conservative excision is the preferred treatment.


[Death after a dental infection].

[Death after a dental infection]. The pertinent features of life-threatening complications of dental infections have been briefly reviewed with particular emphasis on the alterations of the clinical features of these conditions induced by antibiotic therapy. The clinician who deals with dental infection must exercise a high index of suspicion to consistently abort the development of these complications, especially when treating debilitated patients or individuals with compromised immune functions.


[Use of chlorhexidine in the therapy of some stomatological diseases]. A mouthwash or toothpaste containing chlorhexidine gluconate was used to treat spontaneous or provoked bacterial plaque, primary or postoperative secondary gingivitis, and aphthae in 74 male and female subjects (mean age: 37 yr). As observed by other authors the antiseptic was very effective in the prevention of plaque, the healing or primary gingivitis, and the cicatrisation of surgical wounds. It also accelerated the regression of recurrent aphthae.


Sulcal prominence in young chronic schizophrenic patients: CT scan findings associated with impairment on neuropsychological tests. Four of 17 chronic schizophrenic (or chronic schizoaffective) patients between the ages of 20 and 35, in partial remission, and living in the community were found to have mildly or moderately prominent sulci, as disclosed by computerized tomography (CT scan). These four patients were matched for sex and age with four chronic schizophrenic (or schizoaffective) patients without sulcal prominence. The Halstead-Reitan battery (HRB) of neuropsychological tests, including the Wechsler Adult Intelligence Scale (WAIS), was administered to these eight patients with the examiner blind to results of the CT scan. Each of the four patients with sulcal prominence considerably exceeded an established cutoff score for brain impairment on the HRB, whereas only one of the control schizophrenics performed in the impaired range, and that just beyond the cutoff. The WAIS Verbal IQ, mneasured concurrently, was in the normal range for all subjects and similar for the two groups. These findings suggest that mild or moderate sulcal prominence on CT scans among young chronic schizophrenics is associated with impaired neuropsychological functioning.


[Prosthetic rehabilitation with a force-distribution prosthesis. Clinical and statistical evaluation of the results obtained in 79 oral rehabilitations]. The results obtained with 79 odontoprosthetic rehabilitations by means of removable force distribution prosthesis are reported. Using half-round section wires, this prosthesis distributed masticatory forces axially on the abutment teeth and also distributes them evenly over the edentulous crest, thus achieving a mixed dental and mucous support. Clinical and statistical assessment takes in 79 patients of both sexes aged between 22 and 69 treated over the fifteen year period since 1964. All types of edentulism according to the Kennedy classification were treated. The clinical results were considered, particularly the periodontal situation and the mechanical results, above all friction between retention and function elements of the connecting wires. Clinically, 82,2% of results were positive and 74.6% of the results were mechanically positive also.


An electrophysiologic indication of defective information storage in childhood autism. We used a combined behavioral and electrophysiological technique to test the hypothesis that storage of information is impaired in childhood autism. Endogenous event-related potentials associated with the random deletion of stimuli within a regular train of auditory or visual stimuli were examined in three autistic and three normal children. We found that all subjects were able to detect the stimulus deletions, but cortical potentials associated with stimulus omissions were smaller or absent in the autistic subjects. These results are consistent with dysfunction within the system that includes posterior parietal cortex and its connections with the mesolimbic temporal cortex and hippocampus.


Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients. The peripheral interactions of amphetamine with antipsychotic agents may elucidate some central mechanisms by which these drugs affect the behavioral responses to amphetamine. The authors studied the effects of intravenous amphetamine on plasma levels of norepinephrine (NE), dopamine-beta-hydroxylase (DBH), pulse rate, and blood pressure in schizophrenic patients. Amphetamine increased plasma NE, pulse rate, and blood pressure without significantly changing plasma DBH. DBH activity was similar in drug-free schizophrenic and normal subjects. Neither pimozide nor lithium altered these amphetamine effects nor changed any of the cardiovascular parameters measured in the drug-free subjects. Pimozide and lithium alter behavior and the behavioral effects of amphetamine, but neurotransmitters other than NE may be involved.


Seasonality in biochemical determinations: a source of variance and a clue to the temporal incidence of affective illness. Systematic investigation of seasonal variations revealed unimodal annual rhythms in platelet serotonin uptake and DBH activity, bimodal seasonal rhythms in free and total tryptophan, melatonin, and platelet serotonin, and significant fluctuations of higher frequency in platelet MAO activity and protein. The methodological importance of seasonality is emphasized by the fact that the seasonal changes noted were often greater than differences previously found in the same parameters between depressive patients and controls. Since seasonal rhythms are circadian in origin, impairment of a central 24-hour biological clock could provide a common basis for circadian rhythm disturbances and seasonality in affective disorders.


Analgesia to pain stimuli in schizophrenics and its reversal by naltrexone. Psychophysical pain ratings and somatosensory evoked potentials (EPs) were studied in 17 off-medication patients with schizophrenia and 17 age- and sex-matched normal controls. Five of the 17 schizophrenic patients also participated in a clinical trial of naltrexone. In comparison with normal controls, schizophrenic patients were significantly more insensitive to painful stimulation (based on nonparametric analogues of d'from signal detection analysis) and had significantly smaller somatosensory EPs to painful stimuli. Schizophreniucs treated with naltrexone showed significant increases in EP amplitude at higher stimulus intensities and hyperalgesic effects on pain ratings.


Preliminary validation of a set of content analysis scales applicable to verbal samples for measuring the magnitude of psychological states in children. Scores on 17 psychological dimensions of the Gottschalk-Gleser content analysis scales were obtained from 5-minute speech samples of 37 white children hospitalized on the psychiatric service of a general hospital. These content analysis scores were compared to identical scores obtained from a normative sample of 109 white children. Groups of children were classified by the Group for the Advancement of Psychiatry (GAP) system as having Healthy Responses (N = 2), Personality Disorders (N = 17), Reactive Disorders (N = 9), Psychoneurotic Disorders (N = 7), and Developmental Deviations (N = 2), and by DSM-III as having Parent-Child Problems (N = 2), Conduct Disorders (N = 26), Anxiety Disorders (N = 7), and Special Developmental Disorders (N = 2). By either classification, these groups of children showed salient differences in their scores in certain psychological dimensions from the same types of scores occurring with the normative group. These findings provide initial construct validation of the Gottshalk-Gleser content analysis scales when applied to speech samples obtained for children. Moreover, the profiles of children's psychological characteristics obtained by this method provide, in themselves, an objective descriptive and dynamic classification.


Human EEG response to beta-endorphin.

Human EEG response to beta-endorphin. Beta-endorphin, morphine, and saline were given intravenously to a single schizophrenic subject on separate occasions in a double-blind design. EEG spectral analyses performed on data collected before and after drug injection demonstrated that beta-endorphin and morphine produced similar increases in alpha power within 5 to 15 minutes after injection. This effect could be distinguished from two placebo (saline) injections. These data suggest that intravenous beta-endorphin can produce changes in the central nervous system in humans.


Naloxone fails to affect short-term memory in man. The effects of naloxone on memory were studied in 26 healthy male volunteers. Either placebo, or 10 mg, or 20 mg of naloxone was given iv on separate occasions. Ten minutes after each injection, the subjects listened to 8 lists of words (10 words on each list). Immediate recall, delayed recall, and delayed recognition were not affected by naloxone within 60 minutes of its administration. These results provide no support for the hypothesis that edorphins play a role in the short-term auditory memory in man.


Tricyclic-induced mania and MHPG excretion. In order to evaluate the presumed involvement of altered noradrenergic receptor sensitivity in the switch process from depression into mania, we explored the relationship between pretreatment 3-methoxy-4-hydroxy-phenylglycol (MHPG) and tricyclic-induced mania or hypomania in bipolar depressed patients. Within the group of patients developing mania or hypomania on tricyclics, there was a strong positive correlation between pretreatment 24-hour urinary MHPG and the latency of onset of the episode. This finding is consistent with both the reported differences in MHPG excretion between unipolar and bipolar patients and the postulated noradrenergic involvement in the switch process.


Differences in muscle activity before, during, and after responding in a simple reaction time task: schizophrenics vs. normals. Schizophrenics and normals were presented with a series of simple reaction time (RT) trials. Electromyographic techniques were used to partition RT into peripheral and central components. It was observed that contrary to the previously held assumption of "neuromuscular sameness," schizophrenics displayed a qualitatively different pattern of muscle activity in their motor responding. Differences of the observed sort could account, in part, for differences previously thought to be due solely to central dysfunction.


Repression and reactivation of lithium efflux from erythrocytes. Efflux of lithium from human erythrocytes was studied in patients before, during, and after discontinuation of administration of lithium carbonate. Onset of lithium-induced repression of efflux took approximately 10 days and was significantly shorter in patients who had had lithium therapy previously. Reactivation took a longer period of time--approximately 2 week--and was found to be related to duration of lithium therapy. Theoretical pathways of lithium flow through membranes are discussed.


Magnesium concentrations in blood and cerebrospinal fluid during delirium tremens. Magnesium in plasma, erythrocytes, and cerebrospinal fluid (CSF) was measured immediately after hospital admission in 9 patients with delirium tremens (DT) and 11 patients with impending DT. Blood samples were taken daily during the acute state; a second lumbar puncture was performed when the patient's condition had improved. Plasma magnesium was low in patients with DT during the first days of the acute state and then spontaneously normalized. Normal plasma magnesium was consistently seen among patients with impending DT. Magnesium in erythrocytes and CSF was normal in both diagnostic categories. Patients with a high blood-alcohol concentration (BAC) at admission had a decreasing plasma magnesium, patients with a low BAC had a moderately increasing plasma magnesium, and patients with a BAC at nil had a more marked increase in plasma toms or with their duration. This finding, combined with the normal CSF magnesium and the lack of correlation between plasma and CSF magnesium, indicates that disturbances in magnesium metabolism do not play a role in the etiology or pathogenesis of DT; but it may be that disturbances in magnesium metabolism contribute to the development of alcoholic encephalopathy.


Some kinetic parameters of platelet monoamine oxidase in chronic schizophrenia. The michaelis constants (Vmax and Km) for platelet monoamine oxidase (MAO) with tyramine as substrate are found to be significantly lower in chronic schizophrenic patients than in normal controls. Furthermore, these kinetic parameters for the MAO of paranoid chronic schizophrenics are significantly lower than those for nonparanoid chronic schizophrenics. Paranoid chronic schizophrenia may be a separate biochemical disorder from other chronic schizophrenias.


Platelet monoamine oxidase: studies on the rate of heat inactivation in normal and in paranoid and nonparanoid chronic schizophrenic groups. The heat inactivation curves for platelet monoamine oxidase (MAO) in chronic schizophrenic and normal subjects were virtually identical. There were also no differences found when schizophrenic patients were subgrouped into paranoid and nonparanoid types. However, the MAO from one of the normal subjects showed a substantially greater thermolability than that of any other control or schizophrenic subject.


Unique features associated with age of onset of anorexia nervosa. The relationship between age of onset of anorexia nervosa and a variety of personal characteristics was examined in 105 patients. Age of onset of anorexia nervosa had a bimodal distribution, with peaks at 14 1/2 and 18 years. The patients whose onset of illness occurred at the later age tended to have a greater weight loss during their illness, more "underweight problems" before the onset of illness, less of the typical anorectic behaviors and attitudes, greater body disparagement, more symptoms of depression, and a greater number of previous hospitalizations. These associations suggest that an older age of onset of anorexia nervosa might predict a poor outcome.


Visual evoked potentials as a predictor of reported side effects during a trial of zimelidine vs. placebo in chronic pain patients. Before a double-blind controlled study of zimelidine, a new, rather specific inhibitor of serotonin uptake, in patients with chronic pain, visual evoked potentials (EPs) to stimuli of varying intensities were recorded. During the trial the blood levels of zimelidine and its active metabolite norzimelidine were estimated. Side effects were rated by a physician before and after the trial. No significant difference in frequency of side effects could be found between the zimelidine and the placebo groups. Furthermore, there was no significant relationship between the blood levels of the active drug or its metabolite and the frequency of side effects. Instead, a significant relationship was found in the total group between the frequency of side effects and the tendency to react with an increase in maximum amplitude of the EP when stimulus intensity was increased (i.e., augmenting). The same trend was clear both in the zimelidine group and in the placebo group. Thus the augmenting/reducing response in visual EPs seems to be a predictor of the side effects reported irrespective of the drugs given.


Personality traits in chronic pain patients related to endorphin levels in cerebrospinal fluid. Interindividual differences in endorphin levels may relate to widespread changes in adaptive processes, and endorphin levels may thus be related to personality traits. In 40 patients with chronic pain syndromes of both psychogenic and organic origin, endorphin levels in cerebrospinal fluid (CSF) were determined, and the patients completed Eysenck's Personality Inventory (EPI) and the Cesarek Marke Personality Scheme. Twenty-seven of the patients also completed the Zuckerman Sensation Seeking Scale (SSS). As a comparison group 30 healthy volunteers completed the personality inventories. The chronic pain patients were characterized by guilt feelings, need for order, low need for autonomy, and low tendency toward sensation seeking. Low levels of endorphins in CSF were found in patients with high scores on all the subscales in the SSS and low scores on the neuroticism subscale in the EPI.


Chronic Parkinsonism secondary to intravenous injection of meperidine analogues. Abuse of 4-propyloxy-4-phenyl-N-methylpiperidine, a meperidine congener, produced parkinsonism in a 23-year-old man. Unlike other drug-induced motor disturbances, the syndrome persisted for 18 months and responded to drugs that stimulate dopamine receptors. Biogenic amines and metabolites in the cerebrospinal fluid and microscopic evaluation of the brain at necropsy were consistent with damage to aminergic neurons in the substantia nigra.


Sensation seeking and psychopathology.

Sensation seeking and psychopathology. A sample of 2,115 persons responded to an article in a popular magazine by taking the Sensation Seeking Scale (SSS) and supplying personal information by mail, including data about past treatment, hospitalization, and diagnosis of psychiatric disorders. Subjects falling into certain diagnostic categories were closely matched with controls from the same sample who reported no history, treatment, or diagnosis of disorder. SSS scores were not related to general psychopathology, unipolar depression, schizophrenia, or neurosis, but were found to be elevated in persons reporting a history of manic-depressive or sociopathic spectrum (including alcoholism and drug abuse) disorder.


Sodium-dependent lithium efflux from red cells in affective disorders. Steady state red blood cell/plasma lithium concentration ratios were determined simultaneously with the in vitro sodium-dependent downhill lithium efflux from red cells during maintenance lithium treatment in 22 bipolar depressed patients, 17 unipolar depressed patients, and 28 psychiatric control patients. The values of the sodium-dependent lithium efflux were significantly correlated with the steady-state lithium levels in red blood cells and plasma. A profound difference in sodium-dependent lithium efflux from red cells was found between controls and bipolar patients and to a lesser degree between controls and unipolar patients.


Comparative pharmacokinetics of zimelidine and desipramine in man following acute and chronic administration. Single dose and steady-state pharmacokinetics of zimelidine and desipramine were compared in eight depressed patients who were subjects in a double-blind crossover study. Within the same patient, there was no relationship between the pharmacokinetics of desipramine (pharmacokinetically similar to all other tricyclic antidepressants) and those of zimelidin, a bicyclic antidepressant. The weight-corrected dose of zimelidine gives a reasonable index of the concentration of its active metabolite norzimelidine, which predominates over zimelidine by a ratio of approximately 3 to 1. The variation in steady-state concentration of norzimelidine for a given dose of zimelidine in adults is about twofold and can be reduced by correcting for weight.


Differential effects of basolateral amygdala lesions on behavior, corticosterone, and prolactin responses. The present experiment examines hormone-behavior relationships following manipulation of the amygdala. Affective behavior and levels of corticosterone and prolactin were compared in rats with lesions of the basolateral amygdala and in nonlesioned and sham-operated controls. Animals with lesions of the basolateral amygdala were found to be hyperreactive and to have normal resting levels of corticosterone and prolactin but potentiated corticosterone responses to stress. Normal prolactin stress responses were unaltered by the lesion. The results are discussed in relation to behavioral and endocrine changes seen following other limbic system lesions.


Auditory evoked transient and sustained potentials in the human EEG: I. Effects of expectation of stimuli. The characteristics of auditory evoked transient and sustained potentials were recorded using trains of four-tone stimuli of 1-second duration (interstimulus interval = 1 second) presented once every minute. The subject either attentively expected the stimuli or ignored them while reading. The electroencephalogram was recorded from derivations Cz-Al and Fz-Al. Expectation of the stimuli was associated with increased amplitudes of the transient responses both at the first stimulus of the train and during stimulus repetition. In contrast, the sustained potential at the first stimulus of the train was unchanged or smaller when the subject expected the stimuli. During stimulus repetition, however, the amplitude of the potential was enhanced by expectation of the stimuli. The results support the hypothesis of two sustained potential components and stress the importance of stimulus repetition rate when sustained potentials are studied.


Auditory evoked transient and sustained potentials in the human EEG: II. Effects of small doses of ethanol. The effect of small doses of ethanol (0.4 g/kg) on auditory evoked transient and sustained potentials was studied. Tones of 1-second duration were presented in trains of four stimuli (interstimulus interval = 1 second; intertrain interval = 1 minute). The electroencephalogram was recorded from derivation Cz-Al. Ethanol depressed the transient responses both at the first stimulus of the train and during repeated stimuli. The sustained potentials elicited by the first stimuli of the train were not affected by ethanol, whereas the sustained potentials elicited by repeated stimuli were larger in amplitude under the influence of ethanol than during control experiments. It is suggested that the decrease of the transient responses under the influence of ethanol is mainly due to depression of the reticular formation, whereas the increase of sustained potentials reflects ethanol-induced release of intracortical inhibition.


Target velocity and smooth pursuit eye movements in psychiatric patients. Smooth pursuit tracking performance of psychiatric patients and non-hospitalized normal controls was compared for targets oscillating at 0.45 Hz and 0.31 Hz. Psychiatric inpatients exhibited significantly more velocity arrests than psychiatric outpatients or normals under both conditions. Tracking performance of all groups at 0.31 Hz was improved relative to that at 0.45 Hz, but significant improvement occurred only for outpatients and normals. The role of attentional and stimulus factors in the tracking performance or psychiatric patients is discussed.


Hemispheric dysfunction in schizophrenia: assessment by visual perception tasks. Before and after a double-blind trial of haloperidol vs. mesoridazine, 24 hospitalized schizophrenics performed visual perception tasks designed to assess function of the cerebral hemispheres. Tasks involved identifying as "same" or "different" two images (either letters, digits, or unfamiliar shapes) projected tachistoscopically to the right or left visual field or to both together. Multivariate analysis of variance related response latency and accuracy to task type, hemisphere stimulated, and pre- vs. posttreatment testing. Both before and after treatment, subjects responded most slowly and least accurately to letter-matching. Bilateral presentation of stimuli resulted in faster and more accurate responses, except on shape-matching. Neuroleptic treatment improved speed and accuracy overall, though not under certain task conditions. Results accorded more with an impairment in verbal processing and interhemispheric coordination than with a specific left-hemispheric deficit in schizophrenia.


[The condition of the periodontium in patients with clefts]. 41 patients with total clefts, having an average age of 14.6 years, were examined. In these patients, the bone index was determined by means of the radiographic method of Schei et al. (as modified by Engelberger, Rateitschat and Marthaler). Furthermore, the teeth were tested for mobility, and the gingival retraction and the pocket depth were measured. The degree of gingival inflammation was scored using the PMA index according to Mühlemann and Mazor. The findings from the cleft quadrants were compared to those from the non-cleft quadrants of the upper jaw and to those from the mandibular quadrants.


[Changes after presurgical orthopedic treatment in children with unilateral cleft lip and cleft palate]. The study analyses the changes occurring in the maxillary arches of 30 infants with complete unilateral clefts of the lip and palate following presurgical maxillary orthopaedic treatment. 15 similar cases not receiving such treatment were used as controls together with 30 normal subjects. Photocopies of models of the arches at birth and 4 months were analyzed by computer and the area of palatel tissue measured using stereophotogrammetry. In the presurgical cases, the palatal cleft was significantly narrowed due to the transverse and antero-posterior dimensions of the arches increasing less than in the controls. The narrowing of the cleft was particularly marked in the alveolar region because the presurgical treatment minimised the antero-lateral (outward) rotation of the lesser segment which otherwise would have occurred. Somewhat surprisingly, the study showed that presurgical treatment tended to inhibit growth of palatal tissue and it was concluded therefore that the narrowing of the defect was due mainly to the growth pattern of the maxillary arch being modified by the appliances.


[Incidence of caries and periodontal condition in patients with cleft lip and cleft palate]. The data relative to caries experience, provided dental care, periodontal condition, oral hygiene and pocket depth obtained from 158 patients with cheilognathopalatoschisis were recorded. According to age, the findings were subdivided into three groups: deciduous dentition, mixed dentition and permanent dentition group. The data obtained from the upper jaw were compared to those from the lower jaw. Furthermore, the data relative to the different types of tooth and the region of the cleft were compared to the findings from teeth non-neighbouring the cleft. The results permit to draw conclusions as to noteworthy aspects of the orthodontic and the general dental care of patients with cheilognathopalatoschisis.


[Preoperative orthodontic treatment in children with complete cleft, yes or no?]. The authors investigated the necessity for preoperative orthodontic treatment in cases of unilateral complete clefts. For these groups of patients, they propose a pure surgical therapy instead of the preoperative orthodontic treatment.


[Comparative study on the maxillary symmetry in preoperatively treated children with cleft lip and cleft palate]. Comparative studies on the palatal symmetry in healthy new-born babies and in new-born babies with cheilognathopalatoschisis revealed cleft palates with a high degree of asymmetry. Therefore, it is reasonable to measure the treatment results achieved in cleft patients against the degree of palatal symmetry attained. This evaluation was performed in 30 subjects with unilateral complete cleft and in 20 individuals with bilateral complete cleft.


[Methods of primary repair in cleft lip]. The authors made a longitudinal study on 60 children with subtotal or total cheiloschisis to assess the surgical results achieved by means of the methods of Tennison and Millard. The evaluation was based on metric, morphologic and functional parameters. Normal values were obtained from control groups of children without cleft lip. The results show that both operating techniques are well suited for closing the cleft. The method of Tennison should be used in cases of subtotal cheiloschisis; and that of Millard, in cases of total cheiloschisis. The operating technique of Millard provides a favourable correction of the position of the nose, which permits to dispense with difficult modifications.


[Interactions between oral surgery and orthodontics in the treatment of children with cleft lip and cleft palate]. The oral-surgical and the orthodontic treatment of patients with cleft lip and palate are interdependent. Consequently, they cannot be performed separately. In most cases, a continuous coordinated treatment planning by both specialties, from the first day of life, will permit to obtain optimal treatment results. The ultimate aim of co-ordinated treatment is not only the aesthetic and functional rehabilitation, but also the securing of the age-related growth of the midface.


[Otorhinolaryngological aspects in the rehabilitation of patients with cleft lip and cleft palate]. The author emphasizes the importance of otorhinolaryngology to the result from speech therapy, the faculty of hearing, nasal breathing and the general state of physical and mental health. In this connection, some results from hearing tests and ear-drum examinations performed in cleft patients are presented. With due regard to indication, tonsillectomy and adenotomy exert no negative effects on speech. The causes of impaired nasal breathing must be eliminated for orthodontic reasons. Consequently, a close co-operation between otorhinolaryngology and orthodontics is imperative.


[Evaluation of the limits of orthodontic treatment possibilities in surgically treated patients with clefts by means of teleradiography]. Using indices elaborated by himself for the evaluation of lateral teleradiographs, the author attempted to systematize the very divergent forms of postoperative jaw crippling in cleft patients. By substantiating the characteristics on inhibition in growth of the upper jaw, and by establishing a mandibular macrognathia, it is possible to judge of the limits of an orthodontic treatment.


[Multidisciplinary care of patients with cleft lips and cleft palates in Zürich]. Since about 10 years a coordinated timing of procedures has been used in Zürich for the management of CLP cases. It equally considers the requirements of growth and functional development. Early orthopedic treatment can, however, only be efficient if concomitant primary surgery is adequately timed and performed. The importance of two-stage palatal closure (soft palate 18 months, hard palate after 5 years of age) is emphasized. In contrast to results of former treatment methods, present cleft patients show good arch form and intermaxillary relationship in deciduous and early mixed dentition. The need for orthodontic treatment is considerably reduced. As far as speech development is concerned, the procedure proves to be beneficial as well.


[Possibilities of early orthodontic treatment in patients with cleft lip and cleft palate]. Prior to lip operations upon children with cleft lip and palate, the authors make use of denture-like acrylate plates and external elastic rubber bands. Occurring anomalies are treated already in the deciduous dentition. In this way, the very marked jaw deformity in cleft children may be reduced to a minimum.


Ultrasound in orbital diagnosis.

Ultrasound in orbital diagnosis. Ultrasound is a safe and useful method of detecting, localizing, and differentially diagnosing orbital lesions. Diagnosis using B-scan and C-scan techniques depends on the qualitative recognition of patterns based on the location and shape of a lesion together with the distribution in number and amplitude of echoes arising from within a lesion. In addition, the sound-attenuating properties of a lesion, determined by changes in the appearance of deeper structures, may aid in identification.


Lymphoid pseudotumour of the orbit.

Lymphoid pseudotumour of the orbit. A retrospective study of 55 patients with orbital lesions diagnosed on clinical grounds as cases of inflammatory pseudotumor was carried out to discover the relationship, if any, between the clinical and histological features and the response to treatment. It was found that few clinical parameters had a bearing on the subsequent progress of the lesion but B-scan ultrasonography was useful in identifying the lymphoproliferative mass. In 28 cases wherein histological material was available, the presence of follicles with germinal centres was found to indicate a good prognosis, whereas the presence of blast forms distributed randomly through the lymphoid tissue was associated with an inadequate response to corticosteroid therapy. Eosinophils were slightly more common in the corticosteroid-responsive lesions, but the presence of other leucocyte types was not helpful in determining prognosis.


Role of the radiotherapist in orbital disease. With modern techniques it is usually possible to deliver a high dose of radiation to an orbital tumour without destroying vision. Local cure of lymphoma is possible with no risk of complications. Rhabdomyosarcoma now has a very good prognosis if treated energetically by radiotherapy and chemotherapy. Radiotherapy also has a part to play in the management of lacrimal gland tumours, melanoma, and metastases. A recent series of cases provides evidence that radiotherapy may be the best treatment for some cases of pseudotumour.


Squamous metaplasia or epidermalization of the conjunctiva as an adverse reaction to topical medication. Prolonged topical medication causes epidermalization of the conjunctiva in some patients. Loss of the normal conjunctival goblet cells, direct toxic effects on the corneal epithelium, and disturbance of lid function may combine to produce corneal changes which may be misinterpreted and treated with further potentially toxic compounds. Examples of conjunctival changes caused by miotic and non-miotic antiglaucoma therapy, mydriatics, preservatives, and antiviral compounds are presented.


Prognostic value of the visual evoked response. 29 patients with visual defects have been followed up by serial recording of the visual evoked response (VER). Those patients in whom the VER was initially normal all made a satisfactory visual recovery. In others an initial attenuated response was followed by an improvement in vision and this was accompanied by normalization of the VER. A third group of patients with an initially subnormal VER have remained blind and the VER has shown no improvement.


Symposium on pseudocapsular exfoliation and glaucoma. Fibrillopathia epitheliocapsularis: review of the nature and origin of pseudoexfoliative deposits. Although opinions vary to some extent, the general consensus is that the pseudoexfoliative component is an abnormal basement membrane material with amyloid-like characteristics; this is synthesized at a variety of ocular and extraocular sites. The resultant material is found to accumulate within, and in some instances to replace, the normal basement membranes of the producing cells. Also, some of the material detaches and, through aqueous humour dispersal, becomes deposited on a variety of surfaces throughout the anterior segment of the eye.


Prevalence of fibrillopathia epitheliocapsularis (pseudoexfoliation) and capsular glaucoma. A mass screening of 8,537 persons above the age of 40 years in Bergen revealed fibrillopathia epitheliocapsularis (pseudoexfoliation) in 75 persons (i.e. 0.9%) and an increased prevalence with increasing age. Comparable geriatric groups in Birmingham, Bonn, and Bergen showed a prevalence of fibrillopathy of 4.0, 4.7, and 6.3% respectively. These differences are not statistically significant. The proportion of capsular glaucoma among patients with open angle glaucoma is higher in groups representing more severe cases of glaucoma than in groups of patients with more easily treatable glaucoma.


Pseudoexfoliation, an environmental disease? Pseudoexfoliation (PXF) has been considered to be a genetically-determined degeneration. The geographical variation seen in the distribution of PXF has been thought to support this. Australia Aborigines have been found to have a high prevalence of PXF, which occurs in over 16% of those over the age of 60 years. A series of 350 Aborigines was examined in detail to study the possible association of a number of personal and environmental factors with the presence of PXF. The condition occurred more commonly in older age groups, and it was three times more common in males than in females. A strong occupational association was also found; men who had worked as stockmen had a significantly higher rate of PXF than other groups. PXF occurred more commonly at lower latitudes and was seen more frequently with higher levels of global radiation. It is postulated that PXF may, in fact, be an environmental disorder caused by solar radiation. Possible pathogenetic mechanisms are discussed.


Relationship of intraocular pressure and fibrillopathia epitheliocapsularis. The average intraocular pressure is higher in eyes with than in eyes without fibrillopathia epitheliocapsularis (pseudo-exfoliation). Open angle glaucoma was diagnosed in 22.7% of persons with fibrillopathy, compared to 1.2% in persons without fibrillopathy. The increase in intraocular pressure and the development of glaucoma seem in most cases to accompany or closely follow the development of fibrillopathy.


The medical management of enteritis necroticans (pigbel). Pigbel is the commonest cause of death in children over 12 months of age at Goroka Hospital. The clinical features are described. The medical management of pigbel includes intravenous fluids, nasogastric suction, penicillin and chloramphenicol. The development of dehydration, anaemia, hyponatraemia, hypokalaemia and hypoalbuminaemia must be prevented. In severe pigbel prolonged starvation may result in malnutrition that impairs wound healing and increases mortality. Intravenous feeding is therefore desirable in some cases.


Mortality from pig-bel (enteritis necroticans) in children in Tari 1971 to 1976. Pig-Bel makes a major contribution to mortality in Tari despite the absence of cyclical pig feasts in this area and despite the fact that most of the population eat meat at least once per week. Over one half of the deaths due to Pig-Bel occur after hospital treatment. The condition is endemic. There is no indication that its incidence is decreasing with increasing sophistication and socio-economic development.


Comparative circulating serum levels of mepivacaine with levo-nordefrin and lidocaine with epinephrien. Expected blood levels of common local anesthetics have been reported for numerous types of injections. Comparative levels of mepivacaine and lidocaine after dental injection have been only partially evaluated. A study was designed to compare the circulating serum level of 36 mgs. of mepivacaine with 1:20,000 levonordefrin (M) and 36 mgs. of lidocaine with 1:100,000 epinephrine (L) in 1.8 cc dental cartridges after standardized's bilateral maxillary infiltrations. Each of five subjects received 1.8 cc of (L) to the left maxillary second bicuspid and 1.8 cc of (M) to the right maxillary second bicuspid at a rate of one cc per minute. The serum was sampled before the injections and at 5, 15, 30, 60, 90, 120 and 240 minute intervals after the injections and analyzed by gas liquid chromatography. The results indicated that the serum level of (M) peaked at 30 minutes, 0.37 μg/ml of serum and (L) had peaks at 15 and 30 minutes, 0.22 μg/ml of serum. This difference was statistically significant, (p <.01) at all times sampled with (M) always resulting in a higher serum level. Serum levels persisted throughout the four hour test period.


Avoiding patient injury during general anesthesia. Attention to detail when preparing a dental patient for rehabilitation utilizing general anesthesia will prevent a variety of positional and traumatic injuries. The dentist and anesthesiologist must anticipate potential hazards to the unconscious patient.


[Root canal filling materials (electron scanning microscope comparison of root canal adaptation to 3 endodontic filling products)]. The main characteristics required of a good endodontic fillingsmaterial are its perfectly hermetic sealing of the root canal, the eventual secondary canals, and the dentine canals, against bacteria. 48 root canals, sealed respectively with A H 26, Endomethazone and N 2, have been checked by means of the Scanning Electron Microscope in order to discover to what extent these products conform to the qualifications mentioned. 842 photographs have been taken. The results of the investigation are discussed judging from some photographs chosen at random.


Strongyloides species infestation in young infants of papu, New Guinea: association with generalized oedema. Clinical and laboratory details of thirteen infants with "Swollen Belly Sickness" who has abdominal distension, respiratory distress, generalised oedema, and variable disturbance of gastrointestinal function were analysed. The intimate connection between the syndrome and infection with Strongyloides species closely resembling Strongyloides fulleborni - is discussed, and a standard treatment using thiabendazole, plasma transfusion and antibiotics, is proposed.


Myasthenia gravis in a Papua New Guinean. A case of myasthenia gravis in a Papua New Guinean is documented. It is the first time that this disorder has been described in this country. The Clinical features, laboratory diagnosis and management are discussed.


Gilles de la Tourette syndrome in Oriental children. Seventy-four cases of tic syndromes were classified into four groups: chronic multiple tics, subacute multiple tics, chronic simple tics and transient simple tics, and 37 cases of chronic multiple tics (Tourette syndrome) were investigated. Clinical evaluation suggested that a transition existed between the four groups. Posture abnormalities were found in 27% of Tourette syndrome and a relation to dystonia was implied. Clinical evaluation and studies of catecholamine blockers' effectiveness suggested the validity of subtyping Tourette syndrome into four groups whose topographical or biochemical abnormalities differ. It was argued that the neurochemical basis of Tourette syndrome might lie in a multiplicity of biochemical abnormalities including disturbances of dopaminergic and noradrenergic pathways.


A comparison of substance abuse profiles among problem drinkers, problem smokers, and overeaters. Substance abuse profiles were compared among alcoholics, problem smokers, and overeaters. Fifteen scales were investigated under the rubrics of Motivation, Style (Craving, Loss of Control, and Drug Use) and Effects (Beneficial and Harmful). While all three samples were similar on the Motivation scales, Smokers differed substantially from Alcoholics and Overeaters on the Style scales and in terms of Emotional effects. Smoker were more similar to Alcoholics on perceived beneficial effects, and Alcoholics reported more severe harmful effects. Implications of the results for substance dependency theories and for treatment models were discussed.


Studies of the template preference and other characteristics of the DNA polymerases of leukemic guinea pig lymphoblasts. A single peak of DNA polymerase activity was detectable by phosphocellulose chromatography of leukemic guinea pig lymphoblast whole cell extracts. The inability to detect multiple peaks of activity as described with other cell types is shown to be due to the insolubility of a large proportion of the DNA polymerase activity under the extraction condition used. Multiple forms of DNA polymerase with different template specificities were recognized in extracts of the subcellular fractions of these cells after chromatography on phosphocellulose and DEAE cellulose. On Sephadex G-200 gel filtration these enzymes had apparent molecular weights in excess of 140,000 daltons. No RNA polymerase (reverse transcriptase) was detected in any subcellular fraction despite the presence of oncornavirus like particles in these cells.


Development of vision in infant primates. A systematic programme of research on the development of spatial vision (acuity and contrast-sensitivity functions or CSFs) in human and macaque monkey infants (Macaca nemestrina) is described. A forced-choice preferential looking technique has been used to follow the development of acuity in both species. Acuity development is similar across the two species, with the infant monkeys progressing about four times faster than the human infants. Operant conditioning has been used to trace the development of CSFs in monkey infants. Changes in the shape of the CSF are shown for at least 20 postnatal weeks in the macaque infants. Strabismic and meridional amblyopias have also been mimicked in infant monkeys, and the time course of development of strabismic amblyopia in a monkey is described. It is argued that closely parallel behavioural studies, carried out on both species, are important in establishing the monkey as a model for human visual development.


Is amblyopia a peripheral defect?

Is amblyopia a peripheral defect? A class of retinal ganglion cells, the 'sustained' or 'X' cells in the area centralis of the retina, provides the physiological basis of high visual acuity. Our hypothesis, that amblyopia is a functional loss of X-cells due to inappropriate stimulation of the fovea by habitually blurred images during the critical period of development, has been supported by experiments on kittens reared with various types of surgically produced squint or with penalization. Amblyopia was associated with a loss of visual acuity of X-cells in the area centralis of the squinting eyes which had lost the ability to fix or of the penalized eyes, i.e. amblyopia occurred in the eyes which received habitually blurred images during the critical period of development. Thus amblyopia has a peripheral (retinal) cause. Regardless of whether or not the eye was amblyopic, a loss of binocularly driven cells in the visual cortex was a common feature in all uniocularly treated cases. When one eye was amblyopic the cortical cells tended to favour the non-amblyopic eye and the number of cells driven by the amblyopic eye was reduced. These central effects may play a role in suppressing unwanted images from the amblyopic eye while the fixing eye is in use. But the central effects do not cause amblyopia.


Foveal cone electroretinograms in strabismic amblyopia: comparison with juvenile macular degeneration, macular scars, and optic atrophy. A hand-held stimulator-ophthalmoscope was used to elicit foveal cone electroretinograms (ERGs) from fifteen patients with strabismic amblyopia. The ERGs were in response to a 4 degrees stimulus visualized on the fundus and centred on the fovea throughout testing. Foveal cone ERGs from amblyopic eyes were normal in amplitude and normal in b-wave implicit time. Interocular differences in ERGs in patients with amblyopia were no greater than those in normal subjects. Patients with comparable visual acuity loss due to macular scars or juvenile hereditary macular degeneration had abnormal foveal cone ERGs, while patients with optic atrophy had normal responses. These findings support the idea that the defect in strabismic amblyopia does not involve a functional abnormality in the fovea distal to the ganglion cell layer.


Functional development of geniculocortical pathways in normal and amblyopic vision. The geniculocortical pathways of many mammals, including primates, are largely comprised of two neuron types. These are known as X and Y cells. Their functional significance in unclear, but the following highly speculative hypothesis is suggested. Y cells, because of their broad sensitivity to the crucial lower spatial frequencies as well as to the higher ones, are involved in a basic analysis of form vision. X cells, because of their fairly selective sensitivity to higher spatial frequencies, add to this certain details (i.e. enhanced acuity, etc.). If an animal develops with ametropia, Y cells should be adequately stimulated and as the lower spatial frequencies remain undistorted many Y cells would develop and reasonable form vision with milk amblyopia would result. Only X cells would be greatly affected by such an environment. However, if the animal develops with cataracts or is reared in an environment which abolishes all spatial frequencies, then neither X nor Y cells will develop. This would result in poor form vision and a deep amblyopia. Many of these phenomena have been observed in experimental studies of cats. The present relevance for clinical problems of this suggested functional dichotomy for X and Y cells is at best tenuous, and it is offered merely as a working hypothesis for future studies.


Concomitant strabismus and cortical eye dominance in young rhesus monkeys. Optical dissociation of the visual images produces a loss of binocular cells at the striate cortex. Young monkeys wearing base-in prisms lose 50 per cent of their cortical binocular cells within 30 days. Exposure to visually redundant stimulation inside a striped cylinder while wearing the dissociating prisms does not prevent the loss of binocular cells. Once lost, a subsequent period of normal binocular viewing experience up to 3 months in duration does not result in significant recovery of binocular cells.


Altered visual experience reduces cortical binocularity in strabismic kittens. We have studied the relative importance of visual and nonvisual signals to striate neurons in causing the loss of cortical binocularity that occurs when young kittens are subjected to brief episodes of stabismus. In kittens kept in a normally illuminated colony, the reduction in binocularity was the same whether the strabismic was induced optically or surgically. When surgically strabismic kittens were kept in total darkness, cortical binocularity was unchanged. We conclude that anomalous visual input is both necessary and sufficient to cause loss of binocularity in strabismic kittens and that nonvisual (proprioceptive) input from the orbit has no part in producing this effect.


Effects of brief uniocular 'patching' on kitten visual cortex. Studies of the striate cortex of the kitten are reviewed with reference to the effects of very brief periods of uniocular occlusion. It is shown that changes occur in binocular connections within 4 hours after the vision of an eye is blocked. Effects are also found if the occlusion is instituted while an animal is anaesthetized but not if it is paralysed in addition. If 4-hour unilateral 'patching' sessions are given daily, a cumulative uniocular deprivation effect is found if the animals are kept in darkness between the patching sessions. However, the visual cortex is nearly normal if the kittens are allowed binocular vision between patching periods.


Confusion, diplopia, and suppression.

Confusion, diplopia, and suppression. Consideration of the clinical features and animal experimental models suggests that inhibition/suppression is not involved in anisometropic amblyopia. The role of suppression in anomalous correspondence needs further elucidation. Sensory testing in Duane's syndrome, where both BSV and suppression can be highly developed, confirms that diplopia may arise spontaneously at greater ages than previously suspected. The clinical time course of development of strabismic suppression is similar to that of the sensitive period during which binocularity can be established. Blakemore (1978) suggests that it may be more useful to think of a period of heightened sensitivity which tails off gradually. This concept would similarly apply to the time during which suppression may be established which does not have a sharp cut-off at 7 years of age.


Contrast sensitivity assessment of functional amblyopia in humans. Contrast threshold measurements have extended our perspective of human amblyopia by focusing our attention on the perception of objects larger than the resolution limit. This approach has shown that there are two categories of spatial loss in amblyopia, that anisometropic and strabismic amblyopia have a different neural basis, and that suprathreshold anomalies can occur independent of threshold defects.


Abnormal ocular movements in amblyopia.

Abnormal ocular movements in amblyopia. The visual afferent pathways affect the oculogyric centres in two ways: (1) By maintaining the oculomotor tonus; (2) By inducing optically elicited movements. In organic amblyopia the diminution of central visual acuity is not sufficient to impair the oculomotor reflexes which usually remain unchanged until the vision becomes very poor. Howver, abnormal movements are typically observed in the inhibition of strabismic amblyopia. Sensorimotor difficulties are observed in both version and vergence movements. Abnormal version patterns have two main effects: suppression of optokinetic nystagmus and kinetic anarchy of pursuit and saccadic movements. Vergences are found to be much more brittle and vulnerable to amblyopia than versions, and amblyopia is often accompanied by anomalies of fusional, accommodative, and fast vergence movements.


Effect of uniocular occlusion on selected visual functions. Uniocular occlusion (dark patching) of adults for a period of days produces marked reduction in the directional sensitivity of the eye (Stiles-Crawford effect). The effect reaches a maximum 3 to 5 days after the onset of patching. Recovery occurs in a comparable period. The second eye is not affected, and a simple light diffuser fails to produce the same effect. Coupled with alteration in directional sensitivity are an overall increase in sensitivity and modest resolution and perceived colour changes. These findings, with other research, suggest that directional sensitivity is at least partially mediated by light and that orientation of photoreceptors is an active process.


Some functional abnormalities in amblyopia. In discussing the relationship between anomalous retinal correspondence and amblyopia, it is suggested that amblyopia may be due not only to suppression and/or non-use of the deviated eye, but also to a mis-use of this eye. The interaction of the 'focal' and 'ambient' systems in amblyopia and the relationship of the 'ambient' system to the interocular transfer of the motion after-effect are discussed. This effect has been found to be of no clinical significance in predicting the presence or absence of binocular cooperation. It is concluded that in cases of amblyopia there is either no disturbance in the 'ambient' system or an adaptation of the latter to the pathological condition.


Effect of occlusion on the visual evoked response in amblyopia. Average normal values for the VER were obtained in children aged 4 to 11 years. There are slight but significant differences between the values obtained and those found in adults (an increase in the time to peak of P1). In amblyopic eyes the time to peak is increased, and the amplitude reduced, roughly in proportion to the loss of visual acuity and binocularity. The VER is normal in the better eyes of children who have never been treated by occlusion therapy. Occlusion increases the time to peak of the VER, both in serial studies on individuals, and in lateral population studies, so that the response of the better eye is delayed beyond that of the amblyopic eye. After the end of occlusion, the VER change usually returns to normal. In a subgroup of patients with prolonged occlusion, the changes had not completely reversed one year later. In children in whom occlusion therapy had improved visual acuity, the VER returned towards normal.


Critical period for deprivation amblyopia in children. The critical period in which human visual acuity may be lost after visual deprivation can be deduced by studying children with amblyopia which follows uncomplicated unilateral cataract and the subsequent aphakic blur. The visual acuity at the first contact lens fitting increases linearly on a log scale as a function of the age at onset between 3 and 10 years. Correction before 4 months of age produces less visual loss but we cannot specify the function within this period. If the eye is deprived between 6 and 30 months of age finger counting is the best visual acuity achieved. Deprivation commencing between the ages of 3 and 10 years differs only in that vision reduces at a slower rate and is more likely to respond to total full-time occlusion. Similarly, some unilateral high myopes responded well and three unilateral aphakes who are blind in the other eye slowly achieved good vision. Part-time occlusion and Cam treatment were seldom effective. Children appear to have a critical period which continues for longer than expected from animal models.


Reversal of amblyopia in lambs.

Reversal of amblyopia in lambs. We have tried to reverse the effects of shutting one eye in lambs firstly by the use of the CAM stimulator for one hour and secondly by the administration of 4-aminopyridine. Of these 4-aminopyridine produces rather greater recovery than the CAM stimulator, provided the eye has not been closed for more than 15 to 20 days. After this time neither method produces any measurable improvement under our conditions.


The sensitive period.

The sensitive period. A sensitive period exists in humans and experimental animals during which certain visual functions are modifiable by decreased or abnormal visual stimulation. Experiments in monkeys have shown that, at the beginning of this sensitive period, the manifestations of the visual deprivation syndrome develop more rapidly at the cortical than at the geniculate level. Moreover, a shift of cortical dominance as the result of reverse suturing may occur while the geniculate nucleus still reflects the effects of the original deprivation experiment. At the end of the sensitive period the behavioural, electrophysiological, and histological aspects of the visual deprivation syndrome become less predictable. Cortical physiology remains sensitive to abnormal visual input beyond the first 3 months of life. Clinical examples and animal experiments also suggest that the reversal of the effects of visual deprivation may occur long after maturation of the visual system is completed. These findings support the view that abnormal visual stimulation during visual infancy causes a functional reorganization rather than an arrest of development of anatomical retinocortical connections.


Observations in patients with occlusion amblyopia: results of treatment. Further observation was made of 100 cases of occlusion amblyopia (form vision deprivation amblyopia) in order to study the symptomatology and the results of treatment by intensive occlusion of the sound eye. The occlusion was classified into three categories: (1) Short-term total occlusion after entropion or other minor lid surgery, (2) Long-term total occlusion lasting more than 2 weeks as a consequence of unilateral congenital or traumatic cataract, (3) Long-term incomplete occlusion as in the case of a small punctate posterior pole cataract or a linear scar of the corneal endothelium. Ocular deviations, fixation pattern, and retinal correspondence were examined. The visual evoked response (VER) was studied with reference to the recovery of visual acuity after treatment. Th occurrence of amblyopia and the recovery of visual acuity were analysed in relation to the age at the time of occlusion and the age at the time of treatment in order to clarify the critical or sensitive period in the development of visual system in humans.


Current state of therapy for amblyopia.

Current state of therapy for amblyopia. The effectiveness of minimal occlusion therapy and the CAM vision stimulator are discussed as well as optical correction of neonatal aphakia. Results of several early studies and work in progress are given.


[Significance of HLA antigen system investigation in children with malignant lymphoreticular diseases]. These last few years investigations of the HLA system antigens in children with malignant lymphoreticular diseases have been considered as highly significant. The correlation between the frequency of the HLA system antigens and malignant diseases was studied in order to assess the influence of the immunoregulating and other HLA system genes on inclination toward these diseases, their etiology and epidemiology. The study included 50 children with various forms of lymphoreticular malignant neoplasms treated at the Children's University Hospital in Belgrade.


The development of a method of assessing swelling following third molar surgery. A method of measuring post-operative facial swelling following third molar surgery should satisfy the following criteria. Firstly, the accuracy should be assessed, secondly the measurement should be in volume units, and thirdly the method should be both practical and ethical in the clinical situation and not limited by static apparatus. No published method satisfies all of these criteria. In an attempt to develop a satisfactory method, direct physical measurements using a face bow, ultrasound and portable stereophotogrammetry were investigated. None of these three methods was limited by static apparatus. Portable stereophotogrammetry could not be used because of variations in posing for which a correction could not be applied. Repeated measurements on non-operated subjects showed that the face bow was more accurate than the ultrasound method at a single measurement site. Therefore, the face bow method was developed to give volume measurements in cubic centrimetres by using nine measurement sites at the intersections of a square grid located over the swelling. The mean difference between two readings taken on separate occasions on non-operated subjects was -0.94 cc (s.d. +/- 1.90). The mean swelling measured at twenty third molar operation sites was 23.19 cc. It is concluded that this face bow method satisfies the criteria laid down.


Chondrosarcoma of the jaws in Ibadan, Nigeria--a report of four cases. Four cases of chondrosarcoma of the jaws seen in our clinics within a period of 15 years are described. In all, the lesions were initially benign-looking making early diagnosis difficult. The histogenesis of chondrosarcoma of the jaws is briefly discussed. In our environment, the prognosis of this disease is very poor.


Pattern of oral cancer in a Nigerian population. The pattern of oral cancer in a Nigerian population is described. Unlike the benign tumours of the jaws, this disease is relatively rare. It is, however, invariably lethal, mostly as a result of late presentation by the patients. At the present time, no aetiological factor can be identified amongst the population.


Gorlin's syndrome and the heart.

Gorlin's syndrome and the heart. Three further cases of the Multiple Basal Cell Naevi Syndrome are added to the literature. One case developed a neonatal left ventricular fibroma, subsequently successfully excised. An association between the syndrome and cardiac tumours has not been documented before, and the relative frequencies of the two conditions are discussed. Biochemical, radiological and chromosomal studies are evaluated and the rate of growth of odontogenic keratocysts discussed.


Multiple basal cell naevi syndrome: management of the young patient. The principal features of the Multiple Basal Cell Naevi Syndrome are reviewed and the case of a seven-year-old child is described. The diagnosis and the management of young patients with this syndrome are discussed.


Felty's syndrome.

Felty's syndrome. An unusual case is presented in which a patient complained of oral ulceration and soreness of the mouth and throat. The results of clinical and laboratory investigations are reported and it was concluded that these oral symptoms were associated with Felty's Syndrome. After treatment of oral infection and a dental clearance the patient was virtually symptom-free for five months. The patient had a relapse and was admitted to hospital for treatment of overwhelming infection. Splenectomy was performed without sustained benefit and the patient died six weeks later.


Odontoma in the subcondylar region.

Odontoma in the subcondylar region. An instance of a compound odontoma in the condylar process in a 24-year-old female is described. Location of odontomas in the coronoid or condylar processes were not reported. A hypothesis of migration of the third molar bud into the condylar region, an interfering local factor such as trauma or infection are suggested as aetiologic factors to the tumour in this case. Pre-operative radiographic localisation of the mass, are essential for treatment planning. An intra-oral approach was the treatment of choice.


Intractable facial pain.

Intractable facial pain. Case histories of 225 patients with intractable pain attending the Pain Clinic of a large metropolitan teaching hospital were retrospectively analysed. The 29 cases of intractable facial pain were investigated to determine if there were any clinical or historical factors which might indicate intractability and thus speed diagnosis of such cases in future. Significant factors were age, duration of pain, number of surgical interventions and psychiatric factors. Patients with intractable facial pain are more likely to be over 40 years of age, to have pain of long duration, to have had one or more operations, and to require psychiatric assistance than patients with non-intractable facial pain. Temporomandibular joint dysfunction pain and atypical facial pain merged in the intractable state and differ from intractable neuralgias with respect to sex ratio and psychiatric assistance. The incidence of intractable facial pain in South Australia was eight cases per million population per year. Compared to those with intractable pain at other body sites, patients with intractable facial pain have unilateral pain, do not suffer major impairment to their daily lives and are not concerned with monetary compensation. Patients with intractable pain are more likely to show a pattern of organic preoccupation, non-acceptance of reassurance and disease conviction. These findings, together with some current psychiatric aspects of intractable pain, including the concept of illness behaviour, are discussed. It is suggested that early psychiatric assessment will improve management but it is realised that although it is not possible to apply some of the factors studied to each patient, the findings may alert the clinician to potential intractability.


A modified pre-auricular approach to the temporomandibular joint and malar arch. In an attempt to improve visibility and safety in the surgical approach to the malar arch and jaw joint, anatomical dissections of 56 facial halves were undertaken. Observations are made on the relationship of the facial nerve bifurcation and its temporal branch to bony landmarks. Attention is drawn to the dangerous area of fusion of the superficial fascia, the superficial layer of temporal fascia and the periosteum of the malar arch. The safety of approaching the malar arch through the pocket formed by the splitting of the lower part of the temporal fascia is emphasised. Minor modifications to the established pre-auricular approach were made and applied successfully to six sides in five patients.


Malignant degeneration in fibrous dysplasia (presentation of 6 cases and review of the literature). Malignant degeneration of fibrous dysplasia is rare. It occurs with similar frequency at all ages and in both sexes. It is more frequent in cases of polyostotic than in monostotic fibrous dysplasia. In cases of fibrous dysplasia that do show malignant degeneration it is common to find that a high level of alkaline phosphatase persists in the serum, even in adults. Previous radiotherapeutic treatment appears to me a predisposing factor. Osteosarcoma is the most frequent neoplasm, followed at some distance by fibrosarcoma and chondrosarcoma. The tumour is most often localised in the femur; it is not unusual to find it in the tibia, maxilla and mandible. The treatment and prognosis are the same as those of the involved malignant neoplasm.


[Karyotype studies in cases of hereditary hypodontia]. The Authors examined 22 families (including 67 individuals) in whose components one or more teeth were found to be congenitally missing. The morphological characteristics of the chromosomes were analyzed with the technique of Moorhead to observe any aberration in shape, size and pattern. With such method, no alteration of the karyotype was shown in case of oligodontia.


[Mandibular surgical prosthesis].

[Mandibular surgical prosthesis]. The need for prosthesis in patients presenting losses of mandibular substance has been examined, with a subdivision of prostheses into: containment, immediate modelling and reconstructive. Technical difficulties involved in their application are described.


[Oral cavity angioma treatment by cryotherapy]. Localisations, evolutions and complications of oral cavity hemangiomas are discussed in the first part of the work. The Authors enumerate the principal clinical uses of cryosurgery showing its utility in hemangiomas therapy. The Authors report about principal cryo-units, their utilisation and working, examining literature on the argument. Description of five cases of hemangiomas treated by cryosurgery complete the work.


[Cryotherapy of precancerous lesions of the oral cavity]. After a short account of principal precancerous oral lesions the Authors refer about cryosurgery principles and its effects on tissues. After an excursion on the literature about the problem, the Authors refer their experiences on seven cases of oral dyskeratosis treated by cryosurgery.


[The child and his dentist].

[The child and his dentist]. The complex symbology connected with dental pathology and the significance for the patient of his meeting with the professional figure of the dentist are considered. The results of an experiment in which a dentist, psychologist and neuropsychiatrist cooperated in order to throw light on the different psychological implications in the two basic periods of development age, pre-school and primary school, are reported. In both cases, examined on the basis of a standard questionnaire administered by the dentist, it emerged that an approach directed at affective and emotive components has the effect of minimizing the child-dentist relationship and thus aiding the dentist's work.


[Fluoroprophylaxis of odontodystrophy in radiotherapy of the cervicofacial area]. We have discussed the technique of prophilaxis of dental diseases in patients subjected to radiotherapy of the cervical-facial region by means of gel fluorinated carring cradles. We have also discussed the results obtained from 140 patients, 102 of whom were treated for over 2 years.


[General complications of local anesthesia in dentistry: prevention and therapy]. The general complications of local anaesthesia in odontostomatology are reviewed and pathogenesis and symptomatology described. Mention is then made of prevention and treatment. Conclusions refer observation in more than 150,000 cases of local anaesthesia, a line of conduct being suggested to prevent complications, from the simplest to the most complex, and consequently medico-legal responsibilities for the specialist.


[Translocation t(8;14) in acute lymphoblastic leukaemia, Burkitt type (author's transl)]. Two cases of infantile acute lymphoblastic leukaemia, Burkitt type, are reported. The cytogenetic study revealed a translocation t(8;14) similar to that of Burkitt's lymphoma. This chromosomal rearrangement is considered as a further argument which favours uniqueness of the two diseases.


[Diagnostic cytochemistry of acute leukemias (author's transl)]. We have described the principal haematological features of 35 cases of acute leukemias, showing the usefulness of cytochemical reactions for the purpose of a right diagnosis and prognosis. The PAS, Sudan Black B and Peroxidase reactions have been very important in the differential diagnosis between lymphoblastic and myeloblastic acute leukemias. The specific and non specific esterases reactions have been useful in the monocytic leukemias diagnosis.


[Genetic markers and disease susceptibility (author's transl)]. The HLA system includes several genes and each of them is polymorphic. Several associations between some HLA alleles and the susceptibility to various diseases are already described. Three kinds of associations are reported: [1] a constant association between an HLA allele and a disease whatever the tested population, [2] an association between the HLA allele and a disease varying according to the tested populations, [3] an association probably due to a mutation of metabolic gene closely linked to HLA. These three kinds of associations probably correspond to three different mechanisms.


[Geographical pathology and genetic markers: detection of associations (author's transl)]. The study of potential associations between genetic markers and various diseases is an important approach in epidemiology. With such studies it is possible to reveal an hereditary component for multifactorial diseases. There are three kinds of analyses: --comparisons of the frequency of the marker in patients and in a control group; --investigations of genetic markers in families with high incidence of disease; --studies of geographical clines between the incidence of the disease and the marker frequency. The interpretation of such geographical associations is difficult. These associations can be the reflect of the migration of susceptibility genes with genetic markers. The HLA system is the better for this kind of approach.


1913 men study - a longitudinal study of the development of stroke in a population. Risk factors for the development of stroke was studied in a prospective long-term investigation of 855 male in a random population sampled of the same age. After 13 years of follow-up 25 participants had suffered from stroke, which gives an incidence of 19/10,000 annually. At the 1963 year investigation several parametras were studied. The stroke-prone person had higher values of systolic and diastolic blood pressure and had a significant greater total heart volume. Blood parametras as the fasting of serum cholesterole, triglyceride and erytrocyte sedimentation rate were significantly elevated in those who developed stroke. They also tended to consume more coffee and showed a higher tobacco consumption. By applying the multiple regression model it was disclosed that the most predective risk-variables were diastolic blood pressure, erytrocyte sedimentation rate and smoking habits.


Epilepsy as a sequel to cerebrovascular accident. In 1973 345 patients were admitted to Turku City Hospital because of cerebrovascular accident, 21 of them having epilepsy as a sequel after an earlier stroke or developing epileptic seizures during an observation period of 4 years. In the same year 27 patients were admitted because of epilepsy, 11 of them showing onset of seizures after an earlier stroke. Thus 32 patients, or 9,0 per cent of 356 cases with CVD proved to have epilepsy. The incidence of epilepsy did not depend on the nature of the vascular lesion. In three quarters of the cases the onset occurred within two years after the initial stroke. Most patients had generalized seizures, quite a few only convulsions with focal origin or psychomotor attacks. EEGs showed features of epileptic nature in half of the cases, although mostly slight. The importance of diagnosing epilepsy after a cerebrovascular accident is emphasized because recurrences of seizures can be successfully prevented with anticonvulsant therapy. Deepening of the paralytic signs after seizure is often misdiagnosed as a relapse of the stroke itself.


Iron deficiency in the elderly population in Finland. In connection with a large multiphasic screening programme carried out in Finland the prevalence rate of anaemia and iron deficiency were studied. Hb was under 130 g/l in 7.9 per cent of the men aged 65 years or over and under 120 g/l in 3.8 per cent of the women in the same age range. Transferrin saturation was under 15 per cent in 6.4 per cent of the men and in 7.7 per cent of the women. Iron deficiency was especially common in the rural population. A dietary study showed that iron deficient persons consumed less meat products and more liquid milk products than the others. The dietary factors are significant in the etiology of iron deficiency.


Training of spatial orientation with a senile demented patient. An experimental case study. An 82 year old man, with the diagnosis senile dementia, was trained to find his own way to objects of importance on the ward (bed - toilet, dinner table - bed, dayroom - dinner table). The ward distances were divided into smaller units. A single case experimental design was used. During baseline the patient was given the opportunity to walk the distance. As long as he succeeded in finding the final destination, the distance was gradually extended one unit at a time. After one week each unit of the first distance was marked with a distinctive symbol and instructions were provided on their meaning. The two other distances served as control distances under baseline condition. One week later the second distance was also included in the intervention, while the third remained at baseline. Finally all distances were included in the intervention. There was a significant improvement in two of the three distances. This improvement was, however, only temporary.


Work capacity in women in relation to age as judged from a maximal work performance test. Work performance test could be carried out on a population sample of women aged 38-60 years without complications. The work capacity decreased with increasing age and at the same time the maximal heart rate during work decreased with increasing age. Blood pressure increased with age and these differences between the various ages were about the same as at rest. Respiratory frequency and perceived exertion on maximal work were similar in the ages studied. ECG changes were common and were found to be as common as in men who had been studied with the same technique and in the same ages. As ECG changes were very common and as myocardial infraction is very seldom in women of these ages, ECG changes during and after work did not seem to be a good discriminator of women subjected to myocardial infraction.


Long term study of hypnotic medication in geriatric patients. A study of dixyrazine, nitrazepam and amylobarbitone. The hypnotic effect of dixyrazine (a phenothiazine derivate), nitrazepam and amylobarbitone was studied during six months in 52 geriatric inpatients (17, 16 and 19 in each group, respectively) with a mean age of 78 years. The variables registered were the percentage of patients asleep at 10 pm and 6 am and the observed number of awakenings. Certain mental and somatic variables were rated according to a schedule for geriatric behaviour. The observations were made every two to three weeks. No systematic significant change with time was observed for any of the three drugs for the percentage of patients asleep at 10 pm or 6 am or for the number of awakenings. Nor was any difference found between the three drugs in respect of these variables. There was no significant change in somatic or mental variables according to the geriatric rating schedule. The results indicate that dixyrazine, nitrazepam and amylobarbitone retain their hypnotic effect in geriatric patients during continuous use for a six-month period. No side effects were observed that influenced the patient' behaviour. The results do not support the view that barbiturates, i.e. amylobarbitone are inappropriate as hypnotics in the elderly patient.


[Bone marrow culture in aplastic anemia and preleukemias]. After incubation of bone marrow cells obtained from normal subjects and patients with pancytopenia in the double layer agar culture (Robinson-Pike), the clusters of different size and the colonies were counted on days 2, 3, 5, 7 and 10. Aplastic anemia and two types of preleukemia could be distinguished by a different growth pattern. A high incidence of small clusters (4-12 cells) was found in patients with aplastic anemia on days 2 and 3, whereas these aggregates were markedly reduced in preleukemia of type B. In preleukemia of type A an excessive number of small clusters was obtained. The morphology of cells in clusters and colonies was studied by cytochemical staining and electronmicroscopy. In preleukemia marked defects of maturation were demonstrable in the cells.


[Prolymphocytic and hairy cell leukemias as special forms of chronic lymphatic leukemia]. Cytochemical and immunological studies were performed on "hairy" cells from 5 patients. The results, primarily the detection of surface immunoglobulins after incubation in immunoglobulin-free medium support the hypothesis that hairy cells are B-cells. Further parameters for B-cell lineage are the failing suppression of unspecific esterases by NaF, the presence of tartrate-resistant acid phosphatase and the absence of phagocytic capacity and glass adherence (skin window). A lysozyme could not be demonstrated. Of two patients with prolymphocytic leukemia one was characterized as T- and one as B-cell leukemia. Therefore, the prolymphocytic leukemia has to be discussed as intermediate form of ALL and CLL. In both patients the therapeutic results were discouraging with cytostatics (e. g. chlorambucil), splenectomy is considered as the treatment of choice.


[Acute myeloid leukemia with chromosome 5 deletion (a new syndrome)]. This report deals with a new syndrome characterized by refractory anemia, an aberration of chromosome 5 (deletion of the long arm) and the subsequent appearance of acute myeloid leukemia. The results stress the importance of chromosomal studies in cases of unclear, long-lasting and therapy-resistant anemia, since they may allow the early recognition of the development of acute leukemia.


Expression of thymidine kinase activity in hybrids between human leukemic cells and a TK-mouse cell line. A series of actively proliferating clones have been isolated after PEG-induced fusion of a thymidine kinase deficient murine line and white blood cells from two leukemic patients. Their hybrid nature was proved both cytologically and biochemically. All the hybrids tested showed levels of TK activity significantly higher than the TK- mouse parental cell line and comparable to those exhibited by replicating TK+ cells.


Kinetics of lactate dehydrogenase and other enzyme studies in human serum in leukemia. The activity of some of the clinically important enzymes was investigated in leukemic sera at 37 degrees, using the Beckman Enzyme Activity Analyzer were found to be slightly elevated in some untreated cases of leukemia (1.), while ALP was found to be frequently elevated. Untreated patients with l. had normal or below normal SCPK activity. The most characteristic and significant rise in activity, was found to be associated with SLDH and SHBDH in most cases of acute l. (86%) and in CML, while any elevation observed in CLL, was very slight. The general kinetic parameters of SLDH and SHBDH, were investigated at 37 degrees in acute leukemic patients. These included optimum substrate concentrations (NADH, pyruvate, and 2-oxobutyrate), the rate of pyruvate and 2-oxobutyrate reduction, substrate-velocity relationship, Km (pyruvate), Km (NADH), Km (2-oxobutyrate) as well as the effect of temperature and pH on the kinetics of the reaction. These kinetic characteristics were found to be differently affected by the leukemic process.


Acute myeloblastic leukemia considered as a clonal hemopathy. Acute myeloblastic leukemia, like certain other hematologic disorders, originates in pluripotent stem cells. Two general biologic processes underlie development of the disease. Over long times, clonal progression leads from normal polyclonal hemopoiesis through clonal preleukemia to leukemia. Overt leukemia is characterized by the emergence of blast cell populations. Over shorter times, clonal expansion yields cellular diversity based upon randomizing events. The analysis indicates that that blast population is of crucial importance. Characteristics of a colony assay for blast cell progenitors are presented.


Cyclic hemopoiesis and feedback control. Hemopoiesis exhibits a variety of oscillatory phenomena. Since hemopoiesis is controlled by many feedback loops and since feedback loops are potentially oscillatory, it is possible that the observed oscillatory phenomena are the result of movement of hemopoiesis into an area of operation which favors stable oscillation. Although this hypothesis explains many of the observed phenomena and has had some predictive value, its important predictions have not yet been satisfactorily tested.


Telephone performance of persons with hearing handicap in relation to speech reception threshold. This investigation shows that there are four relevant methods of telephoning in Denmark for hearing-impaired persons: 1) Standard telephone without extra equipment for persons with a Speech Reception Threshold (SRT) up to about 40 dB in the better ear. 2) Standard telephone with receiving amplifier for persons with a SRT up to about 60 dB in the better ear. 3) Standard telephone plus individual hearing aid primarily in "T" position. Can be used by hearing-impaired persons with a SRT up to 70-75 dB in the better ear. 4) Standard telephone with receiving amplifier plus individual hearing aid primarily in "T" position. This is an effective and cheap solution for hearing losses above 70-75 dB in the better ear.


Trabeculectomy. Its role in the management of glaucoma. This report describes the changes in intraocular pressure, visual fields, and visual acuity after 108 trabeculectomy operations for various types of glaucoma. Postoperative follow up ranged from 1 1/2 to 3 years and the consequences of any complications were assessed. Trabeculectomy was found to be a relatively safe and effective procedure and may be recommended at an early stage in glaucoma management rather than as a last resort.


Low leucocyte ascorbic acid levels and corneal ulceration. The leucocyte ascorbic acid levels were determined in six patients with infected corneal ulcers. These levels were significantly lower than in a control group matched for age and sex. The potential role of Corynebacteria as pathogens is discussed.


Acute posterior multifocal placoid pigment epitheliopathy: not so benign? A case is described of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) in which one eye shows the typical active disease process while the other shows evidence of extensive degenerative changes of the posterior pole with disturbance of the pigment epithelium. It is postulated the case presented shows that APMPPE may not be as benign a condition as previously thought, and that it may recur after a period of years.


The Montgomery Lecture, 1979. Ocular metallosis. 'Redox processes' and complex biochemical formations offer a simple key to understanding metallotic damage to the eye. Various factors determine the timing and severity of this damage. Siderosis is a process with a chronic course. In a large group of patients with copper-containing foreign bodies the majority showed a more acute course. In the past, the relatively rare cases of chronic chalcosis without fibrotic reactions in the vitreous determined the text book descriptions familiar to our fathers. In our series of 282 cases of copper-containing foreign bodies in the vitreous, the chalcosis took a subacute, acute, or fulminating course in 68 per cent, and only half of the other 32 per cent represented time chronic chalcosis. In 18 per cent the injury was recent and the cellular reaction was only just beginning. Cellular reactions, especially fibrosis, are the chief characteristics of acute chalcosis. Vitrectomy permits the surgical treatment of eyes with severe vitreous fibrosis and retinal detachment, but because these eyes are in the pre-phthisic stage, a fair number of successes is counterbalanced by an increasing number of enucleations.


Perforating eye injuries in Cork. A review. Of 95 cases of perforating eye injury during the 4-year period 1973 to 1976 reviewed, 21 had a retained intraocular foreign body. Sporting activities, including shotgun injuries, were found to be the cause in a significant number of cases. Four cases of perforating injury due to car battery explosions are also reported. None in the series was found to have sympathetic ophthalmitis.


Chromatin conformation during cell differentiation of human myeloid leukemia cells. A novel human promyelocytic leukemia cell line (HL-60) has been shown to form terminally differentiated granulocytes in the presence of dimethyl-sulfoxide (DMSO), some other chemicals, or colony stimulating factor. Compared to chromatin from HL-60 cells, chromatin from DMSO treated HL-60 cells showed an enrichment in low temperature melting material. The decrease in thermostability of chromatin from HL-60 cells after DMSO treatment is similar to the shift in thermostability of chromatin from human lymphocytes after stimulation with phytohemagglutinin (PHA). These results suggest that changes in the thermostability of chromatin may not be specific for cell differentiation or PHA stimulation.


Compound action potential measures of frequency selectivity. In this paper we demonstrate that it is possible to obtain a measure of the frequency selectivity of the ear by means of forward masking of the whole nerve action potential (AP). The AP frequency tuning curves resulting from the forward masking measurements appeared to be similar to single fiber tuning curves. The masker preceding the test tone produced a slow off-response which we suppose to be super-imposed on the AP provoked by a test tone. High and low-pass filtering of the test tone with slopes up to 96 dB/oct improved tuning. Steeper slopes gave no noticeable improvement. Filtered test tones produced AP tuning curves which were wide in comparison with single fiber tuning curves. Moreover, AP tuning curves become even wider at high test tone levels. In spite of this road tuning, changes in frequency selectivity of the ear, caused by noise trauma, are reflected in the AP tuning curve.


[Anemias resulting from iron metabolism disorders]. For the most part iron deficiency, but also disturbances of distribution, transport and utilization of iron, are able to cause anemias. To understand the origin of such anemias, firstly iron metabolism, then the clinical symptomatology as well as the laboratory parameters necessary for diagnosis and finally the usual therapies are described.